This article will explain how medical recommendations can be very wide ranging and completely different, but at the same time they are all true. How can opposite answers both be true?
This happens in nutrition a lot! How can the field of nutritional sciences be so divided up and provide contradictory statements, while all recommendations bring forward sound evidence for their recommendations. How can all recommendations be true, even though they are completely different? In this article I will provide the answer. It is all a matter of scale. The answer we get will depend on the scale of practicality for which we ask the question.
How long is the coastline of California?
When you ask Wikipedia the answer is somewhere between 1350km and 5515km long. And everything in between is true. And everything above 5515km is true also.
WHAT? This is a fucking straight forward and linear question. How can it be that the answer has such an incredible variability? I am asking about the length of the coast line and not quantum physics! …….or am I?
I think this coast line problem is a symptom of a much larger concept we need to get a grip on if we want to truly understand how the human body functions. This seems like a stretch, but let me try to explain. If we go there we will understand how medical recommendations can be so different, yet all be true.
The problem of scale
Okay lets take a map of California.
On my screen this map is scaled to somewhere around 1:10.000.000 as 1 cm in this map is around 100km, 10.000.000cm in the real world. Now if we were to take a thin string and put it exactly on the coast line and then at the end stretch it out we would get to a string length of around 13cm and therefore a result of around 1300km.
Is this result correct? Definitely not. And I will explain later. There are more problems involved than our rough string method. But this answer is very practical. It might be enough for you to estimate how long it would take you to sail by the coastline from north to south.
But it might not be enough for you calculate erosion of the coast line by the pacific. To do that you need to zoom in a bit more.
Because if we zoom in we find that the coastline becomes „rougher“ as we zoom in. Our string now needs to make more curves than it did in the 1:10.000.000 scaled model. We might get a result that is a lot higher than 1300km.
That is why some geologist walk the coastline with measurement devices to capture the „real roughness“ of the coastline.
But you see….where exactly do you walk? Right by the edge of the water? In high tide, or in low tide? Does sand count as „coast line“ or just „rigid“ rock?
What about rivers that enter the ocean? Can you just cross these rivers? Or how far inland can you walk to capture „coast line“?
We do have to create some arbitrary rules to create an „accurate“ measurement. And thats not even the biggest problem.
What would happen if we zoom in even further?
Now what the hell do we do here? Do we include these formations surrounded by water? For our next problem it doesn’t even matter, because lets just say we don’t include these formations surrounded by water and zoom in further on the rock thats part of „main land“. We might as well include them. It doesn’t change the TRUE answer.
To measure our coastline ACCURATELY, to get the TRUTH about our coastline, we would have to measure each indent of each rock that makes up the coast line. This is still not accurate and true.
If we zoom in even we further we end up with this mess :
WHAT. THE. FUCK. Gerrit, I thought we are talking about coast lines here. WE ARE! You see all I am saying is that when we want to truthfully tackle a problem we need to be scalable. Sometimes we need to abandon our models, because these are based on arbitrary subjective boundaries we set up for PRACTICAL reasons. WE set them up. Not nature. WE did that. We did that so our small brains are able to manoeuvre in reality.
Three arbitrary models to capture reality. Three completely different results.
And we are not finished. Because actually rock looks something like this :
And this looks something like this if you just dare to zoom in :
And this is where our current understanding of reality ends. Which doesn’t mean that reality ends there. Just our understanding of scale ends there. The truth is : The coastline is INFINITE. Every quantum physicist would tell you that. And including Heisenbergs uncertainty principle and Schrödingers cat makes it even slightly more complicated.
Now lets zoom back to the real problems we face. I am in the business of performance and health. Some of the biggest frontiers we face are getting a grip on chronic disease, individualising nutrition, integrating our understanding of mind & body, understanding the balance of high industrial speed vs. Slow speed of evolution and balancing nature (genetics) vs. Nurture (epigenetics, environment and behaviour).
This article is called “the scalability of practicality”, because what I am getting to here is that it is a matter of practicality where we draw artificial boundaries in nature. We mostly start out with the roughest and most simple method. When this model is not sufficient anymore we need to zoom in a bit more. We need to scale for the purpose of practicality. And we might reach a completely different conclusion. This is basically how it appears that science has a new opinion every ten years on a wide arrays of topics like cholesterol, carbs, fats, treatment of psychiatric disorders, surgical techniques and so forth.
On the first scale of practicality we look at purely calories and nutritional recommendations emerge. On the second scale of practicality we look deeper, and take into account hormonal interactions of food and other nutritional recommendations emerge. These can be quite contrary to the first recommendations even though they are BOTH TRUE. But they are true on different scales of practicality. Looking even a level deeper, we might take neurotransmitters or the microbiome into account, and the nutritional recommendations might look a lot different than the first and/or the second. They are all true. None of them are false. But they vary widely! How can this be?
I feel that we hinder our progress by arguing if the coastline is 1350km or 5515km long. It doesn’t matter who is right. We are both wrong. True progress can come from realizing we are both wrong because we both argue from different subjective and arbitrary models. Both models are wrong. One might be more PRACTICAL than the other right now, okay. But both are wrong. The best scientists in the world all realise that. When a current model does not function for an individual patient, we should first look at the scale at which we look at that problem and re-check our assumptions about what the think we know.
On a slightly different note I see the scale of practicality as the limiting factor in business success of highly reflected intellectuals. They have problems determining a fixed SCALE on which they act out their business. The moment they have an idea, they zoom in a lot more and realise the TRUTH is a lot more complicated. It is infinite. Yes it is. Their scale of practicality is way to fluid to create something in the real world. So they just sit and ponder. But to create something in reality you have to set a scale on which to act. You have to define the smallest distance with which you measure the coastline of California and base your whole business on that.
Smart intellectuals are often frustrated that seemingly “dumb ideas” or “shortsighted individuals” have incredible business success. It might be because these seemingly “shortsighted individuals” set a scale and believe this scale to be the truth. They might not be reflected enough to see past the scale. But that makes them successful. Because to sell your product your defined SCALE needs to be as close as possible to the customers SCALE of practicality.
So what can we do as simple practitioners, patients, athletes, people who are striving for better outcomes? :
Realise everything we talk about is a model. It is based upon arbitrary and subjective boundaries based on PRACTICALITY.
If our model has problems explaining or helping in reality we have to revisit some of the arbitrary boundaries we set. We have to revisit our ASSUMPTIONS. (e.g. Newtons laws of mechanics have failed to explain the behaviour of planet mercury. It was a model that was good enough for many things, but not to predict mercury. The model of relativity by Einstein did a better job. But this model fails when we learn about quantum mechanics)
To ACT IN REALITY we have to set subjective boundaries based on PRACTICALITY. Without boundaries we would float in nothingness and infinity at the same time and are unable to ACT. Set some rules. But be the first to update these rules if they keep you from the outcomes you want.
If we are stuck with a problem we might have to abandon our boundaries and alter the SCALE with which we look at the problem.
Gerrit Keferstein is a Medical Doctor specialised in Performance & Functional Medicine. He is most known for his work on the optimisation of recovery and adaptation in elite athletes.