[HN Gopher] Correlation between the advent of refrigeration and ...
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       Correlation between the advent of refrigeration and the rise of
       Crohn's disease
        
       Author : fnord77
       Score  : 30 points
       Date   : 2021-12-05 22:04 UTC (55 minutes ago)
        
 (HTM) web link (academic.oup.com)
 (TXT) w3m dump (academic.oup.com)
        
       | DantesKite wrote:
       | It wouldn't surprise me if refrigeration contributes to the
       | development of Crohn's disease.
       | 
       | The causes can be multi-variate and anecdotally, from my own
       | research, microbes (yeast, bacteria, fungi) all seem to play a
       | key role. Anything that disturbs the balance in pathogenic ways
       | can lead to dysfunction, especially antibiotics, but also a lack
       | of plant cell walls in our diets.
       | 
       | Everybody is slightly different, not just genetically, but in
       | terms of the diversity of bacteria.
       | 
       | There have been a few people who have managed to put Crohn's
       | disease into remissions with raw kefir produced at home (the ones
       | at store are not comparable) as well as with Visbiome, a
       | probiotic produced in the lab with many studies behind it. And
       | I've also heard the carnivore diet for short durations may help.
       | 
       | There doesn't seem to be a consistent way to treat Crohn's
       | disease and obviously, medicine to control flares is a must if
       | the situation demands it.
       | 
       | It does seem like a great many gut and autoimmune issues are
       | somehow related to the diversity of microbes though and I look
       | forward to more clinical research like this.
       | 
       | We need all the help we can get.
        
         | bladegash wrote:
         | Likewise on the welcoming of any bit of research! I ended up in
         | the hospital about a year ago and found out it was the result
         | of Crohn's (34 years old).
         | 
         | Another hospitalization, countless diet attempts, medications,
         | and biologics, finally found something that worked, other than
         | prednisone.
         | 
         | If there is one thing I realized, it is that the effectiveness
         | of treatments really is dependent on each individual's biology.
         | Possible foods that trigger me were completely fine for others
         | I had spoken with, and vice versa.
         | 
         | It's encouraging to see as much research as there is and makes
         | me hopeful not just for myself, but for others with the same
         | condition (many who have it far worse than me).
        
           | jcrben wrote:
           | I got Crohn's about the same age (34).
           | 
           | A couple years later at 36 I'm now on better health than I've
           | ever been. I responded well to a biologic (vedolizumab aka
           | Entyvio). But I also did exclusive enteral nutrition for
           | months to help push me the edge. These days I eat a lot of
           | sweet potatoes and chicken, with relatively little processed
           | food.
        
       | moralestapia wrote:
       | Before some "wise guy" comes to parrot about how "correlation
       | does not imply causation" [1], please, take some time to read the
       | article as it has some valuable information.
       | 
       | [1]: We've all heard that already, it doesn't impress anyone
       | anymore.
        
         | [deleted]
        
         | [deleted]
        
         | uniqueuid wrote:
         | And it's not even in the article title.
         | 
         | In fact, the text says " Figure 1A compares the annual
         | incidence of the disease and the household equipment rate in
         | several countries. There is a temporal correlation between
         | these variables."
         | 
         | A temporal correlation is something entirely different to a
         | cross-sectional correlation (arrow of time etc.)
        
           | DantesKite wrote:
           | I tried researching what a temporal correlation is. Do you
           | have short explanation for it?
        
             | uniqueuid wrote:
             | Temporal correlations are a family of things, since there
             | are many degrees of freedom to choose what to compare with
             | what.
             | 
             | A very simple test is the "Granger Causality", which tests
             | whether one timeline significantly predicts another one.
             | You can formulate more complex models such as time series a
             | predicting b with a certain lag.
             | 
             | Ultimately, the idea is most often to remove unrelated
             | factors (such as control variables, seasonality, self-
             | influence i.e. autoregression) and then measure how well
             | one series at t(0) predicts another one at t(1), while
             | optionally doing some sort of hyperparameter optimization
             | for the lag (i.e. determine which lag works best).
        
       | emmelaich wrote:
       | Good paper. If true I wonder how it could be combatted
       | effectively. It's hard to do without refrigeration. Perhaps its
       | related mainly to fast food, where the consistent refrigeration
       | is less sure.
       | 
       | CD has also been associated with Mycobacterium paratuberculosis,
       | because that is implicated in the similar Jahne's disease in
       | cattle and sheep:
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894645/
       | 
       | Lastly, I also wonder if refrigeration has a role to play in
       | Multiple Sclerosis. It also has strong relations with modern
       | lifestyle and latitude (temperature). The suspect virus in the MS
       | case seems to be
       | https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus aka
       | mononucleosis / glandular fever.
        
       | teeray wrote:
       | I wonder if anyone has tried a treatment with a non-refrigerated
       | diet
       | 
       | EDIT: I read some more and found "Nutritional treatment of CD was
       | first proposed by Voitk in 1973. The treatment consists of
       | administering a specific liquid formula..."
       | 
       | It doesn't say if that formula is refrigerated or not. My
       | assumption is that it isn't because it's cited here, but that is
       | an assumption.
        
         | teruakohatu wrote:
         | Essentially they found that tube fed diets do help, and they
         | are effectively refrigeration free.
         | 
         | > "Furthermore, no specific foodstuff has been incriminated in
         | CD, and combining enteral nutrition with a highly controlled
         | oral diet was recently shown to be effective" ... "It should be
         | noted, however, that enteral nutrition effectively excludes
         | refrigerated foods."
         | 
         | They go on to say that enteral nutrition differ from regular
         | diets so that the mechanism that make them work may not to the
         | fact that they are refrigerated.
         | 
         | A refrigeration free diet would not be impossible today, but
         | hard. Given he prevalence of this bacteria today, non-electric
         | cold stores would probably also need to be removed from the
         | supply chain, making even a pre-industrial Western diet
         | problematic.
         | 
         | A sufficiently cooked vegan diet, minus everything that causes
         | problems with people that suffer from Crohn's Disease, maybe
         | would work? Ideally with vegetables that have not been
         | refrigerated. Winter would be pretty bleak.
        
           | ampdepolymerase wrote:
           | If tube fed diets are the trick, why not just go with
           | Soylent? It's about as bacteria-free as food can reasonably
           | get.
        
             | bladegash wrote:
             | For many with Crohn's, this is more or less the treatment.
             | Many times it is less because it's most effective, and more
             | because surgeries removing portions of the large/small
             | intestines has made them incapable of digesting other forms
             | of food. I guess my question would be - would you want to
             | live on Soylent the rest of your life, if it could be
             | avoided? I think most would answer no.
        
         | uniqueuid wrote:
         | Right, this is what the authors demand:
         | 
         | "as no single experiment can definitively confirm the theory,
         | we must continue to test it with additional works. Among them
         | [and even if insufficient to definitively validate the
         | hypothesis], a randomised clinical trial comparing patients
         | with low versus high exposure to Yersinia would be an important
         | step."
        
       | tomrod wrote:
       | This is a bad title. Other trends since 1910 (the last 110 years)
       | 
       | - Electromagnetic wave use increase via radio, television, cell
       | and internet, and microwaves
       | 
       | - Maximum altitude humans have reached
       | 
       | - Number of bodies on Everest
       | 
       | - Increase in pounds of enriched uranium and available thorium
       | 
       | - Increase in the number of people who have read work by Ursula
       | K. Le Guin and Isaac Asimov
       | 
       | None of these have causal implications. But the article does
       | connect a qualitative theory and show correlation -- suggesting
       | the hypothesis could be a thread to chase down.
       | 
       | This is the key thesis:
       | 
       | > According to the cold chain hypothesis, the development of
       | industrial and domestic refrigeration has led to frequent
       | exposure of human populations to bacteria capable of growing in
       | the cold. These bacteria, at low levels of exposure, particularly
       | those of the genus Yersinia, are believed to be capable of
       | inducing exacerbated inflammation of the intestine in genetically
       | predisposed subjects.
       | 
       | EDIT:
       | 
       | Title: Crohn's Disease: Is the Cold Chain Hypothesis Still Hot?
       | 
       | Abstract:
       | 
       | > Crohn's disease [CD] is an inflammatory bowel disease of
       | unknown aetiology. During recent decades, significant
       | technological advances led to development of -omic datasets
       | allowing a detailed description of the disease. Unfortunately
       | these have not, to date, resolved the question of the aetiology
       | of CD. Thus, it may be necessary to [re]consider hypothesis-
       | driven approaches to resolve the aetiology of CD. According to
       | the cold chain hypothesis, the development of industrial and
       | domestic refrigeration has led to frequent exposure of human
       | populations to bacteria capable of growing in the cold. These
       | bacteria, at low levels of exposure, particularly those of the
       | genus Yersinia, are believed to be capable of inducing
       | exacerbated inflammation of the intestine in genetically
       | predisposed subjects. We discuss the consistency of this working
       | hypothesis in light of recent data from epidemiological,
       | clinical, pathological, microbiological, and molecular studies.
        
         | [deleted]
        
         | jessriedel wrote:
         | Your first point is misaimed. They don't just note the
         | historical worldwide rise in refrigeration goes along side a
         | worldwide rise in Chrohn's. They compare the timing for
         | Chrohn's and refrigeration for different demographic groups in
         | different countries and even, if I am reading this correctly,
         | at the level of individuals. The other things you list will not
         | vary in the same way at that level of detail, although one must
         | of course be wary of multiple hypothesis testing, forking
         | paths, etc.
        
           | tomrod wrote:
           | > although one must of course be wary of multiple hypothesis
           | testing, forking paths, etc.
           | 
           | Precisely. My point was in agreement with another on the
           | article: correlation may not be causation, but it can be
           | highly suggestive of it as one drills down. Necessary, but
           | not sufficient, conditions.
        
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       (page generated 2021-12-05 23:00 UTC)