The 30 most recent comments from all posts are listed below. Click on the post title to go to the comment on the post’s page.
- Comment by MR P T STEEPER on The lucrative lie: SCAM and disease prevention Monday 15 June 2026: 15:06 Yes, it’s the same old SCAM — but the robes are now tailored by Stanford, amplified by Silicon Valley, and worn by people who speak fluent mechanistic biology. The psychology hasn’t changed, but the cultural power has — which is precisely how SCAM mutates into SCM: So‑Called Medicine, where the aesthetics of science substitute for its conduct.
- Comment by on The lucrative lie: SCAM and disease prevention Monday 15 June 2026: 13:06 I do not see them as belonging to a ‘new movement’; in my view it’s the same old SCAM in slightly modernised robes. Think of Chopra, or Weil – they have always existed and always played on their cedentials if they had any.
- Comment by on The lucrative lie: SCAM and disease prevention Monday 15 June 2026: 12:06 Professor Your critique of the alternative medicine industry’s preventive claims remains as sharp and necessary as ever. Yet reading your latest piece in the current cultural landscape highlights a striking evolution: the selling of unproven prevention is no longer the exclusive domain of classical “So‑Called Alternative Medicine” — what you aptly term SCAM. We have entered the era of the “Secular Health Guru”, where the most influential purveyors of speculative prevention are not homeopaths or energy healers, but highly credentialed insiders who trade on institutional prestige. Two emblematic figures are Dr Andrew Huberman and Dr Peter Attia. Both possess elite academic pedigrees. Both command vast, monetised media ecosystems. And both have popularised a new genre of health optimisation that uses genuine scientific authority to promote interventions lacking the very thing you have always insisted upon: hard clinical evidence of improved health outcomes. What is fascinating is how closely this new movement mirrors classical SCAM across three structural dimensions: 1. The Monetisation of Noise Public‑health prevention is famously simple: sleep, movement, nutrition, social connection, avoidance of tobacco. It is cheap, universal, and — crucially — unmonetisable. To build a media empire, one must generate novelty, complexity, and endless micro‑optimisations. Thus emerges what might be called the “optimization noise economy”: a perpetual churn of speculative hacks, supplements, and protocols designed not to improve population health, but to maintain audience engagement. This is not far removed from the commercial incentives of classical SCAM, where the product is not efficacy but attention. 2. Mechanistic Speculation Masquerading as Evidence You have long criticised the tendency of alternative practitioners to justify interventions through theoretical mechanisms rather than clinical outcomes. The same pattern now thrives in secular wellness culture. Huberman routinely extrapolates from basic neuroscience to promote a vast array of consumer supplements. Attia advocates for aggressive early screenings and off‑label pharmaceuticals — Rapamycin being the most prominent — based largely on animal models and mechanistic reasoning. This is precisely the epistemic move you have warned against: substituting biological plausibility for demonstrated benefit. Until an intervention reduces morbidity or mortality in humans, it remains speculative — regardless of whether it is sold by a naturopath or a Stanford professor. 3. The Protocol as Ritual The elaborate daily routines promoted by these influencers function as secular rituals. They offer followers a comforting illusion of control over ageing, disease, and mortality. The psychological mechanism is identical to that of acupuncture meridian charts or Ayurvedic doshas: a structured narrative that transforms uncertainty into agency. The ritual is the product. The sense of control is the commodity. And the evidence remains optional. A New Frontier for Scientific Skepticism. If scientific skepticism is to remain effective, it must adapt to this new landscape. The grift of unproven prevention has not disappeared — it has simply been rebranded, professionalised, and embedded within the scientific establishment itself. The challenge is no longer fringe pseudoscience, but credentialed speculation amplified by platforms with audiences in the tens of millions. Your framework remains invaluable. But it now needs to be applied not only to homeopaths and energy healers, but to the charismatic, data‑literate, lab‑coat‑wearing entrepreneurs who have made speculative prevention mainstream. I would be very interested to hear your thoughts on how skepticism can best respond to this new class of wellness influencer — one whose authority derives not from rejecting science, but from selectively weaponising it. Paul
- Comment by on Retirement? Monday 15 June 2026: 12:06 Well… At the same time you’ve managed to enrich and enlighten my soul, tought me loads and heaps, been a role model for learning to scrutinise science and provided a platform for me to train my meager rhetorical skills. Many thanks and many cheers, professor!
- Comment by on The lucrative lie: SCAM and disease prevention Monday 15 June 2026: 08:06 Also note that SCAM often touts healthy lifestyle interventions such as a balanced diet, moderate exercise and other well-known beneficial lifestyle factors – while trying to give the impression that it was SCAM that came up with these principles(*). Which is of course a lie: it is science and, by extension, science-based medicine that identified the benefits of good hygiene, proper diet and exercise, NOT SCAM. The best we can say is that SCAM’ers can spend more time on each patient in the role of ‘lifestyle coach’ – because it is the patients themselves who pay for this extra time and attention. But then these gullible patients also get a hefty dose of useless SCAM with each consultation, which may easily cost € 100 a pop or more. Generally, it’s as the old adage goes: “What is good about SCAM is not special, and what is special about SCAM is not good.” (not sure who came up with this one – maybe Harriet Hall?) *: Then there are of course also some SCAMmers who promote arguably bad dietary habits, such as YouTube quacks Sten Ekberg, and in particular Eric Berg.
- Comment by on Acupuncture for illicit drug use disorders? No, I don’t think so! Saturday 13 June 2026: 18:06 😊✌️
- Comment by on Acupuncture for illicit drug use disorders? No, I don’t think so! Saturday 13 June 2026: 17:06 No
- Comment by on Acupuncture for illicit drug use disorders? No, I don’t think so! Saturday 13 June 2026: 16:06 Thank you for your clear and prompt reply to my previous question. As a follow-up, I was wondering whether you might briefly comment on two prominent pieces of evidence often cited in support of acupuncture for chronic pain: 1) The Acupuncture Trialists’ Collaboration individual patient data meta-analyses by Vickers et al. (2012 and 2018), which reported modest but statistically significant specific effects (real vs. sham) alongside larger pragmatic benefits versus usual care/no treatment. 2) The NICE NG193 guideline (2021) on chronic primary pain, which recommends considering a course of acupuncture or dry needling. In your view, do these sources provide sufficient evidence of specific efficacy to support acupuncture as a primary/standalone intervention in selected patients with chronic primary musculoskeletal pain, Paul
- Comment by on Acupuncture for illicit drug use disorders? No, I don’t think so! Saturday 13 June 2026: 15:06 It’s not my conclusion, I think you are referring to the one by the authors. Regarding your question: the answer is no.
- Comment by on Acupuncture for illicit drug use disorders? No, I don’t think so! Saturday 13 June 2026: 08:06 Dear Professor, Regarding your conclusion on “…acupuncture as a viable monotherapy for drug use disorders”: As a matter of interest, given your knowledge of the current body of trial data, have you ever reported on any clinical scenario or specific disorder where needle based acupuncture (WMA) has demonstrated sufficient specific efficacy to be recommended as a primary, standalone intervention? Paul
- Comment by on Alternatives to Smoking: What Users Ought to Know About Vaping and Nicotine Pouches Friday 12 June 2026: 11:06 an interesting BMJ article on a similar subject: https://www.bmj.com/content/393/bmj-2026-491423?utm_source=etoc&utm_medium=email&utm_campaign=tbmj&utm_content=weekly&utm_term=20260612&nbd_source=adestra&nbd=fb3117a605ac195fe6685573823b55c61945f2642b46593fcc1ba966b7dfb14e&uaa_id=fb3117a605ac195fe6685573823b55c61945f2642b46593fcc1ba966b7dfb14e&utm_campaign=This%20week%20in%20The%20BMJ&utm_medium=email&utm_source=adestra
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 18:06 No worries Richard, pointing out this horrific disease should be done as often as possible.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 15:06 What puzzles me is this: they all seem totally unconcerned about ever being called to responsibility! These people indeed seem to think that they enjoy the same immunity that Trump was given by the Supreme Court for any crimes committed while in office. Which is not true. Don’t forget that these people are stupid. Which is to be expected, given that they’re picked by Trump, not for any form of competence or skills, but for one thing only: their blind loyalty to Trump. Only stupid people will voluntarily go work for Trump and kiss his a$$. As soon as the republicans lose power, many of Trump’s sycophants will be held accountable – and there are lots of people as well as institutions already keeping tally of the lies, crimes and other transgressions that they’re committing on an almost daily basis. The only question is to what extent this accountability will be pursued. This mostly depends on how far the democrats are willing to go: do they merely want justice for all the bad things done by the Trump administration, or do they want to go further and also pursue a degree of vengeance?
- Comment by on Which diet is best for heart health? Thursday 11 June 2026: 13:06 Notice: There’s a documentary film “The Cholesterol Code ” (directed by Jennifer Isenhart and featuring citizen scientist Dave Feldman) available to watch directly on Amazon Prime Video. The documentary tracks Dave Feldman’s transition from a regular software engineer to an independent researcher following an unexpected lipid result on a low-carbohydrate diet, ultimately mapping out the Lean Mass Hyper-Responder phenomenon and funding the clinical imaging trials discussed above.
- Comment by on Which diet is best for heart health? Thursday 11 June 2026: 13:06 Beyond the “Cholesterol-In, Cholesterol-Out” Model: The Lean Mass Hyper-Responder (LMHR) Phenomenon Your point that a subset of lean individuals show pronounced rises in LDL cholesterol and related atherogenic markers during carbohydrate restriction highlights one of the most fiercely debated frontiers in modern lipidology. To explore this specific nuance further, we can look at a rapidly growing body of research driven by citizen scientists and metabolic researchers who have formally categorized this exact subgroup. ## Defining the LMHR Phenotype In recent years, researchers have officially termed this lean subgroup Lean Mass Hyper-Responders (LMHR) (Norwitz et al., 2022). Coined initially by software engineer Dave Feldman and later validated in peer-reviewed literature alongside Dr. Nicholas Norwitz (a Harvard-trained MD/PhD), the LMHR phenotype is a distinct metabolic profile that appears when lean, insulin-sensitive individuals adopt a ketogenic or strict low-carbohydrate diet. Rather than a generic rise in cholesterol, LMHRs exhibit a highly specific lipid triad (Norwitz et al., 2022): * LDL Cholesterol: Extremely elevated (200 mg/dL or higher, often climbing past 400 mg/dL) * HDL Cholesterol: High (80 mg/dL or higher) * Triglycerides: Exceptionally low (70 mg/dL or lower) The Lipid Energy Model: Energy Traffic vs. Disease To explain why this happens preferentially in lean individuals, Feldman, Norwitz, and their colleagues proposed the Lipid Energy Model (LEM). The model argues that when a lean person with low body fat restricts carbohydrates, their systemic glycogen stores deplete rapidly. To fuel the body, the liver must drastically ramp up the trafficking of fat. It does this by packaging lipids into large numbers of Very Low-Density Lipoproteins (VLDLs) to deliver energy (triglycerides) to tissues like skeletal muscle. As the muscles quickly burn up those triglycerides, the empty remnants are left circulating in the bloodstream—which registers on standard blood panels as an astronomical spike in LDL cholesterol. To demonstrate that this is a dynamic metabolic traffic pattern rather than genetic damage, Norwitz famously conducted a highly controlled self-experiment: The Oreo vs. Statin Comparison: Consuming a strict ketogenic diet, Norwitz had a baseline LDL cholesterol of 545 mg/dL. By deliberately adding a standard serving of Oreo cookies (introducing carbohydrates back into his system) to his daily diet for 16 days, his LDL cholesterol dropped by a staggering 71%. This reduction was far more potent than what is typically achieved by maximum-dose statin medications (Norwitz et al., 2022). When carbohydrates became available, his liver simply stopped needing to broadcast mass amounts of fat-carrying vehicles across his system. Citizen Science and the KETO Trial: Because mainstream funding for checking if hyper-high LDL can occasionally be benign is notoriously difficult to secure, Feldman founded the Citizen Science Foundation. Through crowdsourcing and patient-led funding, they partnered with academic institutions—such as the Lundquist Institute at Harbor-UCLA Medical Center—to subject the LMHR phenomenon to rigorous clinical imaging trials. The landmark results of this effort, known as The KETO Trial, were published in the journal Metabolism (Budoff et al., 2024). The study evaluated lean individuals who had experienced carbohydrate-restriction-induced LDL cholesterol spikes of 190 mg/dL or higher (with a mean LDL of 272 mg/dL and some as high as 591 mg/dL) for an average of 4.7 years (Budoff et al., 2024). Researchers used advanced Coronary Computed Tomography Angiography (CCTA) to measure their arterial plaque burden and compared them to a matched, healthy control cohort from the Miami Heart study whose average LDL was much lower (123 mg/dL). The findings challenged traditional cardiovascular assumptions: * No Significant Difference: There was no significant difference in total coronary plaque burden or coronary artery calcium (CAC) scores between the high-LDL keto group and the low-LDL controls (Budoff et al., 2024). * No Correlation: Within the carbohydrate-restricted cohort, there was zero correlation between the absolute height of the LDL cholesterol levels and the presence of coronary plaque (Budoff et al., 2024). Moving the Conversation Forward: This grassroots scientific movement, the execution of these clinical trials, and the fierce medical debate surrounding them is the central focus of the recent Amazon Prime documentary, The Cholesterol Code. As you rightly conclude, individual metabolic risk profiles vary considerably, and we must move past judging single items in isolation. The emergence of the LMHR phenotype proves that lipid panels cannot be interpreted in a vacuum; the exact same elevated LDL number may represent a completely different pathology—or a completely different physiology—depending entirely on an individual’s leanness, insulin sensitivity, and wider dietary context. References Budoff, M., Manubolu, V. S., Kinninger, A., Norwitz, N. G., Feldman, D., Wood, T. R., Cury, R., Feldman, T., Fialkow, J., & Nasir, K. (2024). Carbohydrate restriction-induced elevations in LDL-cholesterol and atherosclerosis: The KETO Trial. Metabolism, 153, 155854. https://doi.org/10.1016/j.metabol.2024.155854 Norwitz, N. G., Soto-Mota, A., Feldman, D., Parpos, S., & Budoff, M. (2022). Case Report: Hypercholesterolemia Lean Mass Hyper-Responder Phenotype Presents in the Context of a Low Saturated Fat Carbohydrate-Restricted Diet. Frontiers in Endocrinology, 13, 830325. https://doi.org/10.3389/fendo.2022.830325
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 10:06 What puzzles me is this: they all seem totally unconcerned about ever being called to responsibility! I was once driven to a lecture by a old professor who violated every trafic rule in the book. Dozens of cars hooted at him and many had to do acrobatics to avoid accidents. Each time, the old Professor shruged his shoulders and mumbled “What can they do? Write to my grandmother?”. The Trump admin reminds me a lot of this worst driver I ever met – only that he never did cause any real damage.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 09:06 @Jashak Oh, you already mentioned SSPE … sorry, I somehow overlooked that.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 09:06 I for one am not confused at all. The whole Trump administration is based on endless lies, misinformation, corruption etc. etc.. RFK Jr. simply lied (and still lies) about his support for measles vaccination, starting with lying to Congress – a felony crime – in order to not jeopardize his confirmation. After that, the lies just kept coming, as clearly shown by the way his words contradict his actions. Just like every other Trump official will constantly lie, following Trump’s example.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 09:06 To confuse the issues, RFKJr supports the measles vaccine verbally while undermining vaccine policy broadly through actions and spreading misinformation that reduces overall vaccination confidence.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 09:06 Beyond its well-known immediate dangers, a measles infection inflicts severe, long-term damage on the human body by causing a phenomenon known as immune amnesia. There’s that too of course. But there is another, far more insidious long-term complication of measles that most people don’t even know about: SSPE. If RFK Jr. gets his way, and every child in the US will get measles again, then annually, up to a thousand of those children will end up with increasing cognitive decline, seizures, and blindness. And after months or even years of ever-increasing suffering, they will die. All of them. All thanks to RFK Jr’s insanity. Now if only there was an organization that would stand up for the health of children, to prevent horrors like the one just described. Maybe something like “Children’s Right to Good Health”, or “Children’s Health Shield”, or something with “Defense” in the name … \sarcasm
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Thursday 11 June 2026: 07:06 All these anti-vaxers should also be aware of the risk that their child will end up with rare, but untreatable and deadly subacute sclerosing panencephalitis, many years after the initial infection.
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Wednesday 10 June 2026: 15:06 Yes. As for this whole Children lark, well, if we could find out what causes it, we could put a stop to it……
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Wednesday 10 June 2026: 14:06 I fear they are not stupid but intentional. Time and time again he’s been shown the evidence that proves vaccines’ efficacy and safety and, for himself, has always ran to conventional medicine for his own treatments. He truly believes diseases should be allowed to weed out the “weak”, hence is statement that “only sick children should die from measles.”
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Wednesday 10 June 2026: 10:06 That’s “personal responsibility”. They should not have children if they are not in a position to buy them iron lungs. And anyway if they followed a healthy natural diet in the first place they would not get infected. sarcasm obviously (i hope).
- Comment by on Measles in the US – RFK Jr., his stupid rhetoric and irresponsible actions erode immunity Wednesday 10 June 2026: 09:06 “Personal autonomy” – I wonder if they will have enough autonomy to buy their own Iron Lungs for their children, when Polio makes a comeback……
- Comment by on Retirement? Sunday 07 June 2026: 19:06 Dear Ernst, Clinical practice (like that of a general practitioner) is more exhausting than academia. We need rest to see dozens of patients a day. I retired three years ago and I remain interested in medicine and continue fighting against pseudoscience. I believe it’s compatible with exercise, reading non-medical books, and any enjoyable activity. Best regards and keep publishing that interesting articles.
- Comment by on Retirement? Sunday 07 June 2026: 18:06 I both envy and admire you, Dr. Ernst. I’ve been a fan since we first crossed paths some years ago. And jst so you know, Doc and Carly are still a thing. They just haven’t gone public yet. Ron
