Amish Paradox

I could so pretend to believe in God if I needed to.....

It occurred to me the other day that we might actually have a control group!

The Amish (https://en.wikipedia.org/wiki/Amish) are a religious group in the United States who seem to have pretty much refused modernity and still live in the same way that Victorian peasant farmers would have lived.

I must say that their faith has guided them well. No cars, no televisions, no telephones, let alone mobile phones or sodding smartphones. As a result, lots of community and personal interactions, good traditional home cooked food, lots of working together outdoors.

But they do seem to accept all the good things about modernity like antibiotics and the various practical consequences of the germ theory. Even washing machines are apparently OK.

It sounds idyllic. I'd love to live like that, amongst other people who lived like that, and if it wasn't for the fact that I imagine that ten seconds after I first opened my mouth they'd probably decide I was an agent of Satan I'd be applying for membership.

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So here we have a bunch of guys with European genetics, living in America the heart of the horror, who might be expected to suffer a lot less from the consequences of whatever it is in modern life that's screwing everyone up.

Before I went and looked, I thought about what I would expect to see. It's always important to make predictions about things before you look. Explaining stuff after you look stops you noticing that you’re surprised and confused.

The first thing I'd predict is that they wouldn't eat much processed food and in particular not much vegetable oil.

Why on earth would you eat that rubbish if you were surrounded by real food?

I'd expect them to eat a fairly traditional rich farmers' diet. Lots of bread and meat and milk and butter and cheese, lots of carbs and saturated fat. All the animals fed by grazing on fields of grass.

And if that's true, then I wouldn't expect them to suffer much from any of the diseases of modernity. In particular I'd expect them to not have much of an obesity problem, and not suffer much from heart disease. And not to suffer from any of the things which look like hypothyroidism, to wit chronic fatigue, fibromyalgia, depression, IBS and all the others. And I wouldn't expect them to suffer from type 2 diabetes. And I wouldn't expect them to have much in the way of mental disorders. And I wouldn't expect them to have any sort of problem with sunburn despite their outdoor life.

And I'd expect that they would also be free of all sorts of other nasty diseases that I haven't yet found a reason to think are caused by polyunsaturated fats. Let's just guess wildly that things like cancers and allergies are going to be on that list too.¹

I'd also expect them to get an awful lot of outdoor exercise, and I'd expect medical "science" to be completely ignoring their miraculously good health on the basis that they get an awful lot of exercise, and if only we would do that we would have the same good health outcomes.

And then I went and looked: (https://en.wikipedia.org/wiki/Amish)

The very first thing I noticed is that the Amish are undergoing a full scale population explosion. Their population has tripled in the last thirty years, and that's presumably despite shedding large numbers of open-minded youngsters in every generation². I hadn't predicted that but I probably would have if I'd thought about it at all.

Also, they're scattered all over the US, but mainly in Pennsylvania, Ohio and Indiana. I knew where Pennsylvania was but I had to look up the other two. It turns out that the Amish have been drifting west and spreading out under population pressure.

Second thing is that they're a collection of independent communities who have different rules about which modern horrors to avoid. Honestly these people should be a gold mine. I wonder why they aren't infested with undercover medical researchers. Maybe their security is too good.

Thirdly they've got a number of interesting genetic disorders, coming from the fact that they're all descended from a few hundred original settlers. Again, not at all surprising even though I didn’t predict it in advance.

Cancer

Overall cancer rates in the Amish are reduced and tobacco-related cancers in Amish adults are 37 percent and non-tobacco-related cancers are 72 percent of the rate for Ohio adults. Skin cancer rates are lower for Amish, even though many Amish make their living working outdoors where they are exposed to sunlight.

That's no big deal. I don't think Amish smoke much (the odd cigar apparently), so maybe a third of the cancers you'd expect have gone missing.

I mean, I'm not saying getting rid of one-third of all cancers wouldn't matter, but it's not the huge reduction I'd expect if PUFAs or some other modern horror were the principal cause of cancers. It's not the spectacular near-absence of cancer that we seem to see in the 1990s Kitavans or people in Victorian times.

Skin cancer is interesting. One thing I think we’re pretty sure about is that giving up PUFAs reduces susceptibility to sunburn. If that’s not having a knock-on effect on skin cancer rates then that’s really surprising.

Mental Illness

Suicide rates for the Amish are about half that of the general population.

Again, that's not nearly as good as I expected. The combination of a more natural outdoorsy way of life and a religion that tells you that suicide is a terrible sin should reduce suicide rates a lot.

And that's about all Wikipedia can tell us about the Amish. No mention of whether they eat much in the way of "vegetable" oil. I'm assuming not.

So now I really really want to know more about the Amish.

If they really don't eat vegetable oil, or even if they only eat a bit, then their health statistics should provide a perfect test of 'PUFAs bad'.

If they only eat a bit of vegetable oil, then their health should look quite like the health of early twentieth-century people, which is to say lots of heart disease but not much else. Maybe not even much heart disease if they don’t smoke much.

If they're in roughly as bad shape as the rest of the American population, whilst eating a roughly traditional organically grown diet, then the whole idea that the 'diseases of modernity' are caused by something in the food is a shambles. I'll cease to believe it on the spot.

Sure, if the 'diseases of modernity' really are modern diseases, and we’re not just being fooled by not having very good statistics from the old days, then they must be being caused by something modern, but it must be something that the Amish are exposed to. An infectious disease, an environmental poison, that sort of thing. Even maybe by genetic adaptation³ to an ancient disease that no longer exists, like tuberculosis or milk sickness or iodine deficiency.

1. And immediately I thought about hayfever... I had hayfever as a little boy. It wasn’t unusual. So at least one allergy is compatible with not eating PUFAs.

2. The unregenerate hanker always after seed oilz

3. But no, I don’t buy that. Hasty genetic adaptations are usually the easiest things to spot. Single Nucleotide Polymorphisms with heterozygote advantage that cause terrible diseases in homozygotes.