Will Elitist Science Crumble? Empower Yourself N of 1 With kNowledge

The n=1 science movement is blossoming. It's beautiful. I see it everywhere, from comments on social media to newspapers to patient reports in the clinic. But some scientists are lashing out, like this famous scientist who called n=1 science an oxymoron, or this other scientist who compared n=1 science to a waterproof tea bag. Now, that's pretty comical, and I don't know this second professor, but he genuinely seems like a lovely guy with a great reputation among his peers at Caltech. Anyway, jokes aside, a pattern I'm finding in these attacks is they are typically incredibly shallow, often flat-out false, with no true substantiation, and coming from people who seem like they really want to think highly of themselves as academics. Now, to quickly debunk the oxymoron comment before I get to the points I really want to make in this video, there is nothing, I repeat, there is nothing about the scientific method that prevents it from applying to a single person. There just isn't. You can develop and test hypotheses on an individual, collect data on that individual to evaluate the hypothesis, and iterate to evolve your models. You can apply science to individuals. In fact, Nobel Prizes have even been won on the backs of n 1 self-experiments, like Barry Marshall, who won the Nobel Prize in Physiology or Medicine in 2005, which arose from an n 1 self-experiment that he performed in the '80s to demonstrate a link between H. pylori and stomach ulcers. And there have been others. There's also Werner Forsmann, who developed cardiac catheterization and won a Nobel Prize in 1956, and Ralph Steinman, who experimented on his own pancreatic cancer and won a Nobel Prize in 2011. And even today, today in top journals like Nature Biomedical Engineering, they publish on n=1 science conducted by exceptionally accomplished scientists like Professor Michael Snyder at Stanford, who believes n=1 science is the future, and honestly, I tend to agree. So forgive the direct play on words, but the claim that n 1 science is an oxymoron is kind of moronic and just false, or at least probably false with a p-value less than 0.05. So why are some scientists getting so defensive? I think I can answer that question by defining science first by what science is not. True science is not a property to be hoarded by the scientific elites, or those who imagine themselves elites by virtue of their degrees, citations, H-indices, and academic affiliations. No, what true science is, plain and simple, is a method for harnessing curiosity to extract valuable insights. We call those data. And then using those insights, those data, to develop your model of how the world works. This is what powers humanity. And when appreciated fully for what it is and who can and should have access to true science and the scientific method, it can save lives. Let me give you a couple of examples drawn from a recent opinion article that I published that if you have the time to read in full, I'd really appreciate it. It will give you a much better sense of where I'm coming from. But with that, let me tell you about the first patient I ever served. Her name, or I'll call her, was B. B was a middle-aged French woman living in Oxford, England, where I completed my PhD. And B was suffering from Parkinson's disease, a debilitating neurodegenerative disease that manifested in her with tremors, difficulty walking, and in B's case, depression. And you add to that inflamed joints and obesity, and B was the epitome of someone who deserved so, so much more than the hand she was dealt in life. Now, she entered my life as a participant in a randomized clinical trial that I was leading for my PhD at Oxford. And when the trial ended, she asked for my support with her diet because she wanted to lose some of the weight that she'd gained during her disease course. And I leapt at the opportunity to potentially help a new friend. Well, I less leapt, then pushed, because I literally pushed her around in a shopping cart at some of the local grocery stores, markets, like Tesco Market on Magdalen Street in Oxford, like a toddler, because she couldn't walk at the time. She was largely immobile because of her disease. She'd pick items off the shelf, ask questions about them, and then slowly surround herself with a carefully curated sea of groceries by the time we arrived at checkout. You can tell I remember it very fondly. It was very cute. And in the coming months, B and I stayed in constant contact. She'd text me pictures of her meals, and she'd reflect on how she felt, collect data on herself, and also ask for my feedback. And we persisted with this pattern, and she made immense progress. But the real progress she made wasn't on the scale. No, metabolic health goes a lot deeper. I'll never forget a text she sent me in November of 2019. It read, "I've hardly had any pain in my right hip today." That was her problem hip. "And I've even started dancing a bit with my kids. When Paul, my husband, came back from London, I was dancing in the kitchen to some old rock song, and he could not believe it. Me neither, frankly." Now, for some further context, Bee had previously been a marvelous dancer. It was an activity she treasured and thought she'd have to give up forever because of her Parkinson's disease and other health problems. So to know that she could once again immerse in her favorite activity with her loved ones, well, I just don't have the words to describe how that made me feel. I think any human can just intuit how that might have made me feel. It was unbelievably uplifting. And Bee's story is actually just a sample Not an outlier, that's why I bring it up. Take another sample, somebody you might know, Dave Danna. Now, for those of you who don't know Dave, when Dave and I met, he weighed over 400 pounds and suffered from depression and financial strain. But I could see in him the glow of a fire, a fierce motivation in his belly to get healthy. But his fire was tempered by learned helplessness from living in a society flooded with with bad advice, patient blaming, dysfunctional social norms, and useless platitudes around health. Nonetheless, the spark, the fire, was there. It just needed some kindling. And as with B, Dave expressed curiosity— here's that word again— in his health journey. He reflected on how every intervention, every tweak, impacted his health. And through objective and subjective measures, he monitored himself. He asked questions and he iterated on his approach. Now, I want you to think for a moment about the process I'm describing. It is science. It is true science. It is authentic science. It is testing hypotheses on yourself and evaluating the results with curiosity rather than with judgment to acquire valuable insights, or if you prefer the word, valuable data. Now fast forward and Dave has lost more weight than I weigh. And this physical change has coincided in him with improvements in his mental, financial, and social health. He's completed his MBA. He got married to the love of his life. They are so cute. And to my pleasure, I got fired as his quote coach, upstaged by someone with a bit more experience in the gym. I'm sure you can recognize this guy, Mr. Arnold Schwarzenegger. Now, I've learned many lessons from Bea, Dave, and the hundreds of other people and patients I've had the privilege of getting to know over the early formative years of my career. And I know it's cliché to say, but it's true. I've learned far, far more outside the classroom in the lab than I ever could have learned therein. But one truth stands out above all the rest. That truth is the immense power of n=1 science. N=1 science captures the philosophy that every single human being has the power to apply the scientific method to their own life. To identify an element of their health that they want to change. To hypothesize about what intervention or interventions may impact that outcome, then to implement that or those interventions, and assess their own outcome data using either objective or subjective measures, and then to repeat ad infinitum for the rest of their life because the metabolic health journey is a forever learning process. N=1 Science empowers people to become citizen scientists, experimenting and refining their health choices to find what works best for their own bodies. This is the self-application of the scientific method to one's own metabolic health journey, and if properly executed, it's the thing that almost guarantees long-term success. It was the secret, quote, secret, to B's and Dave's incredible successes, as well as those of countless others. So for those scientists who call N=1 science an oxymoron or tease it like a waterproof teabag, or otherwise try to diminish this empowering application of the scientific method to each human experience, not only do I think you're entirely wrong and your position non-defensible, but I challenge you to consider that the process of applying the scientific method to a human life and applying attitudes of being a true scientist are powerful tools that can and do save lives. And honestly, people don't have to wait for the holy gift of scientific knowledge to be handed down by the peer-reviewed literature gods. They can express everyday curiosity, test hypotheses on themselves, and improve their lives today. And fortunately, they don't need your permission or approval to do so. And for those of you who are enthused by the n=1 science and citizen scientist movements, I'm working on assembling a suite of tools that you can access, including technology to help you search the literature and develop hypotheses, to get blood tests at home, to monitor glucose control on continuous glucose monitors, etc. I want to help put your data in your hands, enhance scientific literacy so n=1 science can be a more powerful tool for you. If you're interested in any of these things I just mentioned, check out the links below. But as always, All you really need to be a scientist is a curious spirit and an open mind. So stay curious and don't let the haters get you down.