I hadn’t heard of “n=1” before LCHF. I heard it over at the Ketogenic Forums, where it is a category for posts. Wikipedia describes it as; “An N of 1 trial is a clinical trial in which a single patient is the entire trial, a single case study.”
Most informally, “n=1” is another way of saying; “I’ve tried this, and it works for me.” In the LCHF world, helping one to understand what’s going on, and why is critical. LCHF has common, well-funded and ubiquitous critics, warning us of the certain debilitation and death we face for not following their high-carb guidance. I’ve fallen to this guidance, heck, it’s why losing weight was so vexing for me. Despite carefully and rigorously following their food pyramid, avoiding saturated fats, and eating lots of carbs, and engaging in lots of exercise, at least 5 hours per week, and not eating more per day than my estimated caloric intake of food, I should have been fit. I found myself simply gaining weight. My turning to LCHF was more an act of “I’ve got nothing to lose” desperation, than a measured, risk-mitigated change. Again, having a doctor oversee my course of action also greatly ease my fears.
Alone, n=1 is problematic. Relying on anecdotal evidence is woefully insufficient. Ignoring the subjective influences of personal confirmation and selection bias, including the placebo effect, from legitimate observation, analysis and action has been the path of folly. That said, coming to the party with sufficient and reflexive self-doubt and skepticism, as well as being open to all evidence, should go a long way to counter balance those forces.
On the process level, many leading figures in LCHF have been publicly begging for more clinical trials, more evidence that either support or refute their claims. In a December 22, 2017 op-ed in the Globe and Mail, Taubes laments about the lack of clinical trials, despite the growing number of n=1’ers experience with improved health on LCHF.
N=1 isn’t anti-medical, anti-pharmacological or against the scientific method. I owe my life, health and well-being to doctors and the scientific process. This is to say that there’s a lot we don’t know, evidentially, about nutrition. This evidence deficit doesn’t stop powerful groups from making breathless proclamations about what we should or shouldn’t eat.
The lack of relevant research brings us back to policy, and the rent-seeking actions of powerful interests whom game the process for their advantage. That’s a whole different topic. Suffice it to say, without evidence, we do whatever it takes to stem the obesity crisis, such as n=1.
My n=1 is simple. I should be dead based on the fear, uncertainty and doubt of nutritional guidance. Rather, I’ve never been better. My weight has remained below 225 for approaching a year, and my other markers are stable, in a positive measurement. If there’s a problem with LCHF, I cannot find it, and my frequent testing of my markers make self-denial impossible.
n=1 could also be summed up this way. In the 1933 Marx Brother’s movie “Duck Soup,” Chico Marx, playing Chicolini, was caught impersonating. Caught in the act, he defended himself by saying
“Well, who ya gonna believe, me or your own eyes?”