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Andrew Belaveshkin MD PhD, Rome (2026)

20/10/2024

Walking past the beautiful Bank of England building one day, I was reminded of a curious principle named after Charles Goodhart, a former advisor to the Bank of England. In 1975, he formulated a rule now known as Goodhart's Law: "Any observed statistical regularity tends to break down once pressure is applied to it for control purposes." In essence, when we set a target to achieve a certain metric, the old patterns that once made that metric meaningful stop working. Simply put, "when a measure becomes a target, it ceases to be a good measure."

Epigenetic age: When we replace hard endpoints in research with biomarkers, we risk making critical errors. For example, epigenetic age can be reduced by taking vitamin D, growth hormone, folate (B9), B12, and consuming certain foods (like poultry). However, none of these interventions reduce mortality or extend lifespan.

The Vitamin D paradox: High levels of vitamin D in the blood are strongly linked to lower risks of various diseases—cancer, autoimmune disorders, obesity, and diabetes—according to numerous studies. The quality of this research is beyond doubt. However, taking vitamin D supplements above normal levels proves almost useless. Why? Vitamin D levels are a reflection of how much time someone spends outdoors, which correlates with being more physically active, socially engaged, and overall healthier (versus being stuck indoors). Plus, there are other compounds produced under sunlight that supplements can't replace (more than a dozen, from nitric oxide to proopiomelanocortin). This doesn’t just apply to vitamin D, but to many other markers, from homocysteine to zinc.

Weight loss. Many people make weight reduction their primary goal, tracking progress solely by the number on the scale. This often leads to unhealthy practices like extreme diets or loss of muscle mass instead of fat. In the end, the pursuit of their goal leads to burnout and eventual weight gain. The more they lose, the closer they get to failure.

It’s like trying to evaluate a car’s condition based solely on mileage (which can easily be tampered with), assessing love by the number of gifts exchanged, or judging children based on their grades. Goodhart’s Law applies to society as well. If businesses are rewarded based on the weight of their production, products become heavier. If transportation companies are judged by kilometers traveled, routes become more complicated. If education is measured by test scores, the entire system bends toward teaching to the test.

When company rankings or performance metrics become the focus, efforts shift toward manipulating those numbers at any cost. In some cases, countries—like Belarus—falsify economic data or infant mortality rates just to climb higher in UN rankings. The same is true for academic metrics: when citations become the benchmark, the quality of research declines, and the number of low-quality papers skyrockets.

Metrics are useful, but they should guide us, not be our ultimate goals. It's always important to focus on real, meaningful outcomes. When setting goals or evaluating progress, it's crucial to keep Goodhart’s Law in mind, so we don’t lose sight of what really matters.

19/10/2024

As the ancients said (but this is not accurate =)), tempus perdo, sed pondus perdere volo - “I’m losing time, but I would like weight.”

18/10/2024

You are not the consumer of information, information is consuming your attention. Distraction from phone use is responsible for 14% of all injury-related car crashes and 8% of all fatal accidents. Using a mobile phone while driving forces drivers to focus on an additional task, impairing their ability to drive safely. Drivers who text while driving are eight times more likely to be involved in a crash. This cognitive distraction increases the risk of accidents, reduces hazard detection, and leads to poor situational awareness.

😬Mobile distractions result in drivers missing up to 50% of the information in their driving environment. Research shows that drivers using cell phones have slower reaction times than those impaired by alcohol. Using a smartphone for social networking – slows reaction time by 37.60%. Texting – slows reaction time by 37.40%. Alcohol – slows reaction time by 10-30%. Hands-free mobile phone conversation – slows reaction time by 26.50%

🫣Listening to someone on the other end of a phone call reduces brain activity in areas responsible for driving by 37%. When holding a phone for conversation, reaction times slow by around 50%, compared to 26% slower with hands-free devices.

The risk of using a phone while driving can indeed be compared to drunk driving. Casual phone conversations are comparable to mild intoxication (1-2 beers). Texting or using social media is similar to moderate intoxication (3-4 beers). Watching short videos, such as TikToks or Reels, is equivalent to being heavily intoxicated (5+ beers), drastically reducing attention and increasing reaction times.

📴It’s crucial to remember this for your own safety and to be more cautious around drivers with phones in their hands—treat them as if they were drunk and adjust your driving accordingly.

📖A comparison of the cell phone driver and the drunk driver Hum Factors 2006 Summer;48(2):381-91.
A comparison of the effect of mobile phone use and alcohol consumption on driving simulation performance Traffic Inj Prev 2012;13(6):566-74.

18/10/2024

You are not the consumer of information, information is consuming your attention. Distraction from phone use is responsible for 14% of all injury-related car crashes and 8% of all fatal accidents. Using a mobile phone while driving forces drivers to focus on an additional task, impairing their ability to drive safely. Drivers who text while driving are eight times more likely to be involved in a crash. This cognitive distraction increases the risk of accidents, reduces hazard detection, and leads to poor situational awareness.

Mobile distractions result in drivers missing up to 50% of the information in their driving environment. Research shows that drivers using cell phones have slower reaction times than those impaired by alcohol. Using a smartphone for social networking – slows reaction time by 37.60%. Texting – slows reaction time by 37.40%. Alcohol – slows reaction time by 10-30%. Hands-free mobile phone conversation – slows reaction time by 26.50%
Listening to someone on the other end of a phone call reduces brain activity in areas responsible for driving by 37%. When holding a phone for conversation, reaction times slow by around 50%, compared to 26% slower with hands-free devices.

The risk of using a phone while driving can indeed be compared to drunk driving. Casual phone conversations are comparable to mild intoxication (1-2 beers). Texting or using social media is similar to moderate intoxication (3-4 beers). Watching short videos, such as TikToks or Reels, is equivalent to being heavily intoxicated (5+ beers), drastically reducing attention and increasing reaction times.

It’s crucial to remember this for your own safety and to be more cautious around drivers with phones in their hands—treat them as if they were drunk and adjust your driving accordingly.

A comparison of the cell phone driver and the drunk driver Hum Factors 2006 Summer;48(2):381-91.
A comparison of the effect of mobile phone use and alcohol consumption on driving simulation performance Traffic Inj Prev 2012;13(6):566-74.

13/10/2024

A microscope is one of the best gadgets you can buy for your child. Modern digital microscopes are inexpensive, simple and convenient. And they incredibly stimulate children’s curiosity and interest in the world!

30/09/2024

Seven ideas for healthy, efficient rest:

1. Preventive rest instead of burnout recovery. The sooner you start taking breaks and resting, the longer you can work without exhaustion. The idea of "resting only when everything is finished" is flawed. Breaks aren't a waste of time; they’re like "sharpening the saw." Keep your brain in good shape, and don’t overload it.

2. Planned rest instead of whatever comes up. The ideal rest is one that you plan ahead. Try scheduling recreational activities first in your weekly planner. Outline where and how you'll relax, make time for hobbies and enjoyable tasks. Then, fit your work around that.

3. Changing context instead of monotony. Working and resting at the same desk is a bad idea. Use different environments for different activities. Traveling somewhere without work-related associations is an effective way to recharge.

4. Take a full rest instead of “half-work.” Easing the workload or slowing down doesn’t help much. It’s better to take a complete break and fully restore your energy. Then, when you return to work, dive in with full focus.

5. Spontaneity instead of routine. Spontaneity, randomness, and novelty are refreshing and energizing. Roll a dice to decide where to go or pick a random spot on the map. Breaking routine helps you reset. Creativity and a touch of spontaneity help balance out an overworked prefrontal cortex.

6. Active rest instead of passive downtime. Passive rest isn't as effective, like lounging on the couch or chasing quick dopamine fixes (drinking, snacking, scrolling). Active rest teaches you to gain dopamine in more challenging but rewarding ways—dancing, playing tennis, or taking a walk in the autumn park.

7. Transformative rest instead of consuming rest. Rest that involves passive consumption isn't as effective as transformative rest. For example, even media can have a cathartic effect, prompting internal reflection. Creative activities stimulate you to create something new, to transform. You don't just return to your old self; you rise above yourself.

26/09/2024

The face is a mirror of the soul, as Cicero once said. In childhood, we were often warned when making faces, "If you keep doing that, you'll get stuck like that!" Indeed, frequently expressing certain emotions creates conditions for forming static wrinkles where dynamic ones used to be. As a result, even a completely neutral face may carry a permanent emotional imprint. This same emotional trace can form as the face ages. After all, expressions of happiness are associated with the contraction of muscles that lift and expand, while sadness involves muscles that pull down (depressors). With age, the corners of our mouths droop, making it seem as though we are displeased.

This can affect how others perceive and evaluate us, often leading to misunderstandings. Moreover, facial expressions, much like slumped posture, can prime our thoughts in certain directions. For example, try to notice the difference in feelings when you hold a pencil horizontally between your teeth (similar to a smile) versus holding it by the tip (similar to tension).

In one study, scientists focused on expressions of contempt, anger, and dissatisfaction in some people at rest. This phenomenon has even been given the name "Resting Bitch Face" (RBF) in both men and women. Scientists use this term in their research as well. We may perceive others as expressing contempt or dissatisfaction, even if they feel neutral. According to some opinions, RBF is primarily a result of suppressed or even self-hidden emotions. If you feel fine or neutral but are asked, "Why are you angry?" or "Is something wrong? Did I say something you didn’t like?" or "Why aren't you smiling?" — you probably have RBF at that moment. You can check your photo (resting emotions) for Resting Bitch Face here: https://www.testrbf.com. Of course, in certain situations, RBF can serve as an excellent defense against unnecessary interactions, but if used too often, it may become imprinted on your face.

1. Learn to relax your face. Naturally, it's psychologically more pleasant to be in an environment where people have relaxed faces. It helps me relax as well. So, what can you do to avoid a permanent look of dissatisfaction on your face? Start by learning to relax your facial muscles and become aware of tension. Look at people with respect. A half-smile or slight smile is great. Raise your eyebrows when greeting someone. Pressing your tongue lightly against the roof of your mouth also helps relax facial muscles. Of course, cosmetic procedures and corrections can also be helpful.

2. Still face as emotional suppression. A frozen facial expression can be a form of adaptation to an unfavorable environment where spontaneous emotional reactions were condemned, and an expression of disgust towards a dictator’s statue could have cost people their lives. Additionally, in some Eastern cultures, an animated emotional reaction may be disapproved of as a loss of self-control.

However, a lively, animated face is one of the most underrated secrets of attractiveness. When you're able to show a genuine, engaged reaction, you become more understandable and attractive. There’s a simple way to check the "understandability" of your face—take selfies of yourself expressing different emotions and ask others to identify what you're expressing.

3. Smartphones and the frozen face. Prolonged use of smartphones by preschool children increases the risk of a "frozen face"—when no feedback occurs between the person and the phone, and emotional learning is impaired. It’s harmful to adults, too, when they look at their phone during conversations—this degrades the quality of communication and devalues it. A well-known experiment from 1978, the "Still-Face Experiment," shows how negatively a parent’s expressionless face can affect child development.

25/09/2024

Man flu is real. The idea that “man flu” is just an exaggeration has been circulating for years in memes and videos, poking fun at men for seemingly overreacting when they catch a cold or flu. But let's set the record straight: men don't just appear to suffer more—they actually do experience viral infections more severely. Not only are men more prone to complications from these infections, but they are also more likely to die from them. This makes it particularly important for men to take better care of themselves when ill.

Research suggests that men have weaker defenses not only against viruses but also against parasites, bacteria, and fungal infections. They are more vulnerable to sepsis, a life-threatening immune response to infection. Testosterone, the primary male s*x hormone, plays a role in this. While testosterone reduces inflammation, it also suppresses the thymus, where new immune cells are trained, leading to less robust immune cell production. The higher the testosterone level, the more severe the cold can be.

In contrast, estrogen, the dominant female s*x hormone, enhances the activity of immune cells like T lymphocytes and macrophages, resulting in a more potent immune response in women. Moreover, women have greater numbers of certain immune cells, including plasma cells, regulatory T cells (Tregs), CD19+ B cells, mucosa-associated invariant T cells, and naïve CD8+ T cells, compared to men. Women also produce a higher surge of antibodies following vaccination and have longer-lasting immune memory than men.

However, this evolutionary advantage comes with a significant trade-off: women are far more prone to autoimmune disorders—making up 80% of all cases—due to their heightened immune activity.

From an evolutionary standpoint, these immune differences likely exist because women need stronger immune defenses through their reproductive role. A robust immune system helps protect the developing fetus by transferring antibodies. For men, it's less straightforward. Some theories suggest that ancestral male behavior, such as increased risk-taking, exposed them to more infections, but paradoxically, this may have impaired their immunity. There's also the possibility of a trade-off between a strong immune system and reproductive fitness, with testosterone impeding the immune response and making men more susceptible to infections.

What does this mean for us today? Men should take their infections more seriously and stand to benefit significantly from flu vaccinations. Women, on the other hand, should pay closer attention to measures that reduce the risk of allergies and autoimmune diseases.

Scientific basis for 'man flu' Nature Reviews Immunology volume 10, page 290 2010
The conneXion between s*x and immune responses Nature Reviews Immunology volume 24, pages 487–502 (2024)
Gender-Specific Impact of S*x Hormones on the Immune SystemInt J Mol Sci. 2023 Apr; 24(7): 6302.

20/09/2024

When we think about oral behaviors, such as oral s*x or even something as seemingly trivial as picking and eating nose mucus, there’s an underlying biological mechanism at play that can have health implications—this mechanism is known as oral tolerance. While many parents may find habits like nail-biting, thumb-sucking, or eating mucus irritating, it’s worth considering the data before reacting too strongly. Research has shown that children who engage in at least one of these behaviors (nail-biting or thumb-sucking) during their preschool years have a 40% lower risk of allergic sensitization to common antigens as adults.

Now, let’s break down how this works. When children explore their environment, touching objects and putting them in their mouths, they expose themselves to a variety of antigens—tiny particles collected under the nails or those present in the air, which get trapped in nasal mucus. This mucus acts as a filter, gathering information about potential environmental allergens.

Here’s the key: when a child consumes these particles, the immune system learns to recognize these antigens early on. This is critical because the gut is home to a significant number of immune cells that are constantly interacting with ingested antigens. By encountering antigens via the gut, the immune system develops a form of tolerance—this is the concept of oral tolerance. The gut processes these proteins in a way that teaches the immune system to accept them without triggering an allergic response. This is why ingesting antigens is preferable to exposure through the skin or respiratory tract, which can lead to allergic reactions.

Oral tolerance refers to the absence of a local or systemic immune response when antigens are introduced through the mouth, particularly in the case of food proteins. The local immune system in the gut processes these proteins and produces specific immune cells, known as Foxp3+ Tregs and Foxp3-Tregs, which contribute to both local and systemic tolerance, allowing for the safe consumption of food. The effectiveness of this process is age-dependent and influenced by the gut microbiome.

For a long time, the belief was that children should be shielded from highly allergenic foods. However, research shows the opposite is true. The earlier allergens like peanuts or eggs are introduced, the lower the risk of developing allergies. If these antigens enter the body for the first time through the skin or airways, they’re more likely to trigger allergic sensitization. For instance, exposure to peanut antigens on the skin can increase the likelihood of peanut allergies. The optimal window for introducing new foods is between 4 and 7 months of age. Removing antigens altogether doesn’t stimulate the development of tolerance.

So, what’s the takeaway? We shouldn’t be too quick to panic or scold children for these so-called "bad" habits. There’s some benefit to them. However, this immune education essentially ends by age five, so for adults, nail-biting and eating mucus are both unnecessary and, frankly, unpleasant. From an early age, it’s crucial to avoid an overly sterile diet, providing a variety of foods to help the immune system build tolerance and prevent allergies down the road.

Interestingly, oral tolerance mechanisms can also be relevant for adults. Scientific research suggests that oral s*x (involving semen ingestion) can reduce the risk of preeclampsia and miscarriage. This is because the fetus is immunologically foreign, and semen contains high concentrations of male antigens. When these antigens are introduced into a woman’s body, they can stimulate the development of immune tolerance, reducing the risk of immune rejection of the fetus. Fascinatingly, the higher the concentration of specific HLA molecules (such as HLA-G) in semen, the lower the risk of preeclampsia. This is how oral tolerance plays a role in conception and pregnancy.

Annual Review of Cell and Developmental Biology Pediatric Allergic Diseases, Food Allergy, and Oral Tolerance Annu. Rev. Cell Dev. Biol. 2020. 36:511–28
Oral tolerance as antigen-specific immunotherapy Immunotherapy Advances, Volume 1, Issue 1, January 2021, ltab017,
Thumb-Sucking, Nail-Biting, and Atopic Sensitization, Asthma, and Hay Fever Pediatrics 2016 Aug;138(2):e20160443.
Oral s*x is associated with reduced incidence of recurrent miscarriage Journal of Reproductive Immunology Volume 133, June 2019, Pages 1-6
Correlation between oral s*x and a low incidence of preeclampsia: a role for soluble HLA in seminal fluid? Journal of Reproductive Immunology. 2000 Mar;46(2):155-66.

07/09/2024

How weekends make you gain weight. Do you strictly follow all the rules of healthy eating but still see no results? You may have fallen into the weekend trap. Studies show that people tend to overeat in the second half of Friday, Saturday, and Sunday – and these three days can completely undo all your efforts.

Research shows that people aged 19 to 50 consume an additional 115 kcal on weekends (Friday to Sunday) compared to weekdays (Monday to Thursday). Over a year, this weekend indulgence can total an extra 17,940 kcal or nearly 2.7 kg. This additional caloric intake primarily comes from alcohol and fats. Three days of overeating can completely negate the effects of four days of dieting, creating a vicious cycle of "starvation-binge" within a single week. This cycle is often exacerbated by reduced physical activity and disruptions in circadian rhythms.

What to Do?

1. Recognize your behavioral patterns and false beliefs.
Identify where you're avoiding self-monitoring, how you're justifying overeating, and where you're giving up self-control. Examples include: The weekends are my time. This is my only chance to relax. Hey, it’s Friday (or Saturday or Sunday). You only live once! I'll do it next weekend.

These beliefs are rooted in moral compensation (feeling morally exhausted, so you compensate with immoral indulgence), where good behavior justifies bad habits. There's also a cultural inheritance of passive rest from when our ancestors did physically demanding work, making it necessary to rest as much as possible on weekends. Weekends often hide a compulsive overeating cycle (binge on weekends, starve at the start of the week).

2. Plan for non-caloric dopamine.
The desire for a dopamine hit becomes stronger when you're tired. However, never reward yourself with the very thing you're trying to change, as it will sabotage your dopamine system (for example, don't reward yourself with lying down after a workout or food after restricting it). Try non-caloric rewards that are aligned with your goals. If you're trying to lose weight, schedule a massage, a photoshoot, new clothes, or a sauna session instead.

3. Choose active rest instead of passive.
Yes, we get tired, but active rest restores us from stress much faster. A walk is more effective than lying on the couch, and in-person interaction is far more energizing than scrolling through social media. New experiences, travel, social events, and activities all provide dopamine from proactive novelty. Passive rest, on the other hand, increases the risk of weight gain. For example, a 60-minute increase in sedentary time on weekends is associated with a 0.5% gain in body fat.

4. Recognize eating patterns.
An empty fridge by the weekend increases impulsivity. Weekends are often associated with typical food patterns like Friday work treats, alcohol with fatty snacks, fast food, or late-night delivery. What triggers this behavior? What alternatives can you think of? You could cook something delicious yourself, relaxing and enjoying slow cooking with family or friends. Always keep frozen foods on hand to quickly prepare meals when your fridge is empty.

5. Social and food jet lag.
Stick to a schedule all the week. On weekends, many people wake up later, disrupting circadian rhythms and meal timing, similar to jet lag after a long flight. If you wake up even one hour later on weekends, it increases your chances of obesity by 30%. Skipping early meals leads to overeating later in the day. What to do? Wake up at the same time daily, stick to consistent meal times, and don't skip breakfast on weekends.

6. Make weekends champions’ days.
Instead of indulging, focus on activities during the weekends. You have more time, so dedicate more to your health. Plan a 24-hour fast on Saturday or engage in significant physical activity (a cycling trip, basketball game, workout, or a long hike). Studies show that increased physical activity only on weekends is enough for weight loss (on days when you're busy with sports, you automatically eat less). Weekend physical activity mediates the association between baseline fat mass and fat mass after one year of follow-up among adults. "Weekend warriors" – those who are regularly active during weekends – show improvements in both abdominal and general fat reduction.

Influence of Weekend Lifestyle Patterns on Body Weight Volume16, Issue8 August 2008 Pages 1826-1830
The associations of "weekend warrior" and regularly active physical activity with abdominal and general adiposity in US adults Obesity (Silver Spring) 2024 Apr;32(4):822-833.
Weekend Eating in the United States Is Linked with Greater Energy, Fat, and Alcohol Intake 2012 Obesity Research
A Marker of the Variability in Meal Timing and Its Association with Body Mass Index Nutrients 2020, 12(3), 816.

Andrew Belaveshkin MD PhD

20/10/2024

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