FOOD & HEALTH SKEPTIC ARCHIVE
Monitoring food and health news
-- with particular attention to fads, fallacies and the "obesity" war
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A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
A brief summary of the last 50 years' of research into diet: Everything you can possibly eat or drink is both bad and good for you
31 March, 2011
The British town that's banned salt: Shakers taken off chip-shop counters and put out of sight
It began with the food police reducing the number of holes in salt shakers. Now they have gone a step further and removed the shakers altogether to hide them from view.
Fish-and-chip shops, cafes, restaurants, takeaways and curry houses will take salt containers off their counters and table tops under the latest push by a council to cut its residents’ salt consumption. Customers will have to ask staff specifically to hand over the shakers if they want to add salt to their meals.
Stockport council is one of the first councils in Greater Manchester to adopt the ‘out of sight, out of mind’ health initiative. It follows a series of initiatives to reduce the salt added to food by diners.
In 2008 town halls reduced the number of holes in salt shakers from the traditional 17 to five after research suggested this could cut the amount people sprinkle on their food by more than half. Councils ordered thousands of five-hole shakers – at taxpayers’ expense – and gave them away to chip shops and takeaways in their areas.
The scheme has been welcomed by health professionals and celebrity chefs including Paul Heathcote.
But Les Jones, Conservative group leader at Liberal-Democrat-controlled Stockport council, said the move was creating a ‘nanny town’. He said: ‘British people don’t like being ordered around. If you actually want people to use more salt, then tell them not to. It’s a foolish thing to do.’ It could proved to be counterproductive because people did not want to be treated like children, he added.
Diner Paul Edwards, 36, said: ‘It is preposterous. We should all be responsible for our own health – anything less means they’re treating us like idiots. They will be confiscating chocolate bars next.’
Yellow dye used to test Alzheimer's could hold key to living longer -- if you are a worm
A yellow dye used in the diagnosis of Alzheimer’s disease could hold the key to a long and healthy life. Microscopic worms treated with the susbtance, which is used in labs around the world, lived up to 70 per cent longer than expected.
The dye, which is called Thioflavin T, also slowed the symptoms of dementia in worms bred to mimic aspects of Alzheimer’s, the journal Nature reports.
It is thought that it stops a brain protein called beta-amyloid from forming toxic clumps and helps levels of other key proteins stay in balance, something known as ‘protein homeostasis’.
The dye is used to detect Alzheimer’s from samples of brain tissue under the microscope. If it sticks to the beta-amyloid protein, that is a sign that the person had Alzheimer’s.
Professor Gordon Lithgow, of The Buck Institute for Age Research in Novato, California, said: ‘We have been looking for compounds that slow ageing for more than ten years and Thioflavin T is the best we have seen so far.’
Curcumin, the active ingredient in the spice turmeric, also showed promise as an anti-ageing drug.
Researcher Silvestre Alavez described the finding as ‘an exciting new avenue’ in the search for compounds that slow disease.
30 March, 2011
Mother's milk not so good for you?
Not enough if you are a vegan, apparently
Two vegans who fed their 11-month-old daughter only mother's milk went on trial in northern France on Tuesday charged with neglect after their baby died suffering from vitamin deficiency.
Sergine and Joel Le Moaligou, whose vegan diet forbids consuming any animal product including eggs and cow's milk, called the emergency services in March 2008 after becoming worried about their baby Louise's listlessness.
When the ambulance arrived at their home in Saint-Maulvis, a small village 150 kilometres (90 miles) north of Paris, the baby was already dead. The ambulance workers called the police because the child was pale and thin, weighing 5.7 kilos (12.5 pounds) compared to an average eight kilos for her age.
The baby had only been fed on the milk of her mother, who was aged 37 at the time.
An autopsy showed that Louise was suffering from a vitamin A and B12 deficiency which experts say increases a child's sensitivity to infection and can be due to an unbalanced diet.
"The problem of vitamin B12 deficiency could be linked to the mother's diet," said Anne-Laure Sandretto, deputy prosecutor in the city of Amiens where the trial is taking place.
The couple has been charged with "neglect or food deprivation followed by death" and face up to 30 years in prison if convicted.
Tea helps you get slim -- if you are an Indian rat
Drinking tea could help you lose weight, new research has found - but the effects are cancelled out if you add milk. Scientists have discovered that tea contains high levels of compounds that help to reduce the amount of fat absorbed by the gut and can cut cholesterol. However proteins found in cows' milk neutralise this fat fighting ability.
New research has shown that the compounds, called theaflavins and thearubigins, prevent obesity when given to rats that were also on a high-fat diet.
The researchers now believe this could explain why people in Britain appear not to benefit from the healthy affects of tea despite being among the world's biggest consumers of the beverage.
Dr Devajit Borthakur, a scientist the Tea Research Association, in Jorhat, India, said: "When tea is taken with milk, theaflavins and thearubigins form complexes with the milk protein, which causes them to precipitate.
"It means that we don't get the health benefit from these compounds nor from milk protein. Therefore, it is always advised to take tea without milk."
Scientists at the research centre are now working on developing new breeds of tea with higher levels of these compounds, which are known as polyphenols, while also looking for ways of making them less susceptible to being neutralised by milk.
Their research has shown that low doses of ordinary tea extracts reduced the cholesterol levels in rats while also reducing the levels of fatty acids in the animal's blood stream.
A study by scientists in Japan, which is published this month in the journal of Nutrition, reveals that extracts from tea leaves inhibits the absorption of fat in the gut of rats being fed high fat diets.
These rats also had less fat tissue on their bodies and lower fat content in their livers.
Dr Hiroaki Yajima, a scientist with the Kirin Beverage Company in Japan who carried out the Japanese research, said: "Black tea extracts may prevent diet-induced obesity by inhibiting intestinal lipid absorption."
The fermentation process used to make "black" tea leaves, the most commonly drunk type of tea in the UK, has also been found to boost levels of these fat-fighting compounds compared to green tea, which is unfermented.
The research suggests that despite more attention being paid to the health benefits of green tea, black tea may have greater health-boosting properties which are masked by the tendency to drink it with milk.
British researchers have also found that the type of milk used in a cup of tea can impact on the level of the "healthy" compounds.
Dr Lisa Ryan, a senior lecturer in human nutrition at the Functional Food Centre at Oxford Brookes University, has discovered that skimmed milk decreases the levels of these active compounds far more than whole or semi-skimmed milk.
Her team looked at five different brands of black tea sold in the UK, measuring the activity of antioxidant and polyphenol compounds after adding different types of milk.
She said: "The fat content of milk seems to be buffering the antioxidants and polyphenols. Molecules called caseins bind to the polyphenols and lead to a decrease in their availability for the body and in skimmed milk this happens more.
"Although adding milk does impact on the availability of polyphenols, tea is still a significant source of them."
29 March, 2011
Fish-eating Eskimos are healthier
So what is different about Eskimos who eat a more traditional (fish-heavy) diet? It could be more than diet. They might exercise more, for instance.
We have long known that traditional Eskimos are unusually healthy at any given age despite their huge fat consumption. And the recent study below confirms some of that. Saying that it is the Omega 3 component of their diet that causes the better health is however just another epidemiological speculation. Omega 3 might be a marker of heavy fish consumption and a more traditional lifestyle generally while not being the cause of anything. There may (or may not) be something in the fish diet that promotes health but what it is can only be speculated in the absence of a double-blind trial
An amusing note: Eskimos are now Inuit in Canada but are still Eskimos in Alaska! The follies of the human race are unending
A study of Yup'ik Eskimos in Alaska, who on average consume 20 times more omega-3 fats from fish than people in the lower 48 states, suggests that a high intake of these fats helps prevent obesity-related chronic diseases such as diabetes and heart disease.
The study, led by researchers at Fred Hutchinson Cancer Research Center and conducted in collaboration with the Center for Alaska Native Health Research at the University of Alaska-Fairbanks, was published online March 23 in the European Journal of Clinical Nutrition.
"Because Yup'ik Eskimos have a traditional diet that includes large amounts of fatty fish and have a prevalence of overweight or obesity that is similar to that of the general U.S. population, this offered a unique opportunity to study whether omega-3 fats change the association between obesity and chronic disease risk," said lead author Zeina Makhoul, Ph.D., a postdoctoral researcher in the Cancer Prevention Program of the Public Health Sciences Division at the Hutchinson Center.
The fats the researchers were interested in measuring were those found in salmon, sardines and other fatty fish: docosahexaenoic acid, or DHA, and eicosapentaenoic acid, or EPA.
Researchers analyzed data from a community-based study of 330 people living in the Yukon Kuskokwim Delta region of southwest Alaska, 70 percent of whom were overweight or obese. As expected, the researchers found that in participants with low blood levels of DHA and EPA, obesity strongly increased both blood triglycerides (a blood lipid abnormality) and C-reactive protein, or CRP (a measure of overall body inflammation). Elevated levels of triglycerides and CRP increase the risk of heart disease and, possibly, diabetes.
"These results mimic those found in populations living in the Lower 48 who have similarly low blood levels of EPA and DHA," said senior author Alan Kristal, Dr. P.H., a member of the Hutchinson Center's Public Health Sciences Division. "However, the new finding was that obesity did not increase these risk factors among study participants with high blood levels of omega-3 fats," he said.
"Interestingly, we found that obese persons with high blood levels of omega-3 fats had triglyceride and CRP concentrations that did not differ from those of normal-weight persons," Makhoul said. "It appeared that high intakes of omega-3-rich seafood protected Yup'ik Eskios from some of the harmful effects of obesity."
While Yup'ik Eskimos have overweight/obesity levels similar to those in the U.S. overall, their prevalence of type 2 diabetes is significantly lower -- 3.3 percent versus 7.7 percent. "While genetic, lifestyle and dietary factors may account for this difference," Makhoul said, "it is reasonable to ask, based on our findings, whether the lower prevalence of diabetes in this population might be attributed, at least in part, to their high consumption of omega-3-rich fish."
For the study, the participants provided blood samples and health information via in-person interviews and questionnaires. Diet was assessed by asking participants what they ate in the past 24 hours and asking them to keep a food log for three consecutive days. Height, weight, percent body fat, blood pressure and physical activity were also measured.
The median age of the participants was 45 and slightly more than half were female. The women were more likely than the men to be heavy, and body mass index (height-to-weight ratio) for all increased with age.
"Residents of Yup'ik villages joined this research because they were interested in their communities' health and were particularly concerned about the health effects of moving away from their traditional ways and adopting lifestyle patterns similar to those of residents in the lower 48 states," Makhoul said.
Based on these findings, should overweight and obese people concerned about their chronic disease risk start popping fish oil supplements or eat more fatty fish? "There are good reasons to increase intake of fatty fish, such as the well-established association of fish intake with reduced heart disease risk," Makhoul said. "But we have learned from many other studies that nutritional supplementation at very high doses is more often harmful than helpful."
Before making a public health recommendation, the researchers said that a randomized clinical trial is needed to test whether increasing omega-3 fat intake significantly reduces the effects of obesity on inflammation and blood triglycerides. "If the results of such a trial were positive, it would strongly suggest that omega-3 fats could help prevent obesity-related diseases such as heart disease and diabetes," she said.
The National Center for Research Resources, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health funded the study, which also involved investigators from the University of California-Davis.
KFC's 1939kj Double Down Burger
Sounds good. I think I'll try one
OBESITY crisis? What obesity crisis? KFC will tomorrow unleash on the market its latest fat-and-sodium laden creation that has done away with the most basic of burger ingredients - the bun.
The Double Down instead has bacon, sauce and two slices of melted cheese between two pieces of deep fried chicken, The Daily Telegraph reported. The 212g original recipe version has 1939kj and 22.3g of fat, while the 232g Zinger version packs 35.7g of fat 2515kj, well more than a quarter of the average daily adult intake of 8700kj.
However, the kilojoule punch is much less than a McDonald's Double Quarter Pounder, which hits a mammoth 3560kj, while Macca's Grand Crispy Chicken is 2510kj.
Leading nutritionist Dr Rosemary Stanton labelled KFC's Double Down burger "horrifying". In the grips of an obesity epidemic, Australians did not need any more fattening burgers, Dr Stanton said. "Two-thirds of men and more than half of women are overweight [Overweight by what standard? A purely arbitrary standard]. We don't need more of these sorts of things. It's horrifying," Dr Stanton said.
Nutritionist Susie Burrell said it would take an hour of intense exercise to burn off the 1939kj. "It's gross over-consumption because it is above and beyond a regular burger," Ms Burrell said.
KFC said the Double Down should be enjoyed as an occasional treat and part of a balanced lifestyle.
A huge hit in the US and Canada with 15 million sold, the Double Down is being squarely marketed at men in the Down Under marketing campaign. Describing it as one of the "manliest" burgers available, KFC is marking the launch with a "Month of ManTime" in which Aussie men are encouraged to enjoy more time with their mates.
28 March, 2011
Nutty "science". Now walnuts are a "superfood"
Just the dangerous old antioxidant religion again
Eating just seven walnuts a day could protect your health, research suggests. The Christmas favourites contain almost twice as much antioxidants as any other popular nut, as well as fibre, protein, vitamins and minerals.
Study leader Dr Joe Vinson, from the University of Scranton in Pennsylvania, in the U.S., said: 'Walnuts rank above peanuts, almonds, pecans, pistachios and other nuts. 'A handful of walnuts contains almost twice as much antioxidants as an equivalent amount of any other commonly consumed nut. But unfortunately, people don't eat a lot of them. ‘This study suggests that consumers should eat more walnuts as part of a healthy diet.’
Dr Vinson said eating around seven walnuts a day was best to get the maximum health benefit. Including nuts in your regular diet can reduce the risk of heart disease, certain cancers, and type-2 diabetes, studies have suggested.
Scientists analysed the antioxidant content of nine different types of popular nut, including walnuts, almonds and peanuts.
Dr Vinson's team found that walnuts not only had more antioxidants than other nuts, but more powerful antioxidants. Those in walnuts were between two and 15 times more potent than vitamin E, renowned for its antioxidant properties.
The findings were presented at a meeting of the American Chemical Society in Anaheim, California.
Dr Vinson said another advantage of walnuts was that they were usually eaten in their natural state, rather than being roasted. 'The heat from roasting nuts generally reduces the quality of the antioxidants,' he added.
Nuts account for barely 8% of the daily antioxidant consumption in an average person's diet.
Dr Vinson said many people were put off nuts because they were thought to be fattening. But he pointed out that nuts generally contain healthy polyunsaturated and monounsaturated fats rather than artery-clogging saturated fat. Eating nuts did not appear to cause weight gain and might even reduce over-eating by making people feel full.
Lost innovation means lost lives
For those with life-threatening diseases or painful chronic conditions, time is not on their side. When promising treatments languish waiting for approval in a bog of bureaucracy, the cost must be reckoned in lost lives and diminished quality of life.
That’s why it’s so alarming that only 21 new drugs gained FDA approval last year. This was a significant decrease from the previous two years — there were 25 approvals in 2009, and 24 in 2008.
Not only are approvals down, so are applications for approval. This fact portends even further declines in annual approvals down the road. With science more cutting-edge today than yesterday and grants for new research in areas from pediatrics to Alzheimer’s at all-time highs, how is it possible that approvals and applications are both dropping?
The FDA’s review process, in the view of many in the medical and biopharmaceutical communities, has become increasingly turgid. The FDA now frequently calls for extra clinical trials, requiring detailed safety plans that necessitate additional doctor and patient education, and an extended review period.
Of the 21 drugs approved in 2010, there were 21 drugmakers to take credit. Not a single company earned more than one approval. From Pfizer to Bristol-Myers Squibb to Eli Lilly to Merck — all of whom were shut-out for approvals in 2010 — the FDA was an equal opportunity rejecter. Analysts estimate 2010′s lost sales due to the FDA’s delays ran upwards of $1 billion.
And the problem is not limited to medicines. The development of tools that tailor treatments to our individual needs are drowning in a sea of endless confusion. Tests and medical that can help detect and prevent disease and eliminate useless or even harmful care are ironically being held up in the name of ‘patient safety.’
Government policy writ large has now begun to stifle innovation in pharmaceuticals. ObamaCare levies tens of billions in taxes on new medical products through 2019. Comparative effectiveness studies required even after FDA approval as a condition for being added to Obamacare benefits, will delay progress too.
Even worse is that FDA regulators are beginning to consider the comparative effectiveness of products and as a result are raising the bar for approval.
Sound far-fetched? It isn’t. Consider the case of $8,000-per-month Avastin, an anti-cancer wonder drug that blocks blood flow to tumors. In 2007, the FDA granted accelerated approval for the use of Avastin for treatment of metastatic breast cancer. It was clear from the Avastin studies then that while many women would not benefit from the drug, a significant minority could live longer and with less pain.
The FDA asked Avastin researchers to evaluate the drug’s risks and benefits on a larger group of patients with the same standards used to approve the drug in the first place. The study confirmed the 2007 results showing benefit to specific groups of women. But the FDA revoked Avastin’s approval for breast cancer treatment because it didn’t extend life on average.
This is not the first time the FDA has changed gears. It yanked Iressa, a lung cancer drug, after post-approval studies looking at average survival showed no benefit. Additional studies were done to identify subgroups and found that patients with a certain genetic mutation lived longer. And last year researchers found that Iressa can prevent pancreatic cancer from coming back after other therapies stop it. Innovation is the result, not of a top-down decision, but by learning from actually using an invention. Taking products off the market therefore undermines medical progress in many cases.
As a result of the FDA’s slow-to-act review process, ObamaCare’s disproportionate taxation of pharmaceutical firms, and this recent Avastin decision, innovation is in a very precarious position. Most medical innovations come from start-ups with limited capital. For all the happy talk about supporting innovation and small businesses, the trifecta of government tactics is doing just the opposite. Just this month, the Director of the Tufts Center for the Study of Drug Development, Kenneth Kaitin, registered his concern: “The question remains whether developers can bring enough new drugs to market at the pace needed to remain financially viable.”
Meanwhile, China, India and Singapore are inviting America’s innovators to set up shop overseas. As the world’s leader — by far — in scientific research investment, the United States must change course and must do so immediately. Not only are we losing innovation, we are losing lives as well.
27 March, 2011
More on asthma and Buteyko breathing
An abstract from 1998 below. Conclusion: It works but nobody knows howButeyko breathing techniques in asthma: a blinded randomised controlled trial
By Simon D Bowler et al.
Objective: To evaluate the effect of Buteyko breathing techniques (BBT) in the management of asthma.
Design: Prospective, blinded, randomised study comparing the effect of BBT with control classes in 39 subjects with asthma. The study was conducted from January 1995 to April 1995.
Participants and setting: Subjects recruited from the community, aged 12 to 70 years, with asthma and substantial medication use.
Main outcome measures: Medication use; morning peak expiratory flow (PEF); forced expiratory volume in one second (FEV1); end-tidal (ET) CO2; resting minute volume (MV); and quality of life (QOL) score, measured at three months.
Results: No change in daily PEF or FEV1 was noted in either group. At three months, the BBT group had a median reduction in daily beta2-agonist dose of 904 µg (range, 29 µg to 3129 µg), whereas the control group had a median reduction of 57 µg (range, - 2343 µg to 1143 µg) (P = 0.002). Daily inhaled steroid dose fell 49% (range, - 100% to 150%) for the BBT group and 0 (range, - 82% to +100%) for the control group (P = 0.06). A trend towards greater improvement in QOL score was noted for BBT subjects (P = 0.09). Initial MV was high and similar in both groups; by three months, MV was lower in the BBT group than in the control group (P = 0.004). ET CO2 was low in both groups and did not change with treatment.
Conclusion: Those practising BBT reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre.
New injectable drug hailed as milestone in fight against skin cancer
A breakthrough cancer drug hailed as the first to prolong the lives of patients with melanoma as been approved by the Food and Drug Administration.
The injectable drug Yervoy, known chemically as ipilimumab, has been given the go-ahead to treat late-stage melanoma.
The drug only worked in a small proportion of patients studied, and on average they lived just four months longer than patients given older medications. But experts say it's milestone in treating the deadliest form of skin cancer.
Melanoma is the fastest growing form of cancer in terms of new diagnoses. Its growth is attributed to longer life expectancies and increased use of indoor tanning by young people. About 68,000 people in the U.S. were diagnosed last year and 8,700 patients died, according to the American Cancer Society.
'Clearly this is not a home run, but it's a solid base hit,' said Tim Turnham, director of the Melanoma Research Foundation. 'And because we see other things in the pipeline, we think this is the first in a series of important new therapies for melanoma.'
The FDA has only approved two other drugs for advanced melanoma, the last of which was more than 13 years ago. Neither drug has been shown to significantly extend patients' lives.
Ipilimumab is part of a group of targeted cancer medicines that harness the body's immune system, instead of attacking the disease with outside chemicals like chemotherapy.
The drug works by blocking a molecule linked to melanoma called CTLA-4, which interferes with the protective activity of white blood cells. When the molecule is blocked, the cells behave normally and help fight off cancer.
Yervoy's side effects may include diarrhea, swelling of the colon, rash and fatigue, the Associated Press reports. The FDA said severe to fatal immune reactions, such as inflammations of the colon and small intestine, liver, and skin,occurred in 12.9 percent of patients during clinical trials.
The agency has asked its makers Bristol-Myers Squibb to create a risk evaluation strategy designed to identify and reduce the risks associated with the drug.
FDA approved the drug based on a Bristol-Myers study of 676 people with advanced, inoperable melanoma who had already failed two other treatments, giving them a very short life expectancy.
They were given one of three treatments: ipilimumab by itself, ipilimumab combined with another immune-stimulating treatment, or the immune-stimulating treatment alone. The average survival was 10 months with ipilimumab and just over six months with the others.
Mike Brockey of Frederick, Md., was diagnosed with late-stage melanoma in 2008 and tried both conventional and alternative medicines before starting therapy with ipilimumab last September. He took the drug four times every three weeks and says his latest scans show that his tumors are inactive. Mr Brockley said: 'This is the first time in two years I had a sense that anything was going in the right direction.'
Bristol said it would disclose pricing details of the drug in the coming months.
26 March, 2011
A Breathing Technique Offers Help for People With Asthma
Buteyko was ridiculed for many years in the West -- in a typical rejection of anything outside familiar parameters. The anecdotal evidence in favour of the technique was so strong, however, that a few trials have now been done -- with striking results. Buteyko techniques also seem to have been quietly adopted as an option in many mainstream asthma clinics
I don’t often write about alternative remedies for serious medical conditions. Most have little more than anecdotal support, and few have been found effective in well-designed clinical trials. Such trials randomly assign patients to one of two or more treatments and, wherever possible, assess the results without telling either the patients or evaluators who received which treatment.
Now, however, in describing an alternative treatment for asthma that does not yet have top clinical ratings in this country (although it is taught in Russian medical schools and covered by insurance in Australia), I am going beyond my usually stringent research criteria for three reasons:
* The treatment, a breathing technique discovered half a century ago, is harmless if practiced as directed with a well-trained therapist.
* It has the potential to improve the health and quality of life of many people with asthma, while saving health care dollars.
* I’ve seen it work miraculously well for a friend who had little choice but to stop using the steroid medications that were keeping him alive.
My friend, David Wiebe, 58, of Woodstock, N.Y., is a well-known maker of violins and cellos, with a 48-year history of severe asthma that was treated with bronchodilators and steroids for two decades. Ten years ago, Mr. Wiebe noticed gradually worsening vision problems, eventually diagnosed as a form of macular degeneration caused by the steroids. Two leading retina specialists told him to stop using the drugs if he wanted to preserve his sight.
He did, and endured several terrifying trips to the emergency room when asthma attacks raged out of control and forced him to resume steroids temporarily to stay alive.
Nothing else he tried seemed to work. “After having a really poor couple of years with significantly reduced quality of life and performance at work,” he told me, “I was ready to give up my eyesight and go back on steroids just so I could breathe better.”
Treatment From the ’50s
Then, last spring, someone told him about the Buteyko method, a shallow-breathing technique developed in 1952 by a Russian doctor, Konstantin Buteyko. Mr. Wiebe watched a video demonstration on YouTube and mimicked the instructions shown.
“I could actually feel my airways relax and open,” he recalled. “This was impressive. Two of the participants on the video were basically incapacitated by their asthma and on disability leave from their jobs. They each admitted that keeping up with the exercises was difficult but said they had been able to cut back on their medications by about 75 percent and their quality of life was gradually returning.”
A further search uncovered the Buteyko Center USA in his hometown, newly established as the official North American representative of the Buteyko Clinic in Moscow.
“When I came to the center, I was without hope,” Mr. Wiebe said. “I was using my rescue inhaler 20 or more times in a 24-hour period. If I was exposed to any kind of irritant or allergen, I could easily get a reaction that jeopardized my existence and forced me to go back on steroids to save my life. I was a mess.”
But three months later, after a series of lessons and refresher sessions in shallow breathing, he said, “I am using less than one puff of the inhaler each day — no drugs, just breathing exercises.”
Mr. Wiebe doesn’t claim to be cured, though he believes this could eventually happen if he remains diligent about the exercises. But he said: “My quality of life has improved beyond my expectations. It’s very exciting and amazing. More people should know about this.”
Ordinarily, during an asthma attack, people panic and breathe quickly and as deeply as they can, blowing off more and more carbon dioxide. Breathing rate is controlled not by the amount of oxygen in the blood but by the amount of carbon dioxide, the gas that regulates the acid-base level of the blood.
Dr. Buteyko concluded that hyperventilation — breathing too fast and too deeply — could be the underlying cause of asthma, making it worse by lowering the level of carbon dioxide in the blood so much that the airways constrict to conserve it.
This technique may seem counterintuitive: when short of breath or overly stressed, instead of taking a deep breath, the Buteyko method instructs people to breathe shallowly and slowly through the nose, breaking the vicious cycle of rapid, gasping breaths, airway constriction and increased wheezing.
The shallow breathing aspect intrigued me because I had discovered its benefits during my daily lap swims. I noticed that swimmers who had to stop to catch their breath after a few lengths of the pool were taking deep breaths every other stroke, whereas I take in small puffs of air after several strokes and can go indefinitely without becoming winded.
The Buteyko practitioners in Woodstock, Sasha and Thomas Yakovlev-Fredricksen, were trained in Moscow by Dr. Andrey Novozhilov, a Buteyko disciple. Their treatment involves two courses of five sessions each: one in breathing technique and the other in lifestyle management. The breathing exercises gradually enable clients to lengthen the time between breaths. Mr. Wiebe, for example, can now take a breath after more than 10 seconds instead of just 2 while at rest.
Responses May Vary
His board-certified pulmonologist, Dr. Marie C. Lingat, told me: “Based on objective data, his breathing has improved since April even without steroids. The goal now is to make sure he maintains the improvement. The Buteyko method works for him, but that doesn’t mean everyone who has asthma would respond in the same way.”
In an interview, Mrs. Yakovlev-Fredricksen said: “People don’t realize that too much air can be harmful to health. Almost every asthmatic breathes through his mouth and takes deep, forceful inhalations that trigger a bronchospasm,” the hallmark of asthma.
“We teach them to inhale through the nose, even when they speak and when they sleep, so they don’t lose too much carbon dioxide,” she added.
At the Woodstock center, clients are also taught how to deal with stress and how to exercise without hyperventilating and to avoid foods that in some people can provoke an asthma attack.
The practitioners emphasize that Buteyko clients are never told to stop their medications, though in controlled clinical trials in Australia and elsewhere, most have been able to reduce their dependence on drugs significantly. The various trials, including a British study of 384 patients, have found that, on average, those who are diligent about practicing Buteyko breathing can expect a 90 percent reduction in the use of rescue inhalers and a 50 percent reduction in the need for steroids within three to six months.
The British Thoracic Society has given the technique a “B” rating, meaning that positive results of the trials are likely to have come from the Buteyko method and not some other factor. Now, perhaps, it is time for the pharmaceutically supported American medical community to explore this nondrug technique as well.
Melanoma sufferer back from brink of death
This is VERY encouraging news
TO look and listen to Daniel Roper you would never think that a month ago he was at death's door. Melanoma had spread through his body and the Melbourne man, 25, was given two days to live, the Herald Sun reported.
But at the 11th hour a US drug company, hospital ethical boards and brave doctors gave Mr Roper a long shot at life - an experimental course of drugs. Overnight on February 28 he recovered and, just four days later, he walked out of the Austin Hospital.
"I felt like I was going to burst," he said. "It was literally overnight that the fluid started draining and all the signs started moving in the right direction. The speed of it was just amazing."
He had learned only in December that melanoma had spread through his body and by January his spine, liver, lungs and ribs were riddled with tumours.
His only hope was a transfer to the Austin Hospital, where an experimental drug combination, which switches off the cancer gene, BRAF, and disables its driver, MEK, was scheduled for trials in a few weeks. Only 60 people in the world, and five in Victoria, are being selected for the world-first trial.
But Daniel suddenly deteriorated and he blew up with a massive infection in his abdomen.
He had 19 litres of fluid drained from his body in two days, and as he slipped away calls were made across the globe to bring the Victorian part of the trial forward. His situation was so dire that his mother Helen's hope wasn't that he would survive, but that he would hang on for a few more days until his sister arrived from the US. "I could see him going in front of my eyes. I have been nursing for 30 years and I knew he wasn't going to last," Mrs Roper said.
The long-term success of the drug - and Mr Roper's prognosis - is unknown.
The Austin's head of cancer medicine, Prof Jonathan Cebon, said the effort required just to get Daniel the chance of taking the drug was as remarkable as its effects. GlaxoSmithKline fast-tracked approval in the US and the Austin's ethics committee paved the way for the experiment to begin. Specialists fast-tracked weeks of tests so he could be ready in just 24 hours.
In a twist of fate, the randomised trial allocated Daniel to the control group, meaning he received only the BRAF drug, but it was enough to save his life. "It was a race between us and the disease," Prof Cebon said.
Mr Roper's hope now is that the Austin regains its $45 million in state government financing.
25 March, 2011
A bad job is worse for your mental health than unemployment?
Groan! The usual rubbish interpretation of what causes what that we have come to expect of the epidemiological literature: People in dumb jobs tend to be working class and class is second only to age as a pervasive predictor of poor health. The claim (below) that dumb jobs CAUSE poor mental health is not only speculation but is bad speculation. By far the most probable cause of the correlation observed is that poor people are more likely to have bad mental health. Job may have nothing to do with it
AUSTRALIAN research that reveals being miserable in a job is worse for your mental health than being unemployed is making headlines around the world.
A team from the Centre for Mental Health Research at The Australian National University in Canberra analysed data from more than 7000 people to find that jobs offering little control, poor recognition and low pay were at greater risk to mental health than no job at all.
The ANU findings have hit the headlines in more than 100 media outlets around the world including Forbes, Bloomberg, CNN, Time, the UK Express, Toronto Sun, Los Angeles Times and Irish Times.
The research team claim the findings have huge implications for prevailing government social policies that promote “the notion that any job is better than none as work promotes economic as well as personal wellbeing.”
Using data collected in surveys since 2001, the ANU team looked at two key areas –the quality of the jobs held by participants and the state of their mental health in the preceding month leading up to their taking part in a survey.
Head of the research, ANU associate professor Dr Peter Butterworth, reported the team’s findings and methodology in the journal, Occupational Environmental Medicine.
“We looked at four different aspects of work in our study: whether people were working in highly complex and demanding jobs, whether they had a say in how they did their work, whether they considered they received fair pay for their efforts, and whether they felt secure in their job,” he said.
The mental health score was based on asking participants to describe their levels of anxiety, depression, happiness and feelings of calm in the month preceding the survey.
Employed people had an average score of 75.1. Those who moved from unemployment to a good job increased their score by 3.3 points above average and those taking a bad job saw their score drop 5.6 points below average. Remaining unemployed led to a drop of one point.
The ANU researchers say the findings have significant implications for prevailing government social policy that promotes “the notion that any job is better than none as work promotes economic as well as personal wellbeing.”
The study concludes that “psychosocial job quality is a pivotal factor that needs to be considered in the design and delivery of employment and welfare policy.”
The research follows the release of other studies showing job satisfaction levels in Australia are at a critical low right now.
CareerOne.com.au’s Hidden Hunters report was released last week to show job satisfaction levels are at their lowest since the research began four years ago.
Carried out by The Acid Test, the research looks at the triggers that “push” people out of one job and “pull” them into another.
Long hours, getting more work done with fewer resources and the reluctance of organisations to increase salaries were key “push” factors.
The 2011 survey of more than 1000 people found that 37 per cent were actively looking for a new job and 82 per cent were open to offers.
A separate global study conducted by Gallup Consulting including 2000 Australian has found most employees are “just going through the motions” at work right now.
The study found 61 per cent of workers were emotionally detached from work. A third of those not engaged had taken at least three sick days in the past month compared to only 11 per cent of engaged workers.
The Modern Liberal Bureaucrat
Does this sound like a real administrator, or a parody of an Orwellian government planner?
"In order to force choice into the market, we have to limit one choice that's overconcentrated."
"We might discourage businesspeople from going into a certain type of business."
"I don't think we can make the argument of unemployment over public health."
"You have to train people as to what may be beneficial to them."
Well, it's a real guy. Meet Bernard Parks, Los Angeles councilman and advocate of banning new fast food restaurants in certain areas of LA. He thinks that nefarious fast food enterprises are moving into his neighborhood and flourishing, and that somehow, even though they're flourishing, most people don't want them there!
Here's the truth: the fast food restaurants do well because people like them. Parks complains that you shouldn't be able to set up a new fast food restaurant when there are already three on neighboring streetcorners. Well of course you should be able to! And if people don't want you there, they won't come to your restaurant, you'll lose money and close. That's not how it's working in District 8, which he represents. The fast food enterprises are successful because people like them.
Oh, and another note: there are actually fewer fast food restaurants per capita in District 8 than there are in the rest of Los Angeles.
Everything above comes via ReasonTV's newest video, in which they make Bernard Parks look like a buffoon.
24 March, 2011
Warmer Weather May Be Linked to Worsened Heart Health
Marvellous the speculations that the hearts of a group of elderly Bostonians can inspire! If this were serious science, the authors below would go to places where it really is hot for their data -- but it's no great mystery why they don't. I grew up in such a hot place (tropical Far North Queensland in Australia) and I can assure everyone that we don't die of heart attacks in our youth there. And there have been some very good lifespans among my older relatives. I even have a living nonagenarian aunt. Generations of my family have lived there and we would certainly know if we were living in an unhealthy place.
Note that the population in Far North Queensland originates mainly from the British Isles so public health measures (clean water etc.) are similar to those found throughout the developed world. We are a rather good control group for assessing the effects of warm climate per se
Rising temperatures and pollution levels may act together to worsen heart health, a new study suggests.
The results show high temperatures in the summer months in a U.S. city are associated with a decrease in heart-rate variability, or how regular the time between heartbeats is, which acts as a measure of how well the heart is working. Previous studies have linked low heart-rate variability to an increased risk of death following a heart attack.
Temperature was more likely to affect cardiovascular function when ozone levels were high, the researchers say.
The findings are particularly concerning in light of the changes global warming is predicted to bring.
"Given that global warming is likely to increase both heat waves and ozone formation, such an interaction may be important for public health," said study researcher Cizao Ren, of the Harvard School of Public Health. (While ozone in the upper atmosphere protects Earth from the sun's harmful ultraviolet radiation, in the lower atmosphere it's a primary component of smog and acts as a lung irritant.)
The study involved 694 elderly men (average age 73 years) who lived in Boston. Participants had their heart-rate variability measured at least once between November 2000 and December 2008. The researchers also analyzed temperature and air pollution data from the surrounding area up to 20 days prior to the participants' examinations.
The researchers found an association between temperature and heart-rate variability in the warm season, but not the colder months. One reason for this may be that people tend to stay indoors in the winter months, where the temperature is often controlled with heating.
Previous studies have found higher temperatures can increase the risk of death from cardiovascular disease, and this effect is exacerbated by air pollution. But the new study suggests what might be happening on a biological level to cause problems.
Air temperature and ozone may influence the way the automatic nervous system functions. The automatic nervous system is a part of the central nervous system that helps the body adapt to its environment, according to the American Heart Association. It regulates body functions, including the heart's electrical activity and airflow into the lungs. Heart-rate variability is an indicator of automatic nervous system function, Ren said.
Air pollution may cause problems with reflexes in the airways to the lungs. In addition, higher temperatures may make the body more sensitive to toxins, such as ozone.
The researchers note the study involved elderly men in one part of the United States, and the findings may not be representative of the population as a whole.
The study was published in the March 8 issue of the American Journal of Epidemiology.
Obsessive 'healthy' eaters risking their lives with eating disorder orthorexia
Food faddists are hurting people -- with their various false gospels
Extreme diets and fitness regimes are putting one in ten women at risk of malnutrition and even death, experts have warned. The obsessive behaviour, which has been given the name orthorexia nervosa, is an eating disorder that has only recently been identified. It also affects one in 20 men.
Sufferers typically cut out entire food groups – often in the mistaken belief they are unhealthy or their bodies are intolerant to them – thereby depriving themselves of essential nutrition and vitamins. At the same time many over-exercise, leaving themselves weak or even emaciated.
Orthorexia has become increasingly common among women in their 30s. Many start off following celebrity fad diets such as the maple syrup detox diet, used by Naomi Campbell and Beyonce.
Cheryl Cole has championed the blood group diet, whose supporters believe different blood groups affect the body’s ability to break down certain foods.
Experts warned sticking to rigid rules was not just putting health at risk but can put a strain on relationships as people avoid eating at friends’ houses or restaurants.
The key difference between orthorexia and other common eating disorders such as anorexia nervosa or bulimia is that sufferers do not necessarily set out to lose weight but end up doing so because of a misguided belief that they are leading healthier lifestyles. Those most at risk are teenagers who are under pressure from unrealistic role models and exposed to advertisements for healthy eating and diets.
The National Centre for Eating Disorders said it had received 6,000 calls about orthorexia over the past year. It has not collated figures previously but said this represented a ‘concerning rise’ in the number of inquiries.
NCFED psychologist Deanne Jade’s estimate that one in ten women is affected by the disorder is based on her own findings over a career lasting 30 years. No official figures have been collated yet as it is only in recent years that orthorexia has been identified as a health concern. She said: ‘Orthorexia is a hidden disorder which is disguised by the healthy eating tag. ‘I am recognising it in more people year on year... in the community generally and among the people who come to see me.
‘Often people who take an interest in being healthy become overwhelmed by the conflicting information. People start cutting out food groups, like meat, and become convinced they are “intolerant” to other food groups, like wheat and dairy, so they cut those out too. ‘It is rising among young people because they are impressionable to what they read in magazines and what they see on TV.’
The term ‘orthorexia’ was coined in 1997 by Californian doctor Steven Bratman, who combined the Greek ‘orthos’, meaning ‘correct or right’, with ‘orexis’ – appetite.
Removing dairy products from the diet can lead to a deficiency in calcium, which is needed for strong bones and teeth as well as the proper function of muscles and the nervous system.
Avoiding meat deprives the body of an important source of protein and iron. Protein contains amino acids, the body’s building blocks, which help cells to grow and repair. Lack of iron causes anaemia, lack of energy, breathlessness and poor concentration.
Glenys Jones, of the Medical Research Council’s Human Nutrition Research Centre, said concerns about certain foods were fuelling the problem. ‘If there is anything negative about a food they will cut it out forever,’ she added. ‘I saw a person who cut out broccoli because she had seen an article saying she could get a disease from it.’
23 March, 2011
Sufferers blame stress for breast cancer, despite no scientific link
The article below is quite sensible about stress so it is a pity that the authors are so positive about other dubious causes of cancer. Contrary to their assertions, for instance, some big studies show that fat women get LESS breast cancer
STRESS is often blamed for breast cancer despite no scientific proof of a link. And while many point to stress they also commonly overlook other lifestyle-related issues - such as smoking and obesity - where there is a clear link to the cancer. These are the key findings of research which took in the views of almost 1500 Australian breast cancer survivors.
It found just over four in 10 (43.5 per cent) believed there was a factor which contributed to their cancer and, among these women, more than half (58.1 per cent) blamed stress. The women also pointed to previous use of hormone therapy (17 per cent), a family history of cancer (9.8 per cent). Two per cent attributed their cancer to other lifestyle factors.
"It is concerning that only two per cent of the women in the study attributed their breast cancer to lifestyle factors such as diet, exercise and alcohol consumption," said Christine Bennett, chair of the Bupa Health Foundation Steering Committee which part-funded the study. "There is scientific evidence that being overweight, smoking and excessive alcohol are risk factors."
Women aged under 40 were more likely to believe there was a reason for their breast cancer.
Dr Bennett said that while the exact causes of breast cancer were unknown, studies into the effect of stress on the body and looking for potential triggers of breast cancer did not reveal a link. And despite commonly-held views to the contrary, there was "no scientific evidence that points to stress as a cause of breast cancer".
The Bupa Health Foundation and Well-Being after Breast Cancer Study and was led by Robin Bell, Deputy Director of the Women's Health Research Program at Monash University and Alfred Hospital. Professor Bell said it showed women often responded to a breast cancer diagnosis with a new resolve to improve their overall health, usually through improved exercise.
This was beneficial, she said, although women should be wary of making changes which could be counter-productive in the fight against cancer - such as removing all dairy products from the diet. "Cutting out dairy products may remove some fat from the diet but it could have a negative effect on the bone health of women who, due to some cancer treatments, are already at risk of osteoporosis," Prof Bell said.
Of those who blamed stress, Prof Bell said, the women could also feel a sense of mistaken guilt that they should have acted sooner. "If doctors are aware of this guilt, they will be in a better position to help women address their feelings and overcome their distress," Prof Bell said.
The research is published in the March edition of the journal Psycho-Oncology.
Aging brains not so decayed
Perhaps it’s out of a sense of panic but sometime in middle age we begin to develop the ability for bilateralisation — when faced with a perplexing problem, to use both sides of our brain instead of one.
One of the first scientists to spot this was Dr Cheryl Grady, a neuroscientist at the University of Toronto. In the early Nineties she observed the ageing brain with positron emission tomography (PET) scans. These measure changes in blood flow as brain regions activate, and Grady wanted to find out if an older brain acted in the same way as a younger one in routine tasks such as matching faces.
She assumed they’d be much worse and muster fewer brain cells. But to her surprise, the older adults performed just as well as the younger ones, and they consistently used more of their brains, not less. Older adults used their brains in a new way. They tapped into the same brain circuits as the younger adults, but they also recruited an additional region — their powerful frontal cortex, the front of the brain which is responsible for problem solving.
We have two frontal cortex, one on each side of the brain (known as hemispheres). Just a few years after Dr Grady’s discovery, another study found that while young people switched between sides, older adults used them both at once.
An intriguing aspect of this two-brain phenomenon is that it’s not the weakest brains that do this but the most capable who resort to this trick. It’s as if the best and the brightest older brains, accustomed to being held in the highest esteem, simply refuse to give in. As Grady herself concludes: ‘The higher the education, the more likely the older adult is to recruit frontal regions, resulting in better memory performance.’
Despite long-held beliefs that we become less clever as we age, there’s mounting evidence to suggest the contrary — that we become cleverer.
How can that be? How can we possibly be cleverer and be putting the bananas in the laundry basket and unable to remember why we’ve come to the hardware store?
One of the longest, largest and most respected life-span studies, the Seattle Longitudinal Study, was started in 1956 and has systematically tracked the mental powers of 6,000 people for more than 40 years.
Led by Sherry Willis, a psychologist, the study has found that people function better on cognitive tests in middle age, on average, than they do at any other time tested.
The abilities that Willis and her colleagues measured include vocabulary — how many words you can recognise and find synonyms for; verbal memory — how many words you can remember; number ability — how quickly you can do multiplication, division, subtraction, and addition; spatial orientation; perceptual speed — how fast you can push a button when you see a green arrow; and inductive reasoning — how well you solve logical problems.
What the researchers found is astounding. During the span of time that constitutes the modern middle age — roughly 40 through to the 60s — the people in the study did better on tests of the most important and complex cognitive skills than they had when they were in their 20s.
In vocabulary, verbal memory, spatial orientation, and, perhaps most heartening of all, inductive reasoning — people performed best, on average, between 40 and 65.
Top performance was reached a bit earlier for men, who peaked in their late 50s, while women’s scores kept climbing into their 60s.
It’s said that the true test of a human brain is its ability to figure out other human brains. And research shows that judgment does improve with age. Thomas Hess, a psychologist at North Carolina State University, has done studies of what he calls ‘social expertise’, which he finds peaks in midlife, when we are far better than those younger and older at judging the true character of others.
By middle age, we not only have more years of experience, but the brain cells devoted to navigating the human landscape turn out to be exceptionally durable.
Scanning studies show that parts of the brain that deal more with regulating emotion shrink less quickly than other areas as we age. And it’s that mix of emotional control, mental prowess, and life experience that helps us make the right calls.
David Laibson, from Harvard University, has done fascinating studies in the emerging field of ‘neuroeconomics’ — how people use their brains to make financial decisions — and he, too, finds we’re most adept at this in middle age.
When confronting complex money issues, such as mortgages or interest rates, those in middle age make the best choices; in fact, our economic judgment is best in our 50s.
It may be what holds the areas of the brain together that’s also important. This is known as the white matter, which is made up of myelin — the fatty outer coating of the trillions of nerve fibres. Myelin acts like insulation on a wire and makes the connections work.
This layer of fat, some experts believe, is what makes the brain work so well in middle age. Scan studies of the brains of men aged 19 to 76 have found that in two crucial areas of the brain, the frontal lobes and the temporal lobes — the region devoted to language — myelin continued to increase well into middle age, peaking, on average, at around 50, and in some, continuing to build into the 60s.
EVER THE OPTIMIST
Many of us grew up dreading old age and its chronic disappointments. But what actually happens is that our moods get not worse but better.
I must say, this idea seemed more than odd to me at first. In the thick of middle age myself, cheeriness is not the first word that comes to my mind. But as we get older we actually react less to negative things — we know this thanks to scans of the amygdala, a small, primitive part of the brain that decides how we are going to react to a situation.
The amygdala’s default setting is pretty much to respond negatively. But now brain scans have suggested that our amygdalae respond less and less to negative stimuli as we age. Our brains, in some automatic way, begin to accentuate the positive and eliminate the negative.
22 March, 2011
McDonald's-only runner Joe D'Amico finishes in top 30 top at Los Angeles marathon
A reminder that "junk" food is a value judgment, not a scientific description. McDonald's food has a full range of nutrients
A MARATHON runner who vowed to eat only McDonald's in the 30 days leading up to the Los Angeles Marathon has beaten his own personal best time at the event and finished 29th overall. Illinois man Joe D'Amico ran the marathon in two hours, 36 minutes and 13 seconds, last Sunday beating his previous personal record by 41 seconds, the Chicago Sun-Times said.
"It went just as I planned," Mr D'Amico said after completing the 42.1km race. "The course was much tougher than I expected and the wind and rain didn't help, but I felt strong."
In the month leading up to the marathon, D'Amico ate 99 meals at McDonald's. His typical daily intake consisted of hotcakes and an Egg McMuffin for breakfast, a grilled chicken burger and a large Coke for lunch, and a hamburger and fries for dinner.
He allowed himself to drink water and take a daily multivitamin and a runner's supplement.
He said he took on the personal challenge because he loves McDonald's and running, and but insisted he was not trying to make a point. His effort garnered more than 23,000 Facebook fans and raised $US27,000 for Ronald McDonald House Charities.
Mr D'Amico said his wife chose the restaurant where they ate last night. "We managed to walk past a couple of McDonald's restaurants after the race without stopping," he said. "I'll probably be back in a McDonald's sometime next week."
Mothers who drink in early pregnancy 'more likely to have unruly children'
Ho hum! Just the usual class effect. Dumb working class mothers are more likely to booze and their kids take after them
Teenagers are more likely to be unruly, aggressive and badly behaved if their mothers drank early in pregnancy, researchers claim. The risk of anti-social behaviour rose threefold among 16-year-olds whose mothers drank as little as one alcoholic drink a day during the first three months of pregnancy.
A U.S. study of almost 600 youngsters analysed rates of ‘conduct disorder’ at regular intervals from their birth. Conduct disorder was defined as a pattern of behavioural problems that included aggression towards people and animals, destruction of property, deceitfulness, theft and serious rule-breaking.
The risk of ‘lifetime’ bad behaviour patterns went up threefold with one or more drinks a day compared with drinking less, or abstaining. There was no extra risk linked to drinking at a later stage in the pregnancy. Dr Cynthia Larkby, from the University of Pittsburgh, monitored 592 children from birth to age 16, half of whom were African-American with the other half white.
Information was collected about the drinking habits of the children’s mothers, including quantity, frequency and the pattern of alcohol use.
The scientists wrote in the Journal of the American Academy of Child and Adolescent Psychiatry: ‘From a clinical perspective, prenatal alcohol exposure should be considered as another risk for conduct disorder. ‘The next steps in research should be to define the interactions between prenatal exposures, environmental factors, and heritability. This would allow a more complete picture of the relations between prenatal alcohol exposure and conduct disorder.’
The issue of how much is safe to drink during pregnancy has caused controversy in recent years. In 2007 the Department of Health published guidance saying pregnant women should avoid drinking alcohol altogether, as should those trying to conceive. This replaced previous guidance which said it was safe for pregnant women to drink one to two units of alcohol per week.
The Government said its update was not based on new research, but was introduced to provide consistent advice to all women.
The National Institute for Health and Clinical Excellence also advises women to avoid alcohol in the first three months of pregnancy. Heavy drinking in pregnancy is linked to foetal alcohol spectrum disorder in children, which can cause a range of physical, mental and behavioural problems.
Previous U.S. research has suggested that later behavioural problems in children may be linked to drinking during pregnancy.
However, a study from University College London last year found light drinking by pregnant women – one or two units of alcohol a week - was linked to children who were better-behaved than those whose parents had abstained from alcohol.
It showed the risk of behavioural and emotional problems among toddlers increased for mothers who were heavy drinkers – those having at least one drink a day or a binge session of six drinks or more during pregnancy.
Half a pint of ordinary-strength beer counts as one unit, while a small glass of wine equates to one or one-and-a-half units depending on the alcohol content.
21 March, 2011
Tooth loss increases the risk of a stroke?
Mainly because poor people have their teeth pulled rather than filled, I would think. Poor people have worse health generally
Tooth loss increases the risk of a stroke many years later, according to a new Japanese study, and underlying gum disease may be to blame. Researchers have calculated that those with fewer than 24 of their own teeth (adults should have 32) are 60 per cent more likely to suffer a stroke.
Stroke is caused by a disturbance of blood supply to the brain.
The most common type is an ischemic stroke, which occurs when a blood vessel that normally delivers oxygen and nutrients to the brain is blocked. An haemorrhagic stroke is when a blood vessel bursts, causing bleeding into the brain.
In any stroke the nerve cells in the affected area of the brain may die within minutes of being denied oxygen, leading to impairment of bodily functions. An estimated 150,000 people have a stroke in Britain each year, leading to about 53,000 deaths annually.
In the new study, researchers at Hiroshima University looked at the dental conditions of 358 patients and found that stroke patients in their 50s and 60s had significantly fewer remaining teeth than did patients in the same age groups who had been treated for other conditions. The number of teeth remaining was also significantly lower among stroke patients in their 50s than in the general population of the same age.
The researchers then analysed results from four separate studies. They found that having 24 or fewer teeth increased the risk of stroke by 57 per cent compared with those with 25 or more teeth. The researchers also took into account a range of other risk factors associated with stroke, including smoking habits, obesity and alcohol use.
'This review suggests that tooth loss may be related to both ischemic and haemorrhagic strokes,' says Dr Mitsuyoshi Yoshida, who led the study.
Some studies have suggested a link between periodontal disease and heart disease. Periodontal diseases range from gum inflammation to diseases that damage the tissue and bone that support the teeth. Gum disease is one of the main causes of tooth loss after the age of 40.
The mouth is brimming with bacteria, which contributes to the sticky, colourless plaque that binds to teeth. Brushing and flossing helps get rid of plaque.
Research into heart disease has shown that micro-organisms associated with gum disease have been found in atheromas - accumulation of calcified material - in the arteries of patients. It has been suggested that toxins in these micro-organisms damage cells in the lining of the arteries.
One theory is that periodontal disease may cause inflammation in the arteries and brain tissues, and cause greater amounts of compounds involved in clotting.
Dr Sharlin Ahmed of The Stroke Association says: 'It is believed that oral bacteria can contribute to the furring up and narrowing of artery walls, which could result in a stroke. Oral bacteria could also attach to fatty deposits in the arteries, which can lead to a blood clot and could result in a stroke.'
An interesting infographic below
I was rather pleased to see that 5% of Americans are redheads. The Irish influence, I guess
20 March, 2011
Avandia under fire again
This is just part of a war on drug companies. Anything successful or popular is hated. I covered this issue in detail a year ago, where I noted what the research available then showed:
"In other words, a survey of the strongest data available showed that taking Avandia increased your risk of having a heart attack from 1.05% to 1.46%, an increase in risk of less than one half of one percent -- which is vanishingly trivial compared to the risks we take in most things we do. Given the large sample size, however, the result is statistically significant, if not significant in any other sense. If we were to reject such small risks as that we would have NO drugs on the market because all drugs have some adverse side-effects.
But here's the real kicker. Read the last clause in the abstract above. What it means in plain English is this: Although Avandia takers had a minutely greater risk of having heart attacks, the "extra" heart attacks DID NOT KILL THEM. Avandia takers were no more likely to die from a heart attack than anybody else!"
The effects noted in the report below would appear to be equally inconsequential
A study of 810,000 people, published today online in the British Medical Journal, found that those taking Avandia were 23 per cent more likely to suffer congestive heart failure and 14 per cent more likely to die while on it, compared to a similar medication. In addition, they were 16 per cent more likely to have a heart attack.
Last September the European Medicines Agency (EMA) suspended the licence for the drug, after 10 years on the market, saying the evidence of its harmful effects had tipped the balance against it being prescribed.
Today's study is further evidence supporting that decision. It analysed the results of 16 separate studies in 810,000 patients, of which 429,000 were on Avandia (also known by its generic name rosiglitazone) and 381,000 were on Actos (also known as pioglitazone). Most were over 60. The drugs both belong to a class that help control blood sugar levels in patients with Type 2 diabetes.
It found that Avandia could have led to an extra 431 deaths per 100,000 people on Avandia, an extra 170 heart attacks and an extra 649 cases of heart failure.
Dr Yoon Kong Loke, a lecturer in pharmacology at the University of East Anglia, who led the study, warned that although the drug had been withdrawn in the UK patients could still be affected by it. He said: "We don't know yet if stopping taking the drug at once gets rid of the increased risk of heart disease or if the effect lasts over a long period of time. "It is possible that symptoms may develop years afterwards. These are studies that need to be carried out in the future because Avandia has not been around all that long."
Manufactured by GlaxoSmithKline, Avandia was once one of the best-selling drugs in the world, with annual sales peaking at £3 billion in 2006. It is still available on a restricted basis in the US.
A GSK spokesman said that the meta-analysis contained disimilar studies that should not have been combined, a view taken by the Food and Drugs Administration (FDA) in the US last July. She continued: "It is important to note that there are no head-to-head clinical studies with cardiovascular outcomes results between the two medicines.
"GSK believes that definitive conclusions about differences in cardiovascular data of the two medicines are hard to make in the absence of long-term trials directly comparing both medicines.
"GSK stands behind the safety and efficacy of Avandia when used appropriately. Since 2007, results from six randomized clinical trials with data related to the cardiovascular safety of Avandia have been reported. "Taken together, these trials showed that Avandia does not increase the overall risk of heart attack, stroke or death."
Why a steak for pregnant mothers could stop babies crying
In Britain and Australia, black yeast extracts (Marmite; Vegemite) are a popular sandwich spread and are known for their high B12 content. Do British and Australian mothers have babies who are eight times less likely to fret than mothers elsewhere? I think it would have been noticed by now if that were so
Mothers-to-be who boost their intake of a vitamin found in steak during the first three months of pregnancy are up to eight times more likely to have babies who cry less, researchers suggest.
The B12 vitamin occurs naturally in red meat, fish and dairy products and is already known to help the development of the brain and nervous system in unborn children. It also helps prevent dementia, heart disease and even fertility problems later in life.
Mothers-to-be who boost their intake of vitamin B12, found in steak, during the first three months of pregnancy are up to eight times more likely to have babies who cry less, researchers suggest
Now the latest findings by researchers suggest pregnant women who consume only low levels of B12 may have babies whose nervous systems have not fully developed. They say it means a hormone in the brain which lulls babies to sleep may not be released properly, causing infants to cry for longer periods of the day.
The study, published in the journal Early Human Development, involved nearly 3,000 pregnant women. Each had a blood test during their first pre-natal appointment at three months, which measured the amount of B12 in their blood. Once their babies were born, they recorded how often they cried, and for how long.
The researchers found that those women whose test results showed they had the least B12 were up to eight times more likely to give birth to a child who cried for prolonged periods than those who had the most. On average, five per cent of mothers lacking B12 had a distressed baby while just over one per cent of women with the most B12 reported their baby cried excessively.
The researchers, from the Public Health Service in the Netherlands, concluded: 'This study provides first evidence for an early nutritional origin in infant crying behaviour. 'The results suggest infants born to women with a low B12 status during pregnancy are at a higher risk for excessive crying behaviour in their first months of life.'
The researchers suggest that a lack of B12 may affect how much of a supportive tissue known as myelin, which surrounds and protects the nerve cells, is produced in the brain. Less myelin could cause irritability, they suggest. They also say B12 could affect sleep cycles because low levels prevent the release of the body's sleep hormone, melatonin.
Janet Fyle, of the Royal College of Midwives, said: 'This is an interesting relationship and one which needs to be looked at further.'
But nutritionist Yvonne Bishop-Weston warned: 'Meat comes with saturated fats which can hinder the body's use of essential fats needed for the baby's brain and nervous system development.'
19 March, 2011
Fatter but living longer?
A strong hint that the obesity "crisis" is a load of garbage
Britons are living longer than ever before despite concerns about obesity and health problems, a leading scientist has claimed. Average life expectancy has soared to 80-years-old - an incredible eight years more than it was in the 1970s.
The figure is even higher than the U.S.- the country with the highest spending on health care - where people live to on average 78.4 years. [The U.S. figure includes blacks -- where the leading cause of death among teenage males is gunfire]
Increasing life expectancy proves that as a nation we are eating more healthily than ever before [So why is obesity increasing??] and paying more attention to our bodies, professor David Leon says. But Professor Leon warns that unless more is done to tackle obesity among the current generation of youngsters life expectancy could slip back into the 1970s.
'The message here is really to look at how well we have been doing and not squander it. Contrary to what people believe, the USA does not have better life expectancy. 'Despite what many may have assumed, and without being complacent, current trends in European life expectancy are in a positive direction.
'But while the European experience since 1980 underlines the centrality of the social, political and economic determinants of health, many intriguing and important questions remain unanswered about the drivers of these extraordinary trends.'
Professor Leon, of the London School of Hygiene & Tropical Medicine, concluded that in the last five years, most European countries have been improving for the first time in decades - although the gap between East and West remains entrenched.
He added deaths from cardiovascular disease in the UK had seen 'some of the largest and most rapid falls of any Western European country, partly due to improvements in treatment as well as reductions in smoking and other risk factors'.
Fewer infections during childhood thanks to immunisation and better nutrition are also believed to have helped people grow taller and stronger.
Writing in an editorial in the International Journal of Epidemiology, Professor Leon compares life expectancy in western Europe with eastern Europe and the US. He said that the US was at the same level as the lowest of any Western European country, despite spending more per capita on health care than any other country in the world, with the rate for women increasing at a much slower pace than Western Europe.
In 2007, average life expectancy in the US was 78 years compared to 80 in the UK. In 2008, British male life expectancy stood at 77.9 and female life expectancy stood at 82.0, while Russian men could expect to live to 61.8 and women to 74.2, data from the World Health Organisation and the Human Mortality Database revealed.
Professor Leon praised the higher life expectancy and said it was partly due to some of the good work of the NHS. But he warned that long-term effects of obesity on cancer rates and children have yet to be seen. 'The big uncertainty is what will be the health impact of a generation of chubby kids growing into obese adults and what happens when they get to 60', he told the Daily Express. 'That is an experiment that has never been done before.'
Professor Leon said that longer life expectancy heralded certain problems such as an added burden on the state through pensions and the NHS. There are also concerns on a global level about the increasing population combined with a shortage of food, space and natural resources.
Life span can also depend on several factors including location. Although the average Briton now lives to 80 this can be much lower in poorer areas where the average life expectancy was 75.8 in 2008 compared with 80 for wealthier regions.
And earlier this week it was revealed that on the Gurnos estate in Merthyr Tydfil, South Wales the average life expectancy for men is just 58.8 years. There was found to be a ‘culture of despair’ in the former iron and coal town where men don't care about living long healthy lives - because their quality of life is so poor. The grim figures revealed by the local Public Health Board are blamed on poor diet, heavy smoking and a high suicide rate due to unemployment.
Peanut terrorists must be stopped!
Despite protests by angry parents, a school in Florida is standing behind its decision to implement new regulations to protect a first grade student suffering from a severe peanut allergy.
Students at Edgewater Elementary are required to wash their hands and rinse their mouths out before entering the classroom each morning and after lunch. Teachers, who monitor the daily rinsing, must also ensure that desks are being continually wiped down with Clorox wipes. The school has banned all peanut products, eliminated snacks in the classroom and prevented outside food at holiday parties. And last week a peanut-sniffing dog was brought into the school.
District spokeswoman Nancy Wait of Volusia County Schools said the school is legally obligated to take these safety precautions because of the Federal Disabilities Act. “It would be the same thing as putting a handicap ramp for a student that is physically disabled. The only difference with this is that is affects other students,” she told FoxNews.com.
But some parents are saying it is taking away from their children’s learning time.
“On average, it’s probably taking a good 30 minutes out of the day. That’s my child’s education. Thirty minutes could be a while subject,” Carrie Starkey told FoxNews.com.
On Thursday she and other parents protested outside the school, picketing with signs that said, “Our Kids Have Rights Too.”
Experts say the school may have gone too far and that there are easier ways to protect the child.
“I have never seen anything like this,” said allergist Dr. Scott Sicherer with the Food Allergy and Anaphylaxis Network or FAAN, an organization that monitors national food allergy issues. “There are many guidelines on how to manage food allergies in schools… things like no food sharing. There are plenty of relatively simple things the school could put in place that aren’t burdensome,” said Sicherer.
But David Bailey, the father of girl with life threatening food allergy, says that if his daughter even smells peanuts, her reaction could be fatal. "We've fought very hard to put certain things in place… to keep her alive… in school," he told MyFoxOrlando. "She's already a cast-out. She can't do things that most kids can do."
While the school’s actions may seem drastic and invasive the school says it must protect the health of the student. “It may seem like an inconvenience but this student registered her disability at the beginning of the school year and we have to do these things to give her a safe learning environment,” said Wait.
Since the protest was held last week, parents will be looking for some sort of compromise from the school administration. “We understand that they need to protect this girl, but these measures are just extreme. Procedures need to be set in place, but not procedures that will take away from our children’s education,” said Starkey.
18 March, 2011
The Roots of the Vaccine Panic
Do vaccines cause autism or other neuro-developmental disorders? Scientists know that vaccines don't, but the idea lingers everywhere -- on talk shows and blogs and in conversations between parents and their child's pediatrician. It lingers because many people in this country and elsewhere think that vaccines just might not be good for us.
In two books that tell the story of the panic over vaccines, Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia, and Seth Mnookin, a contributing editor at Vanity Fair, argue that bad people pursuing careers or fame or ratings or God knows what became purveyors of falsehoods that duped otherwise decent people into thinking vaccines could harm their children. That duplicity has led parents to make bad decisions -- not to vaccinate their children or to vaccinate them on a non-recommended schedule -- which turn out to be potentially deadly not just for their own children but for others.
How we got into this mess is the focus of both Mnookin's The Panic Virus and Offit's Deadly Choices. The casts of characters overlap, but the emphasis of each is different. Ironically, the journalist (Mnookin) focuses more on the malefactors of science, while the scientist (Offit) focuses more on the malefactors of the media. But each has a special distaste for the one closest to him: Mnookin for the journalist David Kirby, who helped sell the belief that mercury in vaccines caused an epidemic of autism, and Offit for the pediatrician Bob Sears, who willy-nilly invented a "new and improved" vaccination schedule.
As good as these books are, they don't help us fully understand why the anti-vaccine movement caught on. They are missing a sense of the desperation felt by parents when their children begin showing signs of autism. They also fail to appreciate the role that science itself has played in leading people to expect simple explanations of complex phenomena. Together, the desperation and the belief in simple answers have had deadly results.
Although the background story is complicated, the source of the vaccine panic is basically this: The prevalence of autism has increased spectacularly over the past 20 years, and although scientists can explain about 50 percent of the increase, they cannot account for all of it. As a result, a vast network of advocates, epidemiologists, scientists, junk-scientists, clinicians, quack-clinicians, celebrities, geneticists, expert witnesses for hire, snake-oil salesmen, playboy models, comics, charlatans, blog writers, and parents have entered the debate, developing their own or selling others' theories.
The two such theories highlighted in these books are that the mumps, measles, and rubella (MMR) vaccine is dangerous for children either because the measles-vaccine virus resides in the intestines of some children, leading to inflammation, leaky gut, and consequent developmental delays, or that the MMR vaccine contains thimeresol, a mercury-containing preservative, which leads to developmental delays. The first theory is biologically implausible, the product of crooked science conducted by Dr. Andrew Wakefield. The second has been falsified.
As both Offit and Mnookin note, the idea that vaccines are dangerous is not a new belief. It has been around for as long as vaccines have existed. Offit is clearest in explaining the underlying paradox: The belief that vaccines are bad for us is enhanced by their success. Men and women in their 50s and younger have no real memory of polio. Their children and grandchildren have had no experience with measles or rubella. As kids, my generation used to fear tetanus, which we were sure led to slow starvation because our jaws would lock shut midsentence, but I haven't met any children with this phobia in decades. I vividly remember my daughters' disbelief when reading Little House on the Prairie that Mary could go blind from scarlet fever.
All these obscure diseases have, like the bubonic plague, been banished to faraway places or distant pasts, and people in the United States have forgotten all about them. So they have naturally forgotten that these diseases can also lead to blindness, paralysis, brain damage, or death. Offit is brilliant at pointing out the absurdity of anti-vaccine activists' argument that vaccines are superfluous because they prevent us from catching diseases that people no longer catch.
In the history of the eradication of the "diseases of childhood," vaccines have played a role. They have not played the leading role in lives saved. Long before the first baby was jabbed with the diphtheria-pertussis-tetanus (DPT) or the MMR vaccine, mortality rates for diphtheria, whooping cough, and measles had steadily declined. In 1900, the death rate from diphtheria was 40.3 per 100,000. For whooping cough and measles, it was 12.2 and 13.3 per 100,000, respectively. By the end of World War II, all three were around 1 in 100,000. The same declines can be observed for diseases for which we have no vaccines.
Hygiene and improved nutrition are the real heroes in the war against disease, though neither Offit nor Mnookin points this out. It would make their credible arguments more credible if they didn't claim vaccines saved the world all by themselves. But both authors do stress that what vaccines have done is as remarkable as nutrition and hygiene reducing the mortality rate by 500 percent; in some cases vaccines have reduced the rate to essentially zero -- which is why people no longer fear the diseases that used to kill children. Instead, they fear vaccines.
If parents want to be fearful, they should fear unintentional injuries, which account for as many deaths of 1- to 4-year-olds as the next six leading causes combined. Or they can fear obesity. But as with the link between smoking and cancer, it is hard to see the link between gulping down a few donut holes and chronic illness later in adulthood. In contrast, many parents see a direct link between vaccination and autism. In fact, some even saw the link before it could have happened. Jenny McCarthy, for example, is reported by Offit to have asked her son's pediatrician right before her son was given the MMR vaccine, "That's the autism shot, isn't it?"
Human-interest stories abound in both books. All of the leading culprits in fear-mongering about vaccines appear so sneaky and craven that the reader wonders what could possibly motivate them aside from fame and fortune. True believers, though, are often motivated by their belief even if the belief makes no sense (to us). Deeper insight into the worlds of others comes from recognizing this fact. Neither book, however, despite nods in this direction, gets quite deep enough.
The MMR vaccine is routinely given to children in the United States when they are between 15 and 18 months old. At 15 months, most children toddle well, use three or more words regularly, and laugh at funny things. Some can sing, and a few can walk up stairs and walk backward. Two months later, most toddlers have doubled their word use, climb around and explore their environment, and enjoy imaginary games. They also know how to throw a tantrum when they are frustrated, respond to simple directions, play with toys, and stack a few blocks. As every parent knows, these are fantastic developments, but seen in this aseptic light, they are pretty modest achievements.
Many children with autism will miss these milestones. Even so, many children who appear to their parents and even their pediatricians to be developing normally but are later diagnosed with autism seemingly regress around age 2, losing their few words and social skills. Sometimes the regression is associated with a fever or seizures, sometimes not. Sometimes it appears suddenly, and sometimes it is only slowly pieced back together from parental recall.
Whether sudden or not, the regression is terrifying for parents. For many of them (but not all), the temporal simultaneity of the vaccine and the descent into autism cannot be just a chance event. It seems the vaccine caused their child's autism. As pointed out in the Vaccine Court Omnibus Hearings, beautifully described by Offit, the fact that experts can identify an array of developmental abnormalities in children from video taken well before their MMR vaccine, which neither parents nor pediatricians could see because they are not trained to do so, doesn't matter to parents looking for causes.
The strategy that parents are using to account for cause is no different from the theory that some autism epidemiologists have been using to account for increased autism prevalence. If all of a sudden, something happens (like increased autism prevalence), it cannot (ordinarily) be caused by something that happened afterward. So autism scientists have raced to identify the change over the past few decades that has led to the rising prevalence of autism.
Here, too, junk science competes with serious work. Because some articles have suggested that artificially generated electromagnetic radiation causes autism, parents have eliminated wireless computers in their house, disconnected alarm clocks, and thrown away their microwave. Because some economists have argued that autism is the result of "television watching due to precipitation" and that "seventeen percent of the growth in autism in California and Pennsylvania during the 1970s and 1980s is due to the growth of cable television," some parents have thrown away their TV or moved to less rainy climates (where their children can spend time outdoors, exposing themselves to overhead power lines, which have been variously associated in comparably questionable science with such diverse health outcomes as "breast cancer, decreased libido, fatigue, depression, birth defects, reproductive problems, heart disease, stress headaches, trouble sleeping, and many other symptoms. Yikes").
Yikes is right. The "science" here is as good as the science behind the idea that vaccines cause autism. Using the same methods, one could show that frozen yogurt, emo music, tofu, beets, sun-dried tomatoes, or anything else that has increased over the same time period as autism is a potential risk factor. The mistake here is to confuse correlated time series with cause.
It is also a mistake not to take this bad science more seriously. Modeling is important. Should it surprise us that if scientists are confusing correlated time series with cause that parents are doing it as well? That two things happen at the same time does not mean that one caused the other. The most famous example of this is the idea that storks bring babies into the world. Babies come from people. People live in houses and houses have chimneys and storks roost in chimneys so the more people the more babies, houses, chimneys, and storks. It is easy enough to lay the blame on malfeasant scientists and publicity hounds, but when ordinary scientists pursue news stories instead of properly specified models, things can go awry quickly. And in the case of autism science, they often have.
The bad science that causally associates vaccines with autism has led to dangerous changes in parental decision-making. Some children (not statistical abstractions) have died because they contracted whooping cough or measles. In California, rates of vaccine refusal (politely called vaccine exemption) have skyrocketed, threatening the loss of "herd immunity" in many communities. If a few children aren't vaccinated, they are unlikely to contract the disease, but if many are not, the disease may race through a community, threatening a mass epidemic.
Both books feature the real people whose children have been harmed or killed by diseases otherwise avoidable. So the decision to skip a vaccination differs from the decision to switch to battery-powered alarm clocks. Because the diseases that vaccinations prevent pass from person to person (except for tetanus), failure to vaccinate -- that is, free riding on the positive vaccination decisions of others -- is dangerous to everyone.
Mnookin makes an important argument about science: It is self-paralyzing. The problem is that it can never prove anything, just falsify the theories of others. Scientists can say that the idea that vaccines cause autism is not supported by the extant evidence but not that vaccines cannot possibly cause autism. They could, perhaps, in some unknown way in interaction with some unknown variables. And in that little space of enchantment reside the David Kirbys of the world who exploit the humility of science to create the doubt and uncertainty that allows conspiracy theories to flourish. Science needs to speak with a stronger voice to overcome both the assault on reason of anti-science crusaders and the indifference to reason of journalists who train the public to believe that every issue has two sides.
Both books are thrillers. They are true stories after all. The malfeasant doctors, publicity-seeking journalists, blinded activists, and confused celebrities do and say things that are truly shocking. Jenny McCarthy really does tell Oprah that her science is "mommy instinct," and Dr. Bob really does make up a new vaccination schedule.
Even so, telling a one-sided story is difficult. To fill out the pages, Mnookin travels down vaguely related rivers to discuss heuristics and cascades; Offit shows how the "self-interested" decision to refuse vaccination leads to a tragedy of the commons and then, most important, why the decision is only seemingly self-interested. Offit's book has a broader focus than Mnookin's. And Mnookin is a bit breathless for my taste. Offit is in the middle of the controversy. He is, after all, a character in the Mnookin book and reportedly requires bodyguards at talks. It seems as if some of the people who choose not to vaccinate their children feel so strongly about it that they want to harm Offit. They should read his book.
Closed medical minds?
There's a lot of it about. New approaches are often resisted
Last July, we reported on the battle by MS sufferer Mark Walker to have a controversial new treatment not recognised in Britain. Here, he tells how his condition has improved since having it abroad:
My wife’s reaction when she touched my feet on July 1 2010 was unexpected but very welcome. “They’re the same temperature and nearly the same colour,” Natasha announced excitedly. I should explain that my right foot has felt cold to the touch and been purplish in appearance for many years.
The day before, I had undergone a controversial treatment at a clinic in Athens and this was tantalising evidence that something had changed in my body as a result.
I am 51 years old and I have multiple sclerosis (MS). The first symptom – double vision lasting several weeks – developed in November 1991, although I did not receive a definitive diagnosis until April 1997. By 2000, I had accumulating symptoms including numbness, balance and bladder problems and a general feeling that, while it might not be yet apparent to my friends, MS was slowing me down in every way.
In January 2003, I was hit by physical and mental fatigue so debilitating that I could hardly get out of bed. I was forced to give up my much-loved job as a management consultant with IBM, something that left me depressed. I have never recovered sufficiently to return to work. Despite treatment with conventional drugs and therapies, my MS progressed steadily, with mobility on my right side increasingly impaired, and I have had several serious relapses when symptoms have increased in severity. As a qualified pharmacist, I have used my scientific knowledge to research the disease and its management thoroughly. I am what doctors call an “expert patient”. After 20 years of living with MS, I am willing to try any safe, logical therapy.
It was in October 2009 that I first heard about Professor Paolo Zamboni, director of the Centre for Vascular Diseases at the University of Ferrara in Italy. In 2005, his wife Elena was diagnosed with MS, and he embarked on a personal mission to discover everything he could about the disease, from medical literature dating back 100 years to the use of state-of-the-art body scanning techniques.
He concluded that the MS was, in part, a vascular disease caused by restricted, blocked, malformed or twisted veins or vein valves in the neck and trunk. A small clinical study appeared to back his claims. He named the syndrome “chronic cerebrospinal venous insufficiency” (CCSVI – see box) and set about developing treatment to unblock – or “de-stenose” – the veins so that healthy blood flow was restored. He claimed a dramatic improvement in his wife’s condition and that of other MS patients he treated.
News of Zamboni’s theory and treatment spread within the MS community via chatrooms and websites, leading hundreds of people around the world to seek the treatment, known as venoplasty (similar to angioplasty, in which a balloon is inserted into a blood vessel and inflated to remove a blockage).
In June last year I was interviewed by The Daily Telegraph about my battle – and failure – to obtain a diagnosis of, and treatment (if required) for, CCSVI in Britain and my decision to seek help abroad. Neurologists at my local hospital, the John Radcliffe in Oxford, claimed that it was not ethical or prudent to even attempt to diagnose CCSVI because of doubts about Zamboni’s work. Quite why it wasn’t “ethical” to use a safe, non-invasive diagnostic procedure (colour Doppler sonography) – which I was willing to pay for – to look at my veins continues to baffle me.
So I took my quest for venoplasty to a clinic in Athens which had treated many MS patients for CCSVI. You are reading the update on the treatment and my condition that readers were promised in that article.
I was the 45th MS patient to be seen by Constantinos “Costas” Kartkaletsis, a consultant vascular surgeon. After an initial examination, blood tests and a chest X-ray, he explained that a catheter would be inserted into the femoral vein in my groin and guided into my main trunk and neck veins. I was injected with anti-coagulant and put on a drip. I would have a local anaesthetic only and be fully conscious for the whole procedure.
I could feel the balloon inflating inside my veins but there was no pain. Restrictions were diagnosed in four major veins (the azygos vein, hemi-azygos, and the left and right internal jugular veins) in the trunk and neck, and all were treated using balloon venoplasty over three hours.
I had not expected any immediate impact, but Natasha’s surprise at the improved condition of my feet next morning left me elated. I could not explain what had happened but something had changed. Mr Kartkaletsis was interested in Natasha’s observation but he has a policy of treating restricted veins rather than commenting on any change in MS symptoms following treatment.
Back home, I planned complete relaxation for two months. I decided not to try to record frequent changes but to note trends on a monthly basis, as MS symptoms can vary daily.
At the end of the first month I felt my concentration had improved. People with MS use the term “cog fog” to describe the deterioration in cognitive functioning. Friends noticed that I no longer needed regular naps and that I focused better on conversations. After three months, I felt I was functioning mentally at least as well as I was a decade ago.
There were other changes, too: I’d had neuropathic pain (caused by damage to the nervous system) in my right leg for many years. That went and has not returned. After years of not recalling my dreams – an observation reported by many with long-term MS – I have, for the past six months, remembered them again. My need to get up at night to urinate also improved slightly, from three to six times to one to three times a night – something much appreciated by my wife.
My walking and balance have not changed over the past six months, and I still rely on my Musmate walking aid and trekking poles to get about. But, on the plus side, my osteopath David Harsant, at Oxfordshire’s Multiple Sclerosis Therapy Centre, who made extensive notes before and since the procedure, reports gradual improvement in muscle tone, stiffness and spasm in my neck and back. He says my neck muscles felt ''matted, congested and were indistinguishable.’’ but after the venoplasty ''the matted sensation reduced and the palpability of individual muscles increased”.
Professor Zamboni has reported that some patients may require repeat treatments if their veins “re-stenose” after venoplasty. Vascular specialists are defining the best way to diagnose restricted veins, the veins to check, the best size, position, pressure and duration of ballooning. I expect to undergo another procedure when the method is finalised.
CCSVI remains a controversial diagnosis, as does its treatment. However, MS patients are at the forefront of spreading the word and the internet is making that easier. I have watched a doctor from Kuwait present his work on CCSVI to vascular specialists in New York, and heard an interview with a research neurologist who has collated doctors’ reports on CCSVI. Expert patients like me are frustrated by the refusal of the MS establishment in Britain – neurologists and the MS Society – to accept the existence of this condition and consider testing for it. Since I went to Athens, testing for CCSVI and balloon venoplasty has become available to private patients at a clinic in Glasgow. The package costs £7,990 and there is already a waiting list.
Would I recommend the treatment to other MS patients? I would certainly encourage those with progressive MS to think about balloon venoplasty. There is a small risk of vein injury but, based on doctors’ web reports on 2,000 people treated, I believe there is a chance that it may slow or halt progression of the disease. I was lucky that the cost of private treatment was not prohibitive but sadly this is not the case for many. I have tried explaining to neurologists and vascular doctors why CCSVI syndrome should at least be considered as a possibility in patients with MS but to no avail. Only my caring, supportive GP was prepared to listen. Medical journals refuse to publish patients’ point of view – I know because I’ve tried that, too. One has to ask what the neurology establishment is so frightened of: opening the veins of those with MS or opening their own minds.
17 March, 2011
Heavy Drinking Might Raise Risk of Death From Pancreatic Cancer
And pigs might fly. The fact that the effect is observed with hard liquor only should alert us to the probablity that alcohol is not the causative factor. As usual, it is probably a class effect. NASCAR fans (say) are more likely to like their Jim Beam than are New York sohisticates and are also much more likely to be working class. And class is one of the most reliable health predictors there is, second only to age and followed by IQ
Heavy drinkers have an increased risk of dying from pancreatic cancer, new research shows. In fact, people who never smoke, a known risk factor for the disease, but who have three or more drinks of hard liquor a day face a 36 percent higher risk of dying from pancreatic cancer, compared with nondrinkers, the study found.
"Overall, these findings add to the evidence that heavy alcohol intake is an independent risk factor for pancreatic cancer," said lead researcher Susan Gapstur, vice president of epidemiology for the American Cancer Society....
Smoking has long been cited as a risk factor for pancreatic cancer and now it appears that drinking liquor is also a significant player in development of the disease, the research indicated.
The report is published in the March 14 issue of the Archives of Internal Medicine.
To come to these conclusions, the researchers collected data on more than a million men and women who took part in the Cancer Prevention Study II. Over 24 years of follow-up, 6,847 of these people died from pancreatic cancer, the researchers noted.
Although a number of epidemiological studies have examined the association between alcohol and risk of pancreatic cancer, most were too small to tease out the effects of smoking from that of alcohol since people who drink alcohol are also more like to smoke, Gapstur said.
"In this large, prospective study, we were able to examine the association between alcohol intake and pancreatic cancer mortality in never-smokers, and across range of daily intake," she said.
Among people who had never smoked there was a 36 percent increased risk of death from pancreatic cancer for those who drank three or more servings of liquor a day compared with nondrinkers, Gapstur said.
"This association appeared to be only with liquor intake, and not with beer or wine intake," she noted. "Reasons for the differences by beverage type are unclear, but might be due to a higher amount of alcohol actually consumed in a single drink of liquor compared to wine or beer."
Do trans fats cause depression?
So: Poor people are more likely to buy convenience foods which are high in trans fats and poor people get more depressed. Trans fats likely had no effect on depression
New research has found a link between trans fatty acid consumption and depression. Spanish researchers followed 12,059 people for six years and found those who had 1.5 grams of trans fats a day were 48 per cent more likely to develop depression than those who had none.
The researchers believe trans fats may cause depression by inhibiting the nervous system from sending feel-good chemicals throughout the body. "Trans fatty acids cause a decrease in the correct transmission of the nervous response and a decrease in neuroprotection and neuronal regeneration," explains Professor Almudena Sanchez Villegas, the study's lead author.
The total trans fat intake of participants was only 0.4 per cent of their total diet. Food Standards Australia New Zealand says the average Australian's intake is 0.5 per cent of their diet.
And depression isn't the only concern. "Trans fats cause inflammation," nutritionist Lola Berry says. "They're linked to cardiovascular disease and high cholesterol levels and contribute to weight gain, which is a precursor to illnesses including type 2 diabetes."
The researchers also looked at diets containing "healthy fats" such as polyunsaturated and monounsaturated oils. They found those who consumed more than 20 grams of olive oil a day were 30 per cent less likely to develop depression.
Numerous studies show eating oily fish (salmon, tuna, mackerel and sardines) three times a week can help prevent depression and fish oil supplementation can help treat the condition.
Experts estimate reducing trans fat intake by just one per cent could prevent 11,000 heart attacks and 7000 deaths a year in the UK alone.
So why do food manufacturers still use trans fats? "Trans fats give foods the texture people expect and help them stay fresh for longer," says food manufacturer Kraft. "Developing ingredients with the same taste, texture and freshness characteristics as trans fats, but with better nutrition, has been a challenge for the food industry."
Between 2007 and 2009, due to public pressure, many food companies reduced trans fat usage by 20 to 45 per cent. But until they are eradicated, how do we avoid them?
Unfortunately, labelling laws aren't on the consumer's side.
"Manufacturers are only required to disclose the amount of trans fat in the nutrition panel if they make a claim about fat content, but the majority of products aren't required to list it," says Clare Hughes, Choice's senior food policy adviser.
You can spot trans fats on an ingredients list by the words "hydrogenated" or "hydrogenised". Choice, the Heart Foundation and other groups are lobbying the government for mandatory labelling of trans fats.
"For a number of years the government has been working with the food industry to remove artificial trans fat from the food supply," Hughes says. "But an independent panel recently recommended the government require trans fat be declared on the nutrition information panel if the initiative fails to achieve a meaningful reduction in trans fat by 2013."
16 March, 2011
Want to keep your heart and lungs healthy? Avoid traffic pollution (?)
The article below is presumably referring to this -- an advocacy article rather than a research report. I regret to say, however, that I find the pronouncements of official bodies unimpressive. The official wisdom is too dogmatic and reverses course too often for any reasonable person to have much faith in it.
At any event, the whole claim is another old chestnut. I have reviewed various research reports making similar claims. And they all fall down by failing to account for social class variables. They fail to note that working class people are much more likely to be exposed to high levels of traffic pollution by reason of their occupation -- truck drivers, white van men etc. And working class people have worse health anyhow. So, given that the effect is small (admitted in the Lancet article), we are almost certainly seeing a class effect rather than a pollution effect
The main trigger for a heart attack is not vigorous exercise or stress — it’s air pollution, according to a study published in The Lancet this month.
Researchers found spending time in traffic, whether as a driver or pedestrian, tops the list of ‘last straw’ risk factors that bring on a heart attack.
Polluted air contains particles of dust and soot less than ten microns wide (one micron is a millionth of a metre) which get into the lungs and cause inflammation.
Jon Ayres, professor of environmental and respiratory medicine at the University of Birmingham, says: ‘Particles raise the risk of respiratory problems and also seem to increase the stickiness of the blood. So, if you’ve got coronary heart disease, it may contribute to causing a heart attack.’
Air pollution is not only linked to strokes, heart attacks and cancer — it has a profound effect on those with existing respiratory conditions. Asthmatics are more likely to have an asthma attack on days when pollution is high.
Imposing minority requirements on the majority again
If something smells funny about this story, you’re not the only one. A group of legislators in Nevada are proposing a bill that would ban air fresheners and candles in public places because, they say, the fragrances can annoy some. But Critics say the bill would lead to stinky rooms and prohibit priests from using candles in Mass.
Las Vegas Democratic Assemblyman Paul Aizley on Monday presented the proposed legislation, which would set restrictions on pesticides, fragrances and candles to accommodate people with chemical sensitivities.
Proponents said air fresheners give them migraines or asthma attacks and prevent them from going to the movies or to restaurants. A cocktail waitress at a casino said inhaling the fragrances piped through the ventilation system felt like a concrete slab on her chest.
Critics counter the bill would affect everything from candlelit restaurants and weddings – not to mention unmasked odors in public bathrooms that would drive away tourists.
The bill, AB 234, specifically “prohibits the use of an ozone generator, any volatile organic compound, any candle or any air additive, including an air fragrance, air freshener or potpourri, in any area of a place of public accommodation which is open to the public.”
15 March, 2011
Tuna sandwiches 'could help prevent sight loss in old age'
The old, old story: Speculative interpretation of an epidemiological correlation. One alternative possibility: Wealthier people eat more seafood and wealthier people are also healthier
Tuna sandwiches could help protect your eyesight in old age, say researchers. Regular consumption of fish – including canned tuna – and other foods containing omega-3 fatty acids can cut the risk of the most common cause of age-related blindness by 42 per cent, a Harvard study has found.
Around 200,000 Britons suffer from age-related macular degeneration, or AMD, each year. It is the most common cause of sight loss in those over 50 and robs sufferers of their central vision.
A team at Brigham and Women’s Hospital and Harvard Medical School in Boston compiled data on 38,000 women who had not been diagnosed with AMD. Information on their eating habits, including their intake of omega-3 and omega-6 fatty acids, was collected and their eye health tracked over ten years. During this time, 235 cases of AMD were reported.
The researchers found that women who consumed the most fish oils had a 38 per cent lower risk of developing AMD compared with those who ate the least.
And consuming one or more servings of fish a week was linked to a 42 per cent lower risk of sight loss compared with eating one serving a month.
Study leader Dr William Christen said: 'The lower risk appeared to be due primarily to consumption of canned tuna fish and dark-meat fish.' Although tinned tuna does not contain as much fish oil as fresh tuna, the finding is significant because it is so widely eaten in sandwiches.
The study will be published in the June issue of the Archives of Ophthalmology medical journal.
Can a vibrating pill shake off constipation?
A vibrating capsule has been developed as a treatment for constipation. Once it’s swallowed, the high-tech device is programmed to shake, jolt and roll as it passes through the bowel.
The wave of movement triggered by the battery-powered capsule stimulates the muscles that drive the natural movements in the bowel, easing constipation.
The device will be tested in human trials next month. Researchers say that unlike other treatments for the condition, such as some laxatives, the single-use capsule has no side effects.
The usual causes of constipation are poor diet, lack of exercise or certain medications. Twice as many women suffer from it as men; it is also more common with age, with older people five times more likely to be affected.
The problem is that when the bowel becomes constipated, this slows down its muscular contractions, which makes the condition worse.
Earlier studies have suggested that external massage on the abdomen can help, by stimulating muscles in the bowel wall, kick-starting peristalsis — the natural waves of synchronised muscle movements that push food through the digestive tract.
Quite how this works is not clear, although one theory is that the muscles go into spasm during constipation and that massage helps them relax.
However, this technique is difficult and time-consuming, and can be ineffective in patients with a thick or muscular abdominal wall.
As well as kick-starting natural movement of the bowel, it’s thought the new device — which was developed by an Israeli-based company, Vibrant — will also help break up compacted stools.
In a new trial, starting next month, and registered with the U.S. National Institutes of Health, 30 patients will be given a 15.5mm long capsule to swallow. The capsule weighs 10 g, roughly the same weight as a pound coin (9.5g).
Inside the tubular casing is a tiny electrical motor and micro-battery. The motor has an off centre weight attached to it, which makes it spin, wobble and jolt when it is switched on, setting up a vibrating motion.
The capsule will be automatically programmed to start vibrating six hours after it’s been swallowed — the estimated time it will take for it to reach the bowel. It then vibrates for two hours before it’s excreted.
Researchers from Ichilov hospital in Tel Aviv, Israel, who are conducting the trial, will observe the patients for a week. If the gadget is proved safe, researchers will test it in a second trial of 30 patients, who will be observed for two weeks. The idea is that more capsules could be used over time if the problem persists.
Dr Ian McNeil, consultant gastroenterologist at Ealing Hospital NHS Trust and honorary senior clinical lecturer, Imperial College School of Medicine, said: ‘This is an interesting and novel approach to constipation.
14 March, 2011
Could breastfeeding make baby brighter? Just four weeks on mother's milk said to benefit brain
An old chestnut re-roasted. Full research report here.
This is a brave attempt at rigorous research but it falls to the ground over the political incorrectness of IQ. They did not measure maternal IQ so the small effect they observed could be entirely due to that. Given the propaganda in favour of it, it is highly likely that more intelligent women are more likely to breastfeed -- and IQ is highly hereditary
Note that this recent study, which DID control for IQ found no effect of breastfeeding. Sad, eh? No wonder the study below has not made it into the peer reviewed journals
Babies who are breastfed grow up to be more intelligent, scientists suggested yesterday. Just four weeks on their mothers’ milk can have a ‘significant’ effect on a child’s development in primary and secondary school, research has found. Those who have been breastfed do better at reading, writing and maths at the ages of five, seven, 11 and 14.
While breast milk has long been known to boost babies’ immunity, helping them fight ear infections, stomach bugs and even asthma, little was known about its effects on intelligence until now.
Maria Iacovou, one of the authors of the study, said: ‘The issue was that while it looked as though breastfeeding did have an impact on cognitive development, no one knew if that was just because the type of mother more likely to breastfeed in the first place was more likely to nurture brighter children, or whether there was a true causal link. ‘Breast milk has well-known health benefits and now we can say there are clear benefits for children’s brains as well.’
Dr Iacovou, a social scientist at the Institute for Social and Economic Research at the University of Essex, insisted that she didn’t intend ‘to make any mother feel guilty’. She said there were significant challenges to face when trying to change attitudes to breastfeeding and women shouldn’t be pressured to do so. But, she added, ‘we should start focusing more on those women who do want to, try to help them and make it more normal for everyone’.
As well as providing babies with vital nutrients, breastfeeding has been shown to protect the mother from breast and ovarian cancer in later life – due to its effects on hormonal balance. It could even help new mothers return to their pre-pregnancy figures, burning 500 calories a day.
However Janet Fyle, professional policy adviser at the Royal College of Midwives, said that mothers often can’t breastfeed because of pressures to return to work. She added: ‘In this country we are cutting benefits to single parent families and poorer people, and mothers have to get back to work and earn a living, whether it’s in Sainsbury’s or the City – it is what the Government wants them to do.’
The study was conducted by researchers from Oxford University and the Institute for Social and Economic Research at the University of Essex. It looked at test scores of pupils who were still being breastfed when they were four weeks old and others put on formula milk.
Each breastfed child was compared with a bottle-fed child from a very similar background, based on factors such as parents’ income, jobs and whether they were separated.
Despite very similar upbringings, those who had been breastfed consistently did better in maths, reading and writing throughout primary and secondary school, the study of more than 10,000 children found.
Now the British government wants t calorie counts on sandwiches and beer
Fast food and sandwich chains are to display calorie counts on menus, ministers will announce this week. Beer mats and glasses in pubs will also start displaying measurements of drinks’ alcohol units under the deal reached by the Government with several food and drinks firms.
And larger fast food chains will introduce healthier meals thanks to a voluntary deal between the industry and the Food Standards Agency watchdog. This initiatives to improve the nation’s eating and drinking habits, part of the Government’s ‘responsibility deal’, is due to be announced by ministers this week.
A number of major food chains have revealed their efforts to help the nation become healthier. KFC is to start selling healthier griddled chicken alongside the usual fried options and Pizza Hut is promoting a low-calorie menu that encourages diners to eat salad. Burger King and McDonald’s are expected to lead the way among outlets introducing menus with calorie information from September.
Meanwhile Heineken has announced that all 11 million glasses used in pubs and clubs bearing logos of Foster’s, Bulmers, Kronenbourg or its other brands will carry information on the number of units per pint.
And it is expected that a leading brand, thought to be Strongbow cider, will have its alcohol content cut by a fifth to encourage responsible drinking.
The calorie count scheme mirrors a compulsory regime adopted in New York last year that has led to an average reduction of 50 to 100 calories for each order placed. [Rubbish! It made no difference]
Other moves include a pledge by companies to reduce salt by 15 per cent, to help reach the Government’s target of keeping an adult’s daily intake at six grams or less.
FSA chief executive Tim Smith said supermarket shoppers can already choose what to buy thanks to product labels showing the levels of calories, fat, sugar and salt. ‘There is no good reason why people should not be able to come to the same conclusion when they are standing in front of a sandwich counter or in a fast food outlet,’ he added.
But the timing of the move has encountered opposition from the British Hospitality Association, amid claims it will add to costs and threaten jobs in a period of hardship for many businesses.
13 March, 2011
Would you like some popcorn with that fat?
The current version of the official food religion claims another victim
US cinemas are up in arms over a plan that would require them to reveal the fat in their popcorn is equal to nearly three Big Macs. Under the proposed rule, movie theatre chains will be required to display that their popcorn contains as many as 1460 calories.
According to Margo Wootan, the director of nutrition policy at the Center for Science in the Public Interest in Washington, it’s enough to make you pop! "It's easy enough to blow your whole diet for a week from one snack at the movie theater," she said. "Just because you happen to be watching a movie while you’re eating doesn’t mean you aren’t eating out."
The new rule being proposed this month will require chain restaurants with at least 20 US locations to post the calorie content of menu items, and can include snack bars and grocery stores.
With the big theatre chains generating as much as one-third of their annual revenue from snack bars, it’s no surprise they are fighting the move.
Cinemas and grocery stores have united to convince the Food and Drug Administration not to go ahead with the new health law.
National Association of Theatre Owners spokesman Patrick Corcoran said his trade group is recommending the FDA exempt companies that get less than 35 percent of gross revenue from food sales. "Congress didn’t mention theaters in the law and the idea of regulating them never came up at legislative hearings," Corcoran said. "In the basic history of the bill there is no real intent to include movie theaters that we could discern."
Cap'n Crunch sails into obscurity
The Soggies have finally won: Cap'n Crunch is quietly sailing into retirement.
Long derided by health experts for its high sugar content – a single serving contains 12 grams – the cereal is no longer being actively marketed by Quaker, DailyFinance reports. It appears parent company PepsiCo is forcing the good Cap'n to walk the plank.
Cap'n Crunch was once the No. 1 breakfast cereal, but pressure from the White House and health activists is having an effect on how PepsiCo and other food companies peddle their products to kids. Sales of the cereal were down 6.8 percent in 2010.
Last year, PepsiCo vowed to reduce added sugar per serving by 25 percent and saturated fat by 15 percent in its products over the next 10 years.
"PepsiCo is no longer marketing Cap'n Crunch cereal directly to children. In a sense, you could say that they have retired Cap'n Crunch, and that's a good thing," Jennifer Harris, of the Rudd Center for Food Policy & Obesity at Yale University, told DailyFinance. "Unfortunately, children continue to view hundreds of ads per year for high-sugar cereals from General Mills, Kellogg's and Post Foods."
The critics have a point: Children cereals contain 85 percent more sugar, 65 percent less fiber and 60 percent more sodium when compared with adult cereals, according to the Rudd Center research. The average preschooler has viewed more than 500 television ads for such cereals.
12 March, 2011
Life-saving drugs 'are less effective when it's sunny'
The usual leaping to conclusions. For a start, the very extreme variation in Swedish summers and winters may have effects not seen elsewhere.
Secondly, depression and other ailments (including heavy consumption of alcohol) may be common in the Swedish winters and that may be the cause of the effects observed.
Thirdly, it seems reasonable that immunosuppressive drugs might be in a class of their own. It is only theory that says the effect will generalize widely.
Fourthly, in the very sunny part of Australia where I grew up, the same standards for drug prescription are used that are used elsewhere in Australia and I have never heard any rumblings about drugs being less effective there.
Fifthly, what is true of organ transplant patients might not be true of healthier patients
Potentially life saving drugs become less effective when it is sunny, a new study has found. Swedish scientists have shown that the extra vitamin D produced by the body in the summer months, speeds up the body's ability to break down medicines. [They did NOT show that. The cause is speculation]
The findings - based on a study of 6,000 people - suggest that doctors should reduce doses of some medications in the dark winter months, and increase them in prolonged periods of hot sunny weather.
The researchers say the findings could have implications for half of all prescribed medicines - but warned patients not to alter their doses without consulting a doctor.
The study looked at 70,000 blood samples from organ transplant patients taking one of three immune system suppressing drugs in Stockholm, Sweden over 10 years. Samples taken in the winter - when Stockholm gets only a few hours of daylight and almost no sunshine - were compared with samples taken on long summer days.
The concentrations of the drugs varied throughout the year in a way that closely reflected changes in the levels of vitamin D - a nutrient produced by the body in response to sunlight, the researchers report in the journal Drug Metabolism and Disposition.
The highest levels of vitamin D were reached during the summer months at a time when levels of two of the immuno-suppressant drugs were seven per cent and 17 per cent lower.
The researchers believe vitamin D increases the amount of a chemical released by the liver involved in breaking down medications.
Dr Erik Eliasson, who carried out the study at the Karolinska Institute, said the chemical - an enzyme known as CYP3A4 - was involved in the metabolism of around half of all medications.
'The drugs we were studying were being very closely monitored in the patients anyway - but for other drugs which aren't monitored as closely there could also be an effect,' he said.
Stockholm is as far north as the Shetlands where winter days are very short, and summer days long. The effect on daylight on drug metabolism will be less pronounced further south.
Back to Prohibition?
Professor David Nutt – the former government advisor on drug policy – argued in the Guardian yesterday that there is no such thing as a safe level of alcohol consumption. I’m not convinced – as one commenter points out, he uses some anecdotal evidence and an extremely strict definition of ‘safety’ – but for the sake of argument, let’s say that Nutt’s right and alcohol really IS a lot more harmful than we currently think. What would the policy implications be?
For a start, you might want the government to inform people so that they make an informed decision about their drinking. People tend to be distrustful of government information but I suppose it’s worth a shot. It might also encourage rebellious teenagers to drink more, but teenagers like drinking plenty already. Some would want to tax alcohol more highly to discourage drinking. If people are sufficiently informed about the dangers it seems too paternalistic to try to make them act as we’d like them to, but it’s a popular position.
There are plenty of other regulations that people would have across the board, but almost nobody would propose to prohibit alcohol consumption altogether, even if it was shown to be rather more harmful than Nutt is saying. Most people understand that outlawing something altogether makes it more dangerous. As during Prohibition in the US (PDF), a black market would grow (funding organized crime), alcohol would become more dangerous (brewed in people’s bathtubs and cut with things we’d rather not drink), and people would be put into prison for doing things in the privacy of their own home that didn’t really affect anybody but themselves.
On that last point, I hate to think of the social consequences of jailing thousands of people for victimless crimes. Prohibition didn’t work the last time round, and it wouldn’t be any more effective if we suddenly learned that alcohol was a physical evil rather than a moral evil. Most people know these things and accept that even if they hated alcohol’s effect on others, it would be foolish to try to outlaw it.
So why do we have precisely the opposite view of recreational drugs? A social and individual harm reduction policy against a dangerous alcohol would fall far short of outright prohibition. Applying the policy to alcohol has and would be a failure, irrespective of alcohol’s harmfulness. What reason is there to think that cannabis, ecstasy, mephadrone – and even heroin and crack, for that matter – are any different?
11 March, 2011
Coffee tied to lower stroke risk in women
As the authors admit, previous results have been conflicting. So all this proves is that if you do enough studies you will eventually get a positive result by chance alone
WOMEN who enjoy a daily dose of coffee may like this perk: It might lower their risk of stroke. Women in a Swedish study who drank at least a cup of coffee every day had a 22 to 25 per cent lower risk of stroke, compared to those who drank less coffee or none at all.
"Coffee drinkers should rejoice," said Dr Sharonne N Hayes, a cardiologist at Mayo Clinic in Rochester, Minnesota. "Coffee is often made out to be potentially bad for your heart. There really hasn't been any study that convincingly said coffee is bad." "If you are drinking coffee now, you may be doing some good and you are likely not doing harm," she added.
But Hayes and other doctors say the study shouldn't send non-coffee drinkers running to their local coffee shop. The study doesn't prove that coffee lowers stroke risk, only that coffee drinkers tend to have a lower stroke risk.
"These sorts of epidemiological studies are compelling but they don't prove cause," said Dr David S Seres, director of medical nutrition at Columbia University's College of Physicians and Surgeons in New York.
The findings were published online today in the American Heart Association journal Stroke.
Scientists have been studying coffee for years, trying to determine its risks and benefits. The Swedish researchers led by Susanna Larsson at the Karolinska Institute in Stockholm said previous studies on coffee consumption and strokes have had conflicting findings.
"There hasn't been a consistent message come out," of coffee studies, said Dr Cathy Sila, a stroke neurologist at University Hospitals Case Medical Centre in Cleveland.
For the observational study, researchers followed 34,670 Swedish women, ages 49 to 83, for about 10 years. The women were asked how much coffee they drank at the start of the study. The researchers checked hospital records to find out how many of the women later had strokes.
There were 1680 strokes, including those who drank less than a cup or none.
Researchers adjusted for differences between the groups that affect stroke risk, such as smoking, weight, high blood pressure and diabetes, and still saw a lower stroke risk among coffee drinkers. Dr Larsson said the benefit was seen whether the women drank a cup or several daily. "You don't need to drink so much. One or two cups a day is enough," she said.
Dr Larsson, who in another study found a link between coffee drinking in Finnish men who smoked and decreased stroke risk, said more research needs to be done to figure out why coffee may be cutting stroke risk. It could be reducing inflammation and improving insulin sensitivity, she said, or it could be the antioxidants in coffee.
Revolutionary new X-ray treatment that could save the sight of thousands
An X-ray treatment that could save the sight of thousands is being trialled on the NHS. The 15-minute procedure has been shown to halt wet age-related macular degeneration, one of the most common forms of blindness in the elderly.
Around 250,000 suffer from this debilitating condition which, if not treated, can cause loss of sight in just three months. Currently sufferers have to undergo monthly injections in their eye for the rest of their lives to prevent them from going blind, and they are often unable to read, drive or live independently.
But early trials of the new procedure have shown that it could halt the progression of the condition immediately, saving the NHS £300million a year. The trials on 60 people in Mexico showed that half did not need any more treatment while the remainder needed infrequent injections – only a few each year.
Wet AMD is caused when blood vessels grow over an area in the middle of the retina called the macular, which is at the back of the eye. It is currently treated with several drugs, including Lucentis and Avastin, which temporarily stop the vessels from growing.
But the powerful new procedure, called iRay, can destroy the blood vessels completely. Patients sit at the front of a machine and place their chin on a rest while X-rays are beamed into the back of their eye. The procedure lasts between 15 and 20 minutes and is estimated to cost around £4,000 a time. A year’s worth of the monthly injections costs £12,000.
The procedure, developed by U.S. firm Oraya Therapeutics, is being tested at London’s Kings College Hospital and doctors are hoping to recruit 50 more patients to take part in the trials. If successful, it could be rolled out in hospitals nationwide and researchers believe it could save the NHS up to £300million a year.
Consultant ophthalmic surgeon Tim Jackson, who is leading the trial, said: ‘This is an exciting new technology that targets one of the most common causes of blindness in the UK. ‘If the initial results are borne out in these important larger studies then a majority of patients will have something to look forward to – an easily administered, one-off treatment that maintains or improves vision, and fewer injections into their eye.’
There are around 20,000 new cases of wet AMD in Britain every year, mostly Occurring in the over-60s. The condition is more common among women, and is thought to be linked to smoking and heavy drinking.
10 March, 2011
A toxic consensus on toxic substances?
When ducks are in a row, stars align, and Republicans, Democrats, industry and environmentalists agree — it’s time to worry. Such forces materialized at recent congressional hearings where all parties echoed the need for “modernization” of the Toxic Substances Control Act (TSCA). Unfortunately, such “consensus” is likely to produce yet more red tape, reduced choice, stymied innovation, and increased public health risks.
Originally passed in 1976, TSCA is designed to ensure the safe use of industrial chemicals (excluding chemicals regulated on the federal pesticide and cosmetics laws) by granting the EPA authority to review both new and existing chemicals and to regulate any chemical that the agency found posed an “unreasonable risk of injury to health or the environment.” According to a 2007 Government Accountability Office (GAO) report, TSCA covers 82,000 chemicals, of which 62,000 were already in commerce when EPA began implementation in 1979. EPA has reviewed 45,000 new chemicals and has placed 20,000 in the inventory as those allowed in commerce, while restricting the use of five existing chemicals.
The various interest groups each have different motivations for supporting the “modernization” of this process. Industry largely supports TSCA reform for a very practical reason: their Washington lobbyists hope a revised federal toxics law will preempt the dozens of existing and proposed state laws around the nation. After all, it’s easier to follow one master than 50. “As of today, 30 states have introduced legislation. We would like one strong federal standard,” explained Phil Klein of the Consumer Specialty Products Association (CSPA) in a recent issue of CQ Weekly.
CSPA — a trade group representing a host of consumer products from cleaning detergents to bug spray — is part of a larger, industry coalition led by the American Chemistry Council that is pushing for TSCA reform with the hopes of gaining preemption. But there are very few instances in which federal environmental laws preempt state law; it almost never happens. Instead federal laws provide the floor — allowing states to impose more onerous standards in addition to federal standards. TSCA reform bills during the 111th Congress excluded preemption because opposition from environmentalists and state-level policymakers is strong.
Some Republicans support reform based on the idea that it could promote reasonable, science-based standards with a minimal economic impact. In a statement submitted at the hearing, Senator James Inhofe (R-Okla.) explained: “we can reach an agreement to develop a workable bill, one based on the best available science, one that protects human health, and one that balances the need to protect jobs and economic growth.”
But impetus for TSCA reform comes from the left’s desire to depart from hard science and cost-benefit considerations. Environmentalists and Democrats want to replace TSCA’s scientific-based standard with a political one based on the precautionary principle — a concept calling on regulators to act even in the absence of scientific justifications. A meeting of environmentalist activists formalized the concept in 1998 by issuing the so-called “Wingspread Statement” on the precautionary principle. It reads: “When an activity raises threats of harm to the environment or human health, precautionary measures should be taken even if some cause-and-effect relationships are not fully established scientifically.” Other formulations call on industry to prove their products “safe” before they can enter commerce, rather than demanding regulators prove otherwise before regulating.
Ironically, the precautionary approach is dangerous because it rarely considers the risks associated with the regulations themselves — or their economic impacts. Banning a product simply because it “might” pose a risk means replacing it with second-tier products that may pose higher risks, higher costs, or both. Moreover, misguided government bans simply waste the fruits of human labor and ingenuity employed to create the products. The mere threat of onerous regulation impedes innovation and entrepreneurship. Such policies stymie economic growth and eventually produce a lower standard of living for everyone.
Accordingly, those who value science and economic growth would be wiser to support TSCA’s existing “unreasonable risk” standard. The EPA explains on its website:unreasonable risk involves the balancing of the probability that harm will occur and the magnitude and severity of that harm against the effect of a proposed regulatory action on the availability to society of the expected benefits of the chemical substance.
This standard encourages — if not demands — that the agency focus on scientifically robust, well-designed studies and demands cost-benefit considerations. Citizens should demand at least as much before any governmental body issues regulations that undermine the freedoms necessary for society to progress and innovate. But the greens are unhappy with this science-based standard, which is why TSCA reform is on the agenda in the first place. As the Safer Chemicals, Healthy Families — a coalition of left-of-center activists and greens — put it on their website:Over the course of the 34 years since TSCA was enacted, EPA has succeeded in restricting only limited uses of five chemicals. The burden of proof TSCA places on the EPA to prove actual harm before it can regulate a chemical and to show its regulatory action is the least burdensome of all options is so onerous that it prevented the EPA from restricting asbestos, a known human carcinogen.
In reality, the court overturned the EPA’s total asbestos ban because the agency could not scientifically justify the regulation as TSCA (exposure and use of asbestos are regulated by Occupational Safety and Health Administration and other EPA regulations). The court opinion in Corrosion Proof Fittings v. EPAstated: “We conclude that the EPA has presented insufficient evidence to justify its asbestos ban. We base this conclusion upon two grounds: the failure of the EPA to consider all necessary evidence and its failure to give adequate weight to statutory language requiring it to promulgate the least burdensome, reasonable regulation required to protect the environment adequately.”
For example, the court noted that the EPA rule could have increased fatalities because the agency failed to consider the inadequacy of substitutes for asbestos used in automobile brakes. By signing on to misguided TSCA reform, industry and conservatives on the Hill are likely to repeat a colossal error they made in 1996 when they “modernized” the nation’s pesticide law.
During the 104th Congress, agricultural interests, chemical producers, and conservative Republicans worked with the left to replace the 1958-passed “Delaney Clause.” The Delaney Clause is a near zero-risk regulatory standard applied to pesticide residues found on processed food. Improved ability to measure pesticide levels at the time meant that the feds would have to start banning a number of products to meet the near zero-risk standard. The new law was supposed to save these products by replacing Delaney with a more reasonable “modern” standard for pesticides.
Republican and moderate Democrats from agricultural states as well as agricultural industry representatives argued that new law would allow for quicker pesticide approvals, fewer bans, and would help farmers produce a “safe and affordable” food supply. That’s not what happened. They passed the Food Quality Protection Act (FQPA), which set in place an overly precautionary standard. It demands that products meet a “reasonable risk of no harm” standard and employ numerous, other safety factors to ensure products are thousands of time safer than necessary to protect health. The new standard is arguably more stringent than the Delaney Clause. An article entitled “Wake-up Call” in California Farmer explained shortly after FQPA became law:No, you may not gain peace of mind when discovering that the new standard is stricter than Delaney, at least the way EPA and FDA was interpreting it […]. Delaney was interpreted as posing a one in a million chance of additional cancer cases from all crop uses of a pesticide. The new, tougher standard — “a reasonable certainty of no harm to sensitive populations” — applies to all pesticides, not only cancer-causing ones.
Ironically, the FQPA is one of the models that greens would like TSCA reform to follow — despite the fact that it has proven disastrous. Under the FQPA, the EPA has banned and restricted the use of thousands of pesticides — the opposite of what lawmakers desired. In 2006, for example, the EPA completed a 10-year study of 230 organophosphates and carbonates pesticides. It concluded FQPA standards demand that the agency ban 3,200 uses of pesticide products in these categories alone and place restrictions on 1,200 other uses. It deemed 5,237 uses as “safe” under the act. Meanwhile, pest problems are on the rise as fewer and fewer pesticides are available or under development. Many cities around the nation, for example, are scrambling for solutions to bed bug problems in hotels, retirement communities, schools, stores, and homes — but there are few products left to control them. TSCA reform is heading down the same path, and if enacted will promote more precautionary legislation for EPA programs as well as at other federal agencies. In fact, the activists pushing TSCA reform are also pushing precautionary policies elsewhere. In particular, the Campaign for Safe Cosmetics wants the FDA to dispense with science in favor of caution, and precautionary chemical legislation is moving in 30 states — as noted on the activist website saferstates.com.
Margaret Thatcher once explained that “consensus seems to be the process of abandoning all beliefs, principles, values and policies.” The Iron Lady was right about many things, this included; principled lawmakers should heed her warning now.
Pharmacies selling 'quack' health products, CHOICE investigation reveals
AUSTRALIAN pharmacists have been called out for including "quack" healthcare products on their shelves. A CHOICE review of items commonly sold through pharmacies has uncovered a range of products that have purported health benefits but "no credible evidence that they work".
These included ear candles, herbal weight loss remedies and plastic bracelets with a hologram sticker which claim to improve balance, muscle strength while alleviating jet lag and motion sickness.
"Antisnor" rings - a metal ring worn on the little finger - were also for sale despite the Australian Competition and Consumer Commission (ACCC) taking action against its manufacturer to halt its claims it could actually prevent snoring.
"There is an onus on pharmacies to sell products that work and for pharmacists to stand by the safety and effectiveness of products in their store," said CHOICE spokeswoman Ingrid Just. "Pharmacists hold a four year specialist degree in chemistry, and consumers rely on their expert advice."
CHOICE also raised concern about homeopathy remedies appearing in pharmacies, stating the question of whether they had any real effect on the body had been "long debated (and) systematic reviews of clinical trials say no".
Ms Just said many pharmacies had expanded their offerings and they now resembled "full blown retail enterprises" selling "all manner of things from from toilet paper and confectionary to cosmetics and sunscreens".
This was not an issue, she said, where items for sale did not have a therapeutic of health claim attached to them. "But when it comes to health products, they should stick to selling ones that are safe, effective and supported by scientific and clinical evidence," Ms Just said.
The CHOICE probe also asked pharmacists about the efficacy of certain products and some offered "insightful, medically sound advice when asked." Others were "indifferent or who gave advice on quack products with no scientific or medical basis".
Ms Just said the problem was consumers could find themselves out of pocket, and with no relief for the problem they are seeking help for. "When products don't work the consumer may not only have wasted their money, they may have also delayed the opportunity to seek more appropriate treatment," she said.
CHOICE said people should, when considering a new or novel health product, ask their pharmacists if there was any evidence supporting its use.
The Pharmacy Guild of Australia agrees. "Pharmacists take their professional responsibilities very seriously," a guild spokesman told AAP. "The guild agrees with CHOICE's recommendation that the best course of action is to speak to the pharmacist about any new or novel product you're considering, and ask for further information."
9 March, 2011
Poor diet during pregnancy can give your future grandchildren diabetes, researchers say
This is just theory. All they have shown is that malnourished rats have less healthy offspring
A poor diet during pregnancy may increase the risk of a woman’s children and grandchildren developing type 2 diabetes in later life. The disease mainly affects the middle aged, but a study suggests that susceptibility could be programmed into the cells of an unborn baby if his or her mother eats unhealthily. In theory, this diabetes vulnerability gene could then be passed down to the child’s offspring and future generations.
Cambridge University scientists pinpointed the gene in tests on rats that showed it was reprogrammed in the womb by a protein-deficient diet given to the mother.
Other research suggests a range of unbalanced diets may result in an increased risk of diabetes, not just protein-restricted ones.
The Cambridge team, whose work is published in the journal Proceedings Of The National Academy Of Sciences, focused on a ‘master regulator’ metabolism gene that is important both in the development of the pancreas in the womb and its ability to produce insulin.
Feeding mother rats a low-protein diet reduced the gene’s activity, decreased insulin production and made the offspring prone to developing type 2 diabetes in later life.
The scientists say it is likely humans would be affected in a similar way.
Sucking the jelly out of my eyeballs made my annoying floaters vanish
This sounds pretty horrible but I guess it is not. I thought the idea of a cataract operation was horrible but now that I have had that procedure, I am pleased to say that it was much better than it sounds -- JR
One day I was driving to a lunch appointment when flashing lights started appearing out of nowhere on my right-hand side. I continued driving and met my friend, but then went straight to my optician.
He told me that I had Posterior Vitreous Detachment (PVD), when the vitreous jelly — which fills the inside of your eye — had come away from the lining at the back of the eyeball. All the flashing lights I saw were the nerves firing off with the trauma. The next day, my son Matthew drove me to the Eye Unit at Southampton Hospital where the diagnosis was confirmed. The doctor there said there was nothing to do except wait for it to settle down.
The lights did stop flashing, but I was left with dozens of floaters of all shapes and sizes in my line of vision, which only got worse. A few months later the flashing lights suddenly appeared in my left eye, too. I felt absolutely furious and desperate because my left eye was my stronger one. I immediately went to see my optician who said it was the same problem.
For the next four years, I had to put up with a large cloudy patch in my left eye. It was hard to watch TV, use the computer or even read a recipe. It wasn’t painful — just annoying.
In 2009, my optician told me about a treatment for PVD called vitrectomy which a surgeon called Andrew Luff was doing with good results. Apparently, he sucked out the jelly from the eyeballs through a needle and then replaced it with salt water.
I was pretty horrified, and put off my decision for six months. But by April 2010 I felt very low and my vision was worsening, so I made an appointment to see Mr Luff privately.
He looked at my eyes and told me he could perform a vitrectomy operation and, at the same time, would give me new artificial lenses; the vitrectomy surgery makes the lens of the eye go cloudy within a few months, and apparently I had early-stage cataracts anyway.
A few weeks later I went to hospital for the operation on my right eye. The anaesthetist gave me a sedative and injected anaesthetic around the eye. That meant I couldn’t feel a thing, and I thought my eye was closed when actually it was clamped open and Mr Luff was inserting the needles.
Half an hour later, it was all done and I was taken back to my room, my right eye covered with a patch. I went home the same day and removed the patch 24 hours later.
My daughter Jo nearly fainted because I had a black eye and my eyeball was red, but the wonderful thing was that I could see clearly. I rested for a couple of weeks and used antibiotic eye drops. Within a fortnight my eye looked normal.
After all those years of living in shadows, I can now see clearly and in full technicolor.
Andrew Luff, a consultant ophthalmic surgeon at Southampton Eye Unit and at Optegra Solent Eye Hospital, says:
"Many people over the age of 50 will be aware of occasional floaters — these are bits of collagen (the material which holds our skin and bones together) suspended in the vitreous jelly of the eyeball. The jelly is 99 per cent water and one per cent solid, but as we age, the solid bits clump together into visible strands and shapes. Some people experience one large floater, which can be distracting.
People can live with floaters quite easily, but in some cases they become a major irritation and need to be surgically corrected.
They can also become much worse if the vitreous jelly pulls away from the retina, the light-sensitive film lining the inside of the eye. This is called Posterior Vitreous Detachment, and it occurs in around 75 per cent of people over 65. Every time you move or flick your eyeball, such as when you are reading, the jelly containing the collagen clumps sways with the movement.
In a vitrectomy operation, the debris-filled vitreous jelly is removed from the eyeball and replaced by saline. The vitreous never regrows, but the body quickly replaces the saline with clear fluid so the patient can see clearly again.
This procedure has been done for a number of years, but in the past it was offered to a patient only if the alternative was blindness, because there was a risk that the lining at the back of the eye would come away. Now, with better equipment and advanced techniques, the complication rate has dropped dramatically.
We use ultra-fine instruments to make tiny incisions. These are so small they heal without stitches, so there’s less risk of complications.
8 March, 2011
Would Universal Health-Care Coverage Actually Improve Health?
By Jim Manzi
There is a debate going on in the blogosphere between Ezra Klein, Arnold Kling, Karl Smith, Tim Carney, and others about, to put it crudely, whether health care really affects health that much. This is, in part, a proxy debate for whether it is worth it for the U.S. government to provide generous universal health-care financing for all of its citizens (or, I suppose, residents).
Either position can be caricatured. On one hand, no sane person would want to be without the advances of modern medicine. Recently, a little girl I know had scarlet fever. A century ago, this would very possibly have meant burying a small corpse; today, it implies a ten-day cycle of swallowing medicine at breakfast and dinner. There are few people on earth who have as much reason to be proud of how they spend their work week as pharmaceutical researchers.
On the other hand, the link from alternative methods of health-care finance, through the actual differences in provision of medical care these imply in the contemporary U.S., to the actual differences in health outcomes these treatment differences would cause, isn’t nearly so obvious. The net health effect of providing universal health-care coverage versus some alternative financing system is an empirical question, not a philosophy debate.
I’ve written a lot about why randomized experiments are so critical to understanding cause-and-effect relationships in social policy. In the case of health-care financing, the reason is that what system of health-care financing you have (high-quality “go to any doctor” plan; good HMO; catastrophic-only plan; VA; go to an emergency room because you are uninsured, etc.) is bound up with a myriad of other factors that influence health. A randomized experiment allows us to isolate the impact of the system of health-care financing.
To my knowledge, the only large-scale randomized experiment in the U.S. that has tested the actual effects on health of providing various kinds of health-care financing was the RAND Health Insurance Experiment (HIE). In this experiment, thousands of families were randomly assigned to one of five different health-insurance plans that ranged from something like a plan that provides free health care, to something like a pure catastrophic-only plan in which consumers pay out-of-pocket for day-to-day healthcare. The study tracked what exact health-care services each group used, and how their health varied over a period of 3–5 years.
Ezra Klein describes this experiment as “the best evidence we have,” and writes that it “suggests that health-care coverage does much more for the health of poorer people than it does for the health of well-compensated, highly educated people.” His statement is correct, but as a summary of the results of this experiment, seems to me to be radically incomplete. In fact, the experimenters wrote of the findings that “cost sharing reduced the use of nearly all health services,” but “the reduction in services induced by cost sharing had no adverse effect on participants’ health.” Think about that. Providing people coverage of their medical costs caused no average improvement in health.
Klein is correct that there appeared to be a net health benefit for the poorest participants, but this was for a tiny proportion of the population, and for a small subset of medical conditions. According to the study, “The poorest and sickest 6 percent of the sample at the start of the experiment had better outcomes under the free plan for 4 of the 30 conditions measured.” There are technical reasons why conclusions from such a experiment are not reliable for post hoc subgroups in the way that they are for average comparison of a test group versus a control group; but even if we were to accept this finding as valid, it’s not obvious to me that we would want to devise a health-care financing system for the United States around helping 6 percent of the population partially ameliorate about 10 percent of their potential health problems, as opposed to developing some specific supplementary programs for these issues, if they could be addressed feasibly.
Klein clearly has a very sophisticated take on the issue, and wrote in 2009 that health-care reform is not primarily about improving health, but in reducing how much we spend on it. As he put it, “The purpose of health reform, in other words, is to pay for health care — not to improve the health of the population.” Fair enough. But the real debate, then, would be about whether market forces or bureaucratic control would be better at reducing costs, not about which would be better at promoting health for the “poorest and sickest” or anybody else. It wouldn’t be about getting better health outcomes.
A single experiment like the RAND HIE is not definitive. Among other things: it finished in 1982, and we live in a different world; any such experiment requires replication; it might be that the important health effects take much longer than five years to materialize, and so on. But as an observer of the health-care debates, it always struck me as fascinating that the fact that the “best evidence we have” showed that providing health care coverage doesn’t actually improve average health wasn’t treated as more central.
Fascinating, but not surprising. In one social-policy topic after another, experts argue that some program will transform some area of public life, and solve persistent problems. They often have impressive theoretical arguments supported by complex empirical evidence. But what I believe randomized experiments have shown in many such areas — ranging from welfare to criminology to education — is that proposed policy interventions rarely work, and when they do, they tend to produce improvements that are very small as compared either to size of the problem or to the dreams of the advocates. This evidence is often ignored by those who have dedicated their lives to solving these problems, likely because it is so frustrating to almost everyone involved.
SOURCE. Note the corollary of the Rand findings: If people overall did not improve but the poorest did, then some other group did less well
My fingers and toes ached in the cold - until I took Viagra!
The pain first started whenever Anne Mawdsley was out in cold weather. ‘My fingers would turn red and felt like they were burning,’ she says. ‘It sounds like just a minor inconvenience, but I was in excruciating pain. I had to give up working as a PE teacher because being outdoors in cold weather was so difficult. I became a swimming teacher instead.’
However, the problem continued to worsen, and Anne ‘really struggled’ to look after her two sons, then both under two-and-a-half. ‘The pain seemed to reach a peak at night — my fingers would throb, and I’d be shattered because I couldn’t sleep.’
She then developed ulcers on her fingers; one finger even became gangrenous as a result. Anne’s doctor suggested the finger be amputated. ‘Although I was desperate, this sounded like medieval medicine. I was just horrified,’ says Anne, 68, of Alsager, Cheshire.
She managed to avoid this drastic solution, but for the past 30 years Anne has battled to find an effective treatment for her condition, which had also spread to her toes. And two years ago she discovered an unlikely solution — the impotence drug Viagra.
Like ten million Britons, Anne suffers from Raynaud’s syndrome, a disorder triggered by a sudden drop in temperature. The blood vessels in the fingers and toes contract, cutting off blood supply. It can also affect the tiny arteries in the nose, ears and tongue.
Typically, Raynaud’s causes the fingers or toes to turn white and numb. Then, as the blood flow returns, they turn blue and eventually red, accompanied by a burning sensation. Attacks can last from a few minutes to an hour.
Nine out of ten cases are in women, with most sufferers having their first attack before the age of 40. Although attacks peak in the cold winter months, symptoms can be triggered by everyday tasks such as taking food out of the freezer, air conditioning, or even stress — all of which cause blood vessels to contract.
There are two types of Raynaud’s. Primary Raynaud’s, which tends to run in families, is generally quite mild. Most patients can cope by wrapping up warm, although some develop painful weeping ulcers, which can become infected.
Secondary Raynaud’s is far more serious and painful, but about ten times less common. Indeed, it’s only in the past 20 years that doctors have discovered there is a difference between the two.
The secondary form of Raynaud’s, which Anne has, is usually caused by an auto-immune disease such as scleroderma, which causes a hardening of the skin, muscle and internal organs.Here, Raynaud’s is a symptom of the underlying disease. The secondary form is worse, as circulation is less likely to return to normal completely between attacks, so patients can be left in permanent pain.
When Anne appeared on a TV programme to highlight Raynaud’s and received more than 400 letters from people desperate for information, she set up the Raynaud’s & Scleroderma Association, which raises money for research and offers advice to patients.
Meanwhile her own condition worsened. She developed difficulties swallowing and had to have her oesophagus dilated to be able to do so properly.
Two years ago Anne was invited to take part in a trial at the Royal Free Hospital, led by Professor Denton, using the erectile dysfunction drug sildenafil — more commonly known as Viagra.
Viagra helps by increasing blood supply to the body’s extremities. ‘I had to smile when I was offered Viagra, but by that stage I was so desperate I would have tried anything,’ says Anne.
She took the tablets three times a day and immediately noticed improvements in her symptoms. ‘Although the numbness and pain in my fingers didn’t disappear completely, it was a lot less severe, and I can now use my hands more for things like typing,’ she says.
‘Luckily, I haven’t suffered any side-effects you can sometimes get with Viagra, such as dizziness or headaches — and I haven’t noticed any effect on my sex life either!’
The trial compared Viagra with a placebo and results show a benefit, explains Professor Denton. He presented the results at a scientific meeting, and a full paper will soon be published. ‘This is an off-label use of Viagra — meaning the drug is not licensed for this purpose,’ he adds. ‘Viagra would be reserved for treating patients with the most severe types of Raynaud’s and/or scleroderma who had already tried more conventional treatments — we’re not advocating it for everyone.’
7 March, 2011
Happiness 'helps you live longer', review of 160 studies concludes
This is of course largely epidemiological but the confluence of many lines of evidence does indicate a probably correct conclusion
People who are happy and positive about life live longer, scientists have concluded after reviewing dozens of studies about longevity. Researchers found "clear and compelling evidence" that happiness paves the way to better health and longer lifespans.
The review of more than 160 studies found the evidence connecting an upbeat outlook to a healthier life was even stronger than that linking obesity to reduced longevity. [That's not saying much!] It backed previous studies that found a “glass half full” approach was good for your health.
Scientists from the University of Illinois found positive moods reduced stress-related hormones and increased immune function. Their study, published in the journal Applied Psychology: Health and Wellbeing, found happiness lead to quicker recovery from exercise. It also concluded that anxiety, depression, and pessimism were linked to higher rates of disease and a shorter lifespan.
People who felt intense anger or lived in stressful environments were more likely to be sick more often and died earlier. “I was almost shocked, and certainly surprised, to see the consistency of the data,” said Prof Ed Diener, who lead the study.
“The general conclusion from each type of study is that your subjective wellbeing, that is, feeling positive about your life, not stressed out, not depressed, contributes to both longevity and better health among healthy populations. “(The) overwhelming majority ... support the conclusion that happiness is associated with health and longevity."
Prof Diener noted that while current health edicts focus on obesity, smoking, eating habits and exercise "it may be time to add 'be happy and avoid chronic anger and depression' to the list."
"Happiness is no magic bullet, but the evidence is clear and compelling that it changes your odds of getting disease or dying young.”
The review looked at eight different types of long-term studies and experimental trials involving both human and animal subjects.
For example, 5,000 university students studied for more than 40 years provided evidence that the most pessimistic students tended to die younger.
In another study, based on 180 catholic nuns, researchers found those who wrote positive autobiographies in their early 20s tended to outlive those who wrote more negative accounts of their young lives.
Animals who lived in stressful conditions, such as crowded cages, had weaker immune systems and a higher susceptibility to heart disease. They also died at a younger age than those in less crowded conditions.
Found at last, the rogue genes behind heart disease
Genes? What's this about genes? I thought it was junk food that killed you off! Silly me. Can I eat my big Macs openly now?
Heart disease is linked to just a few rogue genes as well as lifestyle choices, landmark research into Britain’s biggest killer has found. The 18 genes that raise the risk of cardiac problems, from heart attacks to hardening of the arteries, have been pinpointed in three studies involving hundreds of scientists worldwide.
The breakthrough opens the door to ways of treating and even preventing heart disease, which is to blame for one in eight deaths around the world – including more than 90,000 a year in the UK. Heart attacks alone kill one Briton every six minutes and cost the economy £9billion a year. The potential of the findings is so great that heart disease could be eradicated within 50 years, say researchers.
The discovery, detailed in the journal Nature Genetics, more than doubles the number of known heart disease genes.
Some of the newly discovered genes affect cholesterol, blood pressure and other processes important to heart health – but how many of the others damage the heart and arteries is, as yet, a mystery. This has excited the scientists because it suggests there are important causes of heart disease yet to be found – and that drugs to combat the effects of the genes could one day make a huge improvement to health.
Dr Robert Roberts, of the University of Ottawa Heart Institute, Canada, said: ‘This is a landmark result because we have identified so many genes and most operate using completely unknown mechanisms to us right now. Now our job is to understand how these genes work, develop a new group of drugs to target them and identify people who will benefit most.’
Professor Nilesh Samani, of the University of Leicester, who co-led the largest of the studies, said: ‘Understanding how these genes work, which is the next step, will vastly improve our knowledge of how the disease develops, and could lead to new treatments.’
The 18 genes were discovered in three studies in which almost 300 scientists from around the world, including many Britons, analysed the DNA of more than 200,000 people.
They focused on genetic links to the narrowing of the arteries that supply the heart muscle with oxygen-rich blood. This narrowing, caused by the build up of fatty deposits or plaques, raises the odds of a host of ills, from blood clots to angina, heart attacks, heart failure and irregular heartbeats.
Dr Thomas Quertermous, of Stanford University, in the U.S., said that drugs tailored to stop the blood vessels from becoming clogged up could ‘profoundly reduce the risk of a heart attack’.
Professor Hugh Watkins, of Oxford University, who co-led one of the studies, said the first new drugs could be on the market in under a decade.
Some of the North American researchers said the breakthrough meant we were ‘inching closer’ to a genetic test that will tell a person their risk of a heart attack. However, for most people, other factors such as smoking, poor diet and a lack of exercise can play a much greater role in causing heart attacks.
6 March, 2011
Millions of surgery patients at risk in drug research fraud scandal
I wish I could believe that this is an isolated incident. But the fact is that he was only caught because he was a very lazy fraud
Professor Dr. med. Joachim Boldt above
Joachim Boldt is at the centre of a criminal investigation amid allegations that he may have forged up to 90 crucial studies on the treatment. He has been stripped of his professorship and sacked from a German hospital following allegations about his research into drugs known as colloids.
Experts described Mr Boldt's alleged forgeries as possibly the biggest medical research scandal since Andrew Wakefield was struck off last year for falsely claiming to have proved a link between the MMR vaccine and autism.
Guidelines for British anaesthetists regarding colloids – used to boost blood volume in patients undergoing surgery – are being revised after it emerged that four of the key studies on which they were based are to be formally retracted.
Mr Boldt, 57, was regarded as a leading specialist in intravenous fluid management, and his work was published widely in British medical journals.
He claimed to have proved that colloids were as safe as other, similar treatments despite earlier studies showing them to be more dangerous. Mr Boldt's alleged forgeries date back up to a decade.
The Consensus Guidelines on Intravenous Fluid Therapy, published by six British medical groups including the Association of Surgeons and the Intensive Care Society, were being withdrawn last night. Prof John MacFie, president of the Association of Surgeons, suggested that some British patients could have been put in danger. He said he would urge other medics to abandon colloids.
"We have withdrawn the guidelines from our website and we will need to rewrite the article," he added. "The profession I represent does not want to be to be associated with potentially fraudulent research.
"Some people are comparing this to the Andrew Wakefield scandal. What Wakefield did had terrible implications on children's lives, and the principle of this is the same." As chief anaesthetist at Ludwigshafen Hospital in the Rhineland, Mr Boldt was the leading advocate of colloids, which are now commonly used across Europe.
He published dozens of papers "proving" their benefits and contradicting studies which suggested they could increase the risk of death in surgery and cause kidney failure, severe blood loss and heart failure.
German medical authorities are scrutinising 92 of his key publications and a criminal investigation is under way into allegations that he forged documents, tested drugs on patients without their consent and fraudulently claimed payments for operations he had never performed.
Mr Boldt received funding from manufacturers of hydroxyethyl starch (HES) – the colloid he most strongly advocated – including B. Braun, Baxter and Fresenius Kabi.
He was frequently paid to speak at international medical conferences where he hailed HES as "the holy grail" of fluid drugs.
HES and other colloids are up to 10 times more expensive than the alternative fluid management drugs, crystalloids, which some experts believe are safer as they contain smaller molecules and are more easily absorbed. Mr Boldt was sacked from Ludwigshafen Hospital last November. It has established an investigating commission to review 29 of the 92 papers which have been identified as "highly suspected" of containing forged or distorted data. The others will be examined if serious evidence of forgery is found.
Prof Eike Martin, head of the investigating commission, told The Telegraph: "At first we thought that all the studies were 100 per cent invented, but now we have found a huge amount of clinical data from trials that were conducted.
"Our suspicion is that the trials are not reported accurately in the papers. Prof Boldt was an advocate for colloids and that was the conclusion of his studies, but the data he published is different from the original data we have seen.”
Prof Martin said investigators examining one study, which purported to show that HES caused less inflammation than another fluid management drug, had found that the original data contradicted the conclusion.
The editors in chief of a consortium of medical journals which published Mr Boldt’s work are also reviewing the 92 publications.
Sources close to the investigation said that the editors would announce the formal retraction of 89 papers next month.
Rhineland state prosecutors are investigating Mr Boldt over allegations that he forged the signatures of his alleged “co-authors” on his studies, conducted drugs trials without official approval and claimed money for operations that he never performed. Police raided his home and his offices at the hospital in December and seized paperwork and computers.
Lothar Liebig, the state’s director of public prosecutions, said: “Boldt
published certain studies about medical drugs in order to get them accepted.
“There there is a strong suspicion that he deliberately failed to obtain the approval of the institutional review board in Ludwigshafen, which is a criminal offence.”
Other medical research has contradicted Mr Boldt’s findings.
Research by Dr Gill Schierhout and Dr Ian Roberts of University College London found in 1998 that the use of colloids during surgery increased the risk of death by four percentage points – equivalent to four extra deaths in every 100 patients.
A review published 10 years later by Konrad Reinhart and Christiane Hartog of Friedrich Schiller University in Jena, Germany cited two large-scale clinical trials which found that HES could prevent the blood from clotting, which can cause heavy bleeding. Other studies have shown that some colloids can result in complications including heart and kidney failure, fluid entering the lungs and anaphylactic shock.
Suspicion first fell on Mr Boldt in October when readers of an article that he had published in the US journal Anesthesia and Analgesia, about the benefits of HES in bypass surgery, noticed that the pattern shown by his data was “too perfect to be believed”.
Dr Rupert Pearse, a senior lecturer in intensive care medicine at Barts and the London School of Medicine, and co-author of the British guidelines on fluid drugs, said last night: “I specifically remember looking at a paper of his last year and being surprised at how lucky he had been with his results.
“For me, it shakes the world I work in and makes me feel less confident in it, and if I were a member of the public I would feel the same.”
'May cause drowsiness' too confusing for modern medicine labels
Warning labels on medicines should be simplified because words such as "drowsiness" and "avoid" are too confusing for modern patients, experts claim.
Research by the British National Formulary (BNF), which advises doctors, nurses and pharmacists, found labelling that has been around for decades is now too difficult for members of the public to understand.
It found phrases such as "may cause drowsiness" are no longer "readily understood" and should now be simplified to say "this medicine may make you sleepy".
Likewise, the phrases "avoid alcoholic drink" and "take at regular intervals" caused indecision among modern takers.
The report recommends the labels should now read "do not drink alcohol while taking this medicine" and "space the doses evenly throughout the day".
The research was carried out by Professor Theo Raynor, and colleagues at the University of Leeds. He said: "Most medicines do contain leaflets which provide detailed information for patients.
"However the leaflet may get lost, which means that the label on the medicine plays a very important part in guiding people's behaviour. "It is vital therefore that wordings on labels are simple and straightforward."
Prof Raynor's team tested a selection of instructions on almost 200 people aged 20 to 80.
The experts reworded phrases that people found confusing, and then retested them in several sittings, including one-to-one interviews.
Prof Raynor said "avoid alcoholic drinks" was a good example. "Our user tests have shown that the word "avoid" can cause confusion and that some people think it only means they should limit their alcohol intake. "This phrase will now be replaced by the instruction: 'do not drink alcohol while taking this medicine', which is far clearer."
Other recommendations include changing "do not take indigestion remedies at the same time of day as this medicine" to "do not take indigestion remedies two hours before or after you take this medicine".
Another phrase, "do not stop taking this medicine except on your doctor's advice", becomes "warning: Do not stop taking this medicine unless your doctor tells you to stop."
The revised phrases are included in a new, updated version of the BNF.
"The software used by large pharmacy chains and independent pharmacist to print instruction labels is updated regularly, so we would expect to see these new phrases appear within the next six months," Prof Raynor said.
Professor Nick Barber, a pharmacologist at London University, said: "When serious errors occur which cause harm to patients, it is often as a result of a series of minor failures at various stages.
"Therefore in taking more care about the wording of detailed instructions we can help improve the safety of medicines.
"With two million prescriptions being issued every day, a small percentage improvement through labels being more understandable could make a significant impact".
Duncan Enright, publishing director at BNF publications, said: "It has never been easier to change labels on medicines given current computerised systems and therefore we hope that the large pharmacy chains and independent pharmacies will adopt these recommendations."
The words "drowsiness" and "drowsy" are thought to date back to 1520 probably from the word drusan or drusian "to sink," also "become languid, slow, or inactive" which are related to dreosan "to fall".
5 March, 2011
Being fat rots your brain?
A remarkable insult to the large numbers of overweight people. Fortunately it is just epidemiological speculation. Let me offer an alternative explanation: Lower class people are more likely to be fat and lower class people are generally less healthy. So all we are seeing is another effect of social class, not an effect of obesity as such
MORE than 1000 Australians every week are diagnosed with dementia and for many the cause is not merely genetic bad luck but a result of being overweight in middle age.
A new analysis of long-term studies of the relationship between dementia and bodyweight has found that people who have been overweight or obese have two to three times the risk of suffering dementia in old age a few years later.
The Australian National University's Centre for Mental Health Research reached that conclusion after assessing the results of reputable studies from around the world involving a total of more than 25,000 people. Kaarin Anstey, a professor at the centre, said the risk of dementia for those aged over 60 rises with bodyweight in earlier middle life, between the ages of 40 and 60.
"This evidence suggests that, while the hormones present in body fat were previously believed to protect cognitive function, it now appears that excess fat in middle age may be extremely harmful over the long term," Professor Anstey said.
The analysis also found that there was a higher risk of dementia in old age among those who had been extremely underweight in middle age, but Professor Anstey said it was likely different processes were involved in triggering that phenomenon.
"Practitioners and policy-makers should be concerned, not just with the short-term effects obesity has on quality of life, but also about the long-term effects that obesity can have on the ageing process."
Professor Anstey said given the results covered people who were much less likely to have been overweight in their youth than today, the results were a warning bell for the future.
The findings underline the need for policy makers to treat dementia not just as a condition of old age but as a chronic disease which can be countered with improved healthcare and education, Glenn Rees, the chief executive of Alzheimer's Australia, said.
Mr Rees said health policies needed to promote the message that a healthy lifestyle not only reduced the risk of obesity, diabetes, heart disease and cancer but also improved brain health.
There also remained difficulties in even ensuring the timely diagnosis of dementia, with sufferers in some cases taking up to three years to be diagnosed, raising the risk of falls and hospitalisation.
FDA pulls 500 cold medicines from the market
Such a broad recall smacks of bureaucratic pettiness. Only drugs with a known problem should be recalled. The Pan Pharmaceutical recall in Australia was similarly broad and ended up costing the taxpayer a lot of money when the businesses affected sued
The FDA today announced steps to remove more than 500 prescription cold, cough, and allergy products from the market because of potential safety concerns.
The FDA asked companies to stop manufacturing the 500 products within 90 days and stop shipping them within 180 days. Some manufacturers must stop making and shipping their products immediately, the FDA warns.
There are no data on how often these now-banned medications are prescribed today, but many doctors may be unaware that they contain unapproved ingredients because these drugs are listed in the Physicians’ Desk Reference and may be advertised in medical journals.
Questions on Drug Safety
The FDA does not know if these prescription drugs are safe or not largely because they were grandfathered in before changes to the FDA’s drug approval process were enacted.
“We don't know what they are, whether they work properly, or how they are made,” said Deborah M. Autor, director of the FDA’s Office of Compliance at the Center for Drug Evaluation and Research (CDER) in Silver Spring, Md., during a teleconference. “The problem is that we don’t know what the problem is.”
For example, some of these cough, cold, and allergy drugs are labeled as “time-release.” These are complicated to manufacture, and the FDA has not reviewed whether the active ingredient is released in a consistent matter over a period of time, she says. “They may be released too slowly, too quickly, or not at all.”
Kids Under Age 2
Others contain an “irrational” combination of the same types of products, such as two or more antihistamines, and some are inappropriately labeled for use by infants and young children, she says. Many contain the same ingredients as the over-the-counter cough and cold products that are no longer supposed to be used in kids under 2.
Yolandra Hancock, MD, a pediatrician at Children's National Medical Center in Washington, D.C., praises the FDA’s move.
“The new FDA decision supports modern-day pediatric practice to avoid cough syrups in children under 2 because they do more harm than good,” she says. Some may slow down breathing, and others decrease cough and allow mucus to sit in the chest, where it can cause other problems such as lung infection, she says.
“I fully support the FDA’s move in controlling access to these medications in children; it is highly appropriate and long overdue,” she says.
As to the risks these drugs pose, “for the most part, [these adverse reactions] are not serious,” says Charles E. Lee, MD, medical officer of the division of new drugs and labeling compliance at the CDER.
After the FDA crackdown on the use of over-the-counter cough and cold medicine in children younger than 2, the number of emergency room visits for adverse events decreased by 50%, he says. “We also know that 15% of these events came from prescription cough, cold, and allergy products and included sedation/drowsiness and irritability,” Lee says.
When asked whether the use of these prescription medicines has increased since the over-the-counter restrictions, Michael Levy, director of the division of new drugs and labeling compliance at the CDER, says, “I don’t think we can say we have seen an uptick, but certainly we were concerned that the same types of ingredients were still being used in unapproved prescription products.”
“These are well-recognized drugs that have been used for decades and there is no reason to suspect that there is a risk involved,” says Harold Nelson, MD, an allergist at National Jewish Health in Denver. “If there were risks such as hypertension or stroke with oral decongestants, it would be more appropriately addressed by eliminating the ingredient from all products whether those that are grandfathered in, available OTC, or FDA-approved.”
These drugs haven’t cleared certain safety hurdles yet, but that doesn’t mean they are unsafe, he says. A full list of the drugs involved in the new FDA action can be found on the FDA web site.
4 March, 2011
Study: Alzheimer’s risk factor tied to mothers
This is a very small sample and known not to be random. May be of some use for hypothesis formation but not otherwise
Besides age, the biggest risk factor for developing Alzheimer's disease is having a parent or other first-degree relative with the condition. A new study adds to evidence that inheriting it from your mother is much worse than inheriting it from your father.
Researchers at the University of Kansas School of Medicine recruited 21 adult children (ages 63 to 83) of Alzheimer's patients who were still "cognitively intact." They examined their brains using an MRI scanner on two occasions, two years apart. Then, they compared those brain scans with those of 32 other healthy adults in the same age group with no family history of Alzheimer's. Members of both groups had similar levels of education and cognitive performance.
Though none of the subjects exhibited any outward signs of dementia, the brain scans revealed that the 11 people whose mothers had Alzheimer's had lost significantly more gray matter over the two-year period than the 10 people whose fathers had the disease and compared with the 32 people with two healthy parents. That cell loss was especially pronounced in two areas of the brain: the left precuneus (which plays a role in episodic memory, among other functions) and the left parahippocampas gyrus (which is involved in encoding and retrieving memories).
Other regions that took a hit were "the anterior cingulate, the bilateral middle-temporal gyrus, the right hippocampus, right precuneus and posterior cingulate," according to a study in today's edition of the journal Neurology.
Apples found to prevent age-related deterioration -- in fruitflies
The anti-oxidant religion again
An apple a day could keep the undertaker away. Scientists have linked the fruit with a longer life – at least in flies. Fruit flies, which share many genes with humans despite their tiny size, were either fed normally or had an apple extract added.
Those fed normally lived an average of 50 days – five days fewer than those whose food was supplemented with apple, the Journal of Agricultural and Food Chemistry reports.
Not only did the flies given the apple extract live ten per cent longer, they also found it easier to walk, climb and move about as they aged. The apple extract also cut levels of various biochemicals found in older fruit flies and linked to age-related deterioration.
The researchers, from the Chinese University of Hong Kong, believe that the antioxidants in the extract mopped up free radicals – dangerous chemicals blamed for a host of ills, including ageing.
A spokesman for the American Chemical Society said: ‘The results, obtained with fruit flies – stand-ins for humans in hundreds of research projects each year – bolster similar findings on apple antioxidants in other animal tests.’
In another study, researchers who quizzed thousands of women about their diets found that those who regularly ate apples were 20 per cent less likely to suffer heart attacks and strokes.
The apple’s genetic code has recently been cracked, paving the way for crunchier, juicier and healthier fruits.
Researchers are already using the information to grow red-fleshed apples bursting with antioxidants credited with keeping eyes and joints healthy and warding off heart disease, cancer, Alzheimer’s disease and diabetes.
Apples that suppress appetite could also be in the pipeline, with the first ‘extra-healthy’ apples on supermarket shelves within just four to five years.
The decoding of the apple’s DNA by a team of almost 100 scientists from five countries has also shed new light on its roots. The research suggests that around 65million years ago, the time when a comet is thought to have wiped out the dinosaurs, the plant that would eventually give rise to the apple tree underwent a massive and rapid genetic change, in which many of its genes were duplicated.
The extra genes allowed the apple to adapt to tougher conditions and sent it along a different evolutionary path from peaches, strawberries and other related fruit.
3 March, 2011
The FDA kills
Europeans have long extolled centralized planning and tolerated large government bureaucracies. But when it comes to approving medical devices, Europe has taken a decidedly decentralized approach — to the great benefit of patients and health care workers. It is an example the United States would do well to follow.
Consider the field of cardiology. A national medical conference, such as the American Heart Association Scientific Sessions, gives you a glimpse into the future. For many American physicians attending these conferences, the future of innovative new therapies in the U.S. is actually the present — as currently practiced by their European counterparts.
Owing to onerous regulations from the U.S. Food and Drug Administration, American doctors sometimes wait years to offer innovative devices and treatments that are often the standard overseas. Nowhere is this delay in new device deployment more evident than in cardiology.
Patients with severely diseased heart valves may have a maximum of one to two years of life expectancy upon diagnosis. There was once a time when state-of-the-art medical care in the U.S. drew these patients here from around the world. Now, increasingly web-wise American patients, aware of the latest medical breakthroughs, travel overseas to receive some of the best treatments.
One example: Transcatheter aortic valve implantation, or TAVI, is a catheter-based option for treating diseased heart valves without carrying the risks associated with open surgery. This novel approach for treating high-risk patients with valvular heart disease has been approved for use in Europe since 2007. Over the past year, long-term data emerging from European cardiology practices demonstrating the advantages of TAVI have sparked significant interest in the American cardiology community.
TAVI is anticipated to clear FDA hurdles by 2012. That's a five-year delay for the U.S., compared with European authorities.
But TAVI is not an isolated case. A study conducted by John Makower, consulting associate professor at Stanford's Biodesign Innovation program, demonstrated that the FDA delays approval by two years, on average, for low-to-medium-risk medical devices, compared with Europe; approval of high-risk devices in the U.S. took 31/2 years longer than in Europe.
Perhaps in response, the FDA finally announced this month its openness to considering reforms to the review process for innovative medical devices. The current premarket review process for new medical devices has been fraught with uncertainty, often requiring companies to produce further unanticipated testing and data for proven products. Regulations force device manufacturers to replicate time- and cost-consuming studies in the U.S., despite the existence of reputable equivalent scientific data gathered overseas.
In contrast to the FDA, the European Medical Devices Directive allows privatized, notified bodies to test device safety to provide the stamp of European market approval.
Last week, the House Energy and Commerce Committee's Subcommittee on Health held a hearing on medical device regulations. In his testimony, Mark Deem of San Francisco Bay area medical device incubator The Foundry blamed the unpredictability of FDA regulatory delays for driving U.S. business to Europe.
"We develop our products here and then run the same large, multicenter randomized trials we would otherwise have conducted in the U.S. overseas," he said. "We are then staying [in Europe] to commercialize the products while we decide when and if to approach the FDA."
Much of the bureaucracy inherent in the FDA approval process has been driven by calls for increased patient safety. However, despite the speed of the privatized European device approval process, there have been no sacrifices in patient safety. A report by the Boston Consulting Group released earlier this year found that the medical device recall rate was similar in the U.S. and Europe.
This is no small issue in an economy still groping to recover from recession. The U.S. is not only at risk of losing its leadership role when it comes to medical innovation but also the jobs associated with the industry.
During the House subcommittee hearing, Mr. Makower highlighted an example from his study of a U.S. firm moving its primary operations to Europe: "The company planned to shut down its U.S. production facility and move another 30 to 40 manufacturing jobs to Europe," he said. "In this particular example, all future growth was also planned overseas. Keeping in mind that every medtech job is indirectly responsible for another 4.47 jobs in the national economy, the effect on U.S. employment could be sizable."
With device approval delays costing companies more than $500,000 per month, on average, according to Mr. Makower's study, the transfer of business away from the U.S. is driven by the basic instinct for a company to survive.
Five-year delays before visualizing profits may hurt a company's bottom line. However, the consequences of a long delay for a patient who does not have the same luxury of time may be far more grim.
Ibuprofen could cut Parkinson's risk - study
The conclusions seem reasonable, though the effect is slight
ADULTS who take the anti-inflammatory drug ibuprofen may reduce their risk of getting Parkinson's disease by about 27 per cent compared to those who do not, said a study published today.
"There is no cure for Parkinson's disease, so the possibility that ibuprofen, an existing and relatively non-toxic drug, could help protect against the disease is captivating," said senior author Alberto Ascherio of the Harvard School of Public Health.
Parkinson's is a neurological disease that attacks the central nervous system and causes tremors and motor difficulty, mainly in people over 50, though it can strike younger people. US-Canadian actor Michael J Fox was diagnosed with Parkinson's when he was 30.
Scientists found an even greater effect when they compared ibuprofen - commonly found in the over the counter pain relievers Advil, Motrin and Nuprin - to aspirin, acetaminophen and other non-steroidal anti-inflammatory drugs (NSAIDs). "We observed that men and women who used ibuprofen two or more times per week were about 38 percent less likely to develop Parkinson's disease than those who regularly used aspirin, acetaminophen, or other NSAIDs," said lead author Xiang Gao, also of Harvard.
"Our findings suggest that ibuprofen could be a potential neuroprotective agent against Parkinson's disease, however, the exact mechanism is unknown."
The study appears in the journal Neurology.
2 March, 2011
Cannabis 'doubles risk of psychotic episodes'
This finding seems sound
Using cannabis in one's youth almost doubles the risk of having psychotic episodes like paranoia and hallucinations, a study has found. A team of international researchers followed the lives of almost 2,000 young Germans, who began with no history of psychosis, for more than a decade.
They discovered that youngsters who started smoking the drug at college age were 90 per cent more likely to have psychotic symptoms in their mid-20s.
In the study, cannabis users were defined as those who had used the drug at least five times between 18 and 21. Rates of psychotic episodes between users and non-users at the age of 26 were then compared. Other factors known to affect likelihood of psychosis, such as childhood trauma, class, and growing up in an urban environment, were accounted for.
The authors, led by Rebecca Kuepper, a research psychologist at Maastricht University in The Netherlands, concluded: "This 10 year follow-up study showed that incident cannabis use significantly increased the risk of incident psychotic experiences."
The scientists believe that exposure to THC, the main psychoactive component in cannabis, makes the brain more susceptible to psychotic episodes.
The study also found that a rise in psychotic episodes followed cannabis use, rather than the other way around, disproving the theory that the relationship between the two was nothing more than people prone to psychosis self-medicating.
Cannabis was downgraded from a class B to a class C drug in 2004. Critics said that gave young people the impression it had been decriminalised. The decision was reversed in 2009.
Sir Robin Murray, professor of psychiatric research at Kings College London, said: "This study adds a further brick to the wall of evidence showing that use of traditional cannabis is a contributory cause of psychoses like schizophrenia."
But he said it did not "address the important question of whether skunk and other potent types of cannabis carry a higher risk of psychosis than traditional resin and marijuana".
Peter Kinderman, professor of clinical psychology at Liverpool University, said the study "offers more evidence that cannabis use is a risk factor for psychosis and recommends a cautious and thoughtful approach to cannabis legislation".
Siesta can protect against high blood pressure
This is a very limited study much in need of replication if its conclusions are to be accepted as generally true. The sampling (or non-sampling) is ludicrous for a start. Findings from available groups of students often do not generalize
Having an afternoon nap can help protect against heart disease, a study has suggested.
Researchers say that having a 45 minute catnap helps lower a person's blood pressure more quickly after a stressful event.
And with the average night's sleep now two hours shorter than it was 50 years ago, researchers claim having a siesta provides a simple way of improving cardiovascular health.
Researchers from Allegheny College in Pennsylvania, USA, conducted an experiment which saw 85 healthy students split into two groups.
One group was allotted 60 minutes each day during which they could sleep, the other did not sleep during the day. Participants in the experiment, the findings of which are published in Springer's International Journal of Behavioural Medicine, were then asked to complete a complex mental subtraction sum designed to raise blood pressure.
Students who napped for between 45-60 minutes were found to have significantly lower blood pressure rates during the post-activity recovery phase than those who had not slept. A questionnaire given to participants also saw those who had a siesta reporting much less sleepiness than those who hadn't.
Study authors Ryan Brindle and Sarah Conklin PhD, said the experiment proved the "recuperative and protective" benefits of a daytime snooze. They said: "Our findings suggest that daytime sleep may offer cardiovascular benefit by accelerating cardiovascular recovery following mental stressors.
"Further research is needed to explore the mechanism by which daytime sleep is linked with cardiovascular health and to evaluate daytime sleep as a recuperative and protective practice, especially for individuals with known cardiovascular disease risk and those with suboptimal sleep quality."
1 March, 2011
Breast cancer is generally rather slow developing so the drop in cancer incidence in 2002-2003 (when an alarmist report came out) cannot reasonably be attributed to women going off HRT. If HRT were a real risk factor, however, the reduction in HRT usage should have led to reduced cancer incidence in subsequent years. It did not
Once-dropping U.S. breast cancer rates now stable
After a large drop in U.S. breast cancer rates among non-Hispanic white women between 2002 and 2003, those rates did not continue to decline between 2003 and 2007. Those are the findings of a new study from the American Cancer Society and the National Cancer Institute that appears online in the publication Cancer Epidemiology Biomarkers and Prevention.
In July 2002 results were published from the Women’s Health Initiative, a long-term national study, finding that postmenopausal women who used combined hormone therapy – estrogen plus progestin - had negative health effects including higher risk for breast cancer, heart disease, stroke, blood clots, and urinary incontinence.
The findings of the study results caused a “dramatic drop” in the use of postmenopausal hormone therapy and “breast cancer incidence rates among U.S. white women remarkably decreased by about 7% between 2002 and 2003,” according to the study. But no studies examined what happened to breast cancer rates in the United States after 2003.
Researchers studied data on female breast cancer incidence from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) 12 registries for the years 2000 to 2007. The data showed Breast cancer rates in non-Hispanic white women dropped between 2002 and 2003 but that drop didn’t continue between 2003 and 2007. There was no significant change in the rate among non-Hispanic white women. For non-Hispanic Black and Hispanic women, the data did not show the same drop from 2002-2003, and the study found no significant changes in breast cancer rates among those groups from 2003 to 2007.
The authors offer several possible reasons for the stabilization in breast cancer rates among non-Hispanic white women after 2003. Menopausal hormones are believed to encourage growth of hormone-sensitive tumors, and while the report shows that postmenopausal hormone therapy use has dropped, although the report indicates that postmenopausal hormone therapy use has continued to decline through 2008, the decrease in hormone therapy use after 2003 may not have been large enough to continue delaying diagnoses. A second factor, according to the study, may reflect the increased sensitivity of mammograms without the use of hormone therapy. Hormone therapy is known to increase breast density; the number of mammograms compromised by breast density would most likely decrease with the decrease in hormone therapy. The report also suggests that stable breast cancer rates may “in part reflect the relatively stable rates of screening mammography in the U.S. since 2000.”
Vitamin and mineral supplements could make you're child smarter
This most likely proves that middle class women are more likely to take supplements
Pregnant women who take iron and folic acid supplements may increase the intelligence of their children later on in life, according to a recent study published in the Journal Of The American Medical Association.
Children whose mothers took these supplements during pregnancy had higher intellectual levels and fine motor ability during school-age years, as well as better organisational skills.
Both iron and folic acid play important roles in a child’s growth and development, especially early nervous system development.
Iron-rich foods that are beneficial for pregnant women include lean red meat, fish, chicken, legumes and green leafy vegetables.
Folate is the B vitamin vital to the baby’s nerve development. Green leafy vegetables are a good source.
SITE MOTTO: "Epidemiology is mostly bunk"
Where it is not bunk is when it shows that some treatment or influence has no effect on lifespan or disease incidence. It is as convincing as disproof as it is unconvincing as proof. Think about it. As Einstein said: No amount of experimentation can ever prove me right; a single experiment can prove me wrong.
Epidemiological studies are useful for hypothesis-generating or for hypothesis-testing of theories already examined in experimental work but they do not enable causative inferences by themselves
The standard of reasoning that one commonly finds in epidemiological journal articles is akin to the following false syllogism:
Chairs have legs
You have legs
So therefore you are a chair
SALT -- SALT -- SALT
1). A good example of an epidemiological disproof concerns the dreaded salt (NaCl). We are constantly told that we eat too much salt for good health and must cut back our consumption of it. Yet there is one nation that consumes huge amounts of salt. So do they all die young there? Quite the reverse: Japan has the world's highest concentration of centenarians. Taste Japan's favourite sauce -- soy sauce -- if you want to understand Japanese salt consumption. It's almost solid salt.
2). We need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. So the conventional wisdom is not only wrong. It is positively harmful
3). Table salt is a major source of iodine, which is why salt is normally "iodized" by official decree. Cutting back salt consumption runs the risk of iodine deficiency, with its huge adverse health impacts -- goiter, mental retardation etc. GIVE YOUR BABY PLENTY OF SALTY FOODS -- unless you want to turn it into a cretin
THE SIDE-EFFECT MANIA. If a drug is shown to have troublesome side-effects, there are always calls for it to be banned or not authorized for use in the first place. But that is insane. ALL drugs have side effects. Even aspirin causes stomach bleeding, for instance -- and paracetamol (acetaminophen) can wreck your liver. If a drug has no side effects, it will have no main effects either. If you want a side-effect-free drug, take a homeopathic remedy. They're just water.
Although I am an atheist, I have never wavered from my view that the New Testament is the best guide to living and I still enjoy reading it. Here is what the apostle Paul says about vegetarians: "For one believeth that he may eat all things: another, who is weak, eateth herbs. Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth." (Romans 14: 2.3). What perfect advice! That is real tolerance: Very different from the dogmatism of the food freaks. Interesting that vegetarianism is such an old compulsion, though.
Even if we concede that getting fat shortens your life, what right has anybody got to question someone's decision to accept that tradeoff for themselves? Such a decision could be just one version of the old idea that it is best to have a short life but a merry one. Even the Bible is supportive of that thinking. See Ecclesiastes 8:15 and Isaiah 22: 13. To deny the right to make such a personal decision is plainly Fascistic.
Fatties actually SAVE the taxpayer money
IQ: Political correctness makes IQ generally unmentionable so it is rarely controlled for in epidemiological studies. This is extremely regrettable as it tends to vitiate findings that do not control for it. When it is examined, it is routinely found to have pervasive effects. We read, for instance, that "The mother's IQ was more highly predictive of breastfeeding status than were her race, education, age, poverty status, smoking, the home environment, or the child's birth weight or birth order". So political correctness can render otherwise interesting findings moot
That hallowed fish oil is strongly linked to increased incidence of colon cancer
"To kill an error is as good a service as, and sometimes better than, the establishing of a new truth or fact" -- Charles Darwin
"Most men die of their remedies, not of their diseases", said Moliere. That may no longer be true but there is still a lot of false medical "wisdom" around that does harm to various degrees. And showing its falsity is rarely the problem. The problem is getting people -- medical researchers in particular -- to abandon their preconceptions
Bertrand Russell could have been talking about today's conventional dietary "wisdom" when he said: "The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd; indeed in view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.”
Eating lots of fruit and vegetables is NOT beneficial
"Obesity" is 77% genetic. So trying to make fatties slim is punishing them for the way they were born. That sort of thing is furiously condemned in relation to homosexuals so why is it OK for fatties?
Some more problems with the "Obesity" war:
1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).
2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.
3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.
4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.
5). Food warriors demonize dietary fat. But Eskimos living on their traditional diet eat huge amounts of fat with no apparent ill-effects. At any given age they in fact have an exceptionally LOW incidence of cardiovascular disease. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?
6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.
7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.
8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].
9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.
10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.
11). A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
12. Fascism: "What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!
Trans fats: For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.
The "antioxidant" religion: The experimental evidence is that antioxidants SHORTEN your life, if anything. Studies here and here and here and here and here and here and here, for instance. That they are of benefit is a great theory but it is one that has been coshed by reality plenty of times.
The medical consensus is often wrong. The best known wrongheaded medical orthodoxy is that stomach ulcers could not be caused by bacteria because the stomach is so acidic. Disproof of that view first appeared in 1875 (Yes. 1875) but the falsity of the view was not widely recognized until 1990. Only heroic efforts finally overturned the consensus and led to a cure for stomach ulcers. See here and here and here.
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
Huge ($400 million) clinical trial shows that a low fat diet is useless . See also here and here
Dieticians are just modern-day witch-doctors. There is no undergirding in double-blind studies for their usual recommendations
The fragility of current medical wisdom: Would you believe that even Old Testament wisdom can sometimes trump medical wisdom? Note this quote: "Spiess discussed Swedish research on cardiac patients that compared Jehovah's Witnesses who refused blood transfusions to patients with similar disease progression during open-heart surgery. The research found those who refused transfusions had noticeably better survival rates.
Relying on the popular wisdom can certainly hurt you personally: "The scientific consensus of a quarter-century ago turned into the arthritic nightmare of today."
Medical wisdom can in fact fly in the face of the known facts. How often do we hear reverent praise for the Mediterranean diet? Yet both Australians and Japanese live longer than Greeks and Italians, despite having very different diets. The traditional Australian diet is in fact about as opposite to the Mediterranean diet as you can get. The reverence for the Mediterranean diet can only be understood therefore as some sort of Anglo-Saxon cultural cringe. It is quite brainless. Why are not the Australian and Japanese diets extolled if health is the matter at issue?
Since many of my posts here make severe criticisms of medical research, I should perhaps point out that I am also a severe critic of much research in my own field of psychology. See here and here
This is NOT an "alternative medicine" site. Perhaps the only (weak) excuse for the poorly substantiated claims that often appear in the medical literature is the even poorer level of substantiation offered in the "alternative" literature.
I used to teach social statistics in a major Australian university and I find medical statistics pretty obfuscatory. They seem uniformly designed to make mountains out of molehills. Many times in the academic literature I have excoriated my colleagues in psychology and sociology for going ga-ga over very weak correlations but what I find in the medical literature makes the findings in the social sciences look positively muscular. In fact, medical findings are almost never reported as correlations -- because to do so would exhibit how laughably trivial they generally are. If (say) 3 individuals in a thousand in a control group had some sort of an adverse outcome versus 4 out of a thousand in a group undergoing some treatment, the difference will be published in the medical literature with great excitement and intimations of its importance. In fact, of course, such small differences are almost certainly random noise and are in any rational calculus unimportant. And statistical significance is little help in determining the importance of a finding. Statistical significance simply tells you that the result was unlikely to be an effect of small sample size. But a statistically significant difference could have been due to any number of other randomly-present factors.
Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology: below:"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.
The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could have been speaking of the prevailing health "wisdom" of today when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."
The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0." Very few of the studies criticized on this blog meet that criterion.
Improbable events do happen at random -- as mathematician John Brignell notes rather tartly:
"Consider, instead, my experiences in the village pub swindle. It is based on the weekly bonus ball in the National Lottery. It so happens that my birth date is 13, so that is the number I always choose. With a few occasional absences abroad I have paid my pound every week for a year and a half, but have never won. Some of my neighbours win frequently; one in three consecutive weeks. Furthermore, I always put in a pound for my wife for her birth date, which is 11. She has never won either. The probability of neither of these numbers coming up in that period is less than 5%, which for an epidemiologist is significant enough to publish a paper.
One of the great pleasures in life is the first mouthful of cold beer on a hot day -- and the food Puritans can stick that wherever they like