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
30 April, 2008
The packed-lunch police
How four British schools are waging war on home-produced forbidden food
Hmm, what's it to be? A lentil korma with brown rice and salad, then fruit and a yoghurt for afters, or a High School Musical bag stuffed with crisps and a couple of bars of chocolate? It sounds absurd but in some schools children sitting next to eat other could be eating such contrasting lunches.
While school dinners have come on nutritionally in leaps and bounds, and thanks to more money for ingredients and training for the dinner ladies, they taste a whole lot better too, there's nothing to stop pupils in many schools bringing in junk from home. A survey last year lifted the lid on lunchboxes to reveal the unappetising truth: what's inside them contains too much saturated fat and up to half the daily allowance of of salt. [Kids under 7 should have no more than 3g of salt a day.] Salads are scarce and only half the children brought in a portion of fruit and vegetables.
Children who aren't eating school dinners are losing out - that's about 60 per cent of primary school kids. And this is why, as part of the Government's attempt to tackle obesity, Alan Johnson, the Health Minister, has suggested that schools should check lunchbox contents.
The School Food Trust, the body set up by the Government to turn round school dinners, suggest drawing up a policy for packed lunches - a few basic rules to bring them in line with a healthier school environment - and make sticking to it part of a code that parents have to agree to. Others say it is impossible for schools to police what children bring in to eat. Margaret Morrissey, of the National Confederation of Parent Teacher Associations, says: "Many parents in this country will feel that it is their decision what they feed their children."
Joe Harvey, of the Health Education Trust, a charity involved in the Better School Food campaign, agrees. "You can't search kids for Kit Kats," he says. So what can schools do about it? "There has to be a process of education and consultation or they'll get the burgers-through-the-fence brigade. It should be part of a whole school food policy." He advises schools to build food rules into any contract the school makes with new parents; do everything possible to make sure children know what's going on in the school kitchen; and make the meal service as attractive as possible.
Britain: The free market beats the tyrants -- as ever
The tyrants call it a "black market" but it is their arrogance and ignorance that is black
Students are operating a black-market trade in food banned in schools, including burgers and chocolate, in a backlash against healthier canteen menus such as those espoused by the celebrity chef Jamie Oliver. Newly installed healthy menus in school canteens and the removal of junk food from vending machines have created a gap in the market that students have been quick to fill. Some of the most sophisticated operations are taking place at business and enterprise schools.
The move to healthier meals in schools was prompted by Oliver's crusade in 2005 against Turkey Twizzlers and other unhealthy foods. The following year the Government published a report setting definitive nutritional standards for school lunches. One young smuggling mastermind, when finally caught, said to his school's headmaster unapologetically: "But we were only doing what you taught us in business studies, Sir."
After a tip from a head teacher at a Dorset secondary who broke up a "seriously big smuggling operation" run by a schoolboy, The Times has uncovered several similar contraband schemes. The head, who did not want to identify his school, was convinced that the switch to a healthy menu and the policy of keeping pupils on the premises at lunchtime had created an opening for entrepreneurs. He became suspicious when he noticed two 14-year-old boys approaching the school weighed down with Lidl carrier bags. "The thin wiry creatures, in full uniform but with shortened ties, shirts hanging out, were walking a heavily laden bicycle. The bags were dripping off the bike's handlebars, crossbars and saddle like a scene from some desperate endeavour on foot and mule to reach a lost city in the Peruvian mountains," he said.
A teacher nicknamed Columbo tracked down the boys and their illicit cargo: 60 cans of fizzy drinks and piles of milk chocolate. "We discovered they were just the buyers. Someone else had funded the purchase, a player who in turn was funded by unknowns, who were taking the lion's share. "Getting to the core of the operation was like peeling an onion, there appeared to be no centre," the head added. He suspects that similar operations are happening to a greater or lesser extent in most schools.
Sure enough, when The Times appealed to head teachers for similar tales, the response was rapid and clear. "It has happened to us. Kids with motorbikes buying McDonald's burgers in bulk and flogging them in the playground. We are a business and enterprise school in Essex so I guess I should not be surprised," one said. "When challenged, the boy at the centre said he was just being enterprising."
Another, this time from Wales, said: "The `McDonald's run', where sixth-formers with cars take orders for the lower school who are locked in at lunchtimes is one of the best bits of student enterprise I have seen for a long time."
It is not just business studies teachers who have been giving children ideas; it is also the parents. Two mothers from Rotherham gained publicity for feeding burgers to their children through the school railings after the introduction of a healthy new menu.
Brian Lightman, president of the Association of School and College Leaders and head teacher at St Cyres School in Penarth, Vale of Glamorgan, said that the healthy eating initiative would only succeed if students were allowed a say. "Because these changes have been imposed without allowing time for them to gain a sense of ownership, schools are reporting cases of students finding innovative ways around the new regulations," he said. Of course, if today's teenager crisp smugglers really want a good excuse when caught, they might be well advised to point to Jamie Oliver himself. As an enterprising 11-year-old he used to lease school-lockers from fellow pupils, from where he would sell sweets he had bought at the cash-and-carry. Alternatively, students could also point to the teachers who regularly sneak out at lunch time for burgers and chips, now that they are no longer on the menu.
PESKY! Food dyes protect against cancer
The hated food dyes, no less! (Only in fish, so far, though)
Synthetic food dyes - long blamed for causing hyperactivity in children - may have a good side: some of them may protect against cancer. Gayle Orner at Oregon State University in Corvallis added the carcinogens dibenzopyrene (DBP) or aflatoxin to the feed of trout for one month, with or without the food dyes Red 40 - one of six recently linked to hyperactivity in children - or Blue 2.
Nine months later, trout that had been fed either of the dyes in combination with aflatoxin had 50 per cent fewer liver tumours, compared with those that had been exposed to aflatoxin alone. Trout that had been fed DBP in combination with Red 40 had a 50 per cent lower incidence of stomach cancer and a 40 per cent lower incidence of liver cancer.
"The public perception is that food dyes are bad, but some of them may have good points as well," says Orner, who presented her results at the American Association for Cancer Research in San Diego, California, last week.
While the amounts of dye eaten by the fish could be matched by eating a lot of sweets and soft drinks, Orner advises against this strategy. Instead, she says the next step is to understand the mechanism by which these food dyes exert their anti-cancer effect.
29 April, 2008
Blood transfusions found to harm some patients
The article below from New Scientist is just a preview of the full article. The full article has however already been put online by someone. See here and here. For ease of reading, click "Full size"
"For the life of the flesh is in the blood. No soul of you shall eat blood." So says the Bible's book of Leviticus, and it is for this reason that Jehovah's Witnesses shun blood transfusions. They do not, however, shun surgery. As long as surgeons use special techniques, Jehovah's Witnesses can have surgery - including operations with the greatest potential for blood loss, such as open-heart surgery - without ever receiving a drop of someone else's blood.
Now some surgeons and anaesthetists are questioning whether every patient shouldn't get the same treatment. Over the past decade a number of studies have found that, far from saving lives, blood transfusions can actually harm many patients.
The problem is not the much-publicised risk of blood-borne infectious agents, such as HIV, but the blood itself. Study after study has shown that transfusions, particularly those containing red blood cells, are linked to higher ...
More on bisphenol battiness and corrupt official science
Wal-Mart announced last week that it would stop selling baby bottles made with the chemical bisphenol A, or BPA. In the past, I would have laid the blame for this junk science-fueled shame at the feet of anti-chemical environmental jihadists, their pseudo-scientist henchmen at universities and government regulatory agencies and Wal-Mart's knuckleheaded executives, who seem to be more interested in appeasing eco-pressure groups than reassuring consumers the products the retailer has sold for decades are safe.
But the banning of baby bottles made with BPA is so mind-bogglingly baseless that I just have to lay the blame where it truly belongs - with the lame-o chemical industry, which utterly failed to defend its product against activist claims and a regulatory process so specious it would cause voodoo practitioners to shudder.
First, there is no evidence anyone has ever been harmed by BPA in a consumer product, despite widespread use in baby and medical products and food and beverage containers; moreover, there's no reason to expect anyone ever would be harmed, as exposures to BPA from consumer products are 100 times lower than the "safe" level determined by government regulators.
If you think about it, products made with BPA are, in fact, safer than, say, Wal-Mart's peanut-containing products that can cause fatal allergic reactions in children. Yet peanut products remain on the shelves. So just how did BPA wind up becoming chemical non grata?
Early activist efforts against industrial chemicals in the environment (circa 1960-1990) largely were based on allegations that they were cancer-causing. But by the early-1990s it became clear that this was not so, particularly at exposure levels typically found in the environment. The activists then switched to claims that small exposures to certain chemicals - so-called "environmental estrogens" or "endocrine disrupters" - interfered with normal hormonal processes to cause a variety of adverse health effects ranging from attention deficit disorder to miscarriages to sterility.
This scare hit the mainstream media in 1996 with the publication of the alarmist book "Our Stolen Future: Are We Threatening Our Fertility, Intelligence and Survival? - A Scientific Detective Story." The book and scare quickly faded, however, as many scientists and the chemical industry responded strongly against the allegations, some of the scare's prominent proponents were found guilty of related scientific misconduct and a review panel of the National Academy of Sciences determined in 1999 there was no evidence to support alarm about so-called endocrine disrupters.
So endocrine disrupter theory advocates went back to the drawing board and came up with a successful strategy: If their claims didn't measure up to what generally was considered as science, then they would change how science was conducted. As reported in this column seven years ago, the National Toxicology Program, or NTP - a federal agency whose mission seems to be scaring the public about industrial chemicals and whose staff is closely tied to the anti-chemical movement - did the activists' dirty work by tossing out the toxicology rulebook in establishing two precedents key to the fate of BPA.
First, the NTP determined it no longer was necessary to show that the risk of health effects from a chemical increased with greater exposure. "The dose makes the poison" had been a fundamental principle of toxicology for hundreds of years. The NTP then also decided it no longer was necessary for scientists to submit reproducible study results; traditionally, before the results of a scientific experiment are accepted as valid, other scientists must be able to confirm the results by replicating them independently.
These changes finally paid off last week as the NTP issued a preliminary assessment of BPA driven by several non-reproducible experiments claiming to indicate that BPA is associated with adverse health effects in mice at doses far below the safe levels determined by traditional testing. "The scientific evidence that supports a conclusion of some concern for exposures in fetuses, infants and children comes from a number of laboratory animal studies reporting that 'low' level exposure to bisphenol A during development can cause changes in behavior and the brain, prostate gland, mammary gland, and the age at which females attain puberty," the NTP concluded.
Although the NTP also acknowledged that "these studies only provide limited evidence for adverse effects on development and more research is needed to better understand their implications for human health," the NTP's finding of "some concern" was enough to prompt Wal-Mart to take action against BPA-containing baby bottles.
So why blame the chemical industry for the nefarious doings of a rogue NTP-activist cabal? The industry had almost seven years to take political and legal action against a clearly corrupted government process. There is no evidence that the industry mounted any sort of vigorous public or behind-the-scenes defense of its product.
Worse, a terrible precedent has been set that will haunt the development and use of chemicals that improve the quality of our lives. While it is quite likely BPA can be replaced by some other chemical and sometimes it does make sense from a public relations perspective for an industry to "switch" rather than to "fight" over a particular chemical, BPA wasn't the only thing at stake. The use of science in the regulatory process also was on the line.
BPA-maker Dow Chemical says on its Web site that "we support the development of responsible, science-based laws, regulations, standards, practices and procedures that safeguard the community, workplace and environment." It's going to take more than Web site lip service to live up to that principle.
PROGRESS IN IDENTIFYING THE GENES BEHIND SCHIZOPHRENIA
That the psychoses have a large hereditary component is known. But which genes are the problem ones?
Rare Structural Variants Disrupt Multiple Genes in Neurodevelopmental Pathways in Schizophrenia
By Tom Walsh et al.
Schizophrenia is a devastating neurodevelopmental disorder whose genetic influences remain elusive. We hypothesize that individually rare structural variants contribute to the illness. Microdeletions and microduplications >100 kilobases were identified by microarray comparative genomic hybridization of genomic DNA from 150 individuals with schizophrenia and 268 ancestry-matched controls. All variants were validated by high-resolution platforms. Novel deletions and duplications of genes were present in 5% of controls versus 15% of cases and 20% of young-onset cases, both highly significant differences. The association was independently replicated in patients with childhood-onset schizophrenia as compared with their parents. Mutations in cases disrupted genes disproportionately from signaling networks controlling neurodevelopment, including neuregulin and glutamate pathways. These results suggest that multiple, individually rare mutations altering genes in neurodevelopmental pathways contribute to schizophrenia.
Science 25 April 2008: Vol. 320. no. 5875, pp. 539 - 543
28 April, 2008
IVF: The speculation continues
There is no evidence of anything much below -- just some old scares long ago debunked plus old speculation about IVF bypassing processes that remove defective genes. The rate of babies being born with defects after IVF is however very low so there is no reasonable action that could be taken even if there is some truth in the speculations. The major cause of the high rate of infertility treatments is undoubtedly the tendency of women these days to defer childbearing to just about the last possible minute. The older the woman gets, the harder it is to conceive
AUSTRALIA is facing an infertility crisis as increasing numbers of infertile and "sub-fertile" couples are having children using IVF and other therapies. A Sunday Herald Sun investigation has revealed a 30 per cent rise in fertility therapies means infertile couples are passing on their defective genes and infertility is being embedded in the national DNA. Figures going back to 2006 show up to one in 20 babies in Victoria is conceived through IVF or with the help of fertility treatment.
A survey of Melbourne IVF clinics has found a boom in treatments in the past 12 months - a trend confirmed by the Infertility Treatment Authority. Experts believe the current figure may be as high as one in 15 and will increase. One in six Victorian couples suffers fertility problems.
A new international study has found sperm counts and birth rates are declining in developed countries, including Australia. Professors Jens Bonde, of Denmark's Aarhus University Hospital, and Jorn Olsen, of the University of California, say sperm counts and birth rates are declining in developed countries. The researchers say infertility now affects about 15 per cent of couples trying to conceive, though not all seek medical help.
Sub-fertility is the term given to couples who have lower than normal fertility but may still be able to conceive naturally. Infertile couples cannot conceive without medical help. The researchers raise the alarm about the possible effect of environmental pollution with gender-bending chemicals. They say that may explain the fertility problems.
Factors such as women choosing to delay motherhood because of careers and the desire for smaller families "may [or may not] mask more worrying biological changes in the population", the researchers say in this month's British Medical Journal. In particular, IVF and other techniques mean many sub-fertile couples who would have been forced to remain childless a generation ago can now have families. Technological advances can compensate for low sperm count and poor quality sperm.
In the past, a woman with normal fertility would have had little chance of becoming pregnant if her partner suffered from such severe sperm problems - most of which are linked to defective genes. But the scientists say these genes are perpetuated as a result of the success of IVF.
Monash IVF co-founder Gab Kovacs confirms the boom in fertility treatments while questioning the claims of an infertility crisis. He has had heard of the research, but says the effects would not be experienced for at least 30 years. "No one is sure about that yet, but I believe the effects would be insignificant because infertility problems are a mix of issues that are not just gene-related," he says.
Who Says You Need Eight Glasses a Day? The history of a debunked theory
A recent editorial (PDF) in the Journal of the American Society for Nephrology is getting wide press coverage for debunking the so-called "8x8" theory-the popularly held belief that drinking eight 8-ounce glasses of water daily helps remove toxins, improve skin tone, and increase satiety, among other health benefits. The authors chalk up the belief to folklore, and newspaper reports claim ignorance as to its provenance. Just how long has this idea been around?
Two-hundred years, at least. The most commonly cited source for the 8x8 myth-highlighted in this 2002 review paper by a Dartmouth professor-is the U.S. government-sponsored Food and Nutrition Board.* The board's "Recommended Dietary Allowances" from 1945 include the following advice:
A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods.
According to this theory, people ignored the last part of the statement, which points out that you can get most of that water just by eating. If you actually had to drink all 2.5 liters, you'd need around 10 8-ounce glasses per day. By 1959, the concept was so entrenched that Groucho Marx could joke about self-righteous centenarians who claim that they eat "raw turkey liver" for breakfast and drink "thirty-two glasses of water a day" instead of "eight glasses a day like the rest of us."
However, the Explainer has uncovered evidence of the 8x8 myth going all the way back to 1796, in a German text by Dr. Christoph Wilhelm Hufeland called Makrobiotik. The book includes an anecdote about the surgeon general to the king of Prussia, a vibrant 80-year-old man who had "contracted the habit of drinking daily from seven to eight glasses" of cold water and thus "enjoyed much better health than in his youth." (An English translation is available in this book from 1843.)
The hydrotherapy craze that swept through Europe and then America in the late 19th century encouraged the notion that people needed to be drinking more water. By 1900, the New York Evangelist reported that a women's association on the Lower East Side was being instructed by a Dr. Vinton that one needed to ingest "at least eight glasses of water a day" and take "four times as much water as food." (Incidentally, the girls were also told that it was dangerous to get one's feet wet, that it wasn't good to "wear many skirts," and that their brains were "soft like jelly.") By the 1910s and 1920s, the popular press was full of exhortations to consume six to eight glasses on a daily basis. Charles Atlas, the bodybuilder whose famous comic-strip ads were highly popular from the '20s through the '70s, was fond of recommending the same amount.
In more recent decades, there have been plenty of proponents of the 8x8 theory. In 1967, Dr. Irwin Stillman, one of the earliest advocates of a high-protein, low-carbohydrate diet, insisted that his followers drink eight glasses of water a day in order to wash away ketones, or "ashes left in the furnace." The controversial 1992 bestseller Your Body's Many Cries for Water, which calls for a minimum of eight to 10 glasses of pure water a day (not coffee, not soda), probably played a role in spreading the myth, as has the bottled-water industry, which has exploded since the 1980s.
27 April, 2008
The forbidden "bacon dog"
The knowall food tyrants of Los Angeles
Amid the hustle and bustle of downtown Los Angeles, there exists another world, an underground world of illicit trade in-not drugs or sex-but bacon-wrapped hot dogs. Street vendors may sell you an illegal bacon dog, but hardly anyone will talk about it, for fear of being hassled, shut down or worse. Our camera caught it on tape. One minute bacon dogs are sold in plain view, the next minute cops have confiscated carts, and ordered the dogs dumped into the trash.
Elizabeth Palacios is one of the few vendors willing to speak publicly. "Doing bacon is illegal," she explains. Problem is customers love bacon, and Palacios says she loses business if she doesn't give them the bacon they demand. "Bacon is a potentially hazardous food," [What utter rubbish! I eat it every day for breakfast!] says Terrence Powell of the LA County Health Department. Continue selling bacon dogs without county-approved equipment and you risk fines and jail time.
Palacios knows all about that. She spent 45 days in the slammer for selling bacon dogs, and with the lost time from work, fines, and attorney's fees, she fears she might lose the house that bacon dogs helped buy. She must provide for her family, but remains trapped between government regulations and consumer demand. Customers don't care about safety codes, says Palacios. "They just want the bacon."
More evidence of social class effects
Wealthy people have a far lower risk of suffering a stroke — but only until the age of 65. Researchers in the United States studied the personal circumstances of almost 20,000 people aged 50 and over. They followed them for more than eight years, on average, in which time there were 1,542 strokes.
In the American Heart Association’s journal Stroke, Mauricio Avendano, of Erasmus Medical Centre in Rotterdam, and colleagues showed that people aged 50 to 64 in the poorest tenth of the population had a risk of stroke that was three times greater than those in the richest 10 per cent. “Wealth is the strongest predictor of stroke among the factors we looked at,” Dr Avendano said. But after the age of 65 the links between wealth and stroke risk disappear.
Lack of resources, and especially money, appear to influence strongly people’s chances of having a stroke at an early age, Dr Avendano said. “This would mean that diminishing the large wealth gap at age 50-64 also could help to diminish the large disparities in stroke.” Comparisons showed that common risk factors for stroke, such as high blood pressure, smoking, inactivity, excess weight and diabetes, were more common in poorer people.
26 April, 2008
Bisphenol scare ratchets up
I looked at the science behind this nonsense on Feb 12th. Amusing that aluminium baby bottles are now seen as an alternative to plastic ones. Has everyone forgotten the scares about aluminium cookware?
Last week, hard plastic baby and water bottles were not considered harmful. Now, in the eyes of many users, they are toxic. Yesterday, CVS said it will join Wal-Mart, bottle-maker Nalgene, and other companies in pulling tens of thousands of the shatter-proof, transparent products off store shelves. Some parents are tossing hiking bottles into the trash, feeding their babies with glass containers, and searching for a safer alternative to see-through sippy cups.
So how dangerous are these bottles? And what should consumers do about the risk? "The truthful answer is that nobody knows" their full health impact yet, said David Ozonoff, a professor of environmental health at the Boston University School of Public Health. "And because we don't know, it's prudent to avoid something that is avoidable."
At the heart of the debate is an odorless, tasteless chemical called bisphenol A that is one of the most commonly used synthetic compounds. It is used to line most canned goods, from soups to soft drinks, to prevent corrosion. It helps make sunglasses and compact discs durable. And it strengthens virtually all transparent, light weight hard plastic baby and water bottles. The chemical has been used for decades, and millions of pounds are produced in the United States each year. Animal studies have linked exposure to small amounts of bisphenol A to reproductive problems and possible cancers later in life, though the level of risk is unknown. A small body of research suggests that exposure to the chemical in the uterus could contribute to later obesity.
But chemicals that harm animals are not always bad for humans, particularly in the small amounts to which most people are exposed. Industry representatives say no study has proved a link between bisphenol A and health problems in humans. Still, the US National Toxicology Program, part of the Department of Health and Human Services, last week released a draft report on the chemical, saying there was "some concern for neural and behavioral effects in fetuses, infants, and children at current human exposures." A few days later, Wal-Mart said it would stop selling baby bottles made with bisphenol A by next year and replace them with a bottle free of the chemical. Nalgene, the maker of the durable and ubiquitous hiking bottle whose parent company, Thermo Fisher Scientific Inc., is based in Waltham, also said it would replace its bisphenol A bottles in stores.
Last Friday, Health Canada delivered another blow, announcing that the compound was potentially harmful to people, especially newborns and infants. If no new scientific evidence is brought forward in the next 60 days, officials announced they would ban it from all baby bottles in the country. "We have concluded that it is better to be safe than sorry," Tony Clement, the Canadian health minister, told reporters.
Even before the latest news, environmental websites and parent blogs were aflutter about bisphenol A, debating its dangers and whether it was better to use glass bottles even though they break easily, or how to find bisphenol A-free bottles. They are sold on the Internet but tend to cost more. Baby bottles are of particular concern because more bisphenol A is released when milk or formula is heated in them.
Heather Kane, a Westborough parent of a two- and a five-year-old, mostly uses aluminum bottles instead of plastic. But she said it can be difficult for parents to find alternatives because most are sold only on the Internet and take time to seek out and buy. While that is changing, she questions why stores are not acting more forcefully. "What I find absurd is that Wal-Mart and these other stores are taking them off the shelves at some future date, but if the bottles are so dangerous, why don't they take them off now?" she said in a phone interview.
A recent study by the US Centers for Disease Control and Prevention estimated that about 93 percent of the US population had bisphenol A in their body. Infants and young children had higher levels than adults. Scientists are most concerned about early development because it is a critical time in determining long-term health. Both the US Toxicology Program and Canadian reviews said there appeared to be a negligible effect from bisphenol A on adults. "These experiments have been going on for a long time . . . that show exposure in utero could produce alterations in several parts of the reproductive process, and increased risk" of certain cancers, said Ana Soto, a Tufts University professor who studies the effect of endocrine disrupters such as bisphenol A on development. She believes adults should phase out exposure to bisphenol A.
Industry representatives vehemently disagree and say even the proposed Canadian ban in baby bottles is based on the precautionary principle, not hard data that show bisphenol A is dangerous. "We agree with the scientific and government bodies worldwide who have reviewed the science and support the conclusion that low levels of bisphenol A is not a risk to public health," said Steven Hentges, executive director of the polycarbonate/BPA global group of the American Chemistry Council, which represents chemical manufacturers. The only thing that the chemical industry and scientists agree on is that more studies are needed.
So what should parents do? "If it is easy for people to reduce their exposure to some sources," such as using a water bottle without bisphenol A, "and if the substitute is not likely to present significant risks itself, then why not?" said James Hammitt, professor of economics and decision sciences at Harvard University, in an e-mail. Just because studies may fail to provide clear evidence of harmful effects, he wrote, does not mean that the chemical is not harmful under some conditions. [And pigs can fly under some conditions too. Just put them on an aircraft!]
"Healthy food" myths for doctors
As Goebbels said: "Tell a big enough lie often enough and people will believe it". The evidence is that "fatty" food is NOT bad for you and that a "low fat" diet has no health benefits. See my side column here. If there is such a thing as "healthy" food, nobody knows what it is. But the anti-fat religion sails on regardless.
A dinner of salmon and arugula might sound like an appealing meal, but for many people, what winds up on the table is more along the lines of frozen pizzas or taquitos. Chefs at the Culinary Institute of America would like to help Americans learn to eat better - and they're starting with a key group of diners. Through a collaboration with Harvard University's medical school, the chefs and at least one med student are training doctors to cook.
At a conference earlier this month at the CIA's campus in St. Helena, Calif., about 300 doctors and health professionals got a crash course in making meals that are healthful and tasty.
One of the instructors was Michelle Hauser, a former professional cook and third-year medical student at Harvard. She demonstrated how to whip up healthy meals in under 20 minutes for less than $20. On the menu today: an easy-to-prepare salmon burger recipe. "So I'll dump my two cans of salmon into this bowl," Hauser says, speaking into a microphone. She talks up the health benefits of all the omega-3 fatty acids in salmon and assures the class that anyone can follow her recipe. "I gave it to someone who absolutely cannot cook. And they made dinner successfully," says Hauser, who whips up a coleslaw to complement the burgers.
As the first of the salmon patties come off the stove, students gather around to taste. "It's delicious - very good," says Dr. Tasha Tomlinson, who has a practice in Hanford, Calif. The salmon burgers are low in saturated fat and packed with nutrients. Tomlinson says she's going to take the recipe back to her patients. "In my practice, we have an epidemic of women who are sedentary and overweight," she says. "And they're always asking for help to get back on track."
Tomlinson says she'd also like to set up demonstrations for the diabetes support group. "They could learn one or a couple new recipes to incorporate into weekly shuffle," she says. As doctors learn from the demonstrations, Hauser says, they may become less intimidated in the kitchen. Then perhaps both doctors and their patients can focus on eating better......
Hauser says she enjoyed working as a professional cook, and that as a physician, she seems to be leaning toward educating people about food. Her biggest "aha" moment, she says, came a few years ago when she was teaching community cooking classes. Her students didn't have much experience in the kitchen. "They'd come back ... and say their blood pressure had improved," says Hauser. "Or they'd name some other health benefit that had come from it. And they were just cooking what they loved." It was Hippocrates who said, "Let food be your medicine." But Hauser's approach isn't far off.
25 April, 2008
Cancer survivors have low levels of physical activity and high levels of obesity
You are less active after undergoing treatment for cancer. Who knew? Who would have DREAMT that those nasty cancer treatments would slow you down? It must have been very disappointing to them that only one in five of cancer survivors was obese, though. And they have the hide to makes policy recommendations on the basis of this crap!
A new study reports that many cancer survivors are inactive and obese, which may negatively affect the control of their disease. The findings, which come from a study of cancer survivors in Canada, show that a cancer diagnosis does not appear to prompt significant behavior change and that interventions to increase physical activity and promote better eating habits among cancer survivors are warranted. The study is published in the June 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.
Obesity and physical inactivity are known to be detrimental to health, and in cancer patients, studies have linked these factors to negative outcomes including disease recurrence, cancer-specific death and reduced quality of life. However, few studies have looked at the prevalence of physical activity and obesity in populations of cancer survivors.
To determine this prevalence and compare it to individuals without a history of cancer, Kerry S. Courneya, Ph.D. of the University of Alberta in Edmonton analyzed data from the 2005 Canadian Community Health Survey consisting of computer-assisted interviews of more than 114,000 adults. Survey participants reported their cancer history, height and body weight (to calculate body mass index), and participation in various leisure time activities.
The study revealed that fewer than 22 percent of Canadian cancer survivors were physically active, with the lowest rates reported by male and female colorectal cancer survivors, female melanoma survivors and breast cancer survivors. Also, nearly one in five (18 percent) of cancer survivors was obese, and one in three (34 percent) was overweight with little variation among the cancer survivor groups. The authors concluded that Canadian cancer survivors have low levels of physical activity and a high prevalence of obesity that are comparable to the general population.
However, some differences were found between cancer survivors and those without a history of cancer. Prostate cancer survivors were more likely to be active and less likely to be obese than men without a history of cancer, and male skin cancer survivors were more likely to be active than their disease-free counterparts. Also, obese breast cancer survivors were less likely to be active compared with obese women without a history of cancer. "This finding is cause for concern because physical activity may be particularly important for obese breast cancer survivors," the authors note. Studies suggest that obese breast cancer survivors may particularly benefit from higher physical activity levels in terms of preventing disease recurrence and improving quality of life.
In light of their findings, the authors recommend that lifestyle interventions be implemented to increase physical activity and promote a health body weight among cancer survivors.
Mother's diet can influence baby's sex
This sounds pretty crazy. It is a gene on the Y chromosome contributed by the MALE that determines sex. I suppose the woman could do some sort of spontaneous selective abortion, though. Note: It is entirely possible that diet-type is a proxy for something else (such as social class) rather than itself being the causative agent for what do seem to be some rather interesting differences. So if you decide to eat up big on the basis of these findings, you could well be wasting your time
Oysters may excite the libido, but there is nothing like a hearty breakfast laced with sugar to boost a woman's chances of conceiving a son, according to a new study. Likewise, a low-energy diet that skimps on calories, minerals and nutrients is more likely to yield a female of the human species, says the study, published in Proceedings of the Royal Society B: Biological Sciences, Britain's de facto academy of sciences.
Fiona Mathews of the University of Exeter in Britain and colleagues wanted to find out if a woman's diet had an impact on the sex of her offspring. So they asked 740 first-time mothers who did not know if their unborn fetuses were male or female to provide detailed records of eating habits before and after they became pregnant. The women were split into three groups according to the number calories they consumed per day around the time of conception.
Fifty-six per cent of the women in the group with the highest energy intake had sons, compared to 45 percent in the least-well fed cohort. Beside racking up a higher calorie count, the group who produced more males were also more likely to have eaten a wider range of nutrients, including potassium, calcium and vitamins C, E and B12. The odds of an XY, or male outcome to a pregnancy also went up sharply "for women who consumed at least one bowl of breakfast cereal daily compared with those who ate less than or equal to one bowl of week", the study reported.
These surprising findings were consistent with a very gradual shift in favour of girls over the last four decades in the sex ratio of newborns, according to the researchers. Previous research had shown - despite the rising epidemic in obesity - a reduction in the average energy uptake in advanced economies. The number of adults who skipped breakfast had also increased substantially.
"This research may help to explain why in developed countries, where many young women choose low calorie diets, the proportion of boys is falling,'' Ms Mathews said. The study's findings could point to a "natural mechanism'' for sex selection. The link between a rich diet and male children might have an evolutionary explanation. For most species, the number of offspring a male can father exceeds the number a female can give birth to, but only if conditions are favourable.
Poor quality male specimens may fail to breed at all, whereas females reproduce more consistently. "If a mother has plentiful resources, then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter,'' thus contributing to the survival of the species, Mathews said. "However, in leaner times having a daughter is a safer bet.''
While the mechanism is not yet understood, it is known from in vitro fertilisation research that higher levels of glucose, or sugar, encourage the growth and development of male embryos while inhibiting female embryos.
24 April, 2008
One scare deserves another: Global warming cancer warning
I was born and bred in the tropics but have fair, Irish-type skin and I have lots of skin cancer so I have no doubt that warmer climates can be bad for you -- but the problem is a known effect of greater exposure to UV, not warmth! The study below is epidemiological so we must not be surprised to see the usual blinkered idiocies in it. And we don't have to look far to find such idiocies. The authors seem to overlook, for instance, the possibility that people go out in the sun more when it is warmer!! So it might not be warmth itself that causes the observed effect but rather the increased UV that people get as a result of going out in the sun more when it is warm. Quite brain-dead. Anyway the worriers below will no doubt be pleased to hear that temperature records kept by the Hadley Centre and others show that global warming peaked in 1998 and has not risen since
Global warming could lead to higher rates of skin cancer by amplifying the harmful effects of the sun's rays, scientists said. New evidence suggests that the same amount of sunshine becomes more likely to trigger cancer as temperature rises. The findings imply that a 2-4% increase in average summer temperatures could produce "substantial increases" in numbers of new skin cancers, say the researchers.
Scientists from the Netherlands and Argentina analysed data from two surveys of non-malignant skin cancer in the US. The incidence of cancer in the 10 regions studied correlated strongly not only with local levels of sunlight, but also with average daily maximum temperature in summer.
For cases of one type of skin cancer called squamous cell carcinoma, incidence increased by 5.5% per degree centigrade rise in temperature. The incidence of another type, basal cell carcinoma, rose by 2.9% per degree centigrade increase.
The findings tied in with previous research on mice which showed that increasing room temperature enhanced the induction of cancer by a given level of ultraviolet (UV) radiation. Effective UV dose in the mouse experiments increased by 3-7% for every degree centigrade of extra warmth.
The new research led by Dr Jan van der Leun, from the energy consultants Ecofys Netherlands in Utrecht, appears in the Royal Society of Chemistry journal Photochemical & Photobiological Sciences.
Ambient UV radiation only explained about 80% of the variation in skin cancer incidence, the scientists said. Other factors included genetic background and sun-seeking behaviour - and now, it appeared, temperature.
The researchers wrote: "Mainly owing to the substantial summer temperature differences between the West coast and other parts of the USA with comparable ambient UV loads [But ambient UV loads may not be the same as experienced UV loads -- due to different behaviors by people under different temperatures], we found evidence that some of the remaining variance in incidence may be attributed to temperature. These figures would imply, for instance, that with a long term increase of summer temperatures by 2-4% we could end up with substantial increases in incidence of skin carcinomas, which have already risen to very high numbers over the last century in white Caucasians."
Thalidomide, the drug that blighted a generation of children half a century ago, is back on the market in Europe as a powerful cancer treatment. The European drug agency yesterday gave clearance for thalidomide to be sold on prescription for treating newly diagnosed multiple myeloma. It has been available, in a limited way, for some years since its powerful effects on cancer and leprosy were identified.
But campaigners, including those damaged by the drug when they were still in the womb, are anxious that its new-found popularity does not lead to more babies being harmed. Freddie Astbury, the president and founder of the campaign group Thalidomide UK, said that since the drug resurfaced, hundreds of damaged babies had been born in Brazil, where it has been used since 1985 to treat leprosy. There had been no such cases in the US or Europe, he said, but admitted that he was worried by the increased availability of the drug. “The trouble is that some hospitals in Europe have chosen to get the drug from Brazil, where it is cheaper,” he said.
Thalidomide UK and other patient groups had been working with the European Medicines Agency (EMEA) for more than five years on a plan to control access to the drug once it was licensed, Mr Astbury said. “We’re never fully going to know how the plan will work until the drug is used on a large number of patients,” he said. “I’d never say there will never be another thalidomide child in Europe, but I think they are the best guidelines we could have achieved.”
The approval given by the EMEA means that the US company Celgene will be the only licence-holder in Europe, and will be responsible for ensuring that the guidelines are observed. No other manufacturers and distributors of thalidomide can now supply the drug across the EU.
Thalidomide was originally marketed in the late 1950s as a treatment for morning sickness in pregnant women. It was only when babies began being born disabled that the dangers became apparent. The catastrophe was a landmark in the development of safer systems for approving drugs.
23 April, 2008
Teenagers blame eating disorders on health messages
As usual, Leftist nuts hurt people under the pretext of helping. It should be noted that the very severe eating disorder known as anorexia is clearly just a type of OCD and, as such, the sufferer would have a substantial genetic susceptibility. Most psychoses do however need to be "triggered" by environmental factors and there is no doubt that the obesity war would have caused all incipient anorexia to become full-blown
SCHOOLGIRLS with eating disorders are blaming the fight against the obesity epidemic for their illnesses, researchers have found. Many teenage girls with eating disorders "strongly believed that their illness was nurtured, exacerbated or sometimes even caused by the well-meaning action in schools", UK newspaper The Daily Telegraph reported.
John Evans, a professor of Sociology of Education and Physical Education at Leicestershires Loughborough University, told the newspaper that many girls said the fight against obesity caused their illnesses. The tales they told were incredibly revealing about what schools were doing, in good faith, that was propelling these girls towards this damaging relationship with food and exercise, Professor Evans said.
One girl told how, in class, the PE teacher pointed to a broomstick and said, 'That's the shape we are aiming for. He said another girl had told him about a class weigh-in. The whole class got weighed and the teacher said, 'Oh, it's the big one,' and I was the heaviest in the year."
Prof Evans said some children were being given the wrong message by their teachers. But he also said those teachers may have formed their opinions on obesity from elsewhere. "I've heard prominent spokesmen compare obese people to the so-called freaks that used to appear in circuses in the 1920s and 1930s," he said. The message being passed down is that obese people can be legitimately laughed at, stigmatised and considered irresponsibly abnormal."
The results of the four-year study will be published in a book later this year.
Saliva may reveal heart attack
Could be useful if confirmed
A SIMPLE saliva test may one day be used in ambulances, restaurants, convenience stores and elsewhere in the community to quickly tell if a person is having a heart attack. "Proteins found in the saliva have the ability to rapidly classify potential heart attacks," said John McDevitt, a biochemist at the University of Texas at Austin.
Dr McDevitt and colleagues developed a nano-bio-chip sensor that is biochemically programmed to detect sets of proteins in saliva capable of determining whether or not a person is having a heart attack or is at high risk of having a heart attack in the near future. With the saliva heart attack diagnostic test, a person spits into a tube and the saliva is then transferred to credit card-sized lab card that holds the nano-bio-chip containing a standard battery of cardiac biomarkers. The loaded card is inserted like an ATM card into an analyser that determines the patient's heart status in as little as 15 minutes.
In a study involving 56 people who had a heart attack and 59 healthy "controls" who did not, "we found that our test could distinguish between heart attack patients and controls with about the same diagnostic accuracy" as that of standard blood tests, Dr McDevitt said.
Many heart attack patients, especially women, had non-specific symptoms or had normal EKG readings, making timely diagnosis difficult, he said. "In our small trial, we had about one third of the patients with these...silent heart attacks on EKG." These patients need to go the emergency department and have their blood drawn and tested for enzymes that are indicative of a heart attack, "which could take an hour to an hour and a half."
The saliva test could be used in conjunction with the EKG and "aid in rapidly diagnosing heart attacks that are silent on EKG," Dr McDevitt said. Larger and more refined studies were planned.
22 April, 2008
Scientists discover drops of truth in medieval belief in urine
Urine testing is not exactly new in modern medicine either -- but the idea that more information can be extracted from urine analysis does sound interesting. I doubt that it could give dietary information with a high degree of certainty, however. A background article is here
Medieval physicians believed that they could diagnose disease by holding up a flask of the patient's urine to the light and squinting at it. According to scientists at Imperial College London, they could have been on to something. A team there has completed the first worldwide study of the metabolites (breakdown products) that are found in urine, reflecting the diet, inheritance and the lifestyle of the people from whom it came. They call such studies "metabolomics" by analogy with genomics, which looks at all the genes that make up the human species, and proteomics, which does the same for proteins.
The study used nuclear magnetic resonance spectroscopy to compare racial and national groups by the composition of their urine. From Japan, Beijing, Corpus Christi, Belfast and West Bromwich, urine differs in subtle ways that could provide a powerful new way of linking diet and health. The metabolites they found come from microbes in the gut, from diet and from the metabolism of the host.
The team believes that the research may provide the basis for a "metabolome-wide association" approach to help to understand interactions between lifestyles, environment and genes and how they determine diseases. The metabolic fingerprints show that people in the US and Britain who share a tendency to high blood pressure and heart problems have similar patterns. Writing in the science journal Nature, the team identifies metabolites linked to high blood pressure, such as the amino acid alanine. Hippurate, another by-product of gut bacteria, is found in people with lower blood pressure who drink less and eat more fibre in their diet.
Scientists from Imperial College, the US, Belgium, Japan and China took samples from 4,630 volunteers aged between 40 and 59. Professor Jeremy Nicholson, from Imperial College, said: "Metabolic profiling can tell us how specific aspects of a person's diet and how much they drink are contributing to their risks for certain diseases, and these are things which we can't investigate by looking at a person's DNA. What is really important is that we can test out our new hypotheses directly, in a way that is not easy with genetic biomarkers."
The war on `passive drinking'
European Union and United Nations officials are plotting to make drinking as socially unacceptable as smoking. Hectoring campaigns over "passive smoking" are credited for Europe's almost total smoking ban. Now alcohol is in the sights of the public health miserablists and they have invented the concept of "passive drinking" as their killer argument.
The Daily Mail takes up a report in New Scientist to trumpet a new "guilt campaign" that is heading our way. "The World Health Organisation's global strategy will aim to match the success of campaigns which have made smokers feel guilty about the harm second-hand smoke does to others," says the report. Ian Gilmore, president of the Royal College of Physicians is wheeled on to confirm the new approach. "The tipping point for banning smoking in public places was third party damage," he said.
The EU public health brigade are not far behind, in fact Brussels miserablists in the European Commission's DG SANCO have been trying to poison the drinking debate with this new assault on reason for years. I took up the EU "passive drinking" debate around two years ago in response to strident claims, in a Commission report, about the high environmental or social toll of alcohol, the "harm done by someone else's drinking".
"The total tangible cost of alcohol to EU society in 2003 was estimated to be 125bn euros (79bn-220bn), equivalent to 1.3 per cent GDP, and which is roughly the same value as that found recently for tobacco," said the report written by Dr Peter Anderson, who has a background in the World Health Organisation (WHO) and who played a leading role in Tobacco Free Initiative Europe. "The intangible costs show the value people place on pain, suffering and lost life that occurs due to the criminal, social and health harms caused by alcohol. In 2003 these were estimated to be 270bn, with other ways of valuing the same harms producing estimates between 150bn and 760bn."
On Thursday, at an informal meeting of health ministers in Brdo, Slovenian Health Minister, Zofija Mazej Kukovic dusted off the report - and its language. "Harmful and dangerous alcohol consumption causes more than seven per cent of the premature morbidity and mortality in our countries. The annual costs stemming from this have been estimated at as much as _125 billion for the EU as a whole. However, the harm caused by alcohol is still underestimated," she said.
The figures are meant to be pretty scary. Drink is responsible for 2,000 homicides, four out of 10 of Europe's annual murders. "The economic cost of alcohol-attributable crime has been estimated to be 33bn in the EU for 2003..while the intangible cost of the physical and psychological effects of crime has been valued at 9bn - 37bn," said the Anderson report.
Children, too, are passive victims of drinking. "Many of the harms caused by alcohol are borne by people other than the drinker responsible. This includes 60,000 underweight births, as well as 16 per cent of child abuse and neglect, and five to nine million children in families adversely affected by alcohol," says the EU report's summary.
The link made by between alcohol and crime today, whether violence or child abuse or other social ills, follows not from hard facts but from an outlook that sees human characteristics as damaging in general. And if human beings, particularly when under the influence of stimulants, are destructive, then, the argument goes, social intervention must follow. The idea that almost any activity - drinking, eating, speaking, even thinking - can cause harm is often blown out of proportion and used to generate frightening figures and policies.
The sheer absurdity of the idea of "passive drinking" would be funny if the public health lobby was not so powerful and unpleasant. I found that in a twist of irony, probably lost on po-faced public health types, that the expression "passive drinking" seems to have originated as a spoof in two Peter Simple columns in the Daily Telegraph in 2002 and 2003, written by the late Michael Wharton.
Mocking the rise of nonsense research to justify social measures, he wrote about research work being carried out by "Dr Ron Hardware of Nerdley University". "They were the first to discover the scourge of `passive drinking', showing by painstaking experiments and finely adjusted statistics that it was just as deadly as 'passive smoking' and equally capable of causing cancer and innumerable other ills," he wrote. It is no longer a joke or satire - do read more here on Spiked. We need to stand up to these people.
Source. Prof. Brignell also once used this idea as an absurd example.
21 April, 2008
Nazism reinvented: The chosen ones of Australia's Left want a smoking ban and fitness tests for everyone
SMOKING would be banned for everyone born next year, junk food would be taxed and everyone would be subjected to a fitness test by 2020. By comparison, the cost of healthy food, including fruit and vegetables, would be reduced to reflect its low environmental impact and obvious ["obvious"? It is not at all obvious in the mortality statistics] health benefits.
These are just a few of the ideas from 100 of the nation's health experts who discussed the best way to combat obesity, reduce illness and promote a healthy lifestyle. Health Minister Nicola Roxon said one idea put forward in a submission was an annual national fitness test where citizens would receive a financial incentive if they pass.
Health stream participants in the 2020 summit also discussed increasing public education about how death can be a "positive experience" to avoid patients panicking when they reach hospital emergency departments.
Health participant, Meredith Sheil, a former Westmead Children's Hospital pediatrician, said many participants had suggested a ban on cigarette sales by 2020. "A lot of the health submissions suggested a ban on smoking by 2020," she said. "You would say, 'OK, from now on everybody born after 2008, you are not allowed to sell cigarettes (to)'."
Nutritionist Rosemary Stanton suggested increasing the cost of artificial and packaged food. "I actually think we need to price foods according to their environmental and health impact, rather than harping at people to eat this or that," she said. "All the artificial foods would become very expensive and the healthy foods would be cheaper." ....
Ski champion Alisa Camplin suggested expanding the active after-school communities program to ease the burden on the health system. "Creating a national program focused on physical activity would provide a pro-active framework for Australians to attain greater general well-being and receive preventative, rehabilitative and curative health support," Camplin wrote in her submission.
You can't win: Thin can still be fat on the inside
The paper behind this report does not appear to have passed peer review but there is a summary of it here. It relies on clinical indices which may or may not have the postulated relationship with longevity. As is common in epidemiological studies, control for social class appears to have been omitted, despite the large evidence of its medical significance
A thin person with a body mass index in the healthy range could actually be dangerously overweight. Researchers from the Mayo Clinic in the US collected data on more than 2000 people with a healthy weight and BMI and concluded that 61percent of them had what they call "normal weight obesity". They looked thin, but their percentage of body fat made them susceptible to heart disease and diabetes, research presented to a meeting of the American College of Cardiology in Chicago showed. British researcher Dr Jimmy Bell has dubbed such people TOFIs, for "thin outside, fat inside".
The findings cast more doubt on the value of the BMI as an indicator of health. The index is calculated by dividing a person's weight in kilograms by their height in metres squared. A BMI between 18.5 and 25 is considered healthy. Melbourne weight-loss expert Leon Massage said body fat percentage is the most important measure of healthy weight. Dr Massage said many people would be unaware that their percentage of body fat had risen as they had become less physically active. "As their muscle decreases, their fat increases and their weight can stay the same," he said.
He recommended people measure their waist circumference and if it exceeded between about 90 and 94 centimetres for men and 80 centimetres for women, have their percentage calculated by a doctor.
20 April, 2008
SOME MEDICAL MYTHS
HAVING SEX CAN CAUSE A HEART ATTACK IN MEN
How wrong is this? Fairly. The risk is hugely exaggerated by the familiar portrayals of men in books, films and dramas gasping their last in flagrante. What are the facts? Research shows that the chances of a 50-year-old non-smoking male suffering a heart attack is about one in a million in any hour. Having sex increases these odds to two in a million, but doubling a barely existent risk means that risk is still negligible. Any related myths? That sex is a form of exercise. In fact, it equates only to climbing two flights of stairs.
HIGH BLOOD PRESSURE CAUSES HEADACHES
How wrong is this? Very. An astronomically high blood pressure might cause a headache, but this is rare. What are the facts? High blood pressure (hypertension) usually has no symptoms at all. It's not a disease, it's a risk factor, so it is treated to reduce your chances of a future stroke or heart attack, not too make you feel better. Any related myths? That high blood pressure causes dizziness. No, dizzyness is a side-effect of the treatment.
DIABETICS CRAVE SUGAR
How wrong is this? Fairly. Diabetics do have to alter their sugar intake and they sometimes require an urgent sugar fix if their blood glucose is too low. So concluding that craving sugar equals diabetes is understandable but wrong. What are the facts? Diabetes isn't caused by excess sugar, it's simply that the diabetic body has problems handling it. Any related myths? That diabetics need to buy special, low-sugar versions of food and drink. They don't - a simple healthy diet will suffice.
WOMEN NEED TO EXAMINE THEIR BREASTS
How wrong is this? Very. What are the facts? Research shows that routine self-examination does no good in terms of breast cancer outcomes because it isn't sensitive enough to detect important lumps. In fact, it can actually cause harm. How? By subjecting self-examiners to increased levels of anxiety. Any related myths? There is an exact parallel with routine self-examination of testicles in males - another discredited activity that continues to receive publicity because it sounds like a good idea.
DIETS CUT CHOLESTEROL
How wrong is this? Fairly. Doctors rarely suggest diet alone if your cholesterol really needs lowering. What are the facts? A healthy diet's a good idea. But if you want lower cholesterol, you'll probably be disappointed. Because, even in trials, the best that's achieved is a 10 per cent reduction. Most cholesterol is made by your liver, with your dietary intake contributing little. Cholesterol is usually treated with statins. Any related myths? That a high cholesterol is a cause for panic - it's simply a risk factor, like high blood pressure, for future problems.
HEADACHES ALONE CAN BE A SIGN OF A BRAIN TUMOUR
How wrong is this? Totally. What are the facts? The stats alone may be ease your headache. After all, your GP sees this symptom daily, but encounters a brain tumour only a few times in his entire career. Nasties of this sort almost always produce other symptoms - fits, personality change or unsteadiness. Any related myths? That a scan is a good idea. The chances of turning up an irrelevant but worrying abnormality are fairly high.
YOU SHOULDN'T MIX ANTIBIOTICS AND ALCOHOL
How wrong is this? Totally, with the exception of the antibiotic metronidazole. What are the facts? Any interaction of alcohol with virtually all antibiotics is nonexistent, or so small as to be irrelevant. Metronidazole, an antibiotic used for a variety of infections, is the exception to this rule. When mixed with even small amounts of booze, it causes vomiting. Any related myths? That you should always finish your course of antibiotics. It usually makes little difference.
YOUR TIREDNESS MAY BE CAUSED BY ANAEMIA
How wrong is this? Fairly. What are the facts? Tiredness is common and, in the absence of other symptoms, is usually caused by lifestyle issues such as stress and lack of exercise. Mild anaemia caused by iron deficiency is common, too, particularly in women. As tiredness often prompts a blood test, it's common for anaemia to be revealed, and assumed wrongly to be the cause. Any related myths? That tiredness will be solved by vitamins - though the chemist might tell you otherwise.
FLU JABS GIVE YOU FLU
How wrong is this? Totally. You might suffer a sore arm or, at most, a slight fever. What are the facts? The vaccine does not contain live germs and so cannot cause flu. But, as it's given in autumn, peak snuffle period, many patients will pick up a virus around the time of their jab. This they misinterpret as flu, which they link to the jab. Any related myths? The idea that if you are healthy, the flu jab isn't necessary. In fact, it's recommended to all over-65s, even if they're fit and well.
Australian man too fat for jail
Obesity has its pluses
A man considered too fat to be jailed has spoken out after escaping time behind bars because of his weight. Shepparton man Claude Jackson was ordered to do community service for smashing a glass over another man's head at a Shepparton bar on January 14, 2007. The victim, Tim Kirkman, received a 4cm cut to his neck in the incident and required hospital treatment. Jackson pleaded guilty to recklessly causing serious injury and affray.
A medical report submitted to the County Court sitting at Shepparton said Mr Jackson, who weighed 190kg, had suffered three heart attacks earlier in life and suffered from ongoing arthritis, sleep apnoea and other weight-related ailments. It said he had once weighed up to 234kg and that "morbid obesity" had been present all his life. The medical report also warned that a jail term would "create great problems" for his health.
While reluctant to talk about the incident, the 21-year-old told the Herald Sun he was deeply sorry and had been keeping out of trouble since the bar brawl. "I would like to say sorry to (Mr Kirkman)," Mr Jackson said yesterday. "If I could take back everything that happened on the night, I would. "But unfortunately it happened and I have to deal with it. I have definitely learnt my lesson."
Mr Jackson, who is studying for a certificate in youth work at a local university, was ordered by the court to undertake eight hours a week of community service at Rumbalara Football and Netball Club, and four hours of counselling a week for the remainder of his sentence. He was initially considered unsuitable for an intensive corrections order by the Office of Corrections.
19 April, 2008
The Junk juggernaut rolls on
Post below lifted from Prof. Brignell. See the original for links
It is rather a depressing thought that the Telegraph is the nearest thing that Britain has to a serious newspaper. This week it has featured an outbreak of empty scares based on meta-studies, absurdly small studies and, of course, ridiculous relative risks (RR).
The first was a scare involving a popular vehicle for of self dosing, vitamins. While it is clear that people on a normal diet with a normal metabolism are wasting their money on these supplements, this is no excuse for spreading unnecessary alarm. With one possible exception, extra vitamins are simply useless. The exception is vitamin A. While a deficiency of this compound can cause serious diseases, including childhood blindness and death, an excess can suppress growth; stop menstruation; damage red blood corpuscles and cause skin rashes, headaches, nausea, and jaundice. Nevertheless, a meta-study yielding RRs of 1.16 or less adds nothing to the sum of human happiness and merely fuels pointless scare journalism.
Breast cancer has long been a favourite of the scare-mongers. For understandable reasons it roused fear in all women. It is frequently used to provide ammunition for the zealots, so the research tends to be directed towards their favourite targets. Now we are told that one glass of wine a day increases the risk of breast cancer (RR 1.07). Sandy tells about the provenance of this vital "research". In the very same week other “experts” picked on another favourite target, obesity. A small study (Trojan Number 547) indicated that fat women with breast cancer are more likely to die than their slim sisters (RR about 1.4). We are not told just how many were regarded as obese, but even if it were about a half of them, the number of excess deaths would be of the order of 12.
As we have observed before, small studies are not just useless, they are malign, as the phenomenon of funnel plots reveals.
Just in case you did not get the message from our sponsors, the risk of Alzheimer’s is increased for smokers, drinkers and those with raised cholesterol. The inclusion of tobacco is interesting, because before the Great Censorship, it was widely accepted that smokers were half as likely to get Alzheimer’s as non-smokers (likewise Parkinson’s to boot). Indeed, this promoted one of the first uses of the word paradox as a paranym. What a strange coincidence it is that the causes of these diseases all happen to be the favourite targets of various groups of zealots and not something else, such as lettuce.
New drug shrinks breast cancer
A NEW breast cancer drug has shown impressive results in shrinking tumours before surgery. Lapatinib (Tyverb) is licensed in the US for advanced breast cancer but not in the European Union. It is similar to Herceptin in the way that it works – it inhibits the action of an emzyme that prompts the tumour to grow.
At the European Breast Cancer Conference in Berlin, Angel Rodriguez, of Baylor College of Medicine in Houston, Texas, reported on a trial in which lapatinib was given to 45 women for six weeks before they underwent surgery. The tumours shrank by an average of more than 60 per cent, and the drug also cut the number of breast cancer stem cells.
This was important, Dr Rodriguez said, because such cells had proved resistant to other drugs used before surgery. Indeed, the effect of conventional drugs was to increase the number of stem cells and enhance tumour growth. “We were excited to see that the results with lapatinib were different,” he said. Cancer stem cells help to maintain the malignant tissue in the tumour by regenerating it after attack from chemotherapy drugs.
“This indicates that the stem cells themselves should be the specific target of chemotherapy drugs,” said Dr Rodriguez. “Rather than the broad-brush approach, in which cells are killed indiscriminately, targeting the stem cells may be more effective and also prevent some of the unpleasant side-effects associated with conventional chemotherapy treatment. “This is an exciting finding and we will be starting further studies on stem cells in order to confirm it. This finding should also apply to other types of cancers, and research of tumour-initiating stem cells in other cancers is ongoing,” he said.
These include studies in lung, colon, head and neck, gastric, oesophageal, and bladder cancer and lymphoma, among others.
Carolyn Rogers, a clinical nurse specialist at Breast Cancer Care, said: “Lapatinib is being considered for use in secondary breast cancer following clinical trials, but to date there is no strong evidence to show its suitability in treating primary breast cancer. “Dr Rodriguez’s study provides an interesting insight into how lapatinib could be used in early breast cancer. However, with a sample of just 45 patients it is clear that much more work needs to be done to gain statistically significant findings. Further trials are under way but it will be many years before we see the full results of these. Current approved treatment options are very successful, with survival rates increasing year on year.”
18 April, 2008
Studies Show It's Often Cheaper To Let People Get Sick
An ounce of prevention may have been worth a pound of cure in households down through the ages, but in the world of health economics the adage, alas, is not true. An ounce of prevention is sometimes worth more than an ounce of cure (although rarely worth 16 times as much, or the equivalent of a pound). Usually, an ounce of prevention is worth considerably less. Often it is worth (to mix measures) only a gram of cure. Or even just a milligram.
This is a seemingly illogical truth. Most of us naturally assume that preventing a disease is cheaper than waiting for the disease to appear and then treating it. That belief is especially dear to politicians, who often view prevention as an underused weapon in the battle against health-care costs. The campaign Web site for Sen. Hillary Clinton (D-N.Y.) notes that her health-care plan is "targeting the drivers of health-care costs, including our back-ended coverage of health care that gives short shrift to prevention." Rival Sen. Barack Obama (D-Ill.) asserts that American families can save up to $2,500 a year each if five cost-containing strategies are implemented, one of which is "improving prevention and management of chronic conditions." (The presumed Republican nominee, Arizona Sen. John McCain, generally has not pushed prevention as a way to control expenses.)
Even when prevention greatly reduces future cases of a particular illness, overall cost to the health-care system typically goes up when lots of disease-preventing strategies are put into practice. This is usually true whether treating the preventable diseases is cheap or expensive. In 1986, a health economist named Louise B. Russell published "Is Prevention Better Than Cure?," in which she concluded that prevention activities tend to cost more than they save. Since the book's appearance, her observation has been borne out by studies of hundreds of interventions -- everything from offering mammograms to all women and prescribing drugs to people with high cholesterol to requiring passenger-side air bags in cars and shortening the response time of ambulances.
On closer look, this isn't so surprising. Nor is it reason for despair. After all, you get something from prevention -- less disease, for starters -- which is worth a lot even if it doesn't come cheap.
There are many reasons prevention usually doesn't save money. Perhaps the most important is that prevention activities target many more people than will ever come down with the disease being prevented. The reason (thankfully) is that people tend to stay healthy for most of their lives, no matter what they do. Take the example of lowering cholesterol to prevent heart attacks.
The vocabulary of cardiac risk uses such terms as "normal," "high" and "very high." But in reality, most people even in the "very high" risk category don't suffer heart attacks over quite long time horizons. Consider a 50-year-old male smoker whose total cholesterol is in the "high" range (over 240); whose HDL, or desirable cholesterol fraction, is "low" (below 40); and who has untreated moderate hypertension. Sounds like a walking time bomb! It turns out his chance of having a heart attack in the next 10 years is only 25 percent. For a woman with the same profile, the chance of having a heart attack is 11 percent. Almost nine out of 10 such people will dodge the bullet by . . . doing nothing.
Preventing those heart attacks is expensive because everyone fitting the risk profile needs to get the intervention. Why? Because there's no way to know in advance who the 1-in-4 unlucky men or 1-in-9 unlucky women are.
If the prevention strategy is taking a statin -- a very effective cholesterol-lowering drug -- it will cost $160,000 for every year of life saved among men with the above-described risk profile. For women, it will be even pricier: $240,000 for every year of life saved, according to a study published in the Annals of Internal Medicine in 2000. (That total bill includes the cost of physician visits and lab tests). It seems like a lot to pay. But who among us would choose 1-in-4 or 1-in-9 odds of having a heart attack if the alternative is to reduce the odds dramatically by taking a pill every day (especially if you don't have to pay for the pill yourself)?
In the answer to that question lies both the appeal of our increasingly prevention-oriented health-care system and the reason why prevention tends to drive costs up over the long run. Prevention can be expensive even when it doesn't involve taking drugs or undergoing procedures. Even giving information can be uneconomical. That's because giving information takes time, and the yield in terms of behavior change that leads to less disease is very low -- as anyone who has been told to eat less and exercise more knows. For example, Australian researchers tried out a program in which general practitioners watched a video and read a booklet about how to help their patients lower their heart attack risk. The patients were then given a series of videos and a self-help booklet on the same topic. How cost-effective is this instruction? When it is provided for women at low risk of heart disease, $9.8 million has to be spent for every year of life saved in the prevention of premature heart attack deaths.
Of course, there are situations in which prevention is the economical choice, even if it still adds to the total spent on health care. Take smoking. Smoking cigarettes is probably the most unhealthful legal thing a person can do. Nevertheless, most lifelong smokers will make it to age 70 without paying the ultimate price. This was borne out in a study published two years ago. Medical researchers in Norway observed the experience of 50,000 Norwegian men and women over a 25-year period. Of the men who smoked more than a pack of cigarettes a day the entire time, 41 percent died between age 40 and 70. Among similarly heavy-smoking women, 26 percent died. (For people who never smoked, the mortality was 14 percent for men and 9 percent for women). Even for heavy smokers, the odds favor survival.
Nevertheless, doing almost anything to help people quit smoking is likely to be a good investment. That's because even though most people get to age 70, lots don't -- but might if they didn't smoke. In just one example of dozens of cost-effectiveness studies examining strategies to reduce smoking deaths, a team of British researchers in 2002 calculated that providing brief counseling, nicotine replacement and the anti-craving drug buproprion to smokers would save one year of life for every $1,300 spent -- an incredible bargain.
There are also some disease-preventing activities that save money, although they are relatively rare. Childhood vaccinations are the classic examples. Many of the infections they protect against -- chickenpox, measles, mumps -- are ones nearly every child would get if not for the shots. Even though few of those cases put children in the hospital or cost much to treat, virtually all that expense (and a few lives) are saved with universal childhood immunization. If vaccines are cheap and easy to administer, the total cost of vaccination is actually less than the cost of treating the cases of illness that would occur in their absence.
Toward the other end of life, providing a single colonoscopy to men 60 to 64 years old also saves money. Even though the procedure costs more than $1,000, it takes such a huge bite out of expensive, painful, life-shortening colon cancer mortality that it costs less to test everybody than to treat the people who would otherwise develop the disease.
"In order to crack this nut [of controlling health-care spending], careful thought and analysis has to go into evaluating what things work, how well things work and how much they cost," said Joshua T. Cohen of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston. Similar to the finding that prevention rarely saves money is the calculation that people in good health probably rack up higher lifetime medical costs than their less-healthy brethren. The reason? Healthy people tend to live longer.
The Framingham Heart Study has followed more than 5,000 people in a town outside Boston since 1948. An analysis published in 2003 found that obese women smokers lost 13.3 years of life, and obese men smokers lost 13.7 years, compared with normal-weight nonsmokers. This loss of longevity can make a big economic difference because people who miss old age miss the high medical costs associated with it.
In the journal PLoS Medicine last month, Dutch researchers led by Pieter H.M. van Baal used mathematical modeling to compare the medical expenses (starting at age 20) of healthy people, obese people and non-obese smokers. Up to age 56, an obese person's annual medical costs are higher than a smoker's, mostly because of problems that often come along with obesity, such as diabetes, arthritis and lower back pain. Healthy people have the lowest annual cost. But over a lifetime, the researchers calculated, healthy people incur the most cost, followed by the obese and then smokers, who die the earliest.
Does that mean we shouldn't try to get people to quit smoking or lose weight? Of course not, says Louise Russell, the "Is Prevention Better Than Cure?" author who is now a research professor at Rutgers University in New Jersey. "People are important, their health is important, and we want to make their lives better in a variety of ways," Russell said. "The point of the medical-care system is to serve people. It is not the point of people to serve the medical-care system." Prevention can be a great investment, but it's still an investment. Nothing in the modern health-care economy is cheap. Not even health.
Prince of Wales's guide to alternative medicine `inaccurate'
The Prince of Wales is being challenged today to withdraw two guides promoting alternative medicine, by scientists who say that they make misleading and inaccurate claims about its benefits. The documents, published by the Prince and his Foundation for Integrated Health, misrepresent scientific evidence about therapies such as homoeopathy, acupuncture and reflexology, say the authors of a new evaluation of alternative treatments.
In a letter to The Times, Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, and Simon Singh, a science writer and broadcaster, call on the Prince to recall the publications, one of which was produced with a œ900,000 grant from the Department of Health. "They both contain numerous misleading and inaccurate claims concerning the supposed benefits of alternative medicine," they say. "The nation cannot be served by promoting ineffective and sometimes dangerous alternative treatments."
Professor Ernst and Dr Singh say the Prince accepted the importance of "rigorous scientific evidence" to alternative medicine, in an article he wrote for The Times in 2000, and point out that more than 4,000 research studies have since been published. They analysed these studies and previous research for their new book, Trick or Treatment: Alternative Medicine on Trial, finding that only a few treatments, such as some herbal medicines and acupuncture for pain relief, are backed up by the evidence that the Prince demanded. "The majority of alternative therapies appear to be clinically ineffective and many are downright dangerous," the letter says, and it calls on the Prince to withdraw the publications Complementary Health Care: A Guide for Patients and the Smallwood report.
The first document is a pamphlet, part-funded by the taxpayer, that gives advice on finding practitioners of alternative therapies. It is misleading, Professor Ernst said, because it includes disorders for which alternative remedies have been shown to be ineffective. It states, for example, that chi-ropractic is used to treat asthma, digestive disorders and migraine, when it has been shown by rigorous trials only to be useful for back pain. The guide also promotes acupuncture for addiction, when studies suggest that it has no benefit, and homoeopathy, which a major review for The Lancet has indicated works only as a placebo. "It explains what these therapies are used for, and that carries an implication that they work when the evidence suggests that many do not," Professor Ernst said.
The foundation has already withdrawn some sections of the pamphlet from its website, such as a claim that research has shown healing to have benefits for some medical conditions. The Smallwood report, commissioned by the Prince from Christopher Smallwood, an economist, argued that greater provision of alternative medicine on the NHS could save taxpayers' money. A study in the British Medical Journal has shown that only five research projects have examined the cost-effectiveness of alternative medicine, and all but one found that greater provision would add to costs.
Professor Ernst was consulted by Mr Smallwood, but said that his criticisms were ignored. Sir Michael Peat, the Prince's private secretary, accused Professor Ernst of breaching confidence by discussing a draft of the report with The Times. Natasha Finlayson, of the Prince's Foundation for Integrated Health, said: "We entirely reject the accusation that our online publication Complementary Healthcare: A Guide contains any misleading or inaccurate claims about the benefits of complementary therapies. On the contrary, it treats people as adults and takes a responsible approach by encouraging people to look at reliable sources of information . . . so that they can make informed decisions. The foundation does not promote complementary therapies."
Claims and counters
A Guide for Patients Chiropractic: used in disorders of musculoskeletal system such as spine, neck, shoulder problems. It may also be used for asthma
Professor Ernst: no good evidence for anything other than back pain
Acupuncture: increasingly used in trying to overcome addictions to alcohol, drugs and smoking.
The reliable evidence suggests it does not work for addictions
Cranial therapists: the conditions they treat range from acute to chronic health problems
No good evidence for any of this
Homoeopathy: most often used to treat chronic conditions such as asthma; eczema; fatigue disorders; migraine; menopausal problems; irritable bowel syndrome; Crohn's disease; allergies; repeated infections; depression.
Data do not show homoeopathic remedies to be more than placebos
Reflexologists: work with conditions including pain, chronic fatigue, sinusitis, arthritis, digestive problems, stress-related disorders and menopausal symptoms.
No good evidence for any of this
Reiki: used for physical, mental and emotional conditions
There is no good evidence that Reiki is effective for any condition
Shiatsu: used for a wide range of conditions, from injuries to more general symptoms of poor health
No good evidence for any of this
The Smallwood report Phytodolor: recommended for treatment of UK arthritis patients.
This German preparation is not available in the UK
Manipulative therapies: offer advantages over conventional treatments for lower back pain.
A Cochrane review concludes that there is no evidence that this spinal therapy is superior to other standard treatments
17 April, 2008
Antioxidant pills 'increase risk of early death'
More bad news for pill poppers and health freaks generally. The claim that antioxidants in food are somehow different is just deep faith. Note that in the madhouse that is the medical literature, a Cochrane study is unusually authoritative
Researchers at Copenhagen University carried out a review of 67 studies on 230,000 healthy people and found "no convincing evidence" that any of the antioxidants helped to prolong life expectancy. But some "increased mortality".
About 12 million Britons supplement their diets with vitamins and the industry is worth 330 million pounds. But little research has been done on the long-term health implications.
The Department of Health said yesterday that people should try to get the vitamins they need by eating a balanced diet and advised care in taking large doses of supplements. A spokesman said: "There is a need to exercise caution in the use of high doses of purified supplements of vitamins, including antioxidant vitamins, and minerals. Their impact on long-term health may not have been fully established and they cannot be assumed to be without risk. "Anyone concerned about their diet should speak to their doctor or dietitian."
Antioxidants, including vitamins A, E, C and beta-carotene and selenium, are said to mop up compounds, called free radicals, which cause disease. It is this action that researchers believe may cause problems with the defence system. The Danish research, released by the influential Cochrane Library, applied only to synthetic supplements and not to vitamins that occur naturally in vegetables and fruit.
It found that vitamin A supplements increased the risk of death in healthy people by 16 per cent. Taking beta-carotene was linked to a 7 per cent increased risk, while regular users of vitamin E supplements increased the risk of an early death by four per cent.
Although the review found no significant detrimental effect caused by vitamin C, it found no evidence that it helped ward off disease. Millions take it in the hope of avoiding a common cold.
Goran Bjelakovic, who led the review, said: "We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases. "If anything, people in trial groups given the antioxidants beta-carotene, vitamin A, and vitamin E showed increased rates of mortality."
But Patrick Holford, a nutritionist who has formulated supplements for the company Biocare, said: "Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits. "When used properly, in combination with a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health."
A spokesman for the Health Supplements Information Service said: "People should get all the vitamins and minerals they need from their diet, but for the millions who are not able to do that, vitamins can be a useful supplement and they should not stop taking them."
However, Catherine Collins, of the British Dietetic Association, said: "This study is deeply worrying and shows that there should be more regulation for vitamins and minerals. "The public can buy vitamins as easily as sweets. They should be treated in the same way as paracetamol with maximum limits on the dosage."
My most frequent commenter has put up a long comment on this post in which he accused the Cochrane authors above of “cherry-picking” what they studied. Cherrypicking is indeed a common and often fatal flaw in meta-analyses but I would be surprised if Cochrane authors had done it irresponsibly.
I did not look closely at the study myself because the finding is one that was already well-substantiated. See here and here, for instance. It is true, however, that a single author -- Bjelakovic -- seems to be behind much of the review literature. That does not, however, erase the original studies that he reviews and his acceptance as a Cochrane reviewer indicates a judgment that his reviews are indeed representative.
A large mumps outbreak in the United States in 2006 may have been caused by the failure of the vaccine, federal health experts reported Wednesday. In a study reported in the April 10 issue of the New England Journal of Medicine, authors urge a more effective mumps vaccine or changes in vaccine policy to eradicate the disease. The study found that 84 percent of people between the ages of 18 and 24 who became ill in the outbreak had received the second recommended dose. The national incidence of mumps was 2.2 per 100,000. The highest incidence was in persons 18 to 24 years of age, with an incidence 3.7 times that of all other age groups combined.
"Despite a high coverage rate with two doses of mumps-containing vaccine, a large mumps outbreak occurred, characterized by two-dose vaccine failure, particularly among Midwestern college-age adults who probably received the second dose as schoolchildren," the study authors wrote. "A more effective mumps vaccine or changes in vaccine policy may be needed to avert future outbreaks and achieve the elimination of mumps."
The authors conclude that further studies are needed to help evaluate national vaccine policy, including whether the administration of a second dose of MMR [measles-mumps-rubella] vaccine at a later age or the administration of a third dose would provide higher or more durable immunity.
Mumps is a disease caused by a virus that usually spreads through saliva and can infect many parts of the body, especially the parotid salivary glands. These glands, which produce saliva for the mouth, are found toward the back of each cheek, in the area between the ear and jaw. In cases of mumps, these glands typically swell and become painful. Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, more than 200,000 cases occurred each year in the United States. Since then the number of cases has dropped to fewer than 1,000 a year, and epidemics have become fairly rare.
16 April, 2008
Some trans fats are good for you
Natural trans fats found in yogurt, some meats are actually beneficial, U of A research shows. Another hole in the conventional wisdom
Not all trans fats are bad for your heart, new research from the University of Alberta has found. In fact, natural trans fats found in yogurt, cheese, milk and your favourite cut of beef or lamb chop may actually lower your cholesterol and help reduce your risk of cardiovascular disease, obesity and diabetes, says Flora Wang, a PhD student in the U of A's agricultural, food and nutritional science department. "We want people to realize that natural trans fats are not necessarily detrimental," Wang said.
She noted that the natural trans fats are far different than the industrial trans fats bursting from butter tarts, doughnuts and margarine squares. "We want to attract more attention and focus in the protective effect of these natural trans fats which might even be beneficial in those people with higher risk of heart disease."
Wang's research focused on foods with trans vaccenic acid, the most prominent natural trans fat found in dairy and beef products. For 16 weeks, she fed obese and diabetic rats a diet enriched with trans vaccenic acid and discovered their total cholesterol was reduced by approximately 30 per cent. Low-density lipoprotein -- or bad cholesterol which can build up in and clog the arteries that feed the heart and brain -- was lowered by 25 per cent.
Triglyceride levels -- a form of fat that is elevated in people who are obese, smoke and drink a lot or eat too many carbohydrates -- went down by more than 50 per cent. "It's kind of challenging the traditional idea of bad trans fat," Wang said. "People, if they know there might be some beneficial components of the fatty acid in the dairy product, they probably could make better choices and have wider alternatives."
With this new information, Wang and her supervisor, Spencer Proctor, want Health Canada to reconsider how they instruct manufacturers to label their foods. Cookie-makers and dairy producers are required to report all trans fats (except a healthy fatty acid called conjugated linoleic acid) on their food labels, but they don't need to differentiate between the good trans fats and the bad trans fats. Most likely, any trans fats identified in a carton of milk or tub of yogurt is 90 to 95 per cent natural -- and good -- trans fats, Proctor said. "We shouldn't be calling all trans fats equal," he said.
He said fast-food outlets and doughnut shops also need to know that as they drain their foods of bad trans fats because of public pressure to offer healthier alternatives, they may be inadvertently getting rid of the good trans fats, too. Wang and Proctor are now searching for funding and planning a clinical trial to feed diets rich in trans vaccenic acid to people. If the natural fat actually lowers people's risk for obesity, diabetes and heart disease, Proctor imagines dairy technology could, in the future, increase the levels of good trans fats in foods to offset the bad ones
Beware of the dog: you may catch MRSA
They might be man's best friend, but dogs should be sold with a health warning, a study suggests. Letting a dog lick your face, picking up its mess or allowing it to sleep on your bed could put you at risk of catching salmonella, campylobacter or MRSA.
Research commissioned by the Department for Environment, Food and Rural Affairs (Defra) from the University of Liverpool Veterinary School, has identified health risks in the interaction between man and dog. The findings, published in The Veterinary Record, may enrage the country's 6.5 million dog owners. Men, in particular, may have to learn cleaner habits because it seems they have a problem picking up dog mess.
Risks of infection from dog to Man at present are low. Carri Westgarth, a researcher on the project, insists that she has no wish to create a scare. Owning a dog has positive health benefits ? people who walk them tend to be fitter and have lower blood pressure.
The research has irritated dog lovers. Caroline Kisko, secretary of the Kennel Club, said that Defra should be spending resources on policies to help to tackle animal welfare. She said: "It has told us nothing, except perhaps to use a bit of common sense."
Carolyn Menteith, a dog behaviourist, was also dismissive. "You are more likely to catch a disease from a child than a dog. I do agree owners should clear up after their dogs, otherwise they cause a social nuisance. Men are worse at it and somehow think it's unmanly to be walking around with a nappy sack. But if you can't do that, don't get a dog, get a stuffed toy."
15 April, 2008
Fatism? Obesity is bad but you must ignore it??
The Left hand does not know what the right hand is doing here. With all the propaganda against obesity, is it any wonder that fatties feel more disrespected these days? If fat-discrimination is to be banned does that mean that all the obesity warriors will become bigots? I think they are myself so that would be amusing. Fancy one of the approved bigotries of our time coming under fire! Maybe anti-Christian bigotry might become recognized for what it is too!
As obesity rates continue to rise in the U.S., so might our acceptance of those who are overweight. But a new study from Yale University suggests the converse trend: rather than feeling tolerance in our society, the overweight and obese say they feel more heavily discriminated against now than they did a decade ago.
Led by Tatiana Andreyeva, a postdoctoral research associate at Yale's Rudd Center for Food Policy and Obesity, a team of researchers questioned 1,100 subjects, aged 35 to 74, twice over a 10-year span (once between 1995 and 1996, and again between 2004 and 2006). The respondents answered 11 questions about whether they had been discriminated against in the context of common life experiences - including applying to college or for a scholarship, renting or buying a home in a neighborhood they desired, applying for a bank loan or dealing with police. Participants answered nine additional questions about everyday experiences, such as how they were treated in restaurants, and whether they had encountered name-calling, harassment or threats. The subjects were asked to indicate the reasons they felt they had been discriminated against (facing police harassment, for example, or being denied bank loans), whether it was because of age, gender, race, height or weight, physical disability, sexual orientation or religion.
Between the two survey periods, the rate of discrimination due to height or weight increased from 7% of respondents to 12% of respondents. (The scientists determined separately that the people who reported discrimination due to height or weight were also more likely than other participants to be overweight or obese.)
The study is one of the first to track patterns of discrimination based on weight. It's worth noting, however, that the survey relied on people's own perception of discrimination - the authors did not require the subjects to document bias in any way. In addition, the authors found that rates of discrimination by age and gender also increased in the same time period, suggesting that several forms of bias - or perhaps sensitivity to perceived bias - is on the rise overall, not just against the overweight.
Nevertheless, the study did track the same population over time, and Andreyeva says that an increase even in people's perceived sense of maltreatment is an important measure of our society's attitudes. In this report, weight ranked third behind age and race as the most common form of prejudice. "If a person perceives he is being discriminated against," Andreyeva says, "it might have significant consequences for his or her health and mental health. Even the perception of discrimination can be important because it is self-perpetuating." And if rates of weight discrimination are indeed on the rise, say the authors, then it's up to society to mandate legal protections for those who are overweight, just as laws protect people from discrimination by race, gender, disability and age.
Trans-fats linked to breast cancer risk in study
This study is an example of the lowest form of epidemiological crap. Not only is the data correlational only but it relies on self-reports. It enables NO causative inferences whatever, let alone scientific dietary recommendations. All that the data probably shows is that lower class people are both less fashionable in their diet and also (for various reasons) have poorer health
Trans-fats, which are being phased out of food because they clog arteries, may raise the risk of getting breast cancer, European researchers reported on Friday. They found that women with the highest blood levels of trans-fats had about twice the risk of breast cancer compared to women with the lowest levels. "At this stage, we can only recommend limiting the consumption of processed foods, the source of industrially produced trans-fatty acid," the researchers wrote in the American Journal of Epidemiology.
Trans-fats or trans-fatty acids are made in creating artificially hardened fats -- in the process of hydrogenization, for instance. They were, ironically, meant to be healthful replacements for artery-clogging saturated fats such as butter and lard. But the process of making vegetable oil behave like butter made it as unhealthful as butter. New York and California have banned trans-fats in restaurant foods. Canada and Britain have considered it and countless food companies have dropped them as an ingredient.
Veronique Chajes of the French national scientific research center at the University of Paris-South and colleagues studied women taking part in a large European cancer trial. They looked at blood samples collected between 1995 and 1998 from 25,000 women who had volunteered to report on their eating and lifestyle habits and then be followed for years to see if they developed cancer. They studied 363 women diagnosed with breast cancer, comparing their blood levels of fatty acids with those of women without cancer.
The higher the levels of trans-fatty acids, the more likely a woman was to have cancer, Chajes and colleagues found. Women with higher levels of omega-3 fatty acids, being studied for their potential benefits to health, were not any less likely to have breast cancer, the researchers found.
Obese women are more likely to develop breast cancer [That is the EXACT OPPOSITE of the truth], among other types of cancer, and high-fat diets are also linked with breast cancer.
Trans-fats can be found in cooking fats, baked goods, snacks and a variety of other prepared foods. Omega-3 fatty acids are found in fatty fish such as salmon, walnuts and leafy green vegetables.
14 April, 2008
Contraceptive for men a shot in the arm
New Australian-developed contraceptive jab for men, taken four times a year, has been proven to be just as effective as birth-control pills for women. Sydney researchers found the hormonal injection is a quick and reliable method of contraception for up to 95 per cent of males. Until now, the only effective non-barrier contraceptive for men was a vasectomy, meaning that women tended to take on theresponsibility. Now there is an alternative - but pharmaceutical companies have shown little interest in making it available to the public.
The new jab works by suppressing sperm output but does not have a permanent effect. Made up of a combination of the hormones androgen and progestin - mostly testosterone - it needs to be administered every two to three months. Researchers from the ANZAC Research Institute, University of Sydney and Concord Hospital studied 1756 men aged 18 to 51 and found the combined jab was quicker and more effective than an androgen-only version.
Associate Professor Peter Liu, co-author of the integrated analysis study, said he was disappointed pharmaceutical companies had pulled out of the project to develop a commercially available male contraceptive jab. "I think there's a real need for it because I see a lot of couples where a female doesn't want to use or is intolerant to a female contraceptive pill or males who want to delay vasectomy" Professor Liu said. "There are also couples who say it's not fair, why should (birth control) be up to the female? I hear that from both partners."
Research has been hindered by a shortage of government interest and funding. "My perception is that people want it but it seems to be that somehow that isn't being heard at a government level," Professor Liu said. "No one has really pushed this issue and I don't know why that is. Sometimes, the Government doesn't know what the community wants so the community has to tell them."
The jab is as effective as a vasectomy without the need for surgery or stopping sperm completely, according to the study which has been published in the Journal of Clinical Endocrinology and Metabolism, and Medical Observer magazine. "We conclude that androgen-progestin administration can suppress sperm output in a timely fashion to concentrations that are compatible with reliable contraception in most, but not all, men," the study authors wrote. "The rate of suppression is comparable to that achieved after vasectomy."
The World Health Organisation is understood to be planning an international study to test a three-monthly androgen-progestin combination injection for men. Countries such as China, where population growth is exploding, are expected to be among the biggest markets for the new jab.
Look, no scars: organs removed via the mouth
The minister charged with overhauling the NHS is testing a new form of scar-free surgery in which diseased organs are pulled out through the patient’s throat. Professor Lord Darzi, chair of surgery at Imperial College London, has conducted preliminary experiments with the technique in which robotically controlled instruments are lowered into the patient’s stomach. A hole is made in the lining of the stomach, then the organ - usually an appendix or gall bladder - is cut out and pulled up through the throat before the hole is stitched, leaving the patient with no external scars and a reduced risk of infection because the wounds are not exposed to the air. [But it is exposed to acid!]
The technique, called natural orifice translumenal endoscopic surgery, has been successfully used on patients in America, France and India. Darzi, who became a health minister last year, is one of the first surgeons in Britain to use the technique in experiments on pigs, before the first human tests. While admitting it was still “early days”, Darzi believes the probe could eventually be used to remove cancers.
The main after-effects include a sore throat and an unpleasant taste in the mouth from having a diseased organ pulled through it. Other orifices could be used but Darzi said he believed the mouth was the most promising. He said some aspects of the procedure needed perfecting. “If we are going to enter through the stomach we need to develop the appropriate tools to make sure we can close the hole properly,” he said.
Darzi’s team are developing a new surgical robot called the iSnake, which they hope will assist in the new procedure and in keyhole surgery. Other research projects on the new procedure are under way at hospitals around Britain. The first operations on patients in Britain are expected in three to four years.
13 April, 2008
Amazing authoritarianism over "obesity" in Japan
I guess that the Bushido code is not dead
To curtail Japan's overweight population, the Japanese health ministry recently mandated that all waistlines among its 56 million workers over age 40 be below "regulation size" of 33.5 inches (for men). Any company failing to bring its employees' weight under control--as well as the weights of their family members--will be fined up to 10% of its earnings by the government.
According to government officials, 27 million Japanese--about half of all adult workers--have health indices (cholesterol, blood pressure, blood sugar and BMI) that don't meet ideal numbers, and will be targeted for mandatory medical intervention. The director of the Medical Urban Clinic in Osaka, Toshio Mochizuki, says he is concerned about the new movement. "I'm worried that the overweight will start to be shunned at the workplace and these new rules will make no one want to hire them," he said.
Faces give away giveaways - psych profs' amazing claim
I think that the mocking tone of the report below is probably justified
In today's pseudoscience news, the quality press is alive with the findings by UK psych researchers that people can fairly reliably tell how slutty someone is merely by looking at a picture of their face. Psychologists at several UK universities teamed up on the research, which will plainly lead in short order to the betterment of humanity. The link between looking dirty and being a tramp was firmly established for both sexes.
This was done by asking students to fill out questionnaires regarding how likely they were to put out, how often they had done so lately etc. Data from such questionnaires is well known to be solidly grounded in fact. This done, the subjects were photographed.
Other students were then asked to look at the photographed faces and say how easy they reckoned the pictured individual might be. In a staggering 72 per cent of cases, they correctly guessed whether the person in the portrait was or was not a slag. Or at least, whether or not they were likely to admit being a slag on an anonymous questionnaire.
"We may be subtly aware of other people's attitudes to sex," says Dr Lynda Boothroyd of Durham Uni, lead author of the groundbreaking slapper-spotting research. "What is far more interesting is that despite the subtlety of the explicit awareness... there is a very strong tendency for women to be attracted to... men who are less interested in casual sex. Men have the opposite preference with female faces; they strongly prefer the [easy] women."
Participants were also asked to rate faces on how masculine/feminine they looked, and the researchers believe this shows a connection between masculine aspect in men and a tendency to be anyone's after a couple of drinks. It seems that the study also supports the idea that "male masculinity" has "negative connotations... for long term partnerships".
In other words, manly men are easy, and women don't like that. Or put another way: "Androgenisation in men is related to less restricted sexual behaviour... women are averse to unrestricted men." Comfort, then, for any chaps out there who don't look very studly and don't get much action - it seems women are much more attracted to your type. Even if they sometimes have an odd way of showing it.
12 April, 2008
Blood pressure treatments
I would like to see all these treatments independently compared with placebo over an extended period. Do the pills make a difference to mortality? Only a double blind study could really tell us. It seems that Micardis has been shown in clinical trials to have anti-hypertensive effects only. Its effect on mortality is just speculation. The "survey which suggested" in the final paragraph below was obviously not a double-blind trial -- and surveys suggest many things that later turn out to be wrong. "But the leap from hypertension reduction to reduced mortality is a highly plausible speculation", someone might say. True. But even plausible speculation can be wrong, as we see in the second study below
Though it is never too late to treat high blood pressure, the sooner it is treated the less likelihood there is of patients suffering strokes, heart attacks, heart and kidney failure. Professor Graham MacGregor, chairman of the Blood Pressure Association, says that poor blood pressure control causes about 125,000 unnecessary strokes and heart attacks every year in the UK, about half of which prove fatal.
The therapeutic inclinations of British doctors are conservative. When prescribing for early, symptom-free high blood pressure, their thoughts are almost welded to the established habit of treating it with a diuretic thiazide tablet - the water pill - with or without a beta blocker. This combination was revolutionary when it was introduced, and it remains the treatment of choice for patients with a history of heart attacks, heart failure or difficult, atypical angina. However, there are now better ways to treat newly diagnosed blood pressure that achieve better results with less risk of side-effects.
The drawbacks of thiazide diuretics are that they increase a patient's likelihood of developing type 2 diabetes, and both they and beta blockers may be factors in causing impotence in men. The British Blood Pressure Association has adapted the NICE guidelines to take into account the newer drugs that control blood pressure with fewer side-effects. Patients currently taking beta blockers with or without the thiazides should never stop taking beta blockers without talking to their doctor. However, in the opinion of Professor MacGregor, they would be advised to discuss with their doctor whether it would help them to change to the newer drugs.
The question of the benefits afforded by careful selection of drugs to treat high blood pressure was a talking point at the recent meeting of American cardiologists in Chicago. The standard treatment pattern for patients under 55 with high blood pressure is either an ACE inhibitor or an ARB. There had been doubts over which was the better one to prescribe. A survey comparing Micardis (telmisartan) and ARB with a standard ACE inhibitor suggested that those high-risk patients taking Micardis suffered fewer side-effects, without any loss of effectiveness. The same trial, which included 25,600 people at high risk of a cardiovascular event, indicated that there was no advantage to taking both an ACE inhibitor and an ARB. Although a patient's blood pressure fell farther, the outcome was not improved and the side-effect profile was worse.
The other talking point at the Chicago meeting was a survey which suggested that elderly people - ie, the over-80s - with high blood pressure could still receive major benefits from having the condition treated, even if they had not done so in the past. With treatment, strokes were reduced by 30 per cent, heart failure by 64 per cent, and there was a 20 per cent reduction in death from all causes.
Cancer vaccine advance
FORMER Australian of the Year Ian Frazer has uncovered a clue as to why vaccines designed to kill cancer rarely work in people Â¿ a discovery which may point the way towards boosting their effectiveness.
Scientists have been trialling vaccines in the treatment of patients with melanomas and kidney cancers but results have been disappointing. "They've worked in animal models but they didn't kill the cancer cells in people," Professor Frazer said.
The Brisbane scientist and colleagues at the University of Queensland's Diamantina Institute believe they have found out why. Once a vaccine is administered, the cancer immediately responds by mounting a counter-attack producing proteins, called cytokines, which block the effect of the treatment.
"In the animal model, we've found that if we block these cytokines so they can't do anything . . . the cancer can be controlled," Professor Frazer said. "We're encouraged that the animal studies have shown us how to overcome a problem which we've previously recognised existed (and) that we didn't know how to sort out. "This is an optimistic step in the right direction."
The scientists hope to start human trials to test their theory within a year. "We've got to show that what works in animals also works in humans and it may not," Professor Frazer said. If scientists can boost their effectiveness, vaccine therapies for cancer offer advantages over traditional ones because they have few toxic side effects. Professor Frazer talked about the latest research to the Sir Mark Oliphant Conference on Vaccine and Immunotherapy Technologies in Canberra.
11 April, 2008
Birth Control Pill Linked to Hardening of the Arteries
This seems fairly sound. It's epidemiological but it is difficult to see what confounds there could be
Researchers at the University of Ghent, conducting a long-term study on 1,300 healthy women aged 35 to 55 living in a small town in Belgium, have observed that those women who take oral contraceptives may have more plaque (a hard, fatty deposit) buildup in their arteries. Atherosclerotic plaque is comprised of cholesterol, bacteria and calcium which adheres to the inner lining of arteries.
Approximately 81 percent of participants had taken birth control pills for at least a year at some point in their lives, and 27 percent were currently taking the contraceptives. The researchers conducted ultrasound examinations of the participants' leg and neck arteries to measure levels of plaque buildup. Every 10 years of oral contraceptive use was correlated with a 20 to 30 percent increase in plaque buildup.
According to lead researcher Ernst Rietzschel, this amount of plaque buildup is cause for concern because of increased risk of heart disease and stroke, and the study indicates a need to conduct new investigation into the safety of oral contraceptives. "It's incredible that a drug which has been taken by 80 percent of women ... is almost bereft of any long-term outcome safety data," Rietzschel said in a NaturalNews report.
Birth control pills are taken by about 100 million women worldwide. Previous studies have shown that synthetic hormones used for birth control greatly increased the risk of blood clotting. This new Belgian study adds the increased risk of atherosclerotic plaque formation, in relatively young women, to the risk of clot formation. Clots typically form in the legs and can cause serious injury and death if they travel to the heart, lungs or brain.
Two years ago, pharmaceutical giant Johnson and Johnson, recalled the Ortho Evra birth-control patch after lawsuits revealed definitive proof that women on the patch were dying of strokes and blot clots three times more frequently than the general population. The lawsuits charged that Johnson and Johnson failed to properly investigate the product's safety and stated that the company deceived the public about the severity of potential side effects, which include strokes and severe blood clots. FDA records show that seventeen patch users between the ages of 17 and 30 suffered fatal heart attacks, blood clots and possible strokes between August 2002 and November 2005.
Women have previously been considered much less likely than men to have strokes or heart attacks due to cholesterol build-up in their arteries. However, women on the pill approach the level of risk of men for plaque formation, according to this study. The link between chemical birth control and breast cancer, though widely studied, documented and published in medical journals, is still ignored by the major media and as a result women taking oral contraceptives seem to be largely unaware of the risks.
Dr. Andrew Penman, CEO of the Cancer Council of NSW (New South Wales, Australia), said that although he still believed the risk of breast cancer in women younger than 50 was minimal, most women were unaware of the possible risks of taking the pill. "The problem with the pill is that it is such a money spinner that the money gets in the way of the risks," Dr. Penman said.
A prize example of pissing into the wind
CHOCOLATE made using child slavery will be banished from Parliament under a plan by South Australian MP Christopher Pyne. Mr Pyne was inspired by World Vision chief Tim Costello and U.S. ethics professor Dr David Batstone, who are attempting to abolish slave labour by removing the market for goods.
In Adelaide this week Mr Costello said Australians were helping to finance international child slavery. He highlighted the plight of children enslaved to provide coffee, chocolate and clothing to the West. "Chocolate is cheap for us because of trafficked children and child labour," he said. "Seventy per cent of the world's cocoa comes out of the Ivory Coast and Ghana (where it is harvested by child slaves [child labour is indeed common in poor countries but "slaves"?])." Mr Costello said many other products, including iron, coffee and clothing come from a supply chain that included children. "The great need is actually for the consumer to really demand transparency in the supply chain," he said.
After meeting Mr Costello and Dr Batstone, Mr Pyne decided to write to Prime Minister Kevin Rudd with his plan to remove all non fair-trade chocolate from vending machines in all Parliamentary offices. "I think this is a very worthy cause," he said. "I think most constituents in my electorate would be horrified to know that there are 27 million slaves in the world today, many are children, and they're being used."
10 April, 2008
MORE LAUGHABLE RESEARCH INTO SMOKING
The brainiacs below found that physically active people are more likely to ATTEMPT to give up smoking. What does that tell us? Nothing that I can see. If they also SUCCEEDED at giving up that might be interesting. I am going to have to give up reading the crap that is the medical literature one day. How much of it can I stand? Or does the April 1 date below tell us something? I sorta hope it does. It's certainly an appropriate date for what they have published
Characteristics of Physically Active Smokers and Implications for Harm Reduction
By Wayne K. deRuiter et al
Objectives: We sought to establish the prevalence of physical activity among smokers, whether or not physically active smokers were more likely to attempt cessation, and who these physically active smokers were.
Methods: We used logistic regression to contrast physically active and inactive smokers in a secondary data analysis of the Canadian Community Health Survey Cycle 1.1.
Results: Physically active smokers represented almost one quarter of the smoking population. Compared with physically inactive smokers, physically active smokers were more likely to have attempted cessation in the past year. Physically active smokers were more likely to be young, single, and men compared with their inactive counterparts. Income had no influence in distinguishing physically active and inactive smokers.
Conclusions: Skepticism persists regarding the practicality and potential risks of promoting physical activity as a harm-reduction strategy for tobacco use. We found that a modest proportion of the daily smoking population was physically active and that engagement in this behavior was related to greater cessation attempts. Interventions could be developed that target smokers who are likely to adopt physical activity.
American Journal of Public Health, April 1, 2008
THIS IS NOT EVEN AN ATTEMPT AT OBJECTIVE SCIENCE
The old secondhand smoke religion defended below. Note that the aim was to "generate locally relevant data to motivate the development of tobacco control policies". That sure is frank: No attempt at objectivity. The conclusion is foreordained. What gets published in the medical journals never ceases to amaze me. And the research is crap. All they showed is that people living with smokers had more exposure to smoke. As if we didn't know that already! There is NOTHING in their findings that supports their conclusions.
Secondhand Smoke Exposure Among Women and Children: Evidence From 31 Countries
By Heather Wipfli et al.
Objectives: We sought to describe the range of exposure to secondhand smoke (SHS) among women and children living with smokers around the world and generate locally relevant data to motivate the development of tobacco control policies and interventions in developing countries.
Methods: In 2006, we conducted a cross-sectional exposure survey to measure air nicotine concentrations in households and hair nicotine concentrations among nonsmoking women and children in convenience samples of 40 households in 31 countries.
Results: Median air nicotine concentration was 17 times higher in households with smokers (0.18 micrograms/m3) compared with households without smokers (0.01 micrograms/m3). Air nicotine and hair nicotine concentrations in women and children increased with the number of smokers in the household. The dose-response relationship was steeper among children. Air nicotine concentrations increased an estimated 12.9 times (95% confidence interval=9.4, 17.6) in households allowing smoking inside compared with those prohibiting smoking inside.
Conclusions: Our results indicate that women and children living with smokers are at increased risk of premature death and disease from exposure to SHS. Interventions to protect women and children from household SHS need to be strengthened.
American Journal of Public Health, April 2008, Vol 98, No. 4, 672-679
9 April, 2008
Brunettes bag the billionaires, blondes get the barmen
These frequencies probably just reflect the frequencies of the different hair colours in the respective populations. And with hair colour very changeable and changing, it is in any case hard to know what is being surveyed here
It's official, if you're a brunette like Carla Bruni, you're more likely to marry a successful man than your blonde counterparts. Experts at LOVE@LYCOS the dating channel of Lycos.co.uk analysed the WAG's hair colour of the world's top 100 billionaires to determine if there is a predominant hair colour wealthy men seen to go for. The majority by a long way were brunettes, with 62% of billionaires marrying women with brown hair.
The results went on to show that fair haired ladies come in a poor second with only 22% of the world's top billionaires marrying blondes. Women with black hair lag behind in third place, enticing on 16% of the world's wealthiest, whilst carrot-tops come in last.
Drug to fight aggressive breast cancer now subsidized in Australia
The breast cancer treatment, Tykerb, has been placed on the the Pharmaceutical Benefits Scheme (PBS), making it cheaper for women affected by an aggressive form of the disease. Federal Health Minister Nicola Roxon announced today that from May 1, Lapatinib, known commercially as Tykerb, would be subsidised under the scheme's arrangements. Tykerb had been found to slow the progress of and improve symptoms associated with advanced HER-2 positive breast cancer, Ms Roxon said. "Without any subsidy, the medicine would cost women between $3500 and $4000 each month," she said. "Lapatinib will be available to people with HER-2 positive metastatic or advanced breast cancer for whom other treatments have proved ineffective."
The drug is used in treating a particularly aggressive form of disease known as advanced HER-2 positive breast cancer. "HER-2 positive breast cancer is an aggressive form of cancer that particularly impacts upon younger women," Ms Roxon said. "Around 87 per cent of patients diagnosed with advanced breast cancer will die from the disease within five years. "About 2000 Australians are diagnosed with HER-2 positive breast cancer each year. "HER-2 positive breast cancer is one that has spread to distant parts of the body (metastasised) or which cannot be removed with surgery."
Ms Roxon said breast cancer was the most common cancer in women and affected 14,000 Australians per year. In 2004, more than 2600 people died from the disease in Australia.
An international study released in 2006 found that Tykerb and the chemotherapy drug Xeloda in combination were effective in women who had failed to react to Herceptin. The combination slowed down the disease's progression compared to chemotherapy alone and reduced the risk of the cancer spreading to the brain. The therapy has already been approved for use in the US and overseas analysts have predicted that Tykerb could eventually record annual global sales of about $A4.5 billion.
8 April, 2008
Moronic body of psychologists doubts that it upsets a kid to see animosity between his or her parents
Feminists at work, no doubt. Women are ENTITLED to alienate their children from their father, you see
Child custody determinations in scores of Family Court decisions could be challenged following a ruling debunking parental alienation syndrome, a controversial diagnosis of the effects on a child when one parent denigrates the other. The Psychologists Board of Queensland last month disciplined prominent Brisbane clinical psychologist William Wrigley, saying he had acted unprofessionally in giving evidence about parental alienation syndrome to the court. An investigation found that Dr Wrigley's evidence three years ago, which had led to a mother losing custody of her two children, constituted "professional conduct that demonstrates incompetence or a lack of adequate knowledge, skill, judgment or care".
The Australian understands that Dr Wrigley has identified the syndrome as a factor in other cases to the Family Court. So have psychologists and psychiatrists throughout Australia. The syndrome was diagnosed in 1985 by US clinical psychiatrist Richard Gardner, an advocate of a father's right to custody, even in cases where he had been accused of abuse. He argued that some parents who criticise other parents or step-parents in front of children were guilty of psychological abuse. Dr Gardner's theories remain highly controversial among psychiatrists, psychologists and therapists, who claim they are simplistic or erroneous.
The complaint was lodged by the Brisbane mother who lost custody of her two children in 2005 when Family Court judge Neil Buckley determined, acknowledging the evidence of Dr Wrigley, that she had affected the children with the syndrome. Justice Buckley said Dr Wrigley's reports provided a "comprehensive and balanced assessment" of all relevant issues. "It has to be said that in terms of objectivity, professionalism, fairness and balance, his reports are in stark contrast to those provided by (other professionals)," he said.
The board advised Dr Wrigley on March 3 of its unanimous decision that he had "acted in a way that constituted unsatisfactory conduct" for "referring to an unrecognised syndrome in his reports". "It was inappropriate for the registrant (Dr Wrigley) to either diagnose the children or state there was a likelihood the children could develop parental alienation syndrome, as it is not a recognised syndrome," it said. "To diagnose a patient as suffering from or demonstrating a potential to develop an unrecognised syndrome is contrary to the code of ethics." However, the board advised that details of the disciplinary action not be recorded on the public register because it was "not within the public interest". The board told The Australian it was precluded by law from commenting on the disciplinary action taken against Dr Wrigley.
Family Court Chief Justice Diana Bryant last year posted on the family law court website a "fact sheet" about the syndrome, which said the malady was used in evidence, but warned that it was not accepted as "a psychiatric disease". Chief Justice Bryant's notice cited several cases "where PAS has been rejected or not accepted as a concept". The cited cases, with names excluded, included the controversial matter for which Dr Wrigley was disciplined by the psychologists board.
Apples shown to reduce heart disease, cancer risk (?)
The original report does not seem to be available online anywhere, but no doubt it is more of the antioxidant religion based on epidemiological speculation and self-reports. That it was produced by a "dietician" rather than by an academic does not inspire confidence. Academics are unreliable enough ...
APPLES are a "nutrition powerhouse" and really do keep the doctor away, according to a new health report. The comprehensive review of scientific research published in the past 10 years, has found apples are one of the only foods identified to reduce the risk of heart disease and certain cancers – two of the biggest causes of death in Australia. Apples are also associated with asthma protection, can reduce the risk of type II diabetes and help with weight loss.
The report also found that apples have the highest antioxidant content of all Australia's popular fruits. The author of The Apple Report, dietitian Shane Landon said yesterday: "Not only does an apple have around 1½ times more antioxidants than a 75g serve of blueberries, it has more than twice the antioxidants of a cup of tea, about three times the antioxidants of an orange and almost eight times the antioxidants of a banana. "We often hear about new foods hitting the supermarket shelves that have had this or that nutrient added to them during processing, but apples are a natural nutrition powerhouse," Mr Landon said.
Australians eat around one apple a week, but if everyone ate just one more serve of fruit or vegetables every day, the Australian Fruit and Vegetable Coalition estimates more than $150 million a year would be saved on healthcare costs for cardiovascular disease alone. "The research is compelling and the health message is simple – we must get back to basics," Mr Landon said. "An apple a day is a very good start."
Meanwhile, breast implants, deodorant and coffee are extremely unlikely to cause cancer, according to a new risk report designed to allay panic that everything can be carcinogenic. The new risk assessment developed by an Australian cancer specialist puts in perspective the risks of contracting the disease from a range of agents, including dental fillings, marijuana and cured meats.
Cigarettes, alcohol, deliberate exposure to sunlight and some relatively rare cancer drugs sit in the highest risk bracket for proven carcinogens, said Professor Bernard Stewart, from the University of NSW and South Eastern Sydney and Illawarra Health. Among the "likely" risks were marijuana, solarium use, eating large quantities of processed meats and living near a waste dump.
The professor all but ruled out risk for a range of other rumoured carcinogens including artificial sweeteners, coffee, deodorant, dental fillings, breast implants and fluoridated water. "No one should seriously lose sleep or change their behaviour in respect of these very, very unlikely things," he said.
7 April, 2008
WHEN IS A CONTROL GROUP NOT A CONTROL GROUP?
One day I am going to find a research report in the medical journals that renders me speechless. The one below came close. A persuasive research report requires a control group and the study below has one. But it is a useless control group. The Tai Chi exponents could more usefully have been compared with themselves before undertaking the program. Instead BOTH groups undertook the program and it is their responses which are reported below. What was needed was for the control group to complete some program that was NOT Tai Chi but which was equivalent in degree of exertion, time spent etc. I would not pass this as as an adequate research design from a third-year student. It is utterly and completely brainless. Yet here is it in a medical journal. I am sure the public believe that medical research is conducted according to the highest standards. I am inclined to think that it is the field where standards are lowest.
Regular Tai Chi Chuan exercise improves T cell helper function of type 2 DM patients with an increase in T-bet transcription factor and IL-12 production
By Shu-Hui Yeh et al.
BACKGROUND-- Exercise has been shown to be beneficial in treatment of type 2 diabetes mellitus (DM); its benefit to immune function, however, remains to be determined.
OBJECTIVE-- This study investigated the effect of a 12-week course of Tai Chi Chuan (TCC) exercise on T cell helper (Th) reaction in type 2 DM patients.
DESIGN AND METHODS -- This study was a case-control design. Thirty pairs of type 2 DM patients and normal age-matched adults completed this study. Fasting blood glucose, HbA1c, mediators (IL-12, IL-4 and TGFfO) and transcription factors (T-bet, GATA-3 and FoxP3) of Th1/Th2/T regulatory (Treg) reaction were measured before and after a 12-week TCC exercise program.
RESULTS -- Fasting glucose and HbA1c levels in the participating type 2 DM patients were significantly higher than age-matched controls before exercise. After the TCC exercise, HbA1c levels in type 2 DM patients significantly decreased (7.59 Ó 0.32 vs. 7.16 Ó 0.22 %; P= 0.047), along with a significant increase of blood IL-12 levels (5.96 Ó 1.10 vs. 12.96 Ó 3.07; P = 0.035). To probe molecular Th1/Th2/Treg reaction, we found that type 2 DM patients had lower T-bet, but not GATA-3 or FoxP3 expression than normal controls before TCC exercise. After the 12-week TCC exercise, T-bet expression significantly increased in type 2 DM patients.
CONCLUSIONS -- A 12-week TCC exercise program decreases HbA1c levels, along with increase of the Th1 reaction. A combination of TCC with medication may provide even better in both metabolism and immunity of type 2 DM patients.
Br J Sports Med. 2 April 2008
Australian doctors welcome new schizophrenia drug
HEALTH experts have welcomed a drug introduced to treat schizophrenia. They hope the Federal Government's decision to subsidise the atypical antipsychotic Invega, which reduces the worst side effects of older-style drugs, will encourage patients to keep taking their medication and help them re-integrate into society.
Dr Harry Hustig has been treating eight patients with Invega (paliperidone) as part of a clinical trial at Glenside Psychiatric Hospital in Adelaide. He said studies showed three-quarters of schizophrenics stop taking their drugs within two years because of side effects such as shaking, sexual dysfunction, restlessness, sedation and weight gain, while others turn to alcohol and drug abuse.
Pharmaceutical company Janssen-Cilag said Invega adjusted the imbalance of two brain neurotransmitters - dopamine and serotonin - involved in schizophrenia and used innovative delayed-release technology to ensure a continuous level in the bloodstream over a 24-hour period. Invega became available on the Pharmaceutical Benefits Scheme last week and is expected to save the taxpayer up to $1 million over five years.
Schizophrenia Fellowship of NSW chief executive Rob Ramjan said: "Some argue there is no need for medication in mental health and it's a socially constructed concept but the illness is horrendous. "If you have spent time with someone having an acute episode they're going through torture."
Schizophrenia affects 1 to 2 per cent of the population. It typically develops in adolescence or early 20s and causes hallucinations, paranoia, delusions, hearing "voices" and psychosis.
6 April, 2008
A father's legacy to a child's health may start before conception and last generations (?)
The idea that characteristics acquired during the lifetime can be passed on genetically is known as Lamarckism. Its best known exponent was Stalin's Trofim Lysenko and the whole idea is now generally ridiculed. Studies with rodents do however suggest that some characteristics caused by chemical exposure can be passed on to offspring even though the DNA remains unchanged. Such phenomena are now called "epigenetic" influences. I will not attempt to make any comment on the rodent studies but I think that the studies in humans mentioned below are unconvincing. The studies are epidemiological so are intrinsically capable of many explanations. Attributing the differences observed to epigenetic effects is therefore pure supposition.
The lack of insight below is in fact rather pathetic. Take this sentence: "the team found that babies of teenage fathers, but not middle-age men, had an elevated risk of still birth, low birth weight, and other birth problems". What does that tell you? It tells me that underclass people reproduce earlier and have more health problems and that they pass those problems on in the normal way. What we are seeing in the data, in other words, is simply the underclass influence. That early childbirth is to a large extent an underclass phenomenon and that lower social rank tends to go with poorer health is well established. So the idea that the differences are passed on "epigenetically" is in fact the least parsimonious explanation and so should have its throat cut by Occam's razor.
Pregnant women know the drill. Don't drink. Don't smoke. Don't eat too much fish. Take vitamins. Mothers have long shouldered the responsibility, and the blame, for their children's health. Fathers don't usually face the same scrutiny.
How a man lives, where he works, or how old he is when his children are conceived doesn't affect their long-term health, scientists used to think. But growing evidence suggests that a father's age and his exposure to chemicals can leave a medical legacy that lasts generations.
Animal studies demonstrate that drugs, alcohol, radiation, pesticides, solvents, and other chemicals can lead to effects that are handed from father to son. Human studies are less clear, but some show that fathers play a role in fetal development and the health of their children.
Teenage dads face increased risk that their babies will be born prematurely, have low birth weight, or die at birth or shortly afterward, a new study in Human Reproduction shows.
Babies of firefighters, painters, woodworkers, janitors, and men exposed to solvents and other chemicals in the workplace are more likely to be miscarried, stillborn, or to develop cancer later in life, according to a review in the February Basic & Clinical Pharmacology & Toxicology.
Fathers who smoke or are exposed at work to chemicals called polycyclic aromatic hydrocarbons put their children at risk of developing brain tumors. And, older fathers are more likely to have children with autism, schizophrenia, and Down syndrome and to have daughters who go on to develop breast cancer.
Though some of these observations are decades old, attitudes lag even further behind, says Cynthia Daniels, a political scientist at Rutgers University-New Brunswick in New Jersey. Dads aren't held accountable if something goes wrong during fetal development. Since men make new sperm every 74 days, people used to reason, the genetic slate is wiped clean every couple of months. And even if a man makes defective sperm, the "all-or-nothing" view of reproduction holds that damaged sperm don't fertilize eggs. No harm. No foul.
So no one bothers to remind men to protect themselves against environmental toxins. There are no images of "crack dads" and "crack babies" in the media like those of women who harm developing fetuses with drug and alcohol use, Daniels said in February at a meeting of the American Association for the Advancement of Science held in Boston....
Older dads also have a higher risk of fathering children with rare mutations that cause dwarfism or a premature aging disease called Hutchinson-Gilford progeria syndrome.
But sometimes aging fathers pass along traits that can't be traced to only a single mutation. Fathers 40 and older have an increased chance that their children will develop complex disorders such as autism or schizophrenia. There is growing evidence that those disorders are caused by defects in many genes and the way genes are turned off and on.
Scientists don't yet understand the changes that age induces in sperm-making germ cells, and environmental exposure presents an even bigger mystery. People come in contact with a plethora of chemicals every day. But it is no easy task to sort out exactly which ones, or which combinations, cause heritable problems. The effects chemicals and radiation may have on offspring don't always follow predictable patterns either.
And when researchers do find a clear link between a father's lifestyle and his children's health, it's not always clear what the data mean. "What we can say is that we identified a group of fathers with adverse outcomes for their fetuses, but we don't have an idea of the mechanism," says Shi Wu Wen of the University of Ottawa in Canada and one of the lead authors of the study showing that babies of teenage fathers have a greater risk of birth problems.
Wen and his colleagues examined birth records for more than 2.6 million babies born between 1995 and 2000 to married, first-time, 20-something mothers in the United States. Looking at the husbands' ages, the team found that babies of teenage fathers, but not middle-age men, had an elevated risk of still birth, low birth weight, and other birth problems. The study was published online Feb. 6 in Human Reproduction.
THE NON-SURPRISE OF THE WEEK
A health characteristic is strongly genetically inherited! How revolutionary!
Blood Pressure Change and Risk of Hypertension Associated With Parental Hypertension
By Nae-Yuh Wang et al.
Background: Parental hypertension is used to classify hypertension risk in young adults, but the long-term association of parental hypertension with blood pressure (BP) change and risk of hypertension over the adult life span has not been well studied.
Methods: We examined the association of parental hypertension with BP change and hypertension risk from young adulthood through the ninth decade of life in a longitudinal cohort of 1160 male former medical students with 54 years of follow-up.
Results: In mixed-effects models using 29,867 BP measurements, mean systolic and diastolic BP readings were significantly higher at baseline among participants with parental hypertension. The rate of annual increase was slightly higher for systolic (0.03 mm Hg, P = .04), but not diastolic, BP in those with parental hypertension. After adjustment for baseline systolic and diastolic BP and time-dependent covariates-body mass index, alcohol consumption, coffee drinking, physical activity, and cigarette smoking-the hazard ratio (95% confidence interval [CI]) of hypertension development was 1.5 (1.2-2.0) for men with maternal hypertension only, 1.8 (1.4-2.4) for men with paternal hypertension only, and 2.4 (1.8-3.2) for men with hypertension in both parents compared with men whose parents never developed hypertension. Early-onset (at age ~55 years) hypertension in both parents imparted a 6.2-fold higher adjusted risk (95% CI, 3.6-10.7) for the development of hypertension throughout adult life and a 20.0-fold higher adjusted risk (95% CI, 8.4-47.9) at the age of 35 years.
Conclusion: Hypertension in both mothers and fathers has a strong independent association with elevated BP levels and incident hypertension over the course of adult life.
Arch Intern Med. 2008;168(6):643-648..
5 April, 2008
IS YOGA GOOD FOR YOUR HEART?
Apparently it is no better than other forms of exercise as far as hardening of the arteries is concerned. But sedentary people have more hardening. The study below is extremely limited, however. It relies on self-report, the sample size was small and included obvious but unknown selection biases and the groups were also nutritionally different. I don't think I would have mentioned it except that it was reported in "The Times" of London. It actually proves nothing. Abstract below:
The influence of physical activity and yoga on central arterial stiffness
By Courtney M Duren
Purpose: Central arterial stiffness is an accepted risk factor for cardiovascular disease. While aerobic activity is associated with reduced stiffness the influence of practicing yoga is unknown. The aims of this study were to: 1) evaluate arterial stiffness in middle-aged adults who regularly practiced yoga, performed regular exercise, or were inactive, 2) evaluate the reproducibility of arterial stiffness measured in the left and right carotid artery and by pulse wave velocity (PWV).
Methods: Twenty six healthy subjects (male and female, 40-65 yrs old) were tested on two separate days. Carotid artery distensibility (DC) was measured with ultrasound. Physical activity was determined by questionnaire.
Results: Yoga and aerobic subjects had similar physical activity levels. Yoga and aerobic groups were not different in either DC (p = 0.26) or PWV (p = 0.21). The sedentary group had lower DC and higher PWV compared to the aerobic and yoga groups (both, p < 0.001). Stiffness measures were reliable day to day (coefficients of variation ~2.5%) and similar between left and right arteries (CV = 2.2%).
Conclusion: Physical activity was a strong predictor of both measures of arterial stiffness, although other factors such as nutritional status need to be accounted for. An independent effect of practicing yoga could not be detected. Stiffness measures were reproducible and left and right sides were consistent with each other.
TERROR? OBESITY? WELCOME TO THE APOCALYPSE AUCTION
Should you be more scared of hoodies or terrorists? Ought global warming make us shiver more than the Cold War? Welcome to the apocalypse auction, where experts and authorities bid up their pet threats to public safety. In competing to win headlines, they all seem to lose a sense of perspective.
Sir Ian Blair, Metropolitan Police chief, now claims that "youth violence" is the greatest "threat to the whole of London, perhaps with the exception of terrorism". Only "perhaps"? After all, Sir Ian has previously said that Islamic terrorism poses a threat to London "far graver" than the Second World War. Prime Minister Gordon Brown prefers to compare terrorism today to the Cold War. Are we to conclude that the hoodies now present "perhaps" as big a threat to our society as the Luftwaffe or the Red Army?
But hold your four horsemen of the apocalypse a minute. An army of experts led by Sir David King, until recently the chief government scientist, has declared global warming an even bigger threat than terrorism. Should we focus all our fears on that instead? Then again, that might underestimate the threat of the enemy within our waistbands, since the Health Secretary, Alan Johnson, has pronounced obesity "a potential crisis on the scale of climate change".
To recap the bids. Youth violence is perhaps as big a threat as terrorism, which is a far graver threat than the Nazis, but not as hot as global warming, which is the same size threat as obesity. We await news of more new little Hitlers and Stalins lurking out there.
What purpose is served by this apocalypse auction? Who does it help to compare the tragic killing of 11 London teenagers this year with a terrorist threat? Come to that, how can it further our understanding of Islamic terrorism - which killed 52 people in London in 2005 - to claim that it is more serious than the wartime Blitz that left 43,000 Londoners dead?
And how complex issues such as climate change and obesity might be clarified by overheated, fat-headed comparisons is anybody's guess.
As they compete to make a media impact, experts raise the scaremongering stakes ever higher. New research even claims that mobile phones are "more dangerous than smoking". (Maybe they'll ban mobiles in public...) The likely results of this my-risk's-bigger- than-yours talk will be to raise public anxieties further - and lower public trust in anything that officials say.
These comparisons are not only odious, but dangerous. In fact, it is surely no exaggeration to suggest that the apocalypse auction might pose a bigger threat to rational discussion than, er, anything else that ever happened before.
Food Fascism hits New Zealand kids
Children in a New Zealand school have been banned from bringing cakes to share on their birthdays, due to new government healthy eating guidelines. Pupils at Oteha Valley primary school north of Auckland have been told they are allowed to celebrate their birthdays, but the cake must stay at home, the New Zealand Herald newspaper reported. The Ministry of Education has been on a fat-busting crusade, introducing sweeping guidelines against unhealthy food in New Zealand schools.
Oteha Valley has a large number of pupils born in September and October, and there can be up to four cakes a week in some classes, principal Megan Bowden told the paper. It had come to the point where parents thought they were required to provide a cake for their child's birthday. The school has advised parents in a newsletter to stop sending cakes to school from the next term.
A Ministry of Education spokesman told the newspaper the government guidelines only applied to food sold on the premises, and schools did not need to monitor food brought in from outside.
4 April, 2008
Stupid food Fascism
Inadvertent leaders in economic research, public school officials seem dedicated to discovering again and again just what it is that sparks the creation of a black market. What have they found? Restricting goods that school kids want inspires many of them to foray into the world of underground entrepreneurship.
California school officials have discovered -- surprise! -- that banning "junk food" creates economic opportunities for kids willing to take a few risks in smuggling and peddling contraband. The lesson comes courtesy of the drive to promote healthy eating, or else, among the nation's pudgy youth. Golden State officials have cracked down on unapproved foodstuffs and put their official weight behind healthier -- but less popular -- alternatives."It's created a little underground economy, with businessmen selling everything from a pack of skittles to an energy drink," said Jim Nason, principal at Hook Junior High School in Victorville. This has become a lucrative business, Nason said, and those kids are walking around campus with upwards of $40 in their pockets and disrupting class to make a sale.The results could have been predicted by an economist or student of history who has paid even cursory attention to repeatedly thwarted efforts by government officials to restrict people's access to goods and services that they want. The situation in California (and in Boulder, Colorado, earlier) not only emulates the reaction to Prohibition and drug bans -- it directly reflects students' response to junk food bans elsewhere. Says the U.K.'s Daily Telegraph:The situation echoes that in the UK where a similar drive to promote healthy eating sparked a playground black market in junk food with pupils trading snacks and fizzy drinks and the most organised staging lunchtime runs to local shops and McDonald's to fill junk food orders.British officials shocked by widespread resistance to their efforts are considering barring students from leaving campus at lunch, and even preventing fast-food restaurants from opening near campuses -- schemes intended to further restrict the flow of contraband. Considering, though, that flat-out outlawing marijuana and heroin has failed to cut off the supply, it's hard to see how tighter restrictions on legal products can do anything more than slightly raise prices (and profit margins) on goods smuggled through school doors.
Oddly enough, surreptitious peddling of cokes and candy may offer public school students the best economic education they're likely to receive in tax-supported institutions. School officials may barely be able to teach kids to read and write, but they're offering an excellent lesson in the hurdles faced by any effort at prohibition and the inevitability of the underground economy.
'Lung cancer' gene discovered
Nice to see medical researchers debating the pathway of causation -- instead of just assuming that it is obvious
A CLUSTER of genes that influence the risk of developing lung cancer has been found, offering insights that could lead to new treatments and ways of helping people to quit smoking. People who inherit a particular genetic variant are 30 per cent more likely to develop lung cancer than those who do not; in those who inherit two copies of the variant, the risk rises by up to 80 per cent.
However, the link between the disease and a genetic region that holds three nicotine receptor genes has divided the three independent teams that have identified it, which disagree over its relationship with smoking. The largest of the studies, from deCODE Genetics, an Icelandic company, found that the increased risk occurs entirely because the variant makes smokers more likely to become addicted and to smoke more heavily.
A French group, however, found that the raised risk applies to people who have never smoked as well as to smokers, suggesting that the gene may have a biological effect independent of its impact on tobacco use.
The third study, led by Richard Houlston, of the Institute of Cancer Research in Sutton, Surrey, also found an independent effect, though this was studied only in current and former smokers. Further research will be needed to settle the issue.
Whatever the explanation, variations in a region of chromosome 15 appear to be sufficiently important to account for nearly one in five cases of lung cancer, and for one in ten cases of peripheral artery disease (PAD) - a circulatory disorder also linked to smoking. That is because while the variant adds only slightly to individuals' risk, it is very common. About 44 per cent of people of European descent carry one copy and another 11 per cent have two copies. As well as its effect on the risk of lung cancer, each copy raises the risk of PAD by 20 per cent. Even if the variant does affect non-smokers, however, all three studies agreed that its impact will be far outweighed by that of smoking.
Paul Brennan, of the French National Institute of Cancer, said that before genetics are considered, smokers have a lifetime risk of lung cancer of about 15 per cent, compared with 6 per cent for former smokers who quit by middle age, and less than 1 per cent for non-smokers. The risk rises to 23 per cent for smokers with the most vulnerable genetic profile, but hardly falls at all for smokers with the least susceptible genotype, who still have a 14 per cent lifetime risk.
This is still about ten times greater than it is for people who have never smoked, but who have two copies of the variant, according to Dr Brennan's results. "If people don't smoke, the background risk is so low that having one or even two copies really doesn't make a difference," he said.
One of the most interesting aspects of the findings, which are published in the journals Nature and Nature Genetics, is that they show how a disease that clearly has a strong environmental component can also be affected by genetics.
In a commentary for Nature, Stephen Chanock, of the US National Institutes of Health, and David Hunter, of Harvard Medical School, said that the results could have important medical implications. "We may be able to evaluate smoking-cessation treatments informed by knowledge of a person's genetic predisposition to start smoking or to nicotine addiction, and thus add new weapons to the anti-smoking arsenal," they said.
3 April, 2008
Lowering "bad" cholesterol does not help
Below is a popular summary of some recent research, followed by a paragraph from the Editorial in the prestigious medical journal concerned (NEJM). The brainiacs found a combination of existing drugs that lowered cholesterol by 27% but the outcome for the patients was unaltered. The original journal abstract can be read here. The results will be no surprise to those who are not of the cholesterol religion
A heavily promoted heart drug endorsed by the National Institute for Health and Clinical Excellence (NICE) may be worthless, according to a newly published trial. Ezetimibe (Ezetrol) was recommended by NICE last year for patients with inherited high cholesterol, to be used in conjunction with a statin drug such as simvastatin. But results published in the New England Journal of Medicine and presented yesterday at the American College of Cardiology annual scientific session in Chicago show that it may add nothing to the effectiveness of the statin.
The trial is highly controversial, with claims that it was deliberately suppressed by the drug's manufacturers and released only in response to congressional pressures. The data were made public in January by Merck and Schering-Plough, which makes the drug, but this is the first formal publication. Ezetrol is hugely successful. It is advertised heavily in America, where its sales exceed $5 billion. In the United Kingdom in 2006 - before the NICE endorsement - more than a million prescriptions for Exetrol were written out, worth more than œ40 million. The trial does not show that Ezetrol is damaging, and confirms that it reduces "bad" LDL cholesterol. The assumption was that it would add to the benefits already proven for simvastatin, producing a double-drug with even better lifesaving effects.
The new trial was designed to compare the effects of simvastatin alone with simvastatin plus Ezetrol in slowing the progression of coronary artery disease in patients with familial hyper-cholesterolaemia - a condition in which a tendency to high cholesterol levels is inherited. This was done by measuring the degree of blockage of the arteries in more than 600 patients given either plain simvastatin, or simvastatin plus Ezetrol, for two years. The result was that adding Ezetrol did nothing to slow the progress of the disease. Plaque build-up on the artery walls was the same in patients who took the combination as it was in those who took simvastatin alone.
Earlier studies have shown that plaque build-up is a good proxy for death rates. The more plaque, the more deaths. So most cardiologists will conclude that prescribing Ezetrol is unlikely to prolong the lives of their patients. Other trials are in progress that will measure actual outcomes, such as deaths or heart attacks, but they are not likely to be published before 2011. Until then, says an editorial in the New England Journal of Medicine, it seems prudent to encourage patients whose cholesterol levels remain high despite an optimal dose of statins "to redouble their efforts at dietary control and regular exercise". Other drugs such as niacin, fibrates and resins should be considered if diet, exercise and a statin have failed.
The results throw the whole science of cholesterol reduction into question. [Again] Until now the greater the reduction, the better. But the trial has shown that it is possible to reduce bad cholesterol significantly and yet come out no better, and maybe worse. That is a shock.
In the US the waters have been muddied by claims that Merck and Schering-Plough completed the trial two years ago but did not publish the results until a congressional inquiry was launched. The trial was completed in April 2006, but both companies say it is time-consuming to analyse scans taken of carotid arteries and they only knew of the results early in January. Executives have denied selling shares in the companies before the trial was made public. Peter Kim, president of Merck Research Laboratories, said: "We stand behind ezetimibe and our science, which has brought these cholesterol-lowering medications to millions of patients around the world." A spokesman for NICE said that it would be looking at the results of the study.
Excerpt from the NEJM editorial
"The ENHANCE trial was conducted in patients with familial hypercholesterolemia, a condition characterized by high levels of LDL cholesterol. Patients were randomly assigned to receive either simvastatin alone or a combination of simvastatin plus ezetimibe. Combination therapy resulted in LDL cholesterol levels that were 27% lower than those achieved with monotherapy, and C-reactive protein levels were also significantly lower with combination therapy. Unexpectedly, however, the trial showed that despite increased lowering of LDL cholesterol in the group that received ezetimibe, the rate of progression of atherosclerotic disease, as measured by intima–media thickness, was the same in the two study groups. It is this paradox, which is at odds with our traditional understanding of the relationship between LDL cholesterol and atherosclerosis, that has puzzled investigators and clinicians alike. The paradox and other important questions that are raised by the trial, including the rationale for the use of carotid intima–media thickness as a surrogate end point, are discussed in detail by Brown and Taylor in an accompanying editorial."
Fasting could help fight cancer
Worth a try
A pilot study is about to start on cancer patients to see if fasting can make chemotherapy more effective, and with fewer side effects such as deafness and hair loss. Making chemotherapy more selective has been a research goal of cancer scientists for decades. Doctors could control the spread of cancers much better, and even cure some, if chemotherapy was not so toxic to the rest of the body
But now an alternative way to improve the treatment has been found, not by targetting chemotherapy at cancer cells with a "magic bullet" but by making normal cells tougher, providing a "magic shield", either by fasting or by drugs to mimic the effects of fasting. Fasting for as little as 48 hours protects healthy cells against chemotherapy, according to a study by a team led by Dr Valter Longo at the University of Southern California, which is preparing to test the method on a small group of bladder cancer patients. The pilot clinical study is planned at the university's Norris Cancer Centre within six months.
Mice given a high dose of chemotherapy after fasting continued to thrive, reports the team, which includes Lizzia Raffaghello at Gaslini Children's Hospital in Genoa, Italy. The same dose killed half the normally fed mice and caused lasting weight and energy loss in the survivors. Test tube experiments confirmed normal human cells were two to five times more resistant than cancer cells to chemotherapy after a short period of starvation. In yeast, the difference was up to 1000 fold. "If we get to just a 10-20 fold differential toxicity with human metastatic (spreading) cancers, all of a sudden it's a completely different game against cancer," Dr Longo says. "My hope is that many places around the world will carefully design small clinical trials on starvation and protection against chemotherapy."
He adds that the effects of starvation can also be mimicked by a drug and this approach will also be tested. "We have identified a drug target and drug as well as a modified diet that appear to work almost as well as starvation. Naturally this is the best way to go because a period of starvation longer than 48 hours may be required but would not be possible (in humans) to obtain the same remarkable effects observed in mice" says Dr Longo.
" This is a very important paper. It defines a novel concept in cancer biology," comments cancer researcher Prof Pinchas Cohen, University of California, Los Angeles, UCLA. "In theory, it opens up new treatment approaches that will allow higher doses of chemotherapy. It's a direction that's worth pursuing in clinical trials in humans."
Dr Felipe Sierra, director of the Biology of Aging Program at the National Institute on Ageing, adds, "This is not just one more anti- cancer treatment that attacks the cancer cells. To me, that's an important conceptual difference." The team stresses that fasting is not the same as malnourishment, when inadequate nutrients are taken in, and can easily be tolerated given progress in cancer care. "We have passed the stage where patients arrive at the clinic in an emaciated state. Not eating for two days is not the end of the world," Dr Sierra says. "This could have applicability in maybe a majority of patients," adds David Quinn, of USC Norris Hospital and Clinics, who is preparing the trial with Dr Longo.
The initial trial will study if a 48 hour starvation is sufficient to generate protection, without the risk of making the patient too weak and even more sensitive to chemotherapy. The finding chimes with a range of work on the anti ageing effects of calorie restriction. Dr Longo had been introduced to this idea 15 years ago by the late Roy Walford of UCLA, who showed that a nutritious diet that is low in calories can make a range of species live longer. Dr Longo's team later demonstrated that the anti-aging effect of calorie restriction is caused in part by the ability of cells to become resistant to stress.
The calorie restriction/starvation based method is effective not only because it protects cells but because of Dr Longo's discovery that the same genes that decrease this stress resistance are the ones involved in cancer. "By definition, cancer cells do not require growth factors for growth and do not respond well to anti-growth orders," he says. "Thus, starvation provides an order to all cells to go into a "anti-chemotherapy protected mode" but the only cells that do not respond are cancer cells."
2 April, 2008
Groan! Another cellphone phobic
An as yet unpublished study so we will see what remains of it after peer review. Anything that is popular will ALWAYS be in the sights of the attention-seekers
Mobile phones could kill far more people than smoking or asbestos, a study by an award-winning cancer expert has concluded. He says people should avoid using them wherever possible and that governments and the mobile phone industry must take "immediate steps" to reduce exposure to their radiation. The study, by Dr Vini Khurana, is the most devastating indictment yet published of the health risks. It draws on growing evidence - exclusively reported in the IoS in October - that using handsets for 10 years or more can double the risk of brain cancer. Cancers take at least a decade to develop, invalidating official safety assurances based on earlier studies which included few, if any, people who had used the phones for that long.
Earlier this year, the French government warned against the use of mobile phones, especially by children. Germany also advises its people to minimise handset use, and the European Environment Agency has called for exposures to be reduced.
Professor Khurana - a top neurosurgeon who has received 14 awards over the past 16 years, has published more than three dozen scientific papers - reviewed more than 100 studies on the effects of mobile phones. He has put the results on a brain surgery website, and a paper based on the research is currently being peer-reviewed for publication in a scientific journal.
He admits that mobiles can save lives in emergencies, but concludes that "there is a significant and increasing body of evidence for a link between mobile phone usage and certain brain tumours". He believes this will be "definitively proven" in the next decade. Noting that malignant brain tumours represent "a life-ending diagnosis", he adds: "We are currently experiencing a reactively unchecked and dangerous situation." He fears that "unless the industry and governments take immediate and decisive steps", the incidence of malignant brain tumours and associated death rate will be observed to rise globally within a decade from now, by which time it may be far too late to intervene medically.
"It is anticipated that this danger has far broader public health ramifications than asbestos and smoking," says Professor Khurana, who told the IoS his assessment is partly based on the fact that three billion people now use the phones worldwide, three times as many as smoke. Smoking kills some five million worldwide each year, and exposure to asbestos is responsible for as many deaths in Britain as road accidents.
Late last week, the Mobile Operators Association dismissed Khurana's study as "a selective discussion of scientific literature by one individual". It believes he "does not present a balanced analysis" of the published science, and "reaches opposite conclusions to the WHO and more than 30 other independent expert scientific reviews".
Blood pressure drugs cut stroke deaths in elderly
Drugs used to lower blood pressure can cut the death rate from strokes in the elderly by almost 40 per cent, an international study has found. Around 4000 people in several countries, including Australia, were surveyed over two years for the survey which found for the first time that treating blood pressure in elderly patients could give them a new lease of life. "The issue of the elderly is obviously becoming more important as the population ages and blood pressure does rise with age in our society," said Melbourne-based Professor Stephen Harrap, president of the High Blood Pressure Research Council of Australia.
"There has been a tendency to think perhaps it's part of growing old and we shouldn't be as aggressive in treating it in an 80-year-old as in someone who is aged 40. "But what this study shows is you should - and the benefits are in terms of lives saved in this particular study."
Prof Harrap said that every year, more than 53,000 Australians suffered strokes, more than half of them over 75. And more than 75 per cent of those elderly Australians suffered from high blood pressure, which was a major contributor to fatal heart attacks and stokes. But until now, the medical profession had been reluctant to treat high blood pressure in the elderly for fear of causing complications. But thiazide-like diuretics, which work on the kidneys, used in conjunction with ACE (angiotensin converting enzyme) inhibitors, had produced a dramatic 39 per cent increase in the survival rate following strokes, he said. The blood pressure lowering treatment also cut the overall death rate by more than 20 per cent.
"The thiazide-like diuretics are particularly good in the elderly," Prof Harrap said. "As we get older, our kidneys aren't as good at getting rid of salt from the body and when we eat our routine diets we tend to build up a bit of salt and that can put your blood pressure up."
Stroke and heart attacks accounted for around one third of all deaths in Australia and elderly people with high blood pressure should not just accept the condition as part of the ageing process, Prof Harrap said. "Doctors would be more inclined to treat with this information, so that's a win-win," he said.
The results of the global study were revealed today at the American College of Cardiology conference in Chicago. The results have also been accepted for publication in the prestigious New England Journal of Medicine. The study had been scheduled to run for five years with half the participants receiving the blood pressure lowering medication and half a placebo. But the huge improvement in life expectancy in those receiving the treatment prompted the researchers to terminate the trial early and extend treatment to all participants. "Those people who were not receiving the treatment were dying more frequently and it was unethical to continue," Prof Harrap said.
1 April, 2008
Experts call to end first aid's 'kiss of life'
Once again medical "wisdom" bites the dust when subjected to proper testing
The "kiss of life" may be ditched by rescuers because research shows it doesn't necessarily save lives. In a controversial move, the Australasian College of Emergency Medicine has recommended that mouth-to-mouth ventilation be abolished from national cardiopulmonary resuscitation (CPR) guidelines and replaced with chest compressions only, saying the move would save more people. The recommendation comes after two prestigious overseas studies found patients were more likely to survive without brain damage if CPR was administered without mouth-to-mouth.
But the Australian Resuscitation Council (ARC), the peak body overseeing CPR guidelines, is resisting recommendations despite last year slashing the rate of breaths to compressions and eliminating pulse checks.
Dr Stephen Bernard, of the Australasian College of Emergency Medicine, told The Sunday Telegraph latest research showed compression-only resuscitation was the best way to improve survival. "The evidence is becoming quite convincing, and it makes one think: should it be the standard?" Dr Bernard said. "My view is that it's not something that should wait. Shouldn't we really look at this as a matter of urgency?" Dr Bernard said data showed that if a decision was made now, "a considerable amount of lives are likely to be saved". "I would call on the ARC to make a decision earlier," he said. "If someone collapsed in front of me, I personally wouldn't do mouth-to-mouth for five to 10 minutes; I would do chest compressions."
Hundreds of thousands of resuscitators - including surf lifesavers, lifeguards, doctors, emergency workers, nurses and workplace first-aid officers - would be affected by the proposal to abolish mouth-to-mouth. But ARC chairman Associate Professor Ian Jacobs said he was not convinced by research showing compression-only CPR was better than the breaths-and-compressions combination. "It shows interruptions to chest compressions are bad - and we know that," he said. "The studies raise concerns for us to be aware of, but they haven't reached the point where we feel we need to change."
Professor Jacobs said research on the issue was not of convincing quality or scope, but conceded there would be an argument for introducing lay people to compression-only CPR. The evolution of CPR has sparked international debate in the past couple of years. A study published in the Journal of the American Medical Association this month found patients of emergency workers who delivered compression-only resuscitation were three times as likely to survive.
Are We Really That Ill?
America has reached a point where almost half its population is described as being in some way mentally ill, and nearly a quarter of its citizens - 67.5 million - have taken antidepressants. These statistics have sparked a widespread, sometimes rancorous debate about whether people are taking far more medication than is needed for problems that may not even be mental disorders. Studies indicate that 40% of all patients fall short of the diagnoses that doctors and psychiatrists give them, yet 200 million prescriptions are written annually in America to treat depression and anxiety. Those who defend such widespread use of prescription drugs insist that a significant part of the population is under-treated and, by inference, under-medicated. Those opposed to such rampant use of drugs note that diagnostic rates for bipolar disorder, in particular, have skyrocketed by 4,000% and that overmedication is impossible without over-diagnosis.
To help settle this long-standing dispute, I studied why the number of recognized psychiatric disorders has ballooned so dramatically in recent decades. In 1980, the Diagnostic and Statistical Manual of Mental Disorders added 112 new mental disorders to its third edition, DSM-III. Fifty-eight more disorders appeared in the revised third edition in 1987 and fourth edition in 1994.
With over a million copies in print, the manual is known as the bible of American psychiatry; certainly it is an invoked chapter and verse in schools, prisons, courts, and by mental-health professionals around the world. The addition of even one new diagnostic code has serious practical consequences. What, then, was the rationale for adding so many in 1980?
After several requests to the American Psychiatric Association, I was granted complete access to the hundreds of unpublished memos, letters, and even votes from the period between 1973 and 1979, when the DSM-III task force debated each new and existing disorder. Some of the work was meticulous and commendable. But the overall approval process was more capricious than scientific.
DSM-III grew out of meetings that many participants described as chaotic. One observer later remarked that the small amount of research drawn upon was "really a hodgepodge - scattered, inconsistent, and ambiguous." The interest and expertise of the task force was limited to one branch of psychiatry: neuropsychiatry. That group met for four years before it occurred to members that such one-sidedness might result in bias.
Incredibly, the lists of symptoms for some disorders were knocked out in minutes. The field studies used to justify their inclusion sometimes involved a single patient evaluated by the person advocating the new disease. Experts pressed for the inclusion of illnesses as questionable as "chronic undifferentiated unhappiness disorder" and "chronic complaint disorder," whose traits included moaning about taxes, the weather, and even sports results.
Social phobia, later dubbed "social anxiety disorder," was one of seven new anxiety disorders created in 1980. At first it struck me as a serious condition. By the 1990s experts were calling it "the disorder of the decade," insisting that as many as one in five Americans suffers from it. Yet the complete story turned out to be rather more complicated. For starters, the specialist who in the 1960s originally recognized social anxiety - London-based Isaac Marks, a renowned expert on fear and panic - strongly resisted its inclusion in DSM-III as a separate disease category. The list of common behaviors associated with the disorder gave him pause: fear of eating alone in restaurants, avoidance of public toilets, and concern about trembling hands. By the time a revised task force added dislike of public speaking in 1987, the disorder seemed sufficiently elastic to include virtually everyone on the planet.
To counter the impression that it was turning common fears into treatable conditions, DSM-IV added a clause stipulating that social anxiety behaviors had to be "impairing" before a diagnosis was possible. But who was holding the prescribers to such standards? Doubtless, their understanding of impairment was looser than that of the task force. After all, despite the impairment clause, the anxiety disorder mushroomed; by 2000, it was the third most common psychiatric disorder in America, behind only depression and alcoholism.
Over-medication would affect fewer Americans if we could rein in such clear examples of over-diagnosis. We would have to set the thresholds for psychiatric diagnosis a lot higher, resurrecting the distinction between chronic illness and mild suffering. But there is fierce resistance to this by those who say they are fighting grave mental disorders, for which medication is the only viable treatment. Failure to reform psychiatry will be disastrous for public health. Consider that apathy, excessive shopping, and overuse of the Internet are all serious contenders for inclusion in the next edition of the DSM, due to appear in 2012. If the history of psychiatry is any guide, a new class of medication will soon be touted to treat them. Sanity must prevail: if everyone is mentally ill, then no one is.