FOOD & HEALTH SKEPTIC ARCHIVE
Posts by Dr. John Ray, 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
"Let me have men about me that are fat... Yond Cassius has a lean and hungry look ... such men are dangerous." -- Shakespeare
What fast food does to girls
30 September, 2011
Eating just THREE eggs a week 'increases chance of men getting prostate cancer'
This is probably just data dredging. See the last paragraph below
Eating three eggs a week could significantly increase a man’s chances of dying from prostate cancer, researchers have warned. Experts in the U.S. claimed that men who consume more than two and a half on a weekly basis were up to 81 per cent more likely to be killed by the disease.
They suggested the damage may be done by the large amounts of cholesterol or choline – a nutrient that help cells to function properly – that are found in eggs.
The average Briton consumes an estimated 182 eggs a year – roughly three and a half per week. Until recently, the British Heart Foundation recommended eating no more than three a week because of fears that they raised the risk of heart attacks and strokes. It dropped the recommendation in 2007 after evidence emerged that very little of the cholesterol contained in eggs enters the bloodstream.
The latest study, conducted at the Harvard School of Public Health in Boston, investigated the role of eggs in prostate cancer following the discovery last year that men diagnosed with low-grade tumours appeared to be more likely to be killed by them if they had an egg-rich diet.
The team examined the eating habits of 27,000 men over a 14-year period. They found no significant links between the amount of meat eaten and tumours – but a higher number of cancer deaths were evident among those who admitted consuming lots of eggs.
In a report on their findings, the researchers revealed: ‘Men who consumed 2.5 eggs or more a week had an 81 per cent increased risk of lethal prostate cancer compared to men who consumed less than half an egg a week. 'Although additional studies are needed, caution in egg intake may be warranted for adult men.’
However, Sarah Williams, health information officer at the charity Cancer Research UK, said: ‘There is a small amount of previous research on the link between eating eggs and the risk of developing and dying from prostate cancer, but the results have been contradictory and it’s still not clear whether there is a real effect.’
Bee sting vaccine on the NHS
A very welcome development
A 'vaccine' that protects people vulnerable to severe reactions from bee and wasps stings is to be made available on the NHS. People who have already suffered a serious reaction to a bee or wasp sting will be able to ask their GP for the 'vaccine'
About one in 200 people suffer from anaphylaxis when stung by a wasp or bee.
Every year between two and nine people die after going into anaphylatic shock - the most extreme form of anaphylaxis - as a result of being stung. Contrary to popular belief, wasp stings actually cause twice as many deaths due to anaphylaxis as bee stings.
Now the National Institute for Health and Clinical Excellence (Nice), which decides on whether treatments can be prescribed on the NHS in England and Wales, has indicated it will approve a product called Pharmalgen.
Given in a series of injections, this works by gradually introducing higher doses of the allergens in bee and wasp venom. Over time, this desensitises a person by gently stimulating their immune system. Treatment is carried out in two phases: the initial phase and the maintenance phase, which lasts three years.
Anaphylactic reactions are when the immune system responds inappropriately to an allergen, releasing large quantities of chemicals called histamines, that cause blood capillaries to dilate and blood pressure to drop. In extreme cases airways can collapse and the heart can fail.
In draft guidance that is highly likely to be confirmed early next year, Nice announced it was recommending Pharmalgen for people who had experienced "a severe systemic reaction to bee or wasp venom".
Nice also recommended it for those who had experienced a "moderate systemic reaction" and were also at "a high risk of future stings", had a raised level of a blood serum known to indicate anaphylaxis, or were "anxious about future stings".
Professor Peter Littlejohns, clinical and public health director at Nice said: "The reactions that some people experience to stings from bees and wasps can be distressing, frightening and sometimes life-threatening.
"People who have had a serious reaction to a sting can often experience extreme anxiety about possible future stings, and this can affect their daily lives. "So we are pleased to be able to recommend Pharmalgen as an effective, preventative treatment in preliminary recommendations issued today."
Pharmalgen is the first preventative medicine for bee and wasp stings that Nice has recommended for approval.
Anaphylaxis can be effectively controlled by quickly administering adrenaline by injection. This constricts blood vessels, relaxes muscles in the lungs to aid breathing, stimlulates the heart to beat properly and stops facial swelling.
However, sometimes it cannot be given quickly enough. Last October farmer John Croall, 52, died after being stung while herding sheep in a remote field near Balkeerie, Angus. Ambulance crews were unable to reach him soon enough and the father-of-three died after suffering anaphylactic shock.
Moira Austin, of the Anaphylaxis Campaign, welcomed Nice's decision to approve it. She said: “The Anaphylaxis Campaign has been participating as a patient/carer consultee in the Pharmalgen appraisal, representing those living with severe allergy to bee or wasp venom.
"We have spoken with many individuals who have been successfully treated with Pharmalgen and who have, as a result, experienced a significant improvement in their quality of life. "We are delighted with the appraisal committee’s preliminary recommendations and look forward to their final recommendations.“
There could be some eyebrows raised about the cost of providing the treatment. Nice usually sets a ceiling of £30,000 per 'quality adjusted life year' (QALY) that a medication brings.
Its appraisal committee modelled the cost at £13,800 per QALY, but this was based on a course of Pharmalgen remaining effective for 20 years, for which members admitted there was no evidence.
The committee also said the cost assumption was highly sensitive to the number of stings a person might receive: the fewer, the less cost-effective it was.
29 September, 2011
Stripping the “fat” from rights
Gov. Rick Snyder of Michigan wants doctors to track the body mass index (BMI) of children through a database that currently tracks immunizations and then to report the collected data to the state. (BMI is the ratio between a person’s weight and the square of his height; it is viewed as an indication of whether that person’s weight is healthy.)
Confusion exists on whether the reporting is required: Snyder calls it “voluntary,” but one of his spokeswomen told the Associated Press that BMI monitoring will become “part of every child’s medical care” in Michigan. So far, all sources agree that the reporting will be anonymous; it will not identify the children. Some parents and privacy advocates are not reassured, however. Too many government programs have promised anonymity but have later been used to take action against specific people.
What action could the state take? “Failure to thrive” is the latest emerging category of child abuse or neglect. Over recent years, child-protective services have started to remove extremely obese children from homes, even loving ones, and to place them in foster care. In less-extreme cases, social workers mandate diets and exercise routines with the implicit (or explicit) threat of criminal charges and loss of custody hanging over parents who do not comply.
As happens with many controversial policies, the state kidnapping of obese children began with extreme cases that elicited little public objection. A headline in the Albany, New York, Examiner (July 21, 2009) read, “Mother loses custody & is charged with criminal neglect for allowing son to become morbidly obese.” The news item opened:Jerri Gray, a 49 year old mother ... was arrested in June on a criminal neglect charge because her son weighed 555 pounds by the time he was fourteen years old. Her son was taken away from her and put into foster care.... What has happened to Jerri Gray is rare but not new. In 2007 New York State charged the parents of a young adolescent named Brittany T. with neglect for allowing her to reach the weight of 261 pounds, although Brittany’s parents were charged with a misdemeanor, while Jerri Gray has been charged with felonies that could result in significant prison time.... [The] court required Brittany’s parents to purchase a gym membership and take her there several times a week. The court also ordered nutritional counseling and cooking classes for the family.
At least three factors are causing government to extend its reach ever further into kitchens and across dinner tables. First, there has been a general expansion and acceptance of the Nanny State through which the government assumes the role of a parent with willful, ignorant children; “unhealthy” food is the new nicotine in terms of its current focus. Second, with Barack Obama’s health-care bill, a person’s health problems cease to be a personal matter and, instead, become a strain on a scarce public resource (medical care) and a drain on the public purse; in other words, your obesity becomes my problem. The third is the invocation of a powerful political tactic — the need to protect children against abuse.
Obesity as child abuse hops the big pond
As with many politically correct trends, the equating of obesity with child abuse seems to have taken root first in the UK. In his article “The onward march of the Obesity Orwellians,” Rob Lyons, the author of Panic on a Plate: How Society Developed an Eating Disorder explained:In 2004, the parents of a nine-year-old girl in Derbyshire were threatened with having her removed due to her weight. In 2007, Newcastle social services made a similar threat in relation to an eight-year-old boy, Connor McCreaddie. In 2008, UK council bosses declared that very fat children should be monitored and taken away from their parents if necessary. It should be blindingly obvious to medics and social workers that children simply cannot become as fat as these children without some significant genetic predisposition towards piling on the pounds. The drastic act of taking a child from his or her parents should only ever happen when there is clear evidence of serious neglect or abuse. Yet in the cases of many of these fat children, there is little or no evidence of any such neglect or abuse. Instead, obesity itself is taken to be sufficient basis for extreme state action.
In the UK, the slippery slope began with the government-sponsored weighing of children and with a campaign to improve their eating habits. Then doctors and public agencies provided alarming statistics on childhood obesity that created widespread panic. Then officials blamed parents for child abuse or neglect; public-health spokesman David Rogers declared that “parents who allow their children to eat too much could be as guilty of neglect as those who did not feed their children at all.” The “solution” of massive government intervention into the home was not far behind. On September 5, 2011, a headline in the UK Daily Mail proclaimed, “Parents of seven told: Your children are too fat, so you will never see them again.” The news item explained,Four obese children are on the brink of being permanently removed from their family by social workers after their parents failed to bring their weight under control.
In the first case of its kind, their mother and father now face what they call the “unbearable” likelihood of never seeing them again.
Their three daughters, aged 11, seven and one, and five-year-old son, will either be “fostered without contact” or adopted.
Either way, the family’s only hope of being reunited will be if the children attempt to track down their parents when they become adults.
In a bitter irony, the children came to the attention of social workers because their parents asked for assistance with an unrelated problem.
The war on obesity and “unhealthy” food
The Michigan Care Improvement Registry of children’s BMI being created by Governor Snyder is a small aspect of America’s raging War on Childhood Obesity and on “unhealthy” food. Declared most loudly by Michele Obama, the war is being pushed forward by the considerable muscle of her husband. For example, as Karen De Coster colorfully explained (September 18), “Unknown to many, Benito Obamalini’s budget included a 5-year freeze on non-security discretionary spending, except that the FDA obtained a $50M boost, and that is just the beginning for the fed’s stepped-up enforcement of its Food Tyranny Act.”
On health grounds, the government is ratcheting up restriction and regulation of the foodstuffs people are permitted to eat. Limit salt. No trans fats. Avoid fast food. No sodas or raw milk! Put calorie counts on every menu. Butter is bad. No candy machines in public schools.
Along with weighing children, there is an aggressive campaign to impose “healthy” eating habits. Entire bureaucracies are being created around the idea of feeding school children vegetables and snatching away their sodas. A recent commentary in WorldNetDaily listed a mere handful of the new federal “guidelines” for public-school cafeterias that will be piled onto old ones this year: “Local School Wellness Policy Implementation, Review of Local Policies on Meal Charges and Provision of Alternate Meals, Procurement and Processing of Food Service Products and Commodities, Professional Standards for School Food Service, etc.”
Despite those efforts, or because of them, a flood of statistics have been announcing a near-panic scenario. TV broadcasters warn that two million children in America are obese. In a 2009 report on California, more than 38 percent of children in some counties are classified as “obese” or “overweight,” the percentages falling into each category being roughly equal. Other reports put states such as Mississippi as high as 44.4 percent. Meanwhile the Child Welfare League of America stated, “Today , according to researchers, almost 66% of adults and 14% to 19% of children and adolescents are considered overweight; approximately 33% of adults and 11% of children are obese.”
The numbers seem high, perhaps because the term “obesity” has been redefined in past years to include a far larger population. The data serve a political function. Just as unemployment and inflation data are calculated in innovative ways to minimize social problems that the government has largely caused, so, too, figures on other problems may be exaggerated in order to allow government to rush in as “the cure.”
Woman unwittingly destroys her liver and dies from a paracetamol (acetaminophen) overdose
This is widely recommended as a "safe" painkiller but it is not. There have been many incidents like the one below. Aspirin is out of favour these days but it is much less likely to be fatal. Many medications contain paracetamol so if you are taking several medications you can very easily exceed the safe dose
A young mother died after overdosing on Lemsip and paracetamol to treat a cold, an inquest has heard. Tragic Donna Bishop, 25, downed a daily cocktail of over-the-counter medication when she fell ill two weeks before Christmas last year.
The pretty mum-of-one was diagnosed with a chest infection by her GP on New Year’s Eve, But she continued to self-medicate and swallowed pills washed down with hot Lemsip drinks and cough medicine. Her health rapidly deteriorated and she died in hospital on January 4 from liver failure caused by a paracetamol overdose.
The inquest at Worcestershire Coroner’s Court in Stourport-on-Severn heard how Donna had travelled to Scotland before Christmas to visit her friend Siobhan Dunn.
She had been suffering from a cold for two weeks before her death and Miss Dunn said Donna was taking ‘high’ amounts of over-the-counter drugs and she had been sick several times. This would lead her to take more medication in the belief she needed a top-up dose after vomiting.
After travelling back to her home in Warndon Villages, Worcester, on December 31 she saw her GP who prescribed antibiotics.
On January 2 she went to Worcestershire Royal Hospital complaining of mouth ulcers and having difficulty in swallowing. A doctor prescribed co-codamol and a throat spray but the next day her sister Kerrie Bishop visited her and found her forgetful, with a yellow jaundiced complexion and unsteady on her feet.
At 2.30am on January 4, she was admitted to hospital and given a bed on the gynaecological ward. Staff said she was ‘fidgety’ and suffering hallucinations.
According to nurse practitioner Andrew Eggleton, Donna denied taking paracetamol but she died later that day. A pathologist report concluded her death was due to liver failure caused by a paracetamol overdose.
28 September, 2011
Painkiller heart alert: Don't stop taking pills, but do talk to your GP, British scientists urge
For once they mention the absolute risk and admit that it is tiny
A painkiller taken by millions can increase the risk of heart attack and stroke by 40 per cent, a study has found. Researchers say that while there is no need for patients to panic, diclofenac should be restricted to prescription only.
In completely healthy patients, a 40 per cent raised chance of heart problems is not at all significant. But for those who already have a high risk of a heart attack or stroke, taking the painkiller could present serious problems.
Last night the Medicines and Healthcare products Regulatory Agency (MHRA) said that patients should not stop taking the drug, but should consult their doctor if they have fears over its safety.
Last year almost 17million prescriptions were written by GPs in England for non-steroidal anti-inflammatory drugs, or NSAIDs, for conditions such as arthritis, back pain, gout, headaches and fever. Of these, diclofenac was the most commonly prescribed and given to 6million patients. It can also be bought over the counter under the brand name Voltarol Pain-Eze for around £6. It is at lower strength but still carries a 22 per cent higher risk.
Dr Patricia McGettigan of Hull York Medical School, who led the landmark review of studies looking at nearly 3million people, said: ‘Diclofenac on prescription was associated with an increase in cardiovascular risk of 40 per cent.
‘People take it because it’s effective, but it’s very important for patients and doctors to know the risks associated with these drugs for high-risk patients. ‘It is now available over the counter, and our study suggests there is a case for looking at that again and making it prescription-only as well as strengthening advice to doctors and patients about how it should be used.
‘There is a very clear increase in risk as the dose goes up, which says to people who perhaps can’t get out of bed due to arthritis and take diclofenac, take a different drug instead and you might be at a lower risk of heart attack and stroke. ‘We have reviewed all the previous studies and are confident that the results are robust enough to inform clinical and regulatory decisions.’
This is the first study to measure the relative risks of different drugs, and it found that ibuprofen and naproxen had the lowest risk of cardiovascular problems.
Many patients were transferred to diclofenac from Vioxx, the painkiller which was withdrawn by manufacturer Merck in 2004 after it was linked to heart attacks and strokes.
Patients will often be at minimal risk. For a young woman, the risk of having a heart attack will be around 0.1 per cent and a 40 per cent rise is still just 0.14 per cent. However for a pensioner who has already had one heart attack, a 40 per cent increase could be significant.
Doreen Maddock of the British Heart Foundation said: ‘The potential risks for heart patients taking certain painkillers have been known for some time and these findings shouldn’t be ignored. But scientists and drug regulators will need to delve deeper before we draw any firm conclusions.
‘As with any medicine there are benefits and potential risks to taking painkillers. If you’re already taking these types of drugs and are worried, don’t simply give up on your medication. You should always speak to your doctor first because the benefits may well outweigh the risks for you.’
A spokesman for the MHRA said: ‘Our priority is to ensure that the benefits of medication outweigh the risks. NSAID treatment is associated with a small increased risk of heart attacks and stroke. The risk is higher with long-term treatment.
‘Clear warnings about the risk of gastro-intestinal and heart problems, along with information about those patient groups in which NSAIDs either should not be used, such as those with severe heart failure, or only used with caution, are contained in the product information including the patient information leaflet that accompanies the medicine.
‘To minimise the risk of side effects, all NSAIDs should be used at the lowest possible dose for the shortest period necessary to control symptoms. ‘People should not stop taking their NSAID medicine, but if they have any questions or concerns about their treatment they should speak to their doctor. ‘The MHRA keeps the safety of NSAIDs under close review and any new data will be carefully evaluated.’
A spokesman for Novartis, which makes Voltarol, said: ‘In our view, this analysis, in the context of the vast clinical experience worldwide, does not change the favourable benefit-to-risk assessment for diclofenac when used as directed. ‘Novartis is confident about the safety profile of diclofenac products.’
Good news for fathers: Having children reduces a man's risk of heart disease by 20%
I think this just means that healthier men are more likely to have children -- and possibly for social rather than medical reasons
It may come as a surprise to father's continually woken by their offspring in the early hours of the morning, but having children could mean they have healthier hearts.
A decade-long study of 135,000 men found that those who remained child-free had a higher risk of dying from heart disease than those who 'sowed their oats.'
U.S researchers said it raised the possibility that infertility may be a potential early warning sign of future heart trouble.
'There is emerging evidence to suggest that infertility may be a window into a man's later health,' said study leader Dr Michael Eisenberg of Stanford University in California.
He said men who are infertile have a higher risk of certain cancers, and his team wanted to look for other signs that infertility might be playing a role later in a man's life.
The researchers, reporting in the journal Human Reproduction, followed more than 130,000 men who were retired and over 50 for a decade.
They restricted the list to men who were either married or had been married because they wanted to compare males who had the intent and the opportunity to have children.
Men with previous underlying diseases, such as stroke, heart disease or some related condition were excluded. Hence, the men in their list started off in relatively good health.
Over the course of the 10-year follow up period, some 10 percent of the men died, and one out of every five of these deaths was from heart disease.
When looking at the parental status of these men, childless participants in the study had about a 17 per cent higher risk of heart disease than those who were fathers.
Dr Eisenberg said it was not possible to determine whether men in the study simply chose not to have children or whether the men's partners were infertile.
But excluding unmarried men offered an approximation of male infertility, and the link to heart disease raises important questions that merit further research. 'My belief it there is a biologic reason,' he said.
The researchers stress that the study does not suggest being childless causes heart problems, but since infertility affects a man's health at a much younger age, understanding this link could help doctors identify heart problems earlier, when there is more time to intervene.
27 September, 2011
British doctors failing 500,000 cancer patients by not spotting medical problems caused by treatment
Doctors are failing cancer patients 'far too often' by not spotting other medical problems caused by their treatment, according to a leading expert on the disease.
Professor Jane Maher, the medical director of Macmillan Cancer Support, said she feared 500,000 people's symptoms for conditions including osteoporosis and heart disease are being missed by GPs.
She said that their lack of knowledge about the long-term side-effects of cancer drugs and a lack of communication with hospitals were to blame.
'GPs and oncologists are failing cancer patients far too often,' Prof Maher told The Guardian. 'By not sharing vital information and recording clearly on the patients' medical records they are putting a significant number of cancer patients at risk of having their work, health, relationships and home lives unnecessarily spoiled by long-term side-effects of their treatment.'
The National Cancer Survivorship Initiative (NCSI) estimates that up to a quarter of those diagnosed with cancer go on experience a consequence of their treatment which affects their health or quality of life.
Prof Maher added: 'Based on the NCSI work looking into consequences of cancer treatment, I fear that up to 500,000 people's symptoms are being missed by GPs.
'GPs need to recognise that people who have had cancer may have health problems related to their treatment, and GPs are the best people to pick these up. But that doesn't happen nearly enough at the moment.'
The medical expert said doctors needed to ensure that cancer survivors' medical records included more detail about their disease and type of treatment. 'At the moment GPs aren't recording whether someone has had chemotherapy or radiotherapy,' she said.
'That's partly because they don't get enough information from hospitals, but also because they don't realise why it's important for them to do that.'
Professor Sir Mike Richards, the Government's national cancer director, said it was essential that GPs and oncologists worked together to ensure patients get the best possible care.
The fact that cancer survival rates are improving year on year with a growing number of long-term survivors made it more important, he added.
Dr Clare Gerada, chair of the Royal College of General Practitioners said doctors needed help with the issue.
Admitting that GPs were generally unaware of the risks associated with specific treatments, she said: 'If Prof Maher and the NHS tell us exactly what cancer someone has had, and what treatment, and what the possible risks are of that, and in a way that's easy to understand, we will do things better.'
Drug that 'shrinks children's brain tumours by 50%' is launched as once-a-day pill
Good to hear that some "orphan" drugs are in fact getting through the system
A drug that can shrink brain tumours by up to 50 per cent in children with a rare disease has been launched in the UK. NHS doctors will be able to apply for funding from health trusts for Votubia (everolimus) for children with growing non-malignant brain tumours associated with a condition called tuberous sclerosis complex (TSC).
The once-a-day pill offers an alternative to surgery and could provide a lifeline for up to 1,600 youngsters in the UK with the tumours.
The drug, which has been granted orphan drug status for rare diseases, has been shown to shrink subependymal giant cell astrocytoma (SEGA) tumours associated with TSC. TSC is a genetic disorder which leads to non-malignant tumours forming in organs, most commonly the brain and kidneys.
Brain tumours occur in up to 20 per cent of patients with TSC, causing physical and mental disability.
Chris Kingswood, head of research at the Tuberous Sclerosis Association, said: 'For a long time there has been a desperate need for a useful alternative licensed treatment to invasive brain surgery.
'Everolimus is the first licensed product we can offer patients to attack the cause of their debilitating condition; it works by blocking a protein that acts as an important regulator of tumour cell growth.
'The way it works in the signalling pathway can be simply likened to blocking a receiver so it cannot process signals from the aerial on an analogue radio, so that the signals can no longer transmit to drive in this case tumour cell growth.'
Dr Finbar O'Callaghan, consultant in paediatric neurology at the University of Bristol, said: 'SEGA is a serious complication in TSC, accounting for much of the increased mortality seen in this condition.
'Until now, brain surgery has been the only option for treatment and the availability of a pharmacological therapy is a major milestone and provides a treatment option in those cases where surgery is difficult or not possible.'
26 September, 2011
Medical optimism gone mad
A London hospital’s trial of a prostate cancer drug has been stopped early because it was so successful doctors felt it would be "unethical" to deny the treatment to other patients.
But that is absurd. As Ioannides and others now often point out, the early results of a research project are often not typical and the effect observed in the research below was actually quite small in absolute terms. It is only the relative results that look good and even the .3 they report below is dismally short of the 2.0 that the Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384) is the threshold for concluding that an agent was more likely than not the cause of an effect.
Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology: below:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data not just a hasty first bite at it
Medics halted tests of the life-extending drug because it would have been “unethical” not to offer the treatment to all 922 cancer sufferers taking part in the trial.
Patients who were given the drug found that it eased pain and caused only minor side effects.
The new drug accurately targets tumours using alpha radiation, which doctors conducting the study said is the most effective form of radiation to eliminate cancer because it limits damage to surrounding tissue. Dr Chris Parker, lead researcher on the project at the Royal Marsden Hospital, said: “It’s more damaging. It takes one, two, three hits to kill a cancer cell compared with thousands of hits for beta particles.”
The drug, Radium-223 Chloride – known as Alpharadin TM – will also do less damage to surrounding tissue because it accurately targets calls, the doctors said. Speaking at an international gathering of cancer experts, Dr Parker, a consultant clinical oncologist, said: “They have such a tiny range, a few millionths of a metre. So we can be sure that the damage is being done where it should be.”
Patients taking the drug has a 30 per cent lower rate of death compared top patients taking a placebo pill. “It would have been unethical not to offer the active treatment to those taking placebo,” Dr. Parker said.
Radium-223 has “a completely different safety profile” to chemotherapy, he added.
The trial’s results were presented this week at the 2011 European Multidisciplinary Cancer Congress in Stockholm.
The researchers, who have pointed out the urgent need for an effective treatment for prostate cancer, will now submit their findings for approval by regulators.
Prof Gillies McKenna, Cancer Research UK’s radiotherapy expert said: “This appears to be an important study using a highly targeted form of radiation to treat prostate cancer that has spread to the bones.
“This research looks very promising and could be an important addition to approaches available to treat secondary tumours – and should be investigated further.”
The cancer risk in your 'healthy' glass of fruit juice which has so much sugar it could bring on tumours
You can't win!
It's supposed to be the healthy way to start the day. But a glass of juice might not be as beneficial as you think – and could even be harmful. Scientists claim fruit juice contains so much sugar it actually increases the risk of certain cancers, rather than preventing them.
In fact, by the time the drink has been processed and packaged, many of the ingredients in fruit that protect against tumours have been lost, they say.
Australian researchers had sought to establish how effective different fruits, vegetables and juices were at preventing the development of bowel cancer. They examined the diets of 2,200 adults, who filled in a questionnaire detailing their daily eating habits. The team then tracked the participants for two years to see how many of them developed the disease.
Unsurprisingly they found that eating apples, sprouts, cauliflower or broccoli on a daily basis all reduced the likelihood.
However, those who consumed lots of fruit juice had a higher risk.
The research, published in the Journal of the American Dietetic Association, found that those drinking more than three glasses a day were more likely to develop rectal cancer, a form of bowel cancer.
Scientists believe the high sugar content in juice may trigger certain tumours.
The Perth team also said that many things found in fruit which help protect against bowel cancer – including fibre, vitamin C and chemicals known as antioxidants – are lost during the juice’s processing.
For years, Department of Health guidelines have advised the public to eat five portions of fruit and veg a day, which can include a glass of juice.
But British researchers claimed earlier this year that fruit juice contains too much sugar to be counted as one of the five. The scientists, of Bangor University, Wales, said people would be better off eating prunes or other dried fruit, as even freshly-squeezed juice contains as much as five teaspoons of sugar per glass.
However, other experts suggest that people shouldn’t shun fruit juice completely, as it is still healthier than other drinks.
Nell Barrie, of Cancer Research UK, said of the latest research: ‘This isn’t a large study, and it doesn’t give us clear answers about whether different fruits and vegetables affect the risk of cancer in parts of the bowel.
‘It’s very tricky to tease apart the effects of a person’s diet on their risk of bowel cancer, but reliable evidence shows that eating lots of red and processed meats increases the risk, while eating plenty of high-fibre foods can reduce the risk.
‘Many fruits and vegetables are a good source of fibre, and eating a diet that’s high in fruits and vegetables could reduce the risk of other types of cancer as well – so it’s a good idea to get plenty of them in your diet.’
25 September, 2011
That evil coffee (?)
Not good for the young?? This sounds like kneejerk Puritanism. Where is the evidence of harm from coffee? When I was growing up kids in Australia were quite normally given a cup of tea with their evening meal and tea is also a caffeinated beverage. I have never heard of any harm from the practice
STUDENTS as young as 12 are being served coffee by a full-time barista employed by one of Sydney's top private schools. Presbyterian Ladies' College Sydney has opened the "Cyber Cafe" as part of extensive library renovations.
The cafe has outraged nutritionists who are concerned there are no restrictions on how many coffees students from the school in Croydon can purchase in a day.
Coffees cost $3 each (50c extra for soy or syrup flavour). Year 11 and 12 students are free to use the coffee shop all day, while Years 7-10 students can only buy before and after school and during recess and lunch.
Nutritionist Rosemary Stanton said the cafe should be restricted to Year 11 and 12 students as younger children should not be encouraged to consume caffeine. "It is too early to be introducing them to coffee," she said. "This is going to need a close watch because it is easy for girls to drink lots of coffee to keep them going instead of eating."
A barista at the cafe told The Sunday Telegraph the students drink a lot of coffee. She said they also add sweet syrups, including caramel and vanilla, which masks the taste.
The cafe makes between 10kg and 15kg of coffee per week, which equates to about 2100 cups, according to owner of coffee academy Barista Basics David Gee. "Say the coffees are $3, they'd be making about $5000 per week just in coffee sales,'' he said.
The school's director of information services Joanna Taylor said the caf is "a very popular space''. "I don't know how much coffee they drink but the reality is, in the morning, even before the caf, the girls come walking up the street holding their coffees.''
Australia: Natural medicine offers risks not relief
HEALTH authorities have failed to keep up with an explosion in natural therapists as lives are put at risk from untested, unproven and potentially dangerous services.
More than 200,000 practitioners work in unregistered health fields Australia-wide and complementary medicines generate almost $2 billion a year, but little can be done when treatments go wrong.
In a damning assessment of consumer-protection measures, Queensland's health watchdog admits it is powerless to respond to the misconduct of alternative healers and other unregistered practitioners.
"The status quo does not sufficiently protect consumers from (the) risk of harm from unregistered health practitioners," the Health Quality and Complaints Commission says in a confidential paper obtained by The Sunday Mail.
Naturopathy, faith and spiritual healing, Chinese medicine, homeopathy and massage are among the unregulated fields in Queensland, with the medical community warning of a health "time bomb".
"This is a public health issue waiting to explode," said UQ School of Population Health researcher Jon Wardle, who has found there are now more alternative medical practitioners than doctors in some areas.
"For half the healthcare sector to be non-regulated is completely inappropriate it is the black market of health."
The Australian Traditional Medicine Society says the industry is "overall very safe" but supports reforms to protect consumers.
Figures obtained by The Sunday Mail show there have been 119 complaints about alternative practitioners to the state's health watchdog in the past three years. Allegations of assault, rough and painful treatment, illegal practices, medication errors and inappropriate treatment are among the complaints.
However, the complaints commission is unable to discipline offenders and can only forward cases to other agencies for action under general consumer and criminal laws.
The state lags a long way behind NSW, where a health complaints commissioner can ban unregistered practitioners who breach a statutory code of conduct. There are no similar prohibition powers in Queensland.
An acupuncturist who caused a collapsed lung was among nine people banned in NSW since 2008.
Doctors' group the AMA says it is aware of dangerous practices, including practitioners claiming to be able to change DNA. "These practitioners sometimes lead patients to believe almost magical things can be done," Queensland AMA president Dr Richard Kidd said.
A further 80 complaints were made about complementary medicines and therapies to Queensland's Office of Fair Trading since 2008.
A huge question mark hangs over the safety of complementary medicines, with a scathing report this month revealing that nine out of 10 products were not meeting regulatory standards.
The Auditor-General's report found the 10,000 complementary medicines registered with the Therapeutic Goods Administration did not have to be tested for safety nor efficacy.
A TGA spokeswoman last week said there were 276 adverse drug reaction reports relating to complementary medicines, or 2 per cent of all reports.
Grave concerns about the policing of alternative operators this year prompted the Australian Health Ministers Advisory Council to launch a review of regulation. The body, due to report to health ministers in November, consulted with representative associations and found there were at least 200,000 practitioners.
Queensland's Health Quality Complaints Commission sent a "private and confidential" submission to the advisory council backing a national code of conduct and banning powers.
The present system allowed repeat offenders to "continue providing health services that harm the public", chief executive Cheryl Herbert wrote.
24 September, 2011
Why 'good' sugar is the secret to a slim figure (?)
The popular article below is a fanciful elaboration of the academic original. I therefore append the academic original. The earth shattering finding of the academic original was that when you are low on nutrients you feel hungry -- and that the brain has got something to do with that
Eating fresh fruit and vegetables helps people resist the temptation of waist-expanding treats, scientists have found.
When our supplies of glucose - found in carbohydrates - drop we begin to lose our ability to control desire, while our urge to eat increases. The lack of glucose – which is used to power the brain – makes us helpless against the urge to reach for high-calorie foods, researchers said.
Obese people are particularly vulnerable, with even the slightest drop in glucose prompting irresistible cravings for carbohydrates, from which we get most of our sugar.
These can be "good" carbs, such as fresh fruit and vegetables, brown rice and pasta and wholemeal bread, or "bad" varieties which include white bread and sugar, fizzy drinks, cakes, crisps and other packet snacks.
Making sure the brain's glucose levels do not drop could be the secret to staying slim, a study published in the Journal of Clinical Investigation suggested.
Eating less and often could lower the chance of succumbing to the temptation of high-calorie foods, particularly for obese people, the researchers said.
Prof Rajita Sinha, of Yale University in America, said: "The key seems to be eating healthy foods that maintain glucose levels.
Volunteers were given injections of glucose and their brains were scanned while they were shown pictures of high and low calorie foods, as well as other objects.
When glucose levels were lower, two areas of the brain which regulate pleasure prompted the desire to eat while the prefrontal cortex – which gives us self-control – lost its ability to control the impulses.
SOURCECirculating glucose levels modulate neural control of desire for high-calorie foods in humans
By Kathleen A. Page et al.
Obesity is a worldwide epidemic resulting in part from the ubiquity of high-calorie foods and food images. Whether obese and nonobese individuals regulate their desire to consume high-calorie foods differently is not clear. We set out to investigate the hypothesis that circulating levels of glucose, the primary fuel source for the brain, influence brain regions that regulate the motivation to consume high-calorie foods. Using functional MRI (fMRI) combined with a stepped hyperinsulinemic euglycemic-hypoglycemic clamp and behavioral measures of interest in food, we have shown here that mild hypoglycemia preferentially activates limbic-striatal brain regions in response to food cues to produce a greater desire for high-calorie foods. In contrast, euglycemia preferentially activated the medial prefrontal cortex and resulted in less interest in food stimuli. Indeed, higher circulating glucose levels predicted greater medial prefrontal cortex activation, and this response was absent in obese subjects. These findings demonstrate that circulating glucose modulates neural stimulatory and inhibitory control over food motivation and suggest that this glucose-linked restraining influence is lost in obesity. Strategies that temper postprandial reductions in glucose levels might reduce the risk of overeating, particularly in environments inundated with visual cues of high-calorie foods.
J Clin Invest. doi:10.1172/JCI57873. 2011
Diet police mug the very hungry caterpillar
ONE Sunday morning the warm sun came up and -- pop! -- out of the egg came a tiny and very hungry caterpillar. He started to look for some food. He ate through an apple, two pears, three plums, four strawberries and five oranges.
Readers of the classic children's book know what happens next. Still hungry, the caterpillar gorges on one piece of chocolate cake, one ice cream cone, one pickle, one slice of Swiss cheese, one slice of salami, one lollipop, one piece of cherry pie, one sausage, one cupcake and one slice of watermelon.
But it seems the grub of today has different -- and healthier -- tastes. In a rendition of the Eric Carle tale performed by Flemington Primary School prep students in Melbourne, the caterpillar spends his Saturday munching through a bowl of cereal, a cheese-and-tomato sandwich on brown bread, a glass of low-fat milk, a slice of (unspecified) cheese, a bowl of spaghetti, steamed broccoli, a piece of chicken, a piece of fish and a tub of low-fat yoghurt.
Curiously, he still ends up with a stomach-ache.
But instead of cleansing his system with a nice green leaf, as Carle wrote, he washes it away with a big bowl of vegetable soup. "After that he felt much better," the kids recited.
All this good living duly produces a glorious butterfly. But that is not where the revised story ends. Once he gets his wings, the butterfly signs up for "PMP", which stands for the Perceptual Motor Program, a fancy prep way of saying exercise class.
Carle might wonder about the reinvention of his most famous book, which has been translated into 55 languages and has sold 33 million copies since it was first published in 1969.
The author of The Very Hungry Caterpillar is now 82, divides his time between the Florida Keys and the hills of North Carolina, and is a regular blogger. The Weekend Australian emailed him to ask his thoughts on the "improvements" made by Flemington prep, but he has not yet replied.
No doubt he would have had a chuckle to observe the kids' accompanying artwork. Mostly, they were pictures of lollipops.
23 September, 2011
Popular weight-loss drug under review over liver failure fears
This is ridiculous. 38 million take the drug with no harm to themselves but when just 4 people become ill it is the fault of the drug???
The most popular weight-loss drug in Britain is under investigation over fears it may be linked to liver failure. The European Medicines Agency said there had been four suspected cases of “serious liver toxicity” linked to the medicine in recent years, one of which was fatal.
Although a small number of cases considering 38 million dieters across Europe have been given the pills by doctors to lose weight, the regulator said it was now looking at what evidence there is linking the drug to liver damage. It will then decide whether or not the licences for medicines containing orlistat need to be changed or even revoked.
Orlistat, available since 1998, stops the intestines absorbing fat so it is excreted instead. It is available in an over-the-counter 60mg form, known as Alli, and a prescription-only 120mg dose, marketed as Xenical.
Official figures show that orlistat accounted for 74 per cent of the 1.45million weight-loss drugs prescribed in England in 2009, which cost £46.8m.
Two other anti-obesity pills, known as rimonabant (Acomplia) and sibutramine (Reductil), worked by altering how patients think about food but have been suspended from sale in recent years, leaving Xenical the main option for GPs to prescribe.
A Europe-wide review took place in 2009 of a possible link between orlistat and “serious hepatic reactions”, meaning liver damage, but found “insufficient evidence”. But the EMA, which licenses drugs across the continent, announced on Thursday it was looking again at the drug.
“The European Medicines Agency has started a review of orlistat-containing anti-obesity medicines, to determine whether the very rare cases of hepatic injury have an impact on their benefit-risk profile and conditions of use," it said in a statement.
“The review includes the centrally authorised prescription-only medicine Xenical (orlistat 120 mg) and the centrally authorised over-the-counter-medicine Alli (orlistat 60 mg), as well as a number of medicines containing orlistat that have either already or are in the process of being authorised at national level.”
It said the “vast majority” of reports of liver damage were not serious, and severe injuries have only been reported “very rarely”. Between August 2009 and January this year, the EMA said it had heard of 21 suspected cases of liver damage linked to the prescription-only dose of orlistat.
Four of these were severe, with one proving fatal and another requiring a liver transplant. Between 1997 and 2011 there were 21 cases where a link could have been present, out of 38m people taking the drug.
Between May 2007 and January this year there were a further nine reports of “suspected severe liver injury” linked to the lower-dose drug, but not all were conclusive and must be seen “in the context of cumulative usage in 11 million patients”.
The EMA concluded: “The Committee is now reviewing all relevant data on the risk of hepatotoxicity of orlistat-containing medicines and will issue an opinion on whether or not the marketing authorisations for these medicines should be revoked, suspended or changed.”
Roche, the pharmaceutical giant that makes Xenical, said it was the most tested diet drug there is and had been in 100 different clinical trials. But a spokesman said it would investigate any patient safety concerns.
Zinc is good for the memory... but too much could 'trigger epilepsy'
Zinc may play a key role in memory - but too much of the mineral in the brain could trigger epileptic seizures, research suggests.
A new study has found that zinc is critical to communication between neurons in the hippocampus, the brain's learning and memory centre.
Scientists used a chemical that binds to zinc to remove it from circulation in the brain's of mutant mice. Without the mineral, communication between neurons was impaired.
Lead researcher Dr James McNamara, from Duke University Medical Center in North Carolina, US, said: 'We discovered that zinc is essential to control the efficiency between two critical populations of nerve cells in the hippocampus. This addresses a long-standing controversy in the field.'
The findings were published online in the journal Neuron.
More than 50 years ago, scientists learned that high levels of zinc were contained in specialised compartments in nerve cells called vesicles.
These package the transmitter chemicals that enable nerves to communicate.
However, evidence that zinc actually played a role in cell signalling was lacking.
Over-communication by the brain cells highlighted in the study was known to occur in epilepsy, pointing to a link between zinc and the condition.
Dr McNamara said people taking zinc supplements should exercise caution.
'Carefully controlling zinc's regulation of communication between these nerve cells is critical to both formation of memories and perhaps to occurrence of epileptic seizures,' he added.
22 September, 2011
Exposed: The health drinks that don't live up to the hype
Comment from Britain
Claims that health drinks help slimming, boost digestion and lubricate joints have been rejected by consumer experts.
Britons spend more than £700million a year on ‘functional’ drinks and food. But research by Which?, published today, suggests that using these products to treat ailments is often a waste of money.
The consumer group said the slimming drink Aspire claims ‘you can burn over 200 calories a can’. The firm’s website boasts that Aspire, which contains several stimulants, ‘raises your body’s metabolism and suppresses appetite’.
Which? tracked down research which found that those who drank it did indeed burn off an average of 209 calories over a three-hour period. But this was only 27 calories more than someone who had consumed a drink making no calorie-burning claims. Twenty-seven calories is the equivalent of one bite of a chocolate digestive biscuit. Aspire costs £1.69 for 250ml.
The consumer group was also critical of NeuroTrim, a drink which promises weight loss support. Ingredients include a fibre gel the company calls LuraLean. In August, the Advertising Standards Authority ruled that a website claim that the drink was ‘designed to promote weight loss’ was misleading.
The orange cordial ActivJuice for Joints, which costs £7.39 for 500ml, contains glucosamine. It claims this will ‘help maintain healthy joints, bones, muscles, tendons and ligaments’. But Which? pointed to a finding by the European Food Safety Authority, which has decided there is ‘not enough evidence’ to back up such claims.
A host of probiotic yoghurt drinks, such as Actimel and Yakult, have in the past made claims that they can help boost digestion and the beneficial bacteria that exist in the gut. But Which? said the EFSA has rejected general claims linking prebiotics and probiotics to improved digestive health. The brands have submitted new evidence to justify their claims, but have had to change their marketing claims in the meantime.
Which? said that some health drinks do offer genuine benefits, particularly those designed to reduce cholesterol levels.
Brittle bone drug offers new hope that it could hold arthritis at bay
Rodent evidence only so far
A drug used to strengthen brittle bones could help to hold arthritis at bay. There is currently no cure for arthritis – which causes inflammation of the joints and bones –and treatments are aimed at simply easing the pain it causes.
However, the osteoporosis drug teriparatide thickened damaged knee joints by almost a third in laboratory tests. This has raised hopes it could also be used to treat osteoarthritis, the most common form of arthritis.
It is caused by the breakdown of cartilage that helps our joints take the strain of bending, lifting, gripping and kneeling, and affects about six million Britons.
Existing drugs simply ease pain of bone rubbing on bone. They do nothing to slow the course of the condition and some raise the odds of heart attacks and strokes.
Hip or knee replacement surgery can improve quality of life in patients but it is a complicated and lengthy process and is not successful in every case. In addition, the artificial joints usually only last for ten to 15 years, meaning some patients have to be operated on over and over again.
In the study, teriparatide was given daily to mice with arthritic knees. After a month, cartilage in the knee joints of the treated mice was 32 per cent thicker than in other animals, the journal Science Translational Medicine reports. In addition, the production of genes and molecules associated with the degeneration of cartilage was suppressed.
The research raises hopes the drug could eventually be used to combat arthritis in humans.
The scientists, from the University of Rochester Medical Centre in New York State, compared the health of arthritis patients who were taking teriparatide for osteoporosis, with that of another group who weren’t taking the drug. Those taking teriparatide, which has the brand name Forsteo in Europe and Forteo in the U.S., said they found it easier to move the damaged joint.
The researchers said that further studies, including proper trials of those with arthritis, could lead to the drug being approved to treat arthritis as well as osteoporosis.
Osteoarthritis is more common in women than in men and usually occurs in the over-50s, although it can also affect younger people. The condition mostly occurs in the knees, hips and hands.However, almost any joint can become stiff, swollen and painful.
Study co-author Dr Michael Zuscik said: ‘We believe that a potential alternative to this cycle of pain and reduced quality of life has gone unnoticed for the past decade.’
The safety of long-term use of the drug would also have to be assessed. Concerns that it raises the odds of bone cancer mean that use in osteoporosis is limited to two years in total.
Professor Phil Conaghan, of Arthritis Research UK, said: ‘We welcome anything that helps to treat osteoarthritis and that reduces the pain and suffering of the six million people in the UK that are affected by this debilitating condition.
‘However, we need to sound a big note of caution, as animal models of osteoarthritis are not like humans with osteoarthritis, and many agents that have worked and looked very promising in animals have not worked in human trials.’
21 September, 2011
Walking through traffic fumes 'can raise risk of heart attack for six hours' (?)
This is a very ambitious study, correlating the TIME of heart attacks with the known level of pollution in the air at the time. Journal article here.
It seems unlikely that epidemiological data can answer the question asked. A firm conclusion would depend on the time of each person's heart attack being known and accurately given in official records -- a very dubious assumption. On the other side of the correlation, the air quality data is taken from the UK National Air Quality Archive. Is that archive specific enough to record what exposure EACH PERSON had to pollution? Surely not. Just being indoors versus outdoors could have a large effect.
The only cautious conclusion we could draw from the results reported is that they are a random walk
Higher levels of air pollution can increase the risk of having a heart attack for up to six hours after exposure, warn UK researchers. Even moderate levels of pollution from traffic carry an extra risk, according to a new study in the British Medical Journal.
The findings come from a detailed analysis of almost 80,000 heart attack cases and the level of pollution to which they were exposed.
Air pollution is currently estimated to reduce the life expectancy of everyone in the UK by an average of seven to eight months, probably by affecting the heart and lungs.
In the latest study Krishnan Bhaskaran, an epidemiologist from the London School of Hygiene and Tropical Medicine, and colleagues found rising air pollution was linked to a rise in heart attacks up to six hours after exposure. However, there was no increased risk after the six-hour period, with the number of heart attacks then falling to a lower level than expected.
The researchers reviewed 79,288 heart attack cases from 2003 to 2006 and exposure, by the hour, to pollution levels. They used the UK National Air Quality Archive to investigate the levels of specific pollutants in the atmosphere. These included pollutant particles (PM10), carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone. Higher levels of PM10 – tiny toxic particles - and NO2 are well-known markers of traffic related pollution from vehicle exhaust fumes, said Dr Bhaskaran.
National air pollution warnings on weather reports alert people to changes using bands ranging from low, to moderate, to high, to very high. People who are sensitive to air pollution are advised to spend less time outdoors during high and very high episodes of air pollution, and not to exercise, along with those suffering asthma and heart disease.
Dr Bhaskaran estimated there would be an extra five per cent risk of a heart attack caused by a change in air pollution from ‘low’ to ‘moderate’ in the following six hours. The risk would increase further during ‘high’ and ‘very high’ episodes but they are uncommon in Britain, he added.
Dr Bhaskaran said the data suggested that after the first six hour period following pollution peaks, the number of heart attacks was lower than expected. Some people who were going to have a heart attack in that later period may have simply had their heart attack brought forward by a few hours as result of the pollution exposure, he said.
‘We know from many studies that there are more deaths when pollution levels are higher, but whether heart attacks make a major contribution to this is not clear.
‘Although we found a short period of increased risk of heart attacks in the few hours after air pollution peaks, the risk was small and had little net impact on the overall number of heart attacks’ he added.
Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, which co-funded the study, said: ‘This large-scale study shows conclusively that your risk of having a heart attack goes up temporarily, for around six hours, after breathing in higher levels of vehicle exhaust.
‘We know that pollution can have a major effect on your heart health, possibly because it can "thicken" the blood to make it more likely to clot, putting you at higher risk of a heart attack.
‘Our advice to patients remains the same – if you’ve been diagnosed with heart disease, try to avoid spending long periods outside in areas where there are likely to be high traffic pollution levels, such as on or near busy roads.’
The study looked at heart attacks in England and Wales.
Electric-shock therapy lifted me from the hell of depression
There is a strong body of thought that the good attention that medical staff give to the patient while conducting the electroshock procedure is the curative influence -- a type of placebo effect. The fact that a series of treatments is needed before any progress is seen supports that view
Life for Tania Gergel could not have been more thrilling. Captivated by academic study, she quickly became one of the highest-achieving students on her Classics degree course at Bristol University, finding time to play percussion with several bands and orchestras, too. Tania, then 19, also met and fell in love with Matthew, a maths student, now her husband.
Then tragedy struck: the couple just returned from their first holiday together when Tania was told that her best friend, Ali, had been killed in a car accident. ‘It was a terrible shock — as though a screen suddenly came down between me and the rest of the world,’ recalls Tania, now 38, from North London. ‘After the funeral, when I went back to university, I felt detached from everyone. My mind had started racing and I couldn’t sleep.’
Within a month, Tania had stopped studying altogether. ‘I remember sitting in a common room waiting for a lecture. It felt like everything was swimming around me and I had to get out of the building.’
Tania was experiencing depression, specifically an episode of bipolar disorder, previously known as manic depression. According to the NHS, around 500,000 Britons have been diagnosed as bipolar, although recent studies suggest the true incidence may be more than five million. Sufferers typically swing between two phases — manic and depressive.
During the manic phase they may experience feelings of euphoria, talk at extreme speed and go for days without food or sleep. The depressive phase is characterised by severe low mood, a loss of sense of purpose and, at its most extreme, thoughts of suicide.
Several weeks after her friend’s death, Tania sought help from her GP who prescribed tricyclic anti-depressants — the standard treatment at that time. ‘It was a shock to be diagnosed with depression,’ she recalls. ‘When the doctor prescribed medication, I realised something was very wrong with me.
‘I’ve since learned that my grandmother had been hospitalised twice for psychiatric depression: she had heard voices.’ (There is strong evidence for a genetic vulnerability to developing the illness.)
However, after five months of taking anti-depressants, Tania was forced to acknowledge they were having no effect. ‘The depression got worse. I was getting two hours’ sleep at night, if that, invariably with sleeping pills involved. ‘I gave my pills to Matthew to look after as I felt I couldn’t trust myself any more not to take them all as an overdose.’
Eventually, Tania went as a voluntary inpatient to a private psychiatric hospital in London, where she stayed for two months. But despite being given every type of major antidepressant, nothing seemed to help and Tania and her family became desperate.
Then, by chance, Tania met a friend of a friend who was a psychiatrist at London’s Charter Nightingale Hospital (now Capio Nightingale). ‘He said it was clear the drugs weren’t working and suggested I come off all the pills and have electroconvulsive treatment.’
Many will recoil at the thought of electroconvulsive treatment (ECT), which was famously depicted in the 1975 Jack Nicholson film One Flew Over The Cuckoo’s Nest. But it is considered an effective treatment for severe depression which is resistant to medication and talking therapies such as Cognitive Behavioural Therapy.
About 20 per cent of all depression sufferers fall into this category, of which more than half would benefit from ECT, says Dr Cosmo Hallstrom, consultant psychiatrist at the Royal College Of Psychiatrists in London.
The treatment involves sending an electric current through the brain, under general anaesthetic, to cause a fit. Although it is not exactly known how it works, one theory is that the fit triggers certain brain chemicals, including the ‘feel-good’ chemical, serotonin, which is thought to be depleted in patients with severe depression.
The treatment was first introduced around 70 years ago but it fell out of favour following the introduction of antidepressant medication in the Fifties and Sixties.
In the past, ECT has been used indiscriminately, at times under duress and without general anaesthetic. As a result, it remains the most controversial treatment in modern psychiatry.
Indeed earlier this year the British Psychological Society called for it to be banned, describing the treatment as ‘inhumane and degrading’, and having only a short-term effect on people with manic depression.
However, many clinical studies show ECT is significantly more effective than antidepressants in inducing a speedy remission for severe treatment-resistant depression, says Dr Hallstrom. ‘It can cure a particular bout of depression — although it does not prevent relapses,’ he says.
Indeed, it is even recommended by the National Institute For Health And Clinical Excellence (Nice).
In 2008 Nice published guidelines on the management of bipolar disorder, which recommended ECT ‘to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening’.
Tania’s brother, then a practising psychiatrist, had himself carried out ECT many times and told her he had seen it have remarkable results. ‘He was very much in favour,’ she says. ‘You know your own brother has your best interests at heart.’
‘It wasn’t what people may think — being restrained in some sort of straitjacket. It was all very civilised. You go under a general anaesthetic for a few minutes and that’s really all you know.’
Dr Hallstrom says patients see an improvement after six twice-weekly treatments. Tania started to feel things changing after five. ‘It was a very sudden thing. I just woke up one day and thought: “I feel like something’s lifted.” Suddenly you’re released from internal torment.’
Six months after completing her course of ECT, Tania returned to her studies and got a First.
The treatment is not risk-free — half of those who undergo it experience side-effects, such as confusion and disorientation, after each treatment. ‘But this tends to fade after a few days,’ says Dr Hallstrom.
A trial is under way in Australia on a new form of ECT, which involves running an electric current through the brain for less time, and has been shown to have less of an effect on memory.
Tania had some memory loss in the period during which she received ECT, ‘but nothing really substantial’ she says. Indeed, after university she went on to gain a Masters and eventually a PhD in Classics, and fulfilled her dream of teaching.
For 11 years, she remained off medication and had no contact with any psychiatrist. Tania and Matthew married and had a daughter who is now seven.
ECT does not cure the problem for good, though, as Tania discovered. When her daughter was two, she became pregnant again. But then she miscarried, plunging her into a severe depression.
‘Within three weeks I was in hospital. My consultant psychiatrist suggested I try ECT again. It worked and after six treatments, all of a sudden I didn’t feel suicidal any more.’
Dr Hallstrom believes more people suffering with severe, medication-resistant depression should be given the option of ECT.‘It can be a lifesaver,’ he says.
Tania can only agree. ‘ECT won’t cure you, but it will get you out of the crisis state,’ she says. ‘Hands down I owe my life to ECT.’
20 September, 2011
Does cholesterol hold the key to a vaccine against Aids? Scientists find way to stop HIV damaging the immune system
Sad if this is seen as further demonization of cholesterol. It in fact demonstrates the importance of cholesterol
Scientists have found a way to prevent HIV from damaging the immune system and say their discovery may offer a new approach to developing a vaccine against Aids.
Researchers from the United States and Europe working in laboratories on the human immunodeficiency virus (HIV) found it is unable to damage the immune system if cholesterol is removed from the virus's membrane.
"It's like an army that has lost its weapons but still has flags, so another army can recognise it and attack it," said Adriano Boasso of Imperial College London, who led the study. The team now plans to investigate how to use this way of inactivating the virus and possibly develop it into a vaccine.
Usually when a person becomes infected with HIV, the body's innate immune response puts up an immediate defence. But some researchers believe HIV causes the innate immune system to overreact. This weakens the immune system's next line of defence, known as the adaptive immune response.
For this study -- published yesterday in the journal Blood -- Boasso's team removed cholesterol from the membrane around the virus and found that this stopped HIV from triggering the innate immune response. This in turn led to a stronger adaptive response, orchestrated by a type of immune cells called T cells.
Aids kills around 1.8 million people a year worldwide. An estimated 2.6 million people caught HIV in 2009, and 33.3 million people are living with the virus.
Major producers of current HIV drugs include Gilead Bristol Myers Squibb, Merck, Pfizer and GlaxoSmithKline.
Scientists from companies, non-profits and governments around the world have been trying for many years to make a vaccine against HIV but have so far had only limited success.
A 2009 study in Thailand involving 16,000 volunteers showed for the first time that a vaccine could prevent HIV infection in a small number of people, but since the efficacy was only around 30 per cent, researchers were forced back to the drawing board.
An American team working on an experimental HIV vaccine said in May that it helped monkeys with a form of the Aids virus control the infection for more than a year, suggesting it may lead to a vaccine for people.
HIV is spread in many ways -- during sex, on needles shared by drug users, in breast milk and in blood - so there is no single easy way to prevent infection.
The virus also mutates quickly and can hide from the immune system, and attacks the very cells sent to battle it. "HIV is very sneaky," Boasso said in a statement. "It evades the host's defences by triggering overblown responses that damage the immune system. ‘It's like revving your car in first gear for too long -- eventually the engine blows out.
He said this may be why developing a vaccine has proven so tricky. "Most vaccines prime the adaptive response to recognise the invader, but it's hard for this to work if the virus triggers other mechanisms that weaken the adaptive response."
HIV takes its membrane from the cell that it infects, the researchers explained in their study. This membrane contains cholesterol, which helps keep it fluid and enables it to interact with particular types of cell.
Normally, a subset of immune cells called plasmacytoid dendritic cells (pDCs) recognize HIV quickly and react by producing signaling molecules called interferons. These signals activate various processes which are initially helpful, but which damage the immune system if switched on for too long.
Working with scientists Johns Hopkins University, the University of Milan and Innsbruck University, Boasso's team found that if cholesterol is removed from HIV's envelope, it can no longer activate pDCs. As a result, T cells, which orchestrate the adaptive response, can fight the virus more effectively.
An antibiotic found in liver of sharks 'could revolutionise human medicine'
And it's a cholesterol type molecule!
An antibiotic found in sharks could be used as drug to treat human viruses and revolutionise medicine, new research has found.
The compound, found in the liver of the predator, could be used as a new type of drug to treat a broad spectrum of diseases from dengue and yellow fever to hepatitis B, C and D.
The antibiotic, squalamine, is already known to be safe for use in humans as an antiviral agent.
Dr Michael Zasloff, from Georgetown University who led the study, said: ‘To realise that squalamine potentially has broad antiviral properties is immensely exciting, especially since we already know so much from ongoing studies about its behaviour in people.’
They found that in both lab and animal experiments squalamine produced antiviral activity against the human pathogens found in the diseases such as some forms of hepatitis which cannot currently be treated.
Along with offering medical advances this discovery may solve the mystery of how sharks with primitive immune systems can so effectively fight viruses that plague all living creatures.
Dr Zasloff said: ‘I believe squalamine is one of a family of related compounds that protects sharks and some other “primitive” ocean vertebrates, such as the sea lamprey, from viruses. ‘Squalamine appears to protect against viruses that attack the liver and blood tissues, and other similar compounds that we know exist in the shark likely protect against respiratory viral infections, and so on.
‘We may be able to harness the shark's novel immune system to turn all of these antiviral compounds into agents that protect humans against a wide variety of viruses. ‘That would be revolutionary. While many antibacterial agents exist, doctors have few antiviral drugs to help their patients, and few of those are broadly active.’
Dr Zasloff discovered squalamine in 1993 and it has already been used in clinical trials to treat cancer and several eye disorders.
‘I was interested in sharks because of their seemingly primitive but effective immune system. No one could explain why the shark was so hardy,’ he said. When he started to ‘play’ with the compound he found that it inhibited the growth of rapidly growing blood vessels, such as those found in tumour growth and certain retinal diseases.
Since 1995 it has been synthesised in the laboratory rather than taking any natural shark tissue.
Dr Zasloff remained interested in how the natural cholesterol type molecule, which has a net positive electrical charge, acted as an immune agent in sharks.
When it enters cells, and it can only access certain cells including those in blood vessels, capillaries and the liver, squalamine ‘kicks off’ positively-charged proteins that are bound to the negatively charged surface of the cells inner membrane.
Some of these displaced proteins are used by viruses to replicate and without the protein a virus's life cycle is disrupted, the microbe is rendered inert and the cell containing it is destroyed.
This means that squalamine seems to be designed to fight certain viral infections, Dr Zasloff claimed. He said: ‘To me, the key to squalamine is that once in the body it times its action to match the life cycle of most viruses. ‘Most viruses take hours to complete their life cycle, the same time period that squalamine renders tissues and organs viral resistant after administration. ‘In addition, it acts fast to stop viral replication, clearing the body of these predators within hours.
‘Furthermore, because squalamine acts by making the host's tissues less receptive for infection, rather than by targeting a specific viral protein, the emergence of viral resistance would not be anticipated.’
In tissue culture studies squalamine was shown to inhibit the infection of human blood vessel cells by the dengue virus and human liver cells infected with hepatitis B and D, which can cause liver failure and cancer.
In animal studies, scientists from across the USA discovered that squalamine controlled infections of yellow fever, Eastern equine encephalitis virus, and murine cytomegalovirus, and in some cases cured the animals.
The study was published in the Proceedings of the National Academy of Sciences Early Edition online yesterday.
19 September, 2011
Two cups of coffee every day 'may cut stroke risk'
The original journal article is much more tentative than the popular report below. And with good reason. The comparision was with people who drink NO coffee! Who are those guys? Alcoholics? Tea drinkers? Mormons? People too poor to buy coffee? Without knowing that the results are meaningless. The conclusion of the journal abstract is the maximum you could realistically say: "Findings from this meta-analysis indicate that moderate coffee consumption may be weakly inversely associated with risk of stroke"
Just two cups of coffee a day can significantly reduce the risk of stroke, research shows.
Experts have previously been divided over the drink, with some suggesting the beverage is a dangerous stimulant, and others that it could save lives. But a comprehensive analysis of the health benefits of coffee has confirmed it can have a powerful preventative effect against one of Britain’s biggest killers.
Scientists at the Karolinska Institute in Stockholm, Sweden, pooled results of earlier studies to find a definitive answer. They gathered statistics from eight studies surveying nearly half-a-million people, carried out from the mid 1960s to 2011.
The results, published in the American Journal of Epidemiology, showed those drinking two cups a day were 14 per cent less likely to suffer a clot on the brain, while drinking three to four cups a day reduced the dangers by 17 per cent.
But consuming more than that does not necessarily boost protection, the study showed. Caffeine addicts drinking six or more cups daily see a reduction in risk of just 7 per cent.
The researchers said antioxidants in coffee may protect blood vessels in the brain from damage caused by lipoprotein, dubbed the ‘bad’ cholesterol. But they stressed there are still lingering concerns that it can increase blood pressure.
The scientists said: ‘Coffee is a complex mixture of substances that may have both beneficial and harmful effects.’
Nanny state health targets take the taste out of the traditional British fry-up
The traditional British fry-up is under threat from government health targets, industry experts warned yesterday. Butchers and retailers say a drive to cut salt levels will make breakfasts with bacon and sausages less appetising.
More than 60 food firms and supermarkets have to cut salt levels by next year to meet targets set by the Government.
At least 80 per cent of sausages are thought to exceed the threshold, which allows 1.13g of salt per 100g. The sausage maker Richmond’s products, for example, typically contain around 2.2g per 100g, while Tesco’s own-brand bangers contain 1.5g per 100g.
For bacon, which will be limited to 2.88g of salt per 100g, most supermarkets’ own brands exceed the threshold with up to 3.6g.
Ministers want to reduce our salt intake to 6g a day from 8.6g in 2008, the last year for which figures are available. They say eating too much salt can raise blood pressure, contributing to thousands of premature deaths every year from heart disease and strokes.
But Andrea Martinez-Inchausti, of the British Retail Consortium, said it was ‘pointless’ to keep reducing salt in products if it meant shoppers just added it at the table. She said: ‘If salt is reduced further there’s a danger that products will no longer taste the way consumers want them to.’
The BRC and the Food and Drink Federation have drawn up a list of eight products for which it is proving difficult to reduce salt without losing flavour. As well as bacon and sausages, they include bread, cheese, cakes and pastries, pesto and other sauces, and canned fish.
So far 62 retailers, including Sainsbury’s, Tesco, Marks & Spencer, Waitrose and Asda, have agreed to comply with the Government’s targets on salt reduction.
18 September, 2011
'Shy' children at risk of being diagnosed with mental disorder
Children who are merely shy or sad are at risk of being diagnosed with mental disorders and given powerful drugs. Psychologists say that new guidelines being developed in America will lead more young people seeing their common problems regarded as illnesses that must be treated, rather than just being given support.
They fear that pupils who are quiet at school could be diagnosed with “social anxiety disorder” while those who become withdrawn after suffering a bereavement are classified as having a “depressive disorder”.
Children who just talk back to adults or lose their temper regularly could be diagnosed with “oppositional defiant disorder”.
As a result, those found to have these increasingly broad mental disorders could be prescribed powerful medication such as Prozac or Ritalin to control or alter their behaviour.
Now the pressure is increasing for a national review of the use of such drugs on schoolchildren as well as more research into their long-term effects, following a vote at the TUC Congress on Wednesday.
Kate Fallon, general secretary of the Association of Educational Psychologists, told delegates: “Behaviours develop over a long period of time, often with a range of complex causes; we can’t ‘cure’ the behaviours we don’t like with a quick fix of medicine. They usually require careful management by all the adults around the child.
“In 2013 we’re expecting new criteria for the definition of mental illness to be adopted here in the UK. These criteria will lead to many more children being diagnosed as mentally ill, based on reports of their behaviours.
“A shy child could be diagnosed with social anxiety; a sad or temporarily withdrawn child could be diagnosed with depression.
“These are conditions which are also likely to be treated with medication – and under these circumstances, Congress, we will be putting potent drugs into children with little or no understanding of what it will lead to.
“In a society that wants quick results using drugs to improve behaviour is very tempting. But there can be other ways of improving children’s behaviour which typically involve time and energy from people.”
Research has found that children under the age of six are being prescribed the drug Ritalin for attention deficit hyperactivity disorder, prompting calls for the Department of Health to investigate the scale of the problem and the potential long-term damage it may be causing.
Recent figures show 650,000 children aged between eight and 13 are on the pscyhotropic drug, up from just 9,000 two decades ago, while others are taking Prozac for depression or anxiety.
Fears are growing that the number of children diagnosed with mental disorders and prescribed drugs will increase still further after 2013, when a new “bible” of the psychiatric profession is published.
Known as DSM-5, the book widens the diagnostic criteria for many supposed conditions including social anxiety disorder, better known as shyness, and will likely be adopted by the health authorities in Britain after appearing first in the US.
The proposed new definition for social anxiety disorder states that it is marked by “fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation), being observed (e.g., eating or drinking), or performing in front of others (e.g., giving a speech)”.
In children this fear could be expressed by “crying, tantrums, freezing, clinging, shrinking or refusal to speak in social situations”.
Young people will be deemed as having oppositional defiant disorder if they display symptoms including losing their temper, arguing with adults, deliberately annoying people or being “spiteful or vindictive at least twice within the past six months” to people other than their brothers or sisters.
The British Psychological Society has also raised concerns about the proposed revisions to the DSM.
It does not dispute that some children have emotional and behavioural problems but says that patients and the public are “negatively affected” by the continued “medicalisation” of natural and normal responses to their experiences, and that classifying such problems as “illnesses” ignores their wider causes.
Prof Peter Kinderman, chairman of the society’s Division of Clinical Psychology, said: “We’re not certain that a diagnosis and a medical response is the best way to help these kids.
“Absolutely understand and help, not necessarily diagnose and treat.”
A 10p vitamin B pill a day from middle age may ward off Alzheimer's
This looks very encouraging but the very high doses used raise serious concerns about damaging side-effects
Taking one vitamin B pill a day from middle age could protect your memory as you grow older – and even ward off Alzheimer’s, British researchers say. The supplement, which costs just 10p, is described as the ‘first glimmer of hope’ in the battle to find a drug that slows or stops the development of the disease.
Pensioners who took high doses of the vitamin once a day for two years did 70 per cent better on a simple memory test than those who did not. The Oxford University scientists say the pill prevents the memory lapses that can be a precursor to dementia. They also found it cut brain shrinkage linked to memory loss by up to 500 per cent.
They say people should consider taking high-dose vitamin B from middle age – but only after seeking their doctor’s advice.
Alzheimer’s and forms of dementia blight the lives of more than 800,000 Britons. That number is expected to double within a generation, as the population ages.
In landmark research published last year, Dr Celeste de Jager and her colleagues, who are also behind this study, showed that high doses of vitamin B cut brain shrinkage linked to memory loss. The latest results, presented at the British Science Festival in Bradford, show that it also helps stop memory from failing.
In the trial, 270 pensioners with mild cognitive impairment – the slight memory lapses that can be a precursor to Alzheimer’s – were asked to take a vitamin B tablet once a day for a year, or given a dummy pill to take instead.
The tablets contained extremely high amounts of vitamins B6, 9 and 12. For instance, the dose of B12 was up to 300 times higher than could be obtained by eating foods rich in the vitamin, such as bananas, wholegrains and meat.
The pill reduced the shrinkage of the brain, which happens naturally with age, by 30 per cent on average – but it halved it in those with the highest levels of a chemical called homocysteine in their bloodstream. In one case, it was cut five-fold.
Homocysteine is a natural compound that builds up in the body as we age and, at high levels, is linked to memory loss and Alzheimer’s. Vitamin B breaks it down. In the study, those with higher than average levels of homocysteine who took vitamin B performed almost 70 per cent better on a memory test than those who took the placebo pill.
It specifically bolsters episodic memory, the type needed to remember things such as shopping lists – and one of the first to deteriorate in Alzheimer’s.
In addition, those with the very highest levels of homocysteine who took vitamin B were less likely to have progressed towards Alzheimer’s, and in some cases, their memory lapses disappeared entirely after the two years.
Researcher Professor David Smith termed the effects ‘striking’. But while the team said those in middle age could benefit from the treatment, they stressed they must speak to their doctor.
High-dose vitamins may trigger cancer and are known to fuel existing cancers. They may also react with medicines including arthritis and psoriasis drugs.
17 September, 2011
Statins and Pregnancy
You may not be old enough to remember the disaster incurred by the widespread practice in Europe in the 1950's of treating depression with the then newly discovered drug Thalidomide. When you take a Lipitor tablet you are taking a drug that, like Thalidomide, is labeled "Class X" with respect to its potential harm to the fetus, and is even worse than Thalidomide in terms of the kind of damage it can do to your unborn child. A woman who is in the childbearing age group should never be advised to take a statin drug. While there are warnings associated with the ads and on the labels claiming that you should "stop taking Lipitor" should you become pregnant, the drug companies seem intent on hushing up the fact that these drugs are toxic to the developing fetus.
Clearly it would be unethical to conduct a controlled experiment that intentionally exposes a pregnant woman to statins, and therefore such controlled studies have not been done. However, in one of the few available retrospective studies of statins and pregnancy, researchers from the U.S. National Institutes of Health found that statin use during the first trimester of pregnancy led to severe central nervous system defects as well as limb deformities. Twenty out of 52 women who had been exposed to statins during the first trimester had babies with severe deformities, which is nearly a 40% rate of severe birth defects.
"Of the 20 babies born with malformations, five had severe central nervous system defects, and five had malformed limbs. One baby had both, according to Muenke. There were also two cases of a very rare birth defect called holoprosencephaly, which occurs when the brain fails to divide properly." (Statins and Birth Defects) .
Doctors in Liverpool have even had the audacity to propose that statins be prescribed to pregnant women, an idea that these authors find wildly disturbing: (Statins during Pregnancy) . There seems to be a general lack of awareness, even among doctors, of the degree of harm these drugs can inflict on the developing fetus.
Great Britain now has the dubious distinction of being the only country where you can buy statin drugs over the counter (NonPrescription Statins) . This means that any naive young woman thinking she can self-treat high cholesterol may end up with a severely malformed baby, and chances are she won't even realize it's due to the drug.
Fat is good for you: Mothers who eat low-fat yoghurt during pregnancy 'more likely to have asthmatic children
This is certainly a good laugh so I won't speculate on the causal chain
Mothers-to-be who eat low-fat yoghurt are more likely to have children with asthma, a study found. The analysis of the habits of tens of thousands of pregnant women also linked low-fat yoghurt with the development of hay fever.
The researchers, from the respected Harvard School of Public Health in the US, said that it may be missing fats that protect against allergies. Previous research has linked low-fat dairy products with difficulty in becoming pregnant.
In the latest study, more than 60,000 women were quizzed on their eating habits while pregnant. The health of the babies they had was then tracked until the age of seven. The results credited milk with helping ward off asthma. However, low-fat, but not full-fat, yoghurt, seems to do the opposite.
Children whose mothers ate low-fat yoghurt while carrying them were 60 per cent more likely to have developed asthma by the age of seven than those who weren’t exposed to the food in the womb.
And their odds of hay fever were three times higher than those of other children, the European Respirator Society’s annual conference heard.
The increased risk only applies to low-fat yoghurt that contains fruit but the researchers are unable to explain why this is. They say that full-fat dairy products may contain fats that help programme the unborn baby’s immune system away from allergies. It may also be the case that low-fat yoghurt with fruit contains ingredients that raise the risk of asthma and hay fever.
Or simply that women who eat this kind of yoghurt are unhealthy in other ways.
The previous research, also from Harvard, revealed that eating low-fat dairy products can greatly increase the risk of infertility. Even small amounts of everyday foods and drinks can reduce a woman’s possibility of becoming mother, with just a pint of semi-skimmed or skimmed milk or two pots of yoghurt a day almost doubling the risk of anovulatory infertility - a very common condition in which a woman stops ovulating.
However, eating full fat dairy products has the opposite effect, with a bowl of ice cream a day being enough to boost the chances of motherhood.
16 September, 2011
Michigan to Require BMI Reports on Children
What business is it of theirs? And they have no control over it anyway. There is no known instance of government meddling having any lasting effect of the sort desired on the population targeted. Though I suppose North Korea might be an exception to that
Michigan Gov. Rick Snyder plans to require doctors to tell state health officials where the children they treat fall on body mass indexes that can indicate if they're overweight or obese. The move would help track a growing obesity problem while opening the way for doctors to be more proactive in offering advice.
The state already requires doctors to report how many children are immunized.
Snyder spokeswoman Sara Wurfel told The Associated Press Tuesday the new requirement will make weight screening part of every child's medical care. She calls it "an important step in managing pediatric obesity."
About 800,000 Michigan children are considered overweight or obese based on height and weight.
Obesity and infant mortality are expected to be top priorities when Snyder announces his health and wellness initiative Wednesday.
What will keep our food safe?
Any conversation about the superfluity of the federal government or her legion of agencies will invariably turn to this question: "Who will keep our food safe?" It is as sure as Godwin's law — except in this case, the fascists have, inexplicably, become the good guys.
Apparently, the FDA and the USDA have a stellar and unblemished track record of keeping the populace safe from tainted food and dangerous medicines. It is a measure of the success of state propaganda that such a glaring untruth is so commonly seen as axiomatic and beyond question.
One of the great challenges for advocates of a truly free society is to present their vision of how certain functions of government would be replaced by the free market and voluntary cooperation. We are no less presumptuous than advocates of central planning if we dogmatically claim a comprehensive vision of how things will be in our "libertopia."
As Murray Rothbard pointed out, the libertarian's primary task is to: "offer a few guidelines on how markets might develop where they are now prevented or restricted from developing; but he can do little more than point the way toward freedom, to call for government to get out of the way of the productive and ever-inventive energies of the public as expressed in voluntary market activity."
While we cannot be about the business of substituting one group of central planners for "our sort" of central planners, the nature of our argument behooves us to offer a vision of freedom — not what it must be, but what it could be.
As it pertains to the role of agencies like the FDA and USDA, we need look no further than the sustainable- and organic-food movement to see how the free market makes up for government failures; and it is no great leap to imagine the same market forces supplanting the public option altogether.
Perhaps ironically, it is luminaries of the modern movement toward "sustainable" food, generally confirmed statists, who furnish the crux of our argument.
There is a general consensus among those who are deeply devoted to such things that the USDA Certified Organic sticker is, at best, a limited indicator of the agricultural practices involved in the production of various foodstuffs. The USDA program is, like any government agency, bloated, inefficient, and inconsistent. It is rife with corruption and requires expenditures of time and money that preclude many small farmers from participating.
As a result, many small producers are eschewing the USDA label as simply not worth it. Michael Pollan, an icon in the sustainable-food movement, consistently encourages people to forgo Certified Organic produce for local, reasoning that "It often is organic, even if not certified, and you can always ask the farmer. The cost of organic certification can also become burdensome for a small grower."
The farm that runs the CSA (community-supported agriculture) to which I belong is explicit in their disclosure of their growing methods, all the while explaining that they have not received "official" organic certification. In short, there seems to be a general consensus among advocates of organic and sustainable agriculture that the government seal of approval is limited in its value.
But simply buying everything from a local producer is a difficult proposition for the majority of us; time and geographic concerns preclude this as a viable option. How, then, can the average consumer be assured that they are buying food products that have been produced in a manner that is consistent with their ideals? In the face of the failure of the government's program, as usual, the free market has provided a solution. And it is in this free-market solution that we see the germ of an idea that could totally supplant the government's role in the inspection and regulation of agriculture and medicine — and do it more cheaply, efficiently, and with far greater accountability.
In the absence of a reliable government organic-food regulatory agency, the market has provided several voluntary options. The Certified Naturally Grown program offers "a non-profit organization offering certification tailored for small-scale, direct-market farmers and beekeepers using natural methods." They rely on voluntary participation and a peer-review system that is less expensive, less paperwork intensive, and more efficient than the USDA program.
Whole Foods Market has developed their own alternative for certifying certain production techniques for livestock and poultry, through a partnership with an animal-welfare nonprofit.
These are two options, but there are several others. All share a focus on voluntary cooperation between food producers and certifiers, and greater accountability to the consumer, as they can't hide their flaws behind the veil of government immunity. These programs, and others like them, are infinitely scalable, completely voluntary, and represent a real challenge to the notion that "only the government can …"
The same organizational structure that has rendered the Certified Organic label obsolete could immediately step in to fill the void left by the absence of the FDA and USDA. Private, third-party certifiers could inspect livestock and produce and affix their seal of approval only when certain standards are met. That the reputations of the inspectors and the farmers are truly on the line would preclude much of the graft and inefficiency that is a constant feature of the current system. Certified, inspected produce would compete with uninspected produce for shelf space and consumer demand. I've focused on the grocery side of the equation, but the same general principles would apply to drug development and regulation.
As Rothbard continues: "No one can predict the number of firms, the size of each firm, the pricing policies, etc., of any future market in any service or commodity. We just know — by economic theory and by historical insight — that such a free market will do the job infinitely better than the compulsory monopoly of bureaucratic government."
15 September, 2011
A healthy childhood 'boosts job prospects' deep into middle-age
Ho hum: This is just another instance of high IQ people being healthier, having less divorce etc. It is the high IQ that confers advantages throughout life, though the other things accompanying high IQ may help
The blessings of a happy and healthy childhood are still a benefit to peoples’ lives deep into middle age, a new study has found. It said that men and women who were well-off and fit as children are more likely to win promotion at work than less favoured children.
And they keep on being more successful at work into their 50s and throughout their careers, it said.
The study by researchers from Princeton University was based on the records of more than 10,000 Whitehall civil servants whose progress has been tracked since the 1980s.
It comes at a time of deepening concern about the effects of a damaged childhood on adults – concern heightened by the August riots and the perception that many of those caught up in a wave of amoral lawlessness had been brought up in troubled families and without fathers.
Children are most likely to enjoy good mental and physical health alongside financial and emotional security if they come from a family headed by married parents.
The Princeton study by academics Anne Case and Christina Paxson said that Whitehall provided few examples of children from poor and unhealthy families but nevertheless their records still provided ‘evidence that health and socio-economic status in childhood influences occupational status in adulthood.
‘Adults who had better childhood health, as measured by childhood hospitalisations and adult height, start at higher grades in the civil service on average, and are promoted to higher grades after they enter Whitehall.’
It added that results had been amended to take into account the advantages won from a good education, so that there could be no doubt that good childhood health played a part in career success much later in life.
The researchers said: ‘In summary, in this selected sample of white collar workers, not only are poorer health and worse social circumstances in childhood associated with lower initial employment grade, but they are associated with a widening of earnings gaps over time.
‘Those who were healthy in childhood and those from higher socio-economic backgrounds are significantly more likely to be promoted.’
The findings are based on the Whitehall study which has plotted the lives and careers of 10,308 civil servants in white collar jobs in 20 government departments. The tracking began in 1985 when the men and women in the study were aged between 35 and 55.
Most research projects over the past 20 years have followed the progress of children only until their late teens. They have shown that those with the best health and the most comfortable financial backgrounds are most likely to well at school and go on to good education and good jobs.
All studies have found that the children most likely to do well are those from traditional married families, which tend have the most money and the best health. Children of cohabitees do less well, and those who are most likely to become failures come from single parent and broken families.
Does breast cancer screening do more harm than good?
Today, around 1.5 million women, mostly between the ages of 50 and 70, are screened in the UK each year and the programme, it is claimed, saves the lives of around 1,300 women annually.
The perceived wisdom is that breast-cancer screening is a no brainer. If you have cancer, any cancer, surely it’s best to catch it as early as possible so that it can be more effectively treated and you have the highest chance of survival. The annual cost of around £100 million to run the programme seems like money well spent.
Unfortunately, there is a growing body of respected medical and research opinion which shows things are simply not that clear cut.
Last week, a paper published in the Journal of the Royal Society of Medicine reiterated the conclusion that, far from being of huge benefit to women, breast-cancer screening may, in fact, be doing nearly as much harm as it does good.
‘I can understand why people find this hard to believe,’ says Dr Karsten Jorgensen, a research scientist with the independent Nordic Cochrane Centre in Denmark, who has carried out in-depth research into the harms and benefits of breast screening.
By comparing survival rates from an area of Denmark that has had no screening against areas that have, the Cochrane Centre found that far from the NHS claim that screening saves the lives of 1,347 lives each year, the true figure is more like 500. This means that for every life saved, 2,000 women have to be screened.
Furthermore, Dr Jorgensen and his team claim that of those women screened, around one in four will receive an incorrect diagnosis — a false positive — during her screening lifetime.
This is when a woman will be told their mammogram has thrown up something suspicious that will need further investigation, such as a biopsy, only to be told later there is no cancer.
Even worse, he says, thousands of women in the UK are being over-diagnosed each year — that is, they are being treated for cancers which they simply do not have.
These figures are backed up by Australian research published in 2010, which found that one in three of all invasive cancers diagnosed by screening falls into this category.
This means that every year in the UK up to 7,000 women receive unnecessary surgery, plus possible chemotherapy and radiotherapy, with all the long-term health risks such as lymphoma, infections and stroke for a cancer which may never have existed.
Unsurprisingly, the findings by medical bodies around the world that challenge the benefits of screening have created a furious debate in the medical and scientific community. ‘These same criticisms have been trotted out a number of times by the same authors,’ says Professor Julietta Patnick, director of the NHS Cancer Screening Programme.
‘On each occasion, they have been comprehensively rebutted in the public domain by various experts.
‘The most recent estimates suggest that screening saves one life for about 400 women screened over a ten-year period. We know that 97 per cent of women with screen-detected cancers are alive five years later compared to just over 80 per cent of all women who were diagnosed without screening, and attending a screening lowers a woman’s risk of having a mastectomy.’
'Once a mammogram picks up an abnormality you go into a system that processes you with little thought about you as an individual'
Dr Trish Groves, deputy editor of the British Medical Journal, a publication which has led the debate on breast screening, doesn’t entirely agree.
‘There are two main issues when we look at breast screening,’ she explains. ‘The first is false positives, when a woman may be told the scan has picked up abnormalities and then is sent for various checks and scans and needle biopsies — even a lumpectomy — only to be told she is clear.
‘The other issue is over-diagnosis and therefore over-treatment. We know around 20 per cent of cases diagnosed by screening are Ductal Carcinoma in Situ (DCIS).’ (DCIS is a very early form of breast cancer. Cells inside some of the breast ducts have begun to turn cancerous, but have not yet spread into surrounding breast tissue.)
She adds: ‘DCIS can only be picked up by mammogram and so is relatively new to us. We know little about how it spreads and grows, although initial research suggests around 50 per cent of this type of cell changes will never spread and are not actually cancerous.
‘But, by and large, DCIS is treated in the same way as all other breast cancers — with surgery, sometimes a lumpectomy but occasionally a mastectomy, maybe even chemotherapy. Although some women may be happy to have a complete regime of treatment for a condition which may not be cancerous, most will not.
‘Either way, we have to accept that screening means that a large number of women will undergo a life-changing, painful, nasty treatment regime when, in fact, there is nothing wrong with them at all.
‘We believe that the leaflets for the NHS Breast Screening Programme don’t really explain the potential harm and instead overstate the benefits of screening, rather than offering mammography to women whose symptoms, family histories or genetic make-up suggests they’re at risk of breast cancer, and the harms aren’t really explained at all. We think that should change.
‘Doctors, the public, politicians and, of course, women and their families, might still think that saving one life is well worth the downside of screening thousands of women and giving hundreds of them unnecessary treatments, but shouldn’t they at least be told that the benefits aren’t certain?’
Dr Emma Pennery, clinical director of the charity Breast Cancer Care, says: ‘What is important is that women are properly informed about the risks of the screening programme as well as the benefits. For example, receiving a false positive may be a completely acceptable risk to one woman if she thinks she may have an early detection of cancer. But to another woman this may bring unimaginable strain.
While the arguments rage, oncologists and surgeons believe there are merits to both points of view. ‘I feel it is great pity that the two sides have become so polarised,’ says consultant breast surgeon Mr Rajiv Vashisht, who practises at the Clementine Churchill Hospital and the West Middlesex University Hospital.
He adds: ‘We all want to improve the outlook for breast cancer, and the Cochrane Review and other research has thrown up issues we should all be debating. ‘Overall, I am in favour of breast screening. It does pick up cancers early, which gives women more choices about treatment.
‘False positives are, of course, an issue. Over-diagnosis is something we all dread, but if the results show a problem, we have to assume the worst and treat our patients accordingly.
‘Watch and wait may be a suitable policy for prostate cancer, but breast cancer has a completely different disease path.
‘Prostate cancer is very slow growing and goes first to the surrounding areas — breast goes first to the lungs, liver and bone, and, once that happens, you are struggling to catch up with it. ‘Anyone who works with breast cancer knows what an awful disease it can be and any weapon we have has to be welcomed.’
So, what now is the best option for a woman offered screening?
‘If you have a high risk of breast cancer — a family or genetic risk — then there is no question but that you should be regularly scanned,’ says Professor Jane Maher, chief medical officer of Macmillan Cancer Support and an oncologist. ‘Other women should make sure they fully understand the risks before screening, and the best source of unbiased information is cancer charity websites. ‘Once you know the risks, decide in advance what you will do if you get a positive result.
‘Remember that with the majority of breast cancers there is no need for immediate action. Go away and think about your options, possibly ask for a second opinion, read up on the different treatments options.’
And she says: ‘Finally, don’t just accept what you are being told. Ask questions until you are satisfied you know all the answers.’
14 September, 2011
Why Statins Do More Harm Than Good
This is the latest from Prof. Seneff. She is of course well out of the mainstream on this and becoming more so but she makes a good case for her conclusions. The acid test would be be in lifetime survival statistics when they become available. Statins may reduce heart disease but do they promote death from other causes?
The severe side-effects of statins create a problem in testing that, however. Because of those side-effects only a minority of people can continue taking statins regularly so that minority may be particularly robust and therefore resistant to other causes of death. In such circumstances theory becomes more important and Prof. Seneff does claim considerable support for testable aspects of her theories
I myself am particularly struck by the "coincidence" of increased Alzheimer's incidence and increased statin use. The mental side-effects of statin use are very similar to Alzheimer's. Taking statins is a rather good way to go rapidly ga ga if you are inclined that way
Americans have been well trained over the past few decades to avoid dietary fat and cholesterol and to stay out of the sun. Their conscientious implementation of this misguided advice has led to an epidemic in obesity and heart disease, along with a host of other debilitating conditions like arthritis and Alzheimer's disease.
Cholesterol is to animals as chlorophyll is to plants. Cholesterol, absent from plants, is what gives animals mobility and a nervous system. It is therefore not surprising that statin drug side effects mainly impact muscles and the nervous system.
The heart, as a muscle, is not exempt from statin toxicity. This is why the incidence of heart failure has steadily risen in step with the widespread adoption of statin therapy, now displacing cardiovascular disease as the number one killer. In this article I am going to take you on a whirlwind tour of the 60,000 foot view of my understanding of the principle causes of the current health crisis in America.
My extensive research has caused me to hypothesize a remarkable feat that the human body can perform in the presence of sunlight, which is to extract sulfur from hydrogen sulfide in the air and convert it to sulfate, taking advantage of the sun's energy to catalyze the reaction.
This process takes place in the skin upon sun exposure, and also in the endothelial cells lining blood vessels, and in the red blood cells, platelets, and mast cells in the blood. This feat is performed by a very interesting molecule called "endothelial nitric oxide synthase,'' a misnomer, since its main responsibility is to synthesize sulfate rather than nitric oxide.
The sulfate so produced plays a huge role in cardiovascular health, both by preventing blood clots and by keeping pathogenic microbes (bacteria and viruses) at bay. But it also plays another role that is just as important, which is to give cholesterol (as well as vitamin D and other sterols) a free ride through the blood stream.
Vitamin D3 (a highly touted nutrient) is synthesized in the skin from cholesterol (a highly demonized nutrient) and its chemical structure is almost identical to that of cholesterol. By attaching to cholesterol or vitamin D3, sulfate makes the molecule water soluble, and this means that it no longer has to travel packaged up inside an LDL particle. LDL, as you probably know, is the so-called "bad'' cholesterol, which will cause doctors to prescribe statins if the level is too high.
A great way to lower LDL levels is to get adequate sun exposure. It's not going to work to take a vitamin D supplement: you have to go outside and soak up the sun, because supplements are never sulfated and vitamin D is not cholesterol. Raw cow's milk is the only dietary source I know of that actually supplies sulfated vitamin D3, but even that is still not cholesterol sulfate.
Because most Americans have inadequate cholesterol in their skin and grossly inadequate amounts of sun exposure, they suffer from a huge deficiency in cholesterol and sulfate supply to the tissues. Not surprisingly, most impacted are the muscles and nervous system.
Because the heart muscle is indispensible, the body has developed a back-up strategy to give it special treatment, which is to synthesize cholesterol sulfate from LDL and homocysteine in the fatty deposits (plaque) that build up in arteries supplying the heart. The macrophages in the plaque extract cholesterol from damaged small dense LDL particles, and export it to HDL-A1. The platelets in the plaque will only accept cholesterol from HDL-A1, which they then convert to cholesterol sulfate.
They obtain the sulfate through yet another process which requires energy and oxidizing agents, extracting the sulfur from homocysteine. With insufficient homocysteine, the sulfur will most likely be extracted from cartilage, which gets its strength from extensive disulfide bonds. This, in my view, is the main cause of arthritis -- depletion of sulfur from the cartilage in the joints. So now you have both cardiovascular disease and arthritis as a consequence of a low-fat diet and aggressive sun avoidance.
Statin drugs dramatically lower LDL levels by interfering with cholesterol synthesis, and this wreaks havoc on the liver, the main back-up supplier of cholesterol to the tissues when cholesterol intake and cholesterol sulfate production are down. With the American diet, the liver has another huge task, which is to convert fructose to fat.
The fat cannot be stored or shipped (via LDL) if there is insufficient cholesterol. As a consequence, the liver abandons this task, and the fructose builds up in the blood, causing extensive glycation damage to blood proteins. One of the impacted proteins is the apoB in LDL, which interferes with LDL's ability to deliver its goods to the tissues, including cholesterol, fats, vitamins A, D, E, and K, and antioxidants. So LDL levels fall sharply with statins, and so does the bioavailability of all these nutrients.
Muscle cells come to the rescue, heroically, by extracting excess fructose from the blood and converting it to lactate, using anaerobic metabolism. They have to switch over to anaerobic metabolism anyway, because coenzyme Q10, another casualty of statin therapy, is in low supply. Coenzyme Q10 is crucial for aerobic metabolism.
Lactate is a great fuel for the heart and liver, but the problem is that the muscle cells get wrecked in the process, due to massive overdoses of fructose, in the context of inadequate cholesterol, which would have offered some protection. This is a principal contributor to the excessive muscle pain and weakness associated with statins. Eventually, the muscles can't do it any more, and you're now on the verge towards heart failure.
People on long-term statin therapy start to notice that their hair is receding faster, they're developing cataracts, they can't hear as well as they used to, they keep forgetting things, they can't open the pickle jar any more, and perhaps they'll need rotator cuff surgery soon, as their shoulders are so sore. They think it's just because they're growing old, but these are all side effects that my research, together with my students at MIT, has uncovered, by comparing statin drug side effects with side effects associated with other drugs in age-matched reviews.
Even more alarming are the rare but debilitating and even life-threatening side effects we've detected, such as ALS and Parkinson's disease, heart and liver failure, neuropathy and severe muscle damage. A 17-year study on the elderly confirmed what I already suspected: low serum cholesterol is associated with increased frailty, accelerated mental decline, and early death. (Ref 1.)
Statins are not the answer for anyone seeking to avoid cardiovascular disease. The answer, instead, is to modify the diet to include foods that are rich in cholesterol and saturated fat, to avoid empty carbohydrates, especially high fructose corn syrup, to eat foods that are good sources of sulfur, and, most especially, to spend plenty of time outdoors in the sun.
Australia: Breakfast food bans could be counterproductive
IF you buy junk food at a drive-through in NSW it may astound you to learn from new mandatory labelling that popcorn chicken is basically fat suspended in a superstructure of chicken eyeballs. This will no doubt shock the people who missed the memo that health food doesn't come in buckets.
Last week the Cancer Council NSW continued its war on fast food with an assault on Bubble O'Bill, the Paddle Pop lion, the Coco Pops monkey and Toucan Sam, long-serving avian ambassador of Froot Loops cereal. Should the Cancer Council succeed, parents can rest assured any food promoted by a jungle creature in drag will be taken off the shelves and replaced, presumably with a plain olive green box.
Once again the food nannies will have succeeded not only in taking the fun out of another meal but in removing what effectively has served as a warning sign for parents that products are junk food. Foods such as Nutri-Grain, many mueslis and "healthy breakfast spreads" such as peanut butter and Nutella are promoted not by cartoons but by sports people.
If Nutella had a cartoon bird on it perhaps people would have worked out faster that just because a marathon runner promotes it, chocolate isn't a breakfast food. Certainly the San Diego mother who sued Nutella for selling her fake health food would have had a harder time proving she was not a complete idiot.
Bans on food and beverage advertisements for products that are high in fat, salt and sugar are defended with studies such as the 2006 Access Economics report on obesity in Australia that claimed it cost us $8.3 billion. Obesity certainly is a serious health problem with links to cancer and diabetes, but picking on the fun foods as the sole culprits and treating parents like idiots reveals an agenda based as much on cultural prejudice as health consciousness.
Mass-produced, commercial junk food is easy to recognise; certainly the mascots help. However, posh food is often as bad for your health but is rarely marketed with anything as crass as a cartoon toucan. Wagyu beef has become increasingly popular in part because it has a high fat content and consequently is full of flavour. Perhaps a Pokemon-style cow mascot would help us remember at the butcher that Wagyu is not a healthy alternative to lean beef, fish or lentils.
At the ice cream fridge the poshest ice creams have the highest milk fat content. That's why they are so delicious. While Paddle Pops are clearly labelled junk food by the presence of the Paddle Pop lion, Maggie Beer's ice cream has a picture of very dignified and grown-up looking treats on the box. Eating a little of either won't hurt you but if you're planning to watch The Notebook, the Lion represents more value for your money.
My waistline has been enhanced by a range of foods both healthy and unhealthy, gourmet and gourmand. There are a remarkable number of kilojoules in fast and slow, fancy and plain, wholesome and junk, the amount of sugar in "diet" foods being an obvious case in point.
The Cancer Council's bans won't address the avalanche of kilojoules available in our prosperous society. What they can look forward to is enabling parents such as the San Diego Nutella mum to blame food producers or the government for their failure to meet a basic parenting requirement: feeding their kids properly.
13 September, 2011
The small benefit and huge burden that Statins impose on the body
I reproduce below a small excerpt of a very large scholarly study that points out the huge stresses that statins place on the body. I have of course long condemned the statin fad and have advised everyone I know not to take them but even I did not realize how very damaging statins are to people. Like thalidomide, they may even be teratogenic. Given the importance of the subject, I am putting up this article only today. Read on:
by Stephanie Seneff
I would like to start by reexamining the claim that statins cut heart attack incidence by a third. What exactly does this mean? A meta study reviewing seven drug trials, involving in total 42,848 patients, ranging over a three to five year period, showed a 29% decreased risk of a major cardiac event (Thavendiranathan et al., 2006). But because heart attacks were rare among this group, what this translates to in absolute terms is that 60 patients would need to be treated for an average of 4.3 years to protect one of them from a single heart attack. However, essentially all of them will experience increased frailty and mental decline, a subject to which I will return in depth later on in this essay.
The impact of the damage due to the statin anti-cholesterol mythology extends far beyond those who actually consume the statin pills. Cholesterol has been demonized by the statin industry, and as a consequence Americans have become conditioned to avoid all foods containing cholesterol. This is a grave mistake, as it places a much bigger burden on the body to synthesize sufficient cholesterol to support the body's needs, and it deprives us of several essential nutrients. I am pained to watch someone crack open an egg and toss out the yolk because it contains "too much" cholesterol. Eggs are a very healthy food, but the yolk contains all the important nutrients. After all, the yolk is what allows the chick embryo to mature into a chicken. Americans are currently experiencing widespread deficiencies in several crucial nutrients that are abundant in foods that contain cholesterol, such as choline, zinc, niacin, vitamin A and vitamin D.
Cholesterol is a remarkable substance, without which all of us would die. There are three distinguishing factors which give animals an advantage over plants: a nervous system, mobility, and cholesterol. Cholesterol, absent from plants, is the key molecule that allows animals to have mobility and a nervous system. Cholesterol has unique chemical properties that are exploited in the lipid bilayers that surround all animal cells: as cholesterol concentrations are increased, membrane fluidity is decreased, up to a certain critical concentration, after which cholesterol starts to increase fluidity (Haines, 2001). Animal cells exploit this property to great advantage in orchestrating ion transport, which is essential for both mobility and nerve signal transport. Animal cell membranes are populated with a large number of specialized island regions appropriately called lipid rafts. Cholesterol gathers in high concentrations in lipid rafts, allowing ions to flow freely through these confined regions. Cholesterol serves a crucial role in the non-lipid raft regions as well, by preventing small charged ions, predominantly sodium (Na+) and potassium (K+), from leaking across cell membranes. In the absence of cholesterol, cells would have to expend a great deal more energy pulling these leaked ions back across the membrane against a concentration gradient.
In addition to this essential role in ion transport, cholesterol is the precursor to vitamin D3, the sex hormones, estrogen, progesterone, and testosterone, and the steroid hormones such as cortisol. Cholesterol is absolutely essential to the cell membranes of all of our cells, where it protects the cell not only from ion leaks but also from oxidation damage to membrane fats. While the brain contains only 2% of the body's weight, it houses 25% of the body's cholesterol. Cholesterol is vital to the brain for nerve signal transport at synapses and through the long axons that communicate from one side of the brain to the other. Cholesterol sulfate plays an important role in the metabolism of fats via bile acids, as well as in immune defenses against invasion by pathogenic organisms.
Statin drugs inhibit the action of an enzyme, HMG coenzyme A reductase, that catalyses an early step in the 25-step process that produces cholesterol. This step is also an early step in the synthesis of a number of other powerful biological substances that are involved in cellular regulation processes and antioxidant effects. One of these is coenzyme Q10, present in the greatest concentration in the heart, which plays an important role in mitochondrial energy production and acts as a potent antioxidant (Gottlieb et al., 2000). Statins also interfere with cell-signaling mechanisms mediated by so-called G-proteins, which orchestrate complex metabolic responses to stressed conditions. Another crucial substance whose synthesis is blocked is dolichol, which plays a crucial role in the endoplasmic reticulum. We can't begin to imagine what diverse effects all of this disruption, due to interference with HMG coenzyme A reductase, might have on the cell's ability to function.
How Statins Destroy Muscles
Europe, especially the U.K., has become much enamored of statins in recent years. The U.K. now has the dubious distinction of being the only country where statins can be purchased over-the-counter, and the amount of statin consumption there has increased more than 120% in recent years (Walley et al, 2005). Increasingly, orthopedic clinics are seeing patients whose problems turn out to be solvable by simply terminating statin therapy, as evidenced by a recent report of three cases within a single year in one clinic, all of whom had normal creatine kinase levels, the usual indicator of muscle damage monitored with statin usage, and all of whom were "cured" by simply stopping statin therapy (Shyam Kumar et al., 2008). In fact, creatine kinase monitoring is not sufficient to assure that statins are not damaging your muscles (Phillips et al., 2002).
Since the liver synthesizes much of the cholesterol supply to the cells, statin therapy greatly impacts the liver, resulting in a sharp reduction in the amount of cholesterol it can synthesize. A direct consequence is that the liver is severely impaired in its ability to convert fructose to fat, because it has no way to safely package up the fat for transport without cholesterol (Vila et al., 2011). Fructose builds up in the blood stream, causing lots of damage to serum proteins.
The skeletal muscle cells are severely affected by statin therapy. Four complications they now face are: (1) their mitochondria are inefficient due to insufficient coenzyme Q10, (2) their cell walls are more vulnerable to oxidation and glycation damage due to increased fructose concentrations in the blood, reduced choleserol in their membranes, and reduced antioxidant supply, (3) there's a reduced supply of fats as fuel because of the reduction in LDL particles, and (4) crucial ions like sodium and potassium are leaking across their membranes, reducing their charge gradient. Furthermore, glucose entry, mediated by insulin, is constrained to take place at those lipid rafts that are concentrated in cholesterol. Because of the depleted cholesterol supply, there are fewer lipid rafts, and this interferes with glucose uptake. Glucose and fats are the main sources of energy for muscles, and both are compromised.
As I mentioned earlier, statins interfere with the synthesis of coenzyme Q10 (Langsjoen and Langsjoen, 2003), which is highly concentrated in the heart as well as the skeletal muscles, and, in fact, in all cells that have a high metabolic rate. It plays an essential role in the citric acid cycle in mitochondria, responsible for the supply of much of the cell's energy needs. Carbohydrates and fats are broken down in the presence of oxygen to produce water and carbon dioxide as by-products. The energy currency produced is adenosine triphosphate (ATP), and it becomes severely depleted in the muscle cells as a consequence of the reduced supply of coenzyme Q10.
The muscle cells have a potential way out, using an alternative fuel source, which doesn't involve the mitochondria, doesn't require oxygen, and doesn't require insulin. What it requires is an abundance of fructose in the blood, and fortunately (or unfortunately, depending on your point of view) the liver's statin-induced impairment results in an abundance of serum fructose. Through an anaerobic process taking place in the cytoplasm, specialized muscle fibers skim off just a bit of the energy available from fructose, and produce lactate as a product, releasing it back into the blood stream. They have to process a huge amount of fructose to produce enough energy for their own use. Indeed, statin therapy has been shown to increase the production of lactate by skeletal muscles (Pinieux et al, 1996).
Converting one fructose molecule to lactate yields only two ATP's, whereas processing a sugar molecule all the way to carbon dioxide and water in the mitochondria yields 38 ATP's. In other words, you need 19 times as much substrate to obtain an equivalent amount of energy. The lactate that builds up in the blood stream is a boon to both the heart and the liver, because they can use it as a substitute fuel source, a much safer option than glucose or fructose. Lactate is actually an extremely healthy fuel, water-soluble like a sugar but not a glycating agent.
So the burden of processing excess fructose is shifted from the liver to the muscle cells, and the heart is supplied with plenty of lactate, a high-quality fuel that does not lead to destructive glycation damage. LDL levels fall, because the liver can't keep up with fructose removal, but the supply of lactate, a fuel that can travel freely in the blood (does not have to be packaged up inside LDL particles) saves the day for the heart, which would otherwise feast off of the fats provided by the LDL particles. I think this is the crucial effect of statin therapy that leads to a reduction in heart attack risk: the heart is well supplied with a healthy alternative fuel.
This is all well and good, except that the muscle cells get wrecked in the process. Their cell walls are depleted in cholesterol because cholesterol is in such short supply, and their delicate fats are therefore vulnerable to oxidation damage. This problem is further compounded by the reduction in coenzyme Q10, a potent antioxidant. The muscle cells are energy starved, due to dysfunctional mitochondria, and they try to compensate by processing an excessive amount of both fructose and glucose anaerobically, which causes extensive glycation damage to their crucial proteins. Their membranes are leaking ions, which interferes with their ability to contract, hindering movement. They are essentially heroic sacrificial lambs, willing to die in order to safeguard the heart.
Muscle pain and weakness are widely acknowledged, even by the statin industry, as potential side effects of statin drugs. Together with a couple of MIT students, I have been conducting a study which shows just how devastating statins can be to muscles and the nerves that supply them (Liu et al, 2011).
I believe that the real reason why statins protect the heart from a heart attack is that muscle cells are willing to make an incredible sacrifice for the sake of the larger good. It is well acknowledged that exercise is good for the heart, although people with a heart condition have to watch out for overdoing it, walking a careful line between working out the muscles and overtaxing their weakened heart. I believe, in fact, that the reason exercise is good is exactly the same as the reason statins are good: it supplies the heart with lactate, a very healthy fuel that does not glycate cell proteins.
Much more here
12 September, 2011
SpongeBob SquarePants bad for concentration
Behaviour changes that last only a few minutes are hardly a great concern but that is all that the report below has demonstrated. That a fast-paced cartoon might wind kids up a bit is is hardly surprising. Any fun game will do the same
Watching fast-paced cartoons such as SpongeBob SquarePants damages young children’s concentration and behaviour, according to psychologists. Tests showed that four year-olds who watched just a few minutes of the popular television show were less able to solve problems and pay attention afterwards than those who saw a less frenetic programme or simply sat drawing.
Researchers say this could be because children mimic the chaotic behaviour of their favourite TV characters, or because the fast-moving and illogical cartoons make them over-excited.
As a result, they suggest that parents consider carefully which programmes they allow their offspring to watch, as well as encouraging them to enjoy more sedate and creative activities such as playing board games.
Angeline Lillard from the University of Virginia, who carried out the experiment, said: “Parents should know that children who have just watched SpongeBob Squarepants, or shows like it, might become compromised in their ability to learn and behave with self-control.
“Young children are beginning to learn how to behave as well as how to learn. At school, they have to behave properly, they need to sit at a table and eat properly, they need to be respectful, and all of that requires executive functions. “If a child has just watched a television show that has handicapped these abilities, we cannot expect the child to behave at their normal level in everyday situations.
SpongeBob SquarePants, an animated series that has been shown on the cable channel Nickelodeon since 1999, tells the tale of an “incurably optimistic and earnest” sea sponge who lives in a pineapple and works in an underwater fast food restaurant. Although its surreal humour has made it popular with adults as well as children, it has been criticised by some evangelical Christians for allegedly promoting homosexuality.
In a new paper published in the academic journal Pediatrics, Prof Lillard and colleagues compared children who watched nine minutes of a Spongebob episode with those who had spent the same time drawing or watching a more realistic and slower-paced Canadian cartoon called Caillou.
They found “little difference” in behaviour and performance between the drawing group and the Caillou group afterwards.
But the four year-olds who had watched SpongeBob saw their “executive function” – the ability to pay attention, solve problems and moderate their behaviour – was “severely compromised”.
Prof Lillard suggested: “It is possible that the fast pacing, where characters are constantly in motion from one thing to the next, and extreme fantasy, where the characters do things that make no sense in the real world, may disrupt the child's ability to concentrate immediately afterward. “Another possibility is that children identify with unfocused and frenetic characters, and then adopt their characteristics.”
Crocus drug that can kill tumours in one treatment with minimal side effects
In mice. The approach is however a clever one so it is to be hoped that its toxicity can be controlled enough to make it usable in humans
A drug derived from plant extracts could wipe out tumours in a single treatment with minimal side effects, according to research. Scientists have turned a chemical found in crocuses into a ‘smart bomb’ that targets cancerous tumours. Crucially, healthy tissue is unharmed, reducing the odds of debilitating side effects.
And unlike other side effect-free drugs, it is able to kill off more than one type of the disease, including breast, prostate, lung and bowel cancer. Potentially, all solid tumours could be vulnerable to drugs developed this way, meaning it could be used against all but blood cancers.
In some tests of the drug, half of tumours vanished completely after a single injection, the British Science Festival will hear this week.
The drug, based on colchicine, an extract from the autumn crocus, is at an early stage of development, and has so far been tested only on mice. But the University of Bradford researchers are optimistic about its potential in humans.
Professor Laurence Patterson said: ‘What we have designed is effectively a “smart bomb” that can be triggered directly at any solid tumour without appearing to harm healthy tissue. ‘If all goes well, we would hope to see these drugs used as part of a combination of therapies to treat and manage cancer.’
Colchicine has long been known to have anti-cancer properties but has been considered too toxic for use in the human body. To get round this, the researchers attached a chemical ‘tail’ to it, deactivating it until it reaches the cancer. Once there, the tail is cut off by an enzyme called MMP, which is found in tumours.
Removing the tail activates the drug, which then attacks and breaks down the blood vessels supplying the tumours with oxygen and nourishment. Cancers use the blood supply to spread around the body and it is hoped that the treatment, called ICT2588, will also combat this.
The first tests on humans could start in as little as 18 months. If successful, the drug could be on the market in six to seven years.
Henry Scowcroft, of Cancer Research UK, said: ‘This is exciting but very early work that hasn’t yet been tested in cancer patients.’ Professor Paul Workman, of the Institute of Cancer Research in London, said the results so far were promising. He added: ‘If confirmed in more extensive laboratory studies, drugs based on this approach could be very useful as part of combination treatments.’
11 September, 2011
Australian Cancer Council wants to kill Paddle Pop lion and Coco Pops monkey
Even though the best evidence is that there is NO harm in sugar, fat and salt
THE Coco Pops monkey and Paddle Pop lion would be scrapped under a Cancer Council proposal to ban cartoon characters and sports stars from spruiking unhealthy kids' food.
Cancer Council NSW, backed by the Obesity Policy Coalition and The Parents' Jury, are seeking a ban on promotional characters, movie tie-ins and the athletes who promote foods high in sugar, fat and salt.
Although stopping short of calling for plain packaging, Cancer Council nutritionist Kathy Chapman said regulations around the marketing of foods to children were urgently needed.
"What we'd like to see is the removal of these promotional characters - whether they're cartoon characters, sporting celebrities or movie tie-ins - from all foods that are high in fat, sugar and salt," she told The Sunday Telegraph.
Research by Cancer Council NSW and the University of Sydney's Prevention Research Collaboration found that nearly 74 per cent of promotional characters on Australian food packets promote products to children that would fail healthy nutritional standards.
Among the foods targeted are Bubble O'Bill ice-creams, which have 25 per cent of a child's recommended daily saturated fat intake in one 65g serve, and Kellogg's Froot Loops, which have almost three teaspoons of sugar per 30g serve. Coco Pops are more than one-third sugar and contain nearly a third of a child's daily sodium intake in one 30g serve.
It is estimated that one in four children are overweight or obese. Obesity Policy Coalition senior policy adviser Jane Martin backed the Cancer Council's call.
"We'd like to see these powerful kinds of endorsements by licensed characters, company-owned cartoons and celebrities not allowed on unhealthy foods," she said.
"Children in particular are vulnerable to this thing. They are familiar with the character so it's not surprising when you are using Sponge Bob Square Pants and Bart Simpson to advertise food that children relate to these characters."
Ms Martin said packaging was a key part of a promotional arsenal. While her organisation welcomed cricketers fronting Weet-Bix, which were high in fibre and low in salt, she said Ky Hurst spruiking the high-sugar cereal Nutri-Grain misleadingly gave it "a healthy halo".
Parents' Jury campaign manager Corrina Langelaan said plain packaging would be the first step in attacking pester power.
Another infliction on ordinary people by the food Fascists and their absurd theories
HP Sauce's recipe secretly changed after 116 years by American owners of the Great British Condiment
For more than a century HP Sauce has been a staple of many a British dining table.
But after 116 years of being produced to a carefully guarded recipe, the brown sauce which famously bears a picture of the Houses of Parliament on the label has been secretly altered at the request of Government health chiefs.
Heinz, the American company which bought the famous British brand in 2005, has changed the celebrated concoction that includes tomatoes, malt vinegar, molasses, dates, tamarind and secret spices to reduce the salt content.
The new recipe of Britain's best-loved brown sauce, synonymous with bacon sandwiches, fry-ups and sausage and mash, now contains 38 per cent less salt. But critics argue the change in salt levels for such small amounts of food makes no difference to our diet.
The previous version of HP Sauce contained 2.1g of salt per 100g. The new version contains 1.3g – but fans claim the change has come at a high price. They say it just doesn't taste the same.
The US company has altered the recipe despite launching a Reduced Salt And Sugar version at the same time. The new HP sauce recipe got the thumbs down from Michelin-starred chef Marco Pierre White.
He said he sent back a meal of sausages and mash at Mail on Sunday columnist Piers Morgan's Kensington pub The Hansom Cab last week. 'I sent the meal back, because I thought it was off,' he said. 'At first, I thought it was the sausages, but it wasn't. It was the HP, which tasted disgusting. It was definitely dodgy. I had no idea they had changed the recipe.
'I was brought up on HP Sauce in Yorkshire. My old man used to say ketchup was for Southerners and HP was for Northerners. My father would turn in his grave if he discovered they changed the recipe.'
Heinz made the changes after signing up to the Coalition Government's Responsibility Deal, a programme of targets for reducing the level of fats and salts used by food manufacturers. The key pledges include an agreement to reducing salt in food so people eat 1g less per day by end of 2012.
Health experts claim this measure will save the NHS £46 million a year within three years and prevent more than 4,000 premature deaths a year.
But as a result of the decrease in salt in the old sauce, the new line has more calories and carbohydrates. The new version also has less fibre, an essential part of a balanced daily diet. It has been reduced from 1.2g per 100g to 0.4g per 100g.
John Northey, from the Isle of Man, contacted Heinz to complain. In a letter to a newspaper, he wrote: 'Gone was the familiar tang and the sauce seemed bland and sickly. Heinz has spoiled a product enjoyed by generations, adversely affected its keeping qualities and, incidentally, increased the calorie count at a time when we're all being warned about obesity.'
The HP brand has not been without controversy in recent years. There was uproar in 2007 when production of this symbol of 'Britishness' was moved from Birmingham to Elst in the Netherlands, with the loss of 125 jobs.
A year later the company was again forced to defend the move after it was revealed that 18 months after axing HP Sauce in Birmingham on the grounds that production costs would be cheaper in Holland, it had also begun making it in Spain.
The sauce's appeal has crossed Britain's class divide, with generous dollops enjoyed at thousands of 'greasy spoon' cafes and by Prime Ministers. In the Sixties, it became known as 'Wilson's Gravy' after the wife of Prime Minister Harold Wilson let slip that his one fault was that 'he will drown everything in HP'.
10 September, 2011
'Surfing the web is turning our brains to mush'
And where is the longditudinal double-blind evidence for this assertion? It's just opinion
HAVE you found yourself watching TV while talking on the phone and checking your emails? Already distracted reading that sentence? Well, you're not alone, the Herald Sun reported.
The internet has not only changed our lives, it's changed the way our brains work, according to research by visiting UK social psychologist Sheila Keegan.
Dr Keegan says the internet is reducing our ability to think and concentrate and, with long-term use, could cause brain dysfunction. "We spend huge and a growing number of hours on the internet and, as a result, our brains are returning to shallow thinking," she said. "We are being more easily distracted, and our thinking has developed a staccato quality that lacks concentration.
"The problem is so widespread that studies have also concluded that long-term internet addiction would result in chronic dysfunction of our brains, which is a pretty scary thought!"
Dr Keegan said more research was needed to be done on the long-term effects of persistent use of the internet, particularly in young children.
She said US research had revealed some children as young as five spent up to six hours a day in front of a screen. Lengthy periods spent alone in front of the TV or on the computer meant many young children were not developing the social skills they needed for later life.
"Kids need to have a good balance. They can learn a lot from the internet," she said. "But the human brain is quite malleable. It's hard to say what the long-term effects will be. There needs to be research. But it's a bit like climate change. We can't wait for it to happen."
Dr Keegan presented her paper, Are we losing our minds and should we be bothered?, at the Australian Marketing and Social Research conference in Sydney this week.
Rake some leaves to cut dementia risk: How exercise that gets the heart pumping slows condition
Garbage in garbage out. This seems mainly to be a survery of epidemiological opinion. Meta-anayses are important but can very easily be biased by author expectations
It might not feel great at the time, but raking in the autumn leaves and shovelling the winter’s snow has a silver lining. In fact, any exercise that gets the heart pumping may reduce the risk of dementia and slow the condition's progression once it starts, according to a Mayo Clinic study published this month in Mayo Clinic Proceedings.
Researchers examined the role of aerobic exercise in preserving cognitive abilities and concluded that it should not be overlooked as an important therapy against dementia. The researchers broadly defined exercise as enough aerobic physical activity to raise the heart rate and increase the body's need for oxygen. Examples include walking, gym workouts and activities at home such as shoveling snow or raking leaves.
'We culled through all the scientific literature we could find on the subject of exercise and cognition, including animal studies and observational studies, reviewing over 1,600 papers, with 130 bearing directly on this issue.
'We attempted to put together a balanced view of the subject,' says J. Eric Ahlskog, a neurologist at Mayo Clinic.
'We concluded that you can make a very compelling argument for exercise as a disease-modifying strategy to prevent dementia and mild cognitive impairment, and for favorably modifying these processes once they have developed.'
The researchers note that brain imaging studies have consistently revealed objective evidence of favorable effects of exercise on human brain integrity.
Also, they note, animal research has shown that exercise generates trophic factors that improve brain functioning, plus exercise facilitates brain connections (neuroplasticity).
More research is needed on the relationship between exercise and cognitive function, the study's authors say, but they encourage exercise, in general, especially for those with or worried about cognitive issues. 'Whether addressing our patients in primary care or neurology clinics, we should continue to encourage exercise for not only general health, but also cognitive health,' Dr. Ahlskog says.
9 September, 2011
Study: Pot smokers may be at lower obesity risk
One suspects the integrity of the self-report data this is based on. Pot users could report themselves as slimmer than they really are for a number of reasons: paranoia, frivolity, poor reality contact etc.
Despite the tendency of marijuana users to experience the "munchies," pot smokers may have a lower risk of obesity that those who don't use the drug, a new study finds. The results show the prevalence of obesity is lower among people who frequently smoke pot compared with those who have never inhaled.
The researchers said they were surprised by their initial results, because they expected to find the opposite. So they examined a second sample of people, and found exactly the same result. Together, the two samples studied more than 50,000 people.
The reason behind the link is not clear. It could be that people who use cannabis also engage in other behaviors that lower their obesity risk. Or it may be that pot smokers exercise more or have a specific diet that keeps them thin, said study researcher Yann Le Strat, a psychiatrist at Louis Mourier Hospital in France.
"On a personal point of view, I would be surprised that cannabis use is associated with a higher rate of physical activity, but this cannot be ruled out," Le Strat told MyHealthNewsDaily.
Another possibility is that components of cannabis may help people lose weight. If this turns out to be the case, researchers should investigate which components these might be and try to put them into drug form, Le Strat said.
Cannabis and obesity
Cannabis use is known to increase appetite. In studies, drugs have been developed to block a receptor in the brain that is activated by cannabis compounds (called the cannabinoid CB1 receptor) in the hope that the drugs would reduce hunger. However, very few studies have looked at the link between cannabis use and obesity.
Le Strat and colleagues examined data from two national surveys in the United States called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the National Comorbidity Survey—Replication, involving about 41,600 and 9,100 people, respectively.
Between 4 and 7 percent of participants in these surveys reported using cannabis at least once in the last year. Obesity was assessed using participants' body mass index (BMI). The survey showed that about 22 to 25 percent of people who don't smoke pot were obese, while 16 to 17 percent of cannabis users were obese.
Obesity was less common among users who smoked pot more frequently. For instance, the NESARC survey showed about 14 percent of participants who used cannabis three days a week or more were obese, the researchers said. Between 0.7 and 1.8 percent of the sample smoked marijuana this frequently.
The participants reported their own BMI as well as cannabis use, so if they did not give accurate estimates of these measurements, the results could be skewed.
Oily fish and nuts 'cut chance of food allergies'
If you are a pig. It's speculation anyway. The changes in the gut observed have NOT been shown to lead to fewer allergies
Mothers-to-be can reduce the chances of their babies developing food allergies by eating a diet rich in oily fish and nuts, new research indicates.
Academics have discovered that omega-3 fatty acids - found in fish like salmon, mackerel and tuna, as well as walnuts, pumpkin seeds and linseeds - prompt the gut to develop in a way that boosts the immune system.
And they warn that more children could now be at risk of food allergies than in the past because consumption of such foods has fallen.
The team, from France's National Agricultural Research Institute (INRA), found that when mothers-to-be ate a diet high in a particular group of polyunsaturated fatty acids (PUFAs), the gut walls of their offspring were more permeable.
This allowed more broken down food substances and bacteria to pass into the bloodstream, triggering the baby's immune system to produce antibodies.
Dr Gaëlle Boudry, from the INRA, explained: "Our study identifies that a certain group of polyunsaturated fatty acids causes a change in how a baby’s gut develops, which in turn might change how the gut immune system develops."
She continued: "The end result is that the baby’s immune system may develop and mature faster – leading to better immune function and less likelihood of suffering allergies."
Food allergy appears to be a growing problem, with the number of related hospital admissions in Britain rising six-fold since 1990.
There is considerable debate about how real the reported increase actually is, however. The National Institute for Health and Clinical Excellence (Nice) last year estimated that while more than a third believed they were allergic to some form of food, only a tenth were found to be allergic when properly tested.
Nonetheless, a recent, robust study from the Isle of Wight found one in 20 children did have an allergy. It also found evidence that the real incidence was growing.
Allergy experts do not really know what is behind the rise. One theory is the 'hygiene hypothesis': that as homes have become cleaner, children's immune systems now have less chance to develop fully.
More and more attention is also being paid to the role of early exposure to foods, both in the first years of life and in the womb.
Dr Boudry said: "There is intense research interest in maternal diet during pregnancy. In the Western diet, the group of polyunsaturated fatty acids that we have shown to help gut function are actually disappearing – our dietary intake of fish and nut oils is being replaced by corn oils which contain a different kind of fatty acid."
Their research, published in The Journal of Physiology, added to evidence that consuming such fatty acids in pregnancy was beneficial for babies, she claimed.
"Other studies have found that a diet containing fish or walnut oil during pregnancy may make your baby smarter – our research adds to this, suggesting such supplements also accelerate the development of a healthy immune system to ward off food allergies."
She emphasised that their study was in pigs, but the research group believe the animal's intestine is an "excellent model of the human gut".
In the study, pregnant and lactating sows were given a dietary supplementation of linseed oil. The permeability of their offsprings' intestinal walls was than compared with that of piglets from sows not given the supplement.
8 September, 2011
Socialising keeps you slim: Having lots of social contact burns off more fat than using a treadmill does
If you are a mouse
Keeping a busy social life amongst lots of friends may keep people slimmer than spending hours on a treadmill, according to scientists. They say that socialising and meeting with friends helps boost levels of 'brown fat' in the body which burns calories to generate heat. Living in a stimulating, social environment was found to reduce abdominal fat in mice by half over four weeks, even if they ate more.
US researchers say that social stimulation aids weight loss by converting white fat into brown. White stores calories and makes us fatter, while brown burns energy to generate heat.
Converting white fat into brown is notoriously difficult, normally requiring long term exposure to cold conditions or activating part of the body's nervous system. However, scientists from Ohio State University now think that having a busy social life is an even more effective way of changing white fat into brown.
The team came up with their theory by studying the effects of various living environments on mice. Those who lived alongside a greater number of mice, had more space and toys to stimulate them lost far more weight over the course of the study than their 'couch potato' counterparts.
Increased levels of brown fat may also be attributed to an increase in a brain chemical called brain-derived neurotrophic factor [BDNF] found in the sociable mice.
Study author Dr Matthew During, whose team's findings appear in journal Cell Metabolism said: I'm still amazed at the degree of fat loss that occurs. ‘The amount that comes off is far more than you would get with a treadmill. It's usually hard to induce the switch from white to brown fat.
‘It takes months of cold - you really have to push - and it doesn't induce brown fat to the same degree as what on the surface appears to be a relatively mild change in physical and social environments.’
Explaining how new technology had threatened face-to-face socialising, he added: ‘It's not just a sedentary lifestyle and high calorie foods, but an increasing lack of social engagement.’
Co-author Dr Lei Cao said: ‘After four weeks in the enriched environment, the animals' abdominal fat decreased by 50 per cent. ‘We often think of stress as a negative thing, but some kinds of stress can be good for your health. ‘In fact, the enriched housing is more taxing for the animals as they have to deal with each other and with a more complex environment.’
Dr Cao added: ‘The new result may offer insight into studies showing a link between loneliness and ill health. ‘Loneliness is a profound factor for cancer and death; it's on par with cigarette smoking. Social engagement is very important.’
Daily tipple boosts health in old age
Appropriate reservations are expressed below but the evidence for benefit from moderate alcohol use is extensive so it may be time to accept the relationship as real
Middle-aged women who indulge in a drink or two a day are boosting their chance of good health in their seventies, a new study claims. Enjoying a small tipple regularly and in moderation improves women's chances of avoiding heart disease, diabetes and other mental and physical disorders in later life, researchers found.
A study of 14,000 female nurses found that those who frequently drank one to two drinks a night, but no more, had a 30 per cent better chance of overall good health in their seventies than those who avoided alcohol altogether.
Drinking moderate amounts of alcohol on a nightly basis was shown to be healthier than indulging just once or twice a week. Women who drank on five to seven nights a week enjoyed a 50 per cent better chance of good health in later life than teetotallers.
Writing in the Public Library of Science journal, the researchers from the Harvard School of Public Health in Boston said their work showed that "regular, moderate consumption of alcohol" in their fifties could boost overall health among women who survive into their seventies.
Experts cautioned that the study did not prove that alcohol is good for the body and claimed the results could have been down to other lifestyle factors.
Associate Prof Jayne Lucke of the University of Queensland, Australia, said: "Drinking a small amount of alcohol may not cause women to age healthily. "Rather women who regularly drink a small amount may also have a number of other characteristics, such as good health, an active social life and a healthy appetite, that all work together to promote successful ageing."
NHS guidelines state that women should not regularly drink more than two or three units of alcohol a day, equal to one and a half standard 175ml glasses of wine or one pint of lager.
A study published last year by researchers in Paris indicated that moderate drinkers had lower rates of heart disease, obesity and depression than people who were teetotal.
The new findings showed that even drinking small amounts of alcohol can have a significant impact on health in later life. The American researchers measured alcohol intake in grams rather than units, with a glass of wine equal to about 10g and a bottle of beer including 13g.
The results showed that women with an average age of 58 who drank between 5 and 15g per night had a 20 per cent better chance of good health than non-drinkers, while those who drank 15g to 30g were 30 per cent more likely to be healthy in old age.
Dr Qi Sun, who led the study, said: "Low to moderate consumption of alcohol will slightly improve health for women in old age. We would still only recommend regular consumption of one drink per day because that is what the US health guidelines are."
But European guidelines are slightly higher and previous British studies have that as many as two drinks a night can have a positive health effect, he said.
Dr Sun added: "Even at moderate drinking levels it is highly recommended that you consume alcohol on a regular basis rather than binge drinking at the weekend. "But for lifetime non-drinkers we would not recommend drinking alcohol just to improve health, because studies have shown that regular exercise and healthy body weight are much more associated with better health at old age than alcohol."
7 September, 2011
How epidemiology works
(Data dredging illustrated)
Ibuprofen 'can double the risk of miscarriage' and many expectant mothers are unaware of the dangers
All that this probably shows is that women in poor health (as shown by their use of strong painkillers) are more likely to have miscarriages. The drug is an indicator, not a cause
Pregnant women who take painkillers such as ibuprofen are twice as likely to suffer a miscarriage, a study claims.
Scientists warn that tens of thousands of expectant mothers are taking the pills unaware of the dangers.
A major study has found that women who took ibuprofen or similar painkillers just before they conceived until the 20th week of pregnancy were 2.4 times more at risk.
Although there are clear warnings on the drugs’ packets stating they should not be used in pregnancy, as many as one in six expectant mothers still take them.
The study involved a group of painkillers known as Non-Steroidal Anti Inflammatory Drugs or NSAIDS, which include over-the-counter ibuprofen and naproxen.
Aspirin is also in this category although it wasn’t included in the study, while paracetamol is deemed safe.
The researchers believe taking any number of the drugs can lead to the embryo not being properly implanted in the womb meaning a woman is far more likely to suffer miscarriage – also known as a spontaneous abortion.
Around one in eight pregnancies end in miscarriage and the majority happen in the first 12 weeks.
Often there is no obvious cause but older women and those who smoke, drink heavily or are obese are at far higher risk.
The study published in the Canadian Medical Association Journal involved 47,050 women aged 15 to 45. Dr Anick Bérard of the University of Montreal said: ‘We consistently saw that the risk of having a spontaneous abortion was associated with gestational use of diclofenac, naproxen, celecoxib, ibuprofen and rofecoxib alone or in combination.
‘Women who were exposed to any type and dosage of non-aspirin NSAID during early pregnancy were more likely to have a spontaneous abortion.’
But doctors pointed out the risks of a woman suffering a miscarriage due to painkillers were very small. They also said the study did not take into account other possible causes such as smoking and obesity.
Dr Virginia Beckett, spokesman for the Royal College of Obstetricians and Gynaecologists, said: ‘It is important that any woman before conception and during pregnancy plans their pregnancy and reduces their risk of any complications through maintaining a healthy lifestyle. ‘It is safe to take paracetamol during pregnancy.’
6 September, 2011
Soda drinking under heavy attack
But where are the double-blind studies showing what harm it does? It's all just theory -- and wrong theories are a dime a dozen when subjected to double-blind test
Half of Americans drink a soda or sugary beverage each day - and some are downing a lot. One in 20 people drinks the equivalent of more than four cans of soda each day, even though health officials say sweetened beverages should be limited to less than half a can.
The Centers for Disease Control and Prevention released the figures Wednesday in a report said to be the government's first to offer national statistics for adults and kids.
Sweetened drinks have been linked to the U.S. explosion in obesity and related medical problems, and health officials have been urging people to cut back for years. Some officials have proposed an extra soda tax and many schools have stopped selling soda or artificial juices.
But advocates say those efforts are not enough, and on Wednesday, a coalition of 100 organizations announced a new push. The effort includes the American Heart Association and the some city health departments that plan to prod companies to stop the sale of sugary drinks on their property or providing them at business meetings - as Boston's Carney Hospital did in April. There will also be new media campaigns, like one starting soon in Los Angeles that will ask, "If you wouldn't eat 22 packs of sugar, why are you drinking it?"
The new CDC report may be ammunition. It found:
- About half the population drinks a sugared beverage each day.
- Males consume more than females, with teenage boys leading the pack. On average, males ages 12 through 19 drink the equivalent of nearly two cans of soda each day.
- Poor people drink more than the more-affluent. Low-income adults got about 9 percent of their daily calories from sugary beverages; for high-income adults, it was just over 4 percent.
- Blacks get more of their calories from sweetened beverages than other racial and ethnic groups.
The study is based on in-person interviews of more than 17,000 people in the years 2005 through 2008. They were asked to recount everything they ate and drank in the previous day. However, diet sodas, sweetened teas, flavored milks and 100 percent fruit juice did not count.
Healthy-eating recommendations call for people to limit sugary drinks to 64 calories per day. That's a little less than half of a 12-ounce can of regular Coca-Cola, which is 140 calories.
In other terms: An average can of sugared soda or juice has 10 to 12 teaspoons of sugar.
There have been efforts to reduce children's access to sodas and sports drinks in schools, with beverage companies agreeing to remove full-calorie soft drinks. But the CDC study found more than half of the drinks are consumed at home. Less than 1 percent are bought at schools or day-care centers.
That's why some members of the coalition argue that parents shouldn't drink sweetened beverages, so they don't serve as a poor example. They hope drinking soda will become as unfashionable as smoking.
A spokesman for Carney Hospital, the 149-bed Boston facility that stopped allowing full-calorie soft-drink sales, said the approach made sense. When the policy was implemented in April, sales of beverages dropped, but have gone back up, as more people apparently are adjusting to water and other non-sweetened drinks.
The hospital's Dorchester neighborhood has high rates of diabetes and other weight-related illnesses, said spokesman Joe Burnieika. "We can't afford to feed people's bad habits if we can give them a healthy alternative," he said.
In a statement, the American Beverage Association on Wednesday suggested that the coalition's effort was misguided. Citing sales data and some other research, the industry group said sales of full-calorie soft drinks had been declining, which they credited to soda makers offering more no-calorie and low-calorie options and improved calorie labeling on the front.
These initiatives "will contribute far more to solving complex health issues like obesity than (the coalition's) sound bite solution that offers plenty of hype but no substance," the statement said.
BAD SCIENCE by Ben Goldacre (Harper Perennial 2009) £12.99
Book Review by Dr. Alick Dowling.
This book is unknown to many MedChi members despite being hugely popular – it has entered the best-seller list recently. I, by chance, received a copy at Christmas from a nephew, who with his wife were fellow medical students with Goldacre in Oxford, qualifying in 1995.
The book proved an enjoyable read. Abounding with common sense as well as much combative material from his Bad Science weekly column in the Guardian, Goldacre’s aim is to correct much nonsense written by ‘scientific’ or ‘medical’ journalists that is wrong, frightens many readers and yet escapes editorial correction. His column has a large and devoted following, many of whom were at the Bath Literary Festival when Ben Goldacre spoke on March 1st 2009. Three hours earlier I had heard James Le Fanu introducing his Why Us? to his audience that Spring morning in the splendid Guildhall Banqueting Room. The review of Why Us? appeared last month on the MedChi website.
I had no thought then of doing the same for Ben Goldacre’s book. It had already reached a wide public; my only criticism would have been that it lacked an index. There are many reasons not to review a book – for example in the Spectator (May 2nd 2009) Nigel Lawson wrote: "As a general rule, I do not believe in reviewing bad books. Review space is limited, and the many good books that are published deserve first claim on it."1
My reason for not reviewing Goldacre’s book was the opposite. It is a good book and needed no more praise. When we were told the astonishing reason why a new (actually the original) version was now available I changed my mind. This includes the pivotal Chapter 10 The Doctor Will Sue You Now, omitted from the version published last year. Goldacre’s account of how this came about is lucid, revealing and gives an example of his style:Ben Goldacre‘s website April 9th, 2009
Chapter 10 in the original book – The Doctor Will Sue You Now, on Matthias Rath was removed, together with the index, from the first published version in Sep 08.
This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court. The chapter is now available in the new paperback edition, and I’ve posted it here for free so that nobody loses out.
Although the publishers make a slightly melodramatic fuss about this in the promo material, it is a very serious story about the dangers of pseudoscience, as I hope you’ll see, and it was also a pretty unpleasant episode, not just for me, but also for the many other people he’s tried to sue, including Medecins Sans Frontieres and more. If you’re ever looking for a warning sign that you’re on the wrong side of an argument, suing Medecins Sans Frontieres is probably a pretty good clue.
Anyway, here it is, please steal it, print it, repost it, whatever, it’s free under a Creative Commons license, details at the end. If you prefer it is available as a PDF, or as a word document. Happy Easter!
You are free to copy it, paste it, bake it, reprint it, read it aloud, as long as you don’t change it – including this bit – so that people know that they can find more ideas for free at www.badscience.net
This chapter did not appear in the original edition of this book, because for fifteen months leading up to September 2008 the vitamin-pill entrepreneur Matthias Rath was suing me personally, and the Guardian, for libel. This strategy brought only mixed success.
For all that nutritionists may fantasise in public that any critic is somehow a pawn of big pharma, in private they would do well to remember that, like many my age who work in the public sector, I don’t own a flat. The Guardian generously paid for the lawyers, and in September 2008 Rath dropped his case, which had cost in excess of £500,000 to defend. Rath has paid £220,000 already, and the rest will hopefully follow. Nobody will ever repay me for the endless meetings, the time off work, or the days spent poring over tables filled with endlessly cross-referenced court documents.
On this last point there is, however, one small consolation, and I will spell it out as a cautionary tale: I now know more about Matthias Rath than almost any other person alive. My notes, references and witness statements, boxed up in the room where I am sitting right now, make a pile as tall as the man himself, and what I will write here is only a tiny fraction of the fuller story that is waiting to be told about him. This chapter, I should also mention, is available free online for anyone who wishes to see it.
The missing index is explained. This is also available on the internet for owners of the original paperback, but unless it is completely rewritten it will only be valid for the first 9 chapters. Read the missing chapter free, and then decide whether to buy the new paperback.
The Chapter Bad Stats and its precursor Why Clever People Believe Stupid Things is of particular interest to doctors – not because they can be assumed to be Clever People, but because many do not realize how easily promoters of dubious theories manipulate us to accept ‘facts’ that are cleverly presented. Older doctors, never taught statistics, are more vulnerable than our younger colleagues. Goldacre uses clarity and simple terms to elucidate the subject. Malcolm Kendrick wrote a similar account about statistics in his book The Great Cholesterol Con (also reviewed on the MedChi website). For a comparison see below.
Goldacre’s aim to make ‘science’ accessible to ordinary readers is difficult to achieve, but he has the knack of doing so. He repeats the mantra: “I think you’ll find it’s a bit more complicated than that” when exasperated by the simplistic ‘explanations’ by ‘science’ journalists and even suggests it as a T-shirt slogan for the whole book.
His chapters on other individuals (including the new extraordinary account of Rath) are riveting. Professor Patrick Holford, the academic lynchpin at the centre of the British nutritionism movement, is dealt with in Chapter 9. It is not surprising that the ‘nutritionist’ Gillian McKeith took exception to Goldacre’s exposure in Chapter 7, but someone who has survived a legal encounter with Rath can easily dismiss her threats of legal action.
Goldacre’s introduction mentions the 50th anniversary of C.P. Snow’s lecture on the ‘Two Cultures’ of science and the humanities. Then arts graduates simply ignored science. No progress apparent since, but he is perceptive in seeing there has been a positive regression: "Today, scientists and doctors find themselves outnumbered and outgunned by vast armies of individuals who feel entitled to pass judgment on matters of evidence – an admirable aspiration – without troubling themselves to obtain a basic understanding of the issues."
The structure of the book is sensible and cleverly laid out – a steady crescendo from a gentle introduction in how science should be taught, through an increasingly serious range of how we should view what we are told by ‘experts’ with suspicion, then through the milder and less dangerous forms of foolishness – homeopathy makes its appearance here – through the placebo effect, onwards to the bigger fish such as Nutritionists, the way the pharmaceutical industry pulls the wool over the eyes of doctors and patients, the misuse of statistics already mentioned and culminating in what Goldacre finds most worrying, how people in positions of great power still commit basic errors when dealing with health scares. If we disagree with him he tells us that we’ll still be wrong but with a lot more panache and flair that we could possibly manage right now.
Received from the author. The chapter about Rath -- who claimed to cure AIDS by vitamins -- is here
Two examples of statistical jiggery pokery:
Newspapers like big numbers and eye-catching headlines. They need miracle cures and hidden scares, and small percentage shifts in risks will never be enough for them to sell readers to advertisers (because that is the business model). To this end they pick the single most melodramatic and misleading way of describing any statistical increase in risk, which is called the ‘relative risk increase’.
Let’s say the risk of having a heart attack in your 50’s is 50% higher if you have high cholesterol. That sounds pretty bad. Let‘s say the extra risk of having a heart attack if you have high cholesterol is only 2%. That sounds OK to me. But they’re the same (hypothetical) figures. Let’s try this. Out of a hundred men in their fifties with normal cholesterol, four will be expected to have a heart attack. That’s two extra heart attacks per hundred. Those are called ‘natural’ frequencies.
Natural frequencies are readily understandable, because instead of using probabilities, or percentages, or anything even slightly technical or difficult, they use concrete numbers, just like the ones you use every day to check if you’ve lost a kid on a coach trip, or got the right change in a shop. Lots of people have argued that we evolved to reason and do maths with concrete numbers like these, and not with probabilities, so we find them more intuitive. Simple numbers are simple.
The other methods of describing the increase have names too. From our example above, with high cholesterol, you could have a 50% increase in risk (the ‘relative risk increase’); or a 2% increase in risk (‘the absolute risk increase’); or, let me ram it home, the easy one, the informative one, an extra two heart attacks for every hundred men, the natural frequency.
(p 192) quoting the Heart Protection Study (HPS) press release: If now, as a result, an extra 10 million high-risk people were to go onto statin treatment, this would save about 50,000 lives a year, that’s a thousand each week. Leaving aside the point that this 50,000 figure actually equates to one life ‘saved’ for every 200 taking the statin – ten million is an awful lot of people to use as your denominator – the concept of saving lives, suggesting as it does, that each of the 50,000 whose lives have been saved will go on to live a healthy life, is not best chosen.
In reality, taking a statin can only delay death, not prevent it. By how much? Well, if one in two hundred more people are alive after one year of taking statins, this means that if you wait another two-hundreths of a year (plus another little bit) the statin group will have caught up on the ‘placebo’ group in total number of deaths.
This represents an increased life expectancy of slightly under two days. So rather than stating that fifty thousand lives would be saved every year by taking statins, it would be considerably more accurate to state that if ten million people (at very high risk of heart disease) took a statin for a year they would live – on average – two days longer.
And if all ten million took a statin for two hundred years, they would all live – on average – an extra year. If we assume that most people would take a statin for thirty years maximum, this would lead to an average increase in lifespan of approximately two months.
Which doesn’t sound quite as dramatic as saving fifty thousand lives a year, or a thousand a week – or however you choose to hype up your figures. But there you go, it happens to be considerably more accurate.
Also remember that this benefit would only be seen in men with pre-existing heart disease. Women and men without pre-existing heart disease would not live a day longer. They would just have the dubious pleasure of thirty years of paying for drugs, worry and side effects.
5 September, 2011
The obesity scare raises its weighty head again
Ignore the doomsayers, and eat what you darn well please. Now for the wine, duck and Armagnac...
By Terry Wogan, a "leading media personality" in Britain
Hardly has the dust settled on urban rioting, than we’re faced with another, apparently major, crisis. Obesity. Don’t panic, Mr Mainwaring! This scare raises its weighty corpse from the dead every three years or so, when the public is perceived as breathing a little more easily. How long ago was it that young women, and girls particularly, were being warned against eating too little, and endangering their health? Now, they and the rest of us are being warned that we’re eating ourselves into an early grave, and worse, costing everybody, including the undeserving fit, a fortune in medical care.
I remember casting aspersions on the sanity of some utter dumbbell of a politician, whose name escapes me, but who, unless the old memory is playing hide and seek, counted obesity as great a danger to the human race as global warming. He’d already claimed that the same global warming was a bigger danger to mankind than terrorism. The logical conclusion: being overweight was more dangerous to life on earth than terrorism.
This time around, the bleating of the doomsayers is well up to speed: the British public should eat only as instructed, and those rotters, the food producers, should be similarly forced to come up with only what some expert has decided is good for us.
Yet doctors, dieticians, scientists and every deranged health-food guru have been at odds about what exactly is good for us since people could afford to be worried about what the next meal was going to be, rather than if there was going to be one.
In the tranquil area of France from which I write at present, the diet of the man in the street with the beret and baguette is one of wine, duck in all its forms (including the fat), lots of bread, and Armagnac to wash it all down. Heart attack on a plate, the rocky road to obesity? The inhabitants of this département live longer than any others in France.
In Spain, I was regularly presented with a chunk of country bread, grilled on an open fire, on which I was invited to spread liberal amounts of lard, until my stomach thought my hand had gone mad. I know, I know. The “experts” will tell me that this is “good” fat, far better for the children of Britain than an oven-baked chip, or a cheap pizza.
Maybe, but what is certain is that nobody, however qualified, has the right to tell anybody else what they should be eating. Or drinking. President Sarkozy of France, a great man for jumping on a bandwagon, is proposing a tax on fizzy drinks. What about human rights? The idea that tax should be levied on “wrong” food and drinks smacks too closely of dictatorship. It is the inalienable right of every man and woman in a free society to go to hell in their own handcart, as long as nobody else gets hurt.
Obesity is not catching, it’s up to you. And only you.
New £2.50-a-day stroke pill 'will help 1 million patients'
Almost anything would be better than warfarin. It's a very dangerous drug if you get the dose just a bit wrong. They poison rats with it
A stroke drug hailed as the biggest advance in blood-thinning for almost 60 years goes on sale today. More than a million Britons could benefit from Pradaxa, which is up to a third more effective than warfarin, the gold-standard blood-thinner, when it comes to preventing strokes.
The £2.50-a-day drug is the first of a new generation of anti-clotting medicines. Its release follows news of a similar drug, apixaban – also known as Eliquis – which was also found to be better and safer than warfarin.
The traditional treatment, which has been in use for more than half a century, is very effective but reacts with countless foods, alcohol and other medicines, with sometimes fatal consequences.
Pradaxa could vastly improve patients’ quality of life by allowing them to eat what they want without fear of upsetting the levels of medication in their blood and triggering a stroke or haemorrhage. It would also remove the need for the frequent blood tests associated with warfarin, which is also used as rat poison.
From today, Pradaxa, which is also known as dabigatran etexilate, can be used to thin the blood in people with atrial fibrillation, in which erratic beating of the heart raises the odds of stroke five-fold.
In a trial with more than 18,000 sufferers of the condition, it was 35 per cent better than warfarin at preventing strokes. Overall, around three-quarters of strokes were prevented. It also had fewer serious side-effects – although some patients struggled with indigestion.
One of the biggest advantages will be its ease of use. Warfarin users have to undergo blood tests as often as every two days to ensure they don’t accidentally take too much or too little of it. Most of them – including many pensioners – must make regular visits to their GP, even when they have been on the drug for years.
Some 1.2million Britons suffer from atrial fibrillation – which is blamed for more than 20,000 strokes a year – but many do not take warfarin because of its associated problems.
Trudie Lobban, of the Atrial Fibrillation Association, said: ‘Our members live in fear of suffering a disabling or fatal stroke. They have waited years for an alternative to current treatment.’
Professor John Camm, of St George’s Hospital in London, added: ‘This is a big leap forward. There are very few interactions with Pradaxa, so patients don’t have to be monitored every few weeks and they still get significant protection. It’s win-win.’
It remains to be seen whether the drugs rationing body, the National Institute for Health and Clinical Excellence, will judge the treatment, made by Boehringer Ingelheim, to be a good use of taxpayers’ money. Warfarin costs less than £15 per year.
A ruling on NHS use in England and Wales is expected by the end of the year. The equivalent body in Scotland is set to decide within two weeks.
2 September, 2011
The Inventiveness of Nanny knows no bounds
With passive smoking on the run, a new menace comes waddling into view (the Guardian reports:Governments around the world need to make immediate and dramatic policy changes to reverse a pandemic of obesity which could affect an extra 11 million people in the UK over the next 20 years, public health scientists have warned.The call to act…comes in a series of papers published on Friday in the Lancet medical journal. The journal begins with a strongly-worded editorial arguing that voluntary food industry codes are ineffective and ministers must intervene more directly…There was a particular need for leadership ahead of a UN summit in New York next month on preventing non-communicable diseases such as diabetes and cancer, said one of the authors, Boyd Swinburn, from the centre for obesity prevention at Melbourne’s Deakin University..Swinburn’s paper comes up with a clear primary culprit: a powerful global food industry “which is producing more processed, affordable, and effectively-marketed food than ever before”. He said an “increased supply of cheap, palatable, energy-dense foods”, coupled with better distribution and marketing, had led to “passive overconsumption”.
Naturally the individual is incapable of deciding these things for himself. And naturally, we have to think of, yes, wait for it, the children.Another study by Steven Gortmaker from Harvard University’s school of public health, concludes that the response by governments has been a failure of will which mirrored previous struggles to tackle tobacco consumption. Ministers knew it made sense to crack down on junk foods but did not have the political appetite to take on such a huge industry.
“I think governments get it, but don’t know what to do about it, and don’t think it’s their responsibility. But it is their responsibility,” he said. His study lists eight cost-effective policies. Topped by a tax on unhealthy food and drink, the rest focus on shielding children from TV advertising or ensuring they exercise more.
Advertising Isn't the Obesity Boogeyman
With nearly one in three American children overweight, it's easy to question why anyone would oppose voluntary government guidelines that would severely restrict which foods can be marketed to children. What isn't addressed by many is the theory behind these proposed guidelines, crafted by a gang of four government agencies called the Interagency Working Group (IWG), without the support of scientific evidence or advertising statistics.
As the nation's obesity epidemic swells, food and advertising companies are coming under intense scrutiny, taking the blame from local and federal lawmakers for America's expanding waistline. The cornerstone of the IWG guidelines works from the predisposition that obesity is caused by advertising, even though no research supports this theory. The fact is, children are moving less and eating more. According to Health and Human Services data, fewer than 33% of children and adolescents aged 6 to 17 are engaged in 20 minutes of vigorous physical activity, while caloric intake for those aged 6-11 has remained relatively constant since 1974. It's no surprise that obesity rates have more than tripled during the past thirty years, when one also factors in the explosive use of technology devices among children.
No one would argue that the factors contributing to obesity range widely. But blaming America's kid bulge solely on television advertising is folly. Children are watching less television each day and therefore seeing fewer advertisements. From 2004 to 2010, food and beverage advertisements viewed per average child aged 2 to 11 years decreased from 2500 to around 1250 while advertising for cookies, snacks, and other candy decreased between 65%-99%.
It is unclear whether less advertising would lead to less consumption of the foods targeted by IWG guidelines. What is certain is that banning advertising for foods that do not meet these strict nutrition principles will increase prices for consumers. Though critics can find examples throughout the years of corporate advertisers knowingly promoting products with a health risk, the burden remains on companies to stay competitive in our free market, capitalist economy by responding to market pressure. More Americans are leading healthier lifestyles and want their children to do the same, so many food companies are tweaking their products accordingly. Recently, McDonald's added apple slices to its Happy Meals. Over the years, cereal companies have switched to whole grains and cut back on sugar and sodium content. And a group of manufacturers released their own guidelines for adjusting the ingredients of food marketed to children, which they had been working on for years before being targeted by the IWG.
In 2006, a group of 17 food manufacturers formed the Children's Food and Beverage Advertising Initiative (CFBAI) and released preliminary guidelines for greater self-regulation of food advertising to children. Once again in response to calls from consumers, the CFBAI has debuted a new set of voluntary guidelines to be enacted by 2014, making consistent recommendations that could lead to further changes in foods advertised to children. The new proposed standards don't give the companies a "pass" on improving. One-third of their products would be adjusted for fat, sugar and sodium content under the new guidelines, a step FTC Chairman Jon Leibowitz called "a significant advance and exactly the type of initiative the commission had in mind."
What's frustrating is this isn't enough for some critics. Lisa M. Powell, the researcher who authored a study for the University of Illinois at Chicago, commented to Reuters that the bulk of children's advertising is still fast food, and that advertising "makes [a parent’s] job that much tougher."
No matter how glitzy and glamorous food ads can be, rarely do they drive consumers to rush to the grocery store and purchase those marketed products. Moreover, children are not the primary purchasers of food for households. They're not behind the steering wheel, pulling up to the fast-food drive thru window or running into the convenient store for salty or sweet treats. It is parents who decide what to feed their children.
Parenting is tough indeed, but part of the job description is making choices that run contrary to what children may want at any given moment. It's rarely a success story when big government tries to parent - and this issue is no different.
1 September, 2011
The freedom to be fat
"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public" – Adam Smith
As usual, Adam Smith was right. Today I can think of no trade about which the above is more true than the medical profession. I don’t just mean doctors’ use of occupational licensure laws to keep their prices artificially inflated. Politically active groups of doctors are possibly the greatest single threat to personal freedom that there is in the UK today. Their motivation isn't necessarily their wallets, but their egos. Bullies like to use the state to push people around so they feel powerful.
There’s a sad example of this in today’s call in the Lancet, a medical journal that is often used as a political mouthpiece by campaigning doctors, for the government to introduce a “fat tax” to curb obesity.
Of course, the proposal is utterly specious. It's pretty dubious whether the "obesity epidemic" claims are true or not. And which diet plan should be implemented? Is it bacon, sugar, bread or something else that makes us fat? Will political parties of this fat tax utopian future be divided between the Low-Carb Party and the Low-Fat Party? And what if fat people's early mortality rates mean that they actually save the government money in pension and care home bills?
The doctors err even by their own logic. As Will Wilkinson has pointed out, if fat taxers thought things through, they would favour a tax on fat people themselves, not on the food they eat. Taxing food punishes people who exercise so that they can enjoy Big Macs, but not people who are so lazy that they balloon out while eating a balanced diet.
The justification for pushing people around like this is the NHS. Shouldn’t people have to pay for their own illnesses? Well, yes – that’s how personal responsibility works. But having an NHS removes the personal responsibility, and artificial attempts to inject it into the system are doubly illiberal and wrong.
The government (and the electorate, for that matter) forces people to be in the NHS. You have no choice in the matter, and you can’t opt out of it. Jamie Whyte put it well: "first the do-gooders conjure up the external costs by insisting that no one should have to pay for his own medical care, then they tell us that they must interfere with behavior that damages our health because it imposes costs on others." This is perverse and illiberal. The tax would only affect the poor – rich people's spending habits wouldn't be dented. How easy it must be for doctors to pontificate about the need for a fat tax, knowing that such a tax would hardly affect them at all.
This creepy, controlling paternalism has plenty of fans in politics on both sides of the partisan divide. Doctors are the politicians' enablers, lending the weight of their “expertise” to the nanny instinct of the political class in exchange for the feeling of being important. No amount of expertise – medical or otherwise – should give somebody the right to interfere with another adult’s choices. Nor should democracy be used as an excuse to violate the sovereignty of the individual. If fat people are costing the NHS money, that's a mark against having an NHS, not against having fat people.
SITE MOTTO: "Epidemiology is mostly bunk"
Where it is not bunk is when it shows that some treatment or influence has no effect on lifespan or disease incidence. It is as convincing as disproof as it is unconvincing as proof. Think about it. As Einstein said: No amount of experimentation can ever prove me right; a single experiment can prove me wrong.
Epidemiological studies are useful for hypothesis-generating or for hypothesis-testing of theories already examined in experimental work but they do not enable causative inferences by themselves
The standard of reasoning that one commonly finds in epidemiological journal articles is akin to the following false syllogism:
Chairs have legs
You have legs
So therefore you are a chair
SALT -- SALT -- SALT
1). A good example of an epidemiological disproof concerns the dreaded salt (NaCl). We are constantly told that we eat too much salt for good health and must cut back our consumption of it. Yet there is one nation that consumes huge amounts of salt. So do they all die young there? Quite the reverse: Japan has the world's highest concentration of centenarians. Taste Japan's favourite sauce -- soy sauce -- if you want to understand Japanese salt consumption. It's almost solid salt.
2). We need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. So the conventional wisdom is not only wrong. It is positively harmful
3). Table salt is a major source of iodine, which is why salt is normally "iodized" by official decree. Cutting back salt consumption runs the risk of iodine deficiency, with its huge adverse health impacts -- goiter, mental retardation etc. GIVE YOUR BABY PLENTY OF SALTY FOODS -- unless you want to turn it into a cretin
4). Our blood has roughly the same concentration of salt as sea-water so claims that the body cannot handle high levels of salt were always absurd
5). The latest academic study shows that LOW salt in your blood is most likely to lead to heart attacks. See JAMA. 2011;305(17):1777-1785
PEANUTS: There is a vaccination against peanut allergy -- peanuts themselves. Give peanut products (e.g. peanut butter -- or the original "Bamba" if you have Israeli contacts) to your baby as soon as it begins to take solid foods and that should immunize it for life. See here and here (scroll down). It's also possible (though as yet unexamined) that a mother who eats peanuts while she is lactating may confer some protection on her baby
THE SIDE-EFFECT MANIA. If a drug is shown to have troublesome side-effects, there are always calls for it to be banned or not authorized for use in the first place. But that is insane. ALL drugs have side effects. Even aspirin causes stomach bleeding, for instance -- and paracetamol (acetaminophen) can wreck your liver. If a drug has no side effects, it will have no main effects either. If you want a side-effect-free drug, take a homeopathic remedy. They're just water.
Although I am an atheist, I have never wavered from my view that the New Testament is the best guide to living and I still enjoy reading it. Here is what the apostle Paul says about vegetarians: "For one believeth that he may eat all things: another, who is weak, eateth herbs. Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth." (Romans 14: 2.3). What perfect advice! That is real tolerance: Very different from the dogmatism of the food freaks. Interesting that vegetarianism is such an old compulsion, though.
Even if we concede that getting fat shortens your life, what right has anybody got to question someone's decision to accept that tradeoff for themselves? Such a decision could be just one version of the old idea that it is best to have a short life but a merry one. Even the Bible is supportive of that thinking. See Ecclesiastes 8:15 and Isaiah 22: 13. To deny the right to make such a personal decision is plainly Fascistic.
Fatties actually SAVE the taxpayer money
IQ: Political correctness makes IQ generally unmentionable so it is rarely controlled for in epidemiological studies. This is extremely regrettable as it tends to vitiate findings that do not control for it. When it is examined, it is routinely found to have pervasive effects. We read, for instance, that "The mother's IQ was more highly predictive of breastfeeding status than were her race, education, age, poverty status, smoking, the home environment, or the child's birth weight or birth order". So political correctness can render otherwise interesting findings moot
That hallowed fish oil is strongly linked to increased incidence of colon cancer
"To kill an error is as good a service as, and sometimes better than, the establishing of a new truth or fact" -- Charles Darwin
"Most men die of their remedies, not of their diseases", said Moliere. That may no longer be true but there is still a lot of false medical "wisdom" around that does harm to various degrees. And showing its falsity is rarely the problem. The problem is getting people -- medical researchers in particular -- to abandon their preconceptions
Bertrand Russell could have been talking about today's conventional dietary "wisdom" when he said: "The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd; indeed in view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.”
Eating lots of fruit and vegetables is NOT beneficial
The challenge, as John Maynard Keynes knew, "lies not so much in developing new ideas as in escaping from old ones".
"Obesity" is 77% genetic. So trying to make fatties slim is punishing them for the way they were born. That sort of thing is furiously condemned in relation to homosexuals so why is it OK for fatties?
Some more problems with the "Obesity" war:
1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).
2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.
3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.
4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.
5). Food warriors demonize dietary fat. But Eskimos living on their traditional diet eat huge amounts of fat with no apparent ill-effects. At any given age they in fact have an exceptionally LOW incidence of cardiovascular disease. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?
6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.
7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.
8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].
9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.
10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.
11). A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
12. Fascism: "What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!
Trans fats: For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.
The "antioxidant" religion: The experimental evidence is that antioxidants SHORTEN your life, if anything. Studies here and here and here and here and here and here and here, for instance. That they are of benefit is a great theory but it is one that has been coshed by reality plenty of times.
PASSIVE SMOKING is unpleasant but does you no harm. See here and here and here and here and here and here and here
The medical consensus is often wrong. The best known wrongheaded medical orthodoxy is that stomach ulcers could not be caused by bacteria because the stomach is so acidic. Disproof of that view first appeared in 1875 (Yes. 1875) but the falsity of the view was not widely recognized until 1990. Only heroic efforts finally overturned the consensus and led to a cure for stomach ulcers. See here and here and here.
Contrary to the usual assertions, some big studies show that fat women get LESS breast cancer. See also here and here
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
Huge ($400 million) clinical trial shows that a low fat diet is useless . See also here and here
Dieticians are just modern-day witch-doctors. There is no undergirding in double-blind studies for their usual recommendations
The fragility of current medical wisdom: Would you believe that even Old Testament wisdom can sometimes trump medical wisdom? Note this quote: "Spiess discussed Swedish research on cardiac patients that compared Jehovah's Witnesses who refused blood transfusions to patients with similar disease progression during open-heart surgery. The research found those who refused transfusions had noticeably better survival rates.
Relying on the popular wisdom can certainly hurt you personally: "The scientific consensus of a quarter-century ago turned into the arthritic nightmare of today."
Medical wisdom can in fact fly in the face of the known facts. How often do we hear reverent praise for the Mediterranean diet? Yet both Australians and Japanese live longer than Greeks and Italians, despite having very different diets. The traditional Australian diet is in fact about as opposite to the Mediterranean diet as you can get. The reverence for the Mediterranean diet can only be understood therefore as some sort of Anglo-Saxon cultural cringe. It is quite brainless. Why are not the Australian and Japanese diets extolled if health is the matter at issue?
Since many of my posts here make severe criticisms of medical research, I should perhaps point out that I am also a severe critic of much research in my own field of psychology. See here and here
This is NOT an "alternative medicine" site. Perhaps the only (weak) excuse for the poorly substantiated claims that often appear in the medical literature is the even poorer level of substantiation offered in the "alternative" literature.
I used to teach social statistics in a major Australian university and I find medical statistics pretty obfuscatory. They seem uniformly designed to make mountains out of molehills. Many times in the academic literature I have excoriated my colleagues in psychology and sociology for going ga-ga over very weak correlations but what I find in the medical literature makes the findings in the social sciences look positively muscular. In fact, medical findings are almost never reported as correlations -- because to do so would exhibit how laughably trivial they generally are. If (say) 3 individuals in a thousand in a control group had some sort of an adverse outcome versus 4 out of a thousand in a group undergoing some treatment, the difference will be published in the medical literature with great excitement and intimations of its importance. In fact, of course, such small differences are almost certainly random noise and are in any rational calculus unimportant. And statistical significance is little help in determining the importance of a finding. Statistical significance simply tells you that the result was unlikely to be an effect of small sample size. But a statistically significant difference could have been due to any number of other randomly-present factors.
Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology: below:"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.
The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could have been speaking of the prevailing health "wisdom" of today when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."
The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0." Very few of the studies criticized on this blog meet that criterion.
Improbable events do happen at random -- as mathematician John Brignell notes rather tartly:
"Consider, instead, my experiences in the village pub swindle. It is based on the weekly bonus ball in the National Lottery. It so happens that my birth date is 13, so that is the number I always choose. With a few occasional absences abroad I have paid my pound every week for a year and a half, but have never won. Some of my neighbours win frequently; one in three consecutive weeks. Furthermore, I always put in a pound for my wife for her birth date, which is 11. She has never won either. The probability of neither of these numbers coming up in that period is less than 5%, which for an epidemiologist is significant enough to publish a paper.
Kids are not shy anymore. They are "autistic". Autism is a real problem but the rise in its incidence seems likely to be the product of overdiagnosis -- the now common tendency to medicalize almost all problems.
One of the great pleasures in life is the first mouthful of cold beer on a hot day -- and the food Puritans can stick that wherever they like