Saturday, November 11, 2006

Trans Fat Hysteria Could Be Lawsuit Bonanza

The takeover of Congress by Democrats could result in a big payday for trial lawyers at the expense of the feckless food industry. Food companies like McDonald's, KFC and IHOP recently announced their intent to stop cooking their foods in trans fats -- industrially-produced vegetable oils used in a variety of food products for their cooking, preservative and cost benefits. The companies are reacting to widely publicized claims that trans fats cause heart disease and more than 1-in-5 heart attacks.

Emanating from a decade-long campaign launched by a small group of Harvard University researchers, anti-trans fat hysteria has been so "successful" that New York City and Chicago have announced moves to ban restaurant use of trans fats. The Washington Post cheered such news in an editorial this week, hoping that it "inspires the federal Food and Drug Administration to catch up" -- more on the significance of this comment later.

The rush to judgment on trans fats is amazing given the "science" used to power the anti-trans fat bandwagon. Consider the most recent review of trans fats research published in the New England Journal of Medicine (April 13, 2006). The review was co-authored by Harvard's Walter Willett, one of the researchers leading the anti-trans fat campaign. Willett's primary claim about trans fats is that they "appear to increase the risk of coronary heart disease more than any other macronutrient." Willett cites three large studies as "the strongest epidemiologic [real-world] evidence" for this assertion. Let's look closely at these studies.

In the so-called "Health Professional Follow-up Study," more than 43,000 male health professionals were studied for six years to examine the association between dietary fats and heart disease. Although the "raw" results indicated positive correlations between trans fat consumption and heart disease, when other confounding risk factors for heart disease were considered, the correlation with heart disease became statistically insignificant and the correlation with fatal heart attacks became inverted - that is, trans fat consumption slightly reduced the risk of fatal heart attack!

In the "Alpha-Tocopherol Beta-Carotene Cancer Prevention Study," the intake of trans fats was studied in almost 22,000 male smokers. The study did not report a statistically significant association between trans fat intake and non-fatal heart attack, and only reported a questionable weak statistical association between very high trans fat intake and fatal heart attacks. But given that the typical lifestyle characteristics of smokers compared to non-smokers - lower income, more stressful lives, worse diet, higher alcohol consumption, and less exercise - tend to significantly impact heart disease risk, the men in this study are probably not good subjects for an evaluation of trans fats in the first place.

In the third study, known as the "Nurses Health Study," 80,082 female nurses were followed for 14 years to study the relationship between dietary intake of different types of fats and heart disease. No overall association was reported between trans fat intake and heart disease, although a weak statistical association was reported for women in the top quintile of trans fat intake. But the size of that statistical association (53 percent), however, renders it quite dubious. As the National Cancer Institute has publicly stated, "In epidemiologic research, [increases in risk of less than 100 percent] are considered small and usually difficult to interpret. Such increases may be due to chance, statistical bias or effects of confounding factors that are sometimes not evident."

So there you have it. Those flimsy-to-exculpatory study results are what Harvard's Willett considers (as of April 2006) to be the "strongest epidemiological evidence" supposedly linking trans fat consumption with heart disease. But if Willett's claims about trans fats were true, wouldn't there be a substantial body of consistent and convincing evidence indicating that trans fats intake causes actual harm among real people? After all, we've only been consuming trans fats since Crisco was commercialized in 1908 - almost 100 years.

So what's all this got to do with this week's elections and trial lawyers? So far, there have been several lawsuits filed against food companies (like McDonald's and KFC) concerning trans fats. None of this has been personal injury or class action litigation, however, which is where the big bucks are for trial lawyers. Despite all the trans fat scaremongering - aided in part by food companies caving in to trans fat-free alarmism by reformulating cooking processes or selling trans fat-free products - the Food and Drug Administration still classifies all uses of trans fats as "generally recognized as safe." This classification obviously serves as a roadblock to successful personal injury litigation. How long trans fats will maintain their "GRAS" status is anyone's guess.

However, the Democrat takeover of Congress raises concerns because trial lawyers are historically among the Democrats' biggest financial supporters - almost 10 times greater than the food industry in 2006 ($65 million vs. $7 million). While Congress has no direct authority over the FDA and its staff, Congress may pressure the FDA and its leadership to change the GRAS status of trans fats in other ways -- such as through its investigative, appropriations and legislative powers. A change in the status of trans fats would clear the way for personal injury lawyers to sue (perhaps on a class action basis) and start collecting big bucks for the alleged 1-in-5 heart attacks that the Harvard cabal blames on trans fats. It could be a multi-billion dollar payday that ranks among the most lucrative personal injury litigation for the lawyers.



If in doubt, Google it, doctors puzzling over a diagnosis have been told. The internet search engine used by millions of people to find a plumber or discover what their house is worth is also pretty handy when it comes to putting a name to unusual ailments. Embarrassing as it may seem to professionals trained for many years in medicine, Google can often come up with the right answer.

In one case described in The New England Journal of Medicine, a doctor astonished her colleagues, who included an eminent professor, by correctly diagnosing Ipex (immunodeficiency, polyendocrinopathy, enteropathy, X-linked) syndrome. It just "popped right out" after she entered the salient features into Google, she admitted. Two Australian doctors have now put Google to a sterner test, using 26 cases from the case records section of the journal. This is a regular feature in which the symptoms of a tricky case are described and readers are asked to come up with a diagnosis. Hangwi Tang and Jennifer Hwee Kwoon Ng, doctors at the Princess Alexandra Hospital, in Brisbane, simply entered words from the case records into Google. The words reflected the symptoms described, and for each case they picked between three and five. They then looked at the first three pages of the Google output - thirty items - and chose what seemed to be the most plausible of the diagnoses offered. In 58 per cent of the cases, Google came up with the right answer, or at least the same answer as given in the journal.

For example, when the case involved a 48-year-old man with multiple spinal tumours and skin tumours, the doctors searched Google by entering the words "multiple spinal tumours" and "skin tumours". Google responded with items suggesting the man had neuro-fibromatosis type 1, the correct diagnosis. In another case, a man lost consciousness while jogging. A search under "cardiac arrest", "exercise", and "young" produced the diagnosis of hypertrophic obstructive cardiomyopathy, which was also right. Other conditions that were diagnosed successfully included Creutzfeldt-Jakob disease, gastrointestinal bleed, amyotrophy (a neurological disorder) and encephalitis (inflammation of the brain).

There were some errors. A condition deduced to be graft versus host disease turned out to be West Nile fever - quite a big difference. But the two doctors conclude that Google is well worth trying. "Useful information on even the rarest medical conditions can now be found and digested within a matter of minutes," they say. "Our study suggests that in difficult diagnostic cases it is often useful to `Google for a diagnosis'. "Web-based search engines such as Google are becoming the latest tools in clinical medicine, and doctors in training need to become proficient in their use."

Irritating medical television series such as House, in which a grumpy know-it-all physician played by Hugh Laurie astonishes his colleagues by his remarkable diagnostic skills, will never seem quite so impressive. How long before he is upstaged by Google? And GPs who grumble when their patients turn up with printouts from the internet claiming that they have some obscure disease will have to be more circumspect. Having access to Google, the patients might just be right.

The doctors started their research after examining a 16-year-old water polo player with a blockage in a vein, and explaining that the cause was uncertain. His father immediately interrupted to say: "But of course he has Paget-von Schroetter syndrome." He had successfully Googled the symptoms and proceeded to give the doctors a mini-tutorial on the cause of the condition - huge neck muscles compressing the axillary vein - and the correct treatment.



Just some 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 salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. 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? It is just about pure fat. Surely it should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). For a summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and no lasting harm from them has ever been shown.


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