Saturday, June 23, 2007

HRT: On again, off again, on again

I condemned the scare stories from the beginning. Most of the health claims both for and against HRT are very flimsily based. Its usefulness in alleviating menopausal symptoms and limiting osteoporosis are the only considerations that should matter in decisions to use it or not. I said more about HRT on this blog on April 21

DOCTORS who alarmed millions of menopausal women by linking hormone replacement therapy with increased risk of heart attack or stroke, now say the drugs can lower the chance of heart disease. An American study published yesterday in The New England Journal of Medicine found that taking oestrogen for seven years or more soon after menopause can reduce calcification of the arteries, a major cause of heart attacks, by up to 60 per cent. Researchers say only older women who delay taking the drugs for at least 10 years are at risk.

The findings are a continuation of the Women's Health Initiative Study that caused a worldwide health scare in 2002 by controversially warning women that oestrogen replacement was potentially dangerous. This caused millions of women to stop using HRT. But the new research, which looked at 1100 women aged 50 to 59 who had undergone a surgically induced menopause through hysterectomy, could put many minds at rest. The lead author of the original study and the latest findings, Dr JoAnn Manson, of Boston's Brigham and Women's Hospital, said the new research would give women considering HRT reassurance that it was "unlikely to have an adverse effect on the risk of coronary events among women who have recently undergone menopause".

The results concur with a study published in the Journal of the American Medical Association in April that found the 2002 research fundamentally flawed. The JAMA study found there was a 30 per cent drop in deaths among women taking oestrogen.

But two international studies published about the same time showed hormone therapies could increase the risk of ovarian and breast cancer. Doctors at the time told Australian women the risks were low and to continue their hormone treatment. Melbourne's Baker Heart Research Institute director, Professor Garry Jennings, said yesterday that conflicting messages on HRT were confusing.

The latest research showed hormone treatment could be beneficial. "We like to think of something as black or white, good or bad, and it becomes a little complicated if it's good under this circumstance and not so good under others," he said. "What this study does is lend support to what has been the more recent practice, that is to still consider them (HRT) in younger women but to not really push them unless there are really disabling symptoms in older women."


Crooked Chiropractors in California home free

When prominent chiropractors claim fake degrees, it does not need others to give chiropractic a bad name. But I guess that false health claims are endemic in California so nobody really cares

The board that oversees chiropractors now says it has no authority to discipline practitioners who claim advanced degrees from unaccredited universities, a reversal of an earlier policy that ensnared current board member Franco Columbu. The board has no regulation that spells out what kinds of claims about Ph.D.s might be misleading to consumers, said interim Executive Director Brian Stiger. As a result, the board can't send out letters to chiropractors who make those claims telling them to prove that the university is legitimate or stop advertising the degree, Stiger said. Some other professional licensing boards do restrict what licensees can claim about other degrees and credentials, Stiger and others say.

The board's new stance fails to protect consumers against misleading claims, said a legislator who has been investigating the Board of Chiropractic Examiners. "It's just another example of how out of control this board is ...," said Sen. Mark Ridley-Thomas, D-Los Angeles. "It goes directly to the issues of integrity and credibility. This drives me nuts."

For years, the board had been challenging chiropractors who claimed Ph.D.s from unaccredited institutions. The board investigates about five to 10 such cases each year, Stiger said. One was Columbu, a chiropractor appointed to the board by Gov. Arnold Schwarzenegger in February 2006. Columbu and Schwarzenegger are longtime friends from bodybuilding days, with Columbu, known as the Sardinian Strongman, standing as best man in Schwarzenegger's wedding. Two years before Columbu's appointment, the board sent him a "cease and desist" letter, telling him that he was in violation of a regulation on false and misleading advertising. The letter demanded that Columbu show proof that the issuer of his Ph.D., Donsbach University, was an accredited institution, or remove the Ph.D. claim from his advertising. The case was closed when Columbu furnished proof that he was no longer advertising the Ph.D.

But as of April of this year, Columbu still included a reference to a "Ph.D. in nutrition" on his Web site in a sales pitch for a $200 nutrition and training program. Columbu's Web site was not accessible Wednesday. After The Bee reported Columbu's situation in April, a lawyer wrote on Columbu's behalf that he had complied with the cease-and-desist letter but "due to an oversight" left one reference to the Ph.D. at the bottom of the Web page. The attorney, Wilkie Cheong, also questioned the board's authority to determine whether or not an institution conferring a Ph.D. was accredited. Columbu did not respond to a voice mail Wednesday.

Stiger said that he did not talk to Columbu about the change. He said it came up as part of his review of a number of board practices since taking over as interim director in March. Two lawyers agreed that the board doesn't have the authority to discipline chiropractors who claim Ph.D.s from unaccredited institutions, he said. Stiger sent out an e-mail Wednesday to the board staff so they would all be aware of the change.

Julie D'Angelo Fellmeth, administrative director at the Center for Public Interest Law at the University of San Diego, said the Columbu situation puts the board staff in an awkward position. "I understand the board staff is between a rock and a hard place," she said. "How would you like to go after one of your own board members?" Another board member, Frederick Lerner, also claims a Ph.D., this one in electromedical sciences from City University Los Angeles. The university is unaccredited and is no longer approved by the state Bureau for Private Postsecondary and Vocational Education. But Lerner said that when he did course work and a dissertation in 1985, the school was legitimate.

Stiger said that in the absence of enforcement, the board would rely on public education, informing consumers about how to check out chiropractors' credentials. The board could also choose to pass a regulation to detail the kinds of claims that chiropractors are prohibited from making. But that option could be costly and time consuming.

Ridley-Thomas said the reversal is "Exhibit A" for why the Legislature should pass a bill asking voters to put the Board of Chiropractic Examiners under the control of the Department of Consumer Affairs. The board is more autonomous than other professional licensing bodies because it was set up by a 1922 initiative governing the chiropractic profession. With the board under tighter control, the Legislature would be able to review appointees like Columbu, he said, and would be more likely to pursue a regulation barring certain advertising claims. "The public deserves better, much better," he said.



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 and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

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.


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