Counterproductive propaganda

Anti-smoking ads have opposite effect on teens

The more exposure middle school students have to anti-smoking ads, the more likely they are to smoke, according to a new University of Georgia study. Hye-Jin Paek, an assistant professor at UGA, found that many anti-smoking ad campaigns have the opposite effect on teenagers, backfiring because they actually encourage the rebellious nature of youth. "They don't want to hear what they should do or not do," Paek said. Instead, she said, ads should focus on convincing teens their friends are heeding the anti-smoking warning because peer pressure has the most direct effect.

Paek and co-author Albert Gunther from the University of Wisconsin-Madison examined surveys from 1,700 middle school students about their exposure to anti-smoking ads and their intention to smoke. The study will be published in the August issue of the journal "Communication Research." The study is the latest in a string of research showing that anti-smoking campaigns often have ad little to no impact on teens. In 2002, a study commissioned by an ant i-smoking foundation found tobacco manufacturer Philip Morris' youth anti-smoking campaign was making students more likely to smoke.

Paek said the data showed middle school students are more like to be influenced by the perception of what their friends are doing, and that anti-smoking campaigns should be more focused on peer relations. "Rather than saying, 'don't smoke,' it is better to say, "your friends are listening to this message and not smoking," she said. "It doesn't really matter what their peers are actually doing."

Source





"Ideal" weight for mothers promoted

Damned if you do and damned if you don't

Mothers who gain or lose a great deal of weight between pregnancies could be putting themselves and their babies at risk, experts have said. Even quite small changes in body mass index (BMI), of one or two units, between pregnancies are enough to have effects, say Jennifer Walsh and Deirdre Murphy, two obstetricians from Dublin. An increase of this size has been linked with a doubling of the risks of high blood pressure, preeclampsia, and having a large baby. Greater increases in weight between pregnancies add to the risk of stillbirth and other complications, they say in an editorial in the British Medical Journal.

On the other hand, they add, women losing a lot of weight run a greater risk of having premature babies, or babies of low birth-weight. The message is that women should try to maintain a healthy weight before, during and after pregnancy ? and to be the same weight at any subsequent pregnancies.

Dr Walsh, a specialist registrar in obstetrics and gynaecology at Coombe Women's Hospital in Dublin, and Professor Murphy, Professor of Obstetrics at Trinity College Dublin, say: "Women of reproductive age are bombarded with messages about diet, weight and body image. "There is growing concern on the one hand about an epidemic of obesity, and on the other about a culture that promotes `size zero' as desirable, irrespective of a woman's natural build. "Pregnancy is one of the most nutritionally demanding periods of a woman's life, with an adequate supply of nutrients essential to support foetal wellbeing and growth. "With at least half of all pregnancies unplanned, women need to be aware of the implications of their weight for pregnancy, birth and the health of their babies. "We should ensure that women of low body mass index attain a healthy weight before conception to reduce the risk of preterm birth and low infant birth-weight. "We should also counsel women with a history of previous preterm birth to maintain a healthy weight to prevent recurrence."

The authors cited studies on the effects of weight gain and weight loss. The first, a Swedish study, followed 207,534 women from 1992 to 2001 to examine the link between changes in body mass index and the impact on a baby and mother's health. The second, which was published last year in the American Journal of Obstetrics and Gynaecology, found that women whose BMI fell by five or more units between pregnancies had a higher risk of premature birth than women whose weight remained stable or increased. The effect was heightened among women who had already experienced one premature birth.

Tam Fry, board member of the National Obesity Forum, said: "I think these doctors are absolutely right. "It's fundamental that we teach girls at school not only to lose weight for their own health but also because of the risks to their child of entering motherhood being overweight." Being overweight was associated with polycystic ovary syndrome, which could result in difficulty conceiving, he said. "There is a known association between overweight and obese parents and the likelihood of a child being overweight themselves. "Women should be aiming for a normal weight before they have their second child. "Women also go the other way and starve themselves to plummet to a goal weight. They try to get down to a certain weight, and that is also wrong."

Source

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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.

*********************

The war on obesity is a war on the poor

`It's the poor wot gets the blame.' That was a popular refrain during the First World War, but it could just as easily be a rousing chorus from the trenches of the War on Obesity. Today there is an assumption that behind every flabby child waddling down the road there are parents who are as thick as mince, with barely enough money to send their overweight offspring to the chip shop for their dinner on the way back from fetching mum and dad's fags. However, two recent pieces of research give the lie to this sketch, suggesting that the middle classes are just as prone to eating crap food and having fat children as the poor.

Just over a week ago, the UK Food Standards Agency (FSA) published research which showed that the poor, far from having a nutrition-lite diet of fat and sugar, actually ate much the same kinds of foods as everyone else (1). In a detailed survey of the eating habits of 3,278 people from households in the most materially deprived sections of the population, the FSA found that the most significant differences in eating habits were related to age, not social class. Younger people, regardless of social class, tended to consume more low-fibre, high-fat, high-sugar and processed foods than older generations. Poor people were no more likely to be overweight or obese than the better-off.

Then, last Sunday, the UK Independent on Sunday declared that `the nation's higher-paid working mothers bear much of the responsibility for the country's ticking obesity time bomb, and not the poorer working-class families who are usually blamed.' (2) Another study, carried out by University College London and Great Ormond Street Hospital, found that children growing up in households with incomes greater than œ33,000 per year were more likely to be obese than those in homes with the lowest incomes. Apparently, middle-class households where the mother works are particularly affected: `Long hours of maternal employment, rather than lack of money, may impede young children's access to healthy foods and physical activity.'

The news that middle-class kids get fat too shouldn't be a shock to anyone. It became frontpage news over the past week only because the problem of obesity has, until now, been readily blamed on the ignorance and moral failings of the working classes; that these `middle classes get fat!' findings have been treated as stunning is testament to the extent to which obesity has been associated with moral turpitude amongst the lower classes. And yet, at the same time as these latest studies seem to have exhonerated the poor, they have also found a new enemy in the War on Obesity: working mothers.

Women who hold down a job, run a home and raise children have got enough on their plates already. Now, apparently, they have to bear responsibility for their children's ill-health, too. As Dr Colin Waine, chairman of the National Obesity Forum, told the Independent on Sunday: `I do not wish to condemn these women but I do think the priority has to be the health of the child and its continued health into adulthood. We are in danger of raising a generation of young people with a much shorter life expectancy than previous generations.' (3) Unfortunately, Dr Waine sounds a bit like those people who say `I'm not a racist, but.' No doubt he will assure us that some of his best friends are working mothers.

Whether being a working mother really is going to make your children fat or not (and we shouldn't leap to conclusions on the basis on one study), the question really should be: does it matter? The fact is, the relationship between ill-health and obesity is a complicated one. It certainly appears to be the case that the very overweight have a lower life expectancy than those who are lighter. But whether this is strictly to do with how much fat they have round their waists is another matter. It is not only the amount of body fat they have that makes the very overweight different to slimmer individuals. For example, obese people tend to take less exercise and there's good evidence that exercise (which in this case means walking regularly rather than running marathons) can offset most of the risks of heart disease, type-II diabetes and so on that are associated with being fat. Moreover, somebody who is capable of being really fat (most people wouldn't get really fat even if they stuffed their faces) may have other physiological problems that increase their propensity for chronic diseases. But for the rest of us - from those of `ideal' weight to the mildly obese - the risk of an early death is pretty much the same across the board.

Nor can we predict an individual's adult health from his or her size as a child. As a thought-provoking new paper by the Australian academic Michael Gard bluntly notes, `no study in the history of medical science has ever established a causal link between childhood fatness and adult ill-health or premature death' (4). So, why all the attention given to obesity in general, and childhood obesity in particular? It's not as if obsessing about our weight has made us any happier (or thinner). For Gard, obesity has become a morality play for those who would like to intervene in our lives: `Unfortunately, many commentators talk about the war on obesity as a war between good and evil; good food versus bad food, wholesome physical activity versus evil technology; and responsible versus irresponsible parenting. If we then factor in the inconvenient fact that obesity research has not produced a "smoking gun" which implicates anyone in particular, the stage is set perfectly for protracted and unhelpful arguments about what research does or does not say about the causes of obesity.' (5)

As the American commentator Paul Campos has noted, the best way to win the War on Obesity is to stop fighting it. But the War on the Poor will carry on regardless of the results of studies into eating habits - after all, it's a war that's been raging for well over a century and serves to confirm the innate superiority of those with a bob or two in their pockets. This extract from a popular English Victorian magazine could have been the product of many a modern-day hack: `The Bethnal Green poor. are a caste apart, a race of whom we know nothing, whose lives are of quite different complexion from ours, persons with whom we have no point of contact.' (6)

Such an explicit statement of the idea that some people are simply of better `stock' than others would be unacceptable today. Nonetheless, the same idea is implicit in the logic of modern thinking on poverty and obesity. Wealthy people who cook decent meals with fresh ingredients are seen as being morally superior - they care about their health and their children's health, and they care for the planet, too. Poorer people, who apparently only eat microwaveable meals or pizzas biked to their homes during an episode of EastEnders, are looked upon as sinful and slothful - they are, in Jamie Oliver's immortal words, `white trash' and `tossers' who allegedly care little for their own wellbeing or that of their families. Today, the sense of a divide between rich and poor is articulated most frequently through issues of health and diet.

The search for some form of moral superiority, rather than a real concern with health, is the driving force behind the authorities' War on Obesity. That is why a campaign ostensibly against fatness can easily shift its attention from feckless `chavs' to working mothers: because it is underpinned by moralistic judgements about our lifestyle choices rather than hard scientific facts about our eating habits. First `white trash' families and now mums who dare to work - the War on Obesity is a war against those who make the `wrong' choices, who refuse to play by the rules laid down by the new elite, and who instead do things their own way. In this sense, the demand that we `eat healthily' and have the correct body shape (whatever that might be) is at root a demand that we conform.

Source





Attack on HIV broadening

HIV laboratories around the world are humming. New discoveries and treatments are tumbling out of the research pipeline at a remarkable pace, one that promises HIV patients a longer, healthier life. This, for a disease that was a death sentence when it was first identified 26 years ago.

Little wonder that when nearly 6000 experts on HIV and AIDS from 133 nations gathered in Sydney this week for the fourth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, they buzzed. "This is an enormously exciting time," says John Kaldor, deputy director of the National Centre in HIV Epidemiology and Clinical Research at the University of NSW. "Over the past two years people have made striking improvements in therapy, especially for people in whom several regimens have already failed. People have also made significant developments in what are considered biomedical tools -- like microbicides -- to help break the cycle of transmission."

Much, too, has been learned about how the insidious human immunodeficiency virus infects its victims, wreaks such damage and is so hard to beat. According to long-time HIV-AIDS researcher Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, new insights into the mechanisms by which HIV harms humans have underpinned development of over 25 anti-HIV drugs. "These medications have had an enormous impact in reducing mortality wherever they have been used," says Fauci who, as a clinically and scientifically trained infectious diseases and immunology specialist, was one of the first experts in the world to see, treat and attempt to unravel HIV infection. "Patients I followed 25 years ago would die within months of getting seriously ill. Now I'm following patients for 10, 15 years. They're doing just fine. The triumph has been great."

Entire new classes of drugs promise to keep the triumphs coming, particularly for patients who are developing resistance to the various combinations of existing drugs. To the outsider they sound baffling, but these classes -- integrase inhibitors, fusion inhibitors, CCR5 antagonists and maturation inhibitors -- promise to bring the biggest improvement in HIV treatment since the discovery in the mid-1990s that combined drug treatment, called Highly Active Anti-Retroviral Therapy (HAART), greatly improved viral suppression.

To get a feel for what such drugs are and do, it's necessary to understand why HIV is such a knotty scientific problem. Firstly, as Fauci explains, it attacks the immune system: "Virtually all of the viruses that have been scourges of mankind -- or even viruses that have been trivial -- are viruses that come in and affect the lung, or the skin, or the brain, or the gastrointestinal tract and the immune system is intact and is able to fight the particular virus," he says.

Not so HIV. It targets the immune system itself, perversely destroying the very mechanism the body entrusts with its own defence. Moreover, it's a retrovirus, a virus that has the ability to insert itself directly into its victim's genetic material. It can hide out there. HIV also replicates quickly. That quick turnover enables the virus to mutate, to change its appearance so fast that even when it does stick its viral head over the parapet, the immune system cannot effectively respond. It's a triple whammy. HIV infects the immune system. It's a retrovirus. It mutates rapidly. "You put those three things together and you have a real problem," Fauci concludes.

Still, researchers did target the culprit and have built weapons to fight it. The first anti-HIV drug, AZT, was licensed in 1987, and works by inhibiting the HIV enzyme reverse transcriptase which the virus uses to convert its single strand of RNA into double-stranded DNA, a necessary first step prior to splicing itself into the host cell's genome.

AZT was hailed as a wonder drug, but the euphoria soon faded when it became apparent that HIV's high rate of mutation quickly allowed resistance to the drug to develop. Later, other "anti-retroviral" drugs were developed, and these are generally now combined into triple or even quadruple drug cocktails to prevent drug resistance developing. Among the most successful antiretrovirals now are Lamivudine, Viread and Ziagen.

US infectious diseases specialist Joseph Eron says the most exciting prospects among the new drugs about to become available are integrase inhibitors. These work by blocking another enzyme, integrase, which HIV uses to insert its genetic material into the host cell's DNA. Two such drugs are in development and one, raltegravir, is already available on a trial basis in Australia.

More are on the way. Last week several biotech companies reported on laboratory, or early trials of even newer drugs. "There is now an opportunity for even our most treatment-experienced (resistant) patients to get their viral load (down) to undetectable levels," claims Eron, from the University of North Carolina. He predicts some of these drugs will be options for first-line therapy.

Southern California-based molecular biologist John Rossi goes further. Last week his group at the City of Hope Beckman Research Institute began the first of two trials of a treatment combining genetically engineered HIV with the healing power of blood stem cells.

So far, the method involves removing HIV-infected stem cells from a patient's bone marrow, growing new versions tweaked to fight HIV, and then returning the rejigged cells to the patient. "As long as these cells persist in the patient we will have resistance to HIV infection, with the goal that there would be reduced viral load," said Rossi, who believes the treatment could eventually be given as a shot or pill and combined with conventional treatment.Meanwhile, scientists such as Perth-based Simon Mallal are giving older drugs a new lease on life. On Wednesday he announced that by using high-tech DNA screening techniques, he and his colleagues at the new $20 million Institute for Immunology and Infectious Diseases, to be built at Murdoch University, have developed and trialled a test to determine if a patient will develop life-threatening reactions to abacavir, a drug sold under the brand name Ziagen, and as combination pills that combine it with AZT or other drugs (one such combination pill being Trizivir). "We've entered the era of personalised medicine," says Mallal.

As Fauci's long-lived patients attest, all these advances in HIV research are working. In fact, treatment is so successful that at the conference British expert Brian Gazzard raised a new conundrum facing HIV clinicians: geriatric AIDS.

According to Gazzard, chairman of the British HIV Association, it's becoming clear that HIV infection increases the risk of suffering any of the "geriatric giants": heart disease, dementia and cancers. What's more, increasing numbers of people are becoming infected with HIV later in life.

Research has also revealed that HIV infection is the cause of serious organ damage that, until now, was blamed on the toxic effect of anti-retroviral cocktails. The finding has triggered a scientific rethink of when HIV people should begin drug therapy.

Usually, patients don't start therapy until the level in their blood of a type of immune cell called CD4 cells drops below a certain point. Fauci says experts now want to conduct trials to test the emerging notion that earlier treatment is better. He also wants more data on another treatment question: to treat or not to treat. "I've been convinced as the years go by that you many not necessarily treat someone who has a trivial level of virus and whose CD4 count is really very good," he observes. After all, a "trivial" level of HIV is the goal of researchers struggling to design a vaccine against HIV. A vaccine, says John Kaldor, is the holy grail of HIV prevention. "From the very early days of HIV we've been hunting for a vaccine," he says. "But a vaccine is considered a huge (scientific) problem and will be one for a long time."

Source

****************

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.

*********************

POT ROTS YOUR BRAIN

Reading the report below in conjunction with various previous reports (e.g. here and here) does lead to the view that cannabis can do serious harm. That is no reason for banning it, though. Alcohol and motorcars do serious harm too. It is more an argument for legalizing it so that any problems can be better dealt with

Cannabis users are 40 per cent more likely to develop a psychotic illness than non-users, a study has found. Heavy users are more than twice as likely to suffer mental illness, according to a group of British academics, who calculate that about one in seven cases of conditions such as schizophrenia is caused by cannabis.

The warnings come as the Prime Minister and the Home Secretary signalled that the "softly softly" era for cannabis may be coming to an end. Gordon Brown said last week that the Home Office would be consulting on whether it had been right to downgrade cannabis from a Class B to a Class C drug in 2004. Jacqui Smith, the Home Secretary, is to ask the Advisory Council on the Misuse of Drugs to review the evidence.

The paper, published in The Lancet, is written by a group of seven psychiatrists and psychologists from Bristol, Cardiff, London and Cambridge. They have pooled the findings from 35 studies in a number of countries, including the United States, Germany, the Netherlands, Sweden and Britain, and concluded that there is "a consistent association between cannabis use and psychotic symptoms, including disabling psychotic disorders".

They admit that they cannot be certain that the association means that there is a simple cause and effect, but say that policymakers "need to provide the public with advice about this widely used drug". They go on: "We believe there is now enough evidence to inform people that using cannabis could increase their risk of developing a psychotic illness later in life."

As well as looking at psychotic illness, they looked for evidence that cannabis could cause affective disorders such as depression, anxiety and suicidal thoughts. Almost all the studies point towards an increased incidence of such disorders. The evidence is less strong, the writers say, but is still of concern.

The study was welcomed by many experts, but others counselled caution. Leslie Iverson, of the University of Oxford, a member of the advisory council, said: "Despite a thorough review the authors admit that there is no conclusive evidence that cannabis use causes psychotic illness. Their prediction that 14 per cent of psychotic outcomes in young adults in the UK may be due to cannabis use is not supported by the fact that the incidence of schizophrenia has not shown any significant change in the past 30 years."

But Robin Murray, of the Institute of Psychiatry at King's College London, called it "a very competent and conservative assessment of what research studies tell us about the relationship between cannabis and psychiatric disorders". He said that the risk could be even higher then the authors had estimated, because the cannabis available today was stronger than in the past. "This report cannot tell us whether the risk is higher with the use of the skunk-like preparations which are now widely available, and which contain a higher percentage of tetrahydrocannabinol," he said. "My own experience suggests to me that the risk with skunk is higher. Therefore, their estimate that 14 per cent of cases of schizophrenia in the UK are due to cannabis is now probably an understatement."

Martin Barnes, chief executive of Drugscope and also a member of the council, said: "Cannabis is not harmless, and although it has been known for some time that the drug can worsen existing mental health problems, it may also trigger the onset of problems in some people." "The challenge is to ensure that information on cannabis use and the associated risks is understood by teachers and health professionals working with young people and conveyed in ways that young people will listen to. Since reclassification, cannabis use has continued to fall. We need to make sure this trend continues."

Marjorie Wallace, chief executive of the mental health charity SANE, said: "The Lancet report justifies SANE's campaign that downgrading a substance with such known dangers masked the mounting evidence of direct links between the use of cannabis and later psychotic illness. The debate about classification should not founder on statistics but take into account the potential damage to hundreds of people who without cannabis would not develop mental illness. "While the majority can take the drug with no mind-altering effects, it is estimated that 10 per cent are at risk. You only need to see one person whose mind has been altered and life irreparably damaged, or talk to their family, to realise that the headlines are not scaremongering but reflect a daily, and preventable, tragedy."

Martin Blakeborough, director of the Kaleidescope Project and a member of the council, said that it would be a waste of public money for the same panel, with the same evidence, to review the issue again. "There is significant danger in reviewing cannabis again, as it takes experts' minds off more important issues. Classification itself, although important, is not as urgent as the increasing epidemic of hepatitis B and C among drug users and the wider community, or the increase of stimulant drugs in our community."

Source






Diabetes drug bad for hearts?

The risk sounds small when you look at the alternatives. There is a more extensive report here that sets out the rather odd findings and says that the results of the study are inconclusive

Drugs prescribed to 100,000 patients in Britain to treat diabetes double the risk of heart failure, a study has suggested. The finding is a blow to GlaxoSmithKline, whose drug Avandia is one of the drugs involved. The new analysis, which pools data from 78,000 patients, finds that one in fifty patients treated with either Avandia or a similar drug, Actos, for two and a half years would be admitted to hospital with heart failure.

The two drugs reviewed in the new analysis in Diabetes Care are prescribed to millions of patients to treat type 2 diabetes. They are approved by the National Institute for Health and Clinical Excellence (NICE) for use on the NHS. The drugs already carry a warning that they are not suitable for patients suffering from, or at risk of, heart failure. But the new study suggests an increased risk even for those who have never suffered the condition. Two advisory panels for the US Food and Drug Administration are now reexamining both drugs.

A study in The New England Journal of Medicine in May linked Avandia to a 43 per cent increased risk of heart attacks. The European Medicines Agency (EMEA) said that its Committee for Medicinal Products for Human Use (CHMP) is carrying out a reevaluation of both drugs. The new research was carried out at the University of East Anglia (UEA) and Wake Forest University in North Carolina, in the US. It was led by Yoon Loke, a clinical pharmacologist at UEA. The experts suspect that the drugs cause fluid retention, which could trigger heart failure.

Alastair Benbow, the European medical director of GlaxoSmithKline, said: "Long-term studies have not shown an overall increase in heart deaths between patients taking Avandia and other diabetes drugs. "Heart failure can be well managed by using diuretics, and we have to remember that type 2 diabetes itself has devastating consequences, including stroke, blindness, amputation and kidney failure."

Source

****************

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.

*********************

Food faddists damage kids' TV

Children are losing high-quality television programmes that reflect their lives because of underfunding and the pursuit of ratings, campaigners say. Floella Benjamin, the former Play School presenter who led the campaign to create a children’s minister, said it was shameful that so little home-grown television was now made as channels increasingly relied on cheap imports. She told the Social Market Foundation in London that more government funding and legislation was urgently needed. Incentives were vital to help not-for-profit organisations to produce high-quality public service shows for children. Doing so, she said, would prove that the Government was serious about its policy of every “child matters”.

The ban on advertising food high in fat, sugar and salt has cut the advertising income generated from children’s programmes by £30 million, a third of the total. ITV responded by scrapping new commissions and long-running hits, including My Parents Are Aliens, pictured right. Drama repeats have replaced children’s programmes on ITV1 at teatime as the channel competes for ratings with Channel 4.

Laurence Bowen, producer of My Life as a Popat, pictured left, the award-winning ITV children’s comedy about an larger-than-life Indian family living in West London, said that the popular series ended because of budget considerations.“Without a broadcasting Bill that can give Ofcom the teeth to really insist that ITV does children’s programmes, and without any other government legislation to follow that, it’s dead.”

Professor Jackie Marsh, of Sheffield University, said her research suggested that television played an important role in a child’s cognitive, linguistic, emotional and social development. The Government needed to encourage broadcasters to make programmes that reflected the daily lives, cultures and concerns of young people. “Not to do so would deny children their rights to a rich and varied diet of cultural activities.”

Source





Switching off genes fights HIV without drugs

THE newest generation of HIV drugs are so potent they can almost eradicate the virus in those who are infected, scientists say. AIDS researchers have outlined the latest cutting edge treatments, including a new class that appears to dramatically limit the effects of the disease. Also showing promise is an experimental therapy in which HIV genes in infected cells are "switched off", effectively allowing sufferers to control their condition without drugs.

An American HIV specialist Dr Joseph Eron told the International AIDS Society conference in Sydney there were more than 20 antiretroviral treatments on the market, but most excitement was being generated by a new class of drugs called integrase inhibitors. These drugs work differently in that they block the HIV virus from infecting new cells. Two drugs are being developed with one, Raltegravir, already available for trials in Australia. Data presented at the congress shows the medication, to be put forward for licensing in the US in September, is more potent than its predecessors and has fewer side effects.

Used in combination with a cocktail of the best drugs available, it was found to be far superior for treating HIV in people who have become resistant to other medications. "There is now an opportunity for even our most treatment-experienced patients to become fully suppressed, to get their viral load to these undetectable levels," said Dr Eron.

Geneticists, too, have come up with new ways to fight the disease. HIV gets into human genes and damages the cells by producing more HIV. A molecular biologist, John Rossi, and colleagues at the City of Hope Beckman Research Institute in California have worked out how to turn off this HIV gene, potentially allowing the disease to be controlled for long periods without drugs.

Professor David Cooper, director of Australia's National Centre for HIV Epidemiology and Clinical Research, said drug and genetic developments had put eradication in the spotlight. "These new drugs, new strategies mean we are talking about eradication . and that's very exciting."

Source

****************

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.

*********************

"Obesity" found to spread socially

There's an element of naivety in the report below. They have certainly rediscovered the old truth that like flocks with like but to say that somebody else CAUSES you to be overweight is hyperbole. As is usual in politically correct research, they have ignored the role of social class. Working class people tend to be fatter and tend to live in their own localities. That alone may well explain most of the results

Are your friends making you fat? Or keeping you slim? The answer may be yes, to both. Obesity spreads among friends and family members in a sort of social contagion, a study has found. So your chances of becoming obese may almost triple if a close friend is that way.

Part of the reason seems to be that each person influences the "social norm" for his or her circle, researchers theorized. That is, "people come to think that it is okay to be bigger since those around them are bigger," said Nicholas Christakis of Harvard Medical School in Boston, one of the study's authors. "Consciously or unconsciously, people look to others when they are deciding how much to eat, how much to exercise and how much weight is too much," added coauthor James Fowler of the University of California San Diego.

Surprisingly, the influence seems stronger among friends than among family members, the researchers added. The study appears in the July 26 issue of the New England Journal of Medicine.

Fowler and Christakis scoured data covering 32 years for over 12,000 adults who underwent repeated medical tests as part of the Framingham Heart Study, a longterm project administered by the U.S. National Heart, Lung and Blood Institute. Archived records from this study reveal not only family members of the participants, but also friends, whose names they wrote down so that researchers could find them if they moved.

Fowler and Christakis used this data for a new purpose: drawing up a giant map of the participants' social networks. The map also includes information on the participants' bodymass index, a commonly accepted measure of body fat. Among the first things the researchers noticed was that -- consistent with other studies finding an obesity epidemic in the U.S.the whole network grew heavier over time.

Also obvious were distinct clusters of thin and heavy individuals, Fowler and Christakis said. Statistical analysis found that these clusters couldn't be attributed only to people making friends with others of comparable weight: rather, they gain or lose weight under friends' influences.

There's "a direct, causal relationship," said Christakis. "It's not that obese or non-obese people simply find other similar people to hang out with." Nor could the effect be chalked up only to similarities in lifestyle and environment, such as people eating the same foods or living in the same area, the researchers added. "Your friend who's 500 miles away has just as much impact on your obesity as [one] next door," said Fowler, a political scientist and expert in social networks.

If a person that a participant listed as a friend was obese, the researchers found, the participant's own chances of becoming obese rose 57 percent. If two people listed each other as friends, the effect multiplied in strength: increase in obesity risk shot up 171 percent. Among siblings, they found, if one becomes obese, the likelihood for the other to do so rises 40 percent; among spouses, 37 percent. No effect was found among neighbors, unless they were friends too.

Fowler and Christakis said they believe people affect not only each other's behaviors but also, more subtly, social norms. They came to this conclusion partly because the study also identified a larger effect among people of the same sex.

The study suggests that in addition to looking for genes and physical processes behind obesity, researchers "should spend time looking at the social side," said Fowler. There are profound policy implications, he added. The social effects extend three degrees of separation -- to your friends' friends' friends -- [indicative of a social class effect] so "when we help one person lose weight, we're not just helping one person, we're helping many," he said. "That needs to be taken into account by policy analysts and also by politicians who are trying to decide what the best measures are for making society healthier."

But "It's important to remember," Fowler said, "that we've not only shown that obesity is contagious but that thinness is contagious."

Source





Britain: Radiation phobics exposed as nutters

People who believe that mobile telephone masts are causing them to feel unwell are deluding themselves, according to a study at Essex University. The three-year study, one of the largest of its kind, found that such people do experience symptoms when they know that they are exposed to radio waves, but they cannot detect when the waves are turned on and off, disproving their belief that they are “radiosensitive”. In double-blind trials -- in which neither participants nor experimenters knew whether the signals were on or off -- no health effects were detected. The finding adds to earlier research suggesting that radiosensitivity is an illusion.

Professor Elaine Fox said that radiosensitivity complainants had genuine symptoms, but phone masts were not the cause. In the past, she said, similar symptoms were reported in relation to TV sets and microwave ovens. It appears that about 4 per cent of the population claim to experience symptoms and tend to project them on to new technologies. The project was designed to investigate whether the effect was caused by phone masts.

Volunteers who claimed to be radiosensitive were matched against those who did not. Both groups were told when the signals were being switched on and off. The radiosensitive group reported headaches and malaise, but the team concluded that the symptoms were triggered by the knowledge of exposure. The researchers then conducted the double-blind trials. If radiosensitivity were a real phenomenon, alleged sufferers should have been able to detect changes and report symptoms. They did not.

Two of the 44 sensitive individuals, and 5 of the 114 controls, judged correctly when the mast was on or off in all six 50-minute tests -- exactly the proportion expected by chance. Professor Fox said: “Belief is very powerful. There are real, clinical effects.” David Coggon, of the University of Southampton, said: “This is consistent with earlier research in suggesting that symptoms of electrosensitivity are psychological in origin.” The study was funded by the Mobile Telecommunications and Health Research programme, with half of the money provided by Government and half by the mobile phone industry.

Source

****************

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.

*********************

Cancer risk: Will the statin fad now come to an end?

The British government recently decided that statins should be given even to healthy people if their serum cholesterol is high. Will they now back down? One hopes that they will. Amusing that the report below says that the cancer risk is low so don't worry. Similar risks elsewhere -- e.g. with HRT -- have led to loud cries for the medication concerned to be withdrawn from use. So we have another example of a "scientific" recommendation that is agenda-driven rather than fact driven. As it happens, the recommendation attached to this research is right. It is just a pity that similar recommendations are not routinely offered for low probability risks. They often are not. Note however that there are substantial other reasons not to take statins: Muscle-wasting anybody?

Lowering cholesterol with statins may slightly increase the risk of cancer, a study suggests. It is not clear whether the cancer cases are caused by the drugs, or are a consequence of the low levels of "bad" LDL cholesterol produced by taking them. The result, which amounts to one extra case of cancer for every 1,000 patients treated, surprised the researchers who discovered it. They were looking for new evidence on the known side-effects of statins on the liver and muscle wasting.

"This analysis doesn't implicate the statin in increasing the risk of cancer," said the study leader, Professor Richard Karas, of Tufts University School of Medicine, in Boston. "The demonstrated benefits of statins in lowering the risk of heart disease remain clear. However, certain aspects of lowering LDL with statins remain controversial and merit further research." The team reviewed the results of 13 previous trials, involving more than 41,000 patients and all published before November 2005. They detected higher rates of cancer among the patients whose use of statins achieved the lowest levels of LDL cholesterol.

This may be important because recent statin trials have shown that a more aggressive lowering of LDL produces greater benefits to the heart. There are moves to lower the cholesterol targets aimed at by GPs, on the assumption that doing so will do no harm. But there have been suggestions that there may be a greater risk of side-effects if a more aggressive statin treatment is used.

The researchers, who published their findings in the Journal of the American College of Cardiology, found that the degree of damage to the liver increased with greater statin doses, but that there was no such effect in muscle wastage. They said the best strategy may be to combine statins at moderate doses with other drugs.

As for cancer, conclusions are difficult to draw. No single form of cancer predominated, so if there is a side-effect of having a very low level of LDL, it would have to apply to all types of cancer. And previous statin trials have not shown any direct effect on cancer risk. But those trials did not compare cancer risk with the degree of lowering of LDL cholesterol.

John LaRosa, of the State University of New York, cast doubt on the findings. If they were caused by a lowering of cholesterol, the effect must have been very rapid, as the trials lasted five years or less. Other explanations, he said, were chance, or simply that people who would otherwise have died of heart disease were living longer, and dying of cancer.

June Davison, cardiac nurse for the British Heart Foundation, said: "We have known about the association between low cholesterol levels and cancer for some time now. While this [research] highlights an association between low levels of LDL and cancer, this is not the same as saying that low LDL or statin use increases the risk of cancer. There is overwhelming evidence that lowering LDL cholesterol through statins saves lives by preventing heart attacks and strokes. These findings do not change the message that the benefits of taking statins greatly outweigh any potential risks. People should not stop taking statin treatment on the basis of this research."

Source






Hope for new drug to control Alzheimer's

SCIENTISTS have developed a chemical compound hailed as the "holy grail" of Alzheimer's research that could stop the disease and enable sufferers to improve memory and learning ability. The man-made chemical created by Scottish researchers was able to prevent the death of brain cells and slow the progression of the disease in rats. It is hoped it will lead to drugs, particularly for early stage Alzheimer's and dementia.

Researchers at the University of St Andrews and scientists in America succeed in blocking the build-up of a toxic protein called amyloid in nerve cells, which kills the cells and collects in clumps called senile plaques. "We have shown that it is possible to reverse some of the signs associated with Alzheimer's disease," said lead researcher Frank Gunn-Moore.

Source

****************

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.

*********************

An ethical and legal minefield for an ambulance service

Adrenalin (epinephrine) does appear to revive people so one can only speculate that this is some sort of bureaucratic quantification exercise

Heart-attack patients will be used as guinea pigs in a controversial medical trial proposed by the Queensland Ambulance Service. Paramedics attending to cardiac arrest cases will inject either a life-saving drug - adrenalin - or a placebo into the patient. Neither paramedic nor patient will know -- only the trial operators.

Adrenalin is used to make the heart beat if it has stopped. A placebo such as a saline solution, will produce no response in a patient suffering a heart attack. Medical experts said the idea of the trial was to evaluate the value of adrenalin in a cardiac arrests and potential side-effects, and was vital to achieving advances in medicine.

But it has been slammed by frontline ambulance officers. "Let's keep these trials out of the ambulance service and get back to concentrating on the basics such as adequate staffing levels and better response times," one paramedic said.

The University of Western Australia recently started a trial to "determine the efficiency of adrenalin on the survival of patients suffering cardiac arrest". The three-year-study was being funded by the National Health and Medical Research Council.

A spokeswoman for Queensland Ambulance Commissioner Jim Higgins confirmed interest here in the trial of adrenalin. The QAS has sought medical ethics approaal from Queensland Health to participate in this trial" she said. "It is not happening here yet. We don't have a timeframe for Queensland." The spokeswoman declined to elaborate further on QAS plans for the trial.

But one senior paramedic expressed outrage yesterday. "I don't think these trials have any place in an emergency pre-hospital setting," he said. "The patient would have no say in participating in such a trial - they are, after all, in cardiac arrest - and you have to ask yourself, `Would this be acceptable for a member of my family in cardiac arrest?' "The answer of course would be No. "I wonder how the Premier, Emergency Services Minister or Commissioner would react if a loved member of their family had a cardiac arrest and a paramedic turned up and started injecting something other than adrenalin, "This is inappropriate use of the ambulance service." The paramedic said that if the trial went ahead, some patients would be injected with a placebo that would not save their lives. "And the QAS would have sanctioned this in the name of a clinical trial," he said.

Details of the trial came to light after a Sunday Mail report last week- and revealed concerns by ambulance officers about a mix-up of drugs. Adrenalin had been "potentially" incorrectly labelled as pethidine or mixed with pethidine. The drugs have the opposite effect. Pharmaceutical supply giant Astra-Zeneca issued a nationwide recall last month, admitting "there is a risk to patient safety through administering an incorrect product". A batch of 75,000 ampoules of adrenalin imported from Britain was under question. One "rogue" ampoule was found at a hospital in NSW, which prompted the recall.

Queensland paramedics said the deaths of two patients - who were supposedly given adrenalin but did not respond - should be investigated. Queensland's Health Quality and Complaints Commission said it would look into the allegations. AstraZenaca's market access director Liz Chatwin said no other wrongly labelled ampoules had been found last week. Testing on the rogue ampoule had yet to be done by the Therapeutic Goods Administration.

The above article by Darrell Giles appeared in the Brisbane "Sunday Mail" on July 22, 2007





Dubious logic behind the proposed British "Fat tax"

Britain is in the midst of an epidemic of chronic ill-health and obesity. Something Must Be Done. Already, the school canteen has been the battleground for Jamie’s jihad on junk. Everything on the supermarket shelf must be labelled for calories, fat, salt and sugar so we can make ‘informed choices’. (And heaven help us if we make the wrong choices, because the National Health Service won’t.) And now the idea of making the ‘wrong’ foods more expensive - the so-called ‘fat tax’ - has been revived as a way of saving us from ourselves.

And yet, critics of the fat tax have generally failed to make the most important point about this latest wheeze: regardless of whether a ‘fat tax’ would have the desired effect of making some people eat healthier, we simply should not allow the government to micro-manage our lives in this way. We should tell the food- and fat-obsessed authorities to get stuffed.

Researchers from Oxford and Nottingham, writing in the latest issue of the Journal of Epidemiology and Community Health, looked into the possible effect of applying value added tax (VAT) to some items of food that are currently not subject to this tax (1). Using an economic model (actually an Excel spreadsheet), the researchers tested the effect of adding VAT to the main sources of saturated fat in our diets, like whole milk, butter, cakes and pastries, and cheese. They then went further and applied a scale of how ‘unhealthy’ a range of foods were, experimenting with their data to find out what would be the best way of applying the tax to decrease cholesterol levels and lower salt and sugar intake amongst the population. Based on various studies into cardiovascular disease in the past, they have concluded that an optimum application of VAT on fatty foodstuffs could avert ‘up to 3,200 cardiovascular deaths’ per year.

Their idea may have provided some food for thought - or fodder for phone-in shows at least - but the results of the report were not nearly as impressive as the news stories suggested. The researchers estimated that the total reduction in deaths from cardiovascular disease would be 1.7 per cent. Or, as the researchers themselves put it in their conclusions: ‘The potential changes in nutrition that would result from an extension of VAT to further categories of food would be modest.’

So modest, in fact, that the only sensible conclusion is not to bother with such a tax at all. The only reason that the researchers’ work generated such dramatic headline figures is that a large number of people die from cardiovascular disease in the UK. If you multiply this death toll by the tiny percentage the researchers found, you get quite an impressively high number of lives allegedly ‘saved’ by the tax. The problem is that in terms of any individual‘s risk from disease or ill-health, a ‘fat tax’ will make as much difference as urinating in the ocean.

Actually, it’s worse than that. The researchers treat the results of epidemiological studies as if they produced accurate measurements of the effect of a risk factor. However, correlation does not equal causation. There are so many confounding factors and built-in inaccuracies in such studies that to treat the figures produced as anything more than very rough estimates is totally inappropriate. Even a broad conclusion that X causes Y should only be drawn if the correlation is strong, consistent and biologically plausible (see An epidemic of epidemiology, by Rob Lyons).

The trouble is that when there have been big studies on the effect of changing diets, the results have been extremely disappointing. To give a recent example: in February 2006, a massive American study found that those put on a low-fat diet had the same death rates as those who ate what they pleased. As the lead researcher, Barbara V Howard, told the New York Times: ‘We are not going to reverse any of the chronic diseases in this country by changing the composition of the diet.’

The authors of the ‘fat tax’ report also make assumptions about how people might react to such a tax. They don’t believe that everyone will start eating salad and oily fish every day just because their usual fare is slightly more expensive. But they do believe that some people will change their behaviour a bit, enough to have an effect on disease rates. But what if they overestimate people’s sensitivity to such things? Perhaps people will react in unexpected ways: there’s evidence that many people react to such taxes by cutting down on ‘healthy’ food rather than junk, in order to balance their budgets. The results of a simple model of economic behaviour and the behaviour of people in the real world are two very different things.

So, it is far from clear that a ‘fat tax’ would work at all (3). But is it even legitimate to try to tinker with our food choices in this way? Many people point to the apparently similar case of applying swingeing taxes to cigarettes and alcohol. Yet, ‘health’ is often the spurious justification for taxes which are really more about balancing government budgets than improving the nation’s health. And if such taxes really did work, surely we would all be non-smoking teetotallers by now?

Efficacy aside, should we really allow the government to determine, through fiscal nudges and prods, how we choose to conduct our private lives? Who are they to tell us whether we should eat broccoli or burgers, chickpeas or cheddar cheese? It’s one thing for your parents to nag you as a child to eat your greens; it’s quite another for the health authorities to nag us when we’ve reached adulthood, and in the process to infantilise us all. Maybe campaigners for liberty should recognise that defending freedom in the twenty-first century will involve standing up for the freedom to choose what passes our lips as well as traditional issues like free speech.

A more active defence of our personal autonomy is a pre-requisite for maintaining a healthy body politic. Instead of a fat tax, the best thing would be to give the meddling health fanatics a big fat finger.

Source

****************

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.

*********************

DOES QUININE PREVENT DIABETES?

It would be very encouraging to those who like a gin and tonic if so. "Tonic" is quinine water. From the research below, it seems that a quinine derivative is beneficial in some cases. Popular summary below followed by journal abstract. It must be noted that the population studied was NOT a general population sample -- so no generalization is possible without further research

Drugs that protect against malaria may also prevent diabetes in patients with rheumatoid arthritis, claims a study in the latest issue of the Journal of the American Medical Association. The anti-malarial drug hydroxychloroquine has long been a safe and inexpensive treatment for joint inflammation in rheumatoid arthritis. The study included 4905 adults with rheumatoid arthritis - 1808 had taken hydroxychloroquine and 3097 had never taken the drug. None of the patients showed any diabetes symptoms at the start of the study, and they were followed for an average of 21.5 years. During this time, diabetes was diagnosed in 54 patients who had taken hydroxychloroquine and in 171 patients who had never taken it. Those who had taken hydroxychloroquine for any length of time had a 38 per cent lower risk of developing diabetes compared with those who had not. Patients who took hydroxychloroquine for more than four years had a 77 per cent lower risk of diabetes compared with those who had never taken the drug.

Source

Abstract:

Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis

By Mary Chester M. Wasko et al.

Context: Hydroxychloroquine, a commonly used antirheumatic medication, has hypoglycemic effects and may reduce the risk of diabetes mellitus.

Objective: To determine the association between hydroxychloroquine use and the incidence of self-reported diabetes in a cohort of patients with rheumatoid arthritis.

Design, Setting, and Patients: A prospective, multicenter observational study of 4905 adults with rheumatoid arthritis (1808 had taken hydroxychloroquine and 3097 had never taken hydroxychloroquine) and no diagnosis or treatment for diabetes in outpatient university-based and community-based rheumatology practices with 21.5 years of follow-up (January 1983 through July 2004).

Main Outcome Measures: Diabetes by self-report of diagnosis or hypoglycemic medication use.

Results: During the observation period, incident diabetes was reported by 54 patients who had taken hydroxychloroquine and by 171 patients who had never taken hydroxychloroquine, with incidence rates of 5.2 per 1000 patient-years of observation compared with 8.9 per 1000 patient-years of observation, respectively (P < .001). In time-varying multivariable analysis with adjustments for possible confounding factors, the hazard ratio for incident diabetes among patients who had taken hydroxychloroquine was 0.62 (95% confidence interval, 0.42-0.92) compared with those who had not taken hydroxychloroquine. In Poisson regression, the risk of incident diabetes was significantly reduced with increased duration of hydroxychloroquine use (P < .001 for trend); among those taking hydroxychloroquine for more than 4 years (n = 384), the adjusted relative risk of developing diabetes was 0.23 (95% confidence interval, 0.11-0.50; P < .001), compared with those who had not taken hydroxychloroquine.

Conclusion: Among patients with rheumatoid arthritis, use of hydroxychloroquine is associated with a reduced risk of diabetes.

JAMA. 2007;298:187-193





DOES HRT ROT YOUR BRAIN?

There seems to be a determination to find something wrong with HRT but the scares about heart disease and cancer have proved poorly founded. So let's take a look at dementia. The study reported below is one of the "panic" studies but the key point to note, however, is the usual one in this field -- that only a tiny percentage (one fifth of one percent) of the HRT takers got Alzheimers. So even if the relationship is causative it is a very low risk as medical risks go -- rather less than the risk of getting a superbug infection in a British public hospital, for instance. Women who take some "herbal" remedies probably undertake much greater risks. It should also be noted that findings concerning women who go straight on to HRT after menopause and those who go on to it much later do seem to differ and it is the late adopters who are concerned below.

Hormone therapy doubled the risk of Alzheimer's disease and other types of dementia in women who began the treatment at age 65 or older, a large study has found. The finding disappointed many researchers and doctors, who had hoped for the opposite result: that hormone therapy would prevent Alzheimer's disease. "No one anticipated this outcome," said Dr. Marilyn Albert, a professor of neurology at Johns Hopkins, in a statement issued by the Alzheimer's Association.

The new report on dementia, being published today in The Journal of the American Medical Association, is one more piece of bad news about hormone therapy. Indeed, it is the latest in a string of studies showing that purported benefits do not exist and that the hormones actually raise the risk of several serious diseases, including some they were thought to prevent.

The latest finding is based on a four-year experiment involving 4,532 women at 39 medical centers. Half took placebos, and half took Prempro, a combination of estrogen and progestin, the most widely prescribed type of hormone therapy. In four years, there were 40 cases of dementia in the hormone group, and 21 in the placebo group. Translated to an annual rate for a larger population, the results mean that for every 10,000 women 65 and older who take hormones, there will be 45 cases of dementia a year, with 23 of them attributable to the hormones.

"The clear message is that there's no reason for older women to be taking combination hormone therapy," said Dr. Sally A. Shumaker, the director of the study and a professor of public health sciences at Wake Forest University, in Winston-Salem, N.C. Researchers said the risk to individual women was slight, and that even though the numbers worked out to a doubling of the risk, 23 cases for every 10,000 women should not be cause for alarm. "A small number doubled is still a small number," said Dr. Samuel E. Gandy, vice chairman of the medical and scientific advisory council of the Alzheimer's Association, and director of the Farber Institute of Neurosciences at Thomas Jefferson University in Philadelphia.

Still, Dr. Shumaker said, women 65 and older who are taking Prempro or other hormone combinations should discuss why they are taking the drugs with their doctors and decide whether to quit.

Because the women in the study were 65 or older, it is not known whether the findings apply to younger postmenopausal women. It is not known, either, whether the results apply to women who take other hormone combinations or estrogen alone. Women who take estrogen alone are being studied separately. Estrogen alone can cause cancer of the uterus and so is prescribed only for women who have had hysterectomies. But adding progestin protects the uterus, so women who have not had hysterectomies are given combination treatment.

The report on the study is accompanied in the journal by two other reports that also have unfavorable findings on combined hormone therapy and the brain. One study found that women on the drugs did not perform as well on cognitive tests as women on placebos; the other confirmed previous research showing that the combination therapy increased the risk of stroke.

About 2.7 million American women take combination hormone therapy, including 1.2 million who use Prempro. Wyeth said that the majority of users were 51 to 55 years old, and only 14 percent of all new prescriptions were for women 65 or older. The hormones were never approved to prevent or treat Alzheimer's disease. They are approved by the Food and Drug Administration for only two purposes: to treat menopausal symptoms like hot flashes, night sweats and vaginal irritation; and to prevent the bone-thinning disease osteoporosis. But because the hormones can slightly increase the risk of breast cancer, strokes and heart attacks, the agency recommends that women use the lowest dose for the shortest time possible, and that they consider other treatments to prevent osteoporosis.

Last July, a large federal study of the combination therapy was halted ahead of schedule because the drugs were found to cause a small but significant increase in the risk of invasive breast cancer. That study, the Women's Health Initiative, also found that hormones increased the risks of heart attack and stroke, which they were once thought to prevent. The drugs increased the odds of blood clots as well. The study, which included 16,000 women, was the first and the largest to compare women on hormones with a group taking placebos. Many women gave up hormone therapy after the study came out. Before it was published, about 6 million women were taking combination therapy.

After the disappointing findings, the last great hope for hormone therapy was that it might protect the brain and help prevent Alzheimer's disease. Some women, encouraged by their doctors, clung to that belief and continued taking the drugs despite the negative reports, figuring that the risks would be worthwhile if hormones could offer that protection from dementia. The dementia study is part of the Women's Health Initiative. Dr. Shumaker said it was the most comprehensive and rigorous study to investigate whether combination hormone therapy could prevent Alzheimer's. "Unfortunately, the risks outweigh the benefits," she said. [In her opinion]

The theory that estrogen might prevent Alzheimer's was based on earlier, survey-type studies suggesting that women on hormones had lower rates of dementia than women not on hormones. But those studies were not considered as reliable as the Women's Health Initiative, because they were smaller and did not contain control groups. Evidence also came from studies in test tubes and in laboratory animals showing that estrogen seemed almost to nourish the brain, making new connections sprout in areas that control learning and memory. The new study suggests that what goes on in the body is much more complicated than what happens in laboratory rats and test tubes. Even if hormones have some good effects on brain cells, Dr. Shumaker said, those benefits may be offset by harmful effects.

She said that it was not known how the combination therapy might increase the risk of dementia, but one possibility was that it increased the risk of blood clots and clogged tiny blood vessels in the brain, which might injure brain cells and contribute to Alzheimer's disease and a condition called vascular dementia.

Some researchers have suggested that hormone therapy may help protect the brain if women take it around the time of menopause, when natural hormone levels plummet, instead of waiting until age 65. They think there may be a "critical period" in which hormone therapy can protect brain cells from the sudden withdrawal of hormones and that once the period is over the damage is done and it is too late. But no one knows whether such a period exists, and no studies now under way will answer that question.

Dr. Gandy said that some of the most promising earlier results on hormone therapy and the brain came from studies of estrogen alone, and that the progestin in the combination pills might cancel out estrogen's good effects. He said that another part of the Women's Health Initiative, still in progress, was studying women who take estrogen alone. That study is scheduled to be completed in 2005. "That is the most likely place to show any benefit against Alzheimer's, if indeed one does exist," Dr. Gandy said.

Dr. Wolf Utian, executive director of the North American Menopause Society, agreed that benefits might come from estrogen alone, and suggested that research should be done to find out whether hormone regimens that use lower doses over all and give progestin only on some days of the month might have less of a negative effect than Prempro and other treatments that use progestin every day.

Source

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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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SMOKERS TEND TO BE DEPRESSED -- AND IT'S GENETIC

Popular summary below followed by abstract. Note that the genes predisposing to smoking also predispose to generally bad behaviour -- which helps to explain the long-known fact that smoking tends to be part of a syndrome of general social disadvantage: Smokers tend to be dumber, poorer etc. The present finding shows how broad that syndrome is

SMOKING and depression have a common genetic link, according to a new study in the journal Twin Research and Human Genetics. The study found that nicotine dependence and major depression are both associated with extreme rebellious behaviour during childhood and adolescence -- a condition known as "conduct disorder". In 1992, the research team conducted telephone interviews with 3360 pairs of male twins aged 35 to 53, who served in the military during the Vietnam War. Fifty-six per cent of the pairs were genetically identical twins, and 44 per cent were fraternal twins who shared half their genes. Answers from each twin were compared to estimate the genetic and environmental influences on nicotine addiction and major depression. Genes that increased a person's risk of developing nicotine addiction and major depression were also found in those with conduct disorder. The findings may also help to explain why smoking seems to run in some families, say the authors.

Source

Journal Abstract follows:

Common Genetic Risk of Major Depression and Nicotine Dependence: The Contribution of Antisocial Traits in a United States Veteran Male Twin Cohort

By Qiang Fu et al.

Many studies that found associations between depression and nicotine dependence have ignored possible shared genetic influences associated with antisocial traits. The present study examined the contribution of genetic and environmental effects associated with conduct disorder (CD) and antisocial personality disorder (ASPD) to the comorbidity of major depression (MD) and nicotine dependence (ND). A telephone diagnostic interview, the Diagnostic Interview Schedule-III-R, was administered to eligible twins from the Vietnam Era Twin (VET) Registry in 1992. Multivariate genetic models were fitted to 3360 middle-aged and predominantly white twin pairs (1868 monozygotic, 1492 dizygotic pairs) of which both members completed the pertinent diagnostic interview sections. Genetic influences on CD accounted for 100%, 68%, and 50% of the total genetic variance in risk for ASPD, MD and ND, respectively. After controlling for genetic influences on CD, the partial genetic correlation between MD and ND was no longer statistically significant. Nonshared environmental contributions to the comorbidity among these disorders were not significant. This study not only demonstrates that the comorbidity between ND and MD is influenced by common genetic risk factors, but also further suggests that the common genetic risk factors overlapped with those for antisocial traits such as CD and ASPD in men.

Twin Research and Human Genetics. Volume: 10, Issue: 3, June 2007, 470-478





SOME HOPE FOR CROHN'S DISEASE

Popular summary followed by journal abstract. The benefit conferred by the drug seems rather weak, sadly. Only a net 8% of patients showed some benefit from the drug after 6 weeks, rising to 10% after 26 weeks. Still no real light at the end of the tunnel

CROHN'S disease -- an inflammatory disorder of the gastrointestinal tract -- affects an estimated 28,000 Australians and has no known medical cure. But a study in the New England Journal of Medicine this week has found that a new drug called certolizumab pegol is an effective treatment for adults with the disease. The drug acts by blocking a protein called tumour necrosis factor (TNF), which is a major cause of gut inflammation. The study involved 662 patients with moderate to severe Crohn's disease, who were randomly assigned to receive certolizumab pegol or a placebo. After six weeks, 35 per cent of patients who received the drug showed improvement in their symptoms, while improvement was seen in 27 per cent of patients who received the placebo. The only side effect of certolizumab pegol was a small increase in the risk for serious infection, including one case of pulmonary tuberculosis.

Source


Abstract:

Certolizumab Pegol for the Treatment of Crohn's Disease

By: William J. Sandborn et al.

Methods: In a randomized, double-blind, placebo-controlled trial, we evaluated the efficacy of certolizumab pegol in 662 adults with moderate-to-severe Crohn's disease. Patients were stratified according to baseline levels of C-reactive protein (CRP) and were randomly assigned to receive either 400 mg of certolizumab pegol or placebo subcutaneously at weeks 0, 2, and 4 and then every 4 weeks. Primary end points were the induction of a response at week 6 and a response at both weeks 6 and 26.

Results: Among patients with a baseline CRP level of at least 10 mg per liter, 37% of patients in the certolizumab group had a response at week 6, as compared with 26% in the placebo group (P=0.04). At both weeks 6 and 26, the corresponding values were 22% and 12%, respectively (P=0.05). In the overall population, response rates at week 6 were 35% in the certolizumab group and 27% in the placebo group (P=0.02); at both weeks 6 and 26, the response rates were 23% and 16%, respectively (P=0.02). At weeks 6 and 26, the rates of remission in the two groups did not differ significantly (P=0.17).

Serious adverse events were reported in 10% of patients in the certolizumab group and 7% of those in the placebo group; serious infections were reported in 2% and less than 1%, respectively. In the certolizumab group, antibodies to the drug developed in 8% of patients, and antinuclear antibodies developed in 2%.

Conclusions: In patients with moderate-to-severe Crohn's disease, induction and maintenance therapy with certolizumab pegol was associated with a modest improvement in response rates, as compared with placebo, but with no significant improvement in remission rates.

NEJM Volume 357:228-238; July, 2007

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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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