Wednesday, April 30, 2008

The packed-lunch police

How four British schools are waging war on home-produced forbidden food

Hmm, what's it to be? A lentil korma with brown rice and salad, then fruit and a yoghurt for afters, or a High School Musical bag stuffed with crisps and a couple of bars of chocolate? It sounds absurd but in some schools children sitting next to eat other could be eating such contrasting lunches.

While school dinners have come on nutritionally in leaps and bounds, and thanks to more money for ingredients and training for the dinner ladies, they taste a whole lot better too, there's nothing to stop pupils in many schools bringing in junk from home. A survey last year lifted the lid on lunchboxes to reveal the unappetising truth: what's inside them contains too much saturated fat and up to half the daily allowance of of salt. [Kids under 7 should have no more than 3g of salt a day.] Salads are scarce and only half the children brought in a portion of fruit and vegetables.

Children who aren't eating school dinners are losing out - that's about 60 per cent of primary school kids. And this is why, as part of the Government's attempt to tackle obesity, Alan Johnson, the Health Minister, has suggested that schools should check lunchbox contents.

The School Food Trust, the body set up by the Government to turn round school dinners, suggest drawing up a policy for packed lunches - a few basic rules to bring them in line with a healthier school environment - and make sticking to it part of a code that parents have to agree to. Others say it is impossible for schools to police what children bring in to eat. Margaret Morrissey, of the National Confederation of Parent Teacher Associations, says: "Many parents in this country will feel that it is their decision what they feed their children."

Joe Harvey, of the Health Education Trust, a charity involved in the Better School Food campaign, agrees. "You can't search kids for Kit Kats," he says. So what can schools do about it? "There has to be a process of education and consultation or they'll get the burgers-through-the-fence brigade. It should be part of a whole school food policy." He advises schools to build food rules into any contract the school makes with new parents; do everything possible to make sure children know what's going on in the school kitchen; and make the meal service as attractive as possible.

More here

Britain: The free market beats the tyrants -- as ever

The tyrants call it a "black market" but it is their arrogance and ignorance that is black

Students are operating a black-market trade in food banned in schools, including burgers and chocolate, in a backlash against healthier canteen menus such as those espoused by the celebrity chef Jamie Oliver. Newly installed healthy menus in school canteens and the removal of junk food from vending machines have created a gap in the market that students have been quick to fill. Some of the most sophisticated operations are taking place at business and enterprise schools.

The move to healthier meals in schools was prompted by Oliver's crusade in 2005 against Turkey Twizzlers and other unhealthy foods. The following year the Government published a report setting definitive nutritional standards for school lunches. One young smuggling mastermind, when finally caught, said to his school's headmaster unapologetically: "But we were only doing what you taught us in business studies, Sir."

After a tip from a head teacher at a Dorset secondary who broke up a "seriously big smuggling operation" run by a schoolboy, The Times has uncovered several similar contraband schemes. The head, who did not want to identify his school, was convinced that the switch to a healthy menu and the policy of keeping pupils on the premises at lunchtime had created an opening for entrepreneurs. He became suspicious when he noticed two 14-year-old boys approaching the school weighed down with Lidl carrier bags. "The thin wiry creatures, in full uniform but with shortened ties, shirts hanging out, were walking a heavily laden bicycle. The bags were dripping off the bike's handlebars, crossbars and saddle like a scene from some desperate endeavour on foot and mule to reach a lost city in the Peruvian mountains," he said.

A teacher nicknamed Columbo tracked down the boys and their illicit cargo: 60 cans of fizzy drinks and piles of milk chocolate. "We discovered they were just the buyers. Someone else had funded the purchase, a player who in turn was funded by unknowns, who were taking the lion's share. "Getting to the core of the operation was like peeling an onion, there appeared to be no centre," the head added. He suspects that similar operations are happening to a greater or lesser extent in most schools.

Sure enough, when The Times appealed to head teachers for similar tales, the response was rapid and clear. "It has happened to us. Kids with motorbikes buying McDonald's burgers in bulk and flogging them in the playground. We are a business and enterprise school in Essex so I guess I should not be surprised," one said. "When challenged, the boy at the centre said he was just being enterprising."

Another, this time from Wales, said: "The `McDonald's run', where sixth-formers with cars take orders for the lower school who are locked in at lunchtimes is one of the best bits of student enterprise I have seen for a long time."

It is not just business studies teachers who have been giving children ideas; it is also the parents. Two mothers from Rotherham gained publicity for feeding burgers to their children through the school railings after the introduction of a healthy new menu.

Brian Lightman, president of the Association of School and College Leaders and head teacher at St Cyres School in Penarth, Vale of Glamorgan, said that the healthy eating initiative would only succeed if students were allowed a say. "Because these changes have been imposed without allowing time for them to gain a sense of ownership, schools are reporting cases of students finding innovative ways around the new regulations," he said. Of course, if today's teenager crisp smugglers really want a good excuse when caught, they might be well advised to point to Jamie Oliver himself. As an enterprising 11-year-old he used to lease school-lockers from fellow pupils, from where he would sell sweets he had bought at the cash-and-carry. Alternatively, students could also point to the teachers who regularly sneak out at lunch time for burgers and chips, now that they are no longer on the menu.


PESKY! Food dyes protect against cancer

The hated food dyes, no less! (Only in fish, so far, though)

Synthetic food dyes - long blamed for causing hyperactivity in children - may have a good side: some of them may protect against cancer. Gayle Orner at Oregon State University in Corvallis added the carcinogens dibenzopyrene (DBP) or aflatoxin to the feed of trout for one month, with or without the food dyes Red 40 - one of six recently linked to hyperactivity in children - or Blue 2.

Nine months later, trout that had been fed either of the dyes in combination with aflatoxin had 50 per cent fewer liver tumours, compared with those that had been exposed to aflatoxin alone. Trout that had been fed DBP in combination with Red 40 had a 50 per cent lower incidence of stomach cancer and a 40 per cent lower incidence of liver cancer.

"The public perception is that food dyes are bad, but some of them may have good points as well," says Orner, who presented her results at the American Association for Cancer Research in San Diego, California, last week.

While the amounts of dye eaten by the fish could be matched by eating a lot of sweets and soft drinks, Orner advises against this strategy. Instead, she says the next step is to understand the mechanism by which these food dyes exert their anti-cancer effect.


Tuesday, April 29, 2008

Blood transfusions found to harm some patients

The article below from New Scientist is just a preview of the full article. The full article has however already been put online by someone. See here and here. For ease of reading, click "Full size"

"For the life of the flesh is in the blood. No soul of you shall eat blood." So says the Bible's book of Leviticus, and it is for this reason that Jehovah's Witnesses shun blood transfusions. They do not, however, shun surgery. As long as surgeons use special techniques, Jehovah's Witnesses can have surgery - including operations with the greatest potential for blood loss, such as open-heart surgery - without ever receiving a drop of someone else's blood.

Now some surgeons and anaesthetists are questioning whether every patient shouldn't get the same treatment. Over the past decade a number of studies have found that, far from saving lives, blood transfusions can actually harm many patients.

The problem is not the much-publicised risk of blood-borne infectious agents, such as HIV, but the blood itself. Study after study has shown that transfusions, particularly those containing red blood cells, are linked to higher ...

More on bisphenol battiness and corrupt official science

Wal-Mart announced last week that it would stop selling baby bottles made with the chemical bisphenol A, or BPA. In the past, I would have laid the blame for this junk science-fueled shame at the feet of anti-chemical environmental jihadists, their pseudo-scientist henchmen at universities and government regulatory agencies and Wal-Mart's knuckleheaded executives, who seem to be more interested in appeasing eco-pressure groups than reassuring consumers the products the retailer has sold for decades are safe.

But the banning of baby bottles made with BPA is so mind-bogglingly baseless that I just have to lay the blame where it truly belongs - with the lame-o chemical industry, which utterly failed to defend its product against activist claims and a regulatory process so specious it would cause voodoo practitioners to shudder.

First, there is no evidence anyone has ever been harmed by BPA in a consumer product, despite widespread use in baby and medical products and food and beverage containers; moreover, there's no reason to expect anyone ever would be harmed, as exposures to BPA from consumer products are 100 times lower than the "safe" level determined by government regulators.

If you think about it, products made with BPA are, in fact, safer than, say, Wal-Mart's peanut-containing products that can cause fatal allergic reactions in children. Yet peanut products remain on the shelves. So just how did BPA wind up becoming chemical non grata?

Early activist efforts against industrial chemicals in the environment (circa 1960-1990) largely were based on allegations that they were cancer-causing. But by the early-1990s it became clear that this was not so, particularly at exposure levels typically found in the environment. The activists then switched to claims that small exposures to certain chemicals - so-called "environmental estrogens" or "endocrine disrupters" - interfered with normal hormonal processes to cause a variety of adverse health effects ranging from attention deficit disorder to miscarriages to sterility.

This scare hit the mainstream media in 1996 with the publication of the alarmist book "Our Stolen Future: Are We Threatening Our Fertility, Intelligence and Survival? - A Scientific Detective Story." The book and scare quickly faded, however, as many scientists and the chemical industry responded strongly against the allegations, some of the scare's prominent proponents were found guilty of related scientific misconduct and a review panel of the National Academy of Sciences determined in 1999 there was no evidence to support alarm about so-called endocrine disrupters.

So endocrine disrupter theory advocates went back to the drawing board and came up with a successful strategy: If their claims didn't measure up to what generally was considered as science, then they would change how science was conducted. As reported in this column seven years ago, the National Toxicology Program, or NTP - a federal agency whose mission seems to be scaring the public about industrial chemicals and whose staff is closely tied to the anti-chemical movement - did the activists' dirty work by tossing out the toxicology rulebook in establishing two precedents key to the fate of BPA.

First, the NTP determined it no longer was necessary to show that the risk of health effects from a chemical increased with greater exposure. "The dose makes the poison" had been a fundamental principle of toxicology for hundreds of years. The NTP then also decided it no longer was necessary for scientists to submit reproducible study results; traditionally, before the results of a scientific experiment are accepted as valid, other scientists must be able to confirm the results by replicating them independently.

These changes finally paid off last week as the NTP issued a preliminary assessment of BPA driven by several non-reproducible experiments claiming to indicate that BPA is associated with adverse health effects in mice at doses far below the safe levels determined by traditional testing. "The scientific evidence that supports a conclusion of some concern for exposures in fetuses, infants and children comes from a number of laboratory animal studies reporting that 'low' level exposure to bisphenol A during development can cause changes in behavior and the brain, prostate gland, mammary gland, and the age at which females attain puberty," the NTP concluded.

Although the NTP also acknowledged that "these studies only provide limited evidence for adverse effects on development and more research is needed to better understand their implications for human health," the NTP's finding of "some concern" was enough to prompt Wal-Mart to take action against BPA-containing baby bottles.

So why blame the chemical industry for the nefarious doings of a rogue NTP-activist cabal? The industry had almost seven years to take political and legal action against a clearly corrupted government process. There is no evidence that the industry mounted any sort of vigorous public or behind-the-scenes defense of its product.

Worse, a terrible precedent has been set that will haunt the development and use of chemicals that improve the quality of our lives. While it is quite likely BPA can be replaced by some other chemical and sometimes it does make sense from a public relations perspective for an industry to "switch" rather than to "fight" over a particular chemical, BPA wasn't the only thing at stake. The use of science in the regulatory process also was on the line.

BPA-maker Dow Chemical says on its Web site that "we support the development of responsible, science-based laws, regulations, standards, practices and procedures that safeguard the community, workplace and environment." It's going to take more than Web site lip service to live up to that principle.



That the psychoses have a large hereditary component is known. But which genes are the problem ones?

Rare Structural Variants Disrupt Multiple Genes in Neurodevelopmental Pathways in Schizophrenia

By Tom Walsh et al.

Schizophrenia is a devastating neurodevelopmental disorder whose genetic influences remain elusive. We hypothesize that individually rare structural variants contribute to the illness. Microdeletions and microduplications >100 kilobases were identified by microarray comparative genomic hybridization of genomic DNA from 150 individuals with schizophrenia and 268 ancestry-matched controls. All variants were validated by high-resolution platforms. Novel deletions and duplications of genes were present in 5% of controls versus 15% of cases and 20% of young-onset cases, both highly significant differences. The association was independently replicated in patients with childhood-onset schizophrenia as compared with their parents. Mutations in cases disrupted genes disproportionately from signaling networks controlling neurodevelopment, including neuregulin and glutamate pathways. These results suggest that multiple, individually rare mutations altering genes in neurodevelopmental pathways contribute to schizophrenia.

Science 25 April 2008: Vol. 320. no. 5875, pp. 539 - 543

Monday, April 28, 2008

IVF: The speculation continues

There is no evidence of anything much below -- just some old scares long ago debunked plus old speculation about IVF bypassing processes that remove defective genes. The rate of babies being born with defects after IVF is however very low so there is no reasonable action that could be taken even if there is some truth in the speculations. The major cause of the high rate of infertility treatments is undoubtedly the tendency of women these days to defer childbearing to just about the last possible minute. The older the woman gets, the harder it is to conceive

AUSTRALIA is facing an infertility crisis as increasing numbers of infertile and "sub-fertile" couples are having children using IVF and other therapies. A Sunday Herald Sun investigation has revealed a 30 per cent rise in fertility therapies means infertile couples are passing on their defective genes and infertility is being embedded in the national DNA. Figures going back to 2006 show up to one in 20 babies in Victoria is conceived through IVF or with the help of fertility treatment.

A survey of Melbourne IVF clinics has found a boom in treatments in the past 12 months - a trend confirmed by the Infertility Treatment Authority. Experts believe the current figure may be as high as one in 15 and will increase. One in six Victorian couples suffers fertility problems.

A new international study has found sperm counts and birth rates are declining in developed countries, including Australia. Professors Jens Bonde, of Denmark's Aarhus University Hospital, and Jorn Olsen, of the University of California, say sperm counts and birth rates are declining in developed countries. The researchers say infertility now affects about 15 per cent of couples trying to conceive, though not all seek medical help.

Sub-fertility is the term given to couples who have lower than normal fertility but may still be able to conceive naturally. Infertile couples cannot conceive without medical help. The researchers raise the alarm about the possible effect of environmental pollution with gender-bending chemicals. They say that may explain the fertility problems.

Factors such as women choosing to delay motherhood because of careers and the desire for smaller families "may [or may not] mask more worrying biological changes in the population", the researchers say in this month's British Medical Journal. In particular, IVF and other techniques mean many sub-fertile couples who would have been forced to remain childless a generation ago can now have families. Technological advances can compensate for low sperm count and poor quality sperm.

In the past, a woman with normal fertility would have had little chance of becoming pregnant if her partner suffered from such severe sperm problems - most of which are linked to defective genes. But the scientists say these genes are perpetuated as a result of the success of IVF.

Monash IVF co-founder Gab Kovacs confirms the boom in fertility treatments while questioning the claims of an infertility crisis. He has had heard of the research, but says the effects would not be experienced for at least 30 years. "No one is sure about that yet, but I believe the effects would be insignificant because infertility problems are a mix of issues that are not just gene-related," he says.


Who Says You Need Eight Glasses a Day? The history of a debunked theory

A recent editorial (PDF) in the Journal of the American Society for Nephrology is getting wide press coverage for debunking the so-called "8x8" theory-the popularly held belief that drinking eight 8-ounce glasses of water daily helps remove toxins, improve skin tone, and increase satiety, among other health benefits. The authors chalk up the belief to folklore, and newspaper reports claim ignorance as to its provenance. Just how long has this idea been around?

Two-hundred years, at least. The most commonly cited source for the 8x8 myth-highlighted in this 2002 review paper by a Dartmouth professor-is the U.S. government-sponsored Food and Nutrition Board.* The board's "Recommended Dietary Allowances" from 1945 include the following advice:

A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods.

According to this theory, people ignored the last part of the statement, which points out that you can get most of that water just by eating. If you actually had to drink all 2.5 liters, you'd need around 10 8-ounce glasses per day. By 1959, the concept was so entrenched that Groucho Marx could joke about self-righteous centenarians who claim that they eat "raw turkey liver" for breakfast and drink "thirty-two glasses of water a day" instead of "eight glasses a day like the rest of us."

However, the Explainer has uncovered evidence of the 8x8 myth going all the way back to 1796, in a German text by Dr. Christoph Wilhelm Hufeland called Makrobiotik. The book includes an anecdote about the surgeon general to the king of Prussia, a vibrant 80-year-old man who had "contracted the habit of drinking daily from seven to eight glasses" of cold water and thus "enjoyed much better health than in his youth." (An English translation is available in this book from 1843.)

The hydrotherapy craze that swept through Europe and then America in the late 19th century encouraged the notion that people needed to be drinking more water. By 1900, the New York Evangelist reported that a women's association on the Lower East Side was being instructed by a Dr. Vinton that one needed to ingest "at least eight glasses of water a day" and take "four times as much water as food." (Incidentally, the girls were also told that it was dangerous to get one's feet wet, that it wasn't good to "wear many skirts," and that their brains were "soft like jelly.") By the 1910s and 1920s, the popular press was full of exhortations to consume six to eight glasses on a daily basis. Charles Atlas, the bodybuilder whose famous comic-strip ads were highly popular from the '20s through the '70s, was fond of recommending the same amount.

In more recent decades, there have been plenty of proponents of the 8x8 theory. In 1967, Dr. Irwin Stillman, one of the earliest advocates of a high-protein, low-carbohydrate diet, insisted that his followers drink eight glasses of water a day in order to wash away ketones, or "ashes left in the furnace." The controversial 1992 bestseller Your Body's Many Cries for Water, which calls for a minimum of eight to 10 glasses of pure water a day (not coffee, not soda), probably played a role in spreading the myth, as has the bottled-water industry, which has exploded since the 1980s.


Sunday, April 27, 2008

The forbidden "bacon dog"

The knowall food tyrants of Los Angeles

Amid the hustle and bustle of downtown Los Angeles, there exists another world, an underground world of illicit trade in-not drugs or sex-but bacon-wrapped hot dogs. Street vendors may sell you an illegal bacon dog, but hardly anyone will talk about it, for fear of being hassled, shut down or worse. Our camera caught it on tape. One minute bacon dogs are sold in plain view, the next minute cops have confiscated carts, and ordered the dogs dumped into the trash.

Elizabeth Palacios is one of the few vendors willing to speak publicly. "Doing bacon is illegal," she explains. Problem is customers love bacon, and Palacios says she loses business if she doesn't give them the bacon they demand. "Bacon is a potentially hazardous food," [What utter rubbish! I eat it every day for breakfast!] says Terrence Powell of the LA County Health Department. Continue selling bacon dogs without county-approved equipment and you risk fines and jail time.

Palacios knows all about that. She spent 45 days in the slammer for selling bacon dogs, and with the lost time from work, fines, and attorney's fees, she fears she might lose the house that bacon dogs helped buy. She must provide for her family, but remains trapped between government regulations and consumer demand. Customers don't care about safety codes, says Palacios. "They just want the bacon."


More evidence of social class effects

Wealthy people have a far lower risk of suffering a stroke — but only until the age of 65. Researchers in the United States studied the personal circumstances of almost 20,000 people aged 50 and over. They followed them for more than eight years, on average, in which time there were 1,542 strokes.

In the American Heart Association’s journal Stroke, Mauricio Avendano, of Erasmus Medical Centre in Rotterdam, and colleagues showed that people aged 50 to 64 in the poorest tenth of the population had a risk of stroke that was three times greater than those in the richest 10 per cent. “Wealth is the strongest predictor of stroke among the factors we looked at,” Dr Avendano said. But after the age of 65 the links between wealth and stroke risk disappear.

Lack of resources, and especially money, appear to influence strongly people’s chances of having a stroke at an early age, Dr Avendano said. “This would mean that diminishing the large wealth gap at age 50-64 also could help to diminish the large disparities in stroke.” Comparisons showed that common risk factors for stroke, such as high blood pressure, smoking, inactivity, excess weight and diabetes, were more common in poorer people.


Saturday, April 26, 2008

Bisphenol scare ratchets up

I looked at the science behind this nonsense on Feb 12th. Amusing that aluminium baby bottles are now seen as an alternative to plastic ones. Has everyone forgotten the scares about aluminium cookware?

Last week, hard plastic baby and water bottles were not considered harmful. Now, in the eyes of many users, they are toxic. Yesterday, CVS said it will join Wal-Mart, bottle-maker Nalgene, and other companies in pulling tens of thousands of the shatter-proof, transparent products off store shelves. Some parents are tossing hiking bottles into the trash, feeding their babies with glass containers, and searching for a safer alternative to see-through sippy cups.

So how dangerous are these bottles? And what should consumers do about the risk? "The truthful answer is that nobody knows" their full health impact yet, said David Ozonoff, a professor of environmental health at the Boston University School of Public Health. "And because we don't know, it's prudent to avoid something that is avoidable."

At the heart of the debate is an odorless, tasteless chemical called bisphenol A that is one of the most commonly used synthetic compounds. It is used to line most canned goods, from soups to soft drinks, to prevent corrosion. It helps make sunglasses and compact discs durable. And it strengthens virtually all transparent, light weight hard plastic baby and water bottles. The chemical has been used for decades, and millions of pounds are produced in the United States each year. Animal studies have linked exposure to small amounts of bisphenol A to reproductive problems and possible cancers later in life, though the level of risk is unknown. A small body of research suggests that exposure to the chemical in the uterus could contribute to later obesity.

But chemicals that harm animals are not always bad for humans, particularly in the small amounts to which most people are exposed. Industry representatives say no study has proved a link between bisphenol A and health problems in humans. Still, the US National Toxicology Program, part of the Department of Health and Human Services, last week released a draft report on the chemical, saying there was "some concern for neural and behavioral effects in fetuses, infants, and children at current human exposures." A few days later, Wal-Mart said it would stop selling baby bottles made with bisphenol A by next year and replace them with a bottle free of the chemical. Nalgene, the maker of the durable and ubiquitous hiking bottle whose parent company, Thermo Fisher Scientific Inc., is based in Waltham, also said it would replace its bisphenol A bottles in stores.

Last Friday, Health Canada delivered another blow, announcing that the compound was potentially harmful to people, especially newborns and infants. If no new scientific evidence is brought forward in the next 60 days, officials announced they would ban it from all baby bottles in the country. "We have concluded that it is better to be safe than sorry," Tony Clement, the Canadian health minister, told reporters.

Even before the latest news, environmental websites and parent blogs were aflutter about bisphenol A, debating its dangers and whether it was better to use glass bottles even though they break easily, or how to find bisphenol A-free bottles. They are sold on the Internet but tend to cost more. Baby bottles are of particular concern because more bisphenol A is released when milk or formula is heated in them.

Heather Kane, a Westborough parent of a two- and a five-year-old, mostly uses aluminum bottles instead of plastic. But she said it can be difficult for parents to find alternatives because most are sold only on the Internet and take time to seek out and buy. While that is changing, she questions why stores are not acting more forcefully. "What I find absurd is that Wal-Mart and these other stores are taking them off the shelves at some future date, but if the bottles are so dangerous, why don't they take them off now?" she said in a phone interview.

A recent study by the US Centers for Disease Control and Prevention estimated that about 93 percent of the US population had bisphenol A in their body. Infants and young children had higher levels than adults. Scientists are most concerned about early development because it is a critical time in determining long-term health. Both the US Toxicology Program and Canadian reviews said there appeared to be a negligible effect from bisphenol A on adults. "These experiments have been going on for a long time . . . that show exposure in utero could produce alterations in several parts of the reproductive process, and increased risk" of certain cancers, said Ana Soto, a Tufts University professor who studies the effect of endocrine disrupters such as bisphenol A on development. She believes adults should phase out exposure to bisphenol A.

Industry representatives vehemently disagree and say even the proposed Canadian ban in baby bottles is based on the precautionary principle, not hard data that show bisphenol A is dangerous. "We agree with the scientific and government bodies worldwide who have reviewed the science and support the conclusion that low levels of bisphenol A is not a risk to public health," said Steven Hentges, executive director of the polycarbonate/BPA global group of the American Chemistry Council, which represents chemical manufacturers. The only thing that the chemical industry and scientists agree on is that more studies are needed.

So what should parents do? "If it is easy for people to reduce their exposure to some sources," such as using a water bottle without bisphenol A, "and if the substitute is not likely to present significant risks itself, then why not?" said James Hammitt, professor of economics and decision sciences at Harvard University, in an e-mail. Just because studies may fail to provide clear evidence of harmful effects, he wrote, does not mean that the chemical is not harmful under some conditions. [And pigs can fly under some conditions too. Just put them on an aircraft!]


"Healthy food" myths for doctors

As Goebbels said: "Tell a big enough lie often enough and people will believe it". The evidence is that "fatty" food is NOT bad for you and that a "low fat" diet has no health benefits. See my side column here. If there is such a thing as "healthy" food, nobody knows what it is. But the anti-fat religion sails on regardless.

A dinner of salmon and arugula might sound like an appealing meal, but for many people, what winds up on the table is more along the lines of frozen pizzas or taquitos. Chefs at the Culinary Institute of America would like to help Americans learn to eat better - and they're starting with a key group of diners. Through a collaboration with Harvard University's medical school, the chefs and at least one med student are training doctors to cook.

At a conference earlier this month at the CIA's campus in St. Helena, Calif., about 300 doctors and health professionals got a crash course in making meals that are healthful and tasty.

One of the instructors was Michelle Hauser, a former professional cook and third-year medical student at Harvard. She demonstrated how to whip up healthy meals in under 20 minutes for less than $20. On the menu today: an easy-to-prepare salmon burger recipe. "So I'll dump my two cans of salmon into this bowl," Hauser says, speaking into a microphone. She talks up the health benefits of all the omega-3 fatty acids in salmon and assures the class that anyone can follow her recipe. "I gave it to someone who absolutely cannot cook. And they made dinner successfully," says Hauser, who whips up a coleslaw to complement the burgers.

As the first of the salmon patties come off the stove, students gather around to taste. "It's delicious - very good," says Dr. Tasha Tomlinson, who has a practice in Hanford, Calif. The salmon burgers are low in saturated fat and packed with nutrients. Tomlinson says she's going to take the recipe back to her patients. "In my practice, we have an epidemic of women who are sedentary and overweight," she says. "And they're always asking for help to get back on track."

Tomlinson says she'd also like to set up demonstrations for the diabetes support group. "They could learn one or a couple new recipes to incorporate into weekly shuffle," she says. As doctors learn from the demonstrations, Hauser says, they may become less intimidated in the kitchen. Then perhaps both doctors and their patients can focus on eating better......

Hauser says she enjoyed working as a professional cook, and that as a physician, she seems to be leaning toward educating people about food. Her biggest "aha" moment, she says, came a few years ago when she was teaching community cooking classes. Her students didn't have much experience in the kitchen. "They'd come back ... and say their blood pressure had improved," says Hauser. "Or they'd name some other health benefit that had come from it. And they were just cooking what they loved." It was Hippocrates who said, "Let food be your medicine." But Hauser's approach isn't far off.


Friday, April 25, 2008

Cancer survivors have low levels of physical activity and high levels of obesity

You are less active after undergoing treatment for cancer. Who knew? Who would have DREAMT that those nasty cancer treatments would slow you down? It must have been very disappointing to them that only one in five of cancer survivors was obese, though. And they have the hide to makes policy recommendations on the basis of this crap!

A new study reports that many cancer survivors are inactive and obese, which may negatively affect the control of their disease. The findings, which come from a study of cancer survivors in Canada, show that a cancer diagnosis does not appear to prompt significant behavior change and that interventions to increase physical activity and promote better eating habits among cancer survivors are warranted. The study is published in the June 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

Obesity and physical inactivity are known to be detrimental to health, and in cancer patients, studies have linked these factors to negative outcomes including disease recurrence, cancer-specific death and reduced quality of life. However, few studies have looked at the prevalence of physical activity and obesity in populations of cancer survivors.

To determine this prevalence and compare it to individuals without a history of cancer, Kerry S. Courneya, Ph.D. of the University of Alberta in Edmonton analyzed data from the 2005 Canadian Community Health Survey consisting of computer-assisted interviews of more than 114,000 adults. Survey participants reported their cancer history, height and body weight (to calculate body mass index), and participation in various leisure time activities.

The study revealed that fewer than 22 percent of Canadian cancer survivors were physically active, with the lowest rates reported by male and female colorectal cancer survivors, female melanoma survivors and breast cancer survivors. Also, nearly one in five (18 percent) of cancer survivors was obese, and one in three (34 percent) was overweight with little variation among the cancer survivor groups. The authors concluded that Canadian cancer survivors have low levels of physical activity and a high prevalence of obesity that are comparable to the general population.

However, some differences were found between cancer survivors and those without a history of cancer. Prostate cancer survivors were more likely to be active and less likely to be obese than men without a history of cancer, and male skin cancer survivors were more likely to be active than their disease-free counterparts. Also, obese breast cancer survivors were less likely to be active compared with obese women without a history of cancer. "This finding is cause for concern because physical activity may be particularly important for obese breast cancer survivors," the authors note. Studies suggest that obese breast cancer survivors may particularly benefit from higher physical activity levels in terms of preventing disease recurrence and improving quality of life.

In light of their findings, the authors recommend that lifestyle interventions be implemented to increase physical activity and promote a health body weight among cancer survivors.


Mother's diet can influence baby's sex

This sounds pretty crazy. It is a gene on the Y chromosome contributed by the MALE that determines sex. I suppose the woman could do some sort of spontaneous selective abortion, though. Note: It is entirely possible that diet-type is a proxy for something else (such as social class) rather than itself being the causative agent for what do seem to be some rather interesting differences. So if you decide to eat up big on the basis of these findings, you could well be wasting your time

Oysters may excite the libido, but there is nothing like a hearty breakfast laced with sugar to boost a woman's chances of conceiving a son, according to a new study. Likewise, a low-energy diet that skimps on calories, minerals and nutrients is more likely to yield a female of the human species, says the study, published in Proceedings of the Royal Society B: Biological Sciences, Britain's de facto academy of sciences.

Fiona Mathews of the University of Exeter in Britain and colleagues wanted to find out if a woman's diet had an impact on the sex of her offspring. So they asked 740 first-time mothers who did not know if their unborn fetuses were male or female to provide detailed records of eating habits before and after they became pregnant. The women were split into three groups according to the number calories they consumed per day around the time of conception.

Fifty-six per cent of the women in the group with the highest energy intake had sons, compared to 45 percent in the least-well fed cohort. Beside racking up a higher calorie count, the group who produced more males were also more likely to have eaten a wider range of nutrients, including potassium, calcium and vitamins C, E and B12. The odds of an XY, or male outcome to a pregnancy also went up sharply "for women who consumed at least one bowl of breakfast cereal daily compared with those who ate less than or equal to one bowl of week", the study reported.

These surprising findings were consistent with a very gradual shift in favour of girls over the last four decades in the sex ratio of newborns, according to the researchers. Previous research had shown - despite the rising epidemic in obesity - a reduction in the average energy uptake in advanced economies. The number of adults who skipped breakfast had also increased substantially.

"This research may help to explain why in developed countries, where many young women choose low calorie diets, the proportion of boys is falling,'' Ms Mathews said. The study's findings could point to a "natural mechanism'' for sex selection. The link between a rich diet and male children might have an evolutionary explanation. For most species, the number of offspring a male can father exceeds the number a female can give birth to, but only if conditions are favourable.

Poor quality male specimens may fail to breed at all, whereas females reproduce more consistently. "If a mother has plentiful resources, then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter,'' thus contributing to the survival of the species, Mathews said. "However, in leaner times having a daughter is a safer bet.''

While the mechanism is not yet understood, it is known from in vitro fertilisation research that higher levels of glucose, or sugar, encourage the growth and development of male embryos while inhibiting female embryos.


Thursday, April 24, 2008

One scare deserves another: Global warming cancer warning

I was born and bred in the tropics but have fair, Irish-type skin and I have lots of skin cancer so I have no doubt that warmer climates can be bad for you -- but the problem is a known effect of greater exposure to UV, not warmth! The study below is epidemiological so we must not be surprised to see the usual blinkered idiocies in it. And we don't have to look far to find such idiocies. The authors seem to overlook, for instance, the possibility that people go out in the sun more when it is warmer!! So it might not be warmth itself that causes the observed effect but rather the increased UV that people get as a result of going out in the sun more when it is warm. Quite brain-dead. Anyway the worriers below will no doubt be pleased to hear that temperature records kept by the Hadley Centre and others show that global warming peaked in 1998 and has not risen since

Global warming could lead to higher rates of skin cancer by amplifying the harmful effects of the sun's rays, scientists said. New evidence suggests that the same amount of sunshine becomes more likely to trigger cancer as temperature rises. The findings imply that a 2-4% increase in average summer temperatures could produce "substantial increases" in numbers of new skin cancers, say the researchers.

Scientists from the Netherlands and Argentina analysed data from two surveys of non-malignant skin cancer in the US. The incidence of cancer in the 10 regions studied correlated strongly not only with local levels of sunlight, but also with average daily maximum temperature in summer.

For cases of one type of skin cancer called squamous cell carcinoma, incidence increased by 5.5% per degree centigrade rise in temperature. The incidence of another type, basal cell carcinoma, rose by 2.9% per degree centigrade increase.

The findings tied in with previous research on mice which showed that increasing room temperature enhanced the induction of cancer by a given level of ultraviolet (UV) radiation. Effective UV dose in the mouse experiments increased by 3-7% for every degree centigrade of extra warmth.

The new research led by Dr Jan van der Leun, from the energy consultants Ecofys Netherlands in Utrecht, appears in the Royal Society of Chemistry journal Photochemical & Photobiological Sciences.

Ambient UV radiation only explained about 80% of the variation in skin cancer incidence, the scientists said. Other factors included genetic background and sun-seeking behaviour - and now, it appeared, temperature.

The researchers wrote: "Mainly owing to the substantial summer temperature differences between the West coast and other parts of the USA with comparable ambient UV loads [But ambient UV loads may not be the same as experienced UV loads -- due to different behaviors by people under different temperatures], we found evidence that some of the remaining variance in incidence may be attributed to temperature. These figures would imply, for instance, that with a long term increase of summer temperatures by 2-4% we could end up with substantial increases in incidence of skin carcinomas, which have already risen to very high numbers over the last century in white Caucasians."


Thalidomide returns

Thalidomide, the drug that blighted a generation of children half a century ago, is back on the market in Europe as a powerful cancer treatment. The European drug agency yesterday gave clearance for thalidomide to be sold on prescription for treating newly diagnosed multiple myeloma. It has been available, in a limited way, for some years since its powerful effects on cancer and leprosy were identified.

But campaigners, including those damaged by the drug when they were still in the womb, are anxious that its new-found popularity does not lead to more babies being harmed. Freddie Astbury, the president and founder of the campaign group Thalidomide UK, said that since the drug resurfaced, hundreds of damaged babies had been born in Brazil, where it has been used since 1985 to treat leprosy. There had been no such cases in the US or Europe, he said, but admitted that he was worried by the increased availability of the drug. “The trouble is that some hospitals in Europe have chosen to get the drug from Brazil, where it is cheaper,” he said.

Thalidomide UK and other patient groups had been working with the European Medicines Agency (EMEA) for more than five years on a plan to control access to the drug once it was licensed, Mr Astbury said. “We’re never fully going to know how the plan will work until the drug is used on a large number of patients,” he said. “I’d never say there will never be another thalidomide child in Europe, but I think they are the best guidelines we could have achieved.”

The approval given by the EMEA means that the US company Celgene will be the only licence-holder in Europe, and will be responsible for ensuring that the guidelines are observed. No other manufacturers and distributors of thalidomide can now supply the drug across the EU.

Thalidomide was originally marketed in the late 1950s as a treatment for morning sickness in pregnant women. It was only when babies began being born disabled that the dangers became apparent. The catastrophe was a landmark in the development of safer systems for approving drugs.


Wednesday, April 23, 2008

Teenagers blame eating disorders on health messages

As usual, Leftist nuts hurt people under the pretext of helping. It should be noted that the very severe eating disorder known as anorexia is clearly just a type of OCD and, as such, the sufferer would have a substantial genetic susceptibility. Most psychoses do however need to be "triggered" by environmental factors and there is no doubt that the obesity war would have caused all incipient anorexia to become full-blown

SCHOOLGIRLS with eating disorders are blaming the fight against the obesity epidemic for their illnesses, researchers have found. Many teenage girls with eating disorders "strongly believed that their illness was nurtured, exacerbated or sometimes even caused by the well-meaning action in schools", UK newspaper The Daily Telegraph reported.

John Evans, a professor of Sociology of Education and Physical Education at Leicestershires Loughborough University, told the newspaper that many girls said the fight against obesity caused their illnesses. The tales they told were incredibly revealing about what schools were doing, in good faith, that was propelling these girls towards this damaging relationship with food and exercise, Professor Evans said.

One girl told how, in class, the PE teacher pointed to a broomstick and said, 'That's the shape we are aiming for. He said another girl had told him about a class weigh-in. The whole class got weighed and the teacher said, 'Oh, it's the big one,' and I was the heaviest in the year."

Prof Evans said some children were being given the wrong message by their teachers. But he also said those teachers may have formed their opinions on obesity from elsewhere. "I've heard prominent spokesmen compare obese people to the so-called freaks that used to appear in circuses in the 1920s and 1930s," he said. The message being passed down is that obese people can be legitimately laughed at, stigmatised and considered irresponsibly abnormal."

The results of the four-year study will be published in a book later this year.


Saliva may reveal heart attack

Could be useful if confirmed

A SIMPLE saliva test may one day be used in ambulances, restaurants, convenience stores and elsewhere in the community to quickly tell if a person is having a heart attack. "Proteins found in the saliva have the ability to rapidly classify potential heart attacks," said John McDevitt, a biochemist at the University of Texas at Austin.

Dr McDevitt and colleagues developed a nano-bio-chip sensor that is biochemically programmed to detect sets of proteins in saliva capable of determining whether or not a person is having a heart attack or is at high risk of having a heart attack in the near future. With the saliva heart attack diagnostic test, a person spits into a tube and the saliva is then transferred to credit card-sized lab card that holds the nano-bio-chip containing a standard battery of cardiac biomarkers. The loaded card is inserted like an ATM card into an analyser that determines the patient's heart status in as little as 15 minutes.

In a study involving 56 people who had a heart attack and 59 healthy "controls" who did not, "we found that our test could distinguish between heart attack patients and controls with about the same diagnostic accuracy" as that of standard blood tests, Dr McDevitt said.

Many heart attack patients, especially women, had non-specific symptoms or had normal EKG readings, making timely diagnosis difficult, he said. "In our small trial, we had about one third of the patients with these...silent heart attacks on EKG." These patients need to go the emergency department and have their blood drawn and tested for enzymes that are indicative of a heart attack, "which could take an hour to an hour and a half."

The saliva test could be used in conjunction with the EKG and "aid in rapidly diagnosing heart attacks that are silent on EKG," Dr McDevitt said. Larger and more refined studies were planned.


Tuesday, April 22, 2008

Scientists discover drops of truth in medieval belief in urine

Urine testing is not exactly new in modern medicine either -- but the idea that more information can be extracted from urine analysis does sound interesting. I doubt that it could give dietary information with a high degree of certainty, however. A background article is here

Medieval physicians believed that they could diagnose disease by holding up a flask of the patient's urine to the light and squinting at it. According to scientists at Imperial College London, they could have been on to something. A team there has completed the first worldwide study of the metabolites (breakdown products) that are found in urine, reflecting the diet, inheritance and the lifestyle of the people from whom it came. They call such studies "metabolomics" by analogy with genomics, which looks at all the genes that make up the human species, and proteomics, which does the same for proteins.

The study used nuclear magnetic resonance spectroscopy to compare racial and national groups by the composition of their urine. From Japan, Beijing, Corpus Christi, Belfast and West Bromwich, urine differs in subtle ways that could provide a powerful new way of linking diet and health. The metabolites they found come from microbes in the gut, from diet and from the metabolism of the host.

The team believes that the research may provide the basis for a "metabolome-wide association" approach to help to understand interactions between lifestyles, environment and genes and how they determine diseases. The metabolic fingerprints show that people in the US and Britain who share a tendency to high blood pressure and heart problems have similar patterns. Writing in the science journal Nature, the team identifies metabolites linked to high blood pressure, such as the amino acid alanine. Hippurate, another by-product of gut bacteria, is found in people with lower blood pressure who drink less and eat more fibre in their diet.

Scientists from Imperial College, the US, Belgium, Japan and China took samples from 4,630 volunteers aged between 40 and 59. Professor Jeremy Nicholson, from Imperial College, said: "Metabolic profiling can tell us how specific aspects of a person's diet and how much they drink are contributing to their risks for certain diseases, and these are things which we can't investigate by looking at a person's DNA. What is really important is that we can test out our new hypotheses directly, in a way that is not easy with genetic biomarkers."


The war on `passive drinking'

European Union and United Nations officials are plotting to make drinking as socially unacceptable as smoking. Hectoring campaigns over "passive smoking" are credited for Europe's almost total smoking ban. Now alcohol is in the sights of the public health miserablists and they have invented the concept of "passive drinking" as their killer argument.

The Daily Mail takes up a report in New Scientist to trumpet a new "guilt campaign" that is heading our way. "The World Health Organisation's global strategy will aim to match the success of campaigns which have made smokers feel guilty about the harm second-hand smoke does to others," says the report. Ian Gilmore, president of the Royal College of Physicians is wheeled on to confirm the new approach. "The tipping point for banning smoking in public places was third party damage," he said.

The EU public health brigade are not far behind, in fact Brussels miserablists in the European Commission's DG SANCO have been trying to poison the drinking debate with this new assault on reason for years. I took up the EU "passive drinking" debate around two years ago in response to strident claims, in a Commission report, about the high environmental or social toll of alcohol, the "harm done by someone else's drinking".

"The total tangible cost of alcohol to EU society in 2003 was estimated to be 125bn euros (79bn-220bn), equivalent to 1.3 per cent GDP, and which is roughly the same value as that found recently for tobacco," said the report written by Dr Peter Anderson, who has a background in the World Health Organisation (WHO) and who played a leading role in Tobacco Free Initiative Europe. "The intangible costs show the value people place on pain, suffering and lost life that occurs due to the criminal, social and health harms caused by alcohol. In 2003 these were estimated to be 270bn, with other ways of valuing the same harms producing estimates between 150bn and 760bn."

On Thursday, at an informal meeting of health ministers in Brdo, Slovenian Health Minister, Zofija Mazej Kukovic dusted off the report - and its language. "Harmful and dangerous alcohol consumption causes more than seven per cent of the premature morbidity and mortality in our countries. The annual costs stemming from this have been estimated at as much as _125 billion for the EU as a whole. However, the harm caused by alcohol is still underestimated," she said.

The figures are meant to be pretty scary. Drink is responsible for 2,000 homicides, four out of 10 of Europe's annual murders. "The economic cost of alcohol-attributable crime has been estimated to be 33bn in the EU for 2003..while the intangible cost of the physical and psychological effects of crime has been valued at 9bn - 37bn," said the Anderson report.

Children, too, are passive victims of drinking. "Many of the harms caused by alcohol are borne by people other than the drinker responsible. This includes 60,000 underweight births, as well as 16 per cent of child abuse and neglect, and five to nine million children in families adversely affected by alcohol," says the EU report's summary.

The link made by between alcohol and crime today, whether violence or child abuse or other social ills, follows not from hard facts but from an outlook that sees human characteristics as damaging in general. And if human beings, particularly when under the influence of stimulants, are destructive, then, the argument goes, social intervention must follow. The idea that almost any activity - drinking, eating, speaking, even thinking - can cause harm is often blown out of proportion and used to generate frightening figures and policies.

The sheer absurdity of the idea of "passive drinking" would be funny if the public health lobby was not so powerful and unpleasant. I found that in a twist of irony, probably lost on po-faced public health types, that the expression "passive drinking" seems to have originated as a spoof in two Peter Simple columns in the Daily Telegraph in 2002 and 2003, written by the late Michael Wharton.

Mocking the rise of nonsense research to justify social measures, he wrote about research work being carried out by "Dr Ron Hardware of Nerdley University". "They were the first to discover the scourge of `passive drinking', showing by painstaking experiments and finely adjusted statistics that it was just as deadly as 'passive smoking' and equally capable of causing cancer and innumerable other ills," he wrote. It is no longer a joke or satire - do read more here on Spiked. We need to stand up to these people.

Source. Prof. Brignell also once used this idea as an absurd example.

Monday, April 21, 2008

Nazism reinvented: The chosen ones of Australia's Left want a smoking ban and fitness tests for everyone

SMOKING would be banned for everyone born next year, junk food would be taxed and everyone would be subjected to a fitness test by 2020. By comparison, the cost of healthy food, including fruit and vegetables, would be reduced to reflect its low environmental impact and obvious ["obvious"? It is not at all obvious in the mortality statistics] health benefits.

These are just a few of the ideas from 100 of the nation's health experts who discussed the best way to combat obesity, reduce illness and promote a healthy lifestyle. Health Minister Nicola Roxon said one idea put forward in a submission was an annual national fitness test where citizens would receive a financial incentive if they pass.

Health stream participants in the 2020 summit also discussed increasing public education about how death can be a "positive experience" to avoid patients panicking when they reach hospital emergency departments.

Health participant, Meredith Sheil, a former Westmead Children's Hospital pediatrician, said many participants had suggested a ban on cigarette sales by 2020. "A lot of the health submissions suggested a ban on smoking by 2020," she said. "You would say, 'OK, from now on everybody born after 2008, you are not allowed to sell cigarettes (to)'."

Nutritionist Rosemary Stanton suggested increasing the cost of artificial and packaged food. "I actually think we need to price foods according to their environmental and health impact, rather than harping at people to eat this or that," she said. "All the artificial foods would become very expensive and the healthy foods would be cheaper." ....

Ski champion Alisa Camplin suggested expanding the active after-school communities program to ease the burden on the health system. "Creating a national program focused on physical activity would provide a pro-active framework for Australians to attain greater general well-being and receive preventative, rehabilitative and curative health support," Camplin wrote in her submission.

More here

You can't win: Thin can still be fat on the inside

The paper behind this report does not appear to have passed peer review but there is a summary of it here. It relies on clinical indices which may or may not have the postulated relationship with longevity. As is common in epidemiological studies, control for social class appears to have been omitted, despite the large evidence of its medical significance

A thin person with a body mass index in the healthy range could actually be dangerously overweight. Researchers from the Mayo Clinic in the US collected data on more than 2000 people with a healthy weight and BMI and concluded that 61percent of them had what they call "normal weight obesity". They looked thin, but their percentage of body fat made them susceptible to heart disease and diabetes, research presented to a meeting of the American College of Cardiology in Chicago showed. British researcher Dr Jimmy Bell has dubbed such people TOFIs, for "thin outside, fat inside".

The findings cast more doubt on the value of the BMI as an indicator of health. The index is calculated by dividing a person's weight in kilograms by their height in metres squared. A BMI between 18.5 and 25 is considered healthy. Melbourne weight-loss expert Leon Massage said body fat percentage is the most important measure of healthy weight. Dr Massage said many people would be unaware that their percentage of body fat had risen as they had become less physically active. "As their muscle decreases, their fat increases and their weight can stay the same," he said.

He recommended people measure their waist circumference and if it exceeded between about 90 and 94 centimetres for men and 80 centimetres for women, have their percentage calculated by a doctor.


Sunday, April 20, 2008



How wrong is this? Fairly. The risk is hugely exaggerated by the familiar portrayals of men in books, films and dramas gasping their last in flagrante. What are the facts? Research shows that the chances of a 50-year-old non-smoking male suffering a heart attack is about one in a million in any hour. Having sex increases these odds to two in a million, but doubling a barely existent risk means that risk is still negligible. Any related myths? That sex is a form of exercise. In fact, it equates only to climbing two flights of stairs.


How wrong is this? Very. An astronomically high blood pressure might cause a headache, but this is rare. What are the facts? High blood pressure (hypertension) usually has no symptoms at all. It's not a disease, it's a risk factor, so it is treated to reduce your chances of a future stroke or heart attack, not too make you feel better. Any related myths? That high blood pressure causes dizziness. No, dizzyness is a side-effect of the treatment.


How wrong is this? Fairly. Diabetics do have to alter their sugar intake and they sometimes require an urgent sugar fix if their blood glucose is too low. So concluding that craving sugar equals diabetes is understandable but wrong. What are the facts? Diabetes isn't caused by excess sugar, it's simply that the diabetic body has problems handling it. Any related myths? That diabetics need to buy special, low-sugar versions of food and drink. They don't - a simple healthy diet will suffice.


How wrong is this? Very. What are the facts? Research shows that routine self-examination does no good in terms of breast cancer outcomes because it isn't sensitive enough to detect important lumps. In fact, it can actually cause harm. How? By subjecting self-examiners to increased levels of anxiety. Any related myths? There is an exact parallel with routine self-examination of testicles in males - another discredited activity that continues to receive publicity because it sounds like a good idea.


How wrong is this? Fairly. Doctors rarely suggest diet alone if your cholesterol really needs lowering. What are the facts? A healthy diet's a good idea. But if you want lower cholesterol, you'll probably be disappointed. Because, even in trials, the best that's achieved is a 10 per cent reduction. Most cholesterol is made by your liver, with your dietary intake contributing little. Cholesterol is usually treated with statins. Any related myths? That a high cholesterol is a cause for panic - it's simply a risk factor, like high blood pressure, for future problems.


How wrong is this? Totally. What are the facts? The stats alone may be ease your headache. After all, your GP sees this symptom daily, but encounters a brain tumour only a few times in his entire career. Nasties of this sort almost always produce other symptoms - fits, personality change or unsteadiness. Any related myths? That a scan is a good idea. The chances of turning up an irrelevant but worrying abnormality are fairly high.


How wrong is this? Totally, with the exception of the antibiotic metronidazole. What are the facts? Any interaction of alcohol with virtually all antibiotics is nonexistent, or so small as to be irrelevant. Metronidazole, an antibiotic used for a variety of infections, is the exception to this rule. When mixed with even small amounts of booze, it causes vomiting. Any related myths? That you should always finish your course of antibiotics. It usually makes little difference.


How wrong is this? Fairly. What are the facts? Tiredness is common and, in the absence of other symptoms, is usually caused by lifestyle issues such as stress and lack of exercise. Mild anaemia caused by iron deficiency is common, too, particularly in women. As tiredness often prompts a blood test, it's common for anaemia to be revealed, and assumed wrongly to be the cause. Any related myths? That tiredness will be solved by vitamins - though the chemist might tell you otherwise.


How wrong is this? Totally. You might suffer a sore arm or, at most, a slight fever. What are the facts? The vaccine does not contain live germs and so cannot cause flu. But, as it's given in autumn, peak snuffle period, many patients will pick up a virus around the time of their jab. This they misinterpret as flu, which they link to the jab. Any related myths? The idea that if you are healthy, the flu jab isn't necessary. In fact, it's recommended to all over-65s, even if they're fit and well.


Australian man too fat for jail

Obesity has its pluses

A man considered too fat to be jailed has spoken out after escaping time behind bars because of his weight. Shepparton man Claude Jackson was ordered to do community service for smashing a glass over another man's head at a Shepparton bar on January 14, 2007. The victim, Tim Kirkman, received a 4cm cut to his neck in the incident and required hospital treatment. Jackson pleaded guilty to recklessly causing serious injury and affray.

A medical report submitted to the County Court sitting at Shepparton said Mr Jackson, who weighed 190kg, had suffered three heart attacks earlier in life and suffered from ongoing arthritis, sleep apnoea and other weight-related ailments. It said he had once weighed up to 234kg and that "morbid obesity" had been present all his life. The medical report also warned that a jail term would "create great problems" for his health.

While reluctant to talk about the incident, the 21-year-old told the Herald Sun he was deeply sorry and had been keeping out of trouble since the bar brawl. "I would like to say sorry to (Mr Kirkman)," Mr Jackson said yesterday. "If I could take back everything that happened on the night, I would. "But unfortunately it happened and I have to deal with it. I have definitely learnt my lesson."

Mr Jackson, who is studying for a certificate in youth work at a local university, was ordered by the court to undertake eight hours a week of community service at Rumbalara Football and Netball Club, and four hours of counselling a week for the remainder of his sentence. He was initially considered unsuitable for an intensive corrections order by the Office of Corrections.


Saturday, April 19, 2008

The Junk juggernaut rolls on

Post below lifted from Prof. Brignell. See the original for links

It is rather a depressing thought that the Telegraph is the nearest thing that Britain has to a serious newspaper. This week it has featured an outbreak of empty scares based on meta-studies, absurdly small studies and, of course, ridiculous relative risks (RR).

The first was a scare involving a popular vehicle for of self dosing, vitamins. While it is clear that people on a normal diet with a normal metabolism are wasting their money on these supplements, this is no excuse for spreading unnecessary alarm. With one possible exception, extra vitamins are simply useless. The exception is vitamin A. While a deficiency of this compound can cause serious diseases, including childhood blindness and death, an excess can suppress growth; stop menstruation; damage red blood corpuscles and cause skin rashes, headaches, nausea, and jaundice. Nevertheless, a meta-study yielding RRs of 1.16 or less adds nothing to the sum of human happiness and merely fuels pointless scare journalism.

Breast cancer has long been a favourite of the scare-mongers. For understandable reasons it roused fear in all women. It is frequently used to provide ammunition for the zealots, so the research tends to be directed towards their favourite targets. Now we are told that one glass of wine a day increases the risk of breast cancer (RR 1.07). Sandy tells about the provenance of this vital "research". In the very same week other “experts” picked on another favourite target, obesity. A small study (Trojan Number 547) indicated that fat women with breast cancer are more likely to die than their slim sisters (RR about 1.4). We are not told just how many were regarded as obese, but even if it were about a half of them, the number of excess deaths would be of the order of 12.

As we have observed before, small studies are not just useless, they are malign, as the phenomenon of funnel plots reveals.

Just in case you did not get the message from our sponsors, the risk of Alzheimer’s is increased for smokers, drinkers and those with raised cholesterol. The inclusion of tobacco is interesting, because before the Great Censorship, it was widely accepted that smokers were half as likely to get Alzheimer’s as non-smokers (likewise Parkinson’s to boot). Indeed, this promoted one of the first uses of the word paradox as a paranym. What a strange coincidence it is that the causes of these diseases all happen to be the favourite targets of various groups of zealots and not something else, such as lettuce.

New drug shrinks breast cancer

A NEW breast cancer drug has shown impressive results in shrinking tumours before surgery. Lapatinib (Tyverb) is licensed in the US for advanced breast cancer but not in the European Union. It is similar to Herceptin in the way that it works – it inhibits the action of an emzyme that prompts the tumour to grow.

At the European Breast Cancer Conference in Berlin, Angel Rodriguez, of Baylor College of Medicine in Houston, Texas, reported on a trial in which lapatinib was given to 45 women for six weeks before they underwent surgery. The tumours shrank by an average of more than 60 per cent, and the drug also cut the number of breast cancer stem cells.

This was important, Dr Rodriguez said, because such cells had proved resistant to other drugs used before surgery. Indeed, the effect of conventional drugs was to increase the number of stem cells and enhance tumour growth. “We were excited to see that the results with lapatinib were different,” he said. Cancer stem cells help to maintain the malignant tissue in the tumour by regenerating it after attack from chemotherapy drugs.

“This indicates that the stem cells themselves should be the specific target of chemotherapy drugs,” said Dr Rodriguez. “Rather than the broad-brush approach, in which cells are killed indiscriminately, targeting the stem cells may be more effective and also prevent some of the unpleasant side-effects associated with conventional chemotherapy treatment. “This is an exciting finding and we will be starting further studies on stem cells in order to confirm it. This finding should also apply to other types of cancers, and research of tumour-initiating stem cells in other cancers is ongoing,” he said.

These include studies in lung, colon, head and neck, gastric, oesophageal, and bladder cancer and lymphoma, among others.

Carolyn Rogers, a clinical nurse specialist at Breast Cancer Care, said: “Lapatinib is being considered for use in secondary breast cancer following clinical trials, but to date there is no strong evidence to show its suitability in treating primary breast cancer. “Dr Rodriguez’s study provides an interesting insight into how lapatinib could be used in early breast cancer. However, with a sample of just 45 patients it is clear that much more work needs to be done to gain statistically significant findings. Further trials are under way but it will be many years before we see the full results of these. Current approved treatment options are very successful, with survival rates increasing year on year.”


Friday, April 18, 2008

Studies Show It's Often Cheaper To Let People Get Sick

An ounce of prevention may have been worth a pound of cure in households down through the ages, but in the world of health economics the adage, alas, is not true. An ounce of prevention is sometimes worth more than an ounce of cure (although rarely worth 16 times as much, or the equivalent of a pound). Usually, an ounce of prevention is worth considerably less. Often it is worth (to mix measures) only a gram of cure. Or even just a milligram.

This is a seemingly illogical truth. Most of us naturally assume that preventing a disease is cheaper than waiting for the disease to appear and then treating it. That belief is especially dear to politicians, who often view prevention as an underused weapon in the battle against health-care costs. The campaign Web site for Sen. Hillary Clinton (D-N.Y.) notes that her health-care plan is "targeting the drivers of health-care costs, including our back-ended coverage of health care that gives short shrift to prevention." Rival Sen. Barack Obama (D-Ill.) asserts that American families can save up to $2,500 a year each if five cost-containing strategies are implemented, one of which is "improving prevention and management of chronic conditions." (The presumed Republican nominee, Arizona Sen. John McCain, generally has not pushed prevention as a way to control expenses.)

Even when prevention greatly reduces future cases of a particular illness, overall cost to the health-care system typically goes up when lots of disease-preventing strategies are put into practice. This is usually true whether treating the preventable diseases is cheap or expensive. In 1986, a health economist named Louise B. Russell published "Is Prevention Better Than Cure?," in which she concluded that prevention activities tend to cost more than they save. Since the book's appearance, her observation has been borne out by studies of hundreds of interventions -- everything from offering mammograms to all women and prescribing drugs to people with high cholesterol to requiring passenger-side air bags in cars and shortening the response time of ambulances.

On closer look, this isn't so surprising. Nor is it reason for despair. After all, you get something from prevention -- less disease, for starters -- which is worth a lot even if it doesn't come cheap.

There are many reasons prevention usually doesn't save money. Perhaps the most important is that prevention activities target many more people than will ever come down with the disease being prevented. The reason (thankfully) is that people tend to stay healthy for most of their lives, no matter what they do. Take the example of lowering cholesterol to prevent heart attacks.

The vocabulary of cardiac risk uses such terms as "normal," "high" and "very high." But in reality, most people even in the "very high" risk category don't suffer heart attacks over quite long time horizons. Consider a 50-year-old male smoker whose total cholesterol is in the "high" range (over 240); whose HDL, or desirable cholesterol fraction, is "low" (below 40); and who has untreated moderate hypertension. Sounds like a walking time bomb! It turns out his chance of having a heart attack in the next 10 years is only 25 percent. For a woman with the same profile, the chance of having a heart attack is 11 percent. Almost nine out of 10 such people will dodge the bullet by . . . doing nothing.

Preventing those heart attacks is expensive because everyone fitting the risk profile needs to get the intervention. Why? Because there's no way to know in advance who the 1-in-4 unlucky men or 1-in-9 unlucky women are.

If the prevention strategy is taking a statin -- a very effective cholesterol-lowering drug -- it will cost $160,000 for every year of life saved among men with the above-described risk profile. For women, it will be even pricier: $240,000 for every year of life saved, according to a study published in the Annals of Internal Medicine in 2000. (That total bill includes the cost of physician visits and lab tests). It seems like a lot to pay. But who among us would choose 1-in-4 or 1-in-9 odds of having a heart attack if the alternative is to reduce the odds dramatically by taking a pill every day (especially if you don't have to pay for the pill yourself)?

In the answer to that question lies both the appeal of our increasingly prevention-oriented health-care system and the reason why prevention tends to drive costs up over the long run. Prevention can be expensive even when it doesn't involve taking drugs or undergoing procedures. Even giving information can be uneconomical. That's because giving information takes time, and the yield in terms of behavior change that leads to less disease is very low -- as anyone who has been told to eat less and exercise more knows. For example, Australian researchers tried out a program in which general practitioners watched a video and read a booklet about how to help their patients lower their heart attack risk. The patients were then given a series of videos and a self-help booklet on the same topic. How cost-effective is this instruction? When it is provided for women at low risk of heart disease, $9.8 million has to be spent for every year of life saved in the prevention of premature heart attack deaths.

Of course, there are situations in which prevention is the economical choice, even if it still adds to the total spent on health care. Take smoking. Smoking cigarettes is probably the most unhealthful legal thing a person can do. Nevertheless, most lifelong smokers will make it to age 70 without paying the ultimate price. This was borne out in a study published two years ago. Medical researchers in Norway observed the experience of 50,000 Norwegian men and women over a 25-year period. Of the men who smoked more than a pack of cigarettes a day the entire time, 41 percent died between age 40 and 70. Among similarly heavy-smoking women, 26 percent died. (For people who never smoked, the mortality was 14 percent for men and 9 percent for women). Even for heavy smokers, the odds favor survival.

Nevertheless, doing almost anything to help people quit smoking is likely to be a good investment. That's because even though most people get to age 70, lots don't -- but might if they didn't smoke. In just one example of dozens of cost-effectiveness studies examining strategies to reduce smoking deaths, a team of British researchers in 2002 calculated that providing brief counseling, nicotine replacement and the anti-craving drug buproprion to smokers would save one year of life for every $1,300 spent -- an incredible bargain.

There are also some disease-preventing activities that save money, although they are relatively rare. Childhood vaccinations are the classic examples. Many of the infections they protect against -- chickenpox, measles, mumps -- are ones nearly every child would get if not for the shots. Even though few of those cases put children in the hospital or cost much to treat, virtually all that expense (and a few lives) are saved with universal childhood immunization. If vaccines are cheap and easy to administer, the total cost of vaccination is actually less than the cost of treating the cases of illness that would occur in their absence.

Toward the other end of life, providing a single colonoscopy to men 60 to 64 years old also saves money. Even though the procedure costs more than $1,000, it takes such a huge bite out of expensive, painful, life-shortening colon cancer mortality that it costs less to test everybody than to treat the people who would otherwise develop the disease.

"In order to crack this nut [of controlling health-care spending], careful thought and analysis has to go into evaluating what things work, how well things work and how much they cost," said Joshua T. Cohen of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston. Similar to the finding that prevention rarely saves money is the calculation that people in good health probably rack up higher lifetime medical costs than their less-healthy brethren. The reason? Healthy people tend to live longer.

The Framingham Heart Study has followed more than 5,000 people in a town outside Boston since 1948. An analysis published in 2003 found that obese women smokers lost 13.3 years of life, and obese men smokers lost 13.7 years, compared with normal-weight nonsmokers. This loss of longevity can make a big economic difference because people who miss old age miss the high medical costs associated with it.

In the journal PLoS Medicine last month, Dutch researchers led by Pieter H.M. van Baal used mathematical modeling to compare the medical expenses (starting at age 20) of healthy people, obese people and non-obese smokers. Up to age 56, an obese person's annual medical costs are higher than a smoker's, mostly because of problems that often come along with obesity, such as diabetes, arthritis and lower back pain. Healthy people have the lowest annual cost. But over a lifetime, the researchers calculated, healthy people incur the most cost, followed by the obese and then smokers, who die the earliest.

Does that mean we shouldn't try to get people to quit smoking or lose weight? Of course not, says Louise Russell, the "Is Prevention Better Than Cure?" author who is now a research professor at Rutgers University in New Jersey. "People are important, their health is important, and we want to make their lives better in a variety of ways," Russell said. "The point of the medical-care system is to serve people. It is not the point of people to serve the medical-care system." Prevention can be a great investment, but it's still an investment. Nothing in the modern health-care economy is cheap. Not even health.


Prince of Wales's guide to alternative medicine `inaccurate'

The Prince of Wales is being challenged today to withdraw two guides promoting alternative medicine, by scientists who say that they make misleading and inaccurate claims about its benefits. The documents, published by the Prince and his Foundation for Integrated Health, misrepresent scientific evidence about therapies such as homoeopathy, acupuncture and reflexology, say the authors of a new evaluation of alternative treatments.

In a letter to The Times, Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, and Simon Singh, a science writer and broadcaster, call on the Prince to recall the publications, one of which was produced with a œ900,000 grant from the Department of Health. "They both contain numerous misleading and inaccurate claims concerning the supposed benefits of alternative medicine," they say. "The nation cannot be served by promoting ineffective and sometimes dangerous alternative treatments."

Professor Ernst and Dr Singh say the Prince accepted the importance of "rigorous scientific evidence" to alternative medicine, in an article he wrote for The Times in 2000, and point out that more than 4,000 research studies have since been published. They analysed these studies and previous research for their new book, Trick or Treatment: Alternative Medicine on Trial, finding that only a few treatments, such as some herbal medicines and acupuncture for pain relief, are backed up by the evidence that the Prince demanded. "The majority of alternative therapies appear to be clinically ineffective and many are downright dangerous," the letter says, and it calls on the Prince to withdraw the publications Complementary Health Care: A Guide for Patients and the Smallwood report.

The first document is a pamphlet, part-funded by the taxpayer, that gives advice on finding practitioners of alternative therapies. It is misleading, Professor Ernst said, because it includes disorders for which alternative remedies have been shown to be ineffective. It states, for example, that chi-ropractic is used to treat asthma, digestive disorders and migraine, when it has been shown by rigorous trials only to be useful for back pain. The guide also promotes acupuncture for addiction, when studies suggest that it has no benefit, and homoeopathy, which a major review for The Lancet has indicated works only as a placebo. "It explains what these therapies are used for, and that carries an implication that they work when the evidence suggests that many do not," Professor Ernst said.

The foundation has already withdrawn some sections of the pamphlet from its website, such as a claim that research has shown healing to have benefits for some medical conditions. The Smallwood report, commissioned by the Prince from Christopher Smallwood, an economist, argued that greater provision of alternative medicine on the NHS could save taxpayers' money. A study in the British Medical Journal has shown that only five research projects have examined the cost-effectiveness of alternative medicine, and all but one found that greater provision would add to costs.

Professor Ernst was consulted by Mr Smallwood, but said that his criticisms were ignored. Sir Michael Peat, the Prince's private secretary, accused Professor Ernst of breaching confidence by discussing a draft of the report with The Times. Natasha Finlayson, of the Prince's Foundation for Integrated Health, said: "We entirely reject the accusation that our online publication Complementary Healthcare: A Guide contains any misleading or inaccurate claims about the benefits of complementary therapies. On the contrary, it treats people as adults and takes a responsible approach by encouraging people to look at reliable sources of information . . . so that they can make informed decisions. The foundation does not promote complementary therapies."

Claims and counters

A Guide for Patients Chiropractic: used in disorders of musculoskeletal system such as spine, neck, shoulder problems. It may also be used for asthma

Professor Ernst: no good evidence for anything other than back pain

Acupuncture: increasingly used in trying to overcome addictions to alcohol, drugs and smoking.

The reliable evidence suggests it does not work for addictions

Cranial therapists: the conditions they treat range from acute to chronic health problems

No good evidence for any of this

Homoeopathy: most often used to treat chronic conditions such as asthma; eczema; fatigue disorders; migraine; menopausal problems; irritable bowel syndrome; Crohn's disease; allergies; repeated infections; depression.

Data do not show homoeopathic remedies to be more than placebos

Reflexologists: work with conditions including pain, chronic fatigue, sinusitis, arthritis, digestive problems, stress-related disorders and menopausal symptoms.

No good evidence for any of this

Reiki: used for physical, mental and emotional conditions

There is no good evidence that Reiki is effective for any condition

Shiatsu: used for a wide range of conditions, from injuries to more general symptoms of poor health

No good evidence for any of this

The Smallwood report Phytodolor: recommended for treatment of UK arthritis patients.

This German preparation is not available in the UK

Manipulative therapies: offer advantages over conventional treatments for lower back pain.

A Cochrane review concludes that there is no evidence that this spinal therapy is superior to other standard treatments


Thursday, April 17, 2008

Antioxidant pills 'increase risk of early death'

More bad news for pill poppers and health freaks generally. The claim that antioxidants in food are somehow different is just deep faith. Note that in the madhouse that is the medical literature, a Cochrane study is unusually authoritative

Researchers at Copenhagen University carried out a review of 67 studies on 230,000 healthy people and found "no convincing evidence" that any of the antioxidants helped to prolong life expectancy. But some "increased mortality".

About 12 million Britons supplement their diets with vitamins and the industry is worth 330 million pounds. But little research has been done on the long-term health implications.

The Department of Health said yesterday that people should try to get the vitamins they need by eating a balanced diet and advised care in taking large doses of supplements. A spokesman said: "There is a need to exercise caution in the use of high doses of purified supplements of vitamins, including antioxidant vitamins, and minerals. Their impact on long-term health may not have been fully established and they cannot be assumed to be without risk. "Anyone concerned about their diet should speak to their doctor or dietitian."

Antioxidants, including vitamins A, E, C and beta-carotene and selenium, are said to mop up compounds, called free radicals, which cause disease. It is this action that researchers believe may cause problems with the defence system. The Danish research, released by the influential Cochrane Library, applied only to synthetic supplements and not to vitamins that occur naturally in vegetables and fruit.

It found that vitamin A supplements increased the risk of death in healthy people by 16 per cent. Taking beta-carotene was linked to a 7 per cent increased risk, while regular users of vitamin E supplements increased the risk of an early death by four per cent.

Although the review found no significant detrimental effect caused by vitamin C, it found no evidence that it helped ward off disease. Millions take it in the hope of avoiding a common cold.

Goran Bjelakovic, who led the review, said: "We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases. "If anything, people in trial groups given the antioxidants beta-carotene, vitamin A, and vitamin E showed increased rates of mortality."

But Patrick Holford, a nutritionist who has formulated supplements for the company Biocare, said: "Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits. "When used properly, in combination with a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health."

A spokesman for the Health Supplements Information Service said: "People should get all the vitamins and minerals they need from their diet, but for the millions who are not able to do that, vitamins can be a useful supplement and they should not stop taking them."

However, Catherine Collins, of the British Dietetic Association, said: "This study is deeply worrying and shows that there should be more regulation for vitamins and minerals. "The public can buy vitamins as easily as sweets. They should be treated in the same way as paracetamol with maximum limits on the dosage."



My most frequent commenter has put up a long comment on this post in which he accused the Cochrane authors above of “cherry-picking” what they studied. Cherrypicking is indeed a common and often fatal flaw in meta-analyses but I would be surprised if Cochrane authors had done it irresponsibly.

I did not look closely at the study myself because the finding is one that was already well-substantiated. See here and here, for instance. It is true, however, that a single author -- Bjelakovic -- seems to be behind much of the review literature. That does not, however, erase the original studies that he reviews and his acceptance as a Cochrane reviewer indicates a judgment that his reviews are indeed representative.

Mumps outbreak

A large mumps outbreak in the United States in 2006 may have been caused by the failure of the vaccine, federal health experts reported Wednesday. In a study reported in the April 10 issue of the New England Journal of Medicine, authors urge a more effective mumps vaccine or changes in vaccine policy to eradicate the disease. The study found that 84 percent of people between the ages of 18 and 24 who became ill in the outbreak had received the second recommended dose. The national incidence of mumps was 2.2 per 100,000. The highest incidence was in persons 18 to 24 years of age, with an incidence 3.7 times that of all other age groups combined.

"Despite a high coverage rate with two doses of mumps-containing vaccine, a large mumps outbreak occurred, characterized by two-dose vaccine failure, particularly among Midwestern college-age adults who probably received the second dose as schoolchildren," the study authors wrote. "A more effective mumps vaccine or changes in vaccine policy may be needed to avert future outbreaks and achieve the elimination of mumps."

The authors conclude that further studies are needed to help evaluate national vaccine policy, including whether the administration of a second dose of MMR [measles-mumps-rubella] vaccine at a later age or the administration of a third dose would provide higher or more durable immunity.

Mumps is a disease caused by a virus that usually spreads through saliva and can infect many parts of the body, especially the parotid salivary glands. These glands, which produce saliva for the mouth, are found toward the back of each cheek, in the area between the ear and jaw. In cases of mumps, these glands typically swell and become painful. Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, more than 200,000 cases occurred each year in the United States. Since then the number of cases has dropped to fewer than 1,000 a year, and epidemics have become fairly rare.