Sunday, May 31, 2009

Bigotry Begets Bloat? So claims a new study--but the evidence is thin


Taranto dissects the illogic and assumptions behind the nonsense below quite well. One thing he misses is however perhaps the most basic: Lack of a control group. Because of affirmative action, a lot of whites feel discriminated against too. Surely their feelings should have been surveyed and their weight gain measured. It would have been interesting at least and would have given (or not) at least some grounds for generalizations. So, if anything, I would interpret the results as showing that neurotic black women tend to eat more and therefore gain weight more

"Perceptions of racism--from being treated with suspicion in a store to unfairness in employment or housing--can heighten stress levels and affect health, research has shown," reports the Boston Globe:
A new study from Boston University links these smoldering signs of racism to weight gain in black women, suggesting a possible explanation for the their higher obesity rates compared to white women.

Yvette Cozier, an epidemiologist at the Slone Epidemiology Center at BU, led a survey of more than 43,000 women enrolled in the long-running Black Women's Health Study. Writing in the June issue of Annals of Epidemiology, she and her co-authors describe participants' reports on their weight, body mass index, and perceptions of racism.

At the beginning of the eight-year study, the women were asked if they sometimes felt they were treated poorly in a restaurant or store, whether they thought people considered them dishonest or less intelligent, and if they had felt unfairness on the job, in housing, or from police. The women, 21 to 69 years old at the study's outset, were placed in four groups based on how frequently they said they experienced these signs of racism. Their weight was recorded every two years from 1997 through 2005. Their waist circumference was measured at the beginning and end.

At the end of the trial, all the women had gained weight. But the women who said they felt higher levels of racism gained more weight and had bigger waist-size increases compared to the women who felt the least racism. That held true after accounting for factors such as education, geographic region, and beginning body mass index.

"Racism is real and it has real effects," Cozier said in an interview. "It can result in real changes in the body."

In fact, Cozier's study--available here at the low, low price of $31.50--offers no support whatever for this statement.

To begin with, nothing in the study addresses the hypothesis that "racism is real," unless one defines racism solely as a phenomenon within the mind of the putative victim. The study purports to measure the prevalence of perceived racism. It does not test the accuracy of its subjects' perceptions.

Further, it appears that for part of the study, even the perception of racism was imputed by the researchers rather than reported by the subjects themselves. Here is how the study describes the questions:
Five questions asked about the frequency in daily life (everyday racism) of the following experiences: "you receive poorer service than other people in restaurants or stores," "people act as if they think you are not intelligent," "people act as if they are afraid of you," "people act as if they think you are dishonest," and "people act as if they are better than you." Response options were "never," "a few times a year," "once a month," "once a week," "almost every day." Three questions asked about lifetime experience of being "treated unfairly due to your race" on the job, in housing, and by the police (lifetime racism). Response categories were "yes" and "no."

The "everyday racism" questions are not about race! The researchers merely assume that if a black woman encounters someone who acts as if he is better than she, it must be because she is black, not because, say, he's a stuck-up jerk--or because she is oversensitive. The "lifetime racism" questions do measure perceived (though not necessarily actual) racism, but the "everyday racism" questions measure only perceived slights.

Cozier's assertion that what she baselessly calls racism "has real effects" is equally unwarranted. The study shows a correlation between what it characterizes as "perceived racism" before 1997 and weight gain in the ensuing eight years; it does not establish that the former caused the latter. To our mind it seems much more plausible to posit that the tendency to see oneself as a victim of racism (or to be perturbed by perceived slights, whether racially motivated or not) and the tendency to gain weight arise from a common cause, which one might describe as an attitude of powerlessness or a lack of self-confidence.

Relatedly, Cozier's study found that "normal-weight women were more likely to use confrontive coping ('tried to change the situation'), while overweight and obese women were more likely to use evasive coping ('put off facing the problem')." But how one copes with a problem is a separate question from one's threshold for perceiving a problem in the first place.

The study concludes by asserting that its findings "underscore the public health importance of continuing antidiscrimination efforts in this country and worldwide." Now there's a brave position! Yet it doesn't follow from the study either. To be sure, antidiscrimination efforts are worthwhile inasmuch as they prevent discrimination. But is there a shred of evidence that they reduce the level of perceived discrimination?


Green tea extract reported to show promise against leukemia

No control group and tiny sample size! Spare us! But it's only a pilot study so nobody should get excited one way or the other. Journal abstract here

Scientists are reporting positive results in early leukemia clinical trials using the chemical epigallocatechin gallate, a substance in green tea. "The majority of individuals who entered the study with enlarged lymph nodes saw a 50 percent or greater decline in their lymph node size," said Tait Shanafelt, a hematologist at the Mayo Clinic in Rochester, Minn., and lead author of the study. Moreover, "patients tolerated the green tea extract at very high doses."

The findings appeared online May 26 in the Journal of Clinical Oncology. The findings tested the chemical's effect on patients with chronic lymphocytic leukemia, the most common type of leukemia in the United States. Currently it has no cure. The illness starts with a mutation in a single blood cell called a lymphocyte. Over time, the altered cells multiply and replace normal lymphocytes in the bone marrow and lymph nodes, organs that are found all over the body and act as filters or traps for foreign particles. The lymph nodes become enlarged as a result.

About half of patients with early stage diseases have an aggressive form of the disease that leads to early death, researchers said. They hope the green tea extract can stabilize early-stage patients or perhaps work in combination with other therapies to improve their effectiveness.

Green tea is made with the leaves of Camellia sinesis, a shrub native to Asia. In the trial, 33 patients received variations of eight different oral doses of Polyphenon E, a proprietary compound whose primary active ingredient is epigallocatechin gallate. Doses ranged from 400 to 2,000 milligrams twice a day. Researchers determined that they had not reached a maximum tolerated dose, even at 2,000 mg twice per day.

The research has moved to the second phase of clinical testing in a followup trial, already fully enrolled, involving roughly the same number of patients. All will receive the highest dose administered from the previous trial. The studies are part of a multiyear project that began with tests of the green tea extract on cancer cells in the laboratory of Mayo hematologist Neil Kay, a coauthor of the study. After the research showed dramatic effectiveness in killing leukemia cells, scientists said, the findings were applied to studies on animal tissues and then on human cells in the lab.


Saturday, May 30, 2009

Surgical stockings ‘don’t prevent blood clots in stroke patients', but have nasty side-effects

Another instance of theory-based medicine doing more harm than good

Surgical stockings commonly given to stroke patients to prevent blood clots do not work, a new study suggests. Doctors have found that the compression stockings have no effect in preventing deep-vein thrombosis (DVT) — a life-threatening form of blood clot that can travel up into the heart or lungs — in people who have suffered a stroke. Research carried out by a team from the University of Edinburgh suggests that cutting the use of stockings in stroke units could save the NHS about £7 million and 320,000 hours of nursing time each year. More than 150,000 Britons a year suffer a stroke.

The stockings have been proven to reduce clots in surgery patients, so experts had long thought that the cheap solution might also help stroke patients. About two thirds of stroke patients are unable to walk on admission to hospital and approximately 15 per cent develop blood clots because of this lack of movement.

The Edinburgh team studied more than 2,500 stroke patients in Britain, Italy and Australia. All were treated with routine care, including aspirin and assisted exercise, and half were offered surgical stockings as well. After 30 days, there was no significant difference between the groups in the occurrence of DVT and the patients using stockings suffered more skin breaks, ulcers and blisters than those without. Compression stockings are still recommended for patients who have undergone surgery and for people travelling on long-haul flights.

The results were simultaneously published in The Lancet and presented at the European Stroke Conference in Stockholm on Wednesday. Martin Dennis, Professor of Stroke Medicine at the University of Edinburgh, said: “Until now, the guidelines on the use of these stockings have been based on evidence collected in surgical patients and not in stroke patients. “We have shown conclusively that compression stockings do not work for stroke patients. The national guidelines need to be revised and we need further research to establish effective treatments for these patients. Abandoning this ineffective and sometimes uncomfortable treatment will free up valuable resources in our health services.”

Charles Swainson, Medical Director of NHS Lothian, said: “This research underlines the huge importance of close collaboration between the NHS and universities. “Professor Dennis and his colleagues in Lothian and beyond could prove highly important in making sure that nursing time and NHS money are used more effectively for the benefit of patients in Scotland and throughout the world.”

Ralph Sacco, president-elect of the American Heart Association, who was not linked to the study, said: “We have used these stockings because we assume they work. But sometimes you’re surprised when you find out the truth with a randomised trial.”

The CLOTS (Clots in Legs or Stockings after Stroke) trials are funded by the Medical Research Council, Chest, Heart and Stroke Scotland, the Scottish Government Chief Scientist Office and the UK Stroke Research Network. They are also supported by NHS Lothian.

David Clark, chief executive of Chest, Heart & Stroke Scotland, which co-funded the study, said: “This important research shows conclusively that compression stockings do not prevent DVT for stroke patients and can often have unpleasant side effects. More research like this, which will make a practical and positive impact on the lives of stroke patients, is needed.”


Stem cells used to help cure sight loss

COATING a common contact lens with stem cells could help restore a person's sight, Australian scientists have found. University of New South Wales medical researchers used the technique to treat the damaged corneas of three patients, all of whose vision improved within weeks of the groundbreaking procedure. The results are published in the journal Transplant, indicating a further unique element of the world-first trial.

Stem cells were harvested from the eyes of each patient and then cultured inside a contact lens, which was then stuck onto a damaged cornea in a "transplant'' of regenerative cells. "The procedure is totally simple and cheap,'' said the university's Dr Nick Di Girolamo. "Unlike other techniques ... there's no suturing, there is no major operation, all that's involved is harvesting a minute amount - less than a millimetre - of tissue from the ocular surface.'' The lens stayed on for 10 days allowing stem cells to change their form, colonise and repair the cornea.

Two of the patients involved in the trial had suffered extensive corneal damage to one eye, caused by multiple surgeries to remove cancerous growths. Dr Girolamo said that in these cases the stem cells were taken from their healthy eye - but the third patient posed an additional challenge because of a congenital disorder which affected both eyes. "We took them from another part of the eye altogether - the conjunctiva which also harbours stem cells,'' Dr Di Girolamo said. "The stem cells were able to change from the conjunctival phenotype to a corneal phenotype after we put them onto the cornea ... that's the beauty of stem cells.''

The procedure could be replicated in third would countries by a surgeon with a laboratory for cell culture, Dr Di Girolamo said. It offered hope to people with a range of blinding eye conditions, he said, and there was also the possibility of adapting the technique to repair skin which behaved in a similar way to the eye.

The stem cell procedure was considered non-controversial, said former Deputy Chair of the Lockhart Committee on human cloning and embryo research Professor Loane Skene. "Provided that patients are told the new procedure is experimental ... and they then consent to have it, this use of a patient's own stem cells is no more ethically contentious than a skin transplant,'' Prof Skene said.


Friday, May 29, 2009

Men with big muscles cut cancer risk by 40 per cent

This is so tediously stupid. Has it occurred to any of these righteous Swedes that you probably have to be in pretty good health to start with in order to undertake long-term weight training? It is most likely the good health that they began with that accounts for their lower incidence of cancer, not the weight-training

Men with stronger muscles from regular weight training are up to 40 per cent less likely to die from cancer than men who do not pump iron, according to new research. The findings, by an international team of researchers, suggest muscular strength is as important as staying slim and eating healthily when it comes to protecting the body against deadly tumours. The scientists who came up with the findings are recommending men weight train at least twice a week, exercising muscle groups in both the upper and lower body.

In recent years, experts have recommended a healthy diet and lifestyle - including regular aerobic exercise such as jogging or cycling to reduce the risks of the disease. But the latest study, published in the journal Cancer Epidemiology, Biomarkers and Prevention, suggests it may be just as important to build up muscle strength.

A team of experts, led by scientists from Sweden's Karolinska Institute, tracked the lifestyles of 8,677 men aged between 20 and 82 for more than two decades. Each volunteer had regular medical check ups that included tests of their muscular strength. Between 1980 and 2003, researchers monitored how many developed cancer and subsequently died from it. The results showed men who regularly worked out with weights and had the highest muscle strength were between 30 and 40 per cent less likely to lose their life to a deadly tumour.

Even among volunteers who had excess tummy fat or a high body mass index, regular weight training seemed to have a protective effect. In a report on their findings the researchers stressed keeping a healthy weight was still crucial for avoiding premature death. But they added: "In the light of these results, it is equally important to maintain healthy muscular strength levels. "It's possible to reduce cancer mortality rates in men by promoting resistance training involving the major muscle groups at least two days a week."

A spokesman for Cancer Research UK said resistance exercise might have some benefit but it was more important to regularly do some cardiac exercise. Health information officer Jessica Harris said: "There's no need to become a body builder. Just 30 minutes of moderate exercise five times a week that leaves you warm and slightly out of breath can have a positive effect."


New drug delays prostate cancer slightly

One has to laugh at the original headline on this story: "Life-saving wonder drug to fight prostate cancer 'available in just two years'"

A new drug that has dramatic effects against prostate cancer could be available in just two years, scientists said last night. Successful trials have shown that it can shrink the most dangerous tumours in up to 70 per cent of cases. The drug, abiraterone, has been hailed as the biggest advance in the field for 60 years, capable of saving many thousands of lives. The British scientists behind it will start trials soon to see if it can also work against breast cancer.

Prostate is Britain's most common cancer among men and the second highest killer, after lung cancer. Some 35,000 people a year are diagnosed with it - and 12,000 die. [I am betting that all of them die. 23,000 immortals is hard to believe]

There are two types, aggressive and non-aggressive. Two-thirds of cases have the non-aggressive variety and can often lead a healthy life. But those with the aggressive version - 10,000 British men a year - usually die within 18 months of diagnosis.

Abiraterone was discovered by the Institute of Cancer Research with funding from Cancer Research UK. The latest trials on men with aggressive cancer found that just four pills a day can control the disease and reduce pain - all with few side effects. The effect does not last indefinitely - tumour growth can resume after an average of eight months. But the scientists have developed a method of prolonging the benefits for another 12 months by combining the drug with a steroid.

They also discovered that men with a particular gene abnormality - thought to drive the growth of the cancer - responded best to abiraterone. The team have developed a test for the abnormality to identify the men likely to derive the most benefit from the drug.

Lead researcher Dr Gert Attard said of the latest trial, involving 54 patients: 'These men have very aggressive prostate cancer which is exceptionally difficult to treat and almost always proves to be fatal. 'We hope that abiraterone will eventually offer them real hope of an effective way of managing their condition and prolonging their lives.'

Hormone therapy, the standard method of treating prostate cancer, involves blocking the body's production of male hormones like testosterone, which 'feed' the tumour. But it can be ineffective on aggressive forms, where the tumours produce their own hormones. Doctors can try chemotherapy, but it may have severe side effects such as nausea, pain, malnutrition, haemorrhages and hair loss. Many patients also have radiotherapy to reduce associated pain in the bones. This can also be dangerous, leaving patients with little quality of life.

Abiraterone uses a different approach, blocking chemicals in the body which help in the production of male hormones, including by tumours. Chief investigator Dr Johann de Bono said: 'This has changed the way the science community looks at prostate cancer.'

The drug is now undergoing a much larger final-stage trial in 150 hospitals worldwide. If it is successful, the scientists, who published their findings in the Journal of Clinical Oncology, hope the drug will be licensed as early as 2011. The rationing body Nice would then decide if it should be available on the NHS. Professor Peter Johnson, chief clinician at Cancer Research, said: 'These early results hold great promise and give real hope for the future. 'We are keen to see the results of larger trials now under way, to find out whether abiraterone should be made generally available.'


Thursday, May 28, 2009

Life expectancy around the world

Note that life expectancy is an actuarial projection, not a report of actual age at death. If the conditions relevant to mortality change, the current projection could be quite wrong. In the case of Japan, error seems likely. There are now many old peoiple in Japan but that is probably true because of limits on total calorie intake that prevailed in Japan up to about 1960. Many Japanese had insufficient food to eat all they wanted up to then. And calorie restriction leads to life extension. In more recent decades, however, Japan has become a rich country and involuntary calorie restrictions should have almost completely vanished. The Japanese of the future may therefore live noticeably shorter lives that their forbears. Japanese diets have changed a lot too but the evidence for dietary effects on lifespan is scant

A GIRL born in Japan today will likely live to celebrate her 86th birthday, the longest life expectancy anywhere in the world. Men fare best in the tiny, wealthy European nation of San Marino, where the average boy will live to 81.

The West African country of Sierra Leone has the shortest life expectancy for men - just 39 - while Afghanistan fares badly for both sexes, with men and women living to 41 and 42 years respectively.

Those figures come from the World Health Organisation, which announced its annual health statistics on Thursday on the year 2007, the latest figures available.

The data showed that some countries have made remarkable progress in increasing life expectancy since 1990 - partly by ending wars, partly through successful health initiatives....

In the United States, the life expectancy was on the rise for both sexes, but not so dramatically: up to 76 from 72 years for men, and to 81 from 79 for women. Other countries, meanwhile, showed a sharp decline since 1990, especially in Africa....

In Russia, the average life expectancy for men dropped to 60 from 64 years since the time of the Soviet Union. For women the drop was less marked, to 73 from 74 years.

The figures are only one of over 100 health indicators that WHO tracks in its 193 member states. Others include mother and child mortality; prevalence of diseases such as HIV, malaria and tuberculosis; access to doctors and medical facilities; and health expenditure per person.


Natural childbirth techniques 'make no difference' to women

Antenatal programmes focusing on 'natural' techniques did not cut rates of Caesarean births. Classes on birth techniques involving breathing, relaxation and massage make no difference to women's experience of labour, claim researchers. Pain-relieving epidural injections were needed for pregnant women who had attended these advanced classes just as often as for those given standard antenatal classes.

The findings will come as a blow to thousands of expectant mothers who, keen to increase their chances of a natural birth, learn yoga breathing exercises and self-hypnosis while their partners are taught how to massage them during labour.

Professor Philip Steer, editor-in-chief of BJOG: An International Journal of Obstetrics and Gynaecology, which is publishing the Swedish research, said: 'The findings of this study are contrary to what many of us would expect. 'The lack of benefit is disappointing, and suggests that parents' experience of childbirth is affected more by their personality and previous psychological orientation than by the relatively limited training that is possible during pregnancy. 'An alternative view is that standard antenatal classes are "good enough" and therefore represent an effective use of limited resources.'

The study, which involved 1,087 first-time mothers and 1,064 of their partners, was run by the Department for Woman and Child Health at the Karolinska Institute in Sweden between January 2006 and May 2007. Participants were randomised into two groups for antenatal classes. The standard care group were provided with information about childbirth and parenting, modelled on the standard Swedish antenatal education programme.

The researchers anticipated that those in the 'natural' group would have fewer Caesareans, epidurals, and instrumental deliveries (i.e., requiring forceps). But the epidural rate was 52 per cent and the spontaneous birth rate 66 per cent in both groups.

The Caesarean section rate was 20 per cent in the 'natural' group and 21.5 per cent in the standard group. The instrumental delivery rate was 14 per cent in the 'natural' group and 12 per cent in the standard group. There were also no statistically significant differences between the groups in the satisfaction of the childbirth experience or postnatal parental stress three months later.

British reaction to the study was muted, with the National Childbirth Trust saying it was impossible to tell how the Swedish experience compared with that in Britain. Belinda Phipps, the parenting charity's chief executive, said: 'This limited study in Sweden compares two slightly different types of antenatal education and does not look at the more common situation in the UK which is no or limited antenatal preparation.

'NCT antenatal classes are valued by parents and cover many topics including parenting, baby-feeding, physical skills for labour and information about the birth as well as relaxation and breathing.'


Wednesday, May 27, 2009

Grow old gracefully to keep dementia at bay

Amusing. Below is a recitation of popular assertions about Alzheimer's. See here for my comments on the "growing old" study that he refers to. As is usual among journalists, he has ignored all the ifs and buts in the study concerned. His recommendations are a house built on sand. Yet the article comes from "The Times", of London, which makes it likely to be widely trusted

Working until you are 70 instead of 65 is one of the ways that you can minimise the risk of brain disease in later life. The Government is rumoured to be considering raising the retirement age to 70 in an attempt to reduce the national debt — plans that will have been given a useful fillip by new research that reveals postponing retirement can delay the onset of Alzheimer’s disease.

According to researchers from the Institute of Psychiatry, at the Maudsley Hospital, southeast London, every extra year worked delays the onset of dementia by just over a month. So working until you are 70 instead of 65 is likely to give you an extra six Alzheimer-free months. I am not sure that is enough of a benefit to warrant the additional effort, but extending your working life is not the only thing you can do to protect yourself.

One person in 20 over the age of 65 in the UK has some form of dementia. Alzheimer’s disease — characterised by a loss of brain cells, shrinkage and protein deposits forming tangles and plaques throughout the brain — may be the most common form, but it is not the only one. Gradual furring up of the arteries supplying the brain accounts for at least 20 per cent of cases and causes similar impairment to Alzheimer’s with resulting loss of memory and cognitive ability, disorientation and confusion. And, while there isn’t much we can do to slow the progression of Alzheimer’s disease, there is a lot that can be done to keep our brain and its circulation healthy — and the healthier your brain the less noticeable any deficit is going to be.

Use it or lose it. The brain is often compared to a muscle in that “exercising” it can slow the damage time brings, and challenging yourself mentally every day will help to keep you sharp. The latter can include hobbies, keeping up an active social life, learning new skills, doing crosswords and puzzles and brain-training games and, as the recent research has shown, working for longer.

The brain is made up of around 100 billion nerve cells, each connected to thousands of others through synapses and it is a decrease in this interconnectivity, rather than the loss of brain cells alone, that is responsible for the slowing of mental agility that occurs with advancing years. Challenging the brain is thought to help by maintaining existing synapses and encouraging the formation of new ones...

Check for diabetes. Ask the nurse at your doctor’s surgery for a blood test if you suspect diabetes — clues include a great thirst, peeing more than normal, recurring infections such as boils or thrush, lack of energy and blurred vision. Those most at risk include the overweight, anyone with a family history of the condition and those of Asian and Afro-Caribbean origin.

Drink in moderation. While sensible drinking — the equivalent of two or three small glasses of wine on most days for a woman and three to four for a man — can protect against some forms of dementia, heavy drinking has the opposite effect. One recent review suggests that alcohol accounts for at least 10 per cent of all UK dementia cases. You don’t have to be middle-aged or elderly to be at risk: there is evidence that heavy drinkers in their thirties and forties already have significant memory impairment.

Eat oily fish. Fresh tuna and tinned salmon, or fish oil capsules, may protect against Alzheimer’s disease and improve brain function. The exact mode of this protection is now under investigation, but it is thought that the omega-3 fatty acids in fish oils may slow the formation of plaques — an effect that may be enhanced by fatty acids also seeming to protect the delicate lining of the arteries supplying the brain, thus helping to maintain good blood flow. One American study found that men and women eating at least one portion of fish a week were half as likely to develop Alzheimer’s as those who didn’t eat any.

But the case is not so strong for another popular brain supplement. It is thought that as many as one person in ten with dementia is now taking ginkgo biloba despite the latest evidence, which suggests that, while the herb may boost blood supply to the brain, this doesn’t translate into any significant benefit.

Consider hormone replacement therapy (HRT). Women who take HRT have been shown in a number of studies to be less likely to develop Alzheimer’s disease later in life. But HRT has no impact on the progression of the disease once a woman develops the condition. Bottom line? It is a useful side benefit, but concerns about Alzheimer’s disease on their own are not a strong enough indication to prescribe HRT in women who are not having menopausal symptoms.


A Low-Carb Diet Can Hurt Your Memory

As a before-and-after study, this would seem to be well-controlled research

Low-carbohydrate diets are notoriously difficult to adhere to for long periods of time. Many of my patients have tried a low-carb diet and lost weight, some over 100 pounds, but most often the weight came back... and then some. Repeatedly gaining and losing weight (yo-yo dieting) can slow metabolism and pose risks to your overall health. Now, scientific studies are questioning whether these diets are dangerous to your brain's memory function, too.

Researchers at Tufts University have found that dieters who strive to eliminate most carbohydrates from their diets scored significantly lower on memory-based tasks than did subjects who simply reduced the amount of calories they ate.

The study subjects included 19 women ages 22 to 55, 9 of whom were put on a low-carbohydrate diet and 10 on a low-calorie but balanced diet. All subjects attended 5 memory-testing sessions in which their spatial memory, attention, cognitive skills, and short and long-term memory were assessed. These sessions were conducted throughout the 3 weeks of the study.

After 1 week of severe carbohydrate restriction, memory performance among the low-carb group, especially when dealing with difficult tasks, gradually decreased compared with the low-calorie group. In addition, the low-carb dieters had slower reaction times and faltered during tests of their visual-spatial memory.

The brain uses glucose as its main fuel but has no way of storing it for future use. The nerve cells use glucose immediately for energy, and if they cannot get this fuel, they aren't able to operate at peak capacity -- potentially leaving you feeling forgetful or unable to concentrate.

I read a study recently that found students and others who continually challenge their minds actually require more carbohydrates, and thus, seem to crave carbohydrate foods in direct proportion to how much they have to exert their brains. Perhaps carbohydrate cravings in such cases are the body's way of getting the brain the fuel it needs.

This study only tracked the dieters for 3 weeks and the study's sample size was small, but the authors suggest that, although low-carb diets can affect weight, they result in a lack of glucose to the brain that may be detrimental to learning, memory, and thinking.

According to the Tufts study, the popular low-carb diets—and particularly the "no-carb" diets—have the biggest potential for decreasing the ability to think and concentrate, and may also negatively affect overall mood. This could be one of the reasons many people have a hard time sticking with a no-carb meal plan.

Although carb-free diets may seem appealing, aim for at least a moderate amount of carbohydrate in your diet. In my weight-loss/nutrition practice at Johns Hopkins Bayview Medical Center, I refer to clinical research findings that suggest that for optimal function the human brain needs a minimum of 125 grams of carbohydrate each day.


Tuesday, May 26, 2009

Three cups of tea a day 'can cut heart attack risk by 70%'

And pigs might fly. This is just tea industry puffery and one would have to look individually at the raft of findings referred to. As far as I am aware, however, all the human studies are epidemiological and hence incapable of enabling causative inferences. See e.g. here. And one of the studies apparently referred to below was downright dishonest

Drinking three cups of tea a day can ward off heart attacks, a dietician has claimed. The beverage could even have anti-cancer properties, a review of previous research suggests. The link between coronary heart disease and tea has been the subject of a large number of studies.

Dr Carrie Ruxton, a member of the Tea Advisory Panel, analysed some of these, which highlighted the effectiveness of naturally occurring compounds called flavonoids in combating heart attacks. One Finnish study found men who drank more than two cups of tea a day had a 21 per cent reduced chance of stroke. French research showed that women who drank more than three cups a day had a 32 per cent lower risk of blocked arteries.

Dr Ruxton said the research showed at least three cups of tea a day can lower the risk of a heart attack by up to 70 per cent. She said: 'We are not sure of the exact mechanism, but it is thought that tea flavonoids could be involved in controlling inflammation, reducing thrombosis, promoting blood vessel function and helping to limit furring up of the arteries.' The studies found tea may be 'a useful addition to an anti-cancer diet', she added, but further research was needed.

Dr Ruxton said: 'Tea may be a national favourite but it also has health benefits thanks to its high flavonoid content. 'My research shows there is a growing amount of evidence which indicates tea can play a role in helping to combat cardiovascular problems such as heart disease and stroke. 'This area of research is very exciting for the future. We also found solid evidence of tea helping to boost cognitive function and reduce stress, probably related to tea's modest caffeine content. 'Some interesting research on the role of tea flavonoids in helping to combat certain neurological conditions is emerging.' She added: 'Research shows you do not need to drink gallons of tea to get real improvements just three or four cups of tea a day are enough.'

Dr Catherine Hood, another Tea Advisory Panel member, said: 'The scientific community is learning more and more about tea and its health properties. 'Studies show that there are some very powerful ingredients in tea that can play a hugely important role in protecting the body from some serious and potentially fatal conditions. 'A cuppa is a great way to relax or unwind but could also give your health a crucial boost. 'Just a few cups a day have been shown to help and drinking more isn't a problem either as up to eight cups a day have been shown to be fine.'

Tea is the most consumed drink after water with 131,150 tons of tea consumed in the UK in 2006/07. Nearly eight in ten adults drink an average of 2.3 mugs a day.


How to lie with statistics — sometimes without even trying

Some old and simple truths below but they are much forgotten truths too

Some time back, there were news stories reporting on studies of several communities that showed smoking bans to be followed by reductions in heart attacks. There are now reports of a much larger study done at the NBER which finds no such effect. How can one explain the discrepancy?

The simple answer is that in some communities heart attack deaths went up after smoking bans, in some they went down, in some they remained more or less unchanged. Hence a study of a single community could find a substantial reduction even if it was not true on average over all communities.

How did the particular communities reported in the early stories get selected? There are two obvious possibilities.

The first is that the studies were done by people trying to produce evidence of the dangers of second hand smoke. To do so, they studied one community after another until they found one where the evidence fit their theory, then reported only on that one. If that is what happened the people responsible were deliberately dishonest; no research results they publish in the future should be taken seriously.

There is, however, an alternative explanation that gives exactly the same result with no villainy required. Every year lots of studies of different things get done. Only some of them make it to publication, and only a tiny minority of those make it into the newspapers. A study finding no effect from smoking bans is much less likely to be publishable than one that finds an effect. A study finding the opposite of the expected result is more likely to be dismissed as an anomaly due to statistical variation or experimental error than one confirming the expected result. And, among published studies, one that provides evidence for something that lots of people want to believe is more likely to make it into the newspapers than one that doesn't.


Monday, May 25, 2009

Pesky! Swine flu did NOT come from industrial farming

It's the greatest of political sins, to fail to make use of a good crisis. One example of those trying to do so might be the recent EU report on financial market regulations. Hedge funds and private equity are to be brought under tighter control despite their having nothing whatsoever to do with the current problems.

Another attempt which is unfolding under our very eyes is the attempt to portray this swine flu as being an example of the evils of industrial farming.
The Mexican swine flu, a genetic chimera probably conceived in the faecal mire of an industrial pigsty, suddenly threatens to give the whole world a fever.

It's not a chimera, of course, as that would be mixed DNA rather than mutated. It's also an interesting thought for that's not really how we expect zoonoses to arise. For a disease to spread from one species to another, to become cross infectious, we actually think we need to have the two species living in close proximity. Like the Hong Kong bird flu of 68 came from the way in which small holding farmers in that at the time poor country lived cheek by jowl with their birds. Or SARS from Vietnam from the similarly close proximity of stock and human. (No, Spanish flu was not thought to come from humans associating too closely with Spaniards.) That is, we expect such diseases, and we've seen that they do historically, to come not from industrial farming, but from small scale peasant farming. Sleeping above the stock (rather than, erm, with it) is the cause, not having tens of thousands of stock that have little inter species contact.

But of course this should not get in the way of using a good crisis to get whatever it is that you've already decided you want, as Caroline Lucas shows us:
More research is urgently needed to explore the potential link between industrialised animal farming, and the spread of disease. Some elements of the Mexican media are already pointing to the potential role of intensive pig farming in Mexico, which has grown substantially in recent years, with some giant operations raising tens of thousands of pigs at a time.

Very well, let us have some more research. How about a bit of empiricism, some collection of relevant facts?
But agricultural in spection officials say there is no swine flu virus among the pigs at these farms.

So theory says we wouldn't expect large single species farms to produce zoonoses and the facts say that it didn't. Another glorious theory ruined by those pesky facts perhaps? But unfortunately I doubt that will be enough to drown out the siren voices desirous of making good use of this crisis.


Hooray! Australian health authorities are being ignored in their battle against the mythical obesity epidemic

Average weight increases among children stopped in 1998

HEALTH authorities are losing the obesity battle, with almost one in two children admitting they go to school with a packet of chips in their lunch boxes. A new survey reveals 46 per cent of children take chips to school, while 11 per cent say they eat breakfast no more than once a month. And hot dogs, chips, hamburgers and pies are the most popular with children who buy their lunches - either at school or on weekends. The number of students ordering the fatty favourites is double those buying fruit and salad, the Cartoon Network survey reveals.

In some good news, 59 per cent of children have fruit in their lunch box each day. But lollies and sweets feature in the lunches of one in five students.

Schools across Victoria are introducing eating programs to help parents pack healthier lunches for their children. Nutrition Australia has helped more than 50 schools with Reclaim the Lunchbox sessions to help parents cut high-fat, high-salt snacks. But project officer and nutritionist Linden Clarke admitted there was still work to do to change the eating habits of school children. "Packaged snacks are not healthy and they can be expensive," Ms Clarke said. She said packets of chips could not only cause constipation in children because of the products' low fibre content, but also create litter problems for schools.

In January 2007, the State Government banned soft drinks, hot chips, battered sausages, cakes and ice cream from school canteen menus. Lollies and sweets were banned from canteens from this year. But principals said some students left the school grounds to buy takeaway lunches nearby.

Oak Park Primary School has led the fight against fat by changing its lunch timetable to 11am to encourage children to eat a main meal earlier in the day. Acting Principal Trevor Daly said the scheme meant children ate slow-burning foods earlier so they concentrated for longer. They had their high-energy snacks in afternoon recess instead.


Sunday, May 24, 2009

Can a junk food diet harm pupils' performance?

The usual "correlation is causation" junk science: No account taken of social class. Middle class people tend to be smarter and many would be mortified to be seen inside a McDonald's. And kids tend to inherit their parents' IQ. That's the probable reason why a "junk food" diet goes with lesser academic achievement. It is because of social class effects, not food effects

The link between junk food and poor performance at school has been proved, say researchers. There is a direct correlation between the amount of high fat and sugary foods pupils consumed and their academic results, according to a U.S. study. Researchers asked more than 5,500 ten and 11-year-olds to record how many times a week they ate at fast food restaurants. Just over half had eaten fast food between one and three times during the previous week. Ten per cent had eaten it between four and six times and two per cent said they ate junk food four or more times a day.

Dr Kerri Tobin, of Vanderbilt University in Tennessee, said the children were given literacy and numeracy tests. The average literacy score was 141.52 points and in numeracy, 115.24 points. Pupils who ate junk food between four and six times a week scored 6.96 points below average in reading. Those who ate it daily dropped 16.07 points and pupils who indulged three times a day dropped 19.34 points.

In maths, those eating fast food between four and six times a week scored 6.55 points below average. Daily junk food led to a 14.82 point drop and a three-a-day habit led to a 18.48 point drop.

Tam Fry of Britain's National Obesity Forum said: 'If you start to feed your children better food, all their educational processes improve - their attention span, learning and behaviour.'


Meat pies and lamingtons hit NYC

Meat pies are Australia's national food. I suffer pie-deprivation feelings if I don't have at least one a week. A pie getting sauced first below followed by a tray of lamingtons

A MELBOURNE businessman is beating the US economic downturn - one pie at a time. University dropout Lincoln Davies, 37, is about to expand his booming pie-making business by opening a second store in downtown Manhattan. "Our business just keeps getting stronger," Mr Davies said. "We expanded as soon as we got the money to do it." April sales at his eastside hangout the Tuck Shop are up 30 per cent on last year and since 2007 weekly turnover has doubled.

Co-owner Niall Grant said there was never a better time to be flogging pies to Americans. "There is more demand than ever for inexpensive, good quality comfort food in New York," Mr Grant said. "We noticed a real spike in October when the downturn really hit."

Now, they sell about 200 meat pies a day, drumming up most of their business through word of mouth. The grungy cafe, which opened in 2005, is well known among Australians but even after four years it still has some locals mystified. "They think a pie is a pizza," Mr Davies said. So how does he educate them? "I just tell them to start eating."

Davies abandoned his business degree at the Melbourne University and fled to Noosa before moving to London where he faked his way through a career in finance by pretending he had an accounting degree. He eventually landed in New York, where he opened the business.


Saturday, May 23, 2009

Is red meat bad for you?

Below is a research summary circulated on a mailing list for medical practitioners. It arrived under the heading: "Red meat is bad for you —and bad for everyone else". Further below is the journal abstract (summary) concerned -- from a very respectable medical journal. The whole thing is, however, one big confidence trick and will achieve nothing other than frightening people off perfectly harmless food that they would otherwise enjoy. The entire report is a scientific, statistical and ethical nothing. Let me tell you very quickly why.

For a start, the "hazard ratios" (relative risks) reported are negligible -- at 1.2, 1.3 etc. The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0."

OK. So who cares about a silly old Federal Reference Manual on Scientific Evidence? But it gets worse. The findings are reported in terms of upper and lower quintiles. In other words they threw away three fifths of the information that they had in order to arrive at their reported conclusions. That is quite simply dishonest and unethical. NO categorization of such data for analytical purposes is now ethically defensible. In pre-computer days, when all calculations had to be performed by hand, doing so could in some cases be justified but with the advent of computers there is NO reason why regression techniques that include ALL the data cannot be used. I note that before I had access to computers, I analysed the data from my first ever piece of research (in 1966) using a regressional technique. Even at that early stage I did not contemplate throwing away any of my data in the course of analysing it.

Had the whole of the data been analysed using a regressional technique, there is no doubt the the resultant correlation between meat consumption and disease would have been derisorily small and maybe even of negative sign, indicating that red meat eating is NOT a cause of cancer, heart disease etc. It is certainly not "bad for you —and bad for everyone else". The authors would of course be aware of that but have nonetheless chosen to present their data in a way that makes mountains out of pimples, which seems to me quite simply unethical.

So how did such a piece of utter crap get published in a medical journal? More particularly, why is such crap ROUTINELY published in medical journals? I am afraid that it is a sad outcome of the "publish or perish" regime that prevails in academe. Researchers need to get papers published in order to be promoted. So a well-meaning consensus has emerged among journal editors that they will accept extreme quintile reports out of solidarity with their colleagues. Otherwise they would have to reject more than half of what they currently publish. That the practice routinely results in the public being deceived is of no account. It is an utter disgrace but I doubt if I will live to see it stopped. An ethical vacuum prevails where the public would normally expect the highest ethical standards.

The emailed circular from DocAlert Messages below:
Further evidence of a link between red meat and poor health has emerged from a large cohort of older US adults. Men and women in the top fifth of red meat intake had a significantly higher risk of death over 10 years than men and women in the bottom fifth (hazard ratio for men 1.31, 95% CI 1.27 to 1.35; for women 1.36, 1.30 to 1.43). The authors also found a link between death and a high intake of processed meat such as bacon, ham, and sausage.

The 545 653 adults were between 50 and 71 when they filled in a detailed food frequency questionnaire in 1995. By 2005, more than 71 000 had died. These large numbers mean the authors were able to estimate with some precision the risks associated with eating red and processed meats for both men and women. The analyses were fully adjusted for other lifestyle factors likely to influence lifespan, especially smoking.

These data add to other observational studies that suggest we should all eat less red and processed meats. Not least because the increasing consumption of meat in many countries is putting a strain on global supplies of water, energy, and food in general, says a linked comment (p 543). It is costlier in all these precious resources to grow meat to eat than to grow vegetables and grains instead.

Journal abstract below:
Meat Intake and Mortality: A Prospective Study of Over Half a Million People

By Rashmi Sinha et al.

Background: High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.

Methods: The study population included the National Institutes of Health–AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire administered at baseline. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of meat intake. The covariates included in the models were age, education, marital status, family history of cancer (yes/no) (cancer mortality only), race, body mass index, 31-level smoking history, physical activity, energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption, and menopausal hormone therapy among women. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.

Results: There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up. Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality. Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes. Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes. When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.

Conclusion: Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

Arch Intern Med (2009) Vol. 169 No. 6. 562-571

In addition to the statistical and ethical failures that I have detailed above, there are of course other large problems with the interpretation of the study. The first or second thing you learn in Statistics 101 is that "correlation is not causation". The authors above were cautious NOT to make causative inferences from their data but that message got lost downstream. Even well-informed people reading the report DID assume a causative relationship. They assumed that red meat eating CAUSED heart disease etc. But NO epidemiological study enables causative inferences. There could easily be third or fourth factors producing the observed association.

Just to give a top-of-the head example of how that could have played out: Given the weak associations reported, maybe a substantial proportion of those who ate little or no meat were Seventh Day Adventists. Adventists are an exceptionally healthy group who encourage vegetarianism. So WHY are they exceptionally healthy? Nobody really knows but it seems likely that the strong social and psychological support that they get from their heavy church involvement reduces stress and thus also reduces stress-related disease. And heart disease is partly a stress-related disease. So even if we accept as proper the statistical jiggery pokery reported above we may be basing our conclusions entirely on the doings of Seventh Day Adventists -- which is not of much relevance to the rest of society.

Research hints kids can defeat autism

I believe this. Austistic people are often highly intelligent and high intelligence can help people learn more adaptive behaviour. The famous John Nash even overcame schizophrenia by himself

Leo Lytel was diagnosed with autism as a toddler. But by age 9, he had overcome the disorder. His progress is part of a growing body of research that suggests at least 10 percent of children with autism can "recover" from it - most after undergoing years of intensive behavioral therapy.

Skeptics question the phenomenon, but University of Connecticut psychology Professor Deborah Fein is among those convinced it's real. She presented research last week at an autism conference in Chicago that included 20 children who, according to rigorous analysis, got a correct diagnosis but years later were no longer considered autistic.

Among them was Leo, a boy in Washington, D.C., who once made no eye contact, who echoed words said to him and often spun around in circles - all classic autism symptoms. Now he is an articulate, social third-grader. His mother, Jayne Lytel, says his teachers call Leo a leader.

The study, funded by the National Institute of Mental Health, involves youths ages 9 to 18. Autism researcher Geraldine Dawson, chief science officer of the advocacy group Autism Speaks, called Fein's research a breakthrough. "Even though a number of us out in the clinical field have seen kids who appear to recover," it has never been documented as thoroughly as Fein's work, Dawson said. "We're at a very early stage in terms of understanding" the phenomenon, Dawson said.

Previous studies have suggested between 3 percent and 25 percent of autistic kids recover. Fein says her studies have shown the range is 10 percent to 20 percent.

But even after lots of therapy - often carefully designed educational and social activities with rewards - most autistic children remain autistic. Recovery is "not a realistic expectation for the majority of kids," but parents should know it can happen, Fein said. Doubters say "either they really weren't autistic to begin with . . . or they're still socially odd and obsessive, but they don't exactly meet criteria" for autism, she said. Fein said the children in her study "really were" autistic and now they're "really not."

University of Michigan autism expert Catherine Lord said she also has seen autistic patients who recover. Most had parents who spent long hours working with them on behavior improvement. But, Lord added, "I don't think we can predict who this will happen for." She does not think it's possible to make it happen.

The children in Fein's study, which is still ongoing, were diagnosed by an autism specialist before age 5 but no longer meet diagnostic criteria for autism. The initial diagnoses were verified through early medical records. Because the phenomenon is so rare, Fein is still seeking children to help bolster evidence on what traits formerly autistic kids may have in common. Her team is also comparing these children with autistic and non-autistic kids. So far, the "recovered" kids "are turning out very normal" on neuropsychological exams and verbal and non-verbal tests, she said.

The researchers are doing imaging tests to see if the recovered kids' brains look more like those of autistic or non-autistic children. Autistic children's brains tend to be slightly larger than normal. Imaging scans also are being done to examine brain function in formerly autistic kids. Researchers want to know if their "normal" behavior is a result of "normal" brain activity, or if their brains process information in a non-typical way to compensate for any deficits. Results from those tests are still being analyzed.


Friday, May 22, 2009

Alzheimer’s research links postponed retirement with later onset

I am glad that there is at least SOME humility expressed below about the implications of the correlation. That early signs of Alzheimers might tend to force people into retirement seems not to have been considered. So which is it?" Early retirement causes Alzheimers or Alzheimers causes early retirement?" Nobody knows -- despite the confident pronunciamentos from some of the people quoted below. The usual epidemiological crap

Working until 65 or beyond could postpone the onset of dementia. A study of 382 men found a significant association between later retirement and later onset of Alzheimer’s disease. The research supports previous theories that keeping the mind active for as long as possible can help to postpone mental decline. In contrast to earlier studies, however, the researchers found that the quality or duration of the men’s education or the type of work they did had no impact on the age of onset of the disease.

The team from Cardiff University and the Institute of Psychiatry, King’s College London, identified men with “probable” Alzheimer’s disease from clinical databases from the Medical Research Council and Alzheimer’s Research Trust. They compared their retirement dates and found that every extra year worked postponed the onset of dementia symptoms by nearly six weeks.

The National Institute for Economic and Social Research has suggested that the official retirement age be raised to 70 within a decade to mitigate the effects of government debt.

Publishing their findings today in the International Journal of Geriatric Psychiatry, the study authors say that the association between later retirement age and later Alzheimer’s onset was “significant”. But, they add, there could be several explanations for this, including previous ill health having influenced a decision to retire. Further studies were needed across a wider group of people to confirm the findings, they said.

The Alzheimer’s Society said: “There could be a number of reasons why later retirement in men is linked with later onset of dementia. Men who retire early often do so because of health conditions, such as hypertension or diabetes, which increase your risk of dementia. It could also be that working helps keep your mind and body active, which may reduce risk of dementia. “The best way to reduce your risk of dementia is to combine keeping physically active, with eating a balanced diet and getting your blood pressure and cholesterol checked regularly.”

There are 700,000 people in Britain with dementia, 417,000 of whom suffer from Alzheimer’s disease. It is expected that a further one million people will develop dementia in the next ten years. The average age of retirement for the men in the study was 63.3 years. The average age of onset of Alzheimer’s was 75.6 years.

Simon Lovestone, scientific adviser to the Alzheimer’s Research Trust and the paper’s co-author, said: “The intellectual stimulation that older people gain from the workplace may prevent a decline in mental abilities, thus keeping people above the threshold for dementia for longer. Much more research is needed if we are to understand how to delay, or even prevent, dementia.”

Rebecca Wood, chief of the research trust, which funded the study, said: “More people than ever retire later in life to avert financial hardship, but there may be a silver lining: lower dementia risk. Much more research into lifestyle factors is needed if we are to whittle down the £17 billion a year that dementia costs our economy.”


MA: State set to mimic NYC calorie listing regs

It has been a year since the nation's biggest city became the first to order McDonald's, Starbucks, and other restaurant chains to post calories on menu boards as prominently as prices.

Now, as health regulators in Massachusetts appear poised to adopt similar rules this morning, residents might want to listen to hungry, harried New Yorkers to know what is coming. From the West Side to the East Side, fast-food aficionados insist they still peek at the calorie counts and, sometimes, make healthier choices when they see, for example, that an angus burger with bacon and cheese at McDonald's is laden with 820 calories.

But the lure of sweet, calorie-rich offerings remains powerful - even if customers know that a single, creamy coffee drink can pack 400 calories or more. Consider Niles Patel. He visited a Midtown Manhattan McDonald's yesterday afternoon, and after reflecting on the menu board summary, he ordered a chicken sandwich wrap, containing just 260 to 340 calories. But he topped off his meal with a sundae, loaded with roughly the same tally of calories. "I do pay attention to it," Patel, 33, of North Bergen, N.J., said of the calorie listing, "but there's no rhyme or reason to whether I follow it."

Surveys by the New York City Department of Health suggest that the calorie counts at least make people think a bit more about what they put in their stomachs. Since the calorie regulation went into effect in New York last May, 67 percent of patrons at national chains reported they saw the postings, and 25 percent of those who noticed the listings said the information factored into their orders.

"That works out to hundreds of thousands of people a day because so many people eat fast food every day," said Dr. Lynn Silver, assistant commissioner for chronic disease prevention in New York. "But the information needs to be front and center on the menu boards to be seen by most people," Silver said.

The calorie rules, which have been adopted in cities as far-flung as Philadelphia and Seattle in the past year, were born of frustration among doctors and health specialists who watched with growing alarm as the nation's collective waistline ballooned during the past two decades. Two of three American adults weigh too much.

And with studies showing that Americans consume one-third of their calories outside the home, fast-food chains, with standardized menus and a penchant for super-sizing, have become a top target for regulators. Even before New York made it the law, Subway sandwich shops, like the one on Ninth Avenue near 53d Street, started listing calories next to prices. The manager, Mustapha Laababer, said a few times every day, customers grill him about the calorie readings. "They care about calories," Laababer said, "especially women....

Fast-food chains have, for the most part, been measured in their response to the calorie posting laws, although several, including Canton-headquartered Dunkin' Donuts, have called for a single national standard rather than a patchwork of local regulations.

In Massachusetts, the rule is expected to win approval today from the Public Health Council, an appointed board of doctors, public health specialists, and consumer advocates. It would apply to chains with 20 or more restaurants in the state. Establishments would have until November of next year to comply, and the regulations would not apply to grocers or school cafeterias.

John Auerbach, the Massachusetts public health commissioner, said his agency was realistic about what the calorie-posting law can accomplish. "We need to work on many fronts in terms of changing people's behaviors and encouraging healthy nutrition and more exercise," Auerbach said. "And menu labeling is certainly one piece of it, but it's not the entire answer to the problem."


Alair heat treatment cuts asthma emergencies

Any good news about asthma is very welcome

AN experimental asthma treatment that uses heat to reduce airway constriction provided some relief from severe asthma that is poorly controlled with medications, US researchers said. They said the Alair device, made by privately held Asthmatx Inc of Sunnyvale, California, cut the rates of extreme asthma attacks by 32 per cent and reduced trips to the emergency room by 84 per cent in patients with severe asthma.

Patients missed fewer days of work or school because of asthma symptoms and had more symptom-free days compared with people who received a placebo, according to results of the late-stage clinical trial.

The Alair device uses a thin tube to gently heat the walls of the lung's air passages, killing off some of the muscle tissue to reduce narrowing of the airways. "In asthma, what happens is these patients develop enlarged smooth muscles surrounding their bronchial tubes," Dr Mario Castro of Washington University said. "That contributes to asthma attacks.

Dr Castro and colleagues tested the device in 297 patients with severe asthma in six countries. Researchers split the patients into two groups. Two-thirds got three treatments with the Alair device, and the rest received a placebo treatment, in which the heat was not applied. The patients were followed closely for a year. Overall, 79 per cent of patients who got the experimental treatment improved. Dr Castro said the other group also improved, [placebo] but the treatment group showed a statistically significant improvement.

He said all of the patients were taking inhaled drugs combining a corticosteroid and a long-acting beta-agonist, such as in GlaxoSmithKline Plc's best-selling drug Advair. But they were still not getting adequate relief.

Asthmatx Inc is seeking US Food and Drug Administration approval for the device, with a decision expected in spring. The treatment has been approved in Europe.


Thursday, May 21, 2009

Happiness Is ... Being Old, Male and Republican

Americans grow happier as they age, surveys find. And a new Pew Research Center survey shows the tendency is holding up as the economy tanks.

Happiness is a complex thing. Past studies have found that happiness is partly inherited, that Republicans are happier than Democrats, and that old men tend to be happier than old women.

And even before the economy got nasty, seniors were found to be generally happier than Baby Boomers. Some of that owes to the American Dream being lived by past generations, while Boomers work two jobs and watch the dream wither. In times like this, it's clear how age can have its advantages. While not all seniors are weathering the recession well, for many the impact is much less severe than it is for younger people.

Why? Many people 65 and older retired and downsized their lifestyles before the economy imploded, according to Pew analysts. Most aren't raising kids and many are not so worried about being laid off. Loss of income can be, of course, a source of stress and displeasure. (While money doesn't buy happiness, a study in February showed cash can help, especially when people use it to do stuff instead of buy things.)

If you're thinking that Republicans are happy just because they perhaps make more money, that does not seem to be the case. The study that found Republicans to be happier than Democrats also showed that it held true even after adjusting for income.

It's those age 50-64 who've "seen their nest eggs shrink the most and their anxieties about retirement swell the most," the Pew survey found. It also finds that younger adults (ages 18-49) "have taken the worst lumps in the job market but remain relatively upbeat about their financial future."

Not everyone in any category is blissful, of course. Other research has shown that happiness in old age depends largely on attitude factors such as optimism and coping strategies. Add financial planning to the list.

In the new Pew telephone survey, taken in March and April of 2,969 adults, here's how many respondents in each age group said they had cut back on spending in the past year:

18-49: 68 percent
50-64: 59 percent
65+: 36 percent.

And is the recession causing stress in your family?

18-49: 52 percent
50-64: 58 percent
65+: 38 percent.

Now for the good news: A study in January found that key groups of people in the United States have grown happier over the past few decades, while other have become less so. The result: Happiness inequality has decreased since the 1970s. Americans are becoming more similar to each other on the happiness scale.


Old-time toys are the best

This may well be true but no research evidence is quoted

CREATIVE play with traditional toys and games is a healthy way to stimulate the imagination and support learning, childhood development experts say. University of Adelaide child psychiatrist Dr Jon Jureidini is concerned about the shift towards electronic toys and computer games. "The role of the child in play becomes more reactive," he said. "Much more of the content is going to be generated by the computer than would be the case if a child was playing with a doll's house . . . The danger is that children aren't having as much stimulation to their imagination and creativity."

Dr Jureidini uses play in therapy. "Playing through some distressing event helps children to come to terms with it and feel less bullied by their scary memories,"he said. "There's the working-through aspect and also the communication aspect."

Deakin University Associate Professor Karen Stagnitti said imaginative play also had been shown to expand children's vocabulary, comprehension and social skills.

Pembroke Junior School visited the Australian Museum of Childhood in Port Adelaide to see how toys had changed over time. Teacher Alison Woodcock said some children had to be taught how to play. "The children are very confident on the computers these days," she said. "We need to help them develop skills in creative play."

Student Julian, 6, said he liked playing with trucks. "I play with them and build things in the dirt, like building New York City," he said.


Why curry could STOP you putting on weight (if you are a mouse)

If you are trying to stop piling on the pounds, eating lots of curry might seem like a bad idea. But it is not as ridiculous as it sounds, according to the latest scientific findings. The flavouring turmeric, used in most Indian meals, has an active ingredient which could help fight obesity.

A meal which includes turmeric will lead to less weight gain than a meal with all the same ingredients apart from the yellow powder. Turmeric contains a plant-based chemical called curcumin which is easily absorbed by the body, according to a study from Tufts University in Boston. Reporting their findings in the Journal of Nutrition researchers found curcumin suppresses the growth of fat tissue in mice and human cell cultures.

In particular turmeric is effective when added to a high-fat meal, suggesting it could help fight obesity. It appears the curcumin prevents the formation of new blood vessels which in turn help expand fatty tissue which is the cause of weight gain. The laboratory tests saw one set of mice fed high-fat diets for 12 weeks and another set given the same food except with 500mg of curcumin added to each meal. After 12 weeks, the mice which were fed curcumin weighed less than those which did not eat it. The researchers found the curcumin-fed mice were not growing as many new blood vessels as the others and had lower blood cholesterol.

Senior researcher Mohsen Meydani said: 'Weight gain is the result of the growth and expansion of fat tissue which cannot happen unless new blood vessels form, a process known as angiogenesis.' 'Based on our data, curcumin appears to suppress angiogenic activity in the fat tissue of mice fed high-fat diets.' The next step will be to perform clinical trials on humans, said the researchers.


Wednesday, May 20, 2009

For heart survivors, a big waistline could be a lifeline

There have been previous reports to this effect, as it notes below, but the causal chain is essentially unknown

Overweight heart attack victims should stay fat as they are more likely to live longer, say researchers. Obese people are likely to outlive their leaner counterparts with the same severity of heart problems, data has shown.

The controversial claim goes against conventional advice to heart patients that they should lose weight as soon as possible. It may mean crash diets could be harmful as thinner people with heart disease tend to die sooner, possibly from having poorer energy reserves. Evidence from a review in the Journal of the American College of Cardiology suggests being fat can be useful for heart patients.

The message is highly contentious as Britain grapples with an obesity epidemic, with more than half of Britons overweight and a further 20 per cent obese. More than 2.6million Britons have suffered a heart attack or are living with heart failure.

The review looked at a number of studies showing that for patients with established heart disease, obesity plays a protective role. They included a U.S. survey of almost 8,000 patients with heart failure which found a progressive increase in death rate when their weight dropped below a Body Mass Index of 30. BMI, which relates bodyweight to height, classifies those with a score of under 25 as being underweight or 'normal' while 25 to 29.9 is 'overweight' and 30 or above is clinically obese.

Author Dr Carl Lavie, medical director of Cardiac Rehabilitation and Prevention at the Ochsner Medical Centre, said the 'obesity paradox' had been known about for a decade. He said 'Obese patients with heart disease respond well to treatment and have paradoxically better outcomes and survival than thinner patients. 'Although these patients have a more favourable short and long-term prognosis, we don't yet know the mechanisms for why this might be the case.'

Dr Lavie said it was possible excess weight might help because patients had more reserves to fight disease than thinner patients. Another explanation might be that obese patients seek medical advice earlier in the disease process because they are out of shape and suffering other symptoms, which gives doctors the chance to diagnose problems earlier. In addition, fat people have higher blood lipid levels which fight inflammation.

However, Dr Lavie warned patients with heart disease should not gain weight in order to have a better chance of fighting heart problems. He said 'Obesity is often what's causing high blood pressure, blockage in arteries and increased risk of death in the first place. 'For example, patients who are overweight or obese are at heightened risk of diabetes which can further-complicate treatment and outcomes. 'We need more research: first to prevent obesity in the first place; second to intervene early enough so that patients who are overweight or obese won't develop heart disease and then to better understand why these patients have a better prognosis once they have heart disease.'

Evidence from other studies suggests obese patients also fare better after being diagnosed with other chronic illnesses like chronic obstructive pulmonary disease, cancer and kidney failure. Experts believe the consequences of obesity in mostly older patients with chronic illness - when the damage is already done - appears to be different from obesity in younger healthy people.


British food industry opposes tougher salt-reduction targets

Food companies are ready to challenge new salt reduction targets, claiming that consumers will not accept the taste of many products. Industry figures say that salt levels set by the Food Standards Agency may also compromise food safety, especially for cheese and ham, which will shorten the shelf life of items in stores and create more food waste.

The agency is demanding a lower salt content for bread, pizza, ready meals and savoury snacks and wants to cut the salt in burgers and grill steaks by 25 per cent. It accepts that many of its targets may be impossible to meet. Thin and frozen burgers are lower in salt than thicker burgers, which require more sodium to bind the ingredients. It is continuing, however, with calls for new recipes and product formulation to try to make 6g of salt a day the maximum average daily intake for an adult.

Health chiefs estimate that 20,200 deaths from high blood pressure and heart disease would be prevented annually if the nation achieved the 6g-a-day average, down from the present average of 8.5g. About 75 per cent of all salt eaten by consumers is in ready-made or processed food.

The agency is also involved in research to test the lowest levels of salt that are needed in some foods so that it can challenge any claims from manufacturers that targets are too difficult.

Rosemary Hignett, head of nutrition at the agency, said that the cooperation of food companies was vital to improve public health. She also said that Britain was leading the way in Europe and beyond in salt reduction. “The reductions which have already been achieved are already saving lives.”

The British Retail Consortium, which represents leading supermarkets, said that many of the new targets would be difficult to achieve. Stephen Robertson, its director-general, said: “In some cases we believe customers won’t accept the change in taste. It’s crucial we take customers with us as tastes don’t change overnight. Salt can also play an important part in preserving food. It would be perverse if we reduced salt to the extent that it reduced a product’s shelf life and increased food waste — compromising a key part of government food policy.”

Bread-makers are particularly concerned that they will not be able to meet the target. Gordon Polson, director of the Federation of Bakers, said: “It is technically impossible for the industry to go beyond the 2010 target of 430mg sodium per 100g to 400mg by 2012.”


Cheerios is a drug?

This claim has been greeted with much derision -- as an attack on a harmless old favorite -- but it should be noted that the cereal itself is not under attack: Just exaggerated health claims made on its behalf. The FDA was moronic and authoritarian in its approach to the matter, however. It should simply have sent a polite letter asking for the unproven health claims to be deleted from the packaging. It is now the FDA that has been discredited, not Cheerios

Popular US breakfast cereal Cheerios is a drug, at least if the claims made on the label by its manufacturer General Mills are anything to go by, the US Food and Drug Administration (FDA) has said. "Based on claims made on your product's label, we have determined that your Cheerios Toasted Whole Grain Oat Cereal is promoted for conditions that cause it to be a drug," the FDA said in a letter to General Mills which was posted on the federal agency's website Tuesday.

Cheerios labels claim that eating the cereal can help lower bad cholesterol, a risk factor for coronary heart disease, by four percent in six weeks. Citing a clinical study, the product labels also claim that eating two servings a day of Cheerios helps to reduce bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol, the FDA letter says.

Those claims indicate that Cheerios -- said by General Mills to be the best-selling cereal in the United States -- is intended to be used to lower cholesterol and prevent, lessen or treat the disease hypercholesterolemia, and to treat and prevent coronary heart disease. "Because of these intended uses, the product is a drug," the FDA concluded in its letter. Not only that, but Cheerios is a new drug because it has not been "recognized as safe and effective for use in preventing or treating hypercholesterolemia or coronary heart disease," the FDA said.

That means General Mills may not legally market Cheerios unless it applies for approval as a new drug or changes the way it labels the small, doughnut-shaped cereal, the FDA said. General Mills defended the claims on Cheerios packaging, saying in a statement that Cheerios' soluble fiber heart health claim has been FDA-approved for 12 years, and that its "lower your cholesterol four percent in six weeks" message has been featured on the box for more than two years.

The FDA's quibble is not about whether Cheerios cereal is good for you but over "how the Cheerios cholesterol-lowering information is presented on the Cheerios package and website," said General Mills. "We look forward to discussing this with FDA and to reaching a resolution."

Meanwhile, the FDA warned in its letter that if General Mills fails to "correct the violations" on its labels, boxes of Cheerios could disappear from supermarket and wholesaler shelves around the United States and the company could face legal action.

According to General Mills, one in eight boxes of cereal sold in the United States is a box of Cheerios. The cereal debuted on the US market in 1941.


Tuesday, May 19, 2009

Tall men AND FAT MEN earn more

The famous joviality of fatties may make them desirable employees

Australian researchers have found that tall workers earn more than their shorter colleagues, especially among men. A man who is six foot can expect to take home a "wage premium" of almost $1000 a year.

The boffins paint a bleak picture for the vertically-challenged, but there's good news for chubby workers: overweight people actually earn more than their skinny workmates.

Researcher Andrew Leigh, an economist at the Australian National University, said a factor in the tall men's pay perk was that they were more capable at some physical tasks, such as reaching the top shelf. "Beyond that is basically discrimination," Professor Leigh told AAP. "We tend to think that tall people are more powerful and smarter, even when they're not necessarily."

Prof Leigh, who stands at 180.34 centimetres, said it was unfortunate that society was biased towards taller people. There was not much short people could do about it. "At the moment they can only try and stand on a box."

Prof Leigh crunched the numbers on the height, weight and pay of thousands of people around the country, in an Australian first research effort. He found than an extra 10cm in height meant 3 per cent higher wages for men, and 2 per cent higher wages for women.

It was a different story when it came to weight. Fat men earn 5 per cent more than their trimmer colleagues. And thin women don't earn higher wages. Prof Leigh said it was possible that being overweight had become so common that it was no longer a problem for workers.


Drink labelling backfires

Youths Use Drink Labels to Choose Strongest Drink at Lowest Cost

Contrary to the industry's position that visible drink labels will promote responsible drinking, young people are, instead, using these visible standard drink labels to increase or even maximize the amount of alcohol they consume at the lowest cost possible.

According to a study in the Drug and Alcohol Review Journal published by Wiley-Blackwell, young people in Australia have very high awareness of standard drink labeling. However, this was predominately to help them choose the drinks that would get them drunk in the shortest time possible. The labels also served as guides, ‘advising' them on which drink would reduce the time needed to get drunk and the least amount they would need to drink - hence getting the best ‘value' for their money.

The study entitled "The impact of more visible standard drink labeling on youth alcohol consumption: helping young people drink (ir)responsibly?" examines the young people's perceptions of standard drink labeling, the purposes for which they use the labels and the potential impact on their alcohol consumption.

"Participants generally agreed that they notice drink labels and take in account what to purchase and consume. While earlier research with adult beer and alcohol drinkers has shown that standard drink labeling enables them to drink safely and responsibly, this motivation is not evident in the consumption choices with young drinkers and might even be counter-productive", said co-author Professor Sandra Jones from the Centre for Health Initiatives, University of Wollongong.

Heavy episodic drinking is a major health issue for Australia, as it is for most developed countries. It has been estimated that, from 1993-2002, over 2500 young people aged 15-24 have died from alcohol-attributable injury and disease, with another 100,000 hospitalized.

Professor Jones adds, "There is a need to consider the deeper implications about alcohol packaging and marketing as they have real potential to impact and reduce alcohol-related harms. There is still an important role for standard drink labeling as long as it is combined with other policies addressing the price, availability and marketing of alcohol - which are of proven effectiveness in reducing alcohol related harm."

More information: This article is published in the May Issue of Drug and Alcohol Review. (Vol. 28, Issue 3, pp 230 - 234).


New kidney cancer pill extends the lives of patients by two years

A kidney cancer pill can extend the lives of patients with advanced forms of the disease by more than two years, research shows. The drug, sunitinib - which became widely available on the [British} Health Service only this year - was found to be far more effective than traditional treatment.

Kidney cancer is diagnosed in more than 7,000 people in Britain each year and causes about 3,600 deaths annually. Until recently NHS treatment options for spreading, or metastatic, kidney cancer were mostly confined to injections of interferon-alpha. But that drug has serious side effects including fatigue, nausea and increased infections.

Research published today in the Journal of Clinical Oncology compared the life expectancy of patients on sunitinib, which is marketed as Sutent, and interferon-alpha. Survival for sunitinib patients given no further treatment after they stopped taking the drug was 28.1 months compared with 14.1 months for those on interferon-alpha.

Professor John Wagstaff, of the South Wales Cancer Institute in Swansea, whose patients took part in the trial, said: 'These data herald a new era in the treatment of metastatic kidney cancer.'


Monday, May 18, 2009

Rise of the soda jerks

The case against sin taxes for soft drinks

"And he shall smite the earth with the rod of his mouth, and with the breath of his lips shall he slay the Pepsi drinker!" There has to be a statement about soft drinks tucked somewhere in Leviticus. I have assurances, after all, that such beverages are wicked.

Sin taxes normally are levied on so-called vices, such as drinking, smoking, and gambling. Now Congress is "studying" a proposal to legislate morality by taxing sugary beverages—which is to say, it is "studying" whether such a tax would be politically feasible.

According to the executive director of the Center for "Science" in the Public Interest —a group that has been pushing this tax, along with a glut of other tragic nonsense —"Soda is clearly one of the most harmful products in the food supply, and it's something government should discourage the consumption of."

There is nothing "clear" about it. Soda can be harmful; it can be harmless; and it is always tasty with a cheese-infused burrito, which we should affix with a massive "discouragement" tax if we're going to be consistent about our gut-busting peccadilloes.

The selective tax also would pursue energy and fruit drinks but not politically correct high-everything beverages, such as Frappuccinos. No one wants a violent insurrection in the malls and trendy urban cores of America.

The Center for Science in the Public Interest also wants government to "pressure" food companies to produce healthier fare (because, god knows, there are barely any wholesome options available for the masses), dramatically raise taxes on alcohol (what fresh hell is this?) and dictate the level of sodium allowable in packaged and restaurant food.

The CSPI is the group that once laughably claimed that 150,000 people perish yearly from salt intake (the "Forgotten Killer") despite lack of any evidence and the ongoing debate regarding the real effects of sodium.

Beyond the health issues, you may want to ask yourself whether it's appropriate for government to use taxes as a tool for strategic social engineering. Isn't it counterproductive to pass one-size-fits-all punitive taxes that target the recreational ginger ale drinker, along with the depraved Coca-Cola abuser? Or is it government's job to provide transparency, allowing consumers to make smart decisions—or not—about what they ingest?

We already have set a precedent with cigarettes. And the argument most often employed by sin tax proponents revolves around economic externalities—or the idea that everyone shouldn't have to pay for the destructive habits of the few. (Though there is evidence that the societal cost of the obese is largely inflated, as it were.) I have a lot of sympathy for this argument. So perhaps all citizens can begin taking fiscal and moral responsibility for their own behavior....

...I'm just kidding. That's crazy talk.

But once we start rationing health care, externalities will only become more of an issue. If we collectively pay for health insurance, then what is to stop the majority of us from dictating to the minority what it can eat or drink? What would stop Republicans—after they roar back to power in 2048—from levying sin taxes on promiscuous behavior? After all, promiscuity burdens all taxpayers through sexually transmitted diseases, unwanted pregnancies, and Lindsay Lohan. If government continues to manage social behavior through taxation, why not give it a shot? It's the moral thing to do.


Memories stolen by Alzheimer's may be retrievable

Researchers have pinpointed a gene said to be responsible for a 2007 breakthrough in which mice with an Alzheimer's diseaselike condition regained lost memories and learning abilities. In the new research, reported in the May 7 issue of the scientific journal Nature, Massachusetts Institute of Technology neuroscientist LiHuei Tsai and colleagues found that drugs that work on the gene HDAC2 reverse the effects of Alzheimer's and boost cognitive function in mice.

Researchers said the findings serve as evidence that memories lost to Alzheimer's and related conditions may not be gone for good. Rather, they could have gotten stuck deep in the brain waiting for the proper medicines to help dislodge them.

The HDAC2 gene, and a molecule it produces, "are promising targets for treating memory impairment," Tsai said. The gene controls the activity of many other genes "implicated in plasticity the brain's ability to change in response to experience and memory formation."

The gene causes lasting changes in how other genes behave, which is probably necessary to increase numbers of connections between brain cells, she added. The researchers treated mice with Alzheimer'slike symptoms using socalled histone deacetylase, or HDAC, inhibitors, a family of 11 enzymes that seem to act as master regulators of gene activity. The drugs are in experimental stages and are not available for patient use. "Harnessing the therapeutic potential of HDAC inhibitors requires knowledge of the specific HDAC family member or members linked to cognitive enhancement," Tsai said. "We have now identified HDAC2 as the most likely target of the HDAC inhibitors" that facilitate plasticity and memory formation.

A person's DNA is packaged as part of a material called chromatin, and certain genes control arrays of other genes simply by restructuring the chromatin. The new research helps clarify how this process works in regulating memory, Tsai said.

Several HDAC inhibitors are currently in clinical trials as anticancer agents. Researchers have also reported promising results with HDAC inhibitors in mouse versions of Huntington's disease.

In the chromatin, molecules called histones act as spools around which DNA winds. Histones are modified in various ways, including through a process called acetylation, which in turn modifies chromatin shape and structure. HDAC inhibitors promote this process. Certain HDAC inhibitors open up chromatin. This allows genes to become active which had been too tightly packaged to go into operation.

The researchers conducted learning and memory tasks using genetically engineered mice that were induced to lose many brain cells. Following Alzheimer'slike brain shrinkage, the mice acted as though they had forgotten tasks they had previously learned. But after taking HDAC inhibitors, the mice regained their longterm memories and ability to learn new tasks, according to Tsai. In addition, mice genetically engineered to produce no HDAC2 at all exhibited enhanced memory formation.

The fact that longterm memories can be recovered by elevated histone acetylation supports the idea that apparent memory "loss" is really a reflection of inaccessible memories, Tsai said. "These findings are in line with a phenomenon known as `fluctuating memories,' in which demented patients experience temporary periods of apparent clarity," she added.