Wednesday, June 30, 2010
Another reversal of official health "wisdom"
'Grazing' used to be king, but now experts say it slows metabolism, and can cause tooth decay and diabetes
For years, nutritionists have been telling us to graze - eat little and often - to keep up our energy levels and as a tactic to avoid overeating unhealthy food.
The problem with grazing is that many people ignore the bit about eating only a little, hearing only the message to 'eat often' - the result is we've become a nation of snackers. Furthermore, we're snacking not on healthy foods, but on chocolate, crisps and other calorie-laden products.
Clearly, eating lots of junk food is not good for the waistline. But now, some experts believe that the very principle of eating between meals - whether it's healthy or junk food - is the real problem. They say snacking makes us even more hungry; it also interferes with the body's ability to burn fat, leads to obesity and type 2 diabetes, as well as tooth decay. What we should really be doing, it seems, is going back to three proper meals a day, with no snacks in between.
'For many, snacking is a major cause of weight gain,' says Professor Stephen Atkin, head of diabetes and metabolism at Hull York Medical School. Adds Naveed Sattar, professor of metabolic medicine at Glasgow University: 'Snacking gives us extra calories and the fact is, extra calories make us fat.'
But not only are snacks often highly calorific; eating all day also undermines our body's ability to burn off fat. When we eat, our body releases insulin - a hormone that helps carry sugar into the cells to burn as energy. This sugar energy will keep us going for around three hours, after which our bodies will start using energy from our fat stores.
If we can hold out for four to five hours between meals, we burn more fat. 'Fat is burned as soon as your carbohydrate stores fall and you start the mobilisation of fat for energy,' explains Professor Atkin.
Snacking also means that organs such as the liver and pancreas are under greater stress, as blood sugar and fat levels stay higher throughout the day, says professor Sattar. This also increases stress on blood vessels and, perhaps, the heart. 'In my view, the ideal would be not to snack at all,' adds Professor Atkin. 'It's normal to feel hungry before a meal.'
Not so NICE
The author below criticizes NICE on liberty grounds. That their "advice" (like most official wisdom) is also crassly ignorant of the best research he overlooks. See the sidebar here for much of what they ignore
In a country where the state controls healthcare to such an extent, the National Institute for Health and Clinical Excellence (NICE) really has to exist in some form. Death panels or not, without serious reforms it is necessary that someone somewhere decides which medicines can be afforded and which can’t.
However, NICE does more than this, it also makes recommendations on “how to improve people’s health and prevent illness and disease”. Much the pity. In the space of a week they have made two headline-grabbing recommendations. First was their suggestions that:
* manufacturers should stop using trans-fats
* a maximum intake should be set set for salt of 6g per day for adults by 2015 and 3g daily by 2025
* hidden saturated fat substantially reduced
* efforts be made to make unhealthy food more expensive than healthy food
* restrictions should be enforced on unhealthy food television advertisements until after 9pm
* planning restrictions should be imposed to time-limit fast-food outlets
* unhealthy food should have traffic light labelling
To top that, yesterday they suggested that all pregnant women should have their breath measured for carbon monoxide levels when booking to see a midwife. The Department of Health is keen on the idea, stating: "We welcome the publication of these new guidelines. Smoking in pregnancy is a major public health concern posing risks to both mother and baby. We want the NHS to use this guidance to develop the best possible services for pregnant women."
It is no surprise that liberty is not a factor in the proposals of a Quango, but even they have to draw a line somewhere. Clearly on this occasion they have gone too far and should have been shot down. There are clear arguments to be made on unintended consequences – whether increased food prices for the poorest or vulnerable smoking mothers avoiding health professionals for fear of condemnation – but ultimately the argument of ‘enough is enough’ needs to win through.
Utility and efficiency are not the only measures of effective policy. Like all Quangos and regulators, their remit needs to be cut down to what is purely necessary in areas that the state is near monopolistic provider and removed entirely from nannying us.
Posted by jonjayray at 10:44 PM
Tuesday, June 29, 2010
Did the anti-vaccine movement help create a whooping cough epidemic?
The nutters kill kids
A whooping cough epidemic has broken out in California, which is now facing what could be the largest outbreak of the contagious disease since 1958. Over 900 cases have been confirmed in the state—more than four times as many as last year—and 600 suspected cases are being investigated. The highly contagious disease can be deadly to infants—five have already died from the disease this year in California—but it’s eminently preventable through vaccination.
Officials are still investigating the causes of the outbreak, but some have already suggested that the anti-vaccine movement could be at least partly to blame. "California is the epicenter of vaccine refusal" in the United States, said Dr. Blaise Congeni from Ohio’s Akron Children's Hospital, according to an ABC News story. While California requires that children be vaccinated from whooping cough before they attend school, "the requirement is waived if parents file a 'personal belief exemption' (PBE), which need not be based on religion or medical necessity," the story continues. And some parents have been flocking to join the vaccine refusalists. ABC News cites Ken August, spokesman for the California Department of Public Health:
He said that the overall rate for PBEs among the state's roughly 7,200 schools is about 2 percent. But rates are much higher in some schools. Records for 2009 indicated that close to 175 schools had PBE rates of 20 percent or more. A few had rates above 70 percent.
Researchers have found that vaccination rates of at least 93 percent are needed to ensure so-called herd immunity against pertussis, which prevents the disease from spreading quickly to unvaccinated individuals.
Fears about vaccines are nothing new, but they’ve been revived in recent years by anti-vaccine crusaders who’ve junked science in favor of medical myths and conspiracy theories. In the US and abroad, they’ve popularized the notion that vaccines cause autism and that whooping cough is not actually fatal, among other falsehoods. There’s also the tireless conservative argument—promulgated by folks like the Eagle Forum’s Phyllis Schlafly—that government-required vaccines infringe upon individual liberty.
The claims by leading anti-vaccine activists have been thoroughly debunked. The US Court of Claims, for example, ruled last year that there was no substantive evidence to support the autism-vaccine link. The main researcher behind the claim, British doctor Andrew Wakefield, has been completely discredited and even stripped of his medical license.
But there's still reason to be concerned about the damage that the movement may have already done. Vaccine-phobia has gripped towns like Boulder, which in 2002 had the lowest school-wide vaccination rate in Colorado—and "one of the highest per capita rates of whooping cough in the United States.” And now children in California are dying of a disease that should have been made obsolete by the 21st century. If vaccine refusals are indeed behind the current epidemic, California needs to figure out the real reasons that parents are putting their own children and others at risk.*
Simple blood test will give women precise age at which they will no longer be fertile
Could be useful even if only approximately right
DOCTORS were set to unveil tomorrow a simple blood test that could tell young women the precise age at which they would no longer be able to have babies.
The test - which measures levels of a hormone produced by the ovaries - could allow women as young as 20 to pinpoint within a few months when they would cease to be fertile.
The procedure, to be launched in Rome at the annual conference of the European Society of Human Reproduction and Embryology, would be valuable to women trying to balance careers with having children.
Among Western women, menopause occurs on average at 51. However, about 15 per cent of women experience it early, under the age of 45.
“Our results suggest that the novel marker anti-Mullerian hormone (produced by the ovaries) could precisely forecast the age at menopause, even in young women,” said Dr Fahimeh Ramezani Tehrani, who led the research.
Dr Tehrani analysed levels of the hormone, which controls the development of the cells in the ovaries from which eggs develop, in 266 women aged 20 to 49.
It was known that levels of the hormone vary between women and also decline with age. Scientists previously suspected that changing levels were linked to menopause, but there was insufficient data to use this knowledge as a predictive tool.
By gathering data from a large number of women, Dr Tehrani believes she created a mathematical model that can predict the age of menopause for any woman.
The test developed by Dr Tehrani, a senior researcher at the World Health Organisation-backed Endocrine Research Centre in Tehran, would need to be validated in large-scale trials before it could come into common use.
Posted by jonjayray at 5:24 PM
Monday, June 28, 2010
Chocolate could help treat high blood pressure
Another tiny effect paraded as if it meant something
Just a chunk of chocolate a day could have the same effect on high blood pressure as half an hour of exercise, new research suggests. For those suffering from high blood pressure the effect of chocolate was so dramatic it could reduce their chances of having a heart attack or stroke by 20 per cent over five years.
Chocolate – and especially dark chocolate – contains chemicals known as flavanols which naturally open up blood vessels in the body. That means blood flows more easily and the pressure drops.
"You don't always need medication to reduce blood pressure," said Dr Karin Ried, at Adelaide University who carried out the research. "This shows that there are some foods that can help."
An estimated 15 million people in Britain suffer from high blood pressure, also known as hypertension – around half of them undiagnosed. About one in 10 sufferers cannot control the condition with medication or cannot tolerate the drugs, leaving them at greater risk. Hundreds of thousands face a lifetime on medication to reduce the risk of suffering heart disease, strokes or kidney failure.
For the latest research, Dr Ried and her team combined the results of 15 other studies looking at chocolate and cocoa between 1955 and 2009 covering hundreds of people. They found that for people with hypertension, eating chocolate could reduce the blood pressure by up to five per cent. For those with normal pressure it had no effect. "This is a significant finding," said Dr Ried. [Really??] "We’ve found that consumption can significantly, albeit modestly, reduce blood pressure for people with high blood pressure but not for people with normal blood pressure”.
She said it will take more research to see what is the optimal amount of chocolate that was needed to make the most difference. She said the studies varied from just one chunk (6g) to a whole bar (100g) a day. The research was published in the journal BMC Medicine.
People with high blood pressure are seen to have it consistently higher than 140mm Hg systolic or 90mm Hg diastolic. Normal is 90/60. The results showed that chocolate would make it drop 5mm in systolic pressure which is comparable to the known effects of 30 daily minutes of moderate physical activity such as brisk walking or swimming.
Chocolate has been found to have health giving benefits in the past. Research published earlier this year showed that people who eat just one bar a week are 22 per cent less likely to suffer a stroke. However the health giving benefits have to be weighed against its contribution to obesity.
A nickel-plated moron
Anger grew today after the deputy editor of a leading British parenting magazine wrote an article describing breastfeeding as "creepy", saying she wanted to maintain the sexuality of her "fun bags".
In Kathryn Blundell's article for Mother & Baby, entitled I formula fed. So what?, she explains how she never breastfed because "I wanted my body back. (And some wine) ... I also wanted to give my boobs at least a chance to stay on my chest rather than dangling around my stomach."
She continues with, "They're part of my sexuality, too - not just breasts, but fun bags. And when you have that attitude (and I admit I made no attempt to change it), seeing your teeny, tiny, innocent baby latching on where only a lover has been before feels, well, a little creepy."
The UK Department of Health (DoH) recommends breastfeeding for six months and launched a controversial "Breast is Best" ad campaign to convince mothers to put down the bottles. According to the DoH, only one in 100 British mums actually does breastfeed for that long.
Of these "quitters", Blundell says, "I often wonder whether many of these women, like me, just couldn't be fagged (did not want to make the effort) or felt like getting tipsy once in a while."
The fallout from the article ranges from breastfeeding group Lactivist condemning Blundell's "generally spreading misinformation" to a Facebook group with 500 members demanding an apology.
"As a formula-feeding mum who was unable to breastfeed, I am left wondering whether, thanks to this piece, people who see me giving my baby a bottle may assume that I am doing so because I could not be fagged to breastfeed/found the idea 'creepy'," wrote one member of the Facebook group.
But Mother & Baby Editor Miranda Levy stands by her deputy's piece, telling the UK's Guardian newspaper: "We have made readers feel 'normal' and less of a 'failure' for not managing to breastfeed - a situation which is incredibly common. The way you feed your baby is not a moral issue, and at Mother & Baby we seek to support all new parents in what is a glorious, but often difficult and emotional, time."
Posted by jonjayray at 6:50 PM
Sunday, June 27, 2010
Methodists 'live more than seven years longer than the rest of the British population'
Staying off the booze probably avoids a lot of harms but a tendency for Methodism to be a religion of the middle class is probably also involved.
Note also that we are comparing churchgoers with a generally irreligious overall population and religious belief does have stress-reducing effects. It would be interesting to see another study of churchgoing Presbyterians. Church of England churchgoers don't count as they rarely believe in anything religious at all
Methodists live more than seven years longer than the rest of the population, according to an academic study. Men belonging to the famously clean-living denomination live to the ripe old age of 83.9, research has found, compared with a national average of 77.
For women the difference in longevity was even greater with female Methodists dying at 91.1 on average – nine years longer than the 82 years enjoyed by most British women.
Last week Stanley Lucas died in Cornwall aged 110, having become not just the oldest male member of the Methodist Church but the oldest man in Europe.
Dr Richard Vautrey, vice president of the Methodist Conference, said, “I’m sure there are many different factors at work for Methodists to attain these numbers. “But I would guess that our emphasis on caring for our spiritual as well as physical health, avoiding excess, engaging with people in our communities and being good neighbours all help.”
Methodism, an evangelical Christian movement that split from the Church of England at the end of the 18th century, is known for its focus on social justice and for many years was at the forefront of the temperance movement that preached “total abstinence” from alcohol.
The increased life expectancy of its followers, who now number 265,000 in Britain, was calculated by researchers working for British Religion in Numbers, based at the University of Manchester.
They studied family announcements placed in the denomination’s newspaper, the Methodist Recorder, which found that the mean age of death for Methodist men and women in 1973 and 2008 was far higher than that of the general population as recorded by the Office for National Statistics.
Study of obituaries for Methodist ministers appeared to confirm the trend, with a mean age of death of 83.4 for men who died in 2009 – again more than six years older than the British average of 77.
The Methodist Conference, currently meeting in Porstmouth, begins each year with a rendition of a hymn called “And are we yet alive?”, written by one of the movement’s founders, Charles Wesley.
Fad diet leaves actress with brittle bones
HOLLYWOOD star Gwyneth Paltrow was a pin-up for "healthy" living but her extreme dieting may have given her the bones of an 80-year-old woman. The 37-year-old actress - who has followed a macrobiotic diet for 11 years and exercises up to three hours a day - has revealed that she has been diagnosed with osteopenia, an illness that can lead to the serious bone disease osteoporosis.
"I suffered a pretty severe Tibial plateau fracture a few years ago (requiring surgery) which led the orthopaedic surgeon to give me a bone scan, at which point it was discovered I had the beginning stages of osteopenia," she wrote on her popular online newsletter, Goop. Osteoporosis - a common ailment among the elderly - increases a person's risk of fractures and is more prevalent among women.
"My doctors tested my vitamin D levels, which turned out to be the lowest thing they had ever seen [not a good thing]," Paltrow said.
She said she was put on prescription-strength vitamin D and told to spend more time in the sun, but some nutritionists believe her diet was also to blame for her brittle bone problem. The macrobiotic diet, which is popular among celebrities, including Madonna, requires followers to eat plenty of vegetables, wholegrains and fruit and small quantities of fish while discouraging dairy and red meat. Alcohol, chocolate, hot spices, sugar and coffee are also off limits as part of the diet.
The mother-of-two and wife of Coldplay frontman Chris Martin relaxed her eating regime between the births of her two children Apple, six, and Moses, four, but has since been following a less severe version of the macrobiotic diet.
"A macrobiotic diet is often lower in protein than a diet that includes dairy foods and meat so if she's doing a lot of exercise but not getting enough protein, she's not getting enough to build her bones either," Sydney nutritionist Sharon Natoli said. "Plus, vitamin D helps calcium absorption so if you're not getting enough calcium but getting enough vitamin D and vice-versa, you really need the two to be working together."
Ms Natoli advised people against following diets that excluded essential food groups. "We don't recommend fad celebrity diets," she said. "If you leave out a whole food group, then you're going to be low on something."
Posted by jonjayray at 8:13 PM
Saturday, June 26, 2010
The nastiness of NICE: The addled tyranny of the anti-junk food crusade
The idea that thousands of lives could be saved if people stopped eating the ‘wrong’ food is pie in the sky
‘Forty thousand deaths a year due to junk food’, declared the UK Daily Telegraph yesterday, reporting on new policy recommendations produced by the National Institute for Clinical Excellence (NICE). But the evidence on which this claim is made is highly dubious. What the report really represents is the coming together of the same-old NGOs and health policy wonks to tell us - for the umpteenth time - how we must live our lives.
The report puts forward 12 recommendations, including:
* Introducing policies designed to cut our consumption of Bad Stuff (salt, saturated fats and trans-fats);
* restricting marketing of ‘junk’ food to children;
* introducing the ‘traffic light’ labelling of foods - green for good, amber for warning and red for unhealthy;
* assessing all government policy for its impact on cardiovascular disease;
* ensuring that EU farm spending promotes healthy foods;
* encouraging ‘physically active travel’ – for example, by scrapping subsidised car parking;
* providing ‘healthy’ meals in public-sector workplaces, schools, hospitals, etc;
* discouraging, via local authorities, the opening of takeaway food outlets near schools and in other sensitive areas.
This mish-mash of different recommendations simply reflects the wide range of groups that want to get their noses in the health trough or foist their particular hare-brained schemes upon us. The evidence that any of these policies would make any serious difference to our life expectancies - never mind save tens of thousands of lives - is flimsy to say the least.
First of all, we need to examine the claim that such measures could save the 40,000 lives apparently being destroyed by junk food. The report says: ‘Most premature deaths from CVD (cardiovascular disease) – that is, among people aged less than 75 – are preventable. In 2006, CVD accounted for around 30 per cent of premature deaths among men and 21 per cent among women, accounting for just over 40,000 premature deaths in that year.’ So actually, even on this basis, it is only most of the 40,000 premature deaths that could be prevented. But even this seems implausible. Genetics, old age, sheer luck, the quality of healthcare available, and environmental factors that aren’t preventable by lifestyle change - like air pollution - would seem to be at the very least as important as what people eat.
Above all, being a man rather than a woman makes a very substantial difference to life expectancy. The latest figures from the Office for National Statistics suggest life expectancy in the UK at birth is now 77.5 years for men and 81.8 years for women. Is this ‘preventable’? Perhaps all men over 50 should be forced to have their balls chopped off. Strangely, this policy recommendation is absent from NICE’s report.
But when we dig a little further into the various recommendations, the suggestion that the policies put forward could have any substantial impact on life expectancy is quickly revealed to be illusory. Let’s look at the evidence for the idea that if we avoid eating the wrong things we will live longer.
Poster campaigns and health professionals are forever telling us that we should reduce salt intake to lower our blood pressure and, in turn, cut cases of CVD. Yet while there may be some benefit in cutting salt intake in those who are already being medicated for high blood pressure or who have kidney disease, for most people there is no evidence that cutting salt is of any benefit at all. Indeed for some people it could be harmful.
There is a certain arrogance about the idea, repeated in the new report, that we should cut salt intake from an average of 8.5 grammes per day to six grammes per day by 2015, and then to three grammes per day by 2050. Firstly, the idea that high salt automatically equates to shortened lives is wrong: the Japanese have a very high-salt diet and enjoy longer lives than anyone else.
Secondly, our bodies are incredibly sensitive to the appropriate balance of salt and water in our blood, regulating it on a minute-by-minute basis to keep it within a very narrow range. Yet the groups and researchers proposing radical changes to our diet seem to believe that salt intake should be regulated by diktat from Whitehall rather than by our internal biology evolved over millions of years.
There is no consensus that such salt-reduction policies would be beneficial. A review in the British Medical Journal on the evidence connecting salt with high blood pressure, published in 2002, concluded: ‘Intensive interventions, unsuited to primary care or population prevention programmes, provide only small reductions in blood pressure and sodium excretion, and effects on deaths and cardiovascular events are unclear.’
There has been plenty of evidence for a very long time that attempts to reduce saturated fat consumption have no effect on cardiovascular disease. For example, the Multiple Risk Factor Intervention Trial (MRFIT), which reported its findings in the early 1980s, encouraged a large number of middle-aged American men with high cholesterol to change their diet in an effort to reduce their saturated-fat intake and, therefore, their cholesterol. These test subjects were also encouraged to quit smoking and to treat their high blood pressure. Meanwhile, another large group of middle-aged men were left to their own devices. The result? Slightly more men in the low-fat diet group died than in the control group, but in reality there was no practical difference in outcomes.
As for trans-fats, the evidence that reducing our intake will ‘save lives’ is once again weak. Trans-fats are a by-product of adding hydrogen to vegetable fats to make them stable at room temperature and give them a longer shelf-life, particularly in things like baked goods. While they’ve been around for decades, they became particularly popular among food manufacturers as an alternative to saturated fats.
So what’s the risk from trans-fats? A review in the New England Journal of Medicine in 2006 says: ‘In a meta-analysis of four prospective cohort studies involving nearly 140,000 subjects, including updated analyses from the two largest studies, a two per cent increase in energy intake from trans fatty acids was associated with a 23 per cent increase in the incidence of [coronary heart disease].’ That figure of 23 per cent sounds impressively high, but epidemiological studies are very blunt instruments.
As the US National Cancer Institute noted in 1994, ‘in epidemiological research, [increases in risk of less than 100 per cent] are considered small and are usually difficult to interpret. Such increases may be due to chance, statistical bias, or the effects of confounding factors that are sometimes not evident.’ As a comparison, the risk of getting lung cancer from being a regular smoker (over the course of decades, usually) is in the order of 2,000 per cent compared to non-smokers. While we can be pretty confident that active smoking significantly increases your risk of a variety of diseases, the small relative risk associated with trans-fats is much more ambiguous.
The other recommendations in the NICE report are a bunch of lame old hobbyhorses or, in the case of demanding that all government policy be assessed for its effect on CVD, they add up to a demand for a health-lobby veto on all lawmaking. Thanks, but no thanks.
But regardless of the evidence, there is a more principled basis on which we should object to these kind of policy proposals – namely, that we, and not NICE or anybody else, should have control over our own lives and our own, sometimes bad habits. Let us eat our junk, slob out on our sofas, smoke our fags and drink our booze. If these things turn out to shorten our lives, so be it (though the evidence that they will is usually as feeble as an old codger who’s avoided a ‘premature’ death). That’s surely a better way to live than to be endlessly subjected to the high-fibre, low-fat, salt-free dictatorship of Those Who Know What’s Good For Us.
The myth of the smokefree health miracle
The evidence that bans on public smoking reduce the number of heart attacks is still woefully thin
Recent reports of a ‘dramatic’ fall in the number of heart attacks in England after July 2007 represented the latest in a long line of attempts to find immediate health benefits from smoking bans. But a serious examination of this body of evidence suggests that the effect of smoking bans is either tiny or non-existent.
The worldwide search began in 2004, when the British Medical Journal reported a 40 per cent decline in ‘acute myocardial infarction’ (AMI), the medical term for heart attack, in the small town of Helena, Montana. Subsequent ‘heart miracles’ claimed drops in AMI of 47 per cent (Bowling Green, Ohio), 27 per cent (Pueblo, Colorado) and 17 per cent (Scotland).
As previously reported on spiked, the widely touted Scottish figure of 17 per cent was at odds with hospital admissions data showing an eight per cent drop in the first year of the ban followed by an eight per cent rise in the second year. When this inconclusive evidence is combined with hospital admissions data from Wales, Denmark, New Zealand and Australia showing smoking bans having no effect on the heart attack rate (1), the most striking aspect of this field of research is the tendency to find dramatic results in small communities and practically nonexistent effects over large populations.
The counterintuitive conclusion was that secondhand smoke was ferociously lethal in one-horse towns in the mid-West, but strangely benign in whole nations. The alternative, if more cynical, explanation was that obscure destinations like Helena and Bowling Green were brought to the world’s attention because anti-smoking campaigners had dredged the data for unusual blips that roughly coincided with provincial smoking bans.
That question seemed set to be resolved when The Sunday Times announced in September 2009 that the smoking ban in England (population 49million) ‘caused a fall in heart attack rates of about 10 per cent’. The source of this claim was never disclosed and the anti-smoking campaign Action on Smoking and Health (ASH) quickly downplayed it, insisting that the 10 per cent figure was ‘not based on any research conducted to date’ (2). Nevertheless, the research was underway and it finally bore fruit a fortnight ago in the form of another British Medical Journal study.
Led by Dr Anna Gilmore, a member of ASH and the director of the Tobacco Control Research Group, the study found a post-ban drop in AMI of not 10 per cent, let alone the 40 per cent found in Helena, but of just 4.3 per cent. A welcome decline, to be sure, but since the final years of ‘smoky’ England saw similar declines of 3.2 per cent and 5.2 per cent, the evidence for a heart miracle in the most populous nation yet studied was less than compelling (11).
heart attack rates in England before and after smoking ban
Faced with data that unequivocally showed heart attacks falling at the same pedestrian rate as before the ban, Gilmore and her team turned to computer modelling. After making adjustments to the data, they concluded that, despite appearances, the smoking ban had a profound effect on the nation’s hearts. Of the 4.3 per cent drop in AMI admissions, Gilmore attributed more than half (2.4 per cent) to the smoking ban. The study concluded that ‘the implementation of smoke-free public places is associated with significant reductions in hospital admissions for myocardial infarction’. A press release was then issued, headlined ‘Smokefree legislation linked to drop in admissions for heart attacks’.
To make life simpler for busy journalists, the press release chose not to mention that this was a computer-generated estimate, instead flatly stating: ‘A 2.4 per cent drop in the number of emergency admissions to hospital for a heart attack has been observed following the implementation of smokefree legislation in England.’ As was helpfully pointed out, this 2.4 per cent drop equated to 1,200 heart attacks being ‘prevented’ by the 2007 legislation. There was no mention of the downward trend in AMI that long predated the smoking ban.
Since the 2.4 per cent figure exists only on a laptop at Bath University, the calculations that led to it can be neither verified nor debunked. The possibility that the smoking ban contributed to part of the drop in AMI admissions after July 2007 cannot be ruled out, particularly if it led to a significant drop in the number of smokers (the jury is still out on whether this happened). But since the number of heart attacks fell at a similar rate after July 2005 and July 2006, the burden of proof rests on Gilmore & Co. Without it, it is as if they were doing a rain dance in the middle of a thunderstorm and demanding credit for the rain. The onus is on them to convince us that the skies would have cleared if they hadn’t showed up, not the other way round.
Gilmore’s case rests on making adjustments for three relevant but hardly decisive confounding factors that might disguise the effect of the smoking ban: surface air temperature, population size and Christmas holidays. This is all good practice, but more significant risk factors such as smoking status, diet, statin use, exercise and stress go unaddressed. It could not be otherwise. Hospital admissions data reveal no personal information about any of the patients beyond their age and gender. This only highlights the immense difficulty of making specific assumptions from a mass of nameless aggregate data.
The only thing that can be said with any confidence is that there were 2,300 fewer heart attacks in 2007/08 than in the year before. With heart attacks and heart disease having hundreds of risk factors interacting with each other in complex and unpredictable ways, using raw data to single out any one of them is like listening out for a kazoo in a stadium full of vuvuzuelas. Any estimate made against this noisy statistical background can only be speculative to the point of wishful thinking.
Perhaps this underestimates the power of the team’s computer model, but if they have truly devised a formula that can predict the number of heart attacks by taking the temperature and seeing what day Christmas falls on, it is not one they are prepared to share with us. Effectively, the reader is told: ‘We know it doesn’t look like the smoking ban had any effect on AMI admissions but we’ve run it through a computer model and it has. Take it or leave it.’ In the context of the dubious and frequently bizarre history of ‘heart miracle’ studies, the reader could be forgiven for leaving it.
If it does nothing else, the English study confirms that the wilder claims of heart miracles in Helena and elsewhere were way off base. In the course of six years, the ‘smoking ban effect’ on heart attacks has fallen from over 40 per cent to less than five per cent. And since the heart attack rate was known to fall by more than five per cent in some years before smokefree legislation was introduced, attributing any part of the secular decline to the smoking ban becomes a matter of interpretation and conjecture.
Not that the hypothetical nature of Gilmore’s study ever impinged on the news coverage devoted to it. No one reading the newspapers two weeks ago could have gone away thinking anything other than that there were 1,200 fewer heart attacks after the smoking ban and that this decline in numbers was an unusual and remarkable event.
As was the case in Scotland two years ago, the statisticians who painstakingly collected admissions data from English hospitals might as well not have bothered. The true figures vanished, replaced by unseen adjustments and unspoken assumptions from the gatekeepers of knowledge at the UK Centre for Tobacco Control Studies. Once again we had findings erroneously leaked to the media months in advance, a press release which failed to get the most basic facts straight, and a study with no verifiable evidence to support its central conclusion. And all published just in time for the government’s review of the smoking ban. If this doesn’t warrant a little scepticism, what does?
Posted by jonjayray at 9:27 PM
Friday, June 25, 2010
Drinking wine could protect your eyes
Now I know why I didn't go into glasses until I was 60! Seriously, though, it's just the resveratrol religion again. I am not entirely clear on what they did but their claims do seem to be much more strongly-based than usual. If they have in fact used resveratrol both in laboratory glassware and mice to produce cell changes they have a good case to transfer their studies to humans. Abstract follows the popular comment below
Researchers have found that a substance found in grapes and other fruits could protect blood vessels in the eye being damaged by old age. It is effective because the compound, known as resveratrol, stops the blood vessels from being damaged.
The substance, which has been linked to anti-ageing and cancer protection in the past, is believed to work because it protects against abnormal angiogenesis – the formation of damaged or mutated blood vessels. This condition is linked to cancer, heart disease and eye diseases such as age-related macular degeneration.
Dr Rajendra Apte, who carried out the research at Washington University School of Medicine, St Louis, said the study should have a "substantial impact" on our understanding of how resveratrol works. He said it was able to "demonstrate that resveratrol, a naturally occurring compound, can directly inhibit the development of abnormal blood vessels both within and outside the eye". This he said could lead to new treatments.
Resveratrol is a natural compound that is produced in a variety of plants to prevent bacterial and fungal infections. It is found in particularly high levels in grape skin (and consequently red wine), and at lower levels in blueberries, peanuts, and other plants. Various studies have shown that resveratrol can decrease the effects of ageing and act as an anti-cancer agent.
Red wine has also received a lot of attention lately for its purported health benefits. Along with reducing stroke, moderate wine consumption has been linked to a lowered incidence of cardiovascular disease — the so-called French paradox.
Despite diets high in butter, cheese and other saturated fats, the French have a relatively low incidence of cardiovascular disease, which some have attributed to the regular drinking of red wine.
This study published in The American Journal of Pathology shows why this works.
Resveratrol Regulates Pathologic Angiogenesis by a Eukaryotic Elongation Factor-2 Kinase-Regulated Pathway
By Aslam A. Khan et al.
Abnormal angiogenesis is central to the pathophysiology of diverse disease processes including cancers, ischemic and atherosclerotic heart disease, and visually debilitating eye disease. Resveratrol is a naturally occurring phytoalexin that has been demonstrated to ameliorate and decelerate the aging process as well as blunt end organ damage from obesity.
These effects of resveratrol are largely mediated by members of the sirtuin family of proteins. We demonstrate that resveratrol can inhibit pathological angiogenesis in vivo and in vitro by a sirtuin-independent pathway. Resveratrol inhibits the proliferation and migration of vascular endothelial cells by activating eukaryotic elongation factor-2 kinase. The active kinase in turn phosphorylates and inactivates elongation factor-2, a key mediator of ribosomal transfer and protein translation.
Functional inhibition of the kinase by gene deletion in vivo or RNA as well as pharmacological inhibition in vitro is able to completely reverse the effects of resveratrol on blood vessel growth. These studies have identified a novel and critical pathway that promotes aberrant vascular proliferation and one that is amenable to modulation by pharmacological means. In addition, these results have uncovered a sirtuin-independent pathway by which resveratrol regulates angiogenesis.
American Journal of Pathology, May 14, 2010
Abortion 'triples breast cancer risk'
Ho hum! The usual determination to ignore social class, despite the fact that it repeatedly shows up as an influence when examined. Like women elsewhere, lower class women in Sri Lanka were most probably more likely to abort and also more likely to get cancer. The possibility that they would have got more cancer anyway, regardless of whether they had abortions, was not considered
An abortion can triple a woman’s risk of developing breast cancer in later life, researchers say. A team of scientists made the claim while carrying out research into how breastfeeding can protect women from developing the killer disease.
While concluding that breastfeeding offered significant protection from cancer, they also noted that the highest reported risk factor in developing the disease was abortion. Other factors included the onset of the menopause and smoking.
The findings, published in the journal Cancer Epidemiology, are the latest research to show a link between abortion and breast cancer.
The research was carried out by scientists at the University of Colombo in Sri Lanka. It is the fourth epidemiological study to report such a link in the past 14 months, with research in China, Turkey and the U.S. showing similar conclusions.
But Cancer Research UK questioned the accuracy of the figures and said women should not be unduly worried. Dr Kat Arney, the charity’s science information manager, said: ‘This is a very small study of only 300 women, so there are likely to be statistical errors in a sample of this size. ‘Much larger studies involving tens of thousands of women have shown no significant links.’
But the findings prompted accusations that women in Britain are not being properly informed of the dangers of abortion. Professor Jack Scarisbrick, the chairman of Life, a pregnancy counselling charity, said: ‘This is devastating new evidence of the abortion-breast cancer link.
‘We have encountered from the pro-abortion lobby manipulation of the evidence on a truly disgraceful scale. This study is further evidence that has been gathering from all around the world that abortion is a major risk factor for breast cancer. ‘When will the (medical) establishment face up to this fact and pull its head out of the sand? ‘It is betraying women by failing to warn that what they are doing to their bodies – the quick fix of abortion – can do grave harm.’
Although the Royal College of Obstetricians and Gynaecologists has acknowledged the possibility of an abortion-breast cancer link, most medical professionals in Britain remain unconvinced. This is because an international study led by Oxford University concluded in 2004 that having an abortion does not heighten a woman’s risk.
Some scientists say, however, that the Oxford research was flawed because many of the women studied were too young to have developed the disease.
Those who believe there is a link say breast cancer is caused by high levels of oestradiol, a hormone that stimulates breast growth during pregnancy. Its effects are minimised in women who take pregnancy to full term but it remains at dangerous levels in those who have abortions.
There has been an 80 per cent increase in the rate of breast cancer since 1971, when in the wake of the Abortion Act, the number of abortions rose from 18,000 to nearly 200,000 a year.
Earlier this year, Dr Louise Brinton, a senior researcher with the U.S. National Cancer Institute who did not accept the link, reversed her position to say she was now convinced abortion increased the risk of breast cancer by about 40 per cent.
Posted by jonjayray at 6:02 PM
Thursday, June 24, 2010
Were the phrenologists right after all?
Phrenology is the long-discredited theory that head-shapes and "bumps" in the skull determine your personality and abilities. From the research summarized below, however, it seems that the phrenologists may have been onto something. Skulls may not be a reliable guide to much but brain differentiation may be.
Most past studies of genetic influences on personality have found that the personality traits studied do in fact show substantial genetic heritability. And Even your political attitudes have been shown to have a substantial genetic basis. So the findings below are not inherently surprising. But I think that most of us have assumed that the brain differences involved are more subtle that what is reported below.
As someone with long research involvement in the field of personality measurement, the major reservation I have is that the way personality is "chopped up" in the study below is rather arbitrary. The five factor model is certainly widely used but so is Eysenck's three factor model and Cattell's 16 factors.
The broad way that extraversion is described below, for instance, has much in common with the early Eysenck but is rather jarring when looked at in the light of the later finding that two of the components in extraversion -- sociability and impulsiveness -- are largely independant of one-another. So which of those is influenced by the "bump" in the brain that was found to be correlated with extraversion? As the old saying goes, more research is needed.
Personalities come in all kinds. Now psychological scientists have found that the size of different parts of people's brains correspond to their personalities; for example, conscientious people tend to have a bigger lateral prefrontal cortex, a region of the brain involved in planning and controlling behavior.
Psychologists have worked out that all personality traits can be divided into five factors, commonly called the Big Five: conscientiousness, extraversion, neuroticism, agreeableness, and openness/intellect. Colin DeYoung at the University of Minnesota and colleagues wanted to know if these personality factors correlated with the size of structures in the brain.
For the study, 116 volunteers answered a questionnaire to describe their personality, then had a brain imaging test that measured the relative size of different parts of the brain. A computer program was used to warp each brain image so that the relative sizes of different structures could be compared. Several links were found between the size of certain brain regions and personality. The research appears in Psychological Science, a journal of the Association for Psychological Science.
For example, "Everybody, I think, has a common sense of what extraversion is -- someone who is talkative, outgoing, brash," says DeYoung. "They get more pleasure out of things like social interaction, amusement parks, or really just about anything, and they're also more motivated to seek reward, which is part of why they're more assertive." That quest for reward is thought to be a leading factor in extraversion. Earlier studies had found parts of the brain that are active in considering rewards. So DeYoung and his colleagues reasoned that those regions should be bigger in people who are more extraverted. Indeed, they found that one of those regions, the medial orbitofrontal cortex -- it's just above and behind the eyes -- was significantly larger in study subjects with a lot of extraversion.
The study found similar associations for conscientiousness, which is associated with planning; neuroticism, a tendency to experience negative emotions that is associated with sensitivity to threat and punishment; and agreeableness, which relates to parts of the brain that allow us to understand each other's emotions, intentions, and mental states. Only openness/intellect didn't associate clearly with any of the predicted brain structures.
"This starts to indicate that we can actually find the biological systems that are responsible for these patterns of complex behavior and experience that make people individuals," says DeYoung. He points out, though, that this doesn't mean that your personality is fixed from birth; the brain grows and changes as it grows. Experiences change the brain as it develops, and those changes in the brain can change personality.
Source. Journal Reference is: DeYoung et al. "Testing Predictions From Personality Neuroscience: Brain Structure and the Big Five", Psychol Sci. 2010 Jun;21(6):820-8. Abstract here
News that will be ignored: Large study finds no cell phone mast link to cancer
The harmlessness of mobile phones is like the racial correlates of IQ: Many people don't want to believe it so they won't, no matter how much evidence is put before them
British scientists who conducted the largest study yet into cell phone masts and childhood cancers say that living close to a mast does not increase the risk of a pregnant woman's baby developing cancer.
In a study looking at almost 7,000 children and patterns of early childhood cancers across Britain, the researchers found that those who developed cancer before the age of five were no more likely to have been born close to a mast than their peers.
"These results are reassuring," said Paul Elliot, director of the center for environment and health at Imperial College London, who worked on the study.
"We found no pattern to suggest that the children of mums living near a base station during pregnancy had a greater risk of developing cancer than those who lived elsewhere."
Use of cell phones has increased dramatically in recent years and questions have been raised about possible health effects, including whether they may be linked to brain tumors or other cancers.
Opinion polls have also shown high levels of public concern about the potential risks of living near mobile phone mast.
But Elliot, whose study was published in the British Medical Journal on Wednesday, said his work would add to a body of scientific research which has found no links between cell phones and cancer.
Experts who studied almost 13,000 cell phone users over 10 year hoping to find out whether the mobile devices cause brain tumors published the results of their research last month and found no clear answer.
But many previous studies have failed to find any links.
For this study, researchers had data from Britain's four national mobile phone operators -- Vodafone, O2, France Telecom's's Orange, and Deutsche Telekom's's T-Mobile -- on all of the 81,781 mobile phone masts in use from January 1996 to December 2001.
Commenting on Elliot's study, Eileen Rubery, former head of British government's public health prevention department, said its methods and findings were robust.
"This is a carefully done study by a highly reputable group of environmental scientists," she said. "It is reassuring that no adverse affects have been found and this fits with the anticipated and known biological effects from such sites."
Posted by jonjayray at 5:06 PM
Wednesday, June 23, 2010
NICE is getting above itself -- entering the diet wars
Their job is to evaluate the economic effectiveness of drug therapies -- a job they do badly, according to most. But they are apparently a very ambitious little bureaucracy so are now striking out in new directions. But the statements below are just conventional crap showing no knowledge of the double blind studies. If that is testament to their scholarly standards, no wonder they do their original job in a way so disappointing to many
More than 40,000 Britons are dying unnecessarily every year because of high levels of salt and fat in their diets, the Government’s public health watchdog Nice has warned. The National Institute for Health and Clinical Excellence (Nice) says that unhealthy foods have wreaked a “terrible toll of ill health” on the nation and placed a “substantial” strain on the economy.
For the first time, the organisation publishes landmark guidance on how to prevent the “huge number of unnecessary deaths” from conditions such as heart disease that are linked to the consumption of ready meals and processed food.
It calls for sweeping changes to food production and government policy to encourage lifestyle changes, and to reduce significantly the amount of salt and saturated fat the nation consumes.
It says “toxic” artificial fats known as trans fats, which have no nutritional value and are linked to heart disease, should be banned. The organisation says that ministers should consider introducing legislation if food manufacturers failed to make their products healthier.
Nice says it has brought together all the available evidence to illustrate the link between unhealthy food and public health, partly in response to increasing concern about obesity in Britain, particularly among children.
It says there are about five million people in the country suffering the effects of cardiovascular disease — a “largely avoidable” condition that includes heart attacks, heart disease and stroke — and that it causes 150,000 deaths annually. Nice says 40,000 of these deaths could be prevented, and hundreds of millions of pounds saved, if its measures were introduced.
The guidance, which was commissioned by the Department of Health, also recommends that:
• Low-salt and low-fat foods should be sold more cheaply than their unhealthy counterparts, through the use of subsidies if necessary;
• Advertising of unhealthy foods should be banned until after 9pm and planning laws should be used to restrict the number of fast food outlets, especially near schools;
• The Common Agricultural Policy should focus more on public health, ensuring farmers are paid to produce healthier foods;
• Action should also be taken to introduce a “traffic light” food labelling system, even though the European Parliament recently voted against this;
• Local authorities must act to encourage walking and cycling and public sector caterers must provide healthier meals;
• All lobbying of the Government and its agencies by the food and drink industry should be fully disclosed.
Prof Klim McPherson, the Chairman of the Nice Guidance Development Group and professor of epidemiology at Oxford University, said: “Where food is concerned, we want the healthy choice to be the easy choice. Going even further, we want the healthy choice to be the less expensive, more attractive choice.
“Put simply, this guidance can help the Government and the food industry to take action to prevent huge numbers of unnecessary deaths and illnesses caused by heart disease and stroke.” The average person in Britain consumes more than eight grams of salt a day. The body only requires one gram to function. Targets are already in place to reduce salt consumption to six grams by 2015 and this should be extended to three grams by 2050, the guidance says.
Nice says children should consume considerably less salt than adults and that, because the bulk of salt in their diets comes from prepared food such as bread, cereal, soups, meat and cheese products, manufacturers have a significant role to play in reducing it.
The organisation says that most consumers did not even notice a difference in taste if salt levels were reduced by 5-10 per cent a year because their taste buds adjusted.
More crap here
'One size fits all' allergy jab for hay fever, asthma and eczema on the way
Sounds unlikely but one can only hope. The results reported from the small study below were fairly weak and there is no indication that they were double blind. Unless they were, the results are not impressive at all
A jab that could provide a "one size fits all" approach to tackling hay fever, asthma and eczema could be available within a few years, a conference heard.
Swiss researchers claimed allergies that blight the lives of 10 million British sufferers could be largely eradicated with a single vaccine. An allergy conference in London heard the “one size fits all” injection that wards off asthma, eczema, hay fever and even peanut allergies could be on the shelves within four to five years.
Experts say if the jab, known only as CYT003-Qbg10 which has been tested on humans, is properly developed it become the “hail grail” of vaccines due to it helping ward off multiple allergies. It would be welcome news to the estimated one in five Britons, or 10 million people, who suffer from hay fever.
A trial, conducted by scientists from Cytos Biotechnology, a firm based in Zurich, concluded that a course of the vaccine was almost as good as steroids at keeping asthma under control.
At the jab’s heart are pieces of synthetic DNA similar to those found in the bug that causes tuberculosis or TB. The DNA fools the body into thinking it is under attack from a dangerous bug, kick-starting a multi-pronged immune response.
A total of 63 asthmatic patients were given the course of the jab or a series of injections of a dummy drug over two or three months. Researchers found it cut asthma attacks or symptoms by a third.
In another trial, an injection every week over a month and half, cut the amount of runny noses and weepy eyes by almost 39 per cent. Quality of life was boosted by 42 per cent, they added.
Dr Wolfgang Renner, the chief executive of Cytos, told the Daily Mail the results were exciting. “We think it is a one-size-fits all mechanism,” he said. “We are very excited about it.”
Dr Renner suggested the first large-scale human trial could start next year and a vaccine within a few years.
A spokesman for Allergy UK said: “It does sound a very promising treatment, giving hope for those with severe asthma/allergy symptoms for whom the usual treatments aren’t enough, but there is still a long way to go before it will be available.”
Leanne Metcalf, director of Research at Asthma UK, added: “Over three quarters of people with asthma also have an allergy, which can often trigger their asthma symptoms. “We are, therefore, excited about the potential of this vaccine to make a real difference to people with asthma and allergies, especially as it has been shown in clinical trials to have relatively few side effects.”
Tuesday is thought to be the worst day of the year for hay fever.
The NHS currently estimates around ten million people suffer symptoms of hay fever – such as sneezing, runny nose and itchy eyes – in the spring and summer as grasses and trees release their pollen into the air.
But that number could reach 30 million within 20 years as city living, pollution and climate change exacerbate symptoms, experts warned earlier this year.
Tuesday, June 22, 2010
Father involvement in pregnancy could reduce infant mortality (?)
The usual confusion of cause and effect. The "particularly if the infant is black" highlights that. A black father who sticks around is of unusual high quality, almost certainly middle class. And middle class people are healthier and pass that on to their children genetically. It's the man's genes, not his presence at the birth, that creates healthier babies
Studies have shown fathers who are active in their children's upbringing can significantly benefit their children's early development, academic achievement and well being. Now, a new study by University of South Florida researchers suggests that a father's involvement before his child is born may play an important role in preventing death during the first year of life - particularly if the infant is black.
The USF team sought to evaluate whether the absence of fathers during pregnancy contributes to racial and ethnic disparities in infant survival and health. Their findings were recently reported online in the Journal of Community Health.
"Our study suggests that lack of paternal involvement during pregnancy is an important and potentially modifiable risk factor for infant mortality," concluded the study's lead author Amina Alio, PhD, research assistant professor of community and family health at the USF College of Public Health. "A significant proportion of infant deaths could be prevented if fathers were to become more involved."
The researchers examined the records of all births in Florida from 1998 to 2005 - more than 1.39 million live births. Father involvement was defined by the presence of the father's name on the infant's birth certificate. While this measure does not assess the extent or quality of a father's involvement during pregnancy, other studies have established a link between paternal information on a birth record and prenatal paternal involvement.
Among the study's findings:
* Infants with absent fathers were more likely to be born with lower birth weights, to be preterm and small for gestational age.
* Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.
* The risk of poor birth outcomes was highest for infants born to black women whose babies' fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
* Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia and placental abruption, were more prevalent among women whose babies' fathers were absent during pregnancy.
* Expectant mothers in the father-absent group tended to be younger, more educated, more likely to never have given birth, more likely to be black, and had a higher percentage of risk factors like smoking and inadequate prenatal care than mothers in the father-involved group.
Paternal support may decrease the mother's emotional stress, which has been linked to poor pregnancy outcomes, or promote healthy prenatal behavior, Dr. Alio suggested. For instance, some studies, including USF's, indicate that pregnant women with absent partners are more likely to report smoking during pregnancy and get inadequate prenatal care. Barriers to expectant fathers' involvement in the lives of their pregnant partners, including issues like unemployment, relationship status, and participation in prenatal visits, must be examined to increase the role of men during pregnancy, she said.
Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, Dr. Alio said. "When fathers are involved, children thrive in school and in their development. So, it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better."
'Health' foods that will rot your teeth
SNACKS perceived as healthy, including some muesli bars and orange juices, are just as likely to rot your teeth as lollies [candies] and fizzy drinks.
Consumer advocate Choice and the Australian Dental Association's Victorian branch compared the sugar content and acidity of 85 processed foods and drinks and their potential for tooth decay. While fizzy drinks and lollies were unsurprisingly considered high risk, energy drinks such as Red Bull and V Energy, Uncle Tobys apricot muesli bars and Golden Circle Orange Juice were among the worst offenders.
Choice spokesman Brad Schmitt said many of the poor performers were commonly found in student lunch boxes.
Australian Dental Association oral health committee chairwoman Dr Philippa Sawyer said the review results highlighted why tooth decay rates were sky-rocketing. "People don't necessarily understand what causes tooth decay," she said. "We've seen a rapid increase in the tooth decay rate of young children in particular and it's because they snack throughout the day, rather than having the recommended three meals and two snacks."
Nutrition Professionals Australia dietitian Tania Ferraretto said many fruits also contained sugar and were acidic, so potentially a risk to teeth, but should not be avoided. "Foods should always be judged on nutritional value and if you brush your teeth twice a day, then you're on track to avoiding tooth decay," she said.
Australian Food and Grocery Council chief executive Kate Carnell said the industry had produced many new low-sugar, fat and salt alternatives in recent years.
A Nestle spokeswoman said the sugar level in Uncle Tobys Apricot Chew Muesli Bar was only seven per cent of the recommended daily intake and the product contained whole grains and fibre, making a "positive contribution" to diet.
A Golden Circle spokeswoman said a moderate intake of fruit juice could be considered as a serve of fruit, while drinking through a straw and drinking juice with a meal could reduce the impact of acid in drinks.
Posted by jonjayray at 4:10 PM
Monday, June 21, 2010
Four coffees a day 'will keep mouth cancer at bay'
This report appears to be based on a press release only. The full article has yet to appear online, apparently. That makes it hard to evaluate.
Note however that the study is epidemiological and, as in most of its ilk, the size of the effect falls well below the standard required to make causal inferences. And note that previous findings have been mixed. A proper meta-analysis might have helped to resolve that but the analysis reported below was based on a small collection of studies (selected how?) rather than being any sort of meta-analysis
Drinking four cups of coffee a day protects against oral cancer, a study shows. People with a heavy coffee habit are 39 per cent less likely to suffer from cancers of the mouth and pharynx, it suggests.
Doctors say people should drink coffee in moderation because caffeine can increase heart rate and blood pressure. However, the researchers insist evidence is strong that some of the 1,000 chemicals in coffee - including antioxidants - can offer protection against the cancers.
The American scientists used information gleaned from nine studies from Europe, America and Central America, which compared the coffee habits of around 5,000 cancer patients and more than 9,000 healthy people.
After taking into account smoking, diet and alcohol habits, they found that regular coffee drinkers were 39 per cent less likely to develop cancers of the mouth and pharynx than people who drank no coffee.
Lead author Dr Mia Hashibe, from the University of Utah in Salt Lake City, said: 'Since coffee is so widely used and there is a relatively high incidence and low survival rate of these forms of cancers, our results have important public health implications that need to be further addressed. What makes our results so unique is that we had a very large sample size, and since we combined data across many studies, we had more statistical power to detect associations between cancer and coffee.'
Around 5,500 Britons are diagnosed with cancers of the lips, tongue, tonsils, gum and other parts of the mouth each year, while 1,800 people die from the disease. Oral cancer - mostly caused by smoking and alcohol - is on the rise in young and middle aged men. It is difficult to treat and is sometimes disfiguring. Other risk factors include a poor diet and harmful ultraviolet rays from the sun on the lips.
Early symptoms include ulcers that fail to heal, or which bleed easily, red or red and white patches in the mouth that do not go away, lumps in the tongue, mouth or throat, difficulty swallowing or chewing and persistent pain.
Studies on the links between coffee and cancer have produced confusing and sometimes contradictory results. These results confused because coffee drinking could be a marker for some other lifestyle factor that increases cancer risk, such as smoking and alcohol.
However, recent studies have shown that coffee may reduce the risk of cancers of the pancreas, colon, brain and gullet.
The study was published in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.
Why beer is one of the healthiest alcoholic drinks available
This sounds like an attempt to correct misconceptions rather than new science but there is no doubt that beer does contain a lot of nutrients
The healthy properties of beer when consumed in moderation are not well understood, according to a new report. The drink is a rich source of vitamins, fibre, minerals and antioxidants and has a relatively low calorific value compared with many other alcoholic beverages, the study says.
The report, commissioned by The Beer Academy, which aims to help people enjoy beer sensibly, found that when drunk in moderation, beer is one of the healthiest alcoholic drinks available.
A spokeswoman said: 'Beer contains vitamins which can help you to maintain a well-balanced healthy diet, fibre to keep you regular, readily absorbed antioxidants and minerals such as silicon which may help to lower your risk of osteoporosis.'
A survey found that while 68% of people consider beer to be Britain's national drink, some 10% wrongly believe that beer contains fat, and 13% incorrectly believe that beer is made from chemicals rather than malted barley and hops.
The report also explores the psychological and sociability benefits of people enjoying a pint in their local pub - yet pubs are closing at a rate of 39 a week.
It argues that the pub is at the heart of every community and a place where people go to enjoy company and find out local news and information.
Pete Brown, an award-winning author, said: 'Still, we persist in the myth that somehow beer is an inferior drink to foreign imports such as wine. From Government receptions through to weddings and business occasions, wine rather than beer is served.
'It has been fashionable to look down on our own national drink in favour of overseas imports. But to do that is to turn our backs on our great British success story and our own heritage, and miss out on the myriad tastes and complexities that beer can offer.'
:: ICM interviewed a random sample of 2,004 adults aged 18 and over online between February 26 and 28 this year.
Posted by jonjayray at 6:21 PM
Sunday, June 20, 2010
Free-range eggs 'contain five times as much pollution as those from caged birds'
Ethical shoppers are being warned that free-range eggs may be less healthy than those from caged birds. Scientists found that free-range eggs contain at least five times higher levels of certain pollutants than normal eggs. Around 17 per cent of the free range eggs had levels that European regulators would have deemed unsafe for consumption. The study was carried out in Taiwan but the findings will raise concerns about the safety of eating free-range chicken eggs in the UK.
Free-range chickens are those that have continuous access to fresh air, sunshine, and exercise, in contrast to chickens that are confined to cages.
But scientists suspect that free-range chickens may risk getting higher levels of exposure to environmental pollutants, particularly PCDDs and PCDFs, potentially toxic substances that are produced as by-products of burning waste. Also known as dioxins, these substances may cause a wide range of health problems in humans, including reproductive and developmental problems and cancer.
They found that the free-range eggs contained 5.7 times higher levels of PCDDs and PCDFs than the regular eggs. The scientists collected six free-range eggs and 12 regular eggs from farms and markets in Taiwan and analysed the eggs for their content of dioxins.
Taiwan is a heavily populated, industrialized island with many of the municipal incinerators that release PCDDs and PCDFs.
But the authors of the report warned that the issue could be more widespread. They wrote: 'The issue of contamination in free range eggs could be a global issue, and more research should be done to identify the factors from the external environment that influence and modify the PCDD/F levels in eggs from free range hens.'
The researchers believe the free range eggs contain pollutants which the hens pick up from being free to feed in the open. They said the chemicals were present in 'feedstuffs, soil, plants, worms and insects'.
Demand for eggs from free-range chickens has increased steadily due to their supposed better nutritional qualities, including higher levels of certain healthy fats.
The findings appear in the Journal of Agricultural and Food Chemistry.
San Francisco pols approve cell phone radiation law
Preferring to err on the side of caution, the San Francisco Board of Supervisors on Tuesday voted 10-1 to require cell phone makers to post notices in their stores with details on the level of radiation each model emits.
The ordinance requires retailers to post information on what is called the "specific absorption rate" (SAR) of its products. The SAR rates measure the amount of radio wave radiation absorbed into the user's body tissue.
San Francisco Mayor Gavin Newsom, who supports the ordinance, is expected to sign it into law. It would take effect in February, with a $300 fine for those found in violation. Other jurisdictions, including Maine and California, have considered similar legislation, but it appears San Francisco would be the first to enact it.
Some worry that prolonged exposure to cell phone radiation may cause brain cancer, although scientific studies have proven inconclusive. The most recent and most comprehensive study, conducted by Interphone and published May 17, found no increased risk for the two most common types of brain cancer.
The lack of certainty [Nothing would make the SF kooks certain] one way or the other poses a conundrum. If the government issues warnings just to be safe, it may scare consumers needlessly. On the other hand, if a risk does indeed exist, the government is obligated to alert the public of the potential harm.
The Federal Communication Commission, which regulates cell phone safety along with the Food and Drug Administration, states on its Web site "there is no scientific evidence to date that proves that wireless phone usage can lead to cancer or a variety of other health effects," but goes on to note that "studies are ongoing."
The FCC has set a standard that no cell phone sold in the United States can have a SAR in excess of 1.6 watts per kilogram.
Enterprising consumers can find SAR information on the FCC Web site, but they need to have the product's FCC ID code. San Francisco's new law would put that hard-to-find data directly in front of consumers in stores.
Not surprisingly, representatives of the cell phone industry oppose the law, citing both the existing FCC standard and the lack of definitive scientific evidence linking cell phone use to brain cancer. John Walls, a spokesman for the Cellular Telecommunications and Internet Association, told the San Francisco Chronicle that the law "will potentially mislead consumers with point-of-sale requirements suggesting that some phones are safer than others, based on radio emissions."
That argument did not sway the lawmakers in city of San Francisco, who say it will serve the public. "This is a modest and commonsense measure to provide greater transparency and information to consumer," Tony Winnicker, a spokesman for Mayor Newsom, told the Chronicle.
Saturday, June 19, 2010
Tea's good for you, says new study
I am almost at a loss for words to describe this deceptive crap. The only important finding of the study is only obliquely alluded to: That both tea and coffee drinking have NO effect on your lifespan -- one way or the other. As you will see from the abstract that I have also reproduced below: "Neither coffee nor tea was associated with ... all-cause mortality". In the circumstances, it is pointless to say anything about the other holes in the study. No wonder that research in the area is plagued by contradictory conclusions when any old rubbish seems to be publishable
Regularly drinking tea and coffee can significantly reduce the risk of developing heart disease, one of the biggest studies of its kind suggests. Researchers found that moderate consumption of both drinks can reduce your chance of death from a heart attack by at least a fifth. At the same time, it showed that risks for other diseases such as stroke were not increased. [Only yesterday, tea increased your risk of autoimmune diseases!]
"Our results found the benefits of drinking coffee and tea occur without increasing risk of stroke or death from all causes," said Dr Yvonne van der Schouw, professor of chronic disease at the University Medical Center Utrecht, Netherlands.
For the research her team studied tea and coffee consumption among 37,514 people, and followed the participants for 13 years to monitor heart disease and death. They found that tea had the biggest impact on heart disease but that all but heavy consumption of coffee was also beneficial.
Those who drink between three and six cups are 45 per cent less likely to suffer coronary problems compared to people who had less than one cup daily, a study found. And drinking more than six cups was associated with a 36 per cent lower risk of heart disease.
It was good news for coffee drinkers too, with the study saying that a modest intake – two to four cups a day – may lead to a 20 per cent lower risk of heart problems.
The researchers believe that the health benefits are down to antioxidants found in both drinks which remove damaging free radicals from the body.
The team, whose research is published in Arteriosclerosis, Thrombosis, and Vascular Biology: Journal of the American Heart Association, also noted that tea and coffee drinkers have different health behaviours – with more coffee drinkers prone to smoke and have a less healthy diet.
This is the latest research into the relative health benefits of two of the world's favourite beverages. It has been claimed that they can reduce risks of some cancers, diabetes, stress and even acne. But they have also been linked to increased rates of cancer, rheumatoid arthritis and high blood pressure.
Ellen Mason, Senior Cardiac Nurse at the British Heart Foundation, said: “This study adds further weight to the evidence that drinking tea and coffee in moderation is not harmful for most people, and may even lower your risk of developing or dying from heart disease. “However, it’s worth remembering that leading a healthy lifestyle is the thing that really matters when it comes to keeping your heart in top condition.
“Having a cigarette with your coffee could completely cancel any benefits, while drinking lots of tea in front of the TV for hours on end without exercising is unlikely to offer your heart much protection at all.”
Tea and Coffee Consumption and Cardiovascular Morbidity and Mortality
By de Koning Gans, J. Margot et al.
Objective-: To examine the associations of coffee and tea consumption with risk of morbidity and mortality of stroke and coronary heart disease (CHD) and with all-cause mortality.
Methods and Results-: Coffee and tea consumption were assessed with a validated food-frequency questionnaire, and 37 514 participants were observed for 13 years for the occurrence of cardiovascular morbidity and mortality. A U-shaped association between coffee and CHD was found, with the lowest hazard ratio (HR [95% CI]) for 2.1 to 3.0 cups per day (0.79 [0.65 to 0.96]; Ptrend=0.01). Tea was inversely associated with CHD, with the lowest HR (95% CI) for more than 6.0 cups per day (0.64 [0.46 to 0.90]; Ptrend=0.02). No associations between tea or coffee and stroke were found (Ptrend=0.63 and Ptrend=0.32, respectively). Although not significant, coffee slightly reduced the risk for CHD mortality (HR, 0.64; 95% CI, 0.37 to 1.11; Ptrend=0.12) for 3.1 to 6.0 cups per day. A U-shaped association between tea and CHD mortality was observed, with an HR of 0.55 (95% CI, 0.31 to 0.97; Ptrend=0.03) for 3.1 to 6.0 cups per day. Neither coffee nor tea was associated with stroke (Ptrend=0.22 and Ptrend=0.74, respectively) and all-cause mortality (Ptrend=0.33 and Ptrend=0.43, respectively).
Conclusion-: High tea consumption is associated with a reduced risk of CHD mortality. Our results suggest a slight risk reduction for CHD mortality with moderate coffee consumption and strengthen the evidence on the lower risk of CHD with coffee and tea consumption.
A bit of booze breeds better babies?
The usual epidemiological rubbish. Women who drink but control it are probably more likely to be middle class and hence heathier anyway -- which they pass on to their children
New evidence has emerged that pregnant women who indulge in one glass of wine a day in their first trimester may have better behaved children than those who abstain from alcohol or drink heavily. In a study of more than 2300 mothers, Perth researchers found pregnant women who drank light to moderate amounts of alcohol had babies with fewer emotional and behavioural difficulties.
The team from the Telethon Institute for Child Health Research set the "moderate" consumption limit at one alcoholic drink a day. But study leader Dr Monique Robinson advised pregnant women to stick to national guidelines, which recommend expectant mothers abstain from alcohol, and to speak to their doctor.
She said that child behavior was "just one of many outcomes that might be assessed with regards to alcohol consumption during pregnancy". "While our study found light drinking during pregnancy was not associated with increased risk for the child, national guidelines recommend the safest choice is to avoid alcohol once the pregnancy is known."
The study, published in the obstetrics and gynecology journal BJOG, was based on 14 years of data. The researchers recorded the weekly drinking habits of women during the early stages of pregnancy, then monitored the behavioural and emotional patterns of their children during their early teenage years.
Almost 60 per cent of expectant mothers had not drunk during pregnancy, but 3 per cent threw back between seven and 10 drinks and 2 per cent consumed 11 alcoholic drinks each week. About 20 per cent admitted to an occasional tipple of up to one drink a week and 15 per cent had consumed two to six drinks a week.
Researchers checked on the 2370 children involved in the study every few years between the ages of two and 14 and concluded mothers who didn't drink during their first trimester had trouble getting their children to behave.
Children of light drinkers early in pregnancy had a "clinically meaningful" lower risk of becoming depressed or reacting aggressively than the children of non-drinkers. The results were determined through a standard checklist used by psychologists.
They have warned against heavy drinking during pregnancy. Researchers noted 13 per cent of children who were born to mothers who did drink heavily had aggression problems and 10 per cent had depression.
Dr Robinson said the research would help alleviate any guilt for women who had drunk alcohol before they found out they were pregnant. "Women may be drinking alcohol in small amounts prior to recognition of the pregnancy and we feel these data highlight that it is unlikely that this has harmed their unborn child's mental health," she said. "Women should not feel guilty or anxious about low-level drinking effects prior to recognition of the pregnancy. However, binge and large alcohol intake should still be avoided as this does have potential for harm."
King Edward Memorial Hospital's Women and Newborn Health Service recommends pregnant women and breastfeeding mothers follow Australian guidelines that suggest there is no "safe" level of drinking.
Women and Newborn Drug and Alcohol Service clinical midwifery consultant Sadie Geraghty said the amount of alcohol consumed, the frequency and timing of consumption are all factors in the way drinking can affect a foetus. "How does one define moderation of alcohol consumption? One standard glass of wine is 100mls - how many people fill their glass and call that a standard drink?" Ms Geraghty said. "There is no safe time to drink alcohol during pregnancy."
Posted by jonjayray at 5:44 PM
Friday, June 18, 2010
Tea's bad for you, says new study
Groan! Americans are almost all coffee drinkers so tea drinkers are outliers anyway. Maybe many are health freaks -- as tea is often promoted as being good for you. And why would somebody be a health freak? Sometimes because they are in poor health anyway. So does this simply show that health freaks are more likely to suffer from auto-immune diseases? Perhaps. Nobody knows what the causal chain is. Saying that tea CAUSES such ailments is a complete abrogation of scientific caution
Drinking a lot of tea increases the risk of developing rheumatoid arthritis, US researchers said on Friday. A US study on more than 76,000 women found consuming tea raised the risk while drinking coffee had no impact. Tea lovers who enjoyed more than four cups a day had the highest risk - being 78 per cent more likely to develop rheumatoid arthritis than those who drank none. But drinking any amount of tea increased the chance by 40 per cent, compared with people who never drank tea.
The findings were presented at the Annual Congress of the European League Against Rheumatism in Rome.
Professor Christopher Collins, from Georgetown University Medical Centre in the US, said he was surprised by the differences between coffee and tea. He said: "We set out to determine whether tea or coffee consumption, or the method of preparation of the drinks was associated with an increased risk of [rheumatoid arthritis]. "It is surprising that we saw such differences in results between tea and coffee drinkers.
"This does make us wonder what it is in tea, or in the method of preparation of tea that causes the significant increase in risk of developing rheumatoid arthritis."
The researchers also examined whether filtered coffee versus unfiltered coffee affected the results, and also looked at the impact of caffeinated and decaffeinated coffee. However, they found no significant associations with rheumatoid arthritis or the autoimmune disease systemic lupus erythematosus (SLE).
The women in the study were aged 50 to 79 and filled in questionnaires on their daily intake of coffee and tea.
Rheumatoid arthritis is a chronic, progressive and disabling auto-immune disease which affects millions around the world. Three times more women get it than men and it usually starts between the ages of 40 and 60. The disease can cause swelling and damage to the cartilage and bone around the joints, most commonly the hands, feet and wrists. Children under the age of 16 have the juvenile form of the disease.
Professor Collins said he did not recommend that people change their tea-drinking habits based on the research. "This was an unusual and complex finding but, from the data we have, there is a relationship between tea and the disease. "There have been other studies which have either stated that tea has no effect on risk of arthritis, and one study which found tea had a protective effect."
He said the team had looked for supporting information that could explain their own findings. "We found a study which said that an increased intake of flavonoids - which are in tea - from various sources resulted in an increased risk of rheumatoid arthritis."
The team had analysed data on caffeine separately and had found no link, suggesting it was something specific to tea, he added. "It's definitely an association but the risk is very small. "Nevertheless, when you look at enough people, a very small relationship can still be meaningful."
Professor Collins said women were only asked about their consumption of tea, and so no detail was available on whether they had drunk black tea, tea with milk or herbal teas.
His team analysed the results to find out how many women who were tea drinkers had developed rheumatoid arthritis during the course of the study. "We did not ask if they had been lifelong tea drinkers," he said. "Some may infer that if they drank four cups at that point in time, they may have done so in the past."
A good example of why epidemiological relationships should be treated with a large grain of salt
Data dredging will always turn up such relationships -- entirely randomly, with no causal relationships at all
If you know a man called Colin, it might just be worth checking he is in good health. But any Daniels in your life, it seems, have nothing to worry about and can look forward to a long and happy existence.
Research has found that men named Colin are more likely to have high blood pressure, and a higher risk of heart attack, while Daniels have the lowest chance of suffering from the condition.
The survey, by Lloyds Pharmacy, also shows that women called Emily are likely to have a much healthier heart than those called Margaret.
Experts compared naming trends over the past 80 years with the rate of heart problems. Their analysis found that some names linked to the working classes or particular parts of the country came off worse.
For example, Colin is a very popular name in Scotland where heart problems are more prevalent than anywhere else in the UK, while Daniel is seen as a middle-class name.
And those with 'older' names, such as Keith and Maureen, are more likely to have heart problems than younger individuals such as Chloes or Sophies. The survey found that men called Colin, Brian and Alan have a 47 per cent chance of having high blood pressure.
Those called Simon, Mark and Kevin have just a 16 per cent chance of raised blood pressure and cardiac problems. And if your name is Daniel, Liam or Thomas then your chance of high blood pressure drops to 6 per cent.
Similarly, women called Linda, Margaret or Ann have a 50 per cent chance of suffering from the condition while those called Emily, Chloe or Sophie have a mere one per cent risk. For a Claire, Helen or Jane the risk of high blood pressure is 10 per cent.
The analysis also found that Brians and Colins are five times more likely than Simons, Marks and Kevins to have diabetes and 20 times more likely to suffer a stroke. In addition, the study showed that those named Brian and Ronald are 72 times more likely to suffer a stroke than Ethan, Joseph or Samuel.
Posted by jonjayray at 8:46 PM
Thursday, June 17, 2010
Excess medical radiation growing risk for Americans (?)
The stuff below is conventional rubbish but it is rubbish nonetheless. How else do they explain the very long life of "Lucky" Yamaguchi -- who survived encounters with TWO nuclear blasts? Low-dose ionizing radiation is in fact good for you. Google "hormesis"
We fret about airport scanners, power lines, cellphones, and even microwaves. It’s true that we get too much radiation. But not from those sources — it’s from too many medical tests.
Americans get the most medical radiation in the world, even more than folks in other rich countries, according to several studies reviewed by the Associated Press. The US accounts for half of the most advanced procedures that use radiation, and the average American’s dose has grown sixfold over the last couple of decades.
Too much radiation raises the risk of cancer. That risk is growing because people in everyday situations are getting imaging tests far too often.
Like the New Hampshire teen who was about to get a CT scan to check for kidney stones until radiologist Steven Birnbaum discovered he had already had 14 of these powerful X-rays for previous episodes. Adding up the total dose, “I was horrified’’ at the cancer risk it posed, Birnbaum said.
After his own daughter, Molly, was given too many scans following a car accident, Birnbaum took action: He asked the two hospitals where he works to watch for any patients who had had 10 or more CT scans, or patients under 40 who had had five — clearly dangerous amounts. They found 50 people over a three-year period, including a young woman with 31 abdominal scans.
Of the many ways Americans are overtested and overtreated, imaging is one of the most common and insidious. CT scans — “super X-rays’’ that give fast, extremely detailed images — have soared in use over the last decade, often replacing tests that don’t require radiation, such as ultrasound and MRI, or magnetic resonance imaging.
Radiation is a hidden danger — you don’t feel it when you get it, and any damage usually doesn’t show up for years. Taken individually, tests that use radiation pose little risk. Over time, though, the dose accumulates.
Doctors don’t keep track of radiation given their patients — they order a test, not a dose. Except for mammograms, there are no federal rules on radiation dose. Children and young women, who are most vulnerable to radiation harm, sometimes get too much at busy imaging centers that don’t adjust doses for each patient’s size.
That may soon change. In interviews, US Food and Drug Administration officials described steps in the works, including possibly requiring device makers to print the radiation dose on each X-ray or other image so patients and doctors can see how much was given. The FDA also is pushing industry and doctors to set standard doses for common tests such as CT scans.
“We are considering requirements and guidelines for record-keeping of dose and other technical parameters of the imaging exam,’’ said Sean Boyd, chief of the FDA’s diagnostic devices branch.
A near-term goal: developing a “radiation medical record’’ to track doses from cradle to grave.
The best guess at how much radiation is risky is based on the 1986 Chernobyl nuclear power plant accident and studies of Japanese atomic bomb survivors who had excess cancer risk after exposures of 50 to 150 millisieverts of radiation.
A chest or abdominal CT scan involves 10 to 20 millisieverts (a measure of dose), versus 0.01 to 0.1 for an ordinary chest X-ray, less than 1 for a mammogram, and as little as 0.005 for a dental X-ray. Natural radiation from the sun and soil accounts for about 2 millisieverts a year. A study last year estimated that 4 million Americans get more than 20 millisieverts a year from medical imaging. Two percent of people in the study had high exposure — 20 to 50 millisieverts.
Health fanatic dies of her fanaticism
No sympathy for such a stupid egotist from me, I am afraid. Though the quacks involved could do with prosecution for holding out false hope
A NURSE has described her "state of shock" upon seeing the distressing condition of a woman who tried to use homeopathy to fight cancer.
In an inquest at the Perth Coroner’s Court, registered nurse and family friend Deborah Combes said she believed Penelope Dingle was dying after being called to assist the ailing woman in October 2003. Mrs Dingle, who attempted to treat her colorectal cancer with homeopathy and natural remedies after being diagnosed in 2003, died in August 2005.
The Coroner's Court was told Ms Combes was called by one of Mrs Dingle’s sisters to help Mrs Dingle shortly before she was admitted to hospital for emergency surgery. Ms Combes told the court Mrs Dingle was in an emaciated state, and was sweaty and breathless with her eyes sunken. She said Mrs Dingle was “writhing in pain” and was “screaming and very frightened”.
She said Mrs Dingle’s husband, prominent Perth toxicologist Peter Dingle, told her she had not seen a doctor “for months” and was instead relying on the directions of homeopath Francine Scrayen.
Ms Combes said Mrs Dingle was “completely obsessed” with the homeopathic regime and initially refused to take pain relief. “I couldn’t understand why someone would go through so much pain and agony,” Ms Combes said. “She would hold her abdomen like a pregnant woman does. “She was in pain - she was ill.
“(But) it was extremely difficult to reason with Pen (so as) not to make a mistake in the complex regime.”
Posted by jonjayray at 7:07 PM