Monday, June 30, 2008

Tap Water Chemicals Not Linked to Penis Defect

Though some research has linked chemicals in chlorinated tap water to the risk of birth defects, a new study finds no strong evidence that the chemicals contribute to a common birth defect of the penis. The defect, known as hypospadias, occurs when the urinary outlet develops on the underside of the penis rather than at the tip. Genetics are thought to play a large role in hypospadias risk, but the other potential causes are not fully understood.

Some past studies have suggested that certain chemicals in tap water -- byproducts of the chlorination process used to kill disease-causing pathogens -- may contribute to the risk of birth defects and miscarriage. Other studies, though, have found no such links.

For the current study, researchers led by Tom J. Luben of the US Environmental Protection Agency used birth records from 934 boys born in Arkansas between 1998 and 2002. Of these children, 320 were born with hypospadias. [WTF! A third of boys born deformed??? Apparently not. It seems that the controls were just a sample] Luben's team analyzed monitoring data from local water utilities to estimate the mothers' exposure to two major classes of water-disinfection byproducts during pregnancy. Overall, the researchers found, women with the greatest exposure to these chemicals were no more likely to give birth to a boy with hypospadias than women with the least exposure.

They report the findings in the journal Occupational and Environmental Medicine. "Our results do not support the hypothesis that continuous or intermittent exposure to tap water disinfection byproduct concentrations within regulatory limits during gestation is associated with giving birth to a son with hypospadias," Luben and colleagues write.

However, the findings are not the final word, either. The researchers did find that when they accounted for mothers' total exposure to certain chemicals -- through drinking, bathing and showering -- there was some evidence of a link to hypospadias.

There was, however, no clear pattern of hypospadias risk climbing as mothers' exposure to tap water chemicals increased. Such patterns, known as a "dose-response" relationship, are considered to be evidence of cause-and-effect. The results, according to Luben's team, "could be due to chance." They call for further studies, with more-precise information on individual women's exposure to tap water chemicals, to help settle the question.

Source. Journal article here

Alcohol shaping women's bodies

I doubt that the effect described is due to alcohol alone. Being overweight generally would seem a likely factor and that need not be due to drinking

As women catch up with men in the drinking stakes, their waistlines are also catching up with the beer belly, according to health experts. An English dietitian has given the apple-shaped body type a new name - the wineglass - due to the love of the drink. Jacqui Lowdon, from the British Dietetic Association, said it was the result of image-conscious women exercising to keep fit, and yet neglecting to cut back their alcohol intake.

The shape is characterised by weight accumulating in the middle, creating a larger upper body and a thinner lower half. Traditionally seen in women after menopause, this barrel-torso physique is now becoming common in the under 30s. Singers Britney Spears, Charlotte Church and Fergie are seen as examples of this emerging body type.

International health and longevity expert Dr John Tickell cited extended drinking hours contributed to the growing number of "wineglass" figures. "The social pressures on the way we eat and drink are just so different to what they were 50 years ago," Dr Tickell said. "What happens now is that most of the kids don't go out until 10 or 11 or midnight, and they stay out drinking in clubs all night."

Dr Tickell explained that our sedentary lifestyles and intake of excess calories through alcoholic drinks such as wine and sweet alcopops contributed to the skinny-leg, big-belly look. "The evolution of the wineglass shape for women, with the thinner legs, is because we don't use our legs," he said. "We don't play netball, we don't climb stairs - we don't do anything." "This is not a genetic thing; it's a lifestyle thing, the accumulation of excess calories you consume starts to go around the tummy."

Dr Tickell said it was a worrying trend and could lead to a number of health problems. "It was sort of OK for a man to look like an apple but now it's becoming OK for a woman to look like an apple or a wineglass, which is terribly unhealthy. "Wineglass equals high-risk diabetes, breast cancer and bowel cancer and all the other cancers."

Nadia Jacobi, 23, a regular at the gym, said she was aware of the emerging trend. "If you go out and drink all weekend there is no point to doing all the gym training," she said. "If you look on the back of a wine bottle you can see how many carbs the wine has that contribute to how many calories there are and I don't think a lot of people are aware of that."


Sunday, June 29, 2008

Food safety stupidity

Leaders of the Black Cultural Council say volunteers and the black community felt "humiliated" after two health department food inspectors threatened to put a stop to a Juneteenth celebration over questions about food preparation for 600 free barbecue sandwiches. Council President Jo Ann Davenport-Littleton said health inspectors told them it was illegal for the group to serve the sandwiches because they were not prepared at the site where they were served.

Gino Solla, the county's top health official, said state law prohibits any food service operation from having food prepared in a private home for public consumption.

"I hate that it happened," Davenport-Littleton said in a story for today's edition of the Odessa American. "I wanted people to go away talking about how great the celebration was this year. All you heard was 'They were going to deny us barbecue. Here we are in modern-day slavery again.' "

The council, which has contracted with an individual to prepare the food offsite for the past 11 years, was eventually able to serve the sandwiches Thursday after police were called to the center and a "heated" argument with the inspectors, the newspaper reported. The group is demanding an apology.

Solla said he won't apologize. "We have to be aggressive when the public interest is involved," he told the paper. "If there was any kind of forwardness and if it was perceived as rude, that I'll apologize for. But when it comes to public health, I don't think I have any apology for that." Solla said he will write a letter to the group and others involved in hopes of working things out.

Juneteenth commemorates the June 19, 1865, arrival of Union Army Gen. Gordon Granger in Galveston with news of freedom for black people still enslaved even after passage of the Emancipation Proclamation.


The Pill ‘has had its day as an effective contraceptive’

An IUD revival? The Dalkon shield must have been forgotten

The Pill is “outdated” and leading to more unwanted pregnancies and abortions because so few women take it correctly, a leading academic has said. Nearly one in 12 women who takes the Pill stands to become pregnant each year by missing occasional tablets, James Trussell, of Princeton University, New Jersey, says.

Increasing access to emergency contraception - the “morning after” pill - would also not have a significant effect on rates of unwanted pregnancy and abortions, he will tell the British Pregnancy Advisory Service conference in London today.

Speakers at the conference on the future of abortion will say that women should use longer-lasting methods such as hormonal implants or intrauterine devices (IUDs) that can be “fitted and forgotten”, but later removed if a woman wants a baby.

The Government wants to encourage more women to use long-acting methods, and guidance has suggested that if 7 per cent of women currently using the Pill switched to a long-acting method, then it would prevent 73,000 unintended pregnancies, saving the NHS 100 million a year.

But Professor Trussell said that few GPs offered long-acting reversible contraceptives or were trained at fitting them, so most women ended up using the Pill by default. “The Pill is an outdated method because it does not work well enough,” he added. “It is very difficult for ordinary women to take a pill every single day. The beauty of the implant or the IUD is that you can forget about them.”

Studies suggest that women miss three times as many pills as they commonly say they do. Computerised pill packs were used to show that although about half of women said they did not miss any pills, fewer than a third actually did.


Saturday, June 28, 2008

Introducing exercise early 'is vital' in tackling obesity (?)

Some "vital" advice for mothers below. It sounds reasonable -- until you read the article following it. Evidence seems to come last in most health advice. The writers JUST KNOW what is right

Something as simple as holding a baby in water at the swimming pool could reduce the risk of obesity, it has been claimed. The Sun has recommended a number of tips to help parents keep their children fit and healthy.

Mother-and-toddler groups or baby classes at local leisure centres are great ways of introducing little ones to activities at an early age, it advised, as they can experience things such as yoga and dance.

Teaching toddlers to walk as much as possible and taking them to play outside is also a great way to involve exercise in their routine, it continued.

Fitness expert Nicki Waterman said: "Healthy children should be introduced to exercise as early as possible. Whether it's swimming, football or dancing, find something they enjoy and encourage them by joining in too."

According to a government report, the number of under-20 year olds who are obese could ride from ten per cent to 15 per cent by 2025.


Gym class does little to lower childhood obesity

May I mention that weight-proneness is 77% genetic?

Pumping up the frequency of phys-ed classes doesn't make a difference to childhood obesity, a B.C. study has found. The research, presented to 700 delegates attending the Canadian Paediatric Society conference here, is apt to deflate the hopes of those pleading for more school-based phys-ed classes as a possible panacea against fatness.

Dr. Kevin Harris, a pediatric resident at B.C. Children's Hospital, helped conduct an analysis of studies on school phys-ed policies to determine if they change Body Mass Index, the common measurement used to assess fat and weight.

While such policies may be "theoretically appealing" and many jurisdictions are either considering or enacting changes to increase physical activity inside and outside school, the analysis shows BMI doesn't change as a result.

Harris said researchers looked at 13 trials of six months to three years duration in which pre- and post-BMI measurements were taken. In studies involving nearly 10,000 children, primarily in elementary schools, none demonstrated a reduction in BMI with those who were assigned to the most phys-ed time, compared to those who didn't have as much.

"School-based physical activity interventions do not improve BMI although they may have other beneficial health effects," he said. "There are improvements to bone mineral density, aerobic capacity, reduced blood pressure and increased flexibility," he added. Childhood overweight and obesity rates have quadrupled in the past 40 years and now stand at about 30 per cent.

Harris said experts have predicted that because of this, the current generation of children may be the first to have a reduced life expectancy because of the conditions associated with obesity such as diabetes, arthritis and cardiovascular disease.

Harris said policy-makers must realize that all the causes of childhood obesity are still not known so merely focusing on in-school phys-ed programs is not enough to reverse obesity trends.


Friday, June 27, 2008

Faked research data surprisingly common, survey suggests

It's the logical extension of all the dishonest interpretation of results that we constantly see. If you are determined to come to certain conclusions no matter what, why not make up the data altogether? There is a zero tolerance policy badly needed here. Stop the "broken windows" of biased interpretations and you might reduce reporting that is totally false

Scientific misconduct, notably including falsification of data, may be far more common than suspected, according to the authors of a new survey of more than 2,000 scientists.

Sandra L. Titus and colleagues at the Office of Research Integrity of the U.S. Department of Health and Human Services in Rockville, Md., surveyed 2,212 scientists at 605 institutions. They found that nearly 9 percent believed they had seen potential research misconduct in the previous three years. The findings are published in a commentary in June 19 issue of the research journal Nature.

The results suggest as many as 2,300 observations of misconduct, 1,000 of them unreported, occur each year in the larger research community funded by the U.S. National Institutes of Health, Titus and colleagues wrote. They added that it's unlikely such behavior is confined to the United States.

Survey participants described misbehavior ranging from scientists' changing numbers to make results look more definite than they really were, to more creative fabrications. One participant told of a colleague using Photoshop to tweak results of chemical tests that appear as blots on sheets of paper.

Suspected misconduct was seen "at all scientific ranks including postdocs, students, and tenured faculty members," the authors wrote. Sixty percent of the cases involved fabrication or falsification, and 36 percent plagiarism "only," Titus and colleagues added.

The authors wrote that the problem arises partly because scientists are reluctant to turn in cheating colleagues, and commonly face ill consequences for doing so. They cited evidence that institutions often encourage whistleblowers to drop allegations. "Institutions must establish the culture that promotes safeguards for whistleblowers and establishes zero tolerance both for those who commit misconduct and for those who turn a blind eye to it," Titus and colleagues wrote. Institutions may also want to consider auditing research records as part of renewed efforts to root out misconduct, they added.

The number of cases reported to the Office of Research Misconduct is very lowabout 24 investigations per year from institutions for cases that involve National Institutes of Health funding, Titus and colleagues wrote.


So now Britain will have degrees in quackery

It's hard to grade nonsense on a scale, but of all forms of medical quackery, psychic surgery must be judged one of the least scrupulous. You might recall the odd television expose of its practitioners - so-called 'surgeons' who appear to be operating on patients with their bare hands, and who seem to be able to remove allegedly diseased tissue without making any incisions. Despite being exposed as hoaxers, 'psychic surgeons' continue to cast their spell over the gullible and desperate – mostly in Brazil and the Philippines. The odd case still crops up in the supposedly less superstitious United Kingdom.

About a year ago the Conservative MP Robert Key wrote to the Department of Health following a complaint by one of his constituents, who had been a victim of such fraudulent "healing." I have the full ministerial reply in front of me. Lord Hunt of Kings Heath told Mr Key: "We are currently working towards extending the scope of statutory regulation by introducing regulation of herbal medicine, acupuncture practitioners and Chinese medicine. However, there are no plans to extend statutory regulation to other professions such as psychic surgery. "We expect these professions to develop their own unified systems of voluntary self-regulation. If they then wish to pursue statutory regulation, they will need to demonstrate that there are risks to patients and the public that voluntary regulation cannot address. I hope this clarifies the current position."

Indeed, it does. It makes it clear that the lunatics have taken over the asylum. For a start, how could Philip Hunt, previously director of the National Association of Health Authorities and Trusts, possibly have thought that "psychic healing" constituted a "profession" – let alone one which would "develop its own system of voluntary self-regulation? What might this involve? A code which declares that members must never perform genuine surgery, lest it brings the "profession" into disrepute?

Last week, in fact, the Department of Health published the report which outlines the regulation hinted at by Lord Hunt. It is called the Report to Ministers from the Department of Health Steering Group on the Statutory Regulation of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and other Traditional Medicine Systems Practiced in the United Kingdom.

It is a scary document, and not just because many of its recommendations stem from something called the "Acupuncture Stakeholder Group". You thought they just used needles, didn't you?

Acupuncture is at the most respectable end of the alternative health spectrum – its practitioners would be affronted to be lumped in with psychic surgeons. Yet what, really, is the difference? There are many "patients" in the Philippines and Brazil who will insist that psychic surgery has cured chronic ailments which conventional medicine failed to alleviate. Such is the power of placebo – the driving force of all unconventional medical treatments, including acupuncture.

A few months ago an investigation into acupuncture, involving 1,162 patients with lower back pain, made a splash in newspapers across the world. The researchers at Regensburg University declared that just 27.4 per cent of those who had only conventional treatments such as physiotherapy felt able to report an improvement in their condition. However, of those who also underwent acupuncture, 47.6 per cent reported an improvement. So all that stuff about "different levels of Qi", "meridians", "major acupuncture points" and "extraordinary fu" is scientifically validated, then? Well, not quite, despite what some of the news reports said.

You see, the cunning researchers of Regensburg had one control group of back-pain sufferers who were told that they were undergoing traditional acupuncture – whereas in fact the needles were inserted entirely at random; and instead being put in to a depth of up to 40mm (as required by the acupuncture textbooks) were merely inserted just below the skin. This was sham acupuncture. And guess what? It worked – within the statistical margin of error – just as well as the "real" acupuncture: 44.2 per cent of the recipients of the sham treatment said that their back pain had been alleviated in a way which they had not experienced through conventional medicine.

Now here's another remarkable thing: the main body of the report produced for the Government last week does not contain the word "placebo" – and it crops up only twice in the appendices. One can understand why the various "stakeholders" who were consulted might have wanted to steer away from this fundamental question, but it's surprising that the chairman of the report, Professor Michael Pittilo, principal of Robert Gordon University, didn't insist upon it.

After all, Professor Pittilo claims that his report was an "echo" of the House of Lords' Science and Technology Committee report on the same subject – which had declared that the single most important question that any such investigation must address is: "Does the treatment offer therapeutic benefits greater than placebo?"

That indefatigable quackbuster, Professor David Colquhoun of University College London is on the case, however. His indispensable blog points out that Professor Pittilo is a trustee of the Prince of Wales's Foundation for Integrated Health, which advocates exactly the sort of therapies that this committee is supposed to be regulating.

Pittilo and his band of "stakeholders" have come up with their own way of "regulating" the alternative health industry – which the Government has welcomed. It is to suggest that practitioners gain university degrees in complementary or alternative medicine. Pittilo's own university just happens to offer such courses, which Professor Colquhoun has long campaigned against as "science degrees without the science."

It will be a particular boon to the University of Westminster, whose "Department of Complementary Therapies", teaches students all about such practices as homeopathy, McTimoney chiropractic, crystals, and 'vibrational medicine'.

One can see how this might fit in with the Government's "never mind the quality, feel the width" approach to university education. One can also see how established practitioners of such therapies might see this as a future source of income – how pleasant it might be to become Visiting Professor of Vibrational Medicine at the University of Westminster.

Thus garlanded with the laurels of academic pseudo-science, the newly professionalised practitioners of "alternative medicine" can look down on such riff-raff as the "psychic surgeons". Yet in one way those charlatans are less objectionable than Harley Street homeopaths: they openly admit that they are faith-healers, rather than pretend to academic status; and while they have made fools of their patients they haven't-yet-made a fool of the Government.


Thursday, June 26, 2008

Another confirmation of long Australian lifespans

There was a similar finding reported 18 months ago. Pesky that Australians are exceptionally long-lived despite the typical Australian diet being just about everything the food-freaks deplore. There are certainly a lot of nonagenarians about in Australia who grew up on food fried in dripping (animal fat) -- fried steak particularly. Fried steak and eggs was a routine breakfast for many Australian working men up until a few decades ago. And they would only have eaten nuts at Christmas. And to this day, very fatty meat pies (see pic above) and sausage rolls are a great favourite.

Going by the results of double-blind studies (e.g here), however, it is doubtful that type of diet has ANY influence on longevity. The fact that two long-lived populations -- Australians and Japanese -- have radically different diets also supports that conclusion.

The explanations for Australian lifespans given in the news report below are entirely speculative. An equally plausible explanation is that traditional Australian skepticism causes most Australians to ignore food freaks.

The only thing about diet that increases lifespan is restricted calorie intake. Which is probably why the Japanese -- who had very little food for much of the 20th century -- live so long. Restricted calorie intake also stunts growth -- which would also explain why older Japanese are so short. So attributing the high Japanese lifespan to a "healthy" diet is also just a guess that fails to consider other possibilities

Australians are living longer than ever as death rates from the big killers of heart disease and cancer fall and smoking continues to wane in popularity. The Australia's Health 2008 report, released yesterday, shows Australians can now expect to live for 81.4 years - and that we have leap-frogged Sweden and Iceland to claim the No2 spot on the world's life expectancy tables, second only to Japan.

Overall, the latest snapshot of the nation's health paints a mixed picture, showing that while Australians are cutting down on smoking and doing better against cancer and heart disease, we are also fatter, boozier, more likely to catch a sexually transmitted infection, and still likely to end up in hospital for something that could have been avoided.

In 2005-06, more than 9 per cent of hospital admissions were considered potentially preventable. We also too rarely make the diet and lifestyle choices that would ward off diabetes, high blood pressure and other problems, and there are poorer outcomes for people of lower socio-economic status which happens worldwide]. While asthma has receded as a health threat, others such as oesophageal disease, are looming larger.

And the picture for indigenous Australians is also mixed: the gap in death rates between indigenous and non-indigenous Australians appears to be narrowing, but otherwise indigenous adults seem to be slipping even further behind the health of their non-indigenous countrymen. [If you saw the way blacks often live, you would not be surprised. Methanol ("metho") is not a healthy drink]

Launching the report in Canberra yesterday, Health Minister Nicola Roxon said it was a "great achievement" that "highlights both the good and the bad". "We can take heart that an Australian born between 2003 and 2005 can now expect to live 42 per cent longer than those born in 1901-10," Ms Roxon said. "That's an extra 25 years for most people." Once the danger years of youth and middle age are past, men who reach 65 can expect to live to 83, and women to 86 - about six years more than a century ago.

The AIHW said one of the biggest factors in extending life was the drop in smoking rates. About one in six Australians were daily smokers last year, one of the lowest rates in the world. Vaccination also continues to enjoy widespread support, with more than 90 per cent of children fully immunised against the major preventable diseases such as whooping cough, measles and mumps.

As well as asthma affecting an estimated 10.3 per cent of the population in 2004-05 - down from 11.6 per cent in 2001 - other good news is that illicit drug use appears to be falling. The percentage of people aged 14 and over who admitted to using marijuana fell from a high of 17.9 per cent in 1998 to 9.1 per cent last year, while those using methamphetamine or "ice" fell from 3.7 per cent in 1998 to 2.3 per cent last year.

Ecstasy use remained level and only cocaine showed any upward trend, being used by 1.6 per cent of respondents to last year's survey, compared with 1 per cent in 2004.

However, AIHW director Penny Allbon said Australia could do more to tackle the main risk factors for chronic diseases. "In rank order, the greatest improvements can be achieved through reductions in tobacco smoking, high blood pressure, overweight and obesity, physical inactivity, high blood cholesterol and excessive alcohol consumption," Dr Allbon said. "The prevalence of diabetes, which is strongly related to these risk factors, has doubled in the past two decades.

"Excessive alcohol consumption not only brings costs in terms of personal health, but tangible social costs in terms of lost productivity, healthcare costs, road accident costs and crime-related costs that have been estimated at $10.8 billion in 2004-05."

The report shows that alcohol caused 3.8 per cent of the burden of disease for males, and 0.7 per cent for females. Four in five Australians aged 14 and over drank alcohol, and one in 10 did so daily. However, the report said these rates "have been fairly stable since 1993".


Useless Menu Labeling Laws

Restaurants in New York City with 15 or more outlets nationwide now must conspicuously post the nutritional content of each item on their menus. Similar legislation is coming to San Francisco and Seattle, and is under consideration in about a dozen other cities and state legislatures.

At first blush, this seems like a good idea. Why not force restaurants to let their consumers know the nutritional value of what they're about to eat? If we're to believe what the public health world says about our bulging waistlines, perhaps a little more information would be a good thing.

The American Prospect's Ezra Klein made this argument last month, writing, "It's a bit rich to watch libertarians and associated anti-government types oppose a regulation that gives consumers more useful information. This, after all, is how markets are supposed to work best. Consumers have better information, can pursue their preferences in a more coherent manner, and the market can provide, adapt, and innovate in response."

It's a compelling argument. But the menu labeling debate is actually a bit more complicated than that. First, it's expensive to send an entree to the lab for testing. Nutritional labs typically charge $850 to $1,000 for the service, and most restaurants will want to test an item more than once to ensure accuracy. Any "have it your way" customization of an item would also need to be tested, which means a typical sandwich might need to be tested dozens of times to account for the various condiments and accouterments a restaurant may want to offer.

There is, however, another way to gauge the nutritional content of menu items that's a bit less expensive. That is to break every item down to its most basic ingredients and their quantities, then to run those ingredients through a nutritional database, which adds the ingredients up, then spits out totals. This too has it's problems, in that it requires restaurants to (a) turn over proprietary recipes for analysis, and (b) abide by those recipes every time, without fail.

The main problem with all of this is that it requires restaurants to slavishly adhere to the recipes of the dishes they originally sent away for testing. Let's say a particular batch of tomatoes delivered to a restaurant were particularly bland, for whatever reason. Don't even think about adding an extra dash of salt to your dish to compensate. If the original dish had only a dash of salt, you've just doubled the sodium content. You can also forget about substitutes, seasonal variety or allowing customers to customize dishes in ways that haven't been sent to the lab.

Forget about "going local," too. Buying from local growers is less predictable than buying from a national network of food suppliers, where shortages or disappointing harvests from one area of the country can be accounted for by purchasing more from other areas.

Menu labeling laws mean every restaurant in a given chain has to make every dish exactly the same way, every time. Most menu labeling laws allow for a 20 percent variance in nutritional labeling. This is the same variance allowed for the nutritional information on manufactured food products, where you have assembly-line machines cutting exact portions and abiding by standardized recipes instead of real live people making dishes from what's available in the kitchen.

Of course, the labeling of manufactured foods is another argument in favor of the futility of these menu labeling laws. We've been labeling packaged foods for decades now - the foods that make up the vast majority of our meals and snacks. And we're still getting fatter.

Supporters of menu labeling laws know that complying with these laws will be expensive and onerous. That's why they've only applied them to chain restaurants - restaurants they say can afford to send dishes off for nutritional testing. Perhaps, but knowing that adding a new dish to the menu could cost several thousand dollars and will almost certainly result in one of two consequences: Either restaurants will dramatically cut down on variety and serve only meticulously portioned cookie-cutter dishes or they'll merely pass the costs of testing each dish on to consumers.

Certainly, the chains that barely make the cut of 10-15 franchises (depending on which law you're talking about) will think twice before offering a perk like daily specials, where each new daily dish could add thousands of dollars to the company's bottom line.

But even large chains are going to be more hesitant about regional variety. And chefs at high-end spots like steakhouse chains are going to be extremely unlikely to create customized meals, or prepare dishes for people with specialized diets.

The other response to the "we're only requiring this of the restaurants who can afford it" argument is that if that's the case, what's the point of having the law in the first place? The New York City law will only affect about 10 percent of the city's eateries. If the goal is to combat obesity, you're missing 90 percent of the places where people are eating.

What's more, according to the National Restaurant Association, we buy just six of our 21 weekly meals from restaurants. Put another way, menu labeling laws mean nutritional information will be slapped in front of the average American for about three of every 100 meals. We aren't getting fatter because there aren't fat-count stickers on our Big Mac wrappers - as if most of us didn't already know a Big Mac isn't the most nutritious meal anyway.

Of course, most of the really large chains already make nutritional information available - either online or in pamphlets you can find at the restaurant. Calorie counters and people watching their sodium or sugar intake can find this information relatively easily if they need it. And they can choose not to patronize the few restaurants that don't make it available.

The menu-labeling crowd wants that information posted in big letters on menu boards or slapped on the packaging of the foodstuffs themselves. The goal of menu labeling legislation, then, is much more paternalistic than merely to "make more information available." It's to force nutritional information on people who aren't necessarily looking for it.

Then there are the lawsuits. When McDonalds voluntarily agreed to post its nutritional information on the Web several years, it wasn't long at all before the nutrition fanatics at the Center for Science in the Public Interest (CSPI) attacked the company because a couple of McDonalds employees served covert CSPI reps overly large ice cream cones.

Earlier this month, a Seattle firm filed a class action suit against the Applebee's chain because of what the firm says were errors in its nutritional menu labeling. Days later, the same firm filed a similar suit in Texas, this time aimed at the Brinker chain, which owns brands such as Chili's and Macaroni Grill. Of course, if these restaurants deliberately mislabeled nutritional information or didn't bother to accurately test food labeled as "healthy," they should be held accountable.

But it's also impossible to make the same dish the exact same way every time. Such is the reason why large chains test the same dish multiple times to arrive at an average. But if you're looking for a reason to sue, you're only going to include in your claim the chains that served dishes that came out over the posted data, not under.

This is the main reason why restaurants have been reluctant to provide nutritional information in the first place. An extra pat of butter, an extra dash of salt, a substitution here or there, or even a generous chef who - God forbid - decides to give a customer a generous portion, can now mean multimillion-dollar class action lawsuits.

These menu-labeling bills have put restaurants in a no-win predicament. Their best bet is to mechanize their kitchens and to take all variety and spontaneity out of their menus - which isn't exactly a good outcome for consumers. And you can bet that when the latest round of menu-labeling bills fails to make us any skinnier, the nutrition activists will start taking aim at the smaller chains and independent restaurants too.


Wednesday, June 25, 2008

British parents harassed in the name of junk science

Parents cleaning out their child's lunchbox at the end of the school day could be in for a nasty surprise — a scolding note from teacher alongside the half-eaten sandwiches and empty crisp packets. The School Food Trust wants teachers to send out warning letters to parents who fail to comply with school healthy-eating policies. And in advice that could be seen as patronising, the government-funded body suggests further that they send congratulatory letters to those who pack healthy lunches for their children.

Schools across the country were ordered to provide healthy lunches and remove vending machines filled with chocolate and fizzy drinks after a campaign led by the television chef Jamie Oliver exposed the poor standard of meals at many schools.

Most schools also ask parents not to give children crisps, biscuits or similar items for lunch, but the guidance from School Food Trust looks to harden the approach to unhealthy lunchboxes. In guidance sent as an example to head teachers and governors, the trust lists the foods pupils should not take to school: crisps, chocolate bars, chocolate-coated biscuits and sweets. “Cakes and biscuits are allowed but encourage your child to eat these only as part of a balanced meal,” it says. Nuts, seeds, vegetables and fruit are welcome, as long as they have no added salt, sugar or fat. “Packed lunches should include at least one portion of fruit and one portion of vegetables every day.”

Most parents are happy to comply with a healthy-eating policy, but could be irritated by the way the trust recommends it is assessed. “Parents and pupils who do not adhere to the packed lunch policy will receive a leaflet in the packed lunch informing them of the policy,” the trust says. “If a child regularly brings a packed lunch that does not conform to the policy, then the school will contact the parents to discuss this.”

A spokeswoman for the National Confederation of Parent Teacher Associations said: “It's no way to communicate with parents and doesn't put healthy food in a positive light. It may make parents feel underrated, dismissed and dictated to. “As a parent, I'll sometimes have a biscuit with a cup of tea - everything in moderation is what's needed for adults and children. It makes you wonder what the staffroom lunchboxes look like.”

Justine Roberts, the founder of Mumsnet, the online forum for mothers, said that advice on packed lunches was helpful for parents because it assisted them to say “no” to their children. But receiving a letter would “feel a bit like the lunchbox police”, she said. “Just occasionally there is really nothing in the cupboard because you haven't done the shopping in time, and you just bung in anything.” She said that the policy should, instead, be made clear at the beginning of each term.

Despite winning praise for making school meals healthier, the Government has been criticised for the way it runs them. The campaign group Food for Life Partnership warned Ed Balls, the Schools Secretary, that the school meal service was “at risk of collapse”. In a letter it sent to the minister yesterday, it said: “The majority of school meal providers are now running at a deficit which they will not be able to sustain. “If urgent action is not taken, the Government risks losing this key opportunity to fight obesity and climate change by changing young people's eating habits. “Unless policymakers start viewing school meals as an education service, not a commercial one, they will end up serving no one.”

The Local Authority Caterers Association backed the partnership. Sandra Russell, chairwoman of the association, said: “School meal providers nationally are encountering financial challenges.”


IVF safe

Women who want to postpone motherhood to establish a career or find the right partner have been given new hope by research that shows the safety of an advanced egg-freezing technique. The most exhaustive study yet of children born after the freezing procedure found that they appeared to be as healthy as those conceived normally or by IVF, paving the way for its widespread use.

Specialists said that the research, into a method known as vitrification, promises to lift the main barrier to routine egg freezing. While dozens of British women have already done this to preserve their fertility, medical groups had advised against it outside clinical trials because of limited evidence of its safety. The study, led by Ri-Cheng Chian, of McGill University, in Montreal, Canada, assessed the outcomes of 200 children born from vitrified eggs. It found that the rate of birth defects was 2.5 per cent, which is comparable to natural pregnancies and IVF.

Dr Chian told The Times: "I have two daughters. If they wanted to preserve their fertility because they were 35 and not married, I would say, yes, they should use this technique. Even if they were 20 or 25 and wanted to use it for social reasons, I would recommend going ahead. We cannot yet say it is 100 per cent safe, but we are starting to amass good evidence that it is not risky so far as we can tell. "The American Society for Reproductive Medicine says egg freezing for social reasons should happen only in clinical trials, because there isn't enough information yet, but I think that is soon going to have to change."

Gillian Lockwood, medical director of Midland Fertility Services, which offers egg freezing in Britain, said: "This is the sort of evidence we have all been seeking. I think in time it will come to be seen as positively perverse to refuse to allow women to have the chance to establish pregnancies with their own frozen eggs." She said that frozen eggs stored when women were in their twenties or thirties might eventually be shown to reduce the rate of birth abnormalities beyond that seen in the McGill study, which is published in the journal Reproductive Biomedicine Online. Such defects become more of a risk when older women conceive with their own fresh eggs.

Allan Pacey, secretary of the British Fertility Society, said that the society did not have a firm policy on egg freezing for social reasons. "A single study isn't enough, but if more data like this emerges we would be more relaxed about it," he said.

While it has long been possible to freeze sperm and embryos for use in fertility treatment years later, it has taken much longer to achieve this routinely for eggs. The prospects of wider use have recently been enhanced by the development of vitrification, which involves flash-freezing eggs after special preparation. Up to 95 per cent of vitrified eggs survive the thawing process, compared with 50 to 60 per cent of those preserved by older slow-freezing techniques. Pregnancy rates for vitrification can be as good as for IVF with fresh eggs.

These advances may encourage more women to freeze eggs as a way of preserving their fertility, which starts to decline steeply when from the mid-thirties. Several British clinics offer women in their twenties and thirties the option of storing their eggs, and more than 100 have done so.


Tuesday, June 24, 2008

Australia's alleged "fat bomb"

I would rather like the report below to be true. It claims that Australians are extraordinarily fat. Since Australia has one of the world's longest life expectancies, it would help to slay the myth that obesity is unhealthy. Some skepticism about the report has already been expressed, however. The report comes from a nonprofit, not a university, so may simply be a trawl for funds. I have left it for a few days to say much about it as I wished to see details of the research first. The sample would appear to be far from random. I have however not so far been able to find the full report online. It is not linked from their home page and there has been some suggestion that their international comparisons are erroneous. The report is certainly deliberately deceitful in failing to note that it is extremes of weight rather than obesity which is unhealthy. The longest life expectancies are for people of middling weight. Not to put too fine a point on it, the alarmist claims of the report are total junk

AUSTRALIA has become the fattest nation in the world, with more than 9 million adults now rated as obese or overweight, according to an alarming new report. The most definitive picture of the national obesity crisis to date has found that Australians now outweigh Americans and face a future "fat bomb" that could cause 123,000 premature deaths over the next two decades. If the crisis is not averted, obesity experts have warned, health costs could top $6 billion and an extra 700,000 people will be admitted to hospital for heart attacks, strokes and blood clots caused by excess weight.

The latest figures show 4 million Australians - or 26% of the adult population - are now obese compared to an estimated 25% of Americans. A further 5 million Australians are considered overweight. The report, Australia's Future 'Fat Bomb', from Melbourne's Baker IDI Heart and Diabetes Institute, will be presented at the Federal Government's inquiry into obesity, which comes to Melbourne today.

A grim picture is painted of expanding waistlines fuelled by a boom in fast food and a decline in physical activity, turning us into a nation of sedentary couch potatoes. Those most at risk of premature death are the middle-aged, with 70% of men and 60% of women aged 45 to 64 now classed as obese.

But some weight specialists have questioned the tool used to measure obesity, saying "entire rugby teams" would be classified as obese if their body mass index (BMI) was calculated. BMI is measured by dividing weight in kilograms by height in metres squared. A BMI of over 25 is considered overweight while more than 30 is obese. But the tool does not distinguish between muscle and fat, prompting calls for the BMI overweight limit to be raised to 28.

However, even leading nutritionist Jenny O'Dea from the University of Sydney - who recently claimed Australia's childhood obesity epidemic had been exaggerated - has backed the new figures, which suggest that the crisis for adults has been drastically underestimated. Professor O'Dea said that while being fat was not necessarily a health risk for everyone, there was no doubt obesity was taking its toll on the nation.

It was previously thought that around 3 million adults were obese. But many past surveys were seen as unreliable as they often required participants to guess their own weight. The latest data was based on more than 14,000 people at 100 rural and metropolitan sites in every Australian state and territory. Each had their BMI recorded by having their weight, height and waist measured as part of a national blood pressure screening day last year.

The report's lead author, Simon Stewart, said that even allowing for the BMI's potential failings, the best case scenario was that 3.6 million adults were battling obesity. "We could fill the MCG 40 times over with the number of obese Australians now, then you can double that if you look at the people who are also overweight - those are amazing figures," Professor Stewart said. "And in terms of a public health crisis, there is nothing to rival this. If we ran a fat Olympics we'd be gold medal winners as the fattest people on earth at the moment," he said. "We've heard of AIDS orphans in Africa, we're looking at this time bomb going off where parents have to think about this carefully," Professor Steward said. "They're having children at an older age, if you're obese and you have a child do you really want to miss out on their wedding? "Do you want to miss out on the key events in their life? Yes you will if you don't do something about your weight now."

The obesity inquiry in Melbourne will be told that a national strategy encouraging overweight Australians to lose five kilograms in five months could reduce heart-related hospital admissions by 27% and cut deaths by 34% over the next 20 years. Among the radical solutions proposed in the report is a plan to make fat towns compete for "healthy" status in national weight loss contests tied to Federal Government funding. Towns that lost the most weight would be given cash to build sports centres and swimming pools. And like the "Tidy Towns" program, communities would have to meet targets to be eligible for a share of the funding pool.

Other suggestions from Professor Stewart's report include subsidised gym memberships, personal training sessions for heavier people and restricting weight loss surgery to those who show they can lose some weight on their own first.

One of Australia's leading obesity experts, Boyd Swinburn, will tell the inquiry in his own submission that a crackdown on junk food marketing to children is paramount in the fight against the epidemic. With the fastest growing rate of childhood obesity in the world, Australia must make radical changes to the way unhealthy food is promoted if the rate is to be reduced, his submission reads. Professor Swinburn, director of the World Health Organisation Collaborating Centre for Obesity Prevention at Deakin University, will argue that better nutritional labelling and more funding for effective treatments such as weight-loss surgery are also necessary. "We've got a huge problem here and we can't bury our head in the sand any more," Professor Swinburn will tell the inquiry. "The previous federal government blamed parents and individuals and told them to pull up their socks . that's not going to achieve anything but make us fatter as a nation. "It's good to see the Rudd Government take obesity seriously with this parliamentary inquiry and the preventative health strategy but that has to be turned into proper policy, regulation and funding."

Ian Caterson, director of the Institute of Obesity, Nutrition and Exercise at the University of Sydney, said innovative government "thinking outside the square" policies were necessary because, "as we get fatter and older as a nation things are just going to get worse."


There really is coffee in coffee-flavoured milk!

Whoda thunk it?

PARENTS have been warned that caffeine levels in some flavoured milks can be more than double the dose found in controversial energy drinks such as Red Bull. Some milk drinks contain up to three times the caffeine hit found in a regular cup of coffee, new research shows. The findings are a wake-up call to parents who buy flavoured milk, believing the drinks are healthy. The National Health and Medical Research Council warns against giving caffeine to children because it can cause disturbed sleep patterns, bed-wetting and anxiety.

Researchers at Griffith University tested more than 20 varieties of iced coffee-flavoured milk to discover the high caffeine content. "A lot of people think it is better for you because it is milk-based," Griffith University researcher Ben Desbrow said. "But actually it is worse." Mr Desbrow's team tested 20 iced coffee products three times over a month, to allow for changes in the product run. "After calculating an average we found several that had very high levels of caffeine per 100ml. But the issue is these products are sold in 500ml, 600ml or 750ml containers. "So if there is 35mg per 100ml, you could be getting more than 175mg of caffeine in a 500ml drink and more than 260mg of caffeine in a 750ml drink." A 250ml can of Red Bull contains 80mg of caffeine.

"Caffeine in iced coffee is considered a natural ingredient so manufacturers are not required to disclose the level of caffeine on the label," Mr Desbrow said. "The product only needs to state that it contains caffeine." "Manufacturers only need to say how much caffeine is contained in a product when it is added." Mr Desbrow said consumers, and especially parents, needed to be aware "because children could be consuming more than your average adult".

Caffeine affects the brain by dampening neuro transmitters that would normally make you sleepy, temporarily improving cognitive function and even athletic performance. The typical consumer drinks about 200mg to 300mg a day in two to three cups of coffee.

Tanya Geary, 28, of Aspley in Brisbane, said she would never give her two boys caffeine because "they would be bouncing off the walls". "But it is quite alarming to think there is that much in flavoured milk," she said.


Monday, June 23, 2008

NO to statins during pregnancy

Sandy Szwarc reports:

Someone must have sent out a press release, because there was no new study... or any study at all to support the sudden appearance of this public health message... yet, news outlets across the UK and around the world all reported this story, all on the same day. Yesterday, the top news story was that statins could help pregnant women avoid caesarean sections, especially fat women blamed for raising C-section rates, with headlines announcing that all "obese pregnant mums" will now be given statins during pregnancy.

This was a false story and one that could risk women losing their babies; delivering premature babies; or having babies with limb, brain and neurological deformities. Before we get into more details, it is important that all women know: There is NO medical expert body in the world recommending statins be used by fat women or any women during pregnancy. Statins are specifically contraindicated for use by pregnant women and women trying to become pregnant.

The United States Food and Drug Administration classifies statins and all cholesterol-lowering drugs as Category X drugs [reviewed here], which identify potentially teratogenic medications.

Category X: Adequate well-controlled or observational studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities or risks. The use of the product is contraindicated in women who are or may become pregnant.

More here

Alarming cellphone videos are fake

CONTROVERSIAL YouTube videos purporting to expose the dangers of mobile phones have been exposed as fakes. Part of an internet marketing campaign, each of the four videos shows kernals of popcorn allegedly being cooked by the radiation emitted by three mobile phones.

But the videos, which have had more than 11 million hits on YouTube, are viral advertisements produced by a French agency hired to boost sales for mobile phone accessories manufacturer Cardo Systems.

The videos, filmed by LastFools, feature various "optical illusions" and "magic tricks" designed to suggest mobile phones emit enough radiation to cook popcorn.

The claim is false. LastFools managing director Frederic Chast says he designed the viral ad campaign in the hope of garnering his client just 30,000 hits. Viral advertising is designed to be so engaging that consumers pass it on to friends.

The videos have angered some people who, in online forums, describe Cardo Systems as having behaved deceptively.


Man Says He Lost 80 Pounds Eating McDonald's

A Virginia man lost about 80 pounds in six months by eating nearly every meal at McDonald's.

Not Big Macs, french fries and chocolate shakes. Mostly salads, wraps and apple dippers without the caramel sauce.

Chris Coleson tipped the scales at 278 pounds in December. The 5-foot-8 Coleson now weighs 199 pounds and his waist size has dropped from 50 to 36.

The 42-year-old businessman from Quinton says he chose McDonald's because it's convenient.


Sunday, June 22, 2008

Cloned cells kill skin cancer

More details here. Note that the patient was the only one of nine treated who benefited. The remission was in other words almost certainly random. I get a lot of skin cancers and about half of them regress spontaneously

DOCTORS have, for the first time, successfully treated a skin cancer patient with cells cloned from his own immune system, according to a new study. The ground-breaking treatment for advanced melanoma, or skin cancer, led to a long remission for the patient and used his own cloned infection-fighting T-cells, said doctor Cassian Yee, the lead author of the study in the New England Journal of Medicine.

Dr Yee and his associates from the Clinical Research Division at Fred Hutchinson Cancer Research Centre in Seattle removed CD4+ T-cells, a type of white blood cell, from a 52-year-old man whose melanoma had spread to a groin lymph node and to one of his lungs. The melanoma was already well advanced and in stage four.

The T-cells which specifically fight melanoma were modified and expanded in the laboratory and some five billion cells were then infused into the patient, who received no other kind of treatment. Two months later no tumours were found during scans of the patient's organs. And he had been cancer-free for two years, Dr Yee said. "We were surprised by the anti-tumour effect of these CD4 T cells and its duration of response,'' Dr Yee said. "For this patient we were successful, but we would need to confirm the effectiveness of therapy in a larger study.''

It was the first ever case to show that cloned cells from a patient's own immune system could successful combat skin cancer. If further tests confirmed the efficiency of the method, it could be used in some 25 per cent of patients with late-stage skin cancer, the study said.

Using a patient's own immune system to combat cancer, called immunotherapy, is a growing area of research that aims to develop less-toxic cancer treatments than standard chemotherapy and radiation.

Some 160,000 cases of melanoma are diagnosed around the world every year, particularly affecting white men living in very sunny regions. Although it usually affects the skin, in rare cases it can also infect the eyes and intestines. According to the World Health Organisation, some 48,000 people die from melanoma every year.


Quite amazing: Obesity illegal in Japan

Japan, a country not known for its overweight people, has undertaken one of the most ambitious campaigns ever by a nation to slim down its citizenry

Summoned by the city of Amagasaki one recent morning, Minoru Nogiri, 45, a flower shop owner, found himself lining up to have his waistline measured. With no visible paunch, he seemed to run little risk of being classified as overweight, or metabo, the preferred word in Japan these days. But because the new state-prescribed limit for male waistlines is a strict 33.5 inches, he had anxiously measured himself at home a couple of days earlier. "I'm on the border," he said.

Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.

Those exceeding government limits - 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks - and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.

To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. The country's Ministry of Health argues that the campaign will keep the spread of diseases like diabetes and strokes in check.

The ministry also says that curbing widening waistlines will rein in a rapidly aging society's ballooning health care costs, one of the most serious and politically delicate problems facing Japan today. Most Japanese are covered under public health care or through their work. Anger over a plan that would make those 75 and older pay more for health care brought a parliamentary censure motion Wednesday against Prime Minister Yasuo Fukuda, the first against a prime minister in the country's postwar history.

But critics say that the government guidelines - especially the one about male waistlines - are simply too strict and that more than half of all men will be considered overweight. The effect, they say, will be to encourage overmedication and ultimately raise health care costs.

Yoichi Ogushi, a professor at Tokai University's School of Medicine near Tokyo and an expert on public health, said that there was "no need at all" for the Japanese to lose weight. "I don't think the campaign will have any positive effect. Now if you did this in the United States, there would be benefits, since there are many Americans who weigh more than 100 kilograms," or about 220 pounds, Mr. Ogushi said. "But the Japanese are so slender that they can't afford to lose weight."

Mr. Ogushi was actually a little harder on Americans than they deserved. A survey by the National Center for Health Statistics found that the average waist size for Caucasian American men was 39 inches, a full inch lower than the 40-inch threshold established by the International Diabetes Federation. American women did not fare as well, with an average waist size of 36.5 inches, about two inches above their threshold of 34.6 inches. The differences in thresholds reflected variations in height and body type from Japanese men and women.

Comparable figures for the Japanese are sketchy since waistlines have not been measured officially in the past. But private research on thousands of Japanese indicates that the average male waistline falls just below the new government limit. That fact, widely reported in the media, has heightened the anxiety in the nation's health clinics.

In Amagasaki, a city in western Japan, officials have moved aggressively to measure waistlines in what the government calls special checkups. The city had to measure at least 65 percent of the 40- to 74-year-olds covered by public health insurance, an "extremely difficult" goal, acknowledged Midori Noguchi, a city official.

When his turn came, Mr. Nogiri, the flower shop owner, entered a booth where he bared his midriff, exposing a flat stomach with barely discernible love handles. A nurse wrapped a tape measure around his waist across his belly button: 33.6 inches, or 0.1 inch over the limit. "Strikeout," he said, defeat spreading across his face.

The campaign started a couple of years ago when the Health Ministry began beating the drums for a medical condition that few Japanese had ever heard of - metabolic syndrome - a collection of factors that heighten the risk of developing vascular disease and diabetes. Those include abdominal obesity, high blood pressure and high levels of blood glucose and cholesterol. In no time, the scary-sounding condition was popularly shortened to the funny-sounding metabo, and it has become the nation's shorthand for overweight.

The mayor of one town in Mie, a prefecture near here, became so wrapped up in the anti-metabo campaign that he and six other town officials formed a weight-loss group called "The Seven Metabo Samurai." That campaign ended abruptly after a 47-year-old member with a 39-inch waistline died of a heart attack while jogging.

Still, at a city gym in Amagasaki recently, dozens of residents - few of whom appeared overweight - danced to the city's anti-metabo song, which warned against trouser buttons popping and flying away, "pyun-pyun-pyun!" "Goodbye, metabolic. Let's get our checkups together. Go! Go! Go! Goodbye, metabolic. Don't wait till you get sick. No! No! No!"

The word metabo has made it easier for health care providers to urge their patients to lose weight, said Dr. Yoshikuni Sakamoto, a physician in the employee health insurance union at Matsushita, which makes Panasonic products. "Before we had to broach the issue with the word obesity, which definitely has a negative image," Dr. Sakamoto said. "But metabo sounds much more inclusive."

Even before Tokyo's directives, Matsushita had focused on its employees' weight during annual checkups. Last summer, Akio Inoue, 30, an engineer carrying 238 pounds on a 5-foot-7 frame, was told by a company doctor to lose weight or take medication for his high blood pressure. After dieting, he was down to 182 pounds, but his waistline was still more than one inch over the state-approved limit.

With the new law, Matsushita has to measure the waistlines of not only its employees but also of their families and retirees. As part of its intensifying efforts, the company has started giving its employees "metabo check" towels that double as tape measures. "Nobody will want to be singled out as metabo," Kimiko Shigeno, a company nurse, said of the campaign. "It'll have the same effect as non-smoking campaigns where smokers are now looked at disapprovingly."

Companies like Matsushita must measure the waistlines of at least 80 percent of their employees. Furthermore, they must get 10 percent of those deemed metabolic to lose weight by 2012, and 25 percent of them to lose weight by 2015.

NEC, Japan's largest maker of personal computers, said that if it failed to meet its targets, it could incur as much as $19 million in penalties. The company has decided to nip metabo in the bud by starting to measure the waistlines of all its employees over 30 years old and by sponsoring metabo education days for the employees' families.

Some experts say the government's guidelines on everything from waistlines to blood pressure are so strict that meeting, or exceeding, those targets will be impossible. They say that the government's real goal is to shift health care costs onto the private sector.

Dr. Minoru Yamakado, an official at the Japan Society of Ningen Dock, an association of doctors who administer physical exams, said he endorsed the government's campaign and its focus on preventive medicine. But he said that the government's real priority should be to reduce smoking rates, which remain among the highest among advanced nations, in large part because of Japan's powerful tobacco lobby. "Smoking is even one of the causes of metabolic syndrome," he said. "So if you're worried about metabo, stopping people from smoking should be your top priority."

Despite misgivings, though, Japan is pushing ahead. Kizashi Ohama, an official in Matsuyama, a city that has also acted aggressively against metabo, said he would leave the debate over the campaign's merits to experts and health officials in Tokyo.

At Matsuyama's public health clinic, Kinichiro Ichikawa, 62, said the government-approved 33.5-inch male waistline was "severe." He is 5-foot-4, weighs only 134 pounds and knows no one who is overweight. "Japan shouldn't be making such a fuss about this," he said before going off to have his waistline measured.

But on a shopping strip here, Kenzo Nagata, 73, a toy store owner, said he had ignored a letter summoning him to a so-called special checkup. His waistline was no one's business but his own, he said, though he volunteered that, at 32.7 inches, it fell safely below the limit. He planned to disregard the second notice that the city was scheduled to mail to the recalcitrant. "I'm not going," he said. "I don't think that concerns me."


Saturday, June 21, 2008

Australia beats US to title of most obese nation, report finds

Pesky that Australians also have one of the world's longest life expectancies, though

The ideal Antipodean, especially in the lead-up to an Olympic Games, may well be trim, taut and trouncing the opposition on the sporting field. But in one field Australians are, unexpectedly, leading the way as the heavyweight champions of the world - with arguably a greater proportion of obese citizens than even the notoriously supersized Americans.

A study released yesterday shows that Australia's obesity epidemic has been considerably underestimated, with almost 60 per cent of the adult population overweight. Described as the most thorough study of the problem in Australia for a decade, it also shows that 26 per cent of adults, or four million people, are obese. Researchers say that the once mid-ranking nation, in terms of obesity, now weighs in at the top.

Simon Stewart, who led the research team, said that obesity was the big threat to Australia's future health, with an estimated nine million people obese or overweight. "That is a million more obese adults than we had thought," he said. The study, which comes before a government inquiry into the epidemic, charted the height and weight of 14,000 adult Australians on a single day in 2005. It shows that the middle-aged are the fattest of all, with about seven in ten men and six in ten women aged 45 to 64 now registering a body mass index (BMI) of 25 or more - a definition of being overweight.

An over-abundance of food, particularly those high in fat and sugar, and reduced levels of physical activity, are blamed for the expansion in Australian waistlines.


The poor are born less healthy

And the British government has failed to shift that, funnily enough

Sixty years in hot pursuit of equity have left Britain a country as divided as ever between healthy haves and unhealthy have-nots. Endless intellectual effort has been put into devising a formula that will allocate NHS resources in such a way as to eliminate such differences. They have failed. Since 1997, inequalities of health have in some respects widened. Targets have been missed.

Alan Johnson's response is to throw another 34million pounds at the problem, and shift the deadline from 2008 to 2010. Ministers' latest wheeze is to inject more money to provide extra GP surgeries in areas that have fewer doctors. Let us pass over the fact that these areas are already well-funded under the allocation formula, so should not need any more. Of course it is right that everybody should have equal access to a GP, so far as human ingenuity can provide it, but by the time most patients reach the GP's surgery the damage is done.

Health inequalities begin in the womb, are nurtured by poor diet and bad parenting, and multiplied by habits such as smoking. Once, high cancer rates in the North would have been explained by occupational exposure in the workplace but that is no longer plausible. Smoking, and increasingly obesity, are the greatest risk factors. There is a near-doubling of lung cancer incidence in men between Surrey, West Sussex and Hampshire (the lowest) and Merseyside and Cheshire (the highest). In women the gap between highest and lowest is wider still.

Breast cancer is much more egalitarian, with only small variations. There are bigger variations in prostate cancer incidence, but this largely reflects local enthusiasm for screening: the differences in death rates are smaller. The literature of health inequalities generally concludes that they follow disparities of wealth: the wider the wealth gap, the wider the health gap. If this is so, then Labour has been caught in a trap of its own making. Gordon Brown was happy to "eliminate poverty" with handouts, but not by squeezing the rich until the pips squeaked, as Denis Healey once promised. And American evidence suggests that there is no threshold above which the wealth-health link diminishes in force. In a world of haves, have-nots, and have-yachts, it is the yacht-owners who do best of all.

So you can have a go-getting economy where entrepreneurs flourish and hedge-fund billionaires proliferate, or you can have Scandinavian-style levelling down and more equal health outcomes. What nobody has yet devised is a way of combining the two.


Friday, June 20, 2008

Diabetes linked to depression risk

So people who have diabetes don't feel well and get depressed? Big discovery! Note that people often feel poorly for many years before they are diagnosed with diabetes. No mention of that below, though

PEOPLE being treated for type 2 diabetes are at increased risk for depression, according to a new report, and individuals with depression have a moderately increased risk of developing type 2 diabetes. To explore the relationship between diabetes and depression, Dr Sherita Hill Golden at Johns Hopkins University School of Medicine in Baltimore and colleagues analysed data on 6814 subjects who underwent three examinations between 2000 and 2005.

Among 4847 participants without depression at the start of the study, the researchers report, rates of occurrence of depression symptoms during follow-up were similar for people without diabetes and those with untreated type 2 diabetes, but about twice as high in people being treated for type 2 diabetes. "The psychological stress associated with diabetes management may lead to elevated depressive symptoms," Dr Golden's team suggests in their report in the Journal of the American Medical Association. They also found that participants who had symptoms of depression were about 30 per cent more likely to develop diabetes during the study than people without depression.

The link between depression and diabetes onset was partially due to lifestyle factors, such as caloric intake and physical activity. "Future studies should determine whether interventions aimed at modifying behavioural factors associated with depression will complement current type 2 diabetes prevention strategies," Dr Golden and her colleagues wrote. Their finding also suggest, they said, "that clinicians should be aware of increased risk of elevated depressive symptoms in individuals with treated type 2 diabetes and consider routine screening for depressive symptoms among these patients".


Placebos the best performance enhancers!

Ever since 1807, when Abraham Wood smoked opium to keep awake for a 24-hour race against Robert Allardyce, athletes have risked their health and professional careers by taking performance-enhancing drugs. It seems that they need not have bothered. Most benefit derived from doping is in the mind, an Australian study suggests.

Over eight weeks at the Garvan Institute in Sydney, athletes were given either growth hormones, which are banned by the World Anti-Doping Association, or inactive placebos - without knowing which substance they were taking. At the end of the study, volunteers who took placebos could sprint faster, jump higher and lift heavier weights.

Ken Ho, who led the study, said that the results showed the power of the mind in sport. "We found that athletes were putting their careers at risk by using growth hormone despite any evidence it actually improves performance," he said. "We wanted to know if any improvement was due to the athlete's own belief. "The results suggest the placebo effect was very powerful. If you really think you are receiving a beneficial treatment, you will perform better. Athletes who believe they are cheating gain an advantage even though they receive no chemical assistance."

At the end of the experiment, the volunteers who were given placebos were asked what they thought they had swallowed. About half thought incorrectly that they had taken growth hormones while the other half guessed correctly they had taken the dummy drug. The volunteers who got it wrong outperformed everyone else in their group.

The placebo effect was greater in males than females, said Dr Ho, who presented the study to the Endocrine Society's convention in San Francisco. Volunteers of both sexes who thought they were taking drugs showed a markedly improved performance. Although the study was carried out on "recreational athletes" who trained twice a week sports psychologists said there was no reason why the placebo effect would not apply to professionals. "The key aspect is confidence," said Rob Robson, a sport psychologist. "If an athlete thinks he's taking a powder that gives him an advantage, he'll become more relaxed. He'll push himself harder and build confidence that improves his times."

Legal experts disagreed on whether athletes who mistakenly thought that they were cheating could fall foul of anti-doping laws. Nick Bitel, who lectures on sports law at King's College London, said: "If someone told their trainer to buy them HGH growth hormone and then took it thinking it was HGH when it was actually sugar, they wouldn't have a defence." A spokesman for the World Anti-Doping Association said that the rules did not cover "placebo dopers". He said: "If the substance involved is not a banned substance, that would not fall under the scope of anti-doping laws, regardless of any intention to cheat."


Thursday, June 19, 2008

Too much television 'is an asthma risk'

Good God! Yet another attack on whatever is popular. If you read the explanation, it is however more reasonable than at first appears. Breathing exercises DO seem to help asthma. It's all epidemiological however so other factors could be at work. Perhaps couch potatoes are more likely to be different physiologically to start with

Children who watch more than five hours of television a day are at an increased risk of developing asthma, scientists have found. Researchers concluded that the danger of them developing the respiratory condition was raised by more than half compared with children who watch just one hour.

This could be attributed to the fact that children who lead a "couch potato" lifestyle sigh much less than their healthier counterparts. Deep inspirations play a significant role in helping lungs to function but sitting for hours leads to shallow breathing. Dr Giuseppe Corbo, who led the research carried out by the Catholic University, Rome, said: "Prolonged sitting is associated with a decrease in spontaneous sighs, which regulate airways."

The study of 20,000 six and seven-year-olds, published in the medical journal Epidemiology, confirmed a strong link with asthma and obesity, but found that salt was the biggest risk. Those with the highest intake were two and a half times more likely to develop asthma. Children who played more computer games and watched more television were also found to be less active and had poorer diets.

The British Lung Foundation said: "Obesity, high TV viewing and a high salt diet get children off to a bad start in life." More than a million children in Britain have asthma.


Vaccine against diarrhoea?

A needle-free vaccine protected more than 70 per cent of visitors to Mexico and Guatemala from traveller's diarrhoea, popularly known as Montezuma's Revenge, researchers reported today. The affliction, more commonly known in Australian travelling circles as Bali or Delhi belly, can lay a traveller out for days on end with more extreme cases resulting in an unscheduled return home for treatment.

Even if travellers did get infected with the stomach bug, Iomai Corp's experimental vaccine patch prevented severe illness, the researchers reported in the Lancet medical journal. "I think it's one of the most exciting new developments in travel medicine,'' said Dr Herbert DuPont of the University of Texas in Houston, who helped test the vaccine. "People could buy this and put it on themselves whenever they take a trip. It is the most convenient form of immunisation I have ever seen,'' DuPont said in a telephone interview.

The vaccine protects against Escherichia coli bacteria - specifically a strain known as Enterotoxigenic E. coli or ETEC. It is the leading cause of diarrhea in travelers to certain areas, causing four to five days of misery including nausea and cramps.

Iomai's team, along with DuPont's independent team and a group at Johns Hopkins University in Baltimore, tested the patches in a Phase II safety and efficacy trial. They got data back from 170 adults travelling to areas known to be hot spots of tummy trouble in Guatemala and Mexico. During and after travel, 15 per cent of the patients who got the vaccine developed diarrhea of any type, and just 5 per cent had ETEC-associated diarrhea. This compared to 22 per cent of travelers who got placebo, 10 per cent of whom had ETEC diarrhea. Eleven per cent of the travelers who got placebo had severe diarrhea, compared to 2 per cent of those who got the patch.

"It looked like it prevented more than 70 per cent of the episodes of moderate or severe traveller's diarrhea,'' DuPont said. "This vaccine is among the best we have for these kinds of diseases.'' The vaccine also appeared to protect against non-ETEC causes of diarrhea. DuPont said it may stabilise the intestine and prevent the reaction to infection that causes diarrhea.

Austrian vaccine maker Intercell is in the process of buying Maryland-based Iomai, which also has a patch that boosts the effects of influenza vaccines. DuPont, who said he receives no payments from Iomai, said the market potential could be large because "we have no vaccine for traveller's diarrhea.'' The needle-free approach could work against other infectious diseases, he said. The company plans a Phase III trial of the vaccine -- the last stage of testing before seeking US Food and Drug Administration approval.


Wednesday, June 18, 2008

How being brainy 'can add 15 years to your life'

There has long been evidence that IQ is in general just one aspect of a syndrome of general biological fitness

It gets you good grades at school, improves your prospects at work and makes you more attractive to the opposite sex. And as if all that weren't enough, being brainy could add 15 years to your life, a study suggests. Researchers found those with rogue copies of a gene linked to intelligence are unlikely to survive beyond the age of 85. However, those blessed with good versions of the gene could live to be 100.

The gene governs an enzyme which destroys a chemical known to dampen brain activity and cause drowsiness. The enzyme - succinic semialdehyde dehydrogenase, or SSADH - also detoxifies the brain by getting rid of excess acid, protecting cells from damage which can accelerate ageing. The gene comes in two common forms, with the so-called 'T' version working 20 per cent less well than the 'C' variety. Previous studies have shown that men and women with two copies of the 'T' version do less well in IQ tests than others. But only now have scientists made the link to life expectancy, this week's New Scientist reports.

The Italian researchers based their findings on a study of 115 elderly men and women. They were asked to complete a test of memory and mental dexterity more usually used to diagnose Alzheimer's disease. The volunteers, who were aged between 65 and 85, had given blood samples to determine which version of the gene they were carrying. Those carrying two copies of the rogue 'T' version of the gene performed significantly worse than the others, echoing the results of the earlier research on young people.

The University of Calabria researchers then used data on how common the versions of the gene were across different age ranges to work out if it was linked with longevity. This showed those carrying two 'T' variants were unlikely to live past 85 - but those with at least one 'C' could expect to live to up to 100. The scientists said that having a double dose of the rogue gene appeared to make people more vulnerable to mental decline in old age, as well as affecting their survival. But they stressed that genes do not tell the whole story.

Professor Giuseppe Passarino said: 'There's no doubt lifestyle such as reading, having challenging work and enriching your cultural life is far more important than having the bad variant.'

Professor Robert Plomin, of the Institute of Psychiatry in London, who in 2004 linked the gene to IQ, said: 'Although the sample size is small...the reported associations with cognitive ability are significant and in line with our previous results.' He added that further studies were needed to confirm the link with longevity.


Coffee may protect the heart, leading experts claim

Some proper caution about the findings expressed below. That coffee is at least not bad for you seems a reasonably firm conclusion, however

Drinking three cups of coffee a day could reduce the risk of women dying from heart disease by a quarter, researchers said today. The team also found that drinking lots of coffee is not harmful, as those who consumed up to six cups a day were not at increased risk of death, as has been suggested previously.

The research published in the journal Annals of Internal Medicine tracked over 84,000 women and 41,000 men for around twenty years. The participants completed questionnaires every two to four years about their coffee intake and other habits including diet, smoking and general health.

Study author Dr Esther Lopez-Garcia, from the School of Medicine at Universidad Autonoma de Madrid in Spain, said: "Coffee consumption was not associated with a higher risk of mortality in middle-aged men and women. The possibility of a modest benefit of coffee consumption on heart disease, cancer, and other causes of death needs to be further investigated."

Women consuming two to three cups of caffeinated coffee per day had a 25 per cent lower risk of death from heart disease during the follow-up period compared with people who did not drink coffee, and an 18 per cent lower risk of death caused by something other than cancer or heart disease. For men, three cups of coffee daily was not linked with either a higher or a lower risk of death.

While accounting for other risk factors, such as body size, smoking, diet, and specific diseases, the researchers found that people who drank more coffee were less likely to die during the follow-up period. This was mainly because of lower risk for heart disease deaths among coffee drinkers. The researchers found no association between coffee drinking and cancer deaths. The lower risk of death did not appear to be linked to caffeine as those who drank decaffeinated coffee also had lower death rates than those who did not drink coffee.

The editors of the journal said the findings should be read with caution as the design of the study does not make it certain that coffee decreases the chances of dying sooner than expected as something else about coffee drinkers might be protecting them. Also the researchers relied on self-reporting of consumption which can increase the chance of errors.


Tuesday, June 17, 2008

ADHD is genetic

ABOUT one in 20 children (those under 18) have a group of symptoms that has come to be known as attention-deficit hyperactivity disorder (ADHD). About 60% of them carry those symptoms into adulthood. For what is, at root, a genetic phenomenon, that is a lot-yet many studies have shown that ADHD is indeed genetic and not, as was once suspected, the result of poor parenting. It is associated with particular variants of receptor molecules for neurotransmitters in the brain. A neurotransmitter is a chemical that carries messages between nerve cells and, in the case of ADHD, that chemical is often dopamine, which controls feelings of reward and pleasure. The suggestion is that people with ADHD are receiving positive neurological feedback for inappropriate behaviour. The surprise is that the variant receptors are still there. Natural selection might have been expected to purge them from the population unless they have some compensating benefit.

Of course, this analysis turns on the definition of "inappropriate". The main symptom of ADHD is impulsiveness. Sufferers have trouble concentrating on any task unless they receive constant feedback, stimulation and reward. They thus tend to flit from activity to activity. Adults with ADHD tend to perform poorly in modern society and are prone to addictive and compulsive behaviour. But might such people do well in different circumstances?

One hypothesis is that the behaviour associated with ADHD helps people, such as hunter-gatherers and pastoral nomads, who lead a peripatetic life. Since today's sedentary city dwellers are recently descended from such people, natural selection may not have had time to purge the genes that cause it.

Dan Eisenberg, of Northwestern University in Illinois, and his colleagues decided to test this by studying the Ariaal, a group of pastoral nomads who live in Kenya. The receptor Mr Eisenberg looked at was the 7R variant of a protein called DRD4. Previous work has shown that this variant is associated with novelty-seeking, food- and drug-cravings, and ADHD.

The team looked for 7R in two groups of Ariaal. One was still pastoral and nomadic. The other had recently settled down. As they report in this week's BMC Evolutionary Biology, they found that about a fifth of the population of both groups had the 7R version of DRD4. However, the consequences of this were very different. Among the nomads, who wander around northern Kenya herding cattle, camels, sheep and goats, those with 7R were better nourished than those without. The opposite was true of their settled relations: those with 7R were worse nourished than those without it.

How 7R causes this is not yet known. It may stem from behavioural differences or it may be that different versions of DRD4 have different effects on the way the body processes food. Nevertheless, this discovery fits past findings that 7R and a set of similar variants of DRD4, known collectively as "long alleles", are more common in migratory populations.

One suggestion is that long-distance migration selects for long alleles (see chart) because they reward exploratory behaviour. This might be an advantage in migratory societies because it encourages people to hunt down resources when they constantly move through unfamiliar surroundings.

As for the Ariaal, there remains the question of why 7R-although it is apparently beneficial to a nomadic way of life-is found in only a fifth of the population. One possibility is that its effects are beneficial only when they are not universal, and some sort of equilibrium between variants emerges. A second is that the advantage is gained when 7R exists along with another version of DRD4 (the genes for the two variants having come from different parents). Unfortunately, the way Mr Eisenberg collected the data does not allow these hypotheses to be tested.

Either way, his research raises the question of whether people suffering from ADHD and conditions related to it, such as addiction, are misfits coping with a genetic legacy that was useful in the evolutionary past, but is now damaging. As society continues to diverge from that evolutionary past, the economic and social consequences of being such a misfit may become increasingly important.


The nanny state has spoken on binge-drinking. But who’s listening?

By Australian columnist Janet Albrechtsen

The nanny state has apparently spoken. I went to bed last night feeling happy after a night out with friends. I wake up in the morning to news that I am a binge drinker because I indulged in more than three glasses of wine.

If you had four middies of beer last night, join the club. You are a binge drinker. That is according to the boffins at the National Health and Medical Research Council who have reportedly drafted new guidelines on safe drinking for Australians. While the Council is refusing to confirm reports in the Fairfax media until the release of its final report next month, perhaps the Council could do with some community feedback on their apparent eagerness to label so many of us binge-drinkers.

Yes, binge-drinking is a problem. Yes, alcohol driven violence is a problem. But surely that means addressing these real problems rather than conflating the issue of alcohol abuse by setting consumption limits at ridiculous levels. Health bureaucrats, whatever their well-intentioned beef, be it setting down eating and drinking guidelines for pregnant women or these latest drinking rules for the rest of us, always seem to frame their rules for the lowest common denominator brain. They treat us all like a bunch of feather-brained numskulls incapable of making sensible decisions about just about anything to do with our lifestyle. Now, we apparently have to endure being labelled a “binge-drinker” if we exceed 4 drinks during a pleasant evening out with friends.

There is another label that comes to mind. It applies to this kind of bureaucratic overreach. It’s called infantilisation. Reducing us to the status of children, they set down rules that end up neutering our ability to take personal responsibility for our actions. Like moves to ban the advertising of fast food, this is just another step by Big Brother to interfere in our choices by applying scary labels of binge-drinking to behavior that many of us would regard as normal.

Former federal health minister Tony Abbott is right to describe these new guidelines as fostering a “moral panic, which is taking over the land.” There is, says Abbott, “no doubt that binge drinking is a problem, but it is no worse than in the past. I am in favour of people improving society but you have to be reasonable about it. Usually these debates are more about establishing the virtue of the people leading the way. In the end what an individual does is his or her responsibility particularly with something that is legal.”

The medical boffins so keen to mould their own vision of utopia should keep in mind that this kind of dogmatic overreach comes with its own risks. When health guidelines are set at patently unreasonable levels, it might just mean people stop listening to these bodies about anything they have to say. It might undermine what is an important educative function if they start laying down rules that seem so preposterous to the social drinker. As Lenore Taylor said on the ABC’s Insiders today in response to claims that the delightful Belinda Neal MP had been the victim of sexism, we need to be careful about devaluing the currency by flinging about inappropriate labels. Likewise, binge drinking should be reserved for real alcohol abuse.

Before the chaps who are so keen to impose new nanny state drinking rules on us conclude their final report next month, they need to get out more. Perhaps have a drink or two with a few social drinkers who take umbrage at this new Puritanism. Labelling us all as binge-drinkers will do nothing to address the real problem of alcohol abuse.