February 1, 2008: Brits, Salts, Clots, and Counterfeits
- Quote to Note: "This is one of the most promising breakthroughs in the management of high-risk pregnancies in more than thirty years." --Dr. John Thorp, about the study he co-authored on how magnesium sulfate -- a familiar ingredient of Epsom salts -- reduce the risk of cerebral palsy in premature births by 50%.
- Over the years, we have mentioned a number of reasons scientists resist being interviewed by the media. Dr. Whelan yesterday encountered another reason: the media wants you to say what they need to hear -- not what is the scientifically correct thing to say.
CNN invited Dr. Whelan to discuss the front-page New York Times story about a Chinese drug company that produced contaminated leukemia drugs, which severely hurt a number of Chinese patients. The same drug company, at another plant, manufactured for U.S. export the drug RU 486 (the "abortion pill"). CNN wanted to know if we thought drugs manufactured in China were safe for U.S. consumption. Dr. Whelan explained that she was not too concerned about U.S. drugs manufactured overseas under the oversight of a major pharmaceutical house that was legally responsible for its quality and safety -- but, she said, this story masked the real problem: substandard and counterfeit drugs coming from China and elsewhere. She warned that consumers should be wary of buying drugs on the Internet (except a small group of approved Internet sites).
At this point in the interview, the CNN reporter (on tape) rebuked her: "We are not doing a show on counterfeit drugs -- we only want to talk about drugs coming here from China." Dr. Whelan protested that you could not unbundle these issues. The interviewer was highly annoyed; presumably she wanted Dr. Whelan to say that the FDA was bungling its task and letting tainted drugs come in through regular channels.
This reminded Dr. Whelan of an interview she did on a Boston TV show many years ago where the topic was to be the dangers of cigarette smoking. When she got to the studio, Dr. Whelan was told the topic had been changed: all they wanted to talk about were "toxic" additives in cigarettes and how harmful they are. "But smoking the cigarette is what is harmful," Dr. Whelan protested. "No! We do not want to talk about that. We want to only talk about the toxic additives," said the TV show representative. Talk about missing the broad picture.
- It sounds like a scam, but it's not: A common chemical found in Epsom salts, when infused into women who go into premature labor, halves the risk of cerebral palsy, U.S. researchers have discovered.
Magnesium sulfate is a cheap and widely available treatment. "It sounds like such a simple solution that it sounds quacky," ACSH's Dr. Ruth Kava said. "But it's not!"
ACSH's Dr. Elizabeth Whelan noted that "quacky-sounding" solutions are often used when it comes to premature births. In the 1930s, intravenous alcohol was used to prevent premature birth! ACSH's Dr. Gil Ross added, "Mag sulfate, as we called it, was often used in the labor room to treat preeclampsia, a potentially severe condition threatening both mother and newborn. This news is an exciting addition to its uses. And intravenous alcohol is still used to reduced premature contractions."
- Brits are in awe right now that prescriptions for obesity drugs number more than 1 million. "They seem to be aghast by the idea that a million prescriptions were written for these drugs," Dr. Kava pointed out. "But I believe they're mistakenly calling these drugs 'quick fixes.' They're nowhere near quick -- people may need to take them for years, if not the rest of their lives."
Furthermore, 1 million prescriptions is the proportional equivalent of 5 million people taking drugs for obesity in the United States. We're curious what the actual U.S. numbers are.
- A recent study published in the Lancet that found patients who had undergone surgery were most likely to develop venous thromboembolism (blood clots) is a "duh" study, Dr. Ross said. But there is a "news" element: half of all patients that are at risk of clotting in the UK are not getting the proper preventive treatment in the hospital. Nor are they probably getting it at home, ACSH staffers supposed. But 50% is a scary number, and one that should be examined further.
February 4, 2008: Shampoo, Estrogen, Cosmetics, Fat, and Abortion
- Quote to Note: "We're working to allay many of the fears that everything can cause cancer, because the risks are often insignificant." --Professor Bernard Stewart, from the University of NSW and South Eastern Sydney and Illawarra Health, on the importance of focusing on real versus over-hyped cancer risks.
- Local headlines may be abuzz with Eli Manning and the Giants win, but national news focused on a study published in the current issue of the medical journal Pediatrics. The article asserted that baby lotions, powders and shampoo that contain phthalates result in detectable phthalates in the babies' urine.
Scientists from the FDA, Consumer Product Safety Commission and universities around the world agree there is no need to worry about phthalates, chemicals that have been used for more than fifty years in a variety of products. Almost a decade ago ACSH held a blue-ribbon panel headed by the former U.S. Surgeon General Dr. C. Everett Koop that also found no human risk to phthalate exposure.
"To me it's very, very sad that parents have something new to worry about," ACSH's Dr. Whelan said. But they need to be reminded that there's no evidence there to justify concern. Dr. Whelan said that the Today show coverage of the Pediatrics article did impress her -- it acknowledged that it was a "small, controversial study."
ACSH's Jeff Stier pointed out that it is typical of activists to drum up fear over children. Parents are uniquely vulnerable when it comes to health scares involving children.
- The celebrating Giants should be thankful their celebration isn't in Mississippi -- the state is trying to pass a bill that would ban restaurants from serving fat people, most likely defined by their BMIs. What about football players who have high BMIs? They'd be sent on their not-so-merry way.
We find this law ridiculous -- it may encourage people to lose weight (which we doubt), but at what cost? Certainly the state of Mississippi doesn't want overweight people to spiral into depression if they are forced to step on a scale before they're allowed admittance to a favorite restaurant.
ACSH's Dr. Ruth Kava felt the article provided some comic relief, and Dr. Whelan said, "I think it's great because it's so absurd!" Maybe we need off-the-charts-crazy proposals like this one to wake up the public to the absurdity of many mandates drafted in the fight against obesity.
- We love hearing scientists speaking out against dubious claims, so we were pleasantly surprised to see a new name in the paper decrying a cancer epidemic and urging people to focus on real risks, not over-hyped ones. Australian professor Bernard Stewart, from the University of NSW and South Eastern Sydney and Illawarra Health scoffed at claims of risk for such rumored carcinogens as artificial sweeteners, coffee, deodorant, dental fillings and fluoridated water.
He encouraged people to instead focus on real risks they can alleviate -- cigarette smoking, excessive alcohol drinking and deliberate over-exposure to sunlight. We were a little skeptical of one of Prof. Bernard's claims, though -- that living near a waste dump is among a "likely" risk of cancer.
- A full-page ad in the Wall Street Journal took ACSH staffers by surprise. The ad accused the FDA of siding against women because it doesn't approve so-called "bioidentical hormones." First of all, here at ACSH, we have no idea what "biologically identical hormones" really means. What we do have a clue about, though, is the danger of using unregulated drugs. The drugs pharmacies call "bioidenticals" are not tested and are made behind the counter -- no one knows exactly what's going into them. We did, however, get a chuckle over the name of the group who paid for the ad -- the HOME (Hands Off My Estrogens!) Coalition.
- This Saturday, Dr. Whelan set the record straight on how cosmetics aren't going to give consumers cancer. Her letter to the editor in the Washington Post encouraged cosmetics users not to fear their lipstick or mascara -- "The mere ability to detect traces of lead in lipstick or mercury in mascara does not mean that they are hazardous in any way," Dr. Whelan wrote. "No one has been shown to have been harmed by typical use of cosmetics."
- This weekend, Dr. Whelan also appeared on CNN, speaking about drug importation and FDA inspection. After an adulterated cancer drug made by the Chinese drug maker Shanghai Pharmaceutical Group was found to leave some users partially paralyzed, some activists feel the entire company (the only producer of RU-486, the "abortion pill") should not be trusted. Dr. Whelan disagreed.
February 5, 2008: Tapeworms, Sleep, Sex, a Death, and the Safety of Children
"This study really supports the view these are safe vaccines. The evidence is now so solid there really isn't a need for further studies here." --David Brown, a researcher at Britain's Health Protection Agency, who worked on the latest study discrediting a link between vaccines and autism.
- ACSH staffers find Kraft Foods' proposed tapeworm-killing food to be a fascinating premise. While the food is still in early development stages, the idea is that it would incorporate deworming chemicals developed by the company TyraTech. ACSH is always interested in using technology to solve public health problems, so this piques our interest -- although we are curious how Kraft Foods is going to get these foods into the hands of those who need it most in Africa, Southeast Asia, and Latin America.
"But there's hope," ACSH's Jeff Stier said half-jokingly. Kraft's former parent, Philip Morris (Altria) "has a knack for getting its products in the hands of people everywhere."
- While we certainly do not need another study on vaccines and autism, more research indicates (surprise, surprise) that there is no link between the two. What's interesting about this study, though, is that it deals with the vaccine for measles, mumps, and rubella (MMR) -- not the thimerosal-using vaccines targeted in the U.S. by a similar scare campaign. In 1998, Dr. Andrew Wakefield of London suggested, in a terribly flawed "study" that somehow got published by The Lancet, that the MMR vaccination caused autism in children (the article was subsequently withdrawn by his co-authors and the journal due to deception in its preparation). Prior to his article, more than 90% of British children received the vaccination; after news of his study, only 80% did, resulting in outbreaks of the diseases. This new report directly addressed Wakefield's claims and again discredited them. ACSH staffers would like to think this final study puts the vaccines-cause-autism debate to rest, but we doubt it will.
- Yesterday, ACSH staffers were saddened to hear of the passing of Dr. Joshua Lederberg, a Nobel Prize winner and friend and admirer of ACSH. Dr. Lederberg won his Nobel Prize at the age of thirty-three for discovering that bacteria could "have sex" (a.k.a. bacterial conjugation) -- a conclusion that acted as a foundation of modern genetics research. ACSH's Dr. Whelan said she remembers speaking with him several years ago. In that conversation, he mentioned how much he liked ACSH, and we admired his work as well.
- If smokers aren't already losing sleep worrying about the health problems and complications caused by smoking, they may be losing quality sleep for other, more direct physical reasons. Researchers from Johns Hopkins University School of Medicine tracked brain activity of smokers and found that they spent less time in "deep sleep" than nonsmokers. As ACSH's Dr. Elizabeth Whelan has said before, cigarettes never cease to amaze us with how many diseases they cause and how much havoc they wreak on peoples' bodies.
February 6, 2008: Plastic, Fat, FDA, and Cell Phones
- Quote to Note: "If one were to assume that phthalates should be regarded as dangerous because vast quantities can make rodents sick, we would also have to fear the myriad natural foods (like mushrooms, table pepper, coffee, and nutmeg) that contain chemicals that cause cancer in rodents -- as plenty of all-natural chemicals do, without any corresponding illness in humans." --ACSH's Dr. Elizabeth Whelan, in her Washington Times op-ed that appears today.
- Proud of your slender physique? Not so quick -- thin people and non-smokers contribute to higher health care costs, while people who are obese and who smoke keep costs down.
"It makes sense," ACSH's Dr. Elizabeth Whelan noted. "The paradox is, if you want to save money on health care [as a society] you don't want people to live long." People who practice a healthy lifestyle (non-smokers who keep their weight down) are typically going to live longer than those who don't, thus draining more money out of the healthcare system.
"Cigarettes are great for Social Security," Dr. Whelan said dryly.
"Phillip Morris should advertise that on the box," ACSH's Jeff Stier added.
- The FDA's approval rate for new drugs is down to 60% in 2007 -- the lowest since 1994 and 16% below that of 2006. While some analysts interpret this decrease as a positive thing -- since the FDA is tightening up its safety requirements for new drugs -- here at ACSH we see it a little differently. ACSH's Dr. Gil Ross pointed out that the FDA's low approval pace is protecting not the American public but the FDA itself. "The FDA is afraid of being criticized by activists, Congress, and the media for allowing 'unsafe' drugs on the market," Dr. Ross said. "But all drugs have some risk, and not allowing new drugs is merely allowing more Americans to die of potentially-treatable diseases. That is not a good tradeoff."
- Dr. Whelan appeared on today's _Washington Times_ op-ed page, attempting to convince parents to stop fearing phthalates. Activists use psychological scare tactics to get their points across, but consumers need to be aware of the actual science and not fall for this manipulation.
- A common activist manipulation is telling consumers that cell phones cause brain cancer. But, oh wait, a Japanese study published by scientists at Tokyo Women's Medical University just showed that they don't. By comparing phone use in 322 brain cancer patients with 683 healthy people, they found that regular use of a mobile phone does not significantly affect the likelihood of getting brain cancer.
Dr. Whelan says she remembers the first time this cell phones-causing-cancer scare surfaced -- on the Larry King show. A guest opined that his wife died of brain cancer because she spoke on her cell phone so often. ACSH has experience with these scares, and we're fairly confident activists will continue to drum up the "danger" of cell phones long after this latest study.
- When we saw photos alongside an L.A. Times story about HIV patients who are aging faster, we couldn't believe our eyes. These men were in their early sixties but appeared to be in their eighties. Dr. Ross said there are a couple factors behind this fast aging. For one, there's HIV itself. But probably more influential are the antiretroviral drugs these men are taking. We'd like to think it's a pretty good tradeoff, since before such drugs were on the market HIV-positive patients would never have stayed alive this long.
February 8, 2008: Artificial Jarvik, Troubled Ledger, Fat Twins, Menaced Babies
- Quote to Note: "He pioneered the artificial Jarvik heart. Now there's an artificial Jarvik." --ACSH's Jeff Stier, upon learning the Dr. Robert Jarvik featured in Pfizer's Lipitor advertisements is actually a double.
- We wish to apologize for there being no Morning Dispatch yesterday. Unfortunately, the Internet was down here, so we were unable to e-mail. Fear not, though, as today is your lucky day! Instead of just one Morning Dispatch, you will be receiving an extra-long one -- combining both yesterday's and today's discussions.
Despite our technological difficulties, we had a big day yesterday: ACSH's Dr. Elizabeth Whelan was interviewed on CNBC about the World Health Organization's new plan to deal with Philip Morris International. ACSH's Dr. Gil Ross was interviewed by two different Canadian national television systems, CTV and CBC, on the safety of plastic baby bottles. ACSH's Jeff Stier was interviewed by Maine Public Radio on the same subject.
- Dr. Ross also appeared in USA Today with a letter to the editor on how the warning about using baby toiletries is overblown. "The mere detection of chemicals in an infant's urine is not an indication that baby toiletries are harmful," Dr. Ross said. "These useful products have been around for more than fifty years with zero evidence of harming humans."
- In a study comparing fraternal and identical twins, researchers from Cancer Research UK's Health Behavior Center concluded that nature beats nurture when it comes to obesity. The study, published in the recent issue of the American Journal of Clinical Nutrition, looked at more than 5,000 pairs of twins and found that genes account for about three-quarters of the differences in a child's waistline and weight. "Well if that were true, than all this stuff about banning foods and advertising isn't going to do any good," Dr. Whelan pointed out.
"I think it determines who can become obese more easily, but you still have to put the calories in," Dr. Ruth Kava said.
- As ACSH discussed two weeks ago, Philip Morris's new spin-off, Philip Morris International (PMI), sets the stage for marketing cigarettes to poorer countries across the globe without abiding by stringent U.S. rules and guidelines. The World Health Organization (WHO) announced plans today to try to combat this plan for increasing cigarette-smoking worldwide. While ACSH staffers believe WHO is acting admirably, we find some faults in its plan. "The WHO's plan is going to be largely ineffective," ACSH's Dr. Elizabeth Whelan said. "It cannot affect what every country does -- WHO can suggest regulations, but many of these countries don't have the money to follow through."
ACSH's Dr. Ruth Kava explained that she'd prefer to work on the demand side rather than the supply side of the issue, encouraging India and Southeast Asian countries to launch massive advertising and education efforts to warn people of the dangers of cigarettes. The problem is, again, that these governments cannot afford it.
Dr. Whelan appeared yesterday morning on CNBC to talk about the WHO's roadmap. This is a public health nightmare, she asserted. When a CNBC anchor insisted that smokers are making informed decisions when they choose to pick up a cigarette, Dr. Whelan reminded him of how in many Third World countries children start smoking at age eight or nine. They buy loose cigarettes, not a box where there is a warning label pronouncing "smoking kills." Thus, by the time they are old enough to buy packages of cigarettes, they are already addicted. There is no freedom of choice if the consequences aren't known.
There are 5.4 million premature deaths each year from tobacco use, and the WHO predicts that by 2030 this number will rise to 8.3 million. There has to be a better way to stop this killer industry than the plan put forth by the WHO.
- A new study by the National Heart, Lung, and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases found results that undercut the typical theory on diabetes -- that lowering blood sugar is going to decrease risk of death. Instead, researchers announced that in the study of type 2 diabetes, the form that affects 95% of people with the disease, people who decreased their blood sugar levels actually had a higher risk of dying.
"It's counterintuitive," ACSH's Dr. Gil Ross said. "The group participating in the study is exactly the group that you need to treat for diabetes -- those who have had diabetes for about ten years, who had higher than average blood sugar levels, and who also had heart disease or other conditions like high blood pressure or high cholesterol."
ACSH staffers agree with doctors at organizations like the American Diabetes Association who said they found the study results confusing and disturbing -- we do not understand the reason for the paradox. But we must emphasize that these results -- if substantiated by other studies -- apply to older persons with heart disease, not all diabetic people.
- On Wednesday, the awaited results of actor Heath Ledger's autopsy were released -- finding the drugs OxyContin, Valium, Xanax, Restoril, Unisom, and doxylamine in his system. The medical examiner said Ledger's death was an accidental overdose.
Dr. Ross pointed out that if Ledger was taking OxyContin -- a big-time opiate also known as "hillbilly heroin," he probably had a drug dependency problem. "Oxycontin is used instead of IV morphine for terminal cancer pain," Dr. Ross explained. "He could have easily ingested enough OxyContin (accidentally) to cause a lethal overdose, especially when combined with the vast numbers of other drugs found in his body."
- Did the Pfizer ad for Lipitor featuring a fit Dr. Robert Jarvik sway your opinion on taking the drug (or asking your doctor about it)? Dr. Jarvik, who pioneered the artificial heart more than twenty-five years ago, has been all over television promoting Lipitor. Or so we thought. But the man rowing briskly across a lake is not Dr. Jarvik (the real Jarvik actually cannot even row) but rather a body double.
ACSH staffers find it hard to defend Pfizer on this. Pharmaceutical companies are constantly under scrutiny for misleading the public. We believe pharmaceutical companies have good products -- products that save lives -- but to pull a stunt like this undermines their cause. ACSH still believes in the manifold benefits of statins such as Lipitor, but based on this marketing duplicity we can see why consumers are increasingly skeptical.
- Yesterday, an activist consortium calling itself the Center for Health, Environment, and Justice released its claim that studies conducted on laboratory animals and cell cultures show that bisphenol A (BPA) is linked to a variety of human ailments, even at low doses. The group is calling for a moratorium on products that contain BPA. ACSH strongly disagrees with this call for an "immediate moratorium."
"The current, very low levels of exposure to BPA from baby bottles and other consumer products do not pose a hazard to human health," Dr. Ross said. ACSH's full report on BPA and ACSH's associated peer-reviewed medical journal article from 2005 demonstrate the lack of human health threat from BPA.
"Don't allow the alarmist claims to make you go thirsty, and parents, don't throw out the baby bottles with the bathwater," Dr. Ross advised.
Corrie Driebusch is an ACSH research intern. Receive these dispatches each workday in your e-mail by becoming an ACSH donor -- donate here, send a tax-deductible donation to the Broadway address at the bottom of this site, or call (212-362-7044 x225) or e-mail DriebuschC[at]acsh.org.