January 12, 2009
PB & Salmonella, Genes and Cancer, Fat and Poverty, Smoke and Alzheimer's, FDA and Gardasil
By Elizabeth Wade
Salmonella outbreak linked to peanut butter
A large institutional-sized container of peanut butter contaminated with salmonella has been discovered in Minnesota, and public heath officials suspect that the strain is linked to an outbreak that has sickened nearly 400 people in forty-two states since September.
"So far, the outbreak seems to be linked to only really big containers of peanut butter that are used in institutional settings," explains ACSH's Dr. Ruth Kava. "The contaminated peanut butter doesn't appear to have been distributed to grocery stores" -- so if you bought a jar of peanut butter at your local market recently, you probably aren't at risk for contracting salmonella.
Parents screen for breast cancer gene
British doctors have announced the birth of the first baby who was screened before conception for a genetic mutation that often leads to breast cancer. The parents decided to have the test done because of a strong family history of the disease, and while ACSH staffers respect their choice, some of us were bothered by this quote from Dr. Paul Serhal, the fertility expert who treated the couple: "The parents will have been spared the risk of inflicting this disease [breast cancer] on their daughter."
ACSH's Jeff Stier says, "In other words, if you don't get this test, you are 'inflicting' breast cancer on your baby? He makes it sound like parents are responsible for possible medical problems in their child's future if they continue with a pregnancy and have a baby with the breast cancer gene."
More Americans are obese than overweight, and the recession won't help
The number of people who are obese in the United States is now higher than the number of those who are overweight. "The rate of people being overweight has remained stable since 1980, but the prevalence of obesity has more than doubled," explains ACSH's Dr. Gilbert Ross.
Dr. Kava says, "This is an illustration of the lack of effectiveness we've experienced in preventing people who are already overweight from becoming obese."
And with the current economic downturn, some experts are worried that people might pack on "recession pounds." As ACSH Advisor and University of Washington professor Dr. Adam Drewnowski says, "People...are going to economize, and as they save money on food they will be eating more empty calories or foods high in sugar, saturated fats, and refined grains, which are cheaper...Obesity is a toxic result of a failing economic environment."
For information on the dangers of obesity, see ACSH's recent publication Obesity and Its Health Effects.
Who still smokes?
The litany of smoking-related health problems grows longer by the day (for example, doctors are now reporting that elderly smokers have an increased risk of developing Alzheimer's disease), prompting CNN to ask the question, "If smoking is so bad for you, who still does it?"
Almost 20% of the U.S. population smokes, and 90% of heavy smokers picked up the habit in high school. "We still need better education in the elementary and middle school age groups to cut smoking rates in the future," Dr. Ross says. For teen-friendly information about the dangers of smoking, check out ACSH's website TheScooponSmoking.org and our publication Cigarettes: What the Warning Label Doesn't Tell You.
ACSH also supports harm reduction strategies to help current smokers quit. See our publication on smokeless tobacco.
FDA delays approval of Gardasil for older women
The FDA has denied approval for the use of Merck's human papillomavirus (HPV) vaccine Gardasil in women ages twenty-seven to forty-five. Since most women will be exposed to at least one form of HPV at some point, it may be difficult to prove that Gardasil is effective at reducing infection and disease in older women.
"But Gardasil protects against four pathogenic strains of HPV," says ACSH's Dr. Elizabeth Whelan. "Even if a woman is infected with HPV, she's probably not infected with all four of those strains."
Dr. Ross says, "Doctors can still prescribe Gardasil off-label to their over-twenty-six female patients, but the expensive series of vaccines probably won't be covered by insurance in that case. Plus, a doctors' liability risk goes up dramatically if they prescribe a medication off-label. However, preliminary data show that Gardasil will likely be as safe in older women as it has been in young women and girls."
For more commentary on this issue, check out the FactsAndFears blog post "Who Should Get Gardasil?"
January 9, 2009
Harm Reduction, Food Industry, Drug Resistance, HRT, and Statins
By Elizabeth Wade
ACSH s harm reduction stance reaches Congress
ACSH is committed to our support for harm reduction programs to help people quit smoking, and we are glad to learn that we have an ally in Indiana Congressman Steven Buyer. He was so impressed with the Washington Times op-ed about harm reduction written by ACSH S Jeff Stier and Dr. Brad Rodu that he sent it around to his colleagues in the House of Representatives with these supportive comments:
For years, Congress has debated various tobacco control proposals.
Unfortunately, these proposals have ignored the merits of lifesaving harm reductions strategies. When we debate this important public health issue this year, I hope you will join me in promoting a pragmatic and realistic harm reduction strategy which has proven to be far more effective in decreasing cigarette smoking than abstinence-only tobacco cessation strategies. As the authors of the article below state, quit smoking should be one of our nation s top public health goals.
Soon I will be introducing an alternative tobacco control bill which moves us away from old abstinence-only proposals and toward effective, science-driven harm reduction strategies.
Stier says, I was very pleased to see the impact we are having on this issue, and we look forward to working with Rep. Buyer to promote harm reduction in the future.
Lancet slams Britain for working with food industry on anti-obesity campaign
ACSH staffers are disappointed that an editorial in the Lancet condemns the British government for working with companies such as PepsiCo and Kellog s to fund an anti-obesity education campaign.
Britain is in desperate need of funds for its health service, but the Lancet is still criticizing the government s willingness to work with the food industry, says ACSH s Dr. Gilbert Ross. It s one thing to be suspicious of tobacco companies contributing to anti-smoking efforts, but we shouldn t do the same with the food industry.
We are particularly disturbed by the Lancet s rhetorical question, So what is the subliminal, or perhaps not so subliminal, take-home message when PepsiCo brings us sports personalities who advocate exercise? If you do exercise, it is OK to drink Pepsi and eat crisps? As Dr. Ross points out, Yes, it is OK, since balance and moderation, rather than deprivation, are the keys to a healthy diet and lifestyle.
Current flu virus develops resistance to Tamiflu
This year s commonest flu strain is highly resistant to the drug Tamiflu, which is often given to vulnerable patients to prevent and treat the disease. This has been a light flu season so far in the U.S., so the skyrocketing Tamiflu resistance isn t necessarily a big deal right now but it could be a huge deal in another season, says ACSH s Dr. Elizabeth Whelan.
GlaxoSmithKline s drug Relenza can serve as an alternative to Tamiflu for some patients, but it is not recommended for children under seven and must be inhaled, which can make it more difficult to take. The government and certain companies have also stockpiled Tamiflu in the case of a flu pandemic, so it could be disastrous if the drug resistance transferred to other, more dangerous strains of the virus including and especially any future pandemic strain of bird flu.
HRT may reduce risk of colon cancer
A new study finds that taking hormone replacement therapy (HRT) substantially decreases the risk of colorectal cancer in postmenopausal women.
When a woman takes HRT for a relatively short period of time, there are more benefits than risks by far, Dr. Ross explains. There does seem to be slight increase in breast cancer in older postmenopausal women who have been taking HRT for over five years, but taking it for a few years after menopause can be very beneficial in a number of ways.
Dr. Whelan says, HRT is very complex it can be risky and beneficial at the same time. ACSH s Dr. Ruth Kava points out, It s great that we re starting to understand which subpopulations are likely to be most at risk and which subpopulations are most likely to benefit from HRT.
Statins may stave off Alzheimer s disease
We are excited but not surprised to hear that statins may reduce a person s risk of developing Alzheimer s disease (AD). We ve heard this for years, and it looks like a pretty significant effect, Dr. Whelan says. Dr. Ross adds, It s impressive that taking any type of statin appeared to reduce the risk of AD. This is one more piece of good news about the cascading benefits of statins.
January 8, 2009
Dr. Gupta, Scrubs, Boys, and Toys
By Elizabeth Wade
Dr. Gupta must stick to the science as surgeon general
Overall, ACSH staffers are pleased with the likely nomination of Dr. Sanjay Gupta for U.S. Surgeon General. "His experience as both a respected neurosurgeon and a medical correspondent for CNN gives him superior credentials in education and public relations, as well as an impressive public profile," says ACSH's Dr. Elizabeth Whelan. "Dr. Gupta has the potential to be the most famous surgeon general since Dr. C. Everett Koop."
ACSH's Dr. Gilbert Ross agrees, "Surgeon general is mainly a bully pulpit position, so it is a good thing that Dr. Gupta is already a media star known by the general public -- that is, if he uses his new position to actually support public health." Some concern was raised at the ACSH breakfast table over his journalistic coverage of both sides of the "debate" over vaccine safety -- since as Surgeon General, his support for vaccines must be based on science, not conspiracy theories.
We agree with science blogger Jake Young's comment, "It is clear to me that in his role as journalist, he has attempted to provide both sides of the [vaccines and] autism story -- in a manner similar to the way politics is presented. He shows more anecdotes than evidence because that is what people want to see on the news. But as a health advisor to the nation, it doesn't work that way. (1) You have to make a decision. (2) If you lend credence to cranks, you are going to confuse everyone AND look like a jackass doing it."
Hospital scrubs can be deadly
ACSH Trustee and chair of the Committee to Reduce Infection Deaths (RID) Dr. Elizabeth McCaughey has an excellent op-ed in the Wall Street Journal today about the dangers of contaminated hospital scrubs. She criticizes doctors and nurses for wearing the same scrubs in the hospital and out in public, writing, "Dirty scrubs spread bacteria to patients in the hospital and allow hospital superbugs to escape into public places such as restaurants."
Dr. Whelan remarks, "Her point is so commonsensical that it is almost embarrassing an op-ed needs to written about it." We hope more hospitals impose tough standards on when and where scrubs may be worn, as well as how they are cleaned.
"You can't tolerate halfway measures on this important issue," Dr. Ross believes. "No doctor or nurse should drag resistant bugs in and out of the hospital."
Gardasil under review for use in boys
ACSH staffers are pleased that Merck is seeking FDA approval for the use of the human papillomavirus (HPV) vaccine Gardasil in boys and young men. HPV is the most common sexually transmitted disease, and certain strains of it can lead to cervical cancer in women, anal and penile cancer in men, and genital warts in both sexes.
"It's simple common sense that the large majority of women and girls who contract HPV get it from men and boys," Dr. Ross says. "Also, there are diseases caused by HPV that can affect boys and men in unpleasant ways as well. To whatever degree it makes sense for girls to receive Gardasil, it makes the same amount of sense for boys."
We hope the FDA approves this new use of Gardasil quickly and that this safe and effective vaccine reaches everyone who could benefit from it.
New lead regulations lead to worry about thrift store toys
New regulations governing lead and phthalate levels in children's products will go into effect on February 10, and they may hit one industry particularly hard -- thrift stores. Stores that sell donated goods have a hard time making sure those goods comply with up-to-the-minute safety regulations, and they don't have samples of products they can provide for testing.
"Of course children shouldn't be exposed to high levels of lead, but going to this other extreme will not benefit public health at all while damaging already-vulnerable industries," explains Dr. Whelan. "This kind of unnecessary regulation is exactly what ACSH is fighting against, but unfortunately average consumers are so worried about lead in toys that they often instinctively side with those who are trying to regulate."
Similar concerns are causing dismay -- indeed, near panic -- for small toy manufacturers and small businesses selling toys and similar products. "The big manufacturers won't have to sweat out these new useless and misguided regulations, while the small mom-and-pop operations will have to comply or go out of business," says Dr. Ross.
For a balanced perspective on the dangers of lead exposure, see ACSH's publication Lead and Human Health: An Update.
January 7, 2009
MMR, Leptin, Diet vs. Exercise, and Le Smoking Ban
Lancet skirts responsibility for low MMR vaccination rates
ACSH staffers find it ironic that the latest issue of the Lancet laments suboptimal vaccination rates against measles in Europe -- when the same journal published Andrew Wakefield's now-discredited study postulating a link between the measles, mumps, rubella (MMR) vaccine and autism in 1998, contributing to the anti-vaccine paranoia that has decreased vaccination. "The Wakefield study was poorly conducted, the conclusions drawn from it were wildly outrageous, and the media hype was devastating," remembers ACSH's Dr. Gilbert Ross.
ACSH's Dr. Elizabeth Whelan agrees, "Wakefield's preposterous theories led to a public health tragedy that didn't have to happen, and is still ongoing."
A comment accompanying the current article on suboptimal vaccination rates admits the UK "is only slowly recovering from its unsubstantiated scare that the measles, mumps, and rubella vaccination was linked to increased risk of autism." However, no mention is made of the Lancet's role in promoting that scare. "It seems that they are evading any responsibility for the low rate of vaccination," says ACSH's Dr. Ruth Kava.
Dr. Ross adds, "The larger tragedy is that the low vaccination rates in the EU led directly to much more severe epidemics in poor regions, where susceptible populations are devastated by imported measles cases from unvaccinated European tourists. At least the editorial had the grace to point this out and call for more responsible behavior by EU parents."
The Wakefield controversy also set the stage for problems with peer-reviewed journals publishing studies that do not meet their rigorous scientific standards. Dr. Ross reminds us that Dr. Richard Horton, the Lancet editor who chose to publish the Wakefield study, did so because "he wanted to stimulate debate, even though he knew it was a bad study." Such attitudes have opened the door to studies like one that attempts to link coffee to a decreased risk of oral cancer, but which, as Dr. Ross says, "is clearly a case of data dredging."
Dr. Whelan wonders, "How do we explain our support for peer-reviewed journals when they are publishing junk science?"
Leptin works for fat mice, but what about fat people?
The media is touting progress on using the appetite-suppressing hormone leptin as a weight loss treatment when it is combined with other drugs, but we believe the headlines are overly optimistic. "It's true that leptin can help regulate appetite, but most obese people have developed a resistance to it," Dr. Kava explains. "It may be possible to overcome that resistance with such drugs or doses, but this study was performed on mice and may not necessarily apply to humans."
Diet trumps exercise for weight loss -- in one study, at least
A new study indicates that diet, rather than exercise, may play the key role in weight loss. When comparing African American women in Chicago and women in rural Nigeria, researchers found that while the two groups tended to burn the same amount of calories through physical activity, the Nigerian women had a healthier diet and tended to weigh significantly less.
Dr. Kava, however, is hesitant to discount the importance of exercise in achieving and maintaining a healthy weight. "There are so many benefits of physical exercise that we don't want to discourage it," she says. "The relative importance of diet and exercise varies from one population to another, so these results shouldn't necessarily be extrapolated to everyone."
France's smoking ban has a positive effect
France recently banned smoking in cafés, bars, and most other public places, resulting in a significant drop in cigarette sales over the past year. "Banning smoking in public places is a very effective way to reduce smoking rates," Dr. Ross says. "It denormalizes smoking, and cigarettes become less available...France, unlike some other European countries, seems to be enforcing its smoking ban."
January 6, 2009
Quitting Cigarettes, Scaring Smokers' Friends, Publicizing Autism, and Labeling Food
By Elizabeth Wade
Despite dismal quit rates, government continues to block smokeless tobacco
ACSH's Jeff Stier and ACSH advisor Dr. Brad Rodu co-wrote an op-ed in today's Washington Times about the benefits of using smokeless tobacco as a harm reduction method -- and how proposed legislation allowing the FDA to regulate tobacco products (which the New York Timesc alls "nearly inevitable" under the next administration) will discourage widespread use of this potentially lifesaving smoking cessation method.
"The pending Kennedy/Waxman bill conceals the fact that cigarettes are vastly deadlier than smokeless products, and it prohibits manufacturers from truthfully disclosing this marked difference to consumers," Stier and Dr. Rodu wrote. "The bill ignores science-based tobacco harm reduction involving substituting safer smokeless tobacco products for cigarettes."
While no tobacco product is completely safe, Stier and Dr. Rodu remind us, "Smokeless tobacco products are at least 98% safer than smoking." They also have the potential to be a much more effective smoking cessation tool than nicotine replacement therapies currently on the market, such as nicotine gum -- which, according to a recent study, yields only a 6% quit rate after six months.
"The statistics on smoking cessation are just appalling, and the government is withholding lifesaving information about smokeless tobacco that could improve the success rate for quitting," says ACSH's Dr. Elizabeth Whelan.
ACSH's Dr. Gilbert Ross agrees that the new data about the effectiveness of nicotine gum can be compared to "angels dancing on the head of a pin. It doesn't rise to the level of good therapy." Even worse, the 6% quit rate was found in smokers who were given a four-milligram dose of nicotine gum, the highest available in the study. "But that is a drop in the ocean compared to the hit of nicotine that you get from a smokeless product," Dr. Ross says.
For more information about the benefits of using smokeless tobacco as a harm reduction strategy, see ACSH's publication Helping Smokers Quit: A Role for Smokeless Tobacco?
Third-hand smoke scare kicks off the New Year
The first health scare of 2009 seems to be concern over "third-hand smoke," or the gases and particles that cling to smokers' hair and clothing even after they have finished a cigarette. "Anyone who has smelled someone who reeks of cigarettes knows that third-hand smoke is horrifically annoying and nauseating," Dr. Whelan says, "but that doesn't mean it's automatically a health problem."
Dr. Ross points out, "Paranoia over third-hand smoke fits perfectly with the belief that trace levels of 'toxic chemicals' are automatically carcinogens."
Dr. Whelan agrees, "This is an example of where a contingent of the anti-smoking movement has gone too far. It challenges the movement's public health credibility by making all anti-smoking activists appear hyperbolic and uninformed about scientific facts."
Tragic death of John Travolta's son raises questions about autism
Much confusion surrounds the recent death of John Travolta's teenage son, Jett -- including what role, if any, autism may have played in his death. While it is said that Jett suffered from Kawasaki disease as a young child and had experienced grand-mal seizures, for which he had been on treatment, it is unclear whether or not he had autism. ACSH Advisor Dr. Marvin Schissel weighed in with an email message to us:
"Surely celebrities can increase public awareness of autism. But I understand that the Church of Scientology, of which John Travolta is an active member, considers autism to be the fault of the individual with autism and refuses to allow scientific treatment. I have read speculations that this is why his son died.
"They say there's no such thing as bad publicity, but in this case [with Travolta and his wife being encouraged to talk about autism] I don't think so -- especially if it adds to the mounting support of quackery and the harm quackery does to this sensitive and desperate population."
For more on the problems with celebrities becoming spokespeople for scientific (or, all too often, unscientific) issues -- including commentary on actress Jenny McCarthy's misguided beliefs about autism -- see ACSH's publication Celebrities vs. Science.
Can food labels lead to healthier choices?
The Wall Street Journal interviewed ACSH's Jeff Stier for an article on the "Healthy Ideas" labeling system being implemented by grocery chains Stop & Shop and Giant Food. While the labels purport to "help customers find their stores' healthiest foods," Stier reminds us, "Even if you see a big bag of chips with a [Healthy Ideas] label on it, that doesn't mean you can go crazy." Portion control and reading the nutritional label, he says, are still the most important things to determine a food's nutritional value.
ACSH's Dr. Ruth Kava adds, "While it's great to see stores trying to communicate with customers, it's important that we not have too many different evaluation systems -- that could simply confound the confusion many people seem to feel about making nutritional choices."
January 5, 2009
Vaccines, Smoking, and Fast Food
By Elizabeth Wade
Good science brought to you by ACSH
As we start the New Year, we d like to thank all our loyal Morning Dispatch readers for your past and continuing support. ACSH Trustee and UCLA epidemiologist Dr. James Enstrom summed up the importance of our mission in this kind remark:
Keep up your great work! I believe that bad science hurts America and that it is necessary to promote good science the way ACSH does.
With your support, we will continue fighting junk science in 2009 and beyond.
Vaccine safety misrepresented in the Washington Times
We are disappointed by the response the Washington Times published to ACSH s Dr. Elizabeth Whelan s op-ed Unfounded Health Scares. In a letter published this weekend, the father of an autistic child took issue with Dr. Whelan s assurance that not only are childhood vaccines safe, but they are necessary to protect individual children and the larger population from dangerous diseases. He blamed the measles-mumps-rubella (MMR) vaccine for his daughter s condition and cited the fact that courts have awarded nearly $1 billion to victims of vaccine-inflicted injury as support for his case.
The letter is filled with misleading statements and false associations, argues ACSH s Dr. Gilbert Ross. For one thing, mercury and lead were never included in the MMR vaccine, as he claims. And the fact that the legal system awards damages to a plaintiff doesn t automatically make the plaintiff s argument true. Scientific and legal evidence are held to different standards. We hope that the readers of the Washington Times will not be mislead by such dangerous misinformation.
For the facts on the safety of childhood vaccines, check out ACSH s booklet What s the Story? Childhood Immunizations. And for more on the health scare surrounding vaccines and autism, see our Top 10 Unfounded Health Scares of 2008.
Do smoking bans really cut heart disease risk?
ACSH staffers are skeptical of the CDC s assertion that instituting an indoor smoking ban, in part because of a reduction in environmental tobacco smoke, cuts a community s risk of heart attacks within as little as 18 months. Indoor smoking bans do indeed discourage people from smoking cigarettes, which is a positive change. But there is no evidence linking secondhand smoke exposure to heart disease, Dr. Whelan explains.
Dr. Ross adds, Even if you believe and argue that secondhand smoke might provoke heart disease, it is bizarre to think that an indoor smoking ban could cut heart disease rates within an 18 to 36 month period.
Anti-smoking education may prevent teens from lighting up
Teenagers who believe that smoking cigarettes carries major health risks and little social value are less likely to take up the habit, according to a new study. While it doesn t say how the teenagers in the study reached their opinions about smoking, it is encouraging that we can influence teenagers behavior by explaining the risks of smoking to them, Dr. Ross believes.
Saying everyone knows the dangers of smoking or putting up vague anti-smoking posters is very different than sitting down and going over the specific health risks of cigarettes with a teenager or an adult, Dr. Whelan says. Our teen-friendly publication Cigarettes:What the Warning Label Doesn t Tell You provides a starting point for an intensive discussion of the health consequences of smoking. Also check out ACSH s website TheScooponSmoking.org.
Fast food blamed for fat kids again
Researchers contend that children who attend school near one or more fast food restaurants are more likely to be overweight or obese than their peers who attend schools further away from such restaurants, but we think, as Dr. Ross says, They are confusing association with causation.
ACSH s Dr. Ruth Kava explains, You have to look at these children s socioeconomic conditions and what the areas surrounding their schools and homes are like to understand the association more completely. She believes that singling out fast food as the cause of obesity is simplistic and says that rather than restricting the locations of chain restaurants, we should focus on offering more healthy alternatives and on getting parents involved by teaching them about good nutrition.
December 31, 2008
Inhaler Switch, Influenza, Insulin, and Antioxidants
By Elizabeth Wade
Say goodbye to your CFC inhaler
Beginning today, Americans with asthma face a shift in how they relieve the potentially deadly symptoms of asthma attacks. Because of environmental concerns, chlorofluorocarbon (CFC) propellants in inhalers are now banned in the United States and must be replaced by hydrofluoroalkane (HFA) propellants.
Asthma patients must be sure to visit their doctors to pick up their new prescriptions and discuss the switch, says ACSH s Dr. Elizabeth Whelan. Suddenly finding yourself without an inhaler in an emergency could have devastating consequences.
HFA inhalers are just as effective as their CFC counterparts, although the spray may feel warmer and less forceful. They also tend to be more expensive because no generic versions are currently available, so concerned patients should speak to their doctors and insurance providers about any cost increase. Several drug companies have also set up programs to help people afford their new HFA inhalers.
University of Iowa pulmonologist and ACSH adviser Dr. Miles Weinberger reassures us, Frankly, the switch to HFA inhalers has been, for the most part, much ado about very little. CFC inhalers have been in short supply for a long time because of the anticipated ban, resulting in common use of the four brand name HFA inhalers for at least the past year. Few patients, in my experience, have made an issue of the different feel of the propelled medication from the metered dose inhalers.
The transition to HFA inhalers presents an opportunity for all asthma patients to make sure they are managing their condition effectively. For all the latest news about asthma treatments including information on the switch from CFC to HFA inhalers see ACSH s recent report Asthma: Causes, Diagnosis, and Treatment.
Britain faces possible flu epidemic
A dangerous strain of the flu virus that killed six children in Australia has arrived in the UK, which has health officials worried about an epidemic this flu season. Britain seems to getting a wake-up call about the importance of vaccination, Dr. Whelan says.
As Professor Steve Field, chairman of the Royal College of GPs, warns, The influenza vaccination programme has been good in some areas but patchy in others. In these areas the NHS [National Health Service] will take a big hit. ACSH s Dr. Gilbert Ross is curious as to how much the vaccination program in Britain still suffers from the effects of Wakefield s deceptions about the phony dangers of the MMR vaccine.
Breast cancer risk linked to high insulin levels
High insulin levels appear to be an independent risk factor for breast cancer, according to a new study. Obesity often results in elevated insulin levels, and it is well documented that postmenopausal obese women have a higher risk of breast cancer than their normal weight peers. But this study suggests that their higher breast cancer risk is linked to increased levels of insulin that come with an elevated body mass index, not to obesity itself, Dr. Ross explains.
Unfortunately, there is currently no method of lowering insulin levels using pharmaceuticals. While I m sure many scientists are investigating the problem from a pharmacological perspective, weight loss remains the best way to get insulin levels down, says Dr. Ross.
Antioxidants still don t reduce cancer risk
ACSH staffers aren t surprised that taking beta-carotene, vitamin C, and vitamin E supplements for years does not lower overall cancer risk. It seems like this story comes back at least once a week, Dr. Whelan says. Indeed, antioxidants taken as supplements have never been shown to have a positive effect on health but as ACSH s Jeff Stier says, This fact always bears repeating because many people still believe otherwise.
Happy New Year!
ACSH would like to wish all of our Morning Dispatch readers a Happy New Year! Morning Dispatch will return on Monday, but in the meantime, start 2009 off on the right foot by checking out our health-related resolutions. We wish you a safe, happy, and healthy 2009!
December 30, 2008
Incentives for Doctors, Taxes on Soda, and Regulations on Diesel
By Elizabeth Wade
Thank you for your support!
ACSH President Dr. Elizabeth Whelan passes along her appreciation to the Morning Dispatch readers who promptly responded so generously to her email yesterday by making a year-end contribution to ACSH. I d like to especially thank those of you who took the time yesterday to give to us online or called in your gift and wished ACSH staffers a happy holiday, she says.
In her email, Dr. Whelan explained that in these busy and difficult times, there are three compelling reasons why ACSH has earned your support:
1) We are effective. We get the job done and as a Morning Dispatch reader, you see the impact we have on public policy every single day.
2) We are unique. As the only organization of scientists defending sound science, we have the credibility, experience, personnel, and know-how to defend and promote our shared beliefs.
3) We are relevant. This is a critical time. Now more than ever, American consumers need ACSH on the front line of defense against attacks on technology and science.
If you have not yet made your contribution or would like to make an additional gift in 2008, please do. Or if you d like to really make our day, please call us during business hours at our toll free number, (866) 905-2694. Beth, Gil, Jeff, or Matt would be glad to talk with you. And thank you again for all you do!
NYC tries out electronic records, but do incentives for doctors go too far?
The New York City health department is encouraging doctors to switch to electronic record keeping, devising a computerized database that will not only help doctors track their patients progress but also provide public health information to the city.
As long as the privacy of patients is protected, ACSH staffers believe that accumulating this type is data is a positive step. But some of us took issue with a proposed incentive program to reward doctors with up to $100 when patients reach goals like controlling their blood pressure or cholesterol.
Something doesn t sit right with me about giving incentives to doctors, says ACSH s Jeff Stier. Because of the program, are primary care doctors now going to focus more on patients they are going to receive higher payments for? But ACSH s Dr. Ruth Kava points out, Maybe those patients need extra attention in order to get their blood pressure under control or take other steps to properly manage their health.
While ACSH s Gilbert Ross agrees that something smells about the proposed program, he says, People do better when they are given an incentive, and that includes doctors. However, doctors might avoid or refer complex cases in order to focus on the easier ones that would earn them more money, and that would be unethical.
New York s soda tax hits You Tube
New York State Health Commissioner Richard Daines recently appeared in a video on You Tube arguing in favor of the proposed tax on non-diet soda. As Dr. Daines told the New York Daily News, Simply because you can t or don t want to do everything doesn t mean you can t do the first thing or the most important thing [to fight obesity].
But as Dr. Ross asks, Since when did sugary soft drinks become the main cause of the obesity epidemic? And why does he have to conflate tobacco and food? That s exactly what the cigarette industry has been trying to do.
Dr. Enstrom weighs in on California s latest regulation
UCLA epidemiologist and ACSH Trustee Dr. James Enstrom recently brought our attention to California s new regulations on diesel emissions. Here s what he has to say on the issue:
On December 12, the California Air Resources Board (CARB) approved the most stringent regulations in the nation governing diesel emissions, justified primarily by CARB s contentions that diesel fine particulate air pollution causes about 4,000 premature deaths per year in California. These regulations are estimated to cost more than $5 billion to implement and will add an unnecessary burden on the already struggling California economy.
Before the vote, I presented CARB with evidence from six different studies that there is no current relationship between fine particulate air pollution and mortality in California. In addition, several other California professors and I provided CARB with substantial additional evidence justifying postponement and reassessment of these Draconian diesel regulations.
However, CARB ignored all of this evidence and instead relied on a CARB Staff Report with selective evidence not applicable to California. In addition, the lead author of this CARB Staff Report falsely claimed to have a Ph.D. in statistics from UC Davis and made other serious errors. I described my indignation at these new regulations and at CARB s obfuscation regarding questions about its report in a December 24 San Diego Union-Tribune editorial. Hopefully, CARB s diesel regulations will be reassessed before California's economy is further damaged.
Dr. Whelan says, Here we have yet another example of a proposed regulation which will cost consumers millions or billions of dollars yet will offer no improvement of public health a classic case of getting nothing for something. ACSH is proud that Dr. Enstrom has the courage and integrity to stand up and protest this misuse of science.
December 29, 2008
Celebrity Science, Smoking Cessation, Breakfast Delays Sex, Stroke Risk, NSAIDS and CRC, War on Chemicals
By Elizabeth Wade
Quote of the Day
[R]esearch can often produce results which challenge our preconceptions: that is why science is more interesting than just following your nose. Dr. Ben Goldacre in the Independent s article Scientific illiteracy all the rage among the glitterati. For more on the danger of trusting celebrities scientific advice, see ACSH s publication Celebrities vs. Science.
Obama s struggle to quit draws attention to nicotine replacement strategies
An article in the New York Times about President-elect Barack Obama s smoking habit raises some good points about how difficult it is to quit such as the fact that it takes the average smoker about eight to ten tries to finally kick the habit. The article also points out that for people who smoke fewer than ten cigarettes a day, like Obama, the addiction to cigarettes is more tied to the behavioral aspect of smoking than to the nicotine itself, says ACSH s Dr. Gilbert Ross.
Obama says he uses Nicorette gum as a form of nicotine replacement, but still falls off the wagon occasionally. We agree wholeheartedly with comments made by Dr. Neal L. Benowitz, an expert on nicotine addiction from the University of California, San Francisco, on the relative safety of nicotine replacement products: If the choice is between taking nicotine or smoking, nicotine is far, far better. We are just disappointed he didn t mention smokeless tobacco as a method of harm reduction.
Teens who eat breakfast tend to delay sex but why?
A new study from Japan concludes that teenagers who skip breakfast as middle school students tend to have sex at an earlier age than those who eat a full meal in the morning. This is obviously a confounder, Dr. Ross explains. Any correlation between the age at which teenagers start having sex and their breakfast habits has more to do with their family situations than whether they happen to eat in the morning.
Waist size linked to stroke risk
ACSH staffers weren t surprised to hear that a large waist circumference likely increases a person s risk of a stroke. This is a refinement of the link between obesity and an elevated risk of stroke, explains ACSH s Dr. Ruth Kava. The link appears to have more to do with waist-to-hip ratio and distribution of body fat than body mass index (BMI) alone.
Certain painkillers may lower risk of colorectal cancer
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and some COX-2 inhibitors, may reduce a person s risk of colorectal cancer when taken regularly over five years. This is old news but it bears repeating because very few people are aware of these drugs protective effect, Dr. Ross says.
ACSH s Dr. Elizabeth Whelan adds, This information is particularly relevant for people with a family history of colon cancer. Colorectal cancer is the second leading cancer killer in the U.S., second only to lung cancer.
War on chemicals continues
ACSH staffers are disappointed by an off-hand reference made to cancer-causing pesticides in the New York Times obituary of the Natural Resources Defense Council lawyer Al Meyerhoff, who was the voice of the activist group during their abortive scare campaign against Alar in 1989 and debated Dr. Whelan during that era.
It s part of the insidious repetition of the concept that pesticides cause cancer when indeed the label carcinogen refers exclusively to high dose animal experiments, Dr. Whelan says. When people constantly hear about the dangers of pesticides, who wouldn t think that they cause cancer in humans? For a more balanced perspective on the chemicals we re exposed to every day, see ACSH s Holiday Dinner Menu.
December 24, 2008
Harm Reduction, Activist Attack, Children and Obesity, Multiple Prescriptions and Letters To ACSH
By Gilbert Ross, M.D.
Delicious Harm Reduction
Yesterday, ACSH staffers were gratified to receive gifts of the brand-new Lean Mean Fryer that uses a patented Smart Spin technique to spin away up to 55% of the fat absorbed in the frying process. It works deliciously with many products: donuts, shrimp, fish, potatoes, among other items. While we here at ACSH always advise watching caloric intake, eating delicious fried foods in moderation can be part of a well-rounded nutrition plan. Getting rid of excess fat excess calories can be an aid in weight loss, a form of harm reduction: indulging in potentially unhealthy behaviors but limiting the harm from them. (Another example: using smokeless tobacco as an aid to quitting deadly cigarettes). We thank the Spin-Fry/George Foreman Grill folks!
In the Holiday Spirit of Giving Why not use this as inspiration to make a charitable donation to The American Council on Science and Health!
When Activists Attack in the Name of Public Health, Watch Out!
Two stories coming to our attention yesterday are related by an anti-big business theme posing in the guise of public health. The FDA has declared that Diet Coke Plus may violate their dictum prohibiting health claims for soda as misleading. Further, the Plus product while containing vitamins and minerals not present in Diet Coke doesn t contain enough extras to qualify for the Plus according to FDA regulations. The restrictions on such terminologies are arbitrary, and ridiculously technical, said ACSH s Jeff Stier. It amounts to counting angels dancing on pinheads.
Another story described the torments being suffered by makers of toys and children s products who are small-volume manufacturers and marketers, thanks to the baseless new law requiring exorbitant fees for testing of all their product lines for lead and phthalates. This draconian regulation applies across-the-board, to tiny mom-and-pop shops as well as to Mattell and Hasbro but only the big names can afford to stay in business while spending hundreds of thousands of dollars (and more) on unnecessary testing. One small toymaker said his tiny operation only used wood and beeswax, but still had to spend more than his net profit to adhere to these regulations ¦and in fact, the protection from the new law will not improve anyone s health, said Dr. Gilbert Ross. It s a classical case of unintended consequences bu t we foresaw that this would happen. The big toy makers can weather this storm, but small- and medium-sized operations will be going out of business, and toy shelves will be empty next Christmas.
Jeff Stier pointed out that these seemingly-unrelated stories have this in common: Activist hypocrisy. In the case of Diet Coke Plus, health activists condemn Coke for the additional vitamins and minerals, pressuring the FDA to act. They would rather see Coke suffer a loss in this campaign than have consumers exposed to what seems like a healthier product. Their bottom line: Down with Big Soda! Too bad for the public.
In the case of the new toy rules, these same activists, seemingly now abashed by the havoc they have wrought with their misguided rules, want to exempt the small and medium makers from the requirements to make safer toys! Wha t utter hypocrisy, exclaimed ACSH s president, Dr. Beth Whelan. They demand safety above all for our precious children and their toxic toys but wait! Let s give a pass to small businesses, they re the heart of our country. Forget about children s health but not when it comes to Mattell, they re a big business, so let s hold them to account. Public health? I don t think so!
Fast Food near schools blamed, again, for obesity in schoolchildren
Just repeating a falsehood may, indeed, make everyone believe it s so. ACSH staffers were dismayed to hear about a study attempting to link the proximity of fast food restaurants to schools and the obesity rate in nearby schools. Such mythology led to a moratorium on new fast food outlets in certain areas of Los Angeles this year. Trying to use macro-epidemiology to support such simplistic theories is, while completely unscientific, going to replicated over the next few years, and gain willing adherent among the blame McDonald s crowd, said Dr. Ross. It bears repeating: for every complex problem, there s always a simple solution and it s always wrong, said Dr. Whelan
Dangerous drug combinations pose risk, especially for the elderly
A new study attracted our attention concerning the dangerous practice of many seniors: taking multiple prescription medications, plus OTC pills, plus supplements (sometimes including sharing and trading with friends!). Some of these combinations lead to serious, potentially lethal interactions. An amazing ten percent of men in the age range 75-85 were found to be taking dangerous combinations of pills, potions and elixirs, said Dr. Whelan. Stier added, These supplements are completely unregulated, and no one knows who is taking what. And adverse reactions are rarely reported, even if someone knows about the various substances in them. Dr. Ross had a suggestion: When I was in practice, I d advise my older patients to brown bag it : bring in everything they take in a bad and let me look it over. But many patients these days no longer have a primary care doctor to oversee their entire situation more s the pity.
Letters, we get letters ¦.
We get all sorts of "Fan Mail" -- and as we go into the holidays, we thought we'd share a couple of the more interesting
ones we got yesterday.
We hope members of our Morning Dispatch Family appreciate the correspondence as much as we did.
Here s one from a fan, in response to our Top Health Scares of 2008--
(note: this is copied and pasted exactly as it came to us):
From: "Dave Merino"
Date: December 23, 2008 4:31:55 PM EST
To: acsh@acsh.org
Subject: where the hell do you get your info from the moon
there are many study's that confirm that cell phone cause drain tumors
Our friend, adviser and trustee Dr. Henry Miller suggested that this writer s credibility had gone down the ¦well, you get the idea!
And here's another one ( we can't make this stuff up!):
Dear Ms. Whelan,
From the general tone of the below advisory, it seems that you must be a mouthpiece for the chemical, vaccine and pharmaceutical industries. Is it really an "unfounded" fear that fluoride is strongly associated with osteoporosis in young boys, despite the paper by Elise Bassin, Ph.D. that Harvard suppressed for $1 million? If fluoride is so safe, why is there a warning on each and every fluoridated toothpaste sold in the supermarket, stating that "if more than a pea-sized amount of toothpaste is swallowed, call a physician or your poison control center immedia tely"?
Now we hear that mercury, the most toxic non-radioactive metal on the planet is safe for infants and pregnant women, to say nothing about horrifying overdoses in vaccines, amalgam fillings that outgas for 50 years or more, and the fact that mercury amalgam excess after teeth are filled, must be disposed of in a carefully controlled manner prescribed by the EPA for "toxic waste"? How did the stuff get so harmless by the simple expedient of putting it into our mouths?
Ritalin and all other psychoactive antipsychotics are banned in the UK for use in children under 18 due to the extraordinarily high number of suicides of children on these drugs. Yet we prescribe them for children as young as two years old! I think we have a right, even a duty, to be very afraid of the very entities who are supposedly protecting us, but who seem intent on poisoning us.
The HPV vaccine has killed well over a dozen young women, injured thousands, yet we hear nothing about these injuries. Instead, the marketing departments of the pharmaceutical manufacturers do EXACTLY what you are complaining about below: they make up some PR campaign to scare parents into giving their daughters the vaccine. When that's not enough, the girls, and now boys and immigrants, are forced to take these potentially lethal vaccines. Many parents have gone to home-schooling to stay out of the clutches of the FDA (the Federal Death Administration). In Maryland, children were forced AT GUNPOINT and UNDER THE NOSES OF ATTACK DOGS to be vaccinated, over their parents' objections. The Maryland Attorney General who forced these (mostly black) parents to have their children vaccinatetd la ter admitted that he was not having his own children vaccinated.
Now, the FDA is starting a media blitz about the "toxicity" of vitamins. There is a scare tactic that is totally without basis. There are fewer than one death a year from vitamins, yet the FDA, in cooperation with its drug overlords, wants to take them off the market. Contrast that instead with 144,000 deaths from VIOXX®, which the FDA said NOTHING about, and you will see who they are protecting.
Science? What a joke! You are in the marketing and fearmongering business yourselves. You are the ones selling death and mayhem to children. You will eventually reap what you have sown, can't get away from it.
Oh, there's much more, but I will wager you don't even read this far before hitting the "delete" key.
Howard Straus, Pres.Cancer Research Wellness Institute316 Mid Valley Center #230Carmel, CA 93923+1 (831) 625 3565
ACSH Staffers participated in a video discussion similar to our daily breakfast meetings which wind up in Morning Dispatch on the subject of our recently published Greatest Health Scares of 2008. Stay tuned for its release, early in the New Year.
Happy Holidays to All Our Morning Dispatch Readers!!
Due to the Holidays, Morning Dispatch will not be going out Thursday December 25th and Friday December 26th.
December 23, 2008
Fish, Fears, Food Poisoning, FDA Weight-Loss Warning, Fat, and Finances
By Todd Seavey
NYT conclusion on FDA vs. EPA: blame Bush
The New York Times grappled to the best of its limited ability with a food safety dilemma in one of today's editorials. The Times board noticed that the Food and Drug Administration is urging women to eat more fish, given studies suggesting healthier and smarter babies may result, while the Environmental Protection Agency, fearing even minuscule amounts of mercury in fish, continues to warn women away from more than occasional servings.
To ACSH, the cause of the discrepancy is pretty clear: When doing scientific studies, "FDA deals with people, not rats," says ACSH's Dr. Gilbert Ross, referring to EPA's largely-irrelevant high-dose rodent experiments, which chronically yield overcautious warnings. (See Ross's blog entry "Eat More Fish.")
To the Times, one possible conclusion to be drawn (they are vague about exactly who is drawing it) is that an evil Bush administration must, in its final gasps, be using the FDA to aid its industry pals in the fish business by using flawed science, an argumentative tactic that will seem even less plausible in a few weeks but probably won't come to an end.
Unfounded Health Scares of 2008
We hope you have a happy new year -- and that you didn't fall for any of the past year's biggest unfounded health scares. ACSH's Dr. Elizabeth Whelan runs down the depressing, often ludicrous list in her column in the Washington Times today. As she says, 2008 seems to have produced a "bumper crop of silly scares." Today, in our new studio, ACSH staffers taped a video discussion of 2008 scares. Stay tuned for a link!
Unhealthy Health Department
Dozens of people were struck by food poisoning at a Lawrence County Health Department party in Illinois, ironically. The incident is a reminder that even the most savvy eaters are not immune to microbes. In this case, the culprit may have been salad bar ham -- but think of it as a reminder to be careful when preparing your meals this holiday season, avoiding cross-contamination and avoiding undercooking.
FDA warns against twenty-eight weight-loss products
Fox noted the FDA's new warning that some twenty-eight weight-loss products are either ineffective or contain unknown ingredients or unpredictable quantities of their active ingredients. Criminal charges against some of the companies involved are possible -- and we can't help being reminded of our own warnings about the dangers of herbal and dietary supplements, so often assumed by customers to be harmless because they are "natural," but potentially dangerous in combination with other medications.
Obesity increases cancer-related lymphedema risk
ACSH was not surprised by a new study seeming to suggest an increased risk for lymphedema -- painful swelling following breast cancer surgery -- among obese women. Obesity also complicates surgery and is associated with negative health effects in many systems of the body, as detailed in our new book-length publication Obesity and Its Health Effects. ACSH's Dr. Ruth Kava comments that it is well known that obesity increases the risk of post-breast cancer lymphedema -- and sad that the condition is not well-recognized, as the authors of the study stated.
Dr. Ross notes that the 40-60% lymphedema incidence increase, over some twenty years, in the obese women is not that substantial given the relatively low base rate of lymphedema -- and the important caveat that the obese are not a broad swath of the population synonymous with all those who are merely overweight. "I recently eased my way into the overweight category," he notes, "but I haven't yet managed to become obese."
More vaccine conspiracy rumors
As if India didn't have enough problems with violence lately, notes Dr. Ross, "there was rioting in southern India over a false rumor that the polio vaccine is tainted and kids were falling ill." Polio vaccination rates plummeted in Nigeria and other areas a few years ago over rumors that doctors were using the injections to render Muslims sterile. Meanwhile, in the U.S., conspiracy theorists claim vaccines contain mercury and thereby cause autism -- and the UK saw vaccination rates drop after a similar vaccine-autism scare propagated by plaintiff lawyers and one dubious, small-scale study later disavowed by the journal that published it. Outbreaks of nearly-banished diseases will be the result of such scares.
Insulated against asbestos news
ACSH's Jeff Stier notes the relative lack of reporting about professional misconduct by lawyers suing asbestos manufacturers (alleging countless cases of illnesses based on only the most cursory examinations by lawyer-affiliated doctors): "If this were a case of...someone on the pro-science [and industry-defending] side, it'd be on the front page of the New York Times. Because it's asbestos lawyers, it's buried in the back of the Wall Street Journal."
"This asbestos litigation is sucking the country dry," adds Dr. Ross, "and it's all based on very little." Not all forms of asbestos are equally likely to cause disease, as explained in our publication Asbestos Exposure: How Risky Is It?
ACSH is a science-friendly port amidst the financial storm
Coming after news of the larger financial crisis, the Madoff scandal has left many investors and donors unsure about where they can safely put their money. That makes this an apt time to recall that ACSH has earned a four-star rating (the highest) from Charity Navigator -- and that we fulfill what experts say are three of the most important qualities to look for in non-profit transparency: an online posting of our 990 tax form, an independent investment committee, and a well-balanced and diversified portfolio of blue-chip stocks. ACSH's long-term financial stability is key to fighting our ongoing battle against junk science. Be a part of that effort by making a donation today!
December 22, 2008
Donate, Holiday Menu, ETS and Fertility Problems, Flu Shots, and Restaurant Woes
By Ruth Kava
"Which side do you want to be on in 2009?" wondered Jeff Stier.
Today's New York Times editorial makes it clear th at President-Elect Obama's science picks are prepared to shake things up.
In "A New Respect For Science" the Times editorial writers suggest that Obama's choices say something about " his appreciation for the processes of science."
We are more skeptical. Just last week, in announcing his environmental appointments, Obama argued his "green" approach was so good for the economy, that the science behind it was somewhere between secondary and irrelevant.
"This is not making science paramount, this is just co-opting science for your political agenda," quipped Stier.
Are you prepared for four more years of former EPA chief Carol Browner? She's been tapped for a special advisory role and helpe d select the new EPA chief, presumably in her image.
ACSH is a small and tightly focused organization. We don't address a broad range of issues like some other think tanks. But with your help, no other organization is as well-suited to defend against the voracious attack on sound science that is now in the works. The other side is putting together a crafty team.
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We need you on our team, defending principled science, free markets and personal responsibility.
Before 2008 comes to a close, please make your voice -- and ours -- heard, by giving to ACSH today.
Holiday Menu Misunderstood
At first, we were deli ghted to find an article in the Kansas City Star about our classic Holiday Dinner Menu, because it seemed the author really got the menu s message. That is, of course, that trace levels of natural carcinogens abound in all foods, and we should learn from that not to listen to scaremongers alarmist messages about minuscule amounts of synthetic chemicals. But as ACSH s Jeff Stier noted as the article goes on, it is evident that even the author doesn't get it. Indeed, she ends her essay by advising readers not to ignore all chemophobic warnings such as the ones recently targeting phthalates! So she missed the point after all. Perhaps she should have read ACSH s paper on phthalates, or viewed our riskometer, that puts such warnings into perspective.
More Blame for Second Hand Smoke
We weren t sure what to believe about an article about a new report in the journal Tobacco Control that asserts that women who were regularly exposed to second hand smoke experienced more pregnancy complications than women who had not been so exposed. The women who were exposed in both childhood and adulthood were 39 percent more likely to have suffered a miscarriage or stillbirth, and 68 percent more likely to have difficulty in becoming pregnant. The article did not, however, discuss whether one group or the other had used hormonal forms of birth control, or other possible confounding factors.
Dr. Gil Ross noted, "Second-hand smoke is highly annoying, and can lead to serious problems in some children exposed to it. I was surprised to learn, while researching our recent publication on asthma, that pregnancy and early-infancy exposure also can cause asthma. Of course, some in the anti-tobacco community have blamed second-hand smoke for many ills that are not supported by the evidence. This problem could be eliminated if smokers could quit more easily--not likely--or switch to a less-harm ful tobacco product such as smokeless, which reduces their own risk and has no second-hand smoke, either."
Flu virus in circulation is resistant to one treatment
The CDC issued an advisory that a medication used to reduce the severity and duration of flu symptoms may be less effective than expected this season. The medication, Tamiflu (oseltamivir), made by Roche, has shown little efficacy against some of the early influenza virus samples tested. Tamiflu is not commonly used to prevent or treat the flu, since it has to be started within the first 48 hours of illness, and the flu is usually not life-threatening. But among older people, especially in nursing homes and those with weakened immune systems, flu can be deadly. Indeed, it kills between 30,000 and 40,000 Americans each year. Dr. Ross warned, "This is potentially bad news, especially for those seniors who would not survive a bout of the flu and depend upon rapid treatment, or even better, prevention. These results may not persist, however, as the flu becomes more widespread and newer strains emerge--it's still early in the flu season. Another option is the anti-viral drug Relenza (zanamavir), but this must be inhaled and thus is not as easily administered."
Dr. Whelan added our oft-repeated reminder: "Of course, everyone should still get their flu shot, which is safe and usually protective. Even though flu can be deadly, only one-half of those who should get the shot a ctually do so. It is available in many drugstores as well as doctors offices and emergency rooms." Apparently this still need to be repeated, so please, get your flu shot!
NYC Board of Health Derelict
ACSH staffers didn't know whether to be amused, or nauseous after reading Sunday's New York Post, which reported that as many as 20 percent of the city's eateries haven't had been inspected since July 2007." This is exactly what we've been warning about," pointed out Jeff Stier. "The Health Department has been chasing trans -fats, overstating the dangers of second hand smoke, and g iving out "free" vouchers for organic vegetables, but they have been derelict in their most basic duty: making sure restaurants meet basic sanitary requirements," fumed Stier.
December 19, 2008
Sugar, Cigarettes, Mercury, Phthalates, and Statins
Smoking cessation before surgery reduces risk of complications
Quitting smoking before surgery greatly decreases a patient s risk of postoperative complications. In a new study, 41 percent of the control group of smokers who did not quit before surgery experienced postop complications, as compared to only 21 percent of the smoking-cessation group.
There s also a very strong linear correlation between the amount of time the person is not smoking before the surgery and the rate of complications afterwards, says ACSH s Dr. Gilbert Ross. For patients who stopped smoking at least three weeks before the procedure, the rate of complications dropped to 15 percent. The rate rose to 22 percent among those who stopped smoking one to two weeks before surgery, while those who failed to quite had a 37 percent rate of complications.
While patients should be advised to stop smoking for as long as possible before a scheduled surgery, they can still reap some benefits if even they quit five or six days before the procedure, says ACSH s Dr. Elizabeth Whelan.
Is breakfast really the most important meal of the day?
A new study finds that eating a healthy breakfast may be an indicator of a healthier overall diet and an appropriate body weight but the article seems to be a bit confused about what counts as healthy. Dr. Ross points out, First they refer to pastries as a bad breakfast, and then they call steak and eggs unhealthy but putting those foods in the same category is ridiculous.
He believes, There is probably a major confounder in this study: people who eat a healthy breakfast are generally going to have a healthier approach to their whole diet. It doesn t all boil down to their choice of breakfast food.
Don t blame sugar for hyperactivity
ACSH is devoted to debunking junk science, so we are glad that the British Medical Journal has published an article calling the idea that eating sugar makes kids hyperactive a medical myth. Dr. Whelan says, Any excitement or energy children show is always blamed on sugar, especially around Halloween. It s nice to see sound science finally coming through.
Still think your kids are hyperactive after eating candy? The authors suggest, Any difference [in children s behavior] may be all in the adults minds.
Another day, another study on phthalates
The National Research Council is advising the Environmental Protection Agency to do an assessment of phthalates, the group of chemicals found in soft plastics that have been the focus of heated debates in the public health community and that were banned by the U.S. Congress this year.
How much more can they do with additional assessments after they ve already banned them? Dr. Ross wonders. It s a case of executing the defendant and then deciding to have a trial. Read more about the phthalates scare next week in our Top 10 Unfounded Health Scares of 2008.
New Yorkers are living longer
New York City Mayor Michael Bloomberg announced yesterday that the average life expectancy for New York City residents has increased by four months since 2005. The city health department seems to taking all the credit for it, Dr. Whelan says. But where s the credit that should go to the pharmaceutical companies for keeping us alive longer with statins and other important drugs?
Jeremy Piven blames mercury poisoning to get out of play
Actor Jeremy Piven is leaving the play Speed-the-Plow early, claiming that high levels of mercury in his body have sickened him. But the New York Post finds several flaws with his story. This is like forging a note to get out of school, Dr. Ross says. He s using any excuse he can latch on to in order to get out of doing what he s supposed to do.
ACSH s Jeff Stier believes, It s unfortunate that he thought mercury poisoning from eating fish and taking supplements is something people would believe when in fact, it s actually a scare we ve debunked several times.
Resolve to Stay Healthy with ACSH
The holiday season can be an exciting and stressful time, but you should never lose sight of your health. For tips on staying healthy through the New Year and beyond, check out ACSH s health-related resolutions.
December 18, 2008
Obesity Tax, Glucose Control, Male Circumcision, Colonoscopy Warning, and Teen Smoking
By Elizabeth Wade
Obesity tax receives questionable support
ACSH staffers are disappointed by Nicholas Kristof s column in the New York Times supporting Governor David Paterson s proposed obesity tax on non-diet soda. Singling out one product as the sole, or even the primary, cause of obesity is ridiculous and counterproductive, ACSH s Dr. Elizabeth Whelan believes. At least Kristof is candid about the fact that the revenue raised by this tax would be used to build highways, not support obesity-fighting programs.
ACSH s Dr. Gilbert Ross adds, He thinks this tax would be a wonderful disincentive, but its main purpose would really be to raise revenue for the state. It s similar to what we see with funds raised by cigarette taxes being directed away from public health and anti-smoking programs.
He continues, Kristof is dead wrong when he tries to equilibrate the toll of sugar-sweetened beverages with that of cigarettes. Doing so is an insult to public health efforts to reduce the deadly toll of addictive cigarettes. He is also wrong to place blame on high-fructose corn syrup, which studies have shown does not make sweetened sodas any more fattening than sugar would.
ACSH s Jeff Stier points out another problem with the logic that taxes act as disincentives: If a program becomes successful and reduces consumption of a certain product, the state loses the revenue from the tax. Taxing products like soda and cigarettes actually makes state governments addicted to them.
Other media outlets opposing the tax seem to be doing so for misguided reasons. Fox News, for example, argues against exempting diet soda from any future tax because studies have found links between drinking diet sodas and obesity and diabetes.
Dr. Whelan says, This is a terribly mixed up article, while ACSH s Dr. Ruth Kava clarifies, That argument is simply not true. There s a lot of good evidence that drinking diet soda can help people lose weight.
Is intensive glucose control too little, too late for some diabetes patients?
A new study published in the New England Journal of Medicine finds that strict glucose control does not reduce the risk of cardiovascular events in patients with type 2 diabetes. Dr. Kava explains, The patients in this NEJM study had diabetes that was already poorly controlled, and they had had sub-optimal responses to other therapies. They may have been having problems long before they were in this study.
Dr. Whelan points out, These were older patients who didn t take good care of themselves or manage their condition well early in life. Getting good care later in life might have been too late.
Male circumcision may prevent spread of HPV
Not only are circumcised men less likely to contract HIV than their uncircumcised peers, but they are also less likely to become infected with human papillomavirus (HPV), the virus that causes cervical cancer in women (and most cases of genital warts in both sexes).
Male circumcision actually reduces a woman s risk of cervical cancer, because it makes men much less likely to become infected with HPV and transmit it to their female sexual partners, Dr. Whelan explains. It s more confirmation that male circumcision cuts back on the transmission of sexually transmitted diseases, which is something we ve observed for decades.
Dr. Ross concludes, Despite concerns some parents may have about circumcising their male children, it seems that male circumcision is a good idea from a health point of view.
Putting colonoscopy warning in perspective
This week s New York Times article questioning the accuracy of colonoscopies is not as discouraging as it appears, according to an explanatory report by ABC News. The original article stated that colonoscopies detected almost none of the polyps on the right side of the colon, but that seems to be a factor of one particular study and not colonoscopies in general, Dr. Ross explains. A good bowel prep is key to a successful colonoscopy, and patients should make sure they are seeing an experienced colonoscopist.
As Dr. Lee Green, professor in the Department of Family Medicine at the University of Michigan, told ABC News, In theory, if the test were always done perfectly, it could prevent 90 percent of cancers. The real world is a much messier place than the theories of academic sub-specialists.
Could threat of obesity curb teen smoking?
Finnish researchers suggest that warning teenagers that smoking cigarettes may increase their risk of obesity later in life might keep them from lighting up, but ACSH staffers are skeptical. Smoking is well-known to keep people s weight down in the short run, and teenagers certainly know that, Dr. Kava says.
Dr. Whelan agrees, It s unrealistic to believe that you could use this to scare teenagers away from smoking cigarettes. For real tips for curbing teen smoking, check out ACSH s website TheScoopOnSmoking.org.
December 17, 2008
Smoking, Cancer, Diabetes, Heart Disease, and Being Chemical Free
By Elizabeth Wade
Smoking increases risk of colorectal cancer
A recent meta-analysis confirms that cigarette smoking is linked to an increased incidence of colorectal cancer, as well as to a greater risk of dying from the disease. This is something the public health community has known about for a long time ACSH even covered it in our booklet Cigarettes: What the Warning Label Doesn t Tell You but I think the news will be a shock to 99 percent of the general public, says ACSH s Dr. Elizabeth Whelan. The link is so strong that doctors are talking about changing screening guidelines so that smokers are screened for colorectal cancer earlier and more often.
Cigarettes are deadly in so many different ways, says ACSH s Dr. Ruth Kava. Dr. Whelan agrees, It s amazing how dangerous they are when used as intended! ACSH encourages all smokers to resolve to quit in 2009, but we understand how challenging the process can be most smokers attempt to quit four to six times before they succeed. But as Dr. Kava says, The wagon is still there. If you fall off, you can always climb back on.
And remember: while quitting aids like nicotine patches, smoking cessation drugs, and smokeless tobacco will help curb your cravings, an emotional support system is still very important for successfully kicking the habit.
Death rates for heart disease and stroke drop dramatically
We are pleased to hear that death rates for heart disease and stroke dropped significantly in the U.S. between 1999 and 2006. As Dr. Gregg C. Fonarow, a cardiologist at UCLA's Geffen School of Medicine, says, It s one of the most remarkable achievements of modern medicine to have this kind of decline.
Dr. Whelan credits recent increases in the use of statins and the fact that fewer people are smoking. But, Dr. Kava points out, There is some doubt that the decline is going to be maintained because risk factors like obesity, physical inactivity, and diabetes are all climbing. We ll have to see where it all balances out.
Can California go chemical free?
A government panel in California recently issued an impossible recommendation: California should immediately start reducing toxic chemicals in the state s products and manufacturing. If they could do that, manufacturing would drop to zero, Dr. Kava says.
They want to be free of chemicals, which is impossible as our Holiday Dinner Menu shows, Dr. Whelan says. This kind of chemophobia is contributing enormously to skyrocketing costs in California.
Diabetes makes some cancers more deadly
A new study shows that cancer patients with diabetes are about 40 percent more likely to die in the years following their diagnosis than those without diabetes. The increased risk of death is particularly significant in patients with uterine cancer, breast cancer, and colorectal cancer.
Diabetics are in a sicker state, so maybe they cannot fight the cancer as successfully, Dr. Whelan says. Researchers also believe that patients may pay less attention to their diabetes after they are diagnosed with cancer, increasing their risk of complications. Also, some cancer therapies can increase blood sugar levels and make diabetes patients more prone to heart disease and other complications.
Book of the Day
Dr. Whelan just finished reading the new book Poisoned Profits: The Toxic Assault on Our Children and says, I ve read a lot of insane books in my life, and this is absolutely the most insane. The authors, Philip and Alice Shabecoff, argue that miniscule amounts of toxic chemicals in food and many household products are causing increases in childhood cancer and autism. They say that the principle the dose makes the poison is out of date and that even the smallest amounts of some chemicals in these products can kill people, Dr. Whelan explains. It s very sad because people are going to be unnecessarily alarmed by this book and get completely distracted from real ways they can protect their children.
December 16, 2008
Light Cigarettes, Obesity Tax, Price Controls, Rheumatoid Arthritis, and Colonoscopies
By Elizabeth Wade
Supreme Court allows light cigarette lawsuits to proceed
In a 5-4 decision, the Supreme Court ruled that plaintiffs may sue Altria for its deceptive marketing of light cigarettes but not for the reason you may think. Rather than seeking damages based on health claims, which are pre-empted in state courts by federal labeling requirements for cigarettes, the plaintiffs instead argued that Altria committed fraud by falsely advertising light and low tar cigarettes as healthier than traditional cigarettes.
They argued that the fact that it was a health claim was beside the point, explains ACSH s Dr. Gilbert Ross. This is a very narrow case, so contrary to what the New York Times editorial board thinks, it does not set a precedent for all pre-emption cases. Instead, it is about false advertising, albeit about a health related issue the fact that the cigarette companies had data showing that smokers inhaled more deeply and more often when smoking light cigarettes but still implied in advertisements that they were healthier.
ACSH s Dr. Elizabeth Whelan says, This is the first time the Supreme Court has weighed in against tobacco companies, and I think it will be a huge setback for them.
New York plans to tax non-diet soda
New York Governor David Paterson recently announced a plan to establish an obesity tax of 15% on non-diet soda drinks, which some estimate will raise $404 million a year for the state. If we are taxing drinks because of calories, what about milk and juice? Dr. Ross asks. This obviously has nothing to with fighting obesity. Dr. Whelan agrees, Like cigarette taxes, it s really just a means of generating money. It has nothing to do with fighting a health problem.
U.S. would pay for drug price controls with shortened lives
A new study from the RAND Institute finds that instituting price controls on prescription drugs in the United States would result in substantial losses to consumers in terms of reduced life expectancy. When you restrain prices for innovative products like pharmaceuticals, you ll pay a different kind of price down the road, Dr. Ross says. There is a long-term detriment in terms of reduced quality of life and shorter life expectancy. People will be sicker without innovative new drugs.
Study questions accuracy of colonoscopies
Colonoscopies appear to detect only 60 to 70 percent of colon cancer cases, instead of the 90 percent they were previously believed to detect. They are particularly inaccurate in the right side of the colon, where, according to a new study, they failed to detect almost every cancer.
These numbers are staggering and their implications are scary, Dr. Whelan says. However, many doctors point out that preventing 60 to 70 percent of cases of one of the leading cancer killers in the U.S. is still an impressive statistic. We strongly believe that people in the groups indicated for colonoscopies should rigorously adhere to the guidelines, Dr. Ross recommends.
While researchers investigate ways to improve the test itself, the best things patients can do to increase the accuracy of their colonoscopies are, as the New York Times says, be compulsive about their bowel prep and be sure the test is done by one of the best colonoscopists in their area.
New approach to treating rheumatoid arthritis works
Treatments for rheumatoid arthritis have greatly improved over the past decade, and ACSH staffers are glad to hear it. We now know that rheumatoid arthritis is a progressive and erosive disease that destroys the joint tissue, explains Dr. Ross, who was a practicing rheumatologist. While we used to wait for major changes to occur before starting aggressive treatment, we now understand that a better course of action is to hit hard with three or four powerful drugs to stop the disease in its beginning stages. It s a devastating disease if it s not treated properly, and if you wait for disability to occur it s far too late.
December 15, 2008
Breast Cancer, Whooping Cough, Mercury Warnings, Colon Cancer, and Quitting Smoking
Many studies presented at breast cancer symposium
ACSH staffers are disturbed by the definitive report presented at the San Antonio Breast Cancer Symposium arguing that taking hormone replacement therapy (HRT) increases the risk of breast cancer for menopausal women. The article is very firm in saying that the risks of HRT outweigh its benefits, says ACSH s Dr. Elizabeth Whelan.
ACSH s Dr. Gilbert Ross reminds us, however, The risk-benefit discussion about HRT extends far beyond the possible slight risk of developing breast cancer. When you hear people making definite statements about controversial subjects, it should raise a red flag.
He also points out that the scientists who presented this information about HRT have a history of making similar claims and seem to have a very strong axe to grind in terms of tying hormones to breast cancer. For more information, stay tuned to ACSH for an upcoming paper analyzing the true benefits and risks of HRT.
Among the other reports from the symposium that piqued our interest is a study indicating that women with tumors that test positive for an amplification of the HER2 gene are more likely than other breast cancer patients to experience a recurrence, even if their tumors are small. It seems to say that even women with small HER2-positive tumors should be treated with Herceptin, a drug that greatly reduces the risk of recurrence in women with HER2-positive cancer, Dr. Ross says.
Finally, a third study indicates that women whose breasts become less dense after taking the chemoprevention drug tamoxifen have a lower risk of breast cancer. While this is an interesting idea, you can t hang your hat on it yet, Dr. Ross believes.
Colon cancer gap widens between blacks and whites
More black Americans than white Americans die each year of colon cancer, and the racial gap appears to be widening. While some scientists point to lower screening rates and poor access to quality health care among blacks as the main causes, ACSH staffers wonder if genetics may also contribute to the gap.
We know that black males are genetically more prone to prostate cancer than white males are, Dr. Whelan says. I wonder if something similar is going on with colon cancer. Dr. Ross adds, Hispanics, despite an even lower rate of screening than blacks, have a lower death rate from colon cancer so there must be some genetic basis for the increased death rate among black Americans.
Whooping cough cases surge in Ohio
The number of pertussis, or whooping cough, cases around Cincinnati has increased dramatically this year, resulting in children who are suspected to have the highly contagious disease to be sent home from school pending a doctor s note.
These kids received the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine, which appears to be wearing off, Dr. Ross says. I think it s time to encourage a DTaP booster shot in the middle school or even late elementary school years. For more information about vaccines, see ACSH s booklet What s the Story? Childhood Immunizations.
FDA encourages seafood consumption despite EPA s mercury warnings
The Food and Drug Administration (FDA) wants to amend a governmental advisory warning against mercury in fish, saying that the benefits of eating seafood outweigh the risks. This reversal of opinion puts the FDA at odds with the Environmental Protection Agency (EPA), which maintains that mercury levels in seafood can be particularly dangerous for pregnant women and children.
I can t even remember a time when the FDA and the EPA simultaneously issued opposite recommendations, Dr. Whelan says. Dr. Ross believes the FDA s switch can be attributed in part to the fact that it pays more attentions to humans and our health than the EPA does.
Dr. Whelan concludes, ACSH supports the FDA decision and reaffirms our position that the FDA is the more scientific and commonsense-oriented of the two agencies.
For more information on the risk-benefit analysis of eating seafood, read Dr. Ross s Facts and Fears post Eat More Fish: Your Baby and Your Heart Will Thank You.
Could smokeless tobacco help Obama kick his cigarette habit?
Anti-smoking advocates continue to hope that President-elect Barack Obama will quit smoking before taking office, despite his repeated attempts to kick the habit. Less than 15% of smokers who try to quit manage to stay off cigarettes for one year, Dr. Ross reminds us. President-elect Obama like the rest of the U.S. population has no access to information about how using smokeless tobacco as a harm reduction method could help him quit once and for all.
It s also important to note that most smokers have to try several times before they re successful in quitting, notes ACSH s Dr. Ruth Kava. It's very difficult to overcome a nicotine addiction!
December 12, 2008
Prescriptions, Asthma, Colonoscopies, and Breast Cancer
By Elizabeth Wade
Matt Lauer thinks prescription drugs have gotten out of hand
This morning, the Today Show included a segment entitled, Are we popping too many pills? which host Matt Lauer introduced with the assertion, We are going to tell you about the incredible number of Americans today who are on prescription drugs. It really has gotten out of hand.
ACSH s Dr. Elizabeth Whelan was shocked, saying, The whole premise was that prescriptions drugs are bad when in reality, they save countless lives. ACSH s Dr. Ruth Kava was also disappointed by the statement. Fifty percent of people are taking prescription medications that are helping them deal with their chronic health conditions, she says. How could that be bad?
ACSH s Jeff Stier reminds us, This is not the first time we ve thought poorly of Matt Lauer see his blog on the Huffington Post for more. And for more foolish statements made by celebrities, check out ACSH s publication Celebrities Vs. Science.
FDA changes label on two asthma drugs
An FDA panel has recommended a label change for the asthma drugs Serevent and Foradil to indicate that the long acting beta-agonists should only be taken in conjunction with an inhaled steroid. (Despite the New York Times misleading headline, neither of the drugs will be banned).
The FDA panel only looked at one side of the risk-benefit equation risk, Stier says. ACSH s Dr. Gilbert Ross points out, however, The FDA is responsible for creating guidelines for populations, not for individual patients. Along with Dr. John Jenkins, head of the FDA s Office of New Drugs, Dr. Ross strongly advises patients not to stop taking their asthma medications without consulting their doctors.
For more information about asthma, see ACSH s recent publication Asthma: Causes, Diagnosis, and Treatment.
Some pre-colonoscopy bowel cleansers may cause kidney damage
Two bowel cleansers sometimes prescribed before colonoscopies have been slapped with a black box warning. The FDA says that Visicol and OsmoPrep can cause kidney damage, especially in patients with already impaired kidney function. The agency also warned against some over-the-counter bowel cleansers, including Fleet Phospho-soda.
It s scary to think that these products could cause kidney damage after only one use, Dr. Whelan says. While such an extreme reaction is unlikely in patients without underlying kidney problems, Dr. Kava reminds us, Sometimes people don t know they have impaired kidneys until something catastrophic happens.
Bone drug may help shrink tumors and prevent breast cancer recurrences
Many stories about cancer treatments are coming out of the American Society of Clinical Oncology meeting, but the one ACSH staffers are most interested in today involves the possibility that the bone-strengthening drug Zometa may help patients fight breast cancer.
Women who were given the drug during chemotherapy to help prevent bone loss experienced greater tumor shrinkage and were less likely to need radical surgery. Zometa also appears to reduce the risk of a breast cancer recurrence in women who develop the disease before menopause.
I get the feeling that this was a subset analysis, so now they have to do a randomized clinical trial, Dr. Ross says. He adds, It s unfortunate that none of the current studies of breast cancer drugs involve a comparison with Evista, an osteoporosis drug that was approved for use in chemoprevention of breast cancer a few years ago. For more on a similar topic, see ACSH s publication Chemoprevention of Breast Cancer.
Celebrating the holidays with ACSH
Going to a Holiday Party in the next week or so? Please tell people you talk with about ACSH and invite them to join you as a Morning Dispatch reader and an ACSH supporter. Our Holiday Dinner Menu is always a fun and thought-provoking topic
December 11, 2008
Flu Shots, Viagra, Obesity, Cancer, Alternative Medicine, and Nuts
By Elizabeth Wade
Many flu shots will go unused this year
ACSH staffers are disappointed that only one-third of U.S. adults have received a flu shot this year and only one-half are planning to do so before flu season ends. Who wants to suffer from influenza if you don t have to? wonders ACSH s Dr. Elizabeth Whelan. How many messages have we seen about getting a flu shot? And they are available many places, including many drug stores, so getting one is quite convenient.
While shortages of the influenza vaccine have been a problem in recent years, a record 146 million doses are available this flu season. There is no way all of those doses are going to be used, notes Dr. Whelan. Why do they make a supply that will have to be thrown out?
ACSH s Dr. Gilbert Ross adds, Apparently the American public needs even more education to know that the flu is often more than a minor inconvenience it kills almost 40,000 of us each year and that the vaccine is painless, safe, and widely available. It amazes me that people are more concerned about nonsensical health risks like phthalates and acrylamide than they are about this real and preventable risk.
New cancer data greeted with pessimism
We wrote yesterday about the many factors contributing to cancer s impending rise to the world s top killer, including longer life expectancies around the world and rising smoking rates in developing countries. ABC News, however, boils the information down to what ACSH s Dr. Gilbert Ross calls a sad and desperate story that puts a bad spin on it.
He explains, Some of the main reasons that cancer is going to be the leading killer is that infectious diseases are in retreat and people are living longer, which is good news. Many cancers, especially in the developing world, are caused by chronic infections and smoking and we should be able to fight those problems.
Happy birthday Viagra!
Viagra debuted 10 years ago, dramatically changing the pharmaceutical industry and our attitudes toward sexual health. Dr. Ross says, It changed the whole discussion about erectile dysfunction, which was essentially an underground issue until Viagra came along.
He continues, I also don t think anybody used the term lifestyle drug before Viagra. While ACSH s Jeff Stier believes that label carries negative connotations for those opposed to the pharmaceutical industry, Dr. Ross reminds us, A big part of medicine is providing a positive service that improves people s lives and Viagra certainly does that for many people. Stier also suggests, It has probably inspired some men who wouldn t go to their doctor otherwise to seek out medical care.
Obesity has as much to do with family lifestyle as with genes
A new study shows that family lifestyle contributes to teenagers weight as much as genetics do. This is nothing new, says ACSH s Dr. Ruth Kava. We know that there s a genetic component to obesity, but obviously lifestyle plays a large role.
Dr. Ross points out, As we delve into the genome more and more, people are going to be spending a lot of time finding correlations between particular genes and various conditions but not all of them are going to be cause and effect relationships. For more on this important difference, see ACSH s publication Distinguishing Association from Causation.
Fear of nut allergies reaches new heights
In a commentary in the British Medical Journal, Dr. Nicolas Christakis from Harvard Medical School posits that the current fear of nut allergies displays characteristics of mass psychogenic illness. It s basically mass hysteria, Dr. Kava explains. Parents are so afraid of their child coming into contact with a peanut that schools have had to ban nuts from everyone s lunches.
Dr. Ross wants the danger posed by food allergies to be put in perspective, saying, I d like to know how many children have suffered illness or death because of an itinerant peanut at school. For more on health scares inspiring mass hysteria, see this piece by ACSH advisor Dr. Glenn Swogger.
Many Americans use alternative medicine
More than one-third of U.S. adults and 12% of U.S. children use alternatives to traditional medicine. This is a particularly disturbing statistic because, as Wallace Sampson, founding editor of the Scientific Review of Alternative Medicine and an ACSH scientific advisor, says, They [alternative medicine practices] are either unproven or disproven.
Dr. Ross also points out that faith in alternative medicine can distract patients from traditional medicines and treatments they may need. If someone is devoted to alternative medicine, almost all a doctor can do is say, that s fine, but don t forget to take your blood pressure medication as well.
December 10, 2008
Cancer, Weight Loss, Vitamins, Overdoses, and Drug Advertising
Cancer will become world s top killer
The World Health Organization (WHO) reports that cancer will be the leading cause of death by 2010, overtaking heart disease as the world s top killer. There s a multi-factorial explanation for why cancer is becoming the leading cause of death worldwide, explains ACSH s Dr. Elizabeth Whelan. The number of deaths from heart disease and infectious diseases are declining, while in the developing world smoking rates are rising and people who don t smoke are generally living longer.
Forty percent of the world s smokers live in India and China, which sets those countries up for major public health problems down the road. Meanwhile, both cancer incidence and mortality rates from cancer are declining in the United States good news that shouldn t be overlooked even while considering the WHO s new data.
Weight loss is difficult but paying people may help
Oprah is speaking candidly about her recent weight gain, which has caused her to reach 200 pounds. Here is a woman with all the support systems in the world and who knows everything about how to lose weight, but she s still having trouble, Dr. Whelan observes. It shows how hard it is for anyone to keep the weight off. ACSH s Cheryl Martin finds Oprah s candor refreshing, saying, She s not blaming anybody and is taking responsibility for her actions and her body.
While it might not work for the already wealthy Oprah, paying people to lose weight seems to provide the extra incentive they need to shed pounds. The only trouble is that when you stop paying them, the weight comes back, says ACSH s Dr. Ruth Kava. She believes, The best way to deal with obesity is prevention.
Preventing obesity may save you from a whole host of related health problems including chronic headaches, according to a new study. Another day, another consequence associated with obesity, Dr. Whelan says. For more on this topic, see ACSH s recent publication Obesity and Its Health Effects.
Fatal drug overdoses are a growing problem
Drug overdose is now the second-leading cause of accidental death in the United States, with many being caused by abuse of prescription painkillers. Many of these deaths are concentrated in the rural South, Dr. Whelan says. I was not aware that this was such widespread problem.
In West Virginia, for example, two-thirds of fatal overdoses were caused by legal drugs the person had no prescription for. Do doctors have some blame here? Dr. Whelan wonders. ACSH s Dr. Gilbert Ross says that while some people can probably fool several doctors into giving them painkiller prescriptions, which they can then either use or sell, some doctors are negligent, dishonest, or just careless.
Antioxidant supplements and vitamins disappoint again
A new study shows that taking selenium, vitamin C, and vitamin E supplements will not prevent men from developing prostate cancer. It seems like every week there s a new study showing that vitamins aren t as helpful as the people who are marketing them tell us they are, says ACSH s Jeff Stier.
Dr. Kava explains, Some vitamins appear to have beneficial effects in observational studies, but those conclusions are not supported when randomized clinical trials are done. For example, observational studies suggested beta-carotene supplements might prevent cancer, but clinical trials of the supplement did not bear out this suggestion. And since randomized clinical trials provide more accurate data, we should be careful about jumping to conclusions based on observational studies alone.
DTC advertising faces restrictions
As the new chairman of the House of Representatives Energy and Commerce Committee, Rep. Henry Waxman wants to limit direct-to-consumer (DTC) advertising for new medicines. PhRMA has responded by placing some voluntary restrictions on drug companies DTC advertising. Clearly PhRMA is under pressure and is trying to preempt Waxman s efforts, Stier says.
Dr. Whelan explains, There are both benefits and risks of DTC advertising. One risk is that patients can become so enamored of a particular drug that they demand it from their doctors. But Dr. Ross points out, The doctor should still only prescribe drugs that are appropriate for each patient s situation. Plus, people can find out about the symptoms of diseases they may not have known they had from DTC advertisements. For more of Dr. Ross s take on the issue, see his 2007 op-ed in TCS Daily.
December 9, 2008
Info, Menthol, Asthma, Syrup, Flu, Pork -- Psych!
By Elizabeth Wade
Quote of the Day
"Too much information about drug safety...might overwhelm patients and raise undue alarm...Consumers may forget about the benefits of a medication if they focus only on risk. And the health consequences associated with stopping a medication, particularly for a chronic condition, may be far worse than the possibility of a side effect." -- from Shirley Wang's Wall Street Journal column "Drug Safety Data: Too Much Information?"
Lorillard misses the point of proposed menthol ban
Lorillard Tobacco Company took out an "op-ad" in the opinion pages of the print edition of the Wall Street Journal today. Entitled "No Choice, No Freedom," it focuses on the hotly debated idea of banning menthol cigarettes.
The company asserts that those advocating a ban "claim that menthol cigarettes confer a higher risk for tobacco-related diseases, or that menthol cigarettes are more addictive than non-menthol cigarettes. Yet, the existing body of scientific evidence does not support those conclusions."
ACSH's Dr. Gilbert Ross observes, "They manage to dodge the actual issue, which is whether menthol increases the lure of smoking. Menthol is perceived by some segments of the smoking population as more pleasant."
ACSH's Jeff Stier agrees: "Menthol cigarettes aren't more addictive, but they may make it easier for some smokers to get addicted by numbing them to cigarettes' harsh effects."
Article increases confusion about asthma risk
An article by Tara Parker-Pope in the New York Times' health section explores some surprising -- and perhaps unfounded -- risk factors for asthma. Parker-Pope writes, "How, when, and where a child is born may all play a role in lifetime asthma risk." She goes on to discuss studies suggesting that babies born in the fall, babies born via C-section, and babies born in the United States have an increased risk of asthma.
ACSH's Dr. Ruth Kava finds the core of the article to be very confusing. "One of the ideas about why more children are developing asthma now is the hygiene hypothesis, which states that children who aren't exposed to a variety of pathogens early in life have a greater risk of developing asthma than their peers who were," she says. "But then there are others who assert that the reason for the increase in asthma is increased exposure to environmental factors and allergens. So which is it?"
Dr. Ross says both could technically be true but adds: "There are a bunch of confusing messages from these studies. What's the typical asthmatic, or a parent of one, to believe?" For the facts about asthma, see ACSH's recent publication Asthma: Causes, Diagnoses, and Treatment.
High fructose corn syrup found to be safe -- again
ACSH staffers aren't surprised by the "news" that high fructose corn syrup is no worse for health than sugar is. "This is such old news. It's been out there for years," Dr. Kava said. "The alleged link between high fructose corn syrup and increased obesity came from just one paper published in 2004 and hasn't been supported by other research." In fact, one of its authors wrote the new study debunking those previous claims.
Irish pork recalled in dioxin scare
News of the latest food contamination problem comes from Ireland, where some pork products have been found to contain elevated levels of dioxins. The Irish government has warned against eating its country's pork products and has even recalled much of the meat.
But, Dr. Ross points out, "The levels of dioxins they are worried about are too low to have any negative health effects. This sort of food 'contamination' should not be confused with salmonella or E. coli, which are bugs that can do real harm and even kill. This, on the other hand, is just a scare based on an arbitrary regulatory guideline."
It's never too late to get your flu shot -- or maybe half of one
A new study shows that half the standard dose of the flu vaccine produces the same immune response as a full dose in people under fifty. Dr. Ross reminds us, "In senior citizens, the standard dose does not result in as strong an immune response, and they may even need a double dose of the vaccine." The new information about half-doses could help us distribute limited supplies of the vaccine more effectively among different segments of the population.
But the most important information about flu shots is that it is still not too late to get one this year. Flu season does not peak until January or February and lasts until March, so December is still a good time to be vaccinated.
Correction
In yesterday's Morning Dispatch, we stated that Jeff Stier spoke at a meeting of the American Academy of Addiction Psychologists -- but the name of the organization is actually the American Academy of Addiction Psychiatry. Thanks to ACSH Trustee Dr. Nigel Bark for pointing out the mistake.
Jeff's presentation about conflicts of interest went so well that he is considering returning to next year's AAAP meeting to speak about harm reduction and smokeless tobacco. Even though the AAAP tends to focus on addictions to alcohol and illicit drugs, Dr. Ross points out, "in terms of mortality, they ought to be paying more attention to the addiction to cigarettes."
December 8, 2008
Presidential Smoking, Malaria Vaccines, Asthma Drugs, Food Safety, and Toxic Toys again
By Elizabeth Wade
Psychologists welcome ACSH s stance on conflicts of interest
ACSH s Jeff Stier traveled to Florida last week to participate in a debate about conflicts of interest at a meeting of the American Academy of Addiction Psychologists.
They are the people fighting on the front lines of these issues because they need effective medications to treat their patients, Stier says. Trustworthy information is essential to them, and they were very open to what I said. Many people expressed gratitude that someone is taking this side during the witch hunt that sees any researcher who has ties to industry as suspect.
See ACSH s report Scrutinizing Industry-Funded Science: The Crusade Against Conflicts of Interest.
Obama still struggling to quit smoking
President-elect Barack Obama is still smoking cigarettes, and he discussed his addiction with Tom Brokaw in an interview that aired on yesterday s Meet the Press. He seemed to give the message that he s still smoking, but won t do so inside the White House, observes ACSH s Dr. Elizabeth Whelan.
Obama conceded that the stress of the campaign made it very hard to quit, and on that note, ACSH s Dr. Ruth Kava says, I d be very surprised if he could quit smoking while he s president either. ACSH s Dr. Gilbert Ross says Obama s struggle shows how devilishly hard it is to quit.
Many previous U.S. presidents have smoked in fact, the White House wasn t declared smoke-free until then-First Lady Hillary Clinton pushed for a ban in the early 90s. The print edition of the free daily AM New York has an interesting sidebar about some presidential smoking habits Ulysses S. Grant died of throat cancer after smoking cigars for many years, and Lyndon B. Johnson couldn t kick the habit even after his second heart attack. (He died of his third.)
Malaria vaccines show promise
Studies published in the New England Journal of Medicine point to promising results in the development of malaria vaccines. An effective malaria vaccine would be a huge boon for public health in many parts of the world, Dr. Ross says. We hope this exciting research can be put into practice as soon as possible.
FDA warns against certain asthma drugs, but not everyone agrees
The FDA has issued a warning about Advair, Symbicort, Serevent, and Foradil four l ong-acting beta agonist drugs (LABAs) used to treat asthma but not all doctors and officials are convinced that the medicines pose a threat.
For example, the New York Times reports that Dr. Badrul A. Chowdhury, director of the division of pulmonary and allergy products at the FDA, cautioned in his own assessment that the risk of death associated with the drugs was small and that banning their use would be an extreme approach that could lead asthmatics to rely on other risky medications.
The increased risk didn t even attain statistical significance in most of the studies, Dr. Ross says. Plus, the risk seems to go away if you use LABAs in combination with steroids and the labels for Serevent and Foradil even instruct doctor s to prescribe them as such.
For more information about asthma and how to treat it, see ACSH s recent publication Asthma: Causes, Diagnosis, and Treatment.
NYC Councilman rails against toxic toys
ACSH staffers are disappointed that New York City Councilman Eric Gioia has jumped on the toxic toys bandwagon just in time to scare parents during the holiday season. The new regulations regarding phthalate and lead levels make this scare even easier t o publicize this year because many toys must be pulled from the market by February 2009.
There s no science behind the new laws, but from a political point of view it s perfectly logical to call for these toys to be pulled from the shelves now, Dr. Ross says. Stay tuned for more coverage of this scare in our upcoming roundup of the top 10 health scares of 2008.
The NY Times weighs in on TB, food irradiation
Two opinion pieces in the New York Times caught our eyes this weekend. In the first, columnist Nicholas D. Kristof confronts the problem of extensively drug-resistant tuberculosis (XDR-TB) in Armenia and considers the danger of the disease spreading to other parts of the world.
This is another example of why we need the pharmaceutical industry to keep doing research on new drugs, Dr. Kava believes. One day we may be able to treat XDR-TB. Dr. Ross added that the same incentives for research should be applied to developing effective drugs against resistant bacteria such as MRSA, although the current political climate is not conducive to pharmaceutical research.
The other piece is an editorial about food safety in the United States and we are extremely pleased that it includes a positive message about food irradiation. The Times deserves two cheers, because while it s great that they mentioned the benefits of irradiating spinach and iceberg lettuce, there are many other approved uses of irradiation that weren t included in the article, Dr. Ross says. For more information on food irradiation, see ACSH s publication Irradiated Foods.
December 5, 2008
Measles, Contagious Happiness, Infertility, CPSC, Feeling Young, ASK ACSH Video and A Year In Medicine
By Gilbert Ross, M.D.
Measles deaths way down due to vaccinations
Hopeful news coming from the W.H.O. indicates major progress in the global battle against measles. This viral infectious disease, primarily among children, was regarded in the U.S. as a minor problem. Indeed, measles parties were held to spread the infection purposely, thus gaining immunity and preventing more severe disease manifesting in adulthood. Then we got the measles vaccine, in 1963, and measles has almost disappeared here. This is far from the case in the poorer regions of the world, where measles continues to extract a frightful toll. The recent decline is impressive from 750,000 deaths in 2000 to 197,000 in 2007 representing a 74% decline, an amazing accomplishment. But that still means almost 200,000 preventable deaths. More vigorous efforts need to be made in pockets of contagion: India, Pakistan, Bangladesh, Nigeria and the Congo.
Is happiness as contagious as the flu?
Well everything seems to be going viral these days obesity, pessimism about the economy now happiness also, according to fairly silly report out of Harvard and published in the usually respected journal, BMJ-online. The author, a Dr. Christakis, is a medical sociologist. That designation alone makes me skeptical about such data. Anyway, the semi-quantitative methods he and his co-author used seem bizarrely inappropriate to such vague measures and unreliable data collection methods. This did not stop Dr. Nancy Snyderman from highlighting this study on her segment of the Today Show on NBC complete with detailed analytical tools of limited value on such a study. In any event, what are we supposed to do with this information?
Does second hand smoke make women infertile?
We here at ACSH have become primed to regard new data alleging major harms from second-hand smoke (SHS) as part of the junk-science campaign to aggrandize these effects and ease the path for more stringent restrictions on smoking. In fact, ACSH fully supports increasing such restrictions in order to lower smoking rates but we oppose at every instance the fudging and manipulation of data to support any cause no matter how beneficial the ends desired. This report exemplifies the lengths to which advocates will go to squeeze their agenda into a scientific study. Asking women to recall the presence of SHS when they were children is a giveaway that this is not a well-designed nor controlled study. Further, the increased risk of pregnancy or fertility problems< /a> in the 25%--39% range are of no significance in such a retrospective analysis (although that unarguable fact did not prevent one of the researchers from describing the results as breathtaking.).
We should take note of the fact that SHS (also know as environmental tobacco smoke, ETS) has been shown to have many adverse health effects, especially among children and pregnant women. We just want the scientific facts kept straight on this and all subjects. See our publication, Environmental Tobacco Smoke: Health Risk or Health Hype?
Consumer advocates try to force the CPSC to break the law
Two activist groups have sued the Consumer Products Safety Commission to force the withdrawal of toxic toys from stores shelves more than two months before the law requires them to do so. Never mind that a)these groups Public Citizen and the NRDC fought for this law to be passed; and b) they are now advocating that the CPSC ignore and violate the law to accelerate the nonsensical ban; and c) there was never any science behind the law banning toys with the plastic flexibilizer DINP (a phthalate) and other similar substances. The law clearly states that manufacturers must phase out DINP by Feb. 10th not that all products with DINP must be removed right away. But these groups don t care about enforcing the law they are solely concerned with promot ing their anti-chemical, anti-business agenda.
As usual, no scientists who know better have come forth to speak out against this baseless campaign. As our own Cheryl Martin, ACSH s associate director, said, I don t understand all this uproar about toys we grew up with much less regulation, and no child was ever harmed by their toys.
70 and 80 are the new 55 and 60: elders look and feel young!
This report is a light-hearted attempt to spread happiness among our senior citizens, hoping it will turn viral (oops, I guess we did that story already). Seriously, a new study in the journal Gerontology: Psychological Science informs us that people over 70 feel between 10 and 13 years younger than their actual age. They feel that they look younger as well. Again not sure what to do with this information, but I know it works for me I m 61, and I refuse to believe it. Inside, I m actually a teenager! Let s party!
Time Magazine has come out with their annual The Year In Medicine
I have no intention to go over all 37 items (why couldn t they stick to the tried-and-true A to Z, which would come to 26?). But I feel it my duty to take note of a few of the more egregiously alarmist now, and will have more to say on Monday:
The section on autism alleges a war over whether childhood immunizations are linked to autism. That war was won by sound science years ago and I don't know why TIME wants to dredge up the thorougly discredited vaccine-autism link. I was really disappointed with this entire year-end review.
They seem worried that Chinese applications of genetically-modified food will cause major contamination of the global food supply (and this is not supposed to be science-fiction).
The item on Gardasil, the anti-cervical cancer vaccine, goes to some lengths to note the allegedly large numbers of girls who have sustained serious side effects from the vaccine. This theory has also been thoroughly debunked by epidemiological studies.
They continue the drumbeat of fear about the ubiquitous and completely safe chemical, bisphenol-A, scaring parents needlessly about their baby bottles.
And, as for the real, proven, most dangerous and preventable cause of disease and death in America cigarettes they contribute the key fact that quitting causes a chain reaction. Is that all they can muster on this crucial topic? Perhaps if they stopped frettin' about tiny doses of chemicals they could devote some space to educating their readers about real risks.
Note: Our own Jeff Stier gave a very well-received lecture this morning in Florida to The American Academy of Addiction Psychologists, on Conflicts of Interest. Ironically, he and other speakers were asked to sign a disclosure form, which of course stuck strictly to financial and consultative conflicts, ignoring other more important potential biases.
Your seat at the table: Ask ACSH
Earlier this month Ask ACSH received an inquiry about MSG and health. And as promised, we responsed. Remember you too can join us at the ACSH breakfast table by participating in our Ask ACSH webcast. E-mail your questions about public health and other issues ACSH regularly tackles to AskACSH@acsh.org and we will feature a video response from our experts in a future Morning Dispatches, as well as on our YouTube channel. This webcast is designed with you in mind. ACSH experts are always just an e-mail away!
December 4, 2008
Anniversary, Obesity Book, Internet Misinformation, Salt, Healthy States, and Toxic Toys
By Elizabeth Wade
Celebrating 30 years of ACSH
Today is ACSH s 30th anniversary! We d like to thank you for your support over the years, and we hope to continue promoting commonsense and sound science for many years to come.
Today also marks the fifth anniversary of ACSH's spectacular 25th anniversary gala dinner, which featured scientific and media luminaries such as John Stossel, Chris Buckley, Barry Farber, Dr. C. Everett Koop, Dr. D.A. Henderson, Dr. Bruce Ames, Dr. Norman Borlaug, and Dr. Scott Gottleib, who represented the FDA in offering a tribute to ACSH.
ACSH explores the consequences of obesity
ACSH s latest publication, Obesity and Its Health Effects, is now online. It explores the negative effects obesity has on almost every body system, from the musculo-skeletal system to the respiratory system and even the skin. With our country currently facing an unprecedented obesity epidemic, this publication is a must-read.
Medical information found online can be misleading
Two stories highlight the dangers of trusting medical information found on the Internet. Last night, CBS Evening News covered the story of a nurse who looked for information online after being diagnosed with breast cancer, only to find out that much of it was misleading and even dangerous. If a nurse doesn t know where to go to get good medical information, how is the general public supposed to know? ACSH s Jeff Stier wonders.
Meanwhile, MSNBC warns against sites that offer stem cell therapies, saying many of them hype miracle cures that are far from having been proven effective or even safe. The Internet has unleashed a torrent of misinformation, says ACSH s Dr. Gilbert Ross. Giving patients and consumers all this medical misinformation is not the same as educating them.
ACSH s Dr. Ruth Kava explains, For example, just because an herbal or other treatment is touted as natural doesn t mean it s safe some can interact with prescribed pharmaceuticals.
CBS offers some important pointers for judging medical information you find online. Always take anecdotal information with a grain of salt, and be sure to check out the medical credentials of so-called experts. Any source offering miracle cures for serious diseases, especially cancer, and any claiming its breakthrough treatments are being suppressed by a medical-industrial conspiracy should be shunned. Most importantly, always talk to your doctor about any medical questions you have.
Salt finally gets the respect it deserves
Nicholas Kristof s latest New York Times column addresses the benefits of providing iodized salt to the developing world. About one-third of the world s population does not consume enough iodine, and as Dr. Kava explains, If a women is iodine-deficient during pregnancy, her child can be born permanently mentally disabled. Indeed, as the Lancet recently reported, Iodine deficiency is the most common cause of preventable mental impairment worldwide.
Iodine deficiency is a real problem that actually causes harm to fetuses and children and it could be ameliorated to a large degree with minimal investment, Dr. Ross says. Just compare this to all the brouhaha about trace levels of mercury in fish or miniscule levels of lead in toys.
Another of salt s benefits is that it acts as a preservative, preventing the growth of dangerous bacteria in foods. A dramatic increase in the incidence of listeriosis in the UK has some people worried that efforts to reduce the amount of salt in foods might lead to even more cases of food poisoning from this dangerous bacteria.
Salt is often unduly blamed for causing or exacerbating hypertension, so it was refreshing to read this pair of articles presenting the other side of the salt picture.
Vermont tops list as healthiest state
Vermont is the nation s healthiest state, according to the latest rankings issued by the American Public Health Association and the Partnership for Prevention. Louisiana replaced Mississippi as the unhealthiest this year. The rankings are primarily based on obesity and smoking rates, but also include categories such as binge drinking, health insurance coverage, air pollution, infectious disease rates, crime levels, and immunization coverage.
This is better than some of the studies that use criteria like the number of health clubs versus the number of fast food restaurants to determine an area s health, Stier says. While Dr. Kava agrees, she also points out, I m not sure that health insurance coverage necessarily correlates to actual health.
Toxic toys scare strikes again!
The toxic terrorists are at it again! Just in time for the holidays, a Michigan-based group called the Ecology Center is claiming that one in three toys on shelves this year are toxic. Other groups climbing on the scare parents at holiday gift-giving time bandwagon are PIRG, EWG and NRDC the usual suspects in such toxic scares.
They know exactly how to time these stories to get themselves at the top of the news, ACSH s Dr. Elizabeth Whelan says. It doesn t matter that these scares have no relation whatsoever to science, health, medicine, or even commonsense.
She reminds us that even when parents and the media were panicking over lead-contaminated toys from China, no child was ever hurt. It is pure scare tactics based on the fact that the lead levels were highter than the extremely conservative guidelines.
Read about this scare and more in our upcoming round up of the top health scares of 2008.
December 3, 2008
Cancer, Generics, Photos, Conflicts of Interest, and Jewish Law
By Elizabeth Wade
Pessimism continues at the NY Times, despite falling cancer rates
The New York Times weighs in on the reported decline in cancer incidence and death in an editorial today. While the editorial board rightly calls the news heartening, ACSH staffers believe it puts too much emphasis on what it calls worrying countertrends.
I m particularly disturbed by the assertion that we have to prevent exposure to carcinogens, says ACSH s Dr. Elizabeth Whelan. What carcinogens are they talking about?
ACSH s Dr. Gilbert Ross notes, They do mention that part of the decline in incidence could be due to fewer women getting mammograms and fewer men getting prostate cancer screenings, which could be a bad thing. But in general, it does seem like they are making lemons out of lemonade.
Cleveland Clinic expands disclosure of conflicts of interest
The Cleveland Clinic will become the first major medical center in the country to publicly disclose the relationships its doctors have with industry, the latest step in singling out medical professionals who collaborate with pharmaceutical companies.
It reminds me of The Scarlet Letter, Dr. Whelan says. Under these new policies, any scientist who works with industry is labeled as different and inferior to other scientists.
Dr. Ross believes that under the observation of groups like the Cleveland Clinic Innovation Management and Conflict of Interest Committee, the burden of proof is going to be on the researchers to show they are not corrupt and how does one prove a negative such as that? Ironically, some of the most complicated cases this committee is addressing have to do with the Clinic s own entrepreneurial activities.
Generics may be just as effective as brand-name drugs
A meta-analysis in the Journal of the American Medical Association (JAMA) finds that despite hesitations about using generics instead of brand-name drugs to treat cardiovascular disease, the generic drugs are just as effective.
Generics may be just as effective as brand name drugs, Dr. Ross says. But like all meta-analyses, this study tries to compare apples and oranges. How do you compare a drug that was new in 1988 and is now generic to a drug that s new in 2008?
The Pharmaceutical Research and Manufacturers of America (PhRMA) quickly released a response to the JAMA findings, but ACSH staffers feel it missed the point of the analysis. PhRMA rightly points out that there wouldn t be generic drugs without the development of new, branded medicines, but they don t really address the main issue of comparing efficacy, says ACSH s Jeff Stier.
Photographs humanize radiology readings
A new study finds that radiologists read scans more thoroughly when the patient s photograph is included in their file. The picture personalizes the diagnostic, Dr. Whelan explains.
The radiologists feel more empathy for the patients after seeing their pictures, Dr. Ross says. But the study also found they reported far more incidental findings when provided with the photos. Incidental findings are not relevant to diagnosis or treatment, so it s possible that the photographs could contribute to health care costs and maybe even needless surgery.
Jewish law encourages vaccinations
An interesting article in the magazine Jewish Action looks at vaccinations through the lens of Jewish law. It s the first time I ve seen a religious angle that s squarely pro-vaccination, Jeff Stier says.
Dr. Edward Recihman, a professor at the Albert Einstein College of Medicine of Yeshiva University and the article s author, does a broad historical analysis to reach the conclusion that Jewish law encourages vaccinations. He writes that rabbis realized that the benefits of vaccinations exceeded their risks, even when vaccinations were first developed and were actually risky, Dr. Ross says.
The first method of smallpox vaccination, for example, involved injecting pus from a patient infected with a mild form of the disease into a healthy person which worked most of the time but could have disastrous consequences. Today s vaccinations are obviously much more sophisticated and do not pose any substantial risk.
December 2, 2008
Halos, Flu, Organic, Poison, HIV, Malaria, Journalism, and Fungus
By Elizabeth Wade
"Health halo" is more dangerous than trans fats
ACSH staffers are impressed by John Tierney's column about the "health halo" that surrounds certain foods or brands -- and that can encourage us to overeat. He particularly examines the effect of a "trans fat free" label on foods and finds that it often gives Americans a false sense that those foods are low in calories.
"When people interpret a 'no trans fat' label, they go way beyond the science and assume they are eating a health food," says ACSH's Dr. Elizabeth Whelan. "Obesity and trans fats are conflated all the time, and it's one of my biggest pet peeves."
We especially like Dr. Pierre Chandon's analysis of the differences between European and American diets: "Too many Americans believe that to lose weight, what you eat matters more than how much you eat. It's the country where people are the best informed about food and enjoy it the least."
Flu vaccine reduces illnesses among college students
A new study finds that college students who get a flu shot are less likely to develop the disease and experience less academic impairment during flu season. While we have no trouble believing these conclusions, ACSH's Dr. Gilbert Ross brings up some problems with the study.
"This is a classic case of an epidemiological magical mystery tour," he says. "Is it not true that the college and university students who get flu shots are already more health conscious, which could also contribute to them experiencing fewer health problems throughout the year?"
He continues, "Of course, it is true that influenza runs rampant among college students during the winter, so the benefits of flu vaccination in terms of reducing flu symptoms is important -- but let's not exaggerate the real effects using flawed epidemiological assumptions."
Eating all organic, all the time
In today's New York Times, Tara Parker-Pope writes about Dr. Alan Greene, a pediatrician who decided to eat only organic foods for three years.
While Dr. Greene maintains he feels more energetic and gets sick less often on his new diet, ACSH's Dr. Ruth Kava raises an interesting point: "He said to cut back on the cost of eating only organic food, he had to cut back on meat. That means he obviously changed his diet, so it's not really a controlled experiment about the effects of organic food."
And ACSH's Todd Seavey points out that asking one person if he feels "more energetic" than he did three years ago is a far cry from a valid study.
For an analysis of the alleged health benefits of organic foods, see ACSH's publication Claims of Organic Food's Nutritional Superiority.
Accidental poisoning still a danger for children
ACSH staffers are surprised by the toll still exacted by accidental child poisonings. In 2004, 86,000 children were treated in the emergency room after ingesting a dangerous substance -- often over-the-counter (OTC) drugs or household cleaning products. These poisonings occurred even though medications, including OTC meds, are required to have "child-resistant" protections.
"This is an actual problem that parents should be aware of, as opposed to many of the other so-called 'toxins' people are so worried about their children being exposed to," Dr. Whelan says. To put more risks in perspective, visit ACSH's Riskometer.
Should HIV screenings start at age thirteen?
The American College of Physicians is now recommending that doctors screen all patients ages thirteen and older for HIV, regardless of their potential risk factors. "This seems like a diversion of resources," Dr. Whelan says. "We know the risk factors for HIV, so why would we have to screen everyone?"
Dr. Ross points out, however, "Many people will not tell their doctors that they have a risk factor for HIV." It is estimated that of the 1 million to 1.2 million Americans infected with HIV, 24-27% are unaware of their infection.
Malaria drug on track for U.S. approval
We're glad to hear that Coartem, Novartis AG's malaria treatment, is being considered for approval in the U.S. It has been used in other countries for many years, but the FDA is currently considering the positive effect it could have on people who return to the U.S. after having contracted the potentially deadly disease during trips abroad.
"Not only are there millions of cases of malaria every year all over the world, but there is also a problem with counterfeit drugs being sold to treat it," says Dr. Ross. "The FDA hasn't approved Coartem yet, but a review panel gave it a thumbs up, which is very good news."
Journalist's conflict of interest exposed
Psychiatrist and radio host Dr. Fred Goodwin has responded to allegations of bias made in last week's New York Times related to his ties to the pharmaceutical industry. He maintains that he never distorted the science and disclosed all of his relationships with drug companies to his producers and to the reporter who wrote the piece, Gardiner Harris.
"Gardiner Harris seems to have taken everything out of context to make his case," says ACSH's Jeff Stier. "I think the real conflict of interest here is him trying to make a career for himself by attacking doctors who have worked with industry."
Quack, quack, quack!
We got a kick out of this video, in which an Italian oncologist explains his belief that cancer is caused by a fungus. "It just shows how much nonsense is still out there," says Dr. Kava. If you find yourself craving some common sense instead, check out ACSH's videos on our YouTube channel.
December 1, 2008
Holiday Menu, FDA, AIDS, Home Cancer Screening, Secondhand Smoke, Smallpox
By Elizabeth Wade
Holiday Dinner Menu in the Wall Street Journal
ACSH staffers were happy to be back at the breakfast table after an enjoyable Thanksgiving. We hope you enjoyed yours as well.
The Wall Street Journal s website celebrated Thanksgiving by posting a story about ACSH s Holiday Dinner Menu, which details the animal carcinogens found naturally at safe levels in our favorite holiday foods.
Honorary seat at the table goes to the FDA
We d like to offer the Food and Drug Administration a seat at the ACSH breakfast table for publicizing its recent approval of irradiation for spinach and iceberg lettuce. While food irradiation has been the target of many unfounded health scares, it is an important tool for reducing the toll of foodborne pathogens. Read more about the process in ACSH s publication Irradiated Foods.
World AIDS Day inspires different reactions
December 1 is the 20th annual World AIDS Day, and this year Dr. Whelan remembers how far we ve come in dealing with the disease in the last two decades. I remember coming out of a meeting about AIDS and thinking that the world was going to end, she says. Today, however, HIV tests and antiretroviral drugs have turned the condition into a chronic disease many people have been living with for years.
That turnaround has some people wondering if the current level at which we funnel money into AIDS research and prevention efforts is improperly taking resources away from other public health initiatives, such as preventing malaria deaths and childhood diseases that take many more lives in developing countries, especially pneumonia and diarrheal diseases. But as ACSH s Dr. Ruth Kava points out, If AIDS were less emphasized than it is, we could really face a huge epidemic.
The New York Times uses World AIDS Day to encourage further research into a study published in the Lancet that used mathematical models to show how AIDS could potentially be eradicated within a decade through widespread HIV testing and availability of antiretroviral drugs.
But as Dr. Ross pointed out in Morning Dispatch last week, the requirements for such a miraculous reduction in AIDS cases are quite idealistic and not likely attainable in the real world. These include: widespread HIV testing, giving HIV drugs to all those who test positive, follow-ups with infected patients, male circumcision, encouraging fidelity, and more.
Meanwhile, the New York City Health Department reports that its initiative to test all adult Bronx residents for the virus has seen some success, with testing rates up 20% in the borough.
Screening for cancer at home
Canada is now encouraging people to perform home screening tests for colorectal cancer. The test screens for traces of blood in the stool, which can be an early sign of cancer (and of many other conditions, including ulcers). This kind of test was part of the routine annual exam when I was in practice, says ACSH s Dr. Gilbert Ross. But since colonoscopies began being encouraged for people over 50, the use of less invasive and less accurate tests has declined.
Dr. Whelan believes, Encouraging home tests is a good thing, but colonoscopies are still the gold standard. ACSH s Jeff Stier wonders, How will this affect the likelihood of patients getting colonoscopies? Because this test can be performed without ever seeing a doctor, you might not be encouraged to get a colonoscopy in addition to the home test.
Dr. Kava suggests this problem might be mitigated if people were required to get the test from a doctor. There could still be oversight if the doctor followed up on it, she says.
Dr. Ross believes, There is the potential problem that this test could create a false sense of security. But I still think more good than harm can be done with the home test.
ACSH advisor takes on junk science about secondhand smoke
ACSH staffers are impressed by the most recent post on Dr. Michael Siegel s blog about tobacco issues, in which he analyzes the information that despite earlier optimism, a ban on indoor smoking in Scotland did not reduce the country s overall number of heart attacks.
There is so much junk science in the anti-smoking community, so Dr. Siegel s efforts really should be recognized, Dr. Whelan says. He s a good watchdog for some of the hyperbole. We re pleased that he has recently become an ACSH advisor, especially considering his support for harm reduction.
Smallpox vaccine provides long-lasting protection
The American Journal of Medicine reports that the smallpox vaccine remains effective for decades after it is given, which is very good news in light of the relatively low numbers of doses of the vaccine currently stockpiled for administration in case of a bioterrorism attack. They found that all the subjects with a history of smallpox or who had been vaccinated against it still had antibodies even the person who was vaccinated 88 years ago, Dr. Kava explains.
Smallpox was eradicated in 1977, but some people worry that the virus could be obtained from a lab and used in a terrorist attack. This new study shows that in case such an attack occurred, the stockpiled vaccines should go to those people who had never been vaccinated, rather than to the entire population. For more information about preparing for a terrorist attack, see ACSH s publication A Citizen s Guide to Terrorism Preparedness and Response.
November 26, 2008
Less Cancer, Less HIV, Less Melamine, and Less Dispatch for Thanksgiving
By Elizabeth Wade
Cancer rates drop
The National Cancer Institute gives us some good news to start our holiday weekend: The overall rate of cancer in the U.S. is declining. For men, the rate of new diagnoses dropped 1.8% per year between 2001 and 2005, while for women the decrease was a more modest half a percent per year. Researchers point to a decline in the incidence of lung cancer among men, tied to their falling smoking rates, as an important force behind the reduction. However, cancer incidence and mortality rates dropped for each of the top three cancers in both women and men.
"This is particularly good news because it will counter environmental activists' claims that there's a 'cancer epidemic' in this country," says ACSH's Dr. Elizabeth Whelan. In fact, the incidence of prostate, colorectal, breast, and (for men) lung cancer has gone down -- but the numbers of some cancers, especially melanoma and kidney cancer, did increase over the same period of time.
ACSH staffers are disappointed, however, that the article implies that the incidence of breast cancer decreased because many women stopped using hormone replacement therapy (HRT) in 2002. "Contrary to widespread public perception, the short-term use of HRT for menopausal symptoms is not linked to an increased risk of breast cancer," explains ACSH's Dr. Gilbert Ross. (Look for an ACSH publication in the coming months about the real benefits and risk of HRT.)
What does appear to increase the risk of breast cancer in women is obesity, according to a different study. "It isn't new information, but I still think many women don't know that being overweight increases their risk of a disease that many of them are so afraid of," Dr. Whelan says. ACSH's Dr. Ruth Kava points out an important fact about the new study: "When women are overweight, it's harder to find lesions in the breast by mammogram. But this study controlled for that and still found they had increased risk."
Could we eliminate HIV?
An optimistic new study in the Lancet posits that HIV could be eliminated within a decade if major public health initiatives regarding testing and drug availability were put in place. "The researchers used computer models, not actual data," Dr. Ross says. "In reality, taking all the steps they recommend -- which include widespread HIV testing, giving HIV drugs to all those who test positive, follow-ups with infected patients, male circumcision, encouraging fidelity, and more -- would involve an incredible amount of infrastructure and pulling together in the public health community. Right now, it's just a fantasy."
Dr. Whelan, however, is encouraged by the theoretical exercise. "AIDS is a relatively new disease, and twenty years ago it was a death sentence. Within ten or twelve years of the first cases, there were very effective treatments available. Today, it's often treated like a chronic disease. And now they're saying it could potentially be eliminated? We've come a long way."
Melamine found in U.S. baby formula poses no risk to infants
Trace amounts of melamine have been detected in baby formula made in the U.S. -- but before you rush to throw it out, heed the FDA's assurance that the chemical is present in such low amounts that it doesn't pose a threat to babies' health.
While thousands of infants were sickened in China because of high doses of melamine being purposely added to formula, no illnesses have been -- or likely will be -- reported in the U.S.
"If you analyze down to the lowest levels of detection we have now, you can certainly find melamine -- and a lot of other chemicals -- in infant formula," Dr. Ross says. "But such low levels do not rise to the level of a risk." Check out ACSH's Riskometer to put other "risks" in perspective.
Enjoy your holiday chemicals!
Thanksgiving always reminds us of the first modern health scare: the "Cranberry Scare" of 1959. "Unfortunately, it's so parallel to what's happening today," Dr. Whelan says. "But the irony is that back in 1959 people were afraid to eat cranberry sauce because trace levels of aminotriazole (which caused cancer in rodents) was found in the cranberry bogs...but it was still fine to smoke cigarettes!" Read more about the Cranberry Scare in ACSH's booklet Facts Versus Fears.
Morning Dispatch will not be published this Thursday or Friday while we at ACSH enjoy our Thanksgiving feasts -- and all the chemicals in them! Check out our Holiday Dinner Menu before you do the same, and stay up to speed with ACSH by following Jeff Stier on Twitter -- he will be updating throughout the weekend!
November 25, 2008
Lawyers, Fat Canada, Blood, Fibromyalgia, Snus, Tumors, and Hairspray
By Elizabeth Wade
Jeff Stier examines effects of lawsuits on consumers' access to pharmaceuticals
ACSH's Jeff Stier has an op-ed on the Manhattan Institute's MedicalProgressToday site about Fred Baron, a wealthy and well-connected trial lawyer who sought out a controversial drug at the end of his fatal battle with cancer.
He writes, "Mr. Baron's struggles...illustrate the complex and personal nature of patients' drug safety decisions and the foolishness of treating pharmaceutical companies (who make life-saving products) like tobacco companies." Stay connected to Jeff and ACSH on Twitter.
Obesity labeled a disability in Canada
Some ACSH staffers question Canada's decision letting severely obese people qualify as disabled, making them eligible for a free extra seat on plane flights. ACSH's Dr. Elizabeth Whelan says, "It seems to legitimize obesity as something that cannot be dealt with."
ACSH's Dr. Gilbert Ross poses the question, "So if you have a medical condition that's your fault, should you be treated differently by not having that condition addressed? What about smokers or those injured as a result of their driving with intoxicated?"
ACSH's Dr. Ruth Kava doubts the extra seat situation will become as controversial as seems on the surface. "It's an interesting issue, but how many people who are massively obese fly frequently?" she asks.
24-hour blood pressure readings give more accurate picture of health
A new study finds that monitoring patients' blood pressure for 24 hours predicts their risk of cardiovascular events more accurately than blood pressure measurements taken in a doctor's office.
"When I was practicing, it always disturbed me that blood pressure is so variable," Dr. Ross says. "This study shows that a good course of action might be to take people whose blood pressure is found to be elevated or borderline a few times in the doctor's office and have them monitor it for a couple of 24-hour periods -- especially before deciding to put them on lifelong medication for hypertension."
Fibromyalgia -- a question of brain chemistry, or maybe "cyberchondria?"
A study showing that some patients with fibromyalgia have abnormal blood flow in the brain has some ACSH staffers wondering about the notoriously vague disorder associated with chronic pain. "There's a large overlap between patients with classic fibromyalgia and those with depression, anxiety, and psychosis," Dr. Ross explains.
Dr. Whelan wonders, "Is fibromyalgia just symptoms looking for a diagnosis?"
Interestingly, Microsoft researchers are studying the chance that people with minor aches and pains, for example, will conduct web searches about their symptoms and conclude they have full-blown fibromyalgia based on the dire information they find about rare diseases. They call the tendency to overreact to health information found online "cyberchondria." "There is much too much junk out there to believe everything you read online," Dr. Whelan says.
Smokeless tobacco targeted again
We're disappointed by an Associated Press story maligning the smokeless tobacco product snus. "The article even quotes people acknowledging that if more smokers switched to snus, rates of heart and lung disease would go down -- but somehow they are still against using it," Dr. Whelan says.
Dr. Kava points out, "They keep saying there's no data on snus's potential for harm reduction, but what about all the positive results that have come out of Sweden?" Swedish men have very low smoking rates -- and much lower rates of smoking-related deaths and illnesses than the populations of other EU countries -- because of their widespread use of snus. For more information on harm reduction, see ACSH's booklet Helping Smokers Quit: A Role for Smokeless Tobacco?
The case of the disappearing tumor
An intriguing new study suggests that some invasive breast cancers may go away without treatment. In Norway, a group of women who had regular mammograms had 22% more cancers than a group of women who did not, and researchers say that the most likely explanation is that some tumors likely disappeared on their own before they were detected in the latter group.
Until there is a way of determining which tumors are likely to recede and which need immediate treatment, this research will not have a practical application. "But it should certainly lead to further investigations," Dr. Ross says. It also calls attention to early detection's possible downsides, which have mostly been discussed in relation to prostate cancer and lung cancer until now.
Dr. Whelan says, "It would be enormously helpful to be able to distinguish dangerous tumors from ones that are unlikely to cause harm. But until we can do so reliably, patients are probably not going to want to take the chance of delaying or forgoing treatment."
Scare links hairspray to birth defects
Another day, another scare: maternal exposure to hairsprays containing phthalates -- among many other ingredients -- is now being blamed for causing genital defects in baby boys. This baseless article will certainly make our list of the Top Health Scares of 2008, which will be released in the coming weeks.
November 24, 2008
Turkeys, Cigarettes, Maggots, Fat, Lungs, Objectivity, and Twitter
By Elizabeth Wade
ACSH comments on the Great American Smokeout
Last Thursday marked the 32nd annual Great American Smokeout, a day when millions of American are encouraged to quit smoking. Learn more about what ACSH medical director Dr. Gilbert Ross has to say about smoking rates, quitting methods, and the tobacco industry in this video.
Maggot therapy wins AMA approval
The American Medical Association (AMA) has approved maggot therapy, a centuries-old practice of putting maggots on infected wounds in order to clean out dead tissue and kill bacteria. The approval may induce insurance companies to start covering the practice.
"When organized medical groups, Medicare, and Medicaid start supporting a medical treatment or practice, it then becomes a tremendous burden on private insurance companies not to support it," Dr. Ross explains.
While the idea of putting maggots on a wound may induce shudders, the larvae used by doctors today are sterile and disinfected. Needless to say, don't try this at home!
Does saturated fat cause small intestine cancer?
ACSH staffers are skeptical of the results of a study allegedly linking cancer of the small intestine to saturated fat intake. "The study points out that eighty people in the sample developed gastric carcinoid tumors -- but that is a type of stomach cancer, not small intestinal cancer," Dr. Ross says.
He continues, "Small intestinal cancer is extremely rare, so any change in incidence would have to be told in absolute numbers, rather than relative numbers, in order to have any significance. The report was completely lacking in such context -- hopefully the study itself is more informative.
Taking a pill for lung cancer
The daily pill Iressa seems to be comparable to chemotherapy for treating lung cancer. Patients receiving the chemotherapy drug Taxotere survived for an average of 8 months, while those on Iressa lived about another 7.6 months. Iressa also boasts fewer and less severe side effects.
"When you're on chemotherapy for lung cancer, you're not in a high survival group," Dr. Ross says. "The only thing that cures lung cancer is surgery -- and not very often." The short survival times highlighted in this study reinforce the importance of reducing your risk for lung cancer -- particularly by quitting smoking.
Radio host investigated for industry ties
Dr. Frederick K. Goodwin, a psychiatrist and host of the public radio program The Infinite Mind, is being investigated for his failure to disclose the fact that he earned at least $1.3 million for giving marketing lectures for drug companies between 2000 and 2007.
"He was advocating the use of particular drug treatments for children with bipolar disorder on his program, for example," Dr. Ross says. "Even if his treatment recommendations were thoroughly valid, it should be mentioned if he made over a million dollars over seven years from drug manufacturers."
Dr. Rossadds, however, "Earning money from drug companies doesn't necessarily make him corrupt. If he believes the positive things he's saying about these drugs on his program, the pharmaceutical companies would obviously want him to give lectures for them."
ACSH's Jeff Stier says, "It would bother me if he went beyond the science whether he is being paid or not. But what if he was on the board of Public Citizen, for example? The underlying potential for bias would be the same." For more information on the conflict of interest debate, see ACSH's publication Scrutinizing Industry-Funded Science.
Elizabeth Wade is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com). Receive ACSH Morning Dispatch in your e-mail in-box each weekday by donating to ACSH and then requesting subscription.