October 22, 2009
ACS, NY Post, ACIP, Dioxin
By Curtis Porter
Brawley and JAMA Against The World
Dr. Otis Brawley, chief medical officer of the American Cancer Society (ACS), is catching some heat after his recent statement in an interview with the New York Times conceding that breast and prostate cancer screenings have historically been oversold by physicians and misunderstood by patients and the media.
"The strident response underscores the fact that it was brave of Dr. Brawley of ACS to come forward and admit this even though it wasn't politically correct and caused a backlash among people in his own organization," says ACSH's Jeff Stier.
"One well-known expert on breast cancer was quoted as saying, in effect, that the more screening you have, the fewer women will die of breast cancer," says Dr. Ross. "That's true. It's also true that if we removed every woman's breasts at age 19 we would virtually eliminate breast cancer. Such statements fail to take into account the effects of detecting indolent lesions, false-positives, which lead to much needless anxiety and surgery. The point is that cancer screening can have downside risks - particularly the risk of detecting tumors that would never be life-threatening, leading to unnecessary invasive diagnostic tests and treatment - and consideration of these downside risks needs to be part of the equation. This is even more true when discussing prostate cancer screening."
A Comedy of Erroneous Logic
Jeff Stier's op-ed in the New York Post last week about New York City's misguided decision to ban flavorings in all tobacco products has ruffled some feathers. Today's Post features two letters--from members of the ACS and American Lung Association, respectively--who seem to have missed the point. Both make for a thumping good read, but the first from Clare Bradley of the ACS is downright farcical:
"[U]sing snus does not eliminate the risk of lung cancer. Smokers who use smokeless tobacco as a supplemental source of nicotine in an effort to quit smoking actually increase their risk of lung cancer ... The best way to quit smoking is not to start, but nicotine-replacement therapy, when paired with a program to help change behavior, is a proven cessation method."
"How people can express such ignorant views in a major news publication, I don't know," says Dr. Whelan. "She has no idea what she's talking about when she says snus causes lung cancer. And how can someone 'quit' smoking if they haven't started?"
"Neither letter is on point, and to the extent that they are, they are false," says Dr. Ross. "Of course people who smoke and use snus do not eliminate their risk of lung cancer. We're not talking about dual use, we're talking about snus as a cessation device. She expects smokers to use 'proven' nicotine-replacement therapies instead--but these methods have been 'proven' to work only 15% of the time."
ACIP Likes Gardasil, Doesn't Love It
The U.S. Advisory Committee on Immunization Practices voted almost unanimously for "permissive" use of the Gardasil vaccine in boys to protect from human papillomavirus (HPV). It is therefore not among those recommended as part of the standard immunization schedule despite the fact that HPV causes genital warts and some types of cancer in males, and cervical cancer in females. The effect of this lukewarm endorsement will be that many insurance plans will not cover it.
"It's very disappointing that they're not giving more robust support for the vaccine in light of all the various benefits it provides," says Dr. Whelan.
Dr. Ross agrees: "HPV is responsible for many anal and penile cancers - and of course genital warts - in addition to cervical cancers. Most importantly, women do not get HPV from the air; they get it from male partners. If you eliminate the virus in men, you eliminate the risk for their partners. This is extremely shortsighted and tantamount to rationing at this point, since the CDC pointed to 'cost-effectiveness' as their rationale for not fully endorsing the vaccine for men and boys."
Dioxin, Most Dangerous Chemical on Earth, Is Not So Dangerous
The American Journal of Epidemiology published a study that disproves the classification of the most common form of dioxin as a known human carcinogen.
"Yet another study has shown that there's no health risk, even for workers highly exposed to dioxin," says Dr. Ross. "An important subsidiary point is that no one - certainly no one in the media - seems to care. I guarantee that you'll continue to see dioxin referred to as one of the most toxic substances known to man in future headlines. That's how it works with some chemicals. People get it in their minds that they're dangerous, and they refuse to believe otherwise. Even today, if you ask 100 people on the street--even an intelligent person who has some education in science--they would still tell you that, for one notorious example, DDT is a horrible, toxic carcinogen. They don't know that the claims against DDT have been proven false over and over again, and they don't know that using it could save the lives of one to three million people, mostly infants and women, every year from malaria."
October 21st, 2009
ACS and ACSH, Suzanne Somers, Coke, and Taxes
By Curtis Porter
ACS Catches Up to ACSH
ACSH staffers were pleased to see an article in the New York Times declaring that "[t]he American Cancer Society (ACS), which has long been a staunch defender of most cancer screening, is now saying that the benefits of detecting many cancers, especially breast and prostate, have been overstated...The cancer society's decision to reconsider its message about the risks as well as potential benefits of screening was spurred in part by an analysis published Wednesday in the Journal of the American Medical Association."
"The ACS is finally backing off and saying, 'Gee, these tests may be doing more harm than good,' which we've been saying for decades," says ACSH's Dr. Elizabeth Whelan. "I admire them for finally having the guts to admit that these tests often pick up inconsequential cancers and people get put into expensive and traumatic treatments that they don't need. While this is getting good media coverage and is consistent with what we've been saying, it leaves consumers in a confusing place. We still haven't figured what we want people to do about this. We certainly don't want to discourage them from getting any kind of testing whatsoever, but we have a long way to go before specifying what the official recommendations should be."
The article quotes Dr. Otis Brawley, chief medical officer of the ACS, who said, "We don't want people to panic. But I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated." Dr. Brawley was similarly level-headed in his analysis of the proposed EARLY Act, which would have encouraged breast cancer screening in young girls and likely would have done more harm than good.
For more information, see ACSH's articles on breast cancer screening and prostate cancer screening.
A Seat at the Table for Dr. Brawley
Though he agrees that some screening methods are problematic, Dr. Brawley defends well-established treatments for cancer such as chemotherapy. In response to Suzanne Somers' latest anti-scientific tirade against cancer treatments, Dr. Brawley told the Associated Press, "I am very afraid that people are going to listen to her message and follow what she says and be harmed by it...We use current treatments because they've been proven to prolong life. They've gone through a logical, scientific method of evaluation. I don't know if Suzanne Somers even knows there is a logical, scientific method."
"It would be a travesty if the media give her time and space to discourage her followers from getting real treatment for cancer," says Dr. Whelan.
Coca-Cola Can't Win
ACSH staffers were exasperated by an article on Slate that analogizes Coca-Cola's introduction of a smaller can with the promotion of "light" cigarettes. "Just when you think you've seen it all," says Dr. Whelan. "It is so outrageous to mention cigarettes in the same breath as a soft drink as though they are equally bad for you. That is unbelievable."
"Usually, you would think that if there's an action that gets a certain response, then the opposite action would get the opposite response," says ACSH's Jeff Stier. "This violates that principle. When soda companies sell a super-sized serving, they get criticized by the likes of the Center for Science in the Public Interest, so you'd think when they do the opposite and offer a choice of a smaller can, they'd get credit."
Soda Tax: Not Even Pretending It Will Work Anymore
New York governor David Paterson announced on a radio show yesterday that he will reintroduce the already dismissed soda tax into his budget address in order to give legislators another chance to increase revenues for the city.
"This soda tax discussion has very quickly degenerated into nothing more than an idea to raise revenue that doesn't have anything to do with fighting obesity," says Dr. Whelan. "At least Governor Paterson is honest about how it is solely to raise cash to fight the deficit."
October 20th, 2009
Bill Gates, Smart Choices, Soda Tax, ADA
By Curtis Porter
Seat at the Table
A seat at the breakfast table goes out to Bill Gates for his address on agriculture made during the annual World Food Prize forum, in which he defended biotech solutions to the problem of worldwide hunger. "Some people insist on an ideal vision of the environment," Gates said. "They have tried to restrict the spread of biotechnology into sub-Saharan Africa without regard to how much hunger and poverty might be reduced by it."
Misdirected Anger
ACSH staffers were pleased to see an op-ed in the online Wall Street Journal that highlights the hypocrisy of people like Connecticut Attorney General Richard Blumenthal and Dr. Marion Nestle of NYU who publicly denounce the Smart Choices food-labeling program despite the fact that its standards are based on USDA dietary guidelines.
"Smart Choices is exactly the kind of program that Mr. Blumenthal and consumer advocates should be in favor of since it makes nutritional information more visible to consumers," writes WSJ's Allysia Finley. "Lately, government officials have been pressuring the food industry to take a more active role in curbing obesity ... But now that the industry is taking the initiative to promote healthier choices, the government wants to criminalize the industry for doing it in a marketable and profitable way."
"Ms. Finley's article pulls the curtain away from the wizard in Connecticut and what his agenda really is," says ACSH's Dr. Gilbert Ross. "The fact that Smart Choices follows government health guidelines is irrelevant. Mr. Blumenthal just doesn't think Froot Loops should be marketed to kids at all - especially if it's marketed successfully and earns a profit."
A Tax Without Results
A study published in Contemporary Economic Policy reveals that existing soda taxes do curb soda consumption, but have minimal impact on body mass index (BMI), which is a metric used to determine obesity rates.
"What this means is that a three percent tax on soft drinks has minimal impact on people's BMI, according to this study," says Dr. Ross. "However, that's much lower than the taxes that are currently being proposed. If they impose a high enough tax, eventually they will dramatically reduce soda consumption, but that outcome is still highly unlikely to have any effect on obesity."
"They don't seem to care that it won't affect obesity," says ACSH's Dr. Elizabeth Whelan. "It makes no sense to single out one food as a source of obesity. Obesity depends on all sources of calories. If you remove one, people will compensate by turning to other foods. And why is no one talking about exercise as part of the solution?"
The ADA Opposes Harm Reduction
ACSH advisor Brad Rodu, D.D.S., of the University of Louisville takes on the misinformation in a letter to the FDA written by the American Dental Association (ADA) in his Tobacco Truth blog: "[T]he ADA uses pseudo-scientific language to advocate for prohibition of all tobacco products, including smokeless tobacco ... [The ADA's] prohibitionist policy towards tobacco use is a disservice to dentists and their smoking patients; it denies them life-saving information about effective and vastly safer smokeless alternatives."
"In other words, if I had a smoker as a patient who said he was interested in smokeless tobacco as a harm reduction strategy, the ADA would say, 'No, keep smoking,'" says Dr. Ross. "How can they justify that? They say it's not a 'healthy' alternative to smoking. That's partially true, I suppose. If you want to be healthy, it's best not to use any kind of tobacco. But they are creating a straw man by saying it's not a healthy behavior. We're talking about saving millions of people from deadly cancers and other diseases caused by smoking cigarettes."
October 19th, 2009
HPV Vaccine, Flu Vaccine, Marion Nestle vs. ACSH, H1N1 vs. Truth
By Curtis Porter
Gardasil for Males, Cervarix for Females
ACSH staffers were pleased to see that the FDA approved Merck's Gardasil vaccine for the prevention of genital warts in males aged nine through twenty-six on Friday. The human pappillomavirus (HPV) vaccine is already approved to prevent cervical cancer in females in the same age range. Cervarix, GSK's HPV vaccine, was approved for women on the same day.
"The FDA panel approved the use of Gardasil for boys to prevent genital warts," says ACSH's Dr. Gilbert Ross. "As a bonus, it will reduce risk of transmission of HPV for girls, which could dramatically reduce rates of cervical cancer. It's not as easy to get attention for the sake of preventing genital warts, so it is unlikely that there will be as much of a push to get boys immunized, but it is good to immunize everyone you can. The vaccine is quite safe."
The Debate We Shouldn't Be Having
According to a Reuters report, "A New York state judge on Friday blocked enforcement of a requirement that all state healthcare workers be vaccinated for the seasonal and the swine influenza...The new vaccine has raised questions as to how well it has been tested, whether it can cause the flu and whether it has any side effects."
"A reasonably intelligent person might ask how well this vaccine has been tested," says Dr. Ross. "The answer is that it is tested the same amount as the annual, seasonal flu vaccine. Every year the shot contains a new viral antigen since the virus is constantly changing. It happens that the novel H1N1 changed quite a bit, but the vaccine is the same basic idea. You could also ask if the shot has any side effects, but here again it is well understood because it is the same process as the seasonal flu vaccine. As for whether it can cause the flu, no it can't, and that suggestion shouldn't be in a newspaper as a question that is up for discussion. It's irresponsible reporting."
Dr. Nestle's Anti-ACSH Playbook
Dr. Marion Nestle of NYU took exception to ACSH's Morning Dispatch coverage of Connecticut Attorney General Richard Blumenthal's distaste for the "Smart Choices" food labeling program. Dr. Nestle frequently takes aim at ACSH on her "Food Politics" blog.
"She mentions us by name on several occasions," says Dr. Ross. "In this case she is insinuating that Jeff -- and thus, ACSH -- believes that Froot Loops are 'good for you.' He of course never said any such thing, nor implied it. Dr. Nestle ought to join us in pursuing some actually effective approaches to obesity interventions that will work in the real world -- and stop misrepresenting ACSH's position on the issues."
Surprise: Lies on the Internet
The FDA is warning against online marketing of unlicensed medicines to protect against the H1N1 flu. "Products that are offered for sale online with claims to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus must be carefully evaluated," FDA Commissioner Dr. Margaret Hamburg said in a statement.
"Any time you have a condition or disease, especially one that's generating a lot of controversy and media attention, you're going to have people online trying to sell 'remedies,'" says Dr. Ross. "You could substitute any condition at all into Dr. Hamburg's statement and say that the products online must be evaluated. It sounds like a very tentative approach to this problem. It's almost like she's trying not to offend anyone, which seems ridiculous."
October 16th, 2009
Food Day, Flavor City, Cancer Month, Paranoia Time, and Tylenol
By Curtis Porter
Today is World Food Day: a reminder that malnutrition -- indeed, starvation -- still stalks the world's impoverished regions. This was the scourge that our late founding trustee and Nobel Peace laureate, Norman Borlaug, fought against all his long life.
Hooked on Harm Reduction
ACSH's Jeff Stier has an op-ed in today's New York Post skewering the New York City Council's decision this week to ban certain flavorings in all tobacco products: "It is a quit-or-die dogma that evades logic...These government actions will do nothing to protect kids. The only effect is to promote the most dangerous form of tobacco use, smoking cigarettes. If the advocates get their way, the only thing addicted smokers will be able to buy are mostly ineffective nicotine gums and patches -- and, of course, cigarettes."
Righteous Anger, Mostly
In honor of Breast Cancer Awareness Month -- which is ongoing -- a headline on the blog Jezebel (warning: article contains salty language) reads "Breast cancer is a disease, not a marketing opportunity." The post goes on to lambaste various marketing attempts to exploit the disease for publicity and eventually veers off onto a tangential screed about environmental chemicals, but for the most part we found it fairly enlightening.
"So many people are out there supporting so many breast cancer groups," says Stier. "The groups say they fight breast cancer, and these well-intentioned people give money to organizations just because they are 'against breast cancer.' Some of these groups actually undermine the cause, by sending us in the wrong direction -- by suggesting environmental chemicals are to blame, or promoting misguided legislation such as the EARLY Act."
"Studies attempting to link environmental chemical exposure to breast cancer have been done hundreds of times," says ACSH's Dr. Gilbert Ross. "No relationship has been demonstrated."
Giving a Voice to People Who Should Stop Talking
ACSH staffers had mixed feelings about a New York Times article by Jennifer Steinhauer that reveals a current of anti-scientific distrust of the H1N1 flu vaccine -- and vaccines in general -- among some Americans who tend to feel strongly on subjects about which they have no expertise. "The key is, she points out a real junk science controversy and debunks it," says Stier. "The message eventually comes through that the H1N1 vaccine is safe."
Dr. Ross is less patient with the blatantly erroneous arguments raised. "I do not feel that this is appropriately balanced, though it certainly has the appearance of being balanced," he says. "It may be polite to give equal time to self-styled 'medical experts' and 'concerned mothers,' but Ms. Steinhauer does a disservice to her readers by creating the false notion that there is confusion among actual health experts over whether the vaccine is safe. The so-called 'debate about vaccines' is like the debate about vaccines causing autism. It's created in these people's minds."
Have no fear, however. Here to offer their own misguided opinions on the subject are various celebrities who also have no medical or scientific background. In a rare reminder that being egregiously irrational knows no political affiliation, both Rush Limbaugh and Bill Maher have spoken out against flu vaccines (warning: the Bill Maher video is painful to watch).
"This issue is attracting attention from celebrities on both ends of the political spectrum," says Stier. "It underscores, whether we like it or not (we don't), the importance of celebrities when the media explores these issues. We must steel ourselves against this phenomenon by reviewing the long history of celebrities versus science."
Out of the ashes of all of this misinformation rises the phoenix that is the quote of the day, as recorded by Ms. Steinhauer:
"I wonder if the people disseminating this false information about this vaccine realize that what they are doing could result in some people losing their lives," said Dr. Jonathan E. Fielding, the director of the Department of Public Health for Los Angeles County. The comments of vaccine dissenters, which he said "politically come from the left and the right," were frequently "not just counterproductive," he said, "but downright disgraceful."
Tylenol and Vaccines
A new study published in the journal The Lancet reveals that giving children acetaminophen to prevent fever when they receive childhood vaccinations can reduce their immune response. "In the routine vaccinated population, acetaminophen should not be administered with vaccine," says Dr. Ross.
"This study is specifically about acetaminophen," adds Stier. "It is unclear if reducing fever is the issue or simply taking acetaminophen. The important thing is parents -- and doctors -- should know not to give it to kids when they receive a vaccine."
October 15th, 2009
Froot Loops, Flavor Ban, Food Safety, and a Fish Study
Curtis Porter
Blumenthal's War on "Smart Choices"
ACSH staffers were not surprised to learn that Connecticut Attorney General Richard Blumenthal is investigating the "Smart Choices" program, an industry initiative which supposedly aims to promote nutritionally superior food options. Mr. Blumenthal told the New York Times, "As a matter of common sense, these sugar-laden or fat-saturated products seem very questionable as so-called 'Smart Choices' nutritionally," referring to items such as Froot Loops and mayonnaise.
"A lot of these arguments go back to sugar-sweetened cereals," explains ACSH's Jeff Stier. "Froot Loops and Lucky Charms have the 'Smart Choices' label. They have sugar in them, but they also contain half of a person's daily requirement of some vitamins. If we're able to give kids those nutrients, it should be okay to give them some sugar. If they sold these products without sugar, kids wouldn't eat them, or they might end up adding even more on their own. Obviously you have to look at variety of issues here. Should a company be able to promote foods as a 'smart choice'? And how good are their standards for what is 'smart'? Even if they do match those standards, don't companies have the right to say those foods are better than others? It's not as if they are making specific health claims, rather these are just comparative claims."
"Not only that, but what is the role of government when companies start making these claims?" asks ACSH's Dr. Gilbert Ross. "Dietary supplement producers can say practically whatever they want -- they just have to point out that their statements haven't been approved by the FDA."
"This Richard Blumenthal is the same one who has been seeking to ban e-cigarettes," says Stier. "Connecticut may have more serious problems to focus on than banning e-cigarettes and worrying about companies trying to point consumers to healthier products. Froot Loops obviously isn't the healthiest food out there, but it's better than many others."
Big Apple Bans Flavor
New York City has officially become the first major city to ban the sale of flavored tobacco products.
"First of all, every government spokesperson that has been quoted on the issue of flavored tobacco has asserted that flavored cigarettes are very popular among kids and, thus, getting the flavor out of cigarettes will reduce numbers of teen smokers," says Dr. Ross. "There is absolutely no data to support this. The percentage of people of any age that smoke flavored cigarettes is very small. The only significant flavor in terms of market share is menthol, which is exactly why the federal government didn't ban it, and why I'm willing to bet that the New York City government won't ban it. These tobacco bans are worse than what the EPA is doing with harmless chemicals. The EPA loves finding solutions to non-problems. What we have here is creating more problems and outlawing the solutions."
"Why would New York City ban flavored tobacco if the federal government has already banned flavorings in cigarettes?" adds Stier. "One possible motivation is that they want to ban flavors in smokeless tobacco. It seems that they think the flavor in smokeless tobacco makes it more appealing than cigarettes, which is good if it keeps people from smoking."
Food Safety
Yesterday, the Waters Corporation convened the 2nd Annual Global Food Safety Policy Forum with the Center for Science in the Public Interest (CSPI) in Washington, DC, supposedly to discuss solutions to imported food safety issues. This follows on the heels of CSPI's list of the top ten "riskiest foods" that are regulated by the FDA.
Jim Prevor of perishablepundit.com thoroughly debunked CSPI's report and said of it in a letter to ACSH, "It was really a terrible disservice to consumers, who might forgo healthy foods because of being scared to death by this publicity, and to farmers, whose livelihoods will be impacted by such publicity. The list is a horrible misuse of surveillance data. It is basically a fundraising tool and a scare tactic to encourage a panicky adoption of food safety legislation rather than allowing for thoughtful consideration of the nature of risk."
"We're all for improving the safety of imported food," says Stier. "We think imported foods can and should be an option, in spite of various campaigns by activists saying we should eat locally produced food only. That's nice if you live in the Bay Area. If you live in New York, you don't have those options all year round. We want Americans eating more fruits and vegetables, and making them cheap and available all year is the only way to do that. CSPI pointed out there are safety issues with some imported foods. Thankfully, Jim Prevor, the 'Perishable Pundit,' sliced and diced up that report."
Weird Study That No One Cares About
A new study published in the American Journal of Clinical Nutrition suggests that two or more servings of fish per week could slightly increase the risk of diabetes. "This is data dredging at its worst," says Dr. Ross. "If you put enough data in and pull enough parameters out, you'll always get some kind of correlation. There's no biological hypothesis whatsoever to suggest why eating fish would cause diabetes."
"There are many other studies that show that fish is good for you, especially as it relates to diabetes risk factors, so this study may just be one big fluke," says Stier. "Fortunately, the study has not garnered much media attention. The media only likes reporting that fish is dangerous because of alleged mercury contamination -- otherwise, fish is a favorite. But imagine if the report were about beef rather than fish 'causing' diabetes. We'd see the media and activist groups piling onto this study."
October 14th, 2009
Conflicts of Interest, Mixed Drinks, and Prostate Pros and Cons
By Curtis Porter
Conflicts of Interest
Today's Wall Street Journal contains an article explaining how medical journals will soon demand more stringent reporting of potential conflicts of interest among contributing researchers: "The requirements will go beyond existing disclosure rules at many medical journals to include items such as financial relationships involving spouses, partners, or minor children. Also required will be disclosure of nonfinancial conflicts, such as religious and political affiliations. Such disclosures are used in medical journals to alert readers to potential biases in research."
"These rules seem to dig much deeper than current conflict of interest reporting," says ACSH's Jeff Stier, who has spoken on conflicts of interest before. "As it is now, if you own stock in a company and you report about a product of theirs, you have to disclose that information. Fair enough. Now, they're saying if your (minor) child owns stock you would have to disclose that as well. One good thing about the new rules is that they do at least take non-financial disclosures into account."
However, Dr. Jerome Kassirer, the former editor of the New England Journal of Medicine who has been pushing for stricter reporting of financial conflicts for a while, said the requirement to disclose non-financial ones is "a little excessive."
"Perhaps reporting what stock your eight-year-old owns is 'a little excessive' as well," says Stier. "I'm curious why someone who is so concerned about financial conflicts is so dismissive about other conflicts. Whether a conflict is financial or non-financial doesn't matter. If you want to have full disclosure, then have full disclosure."
For more information, see ACSH's publication on conflicts of interest in industry-funded scientific research.
Mixed Signals on Mixed Drinks
A new study in the Journal of the American Geriatrics Society calls into question the health benefits of light to moderate alcohol consumption. "Globally taken, these results suggest that the reported protective effect of moderate alcohol intake on physical performance may be only apparent, because lifestyle-related characteristics seem to be the real determinant of the reported association, suggesting caution in attributing a direct benefit of moderate alcohol intake on functional ability," said study author Cinzia Maraldi, M.D., of the University of Ferrara, Italy.
"For some time now, it has been reported in various journals and medical reviews that there are health benefits associated with light to moderate alcohol consumption, especially concerning the risk of cardiovascular disease," explains Dr. Ross. "This report says that's not so -- or at least not as significant as we had thought -- if you make adjustments for lifestyle. They say benefits of light to moderate drinking are to some extent attributable to other factors. There was still some positive health association, but it was weaker after adjusting for those confounders."
New and Shiny Is Not Always Better
Today's Los Angeles Times describes the results of a study on high-tech, minimally invasive prostate surgery procedures, which are often lauded for their lower risk of post-operative complications and their shorter required hospital stays: "The robotic techniques are advertised as safer or better than a traditional open prostatectomy. But a study published Tuesday in the Journal of the American Medical Association found that two of the most serious complications -- incontinence and erectile dysfunction -- appeared more often in men who underwent minimally invasive surgery compared with open surgery."
"There is a lot of hype about procedures like this since people always want to have the latest gizmo," says Dr. Ross. "It's especially common in areas of higher socioeconomic status, despite the lack of data supporting its superiority. People want to have the most up-to-date procedure, so hospitals buy this expensive equipment and the urologists have to learn new techniques. But people undergoing prostate surgery need to be aware that surgeons have a learning curve for new procedures. The take-home message is: if your urologist wants you to have minimally invasive robotic prostate surgery, you should inquire what his or her experiences with the procedure are and what the data shows from his own office compared to data from well-known and well-documented evidence for traditional open prostate surgery."
October 13th, 2009
Vaccines and E-Cigs, plus Irradiation, Zoning, Calories, and COOL
By Curtis Porter
Seats at the Table
We have a crowded honorary breakfast table this morning, as the topic of vaccines weighs on everyone's minds. First, Paul Offit earned an invite with his New York Times op-ed on Sunday dispelling unfounded fears about the safety of flu vaccines and encouraging everyone to get both the seasonal vaccine and the forthcoming H1N1 flu vaccine: "One can only hope that the American public will understand that subsequence isn't necessarily consequence, and not be scared away from a vaccine that can save lives."
Next, we offer a seat to Laura Landro for her article in the Wall Street Journal reminding everyone that adults and children alike can benefit from vaccines against a host of dangerous but preventable diseases, including the flu.
Finally, an honorable mention goes out to California governor Arnold Schwarzenegger for refusing to sign a bill that would ban e-cigarettes in the golden state. "It was a wise move on his part," says ACSH's Dr. Gilbert Ross. "He deserves credit for that. If he defended snus, that would earn him a seat at the table. For now we know that e-cigarettes are obviously less harmful than cigarettes, so banning them would take away a less harmful option from smokers trying to quit cigarette smoking."
A Job for Irradiation
ACSH's Jeff Stier used the power of Twitter yesterday to follow an interview on Larry King Live while simultaneously watching football. King's guest was Pat Boyle, the head of the American Meat Institute, and they were talking about food safety in light of concerns about poisoning from toxic strains of E. coli bacteria.
"They were discussing what is perceived as a food safety crisis in this country, when in fact our food supply is generally safe," recounts Stier. "Of course, there are ways to make improvements. The problem is that it is the fear promoted by activist groups -- especially about irradiation -- that is impeding that progress. Like Pat Boyle said, you can never eliminate the threat of E. coli completely, but the best way to make progress against those threats is to cook the meat properly and use available technology like irradiation to kill harmful bacteria."
Zoning Laws and Loopholes
The L.A. Times tells the story of a proposal to be considered by the Los Angeles City Council that would restrict the number of convenience stores allowed in certain parts of the city. Similar restrictions on fast-food restaurants are already in place.
"There is an easy way around that ban," says Stier. "All a restaurant would have to do to be exempted is sell fresh fruits and vegetables in addition to their other products. This illustrates the lack of understanding of the issue by the proponents of this approach and the simplicity of their proposed improvements. Apparently, they think the problem is that people choose fast food because they have no access to fruits and vegetables, and the solution is to open a McDonald's with an additional shelf for fresh produce. Will that solve the obesity problem? I don't think so."
Calorie-Dense Incentives
In other ironic news, the New York Post reports that the New York City Health Department has apparently been handing out fast food vouchers to tuberculosis patients to encourage them to return to clinics for six-month treatment programs.
"It's ironic that a city which has been such a nanny state under Bloomberg continues to give away fast food coupons," says Stier. "We didn't love it when the city was giving away vouchers for farmers markets specializing in organic produce, but this just shows why the Health Department ought to stick to the basics."
Canada: COOL Not Cool
According to the New York Times, "Canada is asking the World Trade Organization to rule against an American [country-of-origin] food-labeling law that it claims is helping to destroy much of its hog-farming industry."
"Canada is suing over the country of origin labeling (COOL) law that recently went into effect on meats, since it is hurting their exports," says Stier. "There is no safety issue here. We've been saying for some time that COOL is a piece of protectionist legislation. If someone wants to know where their meat came from in a free market, they're welcome to buy only meat with labels on it. The government's role should be limited to ensuring safety, and there is no benefit here in terms of safety or public health."
October 9th, 2009
Soda, Snacks, Drywall, Epstein Amok
By Curtis Porter
Columbus Day
There will be no Morning Dispatch on Monday, October 12 in honor of Columbus Day. ACSH's Jeff Stier would never dream of making you wait until Tuesday for your health news fix, however, so you can follow him on Twitter at http://twitter.com/JeffACSH and get ACSH's take on any breaking news story.
ACSH in the Media
Jeff Stier stopped by CNBC yesterday to debate the soda tax. Stier argued that the tax will have very little impact on public health, and our focus should be shifted to promising food technologies.
ACSH's Dr. Gilbert Ross exposes the misguided motivations for restricting the sale of "unhealthy" snacks in New York City schools' vending machines in today's New York Daily News: "These rules are wholly unscientific. Don't the city's nutrition nannies know that all calories count the same - whether from fat, sugar, or protein? When did they decide that artificial sweeteners were 'unhealthy' too? Did they get that off of fringe Internet sites?"
See also: Ross on Forbes.com on the EPA's anti-chemical crusade.
Dangerous Drywall
An article in yesterday's New York Times tells the stories of several people who have decided that they are sick and the Chinese drywall in their homes is to blame. "The whole report is completely anecdotal," notes ACSH's Todd Seavey. "They didn't quote any medical doctors or scientists, and they featured the usual array of vague symptoms like headaches or ennui."
The article does point out that no such symptoms have been reported by people in other countries who have the same drywall. "I guess Americans are just more susceptible to these sicknesses," jokes Stier. "Of course, there are already tons of lawsuits being filed. That explains the problem right there."
"If nothing else, this is an example of two important trends that are emerging," says Dr. Ross. "First, the assignment of blame to unknown substances for vague symptoms, and second, the New York Times' penchant for reporting such stories as science-related, when in fact these are anecdotal and are more fitting for an Oprah hour with Dr. Phil or Dr. Oz."
Dr. Epstein on the Loose
In similar news, Dr. Samuel Epstein of the Cancer Prevention Coalition (CPC) has been on a characteristic scaring spree in the media recently. Earlier this week, he warned the world of parabens in anti-aging skin creams. "That was just another cosmetics scare," says Stier. "There have been so many. This one mentions parabens, which are old news. It's all addressed in our report on cosmetics."
Yesterday, Dr. Epstein targeted Avon products, citing them as an important cancer risk. "He always likes to point out that there's an epidemic of cancer and that cancer rates are skyrocketing," says Dr. Ross. "Of course, that's not true at all -- in fact, the opposite is true: cancer rates and especially cancer mortality are falling in our country and have been for some years now. Sam should read the scientific literature instead of making it up as he goes along."
October 8th, 2009
Vaccines, Soda, Fried Foods, and BPA All Look a Bit Safer Today
By Curtis Porter
H1N1 Vaccine is Safe
A poll conducted by the Associated Press and market research group GfK reveals that more than a third of parents do not want their children to receive the novel H1N1 flu vaccine, citing concern about vaccine safety and a remarkable lack of concern about the virus' severity. ACSH's Dr. Gilbert Ross took to the nation's airwaves during morning drive time to assuage fears about the vaccine and encourage parents to play it safe by getting their kids vaccinated this flu season.
"I was interviewed on radio stations in five different regions," says Dr. Ross. "Like all flu viruses, the H1N1 flu can kill people, including children, and the vaccine is safe. There's no reason to risk skipping it."
The (False) Case Against Soda
Today's Wall Street Journal features an op-ed by Coca-Cola CEO Muhtar Kent explaining various fallacies behind the notion that soda is a central cause of the nation's obesity epidemic.
"He acknowledges that obesity is a very complex and serious issue," says ACSH's Jeff Stier. "He also points out -- as we've done in the past few years -- that 'it's not just about calories in, it's also about calories out.' In other words, Americans need more exercise, not another tax. He goes on to mention that, over the past twenty years, while obesity rates have been skyrocketing, sales of regular soft drinks have been decreasing, and the average caloric content of soft drinks is down by nearly 25%, which is attributable to improvements in diet sodas. Basically, there's no way to make the case that soda is to blame for obesity."
Stier will be on CNBC today at 1:40pm (Eastern) to discuss the soda tax.
Food Tech, Deep Fried
The L.A. Times health blog relays some interesting information today from the USDA's Agricultural Research Service about a breakthrough in food technology that could dramatically reduce the fat content of deep-fried foods: "Today, we learn of another invention...a rice-based batter that 'absorbs up to 50% less cooking oil than traditional batters,' according to the department's press materials. Rice flour is more resistant to oil uptake than wheat flour."
"News like this stands out in stark contrast to the discussion about soda," says Stier. "We don't think the soda tax will have a significant impact on obesity, yet here there is some positive news about the potential role of food technology to decrease calorie intake and fight obesity in a way that may actually work because it doesn't call for a major upheaval of people's hard-to-change dietary habits. So why are politicians jumping up and down, calling for a soda tax? Instead they should be calling for more research to provide tools and approaches like those we discuss in our publication on obesity and food technology."
BPA-Haters Get Desperate
"Researchers" are stepping up the effort to blame every single malady that exists on exposure to trace amounts of bisphenol-A (BPA), a chemical used to make plastics and prevent the actual physical threat of botulism. This time, they are falling back on outdated gender norms and saying that BPA is responsible for aggression in girls at age two, though (oddly enough) not boys.
"I can't believe that they would try to measure psychological effects of a chemical using the parents' answers to a behavior questionnaire," says Dr. Ross. "Some people would spin these responses to say these young girls are just being more sociable. If they were less aggressive, they might say it is a sign of less-social behavior, like from autism. They could spin this either way. The whole study is just junk."
"Refuting an article like this on scientific grounds is too easy," says Stier. "Let's take a little bit of a different approach on this issue. Some people have criticized us for being predictable and 'pro-industry' for 'defending BPA,' but do they want us to just sit back and let these absurd stories be addressed in such a one-sided way in the media? Would we be more credible in their eyes if we accept that story without even raising questions about it?"
October 7th, 2009
TX Loved Borlaug, NY Hates Snacks, H1N1 Varies
By Curtis Porter
Borlaug Memorial Report
The memorial service for Dr. Norman Borlaug was held yesterday on the campus of Texas A&M University, where he worked for over twenty years. ACSH's Jeff Stier was there to represent ACSH and reports, "I spoke at the symposium after the memorial, along with about forty-five other people. They had a minister speak at the memorial, so I joked, 'His family may be surprised, but I think Dr. Borlaug had some Jewish genes because, like my grandmother, he was always trying to feed people.' I also discussed his relationship with ACSH over the years as a founding board member and the inspiration and impact he brought to our work."
ACSH President Dr. Elizabeth Whelan -- who regrets that she could not personally attend the service honoring her longtime friend and mentor because she is currently traveling in Korea and China -- tuned in to the service on the Internet. She e-mailed us to say that she also wanted MD readers to know that ACSH is going to rededicate itself to advancing Dr. Borlaug's lifelong mission of defending and promoting the responsible use of science and technology to improve the human condition.
Stier offers this cellphone photo from the event: http://twitpic.com/kij7v
NYC's Plan for Student Health: Take Away Food
New vending machine contracts for New York City public schools are expected to be approved today. The contracts come with numerous restrictions ostensibly designed to promote healthier choices for students.
"This is an amazing story," says ACSH's Dr. Gilbert Ross. "No artificially sweetened drinks allowed. Sodium in snacks will also be restricted to 200 mg. I'm not advocating a high-sodium diet, but 200 mg is ridiculous. They go on to say that calories from fat and sugar will be restricted, as though they are worse than other calories in general. Most importantly, previous vending machine contracts brought in $35 million of revenue for the schools, so they're going to take a serious financial hit. They were already restricting physical education and athletics programs because they were underfunded. I assume they are taking these steps to try and address the obesity epidemic, but they don't even consider the importance of exercise. This wrongheaded and unscientific new policy will be more likely to hinder rather than aid the fight against obesity in our kids."
H1N1 Myths
According to the New York Times, officials are attempting to debunk several common rumors about the H1N1 flu since the vaccine became available yesterday: "Thomas R. Frieden, director of the Centers for Disease Control and Prevention, said in an afternoon news conference that the most common misperceptions are that this flu should ever be called a 'mild disease,' that the vaccine is untested, and that it has arrived too late."
"Dr. Frieden is right about all three of these points," says Dr. Ross. "Like any other flu, the novel H1N1 can be mild, but it can also be severe or fatal. We just don't yet know how serious it will be. The same production methods and testing procedures have been used for this vaccine as have always been used for the seasonal flu vaccine. It has been tested on thousands and thousands of people, and it is safe. While it is unfortunate that it was not available earlier, it is far from 'too late' to make a difference. A large majority of the population has not been exposed to this virus yet."
Attack of the Herbicide
Charles Duhigg of the New York Times could barely contain his giddiness at the opportunity to revisit the subject of the herbicide atrazine and its habit of being present in drinking water in insignificant quantities. You may recall that Dr. Whelan already addressed his previous false alarm on the issue. Apparently, the EPA is second-guessing itself, because Duhigg reports today that they have agreed to study atrazine extensively all over again.
"This is obviously based on the recent scare report by the Natural Resources Defense Council (NRDC) and Charles Duhigg's headline emblazoned on the front page of the New York Times in August," says Dr. Ross. "The EPA is feeling pressure from activist groups and has decided to kowtow to their demands and conduct more tests. The facts remain that atrazine is the most common herbicide, it has been used for fifty years and studied numerous times, and the EPA has already said that it is safe when used as approved. But now that the EPA is flush with cash, they will study it again at behest of the NRDC and the New York Times. I predict their findings will duplicate the previous findings of the EPA and numerous other studies and determine once again that atrazine is safe as it is currently used."
October 6th, 2009
Nobelists, Keystone Cops, Flu, Calories, and Autism
By Curtis Porter
Memorial Service Today
ACSH President Dr. Elizabeth Whelan considered ACSH Founding Director and Nobel Laureate Dr. Norman Borlaug an old and dear friend, and his memorial service took place today. Dr. Whelan expressed regrets that she was unable to attend the service because of a prior commitment, but she treasures the fact that she was able to see Dr Borlaug at his ninety-fifth birthday celebration last March. ACSH's Jeff Stier is there now to represent us.
Dr. Blum on the FDA
ACSH's Dr. Gilbert Ross relays a quote by Dr. Alan Blum, Director of The University of Alabama Center for the Study of Tobacco and Society, concerning the various futile attempts by the FDA to regulate tobacco: "It's the Keystone Cops trying to beat Philip Morris at its own game."
"He's pointing out that when you're talking about tobacco regulation, you don't want to work with Philip Morris," explains Dr. Ross. "They're the smartest people in the room. You may think you're pulling one over on them, but you're not. Of course, this was obvious from the get-go, but the FDA and many public health organizations were too eager to get any tobacco 'regulation' passed, no matter how unwise. Now the chickens are coming home to roost, as the real effects of the law become obvious. Dr. Blum also points out once again that the tobacco bill won't accomplish anything for public health -- will in fact be counterproductive by preventing anyone from learning about harm reduction."
Nobel Prize in Medicine
Today's Wall Street Journal, among many other news sources, celebrates the fact that three Americans were awarded the 2009 Nobel Prize in medicine and physiology for discovering how chromosomes act to protect themselves from degrading when cells divide by using an enzyme called telomerase: "Their cell research demonstrates that we're on the cusp of an era of medical innovation that could radically improve lives and life spans, if government lets it blossom...It's worth noting that the British-born Szostak and the Australian-born Blackburn are immigrants who chose to work at U.S. research institutions, which continue to be the world's best."
"This achievement could be a shortcut to breakthroughs in cancer and longevity research," says Dr. Ross.
Vaccine Arrives
The CDC released the first doses of H1N1 flu vaccine yesterday. Supplies are limited, and doctors are struggling to determine the most efficient way to distribute the vaccine.
"The vaccine is a nasal spray that contains a live, attenuated form of the virus," says Dr. Ross. "Therefore, it cannot be administered to pregnant women, young children, or immunocompromised people. It is fine for healthcare workers, however, who should get it whether they want to or not."
Big Surprise
Today's New York Times reports on a study performed by Yale and NYU researchers, which determined that posting calorie counts on restaurant menus does not influence people's eating habits. The article quotes Michael Jacobson of the Center for Science in the Public Interest, which favors the use of calorie labeling, as saying, "Nutrition is not the top concern of low-income people, who are probably the least amenable to calorie labeling."
"In sum, this study demonstrates that calorie postings do not have any influence on calorie consumption at these fast food restaurants," says Dr. Ross. "Michael Jacobson is incredibly dismissive and unscientific about this point. He wants it both ways. He likes labeling to tell obese people -- overrepresented among the poor -- how many calories they consume, then he says they didn't pay attention because they're poor and don't care."
The Autism Puzzle
According to a government report published yesterday in the journal Pediatrics, the rates of childhood autism diagnoses are rising. "This is an excellent study, but what it looks at is the prevalence of the diagnosis, not the disorder," said Dr. Susan L. Hyman, a pediatrician at Golisano Children's Hospital in Rochester, as reported in the New York Times. "The next step scientifically is to see whether those diagnoses are being made accurately." The study, based on a phone survey of over 78,000 homes, showed that almost 40% of children originally thought to have autism later "grew out of it or no longer qualified for it."
"Dr. Hyman has a very important point," says Dr. Ross. "The problem with analyzing rates of autism is that you are comparing current diagnostic criteria to those of twenty years ago, when the condition was much less understood. The question is if we're comparing apples to apples. It certainly seems clear that autism diagnosis is on the increase, but whether autism incidence is rapidly increasing or we just understand it better, we don't know. It is also unclear what could be causing an increase of incidence of autism, though we know it's not vaccines."
October 5th, 2009
Borlaug, McCaughey, BMJ, Bake Sales, Life Expectancy
By Curtis Porter
Memorial Service for Dr. Borlaug Tomorrow
ACSH's Jeff Stier is currently en route to Texas A&M University's campus in College Station, TX for the memorial service of ACSH Founding Director and Nobel Laureate Dr. Norman Borlaug. Texas governor Rick Perry has ordered that Texas flags be flown at half-mast for the occasion. Live streaming video of the event will be broadcast online at http://kamu.tamu.edu/ (click "watch now" for the stream).
Debate Tonight
ACSH Trustee Dr. Betsy McCaughey will be debating healthcare proposals with New York Congressman Anthony Weiner tonight at 7pm in the auditorium of the NYU Medical Center. The debate is presented by DL21C and moderated by Politico's Senior Political Writer Ben Smith.
Some Confusion About Health Hazards
ACSH staffers were not surprised to see an article in the British Medical Journal refuting previous claims that the smoking cessation drug Chantix carries a higher risk of suicidal thoughts and depression than other cessation aids. The product already sports an FDA black-box warning for these alleged mental health side effects.
"I'm channeling ACSH Advisor Dr. Michael Siegel when I point out the unfortunate irony that the FDA has a black box warning label on Chantix, they are aggressively scaring consumers away from e-cigarettes, and they are blocking scientific information about harm reduction, and yet the FDA is now the regulator of cigarettes, which are being sold without any problem," says Stier. "The FDA is, by implication, approving the most hazardous tobacco product there is while restricting information on harm reduction products and warning about other products before the data is in."
"Like all approved smoking cessation products, Chantix has a minimal success rate in helping people quit," adds ACSH's Dr. Gilbert Ross. "On the other hand, Swedish data seem to show that using smokeless tobacco like snus as a harm reduction aid is the most effective means of quitting and is almost harmless. The data on e-cigarettes has yet to be accumulated, but logic and science would indicate that this tobacco-free product and smokeless tobacco are the best cessation products available."
Stopping the Scourge of Team Fundraising
According to the New York Times, "In an effort to limit how much sugar and fat students put in their bellies at school, the [New York City] Education Department has effectively banned most bake sales, the lucrative if not quite healthy fund-raising tool for generations of teams and clubs."
"This is highly unlikely to stem the obesity epidemic, and is another manifestation of the New York City government's overly aggressive approach to personal nutritional choices," says Dr. Ross. "The Board of Education should be devoting itself to educating students. If they want to teach nutrition, and especially if they want to increase the quality and availability of physical education programs, then I support them. Many schools have been cutting down on physical education programs, which is counterproductive in light of the nation's obesity epidemic. However, they are wasting their time attacking bake sales, which are good fundraising opportunities."
Living Longer Despite Activists' Best Efforts
A study published Friday in The Lancet by researchers with the Danish Ageing Research Centre predicts that over half of babies born in rich nations today will live to be 100 years old if current life-expectancy trends continue.
"This is obviously based on a mathematical model," says Dr. Ross. "It's only relevant 'if current trends continue.' Still, this may come as a shock to those people who are always trying to scare us about the toxins all around us -- in our food, water, rubber duckies, and water bottles. There is an aggressive campaign by the EPA to outlaw chemicals in various products that are 'threatening our health,' and yet our life expectancy is constantly increasing. The EPA project is trying to solve a problem that doesn't exist. Instead, they should stick to what they do best: raising money for scare groups and keeping air pollution down like they did in the 70s."
October 2nd, 2009
Breast Cancer Deaths, CSPI, Get Your Flu Shot, Cigs vs. E-Cigs
By Curtis Porter
Breast Cancer Mortality Declines
ACSH staffers were pleased - though not surprised - to read in Scientific American that a report by the American Cancer Society confirms breast cancer mortality rates have been steadily declining over the past two decades. "This is not news to us," says ACSH's Dr. Elizabeth Whelan. "The decline in breast cancer mortality rates worldwide is a very significant phenomenon. In fact, once the use of aromatase inhibitors is established long enough to be a factor, we predict that you will see an even more pronounced decline in mortality."
"Breast cancer diagnoses in this country have remained pretty consistent," says ACSH's Dr. Gilbert Ross. "The same number of women - approximately 200,000 - are getting breast cancer, but mortality is going down because of better diagnosis and treatment. The article attributes some of this trend to the recent diminished use of Hormone Replacement Therapy (HRT). We disagree with that explanation, as we've noted in our publication on HRT. What we do know is that women should follow the advice of their doctors as far as getting regular mammograms at the appropriate age. It's a sad fact that only 60% of women who should be getting screening mammograms get them annually."
"Another important point is that obesity is a known risk factor for breast cancer," adds ACSH's Jeff Stier. "If breast cancer incidence is holding steady at the same time that obesity is increasing, perhaps some other risk factors are decreasing."
For more information, see ACSH's publication on risk factors for breast cancer.
Also, mammograms are available at reduced cost at some locations in every state, which can be found at the following CDC website: http://apps.nccd.cdc.gov/cancercontacts/nbccedp/contactlist.asp
Even CSPI Can Be Right Sometimes
The Center for Science in the Public Interest (CSPI) filed a lawsuit against German drug maker Bayer AG for making false claims that selenium in their "Men's One A Day" multivitamins might reduce the risk of prostate cancer.
"CSPI is like a broken clock: right twice a day" quipped Dr. Whelan. "We agree with them that many of these drug and supplement companies are overstating the health benefits of their products."
"We're glad CSPI is taking this on," says Stier. "They should spend more time on legitimate issues like this rather than on their usual food scares."
Get Your Flu Shot
Perhaps the greatest concern among ACSH staffers relating to the imminent flu season is the reluctance of some high-risk groups of people to get available vaccines. "I have a gut feeling that Americans are underestimating the potential impact of H1N1," warns Dr. Whelan. "I think it's going to be worse than they are predicting."
"What is certain is that only about 15% of pregnant women regularly follow the advice of all public health advisors and get the flu vaccine," says Dr. Ross. "This is a group that has disproportionately high death rates from H1N1, and yet they have had abysmally low vaccination rates for the seasonal flu. Pregnant women and women who may become pregnant should get vaccinated as soon as possible for the seasonal flu -- and again when the H1N1 vaccine becomes available, which will be in a few weeks."
The controversy raging over proposed mandatory vaccination among healthcare workers is another source of consternation for us. "We normally don't approve of government mandates regarding medical care, but for healthcare workers dealing with sick patients, there should be no question," says Dr. Whelan. "I don't understand why they wouldn't want the shot in the first place. They obviously have more to fear from the flu than from the safe vaccine--and they have a duty to protect their patients and colleagues."
"If we mandate that school children must be properly vaccinated in order to interact with other children, it makes perfect sense to mandate the same for healthcare workers who can easily get the disease from and, more importantly, pass the disease on to coworkers and patients," says Dr. Ross. "'First, do no harm' is the medical ethic. This anti-vaccine nonsense is the opposite."
"If they don't want vaccine, that's fine," adds Stier. "Just go get another job."
"We've said it a hundred times," concludes Dr. Whelan. "Go get your flu shot."
FDA Wants Clinical Trials, and They Want Them Now!
ACSH advisor and professor at the Boston School of Public Health Dr. Michael Siegel passed along the news that the FDA considers the use of e-cigarettes to be as dangerous as smoking actual cigarettes: "FDA spokeswoman Siobhan DeLancey contends her agency wants to regulate electronic cigarettes so it can be sure that the people who use them are getting a reliable dose of nicotine, and that there are no far-reaching health effects from long-term use ... 'I feel their pain,' she said. 'We don't know if this [electronic cigarette use] is any better for them [than smoking].'"
Dr. Siegel deconstructs the argument in his blog: "When the FDA tells the public that cigarette smoking may be no more hazardous than the use of a device that essentially delivers just nicotine and propylene glycol, you know we have serious problems with tobacco control in this country."
"The FDA wants to see 'well-designed clinical studies' about the safety of e-cigarettes," says Stier. "Who do they think is going to conduct those studies? There are only two groups who have incentives to perform clinical trials. There are 1) those who manufacture e-cigarettes, whose report would immediately be dismissed as biased, and 2) there are purported public health groups or governmental organizations such as NIH or even FDA, or a group like the National Science Foundation, but they just aren't doing it. We challenge the FDA or the NIH to design a clinical study on their own terms. Or, let the Robert Wood Johnson Foundation do it. Let the America Legacy Foundation do it. We know they won't, though. That's why they're failing us. People are dying, and they are placing obstacles in front of tools that have potential to reduce risk and help people quit smoking cigarettes."
October 1st, 2009
Memorial, Addendum, AIDS, Veggies, Coke
By Curtis Porter
Honoring Dr. Borlaug
ACSH staffers were pleased by the extensive and well-deserved media attention afforded to the memory of ACSH Founding Director and Nobel laureate Dr. Norman Borlaug. "I would like to point out that Dr. Borlaug is still being recognized," says ACSH's Dr. Elizabeth Whelan. "The House of Representatives just passed another resolution to honor him."
A memorial service will be held this Tuesday for Dr. Borlaug on the campus of Texas A&M University in College Station, Texas (alma mater of your faithful ACSH intern), where he taught and continued his research since 1984, holding the office of Distinguished Professor of International Agriculture and the Eugene Butler Endowed Chair in Agricultural Biotechnology. He continued his work to enhance crop yields in the less developed world right up to the end.
ACSH's Jeff Stier will be present to make some remarks at a symposium after the service. "I will rededicate ACSH's mission to carry on Dr. Borlaug's work of advancing the responsible use of technology to improve the human condition," says Stier.
Setting the Record Straight
Morning Dispatch on Tuesday featured ACSH staffers reacting to a letter sent in by a long-standing ACSH advisor concerning our reservations about PSA prostate cancer screening. The reader offers the following addendum to the discussion:
"Your paraphrase of my message ignored the point that screening tests (whether for PSA or BSE) are expected to be high in sensitivity and probably low in specificity. A positive result in a screening test should evoke confirmatory testing, rather than an immediate remedial response. Cancer therapy based on just a high PSA number makes no more sense than chasing PCBs in caulk."
AIDS and Cancer
A study by researchers at University of Texas Southwestern Medical Center in Dallas reveals that non-AIDS-related cancers have become more common among HIV patients than among people without HIV since antiretroviral therapies were introduced in the mid-1990s to treat people with the virus.
"This has to be due to one of three things," explains ACSH's Dr. Gilbert Ross. "The virus which causes HIV could be actively provoking or enabling cancers, or it could be because of chronic immune damage wreaked by the virus, or it could be that the therapy used to treat HIV positive patients actually causes cancer. The last option may seem controversial, but we have to remember the risk-benefit analysis for these therapies."
Dr. Whelan agrees: "Modern medicine has made HIV a chronic disease instead of a death sentence."
Uncle Sam, MD Wants You to Eat Your Veggies
According to CNSNews.com, "The federal Centers for Disease Control and Prevention issued a report on Tuesday saying that none of the states is meeting 'national objectives' for consumption of fruits and vegetables ... The report mentions three strategies that states can follow to boost consumption of healthier food."
"This approach is well within the limits of appropriate interventions," says Stier. "These are the types of things government should do in order to help people be healthy. Contrast this with soda taxes, fast food zoning laws, etc. However, the CDC claims that eating veggies reduces cancer risk. The best argument for increased consumption of fruits and vegetables as a cancer-fighting strategy is that obesity carries a cancer risk and veggies are a good way to combat obesity. Other claims, e.g. 'vegetables have antioxidants that will prevent cancer' are unsupported by scientific research, but sound good for marketers of certain products."
"It's amazing only 10% of high school kids get the recommended daily allowance of fruits and veggies," adds Dr. Ross. "And we wonder what's causing the obesity epidemic. Both young people and adults should eat a more balanced diet and get more exercise. This is one public health intervention that we support."
Soda Tax: A Lucrative Facade of Concern for Public Health
Coca Cola announced yesterday that it will change the packaging on almost all of its products to more prominently display certain nutritional facts, such as calorie count. "Coke executives visited ACSH some time ago to talk about caffeine warning labels," recalls Stier. "Their representative asked us if we knew what the most expensive real estate in the world was. We guessed New York, Paris, Tokyo, and he said, 'No, it's right here,' pointing to the side of a Coke can. They have created a multi-billion dollar business out of selling what is basically just flavored sugar water, and they've done so by creating a look and name recognizable around the world. It is interesting that they're willing to occupy some of the most expensive real estate in the world to print more detailed calorie counts, perhaps to fend off a soda tax. But does anyone not already realize that regular soda is highly caloric?"
"If this is their idea to stave off the soda tax, good luck," says Dr. Whelan. "It's quite clear at this point that this tax is about raising money instead of addressing public health issues."
September 30th, 2009
EPA, Fanmail, Football, Vaccine Safety
By Curtis Porter
Fixing What Isn't Broken
In a speech yesterday at the Commonwealth Club in San Francisco, EPA Administrator Lisa Jackson outlined the Obama Administration's goals for legislative reform of the current chemical management law, the 1976 Toxic Substances Control Act (TSCA). The six principles outlined include promoting "green" initiatives, expanding the EPA's authority, providing a "sustained source of funding" for the EPA (of course), and enlisting the help of the chemical industry. "Demanding industry contribution is code for passing along costs to consumers," says ACSH's Jeff Stier.
"It's unclear why we need to regulate chemicals more strictly, including those Ms. Jackson specifically impugned," says ACSH's Dr. Gilbert Ross. "What are we trying to fix? We all have chemicals in our bodies, indeed, we are made of 'chemicals,' and low-dose theorists say they cause cancer, endocrine disruption, and all sorts of health issues. The problem with that is that the incidences of all of those conditions are declining. The only increasing health concern is obesity, which they don't attribute to these 'toxins' anyway. Lisa Jackson wants us to prove that every chemical present in trace amounts is safe, but you can never conclusively prove something to be safe. This is all part of the huge trend of government overreach based on junk science, including the new "lead-safe" law CPSIA and the counterproductive, anti-public health FDA takeover of tobacco."
Another stated objective is a review of how nano-scale materials are managed under TSCA. "They are focused on very, very small risks here," says Stier, who can't resist puns. "There are many potential benefits to be gained from nanotechnology, including better sunscreen that could be more effective in preventing skin cancers. Instead, the EPA seems intent on focusing only on the risk side of the equation, which is their wont."
Encouraging Words
ACSH staffers are always happy to receive letters of agreement from our Morning Dispatch readers. It is especially encouraging when professional scientists and doctors write to congratulate us on adhering to the scientific principles that they were trained to uphold, so we were pleased to hear from ACSH advisor and Emeritus Professor at New York Medical College Dr. John H. Weisburger when he wrote in yesterday:
"Reading your daily messages are so enjoyable because they are correct from the point of view of sound medicine and reliable scientific information ... [T]he problem is with the 'environmental movement.' They also think they are using science to protect the public, when in fact they are just politicians without accurate and dependable scientific and medical knowledge. As you know, I trained in the field of preventative medicine, the best approach to be in good health for a lifetime ... In my career since 1949, my professor used to tell us students to explore the truth in matters of science and medicine. 'If you feel and demonstrate that your data are correct, then go ahead and publish them.' That is how, over my life, I have published over 550 papers through the peer-review process ... With all good wishes to all at the world-famous organization, ACSH."
Football and Dementia
A study prepared for the National Football League (NFL) indicates that retired NFL players have five times the risk of developing Alzheimer's disease and other forms of dementia, presumably from sustaining repeated blows to the head.
"The NFL is starting to look like big tobacco in the bad old days," says Stier. "For a long time, they denied that dementia, including Alzheimer's, was related to football, but evidence is getting stronger that it is. They are finally acknowledging something that has been obvious to everyone else for a while. The important thing is that we hope scientists can use the findings about this select group of people to learn more about the prevention, if not eventually treatment of Alzheimer's in the general population. Unfortunately, we know frustratingly little about this disease."
UK Girl's Tragic Death Likely Not Related to HPV Vaccine
New evidence in the tragic case of the 14-year-old UK girl who died suddenly after receiving the HPV vaccine Cervarix suggests that she had an unspecified underlying medical condition. ACSH staffers were relieved to learn that officials say that they will not stop the vaccination program in light of this new information.
"They said that they will continue with the program because the death was unrelated to the vaccine, but what if it was related?" asks Dr. Ross. "If you give a medication or vaccine to millions of people, unexpected, severe, and sometimes fatal complications will occur. We should not let the fact that one person out of millions could have a severe reaction stop us from administering a vaccine that could save many more lives."
"The problem is that the initial reports about the death being possibly linked to the vaccine will spread wider than this report that it wasn't," adds Stier. "You can't put the genie back in the bottle."
September 29th, 2009
Germs, PSA, Vaccines, Caulk, UK Girl, H1N1 Parties
By Curtis Porter
Advice, sans Paranoia
The quote of the day belongs to New York infectious disease specialist Eric Neibart, who consoled a deeply distraught Wall Street Journal reporter writing about the looming omnipresence of germs in today's issue: "'Millions of people touch things every day and nothing happens, so just use common sense,' Dr. Neibart advises. 'There's a bigger risk of being injured in a taxicab.'"
Letter to the Editor
Yesterday, a Morning Dispatch reader took issue with our coverage of the news that researchers have faulted PSA testing for prostate cancer as unreliable due to its detection of harmless cancers that often leads to painful, unnecessary treatment.
"It was an interesting story because he has prostate cancer, and he was implying that he wished he had a PSA test earlier since his cancer was detected at the late stage four, after treatment for an enlarged prostate," recalls ACSH's Dr. Elizabeth Whelan. "He says he doesn't blame his doctor for not using the test, since his doctor was listening to same experts we at ACSH are. He might be right, but we could be also. He's dealing with an individual situation where he might have caught it earlier, which would have been preferable. But we're talking about an aggregate, and how this test affects most men in the population."
"There is a difference between screening millions of men for no other reason than that they had walked into the doctor's office, and testing a man who is being treated for an enlarged prostate," explains ACSH's Dr. Gilbert Ross. "I, too, wish he had a PSA test five years earlier. He might have caught his cancer before stage four. But the fact remains that many men are being treated needlessly because of harmless cancers detected by this test."
Investing in Immunity
Today's Wall Street Journal highlights a growing trend among American pharmaceutical companies, who are investing in vaccines with an urgency usually reserved for more lucrative, "blockbuster"-type innovations: "Big drug companies have re-entered the business as prices have risen and researchers develop new technologies for improving production."
"Vaccines are traditionally more risky as an investment for drug companies seeking big returns," says ACSH's Jeff Stier. "The fact that prices have risen is spurring innovation, and allowing these pharmaceutical companies to invest in more research. In the long run this will allow them to develop more life-saving products."
Finally, A Caulk Hotline
An Associated Press article explains how the EPA is attempting to incite panic over trace amounts of PCBs in the caulk used to seal doors and windows of schools around the nation. PCBs are alleged to cause cancer, though such a link has never been scientifically established.
"This is just ridiculous," says Dr. Whelan. "PCBs have never hurt anyone, and here they're worrying about trace levels of it in caulk. It's a travesty." Dr. Ross adds, "Why is the EPA spending hundreds of millions of dollars looking for solutions to problems that do not exist?"
The EPA even set up a "PCB's in caulk" hotline so that sufficiently frightened parents can call in: 1-888-835-5372. "This reads like an article in The Onion," says Stier. "We encourage our Morning Dispatch readers to call this number regularly and make sure their children's lives aren't at risk." It could prove very therapeutic.
Vaccine Reaction
The UK's Guardian reports that parents are being urged not to panic after the death of a 14-year-old girl following injection with the human papillomavirus (HPV) vaccine Cervarix. "Just because this girl died shortly after getting the HPV vaccine doesn't mean that this vaccine caused it," says Dr. Ross. "Of course, as with any other medication, rare and unforeseeable reactions can occur."
"Those risks are heavily outweighed by the manifold benefits and lives potentially saved by the vaccine," adds Stier. "Of course, that doesn't diminish the tragedy of the situation."
H1N1 Parties
ACSH staffers were surprised to see a report in U.S. News about how some parents are hosting "swine flu parties" to spread infection among their children in order to promote immunity while the virus is "still mild" - although there is no evidence that the virus has, or will, become more potent as the fall and winter flu season progresses.
"Some parents are treating H1N1 like chickenpox and having 'parties' to infect children so they can get immunity," says Dr. Whelan. "This is a very bad idea. You never know who is going to have a serious case, or what kind of sequelae might follow infection."
"We don't recommend doing this," says Dr. Ross, "just as we don't recommend it for chickenpox or measles. There's no upside to this. Don't do it."
September 28th, 2009
Obesity Problems, Vaccine Wariness, PSA Flaws, and a Slate of Soda Defenders
By Curtis Porter
Letter to the Editor
After reading last Friday's Morning Dispatch, in which ACSH staffers expressed skepticism about an article comparing the cancer risks of smoking and obesity, ACSH Advisor and Distinguished Professor of UC Davis's Department of Nutrition Dr. Judith Stern wanted to make sure that we were unequivocal about the health risks associated with obesity. "Obesity is a major public health problem," she wrote. "You can address the figures for cancer, but then add something about the 40+ other diseases (comorbidities) associated with obesity."
"We certainly didn't mean to downplay the health consequences of obesity, which go way beyond the increased risk of certain cancers," says ACSH's Dr. Elizabeth Whelan. "As a matter of fact, we have a whole book on the effects of obesity on health. We appreciate Dr. Stern for bringing this important concern to our attention."
As always, we enjoy your input when it comes to spreading our message of good health and sound science.
Hesitant Parents
According to the Los Angeles Times, "In a poll of 1,678 U.S. parents conducted by the University of Michigan's C.S. Mott Children's Hospital, 40% said they would get their children immunized against the H1N1 virus -- even as 54% indicated they would get their kids vaccinated against regular seasonal flu." Some believe the virus is not a serious concern, while others are worried about the possible side-effects of the vaccine.
"I can understand why people are confused, since there have been so many conflicting reports about the severity of the H1N1 flu," says Dr. Whelan. "Also, for children under ten, they would require two shots for H1N1 and one shot for the seasonal flu, which certainly seems like a lot of shots. Still, if that's what it takes to protect against the flu, which can be very serious, then we encourage them to get the vaccine. I'm really concerned about these parents' decision, because it effects not only children involved but those they can spread it to as well."
PSA Test Not Worthwhile
A study by researchers at the International Agency for Research on Cancer in Lyon, France suggests that screening men for prostate cancer using the blood test for prostate-specific antigen (PSA) is not worthwhile, since the procedure cannot reliably distinguish between deadly cancers and those that may not be harmful at all.
"It seems like we see a story about PSA testing every two weeks," says Dr. Whelan. "The emerging consensus, which is really very shocking, is that PSA screening should not be universally used, since the test cannot distinguish between life-threatening and non-life-threatening prostate cancers. What is a middle-aged man to do right now? Not take the test? That seems to be the prevailing opinion. There is increasing skepticism about the value of PSA, since it picks up so many non-life-threatening cases of prostate cancer, which in turn leads to unnecessary treatment, and that really threatens quality of life."
Saletan in Slate on the Slippery Slope
William Saletan's article on Slate posted last week refutes the fallacious justifications for the soda tax, while attacking the idea as both unscientific and paternalistic: "To justify taxes on unhealthy food, the lifestyle regulators are stretching the evidence about obesity and addiction...If studies show that [zero-calorie drinks] indirectly increase calorie consumption 'by promoting a preference for sweet tastes,' the food police are explicitly prepared to tax them. And the crusade won't end with soda. Anything sweet is a target."
"It's great for an article to address the 'good food, bad food' mentality that's been driving the argument that the government should tell you what to eat," says Dr. Whelan. Saletan says the food police are making his Slate co-workers more skeptical about government in general.
September 25th, 2009
Fat, plus Flu in the Hand, Arm, and Nose
By Curtis Porter
ACSH staffers welcome Vicki McKenna's listeners who are joining us at our breakfast table. We got a huge response from Vicki and Jeff's on-air offer to sign people up for our Morning Dispatch (MD) during their visit yesterday. MD relays insights from ACSH staffers during our morning meeting, at which we discuss current public health issues.
Morbidly Overestimated
ACSH's staffers were disappointed by an Associated Press article reporting on a study by European researchers that predicts obesity will soon be the leading cause of cancer among women in Western countries.
"This article is rife with falsehoods and misleading statements," says ACSH's Dr. Gilbert Ross. "Obesity is responsible for 'up to 20%' of cancers in the U.S.? I don't know how you even get a study published with numbers as imprecise as these. It's just not scientific."
"Now people are going to be saying obesity is more important than smoking in terms of death, and it's not," says ACSH's Dr. Elizabeth Whelan. "They say that obesity accounts for 8% of cancers in Europe. I'm not going argue with that, but we're still looking at 36% or 37% caused by smoking. This is not to say that the impact of obesity on many diseases, including many cancers, isn't considerable. But we don't trust this study."
"This type of speculation doesn't help us address public health priorities," says ACSH's Jeff Stier. "We prefer relying on the data. And we've compiled that data and arranged it for you in an interactive and fun webpage called the Riskometer."
For more information, see ACSH's publication on obesity and its health effects.
Washing Hands: Vanity and Striving After Wind
Infectious disease experts are saying that washing hands may not be effective against the transmission of the H1N1 flu virus.
"The same could easily be said about the seasonal flu virus," says Dr. Ross. "I'm pretty certain that there's no difference in the way H1N1 and H3N2 viruses spread, but we never see stories like this for the seasonal flu, which kills thirty to forty thousand Americans every year. Maybe this will be good for raising awareness of the flu in general."
"There may be some controversy about the efficacy of hand washing when it comes to the flu," says Stier. "That it may not be as effective at preventing H1N1 as we'd have hoped does not diminish its importance as a public health measure."
Vaccine Rumors
A study out of Canada is causing some concern by suggesting that those who received a flu vaccine last year are at a substantially increased risk of contracting the H1N1 flu virus.
"First of all, this study has not been published, though it supposedly will be," says Dr. Ross. "Second, this signal has not been detected in other countries, notably Britain, the U.S., and Australia, which have looked for this connection but have not found evidence of any such thing. Of course, this is not to mention the fact that there's absolutely no biological hypothesis as to what might explain this connection."
In other vaccine news, healthcare officials revealed that the seasonal flu shot is twice as effective as the nasal spray vaccine in preventing infection, though they are unsure if the same principle holds for the H1N1 flu. "We do not know what outcome will be for H1N1," says Dr. Ross. "Experts theorize that the nasal spray will be as effective for H1N1 as the shot."
Curtis Porter is a research intern at the American Council on Science and Health (ACSH.org).