DISPATCH 6/20/08: Natural, Biotech, Asthmatic, Clustered, Immune
Debating the definition of natural
A New Jersey judge recently rejected the claim it was deceptive to use an "all natural" label on products containing high fructose corn syrup. "What does 'natural' mean?" asks ACSH's Dr. Elizabeth Whelan. "It's a fascinating topic." A consumer filed the lawsuit against Snapple for labeling its iced tea and juice drinks as "natural" when they were made with high fructose corn syrup, which the plaintiffs called a "highly processed sugar substitute" created through "enzymatically catalyzed chemical reactions in factories."
"So if they made it outdoors it wouldn't be so bad?" asks ACSH's Jeff Stier. Stier also points out that the decision does not attempt to change or influence the definition of natural. "The judge deferred to the FDA," he says. "She didn't adjudicate whether high fructose corn syrup is natural or not."
The Food and Drug Administration's definition of natural is unclear, leaving room for more lawsuits aimed at ridding products of "dangerous chemicals." "None of it makes any difference whatsoever," says Dr. Whelan. Scientifically, she points out, "everything is chemicals. Life is chemicals. We are chemicals."
Britain has a change of heart on biotech
We were happy to read that British Environment Minister Phil Woolas is calling for a greater role for genetically modified crops in his country and the world. "England has been anti-biotech forever," says Dr. Whelan. "This is revolutionary."
The British government seems to be realizing that GM crops could help cut food costs not only in England but in the world's poorest countries, where people are currently suffering the acute affects of a food shortage. "It's the dawning of an understanding that we have a food crisis. This could be a turning point," says Dr. Whelan.
Gambling with asthma and influenza
A new study reached the disappointing conclusion that a majority of Americans with asthma do not get flu shots. "Talk about being at high risk," Dr. Whelan remarks. People with asthma are prone to complications if they contract influenza, but only 36% of those studied were vaccinated against the disease from September 2005 to February 2006.
Vaccination rates rose in patients with recent asthma problems but still hovered below 50% even among those who had to go to the emergency room or seek urgent care for asthma in the previous twelve months. "What do you have to do to make people realize that not getting a flu shot is dangerous, especially if you have a high risk factor like asthma?" asks Dr. Whelan.
New York maps cancer clusters
New York state residents will soon be able to track different kinds of cancer and where they occur on a detailed map based on data collected by the State Health Department. In addition to plotting each reported case of cancer, the map will also include the location of power plants and chemical factories. "The underlying assumption is that cancer is caused by local environmental conditions," says Dr. Whelan.
We were impressed by the New York Times' balanced reporting on this issue. While the article quotes many supporters of the new mapping system, it also notes, "But others say that geographical cancer data is too prone to misinterpretation, especially by people without medical training, and that they lead the public to see a cause-and-effect relationship that is not necessarily there." We couldn't agree more.
Revving up the immune system to treat melanoma
ACSH staffers were excited to read about progress made on an inventive way of treating life-threatening skin cancer. A fifty-two-year-old man with advanced melanoma was apparently cured through immunotherapy, which strengthens the patient's own immune system's ability to fight skin cancer. "It's exciting that we're starting to actually see some results with cancer immunotherapy," says Dr. Gilbert Ross.
The experimental therapy involved drawing blood from the patient and growing more of his "helper T cells" in the laboratory. When the helper cells were infused back into the patient's body, they directed his "killer T cells" to attack the skin cancer. Only one case resulted in successful treatment in the small study, but doctors believe that small steps forward now could lead to a breakthrough later.
DISPATCH 6/19/08: Industry, Infertility, Salmonella, BPA, PCBs, with Coffee
ACSH in the National Post on industry-science ties
An article examining the connection between industry and science by ACSH president Dr. Elizabeth Whelan appears in today's "Financial Post" section of Canada's National Post. She takes on the argument that "anti-corporate claims are by definition 'good science' while claims made in defense of industry or new technology -- by anyone with the slightest ties to industry -- are by definition 'suspect science'."
She worries important medical advances will not reach the public because industry-funded scientists' hard work could be "dismissed as corporate propaganda," no matter how meticulously a study is done or how carefully it is peer reviewed. ACSH previously explored this hotly debated topic in its publication Scrutinizing Industry-Funded Science.
Infertility blamed on trans fat
ACSH staffers were surprised by the Harvard Public Health Review's decision to publish a book review of The Fertility Diet, which argues that women may be able to increase their chances of getting pregnant by avoiding trans fats and making other dietary changes. "How can this be? I went to this school!" exclaims Dr. Whelan incredulously.
We hope that the high-profile nature of this publication does not lend credence to these scientifically questionable claims. Infertility is a painful and complex problem without quick-fix solutions, as a recent article in the New York Times suggests. Arguing that a healthy diet can solve infertility comes uncomfortably close to blaming women's inability to conceive on "bad choices."
More salmonella cases reported in New York City
The killer tomatoes continue their attack, as New York City health officials confirmed six new cases of salmonella caused by eating tomatoes infected with the Saintpaul strain of the disease. The Food and Drug Administration continues to investigate the outbreak, but it is becoming increasingly likely that the source will never be found. "If we irradiated the tomatoes, we wouldn't have this problem," says ACSH's Dr. Ruth Kava, while ACSH research intern Krystal Ford points out that the irradiation must be done close to the point of sale, since "if you irradiate them before they go to the point of contamination, you've just negated the benefit."
Throwing the baby bottle out with the bath water
Four Ohio parents have filed a lawsuit against companies that made baby bottles with bisphenol-A, claiming that because the companies were forced to withdraw their products by a health scare, they must have known the bottles were unsafe all along. ACSH staffers worry that lawsuits like this one, based on junk science and backwards logic, will add to paranoia's undue influence on public health. "Unfortunately, the actual health scares are just the beginning," says Dr. Whelan.
PCBs incorrectly linked to cancer...again
We were disappointed by the New York Times' assertion that polychlorinated biphenyls, or PCBs, are human carcinogens. "The article perpetuates the myth that trace levels of PCBs in the environment cause cancer," says Dr. Whelan. We would like to contest the article's claim that "No one disputes that PCBs are dangerous," because when Dr. Whelan asked the National Cancer Institute if exposure to trace levels of PCBs (like those in the Hudson River) contributed to the cause of human cancer, the spokesman said "no."
Applying skepticism to both coffee and cancer
A study linking a healthy diet, exercise, and stress reduction to changes in gene expression and potentially to a lower risk of prostate cancer drew skeptical responses from around the ACSH breakfast table. ACSH's Jeff Stier points out that the changes in gene expression have not actually been linked to a reduction in cancer rates and believes "People are willing to give bad science a free pass when the changes it recommends are positive changes," like eating healthily and exercising.
Both the gene expression study and a study concluding that coffee was not linked to a shorter life were epidemiological, but only the latter drew skepticism for its methodology. "Saying that coffee isn't harmful doesn't play into people's preconceived notions about what's good or bad," Stier says. "We should allow science to speak for itself."
DISPATCH 6/18/08: Floods, Blood, Drugs, Smoke, and Radiofrequency Ablation
AMA compromises with tobacco industry on new bill
We were not surprised to learn that the American Medical Association is supporting the menthol exemption in the new FDA/tobacco bill. The AMA "is promulgating the falsehood that menthol doesn't entice young African-Americans to smoke," says ACSH's Dr. Gilbert Ross. "The AMA has the most dismal record on smoking you can imagine," adds ACSH's Dr. Whelan. Menthol cigarettes are preferred by 75% of African American smokers, so the exemption has come under fire as discriminatory.
The new bill would give the Food and Drug Administration the power to regulate tobacco and ban several flavors that attract young people to cigarettes, but the menthol exemption is just one of the many reasons why ACSH believes it is not an effective public health measure. The AMA claims it must compromise with the tobacco industry by including the menthol exemption in order to ensure the bill passes; however, as Dr. Ross says, "It's a terrible bill that doesn't need to be saved through compromise."
Staying on top of blood pressure readings
ACSH staffers were surprised by a new study recommending that doctors only monitor systolic blood pressure in patients over fifty. Systolic blood pressure, or the top number in a reading, is the pressure exerted at the beginning of the heart's pumping cycle. It tends to increase with age, causing problems such as hypertension. "For doctors to advise only looking at systolic is a paradigm shift," says Dr. Ross.
Diastolic blood pressure -- the bottom number -- tends to decrease with age and pose fewer risks for older patients. The study's authors worry that presenting patients with two numbers may be confusing and detract from attending to the dangers of high systolic blood pressure. "It's a dramatic shift in understanding how to interpret blood pressure readings," says Dr. Whelan. "It's going to take a while to settle in."
Drug companies cave to advertising restrictions
We are disappointed that some pharmaceutical companies have agreed to a six-month moratorium on direct-to-consumer advertising of new drugs. "Either the drug is dangerous and shouldn't be on the market, or it's safe enough that patients should be able to be informed and speak to their doctors about it," says ACSH's Jeff Stier.
We are also worried that the advertising ban will raise the cost of medicines, since decreased sales of new drugs could decrease companies' profits and make it impossible for them to recoup their research costs without raising prices. "This is just another political tactic targeting the pharmaceutical industry," remarks Dr. Ross.
Study points to new option for metastatic cancer treatment
We were excited to see the promising results of a new study investigating the possibility of treating lung cancer with radiofrequency ablation, a minimally invasive procedure that may be useful to shrink small primary and metastatic tumor nodules. According to Dr. Ross, "They're getting a wonderful response in metastatic disease," or cases in which the cancer has spread to the lungs from another point in the body (often the colon). Currently, metastatic tumors often require surgery, so a less invasive treatment is highly desirable. Early detection also becomes more important, since radiofrequency ablation is most effective on small tumors. "The spiral CT technique for detecting early lung tumors would become much better in terms of the risk-benefit of the procedure," Dr. Ross points out.
Potentially toxic soup floods Iowa
Even though the floodwaters have peaked in the Midwest, Iowa continues to face looming public health problems. The water covering the eastern part of the state is filled with dangerous levels of chemicals, sewage, and human pathogens. "This is not trace levels of insecticide on produce," ACSH's Dr. Ruth Kava points out. "It's massive amounts of agricultural runoff."
"The real thing I would be worried about is human pathogens," says Dr. Whelan -- especially since the acres of standing water are now perfect breeding grounds for mosquitoes. "Obviously, mosquitoes are vectors of disease," Dr. Whelan says. "It's going to be unlivable unless they can bring themselves to do aerial spraying." Chemicals properly applied can be quite helpful.
New York's blood shortage exacerbated by attempts to donate
New York always seems to be running low on blood, but what happens when a New Yorker tries to donate? Dr. Whelan shares the ordeal she went through on Friday:
"The New York Blood Center regularly emails me, asking me and my O-positive blood to come in and donate. This week they had a special urgent request for O-positive blood, and they called me. They gave me a 3:15 appointment and told me to get there early. The address for the drive wasn't very specific, so I assumed it would be a mobile clinic. I was there by 3pm and got checked in with all the preliminaries.
"There were a number of other donors lying on the cots, and as I lay down to start the drawing of blood, two policemen entered the unit and said that everyone had to exit immediately because the mobile unit was going to be towed away for a traffic infringement. The director pointed out they had a permit and only had about ten more units to draw (including from me). But the cops were insistent. I was booted out first, as I was not hooked up -- I do not know what they did with the 'in process' donors.
"Talk about inverted priorities in New York."
DISPATCH 6/17/08: Triple Negative, Double Honors, Freshman 15, Presidential Error, Russert
Honorary seats at the table go to Deputy Sec. of State John Negroponte and NYU's Dr. Steven Lamm
We would like to offer Sec. Negroponte a seat at the ACSH breakfast table for his strong statements promoting the use of biotechnology to help alleviate the current food shortage. "Biotechnology tools can help speed the development of crops with higher yields, higher nutrition value, better resistance to pests and diseases, and stronger food system resilience in the face of climate change," he said at an event announcing the winners of the World Food Prize, which was founded by ACSH Trustee and Nobel Peace Prize winner Dr. Norman Borlaug.
Dr. Lamm, an internist at the New York University School of Medicine, appeared on the Today show this morning to offer a sensible reaction to the new findings that drinking coffee is not associated with a shorter life and may reduce a woman's chance of dying of heart disease. With so many studies on coffee producing contradictory results, we appreciated his effort to put this one in perspective by saying, "This is a population study, and they are prone to some errors at times...however, there seems to be a trend that coffee in moderate doses is probably not harmful." We hope that Dr. Lamm can join us for an honorary cup of coffee soon.
Russert's death offers insight on preparing for emergencies
As the mourning for journalist Tim Russert continues, ACSH staffers are wondering if his death could have been prevented. According to ACSH's Dr. Gilbert Ross, Russert's sudden heart attack reminds us that "many heart attacks occur in people who do not have significant narrowing of the coronary arteries," but are instead caused by pieces of plaque that suddenly break loose from the walls of arteries and form clots that block blood flow.
Heart attacks can be sudden and unexpected, so it is important to have a defibrillator on hand. We were surprised that NBC apparently did not have one in its office. Dr. Ross informs us that new defibrillators have simple directions and are often automatic [UPDATE: This proved to be false]. "If Russert had a large amount of muscle killed or stunned right away, then nothing would have helped," says Dr. Ross. However, he adds, "There's far more to be gained than lost by shocking someone if they pass out and you are not sure of the cause."
Beating triple negative breast cancer
We were concerned about a report on a rare and aggressive form of breast cancer called triple negative. "Triple negative breast cancer is tough to treat because it doesn't have the hormonal receptors" for estrogen, progesterone, and HER2, says Dr. Ross, which rules out hormone therapy as a treatment option. Chemotherapy and surgery are the only known effective treatments, but this specific type of breast cancer still has a high rate of recurrence.
Triple negative breast cancer occurs primarily in African-American women, pointing to genetic risk factors. "How much more evidence do you need about genetic influence?" asks ACSH's Dr. Elizabeth Whelan. Early detection remains the best method for surviving breast cancer, so regular mammograms are key -- especially if a woman has a family history of the disease and a risk factor like the BRCA1 gene mutation.
Freshman five a growing problem
While the freshman fifteen may be a myth, a Canadian study found that women do tend to gain about five pounds during their first year of college. Many lifestyle changes can contribute to the weight gain, from access to all-you-can-eat dining halls to the fact that fewer women play sports in college than in high school. "This could be the beginning of a problem," says Dr. Whelan, although Dr. Ruth Kava points out that some students' weight gain may be healthy, as "some people are still growing when they get to college."
Presidential candidates waver on vaccine safety
We were appalled to discover that both major parties' presidential candidates (and Hillary Clinton) have made statements about a possible link between autism and childhood vaccines. "This is a factual error they can be corrected. I think it's very risky to say something stupid like that," remarks Dr. Whelan. "They don't have good scientific advisors," Dr. Kava concludes, while Dr. Ross believes "candidates should lead, not pander on these issues -- science cannot be voted up or down like some legislation."
We were heartened, though, by the article "Why Babies Need Shots" in the July 2008 issue of Parents, which outlines the sound science behind the benefits of vaccines. We hope that in the future both of the aforementioned presidential candidates will realize fueling health scares is not a way to win votes.
DISPATCH 6/16/08: Chickens, Lungs, Prostates, Fillings, and Russert
Could Tim Russert's death have been prevented?
Like many people across the country, we were saddened to hear about Tim Russert's sudden and unexpected death on Friday. Sudden cardiac arrest causes 310,000 deaths in America every year, and Russert's case reminds us that it can strike without warning. While the journalist had several risk factors for a heart attack, like diabetes and coronary artery disease, he appeared to be healthy during recent checkups.
ACSH's Dr. Gilbert Ross is particularly concerned about reports that Russert's autopsy showed an enlarged heart that was apparently not detected previously. "An enlarged heart is a real red flag," he says. An enlarged heart can appear on chest x-rays, so it is important for even healthy or asymptomatic people to have at least one baseline chest x-ray that can be used for detection of unsuspected enlargement of the heart later.
"How many of us felt like we knew this man?" asks ACSH's Dr. Elizabeth Whelan. "He had more insight than anyone on television." ACSH extends our condolences to Russert's family and friends and hopes his tragic death raises awareness about the risks of heart disease.
Drug seems to lower the risk of prostate cancer
ACSH staffers were excited to read that the drug finasteride has been found to be a safe and effective way of preventing some fraction of cases of prostate cancer. Prostate cancer is not often lethal, but it is the most commonly diagnosed cancer in men in the U.S. and causes 30,000 deaths annually.
Ironically, treating prostate cancer can actually be more harmful than not, since treatments can be invasive and have side effects such as impotence or incontinence. According to Dr. Christopher Logothetis, professor and chairman of genitourinary medical oncology at M.D. Anderson Cancer Center, "Most of the time, treatment wouldn't help and may not be necessary. But the reality is that people are being operated on." One of the benefits of finasteride, ACSH's Dr. Ruth Kava points out, is "this drug can prevent you from needing surgery or radiation."
Finasteride blocks the conversion of testosterone to dihydrotestosterone, a hormone that all prostate cancers need to grow but that is only active in the prostate and the scalp. According to Dr. Ross, the hormone's limited active area means "there is very little risk of unpleasant side effects" from the drug. "It seems to have little in the way of downside," he adds. "If I were a man of a certain age, I would call my doctor today," says Dr. Whelan.
Chicken labels cause controversy
We were puzzled by a recent lawsuit filed by Tyson Foods Inc. against the U.S. Department of Agriculture over the company's label designating chickens as "antibiotic-free." The USDA required Tyson to stop using the label because the company was using antibiotics in its hatcheries days before eggs hatched. Tyson contends that the label "raised without antibiotics" should refer to "the period between hatching and slaughter." "It seems like either the label is accurate or it's not," Dr. Kava offers. "How were they giving unhatched chicks antibiotics? Were the drugs being fed to the mother hens?"
This lawsuit brings to the forefront just how confusing labels like "antibiotic-free" can be -- for companies, governments, and especially consumers. "'Antibiotic-free' is misleading already," comments Dr. Whelan. "It doesn't help consumers make a decision."
Lung cancer still an issue for never-smokers -- especially women
We were concerned to read about a recent study that concluded women who have never smoked are at higher risk for lung cancer than men in the same category. "People who don't smoke have a very low risk of lung cancer; however, it seems to be more common in women," says Dr. Whelan. Among smokers, women and men appear to have equal risk for developing lung cancer.
The link between smoking and lung cancer is strong, but as this study brings to light, it is possible to develop the disease without a history of smoking. Dr. Whelan recalls that a gender gap in never-smokers who develop lung cancer has often been alluded to and says, "I always wondered why it has never been studied." We hope that more studies will be done on this important topic in women's health.
FDA forced to waffle on amalgam dental fillings
We were disappointed to read that the Food and Drug Administration caved to another health scare, this time regarding mercury in amalgam dental fillings -- which are cheaper and more durable than other types. Despite its strong stance on the safety of BPA last week, the FDA seems to have lost sight of the importance of sound science when issuing a warning against silver-mercury amalgam dental fillings -- over concerns that low levels of mercury may be dangerous for pregnant women and young children.
"We are so disappointed in the FDA for not speaking up and saying this is not a risk," says Dr. Whelan. We agree with Dr. Edmond Hewlett, a dental professor at UCLA and an American Dental Association adviser, who told the Associated Press, "We don't want these choices taken away based on junk science. We don't want them taken away based on misguided fears."
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.
