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ACSH Dispatches Round-Up: Smokeless, Vinyl, HPV, Dr. Wind, More
By Elizabeth Wade
April 3, 2009
Congress's Pro-Smoking Bill and Anti-Book Law, plus Radiation Hysteria
By Elizabeth Wade
Quitting smoking just got harder
A story about a study concluding that smokers who use nicotine replacement therapy are twice as likely to quit for six months than those who were given placebos reminds us of the dire straits we are in with regard to tobacco cessation therapy. What isn't reported until the end of the news story is that only 6.75% of the smokers given the nicotine replacement therapy managed to quit for six months -- and only half of them are expected to remain smoke-free in the future.
"These abysmal quit rates show that our current smoking cessation therapies are almost never effective," says ACSH's Dr. Gilbert Ross. "People who close their eyes to alternative cessation therapies, such as smokeless tobacco as harm reduction, are being ostriches at the expense of the over 40 million addicted smokers in this country -- and who knows how many millions around the world."
Unfortunately, the U.S. took a step in the wrong direction yesterday when the House of Representatives passed the Kennedy-Waxman bill giving the FDA regulatory control of tobacco and defeated Rep. Steven Buyer's (R-IN) harm reduction amendment in a 284-142 vote. Lawmakers expect a tighter vote in the Senate, and ACSH looks forward to offering our science-based perspective to the continuing debate. We wholeheartedly agree with Rep. Buyer when he says, "Effectively giving an FDA stamp of approval on cigarettes will improperly lead people to believe that these products are safe, and they really aren't. We want to move people from smoking down the continuum of risk to eventually quitting."
The current battle over the e-cigarette illustrates the problems with our country's approach to tobacco policy. The e-cigarette delivers a hit of nicotine vapor when a person "smokes" it, so smokers who are trying to quit can satisfy their craving without inhaling the harmful products of combustion produced by cigarettes. But because the FDA has yet to approve the e-cigarette as a nicotine-delivery device, this new technology could be banned until it undergoes the approval process. "You can't blame the FDA for enforcing the law, but we have bad laws about tobacco that lead to bad public policy outcomes," says ACSH's Jeff Stier.
Attack of the cell phone towers!
A group of Staten Island parents and lawmakers are up in arms about the possibility of cell phone towers sending low-level radiation into a nearby school. "When they traced the source of radiation, which was above average but not dangerous, they found that it wasn't connected to the cell phone towers at all," Dr. Ross remarks. "But they are still trying to get them removed!"
Dr. Whelan adds, "When people believe scares like this they become totally irrational. When they really believe that these towers are emitting dangerous levels of radiation, how do you convince them otherwise?"
Dr. Ross jokes, "The only way to appease them seems to be getting all the students at this school metal helmets." ACSH debunked the wrongheaded notion that cell phones cause brain cancer in our Top 10 Unfounded Health Scares of 2008. For more information, see our publication The Health Effects of Low-Level Radiation.
CPSIA remains intact, Prop 65 grows even more ridiculous
Unfortunately, the Senate rejected Senator Jim DeMint's (R-SC) amendment to the stimulus bill that would have reformed the Consumer Product Safety Improvement Act (CPSIA). "The Senate failed to take a breath of fresh air," Stier says. As we have written before, the CPSIA places an impossible burden on many small businesses by banning certain types of phthalates and requiring that every children's product be tested for minuscule levels of lead. If a business can't afford the expensive testing, it must throw out the products -- even all-terrain vehicles (ATVs) and children's books!
As summarized so succinctly in today's Wall Street Journal editorial, "With one stroke of the regulatory pen, an estimated $100 million of inventory can't be sold, and the industry loss may reach $1 billion."
In California, we see the results of another absurdly stringent "public health" measure, Proposition 65, which requires warnings to accompany any product that contains "toxic chemicals." To avoid lawsuits, businesses in the state have taken to posting frivolous "warning signs" about products that do not pose any danger to consumers' health.
"Prop 65 is not based on health or science, but rather perceptions and politics," Dr. Ross says. For more on the consequences of the misguided law, check out Stier's op-ed "Perils of Global Warnings" from the Washington Times.
April 2, 2009
Cigarettes, Vinyl, and HPV
By ELizabeth Wade
ACSH quoted in tobacco bill debate
Yesterday the House of Representatives debated the Kennedy-Waxman bill, which would allow the FDA to regulate tobacco, and we at ACSH are proud to have contributed to the discussion. As we have written before, the Kennedy-Waxman bill does not distinguish cigarettes from less harmful forms of tobacco, such as snus and other types of smokeless tobacco. We are pleased that Congressman Steven Buyer (R-IN) introduced alternative legislation focusing on harm reduction, and that he quoted ACSH in yesterday’s debate:
“If we can move our smoking population away from smoking products, the most dangerous tobacco products on our market, and move them to less risky tobacco and nicotine products as we wean them off nicotine and tobacco, we have a chance to decrease the adverse effects of tobacco use by up to 90% over 20 years, according to the American Council on Science and Health. For smokers who are unwilling or unable to quit smoking, we must provide them with the information they can use to decrease health risks.”
“It is exciting to see that our message is getting out there, and even made it all the way to the House floor,” says ACSH’s Jeff Stier. The House voted on the tobacco legislation today, and Buyer’s bill received 142 votes -- although, unfortunately, it was still defeated by a 2-1 majority.
Will “disclosing” ingredients make cleaning products safer?
The Wall Street Journal reports that the makers of many household cleaning products are considering listing the cleaners’ ingredients on their packaging. As a spokesperson for Procter & Gamble states, “Consumers want to know more to ensure the safety of their family. The industry is changing along with that.”
ACSH’s Dr. Gilbert Ross wonders, “How does listing the ingredients in ‘consumer-friendly terms’ make the product any different, safer, or better than it is now?” Even though there is no stated plan to change the ingredients of these cleaners, ACSH staffers think it will only be a matter of time before the debate progresses to that point.
“Once they list some scary-sounding chemicals on the label, activists will start screaming about how dangerous they are,” ACSH’s Dr. Ruth Kava says. “Some of the substances used in cleaning products are dangerous in extremely high doses, but the amounts we are exposed to are small. It is like the difference between concentrated acetic acid, which is very dangerous, and vinegar, which obviously is not.”
Latest autism scapegoat: vinyl floors
A new study claims that children who live in houses with vinyl floors are twice as likely to have autism, but ACSH staffers are obviously skeptical. “When will people stop coming up with these ridiculous alleged causes of autism and focus on real solutions?” Dr. Whelan wonders. “There should to be some kind of biological hypothesis before researchers make these claims.”
Vinyl flooring can emit phthalates, which have been blamed for a multitude of health problems recently -- even though the small doses to which we are exposed have never been found to cause negative health effects in humans. To their credit, the researchers behind the autism study admit that their results are not conclusive and only show an association, rather than causation.
HPV test slashes number of deaths from cervical cancer
In a new study, women who were tested for human papillomavirus (HPV) were half as likely to die of cervical cancer as compared with a control group who only had the routine Pap test. “Cervical cancer is the second-leading cause of cancer death for women in the world, and the problem is particularly acute in developing countries, so the HPV test is a particularly welcome development,” Dr. Ross says.
The HPV test proved to be more effective at preventing cervical cancer deaths than Pap smears or a test to detect tumors. “If a woman tests negative for HPV, she can probably afford to have Pap smears less frequently,” Dr. Whelan states.
HPV is the most common sexually transmitted disease in the world and causes a large majority of cervical cancer cases. The HPV vaccines Gardasil (made by Merck) and Cervarix (made by GlaxoSmithKline) are effective at protecting uninfected women (and perhaps men) from contracting the virus, but so far they are only available to women under 26. “In a perfect world, we could test women for HPV and inoculate all of those who test negative against the virus – and basically wipe out cervical cancer,” Dr. Ross says.
April 1, 2009
Dr. Wind, Philip Morris, CT Scans, and Despondex
By Elizabeth Wade
Seat at the table goes to Dr. Maryland Wind of the CPSC
ACSH staffers were pleased to see an NPR story explaining the safety of phthalates and pointing out that the ban on using the chemicals in children's products isn't justified by the science but is based on "an abundance of caution." We were particularly impressed with the comments of Dr. Maryland Wind, a scientist at the Consumer Product Safety Commission (CPSC). She says that after doing several studies on children's exposure to various forms of phthalates in toys, the CPSC opposed the federal ban because "there was not a risk of injury to children."
Dr. Wind continues, "I know that we did really good science. And sometimes people don't listen to the good science." Don't we here at ACSH know that! ACSH has been defending the safety of phthalates for more than a decade, starting with our blue-ribbon panel's report that these chemicals, which make plastic flexible, are not harmful.
The Consumer Product Safety Improvement Act (CPSIA), the federal law banning certain phthalates in children's products, also imposed stringent lead limits and harsh testing requirements on the makers of children's products throughout the country. "Today, some of the thousands of people who oppose this misguided legislation are rallying against it in Washington, DC," ACSH's Jeff Stier reminds us. You can even participate in the rally online.
Supreme Court dismisses Philip Morris appeal
The Supreme Court dismissed Philip Morris's appeal of punitive damages awarded in Oregon to the widow of a smoker who died of lung cancer. "I testified against Philip Morris in the Williams case in Oregon twelve years ago," Dr. Whelan says. "The award of $79.5 million was the largest judgment against a cigarette company, and the ruling was especially positive because so many of these cases have been settled in favor of the tobacco industry."
While the Supreme Court didn't rule on the merits of the appeal, its dismissal means that the punitive damages award stays intact. "The battle is not quite over, but now it seems as though they are deciding whether to drop Philip Morris from ten feet up or twenty feet up -- with a noose around its neck in either case," says ACSH's Dr. Gilbert Ross.
In related news, the hike in the federal cigarette tax goes into effect today, and by tomorrow the House is expected to pass the bill allowing the FDA to regulate tobacco. "Both of these measures are indiscriminate in terms of which type of tobacco they apply to, which will unfortunately discourage the use of smokeless tobacco as a harm reduction aid to help addicted smokers quit," Stier notes.
Do CT scans increase cancer risk?
We are skeptical, to say the least, about the claim that multiple CT scans may raise cancer risk. "The study concluded that only 7% of patients were exposed to enough radiation from CT scans to raise their cancer risk by just 1%," Dr. Ross points out. "The authors use many devices, such as estimates and extrapolations, to justify their conclusion. Also, they fail to take into account hormesis, or the idea that small amounts of radiation can have positive health effects."
He concludes, "You shouldn't undergo radiation exposure unless it's indicated, but this story is nothing but a scary headline based on smoke and mirrors." For more information, read ACSH's publication The Health Effects of Low-Level Radiation. On a related topic, see the ACSH-commissioned journal article "Nuclear Energy and Human Health."
Too cheerful? Try Despondex!
ACSH staffers are absolutely thrilled to no longer be overwhelmed with joy about the news that the FDA has approved the first depressant medication, Despondex. We are tired of looking on the bright side and hope that this innovative drug will help keep us down in the dumps. Spread the word to all the annoyingly cheerful people you know: Despondex can help!
For more April 1 updates from ACSH, check out Jeff's Twitter page (which, all joking aside, just reached 200 followers!). His first tweet of the day: "ACSH Today Calls on Congress to Ban Any Food and Consumer Product Containing More Than 4/1 Parts Per Billion of Chemicals!"
March 31, 2009
Polypills, P.E. Programs, Pesticides, and Prostates
By Elizabeth Wade
Polypill could make protecting your heart easier and cheaper
The first trial of a "polypill" containing a statin, aspirin, and three types of blood pressure medication has been successful. Done in India, the study enrolled over 2,000 people with one risk factor but no cardiovascular disease. Those given the polypill experienced a greater reduction in blood pressure than those taking individual medications and almost as great a drop in LDL cholesterol as those taking individual doses of the statin included in the pill.
Most importantly, combining the drugs in a polypill did not appear to result in any harmful drug interactions. "The real point of this study was not to determine the pill's efficacy, but rather its safety," explains ACSH's Dr. Gilbert Ross. "It was important to test whether these drugs could be tolerated together or did anything unexpected in combination." Despite the enthusiastic headlines, it has yet to be determined if the polypill actually prevents heart disease or stroke.
Combining multiple drugs in one pill has been shown to improve compliance -- that is, patients find it easier to take prescribed medications if they have to take only one pill instead of several. Further, because it contains generic versions of the five medications, the polypill only costs about one dollar per day.
"Its low price shows the importance of continued pharmaceutical research," says ACSH's Jeff Stier. "When we pay more for a brand-name drug, we are not only funding the drug company's research and development, but we are making it possible to have generic versions in the future. If we tried to make all new drugs cost one dollar, we wouldn't have any new drugs."
Are P.E. programs an exercise in futility?
A new study reports that physical education programs in schools do not reduce obesity rates. But participating in a P.E. program does improve students' blood pressure, muscle mass, bone mineral density, lung capacity, and flexibility. "Exercise is good for a lot more than just preventing obesity, and we at ACSH are very much in favor of physical education in schools," says ACSH's Dr. Ruth Kava.
Organic pesticides challenge belief that natural is safer
While most people believe that organic foods are grown without any pesticides at all, farmers are allowed to use certain "organic pesticides" -- many of which are failing the European Union's stringent safety tests. "When people make arguments for eating organic, there's always the line about 'no pesticides,' even if they understand that organic foods aren't more nutritious," Dr. Kava says. "It is refreshing to set the record straight about the use of organic pesticides."
The EU controversy is a good illustration of the fact that just because something is considered "natural" doesn't mean it's safer. "Synthetic pesticides are more narrowly tailored and more precise, so they could actually be safer than organic ones," Stier points out. As ACSH's Holiday Dinner Menu illustrates, many chemicals found naturally in our food cause cancer in animals at high doses. (But, as always, it's important to remember that the dose makes the poison.)
Dr. Ross offers a logical solution to the organic pesticide dilemma: "If you genetically modify plants to resist pests on their own, then you wouldn't have to use so many pesticides. Of course, I do not mean to imply that pesticides are dangerous -- unless you're a pest."
Pondering prostate cancer
With the recent news that PSA blood tests may not save lives and result in many men undergoing unnecessary and unpleasant treatments, doctors and patients are re-evaluating how to best screen for and treat prostate cancer. An article in the Wall Street Journal tackles the dilemmas involved in detecting the disease and deciding on the best course of treatment.
While MRIs, molecular markers, PET scans, and radioactive dyes are all mentioned as possible detection techniques, ACSH staffers are most intrigued by "3D mapping biopsies," which take 50 or more samples throughout the prostate. "In a study of the procedure, 189 out of 200 men received results that influenced or changed their approach to treatment," Dr. Ross says. "That's a very high yield of important information."
But, he says, tests for prostate cancer don't always have to be so complicated, unpleasant, and expensive. "By considering PSA per estimated volume of prostate, bound vs. free PSA, and the rate of change of PSA, doctors can get a pretty good idea about whether a patient has prostate cancer, and how dangerous a prostate growth might be," he says. "I'm surprised that none of these simple screening tests were mentioned in the article, although even they are far from foolproof and clinical intuition still plays a role."
March 30, 2009
Borlaug, FDA, Tobacco Taxes, Blood Clots, and a Fulbright at ACSH
By Elizabeth Wade
ACSH celebrates with Dr. Borlaug on his 95th birthday
Last Wednesday, ACSH's Dr. Elizabeth Whelan and Dr. Gilbert Ross traveled to Dallas, Texas, to celebrate the 95th birthday of Dr. Norman Borlaug. "We were thrilled and honored to be part of the 200 friends and relatives who gathered to celebrate Dr. Borlaug's birthday and his many accomplishments, which include saving countless lives as the father of the Green Revolution and winning the 1970 Nobel Peace Prize," Dr. Ross says. ACSH has been proud to count Dr. Borlaug among our trustees since our founding in 1978.
Dr. Borlaug's Green Revolution used traditional food technology to dramatically increase the world's production of wheat in the mid-20th century. Most recently, he has been crusading to stop the spread of the devastating wheat disease stem rust. Dr. Whelan says, "His theme is still 'fight, fight, fight' in favor of using modern food technology, especially genetic engineering, to alleviate food shortages and malnutrition around the world." Click on our Events section to see pictures of the celebration.
ACSH extends our message through media
ACSH's criticism of the appointment of Joshua Sharfstein as deputy commissioner of the FDA is being heard across the country, as the op-ed on the subject written by ACSH's Jeff Stier and ACSH Trustee Dr. Henry Miller was recently published in southern California's Orange County Register.
"In the recent survey we conducted of our donors, many of you encouraged ACSH to get our message out to a wider variety of media outlets," Stier says. "We've been heeding your advice and submitting to broader range of newspapers and other outlets, and this latest placement is another success."
Tobacco tax set to increase
A large increase in the federal tobacco tax takes effect this week, with the tax jumping from 39 cents to $1.01 per pack of cigarettes. "Unfortunately, this is truly a tobacco tax rather than just a cigarette tax, as it will affect the price of smokeless and other less harmful forms of tobacco as well," Dr. Whelan points out.
Dr. Ross says, "It is commonly believed that price increases have a particular impact on young people's decision to start or quit smoking, although I'm not sure how much data there is to back up that assertion."
Stier adds, "It's certainly true that prices have consequences, but we'll have to wait and see what those consequences will be."
ACSH staffers find it ironic that the revenue raised by the tobacco tax will fund an expansion of health insurance for children. "Supposedly the tax is to encourage people to quit smoking, but if they do quit, the revenue for this cause will go down," remarks ACSH's Dr. Ruth Kava.
Statins may cut risk of deadly blood clots
The latest good news to come out about cholesterol-lowering statin drugs is that they may also reduce the risk of blood clots, which kill about 100,000 Americans per year when they travel from their origin, commonly in the deep leg veins, and lodge in the lungs. This secondary effect was seen in the widely publicized JUPITER study, which showed that the powerful statin Crestor reduced the incidence of heart attacks and strokes in people with normal cholesterol levels but high levels of CRP, an indicator of inflammation.
"Crestor is the most potent statin, so we still have to see if other statin drugs have the same effect in terms of coronary artery manifestations and blood clots," Dr. Ross says.
He continues, "Among all statin drugs, Crestor also carries the highest risk of muscle breakdown as a side effect. It is still a very small risk compared to Crestor's demonstrated ability to save lives, but Sidney Wolfe of the Naderite activist group Public Citizen is, of course, labeling the drug 'dangerous' and misguidedly calling for it to be removed from the market. He has never learned to distinguish between risks and benefits."
ACSH intern to head south of the border
Good news from the ACSH family: over the weekend, I found out that I have been selected to receive a Fulbright fellowship to Mexico this fall. I will use the award to pursue a master's degree in comparative literature at the prestigious National Autonomous University of Mexico (UNAM) in Mexico City. A big thank you to everyone at ACSH for all their support!
March 27, 2009
Appetite, Proximity Alarm, Supplements vs. Lungs, Three Mile Island
By Elizabeth Wade
Low glycaemic index foods may satiate appetite through hormone production
ACSH staffers are intrigued by new research suggesting that low glycaemic index (GI) foods make people feel fuller for longer because they increase the level of the hormone GLP-1 in the bloodstream. Foods with a low GI rating take longer to digest and release carbohydrates into the body more slowly. GLP-1 is known to suppress appetite, so having elevated levels of it in the blood could be a reason that people tend to feel satiated for an extended period of time after a low GI meal, such as a bowl of oatmeal.
"We've been skeptical about a lot of the claims surrounding low GI foods, but this research explores a possible biological mechanism and seems to have some scientific legitimacy to it," says ACSH's Jeff Stier. "It would be very helpful if we could figure out a way to manipulate people's appetites with other kinds of foods. This research is still in a preliminary stage, but it is the kind of development we are looking for to fight obesity with food technology."
ACSH's Dr. Ruth Kava adds, "It could also be a pharmaceutical issue. If we could develop a pharmaceutical agent that you could take with your meals to decrease your appetite, it could be very helpful." GLP-1 is particularly promising in this category because it is a gut hormone and, therefore, decreases appetite through non-central mechanisms. "That could help avoid a lot of side effects," Dr. Kava points out.
For more cutting edge ideas in the fight against the obesity epidemic, check out ACSH's publications Obesity and Food Technology and Obesity and New Pharmaceutical Approaches.
Fast food near schools again blamed for obesity epidemic
A new study claims that students at schools within a block of a fast food restaurant are more likely to be obese than those whose schools are further away from such establishments. "The main criticism of this study is that it didn't take individual diet and exercise habits into account," says Dr. Kava.
Over the ten-year course of the study, researchers were able to compare the obesity rates at the same school before and after a fast food restaurant opened nearby. "But I would like to know what happened when other types of eating establishments opened close to schools as well," Dr. Kava says. "Bodegas and even salad bars offer many options that can be just as caloric as any fast food hamburger or cheeseburger."
Dr. Whelan agrees: "People are so focused on fast food as the culprit of the obesity epidemic that they lose sight of other equally problematic possibilities."
Dr. Ross adds, "Even with all the confounders and inadequacies of this junk 'study,' the researchers still only managed to come up with a five percent increase in obesity risk as compared to those students whose nearest access was much farther away. It's ridiculous that this kind of result would catch all this media attention."
Could certain supplements cause lung cancer?
The long-term use of beta-carotene, retinol, and lutein supplements may increase the risk of lung cancer, especially in current and former smokers. "While it has been known for many years that beta-carotene supplements are linked to an increased risk of lung cancer, this study expanded its view and looked at more than one type of supplement," Dr. Kava notes.
Researchers observed that the risk of small cell lung cancer appeared to rise more dramatically than more common types of lung cancer. "This smacks of data dredging, which makes me uncomfortable," says ACSH's Dr. Gilbert Ross. "Let's just say that there is no evidence that these supplements reduce the risk of chronic disease and some evidence that they might increase the risk of certain cancers."
For more information about the benefits and risks of dietary supplements, read ACSH's publication Vitamins and Minerals: Does Epidemiologic Evidence Justify General Supplementation?
Remembering Three Mile Island, 30 years later
Tomorrow marks the thirtieth anniversary of the near "disaster" at Three Mile Island. "As Scientific American says, the near melt-down at the Three Mile Island nuclear plant was indeed 'the nation's worst commercial nuclear accident,'" Stier says. "But the fact that no one was hurt, and no significant amount of radioactivity was actually released into the environment, speaks to the safety of nuclear energy."
On the event's thirtieth anniversary, ACSH calls for an end to the scaremongering about nuclear energy. And read more about Three Mile Island-inspired fears and the great potential for nuclear energy in our report written back on the event's twentieth anniversary.
Then, don't miss what is sure to be a lively weekend on Jeff's Twitter page, as he continues to debunk scares and promote sound science.
March 16, 2009
MD 400, Reforming FDA, Removing Prostates and Foreskins
By Elizabeth Wade
ACSH celebrates 400th Morning Dispatch
Today marks the 400th issue of Morning Dispatch -- wow!! Without you, Morning Dispatch wouldn't exist, and we'd like to extend a big thank you to all our readers for being part of the ACSH family and supporting us.
In these tough economic times, we need your help more than ever. Please consider making a gift to ACSH today in honor of our 400th issue. You make MD possible for us, and we want to keep bringing it to you every day well into the future. And again, thank you so much for all you do!
Food safety problems lead to calls for FDA reform
On the heels of the recent salmonella outbreak linked to peanut products, Trust for America's Health and the Robert Wood Johnson Foundation are calling for the appointment of a senior food safety official within the Food and Drug Administration (FDA). "The groups' report identifies three critical weaknesses of the FDA: obsolete statutes, inadequate resources, and a fragmented structure," says ACSH's Dr. Ruth Kava. "They aren't encouraging the creation of more bureaucracy but rather making recommendations to streamline the food safety sector of the FDA."
The FDA has drawn attention and ire over high-profile outbreaks of foodborne illness, including the current peanut product recall and last summer's salmonella outbreak linked to jalapeño peppers. "It used to be that food contamination was mostly an issue with meat and eggs, which the United States Department of Agriculture (USDA) oversees -- and the USDA does a lot more inspections than the FDA," Dr. Kava notes. "But the last few outbreaks have occurred under the oversight of the FDA, which supervises 80% of our food supply."
Last summer's salmonella outbreak, which was first blamed on tomatoes but eventually traced to jalapeño peppers, highlighted how difficult it is for the FDA to trace food -- and any contamination -- back to its source. An article in today's New York Times reports that when federal investigators tried to trace forty food products back to their original sources, they could only complete the chain for five of them. And when the investigators contacted several hundred food suppliers, most of them could not provide adequate information about the source and destination of their products.
"Traceability is very important, because it allows the FDA to locate the source of any contamination and take steps to eliminate dangerous products from our food supply," Dr. Kava says. "It is really hard to understand how so many food suppliers don't know where their products come from -- they have to buy them somewhere! This traceability study is not at all reassuring."
Radiotherapy may not save lives after prostate removal
A new study finds that radiotherapy after the complete removal of the prostate as a treatment for prostate caner does not improve either cancer-specific or overall survival. "This is a blow to people who may have undergone radiotherapy as a follow-up treatment for prostate cancer and experienced any unpleasant side effects," Dr. Kava remarks.
The study was not randomized or controlled, so researchers emphasize that follow-up studies are needed to more accurately evaluate this use of radiotherapy. "There was also an imbalance, because men with higher-stage, more dangerous tumors were the ones who were treated with radiotherapy," Dr. Kava points out. "Their cancer wasn't caught early, which could certainly influence survival rates."
Male circumcision prevents herpes and HPV, but not syphilis
Male circumcision appears to help prevent infection from herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) -- but not syphilis. In a study of 5,500 HIV-negative men, half of them were circumcised immediately, while the other half were circumcised after twenty-four months. After two years, the intervention group was 28% less likely to have contracted HSV-2, which causes genital herpes, and 35% less likely to have become infected with HPV. No significant difference was seen in the incidence of syphilis, however.
"It looks like male circumcision can decrease the probability that men will get not only HIV, which has been determined from earlier studies, but also herpes and HPV," Dr. Kava observes. "That also means that women would be less likely to acquire these infections from their male partners" -- an especially important effect in the case of HPV, which can cause cervical cancer.
March 25, 2009
Borlaug, China, Antibiotics, Soy, and ACSH
by Elizabeth Wade
Happy birthday, Dr. Borlaug!
ACSH's Dr. Elizabeth Whelan and Dr. Gilbert Ross are currently in Dallas celebrating the ninety-fifth birthday of ACSH Trustee and Nobel Peace Prize laureate Dr. Norman Borlaug. Considered the father of the Green Revolution that made use of food technology to almost double the world production of cereal grains, Dr. Borlaug is credited with saving over a billion lives -- more than any person who has ever lived.
"At ninety-five, Dr. Borlaug is just as active and energetic as ever," says ACSH's Dr. Ruth Kava. Recently, he wrote an op-ed for the New York Times about the looming threat of stem rust, a devastating wheat disease, and helped organize a meeting about the importance of stopping its spread by introducing new wheat varieties that are resistant to the fungus.
In a statement this week, Dr. Borlaug reminded us, "Our scientists are making incredibly rapid progress. But we should have no illusions: a global food crisis is still a distinct possibility if governments and international institutions fail to support this rescue mission."
As ACSH's Todd Seavey says, "We should celebrate Dr. Borlaug and his impressive achievements every day."
The latest trade war weapon: junk science
We congratulate ACSH's Jeff Stier on his Forbes.com op-ed "The Empire Strikes Back," in which he argues that China's recent investigation into "carcinogenic" Johnson & Johnson baby care products is a symptom of a trade war fought with junk science. He writes, "The U.S. gave China the ammunition -- and perhaps the motivation -- to launch this counter-attack when we declared Chinese-made toys 'toxic' because some were found to contain low levels of lead. But the vast majority of those toys never posed a threat to children."
Johnson & Johnson products narrowly escaped being banned in China, but the widely publicized investigation certainly harmed the iconic American company's image. In this case, however, Stier believes, "Rather than retaliate, the U.S. should see China's latest counterattack for what it is -- and recognize the consequences of our own unfair attacks on Chinese imports. It's not the toys or baby lotion that's tainted, just the pseudo-science that says they are unsafe. Let's call for a science-based truce. The relationship between our countries would improve, and the economic and public health of Chinese and Americans would be protected."
Stier is currently in Northern California meeting with MD readers. He had breakfast with ACSH Trustee Dr. Henry Miller this morning and hopes to see some of you during his time on the West Coast.
Congress considers banning use of antibiotics in livestock
The farm industry vehemently opposes a bill banning the non-therapeutic use of antibiotics in livestock, which is currently up for consideration in the House and Senate. "What occurs now is that non-therapeutic doses of antibiotics are used to speed up growth, particularly in beef," Dr. Kava explains. "Some people have gotten hysterical because they think that traces of the drugs will end up in the meat, but there is a window of time between when antibiotic use is halted and when the animal can be sold for slaughter, so the whole dose of the drug is metabolized and traces don't remain in the meat."
She continues, "There is also a concern that widespread use of antibiotics could lead to drug resistance, especially among strains of bacteria that infect humans as well as animals." The farm industry argues that the threat posed by banning antibiotics is far greater, as it would impair the health of animals, raise the price of meat, and damage food safety efforts.
"As long as most meat is produced using monocultures -- large groups of animals in close quarters -- we will probably see more disease if antibiotics aren't used," Dr. Kava says. "While drug resistance is an important concern, an industry-wide ban on antibiotics may be too broad. Instead, perhaps there should be incentives for drug companies to produce antibiotics that are used only for animals, so the bacteria wouldn't develop resistance to the human drugs."
Does eating soy as a child reduce the risk of breast cancer?
A new study suggests that Asian-American women who eat the most soy during childhood have a 58% reduced risk of breast cancer. "Women in China and Japan have very low rates of breast cancer, but their risk rises to be on par with white American women after a few generations in this country, so researchers are looking for an explanation," Dr. Kava says. "This result is interesting if it is true, but it really needs replication before we can rely on it."
ACSH donor joins the fight against junk science
ACSH staffers were delighted to read an editorial written by Rich Kozlovich, one of our very own Morning Dispatch readers. He very eloquently promotes ACSH's work and debunks junk science. "We are always encouraged when we see our constituency pitching the plea for good science," notes Dr. Whelan. "It lets us know that our mission of promoting common sense and science is being heard. Thank you, Rich!"
March 24, 2009
Red Meat, Plan B, and Vitamin D
By Elizabeth Wade
Is eating red meat dangerous?
A new study published in the Archives of Internal Medicine claims that consuming large quantities of red meat may increase the risk of death from a variety of factors, but ACSH staffers are skeptical. "There are some real problems with the study," says ACSH's Dr. Ruth Kava. "For example, the participants responded to the dietary questionnaire only at the beginning of the ten-year study, so the researchers must have assumed that their diets didn't change over the following decade."
She continues, "Those in the highest quintile of red meat consumption tended to have the most confounding factors, including smoking, high BMIs, low education and physical activity levels, and lower fruit and vegetable intake -- which may well have resulted in residual confounding. And with half a million people involved, it's such a huge study that any factor researchers looked at was likely to be statistically significant."
Dr. Whelan says, "It seems that every six months there is a story about the dangers of meat, and especially red meat."
Dr. Ross agrees. "Blaming meat consumption for numerous health problems is certainly becoming part of the zeitgeist -- even though, as we see with this study, the evidence for such an effect is not very strong."
Court orders wider availability of Plan B
The U.S. District Court for the Eastern District of New York has ordered the FDA to make Plan B, the emergency contraception pill commonly known as the "morning after pill," available to seventeen-year-olds without a prescription. Previously, all women under eighteen were required to present a prescription for the drug, which prevents implantation of a fertilized egg.
"The FDA has regulations about how to evaluate a drug, and if it rejects an application, it has to give a reason," explains ACSH's Dr. Gilbert Ross. "The federal court in the Eastern District of New York ruled that the FDA's evaluation of Plan B, at least concerning age restrictions, was arbitrary and capricious. It is dangerous to mix politics and science in a regulatory agency."
The court also strongly recommended that the FDA reconsider making Plan B available over-the-counter. Currently, the contraceptive is only available behind-the-counter, so even women who don't need a prescription must ask the pharmacist for the pills.
"This ruling doesn't represent a dramatic a change in the way that Plan B is provided, but it loosens the restrictions a bit and spotlights the political forces that were in effect regarding the regulation of this drug," says ACSH's Dr. Elizabeth Whelan.
Vitamin D enjoys its day in the sun
Many doctors have started touting the benefits of vitamin D at a time when more Americans aren't getting enough of the "sunshine vitamin." "It has certainly taken on a new prominence in medicine lately," Dr. Whelan remarks. "It's something that people didn't really talk about, and suddenly it's in the news all the time and many doctors have started testing for it."
Vitamin D deficiency is well known to be linked to rickets, a bone disorder in children, but recent research claims that it increases the risk of everything from cancer to heart disease in adults. "When I hear about an 'accumulating body of evidence,' however, I worry that researchers are trying to aggrandize a tiny body of evidence," Dr. Ross says.
Dr. Kava notes, "The test to measure vitamin D levels is considered by some to be rather inaccurate, and just a few years ago, it wasn't clear that raising vitamin D intake was going to prevent any disease except rickets and osteomalacia. Whether there has been an accumulation of data sufficient to change that opinion, I don't know." We look forward to more conclusive research into the complex role vitamin D may play in health.
Elizabeth Wade is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com). A SAMPLE REACTION:
The following exchange, between Heritage Foundation's Robert Book and ACSH's Jeff Stier, occurred on April 2 and 3 following the ACSH Morning Dispatch above applauding the HPV vaccine, which combats a leading cause of cervical cancer:
Robert Book wrote:
Jeff,
I’m not sure the conclusion about the HPV issue below is entirely valid. If I recall correctly, the HPV vaccines do not protect against all strains of HPV, just the four most common strains, reducing the risk of cervical cancer substantially but not completely. (I’ve seen figures ranging from 70% to 91%.)
If that’s the case, vaccinating against HPV may not wipe out cervical cancer, and paradoxically it could increase its incidence in the population. The problem is that the vaccine reduces the risk of cervical cancer, under the assumption that behavior is held constant. However, you can’t assume that. If the risk of a particular activity is reduced, normally the incidence of that activity increases. It could increase by enough to completely offset the original reduction in risk, and/or to increase collateral risks.
For example, when seatbelts and similar safety devices are installed in cars, the risk of death to drivers and passengers decreases – on a per-accident basis. You can expect the overall fatality rate to decrease only if you hold the number and severity of accidents constant. But the evidence shows that’s not what happens. Since they are more protected in the event of an accident, drivers drive less carefully and have more accidents. The empirical evidence shows that the number of auto fatalities per mile driven actually stays about the same. However – and this is the big “however” – since there are more accidents, the number of pedestrian fatalities increases! After all, there are more accidents, and pedestrians aren’t protected by seat belts!
Likewise, a reduction in the risk of HPV on a per-incident basis will lead to more incidents. This will mitigate the effect on HPV, and increase the risk of other hazards that come from the same incidents. So if the vaccine currently reduces the probability of contracting HPV in a given incident by 90%, we might see a decrease in HPV case of 60-80%, and an increase in (say) HIV, syphilis, and the like.
See:
Sam Peltzman, "The Effects of Automobile Safety Regulation." The Journal of Political Economy, 1975, 83(4), pp. 677-726.
You might also be interested in:
Sam Peltzman, “An Evaluation of Consumer Protection Legislation: The 1962 Drug Amendments." The Journal of Political Economy, 1973, 81(5), pp. 1049-91.
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Jeff Stier wrote:
Robert,
Thanks for your note and for your critical analysis of Morning Dispatch.
You are correct that the HPV vaccines protect against the strains of HPV responsible for the vast majority of cervical cancer.
And I agree with the general principle that when you reduce a risk of a certain activity, that activity tends to increase as the risk decreases.
But that only should only apply when the decision to engage in that activity is in some way correlated to that risk in the mind of the individual.
If the risk is unknown, a reduction in that risk would not affect the incidence of that activity.
I do not have survey data, but I believe that the specific risk of cervical cancer plays no more than a trivial role in a teen's decision to have unprotected sex. So reducing the risk of HPV will have no measurable effect on a teens decision in that regard.
For the same reason, more widespread use of Gardasil will not increase cases of other STDs.
Good try, but I have to respectfully disagree.
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Jeff,
You’re welcome.
Do you really think that none of the women who get the vaccine know what it’s for? That’s the assumption that would be required to sustain your argument.
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Robert,
No, I don't think the younger women really have that level of understanding.
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