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ACSH Dispatches Round-Up: Mexican/Swine Flu and More
By Elizabeth Wade
April 30, 2009
Flu Reactions, Statin Benefits, Acrylamide Scares
By Elizabeth Wade
World continues to (over)react to swine flu
In response to the growing spread of swine flu across the globe, the World Health Organization has raised its alert level to 5, indicating it believes a pandemic is "imminent." But as ACSH's Dr. Elizabeth Whelan says, "We need to put this situation in perspective by remembering that the U.S. has over 30,000 deaths every year from seasonal influenza."
In the case of swine flu, only Mexico has thus far reported significant numbers of sick and dead -- and even those numbers are in flux, probably due to inadequate data reporting and collection in the rural areas. The one U.S. mortality, a twenty-three-month-old, occurred when the infant was brought here from Mexico for treatment. We have so far documented about 100 cases in several U.S. states -- but these seem to be mild.
In an op-ed on TCS Daily, ACSH Trustee Dr. Henry Miller reassures us that while swine flu has "the potential to become an historic pandemic...[t]hat possibility appears less likely as the data continue to accumulate. There seems not to be the kind of exponential increase of number of infections that sometimes occurs, for example, with norovirus infections that sweep through cruise ships, dormitories, and other isolated populations."
As the epicenter of the outbreak, Mexico is right to take precautions like ordering the closure of many public services and private businesses until Tuesday. But many other countries are taking drastic and unnecessary steps in the name of "protecting" their citizens. Egypt has ordered that the country's 300,000 pigs slaughtered, even though swine flu has not appeared there and there is no evidence that pigs spread the disease. Many nations have (unnecessarily) restricted the imports of pork products and live pigs, while others are imposing bans on travel to Mexico. "But in the U.S., closing the borders would be like closing the barn doors after the horse got out, as President Obama has aptly expressed," ACSH's Dr. Gilbert Ross reminds us.
Despite initial reports, the new strain of swine flu appears to be a reassortment of two pig viruses and doesn't contain human or avian components. While we are glad the virus is being thoroughly studied, we doubt this information will help the general public protect themselves or avoid panic. "Knowing the components of a virus is important if you are trying to make a vaccine, but such information isn't helpful in the trenches of prevention and treatment," Dr. Ross says.
Dr. Miller's op-ed, however, includes many helpful tips on protecting yourself from swine flu. He advises, among other precautions, washing your hands frequently; avoiding touching your nose, mouth, and eyes; covering your nose and mouth with a tissue when you cough or sneeze, and then immediately discarding the tissue; and avoiding unnecessary travel to areas with a significant number of cases. If you develop symptoms of swine flu (which, as with the seasonal flu that occurs each fall and winter, include fever, muscle aches, cough, extreme tiredness, and sore throat), do not go to school or work; see a doctor, and take antiviral drugs exactly as they are prescribed.
Statins appear effective against venous thromboembolism
Cholesterol-lowering statin drugs appear to prevent venous thromboembolism, in which potentially dangerous blood clots form in the veins. "It was suspected that statins would help against this condition, and now an international, multi-center group led by Harvard researchers has published a study in the New England Journal of Medicine showing some evidence that at least one -- Crestor -- might work," Dr. Ross explains.
ACSH's Dr. Ruth Kava remarks, "With all their benefits, statins are becoming the new aspirin!"
Surprise! Acrylamide does not cause lung (or any other) cancer
A new study finds that dietary acrylamide is not associated with lung cancer, and ACSH's staffers aren't one bit surprised. "It seems like every month there is a news story freeing acrylamide from its alarmist label as a 'carcinogen'," Dr. Whelan says. "Unfortunately, chemophobic fear-mongers are still going to say it's dangerous."
Dr. Kava draws our attention to the article's key line: "Despite being a carcinogen in the laboratory, some epidemiological studies have reported that everyday exposure to acrylamide in food is too low to be of concern." For more information, check out ACSH's publication Acrylamide in Food: Is It a Real Threat to Public Health?
April 29, 2009
Whelan on Fox on Flu; plus Autism and Genes
By Elizabeth Wade
Swine flu: Know the facts, resist the fears
Swine flu continues to dominate the nation's health news reports -- and our Morning Dispatch discussions. ACSH Trustee Dr. Jack Fisher joined us for our morning meeting today and weighed in on the recent developments.
A Mexican toddler whose family had traveled to Texas for treatment after he was sickened with swine flu has become the first person to die of the disease in the United States. "We expect to see more cases of swine flu in the U.S., and probably more deaths, so this situation isn't surprising," says ACSH's Dr. Elizabeth Whelan. "The numbers are going to keep climbing, so we shouldn't be alarmed every time a new case is reported by the media."
Dr. Whelan and ACSH Trustee Dr. Elizabeth McCaughey were interviewed about the swine flu outbreak on the Fox Business channel last night, making a valiant effort to distinguish the facts from the fears. Watch the interview in full on Fox's site.
While Dr. Whelan brought up several comparisons to the 1918 influenza pandemic in the interview, she pointed out that today we have antiviral medications such as Tamiflu to fight the disease and antibiotics to prevent many of the subsequent bacterial infections that killed millions in 1918. Dr. McCaughey, who heads the Committee to Reduce Infection Deaths, advises people who develop swine flu symptoms to see their doctors immediately but avoid going to the emergency room, where the bug could spread quickly to other patients and healthcare workers.
While we commend the U.S. media and government for their generally levelheaded response to the swine flu outbreak, other countries aren't meeting the same standards of common sense. Two items of seemingly-lighthearted flu-related matters came to our attention: health officials in Israel are advocating that the disease's name be changed to "Mexican influenza" because they claim that the term "swine flu" is offensive to Jews and Muslims who do not eat pork. Even more laughably, ten countries have banned the importing of pork products.
"I am very surprised at how many very intelligent friends have called me to ask if it is safe to eat pork," Dr. Whelan says. We have said it before and we will say it again: Swine flu is a respiratory disease and cannot be contracted by eating pork products. The best ways to protect yourself are still frequent handwashing and avoiding shaking the hands of others. However, ACSH's Dr. Gilbert Ross suspects, "Until we see a whole lot more cases in New York, you won't see many people taking hygienic precautions like not shaking hands or avoiding crowds here. I saw no masks or other changes in commuters' behavior on the subway, for instance."
If the swine flu continues to spread (or, as in 1918, mutates into a more virulent strain in the fall), governments and public health officials may consider widespread vaccination programs -- provided that we have a vaccine in time. "Vaccines don't just appear out of nowhere. They have to be developed, and then millions of doses need to be manufactured," Dr. Whelan reminds us.
Plus, Dr. Ross adds, "Many vaccine manufacturers have left the market because of the anti-vaccine hysteria and fear of litigation, leaving only a few companies to tackle this important and daunting task."
ACSH Trustee Dr. Fisher wonders if it would be possible to develop a vaccine that protects against both swine flu and next year's seasonal strain of influenza. And Dr. Ross notes, "During other pandemic scares, like SARS and bird flu, people were talking about new ways to manufacture huge amounts of vaccines very quickly. I wonder what the status is on that research now?"
Autism may be linked to genes
A new study shows that many autistic people share genetic variations that affect the way brain cells connect and communicate, lending support to the idea that the disease may have a genetic link. "It's a fascinating breakthrough," Dr. Ross says. We hope the new findings further dispel unscientific superstitions about autism, especially that childhood immunizations cause the disease.
April 28, 2009
Swine Flu, Statins, and Red Meat
By Elizabeth Wade
Swine flu: A round-up
Swine flu continues to spread, and the World Health Organization has lifted its pandemic alert level to phase four, meaning that sustained human-to-human transmission of the virus is causing outbreaks in at least one country. The number of confirmed cases of swine flu in the U.S. has risen to about 50, while the number of deaths in Mexico has climbed to over 150.
Cases of swine flu have also been found in Britain, Canada, Israel, New Zealand, Spain, and South Korea, but no one has died of the disease outside of Mexico. All the schools in Mexico are now closed to prevent further spread of the virus, and the U.S. and many other countries are now tightening their borders. (Check out an informative analysis on Slate about why the virus currently appears to be more deadly in Mexico than in the U.S. and other countries.)
ACSH’s Dr. Elizabeth Whelan has an op-ed answering some of the most common questions about swine flu in today’s online edition of the Wall Street Journal. She clarifies that eating pork is not dangerous, non-surgical face masks do not protect against the virus, and, most importantly, we shouldn’t panic. But, she advises, precautions like washing your hands frequently and avoiding shaking the hands of others are in order.
She continues, “The key role of the public health establishment now is surveillance: monitoring what is going on. Only through minute-by-minute data collection will we learn where this situation is headed.”
ACSH Trustee Dr. Henry Miller agrees in his own Wall Street Journal op-ed: “These events demonstrate that good surveillance is needed in order to detect early on that a new infectious agent, transmissible between humans, has emerged. Unfortunately, conditions in many countries are conducive to the emergence of such new infectious agents, especially flu viruses, which mutate rapidly and inventively,” he writes.
Dr. Whelan says, “Overall, I think the media is doing pretty well in their coverage of the swine flu outbreak. But more people should be emphasizing that wearing face masks in public places will not protect you from the virus.” As ACSH Trustee Dr. D.A. Henderson tells us, “The surgical masks presumably are helpful in preventing spread of virus from a patient to others….For other people, they are useless. Simple breathing gradually clogs the pores of the mask and the air simply enters around the mask. In brief, you are breathing ambient air but it is less complicated to simply breathe it in without the mask!”
While current vaccines will not protect against this new strain of swine flu, vaccine companies say they are on standby to begin developing an effective immunization. Unfortunately, that process could take up to six months. “This is also the time when seasonal flu vaccine is being made for the next flu season, which is a huge commitment of time and effort,” Dr. Whelan points out. Hopefully, this “full-court press” devoted to developing and producing a vaccine against the current epidemic will not lead to a shortage of next season’s flu vaccine.
An important piece of good news is that the antiviral drugs Tamiflu and Relenza appear to be effective against the new swine flu virus. Now the challenge will be distributing those drugs to people in the early stages of infection when they are most effective.
Statins may protect against prostate cancer
In more cheerful health news, cholesterol-lowering statin drugs may also reduce the risk of prostate cancer. “This conclusion hasn’t been published, and it was the result of an epidemiological study rather than a randomized control trial,” says ACSH’s Dr. Gilbert Ross. “But it found that men who were taking statins had a three-fold reduction in prostate cancer, and that is an incredible number.” Dr. Whelan remarks, “Maybe we really should put statins in the water supply!”
Does red meat endanger your health?
ACSH staffers are disappointed by Jane Brody’s New York Times article about the “dangers” of eating too much red meat. “It looks like she’s jumping on the anti-red meat bandwagon,” Dr. Ross says.
ACSH’s Dr. Ruth Kava notes, “It’s always the people who eat unusually large amounts of red meat who are found to be at greater risk for other health problems in these studies. But as the article points out, they also tend to have other ‘less-than-healthful habits,’ such as smoking more, exercising less, and eating fewer fruits and vegetables. I doubt the most recent study controlled well enough for all those factors.”
Dr. Whelan says, “You should eat a variety of foods -- but there is no reason that red meat shouldn’t be one of them.”
April 27, 2009
Swine Flu, Cigarette Exec, Salmonella Sprouts, Hormone Therapy
By Elizabeth Wade
More questions than answers about swine flu
The outbreak of swine flu dominated the health news over the weekend, with the reported number of deaths in Mexico climbing to 103 and at least twenty mild cases being confirmed in the U.S. In the wake of a reported case in Spain, Europe has even issued a travel advisory warning people to postpone visiting Mexico or the United States, although U.S. health officials call the move unwarranted.
As usual with health stories in the popular media, we are hearing a lot of conflicting information about the outbreak of swine flu. ACSH's Dr. Elizabeth Whelan says, "The most glaring mixed message I've seen is the headline 'U.S. Declares Swine Flu Is "Public Health Emergency," a Term That Does Not Signal a Greater Threat'."
Government officials from the Department of Homeland Security (DHS) explain this seemingly confusing "alert" by saying that declaring the outbreak an "emergency" allows them to better direct resources and prepare for the possible appearance of more serious cases in the U.S. (Dr. Ross suspects that DHS is running the public communications operation due to the lack of new leadership under the Obama administration at the CDC, FDA, Health and Human Services, and Surgeon General's offices.)
Meanwhile, Catholic masses were cancelled across Mexico City yesterday, and schools in the metropolitan area (including the university I will be attending this fall) are closed until May 6. Worryingly, young people are dying from the disease there, which is leading some to wonder about comparisons to the 1918 flu pandemic. Health officials are currently trying to get a better idea of how many mild or otherwise unreported cases of swine flu have appeared in the Mexico City area over the past month, in order to better estimate the death rate from the virus there.
Right now there are more questions than answers about the outbreak. Among the most pressing are: Why are people dying of swine flu in Mexico but not in the U.S.? Will anti-viral drugs like Tamiflu be effective against the new strain? And above all, should we panic?
"We absolutely shouldn't panic," Dr. Whelan advises. "The public health community is very good at surveillance, which will be key in this case. In the meantime, I would advise washing your hands and avoiding shaking the hands of others. That is a much more effective way to protect yourself than wearing non-surgical masks."
For an appropriately balanced view of the outbreak and the questions it raises, we recommend Susan Dominus's Big City column in the New York Times. "She councils calm, attacks an alarmist book about preparing for a pandemic of bird flu, and praises NYC Health Commissioner Dr. Thomas Frieden's response to the appearance of swine flu in New York, while still chiding his nanny-state regulations," ACSH's Dr. Gilbert Ross elaborates.
And ACSH's Dr. Ruth Kava would like to clear up one misconception right off the bat: "You cannot contract swine flu from eating pork. It is a respiratory disease, so you are in no danger of catching it that way unless you happened to kill the pig yourself."
Stay tuned to upcoming issues of Morning Dispatch for continuing coverage of this important story. In the meantime, check out the Biological Agents chapter of ACSH's publication A Citizen's Guide to Terrorism Preparedness and Response, which contains some sound, commonsense advice about dealing with outbreaks of contagious diseases.
Targeting international markets to sell a deadly product
ACSH staffers were appalled by this week's cover story of the magazine Business Week, which profiles the CEO of Philip Morris International (PMI), Louis Camilleri. PMI recently split from its U.S. parent Altria and is currently enjoying the lax cigarette regulations in many countries around the world. "The growing use of and addiction to cigarettes is more of a threat to developing countries than swine flu," Dr. Ross says.
Dr. Whelan wonders, "How can Mr. Camilleri get up in the morning knowing that his job is to get more people around the world hooked on a deadly product? It says a lot about human beings' capacity for denial."
Salmonella found in sprouts
The latest foodborne illness advisory runs the risk of being overshadowed in the news this week, but we want to make sure our readers know to avoid raw alfalfa sprouts, which may be contaminated with salmonella. The contamination may be in the seeds, so washing the sprouts won't eradicate the problem (although oft-vilified irradiation would do the trick!). So far, cases of salmonella linked to sprouts have been found in Michigan, Minnesota, Pennsylvania, South Dakota, Utah, and West Virginia.
HRT: "Real Concerns and False Alarms"
Some good news from ACSH: the paper on hormone replacement therapy (HRT) we helped advise is now available online from The Cancer Journal. Check it out.
April 24, 2009
Malaria Day, Vaccine Politics, Cancer War, Swine Flu
By Elizabeth Wade
ACSH honors World Malaria Day
We've mentioned the ongoing fight against malaria several times this week, but tomorrow is the big event: World Malaria Day. "There are many diseases that we don't know how to fight, but we've long known how to fight malaria -- it just hasn't happened as effectively as possible," says ACSH's Dr. Elizabeth Whelan. "Fortunately, there has been a reawakening of interest in eradicating malaria over the last few years." Malaria kills over one million people each year, mostly women and children in sub-Saharan Africa.
In the Wall Street Journal, anti-malaria activist and News Corporation president Peter Chernin argues that we are at a tipping point in defeating this devastating disease. He writes, "Malaria is tragically crippling developing countries. The world has made it a goal to eliminate this disease, we have cost-effective tools to do so, and the systems are in place to make it happen. Now is the time to put our money behind this sound investment."
ACSH's Dr. Gilbert Ross says, "While I'm glad this cause is drawing so much attention right now, the loss of millions of lives to malaria should have become a major topic of conversation many years ago -- ever since the 1972 DDT ban caused a resurgence of the mosquitoes that spread the disease." While we may not be able to eliminate the disease vector without DDT, Novartis recently developed a cherry-flavored malaria drug that can be easily given to children, and researchers at Sanaria Inc. will start human trials of a malaria vaccine next month. We hope these developments help eradicate this devastating disease once and for all.
Vaccine scare takes hold in Florida
Thanks to ACSH Chairman Dr. John Moore for bringing this important issue to our attention: Florida may soon ban the preservative thimerosal from childhood vaccines because of the unfounded fear that the chemical causes autism. "The fact is that thimerosal is only present these days in trace amounts in certain children's flu vaccines," Dr. Ross says. If the preservative is removed, he informs us, "We won't be able to make multi-dose vials, and these flu vaccines will become more expensive, thereby reducing the number of children who get a flu shot. This will lead directly to an increase in flu deaths among infants and children."
Unfortunately, the bill banning thimerosal has strong support in the Florida Senate and from the state's governor. Dr. Whelan echoes a common (but not common enough) sentiment to describe this situation: "There is nothing worse than ignorance in action." ACSH is following up and plans to take swift action of our own against this potentially devastating bill.
The New York Times gets "war on cancer" wrong
ACSH staffers found the New York Times story on the supposedly slow progress against cancer unnecessarily pessimistic. "In 1971, Nixon promised that cancer would be 'cured' in five years. But by exaggerating and generalizing like that, he set up the 'war on cancer' to fail," Dr. Whelan says. "We need to talk more realistically about preventing premature death from various types of cancer so we don't lose sight of all the important advances we have made and will continue to make."
To make matters worse, the article's depressing graph charting death rates from various types of cancer only includes data up until 1994, which leaves out the last fifteen years of progress. "It's an inaccurate and unnecessary downer," Dr. Whelan believes.
Elsewhere in the Times health section, we ran across an article linking smoking to breast cancer. But, Dr. Ross points out, "After many decades of study, we haven't found a relationship between first-hand smoking and breast cancer, let alone secondhand smoke. And there is nothing in this article that gives you any impression of what the data said."
Dr. Whelan says, "This is the 'popular wisdom bias' in action. We know that smoking is bad for many aspects of health, and when you make up your mind that something is 'bad,' you set out to prove it further."
New strain of swine flu reaches U.S.
At least sixteen people (and possibly as many as sixty) in Mexico have died of a new strain of swine flu, and the World Health Organization is concerned about 800 possible cases of the disease there. Seven people in the U.S. have been sickened by this unique virus, but all have recovered. "It is alarming that the virus is new to the scene and that it is coming so late after flu season," Dr. Whelan says.
The new strain of swine flu is a mixture of viruses common in pigs, birds, and humans. The CDC maintains that it is not a major problem in the U.S., although scientists believe that we are likely to see more cases. Doctors should be aware of the new virus and be vigilant about reporting possible cases to the CDC, which is already working on a new vaccine against the strain. "While we are not overly worried about swine flu, surveillance is important, and this is surveillance in action," Dr. Whelan says.
April 23, 2009
Nicotine Gum, Regular Gum, Fructose, Inflammation, and DDT
By Elizabeth Wade
Nicotine gum blamed for oral cancer risk
Harm reduction methods like smokeless tobacco already face an uphill battle in the United States, and their reputation will not be helped by the new claim that certain nicotine replacement products, such as gum and lozenges, increase the risk of oral cancer.
"However, going beyond the misleading headline here is once again key: There is absolutely no evidence from this study showing an increased risk of oral cancer from NRTs," says ACSH's Dr. Gilbert Ross. "The researchers found some genetic changes which have some remote linkage to changes seen in oral cancer cells. There is no real human health story here -- but the headline may frighten smokers who are trying to quit away from their gum or lozenges, which would truly be a tragedy."
Cigarettes are much more dangerous than nicotine replacement products, and it is notoriously difficult to quit smoking even when utilizing all of the available tools. "You cannot suddenly decide that today you'll stop smoking and tomorrow you will stop chewing nicotine gum," Dr. Ross adds. "You are still addicted to nicotine, and if you stop getting it in another form, you'll go right back cigarettes."
ACSH's Dr. Elizabeth Whelan concludes, "We would not discourage anyone to quit any kind of nicotine replacement therapy if you are trying to quit smoking." For more, see ACSH's publication on harm reduction.
Craving dessert after a meal? Try a stick of gum instead
The benefits of chewing sugarless gum after meals are rapidly becoming more apparent, from preventing cavities by washing away acid and bacteria to helping people lose weight by preventing further snacking. Even food cop extraordinaire Marion Nestle admits, "Gum has no calories. If it helps people eat less, it could be useful." (But unfortunately, she still prefaces her comment with a condemnation of the imagined "conflicts of interest" inherent in research regarding what Dr. Ross jokes she sees as "the Big Gum cartel.")
"The idea that chewing sugarless gum would promote weight loss makes a lot of sense to me, since you burn some calories by chewing, and you don't eat more food while the gum is in your mouth," Dr. Ross says. We're more skeptical of the idea that chewing gum can improve academic performance -- but as long as students don't stick it under their desks, we see no problem with allowing sugarless gum in school. In fact, such a strategy has been shown to prevent cavities in Swedish students.
Can fructose vs. glucose study be applied to real-world diets?
A new study finds that drinking beverages sweetened with pure fructose, rather than with pure glucose, may lead to increased abdominal fat and raise levels of triglycerides and LDL (so-called "bad") cholesterol. "While these factors are associated with an increased risk of heart disease, the study wasn't carried on long enough to know if drinking beverages containing pure fructose actually has any impact on health," Dr. Kava says.
"We've known that fructose and glucose are metabolized differently for over thirty years," she continues. Plus, we rarely consume fructose and glucose in their pure forms; for example, table sugar contains a 50-50 fructose-glucose ratio, and high-fructose corn syrup is made up of 55% fructose and 45% glucose. In fact, the researchers caution that their study does not apply to high fructose corn syrup, which lately has been under siege as a so-called "bad food."
Anti-inflammatory drugs do not decrease dementia risk
While many scientists hoped that non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ibuprofen, would lower the risk of developing dementia and Alzheimer's disease (AD), a new study indicates that NSAIDs may actually raise dementia risk. "In ACSH's publication on Alzheimer's disease, we couldn't find any evidence that anti-inflammatory drugs have an effect on the occurrence or progression of AD," Dr. Ross says. "Still, it is surprising that this study found an increased risk."
ACSH hopes you had a happy (and rational) Earth Day
Yesterday was Earth Day, and ACSH staffers would like to join many others around the world in celebrating our environment, conserving natural resources, and making smart energy decisions. As ACSH's Jeff Stier says, "We support the notion of taking good care of the Earth, but we are concerned that the cause has been hijacked by environmental extremists who tend to use junk science to undermine health, as in the case of the DDT ban."
The unscientific ban of DDT in 1972 has led to tens of millions (or more) needless deaths from malaria in Africa and Asia. We'll cover this issue in depth in tomorrow's MD in honor of "World Malaria Day." In the meantime, check out the #1 bestselling book Liberty and Tyranny by Mark Levin for an endnote in Chapter 8 of ACSH's Todd Seavey commenting on the DDT ban.
April 22, 2009
Lice, Walnuts, Burned Meat and Mr. Potato Head
By Gilbert Ross M.D.
ACSH is having a mini-epidemic of colds and such, explaining why I am authoring MD today. Get well quick, Lizzie and Todd!
Scary Headlines, but nothing really to worry about:
ACSH staffers were distressed, as is often the case, with the scary headlines found in so-called “health and science news” stories, even on seemingly reliable news services.
For today’s examples:
“Could Lice Prevent Asthma?” Well, a research group in the UK has published a study showing that mice more heavily infested with lice had “calmer immune systems” than their less-infested cousins. So what, you ask? The scientists make the leap to the conclusion that perhaps more insect infestation leads to less immune stimulation in humans, and therefore excessive cleanliness makes for higher immune activity and, voila, more asthma and other immune-mediated illnesses.
Unfortunately, there is absolutely nothing in the experimental details pertaining to human disease. Even the louse species attacking the mice differs from the type which infests humans. There is no “there” there in this “story.”
“Want to reduce breast cancer risk? Eat walnuts.” Really? It’s that simple? Again, sorry, but no: this advisory comes from another mouse experiment. Researchers at the Marshall University School of Medicine in Huntington W Va found that lab mice bred to develop breast cancer had their tumors delayed—by a few weeks—if fed an amount of walnuts equivalent to 2 oz for us. The authors—speaking at the American Association of Cancer Research (AACR) meeting in Denver—assert that “it is clear that walnuts contribute to a healthy diet that can reduce breast cancer.” In mice—hello! Why do animal researchers insist that their tiny subjects have similar metabolic and physiologic pathways to humans? More publicity I guess—as here.
“Burned meat linked to pancreatic cancer.” Well, this one is at least based on human data. However, it’s another AACR meeting report—meaning, it’s unpublished and thus not peer-reviewed. Further, it’s a small study (based on 200 patients with pancreatic cancer compared to a similar number of people without cancer), it’s based on unreliable dietary recall data, and the increased risk—60%—sounds like a lot, but in epidemiology such an increased risk is often not significant. I wouldn’t worry too much about eating charred meat—smoking is a much more defined risk factor for pancreatic (and many, many other) cancers.
These headlines without anything to support them remind me of the ridiculous assertion in yesterday’s “news” wherein the headline screamed, “Folic acid may raise cancer risk in offspring,” thanks to the Toronto Globe and Mail’s crackerjack headline writer.
Needless to add, there was nothing in the story to justify such irresponsible writing. (See yesterday’s MD for more on that one).
You want fries with that, Mr. Potato Head?
Foolishness a la California has come to Michigan, it appears. A legislator there is trying to protect Michigan’s vulnerable children from toxins in toys (where have we heard that one before?). Rep. Mark Meadows (D-East Lansing) claims that “Mr. Potato Head, Barbie dolls, all contain chemicals that have been found to be harmful to children, like arsenic.” Well, he didn’t say “phthalates,” so at least he’s open to scaring parents about other scary toxins. Rep. Meadows didn’t bother to read ACSH’s classic publication, “The Holiday Dinner Menu,” in which we point out that real, Mother-Nature-made potatoes, also contain the evil arsenic. However—much like their synthetic cousin, Mr. Potato Head—the dose of arsenic in your dinner-plate serving of potatoes is far, far too low to do you any damage. The dose makes the poison, Mr. Meadow. We hope that this proposal does not lead Michigan to adopt a measure similar to California’s ridiculous Proposition 65, which has been a windfall for bounty-hunter litigators but has otherwise done zero to improve anyone’s health.
April 21, 2009
Vaccines, Phthalates, Diet & Cancer, Folic Acid, and Salt
By Elizabeth Wade
Influenza deaths and polio outbreaks could be prevented with vaccines
The CDC reports that out of 45 children who died of influenza during the past flu season, at least 31 had not been vaccinated. “Who is holding the anti-vaccine activists accountable for these tragic deaths?” wonders ACSH’s Jeff Stier. “People often use the excuse of ‘spreading information’ to hype scares, but here we see some real consequences of spreading anti-vaccine misinformation.”
Misinformation about vaccines is also causing a resurgence of polio in many countries where the disease had been eradicated. In northern Nigeria and northern India, certain Muslim communities have been told that polio vaccines are part of a sterilization plot, and the dangerous disease has spread from there into surrounding countries. Worrisomely, polio has now reached the Port of Sudan, from where it could spread to many other places.
“Superstition emanating from some regions had led to a resurgence of a disease that should have been eradicated decades ago,” explains ACSH’s Dr. Gilbert Ross. “The bottom line is that people all over the world should be vaccinated against preventable diseases that are still killing children.”
One scare unites obesity and phthalates
Phthalates and obesity are popular topics for junk science, but we never thought we’d see the day when phthalates would be blamed for the obesity epidemic! “The argument is that you can get fat from exposure to your shower curtain? Are you kidding me?” says ACSH’s Dr. Elizabeth Whelan.
Dr. Ross explains, “They are picking on the targets of opportunity, but there are several lurches in the study’s chain of causation.” First of all, the scary term “endocrine disrupters” is a catch-all that doesn’t actually have any meaningful definition. The studies first linking so-called “endocrine disrupters” to obesity were performed in mice, and scientists only found an association between higher concentrations of phthalates in urine and higher rates of obesity in East Harlem children. As usual, there was no proof of causation. Plus, researchers offer no explanation to why obesity rates did not climb immediately after phthalates were introduced to commercial products.
“This is the definition of junk science,” Dr. Ross says. “Unsurprisingly, the source of this alarmist claptrap is one of our favorite junk-science purveyors, Dr. Phil Landrigan of Mt. Sinai.” We are especially disappointed that this scare was covered by the New York Times’ City Room blog.
Is diet a risk factor for kidney cancer?
A new study claims that eating a lot of red meat, white bread, and white potatoes may increase the risk of kidney cancer, but ACSH staffers are more than skeptical. “I happen to be investigating the risk factors for kidney cancer, and I have never seen anything about diet,” Dr. Whelan remarks. “This makes no sense to us.” Somewhat unsurprisingly, obesity and smoking are the best-documented risk factors for kidney cancer.
Folic acid scare could have tragic effects
A headline in the Toronto Globe and Mail outrageously links taking folic acid during pregnancy to an increased risk of cancer in offspring. “But not only is the study done in rats, they didn’t even find any increased cancer risk in them!” Dr. Ross says. Researchers found that the rats that consumed the most folic acid during pregnancy were more likely to give birth to offspring with genetic changes in the colon and liver, but that those changes diminished as the offspring aged.
While the study barely reached our radar screen because it is so irrelevant to public health, ACSH staffers worry that the inflammatory headline could scare some pregnant women away from taking folic acid supplements, which are important to prevent certain birth defects.
WSJ jumps on salt bandwagon
ACSH staffers are disappointed that the Wall Street Journal health columnist Melinda Beck is encouraging her readers to cut back on salt. “She’s buying into the New York City Health Department’s plan to encourage the food industry to lower sodium levels in processed foods,” says ACSH’s Dr. Ruth Kava.
NYC Health Commissioner Thomas Frieden does make an important point in the article: “After smoking, high blood pressure is the leading cause of preventable illness and death.” But Dr. Ross points out, “A better way to address the problem of hypertension is to diagnose and treat people with high blood pressure. The real problem is that less than one-half of hypertensive patients have been diagnosed and treated adequately. Dr. Frieden is forgetting about individual patients in his rush to encourage a broad dietary change.”
April 20, 2009
Fast Food Ban, Cancer of Lung and Prostate, Foodborne Illness
By Elizabeth Wade
Seat at and under the table for two NYC councilmen
ACSH staffers were disappointed to hear that New York City Councilman Eric Gioia is proposing a plan to prohibit fast food restaurants from locating within one tenth of a mile of a school. While similar plans have been enacted in other cities, this proposal was spurred by the recent study concluding that children who attend school within one block of a fast food restaurant are more likely to be obese. But ACSH's Dr. Gilbert Ross points out, "The study itself, although a typical piece of junk science, only found a 5% increased risk of obesity -- hardly a significant effect in any case."
ACSH's Dr. Ruth Kava notes, "In New York City, one tenth of a mile is about two blocks, and how many other food establishments are within those two blocks? There are plenty of places besides fast food restaurants that sell high-fat, high-calorie foods."
Picking an arbitrary distance to put between schools and fast food restaurants may be politically expedient, but it is not logically sound. As ACSH's Dr. Elizabeth Whelan remarks, "Would restricting fast food restaurants to being two-tenths of mile away from schools cure the obesity epidemic?"
We give Councilman Gioia a seat under the ACSH breakfast table. As ACSH's Jeff Stier says, "His plan shows how quickly a junk science study turns into a policy proposal."
We hope the same kind of political expediency won't encourage the New York City Health Department's proposed study of dietary salt. Fortunately, the salt plan is facing some opposition from City Councilman Tony Avella, who told the New York Post, "I think it's a waste of city money. It's more nanny government. They tell us what to do, and they'll use studies to back it up and justify it." We give Councilman Avella at seat at the table for his astute observation!
Looking for the cause of lung cancer in tobacco smoke
A new study claims that smokers with the highest concentrations of the "nicotine byproducts" NNAL and cotinine in their urine have a higher risk of developing lung cancer. While headlines such as "Cancer 'culprits' in tobacco smoke revealed" are surely more hyperbolic than the study itself, Stier says, "We would be extremely cautious about any study suggesting that there is one or a few chemicals in burned tobacco products that cause cancer. That would give the cigarette companies an opportunity to come up with a cigarette with a reduced amount of this or that byproduct and call it 'safer.'"
ACSH's Dr. Gilbert Ross points out, "We do not know which component or combination of components of the chemical soup in cigarette smoke is responsible for lung cancer. But even if we did, what about heart disease, emphysema, and all the other negative health effects of smoking? The majority of deaths from smoking are not caused by lung cancer."
While blaming smokers for the health consequences of their addiction is a bad public health strategy, we disagree with efforts to entirely divorce lung cancer from smoking. Stier encountered such a position this weekend at a run sponsored by the Thomas G. Lebrecque Foundation. "Their website claims, 'Over 60% of people diagnosed with lung cancer have either never smoked or have quit smoking.' That's a very misleading statistic because they lump together never smokers and former smokers," Stier says. "Such statistical manipulation can be construed to separate lung cancer entirely from cigarette smoking -- which would be completely invalid."
Provenge's revenge in WSJ
The Wall Street Journal published an editorial condemning the FDA's slow-moving approval of the innovative prostate cancer drug Provenge, which many patients hope will be approved shortly, after several years of delay. "In 2007, a panel voted seventeen to zero that Provenge was safe, and we saw that it greatly increased the survival rate after three years," Dr. Ross says. "The fact that it wasn't approved then is an example of the FDA's over-caution and cowardice."
Stier wonders, "Where is the outrage over this? If this situation were reversed and we were seeing unexpected side effects from Provenge after it was approved, it would be a scandal complete with Congressional hearings. It's much easier to target the drug companies when something goes wrong than to blame the FDA for keeping new and experimental drugs from patients in need."
For more on a related issue, check out Stier's op-ed about lawyer Fred Baron's quest to get access to an experimental cancer drug in the last days of his life.
States vary in response to foodborne illness outbreaks
The New York Times investigates why Minnesota seems to have more outbreaks of foodborne illness than Kentucky -- and concludes that it is mainly a side effect of how effectively the state's health department identifies and tracks such outbreaks. For example, investigators in Minnesota were the first to identify the outbreak of salmonella in peanuts and recent problems with contaminated spinach. "And it's hard to believe that the food in Minnesota is actually more contaminated than the food in Kentucky," Dr. Kava says.
April 17, 2009
Sweeteners, Elders, Kutcher, Inspectors, and Coffee + D
By Elizabeth Wade
Stevia sweeteners enter the sugar substitute war
The New York Times recently published a long article about the fierce loyalty and competition present in the world of artificial sweeteners, postulating that the introduction of "natural" sweeteners made from the stevia plant, such as Truvia and PureVia, could change the balance of the decade-long "stalemate" between saccharin (Sweet'N Low), aspartame (used in Diet Coke), and sucralose (Splenda).
As ACSH's publication Sugar Substitutes and Your Health concludes, none of these artificial sweeteners have been proven to have negative health effects in humans. Even the king of food health scares, the Center for Science in the Public Interest's Michael Jacobson, seems to have realized that common sugar substitutes aren't dangerous, even though he can't quite bring himself to admit it: "In general, I would agree that none of the sweeteners are really harmful. But the question is in the margins. Is there a small health risk?" he says in the article.
ACSH's Jeff Stier says, "He's built an entire career on scaring people about artificial sweeteners, so he has to keep clinging to these straws."
In the end, ACSH's Dr. Ruth Kava points out, "There's no way of proving the absolute safety of anything!"
Are elderly patients under-treated for depression?
A new study found that less than one quarter of elderly suicide victims have anti-depressants in their system at the time of their death, indicating that these potentially life-saving medications are under-utilized among those sixty-five and older. "You have to make a few stretches here to reach these conclusions, but it's an interesting study," says ACSH's Dr. Gilbert Ross. "It should at least be a wake-up call for doctors to be more vigilant about diagnosing and treating depression, especially in elderly patients."
Ashton Kutcher beats CNN, wins one for malaria prevention
Actor Ashton Kutcher has become the first Twitter "millionaire," beating CNN in a widely publicized race to reach one million followers on the social networking site. In celebration, Kutcher is donating $100,000 to the charity Malaria No More, which will provide an estimated 10,000 mosquito-blocking bed nets to needy people at risk of contracting the dangerous disease. April 23 is World Malaria Day, which ACSH will be covering on our own Twitter.
Food safety goes corporate
On the heels of the news that some organic (and, therefore, not irradiated) spices are contaminated with salmonella, the New York Times reports that in the face of expensive recalls and an understaffed FDA, many produce growers and other sectors of the food industry are paying for their own inspections by other government agencies.
The thought of inspectors being paid by the people they are evaluating raises some ethical questions, especially, as Dr. Ross says, because "food companies -- and often inspectors -- know that even in the case of contamination, the chance of it resulting in a detectable infection or costly recall is still very low."
On the other hand, Dr. Kava remarks, "Growers don't want to risk losing millions of dollars because of a recall and the fallout from the bad publicity. They have a great incentive to maintain high safety standards and pay for accurate inspections." She continues, "But whether the new inspectors are being paid by the state, the company, or the federal government, the underlying problem is that the FDA is still very understaffed."
Which is more over-hyped: coffee or vitamin D?
Studies about the supposed health effects of coffee seem to make the news every week. This time, researchers claim that women who drink more than four cups of coffee or tea per day have a lower risk of developing endometrial cancer (cancer of the uterine lining).
"Coffee is part of every dietary survey, so when researchers do some data-dredging, they are almost guaranteed to find associations between consuming coffee and a higher or lower risk of some disease," Dr. Ross says. "Next week, I'm sure we will hear that coffee and tea increase the risk of some other form of cancer -- but it's all just junk."
While coffee may reign supreme for now as the most over-hyped focus of health studies, vitamin D is quickly catching up. Today, we hear that pregnant women with a vitamin D deficiency are more likely to have to give birth via a C-section. While a vitamin D deficiency can certainly cause problems like rickets in children and bone softening in adults, ACSH staffers are wary of how much attention is lately showered upon D's association with any and all purported health effects.
April 16, 2009
Fat in Flight, Gene Plight, Bedbugs' Bites
By Elizabeth Wade
Don't fit in your plane seat? Prepare to buy two
United Airlines plans to aggressively enforce its new policy of requiring obese passengers to buy an extra seat on its flights. "It's a sign of the times," believes ACSH's Dr. Elizabeth Whelan. "Obesity is so prevalent now -- United says it receives hundreds of complaints per year from people who had to sit next to someone who didn't fit into a single seat."
Passengers will be required to purchase an extra seat on United flights if they do not fit into one seat, cannot buckle the seatbelt when using one seatbelt extender, and/or are unable to lower their seat's armrests. Southwest Airlines already has a similar policy in place, but American Airlines says it usually manages to provide enough space for everyone on its flights without requiring obese people to pay more.
Is it possible to understand genetics' role in disease?
While many scientists hoped that decoding the human genome would provide insights into genetic causes of common diseases like diabetes and cancer, studying genes' impact on disease is growing increasingly complex. "We always tell people whose parents had prostate, colon, and breast cancer that they are at higher risk of developing the same disease, but apparently that may not be true," Dr. Whelan says. "I doubt it will stop many doctors from saying it, however -- sometimes we can't let go of these kinds of ideas."
ACSH's Dr. Gilbert Ross explains, "There are some single-gene changes that are well-known to increase risk, such as BRCA gene alterations increasing the risk of breast cancer and certain other cancers of the female reproductive tract. But most familial disease impacts come from many gene changes, each contributing a small amount to the overall risk."
Because of the difficulty of studying such polygenic conditions, let alone devising genomic treatments for them, many researchers are questioning the future of medical research of the human genome. As ACSH's Dr. Ruth Kava points out, "These studies don't mean that there are no genetic factors that increase the risk of certain diseases, but they might be variable and will certainly be much harder to ferret out than some people initially thought."
Evaluating the risks and benefits of epilepsy drugs for pregnant women
It is no surprise to ACSH staffers that children born to mothers who took the epilepsy drug valproate during pregnancy tend to have lower IQ scores than those whose mothers took other epilepsy drugs, since valproate is already known to be associated with an increased risk of fetal malformations.
But, Dr. Ross says, "The seizures of some epileptic women don't respond to any other drugs" -- and seizures themselves can be dangerous for the fetus. "It is important that women taking valproate who are or plan to become pregnant have a serious risk-benefit discussion with their doctors," he continues. "Everyone should always know the benefits and risks of their medications."
Don't let the bedbugs bite!
In response to the largest bedbug outbreak since World War II, the EPA is reevaluating its approach to this pest problem. But it will be a long road toward a solution because the agency has already banned many of the most effective pesticides for dealing with the critters. Plus, bedbugs often hitchhike with international travelers, so they have developed a resistance to many of the pesticides still used around the world.
"While bedbugs aren't a particularly dangerous public health threat, this is a good example of the consequences of the EPA regulators banning helpful pesticides because of their rampant chemo-phobia and pressure from anti-chemical activists," Dr. Ross argues. "In the case of malaria especially, the DDT ban has led to a major recurrence of disease and death among human beings, particularly in the developing world."
Elizabeth Wade is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com). Dr. Gilbert Ross wrote the April 22 Morning Dispatch. SAMPLE REACTIONS:
Martin Mattern wrote:
I wonder if you could take up this question: Is it time to question the very idea of substances "causing" cancer. It is beginning to look a little saying the substance, iron, is dangerous because it is the major component in the steel hammer used in a blow to your head. In the case of lung cancer and smoking, is it even possible that any water insoluble substance deposited in the lungs will tend to cause cancer (with age apparently, because it rarely occurs in young people).
Martin Mattern also wrote (of a hypothetical smokeless future):
When the smoking rate goes to 0%, the statistic will become "100% of lung cancer cases are associated with non-smokers."
MECmd wrote:
As I said in my last book, enviromentalists have murded millions by banning DDT because it damaged eggs of some birds!!!
Bill Robertson -- alias "MR YUK" at the Washington Poison Center Seattle -- wrote:
Dear Colleagues: Again, feel compelled -- as spring arrives -- to say how much I enjoy and get caught up in ACSH Morning Dispatch. Keep up the great work. And the writing is so well done -- unlike some other newsletters I get to see.
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