MORNING DISPATCH 9/12/08: McDonald's, FDA, Botox, Helmets, Drinking Water, and Religious Diets
McDonald's counters attacks on its role in obesity epidemic
Peter Bush, the CEO of McDonald's Australia, spoke out against the idea that fast food is the main cause of rising levels of childhood obesity. "He points out that a majority of children's meals do not come from McDonald's and that lack of exercise also contributes," says ACSH's Dr. Elizabeth Whelan. ACSH's Dr. Ruth Kava points out that even though the causes of obesity are complex, "the media, especially in the U.S., tend to blame obesity on food intake only -- especially fast food."
"While the figures Bush cited pertain specifically to Australia, we suspect the issue is quite similar in the United States -- fast food is disproportionately blamed for high obesity rates," says ACSH's Dr. Gilbert Ross. "We wish McDonald's and other businesses that are targeted in the U.S. would speak out in a similar way."
FDA increases staff, but to what effect?
The Food and Drug Administration recently hired 1,300 more doctors and scientists, which will hopefully increase food safety, facilitate drug approvals, and calm the agency's complaints of being understaffed. "We hope this makes a difference for the better rather than for the worse," Dr. Whelan says. ACSH's Jeff Stier adds, "These scientists should be tasked with speeding the drug approval process, not just left to create more levels of bureaucracy."
Botox may help treat chronic migraines
While Botox is famous for smoothing out wrinkles (and sometimes facial expressions), it may also help relieve the pain of chronic migraines. In a Phase III clinical trial, patients receiving Botox injections had significantly fewer headache days than those receiving a placebo. "Migraine pain is at least to some extent related to muscle tension, so Botox could help relieve some of that," Dr. Ross suggests.
Dr. Whelan believes, "It's great that a new treatment for a debilitating condition is being evaluated and pursued, but the data are too preliminary to act on right now."
Massachusetts town tells kids, "No helmet? No bike."
ACSH staffers had an animated discussion about Holliston, MA's decision to allow police officers to confiscate the bikes of children under seventeen who consistently ride without a helmet. "If they are going to have a law saying that children must wear helmets when riding bikes, they have to have a way to enforce it," Dr. Ross says, while ACSH's Todd Seavey argues, "The government shouldn't be able to require all healthy things and ban all unhealthy things."
Following that logic, Dr. Whelan wonders, "If the police can take away bikes from riders without helmets, why shouldn't the government also be able to seize a Big Mac from someone who is obese?" But ACSH's Jeff Stier believes, "Riding a bicycle without a helmet is a completely different level of risk than eating at McDonald's. On the spectrum of public health initiatives, having police officers confiscate the bikes of minors who don't comply with the helmet law makes a lot more sense than an idea like banning trans fats."
Fear of drugs in drinking water spreads
New testing shows that the drinking water supplied to 46 million people across the United States is "contaminated" with trace amounts of pharmaceuticals. "If we test down to parts per trillion or less, either in the human body or in the environment, we can find anything we look for," Dr. Ross says. ACSH would like to remind our readers that the dose makes the poison -- the minute amounts of chemicals found in various water supplies are so small as to have no impact on human health.
Religion may help some lose weight
An article in the magazine Prevention documents the stories of three women whose faith helped them lose weight and lead healthier lifestyles. "It's very interesting that so many religious organizations are getting involved in helping people lose weight," Dr. Whelan says.
Dr. Ross asks why religious groups don't also encourage their members to quit smoking, but Dr. Whelan explains, "Under many religions, gluttony is a sin, while there is no precedent for cigarette smoking."
Dr. Kava sums up her opinion on the issue: "People are motivated for different reasons, so whatever works."
MORNING DISPATCH 9/11/08: 9/11, War, Cigarettes, and Surgery
Remembering 9/11 and preparing for the future
Today marks the seventh anniversary of the terrorist attacks on the Twin Towers and the Pentagon, and ACSH staffers would like to take this opportunity to remind our readers of the continuing importance of terrorism preparedness. "People are losing sight of the important issue of being prepared in the case of a terrorist attack," says ACSH's Dr. Elizabeth Whelan. "It should still be on our list of concerns."
Learn more by reading A Citizen's Guide to Terrorism Preparedness and Response, ACSH's publication about the health effects of potential terrorist weapons and ways people can protect themselves. "It's everything you need to know about biological, chemical, radiological, and nuclear terrorism," Dr. Whelan says.
Cigarettes won't be regulated by the FDA -- this year
ACSH staffers were pleased to hear that the bill allowing FDA regulation of tobacco products would not reach a vote in the Senate this year. "Our view is that this bill would have done nothing to improve public health and, in fact, might have been a detriment to it," says Dr. Whelan. For example, the bill would have impeded efforts to encourage harm reduction through the use of smokeless tobacco, a topic that ACSH's Jeff Stier commented on on HuffingtonPost.
While the bill proposed banning flavored cigarettes, it would have left menthol untouched. "Flavorings, including menthol, can lessen the harshness of inhaling cigarette smoke, which can be very unpleasant and abrasive, especially for first-time smokers," Dr. Whelan notes. Studies even show that when people enjoy the taste of cigarettes, they may be discouraged from quitting.
"The addiction to cigarettes is very complex," ACSH's Dr. Gilbert Ross explains. "While any appeal the flavor may hold is orders of magnitude less physiologically addictive than the nicotine in cigarettes, it can certainly still have an effect on people's addictions and impede their efforts to quit." Those in need of further encouragement to quit may want to consider this: many plastic surgeons will not operate on patients who smoke.
Death of 9/11 recovery worker is more complex than "toxic dust"
A provocative article in the New Yorker explores the medical and political circumstances surrounding the death of James Zadroga, a police officer and recovery worker at Ground Zero who became the first casualty allegedly linked to the site's "toxic dust." It is becoming increasingly likely, however, that intravenous drug use contributed to his death.
"He's a controversial figure," says Dr. Ross. "We need to be sure to look at all the evidence before we blame 'toxic dust' or other conditions at Ground Zero for his death." For more information on this emotional topic, read Stier's New York Post op-ed "Exploiting 9/11."
One type of arthroscopic knee surgery not effective in reducing symptoms of arthritis
A new study shows that patients who undergo arthroscopic "washing out" of debris -- known medically as "lavage" -- to treat arthritis of the knee do not fare any better than those who treat the condition with physical and medical therapy. "In the procedure, the doctor sends fluid into the knee to wash out tiny bone and cartilage fragments," Dr. Ross explains. "Theoretically, it was supposed to improve the condition without the need for a more traumatic and invasive surgical procedure -- but researchers didn't find the benefit they expected."
Both presidential candidates support the war -- on cancer
John McCain and Barack Obama have both pledged more money to cancer research if elected president. In support of their message, they both appeared on last week's Stand Up to Cancer television special. "Neither of them said anything about the 'dangers' of chemicals or environmental hazards -- which is a good thing -- but neither of them mentioned smoking, either," Dr. Ross notes. "It's amazing that, in the twenty-first century, when we know the preventable cause of 37% of cancer, presidential candidates orating on a 'war on cancer' don't find a moment to mention cigarettes."
MORNING DISPATCH 9/10/08: Infants, Children, Students, Nonsmokers, Amish, and Walgreens
Nonsmokers' risk of lung cancer has not risen
New research finds that, contrary to popular belief, lung cancer rates among nonsmokers are not on the rise. Dr. Michael Thun, head of epidemiological research at the American Cancer Society and the study's lead author, said, "there has been a lot of interest lately in those lung cancer cases that affect patients who have never smoked...[and] this increased interest has led to a lot of concern, misperceptions, and misconceptions regarding the state of risk and susceptibility."
By analyzing data from all over the world, Thun and his colleagues found that there has been no increase in lung cancer rates among nonsmokers in the last fifty to seventy years. They also concluded that men who have never smoked are more likely to develop lung cancer than women who have never smoked, a finding that runs contrary to the popular belief that nonsmoking women are more susceptible to the disease.
"The findings of this study go against prevailing opinions," says ACSH's Dr. Elizabeth Whelan. "We hope these data help people put 'dangers' like secondhand smoke in perspective, while making sure that they don't lose sight of the number-one risk factor for lung cancer -- smoking cigarettes."
Walgreens fights ban on cigarette sales in pharmacies
Walgreens is fighting a San Francisco city ordinance that would ban the sale of cigarettes in pharmacies. City officials who support the ban argue that pharmacies should be associated with making people healthy and that selling cigarettes runs counter to that mission, while Walgreens and other officials question why grocery stores and wholesale clubs with pharmacies are exempted from the ban.
"I worry that many of the stores affected by this new law are just going to stop selling pharmaceuticals because continuing to provide cigarettes will be more profitable," Dr. Whelan says. ACSH's Jeff Stier points out that some drug stores and pharmacies in New York already advertise that they don't carry cigarettes. "Not selling them could be a marketing angle," he notes.
Survival rates increase for children with blood cancer
ACSH staffers were happy to hear that survival rates for the most common childhood blood cancers have improved dramatically in recent decades. "This result is quite predictable considering all the advances medical science has made in treatments and pharmaceuticals, but it's always good to hear pleasant news," says ACSH's Dr. Gilbert Ross.
"When I was in medical school and residency in the 1960s and 1970s, developing a blood cancer like leukemia or non-Hodgkin lymphoma was practically a death sentence," Dr. Ross continues. "Now the ten-year survival rate for non-Hodgkin lymphoma is 87%. New drug combinations and treatments like high-dose radiation therapy to the central nervous system have led to major improvements in survival rates."
Dr. Whelan adds, "This is another reason to thank the pharmaceutical industry and to encourage further research into new drugs."
Amish thwart obesity gene with physical activity
Despite eating a diet high in fat, calories, and sugar and often carrying a gene variation linked to obesity, Old Order Amish have extremely low obesity rates. Researchers point to the fact that because most Amish live in farming communities and do not use modern conveniences, their lives include high levels of physical activity -- with some Amish exercising from six to nine hours per day.
"An average American usually takes about 1,000 or 2,000 steps per day, while an Amish man takes about 18,000 -- over nine times our average activity level," Dr. Ross explains. The researchers say that while nine hours of exercise is unnecessary (and unrealistic) for most people, their study shows that physical activity can help people keep off the pounds even if their genes put them at an elevated risk for obesity.
Fewer medical students plan to become primary care doctors
New data show that only 2% of medical students are planning careers in primary care or internal medicine. "This trend has been going on for years -- U.S.-trained medical students are going into the most financially lucrative professions, like dermatology and radiology," Dr. Ross remarks. "Not only are doctors in those fields better compensated, but their lifestyles are less demanding, and the risk of malpractice suits isn't as high."
Hospitals vaccinate parents to protect high-risk infants
Vaccinating parents who are visiting their newborns in neonatal intensive care units (NICUs) may be beneficial for protecting high-risk infants from disease. The Centers for Disease Control currently recommend that adults who have close contact with NICU children receive the tetanus, diphtheria, and acellular pertussis vaccine (DTaP), so researchers decided to educate parents about the vaccine in the NICU itself and provide easy opportunities to get the shot.
"It seems like they corralled the parents and had the nursing staff available to give the shots," Dr. Ross says. "It's an interesting strategy, but I'm not sure how much disease they're actually warding off with this particular vaccine."
MORNING DISPATCH 9/9/08: Autism, Irradiation, Weight Loss Surgery, Stem Cells, Games, and Corn Syrup
Quote of the Day
"Sadly, even after all of this [evidence debunking the idea that vaccines cause autism], many parents of autistic children still blame the vaccine. The big losers in this debate are the children who are not being vaccinated because of parental fears and are at risk of contracting serious -- sometimes fatal -- diseases." --New York Times Editorial Board, "Debunking an Autism Theory."
Honorary seat at the table goes to Dr. Ralph C. Whaley
We would like to offer a seat at the ACSH breakfast table to Dr. Ralph Whaley for his letter (seventh letter down) to the Wall Street Journal supporting the paper's positive stance on food irradiation. "The Food and Drug Administration's action on the irradiation of produce was long overdue," he writes. "Millions of dollars worth of produce has been needlessly destroyed, thousands of individuals have become sick, and some have died, by the failure of the FDA to approve irradiation for all fruits, meats, and vegetables long ago. Its efficacy in killing bacterial pathogens has been widely known for years."
ACSH hopes the FDA extends the rational approach it took in approving irradiation for spinach and iceberg lettuce and approves the process for other foods as well. "Actually, it would be nice if all government agencies relied on science and stopped throwing out useful chemicals and processes because of boogey men," says ACSH's Dr. Gilbert Ross.
Weight loss surgery may save money and reduce cancer risk
Two new findings bode well for the future of weight loss surgery -- not only is the expensive procedure cost-effective, but it can dramatically reduce a person's risk of certain cancers.
While gastric bypass surgery carries a price tag of around $20,000, researchers say that other healthcare savings usually offset the cost within two to four years. For example, the resultant weight loss is already known to diminish the risk of developing diabetes. "This will put pressure on insurance companies to cover bariatric surgery," ACSH's Dr. Elizabeth Whelan believes.
One way that weight loss surgery can save money in the long run is by reducing a patient's risk of certain cancers, thereby avoiding costly treatments for the disease down the line. Researchers at McGill University found that very obese patients who underwent weight loss surgery were 80% less likely to develop breast cancer and 70% less likely to develop colon cancer than people of similar weight and health who did not have the surgery.
Overall, 2% of the surgery group was diagnosed with any type of cancer in the five years following surgery, while 8.5% of the nonsurgery group developed the disease in the same time period. We hope these new findings illuminate the benefits of weight loss surgery -- and help make the potentially lifesaving procedure more affordable.
Stem cells may be used to create red blood cells
ACSH staffers were intrigued by new research suggesting that embryonic stem cells may be usable for making red blood cells for transfusions. "Making red blood cells from stem cells has a lot of potential because scientists don't have to worry about getting the blood cells to function in the body, which is a challenge in stem cell research involving neurological cells," Dr. Ross says. "However, you have to make a trillion or two red blood cells for just one transfusion."
While the research is very preliminary, the military is particularly interested in its potential, since red blood cells are difficult to obtain and store for use on the battlefield. ACSH will be publishing a paper in the coming months on the developing field of blood substitutes.
Can video games help get kids off the couch?
Some of the latest video games incorporate physical activity, encouraging children to exercise and burn calories. "It's ironic that we always hear the argument that children are getting fat because they play too many video games, and here they are exercising in front of their TV screens," Dr. Whelan remarks.
Researchers measured the heart rate and energy expenditure of children playing a seated bowling game, an active bowling game, and an action game that incorporated running, finding that the children burned 39%, 98%, and 451% more calories while playing the respective games than while resting. Dr. Ross is skeptical of widespread benefits, however, pointing out, "While kids who already enjoy being physically active can benefit from playing these games, I'm not sure that kids who are exercise-averse are necessarily going to start using them."
High fructose corn syrup manufacturers fight back
The Corn Refiners Association is running ads refuting the recent health claims made against high fructose corn syrup. "They're really on the offensive, and I admire them for defending their technology," Dr. Whelan says. "If companies using BPA and phthalates had done the same, maybe they could have defused the scares about their products."
ACSH "fan mail"
Dr. Whelan has received some "fan mail" commenting on her New York Post op-ed condemning governmental interference with our diets. "Wellness crusader" Ray Salome even declared, "Someone named Dr. Elizabeth Whelan is trying to poison us." Before he denounces all "industrialized, processed, and laboratory-created" foods again, we suggest he check out the science.
MORNING DISPATCH 9/8/08: FDA, AMA, TV, EPA, UST, MRIs
Quote of the day
"It is very, very important that patients and their physicians understand the benefits and the risks of the drug. To speak about one without the other could have an impact on patient perception of their medications." --AstraZeneca spokesperson Tony Jewell, from the Wall Street Journal article "FDA Unveils List of 20 Drugs in Side-Effect Probes."
For more information on this topic, see the ACSH publication _Weighing Benefits and Risks in Pharmaceutical Use: A Consumer's Guide.
Dr. Whelan takes on the food police
Today's New York Post includes an op-ed by ACSH's Dr. Elizabeth Whelan reacting to the outrageous proposal that governments should regulate our diets, a plan promoted by officials from the New York City Department of Health in a recent issue of the Journal of the American Medical Association. Through taxes, bans, and shoddy science, she writes, "the Food Police are getting warmed up for a major government push to make us eat healthier -- whether or not we want to."
Dr. Whelan particularly questions the idea of drawing a clear distinction between "unhealthy" and "healthy" foods. She wonders, "Is a McDonald's cheeseburger (rich in protein) unhealthy? How about a couple of Oreos with a glass of milk after school? An avocado is loaded with fat and calories -- does that go on the unhealthy list? What about calorie-filled, sugary orange juice? The simple truth is that all these things can be part of a healthy diet -- in moderation."
Dr. Whelan proposes an alternative that would allow us to "have our favorite foods and eat them, too": "encouraging the food industry to use technology to dramatically cut calories in the food people love" -- such as using bioengineered high-starch potatoes and the fat substitute olestra to make healthier French fries. Stay tuned for an ACSH publication on obesity, technology, and food.
Celebrities "Stand Up to Cancer" but overlook education
The Stand Up to Cancer telethon took place on Friday night, with many celebrities participating in the live event broadcast on three networks, which was meant to raise money for cancer research. "There was quite a bit of discussion about the importance of prostate exams, colonoscopies, and mammograms, and they did devote time to lung cancer, pointing out that it is the leading cause of cancer death among both men and women," reports ACSH's Dr. Gilbert Ross.
"However," he continues, "there were two glaring omissions -- the lack of any useful information or education about the dangers of smoking, and the fact that they never mentioned the most important gynecological cancers: ovarian, cervical, and uterine cancers. They could have at least mentioned the cervical cancer vaccine."
"You would never know from watching this program that some 37% of cancer deaths annually in the United States are directly attributable to cigarette smoking," Dr. Whelan notes.
Dr. Ross concludes, "I would give the program a D for education and useful information about how to lower the cancer rate but an A- for raising money for the research they plan to fund."
Federal money funds questionable study
ACSH staffers are skeptical of the federal government's decision to pledge $3 billion to the National Children's Study, which was designed in part by Dr. Philip Landrigan, the chairman of the Department of Community and Preventive Medicine at Mount Sinai's School of Medicine, who is known for seeking out environmental causes for childhood diseases. ACSH's Jeff Stier wonders, "Why would so much money go to the most divisive and controversial character in the important field of children's health?"
Dr. Whelan asked a similar question in a HuffingtonPost op-ed, reacting to last year's EPA decision to help fund the National Children's Study. "Despite conventional wisdom, there is no mainstream scientific evidence that points to children's health being imperiled by trace levels of chemicals in the environment," she wrote. "In other words, the tens of millions of government dollars being consumed here are directed at purely phantom risks." Since she wrote those words, the amount being spent has increased by orders of magnitude.
Cigarette company to buy smokeless tobacco manufacturer
The world's largest tobacco company, Altria Group Inc. (formerly known as Philip Morris), plans to buy UST Inc., the largest maker of smokeless tobacco in the U.S. "Could Altria be getting into harm reduction?" Dr. Whelan wonders.
Stier worries, "Altria might fear that smokeless tobacco will infringe on its profits and just want to bury it" -- while Dr. Ross believes, "The purchase will allow Altria to cater to people who smoke cigarettes and those who use smokeless tobacco -- including those who are using it to quit smoking. It's a win-win for Altria."
MRIs might encourage mastectomies and delay cancer treatment
We were disturbed by the news that women who have MRI scans to detect breast cancer are much more likely to have a mastectomy than women who only have a mammogram. "We're concerned that the well-documented false-positive rate with MRIs may be leading -- or misleading -- women into choosing mastectomies," explains the study's author, Dr. Richard Bleicher of the Fox Chase Cancer Center in Philadelphia.
"I would be wary of what the author calls 'the overabundance of caution' that is leading to potentially unnecessary mastectomies," says ACSH's Dr. Ruth Kava.
The study also found that having an MRI might also result in a three-week delay before surgery, potentially allowing time for the tumor to grow and causing unnecessary anxiety for patients.
Elizabeth Wade is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com). Receive ACSH Morning Dispatch in your e-mail in-box each weekday by donating to ACSH and then requesting subscription.