MORNING DISPATCH 10/10/08: Tobacco, Infections, HIV, and Rights for Plants
ACSH's harm reduction approach attracts criticism
We received many comments yesterday about our support for R.J. Reynolds' new smokeless tobacco products, some taking issue with our harm reduction approach to quitting smoking. "While, in an ideal world, getting all smokers to simply stop being addicted to nicotine would be an easily attainable goal, this is not likely to happen in the real world," reiterates ACSH's Dr. Elizabeth Whelan.
New smokeless products, which dissolve in a user's mouth to deliver an absorbable form of nicotine, are much less dangerous than smoking cigarettes to get the same nicotine fix.
Nicotine is a toxin at high doses and, more importantly, is very addictive. But, as ACSH's Dr. Gilbert Ross says, "We can't just hope that people suddenly stop using an addictive product when 50 million people are already addicted to it. With quit rates hovering around 15%, we refuse to be complacent with the current approach [quit nicotine or keep smoking] alone."
ACSH encourages the use of smokeless products only for smokers who are trying to quit and have not succeeded with other quit aides. "We're highlighting products that could save people's lives if they switched to them instead of smoking cigarettes," Dr. Whelan says.
The readers who objected to our coverage of this topic yesterday failed to take careful note of the ACSH goal and the well-documented science behind it: harm reduction and reducing the toll of cigarette-related death and disease, as enunciated in our publication Helping Smokers Quit: A Role for Smokeless Tobacco?
Infection control guidelines established
A national committee has been formed to address the problem of hospital infections by issuing guidelines on how to prevent six of the most dangerous conditions. Hospital infections are usually preventable through such basic measures as diligent handwashing and proper use of catheters, but as Dr. Patrick J. Brennan, chairman of the federal Healthcare Infection Control Practices Advisory Committee, told the New York Times, "Too often, where we fail is not in the knowledge but in the execution."
"Apparently some hospitals aren't doing as much as they should, particularly with respect to maintaining catheters properly," notes ACSH's Dr. Ruth Kava. ACSH supports efforts to reduce the incidence of hospital infections, particularly those of the Committee to Reduce Infection Deaths (RID), founded by our trustee Dr. Elizabeth McCaughey.
25% of teen girls have received Gardasil
The CDC released data indicating that 25% of teenage girls received the HPV vaccine Gardasil in its first full year of distribution. "25% is pretty high after one year," Dr. Whelan believes. Dr. Kava agrees: "It's even more impressive when you consider all the negative publicity Gardasil has been receiving."
While Gardasil is clearly making progress, ACSH's Jeff Stier says, "I'm interested to see what the numbers are two years from now."
China struggles to treat drug-resistant strains of HIV
HIV infection rates are increasing quickly and dramatically in China, and the country is now confronted with strains of the virus that are resistant to the drugs currently available there.
"In the U.S., when you have a strain of HIV that is resistant to one drug cocktail, it's relatively easy to switch to another cocktail that may better control the infection," says Dr. Ross. "In China, however, they don't have the same variety of drugs." In fact, only seven of the more than twenty available HIV drugs are available in China. Researchers are currently urging the government to import more varieties of the drugs, and we certainly hope they succeed.
Three stories make it to the junk science hall of fame
While junk science often dominates the media, three of today's stories are particularly absurd. First, we have the finding that eating a protein found in chicken legs lowers the blood pressure of hypertensive rats, which Dr. Whelan calls "the worst story of the month."
Then, the attack on bisphenol-A continues with a story claiming that the chemical interferes with chemotherapy. All evidence comes from laboratory tests, however, and there is no evidence that BPA harms humans or interferes with chemotherapy in actual practice.
And finally, we have the news that scientists in Switzerland are being forced to take the "dignity of plants" into account when designing and conducting genetic research. According to Swiss ethics panel member and University of Basel law professor Markus Schefer, the worst part is, "We couldn't start laughing and tell the government we're not going to do anything about it. The constitution requires it."
MORNING DISPATCH 10/9/08: Nicotine, Depression, Ovarian Cancer, Breast Cancer, and Chocolate
R.J. Reynolds introduces dissolvable "clean nicotine" tobacco products
ACSH staffers are impressed with the tobacco company R.J. Reynolds' decision to market dissolvable tobacco products as alternatives to cigarettes. "Contrary to popular belief, nicotine itself is not dangerous," explains ACSH's Dr. Elizabeth Whelan. "The products of combustion inhaled when smoking a cigarette are the harmful components. These products offer new forms of clean nicotine delivery that can help smokers quit through harm reduction."
The three products, called Camel Sticks, Strips, and Orbs, all dissolve in a user's mouth and are made with a very absorbable form of nicotine. Since they are tobacco products, they may carry a small risk of oral cancer -- but much less than the oral cancer risk posed by cigarettes.
"Smoking is a very complex behavior that is not just about the delivery of nicotine, so quitting is difficult even with the use of products like these," Dr. Whelan says. "But hopefully smokers will start using these products in places where they can't smoke, like airplanes, and realize that they satisfy their cravings enough to aid their efforts to quit."
For more information about harm reduction methods, including a discussion of the relatively low oral cancer risk posed by smokeless tobacco products, see ACSH's publication Helping Smokers Quit: A Role for Smokeless Tobacco?
Economic turmoil leads to stress, depression
Over 75% of Americans report being stressed about the economy, which can lead to depression and destructive behaviors like drinking and drug use. "People are worried about their bank failing," remarks ACSH's Dr. Ruth Kava. "Everybody is worrying, 'Is my job safe? Can I keep affording gasoline?'"
We still have yet to confront winter heating bills, which promise to be much higher than in previous years. For her part, Dr. Kava plans to turn the thermostat down. "We'll spend some of the money we save on sweaters," she says.
FDA warns against test for ovarian cancer
The FDA is warning that the new home test for ovarian cancer, called OvaSure, has not undergone the agency's rigorous approval process and therefore is in violation of the law. "This is very serious and scary," Dr. Kava believes. "You have to know how many false positives and how many false negatives a test provides before marketing it. If you get a false negative from this test, you could be in trouble."
Ovarian cancer is often detected only when it has spread outside the ovaries, making it one of the most fatal cancers. OvaSure, which was developed by Yale researchers, measures six proteins in a woman's blood sample and supposedly calculates the likelihood that she has the disease.
But as Rebecca Sutphen, a spokesperson for the National Ovarian Cancer Coalition, says, "Obviously, everyone is on the same page in terms of wanting such a test. But women may be using this information prematurely to make decisions, and the decisions may not be in their best interests." Dr. Whelan agrees: "It's really tragic to take advantage of women's fears like that."
Obesity increases chance of breast cancer recurrence
Because obese women have higher estrogen levels than normal-weight women do, they have an increased risk of experiencing a recurrence of breast cancer. "This is an important finding, but it's not surprising to any of us," remarks Dr. Whelan. "Obesity is a general risk factor for breast cancer, especially for post-menopausal women."
"Losing weight would also make it easier to detect a recurrence of cancer on a mammogram," Dr. Kava points out. "This information may help motivate women to lose weight."
Junk science continues to attract unwarranted attention
We don't put much credence in "new research" that links eating dark chocolate to maintaining a healthy heart. "This is a recurring story," says Dr. Kava.
Dr. Whelan remarks, "By the time you ate enough dark chocolate to get the alleged protective benefit, you'd be obese" -- and indeed, researchers found that the "benefit" they observed from eating the sweet disappeared at higher levels of consumption.
We're also disappointed in the publicity received by a scare about lead in Hannah Montana bracelets. Lead can be a real problem in large amounts, but few Hannah Montana bracelets are likely to be eaten.
MORNING DISPATCH 10/8/08: Vaccinations, Colonoscopies, Exercise, Prostates, and Cigarettes
Dr. Ross encourages new vaccination strategies
ACSH's Dr. Gilbert Ross had a letter (fifth letter down) in the Los Angeles Times on October 6 encouraging strategies to better protect senior citizens from influenza. While it is important that those over sixty-five receive annual flu shots, Dr. Ross also urges parents to comply with the new CDC recommendation that schoolchildren be vaccinated against the virus as well.
He writes, "The 1980s Japanese experience -- wherein a requirement that Japanese schoolchildren get vaccinated against the flu led to a dramatic reduction in the death toll among seniors -- should have led our own CDC to mandate getting our schoolchildren vaccinated against the flu long ago. And it probably would have but for ongoing anti-vaccine superstition."
Dr. Ross also encourages senior citizens to receive the pneumococcal vaccine, which provides some protection against pneumonia for several years after being administered.
In related news, research suggests that a large number of adolescents are not up to date with their recommended vaccinations. Among the 24,000 adolescents studied in Boston, 74% were up to date on their hepatitis B immunizations and 84% were up to date with the tetanus-diphtheria vaccine. Only 67%, however, were up to date on their measles-mumps-rubella (MMR) immunizations. "I wonder how much of that disparity has to do with the disproved fear that the MMR vaccine is linked to autism," Dr. Ross observes.
ACSH questions age limits on colonoscopies
The U.S. Preventive Services Task Force has concluded that doctors can stop recommending regular colon cancer tests in patients over seventy-five. "I find this decision very troubling," says ACSH's Dr. Elizabeth Whelan. "The message it sends is that if you get colon cancer after seventy-five, it will occur so slowly that it won't interfere with your lifespan -- which is not true." Unlike prostate cancer, which is notoriously slow-growing, colon cancer can develop quickly and is often fatal.
As Dr. Ross explains, "The new guidelines are based on the risk-benefit equation and, especially, the public health cost-benefit of the screening procedure. They have nothing to do with individual patients. If a cancerous polyp is detected in an eighty-five-year-old who is in relatively good health, and if the patient and the family wish to proceed, the doctor could, and probably should, still do the surgery."
Exercise recommendations seem a little low
ACSH staffers were surprised to hear that U.S. adults are advised to exercise two and a half hours per week. "That seems so modest," Dr. Whelan notes, while Dr. Ross points out, "My impression is that many adults don't exercise at all. From a population point of view, we'd be a lot better off if everybody got two and a half hours of exercise per week."
We also wonder what these guidelines count as exercise -- does walking to work five days a week count, or should we be lifting weights at the gym? Activity levels also vary geographically; as Dr. Whelan observes, "Even just two and a half hours per week might be a lot in the suburbs, where people are driving all the time."
Good news for prostate health
A trial of Dendreon's drug Provenge suggests that the medicine reduces the risk of prostate cancer death by 20%. "It's an immune stimulator that trains the body to attack prostate cancer cells," explains Dr. Ross. Despite the positive results, the FDA still refuses to accelerate approval of Provenge.
More positive news about prostate health comes in the form of a study suggesting that even though Proscar, Merck's treatment for enlarged prostates, lowers testosterone levels, it does not increase the risk of hip fractures. In fact, it may even prevent them. But, Dr. Ross says, "I still wonder about the drug's effect on bone mineral density."
The argument for selling cigarettes in pharmacies -- and in liquor stores?
We read an interesting analysis yesterday of San Francisco's decision to prohibit pharmacies from selling cigarettes. While many anti-smoking activists support the ban, Mark D. Welsch, the president of the Group to Alleviate Smoking Pollution, takes a different approach. "I don't understand...why you would want to stop pharmacies from selling tobacco instead of requiring them to be the ONLY location that could sell tobacco -- and only by a pharmacist who is required to give every purchaser of cigarettes a flyer about why and how they could quit," he writes. "Requiring people to buy cigarettes only from pharmacists would drastically reduce the availability and visibility of tobacco products.
"This take on the situation illustrates the fact that there are unintended consequences of the ban," says ACSH's Dr. Ruth Kava.
Dr. Ross agrees. "It shows what happens when you only think superficially and don't go to the next step."
And speaking of superficial analyses, we couldn't believe the story that red wine supposedly reduces a smoker's risk of developing lung cancer. "They are practically telling people that it's okay to smoke as long you drink red wine too," Dr. Whelan comments. "It's really irresponsible to publish something like that."
MORNING DISPATCH 10/7/08: Nukes, More Arnold, Supremes, Fat, SIDS, and ADHD
Quote of the Day
"If there's already a proven technology that doesn't spew carbon dioxide into the atmosphere, why fiddle while coal burns?" --John Tierney on one of the many benefits of using nuclear power in the New York Times article "A Gift from the '70s: Energy Lessons"
Another honorary seat at the table goes to Governor Arnold Schwarzenegger
Gov. Schwarzenegger impressed us again today with his veto of a bill that would have imposed a fee on cargo containers passing through the ports of Los Angeles and Long Beach with the aim of reducing diesel exhaust. But as Gov. Schwarzenegger rationally pointed out, "It is vitally important that the state does not worsen the [economic] situation by mandating added costs on business that do not provide any public benefit."
We'd like to thank ACSH Trustee Dr. Jim Enstrom for bringing this issue to our attention. Along with Dr. Henry Miller, another ACSH Trustee, Dr. Enstrom has been challenging the conventional wisdom on the dangers of diesel exhaust with sound scientific evidence. We hope Gov. Schwarzenegger continues to listen to reason when dealing with California's current scare over flame retardants.
"It looks like the current economic turmoil is bringing some common sense back to the opposition to these frivolous regulations," says ACSH's Dr. Elizabeth Whelan. According to Tara Parker-Pope in the New York Times, the economy's poor performance might also result in a decrease in death rates -- although as ACSH's Dr. Ruth Kava points out, "You have to control for many other factors, including improvements in medical care, before you can say that recessions are good for public health."
Supreme Court to rule on two cases related to public health
During its new term, the Supreme Court will tackle two important public health cases dealing with the issue of preemption. "One case has to do with the advertising claim that light cigarettes are less hazardous, while the other deals with drug liability," explains Dr. Whelan.
The plaintiffs claim that the drug company Wyeth and the cigarette company Philip Morris, respectively, should have changed the labels on the products in question to reflect specific risks. Wyeth maintains that only the FDA has the power to dictate what information is included on drug labels, a topic ACSH's Dr. Gilbert Ross commented on in the Washington Times.
Philip Morris, on the other hand, contends that because a federal law on cigarette labeling forbids lawsuits related to cigarettes and health, lawsuits related to the FTC-approved labels of "light" and "low tar" cigarettes are not valid.
"With these two very big cases, it should be a very interesting Supreme Court term," Dr. Whelan notes.
Can fat still mean fit?
A new study claims that just one session of exercise can improve the metabolic health of obese people. "That conclusion is ridiculously exaggerated," says Dr. Kava. "Exercise raises your metabolism transiently," meaning that the results of just one session of exercise cannot be maintained over a long enough period of time to have a positive impact on a person's health.
"Of course you can improve your health by exercising, but there is evidence that an obese person who gets fit but doesn't lose weight is still not going to be as healthy as a lean person who exercises," Dr. Kava adds.
Dr. Kava also challenges the idea that obesity is not always linked to other health issues, a topic covered in this week's New York Times Magazine. "The article focuses on measurements like blood pressure and cholesterol while totally ignoring other problems like arthritis and extra stress on weight-bearing joints," she explains. "At least in this country, obesity is often a sign of being sedentary" -- a lifestyle that increases the risk for a whole host of health problems.
Do fans really reduce the risk of SIDS?
ACSH staffers also took issue with new research claiming that using a fan in a baby's room significantly reduces the risk of sudden infant death syndrome (SIDS). "This is just an association based on parents' recollections of information from some time ago," says ACSH's Dr. Gilbert Ross. Dr. Whelan notes, "Talk about data dredging. This is the perfect example of throwing a bunch of unrelated variables in a pot and picking an association that supports your hypothesis."
Treating ADHD makes teenage girls less likely to smoke
We were pleased to hear that teenage girls taking stimulants like Ritalin to treat attention deficit hyperactivity disorder (ADHD) are much less likely to smoke than their peers who also have the condition but do not take such drugs. "It appears as though it wasn't the specific drugs that helped, but it was more about controlling their ADHD," says Dr. Ross.
People with ADHD are more likely than others to smoke and abuse drugs, perhaps because, as ACSH's Todd Seavey points out, "Some people believe that smoking can help them focus, so it might be something that people with ADHD gravitate toward." It had already been concluded that similar treatments for ADHD in teenage boys make them less likely to pick up the habit.
MORNING DISPATCH 10/6/08: Nobel, Schwarzenegger, Nemeroff, China, NYT, Food, and Flu
Winners of Nobel Prize in medicine announced
We would like to extend our congratulations to Harald zur Hausen, Françoise Barré-Sinoussi, and Luc Monagnier, the winners of this year's Nobel Prize in Physiology or Medicine. Zur Hausen is being honored for his discovery that human papilloma virus can cause cervical cancer in women, a breakthrough that led to the recent development of the HPV vaccines Gardasil (Merck) and Cervarix (GSK). Barré-Sinoussi and Monagnier will share the other half of the prize for their discovery of HIV, the virus that causes AIDS.
Honorary seat at the table goes to Governor Arnold Schwarzenegger
ACSH offers at seat at our breakfast table to Governor Schwarzenegger, who vetoed a bill that would have banned the use of the safe chemical perfluorooctanoic acid (PFOA) in food packaging in California. "Sanity finally emerges from California," says ACSH's Dr. Elizabeth Whelan, while ACSH's Dr. Gilbert Ross clarifies, "I'd call it a lapse in the usual insanity."
ACSH staffers are still concerned about how much media attention the PFOA scare has received. "When you raise alarms about common products and scare people into believing their children are in danger, you will always make the news -- even if all your warnings are based on junk science," Dr. Ross observes.
Psychiatrist fails to disclose financial conflicts of interest
Another story about conflicts of interest hit the newsstands today, this time directed at Dr. Charles B. Nemeroff, a prominent psychiatrist from Emory University. Dr. Nemeroff did not properly disclose the income he earned as a consultant for the drug company GlaxoSmithKline, which well exceeded the federal limit of $10,000 per year.
"He was wrong for not properly reporting what he earned, but he was never accused of any scientific wrongdoing," points out ACSH's Jeff Stier. "The underlying message is that financial conflicts of interests are hurting science and consumers, and in this case, that's not true."
As an excellent editorial in PLoS Medicine reminded us last week, potential conflicts of interest can be much more complicated than just money changing hands. "There are many other sources of bias that aren't investigated as thoroughly as financial ones," Dr. Ross says.
Lung disease reaches astounding levels in China
Tens of millions of people are predicted to die of lung disease in China over the next twenty-five years. "It's just phenomenal that so many people are dying from preventable causes, such as cigarette smoking and burning fuels indoors," says Dr. Whelan. "Do they have any anti-smoking education in China?" she wonders. If not, we think it's about time they started -- before the country's numbers of predicted deaths from diseases like chronic obstructive pulmonary disease (COPD) and lung cancer rise any higher.
New York Times supports biotech but is still not convinced of its safety
ACSH staffers give two cheers to a New York Times editorial about the benefits of genetically-modified animals. But while the editorial board writes "Genetically modified animals should be a boon both for consumers, who may ultimately gain healthier foods and access to scarce medications, and for agricultural producers, who may cut costs with disease-resistant or faster-growing animals," it also argues, "The crucial advance [in the FDA's guidelines] is that the government will require safety and environmental assessments before approving genetically-engineered animal products."
"They still want too much regulation," says ACSH's Dr. Ruth Kava. Dr. Ross explains, "The genetic improvements we're able to make to these animals through biotechnology are more scientifically grounded and less dangerous than the previous guess-and-check practice known as animal husbandry."
Consumers should be wary of food poisoning
Two new food poisoning warnings emerged this weekend. The first concerns an outbreak of listeriosis in Canada that has already killed twenty people. Deli meat processed in a Toronto branch of Maple Leaf Foods, Canada's largest food company, became contaminated with the Listeria bacterium from the plant's slicing equipment. "The public has this impression that food poisoning is not that serious, but as this case proves, it can be lethal," Dr. Whelan says.
The second concerns reports of people contracting salmonella after eating frozen chicken dinners they had prepared in the microwave. "Just because the chicken is breaded doesn't mean it's fully cooked," Dr. Whelan says. ACSH's Dr. Ruth Kava explains, "You can't count on microwaves to fully cook raw meat because they heat unevenly. They should just label these products, 'Do not cook in microwave.'"
To protect children's health, the flu vaccine is a better bet than new drugs
Free samples of new drugs may not be the best way to treat children, even those without health insurance. Many samples of new drugs such as Advair for asthma, Adderall and Strattera for attention deficit disorder, and Elidel for eczema were given to young children before being slapped with serious safety warnings by the FDA. Because the drugs hadn't been on the market for very long, their safety, especially for young children, had not been completely vetted. On the other hand, says Dr. Ross, "The newer the drug, the more effective it tends to be, in general."
While this controversy will be difficult to sort out in retrospect, ACSH would like to remind parents of a tried-and-true way to protect their children: the flu vaccine. Doctors have even found evidence that kids who get vaccinated every year are less likely to develop dangerous staph infections, which can cause lethal superinfections in flu-damaged lungs. "The bottom line is to get children vaccinated," advises Dr. Ross. "Kids who don't get vaccinated have a very high risk of getting the flu, which can compromise their health in a number of ways. Influenza causes over 20,000 children to be hospitalized each year."
MORNING DISPATCH 10/3/08: Smoking, Obesity Drug Failure, Breast Cancer, Coughing Kids, and Phones
ABC's Love plug spreads confusion on breast cancer
ABC News unskeptically noted Dr. Susan Love's plan to create a vast online database of information provided by women with breast cancer. To most people -- including the producers at ABC News -- the idea sounds harmless, even helpful. But as ACSH's Jeff Stier (who warned yesterday that Breast Cancer Awareness Month always attracts some junk science) pointed out at our morning meeting table, this skewed, self-reported assemblage of data will inevitably become a mine for "data-dredging," consulted by -- and created by -- women hoping to find some pattern of external forces (such as environmental chemicals) responsible for their conditions.
Not satisfied with the usual magic-bullet talk of "a cure" for breast cancer (which routinely ignores substantial progress already made in controlling the disease through pharmaceuticals), Dr. Love has vowed to go "beyond a cure" to ensure that no woman gets breast cancer in the first place, and it is implied that this will be achieved by finding some unexpected external factor that is to blame. ABC owes it to viewers to ask tough questions and not just be cheerleaders.
Phlegmatic analysts needed amidst puffery and scares
A group of pediatricians, unsatisfied with recent warnings about potential overdoses of children's cold medications, wants the FDA to ban over the counter children's remedies. At proper dosages, "the FDA says it's safe," counters Stier. "--but not effective," interjects ACSH's Dr. Elizabeth Whelan.
In the benefit-risk calculus necessary before using any drug, even minuscule risks might be considered decisive if there is no clear advantage to using the drug. "If they don't work at all, what's the point?" asks Whelan. ACSH's Dr. Gilbert Ross notes, though, that many children's cold medications at least have decongestant and sedative effects -- though doctors generally recommend fluid intake and rest as the best treatment for the timeless and stubborn curse of the common cold.
The manufacturers of children's medication have recently suggested that the remedies should not be used for infants and toddlers but have assured that the medications are safe at normal dosages for children over two. FDA says this does not go far enough and will oversee new industry studies on the efficacy of some of the drugs' components.
Loss of obesity drug weighs heavily
Drug manufacturer Merck announced that it will not seek FDA approval for nor continue research on its hoped-for new anti-obseity drug Taranabant. The company says that in trials, higher doses of the drug were associated with an unacceptable level of adverse events. With the average cost to bring a new drug to market now estimated to be almost $1 billion dollars -- and with both the FDA and lawsuit-filing customers increasingly intolerant of any side effects -- the failure of a drug like Tarabant is a reminder of the immense financial challenges oft-vilified pharmaceutical manufacturers face.
Increasing attention, reducing harm
Dr. Ross has a letter -- "Smokeless Tobacco for Cigarette Cessation?" -- in the October 4, 2008 edition of The Lancet chastising Dorothy Hatsukami and colleagues for an earlier Seminar piece about tobacco addiction that neglected to mention switching to smokeless tobacco use as a means of harm reduction for hopelessly addicted nicotine-seekers currently using cigarettes. Given abysmal success rates for all the currently approved quit methods and the much lower rate of death and illness from smokeless tobacco (the risk of death from smokeless being some fifty times smaller than from cigarettes), it is irresponsible not to mention the difference.
Nonetheless, Hatsukami et al reply to Ross's letter with the suggestion that we can't know what effect smokeless promotion would have on society as a whole despite its apparent risk-reduction benefits to the individual -- though at ACSH, we're hard pressed to see how even in the unlikely event that most of the population became smokeless users it could result in a net loss for public health if smoking were largely eliminated in the process. Hatsukami et al note in passing that geographic areas where smokeless use is high are also often areas where smoking rates are high, to which Ross says "That's a macro-association of no consequence if ever I heard one."
Hatsukami et al also complain about certain specific, more dangerous forms of smokeless tobacco being promoted, such as one used in India, unlike the Swedish form usually pointed to as an example of past success -- to which Ross can only say, "That's not what I said. She completely ignored my point: to have a seminar on quitting tobacco and not even mention smokeless for harm reduction is irresponsible."
India bans public smoking
Indians may well find themselves wanting a lot of smokeless tobacco soon, since that country has just banned smoking in public places. "240 million tobacco users -- wow," responds Dr. Ross. "That's a lot of policing," adds ACSH's Dr. Ruth Kava skeptically.
Cell phones vs. sperm
As if it weren't bad enough that a recent viral marketing campaign jokingly suggested cell phones can be used to heat popcorn, the latest cell phone scare-study implies cell phones may be reducing sperm quality. Even with an endless variety of implausible claims made against cell phones in the past two decades, this one seems to stretch the limits of biological plausibility to new lengths. "I just think people have it in for cell phones," says Dr. Whelan.
"They didn't even do semen analysis," observes Dr. Ross, "and study sperm motility or whether their little flagella are chunky and healthy -- they measured antioxidants and assumed that was an indicator of sperm health...Why don't you just measure motility and vitality?" Just as certain iconic topics -- Abraham Lincoln, doctors, dogs -- have long been known by media experts to attract extra attention, it seems, says Ross, "This story is cell phones and semen, so it's gonna be a hit."
MORNING DISPATCH 10/2/08: Breasts, Lungs, Celebs, Rats, and Anthrax
October is breast cancer awareness month
Events meant to raise awareness about breast cancer issues, especially the importance of early detection, will be taking place nationwide throughout October. "During Breast Cancer Awareness Month, we all should acknowledge the progress that has been made against the disease," says ACSH's Dr. Elizabeth Whelan. "More women are getting mammograms, and diagnoses are being made earlier. Following lumpectomy and radiation to treat early breast cancer, there are new drugs available (aromatase inhibitors), which dramatically reduce the chance of recurrence."
New technology is also helping us make strides against the disease; for example, researchers found that computers can be used to do second reads of mammograms, improving detection rates while cutting costs.
Any awareness campaign for a disease carries the risk of straying away from purely scientific information, however, so ACSH's Jeff Stier warns, "I think we should all be on the lookout for junk science."
ACSH staffers were also struck by how much more publicity breast cancer awareness receives than other cancers. "Breast cancer is more poignant," observes ACSH's Dr. Gilbert Ross. "With lung cancer, for example, it is easier to say that the victims 'brought it on themselves'." We hope scientific research continues to improve detection and treatment methods for all cancers.
Highlighting the effects of smoking
A new study links depression to smoking, but some ACSH staffers wonder if rather than being a cause of depression, smoking is a symptom of the condition. "Smoking is a sign of depression," Dr. Whelan says. "They have the sequence out of order."
Dr. Ross believes the two may influence each other, saying, "It's a vicious cycle."
Britain's new labels on cigarette packs might depress smokers even further, since they feature extremely graphic pictures of the health effects of smoking, including tumors, diseased lungs, and even open heart surgery. Dr. Whelan is skeptical that the new labels will have the intended impact, pointing out, "High-fear warnings are often the least successful at helping people quit." They may, however, deter nonsmokers from picking up the habit.
Celebrities continue to foment anti-vaccine hysteria
Dr. Ross discussed vaccines and autism today on WRHU's show "Hofstra Morning Wake Up Call," hosted by Ian Scotto. Celebrities like Jenny McCarthy are adding their voices to the anti-vaccine scare, but Dr. Ross emphasized, "While it is unfortunate that she has an autistic child, Jenny McCarthy is not a scientist. Vaccines are safe." He pointed out that McCarthy is using her autistic son to sell her book, which he termed "a tragic exploitation" resulting in innocent children suffering the effects of inadequate vaccine protection.
We hope pregnant women take Dr. Ross's message to heart and get their recommended flu shot. "There is a lot of fear about giving anything to pregnant women, and flu shots have only been recommended for them for a short time," Dr. Ross says. With more obstetricians urging their patients to get the vaccination in October and November, however, ACSH hopes more pregnant women take this important step to protect themselves and their children.
In other vaccine news, the Wall Street Journal reports an unintended consequence of the U.S. government's recommendation of Gardasil: The HPV vaccine is now required for all women ages eleven to twenty-six who wish to immigrate to the United States. "They only have to get the first shot before entering the country, but even that can cost them as much as $120 on top of all the other expenses they face when coming here," Dr. Ross points out. And with no follow-up, the women may not receive the other two shots in the series, thereby missing out on its full benefit.
Your anthrax treatment is in the mail
Mail carriers in several cities are being trained to deliver antibiotics to affected communities in the case of an anthrax attack. "They would get the medication first and would then bring help to areas that had been targeted," Stier explains. Dr. Whelan remarks, "It seems ironic that postal workers would be the ones bringing the treatment, considering that anthrax itself has been delivered through the mail."
Re-thinking rat studies
ACSH staffers often point out that the results of scientific studies done on rats must not be assumed to be universally applicable to humans, but an interesting piece by Dr. Stephen Daniels, the science editor of NutraIngredients.com and FoodNavigator.com, inspired us to analyze our approach.
"He rightly points out that you can't say something is safe because of rat studies and then reject other rat studies because you have a problem with their conclusions," says ACSH's Dr. Ruth Kava. "We should always point out that you can't directly apply the results of rat studies to humans, but I don't like this business of thinking that all rat studies don't mean anything."
At the same time, Dr. Ross maintains, "I've learned enough about rat physiology to know that there is very little overlap between rat pathophysiology and human pathophysiology."
MORNING DISPATCH 10/1/08: Vaccines, E. coli, hormones, cancer, and conflicts of interest
Claims about conflicts of interest make it difficult to navigate medical studies
ACSH staffers are disappointed by challenges to the FDA's approval of bisphenol-A (BPA) based on the fact that the government organization used industry-funded studies to reach its conclusions about the chemical's safety. "Those opposed to BPA use this kind of innuendo to make their case because they don't have any facts," says ACSH's Dr. Whelan, who has written about what she calls "the new scientific McCarthyism" aimed at scientists who work with industry. "But in the end, what's important is the quality of the work, not who funds the study," she continues.
Rather than getting bogged down in the controversy surrounding financial conflicts of interest, an editorial in PLoS Medicine examines the more interesting and important issue of non-financial competing interests and their influence on medical research.
"One possible example discussed in the article is what happens when a peer reviewer receives a paper she or he knows was written by her or his mentor," says ACSH's Dr. Ruth Kava. "Journal editors are trying to figure out a way to get a handle of this sort of thing, but it's so amorphous. It's easier to focus on financial aspects." But as the PLoS editors point out, "private competing interests are perhaps even more potent than financial ones."
All the different kinds of medical studies -- and all the ways they can be challenged -- can be confusing, so Gina Kolata attempted to help readers approach and understand them with a piece in yesterday's health-centric "Science Times." She explains how randomized clinical trials differ from observational studies, laboratory tests, and animal studies and explores why and how the results from a clinical trial can contradict and often trump data from other investigations.
Dr. Kava points out, however, "She gives the impression that clinical, randomized trials are the gold standard, which isn't completely true. What you really have to have in order to believe something is true is independent replication. You can't just accept the evidence of one trial, no matter how rigorous it is" -- especially when trying to distinguish association from causation.
E. coli cases pinned on lettuce
Thirty cases of E. coli in Michigan have been linked to bagged, industrial-sized packages of iceberg lettuce. "Schools have started removing lettuce from their lunch menus," Dr. Whelan observes. Dr. Kava has a suggestion for preventing a similar outbreak of foodborne illness in the future: "What could be easier than irradiating industrial-sized bags of iceberg lettuce? It could be done in the bag if companies used the right packaging."
Celebrities speak out on vaccines
Actresses Amanda Peet and Jenny McCarthy continue to publicly spar over the baseless idea that childhood vaccines cause autism. While we applaud Peet for encouraging all parents to have their children vaccinated, we are disappointed by McCarthy's statements, such as, "She [Peet] has a lot of [nerve] to come forward and be on that side, because there is an angry mob on my side, and I like the fact that I can say she's completely wrong."
Dr. Kava remarks, "I guess if you're angry enough it makes you right," while Dr. Whelan believes, "There's nothing worse than ignorance in action." For more information on how celebrities can influence scientific discussions, see ACSH's publication Celebrities vs. Science.
Pancreatic cancer may be linked to hepatitis B
Researchers have identified a possible link between hepatitis B and pancreatic cancer, finding that pancreatic cancer patients were twice as likely as others to have been infected with the virus. "That is really a dramatic conclusion," says Dr. Whelan.
The study's authors make it clear that their research does not prove that hepatitis B (which is known to cause liver cancer) causes cancer of the pancreas, but they advise those infected with the virus to be vigilant about reducing their risk for pancreatic cancer by not smoking and watching their weight.
Fewer shots of anthrax vaccine still produce immunity
The anthrax vaccine is still effective when delivered via three intramuscular shots, rather than six subcutaneous injections. "Most Americans are thinking, 'What's the relevance of this?'" Dr. Whelan says. "Everyone just forgets that this information is important -- until we face another bioterrorism threat." Read ACSH's Citizen's Guide to Terrorism Preparedness and Response for more information on the subject.
HRT may not increase risk of heart attack
A new study suggests that taking hormone replacement therapy (HRT) to treat symptoms of menopause does not raise a woman's risk of heart attacks, contradicting earlier data from the Women's Health Initiative (which is discussed in Gina Kolota's article on interpreting medical studies).
"It may actually be the way that HRT is used, rather than the therapy itself, that increases a woman's risk of a heart attack" Dr. Kava explains. "Women who took continuous HRT did have a higher risk, but those who took cyclical HRT, in which the hormone doses vary throughout the month like in birth control pills, did not have a higher risk."
"This is a terrible area of confusion for women," Dr. Whelan says. "ACSH is trying to sort it out with a major paper on HRT that we have in the works."
MORNING DISPATCH 9/30/08: Make-up, melamine, alternative medicine, depression, and needless studies
Dr. Ross calms fears about cosmetics in USA Today
ACSH's Dr. Gilbert Ross takes on the health scare about chemicals such as parabens in teen cosmetics in a letter in USA Today. "The minuscule amounts of these chemicals [found in cosmetics] could not possibly cause harm," he writes. "Studies incriminating such chemicals have come from rodent experiments at much higher exposures than humans have, with no relevance to human health."
Dr. Ross also reminds readers, "These chemicals have passed the test of time, as well as other evaluations done by expert panels evaluating their real health risks. Despite these alarms raised about chemicals, our health and longevity continue to improve, and cancer death rates are declining." We hope Dr. Ross' sensible approach inspires more people speak out against baseless health scares.
More Chinese products found to be contaminated with melamine
The latest "made in China" scandal has spread from baby formula to many other products, as the toxic chemical melamine has been found in instant coffee, White Rabbit candy, and even some Cadbury chocolates. "Companies were diluting all kinds of milk with melamine to pass protein tests," says ACSH's Dr. Ruth Kava. "It was out-and-out criminal, and we don't know where it is going to end. Milk is used for so many different types of food products."
ACSH's Dr. Elizabeth Whelan believes, "It's appalling that this chemical was being added to products on purpose." Dr. Kava notes, "I bet they'll start using better tests for protein that are not so easily manipulated." We hope the Chinese government and businesses take action to end this crisis soon and ensure it doesn't happen again -- although as the New York Times reminds us in an op-ed about the decades-long swill milk scandal in nineteenth-century New York City, problems like these are not easy to clean up overnight.
While no one in the U.S. is known to have been sickened by these Chinese products, the scare has brought attention to the issue of whether foods should be labeled with their country of origin. Dr. Whelan believes, "The mere fact that you're doing it implies that foreign products are less safe, which isn't necessarily true." On the other hand, Dr. Kava notes, "Country of origin labeling could make outbreaks of foodborne illnesses easier to trace, which might be a good reason to do it."
Heart disease patients are prone to depression
New research shows that heart disease patients are three times more likely than the general population to develop depression. "There's something basic about your heart that is very central to your identity," Dr. Kava says. "When it is threatened, it can really change your outlook." Dr. Whelan wonders how these statistics compare to the rates of depression in cancer patients, while Dr. Kava notes, "I don't think people feel the same way about their pancreas, for example, as they do about their heart."
It is important that heart patients are screened and treated for depression, since those with the condition are more likely to stop taking their medications and less likely to exercise regularly or stay on a heart-healthy diet.
Unnecessary studies puzzle ACSH
ACSH staffers wonder why researchers decided to do a study linking a baby's birth size to her risk of developing breast cancer later in life. "What is the practical application of this information?" asks Dr. Whelan. "Unless they are able to come up with some kind biological mechanism that explains the correlation, I wouldn't take this study seriously."
We are also unclear on the motivation behind the study concluding that statins do not increase the risk of Lou Gehrig's disease. "Whoever said there was a link?" asks Dr. Whelan, while Dr. Kava notes, "Now that statin drugs are so widely used, it seems like people are looking to find something wrong with them."
Supplements do not help treat arthritis, showing that alternative medicine must be studied
We weren't surprised to hear that two supplements commonly used to treat arthritis, glucosamine and chondroitin sulfate, are not any more effective than a placebo at slowing the loss of knee cartilage. "There is such a widespread belief -- even among physicians -- that these supplements have some efficacy," says Dr. Whelan. "There goes another alternative medicine for you."
As the New York Times points out in a special "Science Times" devoted to health, comprehensive studies like this one are rarely used to determine the efficacy of many alternative medicine practices. A survey of studies done on yoga therapy, for example, revealed that only 40% of them used randomized control trials, so, as Dr. Kava says, "the other 60% aren't of much use."
"I'm glad someone is finally paying attention to this issue," she continues.
MORNING DISPATCH 9/29/08: GM, Nukes, Salt, Calories, Chlorination, and Newman
Honorary seat at the table goes to Dr. William Reville
We would like to offer a seat at the ACSH breakfast table to Dr. William Reville, a professor of biochemistry at Ireland's University College Cork, for his defense of scientific evidence in the face of anti-GM and anti-nuclear activism.
In his essay "Anti-GM and Anti-Nuclear Advocates Need to Be Challenged," he writes, "Environmental activists who take a position on issues contrary to the evidence of mainline science always speak with confidence and passion and often try to shout down opposing voices. They should be opposed with matching vigour. Only then can science win out."
ACSH's Dr. Elizabeth Whelan observes, "It's so unusual for a scientist to make a statement like that." ACSH hopes more scientists follow Dr. Reville's lead.
New York City takes aim at salt
An interesting article in the New York Sun (in what sadly may be its last issue) outlines the beginning of what could be a war on salt waged by New York City's Department of Health and Mental Hygiene. Health Commissioner Dr. Thomas Frieden, who spearheaded the city's laws banning trans fats and requiring chain restaurants to post calorie counts, recently began focusing more attention on the dangers high blood pressure and calling for widespread reduction of salt in food to possibly help alleviate high rates of the condition. "Really, this is something that requires an industry-wide response and preferably a national response," he told the Sun.
In the same article, ACSH's Dr. Gilbert Ross says, "Yes, I do believe this is the first foray in the Department of Health's [campaign] to turn sodium into the next trans fats...The New York City Department of Health is looking for food hobgoblins everywhere."
Dr. Whelan wonders, "What exactly can the government do about salt in New York City? We can't imagine Mayor Bloomberg putting any restrictions on the use of salt" -- especially since it would involve convincing national companies to change how they make their food products.
Dr. Ross also points out, "You can actually do harm by restricting salt for everyone, since some people will have their blood pressure lowered by not taking in adequate amounts of the mineral." ACSH staffers hope that salt is not forced to go the way of trans fats in New York City.
Harvard cuts back on calorie information in dining halls
Harvard University has removed index cards displaying each dish's calorie count and nutritional information from its dining halls this year, citing concerns about the cards' effect on students with eating disorders. "Those individuals [with eating disorders] can place an undue emphasis on calories and other literal food values, making their placement over every food item a real challenge," says Ted A. Mayer, the executive director of Harvard's Dining Services.
Dr. Whelan notes, "This could be a downside of posting calorie counts." The nutritional information once provided on the cards will still be available at kiosks in the dining halls and on the Internet.
Paul Newman's death brings attention to lung cancer
We were saddened to hear that the actor and philanthropist Paul Newman died from lung cancer on Friday at the age of eighty-three. The Lung Cancer Alliance released a statement mourning his passing and advocating research on the disease, which it says goes under-funded because of the "stigma and blame associated with lung cancer." The release points out that announcements about Paul Newman's treatment for the disease in the last months of his life often "referred to him as a 'former chain smoker' with all the insinuations inherent in that label."
"Just because there is a modifiable risk factor for lung cancer -- smoking -- doesn't mean that research should stop or people's deaths shouldn't be mourned," Dr. Ross says. "I would say that the lesson from Paul Newman's death is that former smokers also get lung cancer, so the sooner you quit, the better."
Chlorination has been saving lives for 100 years
September 26 marked the hundredth anniversary of the chlorination of public water supplies in the U.S. Jersey City, NJ, was the first American city to chlorinate its drinking water, dramatically reducing the incidence of pathogens such as cholera and typhoid in its water supply and inspiring other cities to follow suit. Dr. Whelan remarks, "Can you imagine if we proposed putting 'a toxic chemical' -- chlorine -- in the water supply today?"
The article lists twelve other life-saving measures we often take for granted, such as vaccinations, canned food and drink, and plastic. "I have to give the reporter credit for mentioning these breakthroughs, but he undercuts his praise by also bringing up the BPA scare and alleged vaccine-autism link when discussing them," notes Dr. Ross.
MORNING DISPATCH 9/26/08: Peanut allergies, Brockovich, PETA, stem cells, and energy drinks
Peanut allergies lead to lunchroom segregation
In an effort to protect children who have peanut allergies, two elementary schools in New Jersey have started separating students at lunchtime based on what they eat. Children with bagged lunches containing peanut products must sit in one section, while those eating peanut-free lunches sit in another. "School is supposed to teach you how to live life, and life is not like that," says ACSH's Dr. Elizabeth Whelan. "These schools should be teaching students with peanut allergies how to protect themselves, not simply segregating them."
"The question is, at what age can children learn to protect themselves?" argues ACSH's Jeff Stier. "Six-year-olds won't turn down a chocolate that has nuts in it even if they know they are allergic. They just can't think like that yet, so maybe the school should step in and provide more protection for them."
Politically-correct junk science continues to go unquestioned
ACSH staffers were disappointed -- but not surprised -- that the New York law firm of Weitz and Luxemberg, which specializes in asbestos-exposure lawsuits, recently hired Erin Brockovich to be their spokesperson. "It is obvious that they are just looking for more clients to sue asbestos companies," Dr. Whelan notes. "Using Erin Brokovich as their spokesperson is almost as revolting as when the Harvard School of Public Health gave her its highest award for her 'service' to public health, when her real devotion is to litigation-related junk science."
Stier points out another problem with this aggressive plaintiff's law firm: New York State Assembly Speaker Sheldon Silver, who has consistently blocked efforts to institute tort reform, is also an attorney there. "Where are all the 'conflict of interests' activists now?" asks Stier.
Another example of double standards in public health comes in the form of a statement from UC San Francisco's Dr. Stanton Glantz, who said, "Smoking in movies is the number one reason kids start to smoke," in an effort to expose and discourage collaborations between tobacco companies and movie studios.
Stier notes, "He doesn't have any data to support that blanket statement, but people act like it doesn't deserve any scrutiny because he's on the 'right side'."
PETA calls for breast milk ice cream
The animal rights group PETA sent a letter to Ben and Jerry's encouraging the ice cream makers to use human breast milk instead of cow's milk in their products. "This really shows that PETA doesn't care about people," says ACSH's Dr. Ruth Kava. "Extra breast milk is often put in milk banks for premature babies."
Stier points out, "PETA is known for outrageous campaigns aimed at getting its name out there." We hope no one takes this latest request seriously, and we agree with Ben and Jerry's statement, "We believe a mother's milk is best used for her child."
New development in stem cell research might bypass religious restrictions
Researchers have found a way to coax adult cells to regress to an embryonic state, creating new possibilities for stem cell research. Scientists hope that the new development will help them circumvent the religious objections to destroying embryos to obtain embryonic, pluripotent stem cells, as well as the political restrictions those objections have inspired.
"It is good research and an important breakthrough, but the whole reason they had to do it in the first place was because of the brouhaha about destroying embryos to do stem cell research," says ACSH's Dr. Gilbert Ross. ACSH believes that scientists should be able to proceed with all available courses of stem cell research without encountering religious or political stumbling blocks.
Should energy drinks carry warning labels?
The authors of a study on the effects of high-caffeine energy drinks are calling for warning labels to be put on these products, which can contain the same amount of caffeine as fourteen cans of Coca-Cola or about four cups of coffee. "These are megadoses of caffeine and out of the realm of what you might expect to be getting from a drink," Stier says.
Dr. Ross adds, "People who are caffeine-sensitive could get much more than the jitters from doses like these. I have no strong objection to putting a warning label on these drinks."
MORNING DISPATCH 9/25/08: CEI, Flu, Salt, Teeth, and Clots
Honorary seat at the table goes to Iain Murray
We'd like to offer a seat at the ACSH breakfast table to the Competitive Enterprise Institute's Iain Murray, who wrote an excellent review of the book Poisoned Profits: The Toxic Assault on Our Children by Philip and Alice Shabecoff. ACSH staffers were particularly impressed by Murray's assertion, "We live in a world where risk surrounds us every day. The Shabecoffs appreciate that. However, they fail to appreciate that chemicals protect us from much greater risks. That's a tradeoff I'll take for my family any day. I do not want to go back to the Stone Age."
Preparing for flu season -- starting right now
More doses of the flu vaccine will be manufactured this year than ever before, and the shot is predicted to be a better match for the currently circulating influenza strains than last year's was. "The CDC is putting a lot of effort into education and awareness and is especially focusing on the importance of having children vaccinated," says ACSH's Dr. Elizabeth Whelan. "It is an important message, but how many doses will still be discarded this year?"
ACSH's Dr. Gilbert Ross notes, "Last year's match was well below average, but when you look at the effectiveness of the vaccine over a decade, the numbers are generally pretty good. Their bet that this year's vaccine will be better might be based on nothing more than that they are just playing the odds."
In related news, a new study shows that delivering the influenza vaccine directly to the lungs may be more effective than simply injecting it. "Even though this study was done on sheep, the data might be useful for figuring out a way to give older people an extra boost from the vaccine," Dr. Whelan says. But Dr. Ross notes, "It's not easy to administer medication directly into the lungs of human patients. We must remember that this was a study done on sheep and that it's highly preliminary."
ACSH encourages all Morning Dispatch readers to get a flu shot when they become available this year. Dr. Ross advises, "Medically, it's fine to get a flu shot as early as possible, starting right now," while Dr. Whelan reminds us, "The timing of the spike of influenza varies year to year, and sometimes it can happen earlier than we might expect."
New York City takes on hypertension, but blames salt instead of offering solutions
The New York City Health Department issued a statement yesterday that an unacceptable number of New Yorkers go untreated for high blood pressure. While we certainly agree that more extensive diagnosis and more effective treatment of the potentially lethal condition is needed, many ACSH staffers were upset by the Department's focus on preventing hypertension by avoiding "salt in processed foods."
"The real answer is not to stop eating salt," Dr. Whelan says. "The real answer is to get screened and treated appropriately."
That treatment, Dr. Ross points out, "usually involves drugs, often in combination. This campaign is doing a disservice to New Yorkers with high blood pressure by promulgating the unsupported statement that the condition can be adequately controlled through 'reducing intake of salt from processed foods.' Health Commissioner Dr. Thomas R. Frieden is diluting an important message with his own agenda."
Advice for continuing dental health (hint: acupuncture not recommended)
ACSH staffers were surprised to hear that fluoride benefits older people's teeth, too. "I thought fluoride was more important for developing teeth," says Dr. Ross, but the American Dental Association is now warning that _older_ teeth are just as prone to tooth decay as younger ones are. Visiting your dentist regularly and drinking fluoridated water can help keep teeth healthy well into old age.
Dentist and ACSH advisor Dr. Chic Schissel recently brought another study to our attention: Researchers claim that acupuncture may be just as effective as anti-depressants at soothing the menopause-like symptoms that anti-estrogen treatments for breast cancer may induce. The problem, Dr. Schissel points out, is that the study did not include a placebo control group. It may be the case that neither the acupuncture nor anti-depressants were very effective.
Timeframe for clot-busting medicine extended
A promising new study shows that the clot-busting drug TPA (tissue plasminogen activator) may be administered up to four-and-a-half hours after symptoms of a stroke begin, up from the previous three-hour limit. "An extra hour and a half is very important if a patient is having a stroke," says Dr. Ross. Dr. Whelan wonders if the potentially life-saving drug could be available in ambulances in the future.
MORNING DISPATCH 9/24/08: Cancer, Heart Disease, Greek Food, Ritalin, Alcohol, and Reflux
Specter gets an honorary seat at ACSH's table, you get a kidney
We'd like to offer Sen. Arlen Specter a seat at ACSH's morning table -- for introducing legislation that would permit compensation for organ donation. Diana Furchtgott-Roth described the development in the pages of the New York Sun -- and ACSH's Jeff Stier defended organ markets in the New York Post.
Imagine a world of realistic goals
A fundraiser mailing from Memorial Sloan-Kettering, one of the world's most prestigious cancer research and treatment centers but a fount of recurring fuzzy, alternative-medicine-type claims, invites us to "Imagine a World Without Cancer." ACSH's Dr. Elizabeth Whelan says, "That's so misleading," since cancer is not one disease but a host of different conditions, not likely to be eradicated in one blow anytime in the near future. Furthermore, frequent warnings about cancer becoming our #1 killer are misleading, since, notes Whelan, "cancer is a disease of an aging population -- what if everyone dies younger of heart disease instead?"
Cancer drugs for all!
Also beating the cancer drum today in the news is UK Prime Minister Gordon Brown. He announced that the UK's government-run healthcare system will now provide all "cancer drugs" for free -- which will be greeted by some patients with relief. However, with cancer being such a broad and often ambiguous category of diseases, we can't help wondering if there will be an incentive to define some drugs as cancer drugs -- and conditions as cancer -- that previously weren't. If so, don't be surprised if instead of headlines suggesting more people are getting cancer drugs, we soon see headlines suggesting an upsurge in "cancer" in the UK. As ACSH's Dr. Gibert Ross says, perhaps "Britain will now be the 'cancer capital' of the world."
The Omega Fish
As the New York Times reported one week ago, sardines and anchovies are being harvested off Peru to be ground up for inclusion in heart-healthy orange juice. "It's an interesting concept," says Dr. Whelan -- and though many nutraceutical products are as yet unproven or are even quack elixirs, ACSH is very optimistic about the long-term potential for enhancing and fortifying foods in a variety of ways, including through genetic engineering. It's troubling, then, that even a very sympathetic article like the one in the Times must carry the almost-obligatory headline "Superfood or Monster from the Deep?"
"Soy is touted as God's perfect food," observes Dr. Ross. But a new study suggests that genestein, a soy protein, inhibits the functioning of cancer-treating drugs called aromatase inhibitors. It's another reminder that nature is not always helpful -- as Stier recently wrote in the Washington Times -- and that even all-natural products can interact in unpredictable ways with medication, as explained in ACSH's What's the Story brochure on Drug-Supplement Interaction.
Hormone therapy may lower breast cancer risk for some
A new study in the Journal of the National Cancer Institute shows that some women, despite recent fear on this topic, may have their chances of breast cancer reduced rather than increased as a consequence of postmenopausal hormone replacement therapy (HRT). "This is just one in a number of studies," says Dr. Ross, "that have shown that women in the young group -- their early fifties -- who take hormones after menopause, and take estrogen, not progesterone, have a lower incidence of breast cancer."
In contrast, earlier studies had shown some women's odds of breast cancer to be increased by HRT. "Like most epidemiological issues," says Ross, "it's rarely black and white."
Rheumatoid arthritis and lung cancer
A study from Temple University in Philadelphia suggests a correlation between rheumatoid arthritis and an increased likelihood of getting lung cancer, or so reports on the topic seem to say. But is the causality here clear? Might it even be the other way around, asks a suspicious Dr. Ross, that is, might smoking (the major cause of lung cancer, obviously) contribute to rheumatoid arthritis? We are relieved to see an editorial written by Sweden's Karolinska Institute noting that there are so many confounders in the study that it is hard to establish causality.
COPD drugs may increase stroke, heart attack risk
Inhaled anticholinergic agents such as Spiriva and Atrovent, used to combat chronic obstructive pulmonary disease (COPD), appear to increase stroke and heart attack risk according to a new Journal of the American Medical Association report. COPD is almost always caused by smoking -- one of the most common ways smoking kills, along with lung cancer and heart disease, though lung cancer tends to get the most attention and be most strongly associated in the public's mind with cigarettes. Any setback in combating COPD adds to smoking's massive toll on public health.
Mediterranean diets no longer so "Mediterranean"
ACSH's Nutrition Director, Dr. Ruth Kava, notes reports that "people in Greece are no longer eating 'the Mediterranean diet'...the U.N. says that three quarters of people in Greece are obese, the worst rate in Europe." Greece is also one of the poorest nations in Europe, and subsisting on grape leaves and fish may be giving way to eating like the disproportionately-large poor of other Western nations.
In other geographic health news, it appears that your odds of surviving a heart attack may vary as much as fivefold depending on what community you live in.
Ritalin use and abuse
By raising questions about cosmetic personality alteration and behavior control, Ritalin continues to be a hot-button drug-use topic not just for medical experts but for political pundits. Dr. Whelan appreciates the tensions at play: "I waver between thinking Ritalin is a miracle drug and thinking it's overprescribed." We know children and adults who would never be able to function as well without it, but Dr. Whelan also recalls, for example, a child being prescribed Ritalin without even being seen by the doctor first, based solely on the descriptions of his behavior offered by his parents. Distinguishing hyperactivity from mere annoying activity is tricky business.
Mom's drinking may cause different kind of drinking problem for kid
Drinking early in pregnancy may increase the odds of children being born with cleft palates, suggests a new report. "You shouldn't drink in early pregnancy" anyway, says Dr. Ross -- but Dr. Whelan cautions that overemphasizing that warning can have perverse effects. A friend of hers, now the mother of a perfectly healthy child, was told by three different doctors that because she found out she was pregnant just after returning from a wine-soaked vacation, she ought to consider aborting the fetus.
The admittedly real problem of severe alcoholics having babies with fetal alcohol syndrome has led to some paranoia about the effects of relatively small amounts of alcohol on fetuses.
Finally, a brief reminder that not all health conditions that appear diet-related are determined by diet alone: acid reflux and GERD can result from a number of contributing factors, such as a weak sphincter (the muscular barrier between the stomach and esophagus), not determined by the spiciness of the hoagie you just ate. We tend to long for controllable, personally-determined, behavioral factors in health stories, but some things are hard to alter.
MORNING DISPATCH 9/23/08: Spinning, Quitting, Irradiating, and Sweetening
ACSH learns to spin out the fat
ACSH staffers enjoyed a demonstration of a new technique for lower-fat frying yesterday. After deep-frying food, the machine spins the basket to draw the excess oil out of the dish. "It literally spins out 60% of the fat," says ACSH's Dr. Elizabeth Whelan. "You could even taste the food better because the flavors weren't overwhelmed by the oil."
We sampled tater tots, French fries, onion rings, shrimp, and scallops prepared in the machine, which is currently being developed for sale in the United States. "It's a very low-tech innovation, but it could have a big impact," says Dr. Whelan, who wrote an op-ed about the importance of embracing technology in order to make our diets healthier. "We need many tools like this to help us reduce calories without avoiding foods we love to eat, despite the wishes of self-appointed food nannies in and out of government."
New ways -- and reasons -- to quit smoking
In an effort to encourage smokers to quit, the New York City Health Department began giving out matchbooks emblazoned with vivid pictures of the health effects of smoking, including damaged lungs, large tumors, and rotting gums, along with the message "Cigarettes Are Eating You Alive." The matchbooks are free at many cigarette retailers in the South Bronx, East and Central Harlem, and North and Central Brooklyn, all areas with high smoking rates. "If I were a smoker, I would just avoid using those matches," worries Dr. Whelan. "There can be a downside to scare tactics of this magnitude."
ACSH's Jeff Stier points out, "I think the Health Department is more focused on the publicity these matchbooks are getting, rather than the number of smokers who actually use them."
On a related topic, a new study shows that exercise may help pregnant women quit smoking. Those who exercised regularly quit smoking with about the same success rate as people who use nicotine replacement therapies, which these researchers did not study during pregnancy because of concerns about their potential effect on the fetus -- a decision that in itself made some ACSH staffers skeptical.
"Nicotine patches are not potent enough to harm the fetus," argues ACSH's Dr. Gilbert Ross, while ACSH's Dr. Ruth Kava points out, "Using nicotine patches during pregnancy is much less dangerous than continuing to smoke."
We believe that people should be encouraged to use any and all smoking cessation methods that work for them, from nicotine patches to smokeless tobacco for harm reduction -- especially in light of new information that quitting smoking completely improves cardiovascular health much more than just cutting back on cigarette use.
Shorter course of radiation therapy safely and effectively treats early breast cancer
Promising new research suggests that a three-week course of radiation works just as well for treating early breast cancer as the usual course of five weeks or more. While doctors initially worried that a shorter course would necessitate giving patients too high a dose of radiation, a Canadian study shows that a shorter treatment can be just as safe and effective as a longer one for some patients. A shorter course is also more convenient for patients and could allow labs to treat more people with the same resources.
Dr. Ross points out that such a treatment is not ideal for all patients, though. "It is only meant for people in whom the cancer has not spread to the lymph nodes," he says.
Dr. Whelan believes, however, "This is a really big advance for treating early breast cancer and could increase the number of women who are actually able to undergo the full course of radiation."
Splenda study comes under fire -- but for the wrong reason
ACSH staffers were concerned by an article about a new study done on the artificial sweetener Splenda. The study -- which concluded that Splenda contributes to obesity, destroys intestinal bacteria, and prevents the body from absorbing prescription drugs -- is questionable since it was done on rats. But McNeil Nutritionals, the company that makes Splenda, went beyond attacking the questionable science and instead raised the issue of the study's funding -- it was conducted by scientists at Duke University and financed by the Sugar Association.
"It's a rat study and therefore it's irrelevant," says Dr. Whelan. "But the fact that it was funded by the sugar industry should be irrelevant too. We shouldn't accuse these scientists of lying just because they are funded by industry."
Stier agrees, adding, "McNeil shouldn't have even mentioned the funding because it would have been enough to just attack the science."
MORNING DISPATCH 9/22/08: Flames, Babies, Cures, Blood, E-Cigarettes, Fat/Infertile, and MS
Jeff Stier defends use of flame retardants
This weekend, ACSH's Jeff Stier responded to a health scare about the levels of the flame retardant chemicals called polybrominated diphenyl ethers (PBDEs) found in the human body. "The question is -- what is the potential health effect? Just because you can measure something doesn't mean it's harmful," he told the Detroit News.
In fact, including PBDEs in products helps prevent the spread of fire and actually saves lives by delaying flashovers, or eruptions of flames, giving people more time to escape residential fires. "Talk about risk-benefit ratio," says ACSH's Dr. Elizabeth Whelan. "Those who want to ban these life-saving chemicals clearly have their priorities inverted." For more information on this topic, see ACSH's publication Brominated Flame Retardants: A Burning Issue.
Contaminated milk continues to sicken babies in China
The number of infants hospitalized in China due to milk products contaminated with melamine has risen to nearly 13,000. Four children have died and thousands have developed serious complications such as kidney stones. The case has caused several Chinese health officials to resign and countries across Asia to pull Chinese milk products off their shelves.
One of the worst aspects of this case is that the toxic chemical melamine was purposely added to diluted milk in order to mimic protein during quality tests. "Here we are in this country worrying about the phantom scares of BPA in baby bottles and phthalates in rubber duckies, while in China they are dealing with something that's really toxic being added to baby formula on purpose," points out ACSH's Dr. Ruth Kava. We hope all the infants sickened by the tainted formula receive the care they need and that this crisis puts baseless health scares in perspective.
FTC takes on false "cancer cure" claims
We are pleased that the Federal Trade Commission (FTC) is taking action against companies that make unsubstantiated claims about their products "curing cancer." Because most of these products are supplements, not drugs, they are not subject to FDA regulation, leaving enforcement up to the FTC. "I'm glad to hear that the FTC is finally doing its job and cracking down on this misleading and false advertising," Dr. Kava says. ACSH's Dr. Gilbert Ross adds, "Such snake-oil marketing scams cost people their lives by distracting those who are desperately ill from getting effective, urgent medical care and real therapy."
Many doctors don't know blood pressure guidelines
A new study, presented last week at an American Heart Association meeting, showed that only 36% of family doctors surveyed about treatment for high blood pressure said they would start treatment for a middle-aged man with an office blood pressure of 145/92 -- well over the recommended 120/80.
"It's very disturbing that in this day and age some general practitioners still don't know the blood pressure guidelines," says Dr. Ross. We hope doctors take steps to correct any gaps in their knowledge before more people miss out on potentially life-saving hypertension treatment.
Can the electronic cigarette help smokers quit?
The World Health Organization (WHO) recently criticized electronic cigarettes, or nicotine-delivery devices that simulate the act of smoking. "The WHO is arguing that they haven't been assessed for safety and they might not help people quit smoking real cigarettes," Dr. Whelan says. "In any case, it seems like there are far better ways to get a nicotine hit."
Stier counters, "We need to give people as many tools as possible to help them quit smoking. Electronic cigarettes could be a valuable harm reduction tool" -- and harm reduction options are something ACSH consistently advocates. Dr. Ross adds, "Doesn't the WHO have more important things to do than to criticize this rarely-used technology whose only possible effect would be to reduce the consumption of lethal cigarettes among addicted smokers?"
Obese men are less likely to be fathers, but is it cause and effect?
A new study postulates a link between obesity and infertility in men, but ACSH staffers remain unconvinced. "Researchers found that among the men in their small sample, the average BMI for childless men was higher than that of men who had had a child," says Dr. Ross. "But does that mean it was cause and effect? By no means."
Researchers also point to differences in hormone levels; obese men had lower levels of testosterone, luteinizing hormone, and follicle-stimulating hormone in their blood, which could affect fertility. "The hormonal part of the study lends more credence to their findings," Dr. Kava concedes.
Vitamin D deficiency linked to multiple sclerosis
Researchers believe that a vitamin D deficiency in children could increase their chances of developing multiple sclerosis (MS) later in life. "I had no idea that vitamin D is linked to the immune system, but researchers found that kids with lower levels of vitamin D were more likely to develop MS," says Dr. Ross.
Dr. Kava notes, "They are also saying something similar about vitamin D and prostate cancer. These theories have been circulating for a few years."
MORNING DISPATCH 9/19/08: Modification, Pre-emption, Re-importation, BPA Metabolization, and Media
Growing GM cotton helps other crops thrive
We were pleased to hear that genetically-modified cotton is helping farmers in northern China control the pest population -- whether they grow the GM crop themselves or not. "A study found that growing cotton that is genetically-modified to produce the pesticide Bt has a positive effect on neighboring non-GM crops," ACSH's Dr. Ruth Kava says.
The modified cotton helped reduce the population of the cotton bollworm in northern China over a period of ten years, creating "something like herd immunity that we get from vaccinations," notes ACSH's Jeff Stier.
Dr. Kava believes, "The people who are worried that GM crops will cause ecological disaster are really barking up the wrong tree."
Supreme Court will examine drug labels in an upcoming case
ACSH staffers had an animated discussion this morning over the upcoming Supreme Court case involving the pharmaceutical company Wyeth, which revolves around the issue of drug labeling and federal pre-emption.
The plaintiff, Diana Levine, went to a clinic to be treated for a migraine, but because a physician's assistant made the dangerous mistake of injecting Wyeth's nausea drug Phenergan into an artery instead of a vein during a procedure known as an "IV Push," she developed gangrene and had to have part of her right arm amputated. Levine already settled a lawsuit against the clinic and is now suing Wyeth, claiming that Phenergan's label should have prohibited administering the drug by IV push.
"The physician's assistant made a devastating mistake and the clinic was clearly in the wrong," says ACSH's Dr. Gilbert Ross. "But what could Wyeth have done to prevent it?" The drug's label -- mandated by the FDA -- already warned against the dangers of arterial injection.
ACSH's Jeff Stier points out, "The FDA told Wyeth what labels to put on the drug. Even if the company wanted or needed to provide a more specific warning about this, it couldn't."
Pre-emption currently bars injured plaintiffs from suing in state court when the products in question met federal standards. In the case of drug labels, the New York Times says, the Supreme Court will have to rule on this fundamental question: "Do the FDA and other federal regulators set minimum safety standards that states are free to augment? Or do they make judgments about the optimal balance between risks and benefits that states must follow?" ACSH staffers are eager to hear the verdict and hope the court rules in favor of Wyeth.
Presidential candidates change their positions on drug re-importation
Both presidential candidates are re-evaluating their prior stances supporting drug re-importation -- but for the wrong reasons. "They are riding on the tail of the FDA's decision to block the importation of thirty generic drugs manufactured in India and focusing only on safety issues," says Dr. Ross.
But as Stier explains, "Even if we found a way to make drug re-importation safe, we would then have to import the price controls other countries impose on their pharmaceuticals, which would ultimately hurt consumers."
Dr. Ross adds, "I wouldn't give the candidates' new positions three cheers, but I'd give them one."
Steve Milloy counters BPA scare
We were impressed by an article by anti-junk science advocate Steven Milloy criticizing the current scare attempting to link bisphenol-A (BPA) to heart disease and diabetes. "He points out that the data collection in the study was shoddy and unreliable," says Dr. Ross.
Milloy also states that the researchers provided no reasonable biological mechanism by which BPA would cause these conditions -- in fact, as he notes, "[BPA] is metabolized and excreted from the body pretty quickly, usually within twenty-four hours. Without more information on exposure to BPA and disease origins, there is absolutely no basis for linking the two."
The fact that such a problematic study was published in the supposedly reputable Journal of the American Medical Association leads ACSH staffers to question the journal's status in the future. "It seems like the journal is no longer a disinterested party making sure that good science gets done and has instead become more political," says Dr. Kava.
ACSH stands up against libelous claims
After false claims were made about ACSH to a listserv of health reporters, we immediately responded by contacting the ill-informed reporter's editors and demanding that our good name be restored. Stay tuned to see whether the paper defends their reporter or the truth.
The reporter in question told his colleagues, "ACSH is heavily funded by the auto, oil, food, and chemical industries, so I'd say they're the opposite of a reliable, objective source on this issue -- especially regarding the neurotoxin aspertame [sic]. My general rule on ACSH is the more enthusiastically they defend something, the more harmful it must be."
"Every time someone lies about us in this manner, we're going to stand up to them and not let them get away with it," says Stier. "Let this be a lesson to other reporters: Get your facts straight and keep your (ill-informed) opinions to yourself when speaking as a journalist."
MORNING DISPATCH 9/18/08: Allergies, Autism, China, India, BPA, Colonoscopies, and Malaria
FDA investigates allergy labeling requirements for foods
We were pleased to hear that the Food and Drug Administration is reevaluating the requirements for food labels meant to alert consumers to the presence of an allergen in the product. ACSH's Jeff Stier explains, "Right now, every label can say different things." Different warning labels may carry messages saying "may contain peanuts," "processed on shared equipment," or "manufactured in a facility that processes peanuts," for example.
"The variety of labels is confusing and not helpful at all to the purchasing consumer," says ACSH's Dr. Elizabeth Whelan. Any new guidelines that emerge may require a definition of "trace amounts" -- that can be particularly important for allergens such as peanuts, which can trigger a fatal reaction in some people. Dr. Whelan says, "The fundamental question that food labels need to answer is this: if you're allergic to peanuts, dairy, shellfish, or any other major food allergen, should you buy this product?"
Researchers halt study of quack autism treatment
Even better news comes from the National Institute of Mental Health (NIMH), which has called off a controversial study on the effectiveness of chelation for treating autism. Chelation, a process that removes heavy metals from the blood stream, has been touted as an autism treatment by those who are still convinced that mercury in childhood vaccines causes autism. "Mercury is not the culprit behind autism, nor is any other heavy metal," ACSH's Dr. Gilbert Ross says.
Not only is chelation useless for treating autism, it is potentially dangerous. "The process also chelates things like calcium, which you don't want to pull out of the bloodstream," ACSH's Dr. Ruth Kava explains. Dr. Whelan adds, "We were horrified they were ever going to do a study of this quack theory in the first place, so we're glad they came to their senses and called it off."
Powdered milk continues to sicken infants in China
The powdered milk contaminated with melamine continues to sicken and kill infants in China. Over 6,200 babies have become ill after drinking the formula, while 158 have developed acute kidney failure, and three have died. "It's absolutely unbelievable that melamine was put in the milk on purpose," Dr. Whelan says. "It was used to mimic protein and mask the fact that the milk was diluted."
The formula was shipped to several countries outside China, but it is not known if the exports were contaminated. There is some speculation that the news of this dangerous product was suppressed until after the Olympics in Beijing, prompting Stier to wonder, "How many additional babies got sick as a result of a delay in announcing it?"
Can a "virtual colonoscopy" be as effective as a traditional one?
Researchers claim that a new "virtual colonoscopy" procedure is effective at spotting most cancers, but ACSH staffers remain skeptical about any real benefits. "You have to go through the same preparation, which is the most unpleasant part of a regular colonoscopy -- and the part that discourages people from undergoing the important procedure," Dr. Whelan points out.
"There's a 75% false positive rate with the virtual colonoscopy, which means many people would unnecessarily have to go through a traditional colonoscopy afterwards," Dr. Ross adds. "There's also a 10% false negative rate, which is even more disturbing."
The only possible benefit of the virtual colonoscopy ACSH staffers could see is that it is much cheaper than the traditional procedure. "The fact that it costs less could help get more people screened," Dr. Whelan says. But Stier wonders, "Considering all the additional tests needed after false positives, how much money would we actually save?"
Companies unnecessarily search for alternatives to BPA
In the wake of the health scare about bisphenol-A (BPA), many companies have started searching for alternatives to the chemical -- at potentially huge costs to consumers. "They are trying to solve a problem that doesn't exist," Dr. Kava believes.
Dr. Whelan says this topic goes straight to the heart of ACSH's mission. "This is another example of companies spending our money to develop unnecessary alternatives instead of defending the science. Consumers are footing the bill for all this without even knowing it."
FDA cracks down on Indian drug manufacturer
The FDA has blocked imports of more than thirty generic drugs manufactured by India's largest pharmaceutical company, Ranbaxy Laboratories. While no problems have been found with the drugs yet, violations found in two of the company's factories could lead to contamination, allergic reactions, and other problems with the drugs in the future. "Policing international drug manufacturers seems like an overwhelming job," Dr. Whelan notes.
Dr. Ross believes that the FDA is flexing its new muscle after increases in funding and manpower. "Now that its has more resources, the FDA is trying to show that it is using them -- and our tax dollars -- wisely."
WHO releases new malaria estimates
The World Health Organization (WHO) has reduced its estimate of the number of people who catch malaria each year, down from 350-550 million to 247 million in 2006. The WHO cited changing environmental conditions, especially rapid urbanization in Asia, as affecting the populations of disease-carrying mosquitoes. The disease's estimated death toll remained nearly unchanged, however: 881,000 in 2006, compared to "more than 1 million" in previous years.
"The WHO says it encourages insecticide-treated bed nets to reduce the number of malaria cases around the world -- what it doesn't say is that prevention efforts should include the use of DDT," Dr. Ross notes.
MORNING DISPATCH 9/17/08: BPA, Flu, Asthma, Statins, Marathoners' Hearts
BPA under fire, despite FDA's (and ACSH's) assurances of its safety
The assault on bisphenol-A (BPA) continues with a study in the Journal of the American Association that finds an association between concentrations of the chemical in urine and a higher incidence of heart disease and diabetes. An editorial (co-authored by long-time BPA scaremonger Frederick vom Saal) in the same issue of the journal calls for immediate governmental regulation of the chemical, even though, as ACSH's Dr. Elizabeth Whelan points out, "There's no underlying biological hypothesis for why BPA would cause heart disease and diabetes."
"In the midst of this cascade of bad publicity about BPA, the Food and Drug Administration is firmly defending its safety," Dr. Whelan adds. Encouragingly, the New York Times quotes senior FDA scientist Laura Tarantino as saying, "A margin of safety exists that is adequate to protect consumers, including infants and children, at the current levels of exposure."
Dr. Lisa Schwartz of the Dartmouth Institute for Health Policy and Clinical Practice also points out that measuring the concentration of BPA in a single urine sample does not paint a clear picture of the effects of exposure to the chemical. "Measuring who has disease and high BPA levels at a single point in time cannot tell you which comes first," she says.
ACSH's Jeff Stier was quoted in the New York Sun about the importance of distinguishing association from causation before jumping to conclusions based on studies such as this one. Eventually, he says, "you've got to come to a study that shows there is some causation" to justify actions like banning or restricting the use of a chemical. "I can find an association that people who use pencils have higher rates of cancer," he continues. "If you start looking at everything you'll start finding associations. It is the nature of statistics."
Flu vaccine protects pregnant women and their newborns from infection
A new study shows that infants born to mothers who were vaccinated against influenza during pregnancy are less likely to develop the flu and other respiratory illnesses. "Pregnant women are already among the groups that are encouraged to get the flu vaccine, and this study should assuage any fears some may have of doing so," says ACSH's Dr. Gilbert Ross.
Giving mothers the shot reduced the number of influenza infections in infants by 63% and their rate of respiratory illness with fever by 29% (and by 36% in their mothers). Since the flu vaccine is not recommended for infants younger than six months, vaccinating their mothers during pregnancy is a good way to protect them against the potentially dangerous disease.
Day care reduces asthma risk in very young children
Researchers found that children who begin attending day care between the ages of six and twelve months are 75% less likely to develop wheezing problems and possibly asthma. "These data support the hygiene hypothesis, which postulates that the more viruses and bacteria children are exposed to, the more immune defenses they will develop," says Dr. Ross.
While early exposure to pathogens may be one piece of the asthma jigsaw puzzle, it is certainly not the whole picture -- scientists are now investigating how children's genetic susceptibility to allergies and asthma might influence how they are affected by attending day care.
More elderly heart patients could benefit from statins
Despite large increases in the number of heart disease patients taking cholesterol-lowering statin drugs in the last ten years, researchers say that their use remains "suboptimal" among elderly patients with atherosclerosis, or clogged arteries. "I'm not sure how they define 'suboptimal' in this context," Dr. Ross says.
"If you believe that everybody with heart disease should be on a statin, then obviously current levels are 'suboptimal.'" Dr. Whelan says, "I think the bottom line is that more people could be benefiting from statins who are not currently being prescribed them."
Marathoners over fifty still at risk for heart attacks
ACSH staffers were surprised to hear that male marathoners age fifty and up are just likely as other men their age to have calcium buildup in their heart arteries, a major risk factor for heart attacks. "This is rather counterintuitive, especially considering the other study that found that runners tend to live longer," Dr. Whelan notes. Stier, himself a marathoner, points to differences in the physical demands of running regularly for exercise and competing in marathons, while the study's authors suggest that their patients' problems could pre-date their current healthy lifestyles -- half were former smokers, and many had only started running competitively in their forties.
MORNING DISPATCH 9/16/08: Psych, Soda, CDC, Surgical Options, Surgeon General, and Stress
Quote of the day
"People want to blame chemicals where they don't have another explanation for the cause of a disease. I think we need more psychologists rather than more toxicologists." --ACSH's Jeff Stier, quoted in the article "The Scariest Health Threat You've Never Heard Of: Autoimmune Disease," from the September 2008 issue of Glamour
Kids drink soda despite school bans
As ACSH staffers predicted, banning soft drinks in elementary schools only has a small impact on the amount of soda kids consume. A new study by the Rand Corporation shows that fifth graders attending schools that didn't sell soft drinks drank only 4% less soda overall than students at schools where the beverages were available.
"This means the kids drank soda after school or at home," says ACSH's Dr. Elizabeth Whelan. ACSH's Dr. Ruth Kava warns against jumping to conclusions based on data from dietary studies that rely on self-reporting, especially when the subjects are young children: "You can't always trust what they tell you about what, where, and how much they consume."
CDC and Pfizer team up to combat MRSA
The Centers for Disease Control and Prevention is launching a campaign to educate people nationwide about the skin infections caused by the drug-resistant bacteria methicillin-resistant staphylococcus aureus (MRSA) (password required) -- commonly called a "superbug" in the media.
While the campaign will focus mainly on sanitary and hygienic practices aimed at prevention, some groups, like the Center for Science in the Public Interest's "Integrity Project," take issue with the fact that it was developed with a grant from the world's largest pharmaceutical company, Pfizer, which manufactures drugs to treat MRSA infections.
The article balances out that opinion with a quote from our own Jeff Stier, who says, "As long as the CDC's education program adopts a consistent, scientific approach, I see no problem with it. There is always a knee-jerk reaction when a government agency cooperates with a private company. But this is a public health initiative, not an advertising campaign, and we need more of that." Further illustrating the absurdity of CSPI's objection is the fact that if the program's prevention-focused approach were successful, it would lead to fewer drug sales for Pfizer.
Obesity treatments aren't miracle cures
While weight loss surgery is not a miracle cure for obesity, some types seem to be more effective than others in helping patients lose a significant amount of weight and keep it off. Gastric bypass surgery, for example, produced more dramatic and sustained results than the other leading surgical option for weight loss, gastric banding.
"After undergoing gastric banding, you can still stretch the pouch of the stomach by overeating," explains Dr. Kava. "If you have a bypass, it's a lot harder to continue to eat as much -- and you won't absorb as many nutrients." In either case, however, patients need to be disciplined about lifestyle changes in order to avoid gaining back some or all of the weight.
A new treatment for obesity is currently being tested on pigs. After specific blood vessels in the abdomen were injected with the chemical sodium morrhuate, the animals produced much less of the hunger hormone ghrelin and subsequently ate less. Treatment for humans, however, will almost certainly not be so easy because people eat (and overeat) for many reasons that have nothing to do with hunger or hormones. Dr. Kava says, "The most important line of the story is: 'Many studies have shown, however, that treating obese animals is far easier than treating obesity in humans.'"
Surgeon General calls attention to dangerous blood clots
The acting Surgeon General, Dr. Steven Galson, issued a Call to Action about the dangers of deep vein thrombosis and pulmonary embolism (DVT/PE), a condition in which a blood clot forms in the leg and then breaks off and travels to the heart, and then to the lungs. "The primary risk factor for this dangerous type of clotting is immobility," Dr. Whelan says. "We've been told for years that if you are on a long plane fight, you have to get up and move around."
Obesity, smoking, cancer, bed rest, and dehydration are also risk factors for DVT/PE, and a new study suggests that migraine sufferers are more likely to develop clots in their legs. ACSH's Dr. Gilbert Ross points out, however, "Diagnosing DVT/PE is difficult because the condition can be asymptomatic. Because leg pain is much more commonly associated with other, less dangerous musculoskeletal problems, raising people's fears about DVT/PE is alarmist."
Study advances lung cancer detection, while breast cancer is blamed on "stress"
ACSH staffers were excited to hear about the possibility of detecting early lung cancer with a blood test. In a study of smokers, researchers found three proteins or antigens in the blood samples of over half the patients who later developed lung cancer. "This could be very useful, especially if there were a way to use it in conjunction with the spiral CT scans they are using to screen for lung cancer," Dr. Kava notes (although Dr. Ross cautioned that the studies on the real benefits of CT scans for lowering the toll of lung cancer are still in progress).
We were less enthused about the claim that stress is a risk factor for breast cancer. "'Stress' cannot be evaluated objectively, so we could never define or use it as a scientific measure," Dr. Ross says.
MORNING DISPATCH 9/15/08: Economic Health, plus Black Boxes, Salt, BPA, Arthritis, and Cancer
Sensible public health measures can help lower cost of living
As the stock market opened today to the news of Lehman Brothers filing for bankruptcy and Merrill Lynch being sold to Bank of America, financial concerns are at the forefront of everyone's minds. "Much of the current economic stress felt by people across America is related to the rising cost of living," says ACSH's Jeff Stier. "Bans of useful chemicals, fear of nuclear energy, and regulation of the food industry all contribute to increases in the cost of living and create more challenges for families." ACSH staffers hope that we take advantage of all the useful technology at our disposal to continue to improve our lives and keep costs down.
Dr. Ross argues against antidepressants' black-box label
ACSH's Dr. Gilbert Ross had an op-ed in Sunday's Washington Times about the FDA's lethal decision not to remove the "black-box" warning label on antidepressants prescribed to teens. After the label was put on the drugs in 2003, teen suicide rose dramatically in 2004 and 2005 (the last year for which data are available).
"Most experts agree the first such rise in decades was due largely to FDA-generated publicity in late 2003 about drugs for depression causing 'suicidality' -- self-destructive thoughts," Dr. Ross writes. Although the alleged "suicidality" was not linked to an increase in actual suicides, the FDA still slapped the drugs with the menacing warning label.
Dr. Ross continues, "To any objective observer, the cause-and-effect pattern was clear: baseless FDA warnings of 'suicidality' plus black-box warnings led to a decline in physician prescribing (and parental acceptance) of safe and effective antidepressants -- and the rate of teen suicide rose to a historic, and tragic, degree." We hope that doctors and the FDA alike are able to look beyond scare tactics to provide teens suffering from depression the help they need.
Food fight in New York Post
The New York Post ran two letters responding to an op-ed by ACSH's Dr. Elizabeth Whelan rejecting the idea that the government should encourage the consumption of healthy food through regulation and bans. One letter challenged the "unnecessary" level of sodium in our food and the other, written by a co-author of the Journal of the American Medical Association editorial that inspired Dr. Whelan's piece, restated arguments about the need to control today's "dangerous" food environment. "This debate will characterize the next decade of public health discussion and action," Dr. Whelan believes.
Advances made with vaccines to fight cancer
We were very pleased to hear that Merck's HPV vaccine Gardasil has been approved to protect against cancers of the vagina and the vulva. The vaccine is designed to protect against the four strains of human papillomavirus that are most likely to lead to genital warts and cervical cancer, but researchers say that the virus is also implicated in over half of cancers of the vagina and the vulva as well. "This is very good news and another reason to be vaccinated with Gardasil," Dr. Whelan says.
Scientists are also exploring the possibility of developing a vaccine against breast cancer. While the experiments are very preliminary, researchers have been successful at protecting mice against a certain type of breast cancer tumor by injecting them with a cancer-fighting gene. "This could be very hopeful if it could be applied to humans, but we have to do a lot more research before we reach that point," says ACSH's Dr. Ruth Kava.
Added Stier, "With such promising advances, is it any wonder we are so troubled that both of the major parties' presidential candidates see the pharmaceutical industry as the enemy?"
BPA still under fire
Even after affirming that the chemical bisphenol-A (BPA) is safe for use in products like baby bottles, the FDA is reopening the debate about the chemical by assembling a panel to review its original report. "This is just getting absurd," Dr. Whelan says. "Are we going back to assuming that anything that causes a problem in animal studies is dangerous for humans?"
Anti-BPA crusaders continue to criticize the tests that proved BPA safe because they were funded by industry. "It seems right that an industry would pay for the testing of its own product," Dr. Kava believes. But in the BPA debate, Dr. Whelan notes, "There is no room for a legitimate, scientific point of view that says BPA is safe. If you make those assertions, you are cast as a paid liar for industry."
Exercise and weight loss important for treating arthritis
Weight loss and exercise can relieve arthritis pain and can also help stave off or delay joint deterioration. "Weight loss can be helpful because it decreases the stress on joints," Dr. Kava explains. "Building muscle through exercise also helps alleviate stress on joints; however, it's probably hard for people who already have severe arthritis to exercise."
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. Todd Seavey wrote the Sept. 24 and Oct. 3 Dispatches.