FOOD & HEALTH SKEPTIC ARCHIVE
Monitoring food and health news
-- with particular attention to fads, fallacies and the "obesity" war
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A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
A brief summary of the last 50 years' of research into diet: Everything you can possibly eat or drink is both bad and good for you
31 January, 2011
Energy saving light bulbs 'could trigger breast cancer'
This is highly speculative. They didn't actually have any data on CFL usage. But it might jar the know-alls a bit
Energy saving light bulbs could result in higher breast cancer rates if used late at night, an academic has claimed. Abraham Haim, a professor of biology at Haifa University in Israel, said that the bluer light that compact flourescent lamps (CFLs) emitted closely mimicked daylight, disrupting the body's production of the hormone melatonin more than older-style filament bulbs, which cast a yellower light.
Melatonin, thought to protect against some breast and prostate cancers, is produced and secreted by the brain's pineal gland around the clock. Highest secretion levels are at night but light depresses production, even if one's eyes are shut.
A possible link between night time light exposure and breast cancer risk has been known for over a decade, since a study was published showing female shift workers were more likely to develop the disease.
Prof Haim explained that a recent study by himself and fellow colleagues had found a much stronger association than previous research between night-time bedroom light levels and breast cancer rates.
Their study, published in the journal Chronobiology International, found breast cancer rates were up to 22 per cent higher in women who slept with a light on, compared to those who slept in total darkness. They thought one of the reasons for this stronger link could be that people had switched to using energy saving lightbulbs. They wrote: "In the past decade, light bulbs emitting bluer light waves (~460 nm) have been widely introduced to save energy consumption and reduce CO2 emission."
They quoted another study which showed that exposure to bluer, shorter wavelength light for two hours in the late evening suppressed melatonin production more than the same exposure to yellower light (~550nm), which is more typical of filament bulbs.
The bluer light also made people more alert and increased their body temperature and heart rate. Prof Haim thought this was because the bluer light from eco-lightbulbs mimicked the stronger light of midday closer than filament bulbs did.
Speaking to The Daily Telegraph, he said he had subsequently removed eco-friendly lightbulbs from his house, as he thought they caused "light pollution". He said: "Around the world the advice is to change the lights to 'green' bulbs - but they are not really green. They pollute much more light." Because people thought they were so cheap to run, they were turning on more lights at home, he explained.
He emphasised that the study did not prove that using eco-friendly light bulbs late at night or overnight resulted in higher breast cancer rates than using filament bulbs, and that it remained an unproven theory.
British cancer charities echoed that point. Jessica Harris, senior health information officer at Cancer Research UK, said: "As this study didn’t investigate low energy ‘eco’ light bulbs and there isn’t any other evidence that they have an effect on breast cancer risk we can’t draw any conclusions about the risk of breast cancer from low energy light bulbs.
"Although it’s far from settled, the evidence that light at night – from any source - could affect breast cancer risk is strengthening and the World Health Organisation classify shift working as a 'probable' cause of cancer."
Dr Sarah Rawlings, head of policy at Breakthrough Breast Cancer, said the link was "purely speculative". "We know there are a number of lifestyle, genetic and environmental risk factors associated with breast cancer, which require more research," she said.
Waiting to take HRT 'lessens breast cancer effect'
The risk is tiny in absolute magnitude anyway so there is no point bothering about it in any case. It would make more sense to avoid crossing the road
Waiting to take hormone replacement therapy (HRT) after the menopause can lessen its effect on raising breast cancer risk, a new study has found.
Eight years ago Oxford University research based on data from the Million Women study, which had 1.13 million volunteers, found that taking combined HRT (oestrogen and progesterone), doubled the risk of developing breast cancer. Taking oestrogen-only therapy increased the risk by 30 per cent.
Now Prof Valerie Beral, the same Oxford epidemiologist who spearheaded the 2003 study, has found that the increased risk is highly dependent on when HRT is begun.
For those who took combined-therapy, the additional risk dropped to 53 per cent higher than 'normal' among those who waited at least five years after the onset of menopause. For those on oestrogen-only therapy, waiting five years appeared to negate the additional risk altogether.
The authors wrote: "A new finding of this study, which has been little investigated previously, is that the interval between menopause and starting hormonal therapy has a substantial effect on breast cancer risk."
Ed Yong, Cancer Research UK’s head of health information, commented: "We’ve known for a while that HRT can increase the risk of breast cancer. This study suggests that there might be some situations in which that risk is small or negligible."
30 January, 2011
Nanny-staters think that people read labels
The few who do are probably careful about what they eat and drink anyway. The New York experience shows that the sort of labelling advocated below will achieve nothing. Do the brainiacs below think Australians are more sophisticated than New Yorkers? Good luck with that assumption
FOOD police would enforce labels showing nutritional value on packaging and cigarette-style health warnings on alcohol under changes recommended for national laws.
A report released yesterday to improve food labelling laws in Australia and New Zealand contains 61 recommendations, including dropping mandatory "per serve" columns while explicitly stating the inclusion of trans-fats and salt content.
The report, Labelling Logic, was commissioned by the Australia and New Zealand Food Regulation Ministerial Council in October 2009 and compiled by a panel of independent experts, led by former federal health minister Dr Neal Blewett.
Information about food safety would be of primary importance followed by preventative health, new technologies such as genetic modification and lastly consumer values like "free range".
"The crux of the review was to address the tensions between competing interests that drive food labelling policy and seek to resolve them," Dr Blewett said.
Some of the recommendations call for food manufacturers to voluntarily adopt proposals such as a traffic light front-of-pack labelling system before they are legislated.
Food manufacturers attacked the traffic light recommendation, arguing there was a lack of consensus on the best way to label food. "The industry rejects traffic light labelling on the basis that it's badly understood by consumers and the system has been rejected by countries around the world," Australian Food and Grocery Council CEO Kate Carnell said.
The Federal Government has until December to respond to the recommendations.
The State Government has welcomed the review, which recommends fast food chains and vending machines declare energy (kilojoule) content - a move introduced in New South Wales last November which takes effect from February 1.
Under the recommendations, country-of-origin labelling would be tightened along with mandatory identification of any food prepared or treated with new technologies.
Alcoholic beverages would have generic health warnings including specific messages about the risks of drinking while pregnant. Alcoholic drink labels would also have to reveal their energy content.
In July 2010 I wrote a commentary about Bisphenol-A, more commonly called BPA. It is a chemical that has been in wide, safe use for over 50 years, but has come under a horrendous and unrelenting attack by a variety of specious environmental and consumer groups.
Out of curiosity mostly, I initiated a Google Alert earlier this month to inform me whenever BPA was mentioned in a news story on the Web. Within three weeks I received 20 alerts, almost one a day, and each contained notifications on 15 – 25 different article references. That’s just nuts!
Why are Americans being bombarded in the space of a single month with more than 400 articles in magazines, newspapers, and on the Internet that are designed to frighten them into thinking that a good, safe thing is a bad thing? It piqued my curiosity and prompted me to dig deeper. It seems that finding out who is behind these attacks on BPA, none of which has any credible science to support their claims, is proving to be a real detective game.
The result is that I have decided to follow the BPA story on a periodic basis in order to track and report how this classic scare campaign is maintained and spread. My research and writings will appear in “The BPA File”, a series that will ultimately be published on the website of The National Anxiety Center. It will appear monthly and elsewhere in places where readers have grown accustomed to seeing my writings.
I founded the National Anxiety Center in 1990 as a clearinghouse for information about just such scare campaigns and this fresh examination of BPA will be published alongside previous works including, “The Subversion of Education in America” and “The Enemies of Meat,” as well as the archive of commentaries written before I began my daily blog, “Warning Signs.”
The reason for this new series is that we have already seen any number of beneficial chemicals and products targeted in this fashion, often to be driven from the marketplace by class action lawsuits or banned by federal agencies and states.
Classic examples range from Alar and DDT to saccharine, all of which came under withering criticism from questionable sources using junk science, yet all of which have been proved over time to be perfectly safe and harmless when properly used. The same is happening today with BPA.
When the American Council on Science and Health, a consumer advocate group, listed “The Top Ten Unfounded Health Scares of 2010”, number one on its list was BPA. The ACSH wrote, “Bisphenol-A has been in use for over five decades in the manufacturing of certain life-saving medical devices as well as in baby and water bottles, dental devices, eyeglass lenses, DVDs and CDs and other electronics.”
BPA also plays an important role in maintaining a healthy food supply. “In addition,” said the ACSH, “it (BPA) has been used to coat the inside of nearly all metal food cans to protect consumers against deadly diseases like botulism.” If activists are successful in their pressure campaigns to ban BPA, my fear is that less-tested and less-safe alternatives will be forced upon unsuspecting consumers.
Here’s a simple question. If any of the charges against BPA are true, why then – in more than 50 year’s time! – has there been no direct connection drawn between BPA and the disease conditions claimed by anti-chemical activists? Answer: because none has ever been established through reliable scientific testing.
Human beings are chemical-processing machines. That’s what our bodies do all day, every day. We live longer, healthier lives precisely because of the discovery and use of chemicals, many of which exist solely to enhance our health and well-being.
Ultimately, as any chemist, pharmacist, or physician will tell you, “The poison is in the dose.” It is the amount of exposure and the route of exposure that determines whether something is harmful or not. Perhaps the best example of this ancient axiom is water. Too much and you can drown in it. Too little and you will suffer dehydration.
The same holds true for other chemicals, many of which are found in nature. Most crops produce their own pesticides to protect against natural predators and the human race has been ingesting trace elements of these chemicals since the dawn of humanity, along with the fruits and vegetables we know to be healthy elements of our diet. The amounts, however, are so miniscule – parts per billion – that they pose no threat.
This exact pattern exists with BPA as well; the so-called ‘endocrine disruptor’ we’re so breathlessly warned about in BPA is identical to a chemical found in soy products like tofu and soy sauce, soy milk and other related products. Strangely, we’re not hearing panicked cries to banish vegetarian food, Chinese carry-out and alternative dairy products for the lactose-intolerant from American society.
29 January, 2011
Marriage is good for men's bodies and women's minds
This is an old, old story with the usual speculative inferences. Do the findings show that marriage makes you healthier or do they show that healthy people are more likely to be married? There is no way of telling but I would be inclined to think that the latter generalization accounts for at least part of the findings.
That older ladies are more sane if married rather fits what I have seen. Single ladies over 50 are in my observation often "spiritual", in a way suggesting low-grade mental illness. They feel forces that are not there etc. That such females have relationship difficulties is rather to be expected. Lack of reality contact is generally destructive
Marriage keeps men fit but boosts women’s mental health, according to an academic article. A study published in the Student BMJ says that committed couples live longer than singletons, with the health benefits of companionship increasing over time.
Meanwhile having lots of sexual partners can shorten lifespan and divorce can have a devastating impact, the editorial claims.
But spouses benefit from marriage in different ways. Married men are kept physically fit because their wives ensure they lead a healthy lifestyle, while women’s emotional health benefits because they value being in a relationship.
David Gallacher, a trainee at University Hospital of Wales, Cardiff, and John Gallacher, a reader at Cardiff University’s School of Medicine, write: “Love is a voyage of discovery from dopamine drenched romance to oxytocin induced attachment. Making this journey can be fraught with hazards and lead many to question the value of romance and commitment.
“Nevertheless, the impact of stable long term exclusive relationships on longevity is well established. In a study of one billion person years across seven European countries the married persons had age adjusted mortality rates that were 10-15 per cent lower than the population as a whole. So, on balance, it probably is worth making the effort.”
They cite evidence that romances among teenagers are linked to “increased depressive symptoms”, while relationships among young adults do not improve physical health. “So it seems that a degree of maturity is required before Cupid is likely to bring a net health benefit.”
The optimal time for women to establish a committed relationship in terms of health is said to be between 19 and 25, whereas for men it is after 25.
The students believe that being in a committed relationship leads to better social support - from one’s partner, their friends and family – which improves mental health and lifestyle choices. Marriage is thought to provide the largest benefits, because it involves “deeper commitment” than merely living together. Longer relationships are also said to lead to greater benefits to mental health and lower mortality rates.
On the different benefits received by brides and grooms, the authors write: “In terms of physical health, men benefit more from being in a relationship than women, but in terms of mental health women benefit more than men. “The physical health premium for men is likely to be caused by their partner’s positive influence on lifestyle. The mental health bonus for women may be due to a greater emphasis on the importance of the relationship in women.”
However they concede that “not all relationships are beneficial”, and it is better to be single than in a strained relationship.
Splitting up is distressing but less so for women, “because they have more supportive social networks”. However the authors conclude: “Although failure of a relationship can harm health, that is an argument for avoiding a bad relationship rather than not getting into a relationship at all.”
The £1-a-day red wine wonder pill to combat heart disease and cancer
This farce is getting a bit old now. There is evidence (see sidebar) that antioxidants SHORTEN your life. So if that doesn't put people off them, I don't know what would
A £1-a-day red wine wonder pill that claims to ward off heart disease, cancer and diabetes is to go on sale in Britain for the first time. Makers Biotivia claim the resveratrol supplement – derived from an antioxidant found in grape skins and naturally present in red wine – is as beneficial as exercise.
They say the drug can also protect against Alzheimer’s as well as delaying the ageing process and tackling obesity-related health problems.
But other experts warn that the benefits are unproven in humans and that it should not be used as a replacement for regular exercise and a healthy diet. Wine lovers, meanwhile, might argue that there is more enjoyment in cracking open a bottle of the real thing
Some studies have indicated that resveratrol could work by preventing the build up of fatty deposits in the arteries caused by high cholesterol. The pill goes on sale at Nutri Centre health stores next month. On Biotivia’s website it costs just over £30 for a month’s supply. It is already one of the most popular supplements in the U.S. but until now had been available in Britain only over the internet.
However, although some positive results have been found in animal studies, there has been no published research to show it works in humans. Even the animal studies used doses equivalent to 2,000mg a day, while doctors advise that humans should take a daily dose of no more than 50mg. And they warn that it can cause unpleasant side effects such as insomnia, joint pain, diarrhoea and acne.
Biotivia claims the pill can help prevent cancer by triggering the death of malignant cells. They say it effectively protects against a high-fat, high-calorie diet and even though people would still be overweight they would be less likely to suffer from related health risks.
Some studies have shown it can help reduce inflammation inside the arteries and prevent blood cells sticking together and forming a clot. Dr Alex Barber, a GP in Hampshire said: ‘The benefits are widespread and it effectively protects against a high-fat, high-calorie diet. It protects against cardiovascular disease by lowering cholesterol and reducing blood pressure. ‘If you can afford it, it’s got to be a good gamble.’
Other claims made by Biotivia are that it enables the body to function on less sleep and that animal studies have shown that it improves stamina. Studies on mice which were fed the pill have also shown that they didn’t gain weight despite eating fatty foods.
Scientists stumbled on the drug 20 years ago when trying to establish why France has low rates of heart disease. Some theories suggested that by drinking comparatively high quantities of red wine, the French were protected from the build-up of fatty deposits.
Research in 2009 showed the benefits of resveratrol, which is also found in raspberries, blueberries, cranberries and peanuts, extended to helping people to think clearer. Northumbria University researchers found adults given the supplement performed better in mental arithmetic tests.
28 January, 2011
Big discovery: Children like sugary, fatty and salty food! Just like people!
That seems to be the only actual finding revealed below but great castles in the air are built on it
CHILDREN as young as three are getting hooked on sugar, salt and fat and the more they are exposed to junk food the more they want, a new study reveals.
The findings come as a leading Australian nutritionist attacks parents after a disturbing poll revealed as many as one in three children skip breakfast at least once a week.
The US study findings have prompted a warning from the researchers for parents to step in early and feed their toddlers a healthy diet to help turn the tide in the war against childhood obesity.
Lead researcher Professor Bettina Cornwell said fighting childhood obesity should begin at home. "First families should focus on reducing the consumption of low-nutrient 'junk' foods, replacing them with increased servings of healthy foods," Prof Cornwell said. "Salt, sugar and fat have been repeatedly linked to obesity, so parents should not wait for their children to begin school to learn how to make wise food choices."
Nearly 200 youngsters aged three to five participated in the study, published in journal Appetite, which found children both preferred salt, sugar and fat, and knew which fast food and soft drink brands satisfied their cravings.
"Our findings present a public policy message if we want to pursue intervention, we probably need to start earlier," Prof Cornwell said. "Parents need to seriously consider the types of foods they expose their young children to at home and in restaurants, as repeated exposure builds taste preferences."
Sally Shaw, of Hawthorn, said it was important her children, Grace, 7, and Felix Ricketts, 5, ate a healthy diet rich in fruit and vegetables. "Sweet and salty foods are very addictive and I'd rather not have them be addicted to that sort of thing, I'd rather them get their sugars from fruit," Ms Shaw said.
Bread is good for you
And making it is a pleasure too
By LYDIA SLATER
Dr Atkins must be spinning in his grave. After years of demonisation by the diet police, bread — crust, crumb and optional thick layer of golden butter — is back.
Sales of bread are rising for the first time in 36 years: Tesco, Asda and the Co-op have each reported an overall increase of up to 10 per cent, while speciality bakeries are mushrooming, their shelves groaning with ever more inventive breads, studded with everything from chocolate to potato.
And this week nutritionists have declared that far from being a food to avoid, bread is positively beneficial. It’s full of essential nutrients, vitamins and minerals, especially if you opt for wholegrain varieties with added nuts, seeds or dried fruit.
But even white sliced ‘mother’s shame’ has some nutritional value, as it’s a great source of calcium (essential if you’ve cut out that other modern dietary bogey, dairy).
Meanwhile, a new American diet book, The Carb Lover’s Diet, insists that bread, far from being fattening, actually helps to burn calories: wholegrain bread is rich in ‘resistant starch’, a type of carbohydrate that leaves you feeling fuller for longer because it’s hard to digest.
‘Studies show that resistant starch can help to curb cravings, control blood sugar levels and boost metabolism,’ say authors Ellen Kunes and Frances Largeman-Roth.
As it has only 80-100 calories a slice, bread can be a positive aid to weight loss rather than a diet-buster, as long as you don’t slather it with prawn mayo.
Bread is one of the earliest prepared foods known to man, dating back to the Neolithic era. It carries a heavy weight of symbolic value as the staff of life, an offering to the gods in ancient civilisations and a fundamental part of many religious rituals today.
A couple of years ago, worried by the presence of chemical additives in mass-produced bread, I bought a breadmaker to ensure my children ate as healthily as possible. I was worried it would end up in my great appliance graveyard at the back of a cupboard.
On the contrary, it’s been the best investment I’ve ever made. Every third evening, before I go to bed, I chuck in flour, water, honey, olive oil, salt, yeast and a few little extras now I’m an amateur expert and can go off-recipe — a handful of oats, maybe, or a sprinkling of pine nuts.
When the going gets really tough, a proper breadmaking session by hand is called for. If I’ve had a row with my husband, I grab a bag of flour and get mixing.
Just the silky feel of the flour trickling through your fingers is enough to calm shredded nerves. Then there’s the sensual pleasure of squishing up the flour, oil and warm water. The kneading is an enjoyably exhausting process that will leave your dough smooth and you slightly breathless.
My favourite bit, though, is when the dough has risen for the first time and you get to punch your fist into the centre of its satiny billows and squash it back down to size. It’s childishly satisfying.
By this stage of the process, any residual resentment has always dissipated, and I’m free to plump, plait or decorate my loaves before putting them in the oven and waiting for the rich smell of baking to permeate the house. And that’s even before you get to taste your handiwork and bask in the compliments from your family.
The whole breadmaking process seems calculated to put one in a good mood. It doesn’t surprise me to discover that a new social enterprise, Virtuous Bread, has been going into prisons and teaching inmates how to bake bread as a confidence-building exercise (not to mention a new skill).
In my experience, it’s worth hours on the therapist’s couch. So I’m off to cut myself a thick slice of home-made happiness.
27 January, 2011
Breast implants may pose cancer risk, experts warn
The condition discussed is so rare that even if the association were proven, there would be no sense worrying about it: Just another attempt to stigmatize anything popular
US federal health officials say they are investigating a possible link between breast implants and a very rare form of cancer, raising new questions about the safety of devices which have been scrutinised for decades.
The cancer, known as anaplastic large cell lymphoma, attacks lymph nodes and the skin and has been reported in the scar tissue which grows around an implant.
The Food and Drug Administration is asking doctors to report all cases of the cancer so the agency can better understand the association. The agency has learned of just 60 cases of the disease worldwide, among the estimated five million to 10 million women with breast implants.
The agency reviewed the scientific literature going back to 1997 along with information provided by international governments and manufacturers. Most of the cases were reported after patients sought medical care for pain, lumps, swelling and other problems around the surgical site.
"We are very interested in trying to understand more specifically which patients may be at more risk and which breast implants may present a higher risk," said Dr William Maisel, FDA's chief scientist for devices.
The agency saw no difference in cancer rates between patients with saline versus silicone implants. There was also no difference between patients who got the implants for cosmetic reasons versus those who underwent reconstructive surgery after breast cancer.
Because the disease is so rare, FDA researchers suggested the issue may never be completely resolved. "A definitive study would need to collect data on hundreds of thousands of women for more than 10 years. Even then, causality may not be conclusively established," the agency said.
Still, the FDA said it is working with the American Society of Plastic Surgeons to register patients with the cancer and track them over time.
Breast implants are marketed in the US by Allergan Inc and Johnson & Johnson's Mentor Corp. Those companies will be required to update the labelling for their products to reflect the cancer reports.
A handful of researchers have published papers on instances of the lymphoma in breast implant patients over the past three years, prompting FDA's review.
Some research suggests bits of silicone can leak into skin and lymph node cells, triggering the cancer. Even saline implants include trace amounts of silicone to help them maintain shape.
The lymphoma is an aggressive form of cancer though it is often curable, according to experts. Treatments include radiation, chemotherapy and a bone marrow transplant, if the disease returns.
Reports of the cancer among women with breast implants have been reported anecdotally for years, according to Dr Jasmine Zain, a lymphoma specialist at New York University's Langone Medical Centre. "We've seen it from time to time over the years but this is the first time the FDA actually looked at all the case reports and made a statement," Zain said.
The FDA pulled silicone breast implants off the market in 1992, saying manufacturers had not provided medical data showing their safety and effectiveness. At the time, there were worries about a connection to a variety of diseases, including cancer and lupus. Alarming cases of ruptures added to the concern.
But in 2006 the agency returned the implants to the market after most studies failed to find a link between silicone breast implants and disease.
The approval came with conditions, including a requirement that the companies complete 10-year studies on women who have already received the implants to study leaks, as well conduct new decade-long studies of the safety of the devices in 40,000 women.
The FDA said the companies have continued to pursue those studies, though several of them have enrolled less than half of the patients needed to make them statistically useful.
Dr Diana Zuckerman said the studies "will be completely useless unless the FDA can convince the companies to do more to keep women in their studies". Zuckerman's group, National Research Centre for Women and Families, opposed the FDA's decision to re-approve silicone implants.
Wells Fargo analyst Larry Biegelsen, who covers the medical device industry, said the negative media coverage over the issue could hurt implant sales. "At this point, we do not expect breast implants to be removed from the market, but sales growth could be negatively impacted by the media coverage," Biegelsen wrote in a note to investors.
Scientists find key chemical that could boost memory and end the misery of Alzheimer's
Scientists have pinpointed a brain chemical that boosts memory, raising hope of new treatments for Alzheimer's. Scientists have shown that the brain chemical IGF-II plays a key role in the laying down and the strengthening of memories. Learning more about the process could lead to new memory-boosting drugs for Alzheimer’s, stroke and other conditions that rob people of their ability to remember even the simplest things.
The reverse may also be possible, with pills that wipe painful memories being used to help soldiers erase the horrors of battle, as well as those haunted by memories of car crashes and sufferers of crippling phobia.
In a series of experiments the US government-funded researchers showed IGF-II to play a key role in memory. The chemical occurs naturally in the body, and is found in relatively high levels in the hippocampus, the brain’s memory hub. However, levels decline with age.
To find out how it affects memory, rats were given mild electric shocks when they entered the darker side of a box. As the creatures normally like shaded spots, any reluctance to re-enter the area was taken to mean they remembered the painful consequences. So, the more the animal avoided the darkness, the better it was at remembering where not to go.
Tests showed that levels of IGF-II rose as the animals learnt to avoid the dark spot – and that giving them an injection of the substance boosted memory even further. New memories were strengthened and were slower to break down. In other words, the creatures found it harder to forget, the journal Nature reports.
Examination of the animals’ brains reviled that IGF-II had strengthened the cellular connections and mechanisms underlying long-term memory.
Researcher Cristina Alberini, of Mount Sinai School of Medicine in New York, said: ‘The implications of these data are far-reaching and give us new clues about how to investigate memory loss and forgetfulness in people with cognitive impairment, like those with Alzheimer’s disease, stroke or dementia.
‘This study is the first step to understanding the benefits of IGF-II. We have identified some of the mechanisms associated with this effect and look forward to studying them further and exploring the clinical relevance of IGF-II.’
With other experiments showing that blocking IGF-II stops long-lasting memories from forming, the research could also lead to pills that erase bad memories – a process known to medics as extinction.
Dr Thomas Insel, of the National Institutes of Health, which funded the research, said: ‘As we learn more about such mechanisms of fear memory formation and extinction we hope to apply this knowledge to address clinical problems, including post-traumatic stress disorder.’
The ability to erase painful memories has been the stuff of science fiction and Hollywood blockbusters for decades. In the film Eternal Sunshine of the Spotless Mind, a couple, played by Kate Winslet and Jim Carrey, undergo a procedure known as 'targeted memory erasure' to wipe out all recollection of each other after their relationship turns sour.
Dutch researchers recently discovered that beta-blocker drugs used to treat heart disease may also help patients to banish bad memories.
And scientists have shown that maintaining a stiff upper lip in times of crisis can stop bad memories from being laid down. Those who refuse to panic during moments of trauma remember less about what they saw than people who are more emotional.
It is thought that by concentrating so hard on keeping their emotions in check, they overload their brain, stopping it from taking in what is happening.
But the field is not without its critics, with some claiming that holding on to and reviewing bad memories is essential if we are to learn from our mistakes.
26 January, 2011
Traffic noise boosts risk of stroke - study
Findings of this nature are common and it usually transpires that controls for income and wealth have not been applied. Since poor people have worse health and tend to live in less salubrious locations, the findings can be seen as nothing more than another demonstration that poorer people have worse health. People tend to live by busy roads only if they can afford nothing better. The abstract below mentions no controls for income so would appear to fall into that category
As old people tend to be poorer in income terms, the fact that the association was found only among the elderly may reinforce the suspicion that we are looking at an income or wealth effect only.
A complication is that income and wealth are not strongly associated among the elderly and both could affect how well the person could afford to live.
Exposure to road traffic noise boosts the risk of stroke for those 65 or older, according to research published online today in the European Heart Journal.
In a survey of more than 50,000 people, every 10 additional decibels of road noise led to an increase of 14 per cent in the probability of a stroke when averaged for all age groups. For those under 65, the risk was not statistically significant. But the risk was weighted hugely in the over-65 group, where it rose 27 per cent for each 10 decibel increment. Above 60 decibels or so, the danger of stroke increased even more, the researchers found.
A busy street can easily generate noise levels of 70 or 80 decibels. By comparison, a lawnmower or a chainsaw gives off 90 or 100 decibels, while a nearby jet plane taking off typically measures 120 decibels.
"Previous studies have linked traffic noise with raised blood pressure and heart attacks," said lead researcher Mette Sorensena of the Danish Cancer Society. "Our study shows that exposure to road traffic noise seems to increase the risk of stroke."
The study reviewed the medical and residency histories of 51,485 people who had participated in the Danish Diet, Cancer and Health survey, conducted in and around Copenhagen between 1993 and 1997. A total of 1881 people suffered a stroke during this period.
Eight per cent of all stroke cases, and 19 per cent of cases in those aged over 65, could be attributed to road traffic noise, according to the paper.
The researchers suggest noise acts as a stressor and disturbs sleep, which results in increased blood pressure and heart rate, as well as increased level of stress hormones. The study factored in the effect of air pollution, exposure to railway and aircraft noise, and a range of potentially confounding lifestyle factors such as smoking, diet and alcohol consumption.
The survey cohort lived mainly in urban areas and was thus not representative of the whole population in terms of exposure to road traffic noise. Proximity to road noise is also related to social class, as wealthier people can afford to live in quieter areas.
SOURCERoad traffic noise and stroke: a prospective cohort study
Mette Sørensen et al.
Aims: Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before.
Methods and results: In a population-based cohort of 57 053 people, we identified 1881 cases of first-ever stroke in a national hospital register between 1993–1997 and 2006. Exposure to road traffic noise and air pollution during the same period was estimated for all cohort members from residential address history. Associations between exposure to road traffic noise and stroke incidence were analysed in a Cox regression model with stratification for gender and calendar-year and adjustment for air pollution and other potential confounders. We found an incidence rate ratio (IRR) of 1.14 for stroke [95% confidence interval (CI): 1.03–1.25] per 10 dB higher level of road traffic noise (Lden). There was a statistically significant interaction with age (P < 0.001), with a strong association between road traffic noise and stroke among cases over 64.5 years (IRR: 1.27; 95% CI: 1.13–1.43) and no association for those under 64.5 years (IRR: 1.02; 95% CI: 0.91–1.14).
Conclusion: Exposure to residential road traffic noise was associated with a higher risk for stroke among people older than 64.5 years of age.
Fatty Footprints: A Modest Proposal Based on Liberal GroupThink
Fact: The USA is in the midst of a obesity epidemic.
Fact: Fat people are more likely to need health services, work fewer years, and pay less in taxes. They “free ride” by consuming scarce health care resources paid for by those who are healthy and thin.
For their own good, and for the Public Good, the Departments of Health (state and federal) will calculate the “fat footprint” of every product that enters the stream of interstate commerce (by definition, everything in the universe). A new value added tax (VAT) will be added to all food items to cover health care costs and encourage healthy behavior on the part of those “irresponsible” fat people.
The government will also require all state and federal workers to work out at their local gym, eat food from an approved list, and reduce their weight to a level deemed adequate by F.A.T.S. (Federal Agency for Trimming and Slimming America).
This regulation will also extend to employees of businesses that contract with the federal government. Currently. F.A.T.S. is working to devise universal coverage beyond those groups. After all, one reason why children are “left behind” is that they are too fat to catch up with their peers. This must change.
Civil rights laws will be revised to add thin-to-normal weight people to the list of protected classes for affirmative action purposes. Employers must seek out thin-to-normal weight employees by casting a wide net in their recruitment. These workers will boost the bottom line of companies and make for a more socially just distribution of resources. The EEOC will supervise the formulation of goals and timetables to achieve real progress.
The tax code will extend credits to those who can document weight loss. Other candidates for tax subsidies: those with reduced cholesterol levels, lower blood pressure, and other markers of good health.
A half century ago, normal-weight president John F. Kennedy said, “Ask not what your country can do for you, ask what you can do for your country.” His promise lays unfulfilled next to the potato chips on millions of American couches.
Fifty years is too long, we know what you can, should, and must do for your count
25 January, 2011
Below is the first part of an article in the NYT that looks at why we use tests of statistical significance in scientific research. The issue is a relevant one for medical research as every medical journal article one looks at does use and report tests of statistical significance for the findings described in it.
The discussion below is quite right in reporting that many statisticians think we are too lenient in what we accept as statistically significant. I think that too. Accepting a 5% chance that a correlation may be due to chance alone seems risky in medical research. Medical research should surely observe high standards of proof before conclusions are drawn.
What the article overlooks, however, is that statistically aware researchers have never been much impressed by the 5% standard. It is quite common for results significant by that standard to be seen as preliminary or tentative. For researchers to report their results with any confidence about the reality of what they report, a 1% standard has long been the informal criterion. And to the extent to which that is so, the criticisms below rather fall by the wayside: There is already a stronger standard in informal use.
I taught statistical analysis in a major Australian university for a number of years so have had some opportunity to reflect on why we use tests of statistical significance. And I think the major point that is rather overlooked below is that an effect can be significant in a statistical sense but not in any other sense. All a significance test does is exclude randomness. But even a tiny correlation can be shown as non-random if the sample size is large enough. But a tiny correlation may be of no practical importance or use at all.
So the function of significance testing is simply to act as a filter. Such a test enables us to say of some correlation: "This correlation is NOT EVEN statistically significant". And in that case its significance in any other sense is unlikely to be worth bothering about. It is, in other words, just a very preliminary filter which we use to help sort out which correlations may be worthy of our attention
In recent weeks, editors at a respected psychology journal have been taking heat from fellow scientists for deciding to accept a research report that claims to show the existence of extrasensory perception.
The report, to be published this year in The Journal of Personality and Social Psychology, is not likely to change many minds. And the scientific critiques of the research methods and data analysis of its author, Daryl J. Bem (and the peer reviewers who urged that his paper be accepted), are not winning over many hearts.
Yet the episode has inflamed one of the longest-running debates in science. For decades, some statisticians have argued that the standard technique used to analyze data in much of social science and medicine overstates many study findings — often by a lot. As a result, these experts say, the literature is littered with positive findings that do not pan out: “effective” therapies that are no better than a placebo; slight biases that do not affect behavior; brain-imaging correlations that are meaningless.
By incorporating statistical techniques that are now widely used in other sciences — genetics, economic modeling, even wildlife monitoring — social scientists can correct for such problems, saving themselves (and, ahem, science reporters) time, effort and embarrassment.
“I was delighted that this ESP paper was accepted in a mainstream science journal, because it brought this whole subject up again,” said James Berger, a statistician at Duke University. “I was on a mini-crusade about this 20 years ago and realized that I could devote my entire life to it and never make a dent in the problem.”
The statistical approach that has dominated the social sciences for almost a century is called significance testing. The idea is straightforward. A finding from any well-designed study — say, a correlation between a personality trait and the risk of depression — is considered “significant” if its probability of occurring by chance is less than 5 percent.
This arbitrary cutoff makes sense when the effect being studied is a large one — for example, when measuring the so-called Stroop effect. This effect predicts that naming the color of a word is faster and more accurate when the word and color match (“red” in red letters) than when they do not (“red” in blue letters), and is very strong in almost everyone.
“But if the true effect of what you are measuring is small,” said Andrew Gelman, a professor of statistics and political science at Columbia University, “then by necessity anything you discover is going to be an overestimate” of that effect.
Can it really be true that statins won't stop heart attacks?
Cochrane reviews aim to be the most thorough and comprehensive in the medical literature so are generally regarded as highly authoritative
Confused about statins? Hardly surprising, when even the experts seem to disagree. Last week, a major report suggested that if you hadn’t had a heart attack or a stroke, taking one of the cholesterol-lowering drugs was probably a waste of time. That’s because the chance of them preventing a heart attack was very small.
But other experts rejected the report by the respected Cochrane Library, saying it hadn’t included the latest studies. ‘The quality of the data showing the effectiveness and safety of statins is remarkably high,’ argued Dr Colin Baigent of the Cholesterol Treatment Trialists’ Collaboration in Oxford. ‘We now have a very large database of patients that show clear benefits.’
There are just over two and a half million people living with heart disease in the UK and there’s no doubt many will be benefiting from statins.
However, seven million Britons take them and the number is rising. While some of these people are at high risk of heart disease and may be helped by the drugs, several million others are taking them when the evidence for their benefits is conflicting.
And now to add to the confusion, an influential cardiology organisation known as The Joint British Societies is expected to announce even more people should be put on the drugs and given them earlier.
So who is right, why has it taken so long for these doubts to appear, and what else could you be doing? Good Health asks the experts.
I’ve never had a heart attack, do I need statins?
That depends on your age and how healthy you are. The latest report found little evidence that taking a statin would protect people from having a first heart attack unless their risk was high. This risk is calculated by your doctor according to a number of factors including your cholesterol levels.
But if you are female or over 65 and at low risk, the Cochrane review says it’s even less clear. That’s because most trials involve white, middle-aged males so the results don’t necessarily apply to anyone else.
But some experts say that I should take them . . .
These experts were probably relying on studies that some people now say were flawed. This is because they included patients who already had heart problems — there’s little doubt that statins help these patients, so their inclusion skews the results. Critics say you can’t use this evidence to justify treating healthy people with statins.
The evidence for statins can also be made to seem more favourable that it really is. One technique used by drug companies is ‘simply to not say very much about negative findings’, says Dr Shah Ebrahim, senior author of the latest review.
The Cochrane review, carried out by researchers from the London School of Hygiene & Tropical Medicine and the University of Bristol, closely analysed 14 controlled trials that involved 34,272 primary prevention patients — that is, people who’d never had a heart attack.
It found ‘only limited evidence that primary prevention with statins may be cost-effective and improve patient quality of life’. The small size of the benefit is vividly illustrated by this fact: out of 1,000 primary patients taking a statin, only one death from heart disease would be avoided.
If benefits are that small then it becomes more important to balance them against the side-effects.
So what are the side-effects?
On the positive side, the review didn’t find any evidence that the drugs cause some of the adverse reactions that people have worried about in the past, such as cancer, low mood or anger or increased deaths from violence or suicide.
But that still leaves quite a number that you have to weigh against a small benefit. Statins are well known to cause muscle problems, including muscle pain, fatigue and weakness. Estimates of how common they are vary widely — from 1 per cent to 20 per cent.
Other potential reactions include cataracts, acute kidney failure, and moderate or severe liver dysfunction, said to be rare. Recently the Medicines and Healthcare products Regulatory Agency warned about some additional risks — sleep disturbances, memory loss, sexual dysfunction, depression, and (very rarely) interstitial lung disease.
However the review points out that the trials don’t give nearly enough information about side-effects. Over half the trials didn’t report on adverse effects, and there has been no attempt to assess the risk of some potentially serious side-effects such as cognitive impairment or the risk of diabetes when cholesterol is lowered too much.
What if I’m only ‘at risk’ of a heart attack?
The Nice guidelines say that if you have some of the familiar risk factors for heart disease — are male and over 55 (65 for a woman), have high cholesterol, smoke or are overweight — which gives you a 20 per cent or more chance of a heart attack in the next ten years, you should be prescribed statins.
The Cochrane report doesn’t change that advice. It says ‘it is likely the benefits of statins with a raised risk of heart disease are greater than potential short-term harms’, but warns: ‘Long-term effects (over decades) remain unknown’.
Dr David Tovey, head of the Cochrane Editorial Unit, says: ‘This report is a warning against expanding statin use further to people below that level of risk. [This expanded use] is not supported by existing evidence.’
So will GPs stop giving out so many statins?
Despite the latest research, your GP may well start prescribing more. That’s because in a few months’ time the Joint British Societies will issue new guidelines.
This will mean that instead of calculating your risk of heart attack within ten years, your GP will calculate it for your lifetime and start treating you as soon as possible.
But as the doctors’ magazine Pulse recently warned, this means GPs faced with younger patients will inevitably reach for the statins. An editorial decries this ‘latest step on the road to mass medicalisation’.
Are there other ways to protect my heart?
Last year Kausik Ray, professor of cardiovascular disease prevention at St George’s, University of London, published a review that, like the Cochrane Review, also found virtually no benefit from statins in primary prevention. He encourages patients to look at alternatives.
‘The data is very clear that statins can save some lives,’ he says. ‘But we need to get better at predicting who is going to benefit. ‘GPs have been pushed into a tick-box culture that means you get statins if you have certain risk factors,’ says Professor Ray. ‘But ideally you should discuss concerns, like how to handle long-term issues such as side-effects. Statins are unlikely to kill you but they can affect your quality of life.
‘You may want to try other treatments such as the B vitamin niacin, which has proved effective in trials recently. There are lots of options.’ Several trials have shown that niacin can bring down the ‘bad’ LDL cholesterol and raise the ‘good’ HDL. It does have a brief flushing effect on the skin, which some people find unpleasant.
24 January, 2011
Drinking Milk in Childhood Cuts Risks of Cancer (?)
That may be true but the report below is a weak basis for saying so. It is retrospective self-report of unknown reliability and may simply show that people believe milk to be good for them
Good habits of childhood, no matter how resentful they were always end up paying well, it seems. According to a new study, the people who took part in the milk drinking programme during their schooling are at the lower risk of cancer today.
A survey published in the American Journal of Epidemiology recruited around 1000 people, which also included patients with pre-existing bowel cancer. The questionnaire prepared asked them about their milk drinking habits, summing up the total quantity they had per week.
Associate Professor Dr. Brian Cox and Dr. Mary Jane Snyed, who led the study found that there was 30% reduced risk of bowel cancer for those who took drank milk regularly. The results were more significant for those who were the biggest milk drinkers. They reported of being at 38% lowered cancer risk.
The findings of the study are looked up with the great expectations for New Zealand, which has currently the highest number of Cancer cases. It is estimated that approximately 3000 people are diagnosed with the disease, out of which 1200 people die every year.
The researchers claim that the presence of calcium in the milk accounts for healthier bones thereby also contributing towards the negative effect on the growth of bowel adenomas.
Drug may guard against lung cancer death
A very poorly controlled study. How did the women getting and not getting the drug differ?
Tamoxifen, a drug commonly used to treat breast cancer, may also help reduce the risk of death from lung cancer, says a study published in the US peer-reviewed journal Cancer today.
Tamoxifen works by blocking oestrogen. Previous studies have shown that women undergoing hormone replacement therapy to boost oestrogen during menopause showed an increased risk of dying from lung cancer.
Based on the hypothesis that blocking oestrogen might also cut lung cancer death risk, researchers examined data from 6655 women diagnosed with breast cancer between 1980 and 2003 in Switzerland's Geneva Cancer Registry. Close to half of those women, 3066 (46 per cent), were given anti-oestrogen drugs.
The registry's Elisabetta Rapiti, lead author of the study in Cancer, followed all those subjects until December 2007 and looked at how many developed lung cancer and how many died from lung cancer. Rapiti found that among those taking anti-oestrogen drugs, there were 87 per cent fewer deaths from lung cancer when compared with the general population.
When she looked simply at how many women in the study were diagnosed with lung cancer, she found no significant difference between those taking anti-oestrogen therapy and those who were not. "Our results support the hypothesis that there is a hormonal influence on lung cancer which has been suggested by findings such as the presence of oestrogen and progesterone receptors in a substantial proportion of lung cancers," said Rapiti.
"If prospective studies confirm our results and find that anti-oestrogen agents improve lung cancer outcomes, this could have substantial implications for clinical practice," she added.
23 January, 2011
Will this nonsense never die?
A well-known effect demonstrated yet again and the same fallacious explanation given again. What they overlook: People living beside main roads are POOR. Rich people wouldn't want to live there. And poor people have worse health anyway
Residential Proximity to Major Roads and Preterm Births
By Yorifuji, Takashia et al.
Background: Preterm births cause a large public-health burden, and air pollution is considered to be a potential risk factor. We evaluated the association between proximity to major roads (as an index for air pollution) and preterm births, classified by gestational age and specific clinical manifestations.
Methods: Data on parental information and birth outcomes were extracted from the database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,226). Using the geocoded residential information, each birth was classified on its proximity to major roads. We estimated the multivariate-adjusted odds ratios and their 95% confidence intervals (CIs) for the association of proximity to major roads with preterm births, using logistic regression.
Results: We found positive associations between proximity to major roads and preterm births at all gestational ages. Living within 200 m increased the risk of births before 37 weeks by 1.5 times (95% CI = 1.2–1.8), birth before 32 weeks by 1.6 times (1.1–2.4), and births before 28 weeks by 1.8 times (1.0–3.2). Proximity specifically increased the risk of preterm births with preterm premature rupture of the membranes and with pregnancy hypertension.
Conclusions: This study demonstrates that exposure to traffic-related air pollution increases even the risk of preterm births of less than 30 weeks' gestational age and proposes a possible mechanism.
Daily pill for people with MS 'in months'
The first daily pill for multiple sclerosis (MS) could be available in Britain within a few months. At the moment people whose MS returns frequently have to inject themselves with a drug as often as every day to control their symptoms, or travel to hospital for treatment.
But now a committee of the European Medicines Agency (EMA) has recommended that the drugs regulator approves the pill, called Gilenya, to be marketed across the EU. It is already approved for sale in Russia and the US.
Novartis, which makes Gilenya, said a licence allowing Gilenya to be marketed in the UK was expected "in the next few months".
Dr Jayne Spink, policy and research director of the MS Society, welcomed the news as "great for people with MS".
She said: "The availability of a tablet to treat the condition will give people more choice and for many will come as a welcome relief from frequent injections."
Besides from being more convenient and less painful, a trial has also showed Gilenya to be twice as effective at stopping relapses as one of the injectable drugs, called interferon beta 1a.
However, the EMA's Committee for Medicinal Products for Human Use has only recommended the pill for use by patients with highly active relapsing-remitting multiple sclerosis (RRMS) who fail to respond adequately to interferon beta, or who have rapidly evolving severe relapsing-remitting MS.
Once Gilenya receives a UK licence, the National Institute for Health and Clinical Excellence (Nice) will decide if and to whom it should be prescribed on the NHS.
A rival to Gilenya, the brand name for the drug fingolimod, is expected to be granted approval later this year. Cladribine, which only has to be taken between eight and 20 times a year, has shown to be similarly effective.
MS, an auto-immune disease, affects around 100,000 people in Britain. It occurs when immune system cells attack the brain and spinal cord, causing the protective insulation around nerve fibres to be destroyed. The disease can lead to a wide variety of symptoms ranging from mild tingling to paralysis.
22 January, 2011
Americans wait longer for life-saving drugs
The 1962 Kefauver-Harris Amendments have killed a lot of people
How could regulations, which were passed to protect the American public, actually do more harm than good? To answer that question, we must first examine what changes the amendments made in drug development.
A pivotal provision of the amendments concerned the approval process. Prior to 1962, a manufacturer would submit data on a new drug and the FDA had six months to respond. In the absence of FDA concern or questions, marketing could begin. However, the amendments required FDA examiners to actually sign off and approve each New Drug Application (NDA), as a testament to the safety and efficacy of the new drug.
Of course, since no drug is totally safe and efficacious, FDA personnel risked censure by Congress if unexpected side effects, which occur with all drugs, were severe enough to attract public attention. To protect themselves, therefore, regulators began demanding more and more testing, so that they could show “due diligence” in the event they were asked to defend an approval.
In addition, the FDA was given oversight of pharmaceutical advertising, manufacturing, and labeling. The FDA determined which animal safety studies had to be performed prior to testing a new drug in people. Consequently, manufacturers had to do more animal experimentation, perform more quality control work, negotiate every word of advertisements and labels with the FDA, and send literally truck loads of data to the FDA.
One of the primary provisions of the Kefauver-Harris amendments was, of course, the senator’s requirement for “substantial evidence of efficacy.” The FDA decided that giving doctors samples of drugs and getting their evaluation was not enough evidence of effectiveness. Based on the amendments, the FDA began requiring that drug companies perform two U.S. studies that were “double-blind, placebo-controlled.” In other words, some patients would receive the test drug and some would receive an identical “sugar” pill. The capsules or tablets would carry a number, not a name, so that neither patient nor doctor would know what was taken. When the study was done, the code would be broken.
Even if more patients were helped by the drug instead of placebo, it would only be considered effective if the results were “statistically significant.” Because we are not genetically identical, an inactive drug could appear effective simply because one group was going to heal faster naturally than the other.
Therefore, statisticians look for big differences between placebo groups and drug treated groups. When this difference is big enough to have 95% certainty that the drug effect isn’t simply due to chance, we call that “statistically significant.” By requiring two studies with 95% certainty, the FDA set a high standard for new drugs to meet.
Of course, meeting all of these new requirements took time. As you can see from Figure 2, drug development times, which were about 4 1/2 years between 1948 and 1961 started rising dramatically after the amendments were passed. Development times, as used here, are the years between the first time the drug is made (compound synthesis) and FDA approval. How do we know that the increase in development time was due to the 1962 amendments and not some other factor? The time for the FDA to review new drug applications went from about 7 months pre-amendment to an average of 29 months in the years 1963-1969. The extra time taken for the FDA to review the new studies it required was greater in the late 1960s than the time needed to do the studies themselves!
Clearly, the regulators were concerned about the new visibility that the 1962 amendments had given them. They were asked to do the impossible: approve only safe and effective drugs. They did the next best thing. They still approved new drugs, but required more and more expensive studies, driving the cost of development up and raising drug prices.
Figure 2. Average development time of new drugs (known as new chemical entities or NCEs) before (blue bars;) and after (red bars;) passage of the 1962 Kefauver-Harris Amendments. The time saved by passage of the 1992 Prescription Drug User Fee Act is shown (pink bar) for the 1990-1999 period.
In addition, the FDA took more and more time to evaluate the studies, shortening the patent life of the new product. Manufacturers, who have to recover most of their costs before a drug goes generic, had fewer years to do so. Consequently, they raised prices even more.
Meanwhile, in Europe, regulations had not changed as much, even after the thalidomide tragedy. Consequently new drugs, although invented predominantly in the United States, were marketed first in Europe. Europeans had twice as many drugs in their pharmacies as Americans had!
One of these new drugs was propranolol, the first beta-blocker for heart disease. Because of the “drug lag,” propranolol entered the American market in 1968, three years after it had been available in Europe. One study performed in the 1980s estimated that propranolol was saving approximately 10,000 American lives per year. Consequently, at least 30,000 Americans died prematurely during the three-year delay in propranolol approval. This estimate may be low, since propranolol was not approved for its major uses, angina and hypertension, until 1973 and 1976 respectively.
Instead of being complemented for finally approving propranolol, the FDA was criticized by a congressional committee for exposing the American public to a drug with potential side effects. Given this negative feedback, it’s hardly surprising that the FDA increased its regulatory demands even further.
Dieting while pregnant can lower your baby's IQ
For once I agree with the official advice -- at the end of the article below
Expectant mothers who diet during pregnancy are putting their babies at risk of low IQs and behavioural problems, scientists say. A new study found that cutting back on vital nutrients and calories in the first half of pregnancy stunts the development of an unborn child's brain.
Although the study was carried out on animals, researchers says the same findings are likely to be true for women - and highlight the lifelong dangers to babies if their mothers don't eat healthily. Author Dr Thomas McDonald said: 'This study is a further demonstration of the importance of good maternal health and diet.
'It supports the view that poor diets in pregnancy can alter development of foetal organs, in this case the brain, in ways that will have lifetime effects on offspring, potentially lowering IQ and predisposing to behavioural problems.'
Past studies have shown that severe diets, famines and food shortages during pregnancy can harm unborn babies. But the new study looked at the sort of 'moderate dieting' typical of women in Britain and America.
The researchers compared two groups of baboon mothers at the a primate research centre in San Antonio. One group was allowed to eat as much as they wanted during the first half of pregnancy - while the other group was fed 30 per cent less - 'a level of nutrition similar to what many prospective mothers' experience, the researchers said.
Cells did not divide as much as they should and connections between neurons were not made.
Lack of nutrients interfered with the way brain cells connected in the unborn babies and altered the expression of hundreds of genes - many involved in cell growth and development, the researchers report in the Proceedings of the National Academy of Sciences.
Dr McDonald said foetal nutrient deficiency was a special risk for both teenage mothers and women who get pregnant later in life.
In teenage pregnancies, the developing foetus can be deprived of nutrients by the needs of the growing mother, he said. And stiffer arteries in older women reduce blood flow to the womb, reducing the flow of nutrients to the growing baby.
The scientists called for more research into links between maternal diet and their children's risk of autism, depression and schizophrenia later in life.
The study also challenges the widely held view that mothers can protect their unborn babies from poor diets in pregnancy, he said.
The baboon's brain developmental stages are 'very close' to those of human fetuses, the researchers said.
Dr Peter Nathanielsz, of the University of Texas Health Science Centre in San Antonio said: 'This is a critical time window when many of the neurons as well as the supporting cells in the brain are born.'
Guidelines from the Royal College of Obstetricians and Gynaecologists state: 'There is little evidence of harm in the first half of pregnancy - but in the second half concerns arise.'
However, it still advises women not to diet if they find they are pregnant.
Dr Patrick O'Brien, consultant and spokesman for the Royal College of Obstetricians and Gynaecologists said the study might not apply to women. 'All the studies in humans have not suggested that moderate dieting in the first half of pregnancy causes any problems,' he said. 'Our guidance is unchanged - that pregnant women should eat a healthy mixed diet and should avoid dieting, but also avoid "eating for two",' he added.
21 January, 2011
Spread the word: medicinal margarine not worth the money
IF YOU struggle with high cholesterol, you are better off visiting your GP for a prescription than looking for a solution in the supermarket aisles, says a medical paper that casts doubt on the effectiveness of food products claiming to reduce cholesterol reabsorption.
Many margarines and spreads advertise an ability to reduce cholesterol levels in consumers by up to 15 per cent through the addition of plant-based sterol and stanol esters, which compete with cholesterol in the body and inhibit its reabsorption. High cholesterol is a main cause of cardiovascular disease, the leading cause of death in Australia.
But the author of the paper, Sheila Doggrell, a Queensland biomedical writer and pharmacologist, argues that this figure represents only the very top of the cholesterol-reducing capabilities of these products and that under normal consumption conditions they are unlikely to achieve reductions of above 1.3 to 3.8 per cent.
Under the same conditions, prescription treatments for abnormally high cholesterol were shown to reduce the cholesterol levels of participants by more than 20 per cent.
Unilever, which produces the sterol-enhanced spread Flora pro-activ, says that the product is not designed to be relied on as a comprehensive medical solution.
"Plant sterols are not a replacement for medication, however they are effective used in conjunction with some cholesterol-lowering medication," the company said, citing a statement issued by the National Heart Foundation in 2008.
Dr Doggrell argues that the products are not necessary at all. "If you have a problem with high cholesterol you are wasting your money paying extra for cholesterol-reducing products," she said.
Research done by the consumer advocacy group Choice shows that sterol-enhanced products can cost up to three times as much as the regular alternatives.
Dr Doggrell's advice is that the margarines and spreads on the market are simply not effective enough to make any difference to someone who has been diagnosed with abnormally high levels of cholesterol, and that the products provide no benefit to those whose cholesterol falls within the normal range.
Lounging on the couch is bad for your fitness health, experts claim
As far as I can see, the research showed only that unfit people watch a lot of TV. Causative inferences are speculative
FITNESS fanatics who reward themselves by lounging in front of the TV after a gym workout should think again.
Researchers believe long bouts slumped in front of the idiot box or computer screen have an adverse affect on the heart's ability to recover from physical exertion.
The news is a worrying development for couch potatoes. Heart rate recovery is considered an important indicator of heart health, and its speed is associated with the risk of death.
Sitting in front of a screen uses less energy than other sedentary behaviour, such as reading, writing or driving.
Past studies have found that longer screen viewing time is associated with abnormal glucose metabolism, obesity and metabolic syndrome - a "constellation of chemical factors" associated with a higher risk of heart disease.
More than 2000 people in their 30s with no heart disease history and varying levels of cardiovascular fitness took part in the new study.
Researchers measured the speed at which heart rates returned to normal up to two minutes after peaking during eight minutes of exercise on a treadmill.
Participants were quizzed about factors, ranging from blood pressure levels and alcohol consumption to level of physical activity over the past month and the time devoted to watching TV and computer screens.
Researchers found that women who spent long periods in front of a screen had a slower heart rate recovery than men as well as unfavourable metabolic patterns.
Those who engaged in little or no exercise had the slowest heart rate recovery levels, according to the paper published in online journal Heart Asia.
Melbourne fitness trainer Donna Aston insisted it was all about balance. "I don't see a problem with relaxing after exercise. We all need to recuperate," the South Yarra trainer said. "Watching a little TV is fine, but if you are going to sit for hours on end in front of the screen, that's obviously not good for you."
With people spending more time sitting down, she said it was more important to get up and get physical.
20 January, 2011
Forget five, now it's eight portions of fruit and veg a day for good health (?)
The Marmot's at it again. Epidemiogical rubbish, of course. International comparisons are very dicey. There could be many differences in different national populations other than their diets. Just let one fact sink in: Southern Europeans have a much more vegetarian diet than Australians do yet Australians live longer! If the Marmot reads this (unlikely) he would no doubt want to say: "Yes. But there are many other differences ...". To which I would say: "Precisely"
For years the advice has been clear: eating five portions a day of fruit and vegetables is the key to a healthy life. But five may no longer be enough.
A study has found that to get maximum defence against heart disease, you need to eat at least eight daily servings of fresh food.
The Government’s five-a-day advice has its roots in World Health Organisation guidelines to include 14oz of vegetables in a daily diet. But there have been doubts over whether eating more than this level of fruit and veg meant even greater health benefits. Now the new study suggests every extra portion provides added protection.
Significantly, those in the highest category – eating eight or more a day – have a 22 per cent lower chance of dying from heart disease than those who consume three portions, the UK average. A ‘portion’ weighs just under 3oz, equal to a small banana, a medium apple or a small carrot.
The findings come from an ongoing European investigation into diet and health, looking at 300,000 people in eight countries. Dr Francesca Crowe, of Oxford University, is working on the project. She said that although ischaemic heart disease (IHD) – the most common form – was less likely in those who ate lots of vegetables, it could be explained because these people might also have healthier lifestyles.
However, the study specifically showed a reduced risk of dying from IHD of around four per cent for each additional portion of fruit and veg consumed above the lowest category, which was those who ate two or fewer portions.
The average intake of fruit and vegetables across all the countries in the study was five portions. People in Greece, Italy and Spain ate more and those in Sweden less.
Professor Sir Michael Marmot, of the University College London, said the findings were of ‘huge practical importance’. He said: ‘Cardiovascular disease is the most common cause of death. A reduction of 22 per cent is huge. There would need to be big shift in dietary patterns to achieve this healthy consumption of eight portions a day. It is worth trying to move in that direction.’
Scientists have previously suggested 15,000 lives a year could be saved if everyone ate five a day.
Drug offers new hope in treatment of deadly form of skin cancer
SCIENTISTS have heralded a new therapy for one of the deadliest forms of cancer after trials showed a new drug can extend the lives of patients with advanced malignant melanoma.
Patients taking the new drug, which attacks a genetic mutation found in about half of all cases of the aggressive skin cancer, live significantly longer than those given standard treatment, a landmark study has found.
Preliminary results suggest that the drug, known as RG7204 or PLX4032, is the first melanoma therapy with a proven benefit on survival. Though the cancer is treatable if caught early, fewer than 10 per cent of patients survive for a year if it has spread.
The trial has been so successful that Roche, the drug company, has ended its control arm, so that participants who had received a placebo can now take the active drug.
While RG7204 is suitable for only the half of melanoma patients whose tumours carry the right mutation, and only 80 per cent of these respond, scientists said it would transform treatment of the disease.
Richard Marais, Professor of Molecular Oncology at the Institute of Cancer Research in London, said: “What this means is that now, for the first time in melanoma, we have a treatment that actually works for an appreciable proportion of patients.”
James Larkin, of the Royal Marsden Hospital in London, said: “This is an incredibly exciting breakthrough. Malignant melanoma is a very difficult disease to treat and with a growing incidence in younger people the results of this trial are very encouraging.”
The drug also marks a milestone in the development of personalised genetic medicine, as it was designed to target a genetic mutation that is found in about 50 per cent of melanoma patients. The mutated gene, called BRAF, was identified in 2002 by a British team led by Professor Mike Stratton, of the Wellcome Trust Sanger Institute near Cambridge.
The company is also developing a diagnostic test for the BRAF gene targeted by RG7204, to identify which patients can benefit. Such targeted treatment is considered to be the next frontier of cancer medicine.
In a separate study, published in the journal Nature, a team led by Dr Andy Futreal, of the Sanger Institute, has identified a gene that is mutated in one in three cases of kidney cancer.
19 January, 2011
We should stop putting blame on obese people
By Paul Zimmet (Professor Paul Zimmet AO is director emeritus of the Baker IDI Heart and Diabetes Institute, Australia, and an international authority in public health aspects of obesity and diabetes)
It is time to ask if we have the right strategies to fight the national and global obesity epidemics. Since the last Australian Diabetes and Lifestyle study in 2005, there has been no reliable national monitoring data and nothing to suggest we are winning the war. It could be 2013 or 2014 before new data are available.
While the government may be about to enact some of the easier recommendations of the 2009 Preventative Health Taskforce report, the strong message was that the recommendations needed to be implemented as a package. Otherwise, there is unlikely to be any real impact on obesity, which is by far the main driver of the Australian diabetes and heart disease epidemics.
The failure to respond aggressively is very disappointing. We need to challenge the myth that sloth and sedentary behaviour are largely responsible for obesity. We need to stop arguing that individuals and parents are solely responsible.
Politicians and health bureaucrats need to acknowledge the changed thinking of scientists and researchers about the underlying cause of obesity. A significant biological component drives the very behaviour we focus on.
A major part of obesity is hereditary. There are also lifelong consequences of poor or excessive maternal nutrition. Children who have poor nutrition before birth are predisposed to obesity, type 2 diabetes, heart disease and even mental disorders in adult life.
For indigenous Australians, this disadvantage predisposes them to chronic diseases in adulthood.
Maternal diabetes and obesity shape the way the foetus responds, making it more likely that a child will develop obesity and diabetes.
A mother's behaviour during pregnancy has profound effects on her baby's responses to the environment in adult life. Diabetes and obesity in the mother, malnutrition, smoking, alcohol and drug abuse all have an effect on the baby's genetic material.
So these changes create a vicious intergenerational pattern of susceptibility to chronic disease. But appropriate advice and education, intervention during pregnancy, and even before, can reverse this escalating obesity epidemic.
Two renowned Australian researchers, Boyd Swinburn and Garry Egger, have even described the world and our environment as "obesogenic".
Societal changes are so profound that parents can no longer control many of the behavioural, socio-cultural and economic changes that affect their children. Because of the rapid pace of change, many parents do not have the knowledge or skills.
We in the public health arena need to explain more effectively this new way of thinking and present the problem as a combination of individual and population vulnerabilities. Many factors are not the ''fault'' of the individual.
It is unfortunate that much of the media fuels the belief that obesity is primarily caused by sloth and gluttony. This invites a passive response and allows government to put the responsibility on individuals - particularly when it comes to intervening with children.
Intergenerational change and the lack of nutritional understanding mean that parents are ill equipped to deal with nutrition education and other lifestyle issues. Action needs to start before birth and rely on the new science of epigenetics.
Our governments and public health agencies need to work out how to engage meaningfully with the food industry and recruit it to the fight. We need to work out better ways to interact with these companies. Unlike smoking, we cannot live without eating, and we cannot win this battle without their co-operation.
An Access Economics report in 2008 put the cost of obesity in Australia and its impact from chronic disease and economically at $58 billion a year. The potential cost of implementing the recommendations of the Preventative Health Taskforce would seem an absolute bargain against this. It is time to stop the culture of blame. I hope our governments are listening.
Statins 'may cause loss of memory and depression'
And that's not half of it. Many people given statins decide that they would rather take the risk of a heart attack than continuing to take them
Cholesterol-lowering pills taken by millions of Britons may cause memory loss and depression, researchers warn. They say not enough is known about the level of harm posed by statins, prescribed to prevent heart disease and strokes. Leading doctors say that the drugs should only be taken by patients for whom the benefits of the drug outweigh any potential risks.
More than seven million people in Britain now take statins – as many as one in three adults over the age of 40. They are extremely effective in lowering levels of cholesterol, the fatty substance in the blood that clogs up arteries leading to heart attacks and strokes. Many people over the age of 45 are routinely prescribed statins by their GPs if they have slightly high blood pressure or cholesterol.
In addition low-dose pills are increasingly bought over the counter without a prescription. Although they have been proven to be extremely effective – saving up to 10,000 lives a year – researchers warn that not enough is known about their risks.
They warn statins should only be prescribed to those with heart disease, or who have suffered the condition in the past. Researchers warn that unless a patient is at high risk of suffering a heart attack or stroke, statins may cause more harm than good.
The study, published in the Cochrane Library, which reviews drug trials, also points out that the vast majority of trials have been carried out by drugs companies who may play-down any possible risks. Some patients taking statins have suffered from short-term memory loss, depression and mood swings.
Previous studies have also linked the medication to a greater risk of liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy.
The researchers examined data from 14 drugs trials involving 34,000 patients. They found that although the drugs did prevent heart attacks and strokes, there was not enough evidence to prescribe them to patients with no previous history of heart disease.
Professor Shah Ebrahim, from the London School of Hygiene and Tropical Medicine said: ‘When you put the evidence together you certainly find it supports the use of statins. But we found that evidence of potential harm is not being taken seriously. ‘The adverse effects are not included in the trials.’
Lead researcher Dr Fiona Taylor, added: ‘The decision to prescribe statins in this group [who have no history of heart disease] should not be taken lightly.’
Amy Thompson, senior cardiac nurse at the British Heart Foundation, said: ‘This systematic review echoes what we already know – that statins have huge benefits for people with heart and circulatory disease, or those who are high risk – they help to reduce the risk of heart disease including heart attacks.
‘It is still unclear whether statins provide any real benefits for people without heart and circulatory disease and who are at low risk.’
18 January, 2011
Congress affirms that regulations account for over 80% of drug development time
As a consequence of the increasing development times, new drugs often enter the marketplace with only a few years of patent life remaining. Consequently, manufacturers had to charge excessive prices for new drugs in order to make up their increasing research and development costs. To counter this trend, Congress passed the Waxman-Hatch Patent Restoration Act in 1984 to extend pharmaceutical patent life. Companies could recover up to half of the time lost to regulatory requirements, as long as their total patent life at time of marketing didn’t exceed 14 years. (Patents generally expire 17 years from the time of issuance or 20 years from date of patent filing, whichever is later.)
The Act estimated the “regulatory review time” as the number of years of clinical testing and FDA evaluation. When the Act was passed, the regulatory review time accounted for about 84% of drug development time. About two-thirds of the regulatory review time could be directly attributed to the 1962 amendments.
As a research scientist in drug discovery and development at the Upjohn Co., between 1976 and 1995, I was quite aware of the impact of increasing regulatory demands on drug development time. My colleagues and I joked that we spent so much time fulfilling the regulations that we had no time to discover new drugs to treat disease! However, as we’ll soon see, it’s no laughing matter: it’s a matter of life and death!
In 1992, the Prescription Drug User Fee Act was passed. This Act allowed pharmaceutical firms to pay “user fees” of hundreds of thousands of dollars to the FDA. The agency would then hire new examiners to expedite their review of the company’s new drug application. This process shaved about a year from the drug development process. As you can see from Figure 2, had this legislation not been passed, drug development times in the 1990s would have more than 15 years-greater than three times the average development time prior to amendment passage!
Hot flushes during menopause 'halves chances' of breast cancer
A dark cloud with a silver lining, apparently. The research methodolgy was a bit weak but the findings seem reasonable
Women who suffer hot flushes during the menopause may be half as likely to get breast cancer. Those whose lives are blighted by the symptoms of the ‘change’ seem to have significant protection against the disease later in life, say scientists.
The results of a study show the worse the hot flushes are, the lower a woman’s risk of developing the most common forms of breast cancer. It suggests the same hormone deficiency which causes severe menopausal symptoms also lowers the chances of developing a tumour.
It is estimated that women who suffer several hot flushes a day during the menopause have up to 40 per cent less oestradiol – a form of the hormone oestrogen. Oestrogen is known to play a central role in the development of some types of breast cancer.
The findings, by researchers from the University of Washington and the Fred Hutchinson Cancer Research Centre, both in Seattle, will bring some comfort to thousands of women who struggle to cope with the effects of the menopause.
It occurs when the ovaries stop producing oestrogen and progesterone, another female sex hormone, usually when a woman is in her early fifties. The most common symptoms are hot flushes and sweating attacks, affecting three in four women. Lasting three to six minutes at a time, these can happen dozens of times throughout the day.
At night, some women sweat so heavily they have to get up to change the sheets. Depression, mood swings, tiredness and headaches are also common symptoms.
The researchers, whose work was published in the journal Cancer Epidemiology Biomarkers and Prevention, recruited just over 1,000 women aged 55 to 74 who had been diagnosed with breast cancer.
Each volunteer was asked how badly they were affected by symptoms during the menopause and the results were compared with a similar sized group of cancer-free women.
Those who endured severe hot flushes, night sweats, depression and insomnia were up to 50 per cent less likely to go on to develop either an invasive lobular carcinoma or an invasive ductal carcinoma, the two most common forms of breast cancer.
In a report on their findings the researchers said: ‘This is the first study to report that women who experience menopausal symptoms have substantially reduced risk of breast cancer and that the severity of hot flushes is also inversely associated with risk. ‘A plausible explanation is that menopausal symptoms are a marker for hormonal changes relevant to the development of breast cancer.’
Every year, around 38,000 women in Britain are diagnosed with breast cancer, the equivalent of more than 100 a day. A woman has a one in nine chance of developing the disease at some point in her life.
A spokesman for Cancer Research UK said: ‘We already know hormones are linked to breast cancer risk. ‘Women who start their periods later, have more children, breastfeed, or have an early menopause have a lower risk. While it’s too soon to add menopausal symptoms to that list, more research will certainly help further our understanding of this area.’
17 January, 2011
Beauty and brains DO go together! Study claims good-looking men and women have higher IQs
Another of the many positive correlates of IQ
Handsome men and women often appear to be blessed with lucky lives. Now research has shown they are cleverer than most people as well. Studies in Britain and America have found they have IQs 14 points above average. The findings dispel the myth of the dumb blondes or good-looking men not being very bright.
It appears that those already physically blessed attract partners who are not just good looking but brainy too, according to research by the London School of Economics. The children of these couples will tend to inherit both qualities, building a genetic link over successive generations between them.
LSE researcher Satoshi Kanazawa told the Sunday Times: ''Physical attractiveness is significantly positively associated with general intelligence, both with and without controls for social class, body size and health. 'The association between attractiveness and general intelligence is also stronger among men than among women.'
In other research on social standing, he found that middle-class girls tended to have higher IQs than their working- class counterparts.
Among the millions of examples of beauty and brains, there's supermodel Lily Cole who went to Cambridge University, actress Kate Beckinsale, an Oxford graduate, and physicist Brian Cox, one-time keyboard player with D:ream.
In Britain, the study found that men who are physically attractive had IQs an average 13.6 points above the norm while women were about 11.4 points higher.
Kanazawa's findings were based on the National Child Development Study which followed 17,419 people since their birth in a single week in March, 1958. Throughout their childhood up to early adulthood, they were given a series of tests for academic progress, intelligence and marked on appearance.
The American research was taken from the National Longitudinal Study of Adolescent Health which involved a similar study of 35,000 young Americans.
Kanazawa, whose paper was published in the academic journal Intelligence, said: 'Our contention that beautiful people are more intelligent is purely scientific. It is not a prescription for how to treat or judge others.'
Brazilian mothers benefit from vitamin pills
Brazil is a poor country. The pills may have helped make up for nutritional deficiencies
A capsule containing a cocktail of essential oils and vitamins could make PMS less painful for millions of women – not to mention the men in their lives. In tests, the natural supplement cut monthly symptoms by up to two-thirds, with minimal side-effects.
It is thought the pills, which contain a mixture of healthy fats and vitamin E, make the body less sensitive to a hormone blamed for much of the misery of pre-menstrual syndrome.
In a study, 120 women were asked to rate the severity of the bloating, tiredness and aches and pains that often beset them in the days leading to menstruation.
Eighty were then prescribed pills containing varying doses of a trio of polyunsaturated fatty acids and vitamin E, which is found in nuts, seeds and green vegetables. Forty women were given packs of dummy pills.
All were told to take two capsules before bedtime each night leading up to their period and asked to rate their symptoms after three months and again at six months.
Those taking the essential oils experienced a clear easing of symptoms after three months. By six months the effects were dramatic, especially among those taking the highest doses.
In some of these cases the severity of symptoms fell by more than two-thirds, the journal Reproductive Health reports. Side-effects were rare, with one woman experiencing stomach ache and another’s period starting later than usual.
The researchers, from the Federal University of Pernambuco, in Brazil, believe the contents of the capsules make the body less sensitive to prolactin, a hormone blamed for fluid retention and breast tenderness.
Reacting to the study, Nick Panay, a consultant gynaecologist, questioned whether the capsules would relieve psychological symptoms such as mood swings or low self-esteem. But he added: ‘It sounds encouraging and it is good to see that people are doing proper trials.’
16 January, 2011
F.D.A. Plans New Limits on Painkillers
I think that the medicine that people are allowed to use should be a matter solely between the patient and his doctor -- so I oppose bans on the whole.
Nonetheless there is something to be said for the actions mentioned below. There seems to be something of a fad for medical practitioners to recommend paracetamol-based pain relievers -- with the general impression being that it is "safe".
It is anything but. Nothing is completely safe but the side-effects of aspirin are rarely catastrophic -- unlike paracetamol (acetaminophen).
Banning paracetamol in prescription drugs but not in over-the-counter drugs is of course ludicrous -- the sort of thing one expects from a bureaucracy -- but as a signal to slow down the paracetamol bandwagon it should be useful nonetheless
The government announced Thursday that it would sharply restrict some of the nation’s most popular prescription painkillers, saying they cause many patients to poison themselves with overdoses of the drug acetaminophen.
The decision by the Food and Drug Administration fell short of the ban on pills like Percocet and Vicodin recommended by an advisory panel in 2009. Instead, manufacturers of these drugs, which combine narcotics with acetaminophen, have three years to reformulate them or stop making them altogether.
Under the new limit, the pills may contain no more than 325 milligrams of acetaminophen — less than half the amount found in many of them now.
The action does not apply to over-the-counter pills like Extra Strength Tylenol, which also have more than 325 milligrams of acetaminophen and which the advisory panel also recommended banning. But more actions could be ahead, officials said.
The F.D.A. will require more explicit warning labels on the prescription medicines about the risk of overdosing with acetaminophen. “F.D.A. is taking this action to make prescription combination pain medications containing acetaminophen safer for patients to use,” said Dr. Sandra Kweder, deputy director of the agency’s new drug office.
Acetaminophen, which relieves pain and fever and is also known as paracetamol and APAP, is one of the world’s most popular medicines. In 2005, Americans bought 28 billion doses of remedies that contained it. And drugs that combine acetaminophen with opioids like codeine, oxycodone and hydrocodone are prescribed more than 200 million times each year.
The problem, the drug agency said, is that many patients, unaware of the pills’ acetaminophen content, also take over-the-counter painkillers like Tylenol, exposing themselves to side effects that can be life-threatening.
Even recommended doses of acetaminophen can cause liver damage in some people. More than 400 people die and 42,000 are hospitalized every year in the United States from overdoses. Often the overdose results when a patient takes one acetaminophen-based medicine for back pain, another for migraines, and perhaps a third for cough and cold symptoms.
Federal drug regulators have tried for decades to cut down on acetaminophen’s toll, but little changed until June 2009, when the F.D.A.’s panel of experts voted by a bare majority to call for a ban on drugs that combine acetaminophen with narcotics.
Dr. Kweder said Thursday that a ban would have meant “disruption for patients in pain” and that the 325-milligram limit would not weaken the medicines’ painkilling power. “We don’t believe we’re making these products less effective,” she said. “The amount of acetaminophen in these products has gradually crept up over the years.”
Dr. John Markman, director of the Neuromedicine Pain Management Center at the University of Rochester Medical Center, applauded the decision and said an outright ban would have led patients to take other, equally risky drug combinations. Now the F.D.A. will be able to study whether this more moderate step prevents drug-induced liver injuries.
But Dr. William M. Lee, a professor of internal medicine at Southwestern Medical School in Dallas, said he hoped the F.D.A. would eventually ban the combined pain medicines like Percocet and Vicodin because patients in chronic pain end up taking more and more of the pills as they gain tolerance of the opioid component, not realizing that the resulting higher doses of acetaminophen are dangerous.
Half of all acetaminophen overdoses are in patients taking prescription medicines, and many over-the-counter medicines will soon contain more acetaminophen than prescription pills.
The agency has delayed action against the over-the-counter remedies, which would require a far more time-consuming and burdensome regulatory process than the one for prescription pills. “We have not made a decision about what action or actions to take with regard to over-the-counter products,” Dr. Kweder told a news conference. “We’re continuing to consider our options along that line.”
While waiting for the F.D.A. to decide whether and how to act, drug manufacturers “can voluntarily choose not to make the extra strength” formulations, Dr. Kweder said.
But Marc Boston, a spokesman for Johnson & Johnson, said Extra Strength Tylenol and other high-dose formulations provided “many consumers with a safer alternative to other pain medicines.”
Dr. Sidney Wolfe, director of Public Citizen’s health research group, said the government’s inaction against high-dose, over-the-counter pills was inexcusable. “It’s been a year and a half since the advisory meeting,” he said. “What are they doing?”
Abbott Laboratories manufacturers Vicodin with doses of acetaminophen at 500, 650 and 750 milligrams — all of them over the new limit. “Abbott is evaluating the F.D.A.’s guidance and will determine how best to comply,” said Elizabeth Hoff, a company spokeswoman.
A strong handshake predicts a healthy old age?
It appears to among Japanese Hawaiians anyway. That strength and health should go together is not inherently a surprise, however and the odds ratio was rather higher than what we see in most epidemiological studiesMidlife Hand Grip Strength as a Predictor of Old Age Disability
By Taina Rantanen et al.
Context: Poor muscle strength, functional limitations, and disability often coexist, but whether muscle strength during midlife predicts old age functional ability is not known.
Objective: To determine whether hand grip strength measured during midlife predicts old age functional limitations and disability in initially healthy men.
Design and Setting: A 25-year prospective cohort study, the Honolulu Heart Program, which began in 1965 among Japanese-American men living on Oahu, Hawaii.
Participants: A total of 6089 45- to 68-year-old men who were healthy at baseline and whose maximal hand grip strength was measured from 1965 through 1970. Altogether, 2259 men died over the follow-up period and 3218 survivors participated in the disability assessment in 1991 through 1993.
Main Outcome Measures: Functional limitations including slow customary walking speed (≤0.4 m/s) and inability to rise from a seated position without using the arms, and multiple self-reported upper extremity, mobility, and self-care disability outcomes.
Results: After adjustment for multiple potential confounders, risk of functional limitations and disability 25 years later increased as baseline hand grip strength, divided into tertiles, declined. The odds ratio (OR) of walking speed of 0.4 m/s or slower was 2.87 (95% confidence interval [CI], 1.76-4.67) in those in the lowest third and 1.79 (95% CI, 1.14-2.81) in the middle third of grip strength vs those in the highest third. The risk of self-care disability was more than 2 times greater in the lowest vs the highest grip strength tertile. Adding chronic conditions identified at follow-up to the models predicting disability reduced the ORs related to grip strength only minimally.
Conclusions: Among healthy 45- to 68-year-old men, hand grip strength was highly predictive of functional limitations and disability 25 years later. Good muscle strength in midlife may protect people from old age disability by providing a greater safety margin above the threshold of disability.
15 January, 2011
Exercise may not outweigh health effects of "couch potato" recreation
A slightly more sophisticated repeat of some boring old epidemiological rubbish. It probably just shows that people who are not very well or not very vigorous do not exercise much. I suppose it's some comfort that they realized that but controlling for it needs almost Godlike knowledge. Epidemiology just does not enable causative inferences. You need double-blind studies
Spending too much leisure time in front of a TV or computer screen appears to dramatically increase the risk for heart disease and premature death from any cause, perhaps regardless of how much exercise one gets, according to a new study.
The analysis found that people who spend more than four hours daily on screenbased entertainment like TV, computer or videogames are more than twice as likely to have a "major cardiac event" involving hospitalization, death or both compared to people who spend less than two hours on such activities.
The research is published in the Jan. 18 issue of the Journal of the American College of Cardiology. Billed as the first study to examine the association between screen time and nonfatal as well as fatal cardiovascular events, it also suggests metabolic factors and inflammation may partly explain the link between prolonged sitting and the risks to heart health.
"People who spend excessive amounts of time in front of a screen primarily watching TV are more likely to die of any cause and suffer heartrelated problems," said Emmanuel Stamatakis of University College London, who led the research. "Our analysis suggests that two or more hours of screen time each day may place someone at greater risk for a cardiac event."
Compared with those spending less than two hours a day on screenbased entertainment, the study found a 48 percent increased risk of allcause mortality in those spending four or more hours a day and a roughly 125 percent increase in risk of cardiovascular events in those spending two or more hours a day. These associations were independent of traditional risk factors such as smoking, hypertension, excess weight, social class, as well as exercise.
The findings have prompted authors to advocate for public health guidelines that expressly address "recreational sitting" especially as a majority of working age adults spend long periods inactive while commuting or slouched over a desk or computer.
"It is all a matter of habit. Many of us have learned to go back home, turn the TV set on and sit down for several hours it's convenient and easy to do. But doing so is bad for the heart and our health in general," said Stamatakis. "And according to what we know so far, these health risks may not be mitigated by exercise."
Stamatakis said the next step will be to try to uncover what prolonged sitting does to the human body in the short and longterm, whether and how exercise can mitigate these consequences, and how to alter lifestyles to reduce sitting and increase movement and exercise.
The study included 4,512 adults who were respondents of the 2003 Scottish Health Survey, a representative, household-based survey, researchers said. A total of 325 all-cause deaths and 215 cardiac events occurred during an average of 4.3 years of follow up.
Measurement of "screen time" included selfreported TV and DVD watching, videogaming, as well as leisure-time computer use.
The authors also said they took steps to rule out the possibility that ill people spend more time in front of the screen as opposed to the other way around. The authors excluded those who reported a previous cardiovascular event and those who died during the first two years of follow up just in case their underlying disease might have forced them to stay indoors and watch TV more often. Stamatakis and his team also adjusted analyses for [some] indicators of poor health, such as diabetes and hypertension.
NJ: Appeal lost in Denny’s sodium case
A state appeals court has shot down an appeal by a Tinton Falls man who tried suing Denny's restaurant chain over its sodium content.
Nick DeBenedetto, 49, filed a lawsuit claiming the chain wasn't upfront about the high-sodium content of its food. The appeals court upheld a lower court's dismissal of the case.
The three-judge appeals panel found that DeBenedetto couldn't prove Denny's had a defective or dangerous product, or that he was harmed.
DeBenedetto says he was being treated for hypertension and ate at Denny's about 10 times in the year before he filed the lawsuit.
New Jersey Press Media reports that a health, nutrition and food-safety advocacy group represented him in court.
14 January, 2011
U-turn on when to stop breast-feeding
Mothers are being warned that breastfeeding exclusively for six months may not be best for their babies and could put them at risk of allergies, food aversion and even obesity.
New research, which contradicts nearly a decade of official advice, says babies can be safely given solid foods at least eight weeks earlier in life.
British researchers have questioned guidelines issued in 2001 by the World Health Organisation – and supported by the Department of Health in 2003 – which told women to breastfeed for the first six months before giving solid foods to babies. Based on WHO ‘global recommendations’, the aim was to help children worldwide avoid allergies and gastroenteritis.
But experts led by a paediatrician from University College London’s Institute of Child Health now claim the policy may actually have increased the risk of babies suffering allergies and iron deficiency. In addition, it could deter children from eating foods with bitter tastes that are good for them, fuelling the rise in obesity.
The new study in the British Medical Journal has sparked controversy, with the Royal College of Midwives claiming it can only benefit the baby food industry. But other breastfeeding specialists welcomed the ‘common sense’ findings that many mothers instinctively follow despite feeling guilty about ignoring official advice.
The Department of Health last night stuck by the old guidelines, but admitted it has asked a panel of scientists to consider all the evidence and report back this year.
The new study says that when the WHO edict came out in 2001, many Western countries, including two out of three European nations, and the U.S. chose to ignore it. But in 2003, Britain agreed to comply with the recommendation, which sprang from a review of 16 studies. They included seven from developing countries and the remainder from developed countries which were of ‘variable quality’. The conclusion was that babies given breast milk alone for six months had fewer infections.
But another review of 33 studies carried out at the same time found ‘no compelling evidence’ against introducing solids at four to six months, known as weaning. There is growing evidence that breastfeeding alone for six months does not give babies all the nutrition they need, with some becoming iron deficient. Babies fed on formula milk get extra iron, but they too are exposed to other drawbacks of late introduction of solid foods.
The new study says Swedish research links problems with tolerating gluten to a delay in eating it until six months – with the ideal wait being four to six months.
Professor Mary Fewtrell, who led the research team, said: ‘Perhaps the Department of Health might conclude similarly were it to commission an objective, independent review of the evidence.’
Clare Byam-Cook, an independent breastfeeding counsellor and former midwife, said: ‘The findings are long overdue because there is no evidence to show harm from introducing solids at three months or if the baby is over 12 pounds in weight.’
But Janet Fyle, policy adviser at the Royal College of Midwives, said changing official advice would be a retrograde step that ‘plays into the hands of the baby food industry’. She said there was ‘irrefutable evidence’ that breast milk confers many health benefits on babies that last a lifetime.
A spokesman for the Department of Health said: ‘Mothers who wish to introduce solids before six months should always talk to health professionals first.’
Magic bean? Soya could help to fight two cancers
The first study was too small to get excited about and the second was epidemiological specualtion
Soya could boost the battle against prostate and breast cancer, scientists believe. The potential health benefits of the bean have been highlighted in two separate studies.
In one, researchers from Northwestern University, Chicago, found that one pill a day of genistein, a natural isoflavone chemical in soya, seemed to slow or stop the spread of prostate cancer.
Although it was tested on a small group of only 38 men, scientists say the results could lead to the first non-toxic treatment that prevents cancer cell movement.
Professor Raymond Bergan said: ‘The first step is to see if the drug has the effect that you want on the cells and the prostate, and the answer is yes, it does. ‘If this drug can effectively stop prostate cancer from moving in the body, theoretically a similar therapy could have the same effect on the cells of other cancers. 'This could be the first therapy for any cancer that is non-toxic and targets and inhibits cancer cell movement.'
In the second study, of almost 1,300 women, researchers from the University at Buffalo, New York, showed isoflavones from soya can reduce the risk of developing breast cancer. Researcher Anne Weaver found those with the highest isoflavone intake had a 30 per cent lower risk of an invasive breast tumour and a 60 per cent lower risk of a low-grade tumour.
Ms Weaver and colleagues evaluated 683 women with breast cancer and compared them with 611 healthy women. She said: 'Like most dietary studies, these findings are not definitive and need to be considered in the context of further follow-up and confirmation. 'Still, we definitely saw a reduction that deserves further investigation.'
13 January, 2011
Feds propose decrease of fluoride in water
The addition of fluoride to drinking water has been considered one of the great public health advancements of the 20th century. But with fluoride now in nearly every over-the-counter product related to oral hygiene, the US Department of Health and Human Services is now calling for a reduction in fluoride levels in drinking water. The reason? We're now getting too much fluoride, and that's leading to splotches on the teeth of children and other possible health problems.
The splotches, known as fluorosis, appear to be common among adolescents, and the condition has increased among them since the 1980s. Approximately 40 percent of children between the ages of 12 and 15 have it. Fluorosis, which causes slight pitting in the teeth, is a cosmetic condition that's usually only noticed by dentists. But the feds aren't calling for reduction in fluoride levels solely because of splotchy teeth.
Two new reviews of fluoride by the EPA yesterday link high intakes of fluoride over time to brittle bones, fractures and bone abnormalities. the new proposal from HHS calls for fluroide levels to be at 0.7 parts per million. Currently it can be anywhere from 0.7 to 1.2 parts per million, depending on climate. Maybe for those who still consider fluoridation of water a Communist plot, it will also lead to a return of their essence.
How high-pitched music could cure tinnitus by 're-booting' the brain
Colour me skeptical. I think the problem is entirely located in the inner ear
Scientists may have developed a cure for tinnitus, the persistent ringing in the ears that blights the lives of hundreds of thousands of Britons. In tests, researchers were able to stop the irritating noises by stimulating a nerve in the neck while playing a high-pitched tone into the ears.
The technique – which ‘reboots’ the brain – has been successfully tested on rats. Clinical trials on humans are due to start in the next few months.
Around one in ten adults in the UK suffers from permanent tinnitus and around 600,000 have it badly enough to affect their quality of life. It can affect one or both ears and is usually described as a ringing noise, although it can also take the form of high pitched whines, rattling, low beeps or a rushing sound.
Tinnitus is often triggered by exposure to loud noise, which destroys cells in the inner ear that transmit sound signals to the brain.
Scientists believe the brain tries to compensate for the missing signals, leading to phantom sounds. Other causes of tinnitus include injury and normal ageing.
The American researchers carried out experiments on tinnitus-affected rats designed to trigger changes in the ‘auditory cortex’ – the part of the brain that responds to sound.
By electrically stimulating the vagus nerve – a large nerve running from the head and neck to the abdomen – with a small electrode at the same time as playing a high-pitched sound, they banished tinnitus from the rats.
Treated rats showed responses that indicated the ringing in their ears had stopped, the journal Nature reported yesterday. Animals that did not receive the therapy continued to display signs of tinnitus.
Study leader Dr Michael Kilgard, from the University of Texas at Dallas, said: ‘The key is that, unlike previous treatments, we’re not masking tinnitus, we’re not hiding the tinnitus.
We are retuning the brain from a state where it generates tinnitus to a state that does not generate tinnitus. We are eliminating the source of the tinnitus.’
When the vagus nerve is stimulated it releases chemicals that can alter brain circuitry. Patients taking part in the human trial in Europe will undergo vagus nerve stimulation paired with sounds at daily treatment sessions over several weeks.
The stimulation will be delivered by a wireless electrode surgically attached to the left vagus nerve. The device was developed by MicroTransponder, a U.S. biotech firm.
12 January, 2011
Ibuprofen (Nurofen) as dangerous as banned Vioxx -- i.e. only in rare cases
The search for a safe painkiller is a chase after a chimera
Large regular doses of ibuprofen and similar painkillers could treble the risk of strokes and increase the likelihood of heart attacks, researchers are warning.
Scientists have found high doses of ibuprofen may carry a similar health risk to painkillers that were withdrawn from the market several years ago on safety grounds.
Up to eight million Britons are prescribed so-called anti-inflammatory drugs every year, usually to combat arthritis or back pain.
Doctors stress that the stroke and heart risks only exist for those taking high doses of ibuprofen over long periods – and there is no danger in the odd pill for a headache, for example.
Researchers from the University of Bern in Switzerland looked at more than 31 clinical trials involving 116,429 patients.
They had each taken one of seven commonly-used painkillers, The study, published in the British Medical Journal, found that those who had taken ibuprofen over a long period of time were almost three times as likely to suffer a stroke.
The painkiller was also shown to raise significantly the risk of heart attacks and deaths caused by heart disease.
Nurofen has ibuprofen as its active ingredient: 'Only take when genuinely necessary' say doctors
Nurofen has ibuprofen as its active ingredient: 'Only take when genuinely necessary' say doctors
Another commonly prescribed pill, diclofenac, which is also sold under the trade name Rhumalgan, was shown to almost treble the risk of strokes and increase the likelihood of heart disease related death by four times.
The study also suggested that ibuprofen carried a similar risk of stroke and death from heart disease to rofecoxib, also known as Vioxx, which was withdrawn from the market in 2004 over safety concerns.
Professor Peter Jüni, of the University of Bern, said: ‘We looked at patients taking these drugs three to four times a day.
‘They were mainly being treated for osteoarthritis with a few who had rheumatoid arthritis. A lot of them are elderly who are already have lots of risk factors and these will then be duplicated with these painkillers.
‘In terms of stroke, ibuprofen doesn’t look very good. If I was in chronic pain I would not take it as the risks are just too high. I would look at the different options.’
But researchers say those at risk would have to be taking three or four pills a day – a dose of up to 2,000mg – for several months or even years.
Professor Simon Maxwell, chairman of the British Pharmacological Society’s Prescribing Committee, said the finding should be taken in context.
He added: ‘Most users of these drugs will only take them for a relatively brief duration to treat short-lasting episodes of pain and are at minimal risk.’
Doubts about a "miracle" molecule creeping in
About time the resveratrol craze died down
The pharmaceutical company Sirtris announced last month that it had halted the last of its clinical trials of resveratrol, the minor ingredient of red wine that some researchers see as a drug that can extend life.
The decision signifies an apparent divergence of views on the merits of resveratrol between the current head of the company, which was bought by GlaxoSmithKline in 2008 for $720 million, and its founders.
George Vlasuk, Sirtris’s chief executive, said in an interview last week that SRT501, Sirtris’s formulation of resveratrol, “was not an important part of the acquisition of Sirtris by GSK.” Resveratrol has several features that make it unsuitable as a drug, he said. These include the fact that it is hard to maintain a consistent level of resveratrol in the bloodstream and that it seems to have different effects at different doses.
Resveratrol is thought to work in humans by activating a protein called SIRT1, but at some doses it actually inhibits SIRT1, Dr. Vlasuk said.
In addition, from a commercial point of view, resveratrol is a natural substance and not patentable.
Glaxo’s purchase of Sirtris, Dr. Vlasuk said, was more because the company afforded an entry into a new research field, and had developed several small, synthetic, patentable chemicals that mimic resveratrol in activating SIRT1. SIRT1 is thought to extend life in mice fed low-calorie diets, and researchers hope it may do the same in people by enhancing tissue maintenance and postponing the usual diseases of age.
Sirtris has completed three clinical trials with its synthetic resveratrol-mimicking drugs and will announce the results next year. These drugs work fairly specifically on SIRT1, unlike resveratrol, which also affects many other processes in the cell. “We have much more confidence that we are targeting SIRT1 and that it’s an important target. Resveratrol is not that important any more,” Dr. Vlasuk said.
But the co-founders of Sirtris, David Sinclair and Christoph Westphal, retain their confidence in resveratrol. Dr. Sinclair, a researcher at the Harvard Medical School, has long taken resveratrol. Referring to the unpublished results of a new trial with rhesus monkeys, he said that resveratrol “was and remains an excellent proof-of-concept molecule.”
Dr. Westphal said he believed there is accumulating evidence that resveratrol and Sirtris’s resveratrol-mimicking chemicals activate SIRT1, and that sirtuin-activating drugs have beneficial effects in animal and human studies.
Based on preliminary data about the synthetic drugs tested by Sirtris, “I’m as optimistic about the science and the potential of sirtuin activators as I’ve ever been,” Dr. Sinclair said. Sirtuin is the name of a family of proteins of which SIRT1 is the most important. Humans have seven sirtuins, all with different roles.
The rhesus monkey trial has been conducted by Rafael de Cabo, a researcher at the National Institute on Aging. It is similar to a study on mice in which he and Dr. Sinclair showed resveratrol extended the life of obese mice fed on a high-fat diet, but not of normal mice. Even the normal mice, however, showed some improvement on measures of heart function and bone loss. Dr. de Cabo said he could not discuss the results of the study until it is published. It looked at various markers of disease but did not try to assess resveratrol’s effect on longevity, given that rhesus monkeys live 40 years and it takes a long time assess any effect on life span.
“Resveratrol is a complex molecule in that it has many targets, and it behaves differently depending on the tissue and the metabolic status of the organism,” Dr. de Cabo said. That may make it too complex for a pharmaceutical company, which must prove to the Food and Drug Administration that a new drug works by a defined mechanism on a specific target. But resveratrol remains of great interest to researchers. “What is the actual use for humans still needs to be discovered,” he said.
Dr. de Cabo said he does not take resveratrol. “I don’t think it’s a reasonable thing for people to start consuming these compounds without more information,” he said.
11 January, 2011
Futile fight against fat
On New Year’s Day, as the Victorian and Northern Territory governments followed NSW, WA and the ACT by implementing laws preventing cigarettes from being put on display to the public, the Australian Medical Association (AMA) called for a $25 million TV and newspaper advertising campaign showing “damaged vital organs or people drinking liquefied body fat” to shock Australians into giving up junk food and sugary soft drinks.
The good doctors based their call upon a belief that the fear-based advertising campaigns used by the TAC (in Victoria) and Quit have been effective in changing behaviour around driving and smoking. The mistake that they are making is that there is much more to the change of behaviour in relation to driving and smoking than the shock advertisements that have formed part of these long social marketing campaigns.
The advertisements that the AMA are suggesting are based on similar advertisements launched by the New York Health Department in October, 2010, highlighting how much sugar is in a bottle of soft drink. A video that was released as part of the "Pouring on the Pounds" campaign aimed to “educate New Yorkers about the potentially serious health effects of consuming sugary drinks.”
One of the videos in the campaign showed a man drinking fat poured from a soft drink can with the tag saying, “drinking one can of soda a day, can make you 10 pounds fatter a year,” while another showed a man consuming sixteen packets of sugar to demonstrate the amount of sugar in an average-sized soft drink.
And at the far end of the obesity shock spectrum, a viral execution called “Break the Habit” developed as a community service by The Precinct Studio in October, 2010, featured a mother preparing to inject her son with heroin before the scene changed to show him eating a hamburger. The end tag read, “You wouldn’t inject your children with junk, so why are you feeding it to them?”
At face value, and amongst those who think that consumers are rational, thoughtful creatures that just need to be reminded of their vices to persuade them to change their behaviour, this seems like a reasonable approach.
Frighten the masses. Give 'em the facts. Change their behaviour.
But shock advertising, on its own, is unlikely to have the desired effect of getting people to stop eating junk food and eating more healthily. Research in marketing and consumer behaviour suggests that some forms of shock advertising can have the opposite effect of increasing attitudinal loyalty to the brand or the product category, particularly amongst regular users. One explanation is related to the need for the ego to protect itself against any attacks on previous decision-making, thus avoiding or combating feelings of guilt. Advocacy groups need to recognise that shock for its own sake does not change behaviour. An emotional creative execution is useful, because it helps the brain to form memory connections when our emotions are heightened, but we need to be careful not to activate the “reject” or flight response.
In a paper published in April 2010 in the Journal of Marketing Research, Nidhi Agrawal and Adam Duhachek found ads that were designed to trigger guilt amongst the target market actually triggered a defensive processing mechanism. This mechanism, they argued, was explained by the notion that people tend to think things will go much better for them than for the average person. In other words, we think our own personal greatness buffers us from all potential negative consequence, whether it’s driving, smoking, or eating junk food
Futile fight against alcohol
This wasn't just a meal deal. This was a Marks & Spencer meal deal - without alcohol. Yet when the High Street giant trialled the new version of its hugely popular Dine In For Two for œ10 offer with better quality food, but without the usual bottle of wine thrown in, it seems customers were just not interested. Instead of snapping up the deals as usual, the normally loyal shoppers took their business elsewhere, and some even spoke up about their outrage.
Now the trial has come to an end, and Marks and Spencer has no plans to repeat it - promising that the 'Dine In' offer will continue, but with a bottle of wine option included as standard.
The experiment, which was carried out in a handful of stores over the New Year, came after a series of attacks on shops for encouraging heavy drinking by offering cheap alcohol. But middle class Britons have evidently shown that they remain a pushover for bargain booze, in spite of the warnings of experts.
The Dine In For Two offer was launched in 2008 as growing recession made many consumers think twice about eating out in restaurants. In response, Marks and Spencer began offering couples a choice of ready meals for two and a side dish, along with a dessert and bottle of wine, all for œ10.
Although customers are offered a soft drink as an alternative to the wine, campaigners against alcohol abuse raised questions - and over the New Year, the trial alternative without any alcohol was tested. The new version offered upgraded gourmet ready meals - rather than the standard ready meals usually offered, as well as the usual side dish and dessert. But without the customary bottle of wine.
According to the industry magazine The Grocer, feedback on the re-jigged deal on the internet consumer forum Money Saving Expert was overwhelmingly negative. Shoppers, it appeared, feared that the popular promotion was set to change for good - and deprive them of their bottle of wine. One shopper said: 'I saw the poster in-store and thought I had misread it when I could not see the wine listed. 'Such a shame. I regularly bought the Dine In meal but it doesn't seem like such a good deal now.'
Another shopper wrote: 'Haha, this won't wash with me. No wine, no deal. Think again M&S!" A third added: 'I definitely won't be buying again. Without the wine there is no way I'd bother.'
Marks & Spencer Food business development head Jill Bruce told The Grocer the usual offer had been tinkered with as a 'test'. 'We were keen to see if Dine In could work during the festive holiday peak and if the meal offered at this time should be more special,' she said. 'To test this out, a small number of stores ran some different menus.'
She said that they had trialled more premium food options without wine as M&S had received feedback from some customers that they would prefer to choose their own wine. However she insisted: 'We have no plans to change what is a very successful promotion and will have another Dine In event in-store from January 13 with the usual combination of main, side, dessert and wine or a soft drink.'
The Dine In deal has been credited with turning round the fortunes of M&S food, and has been copied by leading High Street rivals including Waitrose and Sainsbury's.
But there have been criticisms. Last October the British Liver Trust claimed such deals should carry health warnings, as they encouraged heavy drinking among middle-aged professionals - yet were promoted in sections of stores away from the alcohol department. The charity made its claim as official statistics showed 22 per cent of the middle classes drink at least five days a week - compared to just 11 per cent of manual workers.
British Liver Trust spokeswoman Sarah Matthews said: 'These meal deals are prominently advertised and make regular drinking at that level seem like a perfectly acceptable everyday habit. They are totally wrong.' 'If a couple share a bottle of wine every night, the woman would be more than double her limit by the end of the week and the man would also be way over.'
And in September, a Scottish National Party member of the Scottish Parliament proposed making it illegal to artificially discount alcohol by combining it with food items. 'I do not believe alcohol should be used as a promotional device at all,' he said.
10 January, 2011
Australian consumer group slams "nutrient" drinks
CHOICE is stepping up the campaign against vitamin water drinks, describing them as "expensive lolly waters" with hyperventilated health claims". Some contain a third of a woman's recommended daily sugar intake in one 500ml bottle.
The consumer advocate CHOICE first complained to the Australian Competition and Consumer Commission (ACCC) in 2008 that Coca Cola Amatil's Glaceau Vitamin Water made a mockery of food labeling laws, but the complaint was rejected. Since that time the market has been flooded with similar products such as Nutrient Water and Smart Water.
CHOICE spokeswoman Ingrid Just said Nutrient Water claimed its Cranberry Grapefruit Multi-Vitamin Water drink offered the same benefits as eight hours sleep, a bowl of steamed greens and pre-dawn power walks.
She said it was time to "get tough on potentially misleading promotions and labelling", such as 'nature approved ingredients' and 'natural flavours', "which mean nothing". "This type of labelling creates the impression that the drinks can be used as a safety net for a poor lifestyle when grabbing an apple and a glass of water will provide you with far more nutrients for a fraction of the cost," she said.
A spokesman for the ACCC would "neither confirm nor deny whether any investigations are underway". However recent actions include labeling changes for Sanitarium breakfast cereals and National Foods juices.
The ACCC was concerned that Berri Australian Fresh "Daily Juice" packaging suggested that it only contained juice that was recently squeezed, when in fact the products within this range may contain either fresh juice or a blend of fresh juice and aseptically stored juice. Sanitarium packaging suggested certain breakfast cereals contained more fruit than was actually the case.
CHOICE has called for the ACCC to take another look at the way vitamin waters are marketed. "These drinks are leading consumers up an imaginary garden path to health and vitality," Ms Just said. "Treat them like any other sugary or artificial drink; enjoy occasionally, not as a means to any kind of wellbeing whatever the label or pretty pictures might suggest."
Prozac 'gives movement back to stroke victims left paralysed'
Taking the antidepressant Prozac may help restore movement in stroke victims and reduce paralysis, according to the largest study of its kind. The drug may aid recovery after a stroke whether patients are depressed or not, researchers found.
They said the beneficial effect of selective serotonin re-uptake inhibitors (SSRIs), the class of drug that includes Prozac, is independent of the effect on depression, a common response to having a stroke. The pills boost serotonin levels and other compounds in the central nervous system which, it is thought, improves nerve growth.
The study investigated the use of SSRIs in stroke after mounting evidence from smaller trials that they improve motor and cognitive functions.
At around £5 for a month's supply, Prozac's cheapness could lead to its widepread use in this area, the researchers added. The team from the University Hospital of Toulouse looked at 118 patients five to ten days after a stroke. Half were given 20mg of Prozac, while the others got a dummy pill. All patients, who had moderate to severe movement problems, also received physiotherapy.
Greater improvements in motor function were found after three months in patients on Prozac, with a 50 per cent increase in scores used to measure recovery, said a report published online in The Lancet Neurology. Importantly, this gain was significant for both the upper and lower limbs, as paralysis and weakness on one side of the body are the most common disabilities left after a stroke. Depression was significantly less common in patients on Prozac, suggesting it could prevent the condition if given early after a stroke, said lead researcher Professor Francois Chollet. He added: `The positive effect of the drug on motor function of recovering patients suggests that the action of SSRIs provides a new pathway that could be explored further in the treatment of acute ischaemic stroke.'
In the same journal, Robert Robinson and Harold Adams from the University of Iowa said the findings raised the question of whether `most patients with motor impairments after stroke should be treated with SSRIs'. But they added that more studies were needed.
Around 150,000 people a year in the UK have a stroke, of whom a third are left with a disability such as paralysis down one side of their body.
9 January, 2011
The fragility of experimental findings
Because of the importance of the topic, I am putting up only one thing here today: A long excerpt of an article that gives many examples of initially exciting findings that fade away as people try to repeat them. Because of my career in academic research, all of the processes described below are very familar to me but they are very little known to the general public.
One thing that amuses me is that many of the findings decribed below that proved false in the long run were really strong-looking findings -- infinitely stronger than the pathetic little relative ratios usually reported in diet-related research. Skepticism is the only well-informed response to all new medical and diet-related findings
On September 18, 2007, a few dozen neuroscientists, psychiatrists, and drug-company executives gathered in a hotel conference room in Brussels to hear some startling news. It had to do with a class of drugs known as atypical or second-generation antipsychotics, which came on the market in the early nineties. The drugs, sold under brand names such as Abilify, Seroquel, and Zyprexa, had been tested on schizophrenics in several large clinical trials, all of which had demonstrated a dramatic decrease in the subjects’ psychiatric symptoms. As a result, second-generation antipsychotics had become one of the fastest-growing and most profitable pharmaceutical classes. By 2001, Eli Lilly’s Zyprexa was generating more revenue than Prozac. It remains the company’s top-selling drug.
But the data presented at the Brussels meeting made it clear that something strange was happening: the therapeutic power of the drugs appeared to be steadily waning. A recent study showed an effect that was less than half of that documented in the first trials, in the early nineteen-nineties. Many researchers began to argue that the expensive pharmaceuticals weren’t any better than first-generation antipsychotics, which have been in use since the fifties. “In fact, sometimes they now look even worse,” John Davis, a professor of psychiatry at the University of Illinois at Chicago, told me.
Before the effectiveness of a drug can be confirmed, it must be tested and tested again. Different scientists in different labs need to repeat the protocols and publish their results. The test of replicability, as it’s known, is the foundation of modern research. Replicability is how the community enforces itself. It’s a safeguard for the creep of subjectivity. Most of the time, scientists know what results they want, and that can influence the results they get. The premise of replicability is that the scientific community can correct for these flaws.
But now all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain. It’s as if our facts were losing their truth: claims that have been enshrined in textbooks are suddenly unprovable. This phenomenon doesn’t yet have an official name, but it’s occurring across a wide range of fields, from psychology to ecology. In the field of medicine, the phenomenon seems extremely widespread, affecting not only antipsychotics but also therapies ranging from cardiac stents to Vitamin E and antidepressants: Davis has a forthcoming analysis demonstrating that the efficacy of antidepressants has gone down as much as threefold in recent decades.
For many scientists, the effect is especially troubling because of what it exposes about the scientific process. If replication is what separates the rigor of science from the squishiness of pseudoscience, where do we put all these rigorously validated findings that can no longer be proved? Which results should we believe? Francis Bacon, the early-modern philosopher and pioneer of the scientific method, once declared that experiments were essential, because they allowed us to “put nature to the question.” But it appears that nature often gives us different answers.
Jonathan Schooler was a young graduate student at the University of Washington in the nineteen-eighties when he discovered a surprising new fact about language and memory. At the time, it was widely believed that the act of describing our memories improved them. But, in a series of clever experiments, Schooler demonstrated that subjects shown a face and asked to describe it were much less likely to recognize the face when shown it later than those who had simply looked at it. Schooler called the phenomenon “verbal overshadowing.”
The study turned him into an academic star. Since its initial publication, in 1990, it has been cited more than four hundred times. Before long, Schooler had extended the model to a variety of other tasks, such as remembering the taste of a wine, identifying the best strawberry jam, and solving difficult creative puzzles. In each instance, asking people to put their perceptions into words led to dramatic decreases in performance.
But while Schooler was publishing these results in highly reputable journals, a secret worry gnawed at him: it was proving difficult to replicate his earlier findings. “I’d often still see an effect, but the effect just wouldn’t be as strong,” he told me. “It was as if verbal overshadowing, my big new idea, was getting weaker.” At first, he assumed that he’d made an error in experimental design or a statistical miscalculation. But he couldn’t find anything wrong with his research. He then concluded that his initial batch of research subjects must have been unusually susceptible to verbal overshadowing. (John Davis, similarly, has speculated that part of the drop-off in the effectiveness of antipsychotics can be attributed to using subjects who suffer from milder forms of psychosis which are less likely to show dramatic improvement.) “It wasn’t a very satisfying explanation,” Schooler says. “One of my mentors told me that my real mistake was trying to replicate my work. He told me doing that was just setting myself up for disappointment.”
Schooler tried to put the problem out of his mind; his colleagues assured him that such things happened all the time. Over the next few years, he found new research questions, got married and had kids. But his replication problem kept on getting worse. His first attempt at replicating the 1990 study, in 1995, resulted in an effect that was thirty per cent smaller. The next year, the size of the effect shrank another thirty per cent. When other labs repeated Schooler’s experiments, they got a similar spread of data, with a distinct downward trend. “This was profoundly frustrating,” he says. “It was as if nature gave me this great result and then tried to take it back.” ....
The most likely explanation for the decline is an obvious one: regression to the mean. As the experiment is repeated, that is, an early statistical fluke gets cancelled out. The extrasensory powers of Schooler’s subjects didn’t decline—they were simply an illusion that vanished over time. And yet Schooler has noticed that many of the data sets that end up declining seem statistically solid—that is, they contain enough data that any regression to the mean shouldn’t be dramatic. “These are the results that pass all the tests,” he says. “The odds of them being random are typically quite remote, like one in a million. This means that the decline effect should almost never happen. But it happens all the time! Hell, it’s happened to me multiple times.”
In 2001, Michael Jennions, a biologist at the Australian National University, set out to analyze “temporal trends” across a wide range of subjects in ecology and evolutionary biology. He looked at hundreds of papers and forty-four meta-analyses (that is, statistical syntheses of related studies), and discovered a consistent decline effect over time, as many of the theories seemed to fade into irrelevance. In fact, even when numerous variables were controlled for—Jennions knew, for instance, that the same author might publish several critical papers, which could distort his analysis—there was still a significant decrease in the validity of the hypothesis, often within a year of publication. Jennions admits that his findings are troubling, but expresses a reluctance to talk about them publicly. “This is a very sensitive issue for scientists,” he says. “You know, we’re supposed to be dealing with hard facts, the stuff that’s supposed to stand the test of time. But when you see these trends you become a little more skeptical of things.”
What happened? Leigh Simmons, a biologist at the University of Western Australia, suggested one explanation when he told me about his initial enthusiasm for the theory: “I was really excited by fluctuating asymmetry. The early studies made the effect look very robust.” He decided to conduct a few experiments of his own, investigating symmetry in male horned beetles. “Unfortunately, I couldn’t find the effect,” he said. “But the worst part was that when I submitted these null results I had difficulty getting them published. The journals only wanted confirming data. It was too exciting an idea to disprove, at least back then.” For Simmons, the steep rise and slow fall of fluctuating asymmetry is a clear example of a scientific paradigm, one of those intellectual fads that both guide and constrain research: after a new paradigm is proposed, the peer-review process is tilted toward positive results. But then, after a few years, the academic incentives shift—the paradigm has become entrenched—so that the most notable results are now those that disprove the theory.
Jennions, similarly, argues that the decline effect is largely a product of publication bias, or the tendency of scientists and scientific journals to prefer positive data over null results, which is what happens when no effect is found. The bias was first identified by the statistician Theodore Sterling, in 1959, after he noticed that ninety-seven per cent of all published psychological studies with statistically significant data found the effect they were looking for. A “significant” result is defined as any data point that would be produced by chance less than five per cent of the time. This ubiquitous test was invented in 1922 by the English mathematician Ronald Fisher, who picked five per cent as the boundary line, somewhat arbitrarily, because it made pencil and slide-rule calculations easier. Sterling saw that if ninety-seven per cent of psychology studies were proving their hypotheses, either psychologists were extraordinarily lucky or they published only the outcomes of successful experiments. In recent years, publication bias has mostly been seen as a problem for clinical trials, since pharmaceutical companies are less interested in publishing results that aren’t favorable. But it’s becoming increasingly clear that publication bias also produces major distortions in fields without large corporate incentives, such as psychology and ecology.
While publication bias almost certainly plays a role in the decline effect, it remains an incomplete explanation. For one thing, it fails to account for the initial prevalence of positive results among studies that never even get submitted to journals. It also fails to explain the experience of people like Schooler, who have been unable to replicate their initial data despite their best efforts. Richard Palmer, a biologist at the University of Alberta, who has studied the problems surrounding fluctuating asymmetry, suspects that an equally significant issue is the selective reporting of results—the data that scientists choose to document in the first place. Palmer’s most convincing evidence relies on a statistical tool known as a funnel graph. When a large number of studies have been done on a single subject, the data should follow a pattern: studies with a large sample size should all cluster around a common value—the true result—whereas those with a smaller sample size should exhibit a random scattering, since they’re subject to greater sampling error. This pattern gives the graph its name, since the distribution resembles a funnel.
The funnel graph visually captures the distortions of selective reporting. For instance, after Palmer plotted every study of fluctuating asymmetry, he noticed that the distribution of results with smaller sample sizes wasn’t random at all but instead skewed heavily toward positive results. Palmer has since documented a similar problem in several other contested subject areas. “Once I realized that selective reporting is everywhere in science, I got quite depressed,” Palmer told me. “As a researcher, you’re always aware that there might be some nonrandom patterns, but I had no idea how widespread it is.” In a recent review article, Palmer summarized the impact of selective reporting on his field: “We cannot escape the troubling conclusion that some—perhaps many—cherished generalities are at best exaggerated in their biological significance and at worst a collective illusion nurtured by strong a-priori beliefs often repeated.”
Palmer emphasizes that selective reporting is not the same as scientific fraud. Rather, the problem seems to be one of subtle omissions and unconscious misperceptions, as researchers struggle to make sense of their results. Stephen Jay Gould referred to this as the “shoehorning” process. “A lot of scientific measurement is really hard,” Simmons told me. “If you’re talking about fluctuating asymmetry, then it’s a matter of minuscule differences between the right and left sides of an animal. It’s millimetres of a tail feather. And so maybe a researcher knows that he’s measuring a good male”—an animal that has successfully mated—“and he knows that it’s supposed to be symmetrical. Well, that act of measurement is going to be vulnerable to all sorts of perception biases. That’s not a cynical statement. That’s just the way human beings work.”
According to Ioannidis, the main problem is that too many researchers engage in what he calls “significance chasing,” or finding ways to interpret the data so that it passes the statistical test of significance—the ninety-five-per-cent boundary invented by Ronald Fisher. “The scientists are so eager to pass this magical test that they start playing around with the numbers, trying to find anything that seems worthy,” Ioannidis says. In recent years, Ioannidis has become increasingly blunt about the pervasiveness of the problem. One of his most cited papers has a deliberately provocative title: “Why Most Published Research Findings Are False.”
The problem of selective reporting is rooted in a fundamental cognitive flaw, which is that we like proving ourselves right and hate being wrong. “It feels good to validate a hypothesis,” Ioannidis said. “It feels even better when you’ve got a financial interest in the idea or your career depends upon it. And that’s why, even after a claim has been systematically disproven”—he cites, for instance, the early work on hormone replacement therapy, or claims involving various vitamins—“you still see some stubborn researchers citing the first few studies that show a strong effect. They really want to believe that it’s true.”
That’s why Schooler argues that scientists need to become more rigorous about data collection before they publish. “We’re wasting too much time chasing after bad studies and underpowered experiments,” he says. The current “obsession” with replicability distracts from the real problem, which is faulty design. He notes that nobody even tries to replicate most science papers—there are simply too many. (According to Nature, a third of all studies never even get cited, let alone repeated.) “I’ve learned the hard way to be exceedingly careful,” Schooler says. “Every researcher should have to spell out, in advance, how many subjects they’re going to use, and what exactly they’re testing, and what constitutes a sufficient level of proof. We have the tools to be much more transparent about our experiments.”
In a forthcoming paper, Schooler recommends the establishment of an open-source database, in which researchers are required to outline their planned investigations and document all their results. “I think this would provide a huge increase in access to scientific work and give us a much better way to judge the quality of an experiment,” Schooler says. “It would help us finally deal with all these issues that the decline effect is exposing.”
Although such reforms would mitigate the dangers of publication bias and selective reporting, they still wouldn’t erase the decline effect. This is largely because scientific research will always be shadowed by a force that can’t be curbed, only contained: sheer randomness. Although little research has been done on the experimental dangers of chance and happenstance, the research that exists isn’t encouraging.
In the late nineteen-nineties, John Crabbe, a neuroscientist at the Oregon Health and Science University, conducted an experiment that showed how unknowable chance events can skew tests of replicability. He performed a series of experiments on mouse behavior in three different science labs: in Albany, New York; Edmonton, Alberta; and Portland, Oregon. Before he conducted the experiments, he tried to standardize every variable he could think of. The same strains of mice were used in each lab, shipped on the same day from the same supplier. The animals were raised in the same kind of enclosure, with the same brand of sawdust bedding. They had been exposed to the same amount of incandescent light, were living with the same number of littermates, and were fed the exact same type of chow pellets. When the mice were handled, it was with the same kind of surgical glove, and when they were tested it was on the same equipment, at the same time in the morning.
The premise of this test of replicability, of course, is that each of the labs should have generated the same pattern of results. “If any set of experiments should have passed the test, it should have been ours,” Crabbe says. “But that’s not the way it turned out.” In one experiment, Crabbe injected a particular strain of mouse with cocaine. In Portland the mice given the drug moved, on average, six hundred centimetres more than they normally did; in Albany they moved seven hundred and one additional centimetres. But in the Edmonton lab they moved more than five thousand additional centimetres. Similar deviations were observed in a test of anxiety. Furthermore, these inconsistencies didn’t follow any detectable pattern. In Portland one strain of mouse proved most anxious, while in Albany another strain won that distinction.
The disturbing implication of the Crabbe study is that a lot of extraordinary scientific data are nothing but noise. The hyperactivity of those coked-up Edmonton mice wasn’t an interesting new fact—it was a meaningless outlier, a by-product of invisible variables we don’t understand. The problem, of course, is that such dramatic findings are also the most likely to get published in prestigious journals, since the data are both statistically significant and entirely unexpected. Grants get written, follow-up studies are conducted. The end result is a scientific accident that can take years to unravel.
8 January, 2011
British Food shoppers face five-a-day nagging at tills as government aims to get the nation in shape
The fact that "5 a day" has no basis in science seems not to worry them
Shoppers will be bombarded with messages at supermarket check-outs about eating fruit and vegetables, under plans being considered by Ministers. Trolleys could even come with a painted line marking where customers should put their healthy produce as part of the proposals which critics will see as an expansion of the nanny state.
Unhealthy options – such as crisps and pies – may be placed on higher shelves than low-calorie and high-fibre foods to dissuade shoppers from buying them. The proposals are part of the Coalition’s attempt to ‘nudge’ Britons towards healthy choices and are the brainchild of the Behavioural Insight Team, which is promoting similar persuasion tactics across government.
A team led by Cabinet Office Minister Oliver Letwin is working with supermarkets to persuade them to support the plans to promote ‘five-a-day’ diets, which have already been tested at Asda.
Other ‘nudge’ ideas include giving children Topshop vouchers and cinema tickets if they walk to school – an idea condemned by opponents as a bribe. And, in an effort to tackle teenage pregnancy, girls could be given toddlers to look after for short periods to persuade them to have safe sex.
A document from the Behavioural Insight Team, released last week, revealed the plan for supermarkets. It said: ‘Visual prompts are already widely used by supermarkets and food manufacturers. 'But there is potential for visual prompts to be introduced in more ways that help people make healthier food choices. ‘Examples include experimenting with the design of trolleys and considering the order or height of healthier options on supermarket shelves.’
It said action needs to be taken because the country’s weight problem, with six out of ten adults overweight, costs the economy £7billion a year.
MA: New blood test that spots cancer cells gets boost
A blood test so sensitive that it can spot a single cancer cell lurking among a billion healthy ones is moving one step closer to being available at your doctor's office. Boston scientists who invented the test and health care giant Johnson & Johnson will announce Monday that they are joining forces to bring it to market. Four big cancer centers also will start studies using the experimental test this year.
Stray cancer cells in the blood mean that a tumor has spread or is likely to, many doctors believe. A test that can capture such cells has the potential to transform care for many types of cancer, especially breast, prostate, colon and lung.
Initially, doctors want to use the test to try to predict what treatments would be best for each patient's tumor and find out quickly if they are working. "This is like a liquid biopsy" that avoids painful tissue sampling and may give a better way to monitor patients than periodic imaging scans, said Dr. Daniel Haber, chief of Massachusetts General Hospital's cancer center and one of the test's inventors.
Ultimately, the test may offer a way to screen for cancer besides the mammograms, colonoscopies and other less-than-ideal methods used now. "There's a lot of potential here, and that's why there's a lot of excitement," said Dr. Mark Kris, lung-cancer chief at Memorial Sloan-Kettering Cancer Center in New York. He had no role in developing the test, but Sloan-Kettering is one of the sites that will study it this year.
Doctors typically give a drug or radiation treatment and then do a CT scan two months later to look for tumor shrinkage. Some patients only live long enough to try one or two treatments, so a test that can gauge success sooner, by looking at cancer cells in the blood, could give patients more options. "If you could find out quickly, 'this drug is working, stay on it,' or 'this drug is not working, try something else,' that would be huge," Haber said.
The only test on the market now to find tumor cells in blood - CellSearch, made by J&J's Veridex unit - just gives a cell count.
Interest in trying to collect these cells soared in 2007, after Haber and his colleagues published a study of Mass General's test. It is far more powerful than CellSearch and traps cells intact. It requires only a couple of teaspoons of blood and can be done repeatedly to monitor treatment or determine why a drug has stopped working and what to try next.
"That's what got the scientific community's interest," Kris said. Doctors can give a drug one day and sample blood the next day to see if the circulating tumor cells are gone, he explained.
7 January, 2011
Prohibitionists: Leave us alone!
Sometimes I drink Scotch and then, to wake myself up, I drink coffee. So what? Many people consume mixtures of caffeine and alcohol in drinks like rum and Coke. Again, so what?
But recently some college kids started drinking pre-mixed combos of alcohol and caffeine with names like Four Loko and Moonshot '69. Moonshot '69 is a pilsner beer with less than a coffee cup's worth of caffeine. Until recently, Four Loko contained 12 percent alcohol -- about the same as wine -- and as much caffeine as a cup of coffee. A few students, after drinking Four Loko, landed in the hospital with alcohol poisoning. Naturally, hysterical news reports followed. A new bogeyman was born: caffeinated alcoholic beverages.
As night follows day, the Food and Drug Administration in November ordered beverage companies to lose the caffeine or shut down. The FDA called caffeine an "unsafe food additive." Phusion Products says it will now produce only noncaffeinated Four Loko. Moonshot '69 is off the market for now, which is bad news for Rhonda Kallman, who founded the company that makes it, New Century Brewing.
"There is nothing new about adults combining caffeine and alcohol," Kallman writes on her company website. "Who hasn't enjoyed a rum and Coke, Irish coffee, Kahlua or espresso martini? ... Moonshot '69 is a beer for beer drinkers that has been enjoyed by craft-beer lovers since 2004."
Her online petition states: "We the undersigned support the right of responsible adults to choose the beer of their choice. We support Moonshot69 and the rights of craft brewers across the country to produce new and innovative offerings for the beer drinking public. ... We call on the federal government to adhere to responsible regulation of alcoholic beverages that allows adults to enjoy the beer of their choice."
Unfortunately, Kallman tries to separate her product from higher-alcohol FDA targets, but Nick Gillespie of Reason magazine argues that the FDA has no business limiting the sale of any of the alcohol/caffeine combos. "This has been going on for as long as there have been colleges and universities," he said. "You can go back to the Middle Ages, and booze and students go together like, I guess, beer and caffeine.
Aren't some drinks more dangerous than others? "I don't think so. But when we raised the drinking age to 21 ... we told young people ... you can vote, you can enter a contract, you can go to war, you can die for your country, but if you want to drink and you're going to college, you better go off campus into a basement apartment somewhere and chug like there's no tomorrow because you don't know when you're going to be able to get drunk again."
He points out that by forbidding pre-21 adults from drinking openly around their elders, we deny them the chance to be exposed to responsible drinking.
About the ban on caffeinated alcoholic drinks, he added, "You can't minimize the overreach by the FDA."
I asked the FDA why Moonshot '69 is included on the ban list when it's not marketed to pre-21 adults and it contains less alcohol than more sugary drinks. They replied that Moonshot was referred to the agency by state attorneys general concerned about alcohol and caffeine. The FDA asked New Century Brewing for data indicating the legal standard for safety had been met, but no data was provided.
Kallman points out that the FDA "didn't fully research it either. So they put the onus on the small entrepreneur to have a scientist. But at the end of the day, it's 5 percent alcohol by volume and less than a half a cup of coffee of natural caffeine. Where will they stop?"
Never. Government never stops.
Gillespie added, "What we should be having instead of bans (of) beverages that people like and ... consume responsibly is ... a national conversation about how, after a couple of hundred years of the American experiment, we can get past the prohibitionist mindset and teach people how to drink responsibly like they do in France, Italy, Spain and many other parts of the world."
Light therapy proves bright idea for treating depressed elderly
Interesting but the effect was apparently quite weak in absolute terms
EXPOSURE to bright light may be just as effective for depressed elderly people as taking antidepressant medication, scientists have found, and the benefits seem to last even after the treatment is discontinued.
In the Dutch study, 89 people aged 60 or older with a diagnosis of major depression were given a light box to take home and instructed to sit beside it for an hour each morning over three weeks.
For half the group, the light it emitted was bright and blue, while others were subjected to a dim red light.
After three weeks, more of those exposed to the bright light experienced a lifting in their mood, measured using a standard psychiatric questionnaire. But after another three weeks, during which the men and women no longer used the light box, the difference between the two groups was even more pronounced.
The bright light treatment group also displayed lower levels of the stress hormone cortisol, and got out of bed earlier than the patients who received dim light, says the study by psychiatrists and neuroscientists from several Netherlands universities. It is the first in the world to include enough patients to draw statistically reliable conclusions.
Bright light, which had proven successful for some people who suffered from the winter depression known as seasonal affective disorder, might be important for depressed elderly people, said the study leader, Ritsaert Lieverse.
"Elderly people expose themselves less frequently to bright environmental light," Dr Lieverse wrote in the journal Archives of General Psychiatry, and might also absorb less light through their retinas. They were also more prone to medication side-effects.
The beneficial effects might in part be due to the resetting of the body clock, said Dr Lieverse, who also observed a bigger evening rise in the circadian hormone melatonin among those who received the bright light therapy.
David Ames, the director of the National Ageing Research Institute in Melbourne, said about one in 100 elderly people were depressed enough to need treatment from a psychiatrist, while 15 per cent had milder forms of the illness. "Some forms of depression do have some characteristics of circadian disturbance," Professor Ames said.
Elderly people who were more vulnerable to depression, because of physical illness or isolation, were also those whose body clocks were likely to be adversely affected by receiving less daylight, he said.
Further research should compare light therapy with antidepressants, Professor Ames said. If it proved effective, bright light would be "reasonably non-toxic" and inexpensive.
6 January, 2011
Study that linked autism with MMR vaccine was fraud: British Medical Journal
A 1998 STUDY that unleashed a major health scare by linking childhood autism to a triple vaccine was "an elaborate fraud", the British Medical Journal has charged.
Blamed for a disastrous boycott of the measles, mumps and rubella (MMR) vaccine in Britain, the study was retracted by The Lancet last year and its senior author disgraced, after the country's longest-running hearing, for conflict of interest and unethical treatment of patients.
But the BMJ, taking the affair further, has today branded the paper a crafted attempt to deceive, among the gravest of charges in medical research. "The paper was in fact an elaborate fraud," the BMJ said in an editorial, adding: "There are hard lessons for many in this highly damaging saga."
It pointed the finger at lead author Andrew Wakefield, then a consultant in experimental gastroenterology at London's Royal Free Hospital. Wakefield and his team suggested they had found a "new syndrome" of autism and bowel disease among 12 children. They linked it to the MMR vaccine, which they said had been administered to eight of the youngsters shortly before the symptoms emerged.
Other scientists swiftly cautioned the study was only among a tiny group, without a comparative "control" sample, and the dating of when symptoms surfaced was based on parental recall, which is notoriously unreliable. Its results have never been replicated.
But the controversy unleashed a widespread parental boycott of the jab in Britain, and unease reverberated also in the United States, Canada, Australia and New Zealand. Hundreds of thousands of children in Britain are now unshielded against these three diseases, said the BMJ. In 2008, measles was declared endemic, or present in the wider population much like chicken pox, in England and Wales.
Wakefield was barred from medical practice last year on the ground of conflict of financial interest and unethical treatment of some children involved in the research.
The BMJ, delving into the accuracy of the study as opposed to its ethics, said Sunday Times investigative journalist Brian Deer had "unearthed clear evidence of falsification". Not one of the 12 cases, as reported in the study, tallied fully with the children's official medical records, it charged.
Some diagnoses had been misrepresented and dates faked in order to draw a convenient link with the MMR jab, it said.
Of nine children described by Wakefield as having "regressive autism," only one clearly had this condition and three were not even diagnosed with autism at all, it said.
The findings had been skewed in advance, as the patients had been recruited via campaigners opposed to the MMR vaccine, the journal added. And, said the BMJ, Wakefield had been confidentially paid hundreds of thousands of pounds through a law firm under plans to launch "class action" litigation against the vaccine.
Deer, in a separate piece published by the BMJ, compared the scandal with the "Piltdown Man" hoax of 1953, when a supposed fossil of a creature half-man, half-ape turned out to be a fake.
The Wakefield study "was a fraud, moreover, of more than academic vanity. It unleashed fear, parental guilt, costly government intervention and outbreaks of infectious disease," he said.
Wakefield, who still retains a vocal band of supporters, has reportedly left Britain to work in the US. Wakefield and his publishing agent did not respond to calls and emails from AFP requesting comment.
Wakefield has previously accused Britain's General Medical Council of seeking to "discredit and silence" him and shield the British government from responsibility in what he calls a "scandal".
The Lancet told AFP it would not comment on the BMJ accusations.
Autism is the term for an array of conditions ranging from poor social interaction to repetitive behaviours and entrenched silence. The condition is rare, predominantly affecting boys, although its causes are fiercely debated.
Wakefield should be burnt at the stake. He killed a lot of kids by frightening parents into avoiding vaccinations
The wonders of green tea again
This is just speculation. No form of disease was actually studied
Green tea could protect the brain against Alzheimer’s and other forms of dementia, say scientists. The drink, which originated in ancient China, may also play a vital role in guarding against cancer, their study suggests.
Scientists at Newcastle University set out to discover whether the protective properties of the tea – previously shown to be present in the freshly brewed form – are still active once it has been digested.
Dr Ed Okello, from the university, said: ‘What was really exciting was that we found when green tea is digested, the resulting chemicals are actually more effective against key triggers of Alzheimer’s. The digested compounds also had anti-cancer properties, significantly slowing down the growth of tumour cells which we were using in our experiments.’
Two compounds are known to play a significant role in the development of Alzheimer’s – hydrogen peroxide and a protein known as beta-amyloid. Previous studies have shown that polyphenols, present in black and green tea, bind with the toxic compounds and protect brain cells.
When ingested, the polyphenols are broken down to produce a mix of compounds and it was these the team tested in their research, published in the academic journal Phytomedicine.
Dr Okello added: ‘Green tea has been used in traditional Chinese medicine for centuries and what we have here provides the scientific evidence why it may be effective against some of the key diseases we face today. ‘There are obviously many factors which together have an influence on diseases such as cancer and dementia – a good diet, plenty of exercise and a healthy lifestyle are all important. ‘But I think it’s fair to say that at least one cup of green tea a day may be good for you and I would certainly recommend it.’
Rebecca Wood, chief executive of the charity Alzheimer’s Research Trust, said: ‘Diet and lifestyle almost certainly play a part in every person’s Alzheimer’s risk.’
5 January, 2011
Beware Fruits, Veggies?
Time in ‘09:
Christopher Ruhm … examined statewide mortality fluctuations in the U.S. between 1972 and 1991 and found that a 1% rise in a state’s unemployment rate led to a 0.6% decrease in total mortality. … In a review of such studies … Stephen Bezruchka … suggests the results could be explained by declines in smoking, excessive alcohol consumption and overeating during recessions as people look for ways to save money.
A higher risk of unemployment is associated with reduced consumption of fruits and vegetables and increased consumption of “unhealthy” foods such as snacks and fast food. … Among individuals predicted to be at highest risk of being unemployed, a one percentage point increase in the resident state’s unemployment rate is associated with … a 2-4% reduction in the frequency of fruits and vegetables consumption, and an 8% reduction in the consumption of salad.
Either we can cross “eat healthier” off the list of possible ways unemployment helps health, or maybe fruits and veggies aren’t as healthy, and fast food as unhealthy, as we suppose.
Labels won’t solve obesity and alcoholism
The National Consumers' NCL says the absence of nutritional labeling on alcoholic beverages contributes to everything from alcohol abuse to obesity, and they want the Alcohol Tax and Trade Bureau (TTB) to do something about it. But the regulations they are pushing are unlikely to solve the ills they describe.
TTB had proposed nutritional-labeling mandates in 2007 when the NCL and the Center for Science in the Public Interest petitioned the agency. After receiving a large number of public comments, TTB chose not to finalize the rule. Now the NCL is renewing pressure for agency action by capitalizing on problems unrelated to alcohol labeling.
For example, the NCL suggests that the abuse of caffeinated alcoholic beverages on college campuses is somehow related to labeling of those products. In a recent press release, the group exclaims: "The nine college students who went to an emergency room for alcohol poisoning after drinking too much of a caffeinated alcoholic beverage earlier this year may not have realized just how much alcohol they were consuming .... Maybe if the standard drinks per container had been required to appear on the labels, they wouldn't have made that mistake."
Does the NCL really think that college kids will moderate alcohol intake because of a government label? It's more likely that college students would use such labels to select drinks with the highest levels of caffeine and alcohol. After all, that's why some of them abuse these products: to get a caffeine or alcohol buzz. Back before these drinks were available, college kids used to drink cough medicine (apparently some still do) to get the same effects. The problem here is not the lack of good labeling.
Similarly, it's highly unlikely that alcohol-labeling mandates will cure our obesity problems, as the NCL also suggests. Consumers already have sufficient access to caloric information online. And it's also conveniently available on smart-phone applications that include calorie information on everything from alcohol to bread and butter. Putting this data on a bottle of wine won't suddenly make people do what they can easily do now: count alcohol-related and other calories.
While benefits are unclear, such mandates pose drawbacks for consumers - both monetary and aesthetic. First, producers will incur costs for creating systems to precisely measure and document calorie content. While generic estimates online are sufficient for consumers to count calories, labeling mandates will require greater precision for each specific product to prevent charges of fraudulent labeling. Producers will pass such costs onto consumers, particularly given existing tight profit margins for various segments within the alcohol industry.
Some producers may decide to reduce other information on labels - information consumers find more valuable - to make space for mandated data. In fact, if wine, beer and spirits buyers placed a higher value on nutritional data, producers would provide it. Instead they use that space to provide something consumers want: product information (tasting notes, food-pairing information) and attractive designs.
Consumers confirm the value they place on this information in survey research, as does the success of Yellow Tail wine's Kangaroo label. Common sense does as well. After all, who doesn't enjoy presenting an attractively packaged wine at a party?
If TTB issues any new labeling standards, it should expand what information producers are allowed to include. A decade ago, the Competitive Enterprise Institute filed comments opposing federal regulations banning health-benefit information on alcohol labels. That ban still stands, even though considerable data indicates health benefits are associated with moderate alcohol consumption. Instead, the federal government forces producers to list only "government warnings" and negative claims about their products.
Regulators should allow producers to provide any information that they want on their labels outside of fraudulent claims. Consumers can vote with their pocketbooks.
4 January, 2011
Soya-based fertility treatment may cut miscarriages and boost pregnancy up to six-fold
Yesterday is was green vegetables that were the miracle cure. What next? The figures as reported are impressive, however, so there may be something in it. Note that the patients all had apparent problems so we may simply be seeing here the correction of a nutritional deficiency -- something that might not generalize to other women
An experimental fertility treatment increases the odds of an IVF pregnancy up to six times while also inhibiting chemicals which cause miscarriages, a study has found. When women who had gone through IVF time and time again without success were given a soya-based substance, half became pregnant. In contrast, fewer than one in ten of those who had conventional fertility treatment alone conceived.
The doctors behind the remarkable study believe that the Intralipid liquid, a fat and calorie-rich potion normally used when tube-feeding very sick patients, could help many more women achieve their dream of motherhood.
Improving success rates would spare women the emotional and financial pain of going through repeated IVF treatments, only for them to fail. The liquid also stems the production by the body of harmful chemicals which can lead to miscarriage.
George Ndukwe, of the Care fertility clinic in Nottingham, said: ‘Every day in my clinic I see women who have had numerous IVF cycles all with the same negative outcome and no baby. ‘I also regularly see couples who have suffered the misery of repeated miscarriages. ‘People talk about the financial implications but the emotional one is as bad or, I would say, worse. ‘These women are at the bottom of a dark pit and can’t climb out and can’t see the light. We are devoting our attention to finding answers when nature goes wrong.’
Dr Ndukwe, the clinic’s medical director, believes that up to one in four women who struggle conceiving have faulty immune systems.
It is thought that extra high levels of white blood cells called natural killer cells ‘fight’ the pregnancy by triggering the production of chemicals that attack the placenta or the embryo.
The chemicals are already known to trigger rheumatoid arthritis and the arthritis drug Humira has shown promise in boosting pregnancy rates. However, it costs up to £2,000 per patient and does not work for everyone.
At around £200 per woman, Intralipid, which is given through a drip around a week before a woman has IVF, is much cheaper.
And the latest research, to be presented at a British Fertility Society conference on Thursday, shows it is also more effective at stemming production of the harmful chemicals.
Dr Ndukwe said: ‘This infusion is inexpensive, well tolerated and easy to administer.’
The fertility expert ran his trial on a group of women who had failed to become pregnant despite enduring an average of six IVF attempts each. One woman had tried and failed at IVF 12 times. Half of those treated became pregnant, compared with just 9 per cent of those not given the fatty substance.
Other doctors are trying to use steroids to lower levels of natural killer cells in the body. Professor Siobhan Quenby, of Solihull Hospital and Warwick University, has already successfully used an asthma drug to curb the immune system response in a pilot trial of women who had suffered repeated miscarriages.
An implant to alleviate arthritis
Good if the implant lasts over time
Chris Blundell is consultant orthopaedic surgeon at the Northern General Hospital, Sheffield. He says:
The big toes take about 70 per cent of the body’s weight, so there are enormous pressures acting on a relatively small joint. It is, therefore, not surprising that there are high rates of wear and tear, and osteoarthritis in this area as people get older.
The pain often leads to patients walking or moving differently, which puts extra stress and strain on other joints, such as the knee.
It can also lead to a more sedentary lifestyle, which can place sufferers at risk of weight gain and cardiovascular disease.
The current treatment for severe osteoarthritis of the big toe is arthrodesis, or fusion, in which we insert a metal strip into the joint between the two bones and fuse the bones together with screws so that they no longer rub against each other. This is usually performed on younger people.
Although fusions do get rid of the pain, the toe is permanently rigid and no longer bends at the joint. In older people, osteoarthritis can be treated on occasions by removing the toe joint altogether.
This new toe implant, made by the American company Carticept, provides a new surface in the joint to stop the ends of the bones rubbing. It is circular, about the size of a large pill, and made of hydrogel, the substance used in contact lenses, which is 60 per cent water and 40 per cent polymer.
The material is designed to have flexibility similar to that of human cartilage, and is strong enough to withstand the load put on the joint. It’s a relatively new material and is being looked at for use in other joints.
The big advantage over fusion is that the implant preserves the joint, which means that the toe can be bent. The procedure takes about 30 minutes.
First, an inch-long incision is made above the joint, so the ends of both bones are exposed. The end of the bone that connects the toe to the foot is then drilled to create a small pocket so that we can insert the implant. Because it is similar to cartilage, it cushions the joint on both sides.
Once the implant is in place, the incision is stitched and the patient goes home.
We are one of four hospitals in the UK which are carrying out these procedures as part of a research study. About 12 people in the UK have had the operation so far.
3 January, 2011
Vegetable diet gives you daughters
If that were true there would be very few males in India, which is a largely vegetarian country. The study reported below is however more complex than that in that it is only one subset of a vegetarian diet that has the alleged effect.
The percentage of girl-births reported is however impressive, despite the small numbers involved. I have however found in my own research that very strong relationsdhips that appeared with a small subject population can wash out entirely when a larger and more representative sample is used.
Assuming that something non-random is going on:
Whether diet was the decisive factor is speculative. Timing of intercourse was also used so no one influence can be singled out.
The fact that the trial does not seem to have been double blind also could have unleashed the powerful forces of suggestion
Also, as these women were all initially strikingly daughterless, there could have been some nutritional deficiency in them that the diet remedied. In that case, the effect could not be expected in normal healthy women
Want to have a daughter? Well, then go on a fruit and vegetable diet, say Dutch scientists. They found that women could increase their chances of giving birth to a girl by consuming food with high levels of calcium and magnesium, such as green vegetables, in the weeks before conception.
Of a group of women who followed a diet drawn up by the researchers, 80 per cent went on to have daughters. By contrast, foods rich in potassium and sodium - such as bananas and potatoes - would be likely to help women who want to have sons, although this has yet to be tested.
The researchers are convinced that following the right diet can help couples increase their chances of choosing the sex of their child, although they don't know the exact role played by other factors such as the timing of conception.
They spent five years working with 172 couples, all of whom wanted to add girls to their families - between them they already had 358 sons and just two daughters.
Each began a diet rich in fruit, vegetables and rice in the nine weeks before they planned to attempt to conceive to increase the levels of calcium and magnesium in their bloodstream.
In addition, they were given daily tablets of the key minerals, had regular blood monitoring and had to learn as accurately as possible their moment of peak fertility each month.
At the end of the trial, out of 32 couples who completed the programme, 26 mothers gave birth to girls and only six had boys.
"People now know that if they do everything we have suggested, their chances of having a girl will improve dramatically," the Daily Mail quoted Annet Noorlander, a biologist with firm Gender Consult, as saying. "This method is experimental, but we have proved it works."
Her company carried out the research with teams from Delft and Maastricht universities.
SOURCEFemale gender pre-selection by maternal diet in combination with timing of sexual intercourse - a prospective study
By A.M. Noorlander et al.
Natural sex selection methods have been applied for several decades, but their use and effectiveness are still a matter of debate among medical professionals. Therefore, we assessed the efficacy of a maternal diet low in sodium and potassium, high in calcium and magnesium, in combination with timing of intercourse well before ovulation as a method to improve the chances of conceiving a girl baby. A total of 172 couples wanting a girl volunteered to participate in the study and the 150 couples that actually started were followed during their treatment and possible pregnancy. Compliance with diet was assessed through mineral analyses of blood. The participants determined timing of intercourse relative to ovulation by ovulation home tests. Based on mineral blood values and on the time interval between intercourse and ovulation, a prediction rule for conceiving a girl was constructed and tested for validity in a new group of 21 couples. In total, 32 women satisfied the conditions of the prediction rule and the observed percentage of female babies in this group was 81%. The conclusion of the study is that a maternal diet together with timing of sexual intercourse and use of a prediction rule will lead to an increased probability of a girl baby. It is important that both diet and timing are followed correctly, which requires of the mother both willpower and meticulousness.
Parents have little influence of what their kids eat
Parents may think they can set a good example for their children by eating a healthy diet themselves, but a new analysis finds that it may not work.
Researchers reviewed 24 studies on parent and child dietary habits, using statistical techniques to combine their results. Their analysis, being published in the February issue of The Journal of Epidemiology and Community Health, found only a weak correlation between what parents and their children eat.
They also found that the association diminished over time — later studies generally showed a weaker connection than earlier ones between child-parent pairs. The authors acknowledge that their conclusions were based on limited data, that only three of the studies were conducted in developing countries, and that methodologies varied.
Still, the researchers, led by Dr. Youfa Wang, an associate professor of international health at Johns Hopkins, concluded that parents’ influence was apparently overwhelmed by other factors. Advertising, food supply and availability, the influence of peers, and opportunities to eat outside the home all contribute to making children’s diets very different from that of their parents.
2 January, 2011
Unhealthy lifestyle 'ingrained by age 16'
The opening claim below is a counterfactual absurdity. If "obesity" etc. is "unhealthy", how come people of middling weight live the longest?
On a personal note, my lifestyle would be greeted with horror by the vastly opinionated do-gooders. I have done no exercise since I was 16 and have always had a sedentary lifestyle. I have always eaten whatever I fancied and I like a drink. Yet far from "a life of illness", all I have had were occasional colds and flu (about one a year) and I am still in good working order at age 67, though not everything works as well as it once did, as is to be expected at my age
Unhealthy lifestyle choices could be so ingrained in us by the time we are 16 that there is no way back from a life of illness, scientists claim. A sedentary lifestyle, bad eating habits and alcohol consumption all kick in by the age of 19, but researchers found that 16 was the 'tipping point' for this type of behaviour. And they recommend that children under 13 should be targetted for health campaigns before it is too late to change.
The findings were presented in a doctoral thesis submitted by Marta Arrue to the University of the Basque Country in Spain.
She said:"The least healthy habits turn out to be eating ones, followed by ingestion of alcohol, sedentarism, risks involving sexual relations, the consumption of tobacco and drugs and, finally, low quality or insufficient sleep.
"Special attention has to be paid to adolescents of 16 years. This is the point of no return, as it were, the age in which either healthy activities are opted for or risk behaviour patterns arise.
"The data point to the fact that young persons show more risk behaviour than expected, more even than they themselves perceive, believing that they are healthier than they really are.
"It is notable that risk behaviour presents itself in early adolescence and that all the habits, except sleep, worsen with the passing of the years."
Ms Arrue studied 2,018 young people from the Basque region who were asked to fill in various questionnaires. With the gathered data, she collated and analysed habits of life according to sex and age, adolescents from 13 to 17 and young persons from 18 to 26.
She added: "Bad eating habits, ingestion of alcohol and sedentary lifestyles are all unhealthy life habits that are already being detected in early adolescence and that are especially predominant amongst women and young people between the ages of 19 and 26.
"The prevention campaigns should take very much into consideration these groups at risk and even take into account those less than 13 years.
"Women show greater risk conduct than men. The weak point of women is sedentarism, tobacco, sleep, risk of becoming pregnant and sexually transmitted diseases. "Men, on the other hand, show weaknesses with alcohol, illegal drugs and eating.
"The results show that adolescents and young people with healthy life habits have higher self-esteem, better psychological wellbeing, greater satisfaction with their bodies and fewer psychopathological indicators.
"A tendency to bad habits is not due to lack of information, as has been borne out by the numerous campaigns undertaken, and so other factors must be involved."
Queensland scientist closes in on world breakthrough to beat killer disease
This is very hopeful news. Dengue is like a very severe flu
A QUEENSLAND scientist is on the brink of eliminating the deadly global disease threat of dengue fever after more than 15 years of painstaking research. The University of Queensland's Professor Scott O'Neill will start his world-first field trials to wipe out the mosquito-borne disease in far north Queensland this week.
The project, funded by the Bill & Melinda Gates Foundation's Global Health Program, hopes to control dengue by introducing a bacteria to mosquitoes that stops them passing on the virus to humans. The bacteria, known as Wolbachia, has a powerful ability to invade natural populations of insects and alter their reproduction and lifespan.
"I was always interested in science but I wanted to do science with a practical outcome," Prof O'Neill, 48, said. "This is very exciting for me and my team - we can provide a real solution to the global burden of disease."
Dengue is a significant disease that has no effective controls or vaccine - it affects billions world-wide and costs millions of dollars to treat. It is carried by an urban-dwelling mosquito that, once established in cities, is almost impossible to eradicate.
Dengue hot spot Brazil spends $US800 million a year on pesticides to control mosquitoes and still has one of the highest cases of infections in the world.
"The scary thing is dengue is getting worse, with a broadening geographic distribution and outbreaks becoming more severe," Prof O'Neill said. "We can see that in our own experience in Australia." There were more than 1000 cases of dengue in Queensland in 2009 - the worst outbreak in 50 years.
But discovering the effect Wolbachia has on the dengue-carrying Aedes aegypti mosquito did not happen in a "lightbulb moment" - it has taken decades.
"When you are doing scientific work more experiments fail than succeed, so you keep chipping away to find ways around the problem," Prof O'Neill said. "I think it's a sickness that a lot of scientists have - they are very obsessive people and that's what makes them so tenacious about their projects."
One member of the Eliminate Dengue team was once required to manually inject 10,000 mosquito embryos with the bacteria to test their survival.
Prof O'Neill was first alerted to Wolbachia by former UQ professor Hugh Patterson when he was Patterson's student in the 1980s. Scientists had been thinking about the bacteria as a way of controlling insect populations but Prof O'Neill wanted to test its ability to prevent disease transmission.
Leaving Brisbane for the US, he kept up his investigations as a junior professor at Yale University for 10 years. Returning to UQ as head of the School of Biological Sciences, his team was the first to apply molecular biology to the bacteria sequencing the Wolbachia genome.
"Dengue is spread by old mosquitoes (12 days old)," he said. "I thought if we could shorten their lifespan we could stop transmission of the disease. "It not only shortened their lifespan but it interfered with the virus's ability to grow in the insect. "That was quite an amazing discovery and it means this approach can be much more effective."
This week Prof O'Neill's team will begin releasing Wolbachia-infected mosquitoes into the wild population.
The CSIRO has done a nine-month risk analysis on releasing Wolbachia mosquitoes into the general population to breed. Prof O'Neill said this type of science was heavily regulated in Australia and they were being extremely careful because they did not want to create another biological problem like the cane toad.
"The cane toad was a foreign organism introduced into a new environment but Wolbachia already occurs naturally in up to 60 per cent of the insect population," he said.
In September the Australia Pesticides and Veterinary Medicines Authority gave the project approval to proceed to field trials at Yorkeys Knob and Gordonvale near Cairns.
Over the past 15 years, the international collaboration has involved more than 14 institutions and 50 scientists from Australia, Vietnam, Thailand, the US and Brazil.
1 January, 2011
Walking for 30 minutes a day lowers colon cancer risk (?)
I suspect that these findings simply prove that people in poor health don't do much exercise
Walking for just 30 minutes a day could lower the risk of dying from colon cancer, new research shows. Taking on an exercise programme could also reduce the risk of heart disease, diabetes and other cancers. And regular physical activity can even be beneficial after a cancer diagnosis has already been made.
In one of the first studies of its kind, a team examined data from a previous study which included more than 150,000 men and women. Researchers compared their levels of physical activity between 1982 and 1997.
They linked those activity levels both to the number of colon cancer diagnoses between 1998 and 2005 and to the number of colon cancer deaths that occurred between 1998 and 2006. It showed that those who exercised consistently for at least ten years had the lowest risk of colon cancer death.
But Dr Kathleen Wolin at Washington University School of Medicine, the first author of the study, said that while the greatest benefits seem to show in those who have exercised for the largest percentage of their lives, it wasn't necessary to run marathons or work out for hours a day.
She said: "You get enormous 'bang for the buck'. You go for a 30-minute walk every day and you're going to reduce your risk of a number of diseases. "And in addition, our research has also shown that you feel better, physically and mentally, so you're able to function better.
"People who were consistently active over the course of their adulthood had a lower risk of death from colon cancer than those who were sedentary.
"People often wonder around the start of a new year whether exercise really will help them stay healthy or whether it's already too late. "It's never too late to start exercising, but it's also never too early to start being active. That's the message we hope people will take away from this study."
Dr Wolin, assistant professor of surgery in the Division of Public Health Sciences, said the benefits of starting an exercise program include not just preventing colon cancer and death from the disease, but also reduced risk of heart disease, diabetes and other cancers.
Herbal drug crackdown: Europe to ban hundreds of natural remedies in UK next year
About time. If orthodox drugs can be prescribed only after rigorous scrutiny of their safety and efficacy, why should herbal remedies escape the same scrutiny? "Natural" molecules can be highly toxic in some cases -- e.g. ricin
Patients are set to lose access to hundreds of herbal medicines next year, as European regulations come into force.
Sales of all herbal remedies, except for a small number of popular products for 'mild' illness such as echinacea for colds, will be banned to the public from May 1.
Under the new law traditional products must be licensed or prescribed by a registered herbal practitioner.
Almost 2,500 UK qualified herbalists and Chinese medicine practitioners will lose the right to supply a wide range of herbal medicines, because they are not signed up to the statutory regulation scheme.
And practitioners have complained that the cost of obtaining licenses are beyond their means. Many traditional medicines are made up of a number of herbs and the Alliance for Natural Health estimates a license for each herb costs in the region of £100,000.
The ANH added that so far no Chinese or ayurvedic medicines had been licensed.
Jane Gray President National Institute of Medical Herbalists, said: 'The fact is that a very large number of our members will lose access to at least some of their medicines. 'I estimate that the impact on my own practice is that I will lose somewhere between 15-20 per cent of my business.
'A good proportion of our members who carry no dispensary at all will lose access to everything except what is available over-the-counter- which is an extremely limited range of herbal medicines and certainly not enough to address the needs of the full range of medical conditions that we see.'
The directive was introduced due to growing safety concerns about the side effects of many alternative medicines.
The UK Medicines and Healthcare Products Regulatory Agency has issued over 10 safety alerts in the past two years. The banned herb Aristolochia caused kidney failure in more than 100 women after they were given it at a slimming clinic in Belgium. Meanwhile black cohosh used by many menopausal women has been linked to liver damage.
But herbal practitioners warn consumers may end up buying potentially dangerous supplies from the black market.
At least six million Britons have consulted a herbal practitioner in the past two years, according to research.
Leading medical herbalist Dr Ann Walker said: 'At present patients have access to top quality herbal products that are manufactured only for professional use, but we won't be allowed to supply them. 'Traditional remedies from China and India will only be available through the internet or backstreet suppliers, which could pose a serious health risk to the public.'
SITE MOTTO: "Epidemiology is mostly bunk"
Where it is not bunk is when it shows that some treatment or influence has no effect on lifespan or disease incidence. It is as convincing as disproof as it is unconvincing as proof. Think about it. As Einstein said: No amount of experimentation can ever prove me right; a single experiment can prove me wrong.
Epidemiological studies are useful for hypothesis-generating or for hypothesis-testing of theories already examined in experimental work but they do not enable causative inferences by themselves
The standard of reasoning that one commonly finds in epidemiological journal articles is akin to the following false syllogism:
Chairs have legs
You have legs
So therefore you are a chair
SALT -- SALT -- SALT
1). A good example of an epidemiological disproof concerns the dreaded salt (NaCl). We are constantly told that we eat too much salt for good health and must cut back our consumption of it. Yet there is one nation that consumes huge amounts of salt. So do they all die young there? Quite the reverse: Japan has the world's highest concentration of centenarians. Taste Japan's favourite sauce -- soy sauce -- if you want to understand Japanese salt consumption. It's almost solid salt.
2). We need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. So the conventional wisdom is not only wrong. It is positively harmful
3). Table salt is a major source of iodine, which is why salt is normally "iodized" by official decree. Cutting back salt consumption runs the risk of iodine deficiency, with its huge adverse health impacts -- goiter, mental retardation etc. GIVE YOUR BABY PLENTY OF SALTY FOODS -- unless you want to turn it into a cretin
Although I am an atheist, I have never wavered from my view that the New Testament is the best guide to living and I still enjoy reading it. Here is what the apostle Paul says about vegetarians: "For one believeth that he may eat all things: another, who is weak, eateth herbs. Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth." (Romans 14: 2.3). What perfect advice! That is real tolerance: Very different from the dogmatism of the food freaks. Interesting that vegetarianism is such an old compulsion, though.
Even if we concede that getting fat shortens your life, what right has anybody got to question someone's decision to accept that tradeoff for themselves? Such a decision could be just one version of the old idea that it is best to have a short life but a merry one. Even the Bible is supportive of that thinking. See Ecclesiastes 8:15 and Isaiah 22: 13. To deny the right to make such a personal decision is plainly Fascistic.
"To kill an error is as good a service as, and sometimes better than, the establishing of a new truth or fact" -- Charles Darwin
"Most men die of their remedies, not of their diseases", said Moliere. That may no longer be true but there is still a lot of false medical "wisdom" around that does harm to various degrees. And showing its falsity is rarely the problem. The problem is getting people -- medical researchers in particular -- to abandon their preconceptions
Bertrand Russell could have been talking about today's conventional dietary "wisdom" when he said: "The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd; indeed in view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.”
Eating lots of fruit and vegetables is NOT beneficial
"Obesity" is 77% genetic. So trying to make fatties slim is punishing them for the way they were born. That sort of thing is furiously condemned in relation to homosexuals so why is it OK for fatties?
Some more problems with the "Obesity" war:
1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).
2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.
3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.
4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.
5). Food warriors demonize dietary fat. But Eskimos living on their traditional diet eat huge amounts of fat with no apparent ill-effects. At any given age they in fact have an exceptionally LOW incidence of cardiovascular disease. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?
6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.
7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.
8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].
9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.
10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.
11). A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
12. Fascism: "What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!
Trans fats: For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.
The "antioxidant" religion: The experimental evidence is that antioxidants SHORTEN your life, if anything. Studies here and here and here and here and here and here and here, for instance. That they are of benefit is a great theory but it is one that has been coshed by reality plenty of times.
The medical consensus is often wrong. The best known wrongheaded medical orthodoxy is that stomach ulcers could not be caused by bacteria because the stomach is so acidic. Disproof of that view first appeared in 1875 (Yes. 1875) but the falsity of the view was not widely recognized until 1990. Only heroic efforts finally overturned the consensus and led to a cure for stomach ulcers. See here and here and here.
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
Huge ($400 million) clinical trial shows that a low fat diet is useless . See also here and here
Dieticians are just modern-day witch-doctors. There is no undergirding in double-blind studies for their usual recommendations
The fragility of current medical wisdom: Would you believe that even Old Testament wisdom can sometimes trump medical wisdom? Note this quote: "Spiess discussed Swedish research on cardiac patients that compared Jehovah's Witnesses who refused blood transfusions to patients with similar disease progression during open-heart surgery. The research found those who refused transfusions had noticeably better survival rates.
Relying on the popular wisdom can certainly hurt you personally: "The scientific consensus of a quarter-century ago turned into the arthritic nightmare of today."
Medical wisdom can in fact fly in the face of the known facts. How often do we hear reverent praise for the Mediterranean diet? Yet both Australians and Japanese live longer than Greeks and Italians, despite having very different diets. The traditional Australian diet is in fact about as opposite to the Mediterranean diet as you can get. The reverence for the Mediterranean diet can only be understood therefore as some sort of Anglo-Saxon cultural cringe. It is quite brainless. Why are not the Australian and Japanese diets extolled if health is the matter at issue?
Since many of my posts here make severe criticisms of medical research, I should perhaps point out that I am also a severe critic of much research in my own field of psychology. See here and here
This is NOT an "alternative medicine" site. Perhaps the only (weak) excuse for the poorly substantiated claims that often appear in the medical literature is the even poorer level of substantiation offered in the "alternative" literature.
I used to teach social statistics in a major Australian university and I find medical statistics pretty obfuscatory. They seem uniformly designed to make mountains out of molehills. Many times in the academic literature I have excoriated my colleagues in psychology and sociology for going ga-ga over very weak correlations but what I find in the medical literature makes the findings in the social sciences look positively muscular. In fact, medical findings are almost never reported as correlations -- because to do so would exhibit how laughably trivial they generally are. If (say) 3 individuals in a thousand in a control group had some sort of an adverse outcome versus 4 out of a thousand in a group undergoing some treatment, the difference will be published in the medical literature with great excitement and intimations of its importance. In fact, of course, such small differences are almost certainly random noise and are in any rational calculus unimportant. And statistical significance is little help in determining the importance of a finding. Statistical significance simply tells you that the result was unlikely to be an effect of small sample size. But a statistically significant difference could have been due to any number of other randomly-present factors.
Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology: below:"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.
The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could have been speaking of the prevailing health "wisdom" of today when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."
The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0." Very few of the studies criticized on this blog meet that criterion.
Improbable events do happen at random -- as mathematician John Brignell notes rather tartly:
"Consider, instead, my experiences in the village pub swindle. It is based on the weekly bonus ball in the National Lottery. It so happens that my birth date is 13, so that is the number I always choose. With a few occasional absences abroad I have paid my pound every week for a year and a half, but have never won. Some of my neighbours win frequently; one in three consecutive weeks. Furthermore, I always put in a pound for my wife for her birth date, which is 11. She has never won either. The probability of neither of these numbers coming up in that period is less than 5%, which for an epidemiologist is significant enough to publish a paper.