Denialism Blog

Author: denialism_bv2x6a

  • Foie gras for all!

    According to a new study released today by the journal Euromed (Volume 1:3, April 1, 2008, pp 13-26), the so-called “French paradox” can be applied to other populations successfully. In an eight year, double-blind, randomized controlled trial, Americans from two major urban areas were fed either their usual diet, or a typical French diet, including, but not limited to, wine with all meals (except breakfast, if breakfast occurred before 8 am), foie gras at least three times weakly, butter-based sauces, and crusty bread. In another arm, an urban French population was given a “typical American” diet, including, but not limited to, at least one meal of fast food daily, four servings of soda-pop, and other specialty foods, such as Philly cheese steaks, Chicago hot dogs, and Detroit coney islands.

    According to Dr. Etienne D’Estang, who headed up the French arm of the study, “Perhaps ‘les sanglots longs des violons de l’automne blessent mon coeur,’ but butter doesn’t.”

    The investigators concluded:

    While our results are by no means conclusive, it appears that a typical French diet, which includes red wine, foie gras, and butter, can improve the health of populations unaccustomed to such habits. Our study did not reveal the reason behind this effect, in which Americans who were on the diet gained an average of 21% increase in longevity, but it appears to be a certain je ne sais quoi. On l’autre main, the French population exposed to typical American merde lost an average of 50% longevity.

    Ms Patricia Watanabe, for People for the Ethical Treatment of Animals (PETA), decried the results:

    The current study in no way should encourage Americans to engage in the cruel production of foie gras. If it means sacrificing a few years of life, well, that’s the price we pay for not torturing our animal brothers and sisters.

    Meanwhile, it’s too early to make any definitive conclusions. First would American’s be willing to eat like the French? What effects might this have on other aspects of American life.

    Charlie Woltanski, of the American Sausage Makers Local #125 in Chicago said, “I don’t care how good for you that crap is, if it isn’t a good frank or brat made on the south side, forget it.”

  • I love bacon

    Blogging on Peer-Reviewed ResearchA reader, who happens to write one of the best-named blogs on teh tubes, pointed me toward an article I never would have seen. This parallels a news story we had here in the States late last year. So, since the story is getting press overseas (albeit late), it’s time to dust off the old post and update it a bit.

    The story repeats the finding that processed meats increase the risk of colon cancer. This news comes from a large report published by the World Cancer Research Fund, which looks at data surrounding diet and cancer. It states that there is no safe level of processed meat consumption when it comes to colorectal cancer risk. It’s going to take a long time to parse through all the data, but since I love my processed meat, I’ll start there, and once again, my scientist colleagues will please forgive me for oversimplifying.

    First, this is a huge report, pooling tons of data. One of the most important conclusions is regarding obesity and cancer risk, but that will have to wait until later.

    Per USAToday, “every 1.7 ounces of processed meat consumed a day increases the risk of colorectal cancer by 21%.” Per the Daily Mail, “[e]ating just one sausage a day raises your cancer risk by 20 per cent.” What does that mean? “Risk” is a complicated concept in medicine. It is easy to draw overbroad conclusions from bits of data. When risk is measured, it is rarely intuitive–small percentages can indicate large increases in risk, large numbers can refer to small increases in risk–it depends quite a bit on the base line incidence and prevalence of the disease. A 50% increase in a disease sounds big, but in the right situation it can be big or small. For example, if your “usual” risk of disease A is 2/100, then a 50% increase makes your risk 4 in 100, meaning out of 100 people, 2 more get the disease then they would without the extra risk. If the “usual” risk is 10/100, then a 50% increase means 5 more people get the disease.

    I hope you haven’t given up on me here. Keep reading…trust me…

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  • I don't usually do this but…

    …I really couldn’t resist sharing some fun links. I guess you’d call it blogrolling.

    First, someone got a hold of the über-seekrit Expelled:Leader’s Guide, and started deconstructing it.

    Next, Steve Novella once again eviscerates a wacky water-woo cult leader at NeuroLogica.

    Panda Bear, M.D. has one of his usual lengthy must-reads.

    Orac goes after the reductio ad Hitlerum arguments of Expelled.

    Finally, N.B. explains why chemistry is everywhere, even in your hair.

  • Hey! Look! Science works! Zetia, not so much.

    ResearchBlogging.orgI love this story because it shows how evidence-based medicine works, even in the face of corporate greed.

    A while back I told you about a cholesterol study with negative results; that is, it failed to show a drug to be helpful. Intimately entwined with the study design was a potential conflict of interest on the part of the drug company, but science won out—data, after all, is data.

    Then, few months ago, another set of (preliminary) cholesterol data was released by Merck and Schering-Plough, after much prodding, regarding their drugs Vytorin and Zetia.

    Zetia has been quite popular. A certain number of patients do not tolerate “statin” cholesterol medicines, and are put on Zetia as an alternative. Zetia lowers cholesterol, but it has never been shown to improve important outcomes such as mortality, heart attack, stroke. That isn’t to say it might not do these things, it just hadn’t been studied. Statin cholesterol drugs have been studied, and have an excellent effect on outcomes.

    Now, interesting new data is emerging. First, according to a study in the New England Journal of Medicine (NEJM) the companies’ marketing campaign appears to be working, at least in North America. Prescribing patterns have changed, with an increase in Zetia prescribing and in costs.

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  • Malawi to curb fake AIDS healers

    The Lancet (Vol 371:9615, March 8, 2008 p. 784) notes that the government of Malawi is working on legislation to prevent traditional and religious healers from deceiving people about AIDS. According to Mary Shaba, a Malawi health official, “when it [the proposed legislation] passes into law, all traditional healers claiming to cure AIDS will be dealt with…. The Act will regulate and protect people from healers who prescribe sex with albinos, the disabled or virgins as a cure for HIV and AIDS.”

    According to the WHO, the HIV rate of about 14% in Malawi has helped reduce life-expectancy to 36 years.

    Health officials say that traditional healers were involved in the drafting of the legislation.

    This is huge. Really. If it works. There is so much bullshit out there about AIDS. The U.S. is full of HIV denialists, and their idiocy spreads to where it can do the most harm—Africa. Top African leaders, such as Thabo Mbeki have fallen prey to the denialists.

    And let’s make no mistake—the “intellectual” home of HIV denialism is the U.S. where the impact is nothing near what it is in Africa. When folks like Peter Deusberg and Henry Bauer (post to follow) spread their nonsense and lies in North America, people have access to all manner of information resources and doctors. Not so much in Africa. If an African leader gets taken in, it can affect policy and have immediate repercussions.

    While the fight against AIDS usually focuses (properly) on prevention and treatment, getting rid of the woos isn’t such a bad idea, and working to co-opt traditional healers is a great idea. The traditional healers could be a potentially powerful force in combating AIDS. The faith-healing churches are another problem altogether.

  • Eat it raw! It's…magic!

    In case you haven’t heard, cooking food is bad–at least according to the raw food movement. This movement has developed over the last 5-10 years, and is still fairly fringe, but fad diets, restaurants, stores, and websites devoted to raw foods are flourishing. Let’s see what they’re up to.

    According to one popular website, we should begin our story by thinking about a few questions:

    What other animal on earth denatures its food by cooking?
    What other animal on earth suffers from all the health challenges that we face?
    What did people eat before there was fire?? They ate it RAW!

    This is as good a place as any to start. The answer to question one is simple…none! To quote Sandy Templeton, my pathology professor, “Is this a good thing, a bad thing, or doesn’t it much matter?” I’ll report, you decide. Let’s add to that question–what other animal uses tools extensively to modify its environment? Uses medicines? Lives past its “natural” life span? Avoids disease through public health measures? Reads and writes books? None! Woo-hoo! We are actually different than other animals!

    Question two, “health challenges”. OK, anyone out there grow up on a farm, or see any wild animals up close? Or read a biology book even? Animals are constantly battling disease. Humans are not unique in our “suffering”, although each species has its own health demons. Animals have parasites–lots of ’em. Animals suffer from horrible viral, bacterial, and prion diseases; animals starve in times of famine. They don’t usually, as far as we know, survive strokes and heart attacks–field mice don’t send a lot of their brethren to medical school.

    Question three answers itself, so I guess I’m off the hook.

    Continued below…
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  • Sexually transmitted diseases—they're successful, we're not

    Sexually transmitted diseases (STDs) are frighteningly common, as highlighted by a study released by the CDC earlier this month. The U.S. is in a unique position: few countries have the resources we do to prevent and treat STDs, and few countries squander such resources so effectively.

    Let me give you a brief front-line perspective.

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  • Gardasil is a good idea

    What if we had a vaccine against cancer? Or even against some cancers? Wouldn’t this be a huge news story, with people everywhere clamoring for the shot? Maybe…

    Or maybe, some people could find a way to turn that smile upside down. Gardasil, the new vaccine approved for prevention of certain cancer-causing strains of the Human Papilloma Virus (HPV), is the first widely available vaccine aimed directly at preventing cancer. (The Hepatitis B vaccine also helps prevent liver tumors, but that’s another story.) Gardasil can prevent cervical cancer, certain mouth and anal cancers, and perhaps other cancers of the naughty bits. So, who wouldn’t love that?

    The Religious Right is who. You see, the infection that leads to these cancers is usually spread by sexual contact. Thats right, sex. SEX!! And sex is a big no-no for the fundies, at least outside of making babies with your opposite-sexed spouse.

    But as much as I dislike fundamentalism, most of the “mainstream” fundamentalist groups have taken a more nuanced stand on Gardasil.

    For school vaccination requirements, Christianity today favors an “opt-in” policy, while Focus on the Family sets a vaguer, “let the parents decide” policy. Both groups, quite wisely, recognize that the vaccine is valuable and that evangelical children are at risk for HPV. The Family Research Council also has an “opt-in” policy with the additional honesty of explaining why they do not like an “opt-out” policy. All of the groups do seem to over-emphasize potential negative arguments, however. Cost comes up as an issue–as it should with any medication. But if the vaccine prevented, say, ovarian cancer, I don’t think anyone would focus much on the price.

    “The wages of sin is death”, and while most Christians do not subscribe to a literal interpretation of this idea, it does infuse the Right’s decision-making, perhaps blinding them to the benefits of this vaccine. In order for the vaccine to be effective, it must be given before the onset of sexual activity (which can even mean touching “down there”). While none of us likes to think about our kids having sex at 14, it may happen, and to punish them with cancer seems, well, excessive.

    An “opt-in” policy for vaccinations is not a good approach to public health. Vaccines work by protecting people before they may be exposed, and by creating herd immunity. Everything that can be done to encourage vaccination should be. Opt-in carries an implication that the vaccine is either unimportant or of uncertain utility. Opt-out, while less negative, makes it too easy for people do put off a decision until it is too late.

    As with any vaccine, safety and efficacy are important. And, as with any disease, education is an excellent public health measure. Mandatory sex education would go a long way toward preventing sexually transmitted diseases and unwanted pregnancies. I wonder how Focus on the Family feels about that?

  • I hate orange urine

    Urinary tract infections (UTIs) are a very common problem, especially in women. The link provided offers some very good information, but briefly, women’s urethrae (the tube the urine comes out of), are closer to the rectum than those of men (who have a built-in “spacer”). This allows bacteria from the colon to creep over to the urinary tract and cause burning, pelvic pain, frequent urination, etc. I treat UTIs daily. Most are uncomplicated, but some are quite serious (usually in the elderly and chronically ill). As medical problems go, I love UTIs. When a healthy, young woman comes in with the usual symptoms, a quick test can confirm the diagnosis, and, usually, three days of inexpensive antibiotics fixes it. The patient is happy, I’m happy, everyone’s happy. But then there’s the orange stuff.

    A few years back, a medication called “phenazopyridine” became more widely available as an over-the-counter drug. It is marketed to treat the symptoms of UTIs. It turns urine and other body fluids bright orange. This medication is useful for reducing the symptoms of UTIs, but does not cure them. The FDA does mandate certain labeling for the OTC preparations, but I can tell you from experience, the subtlety of this distinction is, well, subtle. Fortunately, you don’t have to rely on my experience. Someone bothered to study the question. Most patients do not realize the difference between treating the symptoms and treating the disease. This leads to delay of treatment, and the infection can become more serious. To add insult to injury, phenazopyridine’s orange pigment interferes with the most common tests we use to diagnose UTIs.

    In discussions of medical ethics, the concepts of “paternalism” and “patient autonomy” are often thought of as being in opposition to each other. It is sometimes in the name of autonomy that medications are made more easily available to patients by skipping the physician prescribing process. (Also, over the counter meds are quite profitable). This can be very useful for medications such as ibuprofen, or Plan B (post-coital contraception), but any time you cut out the expert, certain risks accrue. Paternalism isn’t the opposite of autonomy. The two work together. Patients see me for my expertise. They don’t consult me about movies, art, or (thankfully) religion—just medicine. They do this because I’m the one with the training. Giving a patient knowledgeable advice is not paternalistic—it’s what they came here for. I don’t paternalistically command my patients to do anything. I dole out advice, and they are free to follow it or not.

    Orange urine not only removes the expert, it fools the patient. It does not increase autonomy, it actually decreases it by deceiving the patient, perhaps causing them to become more ill.

    <End of rant>

  • Cults are bad for your health

    Cults kill. It’s really that simple. But different cults kill in different ways. It’s not just Jonestown and Killer Kool Aid (OK, Flav-r-Aid). The so-called mainstream cults that are particularly dangerous, because we tolerate them.

    Jehovah’s Witnesses have their own brand of craziness. It’s not bad enough that they come to your door to annoy you in person, but they forbid their members life-saving medical interventions—for no good reason.

    Christian Scientists decline medical care because some lady 150 years ago got better despite the interventions of 19th century quacks.

    Then there’s Scientology. This is a particularly pernicious cult. It preys the most vulnerable—those least able to make rational decisions, and often denied access to health care—the mentally ill. Instead of offering real mental health care to those in need, they inculcate them into their cult, convincing them to avoid modern psychiatry, often with tragic results.

    Look, I’ve got nothing against religion. I’m not religious, but I know it’s possible to be a rational thinker and still be a believer. Unfortunately, it’s also possible to be religious and avoid rational thought completely.

    We often hear that “religious education belongs in the home”, a sentiment with which I’d agree. What’s less often said, but needs to be, is that critical thinking belongs in the classroom, even if it insults a family’s religions sensibilities. Kids need to learn to evaluate evidence and make good decisions. If this means they learn about evolution against their parents wishes, good. If it means they learn to doubt their parents beliefs on transfusions, that’s good too.

    Religion can be comforting, uniting. But in the marketplace of scientific ideas, religion is bankrupt.