Bill Maher, the moronic Food Babe, and the NYT discusses what to call climate change denialists

Bill Maher did it again last night, doubling down on his anti-vax nonsense claiming the real problem is we haven’t done a controlled population-based trial on vaccination vs non-vaccination. Sadly, I don’t have a clip, but I have to say this time at least I was gratified that his panel wasn’t composed of complete morons and they actually challenged him on some of his nonsense. This is actually a classic impossible expectations denialist argument, he essentially proposes an experiment that would be wildly expensive, impossible to perform, and highly unethical. Worse, it still is internally inconsistent. He claims, as he did last week that vaccines are somehow preventing us to experience the benefit of fighting our own individual battles with infectious disease, and that in some Nietzschean fashion, this makes us weaker. But this makes no sense, as vaccines, after all, are antigen exposure. Second, there is no evidence that shows that exposure to infectious disease of one kind somehow makes you stronger, or more able to fight off other infections. It is a point unworthy of debate, not-surprisingly, as Bill Maher tends to make lots of such points. Vaccines have made our populations healthier, live longer, and all but eradicated several devastating diseases in plagues in modern times.

The second interesting article is Justin Gillis at NYT’s What to call a doubter of climate change? You all probably have an idea where we stand, and we have previously discussed the problematic nature of the use of denier as it gives them easy ammo to dismiss critique of denialist tactics as ad hominem. Unfortunately Gillis fails to actually define the problem adequately, in that he fails to describe the behavior and tactics of denialism. As a result his comment section, already at about 400 at the time of writing, mostly consists of Galileo gambits and comparisons of modern denialists to Einstein or Marshall and Warren. This is a newer modification of the Galileo Gambit which hijacks the work of Thomas Kuhn to suggest the denialists aren’t hacks, but revolutionaries!

Of course, the problem is the scientific revolutions that Kuhn described weren’t accomplished using the tactics of denialism. It’s also very important to understand such revolutions don’t invalidate previous data, which are still true. Einstein didn’t invalidate Newtonian physics, he expanded upon them in areas where they don’t work, such as at high speeds or small scales. Climate change denialists aren’t advancing a radical new theory, or compiling an alternative data set, they’re nitpicking existing science and promoting conspiracy theories about fraud that routinely get pants on fire level ratings. It’s a clever tactic, but totally bogus. When Jim Inhofe says that climate change can’t be dangerous because God is in control, that’s not a scientific revolutionary speaking. That’s a crank.

So Gillis makes a critical error, I believe, in the presentation of this problem because he fails to adequately describe the tactics of denialism being criticized, because the tactics are indefensible, and documented from one side of the internet to the other. It’s psuedoskepticism, and psuedoscience, and the key from distinguishing it from actual science that has the capacity to generate a revolution is to point out that no actual science is being done by these jokers, just cherry-picking, conspiratorial fear-mongering and rhetorical tricks. I think he describes the problem well but has opened himself to undue criticism by not making the issue the tactics rather than the specific belief. (of note Gillis spoke to me in prep for this article about some of the history of the debate)

Finally, the Food Babe. She truly presents an abundance of stupidity to debunk, and Orac does it well. Her newest, shockingly-stupid statement is just mind-blowing. She has apparently said, “There is just no acceptable level of any chemical to ingest, ever.”

Her history of doing this is pretty significant and she follows a pattern – she says things that show that she is so mind-bogglingly ignorant that she proves she has no business representing herself as a source of valid information or expertise on any topic. Then she realizes she’s crossed the line of unbelievable ignorance, and tries to hide it from the internet. Notable examples include her now difficult-to-find claim that pilots flood airplanes with toxic nitrogen gas rather than healthy oxygen during flights. Or her claim that brewers use toxic chemicals to fine beer, ignoring, of course, the toxicity of ethanol or that her sub-high school level of chemistry has not prepared her to understand even very basic concepts in organic chemistry.

Let us be very clear. This isn’t even denialism (although she does make those arguments too). This is just abject stupidity. This is such a low level of knowledge and understanding of the physical world it actually falls more into the Not even wrong category of argument. I don’t even need to debunk such a stupid statement, I trust my audience to be smart enough to see the glaring flaws, and there are a few contained in that special little nugget.

But this ties back into Bill Maher in an important way. As we discussed last week, Bill Maher essentially buys into this same ignorant medical belief that toxins are somehow to blame for a significant portion of human illness. On its surface its an appealing piece of woo, because it accomplishes one of the most important tasks of a really attractive piece of nonsense, that is, it offers adherents a false sense of control over their health. If I just avoid “toxins” I can avoid heart disease! And Cancer! and liver forever! Clearly, there are some toxins that humans frequently ingest that can cause disease, like alcohol (she doesn’t pick up on the toxicity of alcohol amazingly), tobacco, and various chemical exposures that at high levels can cause liver disease, heart failure, cancer. It’s entirely possible for toxins to cause disease, this is true. But it’s not in the way that the toxin fanatics think, in which anything natural is falsely seen as “non-toxic” and anything man-made or processed is “toxic”, and it also fails to understand the most important principle in understanding (most) toxic exposures, that is the general association between dosage and toxicity. For the moment we’ll put aside idiopathic toxic reactions, but generally, dosage is important. A chemical like water, the essential molecule of life, can be toxic to humans at high levels, but essential in the range that our body needs to keep all of its complex chemical reactions in equilibrium.

Further, natural foods, plants, etc., contain toxins as a part of their basic make-up. Consider the tomato. A member of the nightshade family Solanaceae, it contains toxins including solanine (as do many other fruits and veggies). Luckily, humans have an organ called a liver, and for most levels of this toxin contained in your all-natural, GMO-free potatoes, tomatoes, blueberries and apples, you’re going to be just fine (unless you eat like 100 potatoes in a sitting).

Toxins are everywhere, they’re in our food, our natural, wholesome, tasty healthy food. We’re just able to process most of them, at the levels that our bodies have adapted to over the millions of years we’ve been evolving on this planet. When morons like the Food Babe, and Maher vaguely refer to “toxins” and then in the next breath talk about eating veggie, avoiding meat (very low in toxins compared to say a nice plant like belladona – or cherries), they just show they have no clue what contributes to health and human disease.

Disease can be avoided, but the only things we really have good evidence for is that we should eat less, exercise more, and avoid true toxins like tobacco and ethanol (although moderation on booze is probably ok – thank your liver). Most of the rest is out of our control and is a combination of genes and luck. There are no superfoods. There are no panaceas, no magic vitamin supplement which has been shown to substantially effect our mortality (read the link, most supplementation is at best useless, at worse, harmful). It would be wonderful if there were, but there simply isn’t good evidence for this nonsense. When someone shows me some real data that we can fool our body into not aging with some specific diet, supplement or food, I’ll happily eat it, but they just don’t have it (and I’ve read the Mediterranean diet data which is pathetic.)

The best advice I can give after studying this stuff for years is that no one knows the ideal diet. It’s important to avoid obesity. Malnutrition is rare with most typical, varied diets so supplementation is likely unneeded outside of specific illnesses or life changes like pregnancy. Eat more high fiber foods like fruits and vegetables, and avoid junk food, avoid calorie-dense foods like sugary sodas, highly-processed food and fast food. Exercise. Sleep. Until we know better, we can’t say much more. And the certainty with which natural-food pronouncements claim foods are “miracles” or “super” is a sure sign of fraud.

Antibiotics in Meat Do Lead to MRSA in Humans

I was extremely disturbed to see in the NYT’s letters a veterinarian’s defense of the practice of overuse of antibiotics in animals that suggested transmission of resistant organisms does not occur. Nonsense! It is abundantly clear that antibiotic use in animals results in resistant strains that then colonize humans. They are being recognized as the newest reservoir for strains of MRSA.

Unlike the GMO nonsense, this is a clear public health issue with a plausible (and demonstrated) mechanism of transmitted risk to humans. The author of the letter, Charles Hofacre, says two, wildly misleading things. For one, he suggests the antibiotics they are using are somehow substantively different from those in humans by saying, “About a third of livestock antibiotics used today are not used at all in human medicine.” Well, that means 2/3rds are the same and just because we don’t use the exact same antibiotics doesn’t mean they don’t share the exact same mechanism. If he’s trying to suggest resistance in livestock antibiotics isn’t relevant to human pathogens, he is just wrong, wrong, wrong. Second he says, “There is no proven link to antibiotic treatment failure in humans because of antibiotic use in animals for consumption — a critical point that is often missed. ” This is such a misleading statement I can’t believe an academic would say such a thing, as it assumes we’re just idiots. This suggests that there is not a transmission issue, or at least none of clinical relevance. But this is also wrong. There is extensive documentation of Methicillin-resistant Staph Aureus (MRSA) becoming more common in livestock, being transmitted to humans, and appearing in hospitals. There hasn’t been a “treatment failure”, because we still have antibiotics that work against MRSA, and MRSA is usually not pathogenic on its own without some failure of the host immune system, broken skin/non-sterile injection, surgery, chemo, etc. That doesn’t mean we should go around spreading MRSA! We have to start taking out the big guns to deal with MRSA infections when they do occur (we don’t treat colonization), and the more we expose these bacteria towards the better antibiotics, the more we’ll train them for resistance to those drugs. But it should be made clear, the transmission of resistant bacteria from farm animals to humans has been documented, just because the patients didn’t die doesn’t mean that there’s no problem here. This is just shameful.

Antibiotic resistance has existed since before we even used antibiotics and will only get worse the more we train the organisms to grow in the presence of antibiotics. These genes for resistance aren’t “new”, but not all bacteria carry them because there is an energy cost associated with production of proteins, and if it doesn’t benefit their survival, those bacterial strains wasting energy will become less common. If we constantly create a selective pressure on bacteria to maintain resistance genes, we are going to increase the proportion of bacteria that carry resistance, and thus the resistant organisms we are exposed to. Then, as we have to use more and more powerful antibiotics to address resistance, we create additional selective pressure on the organisms to carry more and better resistance genes (not all beta-lactamases are created equal), and as they mutate to become more effective, those effective resistance strains will eventually mutate into bacteria for which we have no therapeutic option. These are already starting to emerge as those who followed reports of the MDR-klebs outbreak at NIH know.

In my GMO thread I used the analogy that the beta-lactamase used for genetic modification of organisms by molecular biologists is like a “sharpened stick” it can use against weaker penicillins. This is why those resistance genes aren’t a danger for humans. They’ve been around forever anyway, all the bacteria that are going to carry them already do so we don’t even bother using weaker penicillins on those types of infections, and they can’t beat our stronger beta-lactam drugs like the anti-staph and extended-spectrum beta lactams. The multiple-resistance and pan-resistance bugs that we are finding in our ICUs are the “multiple nuclear warhead” bugs because they beat multiple classes of drugs as well as our extended-spectrum drugs. We’ve created these bugs by the steady application of selective pressure with exposure of the organisms to progressively more powerful antibiotics. The continued injudicious use of antibiotics in animals will invariably lead to the same phenomenon, just all over the place in communities and the workplace rather than just in the ICU. We are going to see a higher prevalence of resistant bacteria, those bacteria will mutate their resistance genes to become more and more effective, they’re already crossing over to humans and hospitals, and we’re going to have to use our big guns more which will speed up the loss of our antibacterials’ efficacy.

Some caveats. One, this represents more of a threat for farm workers than consumers, as MRSA is not carried in the meat itself, although it will likely contaminate the meat at higher frequency (this has indeed been shown) as the prevalence increases from slaughterhouse contamination. MRSA usually colonizes the outside of the animal, the nares, etc., not the inside of the animal. Two, standard practices of food handling will also decrease, but not eliminate our risk. Cooking meat and washing hands with soap after meat handling (which should be your standard practice) kills MRSA. Don’t prepare hamburger then pick your nose people. Clean surfaces on which meat has been prepared etc. However, the packaging, your cutting board, your trash can, all are likely to get contaminated if the meat was surface contaminated. Three, realize MRSA is not pathogenic in normal healthy people. But, something as simple as a cut can introduce staph and create a serious infection. Staph is everywhere, and the human body generally has no problem handling it. But when those defenses are down, MRSA reduces our therapeutic options. You don’t want that. Fourth, this is just one bug we may be exposed to, we’re also training the animals e. coli and enterobacter to become resistant too, and with poor food prep and exposure, you can get colonized with these bugs as well.

From a public-health standpoint it’s important that we reduce the prevalence of resistant bacteria we’re exposed to, so fewer of our infections will require the big-gun antibiotics. There is good news though, and we shouldn’t just develop a fatalistic attitude towards this problem. As we stop the overuse of antibiotics, selective pressure on the bacteria will cause some of them to shed the resistance genes, and there won’t be a reason for the bacteria to maintain and improve their antibiotic resistance genes. Without consistent exposure to antibiotics, they have far less selective pressure to produce proteins and maintain plasmids that provide them no advantage. While the resistance genes will still be out there (always have, always will), we can still benefit from common-sense measures that decrease their prevalence, and thus our individual risk of exposure to resistant organisms. And, the less we have to take out the big guns to treat infections, the fewer multiply-resistant organisms we’ll see.