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OpenMarket: Health and Safety

  • Study "Wounds" the Carbohydrate-Insulin Theory of Obesity

    August 24, 2015 3:53 PM

    Last week a very interesting and, by all accounts, very well-done study made waves among the nutritional science community. For many years, the idea that reducing carbohydrates is the most effective way to reduce fat due to its effect on insulin has been rapidly gaining in popularity.

    Prominent researchers like Dr. Robert Lustig (who famously called sugar a “poison”), and Gary Taubes (author of Good Calories, Bad Calories) have promoted the idea that it’s not just about how much you eat, but what you eat, that leads to obesity. Specifically, that carbohydrates and sugar cause a cascade of problems including insulin resistance, obesity, and type 2 diabetes. This new study, however, casts serious doubt on the hypothesized mechanism by which consumption of carbohydrates, in particular, would lead to these problems.

    The study, led by Dr. Kevin D. Hall, was published in the highly respected Cell Metabolism journal on August 13 and found that restricting dietary fat led to body fat loss that was 68 percent higher than a diet that reduced the same number of calories through carbohydrates for obese adults. The study was small, with only 19 participants, and short, lasting only four weeks.

    However, it was a well-designed and tightly controlled study. As neurobiologist Stephan Guyenet put it, “this study's methods were downright obsessive. The overall study design and diets were extremely tightly controlled, and the researchers took a large number of measurements using gold-standard methods.” The participants were randomly assigned to either the low-carb group or the low-fat group. After five days of baseline eating, the participants had their calories restricted by reducing either fat or carbohydrates by 30 percent (sugar was the same in both groups).

  • Back to School Lunch Scares

    August 19, 2015 3:15 PM

    It’s back to school season, which for many parents means spending money on new clothes, shuttling young people from sports games to ballet, and increasingly, worrying about the kind of nutrition their kids are getting when they’re away from the home.

    This is understandable since they are inundated with hyperbolic headlines like “sugary drinks kill,” “death by salt,” and “processed meat causes cancer”. It’s enough to add a few gray hairs to any parent’s head. While it’s important to teach kids about proper nutrition and make sure they’re eating a balanced diet in and outside of the home, this kind of inflammatory rhetoric doesn’t help parents make healthy and realistic choices for their children.

    So, here are a few tips to help you relax as you send your kids off into the great wide nutritional unknown.

    Soda won’t kill your kids. There is no doubt that excessive consumption of sugary drinks through soda or fruit juice can easily lead to a calorie surplus and weight gain. However, the occasional can of sports drink after a soccer game isn’t likely to cause any damage.

    You may have seen the headline announcing that a study says “Sugary Drinks May Kill 184,000 People Each Year.” It’s pretty scary, but it’s also pretty speculative and its methodology is questionable. The researchers used data from 62 self-reported surveys from only 51 countries between 1980 and 2010. They used “sugar availability,” to calculate consumption, presumably to account for the counties without adequate data. Rebecca Goldin, a Professor of Mathematical Sciences at George Mason University and Director of STATS.org (a group of researchers who work to evaluate and interpret statistical research for accurate reporting in the media) pointed out the many reasons people should be skeptical of this study, including a lack of transparency about how the researchers accounted for missing data such as sugar sources in the diet other than sugary drinks.

    They also failed to say how addressed the uncertainty in the proportion of diabetes/cardiovascular disease caused by sugary drink consumption, and the uncertainty of the proportion of deaths caused by these diseases. When someone goes into the hospital with a heart attack and dies, it’s very difficult to say if it was his five decades of smoking, sedentary lifestyle, or the liter of coke he drank every week.

    As Harry Cheadle over at Vice put it “X behavior causes Y deaths” headlines are always popular because people like numbers, and statements like that at least appear to quantify bad behaviors. Never mind if the numbers don't really make any sense.”

  • Government Nutritionists Wrong… Again

    August 10, 2015 3:40 PM

    Add it to the list of things that the government got wrong when it comes to nutrition: skipping breakfast may not make you fat. It turns out this apparent truism isn’t so true and the idea has only been in circulation for the last five years or so:

    The notion that skipping breakfast might cause weight gain entered the Dietary Guidelines in 2010, during one of the reviews conducted every five years by experts to update its findings… [They] collected research on skipping breakfast. Some of it did, indeed, suggest that breakfast skippers may be more likely to gain weight.

    But the evidence the experts on the Dietary Guidelines Advisory Committee relied on were observational. As Peter Whoriskey commented, “observational studies in nutrition are generally cheaper and easier to conduct. But they can suffer from weaknesses that can lead scientists astray.” And astray they went. When the Advisory Committee decided to enshrine their “breakfast-weight hypothesis” into the Dietary Guidelines, they cited only one randomized controlled trial, which found “no relationship with breakfast alone” and weight gain.

    Last year, however, a team of researchers from Columbia University did a controlled trial to examine this breakfast hypothesis. They divided a large number of people into “oatmeal breakfast,” “frosted corn flakes breakfast,” and “no breakfast” groups. At the end of the trial they found that the breakfast-skippers lost more weight than the other groups.

  • Green Alarmism about Sunscreen Debunked

    August 4, 2015 7:03 AM

    Often spoon-fed alarmist hype by green activist groups, reporters rarely get the science right about the risks associated with trace chemicals found in consumer products. Accordingly, kudos go to the author of a piece published on Fox News (originally published on Health.com), which debunks activist-generated misinformation about chemicals used to make sunscreens. In the past, I have pointed out that Fox News has blindly reported misinformation pushed by greens, particularly the Environmental Working Group, so this latest report is refreshing. 

    The story explains:

    [T]he skin experts Health talked to were adamant that we should be more worried about shielding our skin from the sun’s harmful UV rays than about the chemical makeup of the products we’re using to do that.

    “Five million Americans are treated for skin cancer each year, and an estimated 9,940 people will die of melanoma”— the deadliest type of skin cancer— ”in 2015,” Steven Wang, MD, head of dermatological surgery at Memorial Sloan Kettering Basking Ridge in Basking Ridge, New Jersey, told Health. “The biggest precaution that you should be taking is using sunscreen. There is enough research at this point from various credible bodies that say sunscreens are safe and, when used appropriately, will reduce skin cancer.”

    This reporter appears to understand that we need to consider the benefits of products and weigh them against the risks. And it should be clear to any honest observer, that avoiding the real and substantial risk of skin cancer from sun exposure, is far higher than any theoretical and unproven risks associated with short-term, trace exposures to certain manmade chemicals.

  • Slate Exposes Deceitful Heart of the Anti-GMO Movement

    July 17, 2015 9:13 AM

    Will Saletan has an exhaustively researched and cogently argued piece at Slate on the dishonesty of the anti-biotechnology activists and the harm they have caused. He lays out, for all to see, the naked truth about their efforts. It has nothing to do with the truth. They only care about pushing their agenda, even if it comes at the cost of human lives. As Saletan writes, “[t]hey want more studies. They’ll always want more studies. They call themselves skeptics. But when you cling to an unsubstantiated belief, even after two decades of research and experience, that’s not skepticism. It’s dogma.”

    Saletan describes the tactics employed by activists to hoodwink the public and politicians. Fear-mongering, misinformation, and information-overload are particular effective. Fear-mongering is the easiest one: they can simply say, “We don’t for sure that this thing is safe.” And because science is hard and usually involves reading long, boring blocks of text, few people will bother to dig deeper. Those who do will find plenty of intentional misinformation or manipulation of research. As Saletan points out in this passage:

    Schubert systematically distorted the evidence…Schubert said the study found that “smokers who supplemented their diet with beta-carotene had an increased risk of lung cancer.” He neglected to mention that the daily beta carotene dose administered in the study was the equivalent of roughly 10 to 20 bowls of Golden Rice. He also failed to quote the rest of the paper, which emphasized that in general, beta carotene was actually associated with a lower risk of lung cancer.

    One feature of their methods Saletan left out is the role played by the media. Anti-biotech activists rely on journalists to create an echo-chamber for their baseless claims. In this digital age it’s all about them clicks. And putting up a headline like “Study Finds Golden Rice Causes Cancer!” will get a lot more attention than a title like “Study shows smokers who supplement diet with beta carotene at increased risk for lung cancer, but for everyone else beta carotene has benefits.” For one thing, it is way too long (fire that headline writer), but it is simply not as shocking and therefore less likely to motivate someone to read it. So, most journalists just republish whatever was written in a study’s press release; few have the time to slog through entire research papers.

    And this is what activists count on. They count on individuals and media outlets being too limited in time and interest to actually verify their claims. Sometimes this gets them into trouble, like when a clever journalist published a bunk paper on how chocolate can help people lose weight and then wrote a piece about reporters being gullible. But most of the time, nobody is the wiser and the misinformation gets filed away in the back of peoples’ minds, slowly building a basis for them to “instinctually” share the activists’ bogus claims.

  • More Unintelligible Gibberish on GMO Risks from Nassim Nicholas Taleb

    July 16, 2015 12:47 PM

    A few months ago, statistician and risk analyst Nassim Nicholas Taleb, known mostly for his intriguing 2007 book The Black Swan, teamed up with a handful of colleagues to write a “scholarly” diatribe claiming to demonstrate that “what appear to be small and reasonable risks” with GMOs may “accumulate inevitably to certain irreversible harm.” Therefore, the precautionary principle “should be used to prescribe severe limits on GMOs.” The paper received a lot of attention in scientific circles, but was roundly dismissed for being long on overblown rhetoric but conspicuously short on any meaningful reference to the scientific literature describing the risks and safety of genetic engineering, and for containing no understanding of how modern genetic engineering fits within the context of centuries of far more crude genetic modification of plants, animals, and microorganisms.

    Well, Taleb is back, this time penning a short essay published on The New York Times’s DealB%k blog with co-author Mark Spitznagel. The authors try to draw comparisons between the recent financial crisis and GMOs, claiming the latter represent another “Too Big to Fail” crisis in waiting. Unfortunately, Taleb’s latest contribution is nothing more than the same sort of evidence-free bombast posing as thoughtful analysis. The result is uninformed and/or unintelligible gibberish.

    For example: “The statistical mechanism by which a tomato was built by nature is bottom-up”. The tomatoes we eat today are vastly different than those produced by nature. In the wild, tomatoes are poisonous, marble-like berries. The cultivated tomatoes we eat today are the products of vast genetic changes wrought by human hands. More to the point, what does it even mean that tomatoes were built from the bottom up? Surely Spitznagel and Taleb aren’t claiming tomatoes themselves suggested to we humans what genetic changes to make? On its face, the statement may sound profound, but it simply defies meaningful comprehension.

    “... by tinkering in small steps ...” Sure, early farmers tinkered in small steps. Then the 20th Century came along, and breeders began making many giant leaps in genetic manipulation -- long before the advent of recombinant DNA in the 1970s. For six or seven decades, breeders have been making macro genetic changes using tools like induced mutation breeding, protoplast fusion, and wide crossing, all of which result in changes to the genetic composition of plants that are orders of magnitude greater than those which result from genetic engineering. What, I’d like the authors to explain, makes the alteration of a single gene or small number of genes in an organism a bigger step than randomly scrambling whole genomes via mutation breeding?

  • Not So Fast: Fatally Flawed Research Asserts Alcohol Taxes Save Lives

    May 12, 2015 10:52 AM

    Last month, researchers at the University of Florida published a study in the American Journal of Public Health that concluded, “Increases in alcohol excise taxes, such as the 2009 Illinois act, could save thousands of lives yearly across the United States as part of a comprehensive strategy to reduce alcohol-impaired driving.” Their study presented the case that the 2009 tax increase resulted in a statistically significant reduction in alcohol-related deaths in Illinois. However, as I pointed out in a blog post, there only appears to be a reduction in fatalities because of the authors’ selective inclusion and exclusion of data. Rebecca Goldin, Director of STATS.org and Professor of Mathematical Sciences at George Mason University, found even more flaws in the research.

    In her post, Rebecca takes a bird’s eye view of the crash data in Illinois between 1999 and 2013. She finds a steady decline during this 10-year period with “hardly anything special at all going on at the end of 2009.” Looking closer at the data, she noted (as did I) the curious exclusion of data after 2011. “Results should be resilient to changes in choices, such as whether to use data published 2011-2013,” Goldin notes. When added to the evaluation, this 2011-2013 data shows a small decrease immediately after 2009, but then shows a steady increase in alcohol-related traffic deaths in Illinois. She also found that as a proportion of total traffic fatalities, alcohol-related fatalities on the road have been increasing since 2009 (though only by 2 percent—a statistically insignificant amount).

    Of course, the real story here is that breaking the data at year 2009 may not be an appropriate way of measuring the trends, and certainly it’s not appropriate to “blame” the excise tax for the proportionally increased alcohol deaths in the context of decreasing deaths associated to alcohol. But by the same logic neither is it appropriate to conclude that the excise tax has been saving lives.

    Finally, in addition to the “creative math” and error of conflating correlation with causation (bad scientists, bad!), there’s another potential problem with the study. The grant provided by the National Institutes of Health lists the purpose as “to develop a research program of HIV prevention focused on the intersection of event-level alcohol use… and sexual partner selection among adolescents.” There is no mention in the grant description about taxes or motor vehicle crashes. I say this is a “potential” problem because I have been unable to get answers from anyone at the NIH or the University of Florida researchers who worked on the project. My questions were simple: What was the rationale behind using an AIDS grant for alcohol tax research? And is this sort of change in scope common practice?

    It’s one thing to have public health advocates peddling flawed research in order to advance personal agendas, but it’s another entirely to use taxpayer money to do so.

  • Who Dares Question the Mighty Oz?

    April 24, 2015 11:41 AM

    Yesterday, Dr. Mehmet Oz launched his “counter attack” on several doctors who sent a letter last week to the dean of Columbia University’s medical department complaining about controversial positions and advice that Oz has offered on his show. Oz, who holds faculty and administrative positions at Columbia, exclaimed that he “will not be silenced” by his critics, casting the issue as an attack on his freedom of speech. In an article for Time magazine, Oz stated:

    The dean politely reinforced that the academic tradition of all institutions protects freedom of speech for their faculty, and I assumed the matter was over…. I know I have irritated some potential allies. No matter our disagreements, freedom of speech is the most fundamental right we have as Americans. We will not be silenced. We’re not going anywhere.

    Yet no one is trying to deprive Oz of his right to free speech. The doctors listed on the letter are simply exercising their own right to free speech—and that includes speaking truth to the powerful Oz. They shined a light on Oz’s often questionable, TV-publicized, health advice for good reasons, as many others have done so hereherehereherehereherehere… and the list could go on and on.

    And apparently, shining a light on Oz’s questionable approaches did some good. It prompted eight of Dr. Oz’s colleagues from Columbia University to speak out as well in a USA Today commentary. These doctors note:

    We are members of the Columbia faculty who recognize that the Dr. Oz Show performs a public service by bringing alternative therapies which are generally under-researched and under-regulated into the public forum. However, a 2014 report in The BMJ (formerly the British Medical Journal) reported that less than half of the recommendations on his show are based on at least somewhat believable evidence. This report raises concerns that Dr. Oz's presentations of anecdotal therapies as "miracle cures" occur in the absence of what we see as obligatory discussions of conflicts of interest, possible side-effects and evidence-based medicine (or lack thereof). Many of us are spending a significant amount of our clinical time debunking Ozisms regarding metabolism game changers. Irrespective of the underlying motives, this unsubstantiated medicine sullies the reputation of Columbia University and undermines the trust that is essential to physician-patient relationships.

    And last spring, members of Congress also attempted to rein in Oz when they invited him to testify on Capitol Hill about his claims related to “miracle” weight loss supplements. And apparently, it worked to some degree. On his show yesterday, Oz says that he’s backed away from making claims about miracle supplements. In addition, after the rebuke by his Columbia colleagues, he’s even said he regrets comments he has made about such supplements. That’s progress, but there’s more to do.

    While Oz thanked his colleagues at Columbia for speaking up, he attacked the doctors on the first letter because he says they have an “agenda.” And rather than address their arguments, he attacked them personally on his show. Apparently, it’s inconceivable to Oz and his crew that people can disagree with them based on informed, moral personal views.  

    In particular, he focused on the work of CEI friend and scholar Dr. Henry I. Miller of the Hoover Institution. Dr. Miller’s writings and research on the topic of genetically engineered food are among the most informed and scholarly in the world (he was also the founding director of the FDA’s Office of Biotechnology), and his positions are humanitarian. Rather than attack, it’s time for Oz to take a closer look at this issue and reconsider his position, as he has with supplements.

    Genetic engineering allows researchers to precisely modify plant genes in a process that is far more precise and safer than cross-breeding plants. Using GM, researchers have been able to add vitamin A to rice to reduce vitamin-A deficiency, a major cause of blindness and death, particularly among children, in parts of the world were rice is the staple of the diet, although anti-GM activists have fought this “golden rice.” Scientists also use genetic engineering to make food production easier and more affordable, which is essential to feeding a growing world population.

    Dr. Oz says he’s ambivalent about such foods, although his shows are laced with fear-generating suggestions about these technologies, and his “experts” are mostly anti-biotechnology activists. He did, however, allow one biotech apple farmer to appear on his show last week to offer a little balance in that one segment. 

  • TSCA Reform Debate Is Not about Public Safety

    April 1, 2015 1:59 PM

    At recent hearings on the Frank R. Lautenberg Chemical Safety for the 21st Century Act (S. 697), senators, environmental activists, and local government officials claimed that the Toxic Substances Control Act (TSCA) law is not sufficient protect public health. As I have argued before, that’s certainly not the case.

    There may be an economic reason to reform this law—to preempt a growing patchwork of nonsensical state-level consumer product regulations—but there’s no legitimate “safety” reason for reform.

    Still, activists and some members of Congress at the hearing complained that TSCA’s risk standard has prevented the EPA from banning “a known human carcinogen,” i.e., asbestos. Cosponsor of S. 697 Senator Tom Udall (D-N.M.) exclaimed at the hearing, “I think we all agree: TSCA is fatally flawed. It has failed to ban even asbestos.”

    Activists and members of Congress point out that EPA failed to address asbestos in part because TSCA requires EPA to pick the “least burdensome” regulation to achieve its goals. 

    But how can that be a bad thing? Shouldn’t we want to achieve our goals at the lowest costs? It doesn’t say EPA should pick a regulation that is less safe; rather, it says that EPA should simply pick a less expensive means to meet the safety goal.

    That requirement is part of TSCA’s robust risk standard that holds regulators accountable and prevents them from passing rules that do more harm than good. Under TSCA, EPA may regulate when the agency finds that a chemical may pose an “unreasonable risk of injury to health or the environment.” This standard requires weighing the risks of the chemical against the risks of the regulatory action.

    People who use the asbestos case to push TSCA reform are either grossly misinformed about the case or they are simply being disingenuous. It is true that the rule was thrown out by a federal court in part because EPA did not bother to find the “least burdensome” approach to meet its goals. In addition, the court pointed out that the rule might have produced more deaths than theoretical lives saved. Accordingly, this is not a TSCA failure, it’s a life-saving success!

  • Arsenic in Wine: Dangerous or Beneficial?

    March 26, 2015 2:23 PM

    Dan Nosowitz in Modern Farmer offers some insights on the recent class action lawsuit filed against California winemakers. The plaintiffs found that some inexpensive wines contained arsenic at levels exceeding the federal drinking water standard for this substance. Nosowitz rightly points out that the standard is for water, not wine and “people don’t, or shouldn’t, drink as much wine as water.”   

    Well, let’s not go that far… kidding of course! Moderation is surely a good idea when it comes to alcohol consumption. Yet even if you drank as much wine as you do water, there’s still no reason to be alarmed about arsenic. The levels in wine are still too low to have any significant adverse impacts, and ironically, such small amounts might even have health benefits. 

    Arsenic is an element that naturally occurs in the earth’s crust, so traces of arsenic inevitably appear in food and water. Certainly, high levels of arsenic are not healthy and concentrated exposures can be immediately deadly. But the trace levels found in water and food are rarely an issue. Problems have emerged primarily in developing nations like Bangladesh where poor people drink from untreated water sources with arsenic levels that range in the hundreds of parts per billion (ppb), and sometimes more than 1,000 ppb.

    It’s worth noting that the levels allegedly found in wine are reportedly just five times greater (or 500 percent higher as noted in the press) than the federal drinking water standard of 10 ppb. So, some number of samples—we don’t know how many—tested by the plaintiffs in this case had some level of arsenic near the 50 ppb level. But did you know that until 2006, that was the allowable level in drinking water in the United States and it had been for decades?

    The U.S. Environmental Protection Agency (EPA) changed the standard to 10 ppb in 2001 with full compliance not required until 2006. The 10 ppb standard for arsenic in drinking water is excessively overcautious. When EPA proposed it, it was very controversial because the cost to small drinking water systems was substantial and the benefits highly questionable. EPA’s Science Advisory Board highlighted lots of problems with EPA’s science and maintained that the change could actually undermine public health. The SAB explained that the costs might cause some small communities to disconnect their water systems, forcing people to use untreated well water, but EPA finalized the rule anyway. 

    If you look at the history, you can see that EPA did not change the standard for safety reasons; they did it for political ones. You may remember, environmental activists attacked the Bush administration for taking time to reconsider changing the standard, which the Clinton administration rushed out during the final hours of the Clinton presidency. Green groups made it sound like the Bush administration was adding arsenic to the water supply. And this bad press made a rational and scientific debate impossible.

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