Flashback - Health Advice

[Here is a combination of a flashback and an example of how easy it is to predict future news. In November 2013 I wrote the below essay with the title "Secrets to Good Health." This month the BBC ran an article about a BMJ (British Medical Journal) report that men can live an extra 7 years, 10 years for women, of quality life by adopting five healthy habits: never smoking, healthy diet, exercise, body mass index (BMI) between 18.5 and 24.9 and moderate alcohol use. That's substantially what I told readers over 6 years ago in the following flashback.]

As I read this information from Johns Hopkins on how to maintain good eyesight, it occurred to me that products advertised as the secret to good health must be a scam.

This article from a group of medical experts tells that other than regular checkups, to maintain good eyesight “many lifestyle factors that protect our heart health may also help keep our eyes healthy, including being active; getting enough sleep; controlling blood pressure and diabetes; not smoking; maintaining a healthy weight; and eating a diet rich in fish and leafy, green vegetables like spinach and kale. Wow, that’s almost the same advice for every other health concern, not only heart health, but also improving the effects of arthritis, preventing chronic illness , promoting memory and general mental health.

The real secret to good health is that there is no secret.  Health authorities have not been trying to hide anything from us. There is no big secret "doctors don't want you to know."  In fact they have been shouting from the rooftops at every opportunity. We are told over and over on a number of issues that if we want to avoid problems and just generally feel better we should: get enough sleep, eat healthy, drink alcohol only in moderation, stop smoking, get plenty of exercise, drink enough liquids, use sunscreen, wear work gloves or protective eyewear as appropriate, learn relaxation techniques to reduce stress, brush and floss, wash your hands and get a flu shot. This should come as a surprise to no one. We have heard all this advice or subsets of it many times for many years.

The problem with advice like this is that no one wants to hear it. Americans are looking for the easy way, one that requires little discipline. So every time a new diet book is published or the doctors on TV tell us about a miracle cure or another health secret, people want to sign up for the program (and send in their money). They can’t hold an audience by saying the same things over and over, especially when we are so desperate for secrets, so the authors and television personalities must give us secrets.

The real secret is the boring truth – that there is no secret. Like every other endeavor in life, staying healthy requires a little luck and a lot of discipline to stick to the best course of action. The rest is distraction.

What is Income Inequality?

What is the opposite of income inequality? It certainly can’t be absolute equality of income. Without being more specific, how can the term mean anything?

For years we have heard about goals like clean water and clean air. The US has been moving in the right directions. According to the EPA, “Since 1970, implementation of the Clean Air Act and technological advances from American Innovators have dramatically improved air quality in the U.S.  Cleaner air provides important public health benefits.” Follow the link to find a graph of nine measured pollutants, excluding CO2. It shows a downward trend since 1990 for all, excluding unusual events like dust storms and wildfires. Overall, pollutants have dropped significantly despite the fact that “Americans drove more miles and population and energy use increased.”

All the pollution levels dropped below a line labeled “Most Recent National Standard” as of five years ago. Note that there is a standard that defines an acceptable level of particles in the air. Totally pure air is not a practical or realistic goal.

Similarly, the 1974 Safe Drinking Water Act “resulted in major changes in the way drinking water is managed and treated in the United States, and it achieved substantial measurable benefits in risk reduction and public health protection.”

On a side note, these facts do not seem to sway Americans influenced by media reports designed to stimulate concerns about hypothetical risks related to drinking water. A survey from 4 years ago showed that 56% of Americans “were concerned or very concerned about their tap water, 77% were regular users of bottled water, and 43% used some type of home treatment device.” The water industry and regulators have their work cut out for them figuring out how to promote acceptance and confidence in public drinking water supplies “and to maintain the public’s support for needed improvements.”

Once again there are measurable standards. Customers of public water systems receive a report from their water utility every year showing how the water supply measures up to various standards. Again, absolute purity is unachievable.

The same is true for lakes and rivers. “Human health ambient water quality criteria represent specific levels of chemicals or conditions in a water body that are not expected to cause adverse effects to human health.” 

Applying this to income inequality leaves critical thinkers puzzled.

The news media emphasizes stories about the shrinking middle class. “A graph from Reason, however, shows that about 50 years ago, 53 percent of people were middle-income, making between $35,000 and $100,000 per year. Although that statistic has since fallen to 42 percent, the reason [behind the change] is that many people moved into upper-income brackets. The share making more than $100,000 rose from 8 percent to almost 28 percent. (These numbers are inflation-adjusted.)” It’s shrinking, but not in the direction the news media and politicians imply.

Stories about income inequality don’t mention this information. Instead they attempt to stir up envy toward the super-rich, at least some of the super-rich. Notice that the emphasis is always on bankers, CEOs and hedge fund managers, not on sports stars, celebrities, Internet influencers or software developers. We are supposed to be irate that some people are rich, undeserving jerks, but others deserve wealth because they entertain us. Often the people who report these stories are rich themselves.

Furthermore, the evidence that income inequality negatively effects economic growth or social mobility is based on correlation, and, as every student of statistics knows, correlation does not mean causation. Whether or not income inequality is a drag on economic growth remains debatable.

But beyond that, it makes no sense to get upset about income inequality until it is defined and a goal it set. Anything that can’t be measured can’t be said to improve (or get worse). With no goal, there is no definition of victory. (This can also be said about so many other vaguely defined points of contention such as diversity, sustainability, and social justice.)

Flashback - The Homeopathy Scam

[It's Friday and time for another flashback. This time we go back to April 2015 when I ask, does homeopathy really work? Since then I have posted a few more times on the same subject. All of that research comes to the same conclusion. No, it doesn't. Here is the original.]

In a widely circulated article from the Guardian newspaper, the news from Australia is that it does not. The headline reads: “Homeopathy not effective for treating any condition, Australian report finds.” After a thorough and extensive review of over 200 research papers on the subject, the National Health and Medical Research Council (NHMRC) states: “there are no health conditions for which there is reliable evidence that homeopathy is effective.”

They go on to warn that people who use homeopathic medicine as an excuse to delay or avoid professional medical help may be putting their lives at risk.

What is homeopathy? The article describes it as the belief “that illness-causing substances can, in minute doses, treat people who are unwell,” and by diluting them in water or alcohol, “the resulting mixture retains a ‘memory’ of the original substance that triggers a healing response in the body.” That is the theory.

Wikipedia defines it as “a system of alternative medicine created in 1796 by Samuel Hahnemann based on his doctrine of like cures like, whereby a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people.” 

The fact that it is not effective is certainly not news as the first paragraph of Wikipedia entry immediately goes on to say: “Homeopathy is considered a pseudoscience. It is not effective for any condition, and no remedy has been proven to be more effective than placebo.” References associated with this conclusion date back to 2000 and earlier. It was known for a long time, but the fact that any government agency has come out so strongly against it is new.

The industry has a different take. The National Center for Homeopathy tells us: “Homeopathy is a safe, gentle, and natural system of healing that works with your body to relieve symptoms, restore itself, and improve your overall health.... It is extremely safe to use, even with very small children and pets, has none of the side effects of many traditional medications, is very affordable, is made from natural substances, and is FDA regulated.”

This British source sees it differently. After an extensive explanation of the theory behind it they describe it as being rooted in superstition, ritual and sympathetic magic; and cite a comprehensive study from 2005 showing that it is ineffective. For the theory to be true “we would have to toss out practically everything we have learned over the past two centuries about biology, pharmacology, mathematics, chemistry and physics.”

It seems many people disagree with the industry portrayal. Many studies have shown it as ineffective, but what about the claims of safety and regulation? The US Government’s National Center for Complementary and Alternative Health states: “We have a fair amount of research on homeopathic medicine for a variety of conditions, but less evidence on its safety, particularly for over-the-counter products.” The FDA “doesn’t evaluate these products for safety or effectiveness” and “some contain ingredients or contaminants in amounts that could cause side effects, drug interactions, or other safety concerns.” [Note: As of November 2019, no homeopathic products have been approved.]

If potential contaminants along with the ingredients are diluted beyond the point of detection, usually the worst outcome would result from people relying on homeopathy to the exclusion of professional medical help, especially if they avoid vaccinations.

So what’s the big deal? It’s just people again throwing away money on products that have been known for years to be ineffective. But when a company gets you to pay money for something that doesn’t work, how can that be legal? Doesn’t the government also have an agency to protect us from our own foolishness, like credit card scams, payday loans and fraudulent vacation schemes? Out of curiosity I asked, “Where does the government’s Consumer Protection Agency stand on all of this?”  

Their website lists under the heading “Current Scams That You Should Be Aware Of” the following categories:  Benefits and Grants, Business, Cars, Citizenship and Immigration, Computers and Internet, Family, Home, and Community, Health and Nutrition, International Relations, Jobs and Education, Money, and Travel and Recreation. A closer look at the Health and Nutrition link shows no mention of homeopathy (but there are a large number of other very interesting topics where Americans have been sold worthless or dangerous products). Until there are enough complaints on this topic, I guess we are on our own.

The government can’t (or won’t) protect us from sellers of every product or service that takes our money and give us only promises in return. Again critical thinking and just a little research can eliminate a lot of wasted time and money and possibly keep us safer.

More Food For Thought

Almost three years ago I wrote about the widely advertised supplement, Prevagen. The Federal Trade Commission (FTC) challenged the company’s claims about the product’s safety and effectiveness in improving memory. That FTC action followed a number of warning letters to the company from the FDA expressing similar concerns.

Supplements in general cause regulatory headaches for the FDA. “In 1994, the Dietary Supplement Health and Education Act (DSHEA) defined dietary supplements as a category of food, which put them under different regulations than drugs. They are considered safe until proven otherwise.” (I wonder how many lobbying dollars were spent on that law.) The government may stop a company from selling a supplement if they can prove it “poses a significant risk,” that is, usually “only after they cause harm” to customers. Even then they may face a fight.

Because they are not drugs, rigorously tested for safety and effectiveness, at the end of their advertising they are required by law to carry the disclaimer, “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent disease." Many get around this by making weak promises such as the supplement reduces the risk of certain health problems or it promotes a healthy condition. 

As far as that one and others that claim to improve memory, the Alzheimer’s Association finds such products, not approved by the FDA to be particularly troubling. “One of the biggest problem areas for unsubstantiated claims are dietary supplements...that claim to be beneficial for Alzheimer’s or other dementia symptoms.” But the promotion of these products and introduction of new ones hasn’t slowed down. “In the past five years, the FDA has issued more than 40 warning letters to companies illegally marketing over 80 products claiming to prevent, treat or cure Alzheimer’s disease.” Furthermore, the FDA recently warned that cognitive enhancement supplements “may be ineffective, unsafe, and could prevent a person from seeking an appropriate diagnosis and treatment.”

Now the problems and dangers surrounding the sale of supplements to prevent memory loss or to improve memory has been raised again in the November issue of JAMA Internal Medicine. A research team tested for the presence of Piracetam, a supposed brain-enhancing substance that “is not approved as a drug and is prohibited as a dietary supplement ingredient in the United States.” They found inconsistent labeling with errors ranging from 85% to 188%. This substance has known adverse effects including: anxiety, insomnia, agitation, depression, drowsiness, and weight gain.

These marketing techniques are truly unconscionable. They make every attempt to prey on older Americans who are already scared at the prospect of contracting some form of dementia by the ads, news stories, shared experiences of friends and personal experience with elderly relatives. Some are concerned about the prospect of mentally fading away. Others worry about being a burden on their family. 

Feelings of anxiety every time a name or fact is not at one’s finger tips make it easy to fall into the trap of buying these unproven products with the hope that maybe it really works. Action of the placebo effect on friends and acquaintances whose minds have fooled them into believing in it compound the problem. But reading and understanding the fine print that follows the ads and knowing that now there's a possibility of some products being adulterated with unapproved drugs should act as sufficient deterrent to critical thinkers.

Flashback - A Real Climate Solution

[In November 2013 I posted this calm look at how nuclear power could be the key to reducing carbon emissions. Last month the powers-that-be met in Madrid to agonize over climate change and again nuclear didn't make the agenda. In fact some countries are cutting back on their nuclear programs to satisfy ill-informed public opinion. I was optimistic 6 years ago, but am less so today.]

The very idea of nuclear power gives people chills of terror. For many the words nuclear and radiation elicit an automatic reaction of panic, but be aware that it’s a feeling they may have to get over very soon.

Reasons behind the fear are many and varied. This NY Times article explains how a problem as far away as Japan can seem scarier to Americans than much less remote and more dangerous threats like smoking, radon, auto accidents or natural disasters. Radiation is difficult to understand, complex and potentially deadly. It’s not only associated with bombs and war but it’s also invisible – so you can’t see it coming. Radiation is uncontrollable – how do you turn it off? – and unfamiliar, unlike burning wood or coal or turning a generator with wind or water. Finally, nuclear energy and radiation have had terrible PR. People are influenced by movies and science fiction stories to the point that in a recent survey on perceived risks for 30 activities and technologies, “students and women's group rated nuclear power No. 1. The experts ranked it No. 20.”

Since the UN came out just days ago with a report that the atmospheric CO₂ level has reached a record, even higher than expected, this automatic negative reaction will soon meet head on with a great deal of pro-nuclear effort as they look for alternatives to coal generation of electricity.

Popular alternatives, wind and solar, have serious drawbacks. They have a large geographic footprint, an ecological concern, while people who generally favor the idea, oppose it being set up next door. Renewable sources vary, only available when there is sunlight or sufficient wind. Variability creates more problems than normally expected. Not only do they require another reliable source to fill the gaps, but that source must also be very flexible. This Economist article tells how the wholesale price of electricity in Germany actually went negative one bright and windy day in June, because of the unusually high supply, which also threatened to overload the grid due to the inability to quickly and efficiently flex their coal, gas and nuclear plants. In places where utilities are required to buy the solar- and wind-generated electricity first, the variability is built into the system, utilities are losing value and profits, so the money for future investments in the delivery systems, the wires to your house, is drying up.

Given those circumstances and despite real drawbacks, like cost, spent fuel disposal and one recent atypical disaster, nuclear is beginning to look more and more attractive as a non-polluting alternative. James Hansen, a former NASA official, and one of the early voices warning of climate change, has recently endorsed it and asked key environmentalists to use their influence in favor of more nuclear plants. Others argue that, despite scary news reports, nuclear power has a very good safety record and has caused less than a dozen deaths from radiation over its entire history. They estimate that 1.8 million pollution-related deaths have been prevented by the current use of nuclear power. They minimize the threat of terrorism and argue that 21^st century technology is far superior to that used in any operating plant in the US. (Many of the latest navy ships are nuclear powered.)

Any decisions like this will have a political component. The push in favor is building, but advocates with the opposite agenda will be working hard to influence public opinion. Times like this call for strong critical thinking. Oppose nuclear power, if you are so inclined, based on facts from reliable sources and not on emotion, gut reaction or pseudo-scientific warnings. It’s critical that we get it right.

What’s All the Fuss about CBD?

As I was walking through the local mall, I had to steer around a large sign in front of the GNC store. It read: “CBD Products Available.” It did nothing to raise my opinion of GNC, which I consider to be the epitome of junk science, but I thought I should do some research to make sure my eye rolling was justified.

Cannabidiol (CBD) oil is an extract from industrial-grade hemp or the marijuana plant. It does not have the effect of getting the user “high” as the THC in marijuana does. It recently surged onto the market with a wide variety of health claims. What are the facts?

There is so much information, but it has to be sorted careful, as much of it is pure advertising, telling the stories of miracle cures. Many promises are unreliable to the point that in September the Federal Trade Commission (FTC) ordered three companies to stop making claims that they: relieve pain better than opioid painkillers and that they treat cancer, Alzheimer’s disease, multiple sclerosis (MS), fibromyalgia, cigarette addiction, colitis, autism, anorexia, bipolar disorder, PTSD, schizophrenia, anxiety, depression, Lou Gehrig’s Disease (ALS), stroke, Parkinson’s disease, epilepsy, traumatic brain injuries, diabetes, Crohn’s disease, psoriasis, and AIDS – while using the words miracle and magic to describe the effects. The following month both the FTC and FDA warned a Florida company marketing CBD products about making similar unsubstantiated claims. (These were only the ones that were caught.)

Stepping aside from the hype, Science News published a story earlier this year that is a little more down to earth. “A gaping chasm separates the surging CBD market and the scientific evidence backing it. While there are reasons to be excited about CBD, the science just isn’t there yet.” Trials are underway, but “much of the existing research was done with cells in the lab or in lab animals, with results that don’t necessarily translate to people.”

The next stop was a WebMD article, “CBD Oil: All the Rage, But Is It Safe & Effective?” They remind readers, “experts say the evidence is scant for most of these touted benefits” and it is being sold as a supplement, “produced without any regulation, resulting in products that vary widely in quality.” So far “only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.”

CBS recognized the quality problem in this piece from about three months ago with the warning that “without wide federal oversight, there is no way of really knowing what's inside CBD [products].” They commissioned lab tests of samples from all over the country and found no harmful chemicals but significant differences between the amount of CBD on the label and actual contents making proper dosage a big problem. In addition, “cannabinoids do interact with prescription drugs. But because we lack reliable controlled trials, we don't have enough detail to understand all the interactions.”

The same viewpoint comes from Harvard Medical School. “Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting.” The JAMA network notes that in studies to date "evidence of effectiveness was scarce," and that a California testing company found 85% of samples inaccurately labelled.

This Slate article makes the point clearly. As more and more products, from foods and beverages to creams and lotions, have CBD added “CBD is in everything, but it hasn’t been proven to do much of anything." Despite this, it is forecast to become a $22 billion industry by 2024.

In summary, with no scientific evidence of health benefits outside of the treatment of epilepsy, CBD oil has become all the rage with companies adding it to all sorts of products and selling it as a miracle cure. Some companies have crossed the legal line with their claims, but those that are more careful can easily imply that it’s curative powers are enormous without coming right out and saying it. Instead they rely on endorsements from beneficiaries of the placebo effect, as do many of the other supplements on the market. (In other words, my eye rolling was justified.)

Flashback - Terrifying Children

[This entry comes from not too long ago, August of this year, and was originally titled How to Shade the Truth. As I pointed out, shading the truth to attract viewers or make a political point is both common and cold-hearted.]

Here is a point of view I might want to push: Although there has not been a lot of news lately about school shootings, they are still a major problem. Parents and students alike should still worry about the safety of schools and demand something be done about gun violence.

If I am CNN, I run a headline on July 26, 2019 saying, “There have been 22 school shootings in the US so far this year.” Wow, that is almost one every 10 days!

They define a school shooting as one where someone was hurt or killed and that happened on school property. It includes incidents of accidental discharge and those where the weapon was a BB gun, because they are “potentially lethal.”

Seeing only the headline would cause many to assume that the shootings involved a K-12 student during regular school time. The examples in detail tell a different story.

They are listed in reverse chronological order. The first three happened in school parking lots or playgrounds during summer break. One of the people shot was 36 years old, riding his bike though a high school parking lot. 

The next two victims were a teen shot in the parking lot after a fight broke out, and a 25-year-old man playing basketball at a Chicago elementary school playground.

Four of the incidents happened at Universities, none of them inside buildings. Likewise, of the remaining thirteen incidents, only six actually happened inside a school. One involved a 16-year-old student “trying to buy marijuana from a 17-year-old student.”

The single incident of note was the well-publicized one death and eight injuries at the STEM School in Highlands Ranch, Colorado. “Two male students were charged with murder and attempted murder; one of them told police he sought to target classmates who had bullied him.”

Of course school shootings are bad: one is too many. But let’s be honest about it. There were not 22 since the beginning of the year as most people would understand them. A 46-year-old man shot multiple times by his neighbor in a high school parking lot “amid an ongoing argument over a parking spot” is not really a school shooting in any sense of the term. 

This is the kind of shading and spinning that the media often do to achieve the shock factor desired to retain readership and viewership. It pays to read the rest of the article; it pays to question headlines; it pays to use critical thinking. It especially pays when you know they have a hidden agenda or an incentive to get you all upset – which is always.

[These are not only common but cruel. The 22 in the headline became 6 inside a K-12 school during school hours and only one that fits a commonly held understanding of a school shooting. With over 100,000 public schools in the US, these incidents are exceedingly rare - an impression the news media tries to cover up. What are not rare are headlines like this one: “There are kids who simply are scared to go to school.” How is this practice not a form of child abuse?]