Junkfood Science: September 2007

September 30, 2007

Quote of the Day

When a scientist says “there is no hard science” to support an idea, does that mean that (1) there really is no such research; or (2) there is research, but the the scientist does not believe it; or (3) the scientist has not kept up with research done by other people?

Source: Improbable Research


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September 29, 2007

W is for wifi woo

When the news recently reported of a British woman who’d become so afraid of electromagnetic radiation, that she’d become incapacitated and wore a strange-looking beehive hat that she believed protected her from wifi, a lot of people laughed. News in Europe has been filled with wifi scares and ominous headlines for years. Even this week, the International Herald Tribune reported that “Exposure to the invisible cloud of energy called electrosmog is rising,” with an article that offered nothing constructive but build a foreboding sense that electromagnetic radiation has us surrounded.

Some scientists or skeptics scoff and don’t believe that people are really being frightened by “the sky is falling” stuff. So, they do nothing and say nothing.

But a major announcement this week illustrated, once again, that scare stories do scare people and people do believe these things. Worse, they can have serious repercussions for all of us.... When skeptics aren’t skeptical, scientists aren’t scientific, journalism professionals aren’t professional, and we don’t keep our thinking caps on, people get hurt.

Medical Technology Business Europe reported yesterday that the Directive — the Physical Agents (Electromagnetic Fields) Directive — issued by the European Union Commission in 2004 and is required to be national law in all EU countries by April 2008, will ban the use of magnetic resonance imaging (MRI), an important medical diagnostic test.

Professor Dag Rune Olsen, a scientist of experimental radiation therapy at the Norwegian Radiation Hospital, Oslo, Norway, and chairman of the physics committee of the European Society for Therapeutic Radiology and Oncology, is speaking out and said that the Directive, which set “safe” limits on radiation exposure for workers, were set so low that they will prevent the use of MRIs and deny millions of patients the benefits of MRIs.


How’d that happen?

For years, the European Commission has been monitoring the potential health effects of electromagnetic fields (EMF), financing research, distributing information, and working to establish legal protections, which were embodied, in part, in the Directive, according to the June 2007 Eurobarometer report. This report was commissioned by the Directorate-General Health and Consumer Protection of the European Union to assess the public’s level of concerns about EMF and other environmental exposures. A sampling of 30,000 Europeans were interviewed in their homes last October and November and the results were startling.

It’s well-known among marketing and media professionals that fear sells and they’ve become quite adept at using fear, and taking advantage of the public’s general lack of understanding of science, to promote agendas or products. Whenever we hear something that makes us feel anxious or worried, our emotions are being played and that’s our baloney alert that what we’re hearing is marketing rather than sound, impartial science. Hitchcock was the master of fear manipulation and could convince entire audiences that there was danger in a mere shadow.

When we feel anxious about something(s) we believe could harm us, it’s natural to feel increasingly vulnerable and want to feel safer. And when the risks are uncertain or the possible dangers unseen, any exposure at all seems too much and no amount of risk feels acceptable. Safety becomes the primary focus.

We’re increasingly being inundated with news of “what ifs” and worst case scenarios about everything. They are also being embraced by governmental agencies, especially across Europe, in what Mike Hume of Spiked-online, calls the politics of organized paranoia. Policy makers “dream up fantasy disasters and then try to plan to deal with these hypothetical crisis.”[sic]

Fears and “the sky is falling” worries have led to the growing popularity of the precautionary principle. While there are numerous definitions, generally, it’s the “better safe than sorry” idea that results from trying to avoid risks. If something could potentially cause harm, even when there is no evidence of harm, then people and politicians are encouraged to err on the side of caution and avoid it.

Of course, everything in life, including most scientific and technological developments, comes with possible risks of harm. But under the precautionary principle, the new development is eliminated or restricted “to protect the public,” without carefully weighing:

· the science to determine how realistic the risk is

· the benefits of the development

· the harm that could come from not having the new development

That last one is often forgotten but it is an important reason why the precautionary principle is rarely actually the safest option or the best solution, because it comes at the cost of false positives, as we’ll see happened with MRIs. When leading scientists were asked to name the advances that have made our lives better and safer but could never have come about if the precautionary principle had been in place in the past, “they came up with a scary list, starting with A for aspirin and going through to X for x-rays,” said Mike Hume.

The precautionary principle was officially adopted by the European Union in the Treaty of Maastricht in 1992. One example of it was the expert panel on mobile phones established by Sir William Stewart in 1999. Its conclusions were published in the renowned Stewart Report. It said that, while the balance of evidence showed no adverse health effects from wifi, the panel still recommended to officials that “a precautionary approach to the use of mobile phone technologies be adopted until much more detailed and scientifically robust information on any health effects becomes available.” Specifically, it stated:

Government has in place national guidelines established by the National Radiological Protection Board on the maximum levels of exposure to RF radiation emitted from mobile phones, base stations and other sources.... [which] were based on a comprehensive review of the scientific literature... In 1998, the International Commission on Non-Ionizing Radiation Protection published its own guidelines .... [however,] the maximum levels of exposure of the public are about five times less than those recommended for workers. The reason for this approach was the possibility that some members of the general public might be particularly sensitive to RF radiation. However, no detailed scientific evidence to justify this additional safety factor was provided....

We conclude therefore that it is not possible at present to say that exposure to RF radiation, even at levels below national guidelines, is totally without potential adverse health effects, and that the gaps in knowledge are sufficient to justify a precautionary approach...

We are concerned at the variability and the limited extent of the information made available to consumers on mobile phone products. We recommend that Government circulates a leaflet to every household in the UK providing clearly understandable information on mobile phone technology and on related health aspects...

Skeptics probably already caught the biggest fallacy of logic there: one can never prove a negative and “prove” without a doubt that something is totally safe and completely free from potential effects. No amount of science can, which is why traditional risk analysis weighs what is known and the scientific plausibility of harm against the benefits.

So, for years, not only the media, but public officials have also been raising concerns in the minds of the public about possible health risks from EMF. While it may be easy to laugh at scare-mongering stories or consumers who take to protecting themselves using beehive hats, the fact is, people actually believe these things.

Sadly, the Eurobarometer results illustrated just how effective the continual drumbeat of doomsday scares about the safety of EMF, our food and environment have been. [Keep in mind that our food and water have never been safer and people have never been healthier or enjoyed such long lifespans...]

It found that 91% of people believe “chemicals” are affecting their health — 64% said to a big extent. Following close behind are concerns that the quality of food, air and water are affecting their health, at 89%, 81% and 86%, respectively, with half believing each of these affect their health to a big extent. Three-fourths are concerned about the health effects from EMF — cell phones and towers and high tension wires. Over the past several years, EMF fears had grown more than any other health risk. Most citizens felt that public health officials weren’t protecting them from the possible risks of EMFs and about 7 out of 10 weren’t happy with the information they received and half felt they weren’t being told the whole story.

Combine fear and excessive caution with poor or no science, and the results are unsound and potentially harmful public policies. As we’ll see, this is exactly what appears to have happened with these Directives. There had been no reports of a single worker being harmed from MR exposure or any new research suggesting dangers from EMF leading to their action. It was led by fear.


What have they done?

As Med Tech Business Europe reported this week:

European Directive on radiation exposure will ban MRI scans

...Currently eight million MRI patient examinations per year are carried out in Europe, said Professor Dag Rune Olsen... “But these are likely to have to stop, since the Directive sets limits to occupational radiation exposure which will mean that anyone working or moving near MRI equipment will breach them... A British study into operator exposure to electromagnetic fields from MRI, published by the Heath and Safety Executive in June 2007, found that anyone standing within about one metre of an MRI scanner in use would breach the exposure limits laid down in the directive. The Commission has accepted this, and said that it will consider the HSE report together with the study it has commissioned itself, and which is due for publication in October 2007, when deciding whether and how to propose amendments to the directive or to extend the implementation period.

“But they may already be too late,” said Professor Olsen. “ Slovakia has already implemented the directive, on the grounds that it was based on the assumption that the limits which it sets would have no effect. This would appear to mean that it is now illegal to carry out MRI scanning in the country.”

The directive in its present form poses particular problems to those healthcare staff who care for patients such as children, the elderly, or those who have been anaesthetised, who need help and comfort during scans. It will also stop the use of MRI for interventional and surgical procedures, and will curtail cutting-edge research.

A bit of background: The Health and Safety Executive is under the UK government’s Health and Safety Commission, and is tasked to “ensure that risks to people's health and safety from work activities are properly controlled.” The June report referenced in the news was the HSE’s RR570 Report. A consultant, Professor Stuart Crozier of the University of Queensland, had conducted a project in which he took measurements from magnetic field dosemeters worn by MRI personnel working an average 9.3 hour shifts and attending to 10 scans per day and, with computer modeling, calculated various types of exposures, distances, intensities and durations. He concluded that there are situations which could possibly lead to exposure guidelines being exceeded.


Other MR experts note threats to patients

This isn’t the first report expressing the concerns of science and medical MR professionals that the Directive could severely limit the use of MRIs for research, diagnosis and treatment. In June, the Wellcome Trust and the Medical Research Council surveyed MR professionals at 54 centers across the UK and found that three quarters of medical professionals needed to be in the exam room working within one metre of the MRI scanner. They concluded:

The current exposure limits for gradient fields would prevent [this, and] would prohibit interventional MRI, limit the provision of patient care, and restrict researchers from reaching into the magnet bore, for example for positioning and checking equipment, or providing technical support. Paediatric and neonatal work would be particularly threatened, because expert nursing care is often required during imaging.

The EU Physical Agents (EMF) Directive could seriously limit the use of MRI for research purposes, prohibiting research that has clinical and public benefit. The use of new, more powerful high-field scanners in research will be particularly restricted and the Directive threatens the development of new MR methodologies and improvements in technology.

A 2 1/2 year investigation of the scientific evidence and development of the Directives was conducted by the Science and Technology Committee appointed by the House of Commons. It found that the EU Commission had never evaluated the potential negative impacts on medicine or research when they wrote the Directives. It had reacted only to the possibility of risk.

In addition to eliminating the ability to monitor patients requiring close supervision during imaging — such as sedated or critically-ill patients, children, anxious and psychiatric patients — the investigators noted that the Directives would also affect testing of the magnets during manufacture and maintenance. “Some MRI studies will become impossible—e.g. studies on deaf-blind subjects, where staff ‘sign’ into the palm of the patient during imaging,” they wrote. Finally, “there is likely to be an increase in X-ray and CT imaging in place of MRI, resulting in increased radiation risk to staff and patients, where the risks are known.”


‘No risk’ can be riskier

The Science and Technology Committee concluded:

It is deeply regrettable that the impact of the Directive on MRI procedures was not established before the Directive was adopted. This case study illustrates the potential consequences of the failure of policy makers to seek comprehensive scientific advice early in the policy formulation process and to commission the necessary research to inform this process where uncertainty or gaps in knowledge exist. While there should be an obligation to reduce risks to a reasonable level, to actually pursue the “lowest achievable limit” would entail health and safety practices which most would consider unnecessary and economically unviable, if not counter-productive in certain circumstances. Risks need to be balanced against gains, rather than necessarily minimised [out of hand].

Not only that, but the science investigators found “significant uncertainties around the scientific basis of the guidelines” and that there wasn’t a strong enough case for “enshrining the exposure limits in a Directive.” They found that the views of the MR professional community were “diametrically opposed” to those of the Commission, but those hadn’t been heard. In fact, other MR scientists were publishing similar concerns, questioning the scientific evidence on which the limits are based.

They found the Commission had used the precautionary principle to set public policy, but that this “approach is at present ill-defined and certainly unsatisfactory as a tool for practical use,” adding:

The exposure limits, presented as thresholds for “known short-term adverse effects,” are based on extremely cautious, in effect precautionary, interpretation of limited scientific data....Against this, around 400 million patients have been imaged using MRI, with no evidence of adverse effects at the EMF exposure levels indicated in the Directive.

At a Science and Technology Committee meeting on May 11, 2006, member Dr. Desmond Turner shared the HSE risk assessment, saying: “I can quote from what they said which was that they were “unable to identify any health and safety benefit from the Directive.” Interestingly, it was also revealed that day that the Commission had used a 10-year old risk assessment and not requested an updated one before passing the Directive.

The Science and Technology Committee said that existing guidelines were sufficiently protecting the public and the Directives were unworkable and would impose considerable burdens on MR professionals:

The Directive prescribes action limits, which when exceeded require monitoring to be carried out to check compliance with exposure limits. This requires detailed calculation in each individual case. It can be difficult to measure what values have been exceeded in MRI as an MRI scanner involves the combination of three different EMF.... The exposure of a worker will depend on many factors including: the design of the MRI equipment; the strength and frequency of all the EMF fields used in the system; the precise location of the worker relation to the EMF fields; the speed of motion of the worker; and the sequences that the scanner is running (scanners have different sequences for different medical applications which switch the time-varying fields on and off at different rates).

At the conclusion of this week’s news story, professor Olsen said:

Policy-making should be based on sound science, and to my knowledge there is no scientific evidence of long-term adverse health effects of exposure to static or fluctuating magnetic fields that are commonly found during MR scanning. Hasty decisions without scientific support will in this case have a severe impact on medical diagnostics and must thus be avoided. I hope that the Commission will allow a delay in implementation to enable it to examine this issue again and that the Directive could be amended...


Official “safety thresholds” are not the same thing as risk measures

Professor Olsen reminded readers that setting arbitrary safety limits are meaningless when there’s no real danger to begin with! Yet, this fact is lost or ignored as we get caught up in fear and the sense that we “need to do something.”

We’ve looked at a number of risks levels said to be “high” that aren’t really high, nor measures of actual risk. Crossing an arbitrary safety limit does not mean we’re in any actual risk. Also, exposure does not equal danger. Anything in toxic levels can hurt us, but that doesn’t mean that there’s any harm in the amounts we’re normally exposed to. If that were true, none of us would dare even drink a sip of water.... water intoxication is dangerous, don’t you know?

Who has more reason to be wary of actual health concerns with MRIs and keep up to date with the science, than the medical professionals who work with MRIs everyday? Why are they not scared? The public never hears what they’ve concluded about the science. To help put all of this hubbub into some perspective, let’s take a look.

According to researchers at the University of Southern California and Institute for Magnetic Resonance Safety, Education and Research who reviewed the safety issues and evidence to date in an article for the professional journal Radiology:

The introduction of MR technology as a clinical imaging modality in the early 1980s is responsible for a substantial increase in human exposure to strong static magnetic fields. Most MR systems in use today operate with magnetic fields ranging from 0.2 to 3.0 T. In the research setting, an exceptionally powerful MR system operating at 8.0 T is located at Ohio State University (Columbus). According to the latest guidelines from the FDA, clinical MR systems that use a static magnetic field up to 8.0 T are considered a “nonsignificant risk" for patients.

Schenck conducted comprehensive reviews of biologic effects associated with exposure to static magnetic fields. With regard to short-term exposures, the available information for effects of static magnetic fields on biologic tissues is extensive... In the majority of these studies, the authors concluded that exposures to static magnetic fields produce no substantial harmful biologic effects. Although there have been some reports of potentially injurious effects of static magnetic fields on isolated cells or organisms, none of these effects have been verified or firmly established as a scientific fact. The relatively few documented injuries that have occurred in association with MR system magnets were attributed to the inadvertent presence or introduction of ferromagnetic objects (eg, oxygen tanks, aneurysm clips) into the MR environment [unrelated to these Directives].

With regard to the effects of long-term exposure to static magnetic fields, there are interactions between tissues and static magnetic fields that could theoretically lead to pathologic changes in human subjects. However, quantitative analysis of these mechanisms indicates that they are below the threshold of importance with respect to long-term adverse biologic effects.

And, as with anything, they reiterated that “it may be virtually impossible to demonstrate absolute safety,” but with 150 million MRIs performed to date in the U.S., there’s no reason to believe that when proper safety guidelines are followed they won’t continue to be safe.

And a recent issue of RadioGraphics, outlined the current safety and quality control issues from the AAPM/RSNA Physics Tutorial for medical residents. Concerning MR safety, it advised doctors:

[T]he FDA has published guidelines for the safe operation of MR imaging systems. Manufacturers are mandated to ensure that their equipment operates in accordance with these guidelines, and proof of compliance is required by the FDA before any MR imaging system is approved.

MR safety issues are related to the... static magnetic field, the time-varied magnetic field from the gradient subsystem, and the RF field from the RF subsystem.... Most epidemiologic studies about the effect of static magnetic fields on the human body have been performed in populations of MR imaging technologists and other workers in a controlled environment. Investigators have focused on the long-term exposure of workers [at low levels] and short-term exposure to [high levels]. None have demonstrated a significant increase in any disease rate....

Despite very low or nonexistent risk from high-strength static magnetic fields, there are sporadic reports of headache, vomiting, hiccupping, numbness, and tinnitus, but they have not been substantiated. It should be noted that these sensory effects also were reported when the electrical current through the magnets was turned off.

However, investigators in other studies have shown significant sensory effects at 4.0 T compared with 1.5 T. There also have been reports of an experience of flashing lights ... which are called magneto-phosphenes, are thought to be caused by retinal stimulation by induced currents. In 1996, the FDA designated all field strengths of less than 4.0 T as posing a nonsignificant risk.

The truth is, living is risky. Working comes with risks. And even having fun carries risks. But we pay a very heavy price when we let fear of risks take over and consume us.

This week’s news was just one more example of reacting to scares of a theoretical risk for which there is no scientific evidence of concern at current exposures, no evidence anyone has ever been harmed, and no evidence that lower safety limits will keep anyone safer or improve health at all. All we have are “what-ifs.” In contrast, there is plenty of evidence that by ignoring science and failing to carefully weigh actual risks and benefits, millions of people risk being harmed. How smart is that?


© 2007 Sandy Szwarc


For some weekend reading on the precautionary principle, Spiked hosted a conference at London's Royal Institution in May 2003 called “Panic Attack: Interrogating our Obsession with Risk.” The papers that have been published are linked here.


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September 28, 2007

“I’m too fat…don’t you see?”

It’s become impossible to ignore that little kids are being harmed by the incessant scaremongering about “obesity” and messages to eat right and watch their weight. This excellent article in the student newspaper at the University of Georgia is recommended reading. The author writes compassionately about a disturbing and perceptive observation she made of four year old girls.

Weight issues affect kids, too

The pretty four-year-old blond girl whispered to me: "I'm too fat. Don't you see?" I was a summer camp counselor for a country club, and while I had seen my share of paint-splattered messes and attempted food fights, this was the first time anything at a kids' camp shocked me. Instead of asking me to play another round of Connect Four or declaring her love for "High School Musical," the four-year-old camper pinched the sides of her stomach, showing her so-called "pudginess."

I tried to hide my shock — how many four-year-olds sling around this statement? — and tried to assure her she was far from being overweight. She corrected me, saying this could prevent her from winning a crown or a sash in a beauty pageant— a favorite activity outside of school and camp.

The thoughtful writer reflects many women in not yet being altogether comfortable with her own body or able to bring herself to say that kids and grownups all come in different sizes and shapes and that’s okay. Had the child, or herself, come naturally in size large, would the little girl have been told that she’s okay, too? Children hear a very different message when they’re told about the natural diversity of bodies and that all types are good, rather than reassured that their body isn't too fat (or too black or too whatever). It's an important difference for adults and parents to get, because children do.

She is to be commended for making such helpful and valuable points for her readers, as she went on to write:

What's surprising is she already had started mimicking the body dissatisfaction that would be more common with the adults in her life — a mother, aunt or older sister. While this might seem abnormal for her age, she's just getting a head start on her pre-school pals… According to a 10-year study done by the National Association of Anorexia Nervosa and Associated Eating Disorders, 33 percent of the women and men surveyed reported they struggled with an eating disorder between ages 11 to 15. Ten percent said they started having an eating disorder at age 10 or younger.

Sadly, many of us are partly at fault. Our negative body image affects our younger sisters, nieces and daughters. And who could blame us? We're bombarded with magazine ads eschewing skinny as the norm, and anything more than a size six is considered "curvy" or "plus-size."... As much as we might hate our own sizes, we have to realize those images aren't the norm — that glossy magazine picture is merely an airbrushed package that took a professional team of make-up artists, designers an photographers to craft and cultivate….

The last part of this article, however, gave some mixed messages about the need to teach healthy eating and exercise but not to take things to an extreme, mistakenly believing children and young adults are able to understand such concepts or need to be more concerned with their health, as has been covered here extensively. As Canadian research of school health curriculums published in the journal Body Image a few years ago reported, "healthy eating and healthy weight" educational approaches send mixed messages and actually increase anxieties about body weight, fail to understand the causes of eating disorders and ignore the issues kids face with normal development.

Instead, head right for the end: “We must believe the size label is nothing but a number,” she wrote. The four year old camper and her friends shouldn’t be concerned about such things, she said, because what’s more important at their age is friends and playing… just being kids.


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September 27, 2007

The myth of Health Savings Accounts — Laughing all the way to the bank?

“A different kind of health insurance that puts consumers in control” is the claim. We’re told that health savings accounts offer the best way to lower healthcare spending because we can shop around and the money in our HSA is our’s to spend however we feel best. Said to be the responsible alternative to mandatory insurance or universal healthcare, HSAs purportedly take health decisions away from insurance companies — (plagued by problems with conflicts of interests and health discrimination)— and give them back to us.

What we’re hearing are carefully crafted marketing messages.

Behind the scenes, insurance companies are vigorously promoting HSAs, just as they are mandatory insurance coverage or universal healthcare, because they know what the public doesn’t. They’ve got their bases covered...

The reality of HSAs is that they’ll make more money for insurers while giving consumers the illusion of free market choice. Calling them “consumer-driven” doesn’t make it so. And as uncomfortable as it is to consider, the health discrimination seen in today’s insurance plans — penalizing through higher premiums those with health indices or health problems that are mostly genetically determined — could be government-sanctioned on an even larger national scale.

Before being taking sides in the debate, it can be helpful to remember that there’s just as much misinformation and spin in the massaging for HSAs as there are in the alternative solutions being proposed to reform our healthcare system, such as mandatory insurance coverage or single-payer plans and universal healthcare. Sorting through the marketing means looking at minute details. Since HSAs haven't yet been examined, it’s only fair to take a look at them, too.

The insurance industry and government policy leaders held a summit last fall, called the National Consumer-Driven Healthcare Summit, to craft their massaging in order to “drown out detractors” who are noting that HSAs primarily benefit those who are young, healthy, male and wealthy. Core to their focus, it was determined, must be to promote consumerism. “The shift is going ...to a focus on consumerism, and it’s an important one,” stressed Beth Bierbower, a vice president at Humana.

For instance, HSA proponents often cite a Blue Cross Blue Shield insurance survey claiming that HSAs don’t disproportionately attract younger, healthier people. But what is rarely revealed to the public is that this was a survey of those with and without HSA just within the individual insurance market. As the Center on Budget and Policy Priorities pointed out in a February 16, 2006 white paper, those able to get individual coverage tend to be healthier and younger than those on employer-based plans; a fact that’s been confirmed in recent Government Accountability Office (GAO) reports.

John Stossel at ABC is the Michael Moore of HSAs and has worked hard to promote the free market, consumer choice angle. Last week, he took viewers to Whole Foods Market to example HSA success, portraying enrollees happy with their savings and their ability “to spend the money the way they want to spend it.” No one noticed that Whole Foods employees are primarily young, able-bodied healthy people.

Rather than go through a detailed critical review of the facts, pros and cons, behind HSAs — something which others have done in extensive detail — I want to note two of the biggest fallacies rarely discussed in mainstream media and reveal why insurers are so intent to sell us on HSAs.


The free market, limited government fallacy

It’s ironic that the biggest proponents of HSAs are free market, limited government groups. If the concern was really limited governmental interference into our lives and a free market system, then why is there a need for the government to decide how people can save and use their own money at all? A free market would simply let people spend their money as they chose without federal mandates.

Instead, HSAs add to a large governmental bureaucracy and create a more complicated tax structure, while actually not removing the insurance companies and government from managing how we can spend our money, how much we can save, where we can invest it, and manage our own medical care. Here’s why.

In order to have a federally-approved HSA, you must also have a “high deductible health plan” (HDHP) through a health insurance company. When you put your money into your HSA, it is tax deferred and the amounts you spend are tax-free. But... the money can only be spent on certain approved medical expenses as allowed under the health plan. Not only where your money is invested, but the amounts you can set aside for medical expenses and the deductibles are also determined by the government. According to UnitedHealth Group’s HSA:

If you use your HSA funds for anything other than a qualified health care expense as defined in IRS Publication 502, the amount withdrawn is subject to both income tax and a 10 percent penalty, unless you are over age 65. If you are 65 or older, the amount you withdraw for non-medical purposes is treated as retirement income, and is subject to normal income tax, but not subject to the 10 percent penalty.

The list of fully covered expenses doesn’t include many of the expenses in managing chronic illnesses, Dr. Bill Wright, associate medical director for Kaiser Permanente told the Rocky Mountain News on June 17, 2006. Colorado is the number one market for United Healthcare’s HSA plans, it reported, because it’s a state with a lot of healthy upscale and young people.

What money that enrollees don’t spend on approved medical expenses each year is able to stay in their accounts and grow tax-free interest. Clearly, those with health problems and higher medical expenses won’t enjoy any tax savings benefits. HSA proponents claim that this is a good thing because it encourages healthy behaviors and gives people incentives to do the ‘right’ things to stay healthy. But as we know, such insurance incentives are discriminatory, as most diseases and accidents aren’t in our control, and penalize those with certain genetics, physical attributes or are aging.

HSAs are the only savings accounts that feature both tax-deductible contributions and tax-free withdrawals. They offer unprecedented tax-sheltering opportunities for those making enough money to be able to set aside thousands of dollars at the beginning of each year. Those in high deductible plans are already more likely to be single males, younger and healthier on average, and to earn more than people enrolled in other plans, according to a January 2006 study by the Government Accountability Office. It found 43% of those in HDHPs earned at least $75,000, nearly twice as much as other government employees.

As the Center on Budget and Policy Priorities reported:

There can be no question that the tax benefits of HSAs are tilted toward high-income households and would be tilted still more strongly under the Administration’s HSA proposals. High-income households benefit much more from HSA tax deductions than lower-income households because they are in higher tax brackets. Also, high-income households can afford to contribute much larger amounts to HSAs than people of more limited means. Moreover, for affluent [healthier] individuals who do not expect to incur significant health-care costs, HSAs provide unprecedented tax-sheltering opportunities: they are the only savings accounts that feature both tax-deductible deposits and tax-free withdrawals.

They found that HSAs simply encourage healthier and wealthier people to switch from their current coverage to these plans in order to take advantage of the tax shelters. New proposals to substantially increase allowable HSA contributions, they reported, will “exacerbate this disparity and enable affluent households to use HSAs as highly lucrative tax shelters, in which they could amass hundreds of thousands of dollars tax free.”

These concerns have been proving the reality and the professed success of HSAs appears overstated. The Wall Street Journal reported in June, 2006 that the numbers of people choosing HSAs through their employers was growing only slightly. And the San Francisco Business Times reported that only about a quarter of people who enroll in high-deductible plan ever fund their HSA and that many are signing up with these plans because they need the lower premiums but don’t have the money to open an HSA. Only the wealthiest can afford to take advantage of their tax shelter benefits.


The savings account fallacy

The insurance industry has lobbied hard for HSAs. Blue Cross Blue Shield, for example, is the nation’s largest health insurance provider for federal employees and retirees, covering about 60% of people in the Federal Employees Health Benefits Program. Its lobbying efforts were successful and the 2007 federal budget allowed them to add a high deductible plan with HSA for their federal plans.

Three things about HSAs are worth considering, but are never mentioned:

· Where is all of this HSA money going and who is going to manage all of it?

· How many consumers know that HSAs have been set up to only be available through government-approved companies and that the government has allowed them to charge monthly maintenance fees?

· And... how many people know that the major health insurance companies have gone into banking?

Blue Cross and Blue Shield has launched Blue Healthcare Bank to administer its plans, for example, and anticipates deposits of $500 million within the next three years. It followed in the footsteps of UnitedHealth Group, Inc., which launched its own financial institution called Exante Bank and already holds more than $300 million in HSA deposits. So, insurance companies will not only hold our money, but control access to it and how it’s spent.

Diamond Cluster International financial services optimistically predicted that HSAs will hold more than $75 billion in assets by 2010 and are expected to generate over $450 million every year just in set-up and management fees. As the Atlantic Information Services, Inc., HSA Directory and Resource Guide reported, the top ten HSAs had deposits, as of January of 2006, of $496.17 million. In just 18 months, those deposits had grown by more than a billion dollars to $1.518 billion.

Free market advocates soundly argue against governmental insurance mandates and for limited governmental rule... except when it comes to HSAs and profits?

© 2007 Sandy Szwarc


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September 26, 2007

"Fattening" shoes at school to be banned?

It’s not enough that anti-obesity programs mandate what children can and cannot or should not eat, and the amounts and types of physical activity they must do, initiatives are increasingly deciding how our children must dress. You remember the story a few months ago when British researchers proposed that girls be compelled to wear to school clothes that were “suitable for active play, like sweatshirts, trousers and trainers.” Today, a Chicago Tribune journalist proposed banning children’s shoes that don’t encourage them to run as much as they should: crocs.

In an article called called “Kid must run, not clop along in crocs,” he quoted a coach as saying: “Crocs? Kids can't run in them. You can't play soccer in Crocs. And if you can't run, guess what happens? You get fat.” The journalist's supportive evidence that crocs contribute to obesity? There’s an epidemic of crocs being sold! He doesn’t like those roller shoes, either, for the same reason, even hinting they’re also part of the obesogenic environment leading to diabetes. "I have seen 9-year-olds with type 2 diabetes," [Dr. Sandra Hassink of the American Academy of Pediatrics' obesity task force ] said. "Obesity is an indicator. It tells us about our environment, about our culture. It is the canary in the mine."

Whether this column was serious is hard to tell given the source, but it’s actually surprising that proposals for shoe mandates in the name of childhood obesity have taken this long to surface. Athletic shoe companies have been among the most active corporations working to convince the public that today’s kids aren’t physically active. And they appear to be being incredibly effective, as few people would guess they’ve been sold.

Nike, Inc. has been a long-time sponsor of public awareness campaigns to convince lawmakers and consumers of a “childhood inactivity crisis.” NikeGo co-founded Shaping America’s Youth back in 2003 to coordinate the government’s childhood obesity goals, develop a national action plan and its clinical guidelines. As reviewed earlier this year, SAY is partnered with the American Obesity Association, the Office of the Surgeon General, HHS, American Academy of Pediatrics, American Diabetes Association, American College of Sports Medicine, University of California Davis, and the North American Association for the Study of Obesity. Despite the lack of scientific evidence, SAY’s town meetings continue across the country to discuss the “alarming issue of childhood obesity” and solutions. NikeGo contributed more than $10.5 million in 2003 alone towards these efforts. It’s also been a high-profile lobbyist in Congress, such as for the Childhood Obesity Reduction Act in 2004, when Gary DeStafano, president of the U.S. division of Nike, addressed the Senate making claims that will be familiar to everyone today.

And New Balance Shoes, Inc. has been an enormous sponsor of many childhood obesity initiatives including, for example, a ten-year grant to Tufts University Friedman School of Nutrition Science and Policy for its "Children in Balance: A Childhood Obesity Initiative." Junkfood Science readers will be familiar with one of those Children in Balance initiatives: Shape Up Somerville. Thanks to New Balance, this program will be continued for the next ten years. Along with Robert Wood Johnson Foundation, New Balance also sponsored the infamous Time [Magazine]/ABC News Summit on Obesity in Williamsburg, Virginia, in 2005 to bring national attention to the ‘obesity problem.’ To set the theme for the event, the organizers had used a quote from U.S. Surgeon General Richard Carmona saying obesity “is every bit as threatening to us as is the terrorist threat we face today. It is the threat from within.” Time Magazine’s president Eileen Naughton, went on to talk about the shared sense of urgency and a string of speakers gave all of the most repeated campaign slogans. It was at this event that the keynote speaker, Secretary of Health and Human Services Tommy Thompson said “America is just too darned fat...”

For our children, having their crocs and roller shoes banned and being made to wear athletic shoes to school in order to encourage them to be more active would reinforce the messages they’ve been hearing: that their entire generation is fat and lazy and must be continually physically active at all costs.


© 2007 Sandy Szwarc



With the popularity of cute crocs growing, the success of these shoes could be cutting into the profits of other casual shoe makers, such as high-dollar athletic shoes. Crocs are certified by the U.S. Ergonomics Council and the American Podiatric Medical Association and they’re designed to help with certain foot and circulation problems. Will anti-obesity initiatives be coming after nurses, elderly, cashiers, gardeners, diabetics, and those with foot problems next?


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September 25, 2007

ED hurts

A personal story that appeared in The Independent yesterday, questioned claims that anorexia is caused by the fashion industry, although being surrounded by our society’s glamorizaton of thinness can lure some young girls to diet or make it harder to break out of disordered eating. Young writer, Naomi Hooke, explained that, for her, she grew up feeling her body wasn’t good enough, and the cruelty and fears that accompanied normal body changes and fat gain and with puberty led to her problems. Most importantly, she urged readers to remember that even if someone appears “normal” weight, they could still be suffering, and that she was engaging in the most unhealthy behaviors and was most mentally anguished when she had a “healthy” BMI.

Understanding anorexia: A thin excuse

It was two days before Christmas, and for the third time in my 20-year-long existence I found myself having my blood pressure monitored, my blood taken for biochemical analysis and my mental state being assessed for risk of self-harm and suicide. Once again, I'd been admitted to an eating disorder unit, rescued from my own little world of self-destruction....It hurt to sit up, and hurt to lie down, yet I refused to believe that this was due to starvation and muscle wastage....

I'd suffered from anorexia to varying degrees since I was 11, hiding food and concealing my body under layer upon layer of clothing, and once again it had caught up with me....Although any measure to protect models at risk of eating disorders is to be applauded, to believe that the fashion industry causes eating disorders is to completely misunderstand this most complex of illnesses....Seldom is anorexia acknowledged as the life-threatening medical condition that it is. Many anorexics detest their bodies, refusing even to pose for family holiday snaps....As far back as I can remember, my self-esteem was low and I lacked confidence. Children can be cruel, and although they weren't the “cause" of my eating problems, the bullying I endured throughout my schooldays only added to my feelings of self-hatred.

It is often assumed that the distress in anorexia revolves solely around food and weight. However, the vast majority of eating disorder patients have numerous other difficulties, including low self-esteem or confidence, lack of self-care, and social difficulties. Sufferers are often presumed to pour over the pages of glossy magazines and starve themselves in their aspiration to become glamorous, thinner-than-thin sex goddesses. From my own experiences and from those of numerous other eating disorder patients I have met, I can say unequivocally that nothing could be further from the truth. Beauty has very little to do with eating disorders, and the desire to be thin is merely one of many symptoms. Rarely can a single “cause" be identified....

Focusing on weight and downplaying the gravity of eating disorders can be deadly, she tried to explain. There are those who think it’s just a teen fad or girls just trying to look like models, or even “a lifestyle choice.” Instead, it can be serious and take on an increasingly severe, deadly mental and physical life of its own, and some of these victims need help escaping. As she said:

My fall into the dark world of anorexia was never influenced by fashion or waif-like celebrities, though I knew others whose recovery from life-threatening illness was indeed hindered by the Western world's culture of thinness. I believe that the British Fashion Council's guidelines will go some way to protect the models themselves (of whom 40 per cent are said to suffer from eating disorders). However, I see problems both with the approach taken in Madrid of banning models with a BMI under 18.5, and the recent health certification scheme proposed in Britain.

Although BMI can offer a crude measure of physical health, it can never quantify psychological distress. Despite popular belief, low weight is not the only danger of eating disorders. There have been times in my life in which my BMI has been in the healthy range and yet my eating behaviours and mental state were far from healthy....

The idea that in recent years as many as one in ten healthy young persons has suddenly become afflicted with a mental disorder defies logic. No doubt, there are multiple contributing factors and wide individual variations. There is also no doubt that our culture’s incessant drumbeat against body fat and promotion of thin, “fit and healthy” bodies can both trigger and perpetuate the negative body images and disordered eating that have become the all too common female condition, and growing among men, too. Yet, our culture turns a blind eye to the deadly side effects of it’s anti-fat messaging.

Saddest of all, many eating disorder sufferers don’t realize how significant the role that food restrictions play — whether it be from that first diet, “healthy eating,” an illness, grieving, stress, or food fears — in triggering eating disorders. Many of even the most dramatic physiological and psychological things that are experienced can be normal, natural responses of human bodies to having been starved or had food restricted, as Dr. David Garner, Ph.D., director of River Centre Clinic in Sylvania, Ohio, has explained and the Minnesota starvation studies from the 1950s illustrated. If those with disordered eating were “made truly aware of the scientific evidence” about many of the symptoms they are experiencing, they can be helped and be less likely to persist in blaming themselves, continue self-defeating dieting, and feeling diseased and defensive, he’s said.

With growing numbers of young people getting caught into sometimes lifetimes of dysfunctional relationships with food or decades of full-blown eating disorders, caring people are desperately trying anything and everything if they think it might help prevent them. At the end of last year, the Italian government and fashion industry had adopted an anti-anorexia campaign, calling for a return to a "healthy, sunny, generous and Mediterranean beauty."

One question: Where are those images in the media to help young people see more of what the diverse range of normal, nourished bodies look like?


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Purple tongues and big red grins

Over a century ago, a little eleven year old boy named Frank Epperson took his favorite brightly colored soda pop, put a stick into it, and left it on his porch to freeze. Eighteen years later, he patented his ice pop, which by that time his own kids had renamed the “popsicle.” In 1902, the first Devil’s Food Chocolate Cake (also called Red Velvet Cake because of its deep red color) recipe appeared in an American cookbook called Mrs. Rorer's New Cook Book by Sarah Tyson Rorer. During the Great Depression, around the time Frank was getting his patent, Kool-Aid was born, sporting equally bright colors. And who knew that M&Ms came into being inspired by, as the story goes, soldiers in the Spanish Civil War who were eating little beads of chocolate encased in vividly-colored sugar coating to keep it from melting?

While these aren’t the earliest examples of food colorings in America’s favorite foods — foods have been dyed for centuries — it’s nice to be reminded sometimes that what’s feared today as perversions of a modern diet, aren’t all that modern at all. It’s equally helpful to remember that food additives have never been safer than those used today and far fewer are used today ever in our history. Only 7 food colors are allowed in foods and beverages in the U.S. today. Since 1938, the Food and Drug Administration (Federal Food, Drug and Cosmetic Act) has regulated food additives to prevent adulterated foods that could be harmful (prior to that, the Food and Drug Act of 1906 established a voluntary certification program of food additives administered by the U.S. Department of Agriculture). The 1958 Food Additives Amendments and the 1960 Color Additive Amendments began fresh and required food companies to provide proof that their additives were safe before permitted to use in foods.

In contrast, those making scary claims that ‘food additives are unsafe’ don’t have to provide any proof at all. You’ve heard the one about hyperactivity in kids caused by food additives...

This scare is more than 30 years old and first surfaced in 1973 when a California allergist, Dr. Ben Feingold, claimed hyperactivity was caused by artificial colors and flavors. He convinced followers that 32% to 60% of hyperactive children could improve on his special elimination diet that removed all “processed foods” and artificial colors and flavors. Saying he had no time for science or to conduct a double-blind trial, others have tried to prove his claims and, to date, no one has been able to. Instead, the most well-designed and carefully-conducted clinical studies have disproven them. None has been able to show evidence that food additives and food colors affect the behavior of children. At most, very rare numbers, about 1 or 2 in 10,000 kids, may be sensitive to certain colors resulting in itching or congestion, something that can be said about most any food ingredient. Nor is there any evidence of epidemic hyperactivity among kids in the early part of the last century when far more artificial food colorants were used.

According to the Food Color Facts brochure by the U.S. Food and Drug Administration, “well-controlled studies conducted since [the 1970s] have produced no evidence that food color additives cause hyperactivity or learning disabilities in children.” As reviews have pointed out, invariably when symptoms of hyperactivity are reported, they are subjective impressions by parents, rather than independently or objectively verified, and any changes in the diet have appeared related to changes in the family dynamics, such as paying more attention to the children.

In 1980, the National Advisory Committee on Hyperkinesis and Food Additives, a group of behavioral and medical scientists organized by the Nutrition Foundation, conducted a critical review of clinical trials that have tested Feingold’s claims and concluded:

Based on seven studies involving approximately 190 children, there have been no instances of consistent, dramatic deterioration in behavior in hyperactive children challenged, under double-blind conditions, with artificial food colorings...There are three exceptions to these generally negative conclusions, but, in all three cases, the deterioration is reported by the mother with no other objective, confirming evidence available.... Without the confirming evidence of objective tests and/or outside observers, even these exceptions cannot be considered as definite evidence that there may be an occasional, genetically determined, sensitivity to food colorings. Though one cannot prove that no such children will be found, sufficient numbers of highly selected children have been studied to feel confident that such specific sensitivity, if found, will be rare.

The belief continued, as all good scares do. So, studies attempting to support the claim have continued, too. One study conducted in 2000 by the David Hyde Asthma and Allergy Research Centre, Isle of Wight, received a great deal of media attention and claimed to show that a cocktail of additives given to 3 year olds affected their behavior. The UK Committee on Toxicity (COT), however, reviewed the study and determined that the methodology was deficient and unable to support the conclusion. The children exhibited no difference in behavioral changes when consuming the additive cocktail versus the placebo when assessed in the clinical setting, and objective observational assessments could not detect the behavioral changes reported by the parents.

The reason why scientists and doctors continue see no sound evidence to point to food colors as causing behavioral or learning difficulties in children is that they are looking neutrally at the most objective evidence and at the design of studies. When we, parents or loved ones are emotionally close to a situation, our expectations can influence how symptoms are interpreted. Even researchers’ expectations can influence how symptoms are interpreted. It’s hard to admit, but we really can’t trust our own experiences and medical conditions is one area where they’re not reliable at all. And interpreting children’s behaviors is especially hard.

Many of the symptoms of ADHD, or attention-deficit hyperactivity disorders, are subjective and the same symptom to one person could be seen as normal, high-energy, boisterous kid behavior, while to another be viewed as abnormal. The American Academy of Family Physicians offers a helpful overview of ADHD for parents. As they note, the symptoms of ADHD hyperactivity include: fidgety, runs or climbs inappropriately, doesn’t play quietly, blurts out answers or interrupts people, can’t sit still in seat, talks too much, is always on the go and has trouble waiting his/her turn.

So many things can affect a child’s behavior and also create the perception of a link — tiredness, hunger, stress, fear, excitement, discipline, boredom, etc. — isolating the cause from confounding factors is difficult.

The only way to scientifically overcome observational bias, subjectivity and the placebo effect is through “double-blind” placebo controlled trials. These types of studies have shown scientists time and again that we can’t trust our own eyes. In these studies, a random group of participants is given the treatment and another group are given a pretend treatment (placebo) and neither the researchers nor the participants know which is which until the study ends (they are thus both “blind”). To make things even tricker, double-blind studies are not all created alike. The design, conduct and reporting of these studies can give some more credence than others. Double-blind studies are especially important when testing kids because not only can the parents be influenced by their own expectations, but kids are also very astute to parental expectations and can react to or mirror their parents’ and other adults’ fears, anxieties or positive attitudes.


The latest study in the news

If you’re a parent, no matter how many times and how much careful evidence has shown food additives to be safe, recent news reporting on a study published in the Lancet said to have found that food colorings increase hyperactivity in children may still have been frightening. It claimed to be the first ever to show a direct connection.

No one has bothered to look closely at this study, but here’s why it needn’t worry you.

First the news:

Food Additives Could Fuel Hyperactivity in Kids

Some common food colorings and preservatives appear to increase the risk of hyperactive behavior among children, British researchers report. The link between food additives and hyperactivity has long been suspected, but this is the first study to show a direct connection. The findings have already caused the British government's Food Standards Agency, which funded the study, to issue a warning to parents about food additives.

Attention-deficit hyperactivity disorder (ADHD) is an increasingly common problem, and theories abound to account for that," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. “Among them is the notion that food additives induce hyperactivity....No one factor is solely responsible for rising rates of ADHD," Katz said. “Along with the hazards of a highly processed food supply, children are getting less and less physical activity as a means of dissipating their native rambunctiousness."

In the study, Jim Stevenson, a professor of psychology at the University of Southampton, and his colleagues gave drinks containing additives to 297 children. The children were in two groups: 3-year-olds and 8- and 9-year-olds. The drinks contained artificial food coloring and additives such as sodium benzoate, a preservative.... Over the six weeks of the trial, Stevenson's team found that children in both age groups who drank the drinks containing additives displayed significantly more hyperactive behavior. These children also had shorter attention spans. However, which specific additives caused specific behavioral problems is not known, the researchers said....

“However, we need to remember that there are many factors associated with hyperactive behavior in children. These are thought to include genetic factors, being born prematurely, or environment and upbringing," Dr, Andrew Wadge, chief scientist at the Food Standards Agency, said in a statement. Insights about the causes of ADHD should help parents implement preventive strategies which are urgently needed, Katz noted. “A healthful, unadulterated diet and regular physical activity seem like a good place to start," he added.

This study and the news coverage have many classic earmarks of a marketing agenda, versus sound science.


Remember Peter Wason’s admonitions?

All you have to do is find an instance — in this case, a well-done study — that doesn’t support a claim to decisively eliminate it as being true, whereas a sound claim can be replicated exhaustively. Those trying to scare us about dangers in our food, bodies or world will repeat and try to prove the same disproven scare over and over again, rather than move on. This study wasn’t using some new, more modern method of assessing hyperactivity that thirty years of studies didn’t have available. Nor was it testing some new food colorant on the market that hasn’t been tested before. And a study that was truly trying to identify a possible chemical or combination that might contribute to hyperactivity wouldn’t have created two large cocktails of chemicals, with no rhyme or reason to the combinations, making isolating any potential culprit(s) impossible. A well-designed study would have systematically tested individual chemicals or a progression of combinations, for instance.

There is another telltale sign that this is primarily food politics and being used to scare young parents about “unhealthy” foods and artificial ingredients — besides the fact that mere weeks after the first media blitz about the study, special interest groups are plastering the news again this week with complaints that the UK government hasn’t acted fast enough to ban these ingredients.

Any insinuations by American doctors or health food advocates or the American media that this study supports the dangers of food additives in the “increasing common problem” of ADHD, and the need for an “unadulterated” healthy diet, is bogus. Most of the colorants used in this study — quinoline, carmoisine and ponceau — aren’t even approved for use in foods and drinks in the United States. And another one, sunset yellow is found naturally in squashes and other yellow-colored produce. Nor is there any evidence that British children have more hyperactivity than American kids.

Whenever you find claims of “evidence” to support a fear that’s been repeated shown not to be true, it’s your alert to look closely at how they did it, and how and why you’re being manipulated. Let’s walk through a few details in this study.


Was this study truly double-blind?

Just because researchers claim that the participants and observers weren’t told which beverages were the additive cocktails and which were the placebo beverages... doesn’t mean the parents or kids couldn’t tell. As the researchers explained, the cocktail mixes A and B had different combinations of 6 different food colors and they varied the amounts of fruit juices in them to match the color and taste to the placebo drink. They said they’d conducted masked testing of the drinks on two panels of young adults (not testing individuals independently), and that any differences between the drinks couldn’t be detected. They reported that 40% thought mix A had chemicals and 65% thought the placebo had chemicals. But they didn’t do blind taste tests with any of the parents and, more importantly, they didn’t ask the kids.

And the kids, as we’ll see, were having to guzzle a lot more of these drinks than mere sips in a taste test.

The parents’ ability to detect which drink had the additives, for instance, would essentially eliminate the blindness. When parents believe that their children are getting a chemical that could contribute to hyperactivity, they will be more likely to look for or see signs in their kids. And children are more likely to react to parental expectations and anxieties.

It is also worth noting that the parents who agreed to allow their children to participate in this study were a small fraction of the original cohorts: a mere 17% of the parents of the 3 year olds and 25% of the parents of the 8/9 year olds. And after the study got started, another 20 removed their child from the study and didn’t complete it, bringing down the completion rates to 15% and 20% of the original group, respectively (for a total of 267 kids). These parents appeared to differ from the general population and, perhaps, they were more suggestible or less careful observers. It is noteworthy that only 35% of the participating mothers had attended school to age 16, with only 18% completing college, and only 20% of the parents had higher occupations.

All of this is significant because the children’s hyperactivity was, in part, determined by their parents. Each week, the parents rated their child’s behaviors — “switching activities, interrupting or talking too much, wriggling, fiddling with objects or own body, restless, always on the go, concentration” — which were totaled into a score. Two types of outside observations were also gathered. Children were observed in the classroom for 24 minutes every week (three observation sessions of 8 minutes each) by psychology graduates and a total weekly mean score was derived; and the kids were rated on abbreviated ADHD scales by teachers on questionnaires each week. But since 3 year olds aren’t in school, preschool attendants merely scored the younger children’s behaviors when they changed activities. Finally, just one objective measure was taken, but only on the 8/9-year-old children each week: the Conners continuous performance test II, a test that uses visual stimuli of 14-minute duration to measure attention and control.

But in reporting their results, the researchers combined the objective measures with outside observations and the more subjective impressions of parents, making credible interpretations impossible.


Going to the source

Even so, the results reported in the actual study are considerably different than the spin being reported in the media. For most of the observations, in fact, the confidence intervals are so close to zero that the slightest reduction would have shifted them all into statistical insignificance. Here’s what the researchers actually reported:

In model 2, in which the effects of other factors were controlled, the effect of mix A for the entire sample was not significant (p=0·123) but mix B did have a significantly adverse effect compared with placebo (p=0·012). When the analyses are restricted to those children who consumed at least 85% juice, the adverse effect of mix A on behaviour remained non-significant (p=0·066) but was significant for mix B (p=0·003).... For mix A, the effect for 3-year-old children was greater than for 8/9-year-old children. The effects for mix B were not significant for 3-year-old children because there was greater variability in the response to the active challenges than placebo in this age group. Thus, we recorded substantial individual differences in the response of children to the additives.

Among 8/9 year olds, they reported a 17% increase in ADD behavior for those who finished their juice with Mix B, but not otherwise. So, they found nothing tenable with mix A and only a tiny purported increase, using problematic data, among the older kids with mix B. Whether this represents true clinical hyperactivity, or older kids becoming more impatient and resistant to the study is unknown, but the later is not unreasonable to imagine.

What hasn’t been reported in the news is that these kids were being given 21 ounces a day of a drink (that they might not have even liked), which is considerably more than children their age drink daily of sweetened carbonated drinks (7 oz.) or fruit drinks (3 oz.), according to NHANES and the American Academy of Pediatrics. In fact, only 11% of kids their age drink more than 12 oz. a day of sweetened drinks. Before even beginning the additive cocktail part of the study, the children also had to drink wash-out placebo drinks for six weeks, before being randomized to placebo or additive cocktail mix A or B during weeks 2, 4 and 6 of the study. By then, the kids might easily have been able to tell a difference between the drinks. They also might not have liked them or been sick of them and began acting up more in rebellion at having to drink the cocktails. Or maybe, they just needed to pee. :-)

What were the adverse effects of filling their little tummies with such extreme and unrealistic volumes of sweet drinks every day — over twice what even the small numbers of the highest-consuming kids would ever normally drink — and displacing calcium-rich milk and a variety of foods for so long? Was the potential harm to the overall health to these children considered or part of the informed consents the parents signed? By not monitoring electrolytes and minerals, such as calcium, for example, it’s impossible to know how much of their fidgetiness and other symptoms, even if they’d been statistically significant, might have been due to nutritional issues.

The study concluded by saying:

We have found an adverse effect of food additives on the hyperactive behavior of 3 year old and 8/9 year old children.. The implications of these results for the regulation of food additive use could be substantial.

Not mentioned was that that 'adverse effect' wasn’t statistically significant, but the political angle was. This study has not provided any credible, objective evidence to negate over 30 years of evidence finding that food colorings used in foods and drinks are safe and do not cause hyperactivity in children.


For more information on the causes of ADHD and what parents can do to help their children, the American Academy of Family Physicians has a free brochure, ADHD: What Parents Should Know. Other things that do not cause ADHD, they note, include:

· Bad parenting

·Too much sugar

·Too little sugar

·Aspartame (artificial sweeteners)

·Food allergies or other allergies

·Lack of vitamins

·Fluorescent lights

·Too much TV

·Video games

© 2007 Sandy Szwarc


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September 24, 2007

Two thumbs up

Just when you think that the entire world has lost all reason and that no one will ever get any of this, someone comes along who actually does. :-)

Dr. Westby G. Fisher, MD, FACC, a board certified internist, cardiologist, and cardiac electrophysiologist in Evanston, IL, has written two great posts that will renew your faith — he did mine. Please do read these in their entirety.

The first discusses the magical belief in “wellness” and the promotions of preventive health and “wellness” initiatives mostly by those trying to sell us something, as has been covered here extensively. It’s not popular to admit— by healthcare professionals or by consumers — that such feel-good initiatives are based largely on junk science and on selling fear.

Illness vs. Wellness — What is "wellness?"

I could not find a reference to the word "wellness" before 1995. (It is interesting that this correlates to the time when managed care took hold in medicine.) Could this word have been born of pure marketing fluff?... If one looks closely at how "wellness" is used by some insurers, we see a very different definition (and I suspect motive) for the word. Could it be that insurers have concocted these programs to save their skins in the eyes of the gullible consumers by providing a “feel good" aire to themselves while reaping ridiculous profits and making our patients pay increasingly more of their own health care costs? After all, insurers should be about insuring illness, not providing healthcare in "wellness" clinics.

Take for instance, the wellness initiatives from UnitedHealth. We find that "wellness" means they want to store your health information online through an online database called a “Personal Health Manager." [Or Blue Cross Blue Shield’s version here and Cigna’s here.] Any shread of evidence this promotes “wellness" (whatever that is)? Nope....Could it be that “wellness" is intangible (and therefore non-existent)?

Public health initiatives like smoking cessation is also commonly promoted in “wellness" clinics. To be fair, smoking bans appear to have had a huge impact on the health of societies worldwide. But while insurers offer some tips on smoking cessation to many of their members, their efforts fall flat compared to the efforts of grass-roots organizations enacting legislation. And now, nicotine blood levels are being used to discriminate between insurance rates for smokers and non-smokers. Where's the “wellness" love here? [And the same thing could be said about weight loss programs being sold to members.]

And then comes “health screenings” by “wellness" initiatives. Mammograms. Glucose and cholesterol levels. Colonoscopies. But do these really prevent disease, or provide “early detection” of disease for the insurer? You see, early detection helps insurers know who’s going to be “naughty and nice” regarding costs to their system - it's another way to weed out “high risk" members of your insured population under the guise of “wellness." What happens when insurers find you have coronary disease or hyperlipidemia? Your premiums rise. In the case of mammograms and colonoscopies, early detection with these tests certainly can save lives – but importantly, it does nothing to prevent disease. Many of these maladies are genetically predetermined. The public dissembling by insurers when they encourage people to “live a healthy lifestyle” is ludicrous. People still socialize, people still drink, people still drive, people still age, people are fallible, and yes, despite such smoke-screens, people get sick, and people still need someone to provide insurance when they're ill, not when they have “wellness."...


The second post humorously points out that health discrimination is increasingly real and that, as discussed here, failing to comply with insurers’ ideals of health indices isn’t about health at all.

Health Discrimination is Here

“Sorry, Mrs. Smith, while we appreciate your excellent attendance and work ethic here at Clarian Health, it's come to our attention that you're fat, so we want you to submit to a blood test to measure your cholesterol. If you refuse, you're fired. If your cholesterol is high, you're going to pay more for our insurance."

“What's that you say? Drawing your blood without your permission is assault?.... Our company policy requires this test be taken because ...we know what's best for you."...

“You want us to speak to whom? The ACLU? ...


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