Junkfood Science: February 2007

February 28, 2007

Scientific context

Trevor Butterworth, editor at STATS, has written a great piece about the new publication released by chemical scientists at Sense about Science, called “Making Sense of Chemical Stories.” In the free download, they examine six of the most common misconceptions about chemicals in our lives and help us make sense of them.

As Mr. Butterworth writes:

If someone came into your house and offered you a cocktail of butanol, iso amyl alcohol, hexanol, phenyl ethanol, tannin, benzyl alcohol, caffeine, geraniol, quercetin, 3-galloyl epicatechin, 3-galloyl epigallocatchin and inorganic salts, would you take it?

Or would you place it in a secure container and contact the Environmental Working Group for advice? If recent media coverage of environmentalists’ concerns about our exposure to chemicals has left you feeling paranoid, then you might opt for the second option – or, as is more likely, you’d pour the mix down the drain and leave it for someone else to take care of.

Relax, says research chemist Derek Lohmann, all you’ve been offered is a cup of tea.

The publication, “Making Sense of Chemical Stories,” is fun to read for all ages. You don’t have to be a science nerd. The six misconceptions about chemicals the scientists explain are:

* You can lead a chemical-free life

* Man-made chemicals are inherently dangerous

* Synthetic chemicals are causing many cancers and other diseases

* Our exposure to a cocktail of chemicals is a ticking time-bomb

* It is beneficial to avoid man-made chemicals

* We are subjects in an unregulated, uncontrolled experiment

In helping to explain Myth #1, for example, they talk about why detox diets make no scientific sense and give interesting facts such as: “Did you know that the average person has more than a trillion atoms of uranium in their body and that hundreds of these atoms are radioactively disintegrating every day?”

They offer some very simple ways to help us evaluate claims about chemicals and their risks, such as if they cause cancer. And perhaps one of the most valuable pages shows how “science-y” words are misused to scare us with chemicals.

Defusing fears about bioaccumulation may be especially helpful for those who worry about the cumulative effects of small exposures of chemicals in our modern life, a worry promoted by clinical ecologists.

And if you worry about additives in your food and wine you, they help explain those, too. Do you get drunker drinking the equivalent alcohol in a cocktail rather than a beer?

What’s one of the most powerful poisons known yet used safely every day?

You’ll probably want to read to find out. Good information can only help us better safeguard ourselves and our loved ones from needless worry. As Martha would say, "that's a good thing." :)

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Is non-evidenced based medical care any different from alternative modalities?

Dr. R. W. Donnell recently exposed the promotion of pseudoscience among medical students and, as was also written here, financial benefits can be powerful incentives for mainstream medical professionals to put out shingles selling diets, supplements and alternative modalities. He just posted a poignant rebuttal to assertions that alternative woo is no worse than non-evidence-based conventional medicine. There are very real differences, as he explains:

Why focus on woo?

...As I tried to explain in this post one important difference lies in the area of scientific plausibility: “Although some conventional methods fail to measure up to best evidence they are at least based on known anatomy and physiology. They have some plausibility in the observable biophysical model in contrast to the ‘vital forces’, nebulous ‘energy fields’ and ‘non-local powers of the mind’ which are characteristic of woo.” Viewed in that context they can hardly be construed as “competing mythologies.”

The commenter needs to understand that although I want doctors to practice evidence based medicine my focus is not on what individual doctors do. It’s the hypocrisy of mainstream medical institutions (journals, medical schools, hospitals) claiming to be all ethical and evidence based while promoting unscientific and even fraudulent claims that has my attention....

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Antiscience and reason

Professor Raymond Tallis, of Sense About Science, has just written a column in Times UK explaining why science is regarded with such suspicion today while junk science passing itself off as science is uncritically accepted.

Right, what have the scientists ever done for us? Well . . .

...Hostility to science is largely pretence, of course. The most vocal opponents still help themselves liberally to its benefits at every waking moment of their lives. Nor, when misfortune strikes, do they deny themselves science-based technologies to rescue them. When they fall desperately ill, few proponents of alternative medicine choose ancient remedies over modern drugs and surgical operations, which are rooted in, and draw upon, a vast hinterland of scientific knowledge.

And yet this hostility should not be dismissed. Underplaying the benefits of science and emphasising the things that go wrong feeds into a general pessimism about the future, and about human possibility, that could be self-fulfilling. Junk science, which parasitises the language of science — think of “reflexology”, alternative “immune therapies” — thrives on denigration of the real thing and is looming ever larger in the collective consciousness....

The contribution of medical science — which is increasing as the emphasis shifts from falling infant mortality to (spectacular) declines in mortality in late life — is part of a larger picture of the beneficent impact of science on living conditions, wealth production and technological support for every aspect of daily life....

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Follow-up and some balance on the young boy in England

Government authorities are allowing the eight-year old boy in North Tyneside, discussed here, to remain with his family under undisclosed terms.

While no one actually knows the real story here, many believe they do, based on the media’s presentation. This story has tragically brought out misinformed viewpoints about the causes for extremes of size in children and scares about obesity. But the most extreme thing about this situation isn’t the child’s unusually large size, but the extreme examples of fat prejudice that have surfaced, none worse than that illustrated in the language used by one columnist in Britain who actually published this about the boy:

He has a sweet face and endearing smile but it's impossible to look at his young bloated body without feeling both revulsion and pity. Revulsion because, like Monty Python's blubbery Mr Creosote, you wonder how many more calories it will take before he explodes.... it's obvious the fat police have a mountain of lard to climb if they hope to prevent a health timebomb. And as a symbol of our times you couldn't find a sadder example of a doomed child heading into a future blighted by heart disease, diabetes and kidney failure...

The media was quick to point blame at this mother, upon noting that they caught him eating 4 handfuls of chips and 3 cookies a day they watched him, he doesn’t like fruits and vegetables but does like hotdogs and potatoes, and the family eats “processed” foods and used to eat take-out twice a week. None of this is unlike plenty of families of thin children. It is not uncommon for parents to worry that their kids will only eat "white" foods like macaroni, breads and sweets, and for rapidly growing children to seem hungry all the time to their parents. Moreso, as medical research has shown, when their eating is restricted by adults hoping to make them smaller. But we really don't know the child's actual diet, only the media's interpretation of his "bad" diet.

While many are quick to jump to conclusions that fat children must have eating disorders and can’t “really be hungry” because they’re so large, the fact is that is very rarely the case. And to point to “overeating” especially in this situation, makes no genetic sense at all. “Overeating” might make a child several pounds larger, but as medical professionals know, it’s biologically impossible for food alone to make a young 8-year old child an extraordinary foot taller and larger than his peers.

One media report noted that he'd gone through five bicycles, so this would not appear an unusually sedentary child. And it is impossible to accurately interpret the fact he drags himself to school oftentimes late, as reported by another media story.

There are also no indications from the news stories that, as some have suggested, he has Prader-Willi syndrome, characterized by short stature, small hands and feet, and retardation.

Maybe this is a child with some medical explanation for his extreme height and size. We don't have the facts to know. But just as possible, he’s another example of children like Anamarie or Dakota for whom there are no medical explanations or indications of parental abuse/neglect but simply examples of variations of size at the extreme end. As one obesity author described him, he is built like a future linebacker.

The one thing we do know is that this extreme example is being exploited and held up to illustrate and exaggerate childhood obesity...at the detriment of this child and his family and all fat children, and at the expense of accurate portrayals about children’s natural diversity of sizes.

ABC News this morning showed him jumping on his trampoline and playing like any other kid but eagerly made him a headlining story about parental abuse. Of all the articles in media around the world, only one unnamed editorial today looked at the adults in this situation and commented on them using this situation to create a TV show. The points are worthy of inclusion in this controversy:

TV made a freak show out of Connor‘s misery

Just who is most guilty of abusing eight-year-old Connor McCreaddie?... Frankly, the documentary on poor Connor was a shameful piece of filming. Presenter Fiona Foster’s finger-wagging prurience struck me as a sham. How could anyone with Connor’s real interests at heart have exposed him to national shame and ridicule? Just what sort of reaction will Connor now be getting at school or in his local neighbourhood? Don’t the programme makers have a clue how cruel other children can be or do they simply not care?

We protect children in our courtrooms but are quite prepared to throw them to the television wolves whose only real concern is to achieve good ratings. Was it really necessary to film Connor sitting in his underpants with his rolls of flab hanging over in folds? Exactly what justified such an intrusion? We worry our socks off about paedophilia yet it is OK to strip a child almost naked on national television in order to mock his body.

This quasi-documentary was a clear case of child exploitation....Were all these professionals happy to go along with exposing Connor’s problems to a national audience? Consultant paediatrician Dr Michael Markiewicz, an expert on childhood obesity, told the programme makers that the family’s treatment of Connor amounts to child abuse, however unintentional it is. “They love him, but they actually love him to death. The way they are treating him and feeding him, they are slowly killing him.” ... whatever happened to the idea of medical confidentiality? What chance has poor Connor when even his doctors think it is perfectly OK to discuss his case on national television?

The whole programme was repellent; a skin-crawling experience. Poor Connor and his family were treated like modern freaks by the tut-tutting, skinny, London-based presenter....

A few years ago, when a nine year old girl in Derbyshire County was threatened to be removed from her parents because she weighed more than 13 stone, Spiked-online published an article by Paul Campos who described Anamarie, a fat child removed from her parents in Albuquerque, New Mexico. Its balance is critically important to read again today:

The lock-up diet

...The story of what was done to a child and her parents by an assortment of doctors, social workers, and government bureaucrats is a chilling tale of what can happen when people of modest means and social status find themselves, through no fault of their own, facing the full brunt of the prejudice that fuels the war on fat.

Anamarie - who weighed six pounds, 13 ounces at birth - gained 32 pounds in her first eight months of life. Her mother, Adela Martinez-Regino, realised from the beginning that there was something different about her daughter. 'She was drinking 10 and 12 bottles a day and still wanting more', she says. So Martinez-Regino...started taking her daughter to doctors, in what became an increasingly desperate attempt to determine why her daughter was so large. (Besides her weight, Anamarie soon grew to be nearly twice as tall as other children her age, and developed a full set of teeth by the time she was a year old.)

Over the next few months, a parade of paediatricians, endocrinologists, and specialists in rare childhood syndromes examined Anamarie. None of them was able to successfully diagnose her condition. By the time the girl was 16 months old, her mother had taken Anamarie to 57 doctors' appointments, yet her condition remained as mysterious as ever. And still, Anamarie continued to grow at a remarkable rate: she weighed 67 pounds at 16 months, 97 pounds at 28 months, and 130 pounds by July of 2000, when she was little more than three years old....

What Anamarie's mother didn't know was that the state's Child, Youth and Families Department was already preparing an affidavit that would accuse her and her husband, Miguel Regino, of endangering their child's life by making her fat. According to the social workers who filed this document, Anamarie would 'surely die' if she was not placed immediately on a rigid diet and exercise programme. This, the social workers said, was 'something which the parents have not been willing or able to do'....

The next few days were a nightmare for Anamarie's parents....Martinez-Regino's description of the final scene would chill the blood of any parent....

Although no medical problems were ever found in this young girl despite the claims of authorities that she was in immediate medical danger, she was placed in state custody and put on a 500-calorie a day starvation diet and intense exercise program and continued to grow larger. As Campos noted, “it should be unnecessary to point out that the whole idea that parental dietary practices might play a significant role in producing a 130-pound three-year-old is absurd.” Understanding the genetic regulation of our size, one would know that it is impossible to force feed a toddler to make him/her 90 pounds more than an average 3 year old, he said.

Another disconcerting parallel between these stories was noted in another observation from Campos:

Anamarie's story illustrates the intimate relationship between, on the one hand, slenderness and power, privilege, and money, and on the other, fat and powerlessness, lack of social status, and relative poverty....

We live in a nation in which those in authority can look at a three-year-old girl with the 'wrong' sort of body and decide, on the basis of nothing more than irrational beliefs born of their own fear and loathing of fat, that her family must be torn apart.

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February 27, 2007

Keeping our wits about us

Many dubious scares and claims about our foods, bodies and health continue to appear over and over again — year after year, decade after decade — even though they were long ago laid to rest by science.

When we hear things that leave us feeling anxious or worried, it is helpful to remember that fear is a marketing tactic. True science is impartial and doesn’t use fear to convince us of anything. And one of the most popular marketing tactics is to repeat scares and claims and get them in the news as often as possible. Press releases are issued and get reported, oftentimes when there is really no new science to report. Marketers know that we more easily believe something to be true when we hear it everywhere. And it is so easy for us to become frightened by things that sound “science-y” when, in reality, they really don’t make any scientific sense at all.

Another popular tactic among special interests is to file dockets or suits with a federal agency or court system in an attempt to give their assertions more legitimacy in our minds. Never mind that their concerns are repeatedly examined and debunked under scientific scrutiny — we rarely hear about those outcomes.

You may have caught the recent news report with ominous-sounding claims about the safety of our milk:

Advocate Groups File Petition Against rBST

Three advocacy groups filed a petition Tuesday morning with the FDA calling for the withdrawal of approval for Monsanto's Posilac bovine somatotropin. The groups - Cancer Prevention Coalition, Organic Consumers Association, and Family Farm Defenders - say the injection of Posilac into dairy cows results in increased risks of cancer in humans who consume that milk...

Their petition, FDA Docket 2007P-0059, claims that scientific evidence has shown recombinant Bovine Growth Hormone (rBGH) to increase levels of IGF-1 in people who drink milk and that there are abnormalities in the milk. It was filed on February 15th by Samuel S. Epstein, M.D., head of the Cancer Prevention Coalition, who has written a book on “the industry and government cover up the dangers of rBGH” and led many fears about the safety of our food, and associated interests.

At his website, however, the scientific evidence presented isn’t new. Even so, over the past several decades he has written press releases, petitions and news reports based on the same studies and assertions — be it about scary dangers in milk, meat, irradiated foods, cosmetics, produce grown with pesticides and mammography, or skyrocketing rates of breast cancer and other cancers, that have all been disproven and shown by the most careful science to be without merit.

It might be easy to believe that the FDA has failed to adequately consider these concerns and for us to believe there must be some credible reason why these groups would continue to file petitions — but that would not be factual in this case. The references cited in last week’s FDA petition are old studies and the issues raised have previously been carefully considered and addressed by the FDA and scientific community and been shown to be without merit. The main points were summarized earlier here.

As John E. Rushing, Ph.D., professor of Food Science at North Carolina State University, Raleigh, explained in a review of the science of BGH: “Though the human safety of naturally-occurring bST [bovine somatotropin, also called bovine growth hormone or BGH] had been established in the 1950’s, many more extensive studies were required by FDA prior to the approval for marketing milk from test cows in 1985.”

According to Dr. Henry I. Miller, M.D. who was a research scientist at the National Institutes of Health before serving as the special assistant to the FDA Commissioner, as medical reviewer on biotechnology issues at the FDA, and founding director of the FDA’s Office of Biotechnology, and now serves as a Research Fellow at the Hoover Institution, concerns about the safety of BGH are “scientifically implausible.”

All of these concerns about bST were baseless. The drug underwent one of the most lengthy and comprehensive regulatory reviews in history. Used widely, successfully and safely for two decades, it markedly increases productivity: It allows farmers to produce the same amount of milk with fewer cows and milking machines, less barn space, and fewer veterinarian visits, vaccines, and so on....

Largely as a result of the misguided efforts and bullying...the FDA’s review of this excellent veterinary drug took nine years, while the evaluation of an almost identical product for injection into growth-hormone-deficient children had taken a mere 18 months.

New petitions do not mean new dangers

What no media has reported, and few consumers probably realize, is that these exact same complaints have been filed with the FDA before and thoroughly examined and dismissed. That’s why scientists who’ve followed this issue for the past 30-some years are apt to respond as described here.

For example, an almost identical complaint concerning rBGH was filed with the FDA in 2000 by another citizen activist, Robert Cohen, who has made frightening and negative claims about our milk being a “Deadly Poison” and causing serious health consequences for people, even causing obesity in children. The FDA’s response on April 20, 2000 [summary here] carefully looked at each concern and “new evidence” mentioned in his petition and again reiterated:

FDA has previously maintained and continues to maintain that levels of IGF-I in milk, whether or not from rbGH supplemented cows, are not significant when evaluated against levels of IGF-I endogenously produced and present in humans. IGF-I is normally found in human plasma at concentrations much higher than those found in cow's milk....IGF-I is a normal, but highly variable, constituent of bovine milk with the concentration depending on the animal's stage of lactation, nutritional status and age.

According to Dennis E. Baker, Associate Commissioner for Regulatory Affairs, “the amount of IGF-I in milk from cows (regardless of possible rbGH supplementation) is insignificant compared to the endogenous production of IGF-I in people (less than 0.09%).”

The FDA’s response to the 2000 petition also examined concerns about how rBGH was manufactured and if any new technologies might change its original approval, and stated:

[To] reaffirm that the conclusion the Agency reached in this case was correct, FDA re-examined information previously submitted by Monsanto to support the approval of the rbGH. We also made a site visit to the sponsor to examine batch records that are not required to be submitted to the new animal drug files. Based on this examination, FDA reaffirmed its conclusion that the manufacturing changes resulted in only biologically inconsequential variations in the product used in the safety and effectiveness studies, and therefore, the rbGH product we approved is the same as the product used in the studies.

And concerning the effects or rBGH in milk, the FDA again stated:

Like most dietary proteins, rbGH is degraded by digestive enzymes in the gastrointestinal tract and not absorbed intact.

The FDA’s final determination on this petition again found:

....[T]hese arguments do not demonstrate any human food safety issue related to the use of Posilac. Therefore, the petition requesting withdrawal of the approval of Posilac was denied.

This latest petition will no doubt illicite the very same response, although when it is again debunked and dismissed, it will probably not make headlines.

The take home message for us: There is no credible evidence that milk is anything but a perfectly safe, wholesome and nutritious food for growing children and those who choose to enjoy it. And, FDA petitions and lawsuits do not equate to good science, nor to claims which we need legitimately fear.

Sadly, however, such tactics have proven useful for special interests. And the FDA has not proven to be infallible and has capitulated to similar pressures in the past. That’s why, once again, we have to look at the strength of the actual science, not the marketing, politics or news reports...nor let fears get the better of our common sense.

© 2007 Sandy Szwarc

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Reputable science isn’t apparent by looks, popularity or age

One of the most common fallacies about scientific research is that the validity of a study can be determined by the date it was done. “Outdated” studies are not to be trusted, we’re often led to believe. It’s sort of the junk scientists’ version of numerology.

Sadly, when we become convinced to dismiss studies out-of-hand because of some measure other than the strength of the science itself, we make ourselves vulnerable to being taken advantage of by unsound ideas and to miss out on the best available science...

As was discussed earlier here and here, the soundness of a study is not determined by who conducted, published or funded it... anymore than the date is was published.

The date on a paper can never change its basic science or findings. If it was a carefully-done study with strong findings that haven’t been nullified by better studies, it doesn’t matter if it was done last year or 50 years ago. With the increasing shenanigans appearing in research today, most notably the misuse of epidemiological studies and their interpretations, oftentimes older studies are more credible.

For example, the most definitive and comprehensive clinical trial ever created to examine the effects of dieting was conducted by Ancel Keys, Ph.D., in 1950. The harmful emotional and physical effects were so extraordinary and catastrophic that even he admitted decades later that nothing like it will ever be done again because laws have since been put in place against cruelty and endangerment of human research subjects. Instead, they’ve been confirmed in countless large observational and smaller clinical studies ever since. To dismiss its findings because of the date in the legendary two-volume, Biology of Human Starvation where the results were published, would be to lose invaluable insights.

To better understand how we can be hurt by believing a publication date or some other arbitrary characteristic about a study matters, let’s go back to what we discussed here last week. The value of the scientific process comes in how it tests plausible hypotheses and helps us discover and learn what things we can actually place our trust in. As experiments are able to support a preliminary hypothesis — by testing an idea from various angles and using various methodologies; and testing a hypothesis in increasingly rigorous, detailed and sophisticated ways — a body of evidence is built to support it. Science is continually progressing and advancing, and ideas are fine-tuned, in light of new and better information.

While an idea can never be entirely proven, in time the body of evidence supporting it will be so strong that it will become an accepted hypothesis or a scientific theory: a rational explanation or model based on observation, careful experimentation and reasoning, especially one that has been tested and confirmed as a principle helping to explain and predict natural phenomena — or a scientific fact: things which can be observed and/or measured; something that is supported by unmistakable evidence.

In science, 'fact' can only mean confirmed to such a degree that it would be perverse to withhold provisional assent.Stephen Jay Gould (1941-2002), former president of the American Association for the Advancement of Science

But during the process of science, careful or new studies can show an idea to be without merit and disprove a theory. When that happens, sound scientists move on and do not continue to test and fund studies to repeat the same things ad nauseam. An “old” study disproving something doesn’t need to be continually repeated. Progress is not made by continuing to dredge through ideas that were disproven ages ago or implausible to begin with.

Not so with junk scientists. They will assert their unsound ideas and continue to reassert their ideas and insist more studies are endlessly needed, hoping that one will come up with something different.

When they continue to rely on poorly conducted studies and ideas that have been disproven, that is when our caution is warranted. A flawed study — whether old or new — is still a bad study. They are often counting on the fact, however, that the media and many of us haven’t done our homework to realize they are citing uncredible sources.

We have to be careful here, too, not to believe that we can tell who the junk scientists are by some arbitrary characteristic. Bad “science” can appear anywhere and be popularly believed by even mainstream, seemingly credible sources. Prestige and credentials, and the volume of funding and political momentum behind it, are not necessarily reliable clues to the soundness of the science.

And most importantly, the popularity of an idea is never a measure of its soundness.

Do not believe in anything simply because you have heard it.

Do not believe in anything simply because it is spoken and rumored by many.

Do not believe in anything simply because it is found written in your religious books.

Do not believe in anything merely on the authority of your teachers and elders.

Do not believe in traditions because they have been handed down for many generations.

But after observation and analysis, when you find that anything agrees with reason and is conducive to the good and benefit of one and all, then accept it and live up to it.Gautama Buddha (563 - 483 BC)

When dates can make a difference

When interpreting findings, putting scares into perspective and balancing public health risks in today’s world, that is when using more recent studies and data can help us. Remembering, for instance, advances in medical care; the dramatic improvements in our air quality and pollution levels over recent decades; and changes among our population, such as its aging and increasing diversity, and bettering prosperity and availability of food and immunizations which have led us to be healthier and living longer than ever; can all assist us in putting claims into perspective for our lives today. Examples abound, such as using the most recent data on influenza pandemics rather than deaths of a century ago, or the most recent figures on dropping cancer deaths or astounding reductions in heart disease deaths in light of our diets and weights. :))

© 2007 Sandy Szwarc

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February 26, 2007

Recommended reading: Enough is enough

Michael Gard is a senior lecturer in physical and health education at Charles Sturt University’s Bathurst campus. He co-authored The Obesity Epidemic: Science, Morality and Ideology with Jan Wright. His Op-Ed in today’s Australia National Forum about the war on childhood obesity offers the scientific views and common sense rarely included in national debates.

An open letter to the anti-fat brigade: enough is enough

Have you ever noticed how often nutritionists change their mind? One day high fibre diets help prevent bowel cancer, the next day they increase cancer risk. Then the roulette wheel spins again. Voila! Dietary fat is back in the good books after once being blamed for everything from heart disease to snoring. Ditto dairy foods, bread, pasta, alcohol, water, green food, yellow food, you name it.

If the word “science” is stretched to breaking point with nutrition, the study of exercise and health blows it to pieces....On all of these questions scientists are no closer to agreement than they were 100 years ago....The fact that elite athletes and supermodels are neither healthier nor live longer than other people has been an ongoing source of disappointment to the anti-fat brigade. Their research also tells them that starting an exercise program will either make a minuscule difference to your body weight or none at all. But don’t expect them to admit this in public.

Faced with the persistent refusal of Western populations to heed their dubious advice, nutritionists, exercise scientists and now, it seems, the medical profession have invented the “obesity epidemic”....And as with most moral-panics, it is our children who seem destined to bear the brunt of adult anxieties. This is sad and unnecessary.

He then explains how the measures and definitions for obesity have been changed by interest groups to enable more children to be classified as “obese” and create skyrocketing obesity “rates,” just as had been done in the 1990s.

The statistics currently being thrown around regarding childhood overweight and obesity are patently alarmist. Studies tracking childhood obesity levels over time around the world are quite rare and generally equivocal....And all of this will have been done despite there being no study in the history of science showing that childhood obesity causes you to die young....

Next time you take your kids to school, watch the other children as they arrive. If the scientists are correct, between two and three out of every five children should be so overweight as to endanger their health. This is self-evident nonsense.

Applying his expertise and research into physical activity and its involvement in obesity over the past century, he summarizes the science.

But it doesn’t end there. We are also being told that children are doing less exercise than in years gone by, probably because of increased television, video and computer games usage. The evidence that children are doing less exercise is non-existent. In fact, some researchers concede that children are more, not less, physically active these days.....

The idea that technology causes childhood obesity by reducing physical activity is as dead as a dodo. Part of the problem is that the current “obesity epidemic” is a pseudo-problem with no obvious cause. There is no scientific evidence that we are less active than in the past and there is plenty of evidence that, if anything, we are eating more of the food that nutritionists say we should.

What’s worse (or better, depending on your point of view), some health research suggests that fatter might be healthier than skinnier, particularly for the over 55s....Although much of this runs counter to a lot of what we hear about obesity, the evidence is compelling....There are two other inconvenient “facts” which the anti-fat brigade are keeping quiet about....

Read the complete article here.

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In memory….

Heather MacAllister, 1968-2007: Founder of a burlesque troupe for large women

Friends and allies of Heather MacAllister gathered in Detroit today to recall the woman who was not only an assertive advocate for gay rights and social justice in general, but also a flamboyant performance artist who founded the San Francisco-based Big Burlesque, the Original Fat Bottom Revue, a dance troupe that features large-size women…She died Feb 13 in Portland of ovarian cancer.

Eulogists talked of MacAllister’s outrageous sense of style, “bodacious body,” fierce intellect, passion for social justice, high-energy flirting and her perception that there are links among the struggles to alleviate racial, sexual or body-size discrimination.

MacAllister fought especially hard against “fat phobia,” as a speaker defined it Sunday. “Steeped in shame, blame, buried deep in the folds of our bodies, it is virtually impossible to come across a fat person who has not internalized it to some extent,” said Davis, who read an essay written by several people. “You can’t even be sure when you meet a fat person that they identify as fat at all, or if they can bear to hear the word.”

MacAllister’s burlesque troupe of big-sized women turned fat phobia on its ear. The dancers performed around the country, and caught the eye of Leonard Nimoy, the Trekkie-turned-photographer who immortalized them in a book and photo exhibition for a New York City gallery….

For more information:


[photo: (Shiloh McCabe)]

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Another fat child custody case

News around the world has been following the story of the eight-year old boy in North Tyneside, England who is already nearly the size of an adult man, at 5 feet tall, with size 8 shoes and weighing 89 kg (196 pounds). State officials have threatened to take the child away from his mother and place him in child protective custody because he is too fat, unless his mother improves his diet. A custody hearing was scheduled for today.

The situation has sparked controversy about the role of government in the lives of families and if the panic over childhood obesity is reason or prejudice.

Government health officials have equated his size to parental abuse and neglect and pediatricians have accused the family of “slowly killing him.” This is despite assurances by the mother that he is well cared for. In a Guardian article, the director of the National Obesity Forum in Nottingham, England, called the child’s situation “extremely dangerous” and that intervention was necessary because the boy was at risk of dying by the time he is 30 years of age and developing diabetes, heart disease and “nervous system problems” in his 20s.

No science was cited to support such claims.

One editorial in the Times UK noted that the government is moving to take custody, even though the child has already lost one and a half stone since Christmas due to the mother’s efforts to keep him on a diet. The author asks:

One then has to ask how the child, or the mother, is likely to be improved by his being placed in care. It cannot be sensible. Children in care have a higher chance of going on to commit crime, to underachieve and to end up mired in poverty. It is a step that should only be taken as a last resort: but North Tyneside Council appears not to have waited for that.

The most powerful commentary and food for thought was written by Mike Hume, editor-at-large of Spiked-online:

One fat kid versus a lean, mean army of meddlers

The crusaders running the “war on obesity” are toying with a new weapon: interning children without trial....Time was when fat kids only had to fear the school bully. Now they and their parents risk being bullied by a gang of authorities and experts. Complaining that “People pick on us ’cos of my weight”, Connor says he is “sick of the nutters always shouting at us.” To those picking on his family he can now add two specialist obesity nurses, a consultant paediatrician, two social workers and a police officer, who will all be at the conference....

It is hard to speculate about the causes of obesity in an individual case (although we might note that while Connor is overweight, he is also reportedly 5ft tall with size eight feet — hardly the average eight-year-old). But we can say that none of these antiobesity interventions has been shown to be effective, from the fat camps to care orders pioneered in America. A “strict regime” of diet and exercise may have helped Connor to lose 9kg in two months. The longer-term prospects of success remain slim. What boys like him could do with is a life, not a “regime.”

Indeed, coercive interventions are worse than useless. They can do real harm to those on the receiving end. Connor’s frightened mum said that the prospect of him being taken into care would “be the death of me.”

That there can even be serious discussion about removing children from loving families reflects some fatheaded prejudices. There is a morbid obsession with overweight kids, marked by overblown warnings about child obesity time bombs and epidemics. And there is a bitter prejudice against working-class parents — those crisp-wielding “f***ing a***holes, tossers, idiots” as St Jamie Oliver branded them last year — while Ken Livingstone, the Miserabilist of London, decreed that mothers passing junk food to hungry schoolchildren should be arrested....

[Photo: Scott Heppell, AP]

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February 25, 2007

The question of the week: Diet or Exercise?

The news recently reported on a carefully-done study which debunked a number of widely-held beliefs about the best ways to lose weight. Not surprisingly, the media missed the full story.

Reuters Health reported:

No need to diet and exercise to lose weight

...Researchers report that dieting alone is just as effective as dieting plus exercise....Therefore, if the goal is purely shedding pounds, diet or exercise will work, according to this study....

The study also found that exercise did little to tone specific areas of the body. Fat was reduced consistently across the whole body and not more in any one trouble spot....This suggests that people are "genetically programmed for fat storage in a particular pattern and that this programming cannot be easily overcome by weight loss,” the authors note.

This and other news stories were taken from a press release describing a study by Leanne Redman, Ph.D. and colleagues at the Pennington Biomedical Research Center in Baton Rouge, LA:

The researchers conducted a randomized, controlled trial to examine the effects of diet alone or diet plus exercise in overweight but otherwise healthy study participants. The participants were divided into three groups. One group only reduced caloric intake. A second group reduced caloric intake by a smaller amount, but included exercise as part of their program, and a third set of participants served as a control group. They were all followed for a six-month period.

At the end of the study, the reduced caloric intake group and the group that combined a smaller amount of reduced calories with exercise had similar results. Members of both groups lost roughly 10 percent of their body weight, 24 percent of their fat mass and 27 percent of their abdominal visceral fat, which is fat buried deep in the abdomen and linked to heart disease risk....The researchers also discovered that fat distribution was not affected by either approach. The exercise group was not able to eliminate fat in certain parts of the body: so much for sit ups!

“We found that fat is reduced consistently across the whole body and not more in any one part,” says Redman. “We found some evidence in other studies that suggested the way in which we store fat is linked to our genetics and our study then would indicate that weight loss cannot override the way in which any individual stores fat. Perhaps an apple will always be an apple, and a pear, a pear!” ....

In other words, regardless of how each person increased their calorie deficit by 25% — through eating less alone or dieting and exercising more — they lost the same amount of weight and body fat at the end of 6 months. The 35 study participants were tightly monitored to ensure they followed the precise diets and exercise prescriptions. Their foods were prepared by the Center’s metabolic kitchen throughout most of this study and their compliance was monitored through food records and weight changes. Their 5 days a week exercise regimen consisted of 45-53 minutes of treadmill, stationary bike or stairmaster performed under supervision at least 3 times a week, during which their oxygen uptake was measured by indirect calorimetry and cardiovascular monitoring.

These researchers carefully measured the percentage of body fat at the beginning and end of the study using dual energy x-ray absorptiometry; and computed tomography (CT) was used for visceral fat distribution in the abdomen, liver and spleen. This study’s findings did not support popular claims that exercising — even aerobic exercise 5 days a week — during a diet can prevent the loss of lean body tissue and increase the loss of fat. Nor were efforts at spot reducing effective because our body shapes and where we store fat are primarily determined by our genes and not what we eat or our exercise.

Before we look at the effects of exercise, let’s look closely at the calorie reduction part of the trial because it actually debunks some of the most popularly-believed myths about obesity.


The participants in this study, besides being incredibly good sports about having every minutiae of their bodies and lifestyles examined and micromanaged for six months, were all healthy middle-aged Americans without a history of obesity, eating disorders, heart problems, diabetes or smoking. Their average body mass index (BMI) was about 27, which, until the definition for “overweight” was changed to a BMI >25 by the U.S. National Heart, Lung and Blood Institute in 1998, wouldn’t have even been considered overweight. Today it is, of course, as the new definition added more than 30 million average Americans to the rosters of “overweight.” The men in this study weighed an average of 195 pounds and the women 165 pounds, almost exactly what the U.S. CDC National Center for Health Statistics most recently reported is average for American adults. The study participants were also not obsessive exercisers because people who exercised more than twice a week were excluded. In other words, the calories they needed to maintain their weight were not unusual or extraordinary, but fairly typical for American adults.

The researchers then precisely calculated the baseline calories each person required to maintain their weight using 14-day doubly-labeled water assessments and 14-day in-house closely controlled feedings. They found that the study participants needed an average of 2,768 calories a day to maintain their weight.

Let’s stop right there for a moment. The U.S. CDC National Center for Health Statistics has monitored the daily calories consumed by American adults since 1971. Their latest National Health and Nutrition Examination Survey (NHANES) reported that the average American eats 2,240 calories a day (1,877 among women, 2,618 in men). [We’ll examine later the fallacies behind the claims of an increase over the decades.]

So, average American adults are eating less than calculated to maintain stable weights, not "overeating" as popularly believed.

Bottom line, the facts continually do not support the popular mythologies about fatness being just a matter of calories in and calories out, nor the beliefs that Americans are eating more calories than they “should,” never mind nutrition.

You’ll often see claims being made, typically by activists or those who believe we are not eating “right,” that Americans now eat an average of 2,700 calories a day or the even more ridiculous claim that our average calorie intake has skyrocketed to 3,817 calories a day!

The source of these erroneous beliefs is U.S. Department of Agriculture Economic Research Service data. This is economic information on the supply of food produced in this country, which currently equates to 3,900 calories per person. The term “food consumption” used in these economic reports is a calculation made by dividing food disappearance figures by the population. But extrapolating dietary intakes from food supply data has been repeatedly shown to be faulty and to wildly exaggerate actual consumptions.

Economists at Harvard Institute for Economic Research noted that only in recent years has wastage been accounted for — which they’ve found done imprecisely at best. More significantly, it doesn’t consider industrial and other uses for foods, which are extensive. As David Klurfeld, Ph.D., professor and chairman of the Department of Nutrition and Food Science at Wayne State University, editor-in-chief of the Journal of the American College of Nutrition and Nutrition New Focus wrote about the “absurdity” of using this data to estimate what Americans actually eat: “...soybean oil is used to make ink, lubricants, diesel fuel, plastics and many other useful products....and the U.S. feeds millions more people outside the country and we don't have to eat six meals a day to get rid of surplus crops.” Even school kids know George Washington Carver developed more than 300 uses just for peanuts — from paint, explosives to kitty litter! And Midwest-grown corn is becoming ethanol to fuel our automobiles and farm equipment. Perhaps kids have more common sense than most of us.

In this study, after 6 months of reducing their calories by 25%, the women had lost about 17 pounds and the men about 20 pounds — about 3/4 pound a week. But this study merely showed short term results, not lasting changes. As researchers have repeatedly shown, regardless if weight loss is achieved by diet or exercise, over the long term any meaningful initial weight loss is regained within the first year and virtually all of it by 5 years.

Weight loss the wrong focus

Interestingly, the press release gives the impression that weight loss is important for health benefits. This idea is certainly important to the center where this research was conducted. The 403,000 square-foot Pennington Center, which opened in 1988, is led by Claude Bouchard, Ph.D., outgoing president of the International Association for the Study of Obesity and the world’s largest organization of groups working on the “obesity crisis.” As the Social Issues Research Centre reported, IASO and related special interests are funded largely by major pharmaceutical companies. Pennington’s website notes that in 2002 it received the largest grant in its history from the National Institutes of Health which awarded it $12.4 million over seven years to investigate the benefits of calorie restriction.

Other Pennington researchers, however, have published studies examining the risks and benefits of weight loss and not found good support for this popular view. As Donna Ryan, M.D., at Pennington and a consultant for Abbott Pharmaceutical Company noted in a recent European Heart Journal article, a number of epidemiological studies have associated weight loss with increased mortality:

The Framingham study is one of many studies which have shown a negative relationship between weight loss and mortality. Over an observation period of 20 years, and omitting deaths in the first 4 years, deaths were highest among those who lost weight, even when the data were adjusted for age, BMI, smoking, and other risk factors: compared with subjects whose weight did not change, there was a 44% increase in total mortality rate in men who lost weight and a 38% increase in women who lost weight. Many other studies have shown the same relationship. In addition, some of the studies have demonstrated that this relationship exists whether the individual is overweight, normal weight, or underweight.

In view of the observations from these large epidemiological studies, it is valid to question the health benefits of weight loss.... It has also been demonstrated in numerous studies that weight loss in patients with chronic heart failure is associated with impaired survival.

Dr. Ryan noted numerous studies demonstrating a wide range of harmful effects of dieting and weight loss. She also pointed out that only intermediary factors associated with obesity (not actual clinical outcomes) have been shown to be affected by intentional weight loss measures but that “data from randomized controlled trials will be needed to convince epidemiologists that weight loss is beneficial to health.” The Look AHEAD (Action for Health in Diabetes) trial to examine the effects of weight loss on fat people with type 2 diabetes is underway, she said, and results are expected in 2012. But to date, there is no clinical evidence among people to demonstrate any actual benefits to lifespan from dieting and weight loss.

In contrast, she failed to note the countless studies demonstrating that fatness itself has nothing to do with health and longevity. One of the largest and most famous is the Aerobics Center Longitudinal Study of 25,389 men examined at the Cooper Clinic in Dallas, Texas, from 1970 and followed to their death or until December 31, 1989. Research at the Cooper Institute of Aerobics Research also examined more than 113,000 women. The Cooper Institute is where much of the country’s landmark research on fitness and preventive health has been conducted. Research there has consistently found that being fat does not determine increased mortality risk and that physical activity and fitness — not body weight or waist measurements — are what matter in lowering risk. And despite the stereotypes of what “fit” looks like, they found that about half of “obese” adults are highly fit on maximal exercise testing, not much different from the slender people.

Dr. Timothy S. Church, M.D., M.P.H., Ph.D., now at Pennington Biomedical Research Center, discussed the many controlled randomized trials examining risks and cardiovascular and lifespan benefits of exercise in a December 2006 Medscape examination of exercise in evidence-based medicine. Also participating was renowned aerobics researcher, Steven Blair, PED, currently a professor in the Arnold School of Public Health at the University of South Carolina. Health and longevity are not determined by body mass index or weight, but are influenced by physical activity and fitness, they said. Being active cuts overall mortality in half for both men and women. As has been shown by the research Church and Blair conducted while at the Cooper Institute, exercise not only helps people live longer, it lowers heart disease, stroke, type 2 diabetes and cancers, strengthens bones, reduces stress and improves immune system function. “Fitness is a more powerful predictor of mortality than BMI,” said Blair.

But instead of the word “exercise,” said Dr. Church, we should be saying “physical activity” because formal exercise isn’t required to see health benefits. And it doesn’t take much to see benefits while simultaneously eliminating the risks associated with “exercise:”

When you tell them what it takes, they're surprised by how little it takes. And the basic recommendation still stands of 150 minutes a week, which breaks down into 30 minutes a day 5 days a week of moderate-intensity physical activity....Walking. It's just walking....It's little things that add up through the day. And it just doesn't take that much.

Walking, gardening, housework, bicycling, swimming, dancing, golfing, woodworking or other hobbies and activities enjoyed in our daily lives all count as “activity.”

If all of this is really about health and well-being, then…

Leotards, gyms, team sports and athletic gear are not required. :))

Dieting and achieving bodies that look “fit” are not required. :))

The headline for that Reuter’s news story was actually more accurate than it realized.

© 2007 Sandy Szwarc

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Dear readers

Thank you for your patience over recent weeks during my move. The best laid plans don’t always go without a hitch. Resuming internet access in the new location became lost in bureaucratic red tape and necessitated a change in internet access and ISPs. Hopefully, things are up and running now.

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February 23, 2007

Electronic medical database update: Your insurance cards are like credit cards

We regularly check our credit reports to ensure that there is nothing amiss that might indicate identity theft, but few of us think to carefully examine statements we receive from medical bills or health insurance companies. And when our purses or wallets are stolen, we notify those issuing our credit cards and driver’s license, but rarely think of our insurance cards.

But that’s where real risk can be, according to the office of Attorney General, Tom Corbett. Oftentimes people don’t realize they’ve been victimized by medical identity theft until they’ve been denied coverage for health care, been billed for things they never received, or turned down for employment or insurance because of medical conditions that appear on their own records that really reflect those of a thief.

Randy Griffith writes in the Tribune-Democrat:

Health risk: Are thieves after your medical records?

....The World Privacy Forum estimates as many as 500,000 people have been victimized – often without knowing it. Sometimes doctors and hospital employees are the criminals, raising the California-based organization’s fears of more abuse as electronic health records become the norm.

A hospital spokesperson disagreed, saying:

Used properly, electronic health record systems can help prevent identity theft. Driver’s licenses or other photo ID presented on admission can be scanned into the permanent record and checked against future admissions.

The article explains another angle behind medical identity theft. Although it remains a relatively rare occurance, it favors prudency on the part of consumers:

While some people get medical cards to receive free care, other scam artists tap into hospital records to get illegal financial reimbursements or drugs. All situations can create falsified health records for the victim, sometimes changing the patient’s blood type or adding medical conditions they don’t have. In an emergency, Gray said, false records can lead to dangerous mistakes, but changes can create issues with employment and life insurance....She also encourages members to protect insurance cards as they do credit cards.

As medical records are increasingly placed on electronic databases, professional and consumer organizations have cautioned that medical identity theft will become a greater risk. Privacy issues, how much and what type of information is becoming part of electronic databases, and how our personal information stored on them may be used are among the other concerns being raised, as discussed here.

The healthcare and insurance industry believes that computerized records could eventually make it easier to identify expenses, analyze the cost-benefits of drugs and treatments, and facilitate patient information sharing to increase efficiency, reduce human error and save costs. The transition from paper to electronic records, however, is where concerns for patient safety have been especially highlighted by medical professionals.

Despite potential benefits of electronic patient records, it appears prudent for patients to continue to be vigilant about medical treatments and medications they and their loved ones receive while in the hospital. Last week, in a Los Angeles Times article, “Kaiser has aches, pains going digital,” Daniel Costello reported:

Kaiser Permanente's $4-billion effort to computerize the medical records of its 8.6 million members has encountered repeated technical problems, leading to potentially dangerous incidents such as patients listed in the wrong beds, according to Kaiser documents and current and former employees.

At times, doctors and medical staff at the nation's largest nonprofit health maintenance organization haven't had access to crucial patient information, and system outages have led to delays in emergency room care, the documents show. Other problems have included malfunctioning bedside scanners meant to ensure that patients receive the correct medication, according to Kaiser staff.

Doctors in Pittsburgh analyzed the deaths among all children at their tertiary-care Children’s Hospital after a computerized physical order entry system was implemented. Their results were published in the December, 2005 issue of Pediatrics. They found that deaths among the children seen for specialized care during the 18-months following the computerized record implementation startlingly increased from 2.8% to 6.57% — more than three times, even after they adjusted for possible contributing variables.

The LA Times discussed a 772-page internal Kaiser report documenting the reliability of their computerized medical records initiative and over about nine months, nearly two dozen instances had been reported where patient safety may have been jeopardized. What may seem intuitively beneficial doesn't always prove to be so in reality. The writer shared valuable official company and employee perspectives on costs, effectiveness and potential for Kaiser's Herculean electronic database project. As consumers, healthcare professionals and politicians examine this emerging issue, looking at all sides may help ensure that efforts to save money will also save lives, and enable us to better protect ourselves and our patients in the process.

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February 22, 2007

A study the media overlooked: being fat lowers mortality for women

Many have come to believe that by living well, eating right and having “good” health indices, they will live longer. A long life is viewed as the reward of exemplary living. Conversely, of course, those who don’t meet what is believed to be healthy are accused of risking an early grave. These mythologies have become popular in our culture, except most are unsupported by decades of the most conscientious evidence.

What is rarely revealed, is that the measures popularly believed to be risk factors are actually not good predictors of our risks for death or disease at all.

The December issue of Archives of Internal Medicine published a study led by researchers at the University of California, San Franciscio examining things believed to contribute to premature death in older women. They examined lifestyles, chronic diseases, medication usage, body measurements and weight, vital signs (blood pressure and resting heart rate) and physical fitness of 17,748 post-menopausal women. Over nine years of followup, they looked to see who died and who didn’t.

None of the lifestyle and risk factors popularly believed to be important actually proved to make a relevant difference except for one.

The only risk factor that had a tenable correlation with increased risk of dying among post-menopausal women was a 50-pack year history of cigarette smoking, which was associated with a nearly 4 times higher risk.

And one of the most popularly-believed risks factor for premature death proved to be associated with a 30% lower mortality among these women — obesity.

Sure, it could be said to be a minor correlation, but if it had supported the dangers of obesity it certainly would have been shouted from the rooftops. But since it didn’t, you never heard about this study.

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February 21, 2007

The alternative energy bunny....just keeps going and going

Studies reaching positive findings generate snazzy headlines. They get attention and bring funding for more research.

It is popularly believed that the strength of science comes in proving something.

In actuality, it is the exact opposite.

The ability to disprove a hypothesis in a carefully designed experiment is what sets science apart from pseudoscience. Negative studies which find nothing, and are unable to support a belief, hold the most value. This is the source of Albert Einstein’s famous saying:

No amount of experimentation can ever prove me right; a single experiment can prove me wrong.

Yet these negative studies get little attention and are the ones we rarely hear about. This can be said about so many studies that have examined popular beliefs about our food, health and bodies.

In the process of science, no single study can ever prove a theory, but as each test of a hypothesis is able to support it, and an idea is retested in increasingly finessed experiments, the body of evidence grows to build scientific knowledge. Junk science, on the other hand, is created in poorly designed or conducted research which leads to conclusions that are invalid, unreliable and can never be confirmed. And the single biggest earmark of junk science is its continued holding on to a belief after it’s been disproven....oftentimes again and again, decade after decade.

Junk science keeps going and going like that pink battery-operated bunny.

This also explains why true scientists often roll their eyes and have little patience for junk science and most alternative modalities. It may seem like they are dismissing something out of hand when, in actuality, they know it’s been disproven long ago and they’ve moved on.

The current issue of Mayo Clinical Proceedings published a study by doctors of complementary medicine, led by Max H. Pittler, M.D., Ph.D., at Peninsula Medical School, Universities of Exeter and Plymouth in the United Kingdom. The researchers conducted a review of all double-blind, placebo-controlled, randomized clinical trials of homeopathic interventions for childhood and adolescence ailments. They concluded that the evidence from rigorous clinical trials of any type of homeopathic intervention proved unconvincing and unable to support recommendations for use in any condition.

Their report received little media attention and understandably induced yawns from skeptical scientists. Yet the value of their findings was again ignored by junk scientists.

The efficacy of medicines that contain no measureable therapeutic ingredient defies even plausible, rational explanations in well-demonstrated biophysical science. At some point — after more than 150 clinical trials with all of the most careful, quality studies failing to show that homeopathy has any value over a sugar pill — one would think that the ruse has been exposed so thoroughly that even the junk scientists have to give it up. Yet, incredibly, it continues to be studied and promoted.

The reason it perpetuates was partly explained in a recent hard-hitting Times Magazine article by Dr. Scott Haig, M.D., Assistant Clinical Professor of Orthopedic Surgery at Columbia University College of Physicians and Surgeons. There is so much money being made on these types of modalities, he said, that even mainstream doctors are jumping on the lucrative deal.

According to Dr. Haig, cardiologists and “brilliant pathologists” are making extra bucks by hyping anti-aging alternative remedies such as homeopathy and “magnetic water” even though he knows they know better. Of one doctor friend he wrote: “Now he can finally afford that Range Rover he’s had his eye on.” Doctors, he says, have sold out to market what he calls “nothing-really-works-anyway therapies” (NRWATs).

Headaches, heartaches, backaches, aching feet, fatigue, anxiety and those vague, burning pains in your legs at night — these are the nemeses of real doctors. Many people have these symptoms, but the cruel truth is that there is no reliable cure for any of them. Clever doctors watching their incomes melt away have taken notice, establishing all sorts of lucrative NRWAT practices. They've become chiropractors, osteopathic manipulators, prolotherapists, postural therapists, acupuncturists, even Therapeutic Touch practitioners. Each of these therapies proclaims the existence of force fields, bodily reactions, energies or auras that simply cannot be measured or observed scientifically. The “patients” who pay these docs run the gamut from the hopelessly deceived to the downright self-indulgent. But lest we look down too haughtily on NRWAT providers from the moral high ground of real medicine, we must admit that their patients come back again and again, seemingly happy with the treatments. And they pay them with real money—which seems, alas, to have become the whole idea.

Doctors looking for additional sources of income aren’t the only mainstream health professionals turning to alternative energy modalities. Half of the State Boards of Nursing permit nurses to independently practice as alternative practitioners. There is even a Homeopathic Nursing Association working to promote homeopathy in mainstream nursing care. Homeopathy and other alternative modalities have become so lucrative for healthcare professionals and teaching institutions that they’ve been integrated into medical and nursing school curriculums and continuing education courses. According to the University of Maryland Center for Integrative Medicine, “insurance companies are more likely to cover homeopathy when the person providing the service is a licensed healthcare professional who also practices homeopathy.”

That little bunny is likely to keep on going and going as long as there’s money to be generated.

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