Australian Cancer Council wants to kill Paddle Pop lion and Coco Pops monkey



Even though the best evidence is that there is NO harm in sugar, fat and salt

THE Coco Pops monkey and Paddle Pop lion would be scrapped under a Cancer Council proposal to ban cartoon characters and sports stars from spruiking unhealthy kids' food.

Cancer Council NSW, backed by the Obesity Policy Coalition and The Parents' Jury, are seeking a ban on promotional characters, movie tie-ins and the athletes who promote foods high in sugar, fat and salt.

Although stopping short of calling for plain packaging, Cancer Council nutritionist Kathy Chapman said regulations around the marketing of foods to children were urgently needed.

"What we'd like to see is the removal of these promotional characters - whether they're cartoon characters, sporting celebrities or movie tie-ins - from all foods that are high in fat, sugar and salt," she told The Sunday Telegraph.

Research by Cancer Council NSW and the University of Sydney's Prevention Research Collaboration found that nearly 74 per cent of promotional characters on Australian food packets promote products to children that would fail healthy nutritional standards.

Among the foods targeted are Bubble O'Bill ice-creams, which have 25 per cent of a child's recommended daily saturated fat intake in one 65g serve, and Kellogg's Froot Loops, which have almost three teaspoons of sugar per 30g serve. Coco Pops are more than one-third sugar and contain nearly a third of a child's daily sodium intake in one 30g serve.

It is estimated that one in four children are overweight or obese. Obesity Policy Coalition senior policy adviser Jane Martin backed the Cancer Council's call.

"We'd like to see these powerful kinds of endorsements by licensed characters, company-owned cartoons and celebrities not allowed on unhealthy foods," she said.

"Children in particular are vulnerable to this thing. They are familiar with the character so it's not surprising when you are using Sponge Bob Square Pants and Bart Simpson to advertise food that children relate to these characters."

Ms Martin said packaging was a key part of a promotional arsenal. While her organisation welcomed cricketers fronting Weet-Bix, which were high in fibre and low in salt, she said Ky Hurst spruiking the high-sugar cereal Nutri-Grain misleadingly gave it "a healthy halo".

Parents' Jury campaign manager Corrina Langelaan said plain packaging would be the first step in attacking pester power.

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Another infliction on ordinary people by the food Fascists and their absurd theories

HP Sauce's recipe secretly changed after 116 years by American owners of the Great British Condiment



For more than a century HP Sauce has been a staple of many a British dining table.

But after 116 years of being produced to a carefully guarded recipe, the brown sauce which famously bears a picture of the Houses of Parliament on the label has been secretly altered at the request of Government health chiefs.

Heinz, the American company which bought the famous British brand in 2005, has changed the celebrated concoction that includes tomatoes, malt vinegar, molasses, dates, tamarind and secret spices to reduce the salt content.

The new recipe of Britain's best-loved brown sauce, synonymous with bacon sandwiches, fry-ups and sausage and mash, now contains 38 per cent less salt. But critics argue the change in salt levels for such small amounts of food makes no difference to our diet.

The previous version of HP Sauce contained 2.1g of salt per 100g. The new version contains 1.3g – but fans claim the change has come at a high price. They say it just doesn't taste the same.

The US company has altered the recipe despite launching a Reduced Salt And Sugar version at the same time. The new HP sauce recipe got the thumbs down from Michelin-starred chef Marco Pierre White.

He said he sent back a meal of sausages and mash at Mail on Sunday columnist Piers Morgan's Kensington pub The Hansom Cab last week. 'I sent the meal back, because I thought it was off,' he said. 'At first, I thought it was the sausages, but it wasn't. It was the HP, which tasted disgusting. It was definitely dodgy. I had no idea they had changed the recipe.

'I was brought up on HP Sauce in Yorkshire. My old man used to say ketchup was for Southerners and HP was for Northerners. My father would turn in his grave if he discovered they changed the recipe.'

Heinz made the changes after signing up to the Coalition Government's Responsibility Deal, a programme of targets for reducing the level of fats and salts used by food manufacturers. The key pledges include an agreement to reducing salt in food so people eat 1g less per day by end of 2012.

Health experts claim this measure will save the NHS £46 million a year within three years and prevent more than 4,000 premature deaths a year.

But as a result of the decrease in salt in the old sauce, the new line has more calories and carbohydrates. The new version also has less fibre, an essential part of a balanced daily diet. It has been reduced from 1.2g per 100g to 0.4g per 100g.

John Northey, from the Isle of Man, contacted Heinz to complain. In a letter to a newspaper, he wrote: 'Gone was the familiar tang and the sauce seemed bland and sickly. Heinz has spoiled a product enjoyed by generations, adversely affected its keeping qualities and, incidentally, increased the calorie count at a time when we're all being warned about obesity.'

The HP brand has not been without controversy in recent years. There was uproar in 2007 when production of this symbol of 'Britishness' was moved from Birmingham to Elst in the Netherlands, with the loss of 125 jobs.

A year later the company was again forced to defend the move after it was revealed that 18 months after axing HP Sauce in Birmingham on the grounds that production costs would be cheaper in Holland, it had also begun making it in Spain.

The sauce's appeal has crossed Britain's class divide, with generous dollops enjoyed at thousands of 'greasy spoon' cafes and by Prime Ministers. In the Sixties, it became known as 'Wilson's Gravy' after the wife of Prime Minister Harold Wilson let slip that his one fault was that 'he will drown everything in HP'.

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'Surfing the web is turning our brains to mush'

And where is the longditudinal double-blind evidence for this assertion? It's just opinion

HAVE you found yourself watching TV while talking on the phone and checking your emails? Already distracted reading that sentence? Well, you're not alone, the Herald Sun reported.

The internet has not only changed our lives, it's changed the way our brains work, according to research by visiting UK social psychologist Sheila Keegan.

Dr Keegan says the internet is reducing our ability to think and concentrate and, with long-term use, could cause brain dysfunction. "We spend huge and a growing number of hours on the internet and, as a result, our brains are returning to shallow thinking," she said. "We are being more easily distracted, and our thinking has developed a staccato quality that lacks concentration.

"The problem is so widespread that studies have also concluded that long-term internet addiction would result in chronic dysfunction of our brains, which is a pretty scary thought!"

Dr Keegan said more research was needed to be done on the long-term effects of persistent use of the internet, particularly in young children.

She said US research had revealed some children as young as five spent up to six hours a day in front of a screen. Lengthy periods spent alone in front of the TV or on the computer meant many young children were not developing the social skills they needed for later life.

"Kids need to have a good balance. They can learn a lot from the internet," she said. "But the human brain is quite malleable. It's hard to say what the long-term effects will be. There needs to be research. But it's a bit like climate change. We can't wait for it to happen."

Dr Keegan presented her paper, Are we losing our minds and should we be bothered?, at the Australian Marketing and Social Research conference in Sydney this week.

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Rake some leaves to cut dementia risk: How exercise that gets the heart pumping slows condition

Garbage in garbage out. This seems mainly to be a survery of epidemiological opinion. Meta-anayses are important but can very easily be biased by author expectations

It might not feel great at the time, but raking in the autumn leaves and shovelling the winter’s snow has a silver lining. In fact, any exercise that gets the heart pumping may reduce the risk of dementia and slow the condition's progression once it starts, according to a Mayo Clinic study published this month in Mayo Clinic Proceedings.

Researchers examined the role of aerobic exercise in preserving cognitive abilities and concluded that it should not be overlooked as an important therapy against dementia. The researchers broadly defined exercise as enough aerobic physical activity to raise the heart rate and increase the body's need for oxygen. Examples include walking, gym workouts and activities at home such as shoveling snow or raking leaves.

'We culled through all the scientific literature we could find on the subject of exercise and cognition, including animal studies and observational studies, reviewing over 1,600 papers, with 130 bearing directly on this issue.

'We attempted to put together a balanced view of the subject,' says J. Eric Ahlskog, a neurologist at Mayo Clinic.

'We concluded that you can make a very compelling argument for exercise as a disease-modifying strategy to prevent dementia and mild cognitive impairment, and for favorably modifying these processes once they have developed.'

The researchers note that brain imaging studies have consistently revealed objective evidence of favorable effects of exercise on human brain integrity.

Also, they note, animal research has shown that exercise generates trophic factors that improve brain functioning, plus exercise facilitates brain connections (neuroplasticity).

More research is needed on the relationship between exercise and cognitive function, the study's authors say, but they encourage exercise, in general, especially for those with or worried about cognitive issues. 'Whether addressing our patients in primary care or neurology clinics, we should continue to encourage exercise for not only general health, but also cognitive health,' Dr. Ahlskog says.

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Study: Pot smokers may be at lower obesity risk

One suspects the integrity of the self-report data this is based on. Pot users could report themselves as slimmer than they really are for a number of reasons: paranoia, frivolity, poor reality contact etc.

Despite the tendency of marijuana users to experience the "munchies," pot smokers may have a lower risk of obesity that those who don't use the drug, a new study finds. The results show the prevalence of obesity is lower among people who frequently smoke pot compared with those who have never inhaled.

The researchers said they were surprised by their initial results, because they expected to find the opposite. So they examined a second sample of people, and found exactly the same result. Together, the two samples studied more than 50,000 people.

The reason behind the link is not clear. It could be that people who use cannabis also engage in other behaviors that lower their obesity risk. Or it may be that pot smokers exercise more or have a specific diet that keeps them thin, said study researcher Yann Le Strat, a psychiatrist at Louis Mourier Hospital in France.

"On a personal point of view, I would be surprised that cannabis use is associated with a higher rate of physical activity, but this cannot be ruled out," Le Strat told MyHealthNewsDaily.

Another possibility is that components of cannabis may help people lose weight. If this turns out to be the case, researchers should investigate which components these might be and try to put them into drug form, Le Strat said.

Cannabis and obesity

Cannabis use is known to increase appetite. In studies, drugs have been developed to block a receptor in the brain that is activated by cannabis compounds (called the cannabinoid CB1 receptor) in the hope that the drugs would reduce hunger. However, very few studies have looked at the link between cannabis use and obesity.

Le Strat and colleagues examined data from two national surveys in the United States called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the National Comorbidity Survey—Replication, involving about 41,600 and 9,100 people, respectively.

Between 4 and 7 percent of participants in these surveys reported using cannabis at least once in the last year. Obesity was assessed using participants' body mass index (BMI). The survey showed that about 22 to 25 percent of people who don't smoke pot were obese, while 16 to 17 percent of cannabis users were obese.

Obesity was less common among users who smoked pot more frequently. For instance, the NESARC survey showed about 14 percent of participants who used cannabis three days a week or more were obese, the researchers said. Between 0.7 and 1.8 percent of the sample smoked marijuana this frequently.

The participants reported their own BMI as well as cannabis use, so if they did not give accurate estimates of these measurements, the results could be skewed.

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Oily fish and nuts 'cut chance of food allergies'

If you are a pig. It's speculation anyway. The changes in the gut observed have NOT been shown to lead to fewer allergies

Mothers-to-be can reduce the chances of their babies developing food allergies by eating a diet rich in oily fish and nuts, new research indicates.

Academics have discovered that omega-3 fatty acids - found in fish like salmon, mackerel and tuna, as well as walnuts, pumpkin seeds and linseeds - prompt the gut to develop in a way that boosts the immune system.

And they warn that more children could now be at risk of food allergies than in the past because consumption of such foods has fallen.

The team, from France's National Agricultural Research Institute (INRA), found that when mothers-to-be ate a diet high in a particular group of polyunsaturated fatty acids (PUFAs), the gut walls of their offspring were more permeable.

This allowed more broken down food substances and bacteria to pass into the bloodstream, triggering the baby's immune system to produce antibodies.

Dr Gaëlle Boudry, from the INRA, explained: "Our study identifies that a certain group of polyunsaturated fatty acids causes a change in how a baby’s gut develops, which in turn might change how the gut immune system develops."

She continued: "The end result is that the baby’s immune system may develop and mature faster – leading to better immune function and less likelihood of suffering allergies."

Food allergy appears to be a growing problem, with the number of related hospital admissions in Britain rising six-fold since 1990.

There is considerable debate about how real the reported increase actually is, however. The National Institute for Health and Clinical Excellence (Nice) last year estimated that while more than a third believed they were allergic to some form of food, only a tenth were found to be allergic when properly tested.

Nonetheless, a recent, robust study from the Isle of Wight found one in 20 children did have an allergy. It also found evidence that the real incidence was growing.

Allergy experts do not really know what is behind the rise. One theory is the 'hygiene hypothesis': that as homes have become cleaner, children's immune systems now have less chance to develop fully.

More and more attention is also being paid to the role of early exposure to foods, both in the first years of life and in the womb.

Dr Boudry said: "There is intense research interest in maternal diet during pregnancy. In the Western diet, the group of polyunsaturated fatty acids that we have shown to help gut function are actually disappearing – our dietary intake of fish and nut oils is being replaced by corn oils which contain a different kind of fatty acid."

Their research, published in The Journal of Physiology, added to evidence that consuming such fatty acids in pregnancy was beneficial for babies, she claimed.

"Other studies have found that a diet containing fish or walnut oil during pregnancy may make your baby smarter – our research adds to this, suggesting such supplements also accelerate the development of a healthy immune system to ward off food allergies."

She emphasised that their study was in pigs, but the research group believe the animal's intestine is an "excellent model of the human gut".

In the study, pregnant and lactating sows were given a dietary supplementation of linseed oil. The permeability of their offsprings' intestinal walls was than compared with that of piglets from sows not given the supplement.

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Socialising keeps you slim: Having lots of social contact burns off more fat than using a treadmill does

If you are a mouse

Keeping a busy social life amongst lots of friends may keep people slimmer than spending hours on a treadmill, according to scientists. They say that socialising and meeting with friends helps boost levels of 'brown fat' in the body which burns calories to generate heat. Living in a stimulating, social environment was found to reduce abdominal fat in mice by half over four weeks, even if they ate more.

US researchers say that social stimulation aids weight loss by converting white fat into brown. White stores calories and makes us fatter, while brown burns energy to generate heat.

Converting white fat into brown is notoriously difficult, normally requiring long term exposure to cold conditions or activating part of the body's nervous system. However, scientists from Ohio State University now think that having a busy social life is an even more effective way of changing white fat into brown.

The team came up with their theory by studying the effects of various living environments on mice. Those who lived alongside a greater number of mice, had more space and toys to stimulate them lost far more weight over the course of the study than their 'couch potato' counterparts.

Increased levels of brown fat may also be attributed to an increase in a brain chemical called brain-derived neurotrophic factor [BDNF] found in the sociable mice.

Study author Dr Matthew During, whose team's findings appear in journal Cell Metabolism said: I'm still amazed at the degree of fat loss that occurs. ‘The amount that comes off is far more than you would get with a treadmill. It's usually hard to induce the switch from white to brown fat.

‘It takes months of cold - you really have to push - and it doesn't induce brown fat to the same degree as what on the surface appears to be a relatively mild change in physical and social environments.’

Explaining how new technology had threatened face-to-face socialising, he added: ‘It's not just a sedentary lifestyle and high calorie foods, but an increasing lack of social engagement.’

Co-author Dr Lei Cao said: ‘After four weeks in the enriched environment, the animals' abdominal fat decreased by 50 per cent. ‘We often think of stress as a negative thing, but some kinds of stress can be good for your health. ‘In fact, the enriched housing is more taxing for the animals as they have to deal with each other and with a more complex environment.’

Dr Cao added: ‘The new result may offer insight into studies showing a link between loneliness and ill health. ‘Loneliness is a profound factor for cancer and death; it's on par with cigarette smoking. Social engagement is very important.’

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Daily tipple boosts health in old age

Appropriate reservations are expressed below but the evidence for benefit from moderate alcohol use is extensive so it may be time to accept the relationship as real

Middle-aged women who indulge in a drink or two a day are boosting their chance of good health in their seventies, a new study claims. Enjoying a small tipple regularly and in moderation improves women's chances of avoiding heart disease, diabetes and other mental and physical disorders in later life, researchers found.

A study of 14,000 female nurses found that those who frequently drank one to two drinks a night, but no more, had a 30 per cent better chance of overall good health in their seventies than those who avoided alcohol altogether.

Drinking moderate amounts of alcohol on a nightly basis was shown to be healthier than indulging just once or twice a week. Women who drank on five to seven nights a week enjoyed a 50 per cent better chance of good health in later life than teetotallers.

Writing in the Public Library of Science journal, the researchers from the Harvard School of Public Health in Boston said their work showed that "regular, moderate consumption of alcohol" in their fifties could boost overall health among women who survive into their seventies.

Experts cautioned that the study did not prove that alcohol is good for the body and claimed the results could have been down to other lifestyle factors.

Associate Prof Jayne Lucke of the University of Queensland, Australia, said: "Drinking a small amount of alcohol may not cause women to age healthily. "Rather women who regularly drink a small amount may also have a number of other characteristics, such as good health, an active social life and a healthy appetite, that all work together to promote successful ageing."

NHS guidelines state that women should not regularly drink more than two or three units of alcohol a day, equal to one and a half standard 175ml glasses of wine or one pint of lager.

A study published last year by researchers in Paris indicated that moderate drinkers had lower rates of heart disease, obesity and depression than people who were teetotal.

The new findings showed that even drinking small amounts of alcohol can have a significant impact on health in later life. The American researchers measured alcohol intake in grams rather than units, with a glass of wine equal to about 10g and a bottle of beer including 13g.

The results showed that women with an average age of 58 who drank between 5 and 15g per night had a 20 per cent better chance of good health than non-drinkers, while those who drank 15g to 30g were 30 per cent more likely to be healthy in old age.

Dr Qi Sun, who led the study, said: "Low to moderate consumption of alcohol will slightly improve health for women in old age. We would still only recommend regular consumption of one drink per day because that is what the US health guidelines are."

But European guidelines are slightly higher and previous British studies have that as many as two drinks a night can have a positive health effect, he said.

Dr Sun added: "Even at moderate drinking levels it is highly recommended that you consume alcohol on a regular basis rather than binge drinking at the weekend. "But for lifetime non-drinkers we would not recommend drinking alcohol just to improve health, because studies have shown that regular exercise and healthy body weight are much more associated with better health at old age than alcohol."

SOURCE

How epidemiology works

(Data dredging illustrated)







Ibuprofen 'can double the risk of miscarriage' and many expectant mothers are unaware of the dangers

All that this probably shows is that women in poor health (as shown by their use of strong painkillers) are more likely to have miscarriages. The drug is an indicator, not a cause

Pregnant women who take painkillers such as ibuprofen are twice as likely to suffer a miscarriage, a study claims.

Scientists warn that tens of thousands of expectant mothers are taking the pills unaware of the dangers.

A major study has found that women who took ibuprofen or similar painkillers just before they conceived until the 20th week of pregnancy were 2.4 times more at risk.

Although there are clear warnings on the drugs’ packets stating they should not be used in pregnancy, as many as one in six expectant mothers still take them.

The study involved a group of painkillers known as Non-Steroidal Anti Inflammatory Drugs or NSAIDS, which include over-the-counter ibuprofen and naproxen.

Aspirin is also in this category although it wasn’t included in the study, while paracetamol is deemed safe.

The researchers believe taking any number of the drugs can lead to the embryo not being properly implanted in the womb meaning a woman is far more likely to suffer miscarriage – also known as a spontaneous abortion.

Around one in eight pregnancies end in miscarriage and the majority happen in the first 12 weeks.

Often there is no obvious cause but older women and those who smoke, drink heavily or are obese are at far higher risk.

The study published in the Canadian Medical Association Journal involved 47,050 women aged 15 to 45. Dr Anick Bérard of the University of Montreal said: ‘We consistently saw that the risk of having a spontaneous abortion was associated with gestational use of diclofenac, naproxen, celecoxib, ibuprofen and rofecoxib alone or in combination.

‘Women who were exposed to any type and dosage of non-aspirin NSAID during early pregnancy were more likely to have a spontaneous abortion.’

But doctors pointed out the risks of a woman suffering a miscarriage due to painkillers were very small. They also said the study did not take into account other possible causes such as smoking and obesity.

Dr Virginia Beckett, spokesman for the Royal College of Obstetricians and Gynaecologists, said: ‘It is important that any woman before conception and during pregnancy plans their pregnancy and reduces their risk of any complications through maintaining a healthy lifestyle. ‘It is safe to take paracetamol during pregnancy.’

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Soda drinking under heavy attack

But where are the double-blind studies showing what harm it does? It's all just theory -- and wrong theories are a dime a dozen when subjected to double-blind test

Half of Americans drink a soda or sugary beverage each day - and some are downing a lot. One in 20 people drinks the equivalent of more than four cans of soda each day, even though health officials say sweetened beverages should be limited to less than half a can.

The Centers for Disease Control and Prevention released the figures Wednesday in a report said to be the government's first to offer national statistics for adults and kids.

Sweetened drinks have been linked to the U.S. explosion in obesity and related medical problems, and health officials have been urging people to cut back for years. Some officials have proposed an extra soda tax and many schools have stopped selling soda or artificial juices.

But advocates say those efforts are not enough, and on Wednesday, a coalition of 100 organizations announced a new push. The effort includes the American Heart Association and the some city health departments that plan to prod companies to stop the sale of sugary drinks on their property or providing them at business meetings - as Boston's Carney Hospital did in April. There will also be new media campaigns, like one starting soon in Los Angeles that will ask, "If you wouldn't eat 22 packs of sugar, why are you drinking it?"

The new CDC report may be ammunition. It found:

- About half the population drinks a sugared beverage each day.

- Males consume more than females, with teenage boys leading the pack. On average, males ages 12 through 19 drink the equivalent of nearly two cans of soda each day.

- Poor people drink more than the more-affluent. Low-income adults got about 9 percent of their daily calories from sugary beverages; for high-income adults, it was just over 4 percent.

- Blacks get more of their calories from sweetened beverages than other racial and ethnic groups.

The study is based on in-person interviews of more than 17,000 people in the years 2005 through 2008. They were asked to recount everything they ate and drank in the previous day. However, diet sodas, sweetened teas, flavored milks and 100 percent fruit juice did not count.

Healthy-eating recommendations call for people to limit sugary drinks to 64 calories per day. That's a little less than half of a 12-ounce can of regular Coca-Cola, which is 140 calories.

In other terms: An average can of sugared soda or juice has 10 to 12 teaspoons of sugar.

There have been efforts to reduce children's access to sodas and sports drinks in schools, with beverage companies agreeing to remove full-calorie soft drinks. But the CDC study found more than half of the drinks are consumed at home. Less than 1 percent are bought at schools or day-care centers.

That's why some members of the coalition argue that parents shouldn't drink sweetened beverages, so they don't serve as a poor example. They hope drinking soda will become as unfashionable as smoking.

A spokesman for Carney Hospital, the 149-bed Boston facility that stopped allowing full-calorie soft-drink sales, said the approach made sense. When the policy was implemented in April, sales of beverages dropped, but have gone back up, as more people apparently are adjusting to water and other non-sweetened drinks.

The hospital's Dorchester neighborhood has high rates of diabetes and other weight-related illnesses, said spokesman Joe Burnieika. "We can't afford to feed people's bad habits if we can give them a healthy alternative," he said.

In a statement, the American Beverage Association on Wednesday suggested that the coalition's effort was misguided. Citing sales data and some other research, the industry group said sales of full-calorie soft drinks had been declining, which they credited to soda makers offering more no-calorie and low-calorie options and improved calorie labeling on the front.

These initiatives "will contribute far more to solving complex health issues like obesity than (the coalition's) sound bite solution that offers plenty of hype but no substance," the statement said.

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BAD SCIENCE by Ben Goldacre (Harper Perennial 2009) £12.99

Book Review by Dr. Alick Dowling.

This book is unknown to many MedChi members despite being hugely popular – it has entered the best-seller list recently. I, by chance, received a copy at Christmas from a nephew, who with his wife were fellow medical students with Goldacre in Oxford, qualifying in 1995.

The book proved an enjoyable read. Abounding with common sense as well as much combative material from his Bad Science weekly column in the Guardian, Goldacre’s aim is to correct much nonsense written by ‘scientific’ or ‘medical’ journalists that is wrong, frightens many readers and yet escapes editorial correction. His column has a large and devoted following, many of whom were at the Bath Literary Festival when Ben Goldacre spoke on March 1st 2009. Three hours earlier I had heard James Le Fanu introducing his Why Us? to his audience that Spring morning in the splendid Guildhall Banqueting Room. The review of Why Us? appeared last month on the MedChi website.

I had no thought then of doing the same for Ben Goldacre’s book. It had already reached a wide public; my only criticism would have been that it lacked an index. There are many reasons not to review a book – for example in the Spectator (May 2nd 2009) Nigel Lawson wrote: "As a general rule, I do not believe in reviewing bad books. Review space is limited, and the many good books that are published deserve first claim on it."1

My reason for not reviewing Goldacre’s book was the opposite. It is a good book and needed no more praise. When we were told the astonishing reason why a new (actually the original) version was now available I changed my mind. This includes the pivotal Chapter 10 The Doctor Will Sue You Now, omitted from the version published last year. Goldacre’s account of how this came about is lucid, revealing and gives an example of his style:

Ben Goldacre‘s website April 9th, 2009

Chapter 10 in the original book – The Doctor Will Sue You Now, on Matthias Rath was removed, together with the index, from the first published version in Sep 08.

This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court. The chapter is now available in the new paperback edition, and I’ve posted it here for free so that nobody loses out.

Although the publishers make a slightly melodramatic fuss about this in the promo material, it is a very serious story about the dangers of pseudoscience, as I hope you’ll see, and it was also a pretty unpleasant episode, not just for me, but also for the many other people he’s tried to sue, including Medecins Sans Frontieres and more. If you’re ever looking for a warning sign that you’re on the wrong side of an argument, suing Medecins Sans Frontieres is probably a pretty good clue.

Anyway, here it is, please steal it, print it, repost it, whatever, it’s free under a Creative Commons license, details at the end. If you prefer it is available as a PDF, or as a word document. Happy Easter!

You are free to copy it, paste it, bake it, reprint it, read it aloud, as long as you don’t change it – including this bit – so that people know that they can find more ideas for free at www.badscience.net

This chapter did not appear in the original edition of this book, because for fifteen months leading up to September 2008 the vitamin-pill entrepreneur Matthias Rath was suing me personally, and the Guardian, for libel. This strategy brought only mixed success.

For all that nutritionists may fantasise in public that any critic is somehow a pawn of big pharma, in private they would do well to remember that, like many my age who work in the public sector, I don’t own a flat. The Guardian generously paid for the lawyers, and in September 2008 Rath dropped his case, which had cost in excess of £500,000 to defend. Rath has paid £220,000 already, and the rest will hopefully follow. Nobody will ever repay me for the endless meetings, the time off work, or the days spent poring over tables filled with endlessly cross-referenced court documents.

On this last point there is, however, one small consolation, and I will spell it out as a cautionary tale: I now know more about Matthias Rath than almost any other person alive. My notes, references and witness statements, boxed up in the room where I am sitting right now, make a pile as tall as the man himself, and what I will write here is only a tiny fraction of the fuller story that is waiting to be told about him. This chapter, I should also mention, is available free online for anyone who wishes to see it.

The missing index is explained. This is also available on the internet for owners of the original paperback, but unless it is completely rewritten it will only be valid for the first 9 chapters. Read the missing chapter free, and then decide whether to buy the new paperback.

The Chapter Bad Stats and its precursor Why Clever People Believe Stupid Things is of particular interest to doctors – not because they can be assumed to be Clever People, but because many do not realize how easily promoters of dubious theories manipulate us to accept ‘facts’ that are cleverly presented. Older doctors, never taught statistics, are more vulnerable than our younger colleagues. Goldacre uses clarity and simple terms to elucidate the subject. Malcolm Kendrick wrote a similar account about statistics in his book The Great Cholesterol Con (also reviewed on the MedChi website). For a comparison see below.

Goldacre’s aim to make ‘science’ accessible to ordinary readers is difficult to achieve, but he has the knack of doing so. He repeats the mantra: “I think you’ll find it’s a bit more complicated than that” when exasperated by the simplistic ‘explanations’ by ‘science’ journalists and even suggests it as a T-shirt slogan for the whole book.

His chapters on other individuals (including the new extraordinary account of Rath) are riveting. Professor Patrick Holford, the academic lynchpin at the centre of the British nutritionism movement, is dealt with in Chapter 9. It is not surprising that the ‘nutritionist’ Gillian McKeith took exception to Goldacre’s exposure in Chapter 7, but someone who has survived a legal encounter with Rath can easily dismiss her threats of legal action.

Goldacre’s introduction mentions the 50th anniversary of C.P. Snow’s lecture on the ‘Two Cultures’ of science and the humanities. Then arts graduates simply ignored science. No progress apparent since, but he is perceptive in seeing there has been a positive regression: "Today, scientists and doctors find themselves outnumbered and outgunned by vast armies of individuals who feel entitled to pass judgment on matters of evidence – an admirable aspiration – without troubling themselves to obtain a basic understanding of the issues."

The structure of the book is sensible and cleverly laid out – a steady crescendo from a gentle introduction in how science should be taught, through an increasingly serious range of how we should view what we are told by ‘experts’ with suspicion, then through the milder and less dangerous forms of foolishness – homeopathy makes its appearance here – through the placebo effect, onwards to the bigger fish such as Nutritionists, the way the pharmaceutical industry pulls the wool over the eyes of doctors and patients, the misuse of statistics already mentioned and culminating in what Goldacre finds most worrying, how people in positions of great power still commit basic errors when dealing with health scares. If we disagree with him he tells us that we’ll still be wrong but with a lot more panache and flair that we could possibly manage right now.

Received from the author. The chapter about Rath -- who claimed to cure AIDS by vitamins -- is here

Two examples of statistical jiggery pokery:

Goldacre:

Newspapers like big numbers and eye-catching headlines. They need miracle cures and hidden scares, and small percentage shifts in risks will never be enough for them to sell readers to advertisers (because that is the business model). To this end they pick the single most melodramatic and misleading way of describing any statistical increase in risk, which is called the ‘relative risk increase’.

Let’s say the risk of having a heart attack in your 50’s is 50% higher if you have high cholesterol. That sounds pretty bad. Let‘s say the extra risk of having a heart attack if you have high cholesterol is only 2%. That sounds OK to me. But they’re the same (hypothetical) figures. Let’s try this. Out of a hundred men in their fifties with normal cholesterol, four will be expected to have a heart attack. That’s two extra heart attacks per hundred. Those are called ‘natural’ frequencies.

Natural frequencies are readily understandable, because instead of using probabilities, or percentages, or anything even slightly technical or difficult, they use concrete numbers, just like the ones you use every day to check if you’ve lost a kid on a coach trip, or got the right change in a shop. Lots of people have argued that we evolved to reason and do maths with concrete numbers like these, and not with probabilities, so we find them more intuitive. Simple numbers are simple.

The other methods of describing the increase have names too. From our example above, with high cholesterol, you could have a 50% increase in risk (the ‘relative risk increase’); or a 2% increase in risk (‘the absolute risk increase’); or, let me ram it home, the easy one, the informative one, an extra two heart attacks for every hundred men, the natural frequency.




Malcolm Kendrick:

(p 192) quoting the Heart Protection Study (HPS) press release: If now, as a result, an extra 10 million high-risk people were to go onto statin treatment, this would save about 50,000 lives a year, that’s a thousand each week. Leaving aside the point that this 50,000 figure actually equates to one life ‘saved’ for every 200 taking the statin – ten million is an awful lot of people to use as your denominator – the concept of saving lives, suggesting as it does, that each of the 50,000 whose lives have been saved will go on to live a healthy life, is not best chosen.

In reality, taking a statin can only delay death, not prevent it. By how much? Well, if one in two hundred more people are alive after one year of taking statins, this means that if you wait another two-hundreths of a year (plus another little bit) the statin group will have caught up on the ‘placebo’ group in total number of deaths.

This represents an increased life expectancy of slightly under two days. So rather than stating that fifty thousand lives would be saved every year by taking statins, it would be considerably more accurate to state that if ten million people (at very high risk of heart disease) took a statin for a year they would live – on average – two days longer.

And if all ten million took a statin for two hundred years, they would all live – on average – an extra year. If we assume that most people would take a statin for thirty years maximum, this would lead to an average increase in lifespan of approximately two months.

Which doesn’t sound quite as dramatic as saving fifty thousand lives a year, or a thousand a week – or however you choose to hype up your figures. But there you go, it happens to be considerably more accurate.

Also remember that this benefit would only be seen in men with pre-existing heart disease. Women and men without pre-existing heart disease would not live a day longer. They would just have the dubious pleasure of thirty years of paying for drugs, worry and side effects.

The obesity scare raises its weighty head again



Ignore the doomsayers, and eat what you darn well please. Now for the wine, duck and Armagnac... 



By Terry Wogan, a "leading media personality" in Britain



Hardly has the dust settled on urban rioting, than we’re faced with another, apparently major, crisis. Obesity. Don’t panic, Mr Mainwaring! This scare raises its weighty corpse from the dead every three years or so, when the public is perceived as breathing a little more easily. How long ago was it that young women, and girls particularly, were being warned against eating too little, and endangering their health? Now, they and the rest of us are being warned that we’re eating ourselves into an early grave, and worse, costing everybody, including the undeserving fit, a fortune in medical care.



I remember casting aspersions on the sanity of some utter dumbbell of a politician, whose name escapes me, but who, unless the old memory is playing hide and seek, counted obesity as great a danger to the human race as global warming. He’d already claimed that the same global warming was a bigger danger to mankind than terrorism. The logical conclusion: being overweight was more dangerous to life on earth than terrorism.



This time around, the bleating of the doomsayers is well up to speed: the British public should eat only as instructed, and those rotters, the food producers, should be similarly forced to come up with only what some expert has decided is good for us.



Yet doctors, dieticians, scientists and every deranged health-food guru have been at odds about what exactly is good for us since people could afford to be worried about what the next meal was going to be, rather than if there was going to be one.



In the tranquil area of France from which I write at present, the diet of the man in the street with the beret and baguette is one of wine, duck in all its forms (including the fat), lots of bread, and Armagnac to wash it all down. Heart attack on a plate, the rocky road to obesity? The inhabitants of this département live longer than any others in France.



In Spain, I was regularly presented with a chunk of country bread, grilled on an open fire, on which I was invited to spread liberal amounts of lard, until my stomach thought my hand had gone mad. I know, I know. The “experts” will tell me that this is “good” fat, far better for the children of Britain than an oven-baked chip, or a cheap pizza.



Maybe, but what is certain is that nobody, however qualified, has the right to tell anybody else what they should be eating. Or drinking. President Sarkozy of France, a great man for jumping on a bandwagon, is proposing a tax on fizzy drinks. What about human rights? The idea that tax should be levied on “wrong” food and drinks smacks too closely of dictatorship. It is the inalienable right of every man and woman in a free society to go to hell in their own handcart, as long as nobody else gets hurt.



Obesity is not catching, it’s up to you. And only you.



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New £2.50-a-day stroke pill 'will help 1 million patients'



Almost anything would be better than warfarin. It's a very dangerous drug if you get the dose just a bit wrong. They poison rats with it



A stroke drug hailed as the biggest advance in blood-thinning for almost 60 years goes on sale today. More than a million Britons could benefit from Pradaxa, which is up to a third more effective than warfarin, the gold-standard blood-thinner, when it comes to preventing strokes.



The £2.50-a-day drug is the first of a new generation of anti-clotting medicines. Its release follows news of a similar drug, apixaban – also known as Eliquis – which was also found to be better and safer than warfarin.



The traditional treatment, which has been in use for more than half a century, is very effective but reacts with countless foods, alcohol and other medicines, with sometimes fatal consequences.



Pradaxa could vastly improve patients’ quality of life by allowing them to eat what they want without fear of upsetting the levels of medication in their blood and triggering a stroke or haemorrhage. It would also remove the need for the frequent blood tests associated with warfarin, which is also used as rat poison.



From today, Pradaxa, which is also known as dabigatran etexilate, can be used to thin the blood in people with atrial fibrillation, in which erratic beating of the heart raises the odds of stroke five-fold.



In a trial with more than 18,000 sufferers of the condition, it was 35 per cent better than warfarin at preventing strokes. Overall, around three-quarters of strokes were prevented. It also had fewer serious side-effects – although some patients struggled with indigestion.



One of the biggest advantages will be its ease of use. Warfarin users have to undergo blood tests as often as every two days to ensure they don’t accidentally take too much or too little of it. Most of them – including many pensioners – must make regular visits to their GP, even when they have been on the drug for years.



Some 1.2million Britons suffer from atrial fibrillation – which is blamed for more than 20,000 strokes a year – but many do not take warfarin because of its associated problems.



Trudie Lobban, of the Atrial Fibrillation Association, said: ‘Our members live in fear of suffering a disabling or fatal stroke. They have waited years for an alternative to current treatment.’



Professor John Camm, of St George’s Hospital in London, added: ‘This is a big leap forward. There are very few interactions with Pradaxa, so patients don’t have to be monitored every few weeks and they still get significant protection. It’s win-win.’



It remains to be seen whether the drugs rationing body, the National Institute for Health and Clinical Excellence, will judge the treatment, made by Boehringer Ingelheim, to be a good use of taxpayers’ money. Warfarin costs less than £15 per year.



A ruling on NHS use in England and Wales is expected by the end of the year. The equivalent body in Scotland is set to decide within two weeks.



SOURCE

The Inventiveness of Nanny knows no bounds



With passive smoking on the run, a new menace comes waddling into view (the Guardian reports:

Governments around the world need to make immediate and dramatic policy changes to reverse a pandemic of obesity which could affect an extra 11 million people in the UK over the next 20 years, public health scientists have warned.The call to act…comes in a series of papers published on Friday in the Lancet medical journal. The journal begins with a strongly-worded editorial arguing that voluntary food industry codes are ineffective and ministers must intervene more directly…There was a particular need for leadership ahead of a UN summit in New York next month on preventing non-communicable diseases such as diabetes and cancer, said one of the authors, Boyd Swinburn, from the centre for obesity prevention at Melbourne’s Deakin University..Swinburn’s paper comes up with a clear primary culprit: a powerful global food industry “which is producing more processed, affordable, and effectively-marketed food than ever before”. He said an “increased supply of cheap, palatable, energy-dense foods”, coupled with better distribution and marketing, had led to “passive overconsumption”.

Passive eating?



Naturally the individual is incapable of deciding these things for himself. And naturally, we have to think of, yes, wait for it, the children.

Another study by Steven Gortmaker from Harvard University’s school of public health, concludes that the response by governments has been a failure of will which mirrored previous struggles to tackle tobacco consumption. Ministers knew it made sense to crack down on junk foods but did not have the political appetite to take on such a huge industry.



“I think governments get it, but don’t know what to do about it, and don’t think it’s their responsibility. But it is their responsibility,” he said. His study lists eight cost-effective policies. Topped by a tax on unhealthy food and drink, the rest focus on shielding children from TV advertising or ensuring they exercise more.

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Advertising Isn't the Obesity Boogeyman



With nearly one in three American children overweight, it's easy to question why anyone would oppose voluntary government guidelines that would severely restrict which foods can be marketed to children. What isn't addressed by many is the theory behind these proposed guidelines, crafted by a gang of four government agencies called the Interagency Working Group (IWG), without the support of scientific evidence or advertising statistics.



As the nation's obesity epidemic swells, food and advertising companies are coming under intense scrutiny, taking the blame from local and federal lawmakers for America's expanding waistline. The cornerstone of the IWG guidelines works from the predisposition that obesity is caused by advertising, even though no research supports this theory. The fact is, children are moving less and eating more. According to Health and Human Services data, fewer than 33% of children and adolescents aged 6 to 17 are engaged in 20 minutes of vigorous physical activity, while caloric intake for those aged 6-11 has remained relatively constant since 1974. It's no surprise that obesity rates have more than tripled during the past thirty years, when one also factors in the explosive use of technology devices among children.



No one would argue that the factors contributing to obesity range widely. But blaming America's kid bulge solely on television advertising is folly. Children are watching less television each day and therefore seeing fewer advertisements. From 2004 to 2010, food and beverage advertisements viewed per average child aged 2 to 11 years decreased from 2500 to around 1250 while advertising for cookies, snacks, and other candy decreased between 65%-99%.



It is unclear whether less advertising would lead to less consumption of the foods targeted by IWG guidelines. What is certain is that banning advertising for foods that do not meet these strict nutrition principles will increase prices for consumers. Though critics can find examples throughout the years of corporate advertisers knowingly promoting products with a health risk, the burden remains on companies to stay competitive in our free market, capitalist economy by responding to market pressure. More Americans are leading healthier lifestyles and want their children to do the same, so many food companies are tweaking their products accordingly. Recently, McDonald's added apple slices to its Happy Meals. Over the years, cereal companies have switched to whole grains and cut back on sugar and sodium content. And a group of manufacturers released their own guidelines for adjusting the ingredients of food marketed to children, which they had been working on for years before being targeted by the IWG.



In 2006, a group of 17 food manufacturers formed the Children's Food and Beverage Advertising Initiative (CFBAI) and released preliminary guidelines for greater self-regulation of food advertising to children. Once again in response to calls from consumers, the CFBAI has debuted a new set of voluntary guidelines to be enacted by 2014, making consistent recommendations that could lead to further changes in foods advertised to children. The new proposed standards don't give the companies a "pass" on improving. One-third of their products would be adjusted for fat, sugar and sodium content under the new guidelines, a step FTC Chairman Jon Leibowitz called "a significant advance and exactly the type of initiative the commission had in mind."



What's frustrating is this isn't enough for some critics. Lisa M. Powell, the researcher who authored a study for the University of Illinois at Chicago, commented to Reuters that the bulk of children's advertising is still fast food, and that advertising "makes [a parent’s] job that much tougher."



No matter how glitzy and glamorous food ads can be, rarely do they drive consumers to rush to the grocery store and purchase those marketed products. Moreover, children are not the primary purchasers of food for households. They're not behind the steering wheel, pulling up to the fast-food drive thru window or running into the convenient store for salty or sweet treats. It is parents who decide what to feed their children.



Parenting is tough indeed, but part of the job description is making choices that run contrary to what children may want at any given moment. It's rarely a success story when big government tries to parent - and this issue is no different.



SOURCE

The freedom to be fat



"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public" – Adam Smith



As usual, Adam Smith was right. Today I can think of no trade about which the above is more true than the medical profession. I don’t just mean doctors’ use of occupational licensure laws to keep their prices artificially inflated. Politically active groups of doctors are possibly the greatest single threat to personal freedom that there is in the UK today. Their motivation isn't necessarily their wallets, but their egos. Bullies like to use the state to push people around so they feel powerful.



There’s a sad example of this in today’s call in the Lancet, a medical journal that is often used as a political mouthpiece by campaigning doctors, for the government to introduce a “fat tax” to curb obesity.



Of course, the proposal is utterly specious. It's pretty dubious whether the "obesity epidemic" claims are true or not. And which diet plan should be implemented? Is it bacon, sugar, bread or something else that makes us fat? Will political parties of this fat tax utopian future be divided between the Low-Carb Party and the Low-Fat Party? And what if fat people's early mortality rates mean that they actually save the government money in pension and care home bills?



The doctors err even by their own logic. As Will Wilkinson has pointed out, if fat taxers thought things through, they would favour a tax on fat people themselves, not on the food they eat. Taxing food punishes people who exercise so that they can enjoy Big Macs, but not people who are so lazy that they balloon out while eating a balanced diet.



The justification for pushing people around like this is the NHS. Shouldn’t people have to pay for their own illnesses? Well, yes – that’s how personal responsibility works. But having an NHS removes the personal responsibility, and artificial attempts to inject it into the system are doubly illiberal and wrong.



The government (and the electorate, for that matter) forces people to be in the NHS. You have no choice in the matter, and you can’t opt out of it. Jamie Whyte put it well: "first the do-gooders conjure up the external costs by insisting that no one should have to pay for his own medical care, then they tell us that they must interfere with behavior that damages our health because it imposes costs on others." This is perverse and illiberal. The tax would only affect the poor – rich people's spending habits wouldn't be dented. How easy it must be for doctors to pontificate about the need for a fat tax, knowing that such a tax would hardly affect them at all.



This creepy, controlling paternalism has plenty of fans in politics on both sides of the partisan divide. Doctors are the politicians' enablers, lending the weight of their “expertise” to the nanny instinct of the political class in exchange for the feeling of being important. No amount of expertise – medical or otherwise – should give somebody the right to interfere with another adult’s choices. Nor should democracy be used as an excuse to violate the sovereignty of the individual. If fat people are costing the NHS money, that's a mark against having an NHS, not against having fat people.



SOURCE