Archive for the 'Science and Medicine' Category

Jun 26 2014

Pesticides and Autism

A study has been making the rounds on social media claiming an association between prenatal exposure to pesticides and the risk of autism and developmental delay. This means that I am getting asked by many people what the study actually shows. Spoiler alert – not much. But let’s break it down.

Autism spectrum disorder (ASD) is a neurological disorder involving brain development resulting in decreased communications among neurons in the brain and characterized by reduced social ability. Our current scientific understanding is that ASD is largely a genetic disorder. While environmental factors cannot be ruled out, it seems that genes are the primary factor. It’s reasonable to search for environmental risk factors, but so far none have been clearly established.

Those who feel there likely is an environmental factor also tend to believe that there is an autism epidemic – that the incidence of autism is increasing in a way that is not easily explained by genetics, and therefore suggests and environmental factor. While it is uncontroversial that the number of ASD diagnoses has been increasing over the last two decades, this does not necessarily mean that the true incidence of ASD has been increasing.

The evidence actually shows that diagnostic substitution, broadening of the definition of ASD, and increased surveillance account for much of the increased recorded incidence. It’s possible that changes in diagnostic behavior entirely accounts for the apparent increase. It’s also possible that a subset is due to a true increase, but that has not been clearly established.

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Jun 06 2014

PETA Responds

Last week on Science-Based Medicine I wrote an article about the embrace by PETA (people for the ethical treatment of animals) of pseudoscience – in this case they are engaging in a fearmongering campaign linking dairy products to the risk of autism or increasing the severity of autism.

Yesterday I received an e-mail from PETA, essentially doubling down on their prior embrace of pseudoscience:

Dear Steven,

I want to follow up on your story last week about PETA’s campaign that points out how a dairy-free diet may help children with autism. PETA’s website and campaign serve to provide parents with potentially valuable information, albeit mostly anecdotal, from families’ findings—for example, just this week, the editor of Autism Eye magazine, Gillian Loughran, who has a 14-year-old son with autism, contacted us in support of our campaign and wrote a letter to the editor on our behalf (see below). Until such time as there is a large study into whether there is a dairy-autism link (and one we hope will not be funded by the dairy industry), it seems unwise to overlook a growing body of anecdotal information supporting that removing dairy and gluten from the diet of a child with autism may improve the child’s sleep, behavior, and concentration. We hope this letter will change your mind about PETA’s campaign—or, at least, that you will share this letter with your readers so that they can arrive at an informed opinion.

Thank you for your time.

Best regards,

Heather 

There are multiple problems with this position.

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Jun 02 2014

The Clinical Evidence for Homeopathy

Dana Ullman is a notorious apologist for homeopathy. He has a reputation, at least among skeptics, for cherry picking data and making dubious arguments – whatever it takes in order to defend his beloved homeopathy. He then tops it off by accusing skeptics of being closed-minded for not accepting his drivel.

An article of his recently popped up on the Skeptic subreddit (posted by rzeczpospolita) with the challenge, “Countless scientific studies showing that homeopathy works. Or are you “skeptics” too closed minded to accept this fact?”

The article is too long to deconstruct in one blog post, so I will focus on the key claim – that clinical evidence demonstrates that homeopathy works. His primary piece of evidence is this:

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May 30 2014

Measles Coming Back

There are some topics I just have to revisit from time to time. I consider this a public service announcement. So far this year there have been 288 confirmed cases of measles. This is the largest number of cases since endemic measles was declared eliminated from the US. The previous worse year was 2011, which saw 220 cases total. 

There is no question that this is tied to vaccine non-compliance. The anti-vaccine movement is scaring people with misinformation and pseudoscience into not vaccinating their children, and as a result we are seeing the return of vaccine-preventable diseases.

When a disease is endemic that means there is a self-sustaining infection – there is always someone infected somewhere and it keeps getting passed around. The MMR vaccine (especially after the second dose was added) resulted in herd immunity, which is a high enough immunity rate so that the infectious disease cannot be passed around indefinitely. High vaccination rates in the US resulted in eliminated measles as an endemic disease by 2000.

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May 22 2014

CIA Ends Vaccine Cover

The White House has announced that in August of 2013 CIA policy banned the use of vaccination programs as cover for CIA ops. Thus, hopefully, ends a blatantly unethical policy.

Back in 2011, the CIA suspected that they had located Osama Bin Laden in a compound in Abbottabad, Pakistan. They needed to confirm his presence, however. So they created a fake vaccine drive. They enlisted the help of a local physician and health official, Shakil Afridi, who set up a program to give free hepatitis B vaccines (all funded by the CIA). The goal of the vaccine program was to procure DNA from children in the compound to see if they were related to Bin Laden, thus confirming his presence.

The ploy worked, and as you probably know, Bin Laden’s compound was raided and he was summarily executed.

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May 20 2014

New Study Shows Fluoride Safe

Public controversy over the safety of fluoridation programs continues, in some towns leading to successful resistance to water fluoridation. As a public health issue, the scientific evidence for risks vs benefits should be at the core of this debate. A new study sheds significant light on this question.

Some anti-fluoridation activists will latch onto any claim they feel supports their opposition (common behavior in any context), and this leads to a great deal of nonsensical conspiracy-mongering. My favorite is the claim that public water fluoridation is all a plot to allow companies to cheaply dump industrial waste into the public water supply.

These sorts of claims distract from the real issues, and in my opinion does a disservice to the anti-fluoridation movement. I don’t mind the existence of opposition movements, even if I disagree with their position. They can serve a useful function in driving public debate and keeping the powers that be honest and transparent.

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May 19 2014

Drinkable Sunscreen

Recently the Daily Mail (some like to call it the “Daily Fail”) ran an article reporting, without any critical analysis, that a company is now offering drinkable sunscreen.

At first the claim seems extraordinary, but it is not impossible. It is theoretically possible to drink a substance that becomes deposited in the skin and absorbs or reflects UV radiation providing protection. However, upon reading the details it becomes immediately apparent that the product in question is pure snake oil.

The product is Harmonized Water by Osmosis Skin Care. In fact, UV protection is just one claim among many for the harmonized water line of products. The website claims:

  • Remarkable technology that imprints frequencies (as standing waves) onto water molecules.
  • Advances in the ability to “stack” thousands of frequencies onto one molecule.
  • Revolutionary formula allows us to reverse engineer the frequencies of substances found in nature and/or the human body.
  • Newly identified frequencies that have beneficial effects on the body.

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May 15 2014

Non-Celiac Gluten Sensitivity

About a third of Americans report that they are trying to reduce or avoid gluten in their diet. If Jimmy Kimmel’s funny stunt is any indication, most probably don’t know what gluten even is. The gluten-free diet has officially become a fad, and “gluten” has been tagged as something vaguely bad that should be avoided.

About 1% of people have a disease called Celiac, which is an autoimmune reaction to gluten. This is a serious disease that can make people very ill if they consume even the smallest amount of gluten. A diagnosis of Celiac can be confirmed with an antibody test (anti-gliadin antibodies), or, if necessary, a stomach biopsy.

Gluten is a composite protein composed of two parts, gliadin and glutenin. It is found in wheat, rye, barley, spelt, and related grains. It is a springy protein that gives bread its elasticity. Celiac disease is an immune reaction to the gliadin part of the protein.

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May 13 2014

Resveratrol – Reason for Skepticism

Dr. Oz recommends resveratrol as a supplement to reduce inflammation and protect the heart. On his website you will find:

While resveratrol has been recommended for fighting the physical effects of aging, a brand new study shows it reduced inflammation of the heart in the study’s participants by 26%. Taking one 500 mg capsule of resveratrol daily with food will help you maintain a strong, healthy heart.

How evidence-based is this recommendation? At present we have preliminary in vitro and in vivo studies showing that resveratrol has interesting biological effects that are potentially beneficial, particularly in heart disease. There are some short term human studies as well.

The question is – how predictive are such early promising research results to later long-term clinical studies? I have written many times arguing that the answer is – not very much. There is researcher bias, exploiting degrees of freedom, and publication bias to contend with, all favoring false positive results in the literature.

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May 05 2014

David Katz on Evidence in Medicine

David Katz is a fellow physician at Yale, and he is also a strong proponent of so-called “integrative medicine.” He has written a recent commentary at the Huff Po, defending the integrative approach. He writes:

Integrative Medicine — a fusion of conventional and “alternative” treatments — provided patients access to a wider array of options. So, for instance, if medication was ineffective for anxiety or produced intolerable side effects, options such as meditation, biofeedback, or yoga might be explored. If analgesics or anti-inflammatories failed to alleviate joint pain or produced side effects, such options as acupuncture or massage could be explored.

His basic argument is this – when we lack strongly evidence-based options, we need to explore not-so-evidence-based options, for the good of our patients. Mainstream medicine is not that evidence-based either. And – mainstream medicine relies on money-driven research, which is biased against integrative approaches.

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