May 18 2007

More CAM Propaganda

In response to my blog entry about CAM propaganda, “Jim” wrote the following comment, giving me still more grist for my blog mill.

We are a nation of overweight gluttons. Obesity and subsequent diabetes are epidemic. Neurological dicorders in children are increasing. The honeybees are disapeering because their immune systems are depressed. Our waterways are polluted with mercury to the point that most all fish consumption is not advised. Childrens toys are laiden with chemicals that have been banned in other countries. Our nation is rated 22nd amoung industrailized nations in infant mortality. We are rated 20th in overall health although we spend the most money for health care.

Get real Doc! Corporate interests run this counrty. It’s the reason the Drug companies lobbied hard to continue direct to consumer advertising. Why do they need to advertise to the general population? Shouldn’t their doctor be able to diagnose and prescribe the appropriate medcations. You really need to do some soul searching and open your eyes to the medical tyranny in this county. All those cancer walks and billions of dollars and tell me what really have we cured? This is all about money and feeding off the sick people with federal tax money to foot the bill. Out of all the medical propeganda I’ve seen about cancer, I never hear anything about prevention. Natural sunlight has been scientifically proven to reduce cancer but you’ll never hear that from your doctor. The chemical laiden sunscreen lobbysists won’t be having it.

I don’t want to even get into the crap that is put into our food that is directly marketed to our kids. Scientists knew 30 years ago that hydrgogenated fats were poisonous to human health. Unfortunately it took that long for grass movemnet politics to raise the awareness to the people.

Get you head out of the sand Doc and breath the polluted air!

All this doesn’t really matter because one day soon our mother earth will have the last laugh on the human race.

We are a nation of overweight gluttons. Obesity and subsequent diabetes are epidemic.

True enough, but I’m not sure if there is a point there or not. The medical community has both documented this epidemic and has been seeking both explanations and solutions to the problem. The likely culprits are the increasing portion sizes typical of the American diet combined with an increasing sedentary life style, in part resulting from the dramatic increase in computer use and multi-media entertainment. In short, people are eating more and exercising less.

Neurological dicorders (sic) in children are increasing.

Actually, the diagnosis of such disorders is increasing, but it has still not been established that the disorders themselves are increasing. It is more probable that expanding diagnostic criteria, greater awareness, and increased efforts are responsible for the higher diagnosis rates (see my blog yesterday for more details).

The honeybees are disapeering (sic) because their immune systems are depressed.

As far as I can tell Jim just made this up. The honeybee colony collapses are still a mystery. Environmental toxins have not been ruled out, but neither have any particular toxins been implicated. Other possibilities include an epidemic infection or environmental changes. There is no evidence that the honeybee’s immune systems are depressed.

Our waterways are polluted with mercury to the point that most all fish consumption is not advised.

Mercury in the water is a very legitimate concern, but Jim is overstating and oversimplifying it. In fact studies looking at various measures of health and fish consumption show that fish eaters are more healthy – therefore the health benefits (mainly to nervous system development) of eating fish outweigh the negative effects of the mercury. There are already efforts to reduce mercury contamination, to identify fish that have too much mercury and remove them from the market, and to minimize cumulative human exposure to mercury. Although we need to make more progress in this area, hysterical fears are not warranted at this time.

Childrens toys are laiden with chemicals that have been banned in other countries.

I would better be able to discuss this point if Jim pointed out what “chemicals” he is talking about. Different countries ban different chemicals, and in fact the US tends to have a lower threshold for banning possible toxins than other countries.

But it is clear what Jim is doing with the above points – trying to paint the picture that our environment is “laiden” with chemicals and toxins that are attacking our bodies and destroying our health. Certainly we need to be aware of all the substances we are putting into our environment and our bodies and make efforts to keep them below toxic levels, but what Jim is doing (a common CAM tactic) is just fear-mongering – arousing fears of vague chemicals and toxins without citing specifics or giving evidence.

Many CAM treatments claim to remove toxins from the body, again without evidence or even identifying specific toxins. Other treatments, like chelation, are directed toward specific toxins, like mercury and other heavy metals, but the evidence shows that chelation therapy does not work for autism or other diseases that are allegedly due to mercury toxicity. (Although, to be clear, there is a legitimate syndrome of mercury toxicity and this is treated with chelation.)

Our nation is rated 22nd amoung industrailized nations in infant mortality. We are rated 20th in overall health although we spend the most money for health care.

This is true. The reasons are complex, and it is difficult to make direct comparisons with much smaller countries that have a more homogenous population and very different social structure. The primary reasons for the disparity are likely related to health care delivery – not the quality of the medicine that is being delivered. America still has among the best trained doctors in the world with access to the highest tech diagnostic and therapeutic modalities. But this doesn’t help if there are 40 million uninsured people who use the emergency room for their primary care.

In short, this is primarily a social problem – not a problem with the science or quality of medicine. Further, the other industrialized nations that have better health outcomes than the US practice scientific medicine the same as in the US – so it is not logical to use this as an argument against scientific medicine.


Get real Doc! Corporate interests run this counrty. It’s the reason the Drug companies lobbied hard to continue direct to consumer advertising. Why do they need to advertise to the general population? Shouldn’t their doctor be able to diagnose and prescribe the appropriate medcations. You really need to do some soul searching and open your eyes to the medical tyranny in this county.

Yes, we live in a capitalist society and corporations wield a great deal of power and influence. But they do not “run” the country – that is an oversimplification and is just appealing to paranoia. There are other types of institutions in this country that also wield real power – democratic, academic, professional, scientific, and charitable, for example. And for the record I am an academic neurologist working for a university and practicing scientific medicine. I have no significant corporate ties or interests.

Regarding pharmaceutical direct to consumer advertising – the purpose of such ads is primarily to increase awareness among the public that there are drugs available for certain conditions. If you have asthma, see your doctor and ask them about this medication. Such advertising remains controversial because it has both positive and negative effects.

Pharmaceutical advertising can actually have a beneficial effect in terms of alerting the public to certain treatment options. Sometimes the interests of patient, public health, and drug companies are the same – just because a drug company benefits from increased sales does not mean that it is a bad thing. We want more patients taking preventive medications for strokes and heart attacks, we want more asthmatic on effective drugs rather than going into the ER in crisis, or worse dyeing of an asthma attack, etc.

For many benign conditions, like migraine, most sufferers do not seek medical attention because they are not aware that there are effective treatments available. Is it wrong to make them aware of such treatments? This would assume that they somehow do not deserve to be treated.

The downside is that advertising drives utilization of medical services. We cannot deliver all the medical intervention that we have the ability to deliver and which is appropriate. So we ration healthcare, whether or not you are aware of this. Part of that rationing is the self-selective process of who chooses to seek medical attention. We want people to seek medical attention if it makes a significant difference in their quality and length of life, but also if it is cost effective. Advertising is biased toward the latest expensive drug – not necessarily the most cost-effective option.

Further, advertising can cause patients to ask for specific brand-named drugs by name. Given multiple medically equivalent options, physicians are likely to be tempted to give the patient what they ask for to make them happy. This does not mean it is not medically appropriate – but it may not be the most cost effective option.

And of course often physicians many just ignore what the patient says they want, and just give them what they think is most appropriate and cost effective. I do this all the time.

The bottom line is that drug advertising is a mixed bag, but it is not the corporate take-over of medicine Jim would have us believe.

All those cancer walks and billions of dollars and tell me what really have we cured? This is all about money and feeding off the sick people with federal tax money to foot the bill.

Jim’s premise is that cancer research is a con and has not improved the treatment of cancer. Even just a few minutes searching the internet, if Jim were really interested in the facts, would have yielded copious evidence that cancer survival has been steadily improving over recent decades. In this summary we see that overall cancer 5 year survival has increase from 50% in the 1970’s to 65% for 1995-2001. Some specific cancers have had dramatically improved survival over that time: breast cancer is up from 80% to 98%, prostate cancer from 67% to almost 100%.

Other countries with scientific medicine have recorded similar statistics. In Britain 10 year survival over this period has increased from 23.6% to 46.2%.

So the claim that cancer treatment is not effective or is not improving with research is simply wrong. Jim’s choice of words is very telling – “what really have we cured?” Well, a nearly 100% survival rate for prostate cancer sounds like a cure to me – but the real point is that there probably will not be a single and sudden “cure for cancer.” Cancer is many diseases that require many different types of treatment, all highly individualized. Cancer research is progressing baby step by baby step, but with steady progress. Cancer will be cured not with one big breakthrough but with 100 breakthroughs (probably – of course we may be surprised by an unexpected breakthrough, it’s just unlikely).

Out of all the medical propeganda (sic) I’ve seen about cancer, I never hear anything about prevention.

Then you are not listening. The medical community has been extremely active in identifying risk factors for various kinds of cancer, making the public aware of them, and promoting the reduction of cancer risk factors. There is research published almost every day that looks at risk factors for cancer. The use of a vaccine to prevent human papilloma virus, which is the main risk factor for cervical cancer, is just the latest attempt by scientific medicine to prevent cancer.

Natural sunlight has been scientifically proven to reduce cancer but you’ll never hear that from your doctor. The chemical laiden sunscreen lobbysists won’t be having it.

The role of exposure to sunlight in cancer and immunity in general is an evolving story, but again medical scientists are asking questions, doing research, and fleshing this story out. Here is a recent article reviewing the data so far. Briefly, vitamin D, which is made by exposure to sunlight, has been known for a long time to play a vital role in calcium and bone regulation. Only recently, however, we have been learning a great deal about its role in the health of the immune system. Lack of vitamin D has now been linked to multiple sclerosis. It’s role in cancer is less clear, but there is reason to believe that vitamin D deficiency is a risk factor.

But the notion that doctors are being silenced by the sunscreen lobby is downright absurd. The research is actively going on, and as it comes in doctors are publishing articles saying that we need to increase screening for vitamin D deficiency as a preventive measure.

On the flip side, sunlight is a proven risk factor for skin cancer, and is the greatest risk factor for melanoma, which is a very dangerous and aggressive cancer. So any recommendations about exposure to sunlight have to balance the benefits with the risks.

I don’t want to even get into the crap that is put into our food that is directly marketed to our kids. Scientists knew 30 years ago that hydrgogenated (sic) fats were poisonous to human health. Unfortunately it took that long for grass movemnet politics to raise the awareness to the people.

Hydrogenated fats are indeed a risk factor for vascular disease (although calling them “poisonous” is not technically accurate). But it is pure historical revisionism to characterize the last 30 years as the medical establishment being silent (or silenced) while grass-roots politics eventually brought this to public attention. It makes me wonder if Jim lived through the last 30 years. Perhaps he is not that old.

In fact, doctors and nutrition experts have been researching the role of various types of fats in health and disease for a long time, and the results of this research have been readily available to the public throughout this time. It often seems that every new study results in a media frenzy about the latest poison or miracle cure. Remember the oat bran craze of the 80’s, and the “eggs are evil” period?

If anything the real problem is that the public has been getting too much information too fast, before it has been properly digested by the medical community and proper evidence-based recommendations could be made. But scientists keep plugging away, and eventually we learn more and more about the role of fats in health and disease, good fats vs bad fats, etc.

The story is also complicated by social and corporate factors. Food manufacturers and restaurants make decisions about their products not based purely on health. They also want their food to be appealing and to taste good. There has been a free market, in effect, of food quality covering all these attributes. Companies have marketed “healthy” food choices for a long time. But what has happened is that people did not buy food that did not taste good, just as they did not go to restaurants that served small portion sizes or less satisfying dishes. Jim, it seems, would blame the medical community for the market forces that drove corporate behavior.

One could also argue that the public knew what they were choosing, and it is their right to do so. There are those who challenge the “nanny state” mentality that says we should protect people from making their own health choices. Maybe some people are willing to accept a little health risk in exchange for food that they really enjoy.

But all of that aside – the fact remains that mainstream medical and nutrition scientists are the ones who discovered the role of hydrogenated fats as a vascular risk factor and put that information in the hands of the public. Now, in response to greater public demand, which in turn is likely due to an increasing awareness of the obesity problem in this country (which is also brought to the public by medical scientists), food manufacturers and restaurants are trying to move away from using hydrogenated fats. This is a good thing.

Conclusion

Each of Jim’s points are based upon misinformation or grossly incomplete information. His post has the typical features of propaganda – it uses inflammatory and emotional language, speaks in absolutes, cherry picks data, does not give enough information to really judge a situation, but rather provides only that information which seems sinister or negative, and freely rewrites history as necessary to support his position.

It is also completely typical. I took the time to pick apart his claims not because they represent the idiosyncratic views of a lone crank, but rather because they are representative of the anti-mainstream CAM world. I have personally received hundreds of e-mails making the same or similar claims, and they can easily be found parroted on many pro-CAM websites.

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