May 26th, 2009 by admin in Better Health Network, Quackery Exposed
No Comments »
By Dr. John Snyder of the Science Based Medicine Blog
I recently saw a 14 year old girl in my office with a 2 day history of severe abdominal cramps, bloody diarrhea, and fever. Her mother had similar symptoms as did several other members of her household and some family friends. After considerable discomfort, everyone recovered within a few days. The child’s stool culture grew a bacterium called Campylobacter.
Campylobacter is a nasty little pathogen which causes illness like that seen in my patient, but can also cause more severe disease. It is found commonly in both wild and domestic animals. But where did all these friends and family members get their campylobacter infections? Why, from their friendly farmer, of course!
My patient’s family and friends had taken a weekend pilgrimage to a family-run farm in Buck’s County, Pennsylvania. They saw farm animals and a working farm. And they all drank raw milk. Why raw milk? Because, as they were told and led to believe, raw milk is better. Better tasting and better for you.
In 1862, the french chemist Louis Pasteur discovered that heating wine to just below its boiling point could prevent spoilage. Now this process (known as pasteurization) is used to reduce the number of dangerous infectious organisms in many products, prolonging shelf life and preventing serious illness and death. But a growing trend toward more natural foods and eating habits has led to an interest in unpasteurized foods such as milk and cheese. In addition to superior taste, many claim that raw milk products provide health benefits not found in the adulterated versions. Claims made about the “good bacteria” (like Lactobacillus) conquering the “bad” bacteria (like Campylobacter, Salmonella, and E. coli) in raw milk are pure fantasy. Some even claim that the drinking of mass-produced, pasteurized milk has resulted in an increase in allergies, heart disease, cancer, and a variety of other diseases. Again, this lacks any scientific credibility.
With this growing interest in unpasteurized dairy products has come an increase in the rate of food-born infections. The federal government developed the Grade ‘A’ Pasteurized Milk Ordinance in 1924, providing a set of guidelines for the safe processing and handling of milk products. Although all 50 states have voluntarily adopted these guidelines, the FDA has no oversight jurisdiction. It is up to individual states to determine their own safety protocols and enforcement strategies. While selling raw milk is currently illegal in 26 states, those with a will have found a way to skirt the law to get their fix of the real deal.
My patient was a victim of a recent outbreak in Pennsylvania, but similar outbreaks of infectious disease due to unpasteurized milk products are a recurring headache for public health officials. Between 1973 and 1993 there was an average of 2.3 milk born disease outbreaks per year. That number increased to 5.2 per year between 1993 and 2006. Whatever the numbers are, there is no question that the increasing consumption of raw milk is a genuine threat to public health.
The health claims made for raw milk, and against its pasteurized cousin, are being heavily pushed by a small but passionate contingent one might refer to as “food guardians.” These are people who espouse a return to the good old agrarian days of wholesome, farm-raised foods, free from man-made chemicals and mass-market processing. Some of these ideals are highly respectable and healthful responses to the ways in which society has dealt with the need to push products to a mass market at profit. For example, the use of pesticides, animal hormones and antibiotics, and farm run-off can have deleterious environmental and human health consequences. However, many of the health claims that are made about products like raw milk are not supported by scientific evidence, and lack scientific plausibility. Despite this lack of evidence, however, the allure of raw milk products is clearly on the rise.
Beyond the obvious public health consequences of this trend lies the problem of an increasing public credulousness when it comes to pseudoscientific claims. This is similar to the trend we are seeing regarding concerns about the dangers of vaccines and excessive fears concerning certain potential environmental hazards.
Unscientific and outright fraudulent claims about the health benefits (as well as the hidden dangers) of a variety of foods is on the rise. And bogus or unsupported nutrition claims are big business. From the immune boosting and weight loss powers of the acai berry, to the cancer protective effects of vitamins, nutrition pseudoscience is all the rage. While raw milk will never have quite the celebrity cache of these “super foods”, it is promoted with the same lofty yet empty claims, and provides the added bonus of infectious diarrhea.
On a recent visit to a local high-end wine shop, I came face-to-face with the ease with which people fall prey to the marketing of food pseudoscience. A woman was examining a bottle of wine when the store keeper approached to offer help. She told her a little about the wine and then said, “And all of their wines are biodynamic.” To this, the shopper exclaimed “Oh wow, that’s great.” She bought the wine, likely without having a clue what the term “biodynamic” even means. Biodynamic farming is a mixture of Gaia-like principles (the earth is a living organism) and organic practices, with a smattering of mysticism, alchemy, and astrology. In essence, a smorgasbord of pseudoscientific farming practices perfect for the current culture of armchair environmentalism and the new found heal-thy-self mantra of the well-to-do. While the motivating factors and socioeconomic status may differ between those drinking biodynamic wine and those drinking raw milk, both are relying on false beliefs and unsupported claims in making their choices to consume these products.
As a lover of cheese, I appreciate that there are those whose refined palates favor the delicacy of unpasteurized, aged cheeses so prevalent in other countries. But to stretch this taste preference to include health benefits unsupported by science and even common sense is not just misguided, it can be dangerous. Dangerous because it increases the risk of infectious disease, but also because it perpetuates a credulous perspective that adds to the ongoing erosion of our appreciation and acceptance of science.
*This blog post was originally published at Science-Based Medicine*
May 25th, 2009 by admin in Better Health Network
No Comments »
I am always on the lookout for a new snack and I found one I just had to tell you about. I have a big sweet tooth so sweet snacks are usually my first choice (although I also do love my popchips). I firmly believe in the glycemic index for snacks and try to choose things with fiber and/or protein so that they give me sustained energy instead of a spike and drop in my energy. I hate it when I eat something only to be hungry or feel lethargic 30 minutes later.
The new favorite sweet snack is SmartFood popcorn clusters. Mmmmm. You may remember or still have on your store shelves the SmartFood popcorn that is cheddar flavor, but this is completely different. These are sweet and in individual bags.
The SmartFood clusters are sweet, sweet, sweet. They hit the spot a few minutes ago when I ate a pack. I had the Cranberry Almond flavor and it is tart along with the sweet for a nice combo. They also come in Honey Multigrain which taste JUST like caramel corn and a Chocolate Cookie Caramel Pecan Flavor which is a bit more rich than the others.
The reason I love them is that they are also nutritious (of course!). They have 5 grams of fiber (which makes them lower glycemic) and are an excellent source (20%) of calcium. They are made with brown rice syrup instead of high fructose corn syrup and are low in fat with no saturated or trans fat. Each pack is 110-120 calories and are quite convenient to throw into your purse or briefcase or desk drawer.
Check them out and let me know what you think. I found them in the chip aisle in my grocery store.
This post, Yummy New Snack, was originally published on
Healthine.com by Brian Westphal.
May 25th, 2009 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network
No Comments »
During the recent Mother’s Day weekend, I found myself driving north to New Hampshire to take a tour of an overnight camp my youngest daughter, almost 12, came home from school the prior week and announcing she “had to go to” this summer with her friends. While this is very age-appropriate, any one who knows my daughter who is reading this is at this very moment reading the last paragraph and shouting out loud “Get out! M…shy little M!!??” Yup…the one and only.
This is a child who used to talk about living at home “forever”.
This is a child whose dream college was “definitely in Boston…maybe Connecticut” – so she could come home and visit when she felt the urge.
This is a child who, until this year, “wasn’t a fan of sleepovers”. She used to explain “it’s a bed thing – I like my own bed.”
So, when this same child came home last week and started off telling me about her day with “So, about the summer…there’s this camp in New Hampshire…” I almost fell off my seat and I’m sure my heart skipped a beat.
Every relative who heard this story has had the same reaction. First, shock…”M??” then pure excitement (“All right, M!!”).
This isn’t a child who will be living at home forever – this child is growing up.
This isn’t a child who will just look at Boston or Connecticut for colleges some day – this child is starting to see a world around her and want to explore it!
This child is now a fan of sleepovers because “how else can you sleep somewhere other than home and be with your friends.” Good thing because the camp has bunks!!
So, never say ‘never’ when it comes to your kids. They bloom in the most amazing ways when they are ready, not when we think they are ready, and often do so when we least expect it. All we can do as parents is prepare for the unexpected and be their best cheering squad through their new found courage, excitement and interests.
BTW, I used to worry about this child, my previously shy, no longer little M. Not any more! This child has clearly emerged from her cocoon and sprouted wings that are sure to take her in many exciting directions – and we’re happy to help her snatch some air space to take a few practice runs before she’s old enough to really wonder from home. I hope you’ll do the same with your tweens and teens. Just like a new pilot takes many test runs before flying solo, our tweens and teens will need many new experiences with us close at hand, but just a bit out of reach, before they are finally on their own in the adult world.
Image
*This blog post was originally published at Dr. Gwenn Is In*
May 25th, 2009 by EvanFalchukJD in Better Health Network
No Comments »
Writing about health care reform, Peggy Noonan complains of the decay of the English language:
A reporter asked a few clear and direct questions: What is President Obama’s health plan, how would it work, what would it look like? I leaned forward. Finally I would understand. [Secretary of Health and Human Services Kathleen] Sebelius began to answer in that dead and deadening governmental language that does not reveal or clarify, but instead wraps legitimate queries in clouds of words and sends them our way. I think I heard “accessing affordable quality health care,” “single payer plan vis-a-vis private multiparty insurers” and “key component of quality improvement.” . . . . As she spoke, I attempted a sort of simultaneous translation. . . . But I gave up. Then a thought crossed my mind: Maybe we’re supposed to give up! Maybe we’re supposed to be struck dumb, hypnotized by words and phrases that are aimed not at making things clearer but making them obscure and impenetrable. Maybe we’re not supposed to understand.
Noonan is on to something, but it’s not what she thinks. What she’s hearing is real-life language of our health care system from the people in charge of it. And it’s not just government officials who talk this way — Sebelius’ language is just as common in the private sector.
It reveals the deepening divide between how people talk about health care and what it really means to be sick. Noonan jokes that if Sebelius’ child were to get a high fever she might say “This unsustainable increase in body temperature requires immediate access to a local quality health-care facility,” instead of just “We have to go to the hospital.” But I don’t believe that.
When a loved one is sick, all the abstract ideas melt away. It becomes about trying to get help from a doctor, and a doctor doing his or her best to help.
You might think our health care system would be set up to make that process easier. But it isn’t.
Patients and doctors report in overwhelming numbers how dissatisfied they are with what they see as the interference of well-meaning insurers, governments and others.
You might also think that the reform conversation happening in Washington would have the doctor-patient relationship at the forefront. But it doesn’t.
Look at the “eight principles of health care reform,” proposed by the President and supported by the big players in health care:
(1) protecting families’ financial health, (2) making health coverage affordable, (3) aiming for universality, (4) providing portable coverage, (5) guaranteeing choice, (6) investing in prevention and wellness, (7) improving patient safety and quality, and (8) maintaining long-term fiscal sustainability.
What does all of this stuff mean? How do you talk about health care and not even use the word “doctor” or talk about “patients”? Worse, I’m not sure more than one or two of these even qualify as “principles” as that word is normally used. So what’s going on?
I don’t think anyone is trying to deceive anyone. Like Sebelius’ choice of words, the list is as much of a description of the problem as a solution to it. We don’t have a consensus of what is really important in health care, so we avoid the problem altogether by using vague language that everyone can support. What’s worrisome is that vague, abstract talk is almost certain to lead to vague, abstract solutions.
Before we try to reform health care, let’s first talk about it in plain, clear language.
*This blog post was originally published at See First Blog*
May 24th, 2009 by eDocAmerica in Better Health Network, Health Tips, Humor
No Comments »
One of our most revered faculty members, Lee Archer, MD, a neurologist, provided a copy of the handout he gives to his headache patients. With his permission, I adapted it for use with my own patients. I thought it was so good that I asked him if I could publish it on my blog so that others could benefit from his advice.
Headaches are incredibly common and usually frustrating for providers. It has become increasingly evident that chronic or frequently occurring headaches are often virtually impossible to identify as either “migraine” or “tension” headaches and often simply are called “chronic headaches”. Treatment often becomes a revolving door of trying new medications that sometimes work, but more commonly don’t. And, even worse, many headache patients gradually simply become dependent on addictive pain medications just to try to cope with their often daily discomfort.
But, there are some really basic things about dealing with chronic headaches that we should never forget to try. So, without further ado, here is his advice:
Ten Steps to Overcoming Your Headaches
There are some things that everyone can do to help their headaches. There are a number of things you can besides just take medication to help their headaches. If someone follows all of these directions, the need for prescription medication is often dramatically reduced if not eliminated.
1. First and foremost, taking pain medication everyday is definitely not a good idea. Daily pain medication tends to perpetuate headaches. This is true for over-the-counter medications like Excedrin and BC powders, as well as prescription medications like Fiorinal, Midrin, and “triptans” like Imitrex, Zomig, Relpax, Frova, etc. Exactly why this occurs is unclear, but it is a well established clinical finding. Anyone who takes pain medications more than twice a week is in danger of perpetuating their headaches. Occasional usage of pain medications several times in one week is permissible, as long as it is not a regular pattern. For instance, using pain medication several days in a row during the perimenstrual period is certainly permissible.
2. Regular exercise helps reduce headaches. Exercise stimulates the release of endorphins in the brain. These are chemicals that actually suppress pain. I encourage people to aim for at least 20 minutes of aerobic exercise (like walking or swimming) five days a week if not daily. In addition to helping reduce headaches, this also will prolong your life because of the beneficial effects on your heart.
3. Stress reduction is a definite benefit in reducing headache frequency and severity. Headaches are not caused by stress alone, but can make most headaches worse. There are no easy answers for how to reduce stress. If it is severe, we can consider referral to a therapist for help.
4. Too much or too little sleep can trigger headaches. Pay attention to this, and note whether or not you are tending to trigger headaches from sleeping too little or too much. People differ as to how much sleep is “right” for them.
5. Caffeine can precipitate headaches. I encourage patients to try stopping caffeine altogether for a few weeks, and we can decide together whether or not caffeine might be contributing. Abruptly stopping all caffeine can trigger headaches, too, so try to taper off over a week.
6. NutraSweet (aspartame) can cause headaches in some people. If you are drinking multiple servings/day of beverages containing NutraSweet you might consider trying to stop that, and see if your headaches respond.
7. There are some other foods they may trigger headaches in some people. Usually people learn this very quickly. For instance, red wine will precipitate migraines in many people, and chocolate, nuts, hot dogs and Chinese food triggers headaches in certain cases. I generally don’t advise omitting all of these foods, unless you notice a pattern where these foods are causing headaches.
8. If I give you a prophylactic medication for headaches, you should take it daily, as prescribed. If you have trouble tolerating it, please let me know and we can consider using something else. No prophylactic medication works in every patient with headaches. Generally, each of the medications works in only about 60% of people. Therefore, it is not uncommon to need to try more than one medication in any given patient. We must give any of these medications at least four to six weeks to work before giving up on them. It generally takes that long to be sure whether or not a medication is going to work.
9. Keep a calendar of your headaches. Use a standard calendar and mark the days
that you have a headache, how severe it is on a scale of one to ten, what you took
for it and how long it lasted. Also note anything that you think could have
precipitated it. By keeping this over time we can tell if our efforts
are helping.
10. Riboflavin (vitamin B2) 400mg daily helps prevent migraines in many people. It
comes in 100mg size tablets, so you will need to take four of them each day. You
can add it to anything else we try. You do not need a prescription for it.
Do you have chronic headaches? If so, I challenge you to apply these ten principles, then come back and provide a comment on this blog post!
Thanks and good luck!
*This blog post was originally published at eDocAmerica*
