July 15th, 2007 by Dr. Val Jones in News
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I read an interesting series of articles about improving nutritional status in the US and Britain. First, the New York Times reports that trendy Manhattan bars are offering vitamin-fortified cocktails – fresh, organic fruits and/or veggies are muddled with vodka martinis to create a “healthy” alternative to your typical beverages. I’m skeptical – given the volume of fruits and veggies recommended for a healthy diet, you’d have to drink a whole lot of vodka martinis to get the vitamins you need in a day. Probably better to go for a fruit salad.
The British are still debating the utility of a “fat tax” as a way to discourage people from eating food high in refined sugar, flour or unhealthy oils. So far the government’s position is that taxing non-nutritive food is too controlling (creates a “nanny state”), and that people will just find an unhealthy alternative to the taxed foods. Interestingly, some research suggests that if all unhealthy foods were taxed, and healthy foods were made less expensive, thousands of heart attacks and obesity-related conditions might be avoided each year. However, this study has been received with much skepticism.
And a new British study also showed a surprising similarity between middle class and lower income eating habits. Both groups ate equally poorly, though the lower income group was more likely to smoke and engage in less physical activity. The similar eating habits came as a surprise, as it had been incorrectly assumed that the lower income group had a substantially poorer diet.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 12th, 2007 by Dr. Val Jones in News
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The New England Journal of Medicine published a letter to the editor about a man who was struck by lightning while wearing his iPod. He was jogging home in a thunderstorm, listening to some energy-boosting music when -whammo- the poor Canadian man got more than he bargained for on the energy front. A nearby tree was struck by a lightning bolt, and the side flash reached him, and followed the wiring to his ear buds. The electrical shock passed from one ear bud to the other, blowing out his ear drums and causing such a violent contraction of all his facial muscles that his jaw snapped under the tension.
So this begs the question: could this happen to you? Does carrying a cell phone or iPod put people at higher risk for being struck by lightning?
Well, because lightning strikes are exceedingly rare there are very few case reports in the literature about folks who have been struck while talking on their cell phone or carrying an electronic device. And best I can tell, this is the bottom line: carrying a cell phone or iPod does not increase your chance of being struck by lightning (there is not enough metal in those items to act as a lightning rod). The lightning is more likely to strike a nearby tree or tall object than it will a human. However – if you are struck (such as the man described above) any metal objects (even ions found in your sweat) that you are in contact with can influence the direction of the current. Normally, lightning passes over the skin externally, but if you are wet or have metal in your ears, it can direct the electricity internally, where it can do more damage.
So if you’re caught in a lightning storm, I’d consider keeping metal out of direct contact with your skin. But the chance of you being struck by lightning in your lifetime is almost one in a million, so I think there is little cause for general alarm. Or to use a bad pun: we can all lighten up about lightning risks.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 9th, 2007 by Dr. Val Jones in News
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In a charming news article, the BBC reports that the British Sandwich Association is concerned about high salt levels in national fare. If you have high blood pressure, there is now new evidence that avoiding soup and potato chips will not be sufficient in curbing your salt intake. Yes, even the humble sandwich can be a good hiding place for sodium. But this article is even more whimsical than informative.
First of all, I think it’s terribly funny that the “British Sandwich Association” actually exists – and that its public health warnings are taken very seriously. Second, I think that the contents of common British sandwiches are somewhat disturbing: a “prawn mayonnaise” sandwich lacks a certain appeal in my mind. And the fact that this variety of sandwich was selected as a representative example of a typical sandwich is also amusing.
And finally, the website for the British Sandwich Association is hilarious. Check out part of their mission statement:
“To safeguard the integrity of the sandwich market by setting standards
for sandwich making, by encouraging excellence in sandwich making and
by encouraging the development of the industry in terms of skills,
innovation and overall market development.”
And the BBC includes this very astute quote from the organization’s director:
“Sandwiches involve the assembly of ingredients,” said Jim Winship, director of the organisation. “The fact is that the salt is already in the ingredients…”
Well, I think the take home message here is that if you have high blood pressure or are on a low salt diet, remember that sandwiches often contain very high sodium levels. The message between the lines is that the British are inherently funny and have bizarre taste in food.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 8th, 2007 by Dr. Val Jones in Quackery Exposed
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The most outrageous lies that can be invented will find believers if
a man only tells them with all his might.
–Mark Twain
I’ve always liked the term “magical thinking.” I first discovered it in medical school when
we were learning about normal childhood development. There is a period of time (about ages 3-6) in
which all children believe in magic – things that are not possible or rational
appear plausible to them. I suppose that
Peter Pan is based on this psychological window – when children grow too old
they can’t go to Never Never Land anymore because they lose their ability to
fly (aka believe in magic).
As adults, we often remember our childhood fantasies with
fondness. We relive the experience with
our kids, and enjoy the carefree wonder that comes along with fully believing
in implausible things. In general,
magical thinking is an enjoyable part of childhood.
But there is a more sinister form of magical thinking – and
that develops when adults abandon reason for implausibility. We see this in medicine quite a bit, as it is
the soil in which the proverbial snake oil salesman can grow his thorny weeds. Preying on fears in a vulnerable victim, the
snake oil salesman leads the person down a common garden path of partial
truths, twisted facts and sheer lies.
Here are some of his favorite tactics:
- Trust
erosion. “Your doctor is keeping
important (if not life-saving) treatment options from you.” Snake oil salesmen love to write books with the
following titles “What your doctor won’t tell you about X.” or “New
scientific break through X that your doctor doesn’t know about…” This tactic is meant to break the trust
between physicians and their patients, causing second guessing and
unnecessary rifts. More often than
not, your doctor doesn’t know about treatment X because it’s so ridiculous
that they wouldn’t give it a second thought or the medical community has
already disproven it.
- Conspiracy
theories. Snake oil hucksters love
to tell you that the government (or your hospital, or your pharmacist, or
your health plan, or your healthcare provider) is conspiring against you
with the pharmaceutical companies (or your health insurance, or your
doctor, etc.) to prevent you from getting the care you need or to coerce
you into getting treatment that you don’t need. Conspiracy theories are ubiquitous in
the snake oil world and they are the most obvious red flag identifier in
their arguments. So if the next
treatment option you’re considering is promoted with arguments that it’s
best for you specifically because the evil government/pharmaceutical
company/hospital/doctor is trying to prevent you from taking it – be very wary indeed.
- Playing
the victim. When rational
scientists poke holes in the snake oil salesman’s pitch, his favorite
argument is “I’m being attacked and suppressed by those who don’t want YOU
to know the truth. This proves that what I’m saying is true – why else
would they want to silence me!?”
- Making
you feel inferior. The snake oil
salesman loves to point to the “wild success” of treatment X in Europe, Asia, or any other country than your own. He wants you to feel that you’re late to
the party, and that everyone else is ahead of you and has already been
enlightened. You feel ashamed of
your ignorance and want to get in on something that has thousands (perhaps
millions) of foreign supporters – so it must be safe/true/right.
- Pseudoscience
jargon. To give their snake oil an
air of credibility, the salesman will use medical-sounding words to
describe its purported mechanism of action. This is where the salesman can
really work his art into the minds of magical thinkers. The more convoluted and implausible the
story, the more magical it is – and the better able to capture imaginations.
- A secret cure. Diseases can be crippling and devastating, leading people to despair. The most serious and life threatening diseases (especially if there is no known cure) are the favorite target of snake oil salesmen. Desperation breeds magical thinking, and opens the door to all kinds of false promises on the part of hucksters who have no qualms making money on fruitless “cures.” They often pitch their snake oil as a secret cure that only a select few people know about (or have access to). If a disease has no known cure, you can be 99.9% sure that a promise of a “secret cure” is an unconscionable ploy to gain financially from the suffering of others.
And so, dear readers, one must never underestimate the power
of magical thinking. It is the bedrock
of bad medicine, can lead people away from life-saving therapies, and will
continue to exist for as long as people are willing to entertain the arguments
of the snake oil huckster. Sadly, I
predict that snake oil will be around for as long as human suffering exists –
and it will inflict its venom most effectively on the ignorant, desperate, and
vulnerable. It can be vanquished,
however, on a case-by-case basis by its only natural foe: the scientific
method. Hold fast to evidence based
medicine, and you will avoid much of the pain of pseudoscience, thorny lies,
and snake oil. I will be there with you,
fighting the good fight.
In my next post I will describe the power of positive
thinking – which has value in medicine, as do placebos. I will explain the difference between the
placebo effect and snake oil, an often confused but important distinction.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 7th, 2007 by Dr. Val Jones in News
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There is a new diet pill undergoing testing in Italy. The pill expands in your stomach, suppressing
appetite by giving you a false sense of fullness, sort of like those dehydrated
sponges that expand dramatically when you get them wet.
On the surface it sounds as if this pill might be a
reasonable approach – but there are 2 big problems:
- This
method (filling the stomach to give a sense of fullness and reduce eating)
has been tried before and has failed to produce the desired result. Back in the 1980’s scientists attempted
to use an inflated stomach balloon (Garren Bubble) to suppress hunger. Unfortunately it didn’t work, and put
people at high risk for gastric ulcers and other dangerous side
effects.
- There
is a serious risk of bowel obstruction with this pill. Once the tablet dissolves in stomach
acid, the cellulose condenses to produce a bezoar (rock like substance)…
the pill’s contents can then become wadded up like a rubber tennis ball
and not pass through the gut safely.
In fact, the pill could cause a fatal obstruction.
So, as we continue on our quest for the magic pill to cure
our obesity epidemic – we must reject yet another valiant effort. Sorry folks, it’s back to good old diet and
exercise for most of us.
*Many thanks to Dr. Brian Fennerty who discussed this pill’s
safety with me in a recent interview.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
