Like Smoking, Soda Needs to be Taxed

Sugar intake, especially in children, is a major US health problem.  It is a major contributor to obesity and is creating an epidemic of diabetes in children, a disease once considered an adult problem.  The soda industry, much like the tobacco industry in the 80’s, markets heavily to children knowing that if they can form the habits of soda drinking young, they will most likely have a life long costumer.

While soda is not chemically addictive, although some would argue that point, it certainly creates dependency.  It does so by setting up a dangerous process within the body by which a person can become dependent on the sugary surge they get from a soda to feel normal.  Also consider that many sodas contain caffeine.  This caffeine also have a profound affect on a person and can actually cause withdrawal symptoms just like a drug.  The withdrawal symptoms can be very uncomfortable and include  headache, fatigue, sleepiness, inability to focus and concentrate. Others report experiencing flu- like symptoms, irritability, depression and anxiety.

The real problem of soda, however, is the sugar in soda.  It forces the body to release a hormone called insulin in such large quantities that children quickly become insulin resistant and soon thereafter are diabetic.  Soda creates a disease in children that used to take decades to develop in adults.  These children are also overweight increasing their risk for just about every chronic disease ranging from heart disease to cancer.  This places a huge financial burned on our health care system, driving cost up higher and higher.  The way to off set this?  Perhaps a soda tax is the answer.

The Joint Committee on Taxation calculated that a 3-cent tax on each 12-ounce sugared soda would raise $51.6 billion over a decade.  This is quite a lot of money.  A 12 pack of Coke costs about $2.99 so that would up the price to $3.35.  It certainly isn’t enough to stop people from buying their sodas, but it would provide some income to help fight the health problems it is causing.  Proponents of the tax say the money would be used to fund a health marketing campaign to teach people how to eat healthy.  This is a good idea only if they teach it correctly and disregard the whole low fat paradigm.  Studies show that sugared beverages are the No. 1 source of calories in the American diet, representing 7 percent of the average person’s caloric intake and up to 10 percent for children and teenagers.  You will notice sugared beverages are fat free!  Maybe the beverage industry should start advertising that.  The problem in this country is the carbohydrate consumption is through the roof.  Teaching people about eating fat free is a terrible idea because it will only push people towards things high in sugar like soda.  They are fat free after all!

The marketing campaign needs to focus on low glycemic, low carbohydrate options.  This is the only way to change the health picture in the US.  We need to shift our paradigm and consider that fat is not the enemy.  Carbohydrate is.  Simple and refined carbohydrates cause disease and keeping them out of the diet is the single most important factor in long term health.

Pregnancy, Depression and Drugless Relief

Up to a quarter of all women suffer from depression during pregnancy, and many are reluctant to take antidepressants. Now a new study suggests that acupuncture may provide some relief during pregnancy, even though it has not been found to be an effective treatment against depression in general.

The Stanford University study recruited 150 depressed women who were 12 to 30 weeks pregnant, and randomly assigned 52 to receive acupuncture specifically designed for depressive symptoms, 49 to regular acupuncture and 49 to Swedish massage.

Each woman received 12 sessions of 25 minutes each; those given acupuncture did not know which type they were getting. (In the depression-specific treatment, needles are inserted at body points that are said to correspond to symptoms like anxiety, withdrawal and apathy.)

After eight weeks, almost two-thirds of the women who had depression-specific acupuncture experienced a reduction in at least 50 percent of their symptoms, compared with just under half of the women treated with either massage or regular acupuncture.

There was no significant difference in the rates of complete remission — about a third in each group. The findings appear in the March issue of Obstetrics & Gynecology.

The lead author, Rachel Manber, a professor of psychiatry and behavioral sciences at Stanford, said the results suggested that some symptoms of depression during pregnancy might be related to physical discomfort that is alleviated by acupuncture.

Still, the results were striking, she said, adding, “It’s quite remarkable, especially since the prevalence of depression is highest in the third trimester of pregnancy, so it goes against the course of how you would expect depression to go.”

via Vital Signs – Pregnancy – Some Depression Relief, Without Drugs – NYTimes.com.

Dr. Court’s Comments

Taking any drug is dangerous during pregnancy.  The fact that acupuncture can provide some relief is wonderful news.  Tissues that are most likely to be affected by pharmaceuticals are tissues with high metabolic activity.  Every single tissue in a baby’s body is highly metabolically active because it is growing so fast.  What is particularly scary is that most doctors will say you must weigh the benefits of taking them against the risks, yet antidepressants have shown to be no better than placebo at helping depression! To expose a growing fetus to a drug that has little to no actual value should be criminal.

Below is a list of drugs that are approved for use to treat depression and their potential side effects on growing babies.

Citalopram (Celexa)

Risks: Has been associated with a rare but serious newborn lung problem (persistent pulmonary hypertension of the newborn, or PPHN) when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with a birth defect that affects the brain and skull (anencephaly), a birth defect that affect sutures on the head (craniosynostosis) and a birth defect that affects the abdominal organs (omphalocele)

Pregnancy Category C (see below for key)

Fluoxetine (Prozac, Sarafem)

Risks: Has been associated with PPHN when taken during the last half of pregnancy

Pregnancy Category C (see below for key)

Paroxetine (Paxil)

Risks: Has been associated with fetal heart defects when taken during the first three months of pregnancy; has been associated with PPHN when taken during the last half of pregnancy; has been associated with anencephaly, craniosynostosis and omphalocele

Pregnancy Category D (see below for key)

Sertraline (Zoloft)

Risks: Has been associated with PPHN when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with omphalocele

Pregnancy Category C (see below for key)

Amitriptyline

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies

Pregnancy Category C (see below for key)

Nortriptyline (Pamelor)

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies

Pregnancy Category D (see below for key)

Phenelzine (Nardil)

Risks: May cause a severe increase in blood pressure that triggers a stroke

Pregnancy Category C (see below for key)

Tranylcypromine (Parnate)

Risks: May cause a severe increase in blood pressure that triggers a stroke

Pregnancy Category C (see below for key)

Bupropion (Wellbutrin)

Risks: No established risks during pregnancy

Pregnancy Category C (see below for key)

Key:

Category C:

Use with caution if benefits outweigh risks.  Animal studies show risk and human studies not available or neither animal studies nor human studies done.

Category D:

Use in LIFE-THREATENING emergencies when no safer drug available.  Positive evidence of human fetal risk.

The risks associated with these drugs is outrageous considering studies have shown they are ineffective for most people.  You should read category C very carefully.  It says to use with caution is the benefits outweigh the risks.  But the next line says that the studies that were conducted on animals showed that there was risk OR that animal or human studies have not been conducted.  In plain English that means one of the following:

1. The drug was studied in animals and was shown to have some serious risk or…

2. It was never studied in animals or humans.

Do you really want to risk your baby’s health on something that may or may not have been tested and if it was tested (on animals) it was shown to be dangerous?  You must understand that no matter how you look at it, these drugs have never actually been tested on humans while they were pregnant (thankfully!).  This makes them extremely unsafe, particularly when there is a safe alternative out there like acupuncture.

The pharmaceutical industry would love to tell you that their drugs are safe and can be taken by just about anyone.  What they fail to tell you is, in the case of antidepressants, is that they are ineffective wastes of money and the only affect they have is harmful.

If you happen to be pregnant and depressed, which is quite common, I would suggest a trial of acupuncture before you try any sort of medication.  They are no better than placebo therefor making the risks always outweigh the benefits.

Learning to Read Labels

When I put patients on a diet, I routinely ask them to look at the labels when they’re buying various products.  It is not uncommon, however, that people aren’t very efficient readers of food labels.  You know, that small black and white box of letters and numbers on the sides of food containers?  The reason I ask patients to read these is because it contains valuable information on it.  I like people to look at the carbohydrate content because this will be most reflective of whether it is a healthy food or not.  Foods with high carbohydrate content and high amounts of sugar are obviously not healthful.  After several months of reading labels it becomes very natural and you can actually begin to guess what the contents of certain foods are without even looking at the label.

The problem though is that the current food labeling system can be quite confusing.  There are a lot of people that don’t know what a calorie is.  There are a lot of people that don’t know the difference between fat, carbohydrate and protein.  There are a lot of people that don’t know that all three have profoundly different affects in the body when consumed.  Learning these are of utmost importance for being able to understand the nutrition label.

What is a calorie?

The definition of a calorie is a unit of heat equal to the amount of heat required to raise the temperature of one kilogram of water by one degree at one atmosphere pressure.  Not helpful?  Didn’t think so, but that’s the definition.  Basically a food’s caloric content is measured using this definition and chemical process.  When speaking of food calories we are actually talking about kilocalories because there are other caloric measurements.  The basis of caloric measurements is based on gram calories or 1/1000 of a kilocalorie.  If we used gram calories as the standard, food would contain hundred of thousands of “calories” and would difficult to calculate caloric content.  So, kilocalories are used to measure food and the term -kilo is dropped from the word to give us simply a calorie.  Calories are measured in a ‘calorimeter.’ A substance can be combusted (literally burned) in the presence of oxygen, to measure the amount of heat generated per gram. From such basic measurements, and by extrapolation to mixtures of different ingredients, the ‘calorie count’ can be applied as a measure of the energy derivable from a food source.

Basically, what you need to remember is that a calorie is energy.  We use the energy, or calories, from our food to survive.  They allow us to pump blood, breath, think, etc.  Without calories we cannot survive.

What is Fat, Protein and Carbohydrate?

These are considered the macronutrients and they contain different amounts of calories.  Protein and carbohydrates both contain 4 calories per gram.  Fat contains 9 calories per gram.  Basically what this means is that any amount of fat contains a little more than twice the energy that the same amount of protein and carbohydrates does.  

Protein

Protein is used to do a lot of things in the body.  It is used for cell signaling, cell structure, enzymes, neurotransmitters, muscle function and many other things.  It supplies a small amount of energy when needed.  It is very important.

Fat

Fats play a vital role in maintaining healthy skin and hair, insulating body organs against shock, maintaining body temperature, and promoting healthy cell function.  It is also a great energy source.  They are also important in that they must be present to absorb the fat soluble vitamins which are vitamin A, D, E and K.

Carbohydrates

Carbohydrates are the most common source of energy in living things.  Just because they are common, does not mean they are necessary for survival.  There is no such thing as an “essential” carbohydrate.  You can obtain all the energy you need from fats and proteins.  There are, however, essential proteins and fats.

So What’s Wrong with the Current Food Label?

The current food label is confusing and should be set up a little differently.  To see a great example of what it should look like click here and scroll to page 6.  This is from the Center for Science in the Public Interest.  There are some things that I agree with on this “new” label and some I do not.

I agree that there needs to be clarification with regards to the amount of calorie in each serving.  People often see 350 calories listed and can’t figure out how much food they can have for their 350 calories.  On the new label clearly stating that there are 350 calories in one serving makes that a little easier.  Secondly, the larger typing on the whole label makes it a lot easier to read.  Thirdly, there are a lot of foods that claim they have whole grain content.  At the top of this new label, companies would be required to tell you how much is whole grain.  In this case, it’s a lowly 2%.  I think that is a great idea because the food industry is getting away with marketing their products a whole grain when it fact they contain very little of it.  I also like the red numbering and lettering letting you know that you should pay attention to what’s been highlighted.  Although I believe they should highlight the total carbohydrate content rather than just the added sugar, it’s a good start.  It’s lets people know they need to pay attention to these things because they are important.  I also like how the major and minor ingredients have been broken down so you can see clearly what this food is actually made up of.  Separating the ingredients by bullets and taking out all the capital letters is also very helpful.  I have many patients with allergies and the allergy information at the bottom would be a life saver for these people.  It’s a great idea to have it listed on every package.

People need to take their own health into their hands and not rely on others to do it for them, but this is a great step in the right direction.  Making the food labels easier to understand would probably help a lot of people manage their diets more effectively.

Can What You Eat Cause Infertility?

Apparently, the answer is yes.  Recent research has shown that women who have celiac disease are much more likely to have trouble getting pregnant than women who are not gluten sensitive.

Celiac disease is a genetic disorder in which gluten, the main protein found in wheat, is not properly processed.  It causes an autoimmune reaction in the body leading to ulceration and inflammation in the gut.  Symptoms include diarrhea, gas, bloating and fatigue.  A person with celiac disease may be asymptomatic or may have very severe symptoms.  Although wheat is the main offender, gluten is also found in rye, barley and oats.

The reaction the body forms to gluten causes the lining of the small intestine to atrophy.  This problematic because this is the portion of the digestive tract that is most responsible for absorbing nutrients.  If you cannot absorb nutrients your body cannot thrive.

Women with untreated celiac disease are more likely to have problems getting pregnant.  They also will have higher incidences of miscarriage and premature births.  Believe it or not, men will also have issues with fertility if they have celiac disease.  There are also other problems associated with untreated celiac disease for women.  Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia lists the following problems.

• Later onset of menstruation
• Earlier menopause
• Secondary amenorrhea (a condition in which menses starts but then stops)

These menstrual problems cause a woman to ovulate less which results in a smaller chance of getting pregnant.  Men may also have trouble with fertility as mentioned above.

• Abnormal sperm (reduced sperm count, altered shape, and reduced function)
• Reduced testosterone levels

Dr. Crowe recommends that if you and your partner are having trouble getting pregnant, you should both be screened to see if celiac plays a role.  Remember, you may not have symptoms and still have celiac disease.  The test is a relatively simple blood test.  Be sure to continue to eat gluten throughout because if you go gluten free before the blood test it may not show up.  If the blood test comes back positive, a tissue biopsy may be performed to confirm the diagnosis.  The pathologist will look at the cellular lining of the small intestine to confirm that there is in fact atrophy.

Treatment for celiac is relatively simple.  Avoid gluten.  This is becoming more and more common place and grocery store chains are starting to carry more foods that are gluten free.  A simple diet change is enough to solve this problem.

Low Carb is Still the Way to Go

A large portion of carbohydrate products are made from grain.  The most common grain used is wheat and wheat contains large amounts of gluten.  I am huge proponent of low carbohydrate diets for overall health.  While celiac disease might cause auto-immune reactions that disrupt fertility, obesity is also a known risk factor for infertility.  Women who are obese are 43% less likely to conceive a child than normal weight or even overweight people. If you think about this in terms of evolution it makes sense.  A woman who is obese is less likely to survive child birth because of the strain it puts on the body.  It is not unreasonable to assume that the lower rates of pregnancy in obese women is some sort of protective measure, evolutionarily speaking.

Research has shown that low carbohydrate diets are more effective for losing weight and improving measurable health outcomes over the traditional low fat diet.  See our old post. If you are having trouble conceiving a child and you are significantly overweight you should try losing weight and possibly think about getting tested for celiac disease.  These are efforts you should undertake before considering fertility treatments.

Napping Improves Brain Function!

Bring back the siesta.

It turns out that toddlers are not the only ones who do better after an afternoon nap. New research has found that young adults who slept for 90 minutes after lunch raised their learning power, their memory apparently primed to absorb new facts.

Other studies have indicated that sleep helps consolidate memories after cramming, but the new study suggests that sleep can actually restore the ability to learn.

The findings, which have not yet been published, were presented Sunday at the annual meeting of the American Association for the Advancement of Science in San Diego.

“You need to sleep before learning, to prepare your brain, like a dry sponge, to absorb new information,” said the lead investigator, Matthew P. Walker, an assistant professor of psychology and neuroscience at the University of California, Berkeley.

The study recruited 39 healthy young adults and divided them into two groups. All 39 were asked to learn 100 names and faces at noon, and then to learn a different set of names and faces at 6 p.m. But 20 of the volunteers who slept for 90 minutes between the two learning sessions improved their scores by 10 percent on average after sleeping; the scores of those who didn’t nap actually dropped by 10 percent.

via Vital Signs – Afternoon Naps Can Increase Ability to Learn, Study Suggests – NYTimes.com.

Dr. Court’s Comments

This truly is good news!   The fact that napping is good for the brain was something Dr. Carrie and I were sure was true while we were in chiropractic school.  We had class from roughly 7 AM until 3 or 4 PM with an hour for lunch and an hour for club meetings.  These meetings were generally academic in nature, so the class load was quite high.  We took every chance we had to get some extra sleep because we were often up late studying and needed to get up early to be at class by 7.  We did not, however, have 90 minutes to sleep.  More like 20….or 30.

The naps did help when we had the chance to get them and know we know why.  This study shows that neurons in the brain need rest just like a muscle needs rest to function at its best.  This is something I routinely tell my patients when they are rehabbing their brains.  I specifically tell them not to perform their exercises when they’re tired or hungry.  Neurons that are fatigued or do not have enough energy supply are more apt to fail and cause more problems.

Obviously, not all of us have time to take a 90 minute nap in the middle of the day.  The best way to get the most out of our brains is to sleep well at night.  This means keeping good sleep habits.  These include:

• Getting to bed at a regular hour every night and waking at a regular hour every morning.  This helps to maintain the natural circadian rhythm of many of the hormones in the body.  Sometimes when these hormones are disturbed, sleep becomes difficult.
• Keeping at much light out of your bedroom as possible.  No one should have a television in their room.  I know many patients use it to “fall asleep” but it is not an effective tool for most.  Even the light from your alarm clock is enough to stop the production of the neurotransmitter melatonin.  My suggestion is to take a magazine or a small piece of cardboard and cover up the light coming from the clocks in your room.  The darker the room the better.
• Avoiding things that might disrupt sleep like alcohol and caffeine before bed.  Caffeine is a stimulant and there’s a reason people drinking it when they wake up.  Alcohol, a depressant that usually makes people sleepy, has a rebound effect that can actually wake you 2-4 hours after you go to sleep.  It is not an effective way to manage insomnia as some people use it for.
• Lose weight if you need to.  Being overweight increases the risk of sleep apnea, a sleep disorder that causes a person to stop breathing at night.  This cessation of breathing can cause a person to wake up unknowingly, sometimes hundreds of times per night.  If you know you have sleep apnea, get a CPAP machine.  CPAP stands for Constant Positive Airway Pressure.  Basically the machine keeps you throat open so air can pass uninterrupted into your lungs.

Of course if you need to take a nap and you have the time, indulge yourself!  It is good for your brain.  But remember the nap should supplement your positive sleep habits and should not serve as a replacement.

A Window into Big Pharma

A recent story published in the NY Times tells the story of Dr. Steven E. Nissen, a cardiologist at the Cleveland Clinic.  He conducted a large study of the diabetes drug, Avandia.  His conclusions in the study were not favorable for the drug or the pharmaceutical company, GlaxoSmithKline, that produces it.  There is quite the controversy over the drug because of the dangers it poses to patients who take it and because of the cover-up that has ensued from GlaxoSmithKline. Now more evidence of crooked behavior on behalf of executives from GlaxoSmithKline.

Dr. Nissen conducted a landmark study that suggested that the best-selling diabetes drug Avandia raised the risk of heart attacks. The study led to a Congressional inquiry, stringent safety warnings, a sharp drop in the drug’s sales and a plunge in the share price of GlaxoSmithKline.  The battle between GSK and Dr. Nissen was kept professional and legitamate until May 10, 2007, 11 days before his study was to be published in the New England Journal of Medicine.

Dr. Nissen was set to meet executives from GSK about his upcoming study and was nervous.  In my opinion, rightly so.  There are many published reports of powerful pharmaceutical companies trying to suppress scientific information that is unfavorable and ruining the careers of researchers who are only trying to do what’s best for the public.  He was so nervous, in fact, that he decided to record the encounter.

Let The Lies Begin

The amount of lying from the executives in this meeting is astounding.  For example, executives in the meeting repeatedly said they would immediately begin a new analysis of the safety of Avandia.  Three years later this study has yet to be published.  They did, however, release the results of this study on their website, which of course were favorable for the drug.  The fact that it has not been published means that it doesn’t hold up under peer review and was most likely an attempt to look like they were doing the right thing all the while making sure the numbers looked good too.  It is an underhanded way of trying to get data to the public without the rigors of peer review.

“Also during the meeting, Dr. Ronald L. Krall, GlaxoSmithKline’s chief medical officer, predicted almost exactly the results of another crucial study of Avandia that was two months from publication and whose results, according to scientific protocols and the company itself, should have been kept secret from the company. In an interview, Dr. Nissen said the recording showed that the executives hoped to persuade him not to publish his study by suggesting that they had contradictory information they would share with him in a joint study.

‘In retrospect, it seems clear that neither statement was true,’ Dr. Nissen said. ‘They did not have contradictory data, and they never intended to cooperate in any analyses.'” (From the NY Times)

GSK said in response that they were not aware that Dr. Nissen was recording the interview and were disturbed that he did so without telling them.  It’s probably a good thing that he didn’t tell them because it would have changed the entire meeting and we wouldn’t have this window into just how corrupt Big Pharma is.

GSK was sued in 2004 by the State of New York for not publicizing the results of studies that showed antidepressants led to an increase in suicide in teenagers.  The settlement of the suit required GSK to post the findings on the internet.  This crooked behavior was what fueled Dr. Nissen to record his meeting with these executives.

During the meeting the four executives spoke as if they were unaware of the results of the study Dr. Nissen has completed.  It was clear they were lying about this as well because one week before the meeting these executives were faxed a copy of the study secretly and inappropriately.  This was only later found out by Congressional investigators.  Who would do something like this?  A journal reviewer who also worked as a consultant for GSK.  That’s right.  The very same people who are supposed to review our literature and make sure it is accurate and without bias also work for Big Pharma. Talk about a conflict of interest.

At one point, the executives said that studies showed that Avandia had no impact on cardiac death rates.  This is a fact they unequivocally knew was not true. Dr. Nissen’s study had concluded that the risk was increased by 64 percent.  They then, again, spoke as if they did not know the results of Dr. Nissen’s study, which Congressional investigators have shown they did.

“I get different numbers on this, but we’ll talk about it later,” Dr. Nissen said.

“Hmm!” one executive responded. “I would like to hear more about that.”

Another executive said, “That would be interesting to see.”

“This is one that is important to us,” Dr. Krall concluded.

Dr. Nissen was clearly tired of the push he was getting because it was clear they wanted him to forgo publishing the study.  He’d had enough.

“Dr. Nissen lost patience regarding the increased risk of heart attacks, or myocardial ischemia, in Avandia patients. ‘I hope you guys understand how much trouble G.S.K. is in here,’ he said. ‘You’ve got a bunch of people who are incredibly vulnerable to myocardial ischemia, and you’ve had evidence that you’re provoking ischemia in those people, and that is of grave public health consequences.'”

Internal emails obtained by the Congressional investigation show that they company was well aware of the dangers of the drug despite what the executives were saying in this meeting with Dr. Nissen.

“‘There is no statistical reason for disregarding the findings’ of Dr. Nissen’s study. In another, Dr. Moncef Slaoui, head of research at GlaxoSmithKline, wrote that federal drug regulators, Dr. Nissen and the company’s own researchers all seemed to agree that studies of the drug showed that it substantially increased the risks of death and heart attacks, also known as ischemic events.'”

GSK has responded to Dr. Nissen’s study calling it flawed and with some serious limitations.  They are saying these things even though their own studies have come up with similar numbers.  This is entirely about the money that Avandia brings in for the company.  Although its sales have dropped dramatically, it still made $1.9 billion last year. These executives, while MDs, and PhDs, ceased to care about the public the day their jobs became to get money into the pockets of their shareholders.  And pulling a drugs that has been as successful financially as Avandia certainly will not endear them to the board members that make the decisions about their careers.

I will leave you with this.  Thousands of people per year have unnecessary heart attacks and die by taking this drug, yet the executives at GSK want to cover up this evidence just to make more money.  To me this is not just a failure of our regulation of drugs and the FDA, but also of health care in general.  If “mainstream” doctors just understood more about nutrition and actual health and weren’t so quick to prescribe medication for a disease which, by all accounts, is most easily and successfully treated with diet and exercise, we wouldn’t be in this mess to begin with.

Want Cancer? Drink Soda…

A new study shows that drinking as little as two sodas per week significantly increases your risk of pancreatic cancer.  Pancreatic cancer is dangerous because it is aggressive. There are usually few symptoms until the cancer is advanced. Symptoms include abdominal pain, weight loss, diarrhea, and jaundice.

People who drank two or more soft drinks a week had an 87% increased risk — or nearly twice the risk — of pancreatic cancer compared to individuals consuming no soft drinks,” says study lead author Noel T. Mueller, MPH, a research associate at the Cancer Control Program at Georgetown University Medical Center, Washington, D.C. The study is published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

I am sure you will be surprised to know that they beverage industry took exception to this study calling it flawed and poorly designed.  The study, however, was quite comprehensive.  It looked at over 65,000 people and followed them for 14 years.  The researchers hypothesized that the increase in cancer was as a result of poor insulin control.  Drinking sugary sodas causes massive amounts of insulin to be released by the pancreas.  Insulin, while a vital hormone needed to maintain life, is detrimental in excess.  It’s already the main culprit in obesity and diabetes and has been linked to Alzheimer’s disease.  Now researchers hypothesize it may increase the risk of pancreatic cancer.  There are other studies that show a positive correlation between intake of high fructose corn syrup, the main sweetener in soda, and pancreatic cancer as well.

A Dangerous Trend

While people are living longer and longer with cancer and cure rates are going up, the number of new cases of cancer is also going up.  We are not doing anything that is helping to reduce the number of newly diagnosed cancers in this country.  Perhaps part of the problem is soda.  Consider the following:

According to the National Soft Drink Association (NSDA), consumption of soft drinks is now over 600 12-ounce servings (12 oz.) per person per year. Since 1978, soda consumption in the US has tripled for boys and doubled for girls. Young males age 12-29 are the biggest consumers at over 160 gallons per year—that’s almost 2 quarts per day. At these levels, the calories from soft drinks contribute as much as 10 percent of the total daily caloric intake for a growing boy.  (From the Weston A. Price Foundation)

These numbers are mind boggling.  The average person drinks 600 12 oz. servings per year!  You have to remember that takes into account the people who don’t drink any soda because it is an average.  I never drink soda so for that number to be that high, there has to be a lot of people drinking a lot of soda.  Males aged 12-29 drink 160 gallons per year or 2 quarts per day.  To put that into perspective, that’s just over 5 sodas per day. This study says that as little as two sodas per week is enough to significantly raise pancreatic cancer risk.

The soft drink industry is a large reason that this country is so unhealthy.  Most people do not realize the amount of sugar in a soda.  There is more sugar in one soda than in 1 bag of M&M’s.  Most parents would not let their children it 5+ bags of M&M’s in a day but don’t think twice about letting them drink soda all day.  One with breakfast, one with lunch, one with dinner and a couple in between for snacks and pretty soon a whole six pack of soda is gone.  Good thing it’s cheap.  That is also part of the problem.  The availability of inexpensive soft drinks makes it that much easier to get.  But here’s the funny thing – water is much cheaper!  If people replaced their soda intake with good, clean, healthy water many of the health problems in this country would evaporate.

Do yourself a huge favor; if you drink soda, stop.  I have had many patients with health issues and cutting out the sugary drinks is a must.  The soft drink industry would have you believe you can be a healthy individual and enjoy soda, but it isn’t true.  Just like the tobacco industry used to tell you smoking in moderation wasn’t bad for your health, the soda industry will continue to perpetuate the lie until they are forced to change.  Even if we forget about all the other bad aspects of soda – the acidity, the preservatives, the additives – and just consider the sugar, it’s a dangerous product.  Don’t drink it if you value your health or your family’s health.

Vital Signs – Study Finds Sharp Increase in Chronic Health Problems in Children – NYTimes.com

Childhood rates of chronic health problems, including obesity, asthma and learning disabilities, have doubled in just 12 years, a new study reports — to 1 in 4 children in 2006, up from 1 in 8 in 1994.

But the findings, which appeared in the Feb. 17 issue of The Journal of the American Medical Association, held a welcome surprise, the researchers said: many chronic conditions resolve themselves during childhood.

While half of the children followed from 2000 through 2006 had a chronic condition at some point during the period, only one-quarter did at the study’s end.

“There is much to be hopeful about,” said the paper’s lead author, Dr. Jeanne Van Cleave, a pediatrician at the Massachusetts General Hospital for Children in Boston. “We’re now wondering what’s going on with those kids, and why a chronic condition resolves in one child while another child may not experience the same thing.”

The study analyzed data from the government’s National Longitudinal Surveys that included three nationally representative groups of children ages 2 through 8. Besides obesity and asthma, the scientists looked at allergies, heart trouble, impaired vision and hearing, and behavior and learning problems like attention deficit hyperactivity disorder.

Though the researchers did not study the reasons for the increases, they suggested several possible factors: improvements in screening and diagnosis that led to more reporting of the chronic conditions; the rise in childhood obesity, which can lead to other problems; and the increasing survival of premature babies and children with cancer and other diseases, who are more likely to have chronic health problems.

via Vital Signs – Study Finds Sharp Increase in Chronic Health Problems in Children – NYTimes.com.

Dr. Court’s Comments:

To me, it is not a surprise that these chronic health conditions are on the rise.  Steadily over the last twenty years children have become more sedentary and diets have become poorer.

This study did not hypothesize why these conditions might be on the rise, but the dangerous combination I mentioned above is as good as any.

The link between diet and obesity is an easy one.  Children are eating more and more processed and refined foods which are loaded with bad carbohydrates and contain very little actual nutrition.  The asthma/diet link is also an easy connection.  Many children consume copious amounts of foods they are allergic to.  Routinely, I place children on elimination diets to rid them of any possible allergies.  The likely culprits are dairy and wheat, but others may exist.

The link between diet and learning disabilities is also there.  Elimination of offending foods often results in better behavior and increased concentration at school.  Also, there must be more activity for these children.  Active children are much less likely to suffer from ADHD and other similar problems.  When I treat children with ADHD I always recommend that they child get into some kind of organized activity.  If they don’t, they end up with too much “screen time.”  That is, they spend too much time in front of the TV or computer.  This is very detrimental to their brain development.

If we want to change this disturbing trend we have to get our children better nutrition and get them active.  Parents must understand that these conditions don’t develop because they are “unlucky” or have “bad” genes.  These are controllable and need to be addressed with corrective measures and not covered up with drugs that only relieve symptoms.

More Pharmaceutical Cover-Ups

Type II diabetes is a major problem in this country.  Type II diabetes is caused from years of eating poorly and can lead to serious health problems such as heart attack, heart failure and even death.  In the US 23.6 million people have diabetes.  The pharmaceutical industry knows this and makes a host of drugs to treat this disease, when it is most easily treated with diet and exercise.  One of these drugs is Avandia and new research shows it is very dangerous.

Avandia is an oral diabetes medication that works by making the body’s cells more sensitive to insulin.  A low carbohydrate diet and exercise also have the same effect, but without the risk of death.  Now, the FDA is recommending that Avandia be removed from the market.  GlaxoSmithKline, the drug’s maker, disagrees of course and from the outset has sought to cover up the potential problems with the drug.  Reports, obtained by The New York Times, say that if every diabetic now taking Avandia were instead given a similar pill named Actos, about 500 heart attacks and 300 cases of heart failure would be averted every month because Avandia can hurt the heart.  What if those people had been on an intensive diet and exercise program instead?  Avandia also caused 304 deaths in the third quarter of 2009.

GlaxoSmithKline has attempted to cover up the information and it has been shown they did not warn the public of the dangers despite knowing more than 10 years ago that it was dangerous.  The reason?  It was a huge seller.  Avandia was once one of the biggest-selling drugs in the world. Driven in part by a multimillion-dollar advertising campaign, sales were $3.2 billion in 2006.  An upcoming bipartisan multiyear senate investigation sharply criticized GlaxoSmithKline for not waring of the potentially deadly side effects.

‘Instead, G.S.K. executives attempted to intimidate independent physicians, focused on strategies to minimize or misrepresent findings that Avandia may increase cardiovascular risk, and sought ways to downplay findings that a competing drug might reduce cardiovascular risk,’ concludes the report, which was overseen by Senator Max Baucus, a Montana Democrat, and Senator Charles E. Grassley, an Iowa Republican.

Mr. Baucus said of the report, ‘Patients trust drug companies with their health and their lives, and GlaxoSmithKline abused that trust.’ (From The NY Times)

The first mistake is that you should never trust a pharmaceutical company.  They are the most deceitful companies in existence and are only interested in big profits, even if it destroys lives.  They seek to cover up unfavorable information and when confronted with the proof  they attempted a cover up, simply deny or “disagree” with the findings.

Unfortunately, there is an internal battle within the FDA.  Some are adamant that this drug should be removed.  This comes from the public safety arm of the FDA.  Other are not so sure.  The FDA has requested that GlaxoSmithKline undertake a study to prove whether this drug actually does cause heart problems.  First of all, this is a dangerous undertaking because the drug has already been shown to cause these problems, hence the reason the FDA is recommending it be removed from the market.  Secondly, asking the drug’s maker to conduct the study is like asking the family dog to watch your food for you while you go to the bathroom. Nothing good can come of it.

Senator Grassley said the internal agency battle showed that the agency needed to be restructured to give more power to safety officials like Dr. David Graham and Dr. Kate Gelperin (who are part of the FDA and have recommended it be removed) over their counterparts who approve medicines and deal more directly with drug makers.

‘It doesn’t make any sense to have these experts who study drugs after they have been on the market for several years under the thumb of the officials who approved the drug in the first place and have a natural interest in defending that decision,’ Mr. Grassley said. ‘The Avandia case may be the most alarming example of the problem with this setup.’

Below is an exerpt from the NY Times article about the process through with Avandia has gone and shows that it has been known for years that this is dangerous.

The Senate investigation — the result of years of digging through more than 250,000 internal company documents — concludes that GlaxoSmithKline and by extension the F.D.A. delayed far too long in this process.

In November 2003, for instance, the company completed a study in which diabetics given Avandia had far more heart problems than those given placebos. Two months later, the World Health Organization sent the company an alert linking Avandia to heart ailments. In a June 2004 meeting, the company’s Global Safety Board said a hard look should be taken at all Avandia clinical trials for more signs of heart problems, documents show.

European regulators had earlier ordered GlaxoSmithKline to conduct a study — called the Record trial — to examine Avandia’s heart risks because hints of these problems appeared in the company’s earliest trials.. But the Senate report shows that by at least 2004, company executives were aware that the Record trial was going so poorly that it would never answer the heart question with any kind of certainty.

So company executives gathered dozens of Avandia studies and sifted their combined data. Called a meta-analysis, this combined look found first in 2005 and in an updated look in 2006 that Avandia increased the risks of serious heart problems by nearly a third, the Senate investigation shows. Because two-thirds of diabetics die of heart problems, this was hugely worrying.

In 2005, executives revealed the results of their meta-analysis to the F.D.A., and in 2006 they provided the agency with the underlying data.

Two large company-sponsored trials — called Dream and Adopt — were published near the end of 2006, and each provided more hints that Avandia hurts the heart, the documents show. In a March 2007 meeting of the company’s Diabetes Franchise Cardiology Advisory Board, advisers called the safety worries found in these many studies “disquieting.” Negotiations with agency officials about how and whether to alert the public continued.

All while this is going on, GlaxoSmithKline continued to market the drug aggresively, all the while knowing it was dangerous.  The senate inquiry shows that as far back at 1999 there were attempts to silence doctors who spoke out publicly about Avandia.

Dr. John Buse, a professor of medicine at the University of North Carolina, gave presentations at scientific meetings suggesting that Avandia had heart risks. GlaxoSmithKline executives complained to his supervisor and hinted of legal action against him, according to the Senate inquiry. Dr. Buse eventually signed a document provided by GlaxoSmithKline agreeing not to discuss his worries about Avandia publicly. The report cites a separate episode of intimidation of investigators at the University of Pennsylvania. GlaxoSmithKline said that it “does not condone any effort to silence” scientific debate, and that it disagrees with allegations that it tried to silence Dr. Buse. Still, it said the situation “could have been handled differently.”

Again, there is a plethora of proof that:

A) GlaxoSmithKline knew this was dagerous for years and did nothing about it.

B) They actively engaged in covering up the data.

C) Tried to suppress and intimidate doctors who spoke out publicly about the drug.

GlaxoSmithKline will probably get a slap on the wrist for this, but they should be fined billions.  Avandia is only one example of how crooked the pharmaceutical industry is.  Until we get the lobbying money out of politics things will continue as is and people will continue to get hurt by corporate giants that have no regard for peoples’ health and safety.

Prescribing Alcohol…

Below is an article I read in the NY Times. Read on and let me know what you think.

There is a lot of evidence linking low-risk drinking with lower rates of heart attacks, strokes and dying, especially among middle-aged and older adults. However, most of this is correlational, meaning these things tend to go together without being able to say what causes what.

There is a clinical trial under way to actually test whether “prescribing” a daily dose of alcohol reduces cardiac risk or not, and what harmful effects there might be. In the absence of such studies assessing risk versus benefit, it is premature to “prescribe” drinking.

On the other hand, low-risk drinking is associated with many other good health outcomes, including a reduced likelihood of diabetes or Alzheimer’s disease.

However, even low-risk drinking is associated with a higher incidence of breast cancer in women, and drinking may harm fetuses at any level, so pregnant women are urged to abstain.

The evidence regarding wine versus other beverages like grape juice is mixed, so I don’t think it’s possible to draw firm conclusions at this time. It’s most likely that both alcohol, per se, and the resveratrol found in grape skins have independent effects.

A more detailed review of the evidence regarding moderate drinking is available at the alcohol institute’s Web site, “Moderate Drinking.”

One final note: the way different groups or agencies describe moderate drinking can be confusing. For example, the Dietary Guidelines for Americans 2005, from the United States Department of Agriculture, defines moderate drinking as “the consumption of up to one drink per day for women and up to two drinks per day for men.” These are best thought of as averages over time, and if you divide the alcohol institute’s weekly guidelines — 14 drinks for men, 7 for women — by seven, you arrive at the same average intake of two drinks per day for men and one per day for women. The U.S.D.A. guidelines don’t specifically address a limit for any one day. Thus, the alcohol institute and U.S.D.A. guidelines are consistent, but the institute’s provide additional guidance.

My personal take on all this is that for most people, low-risk drinking is not harmful to health — and may be helpful. Anyone with existing medical conditions or who takes medications should discuss whether to drink with their doctor. However, I would discourage people from drinking in order to improve their health.

Dr. Willenbring is an addiction psychiatrist in St. Paul, Minn. His blog, Substance Matters, is devoted to substance use conditions.

Dr. Court’s Comments:

This debate has been raging ever since it was found that consuming a moderate amount of alcohol has some health benefits.  The main benefit has come from red wine.  There is a substance in red wine called resveratrol.  Resveratrol is a substance that is found in the skins of grapes that are used to make wine.  Scientists think this is the substance that provides all of the health benefits.

Studies have shown that resveratrol is quite amazing.  It has been shown to slow aging and is a potent antioxidant and anti-inflammatory.  Resveratrol is the real deal.  It is not this that I have a fundamental problem with.  My problem is that recommending that people drink alcohol for their health is like recommending people eat McDonald’s because it supplies the recommended daily allowance of B12. The detrimental effects of over consumption far outweighs the positive effects one might receive from the resveratrol.

Secondly, resveratrol is readily available in a pill form from reputable supplement companies.  It must come from a company with exceptional quality control because resveratrol is notoriously unstable.  Why drink alcohol to get the resveratrol when all you have to do is take it in a capsule?  This would avoid all of the potential harmful effects of the alcohol.

I was happy to see that Dr. Willenbring recommends against drinking to improve health.  All too often I find that doctors are recommending this as a way of getting healthier.  This is the wrong way to go about it.  If you want to improve your health eat a healthy diet, exercise and take a select list of supplements.  I routinely take resveratrol for my health.  It is not something that requires drinking alcohol.  Alcohol should be enjoyed in moderation, but just for that, enjoyment.  Do not drink to improve your health.