March 2009 Health in the News Archive

[ Monthly Index of New Briefs ]

More and more children are developing kidney stones

March 31, 2009

Dr. Pat Cassali of Children's Hospital of Philadelphia reports kidney stones are "now a growing trend among children." According to Dr. Cassali, "family history can be a risk factor, but something else has to account for the sudden rise. This problem isn't confined to children who are overweight or have other health issues."

Dr. Cassali said that "the typical kid that comes in is a young girl between the age of eight and twelve who doesn't like to drink a lot of water, is very active, and loves fast food." Dr. Snyderman explained that "fast food and sports drinks have lots of salt that can strain the kidneys and cause calcium deposits to form stones."

Dr. Grout's Comment:

Fast foods and sodas again would seem to be a culprit, whether the child is obese or not. Dark colas in particular contain oxalate, an acid that can lead to the formation of calcium oxalate kidney stones. Phosphoric acid is thought to affect calcium metabolism in ways that might increase kidney stone recurrence risk. Let's get back to basics – healthy food, healthy water intake – to treat an almost totally preventable disease.

Mammography under attack in Britain

March 31, 2009

The conventional wisdom about breast cancer screening is coming under sharp attack in Britain, and health officials there are taking notice.

They have promised to rewrite informational fliers about mammography after advocates and experts complained in a letter to The Times of London that none of the handouts "comes close to telling the truth" — overstating the benefits of screening and leaving out critical information about the harms.

What women are not told, the letter said, is that for every woman whose life is saved by breast cancer screening, up to 10 healthy women are given diagnoses — and, often, surgery — for a cancer that is so slow-growing it would never have threatened a woman's life.

"The culture is just that mammography is such a very sensible thing to do, so you chug along and have it done," said one of the signers, Hazel Thornton, in a telephone interview.

The idea that mammography may do more harm than good may be alien to many American women. The message has emphasized that screening protects women from breast cancer, and one survey of 479 women found that only 7 percent were aware that some cancers grow so slowly that even without treatment they will not affect a woman's health.

Dr. Ned Calonge, chairman of the United States Preventive Services Task Force, says mammography has been oversold to American women.

Ultimately, women have to make their own decision about whether to be screened, said Dr. Lisa M. Schwartz, an associate professor at Dartmouth Medical School, who is co-author of Know Your Chances (University of California, 2008), a book about how to interpret health statistics and risk.

"You're not crazy if you don't get screened, and you're not crazy if you do get screened," said Dr. Schwartz, who also signed the letter to The Times. "People can make their own decision, and we don't need to coerce people into doing this.

Dr. Grout's Comment:

Mammography versus thermography is kind of like the old VHS versus Beta battle that took place years ago in the video cassette arena. The beta technology was clearly better, but VHS won the marketing battle.

But with mammography, we are talking of an imperfect screening technology that comes with two definite health risks – radiation and compression. It has been estimated that 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation. This includes mammography, x-rays and other medical and dental sources. An annual dose of radiation is simply an invitation to cancer. And if you have cancerous tissue, the last thing you want to do is to give it a hard squeeze – exactly what is done during the compression required for mammograms.

At the Arizona Center for Advanced Medicine, we used the more advanced form of screening – thermography. Thermography can spot suspicious tissue 10 years before it can be detected by mammography. How? Chemical and blood vessel activity in the area surrounding a developing breast cancer is almost always higher than in the normal breast. When a tumor is forming, it develops its own blood supply to feed its accelerated growth and this increased blood flow can increase the surface temperatures of the breast. Thermography can "see" this increase in temperature.

Patients with multiple conditions confound conventional medicine

March 30, 2009

The New York Times reports that people with multiple health problems — a condition known as multimorbidity — are largely overlooked both in medical research and in the nation's clinics and hospitals. The default position is to treat complicated patients as collections of malfunctioning body parts rather than as whole human beings.

"Very often, there is nobody looking at the big picture or recognizing that what is best for the disease may not be best for the patient," said Dr. Mary E. Tinetti, a geriatrician at the Yale School of Medicine.

And treating one disease in isolation, she added, can make another disease worse. In controlling diabetes, for example, doctors often seek to reduce levels of a blood-sugar marker called hemoglobin A1C. "But we know that for some people with complicated diseases, that's not always the best move," Dr. Tinetti said.

In a medical system geared toward individual organs and diseases, there is no champion for patients with multiple illnesses — no National Institute on Multimorbidity, no charity Race for the Multimorbidity Cure, no celebrity pressuring Capitol Hill for more research.

And because studies involving uncomplicated populations are cheapest and easiest to interpret, patients with multiple diseases are routinely shut out of drug trials. A 2007 study found that 81 percent of the randomized trials published in the most prestigious medical journals excluded patients because of coexisting medical problems.

"We often don't know what the real safety or efficacy is for patients with multiple illnesses," said Dr. W. Douglas Weaver, president of the American College of Cardiology.

Time pressures intensify the doctors' predicament. A typical 15-minute appointment leaves too little time to weigh the risks and benefits of a complex treatment plan, much less to fully consider the patient's preferences and priorities.

Quality-improvement measures, which tie doctors' compensation to how closely they follow evidence-based practice guidelines, further complicate matters, and some worry that they provide a financial incentive for physicians to sacrifice individualized decision-making.

"Doctors know that it's not right for someone to be on 15, 18, 20 medications," said Dr. Tinetti, the Yale geriatrician. "But they're being told that that's what's necessary in order to treat each of the diseases that the patients in front of them have."

Dr. Grout's Comment:

I applaud that the conventional medical arena is beginning to verbalize the problem. "The default position is to treat complicated patients as collections of malfunctioning body parts rather than as whole human beings." Exactly. In med school, doctors are taught to look at one thing, and treat that one thing. There is a bone specialist, a lung specialist, a heart specialist, etc.

Homeopathic physicians got out of that box and learned different standards of care that address the person as a whole. We recognize chronic disease is the culmination of a cascade of things gone wrong in the body over time. We are not in bed with the drug industry, so homeopathic physicians have a much larger tool box with which to solve medical problems at their root. This approach means we spend time with our patients. My first appointment is typically two hours. Most of my patients have been through the "insurance mill" and frankly, got fed up with the ten minute appointments and the growing list of prescriptions and their side effects.

The news article says that the problem of multiple illnesses is a problem of the elderly. Sadly, it is not. Kids now have diabetes and other "adult" diseases. Doctors do indeed need to learn how to address the whole patient – young and old. It is bad enough that a 75-year-old may be on 15 medications, but the system must allow for better ways to treat the 25-year-old who has multiple conditions.

New "polypill" promoted as global answer to health

March 30, 2009

The combination pill made of three blood-pressure-lowering drugs, a statin, and aspirin could substantially reduce cardiovascular events in healthy individuals, according to a study published in The Lancet and presented at the American College of Cardiology meeting.

The formulation is called a "once-a-day polypill" and is reported to reduce the risk of heart attack and stroke, potentially offering an inexpensive way to save millions of lives. "The experimental five-drug combination proved about as safe and effective as each drug given alone," and "cut a patient's risk of heart attack by 62 percent and stroke by 48 percent."

Researchers tested a formulation by Cadila Pharmaceuticals of Ahmedabad, India, containing low doses of three blood pressure medicines - atenolol, ramipril, thiazide - plus the generic version of the cholesterol-lowering statin drug Zocor [simvastatin], and 100 milligrams of aspirin. Investigators recruited about 2,000 people at 50 centers across India, average age 54, with at least one risk factor for heart disease, such as high blood pressure, high cholesterol, obesity, diabetes, or smoking. Of the participants, 400 were given the polypill, and the remainder were placed in eight groups of 200 and given individual components of the pill or various combinations for 12 weeks.

The one-pill approach needs far more testing as well as approval from the Food and Drug Administration, something that could take years. Christopher Cannon, MD, of Harvard Medical School, said the study "raises hope that, in conjunction with other global efforts on improving diet and exercise, the polypill could one day substantially reduce the burden of cardiovascular disease in the world."

Dr. Grout's comment:

Better living through chemistry! So now we can just continue our bad habits, our poor diet, our lack of physical exercise, and put all our faith in a pill. This smacks of marketing, not preventive medicine. And it ignores the increasing documentation of the side effects of statins, including muscle weakness and mental problems. But most disturbing is that this again promotes the inaccurate idea that high cholesterol is the cause of heart disease; half the people who have heart attacks do not have high cholesterol. It does not address the fundamental issues of heart disease – chronic inflammation driven by lack of proper nutrients and environmental pollution. We are not ill because we are deficient in pharmaceutical drugs.

Air Pollution Linked to Higher Heart Attack Risk

March 23, 2009

Research from the relatively new field of environmental cardiology includes a Harvard University study conducted over 16 years of six U.S. cities that found fine particulate pollution, even at levels below the federal health standard, can shorten lifespans by two years. A majority of these earlier deaths were due to heart disease.

Another study in Salt Lake City found that when a steel mill shut down for a period of months, there was a four to six percent drop in mortality in neighboring areas. The mortality rose to previous levels when the steel mill reopened.

A study of 250 metropolitan areas around the world found that a spike in air pollution is followed by a spike in heart attacks.

In animal experiments, Dr. Aruni Bhatnagar has found that aldehydes - a toxic class of chemicals found in most forms of smoke, including cigarette smoke and car exhaust - increase blood cholesterol levels and activate enzymes that cause plaque in the blood vessels to rupture. When plaques rupture, it can cause a blood clot, which may block an artery and lead to a heart attack. Aldehydes are present in high concentrations in smog and are generated during combustion of any kind of organic material coal, wood, paper, or cotton.

Dr. Grout's Comment:

It is good to see that the cardiology branch of medicine is recognizing that environmental factors impact human health. Dr. Bhatnagar of the University of Louisville put together a symposium called Environmental Factors in Heart Disease that will take place April 21 in New Orleans.

Research shows that blood vessels react to pollutants by producing an inflammatory response to attack the foreign particles and that can trigger a complex physiological reaction harmful to the blood vessels. The medical community is discarding the old "cholesterol is the key marker for heart disease" mantra and coming to accept that heart disease is a primarily a matter of chronic inflammation.

A simple, non-toxic process called chelation can reduce inflammation in the blood vessels and stimulate more NO (nitric oxide) which helps keep arteries clean and flexible. It is a safer approach than statin drugs which come with significant side effects.

Vitamin D affects adolescent weight gain

March 13, 2007

Too little vitamin D can lead to fatter adolescents, researchers say. A Medical College of Georgia study of more than 650 teens age 14-19 found that those who reported higher vitamin D intakes had lower overall body fat and lower amounts of the fat in the abdomen, a type of fat known as visceral fat, which has been associated with health risks such as heart disease, stroke, diabetes and hypertension.

"We already know that encouraging teens to get an adequate amount of vitamin D in their diets will help promote a healthy body as they grow and develop," Ms. Stallman-Jorgensen says. "Now we need to do intervention studies where we give teens vitamin D supplements to determine if there is a cause and effect relationship between vitamin D intake and fat."

The American Academy of Pediatrics recommends adolescents get at least 400 units of vitamin D per day - either from milk or sun exposure. There are typically 100 units in one 8-ounce glass of whole milk. The recommended daily dose from the sun would require at least 30 minutes of adequate exposure to direct sunlight two or three times a week at peak hours, between noon and 3 p.m.

"As humans, our largest source of vitamin D should be the sun. But we don't spend enough time outdoors to get enough sun exposure and when we do, we're often covered up and wearing sunscreen," Stallman-Jorgensen said. "We can get vitamin D from certain foods, like fatty fish and liver, but it's not in a lot of foods that we commonly consume. In this country, our milk is fortified with vitamin D. Unfortunately, teens just don't drink enough milk to get their daily requirements. Most teens want to drink sodas and sugary drinks."

Dr. Grout's Comment:

For too long, the medical community erroneously told people to stay out of the sun and slather on (toxic) sunscreen lotion. Most people are deficient in vitamin D. Low levels of vitamin D have been linked to diabetes, cancer, and even autism. Exposure to the noonday sun for about 20 minutes results in production of between ten and twenty thousand IU (international units) of the active form of vitamin D. This would be more than enough to supply the body with its requirement vitamin D.

Childhood obesity typically stems from a combination of things – empty calories like processed foods and soda pop, lack of good nutrients like fish oil, an increasing body burden of environmental toxins that the body stores in fat cells, stress, lack of exercise [preferably outdoors in the sunlight]

It only makes sense that a low level of vitamin D would also be associated with weight gain.

Medical ethics for sale

March 11, 2009

A Massachusetts anesthesiologist, Dr. Scott Reuben, has been accused of faking data used in 21 "scientific" papers published in peer-reviewed medical journals from 1996 - 2008. Journals have begun retracting papers authored by Dr. Reuben.

Celebrex and its relatives have been shown in some studies to interfere with bone healing - but not in Reuben's research. Reuben's studies reported favorable results from painkillers including Pfizer Inc.'s Bextra, Celebrex and Lyrica and Merck & Co. Inc.'s Vioxx. His studies also claimed Wyeth's antidepressant Effexor could be used as a painkiller. Pfizer gave Reuben five research grants between 2002 and 2007. Reuben also was a member of the company's speaker's bureau, giving talks about Pfizer drugs to colleagues.

Reuben was employed at Baystate Medical Center. A hospital review found that Reuben made up some or all of the data. Hospital officials said Reuben did not admit to the fabrications. The doctor couldn't be reached for comment.

Benzon, the chief of pain medicine at Chicago's Northwestern Memorial Hospital, called the revelations about Reuben's research "very disappointing. We're talking about 12 to 13 years that this has been going on with over 20 publications."

"Doctors have been using (his) findings very widely," said Dr. Steven Shafer, editor of Anesthesia and Analgesia. "His findings had a huge impact on the field."

In an editorial in Anesthesiology's April edition, editor-in-chief Dr. James Eisenach calls for new research "re-examining the questions that seemed to be answered by Reuben."

Dr. Grout's Comment:

Perhaps the most amazing thing to me about this story is that editor-in-chief Eisenach thinks all he needs to do is "re-examine answers that seemed to be answered by Reuben." How about a broad-based call to clean up the well documented problems with drug companies paying for research that makes their products look good, and then journals printing it?

Medical journals not only print articles, they also run advertising. And therein lies the conflict of interest that can cause editors to cast a blind eye to some content. It's not unlike the situation with lawmakers who are directed to look out for citizens' best interests but also receive campaign contributions from corporate entities with deep pockets.

So in the end: Reader beware. Consumer beware.

Carcinogen still found in personal products

March 6, 2009

The Organic Consumers Association (OCA) spearheaded testing of leading conventional and "natural" and "organic" brands of personal care and household cleaning products, looking for levels of the contaminant 1,4-dioxane.

Products bearing the USDA Organic seal (such as products from Dr. Bronner's, Intelligent Nutrients and Terressentials), were totally free of 1,4-dioxane.

Meyers Soap

Some of the leading brands with products testing at the highest levels for the carcinogen 1,4-dioxane were Dial, Palmolive, Head & Shoulders, and Body Essence. Mrs. Meyers Clean Day Liquid Dish Soap had the highest levels of the carcinogen at an alarming 204 ppm (parts per million), ten times higher than any other product's current results in the study.

1,4-dioxane is a petrochemical "known to the State of California to cause cancer" under Proposition 65. Due to its toxicity, many consumers would not expect to find it in "natural" or "organic" branded personal care products. The contaminant 1,4-dioxane is a byproduct of the ethoxylation process, "which is a cheap shortcut companies often use to provide mildness to harsh cleaning ingredients. 1,4-dioxane is also a suspected kidney toxicant, neurotoxicant, and respiratory toxicant, according to the California EPA, and it is a significant groundwater contaminant." While previous studies have revealed the presence of 1,4-dioxane in baby, children and adult products and those mislabeled as "organic" and "natural", this latest study shows the toxin is being significantly reduced as many brands reformulate.

OCA conducted a similar study last year which prompted many companies to reformulate their products. OCA reported that several brands which tested badly last year claimed to be working on product reformulations that were not ready in time for this study: Nature's Gate, Healthy Times, The Village Company, and Whole Foods Market's private label 365 Everyday Value.

Brands whose products showed significant improvement since the last study include: Earth Friendly Products, Ecco Bella, Giovanni, Jason, Johnson & Johnson, Kiss My Face, Life Tree, Method, Nature's Gate, Planet Ultra, and Seventh Generation.

Dr. Grout's Comment:

You can view the chart with the study's full listing of products at http://www.organicconsumers.org/bodycare/DioxaneResults09.pdf

The organic standards for personal care products are not as black and white as those for food. Personal care products have the word "organic" in their brand name or on the product label, but unless they are USDA certified, the main cleansing ingredients and preservatives are often made with synthetic and petrochemical compounds.