Supplements, Especially Those for Bodybuilding and Weight Loss, Linked to Liver Disease

Today’s MedPage includes a report on a study linking supplement use to liver damage.

A few comments…

I find it revealing that the study’s authors report a long list of drug company conflicts of interest and that “supplements” are to a large extent lumped into one overall category, which has the effect of creating a generalized anti-supplement narrative.

That said, the fact that bodybuilding and weight loss supplements seem to be the main culprits appears to be an important finding.

It would be most helpful to find out exactly which supplements we’re talking about. But all we’ve got at this point is an abstract from a poster presentation at a digestive diseases conference.

I will be interested to see if this results in a flurry of anti-supplement stories in major media in the coming days, despite the lack of publicly available data to analyze the findings and respond to the clearly anti-supplement narrative.

If certain supplements are dangerous, that’s definitely worth publicizing. But to tar all supplements with the same brush is disingenuous at best.

Congressional Committee Calls Chiropractic “Key Benefit” Within DoD Health Care System, Urges Pay Equity System

Over the past decade and a half, chiropractic has increasingly become an integral part of the health care systems serving America’s active duty military and its veterans. DCs now work at 45 VA hospitals and outpatient facilities as well as 60 Department of Defense treatment centers.

This news release from the American Chiropractic Association just arrived:

Congressional Committee Calls Chiropractic “Key Benefit” Within DoD Health Care System, Urges Pay Equity System      

Arlington, Va.- Members of the House Armed Services Committee have approved the inclusion of a strong, pro-chiropractic directive in their official committee report accompanying the FY 2013 National Defense Authorization Act. The committee language asserts that services provided by doctors of chiropractic (DCs) for our nation’s men and women in uniform is of “high quality” and has become a “key” benefit within the military health care system. Read relevant pages from the committee report here.

According to the American Chiropractic Association (ACA) and Association of Chiropractic Colleges (ACC), the language is significant for several reasons. “What we have here–and this is very important–is an official statement from one of the House’s oversight committees with authority over the Pentagon that directly links the services of DCs to the treatment of conditions experienced as a result of combat operations. This is a huge validation that chiropractic services are of significant, direct value to a combat fighting force,” said ACA President Keith Overland, DC.

Equally significant, the thrust of the language is aimed at ensuring that DCs within the military achieve “pay equality” and appropriate “job classifications” that are on par with other health care providers with similar training, education and scopes of practice. Regarding that language, Dr. Overland noted, “Our advocacy efforts have not only been aimed at getting DCs into federal health care programs such as the DoD’s, and expanding their presence there, but they also have been aimed at ensuring that DCs are provided with appropriate status, authority, salaries and other benefits equal to those enjoyed by comparable-level providers. This is a major step forward in this advocacy process. It demonstrates that Congress is not just interested in simple DC inclusion, but inclusion in the right way which fully recognizes the status, training and professional capabilities of a DC. Part of the ACA’s mission is to level the playing field down to every last detail.”

Inclusion of the language follows a bi-partisan letter sent last year to the Assistant Secretary of Defense for Health Affairs, signed by 15 members of the House Armed Services Committee, requesting the Department of Defense take action to correct the wage rate disparity experienced by doctors of chiropractic within the DoD. Full congressional action on the Defense Authorization bill that includes the House committee language has not yet taken place, but enactment is expected later this year, according to ACA officials, and will be a positive indicator that Congress continues to support a robust chiropractic program within the Department of Defense.

“The Association of Chiropractic Colleges is gratified that the extensive education and training that doctors of chiropractic receive has been recognized and that appropriate compensation is vital,” said ACC President Dr. Richard Brassard. Dr. Overland added, “I want to thank House Armed Services Committee Chairman Buck McKeon, Ranking Member Adam Smith and especially Congressmen Mike Rogers of Alabama and Dave Loebsack of Iowa for moving this issue forward.”

For further information on chiropractic inclusion in the military, or to learn more about ACA’s ongoing legislative efforts, go to ACA’s Advocacy webpage at www.ACAToday.org

 

Food Lobby Dominates Policy Making, Follows Trail Blazed By Tobacco Industry

Since joining the Association for Healthcare Journalists recently, I’ve come to appreciate the importance of investigative reporting and analysis more than ever.

Here’s a recent post on the AHCJ website highlighting the scope of Big Food’s toxic influence on health policy.

 

After aggressive lobbying, Congress declared pizza a vegetable to protect it from a nutritional overhaul of the school lunch program this year. The White House kept silent last year as Congress killed a plan by four federal agencies to reduce sugar, salt and fat in food marketed to children. 

And during the past two years, each of the 24 states and five cities that considered “soda taxes” to discourage consumption of sugary drinks has seen the efforts dropped or defeated.

At every level of government, the food and beverage industries won fight after fight during the last decade. They have never lost a significant political battle in the United States despite mounting scientific evidence of the role of unhealthy food and children’s marketing in obesity

That success has come through what the authors imply is a sort of big-tobacco model, in which the industry combines promises of self-regulation with huge amounts of money, and thus creates an irresistible package for lawmakers. For a blow-by-blow on how the lobbying muscle swayed the decision-makers in recent battles, I strongly recommend you read the full piece, which draws heavily from both data and extensive interviews. Particularly interesting? The examples of how the Citizens United decision has impacted far more than just election politics.

Learning What Your Genome Contains

From today’s Wall Street Journal health blog, here’s the story of a Stanford professor who used information from his genome to change his diet and exercise patterns to bring his blood sugar levels back to normal. It appears to illustrate the upside of genetic testing.

Snyder, who is 56, two years ago decided to see what genetics might tell him about his own health. He’s not alone, as the cost of mapping a person’s full genetic profile has been dropping quickly, as WSJ reports, raising questions about how best to use the information. Colleagues sequenced Snyder’s whole genome, which revealed a number of potential health issues.

He learned he has an elevated risk for heart disease, not unexpected since “everyone on my father’s side died of heart failure,” he says. Surprisingly, he also discovered he is at higher risk for Type 2 diabetes. “For me, that came out of nowhere,” he says.

Snyder is physically active and isn’t overweight. And, at the time of the genome test, his glucose level was normal. But the level began rising gradually over the next few months. Finally, at a physical, the doctor told him the latest tests showed, “You are diabetic.”

He ramped up his bike riding and added running to his regimen. He cut out most sweets. “It took six months, but my glucose came back to normal,” he says. His doctor now calls him a “managed diabetic,” says Snyder, who has so far avoided needing medication.

Snyder is one of the drivers behind a Stanford study of faculty members in the genetics department who were offered the chance to get their genome sequenced and interpreted. Participants will be followed for more than a year to see how they use the information to manage their health, how they react to unexpected findings and other issues.

A downside of having your genome analyzed is that, legally or illegally, risk factors could potentially be used against you by employers or insurers. Federal law has some protections in place against such abuses, but we are at such an early stage in the application of this technology that the future is very much uncharted territory.

An interesting sidelight of this doctor’s story, not fully addressed in this article, is the fact that his diabetes first emerged very shortly after he was told that he had a genetic predisposition to that disease.

Certainly that could be a coincidence and there’s no overt indication to the contrary. But what an odd coincidence!

 

House Budget Slashes Public Health, Nutrition Assistance to the Poor

The House of Representatives seems hellbent on destroying (or if that fails, undercutting) the nation’s public health efforts, cutting whatever they can whenever they can.

From today’s Public Health Newswire:

House passes bill that cuts health programs while sparing defense
On Wednesday, the American Public Health Association sent a letter to House members that urged lawmakers to vote against the bill, which includes provisions to repeal the healthcare reform law’s Prevention and Public Health Fund; reduce funding for both Medicaid and CHIP; and cut about $36 billion from the Supplemental Nutrition Assistance Program, which the association said would eliminate benefits to about 2 million Americans.

Cutting food aid to the poor at a time when more have need for it is quite a statement of principles on the part of the House Republican majority.

 

 

Climate Change: Last Chances to Avoid Disaster Fast Approaching

This has far greater implications for long-term population health than most of what we usually call health policy. The Obama Administration’s upcoming decision on the Keystone Pipeline is the central focus, but the issue goes much deeper.

From one of the nation’s top climate scientists, James Hansen of NASA, in today’s New York Times:

If Canada proceeds, and we do nothing, it will be game over for the climate.

Canada’s tar sands, deposits of sand saturated with bitumen, contain twice the amount of carbon dioxide emitted by global oil use in our entire history. If we were to fully exploit this new oil source, and continue to burn our conventional oil, gas and coal supplies, concentrations of carbon dioxide in the atmosphere eventually would reach levels higher than in the Pliocene era, more than 2.5 million years ago, when sea level was at least 50 feet higher than it is now. That level of heat-trapping gases would assure that the disintegration of the ice sheets would accelerate out of control. Sea levels would rise and destroy coastal cities. Global temperatures would become intolerable. Twenty to 50 percent of the planet’s species would be driven to extinction. Civilization would be at risk.

That is the long-term outlook. But near-term, things will be bad enough. Over the next several decades, the Western United States and the semi-arid region from North Dakota to Texas will develop semi-permanent drought, with rain, when it does come, occurring in extreme events with heavy flooding. Economic losses would be incalculable. More and more of the Midwest would be a dust bowl. California’s Central Valley could no longer be irrigated. Food prices would rise to unprecedented levels.

If this sounds apocalyptic, it is. This is why we need to reduce emissions dramatically. President Obama has the power not only to deny tar sands oil additional access to Gulf Coast refining, which Canada desires in part for export markets, but also to encourage economic incentives to leave tar sands and other dirty fuels in the ground.

The global warming signal is now louder than the noise of random weather, as I predicted would happen by now in the journal Science in 1981. Extremely hot summers have increased noticeably. We can say with high confidence that the recent heat waves in Texas and Russia, and the one in Europe in 2003, which killed tens of thousands, were not natural events — they were caused by human-induced climate change.