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!

 

Pink Slime Update Plus USDA Proposal to Remove Federal Inspectors from Industrial Chicken Operations

An excellent discussion from the Up with Chris Hayes show, featuring Mark Bittman of the New York Times, whose excellent food columns I read regularly. 

This 20-minute video offers a perspective rarely seen on television.

h/t Erik Marcus

Bayer’s Neonic Pesticides Linked to Colony Collapse Disorder in Bees

Few things, if any, have the potential to cause the level of catastrophic health effects in humans that would attend a substantial spread of colony collapse disorder. Most of the food eaten by the world’s humans relies on pollination by bees. Without them, most of the grains and fruits we eat would only be available in far smaller quantities.

Thus, when three new studies in prestigious journals implicate Bayer’s neonic pesticides in colony collapse disorder, the implications are huge. Essentially the entire U.S. corn crop is grown using that pesticide. Organically grown corn is the exception; even then, however, if pesticides are blown by the wind or carried by water into organic fields, that safe haven vanishes.

Last year, the Whole Foods stores in my area carried no organic corn. Except for organic farmer’s markets or growing it yourself, there’s no other option around here. And this is in the heart of the Midwest.

As Tom Philpott notes at the end of this article from Mother Jones, this situation cries out for regulatory action. Thus far, the Obama Administration has shown no inclination to take on corporate agriculture. What would it take for that to change?

It’s springtime, and farmers throughout the Midwest and South are preparing to plant corn—and lots of it. The USDA projects this year’s corn crop will cover 94 million acres, the most in 68 years. (By comparison, the state of California occupies a land mass of about 101 million acres.) Nearly all of that immense stand of corn will be planted with seeds treated with neonicotinoid pesticides produced by the German chemical giant Bayer.

And that may be very bad news for honey bees, which remain in a dire state of health, riddled by large annual die-offs that have become known as “colony collapse disorder” (CCD). 

In the past months, three separate studies—two of them just out in the prestigious journal Science—have added to a substantial body of literature linking widespread use of neonicotinoids to CCD. The latest research will renew pressure on the EPA to reconsider its registration of Bayer’s products. The EPA green-lighted Bayer’s products based largely on a study funded by the chemical giant itself—which was later discredited by the EPA’s own scientists, as this leaked memo shows.

 

 

Homebirth Midwives: Better Outcomes, Moving Toward Broader Acceptance

From John Weeks in the Huffington Post, positive news from out west:

“Midwives have a central focus in our strategic plan. We are hoping Washington State can double out-of-facility births in the next two or three years.”

The speaker was Jeff Thompson, M.D., MPH, chief medical officer of the state of Washington’s Medicaid program. He spoke in a taped interview for Symposium 2012 — Certified Professional Midwives and Midwifery Educators: Contributing to a New Era in Maternity Care. The gathering took place at Warrenton, Va.’s Airlie Center on March 18, 2012.

Thompson, a member of the National Advisory Council for Healthcare Research and Quality, works in the state with the most evidence-based exploration of the value and risks associated with direct-entry, licensed, non-nurse, midwives. His state’s heightened interest began with a state requirement in 1996 that health plans cover midwives. Washington, like 11 other states, presently also covers midwives via Medicaid.

If the certified professional midwives (CPMs) get their way in Congress, CPM services will be reimbursed by Medicaid in all 26 states where CPMs are licensed. Passage would significantly expand access to low-income women across the country. The Access to Certified Professional Midwives Act was introduced in the U.S. House of Representatives in 2011 by Congresswoman Chellie Pingree (D-ME). Passage would energize a slight bump in home births captured in recent data from the Centers for Disease Control.

When the Supposedly Safer Alternative Appears to be More Dangerous

This is a fascinating and meaningful research project by my friend, Sarina Farb.

Though only a high school senior, she is pursuing a line of research that has the potential to prevent a great deal of illness and suffering from these apparently dangerous environmental chemicals (BPA and BPS) to which we are all exposed.

Farb noticed that the Lawrence Public Library and The Merc promote BPA-free receipts, as BPA is used in the ink and found on the surface of receipts. Studies have suggested that the BPA found on receipts is absorbed into the body when handled.

So instead, the receipts at The Merc and the library contain BPS, or bisphenol S, which is similar to BPA. However, very few studies have examined whether BPS is any safer than BPA. So Farb set off to find out.

Farb talked her way into a lab at Kansas University, and with the assistance of Kristi Neufeld, a molecular biology professor, obtained some lab space and the necessary testing supplies.

Farb spent “hundreds of hours” over the past year testing whether BPA and BPS cause an increase in the growth of breast cancer cells.

The results?

“BPS is worse,” said Farb, as her results showed that BPS caused more growth in the breast cancer cells than BPA.

Cancer v. the Constitution

A human tragedy, which could become much less common or much more common depending on what the Supreme Court decides.

She hadn’t gone to the doctor because she had no health insurance. The only kind of work she could get in a struggling rural community was without benefits. Her coat and shoes beside the gurney were worn and her purse from another decade. She could never afford to buy it on her own. She didn’t qualify for Medicaid, the local doctor only took insurance, and there was no Planned Parenthood or County Clinic nearby.

So nothing was done about the bleeding until she passed out at work and someone called an ambulance. She required a couple of units of blood at the local hospital before they sent her by ambulance to our emergency department.

I looked at the fungating mass on her cervix. Later the Intern wondered why she hadn’t picked up on the smell. Probably a combination of it being so gradual and denial. It’s amazing what people learn to tolerate when their options are limited.

“I’m very sorry to tell you this looks like a cancer of the cervix,” I said

She looked surprised. “Oh.” She paused in silence as she adjusted to the news. And then quietly she added, “But the doctor back home said you could fix me up. He said you can offer free care because you have the university.”

But we didn’t have free care at the university hospital.

h/t Meteor Blades

Pink Slime Surprisingly Unpopular for School Lunch Menus

Who could have guessed?

Today’s New York Times has an up-to-the-minute pink slime report. Apparently, this is a fast-moving story.

The Miami-Dade school district, one of the nation’s largest, has already said it would opt for pink-slime-free beef, even though it expected it to cost more (exactly how much remained uncertain). State officials in South Carolina said they would procure only the pink-slime-free ground beef once it became available.

But for some school districts — with administrators fielding phone calls from concerned parents and fretting about past food scares — next fall is not soon enough. The Boston school district, among others, has taken the step of purging all ground beef from its menus. Other districts, like the New York City schools, have begun phasing out ground beef containing the additive from their lunchrooms.

Michael Peck, the director of food and nutrition services for the Boston schools, said the district had decided to hold and isolate its entire inventory of ground beef, leaving over 70,000 pounds of beef — worth about $500,000, Mr. Peck estimated — confined to a warehouse until the district knows more about what is in it.

“It’s another example of the alteration of our food supply,” said Mr. Peck, who is concerned about the use of ammonia hydroxide gas to kill bacteria in the product. “Have we created another unknown safety risk?”

The district will put the meat back into circulation if it finds that it is free of the filler, but like many districts, it is frustrated by the difficulty of determining what does and does not contain lean finely textured beef, which does not have to be listed as an ingredient.

“It does speak to the U.S.D.A.’s ability to trace,” Mr. Peck said. He added that the ground beef would be donated or thrown out if the district found that it contained pink slime.