Milk, Particularly Skim Milk, Associated with Acne

In a finding that contradicts longstanding claims by the American Dairy Council, the Harvard Nurses health study has found an association between milk, particularly skim milk, and acne.  The most likely explanation is the hormone content in the milk, which is present in both organic and conventional milk.

From the accompanying editorial in the Journal of the American Academy of Dermatology:

“The papers…from the Harvard School of Public Health establish an association between milk consumption and acne. But how could milk cause acne? Because, drinking milk and consuming dairy products from pregnant cows exposes us to the hormones produced by the cows’ pregnancy, hormones that we were not designed to consume during our teenage and adult years. It is no secret that teenagers’ acne closely parallels hormonal activity…So what happens if exogenous hormones are added to the normal endogenous load? And what exactly is the source of these hormones? Consider that, in nature, milk is consumed from a mother, whether human or bovine, until weaning occurs. Normally, the mother then ceases lactation before the next pregnancy occurs—so that consuming milk from a mother pregnant with her next offspring is not a common occurrence. We’ve all seen nature films of animals chasing their offspring away to encourage weaning at the appropriate time. Further, in nature the offspring consumes only the milk of its own species—but both of these natural rules are broken by humans. Viewed objectively, human consumption of large volumes of another species’ milk, especially when that milk comes mainly from pregnant cows during the human’s normally post-weaned years, is essentially unnatural.”

FDA Endorses Industry-Sponsored Physician Education on Opioid Prescribing

The upside is that there is a clear recognition of the scale of the problem of over-prescription and inappropriate use of addictive painkillers. As noted in this Medpage article, “the prescription painkiller epidemic … was responsible for about 15,600 deaths in 2009, the latest year for which there are data.”

But industry sponsorship is a major red flag, leading some to opine that these educational programs fall far short of constituting an adequate response to the problem.

“The FDA’s goal is to ensure that healthcare professionals have the education they need to prescribe opioids and that patients have the know-how to safely use these drugs,” FDA Commissioner Margaret Hamburg said during a press call.

But critics cite a number of problems with the guidance, including its reliance on industry sponsorship of education, even with middle-man medical education companies. Also, extended-release and long-acting opioid analgesics training will not be mandatory for prescribers.

Finally, the program will not cover powerful short-acting opioids such as hydrocodone (Vicodin) that have an equally high potential for abuse.

“These educational programs are likely going to do more harm than good,” said Andrew Kolodny, MD, chair of psychiatry at Maimonides Medical Center in New York City. “Nowhere does it say that prescribers should tell patients these drugs are addictive. And these programs give the implied message that there’s evidence for using opioids in long-term, noncancer chronic pain.”

The Supreme Court Speaks, Health Reform Continues

My editorial on the health reform law has been posted as part of the new issue of Health Insights Today, here. There’s a focus on the potential effects of the law for chiropractic and CAM, along with broader societal effects that will come with implementation (or repeal).

I hope you all click through to the full editorial. Here’s an excerpt.

First, the landmark provider nondiscrimination rule, Section 2706:

Since most readers of Health Insights Today have a strong interest in chiropractic and complementary and alternative medicine (CAM), let’s begin with the provisions directly related to those fields. First and foremost, the Affordable Care Act’s Section 2706 enacts for the first time a nationwide provider nondiscrimination policy, prohibiting insurance companies from denying coverage based on provider type for services provided by licensed health care practitioners. For example, this policy appears to indicate that if spinal manipulation or acupuncture (or any other service within a practitioner’s scope of practice) is covered when performed by a medical or osteopathic physician, insurers cannot have a policy denying such coverage when the service is performed by a chiropractor or acupuncturist. In the past, such discriminatory policies have had the effect of routing patients away from DCs, LAcs and other non-MD/DO practitioners.

The nondiscrimination rule is a landmark step forward and marks the first time that legislation applies such a policy across the entire nation. However, it does not bar all forms of discrimination. Importantly, insurers are not barred from paying some types of practitioners more than others for the same services. Chiropractors and a variety of other non-MD/DO practitioners sought such a ban but did not achieve it in this legislation. Success on that front will have to wait until later.

The full ramifications of Section 2706 will become clearer over time, as uncertainties are resolved through state and/or federal regulatory actions or litigation. For now, it is seen by chiropractic and CAM leaders and attorneys as the most significant piece of federal legislation in many years. The American Medical Association House of Delegates approved a resolution at its June 2012 national meeting that calls for the repeal of the nondiscrimination policy. While vigilance on the part of chiropractic and CAM organizations remains necessary, this AMA repeal effort faces a steep uphill climb unless the November 2012 election brings a president, House, and Senate that repeals the entire Affordable Care Act. Senate Republican Leader Mitch McConnell and House Speaker John Boehner have pledged to seek full repeal in early 2013. 

I ask each of our readers … please familiarize yourself with what is in the law, so that you will be able to evaluate all claims — pro or con — based on facts rather than distortions.  

 

 

 

Despite Decline in Meat Consumption, America Is Still #1

Per capita meat consumption is not one of the categories where you want to lead the world, if you’re concerned about the health of your people.

Agricultural subsidies and other policies that continue to encourage overconsumption are damaging to the environment, our health, and, of course, the animals.

Americans are eating less and less meat: Consumption is projected to drop 12.1 percent just between 2007 and 2012.

That being said, we still eat a lot of meat, about three times more than your average Ukrainian and 12 times more than a Bangladesh resident. In fact, the United States holds the title for highest per capita meat consumption, just barely edging out Australia. Here’s what that looks like in map form, via NPR:

Drug Company Corruption, Pfizer Edition

The level of pharmaceutical company corruption is breathtaking.

A research director for Pfizer was positively buoyant after reading that an important medical conference had just featured a study claiming that the new arthritis drug Celebrex was safer on the stomach than more established drugs.

“They swallowed our story, hook, line and sinker,” he wrote in an e-mail to a colleague.

The truth was that Celebrex was no better at protecting the stomach from serious complications than other drugs. It appeared that way only because Pfizer and its partner, Pharmacia, presented the results from the first six months of a yearlong study rather than the whole thing.

The companies had a lot riding on the outcome of the study, given that Celebrex’s effect on the stomach was its principal selling point. Earlier studies had shown it was no better at relieving pain than common drugs — like ibuprofen — already on the market.

 

As We Await the Supreme Court Health Care Decision, Remember the Impact on Individual Lives

From today’s New York Times:

His wife called every major insurance company she found on the Internet, but none would cover him: His cancer was a pre-existing condition. In desperation, the Richters agreed to pay half their hospital bill, knowing they could never afford it on their combined salaries of $36,000 a year.

No other group of Americans faces higher stakes in the impending Supreme Court ruling on the Affordable Care Act than those with pre-existing conditions. The law, once its major provisions take effect, would prohibit insurance companies from turning people away or charging them more because they are sick. In exchange, most Americans would be required to have insurance, broadening the base of paying customers with an infusion of healthy people. Those who did not buy insurance would be subject to financial penalties.

The Government Accountability Office estimates that 36 million to 122 million adults under 65 have a pre-existing condition. As many as 17 million do not have insurance. Many try to buy coverage on the individual market, but in most states that is either impossible or too costly.

 

Gambling with Our Genetic Future: GMOs and the World Food Supply

This interview with Jeffrey Smith appears in the June 2012 issue of Pathways, a Washington, DC, community quarterly. The web version here includes a list of references at the end which is not included in the print version.

Jeffrey M. Smith is a consumer advocate who has written extensively about genetically modified organisms (GMOs). As executive director of the Institute for Responsible Technology, he advocates against their inclusion in the food supply.

In this interview with Dr. Daniel Redwood, Smith describes the scientific studies that raise red flags about the safety of GMOs; several European nations’ current bans on GMOs in foods and how their regulatory processes differ from the United States; the British scandal in which veteran scientist Arpad Pusztai’s work was suppressed until revealed by a Parliamentary inquiry; court documents revealing that FDA scientists were overruled by a political appointee to allow the first introduction of GMOs into the U.S. food supply in the 1990s; and the revolving door that has allowed a top Monsanto official to rotate back and forth multiple times between corporate and regulatory positions of power in the U.S. federal government.

Smith also explains that as a non-scientist writer and advocate, he follows a policy of having his writing reviewed for accuracy by at least three scientists prior to publication.

Smith’s first book was Seeds of Deception: Exposing Industry and Government Lies about the Safety of the Genetically Engineered Foods You’re Eating. His second, the comprehensively documented Genetic Roulette: The Documented Health Risks of Genetically Engineered Foods, covers research linking GMOs to a wide variety of health risks in humans and animals. In his foreword to Genetic Roulette, former UK Environment Minister Michael Meacher writes, “This is a brilliant book which combines shrewd dissection of the true nature of GM technology, a devastating critique of the health and environmental hazards of GM crops, and scarifying examples of the manipulation of both science and the media by the biotech industry.”

Jeffrey Smith has lectured in 30 countries and has been quoted in The New York Times, Washington Post, BBC World Service, Nature, The Independent, Daily Telegraph, New Scientist, The Times (London), Associated Press, Reuters News Service, LA Times, Time Magazine and Genetic Engineering News. His radio and TV appearances have included BBC, NPR, Fox News, Democracy Now and the Dr. Oz Show. He writes an internationally syndicated column, Spilling the Beans, and has a regular blog on The Huffington Post.

Pulitzer Prize winning ecological poet and essayist Gary Snyder was once asked what he feared most. This was a broad question—his answer could have been Alzheimer’s, starvation, fascism or anything else. His answer was, “Contamination of the gene pool.” You’ve devoted your life to this issue. To begin at the beginning, what is a genetically modified organism and how do these GMOs become part of the food supply?

GMOs are organisms—plant, animal, etc.—where genes from the DNA of one species are forced into the DNA of other species. In our food supply, foods like soybeans and corn have been genetically engineered with bacteria genes, allowing the crop to withstand doses of herbicide, or in the case of corn, to also produce their own toxic pesticide.

They were introduced into our food supply through deception and manipulation. The person in charge of policy at the FDA was Michael Taylor, the former attorney to biotech giant Monsanto, who claimed in the policy of the FDA that the agency was not aware of information showing that these foods were significantly different. Therefore, companies like Monsanto, who had previously told us that PCBs, Agent Orange and DDT were safe, were able to determine whether their GMOs were safe–no safety studies were required. They can introduce a new GMO without having to tell the FDA or consumers.

But documents made public from a lawsuit, Alliance for Biointegrity v. Shalala, revealed that the policy at the FDA was based on a lie. In fact, the overwhelming consensus among the FDA’s own scientists was that genetically modified foods were not only different but dangerous and could create hard-to-detect allergens, toxins, new diseases and nutritional problems. They had urged their superiors to require testing but were ignored.

Michael Taylor then went on to become Monsanto’s Vice President and chief lobbyist.  He is now back at the FDA as the U.S. food safety czar.

Long-Term Opioid Use Questioned at FDA Hearing

Recently, I’ve been reading and thinking a great deal about the use of prescription drugs for pain. Opioids are clearly the flashpoint for current debate.

From today’s MedPage:

Opioids used to be prescribed primarily for cancer pain and short-term relief immediately after surgery or an accident. But that changed in 1996, when the American Academy of Pain Medicine and the American Pain Society — organizations that get substantial funding from drug companies — issued a joint statement endorsing the use of opioids to treat chronic pain and claiming the risk of addiction was low.

Since then, drugs like OxyContin and Vicodin increasingly have been used to treat a wide array of chronic pain syndromes including low back pain and fibromyalgia, despite a lack of good scientific evidence to prove that their benefits outweigh potential harm when used long term. Opioids are also increasingly being prescribed to the elderly, often for chronic pain.

The Obama administration has called the current prescription drug abuse epidemic a “public health crisis” worse than the crack and heroin epidemics of past decades. In 2007, there were 28,000 deaths from prescription drug overdoses — five times the number in 1990. Those deaths were driven largely by the abuse of prescription painkillers. Painkiller abuse now matches abuse of illegal drugs.

“[Opioids’] increasing use has resulted in a clearly unacceptable increase in addiction, overdose, and death,” Douglas Throckmorton, MD, deputy director for regulatory programs at FDA’s Center for Drug Evaluation and Research, said at the meeting.

But the meeting didn’t focus on safety concerns with opioids; rather, it focused on efficacy and effectiveness, and attendees discussed the existing evidence to support giving pain patients opioids long term.

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