Archive for the ‘Health’ Category
Extremely interesting article by Elizabeth Kolbert in the New Yorker:
The black rat—also known as the ship rat, the roof rat, and the house rat—is actually gray. It has large ears and a tail that’s longer than its body. The black rat (Rattus rattus) probably evolved in tropical Asia, and then was spread around the world by humans—first by the Romans and later by European colonists. According to Juliet Clutton-Brock, the author of “A Natural History of Domesticated Mammals,” it has been blamed for causing “a greater number of deaths in the human species than any natural catastrophe or war.” But perhaps the rat has gotten a bad rap?
A paper published the other day in the Proceedings of the National Academy of Sciences, which quickly made headlines all around the world, argues that the prevailing theory of how the Black Death spread is unfair to rats. Really, the authors of the study contend, the animal responsible was a Central Asian species like the great gerbil. (Great gerbils are only distantly related to the fuzzy rodents that American kids keep as pets, though they may look a lot alike to parents.)
The authors of the study were trying to address one of the mysteries about the Black Death. Why, after killing something like twenty-five million people in Europe in the mid-fourteenth century, did outbreaks of plague keep flaring up and then dying down again? (The Great Plague of London, in the mid-seventeenth century, killed roughly a fifth of the city’s population.) The prevailing theory is—or was—that bacteria responsible for the plague, Yersinia pestis, lived on Europe’s black-rat population. The rats transmitted the bacteria to fleas, which, episodically, transmitted them to humans. But the scientists who conducted the PNAS study concluded that there were no “permanent plague reservoirs in medieval Europe.”
Instead, they posit, the plague bacterium kept being reintroduced to Europe from Asia, where it lived on the native rodent populations. They came to this conclusion after comparing tree-ring records from Europe and Asia with records of plague outbreaks. What they found was that plague seemed to show up at port cities in Europe several years after climate conditions favored a burst of population growth among rodents in Central Asia. (This theory does not completely exonerate black rats, as they would still have helped their Asian rodent brethren spread the disease once it reached Europe.)
“We show that, wherever there were good conditions for gerbils and fleas in Central Asia, some years later the bacteria shows up in harbor cities in Europe and then spreads across the continent,” one of the authors of the study, Nils Christian Stenseth, a biologist at the University of Oslo, told the BBC.
Plague is no longer a worry in Europe, although there are still occasional outbreaks in other parts of the globe. What’s perhaps the most important insight from the study has little to do with Yersinia pestis or giant gerbils. It’s that climate and human health are, in significant though often roundabout ways, related. As the climate changes, this has important—and, at the same time, hard to predict—implications.
The list of diseases (and disease vectors) that could potentially be affected by climate change is a long and various one. It includes tick-borne diseases, such as Lyme disease, and mosquito-borne diseases—dengue fever, West Nile virus, malaria. It also includes waterborne diseases, such as cholera, and fungal diseases, such as valley fever. An upcoming issue of Philosophical Transactions B, a journal of Britain’s Royal Society, is wholly devoted to the subject of “climate change and vector-borne disease.”
Rising temperatures may already be contributing to the spread of some diseases, like . . .
You may recall that Dana Perino, Press Secretary to George W. Bush, assured us that global warming would reduce illnesses overall because winters would not be so severe. I wonder if she is helping out with this research.
They’ve changed their recommendations in light of evidence, but no apologies for the years of bad advice they previously disseminated. Nina Teicholz writes in the NY Times:
FOR two generations, Americans ate fewer eggs and other animal products because policy makers told them that fat and cholesterol were bad for their health. Now both dogmas have been debunked in quick succession.
First, last fall, experts on the committee that develops the country’s dietary guidelines acknowledged that they had ditched the low-fat diet. On Thursday, that committee’s report wasreleased, with an even bigger change: It lifted the longstanding caps on dietary cholesterol, saying there was “no appreciable relationship” between dietary cholesterol and blood cholesterol. Americans, it seems, had needlessly been avoiding egg yolks, liver and shellfish for decades. The new guidelines, the first to be issued in five years, will influence everything from school lunches to doctors’ dieting advice.
How did experts get it so wrong? Certainly, the food industry has muddied the waters through its lobbying. But the primary problem is that nutrition policy has long relied on a very weak kind of science: epidemiological, or “observational,” studies in which researchers follow large groups of people over many years. But even the most rigorous epidemiological studies suffer from a fundamental limitation. At best they can show only association, not causation. Epidemiological data can be used to suggest hypotheses but not to prove them.
Instead of accepting that this evidence was inadequate to give sound advice, strong-willed scientists overstated the significance of their studies.
Much of the epidemiological data underpinning the government’s dietary advice comes from studies run by Harvard’s school of public health. In 2011, directors of the National Institute of Statistical Sciences analyzed many of Harvard’s most important findings and found that they could not be reproduced in clinical trials.
It’s no surprise that longstanding nutritional guidelines are now being challenged.
In 2013, government advice to reduce salt intake (which remains in the current report) was contradicted by an authoritative Institute of Medicinestudy. And several recent meta-analyses have cast serious doubt on whether saturated fats are linked to heart disease, as the dietary guidelines continue to assert.
Uncertain science should no longer guide our nutrition policy. Indeed, cutting fat and cholesterol, as Americans have conscientiously done, may have even worsened our health. In clearing our plates of meat, eggs and cheese (fat and protein), we ate more grains, pasta and starchy vegetables (carbohydrates). Over the past 50 years, we cut fat intake by 25 percent and increased carbohydrates by more than 30 percent, according to a new analysis of government data. Yet recent science has increasingly shown that a high-carb diet rich in sugar and refined grains increases the risk ofobesity, diabetes and heart disease — much more so than a diet high in fat and cholesterol.
It’s not that health authorities weren’t warned. “They are not acting on the basis of scientific evidence, but on the basis of a plausible but untested idea,” Dr. Edward H. Ahrens Jr., a top specialist at Rockefeller University and prominent critic of the growing doctrine on dietary fats and cholesterol, cautioned back in the ’80s. In the face of urgent pressure to offer a solution to the rising tide of heart disease, however, he turned out to be the Cassandra of his day.
Today, we are poised to make the same mistakes. . .
Amanda Zamora and Terry Parris Jr. report at ProPublica with links to Muck Reads. The first few:
“Illegal … immoral … ineffective … unconstitutional.” That is how the deputy commander of a now-defunct Guantanamo task force described the interrogation tactics of Richard Zuley, a Navy reserve lieutenant who was known for extracting intelligence from his subjects through prolonged shackling, threats against family members and sleep depravation. The Guardian traced some of Zuley’s methods at Gitmo to the police precincts of Chicago, where his detective work helped put at least one innocent man in prison and has generated serious allegations of abuse. Zuley declined to comment. — The Guardian via @attackerman @guardianus [This one is amazing, and reflects the sorry state of American police departments. – LG]
It’s called popcorn lung. Diacetyl — used to flavor items like candy, coffee, chips and increasingly popular e-cigarettes — has been linked to hundreds of injuries and at least five deaths among workers in popcorn factories and flavoring companies over the last 15 years. When inhaled in large, concentrated amounts, it can obliterate your lungs, experts say. Researchers and regulators have known about the harmful affects of the chemical for years, but the National Institute of Occupational Health and Safety has issued nothing more than an advisory bulletin to manufacturers on how to reduce exposure. And while most studies focus on the nicotine risks of e-cigarettes, one study found nearly 70% of flavored “smoke juice” contained diacetyl. “These are avoidable risks,” said one researcher. — The Milwaukee Journal Sentinel via @john_diedrich
Surprise? “Consumer protection rules rarely apply to government debts.”Government agencies are outsourcing debt collection to private firms for things like unpaid taxes, parking tickets and traffic tolls. Although these are government debts, consumer protection laws usually don’t bind the private firms collecting against them. One of those firms is Linebarger Goggan Blair & Sampson, which “has gone so far as to argue it has immunity because it is an extension of the government,” CNN Money reports. These firms have “the power to threaten debtors with the suspension of their driver’s license, garnishment of their wages, foreclosure and arrest to get them to pay up.” They are also able to charge debtors directly, while consumer creditors collect fees from the debt itself. — CNN Money via @MarkObbie
The ‘Watchtower’ will decide which abusers are predators. Internal documents portray a religious hierarchy more concerned with protecting its members from criminal prosecution than from sexual abuse. The Watchtower Bible and Tract Society of New York, which governs Jehovah’s Witnesses around the world, has repeatedly instructed church elders to handle allegations of sexual abuse against children in secret, and to “avoid unnecessary entanglement with secular authorities who may be conducting a criminal investigation.” In a written statement, church officials told Reveal they “continue to educate parents and provide them with valuable tools to help them educate and protect their children.” — Reveal via @Rachael_Bale . . .
And there are more. Click the link.
Apparently the admission of an egregious error—making dietary recommendations based on fad rather than evidence—is only implicit: no mea culpa to be seen. Still it is progress. How many people were driven to a high-carb diet (with the various problems that creates) by the government recommendations unsupported by evidence? How many people devoured trans fats (e.g., margarine) based on government recommendations unsupported by evidence?
The USDA did enormous damage, and so far as I can tell they are not really concerned about that. “Look forward, not back” is always the motto of those who have a done a grievous wrong. (For an evidence-based diet, see this post.)
Peter Whoriskey reports in the Washington Post:
The nation’s top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption.
The group’s finding that cholesterol in the diet need no longer be considered a “nutrient of concern” stands in contrast to the committee’s findings five years ago, the last time it convened. During those proceedings, as in previous years, the panel deemed the issue of excess cholesterol in the American diet a public health concern.
The finding follows an evolution of thinking among many nutritionists who now believe that, for healthy adults, eating foods high in cholesterol may not significantly affect the level of cholesterol in the blood or increase the risk of heart disease.
The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.
The new view on cholesterol in food does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.
While Americans may be accustomed to conflicting dietary advice, the change on cholesterol comes from the influential Dietary Guidelines Advisory Committee, the group that provides the scientific basis for the “Dietary Guidelines.” That federal publication has broad effects on the American diet, helping to determine the content of school lunches, affecting how food manufacturers advertise their wares, and serving as the foundation for reams of diet advice. . .
And it points the finger squarely at the media, which seems to be run by ratings-chasing idiots. Listen here.
Before going further, read this article by Wyl S. Hylton in the New Yorker. It begins:
Late one night in September of 2013, Rick Schiller awoke in bed with his right leg throbbing. Schiller, who is in his fifties, lives in San Jose, California. He had been feeling ill all week, and, as he reached under the covers, he found his leg hot to the touch. He struggled to sit upright, then turned on a light and pulled back the sheet. “My leg was about twice the normal size, maybe even three times,” he told me. “And it was hard as a rock, and bright purple.”
Schiller roused his fiancée, who helped him hobble to their car. He dropped into the passenger seat, but he couldn’t bend his leg to fit it through the door. “So I tell her, ‘Just grab it and shove it in,’ ” he recalled. “I almost passed out in pain.”
At the hospital, five employees helped move Schiller from the car to a consulting room. When a doctor examined his leg, she warned him that it was so swollen there was a chance it might burst. She tried to remove fluid with a needle, but nothing came out. “So she goes in with a bigger needle—nothing comes out,” Schiller said. “Then she goes in with a huge needle, like the size of a pencil lead—nothing comes out.” When the doctor tugged on the plunger, the syringe filled with a chunky, meatlike substance. “And then she gasped,” Schiller said.
That night, he drifted in and out of consciousness in his hospital room. His temperature rose to a hundred and three degrees and his right eye oozed fluid that crusted over his face. Schiller’s doctors found that he had contracted a form of the salmonella bacterium, known as Salmonella Heidelberg, which triggered a cascade of conditions, including an inflamed colon and an acute form of arthritis. The source of the infection was most likely something he had eaten, but Schiller had no idea what. He spent four days in intensive care before he could stand again and navigate the hallways. On the fifth day, he went home, but the right side of his body still felt weak, trembly, and sore, and he suffered from constant headaches. His doctors warned that he might never fully recover.
Three weeks later, Schiller received a phone call from the Centers for Disease Control and Prevention. An investigator wanted to know whether he had eaten chicken before he became sick. Schiller remembered that he’d bought two packages of raw Foster Farms chicken thighs just before the illness. He’d eaten a few pieces from one of the packages; the other package was still in his freezer. Several days later, an investigator from the U.S. Department of Agriculture stopped by to pick it up. She dropped the chicken into a portable cooler and handed him a slip of paper that said “Property Receipt.” That was the last time Schiller heard from the investigators. More than a year later, he still wasn’t sure what was in the chicken: “I don’t know what the Department of Agriculture found.”
Each year, contaminated food sickens forty-eight million Americans, of whom a hundred and twenty-eight thousand are hospitalized, and three thousand die. Many of the deadliest pathogens, such as E. coli and listeria, are comparatively rare; many of the most widespread, such as norovirus, are mercifully mild. Salmonella is both common and potentially lethal. It infects more than a million Americans each year, sending nineteen thousand victims to the hospital, and killing more people than any other food-borne pathogen. A recent U.S.D.A study found that twenty-four per cent of all cut-up chicken parts are contaminated by some form of salmonella. Another study, by Consumer Reports, found that more than a third of chicken breasts tainted with salmonella carried a drug-resistant strain.
By the time Schiller became infected by salmonella, federal officials had been tracking an especially potent outbreak of the Heidelberg variety for three months—it had sent nearly forty per cent of its victims to the hospital. The outbreak began in March, but investigators discovered it in June, when a cluster of infections on the West Coast prompted a warning from officials at the C.D.C.’s PulseNet monitoring system, which tracks illnesses reported by doctors. Scientists quickly identified the source of the outbreak as Foster Farms facilities in California, where federal inspectors had discovered the same strain of pathogen during a routine test. Most of the victims of the outbreak confirmed that they’d recently eaten chicken, and many specifically named the Foster Farms brand. On August 9th, investigators joined a conference call with Foster Farms executives to inform them of the outbreak and its link to the company.
Identifying the cause of an outbreak is much simpler than trying to stop one. Once officials have traced the contamination to a food producer, the responsibility to curb the problem falls to the U.S.D.A.’s Food Safety and Inspection Service, or F.S.I.S. In the summer of 2013, as the outbreak spread, F.S.I.S. officials shared the C.D.C.’s conclusion that Foster Farms meat was behind the outbreak, but they had no power to force a recall of the tainted chicken. Federal law permits a certain level of salmonella contamination in raw meat. But when federal limits are breached, and officials believe that a recall is necessary, their only option is to ask the producer to remove the product voluntarily. Even then, officials may only request a recall when they have proof that the meat is already making customers sick. As evidence, the F.S.I.S. typically must find a genetic match between the salmonella in a victim’s body and the salmonella in a package of meat that is still in the victim’s possession, with its label still attached. If the patient has already eaten the meat, discarded the package, or removed the label, the link becomes difficult to make, and officials can’t request a voluntary recall.
As the Heidelberg outbreak continued into the fall, F.S.I.S. investigators tracked down dozens of patients and asked them to search their homes for contaminated chicken. In some cases, they discovered Foster Farms chicken that tested positive for salmonella—but they could not find a genetic match. David Goldman, who oversees public health at the F.S.I.S., told me, “We started about a hundred and forty trace-back efforts. And we failed in every case.”
Meanwhile, Foster Farms was still producing chicken. By mid-September, on the week that Schiller checked into the hospital, at least fifty new patients had been infected—the most of any week since the outbreak began. On October 8th, the C.D.C. issued its first warning to the public: two hundred and seventy-eight patients had now been infected with Heidelberg in seventeen states, the agency reported, and Foster Farms chicken was the “likely source” of the outbreak. On November 15th, the C.D.C. raised the number to three hundred and eighty-nine victims in twenty-three states. By early July, 2014, there were six hundred and twenty-one cases. Scientists estimate that for each reported case twenty-eight go unreported, which meant that the Foster Farms outbreak had likely sickened as many as eighteen thousand people.
Finally, on July 3, 2014, more than a year after the outbreak began, officials at the F.S.I.S. announced a genetic match that would allow the agency to request a recall. Foster Farms executives agreed to withdraw the fresh chicken produced in its California facilities during a six-day period in March of that year. All other Foster Farms chicken would remain in distribution.
A few days later, I stopped by the office of Representative Rosa DeLauro, a Democrat from Connecticut and one of the most vocal advocates for food safety in Congress. After twenty-five years in the capital, DeLauro is not easily surprised, but when I mentioned the Foster Farms outbreak she slammed a fist on the table. “They’re getting a tainted product out!” she said. “What in the hell is going on?”
Rick Schiller wondered the same thing. Last spring, as his leg healed and the headaches faded, he searched newspapers for signs of a recall. Then he started calling lawyers. Eventually, he found Bill Marler.
During the past twenty years, Marler has become the most prominent and powerful food-safety attorney in the country. . .
And add to that this article by Lindsay Abrams in Salon:
Joe Ferguson knows better than most where Americans’ meat comes from. Before retiring last year, he spent 23 years as a USDA inspector working in beef, turkey and pork plants. It was at the latter that he first encountered the USDA’s proposed new model for pork inspections — and what he experienced there led him, last week, to publicly condemnwhat he says is a dangerously flawed program.
Working with the Government Accountability Project, Ferguson joined three other, anonymous inspectors in warning consumers about the Hazard Analysis and Critical Control Point-based Inspection Models Project — better known as HIMP — a USDA-led attempt at reform that increases line speeds while simultaneously reducing the number of USDA inspectors monitoring them.
“I am not a disgruntled former employee, nor do I have a vendetta against Hormel [the company targeted by GAP’s Change.org petition],” Ferguson said. “It’s just that I’m concerned with the way that meat inspection is going.”
In 1998, the USDA adopted the Hazard Analysis and Critical Control Point — or HAACP — model of meat inspection, the first major overhaul since the days of Upton Sinclair’s “The Jungle.” The idea was to switch the emphasis from the physical monitoring of carcasses to microbial testing, in order to better identify pathogens like E. Coli and salmonella. It was an important focus, but one that critics say consequently allows meat with defects and visible signs of contamination (think: lesions, cysts and yes, feces) to go undetected. At the same time, the program shifted the responsibility for carrying out those test from USDA inspectors to the meat pant operators themselves, a move that some argue give the industry way too much power.
Now, they’re doing it again. HIMP, Ferguson argues, intensifies those same problems: the USDA is continuing to give up control over meat inspections, while sped up lines are making it harder than ever to detect flaws. “I was skeptical initially,” he told Salon of the program’s implementation, “but then as time progressed, it was apparent that this wasn’t what they told us it was going to be.”
In his affidavit, Ferguson describes how the rapid lines made it harder than ever for him to do his job:
Line speeds are running 1,300 carcasses per hour and the company is killing as many as 19,000 hogs per day. This is a dramatic increase from previously, when they ran at about 1,100 carcasses per hour. It’s impossible to see any defects now. We used to be [allowed to] stop the line for bile contamination, chronic pleuritis, hair/toenails/scurf and have these defects trimmed/removed, uner HIMP, these are considered “Other Consumer Protections” and we are no longer allowed to stop the line so they may be remove. Put ‘em in the cooler and ultimately out to the consumer. The only time we are allowed to stop the line is for food safety concerns, and even then we get yelled at. It’s just nuts.
“I think the whole thing is misguided,” Ferguson told Salon. “They’ve got issues. They need to just start over from square one.” . . .
DietDoctor.com is a blog belonging to a Swedish physician who supports the LCHF diet. We follow this diet, with the enthusiastic support of our primary-care physician, and it has helped improve the results of various blood tests (which I get from time to time since I have type 2 diabetes). Indeed, I’ve been able to drop some meds and cut back on others—plus I like the food more.
Diet Doctor takes a look at the recent book The Big Fat Surprise and likes what he sees, particularly the takedown of the Mediterranean Diet.