Sara here. My Danish grandmother will be horrified by this post, but in my selfless devotion to you Apples, I’m taking that risk.
And so, I have to ask: What is up with Denmark? (Huh? you ask. Just go with me on this.) I’ve noticed a strange trend over the last decade. This could be my own erroneous inductive research here – in fact, I actually hope so – but the Land of Lutefisk seems strangely supportive of Big Pharma and the status quo (sorry, Grams).
First, two years ago, I heard about some “landmark” studies that came out of Old Dansk announcing that there is absolutely no link between autism and vaccinations containing thimerosal (a form of mercury). Nevermind that autism rates sharply increased around the same time that vaccines started being preserved with thimerosal. Nevermind that mercury poisoning symptoms and autism symptoms are virtually indistinguishable. Now, to be fair, the mercury/autism debate is hugely controversial precisely because we don’t have a definitive answer yet. I suspect the eventual conclusion may implicate thimerosal, at least as part of the equation.
But, then, there was the fish study. Once again, researchers in Denmark came up with – er, concluded – that fish oil does not help those interested in reducing their heart disease risk. The study was a review, which is right up there with questionnaires in terms of scientific accuracy. Even worse, it was a review of cohort studies (cohort studies can have major problems with causation vs. correlation). Moreover, reading the fine print (not just the abstract), what the study essentially “discovered” was that people who are at a high risk for heart problems do benefit from fish oil, while people who are at a low risk do not. Now, think about that. In other words, people who don’t have a problem will not benefit from a solution. Kind of like how my grease-cutting counter disinfectant won’t do a great job of cleaning my freshly-scrubbed counters, either. But after this study was reported in the European Journal of Clinical Nutrition, amazingly, what got media attention was that fish consumption just doesn’t help heart issues. No one got excited about the additional finding that high-risk people can help their hearts with fish oil – just 40 to 60 mg a day can help! (That’s actually okay, since there are already hundreds of rigorously-conducted studies proving fish oil is good for reducing your heart disease risk.)
The lesson: Apparently, 1) Create a study following less-than-ideal methodology, 2) determine absolutely nothing from it, and 3) leave out the important part and splash the meaningless part all over the news. Hey, if it looks like a duck…it might be a Danish study.
Now, since then, there have been some pro-fish studies, so I’m willing to give the motherland the benefit of the doubt. Although I have seen several other pro-dairy, pro-drug, pro-status quo studies from Denmark, I will withhold judgment until more evidence presents itself.
Except, now, hot off the presses, an authoritative announcement out of – you guessed it – Denmark: cell phones do not have any negative effect on the brain. Scientists in Copenhagen compared over 400,000 Danish cell phone users to the rest of the Danish population. They say that there was no compelling data to indicate that cell phone users had any greater risk of cancer or brain abnormalities. This does seem to confirm what the majority of cell phone studies have already concluded (except ones like this). The electromagnetic rays emitted by cell phones haven’t been found to have any impact on our DNA or cell structure. Fair enough.
But I’m watching you, Denmark.
Pfizer announced yesterday that they were abandoning their newest “miracle drug”, torcetrapib. Rolls off the tongue, doesn’t it? Torcetrapib.
Turns out that in a recent large-scale controlled study, “rolls-off-the-tongue” killed more people than even the previous miracle drug, Lipitor. Pfizer had invested over $800 million in their most recent attempt to stem the rise of heart attacks and stroke by lowering cholesterol.
The main focus of torcetrapib was to raise HDL (the “good” cholesterol that has been shown to reduce fatty plaque formation on arterial linings). Since Lipitor is coming off patent soon, Pfizer needs a new blockbuster to fill the income pipeline – now at $51 billion a year. Meanwhile, news wire services are suggesting that this is a huge setback for millions with heart disease who have been awaiting another magic pill to reverse the damage brought on by poor lifestyle choices.
Here’s the deal: as long as the medical community continues to approach heart disease by promoting cholesterol reducing drugs, they will fail.
Cholesterol is not necessarily the bad guy here. It is the inflammatory processes of C-reactive protein and homocysteine, occurring within the arterial walls, that begin the process of coronary artery disease. These inflammatory processes are the real culprits. Cholesterol production is merely the response mechanism! Attempting to avert heart problems by reducing cholesterol is literally akin to removing scabs from wounds as they try to heal. (If that analogy turns your stomach, you’ll have an inkling as to how sickened I am by Big Pharma.)
The root cause of inflammation is a combination of poor diet, sloth and stress. The good news is that most cardiovascular disease is completely preventable and largely curable without side effects.
Cholesterol is the unfortunate scapegoat in all this. It’s a shame, because this endlessly-eviscerated lipid is one of the body’s most useful and dynamic substances. Among other duties, it’s a necessary component of every cell membrane and it’s involved in hormone production. The body makes about 1400 mg a day just to keep reserves up. Unfortunately, when you have a stressful lifestyle, toss in a bad diet and lack of exercise and you can get an inflammatory process within the arteries that causes lesions on arterial walls. The inflammation problem is completely unrelated to amounts or types of cholesterol.
Nevertheless, the ever-inventive human body adapts to this inflammation sequence by using cholesterol as a band-aid to cover up the lesions until healing can take place – which, of course, almost never happens since most of us keep living the inflammatory lifestyle with little regard for how destructive it is. We’re inflammation rock stars.
Eventually, the cholesterol band-aids harden (sclerosis), narrow the arteries and sometimes break off, causing a heart attack or stroke. Of course, we blame the cholesterol for all this and embark on a national campaign to rid the body of this important substance by dousing everyone with drugs, instead of focusing on the foods (and other stresses) that promote inflammation in the first place. And these drugs have some pretty nasty side effects. And yet, we continue to worship at the idol’s altar.
Bottom line: In my opinion, diet, exercise, stress reduction and prudent supplementation should be the primary focus of any primary care physician.
UPDATE 12/11/06: Another interesting analysis.
Until we make it stop. If you’re interested in learning more about just how cozy-cousin Congress and drug
lords lobbyists are, check out this article. While not hot off the presses, it’s completely relevant and still accurate. 2006 numbers aren’t in just yet.
Lying, Twisting and Manipulating: The Statistics Game Drug Companies Play
Faced with high insurance rates, long hours, endless paperwork, and high-pressure demands, doctors don’t have an easy time of it. If you’re blessed enough to have a thoughtful, proactive, cautious M.D., let them know, by all means. Doctors are inundated with free drug samples, bonuses and perks from Big Pharma, and even the most well-intentioned practitioner can face dilemmas.
Case in point: even the most careful doctors are getting misleading information from many medical journals.
It’s one of the most serious problems facing healthcare and medicine today. Scientists and medical experts are expressing increasingly loud concerns about the ethical standards of medical publications. Some journals and publications have essentially become an extended limb of advertising for drug companies.
The problem isn’t just in the expensive pharmaceutical ads that provide a means of financial survival for scientific and medical news publications.
Many of the studies themselves are funded directly by pharmaceutical companies, making the journals de facto supporters of such companies. Or, doctors participating in the studies also serve positions in various companies.
It’s troubling enough that independent news sources, supposedly impartial and peer-reviewed by other scientists and medical experts, are vulnerable. But even government agencies aren’t immune. The CDC, FDA and NIH have all faced huge criticism in recent years for obvious conflicts of interest.
How is Big Pharma getting away with this? Simple: we let them.
Here is what frequently occurs:
For starters, when companies fund studies of their own drugs – big shock – there are almost never unfavorable results.
When there are, they’re simply omitted, or a new study is funded. A fairly recent review found that when a study is funded by the company producing the drug, positive results happen four times more often than when impartial studies by independent researchers are conducted.
According to the Public Library of Science, an impartial public access resource (check it out in my Daily Reads at right), “between two-thirds and three-quarters” of the studies reported in the top journals are paid for by pharmaceutical companies.
According to the Library, companies aren’t bold enough (or unwitting enough) to skew the results. They simply ask questions they know will yield the “right” results. How convenient.
Another problem: even though journals are usually reviewed by colleagues, if companies are using the same study again and again, but presenting it in different ways, editors have no way of knowing. Editors try to maintain strict ethical integrity, but it can be next to impossible to know the origin, conflicts or “right questions” involved in some studies.
Before I started Primal Nutrition, I served a stint as an editor of a large national health magazine, and I certainly empathize with editors – as my staff knows all too well, information is always changing and getting to the truth is a ceaseless quest that demands constant vigilance. Of course, the truth is worth it. The stakes – Americans’ health – are too high.
Clearly, this is frustrating for anyone who’s even remotely health-minded and trying to arm themselves with the right information about health. If drug companies are paying for studies in order to get certain results, how safe, really, are these drugs? (Yet stevia must be sold as a skin-care treatment.)
There are several ways pharmaceutical companies get around the suspicions of journals and experts:
- They often test their new drug against an old one already proven to be useless or inferior.
- They test their drug against a weaker dose of the competitor’s drug (or a stronger dose, if there are side effects).
- They sponsor ongoing trials and pick information at points where results are most favorable.
- They sponsor tiny trials that only study a few people or a specific group of people.
My biggest contention is what I call the Statistics Game. Crass manipulation of statistics happens more than any of us wants to know. For example, a drug company will study 1,000 people with a particular illness or disease. Let’s say 6 of the 1,000 died. The company then creates a drug that reduces that number to 3. You can guess what the headline will say (because the company will provide the media with it): “Deaths cut by 50% with new drug!” when the real headline should say: “.3% die instead of .6%” or, better yet, no headline at all, because three people out of 1,000 is not even close to being statistically significant. Statistical significance is a benchmark standard in all science. In medicine, 15% is typically what’s required to be considered worthy of any attention, funding or recommendation. You can see where the Statistics Game gets manipulated here.
In other words, using my example (which, unfortunately, is all too real), what doctors should say is:
“If you don’t take this drug, you will be among the 994 of 1,000 that still live regardless. If you do take this drug, you will suffer a loss in quality of life, put up with side effects and complications and will be among 997 of 1,000 that live.”
What can you do?
First and foremost, seek a preventive lifestyle that avoids the need for possibly harmful medications. Vitamins, antioxidants, a fiber-rich diet, and daily exercise are proven, in hundreds upon hundreds of ethically-conducted studies, to be the best course in your journey towards good health.
Every month, new research from prevention-minded resources like the American Journal of Clinical Nutrition and the Public Library of Science reveal that simple lifestyle changes like exercise, diet, supplements and stress management are the true keys to unlocking great health.
Simply losing weight can halve your risk of diabetes, heart disease and other common health concerns. Doctors say the majority of arthritis sufferers would benefit if they just exercised on a daily basis. The vast majority of heart attack victims could help avoid these life-threatening incidents by simply reducing inflammation. (Ways to do this include taking Omega-3 fish oil supplements and exercising, in addition to cutting out alcohol, stress, smoking and high salt intake.)
Of course, I’m on a relentless mission to help you get started in the right direction. One way I can do that is to share my knowledge of studies with you. Here’s what I personally look for: studies that are reasonably controlled, have a variety of patients, and examine a large enough number of individuals over a long enough time period. I watch for drug company sponsorships in the hundreds of studies published every month, and my goal is always to separate the health from the hype. (One of my favorites: the big dairy campaign that claims three daily servings of milk or cheese will help you lose weight. Want to know what that was based on? A University of Tennessee study, funded by the Dairy Industry. The results? Even with Big Dairy backing the study, the average difference in weight loss between dairy-dieters and non-dairy participants was two pounds. Yes, two whole lb’s, folks. Unless you’re a five-year-old, I think many of us could lose that by skipping a dinner or two.)
Finally, you are your own best judge. Only you can decide what is best for your health. If something seems too good to be true, or appears to be a band-aid solution, it probably is. There’s no short-cut, drug or device that can give you good health. On the other hand, good health isn’t about deprivation or misery, either. It’s about smart daily decisions over a lifetime.
To do this, you don’t need to be a scientist or doctor – as this post shows, even the experts are vulnerable to biased influence. Let common sense be your guide and a positive, preventative lifestyle, your approach. And tell me what you think.
Technorati Tags: Big Pharma, pharmaceutical, medical journals, medical studies, medicine, FDA, pharmacology, reduce risk, diabetes, heart disease, arthritis, prevention, inflammation, obesity, CDC, Public Library of Science, PLoS
Something I read in the New York Times the other day got me steamed faster than fresh spinach. Apparently, fish oil prescriptions are not only standard practice in Europe – they’re handed out like candy corn on Halloween – but heart patients who don’t get a prescription can actually sue for malpractice.
Pure fish oil is so clearly supported by the international body of science that European doctors who don’t prescribe the stuff to anyone worried about their cardiovascular health are considered grossly incompetent.
Hundreds of peer-reviewed studies support fish oil for great health. Some of the healthiest peoples in the world – from Japan to the Mediterranean – rely heavily on fish fats for great health. Fish oil = better body is not some radical new idea, but try telling that to the American health business. Er…health establishment.
Now, this doesn’t really surprise me; after all, the safest, longest-lasting, most effective, non-drug form of birth control favored in Europe and tested safe for decades is also basically nonexistent here in the Fabulous 50. America may have the best life-saving surgery techniques in the world, but when it comes to basic illness recovery or health maintenance, one would think fish oil must be some risky, mind-altering substance right up there with caffeine and alcohol. The difference being those are both substances prescribed by doctors.
I’m not asking a lot of our federal government. I know they have lobbyists to cuddle. But would it kill anyone over at the FDA or the N.E. Journal of Medicineyness to admit that fish oil has excellent therapeutic properties for people in general and heart patients in particular, and – gasp – recommend prescribing the stuff? They accept the data. Why not recommend?
Here’s the part of the article that really burned my mocha:
“For example, on Solvay Pharmaceutical’s Web site for Omacor (a Euro fish oil supplement), the first question a user sees is ‘Are you a U.S. citizen?’
If the answer is yes, the user is sent to a page where heart attacks are not mentioned.”
I’m so thrilled with our government for censoring accurate scientific information about cardiovascular health on a European company’s website so we citizens can remain both ignorant and unhealthy. Fish fat in its pure form is vital to cardiovascular health, brain health, and the strengthening of the linings of cells. Considering the damage that free radicals and inflammation whack cells with every day, and the difficulty in getting low-mercury fish filets at the local market, wouldn’t recommending and even prescribing fish oil be a prudent thing for the medical “establishment” to do?
Thanks to Elisabeth Rosenthal at the Gray Lady (the Times) for this piece. To the rest of you, get thee to a fish oil supplement, stat!
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