Extra Credits
Published on 26 Jul 2018Pellagra can cause depression, dementia, and diarrhea, eventually leading to death. Dr. Joseph Goldberger was put on the case to crack it.
July 28, 2018
Pellagra – A Medical Mystery – Extra History
Comments Off on Pellagra – A Medical Mystery – Extra History
July 17, 2018
Juul threat
John Tierney on the good news/bad news in the most recent smoking statistics in the United States:
Tobacco-company stocks have plunged this year — along with cigarette sales — because of a wonderful trend: the percentage of people smoking has fallen to a historic low. For the first time, the smoking rate in America has dropped below 15 percent for adults and 8 percent for high school students. But instead of celebrating this trend, public-health activists are working hard to reverse it.
They’ve renewed their campaign against the vaping industry and singled out Juul Labs, the maker of an e-cigarette so effective at weaning smokers from their habit that Wall Street analysts are calling it an existential threat to tobacco companies. In just a few years, Juul has taken over more than half the e-cigarette market thanks to its innovative device, which uses replaceable snap-on pods containing a novel liquid called nicotine salt. Because the Juul’s aerosol vapor delivers nicotine more quickly than other vaping devices, it feels more like a tobacco cigarette, so it appeals to smokers who want nicotine’s benefits (of which there are many) without the toxins and carcinogens in tobacco smoke.
It clearly seems to be the most effective technology ever developed for getting smokers to quit, and there’s no question that it’s far safer than tobacco cigarettes. But activists are so determined to prohibit any use of nicotine that they’re calling Juul a “massive public-health disaster” and have persuaded journalists, Democratic politicians, and federal officials to combat the “Juuling epidemic” among teenagers.
The press has been scaring the public with tales of high schools filled with nicotine fiends desperately puffing on Juuls, but the latest federal survey, released last month, tells a different story. The vaping rate last year among high-school students, a little less than 12 percent, was actually four percentage points lower than in 2015, when Juul was a new product with miniscule sales. As Juul sales soared over the next two years, the number of high-school vapers declined by more than a quarter, and the number of middle-school vapers declined by more than a third — hardly the signs of an epidemic.
Comments Off on Juul threat
July 4, 2018
QotD: “The world is rich and will become still richer. Quit worrying”
Not all of us are rich yet, of course. A billion or so people on the planet drag along on the equivalent of $3 a day or less. But as recently as 1800, almost everybody did.
The Great Enrichment began in 17th-century Holland. By the 18th century, it had moved to England, Scotland and the American colonies, and now it has spread to much of the rest of the world.
Economists and historians agree on its startling magnitude: By 2010, the average daily income in a wide range of countries, including Japan, the United States, Botswana and Brazil, had soared 1,000 to 3,000 percent over the levels of 1800. People moved from tents and mud huts to split-levels and city condominiums, from waterborne diseases to 80-year life spans, from ignorance to literacy.
You might think the rich have become richer and the poor even poorer. But by the standard of basic comfort in essentials, the poorest people on the planet have gained the most. In places like Ireland, Singapore, Finland and Italy, even people who are relatively poor have adequate food, education, lodging and medical care — none of which their ancestors had. Not remotely.
Inequality of financial wealth goes up and down, but over the long term it has been reduced. Financial inequality was greater in 1800 and 1900 than it is now, as even the French economist Thomas Piketty has acknowledged. By the more important standard of basic comfort in consumption, inequality within and between countries has fallen nearly continuously.
Dierdre N. McCloskey, “The Formula for a Richer World? Equality, Liberty, Justice”, New York Times, 2016-09-02.
Comments Off on QotD: “The world is rich and will become still richer. Quit worrying”
May 31, 2018
QotD: Difficulties in using self-reported data
Nick Cohen, over in the Guardian, is busy telling us all that we must drink less and that Scotland raising the minimum price of alcohol (hitting poor people’s cheap cider and bargain booze, but not directly affecting craft lagers, appellation d’origine contrôlée wines and artisan gin) is a Good Thing because the industry makes its profits by exploiting addicts who are drinking themselves to death en masse.
It is a truth universally unacknowledged that, like drugs cartels, the drink industry makes most of its money from addicts. It thrives on hooked customers, who put boosting the brewers’ profits before their and their families’ health and happiness. Sixty per cent of alcohol sales – worth £27bn a year in England – are to “increasing risk” drinkers taking more than 21 units of alcohol a week, in the case of men (about 10 pints or two bottles of wine), and “harmful” drinkers taking more than 50… Twenty one units (14 for women) does not sound much in my world of journalism, but it is a sign of people who cannot go a day without a shot of their drug, which is as good a definition of an addiction as any.
Now, there’s a question there about who decided what that “risk” was and how large it was. Cohen gets into the Salvation Army-style temperance-league apocalyptic warnings about the horrors of heavy drinking and warns that by the time you’re knocking back fifty units a week (for men, thirty-five for women) you’re undergoing “full degeneration”.
But is that based on any firm evidence? One interesting study, reassuring to the toper, can be found here, which among other things makes the gentle point that since we either under-report what we consume, or we pour away half of the booze we buy undrunk, planning policy on what we admit to consuming may not be accurate.
Jason Lynch, “How Much Is ‘Too Much’?”, Continental Telegraph, 2018-05-08.
Comments Off on QotD: Difficulties in using self-reported data
April 20, 2018
Disease, War and The Lost Generation I Between 2 Wars I 1918 Part 2 of 2
TimeGhost
Published on 19 Apr 2018As World War One ends the dying takes on new proportions when the Spanish Flu ravages the world. A whole generation of young people that should be starting their adult life is instead decimated at a devastating rate. The suffering at the end of 1918 will have consequences that last until this day.
Join us on https://timeghost.tv
or on Patreon: https://www.patreon.com/TimeGhostHistoryHosted by: Indy Neidell
Written by: Spartacus Olsson and Indy Neidell
Directed by: Spartacus Olsson
Produced by: Astrid Deinhard
Executive Producers: Bodo Rittenauer, Astrid Deinhard, Indy Neidell, Spartacus OlssonA TimeGhost chronological documentary produced by OnLion Entertainment GmbH
Additional information from TimeGhost:
In the new episode of Between 2 Wars we look at death and suffering in 1918 from another source than the World War: the Spanish Flu and its effects on the young adults of the time. This is the first, but not the last episode in the Between 2 Wars series that focuses on non-military and non-geopolitical events.
To understand these decades we will look occasionally at fashion, technology, design, arts, culture and civil life in general. After all the 1920s and the 1930s is very much the time period when the world became modern in the true sense of the word.
Much of what we still consider contemporary (both things and thoughts) was created in the 20s and 30s. Already the next episode will also focus on civil life as we look at the birth of civil aviation and the radio. After that we dive right back into war with the Russian Civil War!
Comments Off on Disease, War and The Lost Generation I Between 2 Wars I 1918 Part 2 of 2
April 14, 2018
Alcohol and health – if you torture the data long enough, it will give you the answer you want
Tim Worstall isn’t convinced that a recent study summarized in The Lancet is either honest or useful:
We have a new study out, in the Lancet no less, telling us that the new, lower, limits for reasonable alcohol consumption are just right. Well, of course the report says that, right? The problem being that it’s entirely contrary to the more general experience we’ve got of booze consumption. For, yes indeedy, there’s a level of drinking which will – as always, on average – shorten life. But our experience to date is that it’s several times what is the current measure of safe consumption. This basic understanding of ours being that no booze lowers lifespan, too much lowers it, a modicum increases it. The argument being the definition of modicum of course.
Observation of large populations being that modicum is anything from some up to perhaps 40 or even 50 units a week. This isn’t what the current study shows at all […]
I’m not in any manner a medical expert but that does look odd. 5 million observation years on half a million people, looks like 10 years on average per person. They’re using this to predict lifespan at age 40? When lifespan at 40 is, these days, a further 40 to 50 years or so? OK, maybe there’s some sekkrit decoder ring for epidemiologists here but anyone want to try and explain it?
Ah:
We focused our study on current alcohol drinkers
So the comparison doesn’t include those who don’t drink. We’re not therefore getting a baseline of no alcohol consumption to compare with. That is, by design, the study excludes the known to be higher death rates (or lower lifespans) of the temperance types. No, really:
Third, never-drinkers might differ systematically from drinkers in ways that are difficult to measure, but which might be relevant to disease causation.
Our more general stats do indeed say that heavy drinkers (that 40 to 50 unit level perhaps) and never drinkers have about the same lifespans. Quick, gotta exclude that information, eh?
As far as we’re concerned that’s probably enough. We’ll see what Snowdon has to say about it, shall we? Because this finding is contrary to pretty much everything else we know about booze consumption. Explaining why it is will be important.
Update, 15 April: It’s no wonder that people are confused about the benefits and/or drawbacks of drinking…
What you end up with when drawing strong conclusions based on non-experimental data with selection bias, lots of measurement error and dodgy comparison groups. (h/t: @RadaWilinofsky) pic.twitter.com/iUZQbTh6sB
— Amir Sariaslan (@AmirSariaslan) April 14, 2018
Comments Off on Alcohol and health – if you torture the data long enough, it will give you the answer you want
April 4, 2018
The bias against reporting good news
Last month, Matt Ridley looked at the contrast between how readily bad news is shared and how reluctant we seem to be to share good news:
[…] It also feeds our appetite for bad news rather than good. Almost by definition, bad news is sudden while good news is gradual and therefore less newsworthy. Things blow up, melt down, erupt or crash; there are few good-news equivalents. If a country, a policy or a company starts to do well it soon drops out of the news.
This distorts our view of the world. Two years ago a group of Dutch researchers asked 26,492 people in 24 countries a simple question: over the past 20 years, has the proportion of the world population that lives in extreme poverty
1) Increased by 50 per cent?
2) Increased by 25 per cent?
3) Stayed the same?
4) Decreased by 25 per cent?
5) Decreased by 50 per cent?
Only 1 per cent got the answer right, which was that it had decreased by 50 per cent. The United Nations’ Millennium Development goal of halving global poverty by 2015 was met five years early.
As the late Swedish statistician Hans Rosling pointed out with a similar survey, this suggests people know less about the human world than chimpanzees do, because if you had written those five options on five bananas and thrown them to a chimp, it would have a 20 per cent chance of picking up the right banana. A random guess would do 20 times as well as a human. As the historian of science Daniel Boorstin once put it: “The greatest obstacle to discovery is not ignorance — it is the illusion of knowledge.”
Nobody likes telling you the good news. Poverty and hunger are the business Oxfam is in, but has it shouted the global poverty statistics from the rooftops? Hardly. It has switched its focus to inequality. When The Lancet published a study in 2010 showing global maternal mortality falling, advocates for women’s health tried to pressure it into delaying publication “fearing that good news would detract from the urgency of their cause”, The New York Times reported. The announcement by NASA in 2016 that plant life is covering more and more of the planet as a result of carbon dioxide emissions was handled like radioactivity by most environmental reporters.
What is more, the bias against good news in the media seems to be getting worse. In 2011 the American academic Kalev Leetaru employed a computer to do “sentiment mining” on certain news outlets over 30 years: counting the number of positive versus negative words. He found “a steady, near linear, march towards negativity”. A recent Harvard study found that 87 per cent of the coverage of the fitness for office of both candidates in the 2016 US presidential election was negative. During the first 100 days of Donald Trump’s presidency, 80 per cent of all coverage was negative. He is of course a master of the art of playing upon people’s pessimism.
Comments Off on The bias against reporting good news
March 28, 2018
QotD: Rent-seeking through “health concern” trolling
Producers too often shamelessly use whatever excuses are at hand to justify their prodding the state to prevent consumers from patronizing rival producers. Trumped-up health ‘concerns’ are a prominent set of easy excuses when the good in question is food or drink. “Those foods offered by our rivals are likely to kill or injure our beloved consumers!” cry rent-seeking producers, feigning an overriding concern for the health of the public. “For the health of our citizens, our rival producers must be stopped from selling their foul foods in our market!” Conveniently, of course, when such restrictions are implemented the favored producers no longer must compete as vigorously for consumers’ patronage. (Question: What does diminished competition do to producers’ incentives to maintain the safety of the foods they sell to the public?)
Anyway, here’s a history lesson: today’s expressed concerns about the safety of genetically modified foods and the calls for governments to restrict consumers’ freedom to buy these foods are, in their essence, nothing new. In the late-19th century similar ‘concerns’ over the safety of American beef and pork were used by some beef and pork producers to sic state restriction on rival beef and pork producers. European ranchers and farmers, disliking the competition from American ranchers and farmers, played the safety card as means of securing protection from their American rivals. Likewise within the U.S.: local butchers and local slaughterhouses throughout the U.S. played the same safety card as a means of securing protection from the upstart and wildly successful Chicago meatpackers such as Swift and Armour. That this safety card was illegitimate – that is, that charges of unsafe beef and pork were unwarranted – doesn’t matter if enough people believe the charges. The widely believed myth of dangerous foods enables the state to protect powerful producers from competition.
Cronyism and rent-seeking are nothing new. But they are perhaps becoming more widespread as the scope of state involvement in private affairs expands.
Don Boudreaux, “If Only We Could Be Protected From the Disease of Rent-Seeking”, Café Hayek, 2016-07-14.
Comments Off on QotD: Rent-seeking through “health concern” trolling
February 11, 2018
Bay area food entrepreneurs shut down by local health authorities
In Reason, Baylen Linnekin recounts the rise and fall of Josephine, an online operation intended to connect home cooks with willing buyers:
A dozen or so years ago, as my friend Dave was planning a move from Washington, D.C., to Philadelphia, he used the need to clean out his fridge before the move as an excuse to offer a half-empty jar of homemade kimchi for sale on Craigslist. While I don’t think the kimchi sold, Dave’s effort opened my eyes to the seemingly limitless possibilities of homemade online food sales.
The truth is that while those possibilities are limited theoretically only by imagination, they very often bump up in the real world against — to paraphrase Waylon Jennings — the limits of what the law will allow.
That truth was evident last week, when Bay Area food startup Josephine announced it will close its doors in March.
As I described in a Sacramento Bee op-ed in support of Josephine last year, the company launched nearly four years ago with a mission to provide cooks who are typically underrepresented in restaurant leadership — including women and immigrants — with a platform by which to sell home-cooked meals with their neighbors.
It’s a cool idea. And it worked quite well for a time. That is, as I noted, until local health officials “sent cease-and-desist letters to several Josephine cooks.”
Josephine responded by trying to work with lawmakers and regulators, pushing a bill in the state legislature that would provide some legal avenue for its cooks. Despite the fact that the bill is now moving through the California legislature, the company decided its passage would be too late for Josephine and its funders.
Josephine didn’t have to die. The regulations that have made it impossible for the company to operate should have died instead. But its fate mimics that of other similar home-food startups. A similar New York-based startup, Umi Kitchen, flamed out last year after just four months of operations. I wrote an appreciation of Forage Underground Market, the inventive San Francisco food swap that was shuttered by California state and local health authorities, way back in 2012. And I predicted at the time the food underground movement was just beginning to blossom.
Comments Off on Bay area food entrepreneurs shut down by local health authorities
February 3, 2018
February 1, 2018
Penn and Teller on Vaccinations
UltraMiraculous
Published on 20 Aug 2010
Comments Off on Penn and Teller on Vaccinations
November 22, 2017
QotD: Anti-smoking fanaticism
Whenever I am in Paris I stay near Père-Lachaise, the greatest cemetery in the world, and I always take at least one walk in it. It is, like life and literature, inexhaustible; and after all, the paths not only of glory but of journalism, too, lead but to the grave.
On the way there this time I was passed by a road-sweeping vehicle with an excellent advertisement on its side. It showed a vast pyramid of cigarette ends, with the legend “350 tons of cigarette ends per year”: the sum of such annual sweepings in Paris. This must equate to an awful lot of death.
On the matter of smoking I suffer not so much from cognitive as from emotional dissonance. On the one hand I detest the filthy habit, and whenever I see the slogan SMOKING KILLS on a discarded packet on the ground, I think, “Yes, but not quickly enough.”
On the other hand, I detest the antismokers, the Savonarolas of public health. I want people to spite them by smoking, though not in my breathing space.
Theodore Dalrymple, “Of grave concern”, Taki’s Magazine, 2016-04-02.
Comments Off on QotD: Anti-smoking fanaticism
August 17, 2017
Safe injection sites go rogue … to save lives
In the National Post, Chris Selley wonders why the federal government has been so slow to come around to accepting the overall harm reduction offered by legal safe injection sites:
I suspect this generation of policymakers, and the previous one especially, will struggle to explain to their grandchildren just what on earth they thought they were doing about opioid addiction. I don’t mean the likes of Donald Trump, who seems to think a get-tough policing approach — a “war on drugs,” perhaps — might get the job done. I mean smart, reasonably compassionate Canadians, by no means all conservatives, whose worries about safe injection sites in particular look bizarre even today, when people are still using them.
“It’ll attract rubadubs” — as if Vancouver’s Downtown Eastside was a middle-class utopia before Insite set up shop. “There’ll be needles in the streets” — more than if the safe injection site weren’t there, you mean? And, of course: “Addicts should go to treatment instead” — as if people haven’t been trying and failing to get and stay clean this whole time; as if the alternative, on a day to day basis, might be not waking up the next morning to go get treatment.
To its credit, the Liberal government in Ottawa has loosened the regulatory reins. There are nine approved “supervised consumption sites” up and running across the country: five on the Lower Mainland, one in Kamloops, and three in Montreal. Six more, in Victoria, Ottawa, Toronto and Montreal, are approved and awaiting inspections. An additional 10 are in the approval process; four in Edmonton applied more than three months ago; one in Ottawa has been in the works, officially, since February.
This looks like progress, and to a great extent it is. But on Sunday, a group of activists in Toronto implicitly asked another trenchant question: why does it take so bloody long to set up a supervised injection site? Why are we waiting? It’s just clean needles, chairs and tables, overdose treatment medication, a nurse and a phone.
Comments Off on Safe injection sites go rogue … to save lives
April 29, 2017
“Don’t count fat; don’t fret over what kind of fat you’re getting, per se. Just go for walks and eat real food”
Earlier this week, Colby Cosh rounded up some recent re-evaluations of “settled food science”:
Their first target was the Sydney Diet Heart Study (1966-73), in which 458 middle-aged coronary patients were split into a control group and an experimental group. The latter group was fed loads of “healthy” safflower oil and safflower margarine in place of saturated fats. Even at the time it was noticed that the margarine-eaters died sooner, although their total cholesterol levels went down: the investigators sort of shrugged and wrote that heart patients “are not a good choice for testing the lipid hypothesis.” Their data, looked at now, shows that the increased mortality in the margarine group was attributable specifically to heart problems.
The team’s reanalysis of the Minnesota Coronary Experiment (1968-73) is more hair-raising. This study involved nearly 10,000 Minnesotans at old-age homes and mental hospitals. The investigators had near-complete control of the subjects’ diets, and were able to autopsy the ones who died. But much of their data, including the autopsy results, ended up misplaced or ignored. Some of it disappeared into a master’s thesis by a young statistician, now a retired older chap, who helped with the 2016 paper and is named at its head as one of the authors.
In the Minnesota study, replacement of saturated fats with corn oil led, again, to reductions in total cholesterol. This finding was touted at major conferences, and it became one of the key moments in the creation of the classic diet-heart myth. This time nobody but the guy who wrote the thesis even noticed that the patients in the corn oil group were, overall, dying a little faster. The 2016 re-analysis uncovered a dose-response relationship: the more the patients’ total cholesterol decreased, the faster they died.
The Sydney and Minnesota studies themselves may have caused a few premature deaths, which is a possibility we accept as the price of science. But the limitations and omissions of the researchers, and the premature commitment of doctors to a total-cholesterol model, helped create a suspicion of saturated fats. This flooded into frontline medical advice and the wider culture, and it put margarine on millions of tables, pushed consumers toward deadly trans fats, and put millions of people with innately high cholesterol levels through useless diet austerity. The scale of the error is numbing, unfathomable.
Comments Off on “Don’t count fat; don’t fret over what kind of fat you’re getting, per se. Just go for walks and eat real food”
April 15, 2017
QotD: “Healthy” food choices
Whenever I find myself choosing my next meal I always like to look out for the sign that says “healthy option.” In this age of variety and abundance it can often be hugely difficult making up your mind as to what to eat next. “Healthy option” makes things so much easier. It tells me: “Avoid like the plague.”
Good news, then, for takeaway customers in Rochdale, Greater Manchester. No fewer than six local fish and chip shops have taken on board the advice of their local council’s Healthier Choices Manager and introduced special, non-greasy, low-fat menu options. So now when customers find themselves torn between the battered sausage, the chicken nuggets and the “rock salmon” at least they can be sure of what they don’t want: that insipid-looking fillet of steamed cod on a bed of salad, with so few chips they barely even qualify as a garnish.
“It’s too early to say if steamed fish will be a hit,” says an article on the council’s website. And I’ll bet when they know the answer they won’t tell us. That’s because this well-meaning scheme is doomed to flop like a wet kipper. Of course it is. No one in their right mind goes to a takeaway as part of a calorie controlled diet. You do it when you fancy a treat.
And the reason it’s a treat is precisely because that food is so deliciously greasy. As the late Clarissa Dickson-Wright, the generously girthed cook from TV’s Two Fat Ladies, once explained to me, fry-ups, sizzling bacon, battered fish, and so on will always taste nicer than the “healthy option” because fat is a great carrier of flavour.
Clarissa (who was as big an expert on the science of food as she was on cooking and eating it) remained, to the end, a great defender of butter, cream and full-fat milk. She claimed they were much better for you than most of the supposedly healthy, low-fat alternatives. And it turns out she was right. Recent studies have shown that it’s the “trans-fats” in artificial health products like margarine that are the killer, not natural animal fats you find in butter.
What’s more, the evidence increasingly suggests, that it’s sugar not fat which is most responsible for our supposed obesity epidemic. So by trying to stop customers eating fried fish in Rochdale, the council is barking up the wrong tree. It’s the cafes pushing sweet cakes and doughnuts they should be investigating.
James Delingpole, “I prefer my cod in batter, thanks very much”, James Delingpole, 2015-08-15.
