More and more, the history of dietary guidelines that our public-health authorities promulgate resembles the Woody Allen comedy Sleeper, in which the main character, awaking from a centuries-long slumber, learns that every food we once thought bad for us is actually good, starting with steak and chocolate. But you wouldn’t know that from government experts’ increasing efforts to nudge us into their approved diets. In 2006, New York City passed the nation’s first ban on the use of trans fats by restaurants, and other cities followed suit, though trans fats constitute just 2 percent of Americans’ caloric intake. Now the Bloomberg administration is trying to push food manufacturers nationwide to reduce their use of salt — and the nutrition panel advising the FDA on the new guidelines similarly recommends reducing salt intake to a maximum of 1,500 milligrams daily (down from 2,300 a day previously). Yet Dr. Michael Alderman, a hypertension specialist at Albert Einstein College of Medicine, observed in the New York Times that because sodium is an essential component of our diets, the city’s effort amounts to a giant uncontrolled experiment with the public’s health that could have unintended consequences. And in 2006, Harvard Medical School professor Norman Hollenberg concluded that while some people benefit from reduced salt intake, the evidence “is too inconsistent and generally too small to mandate policy decisions at the community level.”
Steven Malanga, “Egg on Their Faces: Government dietary advice often proves disastrous”, City Journal, 2010-07
July 31, 2010
QotD: Take experts’ advice with a pinch of salt
May 26, 2010
The pandemic juggernaut of doom . . . that failed to materialize
Lorne Gunter has a good wrap-up of the bone-headed approach of public health officals in Canada to the Swine H1N1 flu “pandemic”:
Good on ordinary Torontonians. Despite all the H1N1/swine flu hype this past winter, just 28.2% of that city’s residents bothered to get vaccinated against the “pandemic;” that’s less than the 35% who usually get shots each year against the seasonal flu.
Even Toronto health care workers couldn’t be stampeded into getting the shots. Only 60% of them bothered.
[. . .]
Even from the start, the World Health Organization and other experts where told this strain of flu was weak and easily defeated. Infection rates never came remotely close to forecasts and death tolls were thankfully much, much lower than for typical seasonal infections.
The trouble, I think, was that so many public health officials have predicted so many pandemics for so long — SARS, bird flu, swine flu — that they simply got caught up in their own warnings and projections. They wouldn’t listen to contrary evidence.
The relevant public health authorities would have served the public interest (and their own credibility for the future) if they’d been much more forthcoming as the early stages of the pandemic showed H1N1 not to be the second coming of the Black Death. Instead, they doubled-down and raised the propaganda bar even higher.
October 27, 2009: Given that regular seasonal flu causes thousands of deaths annually, you’d think it would be good statistical discipline to count the cases of H1N1 separately, both the gauge the severity of the disease and to chart the effectiveness of the vaccination program. Lumping seasonal flu and “flu-like symptoms” together with H1N1 seems a big step backward from normal public health practice.
This would have been a good opportunity for de-escalating the panic mongering (and perhaps even attempting to rein-in the media, who were equally to blame for the tone of the information getting to the public). They chose, instead, to actively hide the fact that H1N1 cases were running below the level of ordinary seasonal flu cases (total H1N1 deaths: approximately 18,000 — typical annual death toll from seasonal flu: 250,000-500,000).
The biggest problem isn’t that they over-reacted this time, it’s that it has reduced their credibility the next time they start issuing health warnings. And that’s a bad thing. Unless they pull the same stunt next time, too. In which case, we may start hearing talk about setting up competing organizations to do the job the current entities appear to have given up on.
February 9, 2010
This week’s silly health panic: third-hand smoke.
Don’t worry, anti-smoking campaigners! Even though the evil smoking empire is in retreat, and smokers get worse press than child molesters and people who talk at the theatre, there’s a new moral front opening up: third-hand smoke! The war isn’t over yet:
Lingering residue from tobacco smoke which clings to upholstery, clothing and the skin releases cancer-causing agents, work in PNAS journal shows.
Berkeley scientists in the US ran lab tests and found “substantial levels” of toxins on smoke-exposed material.
They say while banishing smokers to outdoors cuts second-hand smoke, residues will follow them back inside and this “third-hand smoke” may harm.
Efforts are currently underway to determine if there’s a strong media response to this “new threat”. If so, funding will be sought to research the possibility of “fourth-hand smoke” and possibly even “fifth-hand smoke”.
November 11, 2009
The only surprise is that it’d only be 33%
Alison Martin summarizes a survey of Quebec workers which found (among other things) that 33% of men would show up for work even if they or a family member had H1N1:
According to a poll of Quebec workers, many employees in Quebec would still show up for work even if they had the H1N1 flu virus.
Close to one-quarter of respondents to the poll conducted in September 2009 on behalf of the Ordre des conseillers en ressources humaines agréés said that they would still go to work even if they or a member of their household had the H1N1 flu virus. This attitude is even more prevalent among men, with one in three (33%) reporting that they still intended to go to work if they or a relative caught the virus.
Close to 60 per cent of respondents said that they show up for work even when they really aren’t feeling well.
“We’ve already noted that employees in Quebec tend to show up at work even when they’re ill. They don’t seem to be sufficiently aware of the risks of such behaviour, which in the end benefits neither the employee nor the employer, and definitely should be stopped,” explained Florent Francoeur, CHRP, Ordre president and CEO.
The question was clearly worded to elicit the most newsworthy headline: it’d be an odd family if everyone stayed home if even one person in the family was ill . . . and a family with limited long-term employment prospects. Private sector employers tend not to have the same kind of generous sick time provision that public sector employees get, so employees don’t tend to take as much sick time as civil servants.
For many workers, if they don’t show up for work, they don’t get paid. This is especially true at lower income levels, where missing a few days pay can be a severe economic dislocation.
October 27, 2009
Statistical measurements are important
So why, especially right now, have the US government’s key players in the public health arena stopped counting swine flu cases?
Part of the mystery comes from a federal government in such a tizzy to spread its vaccine and declare “national emergencies” that it doesn’t think it’s necessary to keep counting. Via CBS News:
In late July, the CDC abruptly advised states to stop testing for H1N1 flu, and stopped counting individual cases. The rationale given for the CDC guidance to forego testing and tracking individual cases was: why waste resources testing for H1N1 flu when the government has already confirmed there’s an epidemic?
Given that regular seasonal flu causes thousands of deaths annually, you’d think it would be good statistical discipline to count the cases of H1N1 separately, both the gauge the severity of the disease and to chart the effectiveness of the vaccination program. Lumping seasonal flu and “flu-like symptoms” together with H1N1 seems a big step backward from normal public health practice.
September 8, 2009
John Snow and the start of modern epidemiology
Another “on this date” entry for you: in 1854, John Snow persuaded the local authorities in a London borough to remove the handle from a water pump at the centre of a cholera outbreak. The move was successful, and the death rate dropped immediately. Randy Alfred has the story:
Physician John Snow convinces a London local council to remove the handle from a pump in Soho. A deadly cholera epidemic in the neighborhood comes to an end immediately, though perhaps serendipitously. Snow maps the outbreak to prove his point . . . and launches modern epidemiology.
The Soho neighborhood was not then filled with galleries, clubs, restaurants and other fine urban diversions. Some of it was an unsanitary slum where centuries-old cesspits sat chockablock with the wells that provided drinking water to a crowded populace.
Asiatic cholera had stricken Britain in successive waves since 1831. Snow, an obstetrician who pioneered the use of anesthesia in Britain, published On the Mode of Communication of Cholera in 1849. His hypothesis (and supporting data) held that the scourge was caused by sewage pollution in drinking water and “always commences with disturbances of the functions of the alimentary canal.”
