Water fluoridation-an update
This is an update of an article from 30 January 2013 to include recent studies about the efficacy of fluoridation.
Water fluoridation is a controversy that just doesn’t seem to go away, despite the overwhelming evidence of successfully reducing the rate of cavities in children (and adults), while also having little or weak evidence that there are any risks. When I was a kid, I remember controversies about fluoridating water. But I just hated dentists, so to my young, immature scientific mind, if fluoridation kept me from the dentist, that was a good thing!
Today, fluoridated water has become ubiquitous in the USA and many other countries. Unless you drink bottled or filtered water, or avoid fluoride toothpastes (or mouthwashes), most children and adults get an adequate level of fluoride to maintain good dental health. I actually thought that the fluoridation controversy had passed into history with rotary phones, the Soviet Union, and the slide rule.
Yes, there are groups that still fight against water fluoridation, and there are many people who think that fluoridation is bad.
The John Birch Society, a right wing conspiracy group that I thought had passed into history, still considers water fluoridation to be mass medicine and once thought of it as a communist plot to poison Americans (see Schneider & Lilienfeld, 2011). Ironically, on the opposed side of the political spectrum, leftists, like the UK’s Green Party, are opposed to fluoridation because of the mass medicine idea, a concern occasionally expressed by antivaccine proponents. So it’s really not a right or left political issue. It seems to be, like many medical issues (for example, vaccinations), a matter of good science versus bad science (or even no science).
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Vitamin D reduces breast cancer risk–is there anything to it?
One of my favorite topics to debunk is the use of supplements to prevent (or worse yet, cure) cancer. As I have discussed in the past, supplements are, with just a couple of exceptions, worthless in preventing cancer.
Potential causes for cancer are numerous. Infections. Radon gas. Cigarette smoking. Sun exposure. Obesity. With over 200 types of cancer, each with a different pathophysiology, there may be an equal (and probably greater) number of causes for “cancer.” Although many causes of cancer can be easily avoided, such as stopping smoking, testing your house for radon, getting an HPV vaccine to prevent human papillomavirus infections, and wearing sunblock to reduce the risk of melanomas, the sheer complexity and number of types of cancer means that there is probably not going to be any simple panacea to preventing (or even curing) cancer.
But because cancer is so frightening, and treating it is risky, debilitating and, in some cases, fruitless, we look for the easy solution, the easy prevention with a pill. But the evidence science has found indicates that this doesn’t really work. Of course, according to 2012 cancer statistics, 577,000 people died of various cancers in 2012, and about 160,000 died directly as a result of smoking (or second hand smoking). So, you can easily drop your risk dying of cancer by more than 25% just by quitting smoking. Otherwise, it’s just not that simple.
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Water fluoridation-the 47 millionth blog post on the issue
When I was a kid (probably 6 or 7), there was a big controversy in our community whether the water would be fluoridated or not. Now, I was just becoming fascinated by science, medicine, health, and sports at that time, so I tried to figure out what was happening. To my ears and adolescent brain, the argument boiled down to no fluoridation (which meant cavities and visits to the dentist) vs. fluoridation (which was a communist conspiracy). Scary choices. Though Nazi dentists were also plenty scary.
But I grew up, and fluoridation because more common. Water systems are mostly fluoridated (unless you drink bottled water). And fluoride is in toothpaste and various mouthwashes. I thought the fluoridation controversy had passed into history with rotary phones, Soviets, and the slide rule.
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Antioxidant supplements for cancer–myth vs. science
I’ve never been a fan of vitamin supplements. Aside from a very few supplements intended for a few specific clinical conditions, like vitamin C and scurvy, they have little use in preventing or treating diseases. In fact, because mammalian physiology has evolved a homeostasis for these chemicals, any excess amount that can’t be stored in the fat or other tissue is cleared by the kidneys and becomes part of your urine. I’m willing to venture that the urine of many Americans is quite expensive, with all of the cleared vitamins and other micronutrients. A balanced diet over several weeks is sufficient to provide the body with all of the nutrients and vitamins to be healthy and strong. You are not even required to have all vitamins and nutrients every day, as storage of a few nutrients will be released as necessary, and clinical manifestations of nutrient deficiency may take weeks or months.
MSG-myth versus science
Food additives are one of the most passionate issues amongst people who eat (which would be everyone). High fructose corn syrup. Salt. Sugar. Trans fats. Polysorbate 80. Some of the angst caused by these additives is that they have scary chemical names. Obviously the “low fructose corn syrup” has got to be better? Right?
But the one food additive that will bring fear to the minds of all consumers of food is MSG. How many times have you been to a Chinese restaurant where they put up signs with NO MSG ADDED. Just so you know, unless that restaurant isn’t using soy sauce (one of the major components of nearly all Chinese food flavorings), the amount of MSG in your Kung Pao Chicken is still quite high, because that soy sauce has more MSG in it than could possibly be added by a shaker of MSG.
Background
MSG has no taste by itself, but it is used by many cooks as a flavor enhancer, improving and enhancing the flavor of almost any food at lower concentrations. The taste that is enhanced by MSG is different than the standard sour, sweet, bitter and salt flavors–it is called “umami,” which also is enhanced by substances like soy sauce. It’s the savory flavor that one finds that is different from the older “four tastes” that chefs used to consider. The flavor enhancing quality of MSG is not well understood, but it’s possible that humans evolved the pleasurable taste of umami as a result of natural selection favoring those who enjoy eating high quality protein foods.
MSG has been used as a flavor enhancer for several thousand years. It is one of the key components of many Asian cuisines, especially Japanese who have extracted MSG from kelp for centuries. The Romans used a sauce called garum, made from fermented fish, that was used instead of more expensive salt. In fact, MSG can be used to mask bad flavors, such as spoiled meat, just like salt.
How science deniers use false equivalency to pretend there’s a debate
If you read a news article, Google a scientific topic, or watch TV, you’d think that some scientific principles were actually being debated by scientists. From listening to the screaming and yelling, you’t think that scientists aren’t sure about evolution, vaccines, global warming, and the age of the earth (or even the age of the universe). There are even those who think there’s a debate that HIV doesn’t cause AIDS.
Part of the problem is that the public falls for the false equivalency logical fallacy. They think that to be balanced, both sides of a scientific argument are equivalent in quality of opinion and evidence. But rarely is this true, especially in scientific principles that have been well-studied and supported by a massive amount of evidence.
Part of the problem is that some people think that science is unapproachable and too hard to comprehend. It isn’t. Now, that doesn’t mean it’s easy, because it shouldn’t be.
To become a world class architect and designing a skyscraper isn’t easy, but we, non-architects, can observe what we see, and accept that the building isn’t going to topple over in a hurricane. Do we presume to know how the foundation has to be built to support the building? Or what materials are used to give flexibility in a wind, but strong enough to not collapse? Mostly, we don’t, we trust that there isn’t a massive conspiracy to build unsafe skyscrapers because architects are being paid off by Big Concrete to use cheaper materials.
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Dr. Oz falls for the overhyped and debunked GMO corn study
A few weeks ago, Gilles-Eric Séralini and his homeopathy loving coauthor published an article in Food and Chemical Toxicology that concluded that glyphosate (known as Roundup)-resistant NK603 GMO corn, developed by Monsanto, causes severe diseases such as tumors in rats. That study was quickly picked up by many anti-science groups and broadcast widely as “GMO corn cause cancer.”
But like I wrote here and here, the scientific and skeptical community has blasted the study. Here is just a small excerpt of the critics:
- Science-Based Medicine » Antivaccine versus anti-GMO: Different goals, same methods.
- Bad science about GMOs: It reminds me of the antivaccine movement – Respectful Insolence.
- NeuroLogica Blog » The GM Corn Rat Study.
- Study linking GM crops and cancer questioned – health – 19 September 2012 – New Scientist.
- Control Freaks » Blog Archive » Why I think the Seralini GM feeding trial is bogus.
- Illumination: Rats, Tumors and Critical Assessment of Science.
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Effectiveness of pertussis vaccines–myth vs. reality
Over the past few months I have written extensively about the the current whooping cough (Bordetella pertussis) outbreak which has reached epidemic levels in areas like the Washington state, and has been considered one of the worst outbreaks in the USA during the past several decades. The outbreak has lead to several deaths here in the USA and in other countries such as the UK. Of course, this outbreak has lead to the blame game from the antivaccination crowd, because they claim that since A) most kids are vaccinated, and B) we’re having this outbreak then C) either the vaccines are useless or are actually the cause of the outbreak. Seriously. They blame the vaccines.
So I decided to search the internet (or just read the comments section of my blog) to find the most popular vaccine denialist arguments regarding pertussis vaccinations, and deconstruct and debunk them. Hopefully, it will be a useful tool for you when you’re engaging a ridiculous argument with one of those antivaccinationists. Of course, I could use the information too.
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Whooping cough update: Washington state epidemic hits 3400 cases
The Washington State Department of Health is reporting that as of August 4, 2012, the current whooping cough (Bordetella pertussis) epidemic has hit 3400 cases, over 15X more than the 214 cases reported at the same time last year. The epidemic has finally shown a big drop off in new reports this past week (pdf), although there are concerns that the numbers will increase against this fall as children return to school in the autumn.
Pertussis cases by week 2012 (red) vs 2011 (blue)
According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die.
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Weight loss remedies that are just plain pseudoscience
The worlds best weight loss system.
Here comes weight-loss pseudoscience appearing in spam, the Dr. Oz show, or random google search. Weight loss scams, especially those that easy, are an American obsession, since the country is experiencing an obesity epidemic. Americans are seeking easy, simple, and effective ways to lose weight that don’t require them to change any behavior at all. In other words, let us eat our Big Macs and never exercise while taking a miracle pill, while maintaining a perfect Body Mass Index, and Americans will be a happy lot.
Two of the recent weight loss scams hitting the public consciousness these days are raspberry ketone and green coffee beans. Dr. Oz, who despite a solid education in science-based medicine has taken to promoting everything from homeopathy to Joe Mercola‘s various lunatic cures, has been pushing both of these weight loss non-working treatments lately.
Let’s start with the raspberry ketones. It is essentially a phenolic compound produced by the raspberry that gives the raspberry’s aroma that we recognize. However, because it is produced in such small amounts by the plant, the supplement industry must synthesized it chemically to manufacture it in sufficient quantities to be sold as a weight loss pill. So it isn’t a natural product by any means. The belief that these ketones would reduce weight was based on a single study in rats where 2% of the rat’s high fat diet was replaced with these ketones. That would be an impossibly large amount of the ketones in the diet. Other studies have shown no evidence of weight loss in rats even at levels that are equivalent to 200X the amount that a human would consume. And there is not one single clinical trial that has been published showing that raspberry ketones have any benefit in weight loss. Let’s be honest, despite Dr. Oz’s pseudoscientific push, it has no use.
Next up as a weight loss panacea are green coffee beans, which are unroasted coffee beans, that resulted from a study that touted the “efficacy of green coffee extract in weight loss.” This caused the next big thing in weight loss. However, as with most one-off studies, it’s very easy to criticize these things. Let’s turn to the good people at Science Based Medicine, who can spot a good medical scam with one eye and both hands tied behind their backs, who take apart the study:
- It only involves 16 patients. A good clinical trial requires numbers that are adequate to gain some level of statistical significance, and 16 isn’t going to cut it.
- “This study was never registered at clinicaltrials.gov. And there’s no evidence provided that a research ethics board ever reviewed the protocol. I find it hard to believe that any investigator would undertake a clinical trial of an unproven supplement without obtaining prior ethics approval – but that seems to be the case.”
- It is published in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, which does not have an impact factor yet. Other journals by Dove Press, the publisher of the journal, have impact factors between 1-3, at the very low end of the scale. In addition, even though the journal claims to be peer-reviewed, the time period from submission to editorial decision was 12 days which means review was “cursory”.
- None of the authors were clinicians or experts in the field.
- The authors claimed that the study was double blinded, but because of the the way the study was constructed it was not blinded to either the patient or the clinician.
If you want more detail on the critique of the study, the Science Based Medicine article does it in detail. The most conclusive piece of evidence is that there is no confirming evidence yet published. There are no green coffee clinical trials listed in clinicaltrials.gov as of this date. There are no further animal or clinical trials listed anywhere.
Weight loss is rather simple. Calories burned has to exceed calories taken in. Eat less. Burn more. Your choice. If you’re looking for the miracle weight loss, other than the mythical placebo effect (you think it’s going to work so maybe you eat less or walk more, who knows), it’s not going to do anything for you. Walk a couple of miles. Quit eating those potato chips. That’s my expert recommendation!
Whenever someone uses “Allopathy”, turn on the skeptical radar
While catching up on my favorite blogs (and nearly giving up after reading the 300th one regarding the recent Supreme Court ruling on Obamacare), I ran across Liz Ditz’s short and to-the-point Why I Dislike the Term “Allopathy” on I Speak of Dreams. Allopathy is an invented word that, according to Kimball Atwood at Science Based Medicine (Homeopathy & Evidence-Based Medicine),
…was the term coined by (Samuel) Hahnemann (founder of homeopathy) to dramatize the contrast between homeopathy and its competition. According to Hahnemann, “allopathic” medicine sought to give only medicines that suppressed symptoms.
You’ll find allopathy being used by just about any woo-meister in alternative medicine universe. Joe Mercola, anti-vaccine quack and promoter (and when I say promoter, I mean seller of all things alternative medicine) uses the term “allopathic” in 53 articles on his website to attack sound, evidence-based medicine. That’s basically proof that the word is a pejorative like “Western medicine” or “traditional medicine.” It tries to make it sound like evidence-based medicine is closed minded, stuck on tradition, when, in fact, it’s open-minded to new theories and techniques.
In Wikipedia’s article on allopathy, “the meaning (as) implied by the label has never been accepted by conventional medicine, and is still considered pejorative by some.” However, in Wikipedia, the resource for all things woo, allopathy is often used by anti-science pushers to make their articles fit their pseudoscientific view of the world, and it is almost always used in a pejorative fashion to make alternative medicine appear to be somewhat more “open minded”. For example, here’s a discussion amongst the well-known pseudoscience pushers on Wikipedia claiming that allopathic medicine is not science based. Or Dana Ullman, the biggest promoter of homeopathy in the world, spending huge amounts of bandwidth trying to get Wikipedia to use allopathy to describe science based medicine. Of course, Dana was permanently banned from editing anything to do with homeopathy on Wikipedia based on his horrible behavior issues. If you see “allopathy” in a Wikipedia article, be prepared for pseudoscience.
Or as Liz Ditz puts it:
The chiroquacktors use the word allopathy a lot to disparage medicine (as opposed to their fantasy world).
Yup. They do.
Checking for pseudoscience in real science news (updated)
One of the larger problems of the internet (OK, there are a lot) is how science is discussed out in the world. Google any science topic, and you’ll get thousand or millions of hits on any idea in science or medicine. The information is derived from other websites, news reports, rumors, or, to be cynical, from outright fabrication. In the fields of science and medicine, critical thinking is absolutely necessary to understanding it. Because it’s hard work, pseudoscience and anti-science have become quite prevalent lately.
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Joe Mercola using random nonsense words to push vaccine denialism
The anti-vaccination lunacy is made up of lot of individuals who push the various myths and pseudoscience regarding vaccines onto the planet. There’s Andy Wakefield, whose original article was withdrawn by the medical journal who published it, and who was stripped of his medical license because he perpetrated a fraud. Why he’s not sitting in a British prison is beyond my understanding.
Then there’s Jenny McCarthy, an anti-vaccine advocate whose education included posing nude and starring in bad movies.
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Joe Mercola: Proof positive that quackery sells
Orac, in his blog post, Joe Mercola: Proof positive that quackery sells : Respectful Insolence, hits the nail on the head about Mercola, one of the biggest quacks on the internet. I don’t know if Mercola actually believes in his particular brand of science-denialism, but he uses it for one reason: to have people with legitimate medical concerns send their money to him. In case you don’t click on the outlink above, here are some precious quotes from Orac.
Putting the word “visionary” in the same title with the word “Dr. Mercola” is profoundly offensive to anyone who values reason, science, and science-based medicine.
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