Contaminated supplements – spiked with potentially dangerous ingredients

contaminated supplements

The supplement industry is huge and unregulated. Americans spend more than $30 billion annually on them, yet contaminated supplements are part of the industry’s method to make their mostly useless products appear to have some clinical effect.

There is growing evidence that these contaminated supplements contain unlabeled ingredients that are found in regulated pharmaceuticals – all without telling the consumer about them. Or testing them. Or listing warnings for their use.

As I’ve written many times, supplements are basically worthless, unless you have specific chronic medical conditions or suffer from chronic malnutrition that prevents you from receiving enough micronutrients, like vitamins and minerals. In addition, those on highly restrictive diets, like vegans or those who have had weight-loss surgery, may require supplementation, although both could be considered “chronic medical conditions.”

For example, in modern prenatal care, the pregnant mother is urged to take folic acid supplements to reduce the risk of neural tube defects in the developing fetus. But after the pregnancy is over, folic acid is no longer needed – in fact, continued use of folic acid may actually increase the risk of some forms of cancer, in individuals who have no medical need for the supplement.

Because a lot of people favor confirmation bias as their go-to argument, I constantly hear, “hey Skeptical Raptor, vitamin C prevents scurvy, ergo all supplements are the greatest thing we can consume.” Scurvy is fairly rare these days in developed countries, but it can happen especially to smokers since cigarette smoke inhibits uptake of vitamin C (and another reason not to smoke).

So unless your diet only includes steak, ice cream, and junk food, an average American or European will get more than adequate amounts of vitamin C from their diet. Anyone deficient in vitamin C could be considered to be malnourished, and, of course, they will benefit from a vitamin C supplement. But vitamin C does not prevent colds, flu, or cancer. It is not a miracle vitamin, despite the oft-debunked claims of the pseudoscience-based supplement proponents.

Despite the utter lack of or weak evidence of the usefulness of supplements, unsurprisingly, over half of all Americans take dietary supplements. I guess chronic malnutrition and medical conditions afflict over half of Americans. The facts are that human needs for nutrients, like vitamins, are more than adequately met by a broad, healthy diet that includes a lot of fruits and vegetables.

But there’s more bad news, and it’s more than just overpriced, mostly useless products. It’s that contaminated supplements are widespread in this industry.  Continue reading “Contaminated supplements – spiked with potentially dangerous ingredients”

Cancer cures with complementary medicine? No, it’s ineffective and can kill

cancer cures

As I have mentioned before, I occasionally answer questions on Quora regarding complementary and alternative medicine (CAM) cancer cures. Of course, there are few, if any, CAM cancer cures that actually do what they claim. If they did work, they’d just be medicine.

Of course, many of the answers provide answers that are supported by scientific evidence – CAM cancer cures do not work. Of course, there are a few scam artists answering the questions who make outlandish claims about cancer cures. And the number of times someone claims that cannabis is one of the best cancer cures is ridiculous – the evidence is extremely weak (see Note 1).

A paper was recently published that examined the survivability of individuals with curable cancers that refused conventional cancer treatments and chose complementary and alternative medicine. We will get to that article, but spoiler alert – CAM doesn’t work and may be dangerous.

What is complementary and alternative medicine?

CAM is any “medical” treatment that is not supported by robust scientific evidence or incorporated into evidence-based medicine. Most complementary and alternative medicine have no clinical effects beyond placebo (see Note 2), and it cannot treat any serious medical condition. CAM is pure pseudoscience.

CAM is known by its other names – quackery, quackademic medicine, snake oil, woo, or junk medicine. CAM quacks invent absurd pejorative names for evidence-based medicine just to create a silly false balance – terms like allopathy, conventional medicine, or Western medicine. You science-based readers will see through this nonsense, and understand what they really mean is “evidence-based medicine, but we prefer our pseudoscientific medicine.”

CAM includes traditional Native American remedies, traditional Chinese medicine (like acupuncture), chiropractic, homeopathy, New Age nonsense, and many other kinds of woo. Of course, many CAM scammers push their cancer cures, none of which have been shown to work.

CAM is popular because it provides false hope to those interested. These quacks can make outrageous claims about cancer cures because they can play to fears of cancer patients about surgery, chemotherapy, or radiation therapy. These scammers promise cures that are easy, but these “therapies,” in fact, don’t work.

As Tim Minchin famously said,

You know what they call alternative medicine that’s been proved to work?

Medicine.

Cancer primer

Cancer is a group of diseases characterized by abnormal cell growth which can invade or metastasize to other tissues and organs. Although people use tumor and cancer interchangeably, not all tumors are cancer. There are benign tumors that do not metastasize and are not cancers.

The National Cancer Institute claims that there are over 100 types of cancer.  Cancer Research UK states that there are over 200 types of cancer.  The American Cancer Society lists over 70 types of cancer (although some are more classes of cancer rather than a single type).  Wikipedia lists over 180 different cancers.

The variance in number results from the lack of precise definitions for some cancers. So researchers may group several different cancers into one heading. But clearly, there are up to 200 or more different cancers.

Furthermore, each of these cancers has a different etiology (cause), pathophysiology (development), treatment and prognosis. When someone is called a “cancer researcher,” they are rarely studying all cancers, but they’re studying one small part of the story of one of the 200 or so cancers.

Cancer usually requires numerous, up to 10, independent genetic mutations in a population of cells before it can become a growing, metastatic cancer. Each mutation is selected, as in natural selection, because it provides some benefit to the cancer cell, such as causing blood vessels to supply the cells for nutrition and oxygen, or the ability to divide rapidly, whatever the feature is.

A recent study published in the journal Science makes a strong case for random chance as the most important factor in cancer development. According to the study, the vast majority of cancers are just a simple error in DNA replication. If this is so, developing one of the 200 (or more) different cancers may be unavoidable, despite a “healthy lifestyle” or attempting to “boost” your immune system.

Geneticist Bert Vogelstein and mathematician Cristian Tomasetti, at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, conducted the study, a follow-up to an earlier one, which arrived at the same conclusion. The researchers wanted to know whether replications errors were behind most cancers, versus other factors, such as tobacco.

The researchers found, after examining 32 different kinds of cancer, that 66% of these cancers were a result of chance mutations in cells, 29% resulted from the environment, and 5% from inheriting a mutation.

These mutations aren’t “naturally” a part of the cell’s physiology. Moreover, these mutations can have a lot of different causes – environmental (like smoking or UV radiation), viral (hepatitis B and human papillomavirus are the most famous), heredity, and maybe other things. These mutations are more or less random, and they can’t be prevented by anything special–if only it were that easy.

There are a few things you can do to prevent cancer, such as quitting smoking, staying out of the sun, getting your hepatitis B and HPV vaccinations, not drinking alcohol, keeping a low body weight, and eating a balanced diet. But even if you are a paragon of healthy living, a random mutation in some cell in your body can lead to cancer.

One last thing. A lot of our ideas about what may or may not cure cancer is based on preclinical research, which very rarely is brought into clinical trials or is successful in clinical trials. In fact, there seems to be a lot of evidence that it is difficult, if not impossible, to repeat the preclinical studies, so it makes it difficult, if not impossible, to accept the results of them. Simply, a lot of research that is publicly touted often ends up meaning nothing.

Oh, one more thing. Big Pharma isn’t hiding a secret cure for “cancer.” But they have brought the world thousands of effective treatments, in combination with evidence-based oncology, that has led to a substantial reduction in the cancer mortality rate over the past two decades.

Now, that CAM cancer cures are dangerous paper

The study, by Skyler B Johnson, MD, of the Yale School of Medicine, was published in JAMA Oncology in July 2018. The researchers examined a huge database of cancer patients over a 20-year period of time – it included an impressive 2 million individuals. They sorted to through the records to compare patients who used alternative medicine to treat their cancer to a matched sample of individuals who relied upon evidence-based cancer treatments.

I also want to emphasize that the researchers specifically selected for individuals who had easily treatable cancers.

Let’s cut to the chase – after controlling for confounding variables, that is, variables that can influence both the cause and the effect, individuals who utilized CAM for cancer treatment were statistically much worse off.

  • CAM users had a much lower chance of surviving 5 years after cancer diagnosis.
  • They were 2X more likely to die of cancer.
  • Less than 70% of CAM users were alive seven years after diagnosis. This compared to more than 82% of those who relied upon evidence-based medicine who survived seven years.
  • The mortality risk for those individuals who used CAM increased every year that they avoided standard cancer therapy.

Now, this doesn’t mean that the study found that CAM had a negative effect on cancer patients. CAM is worthless, it has no effect on health. However, what the researchers did state is that those individuals who preferred CAM were refusing or delaying conventional cancer treatments that actually work.

Because CAM is worthless, it probably doesn’t matter if the patient uses it along with conventional cancer therapy. It is amusing that many patients will give credit to the CAM therapy rather than the conventional one when their cancer goes into remission. Of course, most of us know the scientific facts about it.

Like I wrote in a previous epidemiological study, this is an observational study. It cannot show causality, except when it does. Moreover, size matters – this is a 2 million person study which allows us to see small statistical differences.

Summary of CAM cancer cures

If you have a cancer diagnosis, use real evidence-based medicine to treat it, not CAM quackery. Despite patient fears of surgery, chemotherapy, and radiotherapy, the evidence has shown us that they work and that the mortality rate for many cancers continues to drop every year. The trope that Big Pharma, Big Hospital, and Big Oncology are hiding the one cure to cure them would be amusing if it weren’t so dangerous.

Let’s be clear – complementary and alternative medicine is worthless. The evidence that it provides cancer cures just doesn’t exist – the best, most robust, highest-quality evidence shows the way we treat cancer is best done by real physicians with real backgrounds in oncology.

Notes

  1. If any compound of the marijuana plant can actually treat cancer, it will be isolated by real medical researchers, they will create a method to deliver that component directly to the site of the cancer, they will test it for efficacy and toxicity, and then seek FDA approval. Anecdotes and weak pre-clinical studies for any of the claimed cancer cures are nearly valueless to real science-based medical treatments for cancer.
  2. Many people overstate the value of placebos – officially, a placebo means that the effect is nothing more that can be found by giving the patient a sugar pill. The effect is almost always psychosomatic, so placebos effects are more prevalent with neurological conditions like pain, although the evidence that CAM can treat pain is laughably inconsistent. However, placebos have never been shown to treat cancer, mend a broken bone, cure an infectious disease, save a trauma victim, or do anything for other serious medical conditions. In science, anything with a “placebo effect” is considered a failure, and it would never receive FDA approval. The placebo effect is simply a myth.

Citations

Measles epidemic in Europe is killing children – blame anti-vaccine religion

measles epidemic

Maybe some of you haven’t been following the reports about the European measles epidemic, but it’s scary news. The BBC News reported that more than 41,000 people have contracted measles in the first six months of 2018. Worse yet, 37 of those people have died of that virus.

Let me be blunt – nearly every one of those 41,000 cases and 37 deaths could have been prevented by the MMR vaccine (for measles, mumps, and rubella). Period. Full stop. End of story.

In case I wasn’t clear, let me repeat myself – indulge me, we’re talking about children dying of an entirely preventable disease. Every single case of measles could have been prevented. Every single death could have been prevented. This isn’t a complicated story.

Maybe you think that Europe is a big area with over a half billion people, so this might be expected. That would be incorrect. Measles was almost extinct in much of the developed world. In 2016, there were just 5,273 measles cases for the whole year. In 2008, there were only 3,575 cases and one death. Measles was almost eliminated.

Let’s take a look at how this happened, and place blame right where it belongs – in the misinformation, pseudoscience, and outright lies of the anti-vaccine religionContinue reading “Measles epidemic in Europe is killing children – blame anti-vaccine religion”

Recognizing good and bad science in vaccine research

bad science

Figuring out the quality of sources, that would separate good from bad science, took me a long time. I was sleep-deprived, had postpartum anxiety, and was scared of something I had not previously thought that much about before having kids.

The woman who had been a mentor to me in my career, with whom I had entrusted my life and that of my child through my pregnancy and birth, whispered in my ear a few minutes after my son was born to not let the hospital give him the hepatitis B vaccine. This was the first and last communication we had about vaccination, but filtered through my trust for her it planted a seed of doubt and convinced me at the time there was a good reason to avoid it. Her suggestion that I followed could have cost my son his life, but it took me almost two years to figure out why.

I set out on a path of sleepless nights to figure out what those reasons might be, and the internet can certainly deliver on that front. The problem was, most of what I was reading was misinformation designed to exploit my fears. I wasn’t yet familiar with the idea of confirmation bias or that search engines had a lot of first page hits for poor sources because of the way the search algorithms work. 

It took me some time to figure out that Google is the confessional of our anxieties, the most commonly typed in fears get boosted, and higher quality links with more technical language tend to lag behind as we often don’t know what keywords will give us the answers we are looking for. If we think of the internet as a library, it would be like if register adjacent tabloids and flyers handed to you on the street by conspiracy theorists were filed in the most prominent shelf spaces amongst the reference books.

Quality information is available, but it can take some digging to get to it. As a result, I got a lot more scared before I learned how to better interpret the quality of what I was finding. I eventually learned to type whatever scared me alongside “+criticism” or “+debunked” if I wanted to find a different perspective on a topic. Doing that is how I stumbled upon Skeptical Raptor’s well-cited breakdowns of things I had been reading that had me all twisted up in knots. Learning to use Google Scholar for searches also helped to cut through the noise when I was looking for actual research.

I feel a lot of regret for the time I left my child vulnerable to vaccine-preventable diseases because of fear, and hopefully some tools I found along the way to help me evaluate sources might be helpful for other parents who find themselves facing the same stress. Continue reading “Recognizing good and bad science in vaccine research”

Testing vaccines – another anti-vaccine myth requiring debunking

testing vaccines

There are so many myths, tropes, and memes pushed by the anti-vaccine religion that it’s almost a full-time job to keep up with it all. One of the most ridiculous is that vaccines aren’t tested, especially in clinical trials. This is ridiculous on so many levels, the most important of which is that testing vaccines are critical to receiving regulatory approval across the world.

The anti-vaccine religion believes that vaccines aren’t tested thoroughly before being used on unsuspecting infants. I do not know where this started, or why it started, but like much in the anti-vaccination world, it really doesn’t matter. It just passes from one person to another across social media, and individuals with no research background hold this particular belief as if it were the Truth™.

On the contrary, testing vaccines is a thorough process – each vaccine is tested for safety and effectiveness before being marketed. Not only are vaccines thoroughly tested for safety and efficacy before being marketed, they also are rigorously tested in various combinations with other vaccines. And I’m not cherry picking a few articles to support my point of view, unless by cherry picking you mean I’m picking the best articles from the highest quality journals in medicine.
Continue reading “Testing vaccines – another anti-vaccine myth requiring debunking”

Supplements for cardiovascular diseases – more evidence that they don’t work

supplements for cardiovascular diseases

I have been skeptical of supplements for a long time – not because I have some predisposition against them. My skepticism results from the relative lack of any robust evidence that supplements have any positive effect on human health other than in unique situations of chronic diseases or malnutrition. In fact, most of the high-quality evidence about supplements show that it does not work. And a recently published review shows that using supplements for cardiovascular diseases are expensive and useless.

Since many readers fail to read what I wrote above, let me repeat myself for clarity. Supplements are not completely useless – of course, they are important for those who have chronic diseases or conditions may require supplements of some or many micronutrients. Someone who has had bariatric surgery or other types of serious gastrointestinal surgery may not be able to consume enough vitamins and minerals from food, and they will require multivitamins.

Also, some individuals may be malnourished, which doesn’t mean just not eating enough, but not eating some foods that have specific nutrients. For example, avoiding certain foods that contain vitamin C could put you at risk for a disease called scurvy, which can be deadly. There are several other diseases that result from missing key nutrients. However, in the modern developed world, these diseases are extremely rare because of the varied diet we have – and the availability of supplements to treat those diseases.

However, several points have got to be made. Just because vitamin C can treat scurvy doesn’t mean that more vitamin C makes your immune system suddenly powerful enough to destroy the common cold or flu or cure cancer. Vitamin D, although there are many cases of deficiency in many countries, is not a miracle supplement. It cannot cure or prevent cancer. It does not impart superpower abilities to your immune system.

The whole supplement industry has an overreliance on logical fallacies (like appeal to popular belief or appeal antiquity) or anecdotes (which aren’t data) to convince customers to buy their nonsense. They do this because they are not required to undergo gold-standard clinical trials to convince the FDA to approve their claims. Real pharmaceuticals, on the other hand, take 10-20 years of research and clinical trials before they are approved for use.

Big Supplement (yeah, it’s a huge industry, over US$100 billion annually, worldwide) also pushes the trope that if a little helps, a lot is better. This is not good science. The millions of years of human evolution (following up a billion years of immune system evolution) has led to a rather powerful immune system that is exceedingly complex and has always been able to do its job without the addition of supplements (unless early Homo sapiens had access to a GNC someplace).

But let’s take a look at supplements for cardiovascular diseases (stroke, heart attacks, and other cardiovascular conditions) – a new review shows us, once again, that there’s nothing there. Continue reading “Supplements for cardiovascular diseases – more evidence that they don’t work”

Omega-3 supplements have little effect on cardiovascular disease and mortality

omega-3 supplements

I have been skeptical of supplements for a long period of time. Supplements are generally of low quality, they don’t prevent or cure cancer, they don’t prevent colds, they can’t boost the immune system, and they don’t prevent heart disease. Now there is a powerful review of omega-3 supplements that shows that it has little effect on cardiovascular disease.

Unless one has a chronic disease or is chronically malnourished, there are precious few instances where supplements are necessary. A couple of cases where supplements may be critical include prenatal folic acid supplements to prevent neurological defects in the developing fetus, vitamin C to prevent scurvy, and vitamin D supplements for individuals who do not produce enough endogenous vitamin D. In each of these cases, however, supplements are necessary to counteract a micronutrient deficiency that results from a chronic deficiency in the diet.

The benefits of omega-3 supplements have always been intriguing to me because it is a supplement that I thought might be useful for improving cardiovascular health. But as I reviewed before, the evidence seemed awfully weak. With this new study, there may be no evidence whatsoever supporting the use of omega-3 supplements, at least for cardiovascular disease. Continue reading “Omega-3 supplements have little effect on cardiovascular disease and mortality”

Andrew Wakefield and Elle Macpherson – woo attracts woo while we laugh

Andrew Wakefield and Elle Macpherson

Celebrity romances rank with soccer, Game of Thrones, and iPhone vs. Android as the things I couldn’t care less about. I wouldn’t know anything about anyone. But, there are exceptions, like when the USA is actually in the World Cup. When I see stories about Andrew Wakefield and Elle Macpherson, I cannot stop myself. I have to read about it, and I have to make fun of it.

Now, most of us know all about one of the greatest scientific frauds of the past 100 years – Mr. Andrew Wakefield and his false, and ultimately retracted, claims that somehow the MMR vaccine was linked to autism spectrum disorder. Of course, there is a mountain of affirmative evidence that has refuted the claim of a link between the vaccine and autism. That’s settled science, except, of course, in the minds of Wakefield sycophants who believe otherwise.  Continue reading “Andrew Wakefield and Elle Macpherson – woo attracts woo while we laugh”

“Bad Advice” by Paul Offit – a book review by Dorit Rubinstein Reiss

Bad Advice

A new book, “Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Informationby Dr. Paul Offit, is different from his previous writings in two ways – much of it is autobiographical, with a lot of personal anecdotes, and it is about science communication rather than the actual science.

“Bad Advice” opens with a story of a 1997 TV interview Dr. Offit has, and how he bungled – by his account – a question about which vaccines children get, how many, and when. The story sets the tone for the book – it’s funny, it’s candid about what Dr. Offit did, in his view, wrong, and it offers sound advice for other science communicators.

To a large extent, this book was written for those engaged in science communication, and it is full of tips that can help every current or would-be science communicator.

What gives the book its charms are the anecdotes and the humor sprinkled throughout it, and its accessible and conversational tone, but I don’t think I can mirror that here without spoiling the effect – I think these are best enjoyed in context. So this review describes the content but does not capture what makes “Bad Advice” so much fun.

For full disclosure, I highly admire Dr. Offit, have sought his advice and help on many issues in my writing on and advocacy related to vaccines, and consider him a personal friend. I have also read a draft of the book and provided comments. 

Why Science Communication?

The first three chapters of “Bad Advice” provide important background by explaining why science communication is needed, and some of the obstacles to it. 

The first two chapters of the book set out what science is and what scientists do, and why their training and background make it difficult for them to be effective science communicators. Among the things covered – again, with a lot of humor, humility, and personal anecdotes – are that much of the scientific work is done alone, and much of what it requires makes people less, rather than more, suited to work with people. 

Dr. Offit discusses the fact that the scientific method trains scientists away from using absolute statements, but qualified statements can backfire when communicating about science; the challenge of reducing complex, nuanced reality into sound bites that work in a digital age; and more.

The next chapter analyzes why we need science communication, why people – however smart – may fall for misinformation. It looks at several natural, human features that make us easily wrong on scientific issues. “Bad Advice” also examines our difficulty identifying and assessing risks, the pull of celebrities as authority figures, even though they may not have the background to provide good information, and may, in fact, promote bad information (for example, Robert F. Kennedy Jr.  – revisited later in the book – constantly provides bad information about vaccines  ). The chapter also talks about other limits on the ability of humans to think rationally and the ways we acquire knowledge.

After thus setting the stage for why it’s important to engage in science communication and some of the challenges, Dr. Offit is ready for the next stage.

Good advice vs bad advice

Chapters 4 through 7 offer direct advice on communications through personal anecdotes of things that worked and things that didn’t in Dr. Offit’s over 20 years of doing it.

In chapter 4, Dr. Offit offers “some painful, hard-earned, and occasionally humorous lessons gleaned from personal experience” on communicating with the public. These range from the deeply practical (“be comfortable”) to the content based (“be sympathetic,” in the context of an eleven-year-old diagnosed with AIDS at the time when HIV was a death sentence, and “Don’t panic.

The facts are your safety net.”). But they’re invariably written as amusing anecdotes leading to a useful punchline. In one of the stories, Dr. Offit describes how he arrived at the famous “10,000 vaccines” quote that anti-vaccine activists like to misuse. The punchline? “You are going to say things that, although scientifically accurate, you will regret. It’s unavoidable.”

Chapter five addresses whether it’s appropriate for scientists to debate science deniers, using several examples. Dr. Offit’s recommendation is to avoid it, but he does provide three successful examples of such debates. His conclusion is that he, personally, is too angry and passionate on vaccine issues to successfully participate – because he annually sees children die from preventable diseases, “invariably, .. because parents have chosen not to vaccinate their children. And the reason they had made that choice was that they had read or heard bad information..”

Bad Advice ends with a recommendation that “debating the undebatable is worthwhile,” if, and only if, scientists can see the discussion as a teachable moment, and not focus on the people they are debating or the others in the room.

I’m not sure I agree, at least in terms of a televised debate. I think Dr. David Gorski said it well when he wrote:

…debating cranks doesn’t sway anyone, sharing the stage with a real scientist does unduly elevate the crank in the eyes of the public. Besides, whatever the seeming outcome of the debate, you can count on the crank to declare victory and his believers to agree. In any event, science isn’t decided by the metrics used to judge who “wins” a public debate, which rely more on rhetoric and cleverness rather than science to decide the outcome. Finally, such debates are not without risks. Although Julian Whitaker, for example, was terrible at it, other cranks are adept at the Gish Gallop, and an unprepared skeptic or scientist can be made to appear clueless in front of a crowd that is almost always packed with supporters of the crank, not the skeptic.

I think I agree with Dr. Offit’s initial position that agreeing to a debate is a bad idea.

Chapter six looks at the role of comedians in combating misinformation about science, focusing on vaccines – covering the Penn and Teller episode, Jimmy Kimmel, the Daily Show and the Colbert Report. And I’m really going to let you read that by yourselves. It’s fun.

Chapter seven looks at the ways the cinema helps or harms science communication. It opens by comparing two films about outbreaks – “Contagion,” that got the science right, and “Outbreak,” that did not. To give a flavor, when talking about “Outbreak,” Dr. Offit describes how a monkey carrying the harmful virus was caught, and the movie scientists had to “determine which antibodies are neutralizing the mutant virus, synthesize those antibodies, and make several liters of life-saving antisera. Assuming everything goes well, Hoffman’s task should take about a year. Cuba Gooding Jr. does it in a little less than a minute. (Now I understand why people are angry that we still don’t have an AIDS vaccine.).”

Nonetheless, Dr. Offit sees an important role for movies in science communications, and urge scientists to work with filmmakers to get it right.

Science communication in action – confronting the anti-vaccine movement:

The last part of the book uses the anti-vaccine movement as a story of the pitfalls and successes of science communication.

Chapter 8 of “Bad Advice” looks at how charismatic figures can promote anti-science misinformation. Although it covers several examples, the heart of the chapter is the case of Andrew Wakefield, the British doctor who promoted misinformation about MMR. Dr. Offit tells the dramatic story of Wakefield’s rise, the scientific literature that showed him wrong, and the discovery of his misdeeds, that led to his fall. He describes Wakefield’s situation today – thoroughly discredited, on par with other conspiracy theorists – through his participation in the infamous Conspirasea Cruise.  The end of the chapter examines different explanations for why Wakefield sticks to his original claims, years after they’ve been thoroughly disproven. I’ll let you find out yourselves. It’s not exactly flattering to Wakefield, though. 

Chapter 9 looks at the role of politicians in promoting anti-science misinformation, focusing on Dan Burton’s hearings that tried to make a case that vaccines cause autism (YouTube snippets of the hearings, out of context, are still used by anti-vaccine activists. Dr. Offit will give you a more comprehensive view). Dr. Offit also tells of his own experience in the hearing, and what he sees as errors committed because of his naiveté and inexperience. It’s half sad and half comical to read through both his preparation for the hearing, and the actual experience of Mr. Burton, who came into the hearing with a set conclusion and a set role he wanted Dr. Offit to play, trying to delegitimize him. 

Chapter 10 warns science communicators to expect a campaign of personal delegitimization and attacks, drawing on Dr. Offit’s own extensive experiences with anti-vaccine efforts to attack him. It goes from hateful emails, through lawsuits, to death threats. It’s painful but incredibly important for people who go into these areas to be prepared for the ugly reaction from misguided but passionate people on the other side, in all its extreme forms. 

Chapter 11 goes more deeply into Dr. Offit’s own reasons for entering the fray. It is very autobiographical (some of the events in it were described in some of Dr. Offit’s other books, but many will be new to readers), telling his career story – again, with lots of humor, more than a few lumps. This is to explain what motivates him to speak up, and to some degree, to counter the claims accusing him of having a conflict of interests because of his involvement in the creation of the rotavirus vaccine. It’s a powerful chapter.

Chapter 12 ends on an optimistic note, pointing out things that have improved in the war for science – the rise of science bloggers, the better attitude of the media. And in the epilogue, Dr. Offit ends with the March of Science, as an embodiment of the willingness of science supporters to fight back.

Takeaway

In this very autobiographical, often humorous, extremely candid and full of good advice book, Dr. Offit does a service to science communicators by telling them what worked, what didn’t, and some thoughts on what comes next. You may not always agree with his advice, but you are very likely to agree with large parts of it, think about much of it, and enjoy the way it’s delivered. It’s a very fast read, and worth reading and probably rereading. And rereading.





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Celiac disease is not caused by modern wheat, despite internet claims

celiac disease

Although this blog focuses on vaccines, there are really so many myths and tropes on the internet that are based on the misunderstanding of science, on pseudoscience, or just plain ignorance. One of those myths is that human meddling in plant genetics, which led to modern wheat, is the root cause of all gluten sensitivity, including celiac disease.

Of course, the quack medicine world has vastly overrated the “dangers” of gluten – those with real gluten issues, with properly diagnosed celiac disease and wheat allergies, represent less than 1% of the population. The internet quacks also have no understanding of real gluten sensitivity – it’s an on/off switch. With some relatively rare exceptions, gluten causes significant symptoms in those with gluten sensitivity, not vague feelings. And there’s no dose-response curve – a tiny amount has almost the same effect as a large amount of gluten.

Although I doubt it will have any effect on these anti-gluten food fads, a new peer-reviewed paper in a respected journal clear shows that that modern wheat is not responsible for celiac disease. Gluten from 2018 probably is the same as the gluten in wheat when it was first domesticated 12,000 years ago.

Let’s take a look at celiac disease, wheat, gluten, and the paper. I hope it makes sense. Continue reading “Celiac disease is not caused by modern wheat, despite internet claims”