Saturday, 8 September 2018

How Old Is Your Heart?

Public Health England (PHE) in collaboration with the British Heart Foundation (BHF) has launched a heart check-up to identify ‘your heart age compared to your real age’.  Is it a valuable public health intervention or a waste of time and money?

It begins by asking age, gender, ethnicity and postcode.

Then: Do you have cardiovascular disease? No.

Do you smoke? No.

But I did. I quit two years, three months and thirteen days ago. Not that I’m still counting. But this does make a big difference. My heart is ‘older’ than it would be if I’d never smoked, I know that. It can take up to ten years for risk levels to return to those of a non-smoker.

Next it asks for height, weight and a few questions on medical history. Pretty standard.

Then it asks what your cholesterol level and blood pressure are. How many people know that?

And that’s it, end of test. It tells me that my heart age is four years older than my real age and says this:
 Your risk of having a heart attack or stroke within the next 10 years is 5.8%

Your heart age is an estimate because you don't know all your numbers. We've based your result on the national average.

If you have high cholesterol and blood pressure, your heart age could be as high as 69.

Make an appointment with your doctor, nurse or pharmacist to get your blood pressure and cholesterol tested.

There are no questions about alcohol and drug consumption, diet and exercise, all things which the NHS and PHE normally tell us make a big difference to heart health. I’ve lived in central London all my adult life and we keep being told how damaging pollution is to health and longevity so it might be a good idea to include a question on that.

The NHS is already struggling, does it really need a few million people making appointments to get their BP and cholesterol checked? Or do they expect people to rush out and buy self-testing kits? And then going to the GP when they get a high result. GPs have not surprisingly expressed concern about this test adding to their already extreme workload.

Is it good public health policy to frighten people with an unrealistic heart age? Who is the mythical ‘average’ person the figures are based on? I’m considerably taller, lighter and fitter than the average woman, for example (and an ex-smoker, yes, I know) so they can't use her to scare me like some sort of Baba Yaga.

There’s also the question of efficacy. NICE has already rejected the use of lifetime risk scores because of a lack of evidence, which means they will scare people, overload GPs - and not have any effect. It’s not even a case of the end justifying the means.

The people behind the project are defending it in various parts of the media by saying it will raise awareness and start a conversation. As an awareness raiser it fails because all it will do is frighten people into going to the GP, or frighten them and then they’ll carry on as normal, or make them think about making some changes and then give up after a few weeks because that’s how we operate. No imminent threat, no motivation.  Will there be any follow-up to see if people have taken action? Doubtful.

If it’s a way of collecting information about the population, then the holes in it make that information of very limited value – unless all PHE wants to know is how many of us don’t know our BP and cholesterol. This is not a compulsory test. The people doing it are self-selecting, opting in, and the reasons they do this could skew the results. Is it idle curiosity, concern, fear or some other reason? Is it mostly the group known as the ‘worried well’? People on very low incomes and many old people will be excluded because of lack of online access.

Heart disease is a serious and growing problem that takes long-term investment and lifestyle management to tackle.  According to the British Heart Foundation:

Heart and circulatory diseases cause more than a quarter (26%) of all deaths in the UK - over 150,000 deaths each year, an average of 420 people each day or one death every three minutes.

But hang on a minute… it also says:

Since the BHF was established the annual number of deaths from heart and circulatory diseases in the UK has fallen by more than half.

In 1961, more than half of all deaths in the UK were attributed to CVD (320,000 deaths).

Since 1961 the UK death rate from heart and circulatory diseases has declined by more than three quarters.

Would it not perhaps be worth looking at why rates have fallen, what else people are dying of, what interventions have worked in the past, where limited resources could be most usefully targeted? For example, obesity has risen since 1961, smoking rates have fallen and life expectancy has risen so people are more likely to have multiple comorbidities that accumulate with age – more than one potentially life-limiting condition at once.

As it happens, I did have my BP checked this week as part of an ongoing treatment for something not heart-related. I didn’t put it in the test because I wanted to see what results came up. The nursing assistant who checked it said he’d tried to take the test but it didn’t work because he was too young. He agreed with me about the flaws in the design. (My BP is great, thanks for asking).

If you do want to know about the state of your heart and its future, you’d be better off doing this:

Friday, 16 February 2018

Modern Life Is Toxic

There are two narratives we’re being fed at the moment, scare stories that are essentially about how modern life is killing us. Everything we breathe, everything we eat, can either kill us or make us fat or damage our children. There’s an underlying message of nostalgia for ye olden days when food was safe and chemicals were safely confined to the periodic chart on the classroom wall. The days before Brexit and Trump and Facebook and everything going to hell in a hand cart.

A study has found that the chemicals in cleaning products can cause serious lung function decline in women.

It says that ‘According to new research, women who work as cleaners or regularly use cleaning products at home experience a greater decline in lung function over time than women who do not clean.’

And of course the effect is being compared with smoking, because everything is these days, including sugar.

The phrasing is odd: ‘The effect of occupational cleaning was thus comparable to smoking somewhat less than 20 pack-years’. ‘Somewhat less’ is meaningless. Does it mean a bit less or a lot less? The effect of smelling a lovely flower is somewhat less than smoking.

The hydra of chemical versus natural is rearing its ugly heads again. In this vision of the world, natural (ie unprocessed) is always better even though cancer, ricin, deadly nightshade, botulism and many more things are natural. And a chemical is a chemical whether it comes from a lab or from a plant. The cleanest mountain air or spring water are made of chemicals.

The point is not whether these chemicals are harming us, it’s that the reporting is gleefully playing on our fears. At a time of national and global insecurity, people are more vulnerable to scare stories, we’re hyper-alert to yet more things that are threatening Life As We Know It.

The Evil Chemicals narrative ties in with the Ultra-processed Food narrative, the other monster that is crawling out of the night to stalk us.

The report the media has picked up on says that ‘a 10% increase in the proportion of ultra-processed foods in the diet was associated with significant increases of 12% in the risk of overall cancer and 11% in the risk of breast cancer’.

However, Professor Linda Bauld, Cancer Research UK's prevention expert, said: 'It's already known that eating a lot of these foods can lead to weight gain, and being overweight or obese can also increase your risk of cancer, so it's hard to disentangle the effects of diet and weight.'

Dr Ian Johnson, from the Quadram Institute in Norwich, said the study had ‘identified some rather weak associations. The problem is that the definition of ultra-processed foods they have used is so broad and poorly defined that it is impossible to decide exactly what, if any, causal connections have been observed.’

And Professor Tom Sanders at King's College London said that mass-produced bread would be classed as ultra-processed, but a home-made loaf or bread from a posh local bakery would not. 'This classification seems arbitrary and based on the premise that food produced industrially has a different nutritional and chemical composition from that produced in the home or by artisans. This is not the case.'

This study is highly critical of the classifications used for ultra-processed food too.

There's a significant point in Professor Sanders’ comment about bread; there's a lot of food snobbery and smuggery going on, with the foods that are identified as being mostly eaten by lower income people being demonised whereas middle class food is more 'wholesome' and 'virtuous'.

The moral high ground food police probably don't count craft ale or artisan gin as highly processed and don’t seem to have noticed that even porridge made with soya milk and honey counts as 'ultra-processed'.

The smugness is about doing things more simply or more traditionally, buying food that doesn’t come in packaging. Yes, plastics are destroying the environment but food packaging extends the shelf life of products, causing less wastage and less environmental harm from producing (even) more than we need. It’s also a great boon to people too busy to shop for fresh produce and ingredients every day. It’s a complex problem not solved by ill-informed moralising or nostalgia.

Toxins (aka chemicals) have taken the place of diphtheria, polio and smallpox as the Invisible Evil (and plague if you go back further). But never fear, you can buy a detox from a wellness guru because your fear is their marketing opportunity.

It's not like things were any better in ye olden days when people breathed in coal or wood smoke or smog, and lots more people smoked. Sitting around in the cave or wooden houses before chimneys were invented during the long winters didn’t just make people smell like kippers, it caused serious lung damage.

Employment was much more lung-unfriendly too - mining, dyeing and tanning, the cloth industry or industrial scale laundries just to name a few.

Has there ever been a time in human history when our lungs were pink and flawless since we first learnt to make fire? It’s not modern life that’s killing us, being alive has always been dangerous. We just have more media to scare us about it now.

In ye olden days food was full of germs and poo and parasites as well as adulterants – for example alum, plaster of Paris and ash in bread.

In 1872, adulterants in food were found to include ‘strychnine, cocculus inculus (both hallucinogens) and copperas in rum and beer; sulphate of copper in pickles, bottled fruit, wine, and preserves; lead chromate in mustard and snuff; sulphate of iron in tea and beer; ferric ferrocynanide, lime sulphate, and turmeric in chinese tea; copper carbonate, lead sulphate, bisulphate of mercury, and Venetian lead in sugar confectionery and chocolate; lead in wine and cider; all were extensively used and were accumulative in effect, resulting, over a long period, in chronic gastritis, and, indeed, often fatal food poisoning. Red lead gave Gloucester cheese its 'healthy' red hue.’ Ice cream was found to contain ‘cocci, bacilli, torulae, cotton fiber, lice, bed bugs, bug's legs, fleas, straw, human hair, and cat and dog hair’.

Yum. So much for hipster nostalgia.

 Of course we need to avoid harm where we can but we need to separate real harm from hysteria, conspiracy theories and marketing opportunities. Headlines about city air being as bad as smoking don’t help. We’re never going to live some bucolic idyll in the Shires like hobbits.

Fear and guilt make for good headlines and clickbait but things are not getting worse. They’ve always been bad. The history of humanity is about processing, ingesting and inhaling stuff that's bad for us. Sometimes for fun.

Wednesday, 13 December 2017

Nonsense on Stilts 2017

Another year, another round-up of the dangerous and the daft. There was so much to choose from this year so this is just the tip of the iceberg of nonsense on stilts. As ever, it’s divided into health, diet and general craziness.

The Queen of Quacks, Gwyneth Paltrow’s Goop business has spewed out some terrible old cobblers this year, some of which is potentially very harmful. Here is her nonsense about toxic tampons debunked by the excellent Dr Jen Gunter.

Advice given at her ‘health’ conference can be fatal and just in case you thought it couldn’t get any more insane, she is now selling psychic vampire repellent. Yes, really. 

Also in America, anti-vaxxers offered $100,000 for proof that vaccines work. Oh dear. The fact that they’re alive to perpetrate such arrant nonsense is proof enough, isn’t it? One word, anti-vaxxers: polio. Ever been in an iron lung? No. Why is that?

If further proof were needed, the tedious and notorious anti-vaxxer Wakefield managed to cause a measles epidemic in the US.

Earlier in the year it looked like homeopathy would escape an NHS prescribing ban despite cutbacks and despite the Chief Medical Officersaying it’s ‘rubbish’But reason and science have for once prevailed. NHS England has called for homeopathy to be blacklisted as a useless waste of money. Very well done to the Good Thinking Society for their campaigning work on this.

Vets also joined the campaign against homeopathy and then later in the year the Royal College of Veterinary Surgeons issued a new position statement on the veterinary use of complementary and alternative medicines, homeopathy in particular, saying that vets must offer treatments that "are underpinned by a recognised evidence base or sound scientific principles." The new position statement makes it very clear that homeopathy falls below this benchmark: "Homeopathy exists without a recognised body of evidence for its use. Furthermore, it is not based on sound scientific principles."

One of the newer health fads is turmeric. Eat it, drink it, medicate with it. Harmless nonsense for people with more money than sense? Not when a naturopath kills a woman with a turmeric injection or when claims are made for it curing cancer.

I had an awkward conversation not so long ago with a woman who swears by turmeric lattes every day and demanded to know how I dare challenge ‘all the thousands of research papers’ that show it works. To her I say: show me this evidence. It could be a long wait.

And while we’re on spices, cinnamon won’t help you magically lose weight either. Sorry. 

The long-enduring myth that women synchronise periods was debunked. There is no ‘dominant super uterus in a group of women that makes everyone adjust their cycles’. So Super Uterus won’t be making an appearance in the next DC movie, damn it. She’d be so much more interesting than Superman, the most boring of all the supers.

As if UKIP wasn’t bad enough, one of their ‘politicians’ now sells industrial strength bleach as a medical cure at £22 for 60ml. David Colquhoun, professor of pharmacology at University College London, said “You don’t absorb oxygen through your stomach. There’s not the slightest reason to think it works for anything.” Assemble your own joke using the words UKIP, toxic, liars and why is Farage constantly on the news when they have zero seats in Parliament?

A wealthy autism charity is risking children’s lives, offering to pay for them to attend clinics offering pseudoscientific treatments and bogus diets, and it appears to endorse links between vaccines and autism. One of the treatments promoted is MMS, which the National Autism Society describes as a “bleach banned for human consumption”. There are claims it has been linked to at least one death. The Food Standards Agency has warned about its use, calling it an “industrial-strength bleach”. Yes, we’re looking at you, Mr UKIP.

There is yet more evidence that chiropractic is harmful and potentially deadly, and now chiropractors trying to scare women about our clothes, saying skinny jeans, handbags and big fluffy hoods are wrecking our backs. Dr Mary O'Keeffe, a back pain expert at the University of Limerick, says their research is "complete scaremongering and there is no scientific evidence to support any of it".

Earlier this year, a quack claiming to cure cancer by Skype (for money, of course) was found guilty under the Cancer Act and is now facing jail.

The spread of fake health ‘news’ is putting lives at risk. Some of the claims may contravene the Cancer Act 1939: you can report any claims that break the law to Advertising Standards.

I’m happy to report that the backlash against the vile, smug, judgemental and dangerous clean eating movement is gaining momentum. But nature abhors a vacuum so as soon as one diet fad dies, another rises to take its place. But calling them diets is so last year. Now it’s all about Wellness. There are endless books, videos and evangelists promoting their own brands of ‘better living’ which are really just diets wrapped up in very expensive merchandising and ingredients. Because wellness means thinness. There are no overweight Wellness gurus.

Celebrity-endorsed fad diets (sorry, Wellness programmes) are nothing new. Lord Byron’s apple cider vinegar diet was taken up by his many fans in the early nineteenth century and now it’s back. But without the poetry. Which is a blessing.

The low fat versus low carb battle rages on with both sides claiming the other will kill you. Some of the research is very flawed and the screaming headlines don’t help.  There is more and more conspiracy talk about Big Sugar.  The sugar lobby is undeniably powerful but conspiracy theorists have attributed it god-like powers to ensure that we poor fools think saturated fat is the devil. 

As Anthony Warner, aka the Angry Chef, says, this would require ‘paying off the medical establishment, the World Health Organisation, numerous charities, public health bodies and nutrition researchers around the world, and keep producing systematic reviews that show links between consumption of saturated fats and increased risk of heart disease.’ 

The amount of rage generated by daring to question the low carbers should set off the alarm bells that this is not just about food – as Dr Margaret McCartney found out to her cost on Twitter when she dared to write this reasonable piece about the lack of evidence. This is my piece on the cult-like ferocity of the low-carbers.

What no one has pointed out is that if we care about the planet, we should be eating fewer animal products, not more. High protein/high fat means more eggs, fish/seafood, meat and dairy when we should be aiming for a more plant-based diet. And shouldn’t we give at least a moment’s thought to the fact that there are still more underweight 5-19 year olds in the world than obese ones?

There’s a myth doing the rounds that sugar and other carbs ‘feed’ cancer. They don’t.

Do artificial sweeteners cause dementia and strokes? No.  

Does sugar cause or worsen Alzheimer’s? According to the tabloids, yes it does. According to the Alzheimer’s Society “What we don’t know is whether changes in brain glucose metabolism play a role in causing or worsening Alzheimer’s disease or whether the changes are just a by-product of damage already occurring to brain cells.”

Another potentially dangerous diet fad is the Ketogenic diet, which claims to cure everything from cancer to Alzheimer’s to pretty much anything you can name. Here’s a good video explaining what it is and why it is not a miracle (yes, he is a vegan but everything he says about keto stands up).

Yet another bit of dangerous garbage is the idea that everything bad that happens can be cured with an alkaline diet. And while we’re at it, you can’t cure cancer with ‘alkaline’ baking soda either.

Back to the Angry Chef who this time gets quite rightly angry about PETA claiming dairy products cause autism.

The Pioppi diet has gained popularity this year. As the British Dietetic Association commented: “the authors may well be the only people in the history of the planet who have been to Italy and come back with a diet named after an Italian village that excludes pasta, rice and bread – but includes coconuts”. Here’s conclusive proof that coconuts have never been part of a traditional European diet.

Do we need more protein in our diets? Only if you want to make very expensive wee wee.

A Church says starve for three days to cure homosexuality and that people are just claiming to be gay to get attention because they see celebrities doing it. This really doesn’t help when nearly half of lesbian, gay, bi and trans young people are bullied for being LGBT at school and when homophobic attacks in the UK rose by 147% in three months after the Brexit vote.

On a more cheery note there’s the daftness of dopamine dressing – dress yourself happy with bright colours. Unless you’re me and hate them. It’s yet another case of if you believe something you make it true, like wearing lucky pants can make you feel more confident and so perform better.

For a change, a bit of abuse of history instead of science: why lazy journos comparing Trump with Roman emperors are wrong.

Slimming pants! This is hilarious. There is no way that any of these claims stand up – detox, lose cellulite, lose weight, all the usual suspects. Plus, you look like a twat. No wonder they're on offer.

Men are better at understanding projection and therefore physics because they have to learn to pee standing up, according to three 'scientists'“Playful urination practices – from seeing how high you can pee to games such as Peeball (where men compete using their urine to destroy a ball placed in a urinal) – may give boys an advantage over girls when it comes to physics,” the academics wrote. They said this is significant, since the physics curriculum often uses projectile motion as the starting point for more sophisticated mechanics concepts such as force, energy and momentum.

If only the average man's aim was that good. And I’m not sure about the phrase ‘playful urination practices’. Oh, and correlation, causation, yadda yadda.

Not so funny is this: the United Nations pulled staff out of two districts in southern Malawi where a vampire scare triggered mob violence in which at least five people were killed.

No werewolf sightings this year but belief in ghosts is on the increase in America. Add your own Trump-based joke.

Eight out of ten UK water companies still use dowsing rods to 'find' water. Yes, really. I often consult the spirits of the dead for cooking tips. Who doesn’t? 

A lot of the media and some skeptics have dismissed dowsing as mediaeval. Here’s a good explanation of why that’s a lazy assumption. Have they looked at a cathedral or an illuminated manuscript lately? Mediaeval people were not morons, they just had less access to information than we do – although some of us still choose to ignore it. What’s more, ‘records of dowsing do not begin until the 16th century, and its popularity does not appear to have peaked until the 19th and 20th centuries’.

DNA sampling reveals that nine yeti specimens were in fact eight bears and a dog. Damn. 

Finally, an ancient fairy curse causes dips in the road in Ireland, according to an Irish MP. I love this one and really wish it were true. He said “if someone told me to go out and knock a fairy fort or touch it, I would starve first.” The council’s road department said the dip was due to an “underlying subsoil/geotechnical problem.” They’ll be sorry when their socks go missing and their cows’ milk dries up.

That’s it for another year. To help inoculate yourself against nonsense, this is a very good primer on how to read and understand a scientific paper and this is a handy 12 point guide to spotting bad science. Happy hunting.

Join us at London Skeptics in the Pub for a monthly dose of sanity. 

Sunday, 15 October 2017

Don't Put That In Your Mouth!

There have always been fad diets and people making money out of them, like Atkins or the grapefruit diet or swallowing tapeworm eggs. It’s getting harder to know who to trust as the diet messiahs compete for our money, harder to hack through the jungle of lies, empty promises and dangerous bullshit to find the truth. And lately the diet world has been getting vicious.

Weight loss means that using more calories than you consume. As simple as that. Cutting out a whole food group restricts calories, weight loss happens, but as soon as you go back to eating a healthy balanced diet or back to your unhealthy one, the weight comes back.

Nature abhors a vacuum so as soon as one fad loses its shine, another is spawned to take its place, along with all the expensive accessories – courgette rice, gluten free everything, spiralisers. That’s the marketplace in action.

The current crop includes paleo, LCHF (low carb-high fat, sometimes called low carb-high protein), ketogenic, clean eating.

Some messiahs are alert to public weariness with diet books and have rebranded their Gospel as ‘wellness’. Every single Wellness lifestyle is really a diet in disguise. All the Wellness messiahs are skinny and glossy and young.

Why are these diets a problem?
If dieting worked, there would only need to be one diet, everyone would do it and no one would put the weight back on. But that doesn’t happen. We have a short attention span. We want a quick fix, we all want to feel shiny and special. When one diet doesn’t work, we move on to the next one that promises us salvation. Life as a diet messiah is short. There’s always another one waiting in the wings so you have to make big claims to get attention and excommunicate the competition as heretics.

 The problems start when essential nutrients or dietary elements are being missed – vitamins, minerals, fibre – or an excess of fat/protein raises risks of conditions like kidney stones, osteoporosis, heart disease, liver disease and so on.

Fibre is the orphan child of many current diets. Without fibre it is very hard to poo. Pooing should not be under-rated as long-term constipation can have serious consequences. It’s also a natural detox, along with peeing. So regular trips to the loo will save you buying all those detox products and laxatives (but not prunes as the European Food Safety Authorityruled that they do not have a laxative effect). 

And of course carbs are cheap. Baked beans on wholemeal toast is a balanced, poo-friendly meal but it has no swank factor. Your Instagram followers will not be impressed.

How to tell crap from Christmas?
There’s a link between fad diets and fake news – they look plausible, they use science words, they fit with what you would like to be true and it takes an effort to research if they are genuine. It’s getting harder to tell crap from Christmas.

Once you’ve invested in something financially and emotionally, you’re likely to defend it whatever the evidence. Cognitive bias means you’ll ignore the evidence against your beliefs and cling onto anything that appears to confirm them.

You’re part of a tribe. You read the book, buy the products, join the online forums, identify with skinny glossy, hench celebs doing the same diet, Instagram your meals and get thousands of Likes, worship at the church of your chosen messiah. And your tribe hates all the other tribes, especially the Science Tribe who will insist on pissing on your chips (which are made of lard if you’re on the low carb diet).

Do not dare to question the Chosen One or we will smite you with the wrath of social media. It’s all gone a bit Old Testament.

I’ve been harangued by women for daring to question their proselytising of paleo and of turmeric as a miracle ingredient in everything.

Margaret McCartney, who is a real medical doctor (unlike me), had the temerity to point out that fad diets like LCHF are not a miracle fix and received a shitstorm of hatred on Twitter.

Where’s the harm?
The risks of the LCHF diet are not hard to find despite the fact that its advocates can get pretty vicious. 

Clean eating advocates are particularly vocal with their loathsome conflation of moral value and food which, in some cases leads to orthorexia and other eating disorders. 

Sometimes dietary claims get even nastier, like the claims that dairy products cause autism and anyone feeding their child dairy is risking their lives. 

Then they get nastier still, like the claim that the ketogenic diet can cure cancer.

Who can we trust?
Just as with other forms of fake news, it can be hard to know who to trust. The Pioppi diet is best described as ‘a superficial lifestyle guide based on distorted evidence’ even if one the authors of the diet book is a cardiologist. Most people would think it’s safe to believe a cardiologist. But as the author of this article points out: ‘Pasta is as central to the Italian diet as potatoes are to Britain’s. So too is bread. This is the elephant in the room for anyone trying to pretend that Italians eat a low carb diet’.

There’s another cardiology scientist recommending eating a lot of salt against all expert advice. Trust me, I’m a doctor? Maybe not. 

Sometimes the boundary between saints and sinners is blurred. For example, in this video, a vegan looks at the evidence for the dangers of the keto diet. One of the experts he cites is called Paleo Mom. They both have an agenda but the science is right – keto can be very dangerous, especially for children. Because it’s not just middle class adults wasting their money and messing with their bodies.

Other fake news tactics the diet messiahs use include taking evidence and distorting it, making the false link between correlation and causation, cherry-picking data, using facts out of context, ignoring confounding factors that don’t suit them, picking an arbitrary period in evolution for which the evidence is obscure and declaring that is our most ‘natural’ diet.

It gets crazier
The next step is the conspiracy theory. The sugar lobby is undeniably powerful but conspiracy theorists have attributed it god-like powers to ensure that we poor fools think saturated fat is the devil. 

As Antony Warner, the Angry Chef, says, this would require ‘paying off the medical establishment, the World Health Organisation, numerous charities, public health bodies and nutrition researchers around the world, and keep producing systematic reviews that show links between consumption of saturated fats and increased risk of heart disease.’

Once a conspiracy theory gets going, any evidence against it is taken as part of the conspiracy. The believers think that they and they alone know the truth. They feel powerful and clever and smug. And presumably constipated.

Yes, the parallels with religion are all there, the In Group and the Out Group, the access to privileged information, the righteousness, the smiting of enemies, feeling persecuted, the Gospels (the lucrative book deal is the Holy Grail of the Messiahs), the Way, the Truth and the Life. There’s no point being Saved unless others are Damned. Preferably on Twitter.

What’s the answer?
How are people to know what is a healthy diet and what isn’t? It’s so much easier to join a tribe and buy the book/watch the videos/follow a messiah on social media than to go and see a clinical dietitian.

Basically, if a diet involves eating less saturated fat, cutting out processed carbs but keeping whole grains, fruit and veg, reducing salt and sugar, reducing portion size and getting some exercise, it’s a good one. Basically, it’s just common sense. Which doesn’t make anyone any money.

Most people aren’t stupid but society puts pressure on us all to be thin and healthy. Desperation can lead us to make bad choices. The Internet should make it easier to get access to good information but the proliferation of messiahs makes it so much harder. They are all false prophets of diet salvation. We need to become diet atheists.

Thursday, 22 June 2017

Is it sex that’s keeping Granny going?

Is regular sex good for your brain as you get older?

The journal Age and Ageing published some research in 2016 on the effects of sex on the brains of older people called Sex on the brain! Associations between sexual activity and cognitivefunction in older age

The Journal of Gerontology has just published Frequent Sexual Activity Predicts Specific Cognitive Abilities in Older Adults, which says it ‘replicates and extends the findings’ of the first study.

Any article purporting to be about the science of sex makes for good headlines, but is the science any good? (Spoiler: No).

First, the Sex on the Brain research. Let’s set aside the dreadful title. Has anyone done research into the tendency of academic studies to make themselves sound like tabloid articles?

For the purposes of this study, ‘sexual activity could include intercourse, masturbation, petting or fondling’. I’m not sure what counts as petting and fondling except that there used to be signs at swimming pools saying: ‘No petting’.

The aim of the study is to explore ‘the relationship between cognition and sexual activity in healthy older adults’ (aged 50-89). The tests used were number sequencing and word recall. The findings were that ‘there were significant associations between sexual activity and number sequencing and recall in men. However, in women there was a significant association between sexual activity and recall, but not number sequencing’.

The word to keep in mind here is ‘association’. We’ll come to that.

People in the study were asked about sexual activity in the last 12 months. The findings were that ‘sexually active men and women to have significantly higher scores on the number sequencing and recall tests than sexually inactive men and women (all P < 0.001)’.

This is where the alarm bells start to go off.  

As all good skeptics know, correlation does not imply causation – or ‘association’ as the study calls it. That’s at the core of the problem with this research. Both studies admit this: ‘we can only speculate as to a causal relationship at this time’ and ‘we cannot infer a causal relationship between SA and cognitive function’. So all the studies are really saying is that people who say they have more sex when they are older do better on certain tests.

It’s important to have a control group when researching: people who did not receive the treatment or got a placebo or who didn’t do something to others did, for example. You need something to compare your results with.

The control group here is people not having regular sex. This might work if there were no other variables and confounding factors. But that’s not the case. It would be a much better indicator if the people who did score higher had no sex for 12 months and were then retested. Did their abilities change?

Another problem is that the average age of people having sex was 64.4 years and those not having sex was 72.9 years. That’s quite a big difference in terms of ageing; changes to the body over those 8.5 years are not considered. Women at the lower end of the age range were not asked if they had been through menopause, which can affect sexual activity and interest.

There was no indication of whether the participants were straight or LGBT, trans or cis.

The sample size is good, 3,060 men and 3,773 women, enough to produce significant results. But there were 2349 men who were having regular sex and only 711 who weren’t, which could skew the results.

A further problem with the research is that ‘sexually active men and women were more likely to have a higher level of education, be younger, wealthier, more physically active, not depressed, less lonely and have a better quality of life’.

This is where another klaxon goes off.

People with more money and a better education scored higher. They were also more likely to be living with a partner and so have easier access to sex. The study could just as well be called ‘Educated, wealthy old couples have more sex!’ (Not quite so catchy as titles go)

It could also have been called ‘People with depression, illness and loneliness have less sex!’ These conditions don’t just affect older people but everyone and can reduce sexual desire or activity.

Masturbation was included as sexual activity but not split into solo or mutual groups. So it could be that DIY is just as effective as sex with someone else – there’s no way of knowing from this study.

Both studies speculate that the cause could be the ‘potential cognitive enhancing effects of dopamine’ and ‘enhanced oxytocin release’. These two have been shown to improve cognitive functioning but levels were not measured in participants.

There’s also the problem of self-reporting. How honest were the answers?

The participants were not asked if they were having good quality sex or how their sexual activity had changed over time.

The second study replicated the findings of the first and tested for a wider range of cognitive functions. But there were only 73 participants (aged 50-83), not enough to be statistically significant. One of the tests was to list as many words beginning with F as possible. Don’t tempt me.

How are the media reporting these findings? One guess.

The Express says ‘University boffins have discovered older people can boost their brain power - by having more sex’ and thoughtfully includes a badly-drawn diagram on a sex position for people with arthritis. Props for using the word ‘boffins’ though, that always makes me laugh, especially in an article about sex. 

The Evening Standard goes with ‘Over-50s can boost their brain power by having more sex, new research has found’. That’s an interesting but not unexpected use of ‘found’.

The Daily Mail says ‘Sex is the key to staying sharp in old age!’ What are we to infer from the exclamation mark? That it’s a surprise? That old people are having sex? Or just that it’s about SEX!

So yes, the expected uncritical response because it’s SEX. And we all like to read about SEX. Or SEX! to be more accurate.

What do we take away from this research?

That some people do better on some cognitive tests than others and that they are likely to be better educated, wealthier and healthier. They also have more sex.

There’s no consideration for people who either can’t have sex or don’t want to and how articles like this might make them feel. The research is carefully neutral but the media coverage implies that people should be having sex to preserve cognitive faculties. It’s up to you, shag or go senile. No pressure.

As a positive takeaway, if you’re not having sex, your brain is not doomed to shrivel up. Dopamine levels can be increased through exercise, getting enough sleep, achieving goals (even small ones) and eating bananas. Oxytocin levels can be increased by holding hands, stroking pets, laughing, exercise and even looking at pictures of cute things.  So go eat a banana and look at some kittens.  

Appendage: The picture at the top is only vaguely linked to the subject but all the words I could think of to put into an image search would have taken me somewhere I may not have wanted to go.

Wednesday, 24 May 2017

Quit It - Part Three

Part Three of dispatches from the front line after ONE YEAR without smoking

Have I smoked in the last year? No. Not one. Do I still want to? Yes. Will I give in? The hell I will.

The addict part of my brain will always be there but it’s become a puny, mewling thing.

One of the strongest triggers now is leaving a cinema; my first thought is still to light up. Last week I dreamed I was smoking and really enjoying it; for the next couple of days I really wanted one. An ex-smoker I know said this still happens to her occasionally, even after years.

People keep saying that I must feel so much better. In theory, my immune system should now have recalibrated, the cilia and cells in my airways regrown. My risk of coronary heart disease, heart attack and stroke has dropped to less than half that of a smoker. But it’s only in the last couple of weeks that I’ve actually started feeling well after being almost constantly ill for more than eight months - not just with post-smoking coughs and colds but with non-respiratory viruses.  The GP tells me this is normal. Bloody marvellous.

I’ve just got back to my pre-quitting weight. Maintaining it is hard and means not even looking at lovely, lovely sugar more than once a week. I’m eating less overall than I was too, which is a real challenge.

My knees have adjusted to the extra cardio and my bum muscles are a bit firmer than they were.

I’ve saved myself a couple of thousand pounds (my brand, Silk Cut Silver, now sells for £10.45 in my local supermarket, of which £5.19 is tax). Am I saving the NHS money? I may not need it for smoking-related diseases but if I live longer, I will need it for other things.

Since I quit, standardized cigarette packaging has been introduced and the ten pack is no longer available. The idea is that the drab boxes with big ugly health warnings will make more people quit and put children off starting. The evidence for quitting is very slim but there is some evidence that the boxes are less attractive to teenagers. 

Most of the legislation, constant price increases and public health strategies are aimed at preventing young people from starting. They won’t put off the addicts – and certainly wouldn’t have made me stop.

You can see why vaping is becoming more popular with its pretty colours and no health warnings or gruesome images. So far. Evidence is growing of the dangers of vaping if it is not used as a short-term quitting aid. 

Some tobacco companies have started selling tins to avoid the new packaging rules and keep their branding visible. One expert said “The fact that these tins appeared almost immediately prior to the branding and size restrictions coming into force is suspicious.” It’s not suspicious, it’s predictable. They are not going to go down without a fight for a global industry currently worth $770 billion a year.

I’ve learnt a lot about quitting in the last year, some of it scientific, some of it personal. The main messages are:
  • Quitting is bloody awful but if it was easy everyone would do it. I am super special sparkly
  • There is no good time to stop. This last year has been a bugger for many reasons
  • It’s different for everyone
  • Think before you open your mouth around a quitter
  • There will be consequences. Quitting is damage limitation, not resetting to zero
  • There are both genetic and cultural components to addiction
  • Public health information and support is very inadequate
  • It’s really important to get support from anyone who will listen to you constantly whining
  • Punching people won’t make you want to smoke any less

So that’s my year of quitting. Now give me that damn cake.


Nearly two years in and I am now a much greater drain on the public purse than when I smoked. Sorry about that.


I keep dreaming I'm smoking again, possibly because it's coming up to two years since I quit and it's on my mind. Sometimes you just have to wake up and say Fuck off, brain.

We had an interesting talk at London Skeptics (which I run) about harmful behaviour. The speaker, Dr James Erskine, has done research that shows not thinking about something isn't the answer. That just increases the cravings and the likelihood of giving in. And when you do give in, you'll do way more than you used to as a kind of rebound effect (the return of the repressed). The trick is to acknowledge and observe the thought, which helps 'decouple it' (his words) from acting on it.

Sunday, 9 April 2017

Beyond Belief

A Comres survey commissioned by the BBC for Palm Sunday** does not look good for the Church of England despite a predictable effort to spin the findings.

In the survey, 51% of people surveyed identified as Christian. Half of the people surveyed said they didn’t believe in the resurrection, while only 31% of people identifying as Christian said they did. Only 17% of people thought the Bible version was literally true while 26% believed but thought the Bible shouldn’t be taken literally.

Although Christmas is now far more celebrated, the resurrection is the core tenet of Christianity and Easter is its most important festival. No resurrection, no Christianity.  To quote the Bible: Jesus said unto her, I am the resurrection, and the life: he that believeth in me, though he were dead, yet shall he live. (John 11:25) And yet more than two thirds of Christians don’t believe that.

Belief and church attendance have been falling for quite some time. The figures for belief in this survey are slightly better than those in a YouGov survey from last year which found that only 46% of people identify as Christian. This was a much bigger survey and so is more likely to represent the population as a whole (nearly 12,000 as opposed to around 2,000 people). The YouGov survey also found that more people believe in ghosts than in a Creator.
According to the current survey, 37% of people identifying as Christian never go to Church. Another survey by the Church of England itself found that only 2% of the population go to the Church of England at Easter. The flock really has strayed far from the Good Shepherd (probably because they know he’s going to herd them off to the slaughterhouse so we can all eat our traditional Easter roast lamb and rosemary). 

The survey also looked at belief in life after death. It found that only 46% of people said they believed in it and the same number said they didn’t. If you don’t believe in an afterlife then the Church’s carrot and stick tactics are not going to work on you.

Sidebar: of those who do believe in an afterlife, 56% were women and 36% were men. I looked at why women may believe more than men in many kinds of supernatural phenomena (and non-evidence based medicines) here.

The Church is fighting a rearguard action and trying to spin the findings that 20% of the non-religious believe in some sort of life after death and that 9% of non-believers do believe that the resurrection happened.

The Bishop of Manchester, the Right Reverend David Walker,said: "This important and welcome survey proves that many British people, despite not being regular churchgoers, hold core Christian beliefs”. He describes the results as “surprisingly high levels of religious belief among those who follow no specific religion, often erroneously referred to as secularists or atheists”.

Let’s unpack this a bit. Firstly, the Church doesn’t have a monopoly in life after death belief. About a third of the people (32%) who believed in some sort of life after death believe in reincarnation, hardly a Christian doctrine.

Secondly, 9% believing in the resurrection is not a ‘surprisingly high level’ when you look more closely and see that these are people who ‘do not belong to a religious group’ according to the survey. They are not identified as non-believers or claiming to be atheist or secular, he’s just grasping at straws because any kind of belief, however small or tenuous is better than nothing.  He does deserve credit for his top skills at ignoring all the stats that don’t reflect well on the Church though. That’s quite an impressive mental contortionist act.

Thirdly, he is conflating atheists and secularists. Atheism means no belief in God whereas secularism is a political belief in the need for separation of Church and State. You can be religious and secular, as many people are.

Like a lot of Easter eggs, the Bishop’s claims are hollow and crack under the slightest pressure.

There is also dissension in the Christian ranks. Reverend Dr Lorraine Cavenagh is the acting general secretary for Modern Church, which promotes liberal Christian theology. She said "Science, but also intellectual and philosophical thought has progressed. It has a trickle-down effect on just about everybody's lives.

"So to ask an adult to believe in the resurrection the way they did when they were at Sunday school simply won't do and that's true of much of the key elements of the Christian faith."

A cynical person might say that the Church wants us all to believe like children at Sunday School do. Many of these children also believe in Santa.

Would it be mean to point out that in 2002 a survey found that a third of Church of England clergy don’t believe in the physical resurrection? That’s a bit of an own goal. It’s also unfair to people who do believe if they’re being led by people who don’t.  

These findings follow the Cadbury Easter egg fiasco where self-proclaimed vicar’s daughter Theresa May and Archbishop Sentamu got very hot under the dog collar about Cadbury’s and the National Trust dropping the word Easter from their eggs and egg hunt. I wrote about that here (short version – it’s not true).  

Does any of this really matter to most of us who are more interested in hot cross buns, chocolate eggs and maybe some roast lamb next Sunday?

The Bishop of Manchester also said: "This demonstrates how important beliefs remain across our society and hence the importance both of religious literacy and of religion having a prominent place in public discourse."

This is the crux of the matter. The Church will not give up its power and influence. It will not give up unelected bishops in the House of Lords or its tax-free benefits or state-funded Church schools and hospital chaplains or its general right to meddle in people’s lives. It wants the right to cherry-pick who gets to go to its schools, to mislead children in sex education classes and to discriminate against women and non-hetero cis men.

Church leaders are deluding themselves about the relevance of their beliefs and their jobs in a multi-cultural society. Yes, this country has a Christian heritage, religion has shaped society and history but it is not the sole influence. Societies evolve and the Church is looking increasingly like a dinosaur just before the meteors hit. Or, to add another simile, the Church is like a ferret that will not let go once its jaws have locked on.

However, this survey is no reason for celebration. Politicians won’t do anything to secularise the country because they’re afraid of losing votes. Anglicans (Church of England) are more likely to vote Tory, for a start. This government is very good at ignoring research it doesn’t like in any area and at dismissing ‘experts’ as irrelevant. 

So the Church of England has the last laugh. Whatever surveys show, there is no prospect of change any time soon. It’s much easier to hold onto power than to gain it. Inertia, cowardice and the status quo prevail.

Happy Easter.

** Palm Sunday is the one before Easter where the Bible says Jesus entered Jerusalem on a donkey and people waved palm leaves at him.