Monday, 17 December 2018


Here we go again, then. The annual round-up of the good, the bad and the ugly in healthcare, nutrition and general daftness.

Let’s start with some good news: this is a great thread by Simon Singh on Skeptic successes in the past few years. 

Following a consultation, the Charity Commission has decided that charities must support their alternative medicine claims with good scientific evidence.

In other good news, homeopathy is no longer publicly funded on the NHS – and about bloody time too - but of course they won’t go down without a fight: homeopaths are going to take the NHS to court

Homeopathic vets also had a hissy fit because the RCVS demands its members use evidence-based treatments. Because science doesn’t know everything, right? Even though vets are scientists. 

Cancer patients using alt med rather than conventional treatments have a worse survival rate. And it’s not just people self-treating; research finds that ‘Doctors who are attracted to homeopathy despite a lack of evidence may be generally less good at keeping up to date on treatment guidelines and safety alerts or be less willing to work with colleagues to improve. Doctors who offer it to patients tend to do worst on scores for effective use of conventional medicines.'

Mixing alt med with real meds is like running an unsupervised and potentially deadly experiment.  Natural does not equal better. Or safe. Look at what happened to that great self-doser Dr Jekyll.

Twenty years on, the legacy of the MMR vaccine and autism scare lies continues to take its toll across Europe. Cases of measles have hit a record high, according to the World Health Organization. Experts blame the surge in infections on a drop in the number of people being vaccinated. Although, inevitably, it’s a bit morecomplicated than that.

There has been some interesting research on how anti-vax attitudes correlate with belief in conspiracy theories and how this may affect pro-vax campaigns. It’s not surprising that there would be cross-overs as the same mindset is transferrable from one false belief to another.

It wouldn’t be a Skeptic Round-up without some mention of La Paltrow. Don’t put coffee up your bum even if she tells you to. And don’t use live bee stings either, even if she says ‘I’m open to anything. I’ve been stung by bees. It’s actually pretty incredible if you research it.’ Probably not so incredible for the bees, though.

Paltrow says anyone who challenges the healing powers of her 'wellness' products is against the empowerment of women. As if that passive aggressive act would shut down all debate. Lucky for us, her main challenger is a woman.  The wonderful Dr Jen Gunter attended the GOOP conference and reported from the frontline of 'wellness' where she found that the Goop store is “90% quackatorium, and there was no evidence supporting Gwyneth Paltrow’s claim that Goop does not engage in pseudoscience as a commercial venture."

There is some good news. Goop has agreed to pay a substantial settlement over unproven claims about the health benefits of its infamous vaginal eggs.  ‘Under the settlement Goop is banned from making any claims regarding the efficacy of its products without reliable scientific evidence.’

Enough about her.

Plain packaging doesn’t decrease the number of smokers – quite the opposite. It’s also failed in France and Australia. It certainly wouldn’t have deterred me when I smoked. The intention may be to deter new smokers (children) but it's impossible to determine accurately whether any one factor has an influence on either current or potential smokers.

A naturopath treated a child with rabid dog saliva to cure behavioural problems, claiming he was in a ‘dog state’. She claimed that "The dog that bit him may have recently been vaccinated with the rabies vaccine or the dog bite in and of itself may have affected the boy with the rabies miasm … Either is possible and the phenomenon is well-known in homeopathy. A bite from an animal, with or without rabies vaccination has the potential to imprint an altered state in the person who was bitten, in some ways similar to a rabies infection."

A miasm is a homeopathic term for ‘the ghost of the disease state still rampant in the energy system.’  The non-homeopathic definition of the word is ‘noxious exhalations from putrescent organic matter; poisonous effluvia or germs polluting the atmosphere’. Pretty much sums it up. Just as well it wasn’t a werewolf that bit him.

Another naturopath is promoting peat tampons. Just don’t go there. 

Weight loss magnets – at last, what we’ve all been waiting for! Oh, wait a minute … This is why magnets don’t work like that.

Taking fish oil supplements for a healthy heart is nonsense says a Cochrane report.

Is sugar the new heroin? Normally everything ‘bad’ is compared with smoking these days. And ‘bad’ has become shorthand for ‘I disapprove of…’ Sugar is not addictive. Repeat. Sugar is not addictive. Sugar is not addictive.

The truth about Public Health England’s sugar reduction scheme: ‘The idea is to reduce sugar content in most foods by 20 per cent by 2020. The first target was a five per cent reduction by 2017 but this has not happened. It was never likely to happen. Instead, there has been a two per cent reduction across the eight categories that PHE is most interested in… Food companies need little incentive to shrink their products while keeping the price the same (NestlĂ© and Mars were frantically shrinking their products before the sugar reduction plan officially began - and before Brexit). But the government is now encouraging them to do it. Indeed, it is effectively compelling them to do it because that is the only realistic way of cutting sugar content in chocolate, confectionery and biscuits, which are the main sources of sugar.’

In some cases, the sugar content has gone down but overall calories have gone up. If you take the sugar out you have to put something in so that the product doesn’t taste like cardboard smeared in brown fat.

And other research states "We were unable to find evidence that any sugar tax actually implemented anywhere in the world has led to improvements in health." Sorry, Jamie Oliver. 

Water has become a big fad this year. There has been a new raw water craze. Mmm yummy poo and germs and bits of twig and insects and insect poo.

Need a mental boost? Try rosemary water. Only £4 a bottle. Check out the science section: ‘The herb features in Greek mythology, the New Testament, and Shakespearean drama’. Yes, it did say science.

Or there’s alkaline water that has been treated to have a higher pH level than the usual 6.5-7.5. The makers say it provides “better hydration” and is “designed to obtain optimum body balance” because it “uses specialized electronic cells coated with a variety of rare earth minerals to produce scientifically engineered water”.

Science says: “Your body regulates its [blood] pH in a very narrow range because all our enzymes are designed to work at pH 7.4. If our pH varied too much we wouldn’t survive… you’re literally just flushing money down the drain”.

A sceptical look at the long history of Personality Testing – including the bunk that is Myers-Briggs which is basically corporate astrology. 

Exorcism is on the rise. These truly are the Dark Ages.

A Mexican priest claims: ‘The vast majority of people who see him have normal problems or mental illnesses, and he says he has sent people to seek psychiatric help. But he says 2-3% show signs of demonic “vexation” … His subjects, he says, have problems that cannot be explained in normal medical terms. One, who he believes may have been cursed by her mother-in-law, feels an almost constant sensation of daggers entering her legs, knitting needles in her arms, and a clenched hand at her chin. Another was so obsessed by self-gratification that he masturbated 40 times a day. “Normally speaking it is humanly impossible … so that is a satanic thing”.’

I do like the term ‘vexation’ and will attempt to use it in general conversation. How does the woman know what daggers entering her legs actually feel like, or knitting needles in her arms? As a knitter, I can say that it would be bloody hard to stab with a knitting needle, they’re just not sharp enough. I’d use an embroidery needle.

It’s not just Mexico where exorcism is on the rise. A top Irish exorcist called for more exorcists because ‘there has been increasing evidence of the malicious activity of the evil one’. Pope Francis gave formal recognition to the International Association of Exorcists in 2014. According to Fr Collins, ‘it’s only in recent years that the demand has risen exponentially’ and he blames ‘a growing apostasy within the Church’. Scare tactics, then. Come back to Church or the Evil One will get you.

The ‘malicious activities of the evil one’ has a great ring to it. I shall be using it to refer to anyone I don’t like in future.

According to vets, the government is being very economical with the truth about the efficacy of badger culling: “Badger culling has not worked. They are issuing barefaced lies in this matter." The former head of DEFRA’s wildlife epidemiology unit who advised the department on its TB strategy for more than 40 years says: "Defra has been cherry-picking the science since they started culling. The fact that they are rolling it out on such a vast scale is a travesty of the available science." 

The Indian education minister says evolution is ‘scientifically wrong’ because no one has ever seen an ape turn into a man. He seems to be confusing science with shape-shifting. I have however seen a man turn into an ape on several occasions. Generally after the application of alcohol.

This debunks the myth that women talk more than men. Men of course have much more important things to say. At great length. Even when we’re the expert in the subject and they just read an article by Jordan Peterson and shut up or I’ll send you death threats on social media for daring to mention this. 

The ‘psychology’ of the power stance has also been debunked. Politicians should keep on doing it. So much of what comes out of their mouths is inane/terrifying/depressing that they might as well give us a laugh.

So-called ‘healing crystals’ often come from ethically and environmentally dubious sources. So they’re not just pretty shiny things.

Koko the gorilla’s language skills were not at all as we’d been lead to believe, more a mixture of wishful thinking and ignorance about how language actually works. Damn it.  Who doesn’t love a chatty gorilla with a pet kitten? 

There is no evidence that tech is as ‘addictive as cocaine’. Nor are cupcakes, ice cream, power, carbs, World of Warcraft, sugar etc etc. Claims are often based on a misunderstanding of what addiction is and an oversimplified description of what the brain chemical dopamine does, according to clinical psychologist Vaughan Bell.

Hunt’s screen time limits for kids is yet more evidence free policy, yet another moral panic: ‘the recognition of so-called gaming disorder by the World Health Organisation is premature.’.

Andy Przybylski, associate professor and director of research at the Oxford Internet Institute said: “The thing that is very, very important to understand about this is that these correlations are extremely small,” he said. “And 99% of a child’s wellbeing has nothing measurable to do with screens, no matter how you measure them.”

It turns out it’s a myth that Victorian doctors treated hysterical women with vibrators. Damn, that’s another fun one out the window then.

There are times when I so wish magic was real. A coven of New York witches put a hex on US Supreme Court Justice Brett Kavanaugh and, just to make the story even more fun, a Catholic priest and exorcist in California countered the spell by saying prayers for the justice at Mass, saying "This is a conjuring of evil - not about free speech."

They claim that similar hexes on Trump have been successful "We feel the rituals were a success as they sought to expose Trump for what he is, and that has happened on many levels; from the Russia probe to the exposé on his finances to Stormy Daniels."

It is of course impossible to tell without an unhexed control Trump whether they worked or not.

A real treat to end with– an archive of occult recordings. Everything from the voice of Alistair Crowley to voices beyond the grave to all manner of spooky shit. Enjoy.

For vaccination against nonsense, dangerous or otherwise, join us at London Skeptics in the Pub  or find your local Skeptics group. London is the original SitP and 2019 sees the twentieth anniversary of our founding. There will be celebrations and they will not be carb-free.

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.