POSSIBLE ALTERNATIVES TO PRESCRIPTION SLEEP AIDS

As people age, often the typical sleep patterns of youth changes to more interrupted sleep, which can become annoying and affect general health in many areas as well. Prescription medicines for this problem exists but frequently have unwanted side effects. Even without the dangers, none of these are intended for long-term use. Some turn to “natural” supplements—herbal or other remedies that naturopathic physicians may suggest.

It is easy to find information on this type of aid on the Web. Searching on the term “sleep” on Amazon.com will bring up a list of books on the subject. One good starting point for herbal remedies is webmd.com . Here you will find information, both pro and con on Valerian, Chamomile and Melatonin as well as forms of Cognitive Behavior Therapy.

For more in-depth information on Valerian, see:

1)     “Valerian for Sleep: A Systematic Review and Meta-Analysis,” PMC (PubMed Central®) a free full-text archive of biomedical and life sciences journal literature from the NLM. The final edited form was published in American Journal of Medicine December 2006 Volume 119, Issue 12, Pages 1005–1012.

2)     Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials, Sleep Medicine. 2010 Jun;11(6):505-11. Epub 2010 Mar 26.

for Melatonin, see: “Meta-analysis: melatonin  for the treatment of primary sleep disorders,” PLoS One. 2013 May 17;8(5):e63773.

Some additional suggested sleep aids are: Magnesium, Lavender, Passion Flower, Glycine, Tripophan, Ginkgo biloba and L-Theanine. These are listed on healthline.com in “ 9 Natural Sleep Aids That Are Backed by Science.”

Finally, despite the poor reputation homeopathic remedies have among most allopathic physicians, naturopaths tend to have differing opinions on the subject. Personally, I have found several homeopathic forms that do exactly what they claim to do. While they may not work for everyone and perhaps a placebo effect comes into play, I am of the opinion that if it works, don’t knock it! Readers might want to read the 26 positive and three critical reviews of Coffea cruda 30C on amazon.com for comments on this sleep aid. Another article is “Effects of homeopathic medicines on mood of adults with histories of coffee-related insomnia,” in Forschende Komplementarmedizin, 2010 Oct;17(5):250-7 Epub 2010 Oct 1. (Ed. Note: The Europeans have a long history of being more sympathetic to complementary medicine and homeopathic remedies.)

In a future blog I plan to discuss the topic of a possible explanation for why homeopathic treatments might work in the more recent physics theories involving superstring theory and membrane quantum mechanics.

SLEEP AND INTELLIGENCE

[Note: to the Reader: While you might wonder at the connection between this post and the subject of the blog, an upcoming post will deal with natural ways to improve sleep.]

Sleeping Beauty

The recent brouhaha over President Trump’s sleeping habits—four to five hours a night—prompted me to look into the issue of sleep as it relates both to health and mental functioning.  Periodically, media headlines trumpet the alarming news that Americans are chronically sleep-deprived. A few years back, the Centers for Disease Control (CDC) in a major study claimed “more than a third of American adults are not getting enough sleep on a regular basis.” The report went on to warn that, “Sleeping less than seven hours per day is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.” More recently (January 2017) a sleep statistics study  based on 20,000 participants found a “whopping 79% of Americans are getting less than the recommended seven to eight hours of sleep each night and over 30% have a SleepScore of 55 or less.” Actually, these reported percentages vary widely depending on the study, of which there are quite a few to be found. Still, the figure of seven to eight or nine hours sleep a night for healthy living seems to be fairly constant.

One aspect of the media focus on this question seems to involve how sleep deprivation might cause problems for persons in positions of power, both in the area of mental functioning and possibly by extension even in intelligence. So, I thought it would be interesting to see how these shortfalls in sleep might have affected some famous historical figures.

Einstein, acknowledged by all as a great genius, is said to have slept punctually for 10 hours each night, which is considerably more than the average sleep duration – added to this were daytime naps. Wouldn’t this excess of sleep have muddled his thinking? Nikola Tesla, responsible for us using AC electricity today as well as nearly 300 other patents, slept for no more than a couple of hours each night.  He did take some regular naps during the day, though. In sum, he seems to have gotten about five hours of sleep in every 24. With all the presumed attendant health risks, how could he focus on so many brilliant inventions? And he lived to be 87. Thomas Edison, who was 84 when he died, followed the same schedule. Tesla and Edison were well into the sleep deprivation area that seems to be so worrisome today. https://www.thesleepjudge.com/the-strange-sleeping-habits-of-five-great-geniuses/ 

This pattern of short periods of regular sleep with relatively brief naps of between 20 minutes to two hours is called the Da Vinci Sleep Schedule, although Da Vinci himself is thought to have used the Uberman cycle , with naps every four hours lasting about 20 minutes. According to a Big Brand Beds (U.K. manufacturer) study, a few other well-known individuals apparently were known for getting far less than the allegedly optimal seven hours per night. These were people like Benjamin Franklin, Voltaire, Sigmund Freud, Margaret Thatcher, Barack Obama (does anyone recall media concern about this?) and Indian Prime Minister Narenda Modi. With allowances made for differing opinions about the intelligence level of all these people, still most people would consider all of them to be relatively bright. So, what is it about sleep that really affects intelligence and the ability to reason?

New information is emerging about the mechanics of sleep as it affects the brain. Until fairly recently, the period of sleep known as Rapid Eye Movement (REM), which comes about every 90 to 120 minutes during sleep and is associated with dreaming, was believed to be very important for health, learning and memory. Now it seems this is not the full story. Instead, Non-REM sleep, which accounts for about 60% of the time we are asleep, includes thousands of seconds-long but intense bursts of activity, called “spindle events” from their shape on an EEG. The more you sleep, the more of these events you have.

From research, it seems these spindle events are correlated with intelligence. It is still a bit of an open question whether people who have more of these events are more intelligent or whether more intelligent people tend to have more events—sort of the chicken or the egg puzzle. Also, for a yet-unknown reason, research shows women have more spindle events during overnight sleep while men have more during daytime naps.

For more details, see these articles:

Scientific Reports  2015 Nov 26; 5:17159. “Nap sleep spindle correlates of intelligence.”

Abbreviated Abstract

Sleep spindles are thalamocortical oscillations in non-rapid eye movement (NREM) sleep, that play an important role in sleep-related neuroplasticity and offline information processing. Several studies with full-night sleep recordings have reported a positive association between sleep spindles and fluid intelligence scores, however more recently it has been shown that only few sleep spindle measures correlate with intelligence in females, and none in males.

 Journal of Neuroscience . 2014 Dec 3;34(49):16358-68. “Sleep spindles and intelligence: evidence for a sexual dimorphism.”

Abbreviated Abstract

Sleep spindles are thalamocortical oscillations in nonrapid eye movement sleep, which play an important role in sleep-related neuroplasticity and offline information processing. Sleep spindle features are stable within and vary between individuals, with, for example, females having a higher number of spindles and higher spindle density than males. Sleep spindles have been associated with learning potential and intelligence; however, the details of this relationship have not been fully clarified yet.

Scientific Reports. 2017 Dec 22;7(1):18070.  “The sleep EEG spectrum is a sexually dimorphic marker of general intelligence.”

Abbreviated Abstract

The shape of the EEG spectrum in sleep relies on genetic and anatomical factors and forms an individual “EEG fingerprint”. Spectral components of EEG were shown to be connected to mental ability both in sleep and wakefulness. EEG sleep spindle correlates of intelligence, however, exhibit a sexual dimorphism, with a more pronounced association to intelligence in females than males. In a sample of 151 healthy individuals, we investigated how intelligence is related to spectral components of full-night sleep EEG, while controlling for the effects of age. A positive linear association between intelligence and REM anterior beta power was found in females but not males. Transient, spindle-like “REM beta tufts” are described in the EEG of healthy subjects, which may reflect the functioning of a recently described cingular-prefrontal emotion and motor regulation network. REM sleep frontal high delta power was a negative correlate of intelligence. NREM alpha and sigma spectral power correlations with intelligence did not unequivocally remain significant after multiple comparisons correction, but exhibited a similar sexual dimorphism. These results suggest that the neural oscillatory correlates of intelligence in sleep are sexually dimorphic, and they are not restricted to either sleep spindles or NREM sleep.

Neuroscience and  Biobehavioral Reviews 2011 Apr;35(5):1154-65. “The function of the sleep spindle: a physiological index of intelligence and a mechanism for sleep-dependent memory consolidation.”

Abbreviated Abstract

Until recently, the electrophysiological mechanisms involved in strengthening new memories into a more permanent form during sleep have been largely unknown. The sleep spindle is an event in the electroencephalogram (EEG) characterizing Stage 2 sleep. Sleep spindles may reflect, at the electrophysiological level, an ideal mechanism for inducing long-term synaptic changes in the neocortex. Recent evidence suggests the spindle is highly correlated with tests of intellectual ability (e.g.; IQ tests) and may serve as a physiological index of intelligence.

NEWS NOTES

 

The efficacy of probiotics in maintaining healthy bacterial levels in the gut has been well known and studied for years. Research in recent years shows the importance of such “good” bacteria in maintaining a well-functioning immune system. Since immune support tends to decline with age, it is reasonable to hope that keeping a healthy gut might prevent or at least lessen the effects in diseases such as upper respiratory infections. At least for the past 10+ years, some studies have shown how certain probiotics can improve resistance to, or at least shorten the effect of upper respiratory infections.

For example, there was a study in 2008 in the Journal of Clinical Gastroenterology, Sep;42 Suppl 3 Pt 2: S224-33 titled “A new chance of preventing winter diseases by the administration of symbiotic formulations.” Results noted that influenza type illnesses were “significantly reduced” with administration of some specific probiotics. These were “strains of Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium lactis. This study covered three different winter periods.

A later study in Immunity &  Ageing 2015 Dec 3;12:24, “Probiotic strain Bacillus subtilis CU1 stimulates immune system of elderly during common infectious disease period: a randomized, double-blind placebo-controlled study,”  found similar results with the addition of another strain of probiotics, Bacillus subtilis CU1.

Several reports from the Cochrane Database of Systematic Reviews 2015 Feb 3;(2) confirm these  results, with a caveat, after reviewing multiple studies. The most recent review,” Probiotics for preventing acute upper respiratory tract infections,” said “Probiotics may improve a person’s health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections . . . Probiotics were better than placebo in reducing the number of participants experiencing episodes of acute URTI, the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This indicates that probiotics may be more beneficial than placebo for preventing acute URTIs.” However, the reported also noted, “the quality of the evidence was low or very low.”

Life Extension Magazine in its February 2018 issue has a lengthy article on this subject.

 

CURCUMIN—PANACEA OR FALSE HOPE?

Even if you are not interested in alternative remedies for diseases and other health conditions, it is likely you have heard of the supposed benefits of curcumin. Perhaps the most striking recent report is one in the Daily Mail. A woman in the U.K. named Dieneke Ferguson battled blood cancer (myeloid leukemia) through multiple rounds of chemotherapy and four stem cell transplants. At 67, she stopped medical treatments and began started taking eight grams of curcumin a day. Five years later tests show her stable and any remaining cancerous cells were negligible.

Doctors wrote in the British Medical Journal Case Reports  February 19, 2017 that, “To the best of our knowledge, this is the first report in which curcumin has demonstrated an objective response in progressive disease in the absence of conventional treatment.” The report went on to report, “The patient continues to take oral curcumin eight grams daily without further antimyeloma treatment. Over the last 60 months, her myeloma has remained stable with minimal fluctuation in paraprotein level, her blood counts lie within the normal range and she has maintained good quality of life throughout this period.”

Curcumin comes from turmeric (Curcuma longa) and accounts for the yellow color of turmeric. The spice contains only a small amount of actual curcumin. Unless taken in a concentrated supplement, it would be difficult to consume enough original turmeric for any therapeutic benefit,

Over the past few years increasing numbers of research reports as well as excited headlines in the popular press have been published examining the multiple health benefits of curcumin. These were accompanied by a dramatic increase in the production of the product. By 2013 turmeric/curcumin supplements grew by 26% and was then the top selling item in natural supplements. Worldwide consumption is expected to more than double by 2020.

Curcumin supposedly is an effective painkiller, reduces the risk of cancer, lung disease, cardiovascular disease, depression and even heart disease, depression, even Alzheimer’s. See for example:

Pharmacological Research, Dec. 28, 2017. pii: S1043-6618(17)30783-1[Epub ahead of print], “Botanicals and phytochemicals active on cognitive decline: The clinical evidence.”

Nutrients. Dec. 28, 2017 Dec 28;10(1). pii: E28. “Neuroprotective Effects and Mechanisms of Curcumin-Cu(II) and -Zn(II) Complexes Systems and Their Pharmacological Implications.”

On the other hand, as often happens in the field of medical literature and research, more recent publications have begun to throw a bit of cold water on this near-miracle supplement.

In “The Essential Medicinal Chemistry of Curcumin,” Journal of Medicinal Chemistry, January 11, 2017, 60(5), pp. 1620-1637, an impressive collection of authors with diverse backgrounds in such fields as Clinical Pathology, Structural Biochemistry, Pharmacology, Medicinal Chemistry and Natural Products Chemistry and Pharmacognosy offer a 17-page “Miniperspective” with 164 footnotes.

Among other criticisms, the authors point out, “Additionally, many researchers have described the potential “dark side of curcumin” (5-9). The drawbacks noted include its poor pharmacokinetic/pharmacodynamic (PK/PD) properties, low efficacy in several disease models, and toxic effects under certain testing conditions.” They go on to note, “These cautionary reports appear to have been swept away in the torrent of papers, reviews, patents, and Web sites touting the use of curcumin (and its primary commercial source, turmeric) as an anticancer agent,(10, 11) a therapeutic for Alzheimer’s disease,(12) a treatment for hangovers,(13, 14) erectile dysfunction,(15, 16) baldness,(17, 18) hirsutism,(19) a fertility-boosting,(20) and contraceptive(21) extract, collectively establishing the properties expected of a panacea.(22, 23).” [Numbers in parentheses refer to article footnotes.]

Given the differing information on curcumin, what is the layperson to believe? It could be worth keeping in mind that, despite the popular KISS (Keep It Simple Stupid) principle, very little in Life is simple, particularly when it involves the human body. Second, keep in mind the idea of synergy, that individual elements, taken together, can produce effects greater than any of the parts. It seems perfectly possible that the reported effects may result from a combination of factors, that, when studied independently might not lead to a positive conclusion. Even the last review article above, in discussing the need for more research, used the term holistic. In other words, look at this in the broader perspective of the whole body.

 

 

NEW ANTIBIOTIC FROM NATURAL SOURCE

 

The Berkeley Pit, Butte MT

Paraphrasing an old song title, “Lookin’ for love in all the wrong places,” two University of Montana chemists, Andrea A. Stierle and Donald B. Stierle, have been looking for useful compounds in what many might consider the wrong place—the Berkley Pit—an open pit copper mine in Butte, Montana that was closed years ago. It is one of the most toxic waste sites in the U.S., 1.5 miles east/west and one mile north/south in diameter. The pit is 1,780 feet deep, with very acidic water that continues drain into the pit at a rate measured in 2005 of 2.55 million gallons per day. This water is contaminated with all sorts of toxic chemicals such as arsenic, copper, cadmium, cobalt, iron, manganese, zinc, and sulfate, plus other inorganic substances.

 

Nevertheless, some fungi and bacteria have found a happy medium (chemically-speaking) in the Berkley Pit waters. The Montana U. scientists have been analyzing the unusual products from these living creatures for more than 20 years. Among other discoveries is a cancer-killing fungus called Taxomyces andreanae and some other substances that can produce organic chemicals capable of affecting inflammatory and aging qualities.

 

In one case, the Stierle’s cultured two types of Penicillin fungus found in the waters and found a completely new substance produced by the culture,

Berkeleylactone A

, (research published in J. Nat. Prod. 2017, DOI:

10.1021/acs.jnatprod.7b00133

v) with antibiotic capabilities of treating some strains of Methicillin-resistant Staphylococcus aureus (MRSA), previously believed to be resistant to most antibiotics, plus anthrax, strep throat and candida yeast infections.

 

Given the glacial slowness of FDA approval (unless spurred on by major pharmaceutical interests), it could be years before substances like this from hazardous waste sites become available as new miracle drug, but it is interesting that even in the deadliest environments on Earth, some benefits can be found.

 

 Publications of Interest

 

In what sounds like a worthy follow-up to Dr. Jerome Groopman’s classic

How Doctors Think

¸ Dr. Danielle Ofri has published an interesting title:

What Patients Say, What Doctors Hear

. As described in a lengthy review in the British medical journal, Lancet, this book has some useful information for patients:

 

“For all the sophisticated diagnostic tools of modern medicine, the conversation between doctor and patient remains the primary diagnostic tool.” This idea lies at the heart of Danielle Ofri’s new book What Patients Say, What Doctors Hear, in which she acknowledges, dissects, experiments with, and analyses the complexities and miscues of the patient–doctor exchange.”

 

Hospital Dangers Changing Direction


This blog, begun in February 2011 and based originally on some on unhappy personal experiences in a hospital seems to have run out of steam. This might be obvious from the past months’ dearth of posts. However, there are still plenty of topics to write about in the healthcare field, particularly as changes take place in insurance coverage and in new ways of thinking about treating consumers’ ills.

 

Therefore, Hospital Dangerswill be morphing into a different content area. I intend to explore and report upon the latest research and opportunities in healthcare that have not necessarily been approved of or adopted by the medical/pharmaceutical establishment. Some of this information even may have been published in medical journals. However, the time difference between research appearing in this form and being accepted or adopted by practicing physicians can be both lengthy and costly in terms of their patient’s health. A  considerable body of research in this area is published in foreign journals, which while indexed by the National Library of Medicine’s databases, may not be readily available to practicing physicians.

 

Sometimes, big Pharma is ahead of traditional medical practitioners in accepting treatments derived from naturopathic practices. This is evidenced by pharmaceutical companies when they try to develop derivatives or combinations of natural substances used for years into patentable medicines to increase their profits. 

 

One example is of this practice is Red Yeast Rice, known for many years to lower cholesterol safely without the potential side effects found in prescription strength statin drugs. Years ago, a few drug manufacturers filed patents on special formulations of Red Yeast Rice even though they didn’t necessarily proceed to complete the extensive testing needed to obtain FDA approval. At the same time drug company-funded studies continued to report on doubtful benefits of Red Yeast Rice. Only recently are reputable studies appearing in the literature showing that the precursor of the statin drug, lovastatin, found in Red Yeast Rice can be just as effective without dangerous side effects found in the prescription version of lovastatin and other statin drugs.

 

CAUTION: Nothing that you may read about substances mentioned in this blog is intended to be nor should it be taken as medical advice or specific recommendations. The information presented here is solely intended as medical information. It is based on published research available on the Internet.

 

Finally, given the different focus the Hospital Dangers blog will have a new name. This will be announced in the next post. It will still be under the current blog title to give current subscribers and followers time to adjust their subscription should they be interested in continuing to follow the blog.

 

New Blog Launch: “Mushrooms and Your Health.”

 

 

 

Did you know that mushrooms have an incredible amount of nutrients that can support healthy functioning in a number of areas? Mushrooms may prevent age related memory loss, have anticancer benefits, reduce cholesterol, protect the liver and kidneys, strengthen your immune system, decrease the risk of diabetes, help control blood pressure and improve digestion. As reported in an article in the journal Molecules(July 20, 2016, 21:7), “Studies show that mushroomspossess various bioactivities, such as antioxidant, anti-inflammatory, anticancer, immunomodulatory, antimicrobial, hepatoprotective, and antidiabetic properties . . ..”  

 A similar study in the same journal (October 27, 2015: 20 (10): 19489- 525), reported “Edible mushrooms might be used directly in enhancement of antioxidant defenses through dietary supplementation to reduce the level of oxidative stress.”

The full range of health benefits from several types of mushrooms is described and evaluated in an article titled “Chemistry, Nutrition, and Health-Promoting Properties of Hericium erinaceus (Lion’s Mane) Mushroom Fruiting Bodies and Mycelia and Their Bioactive Compounds.” This was published in the Journal of Agricultural and Food Chemistry, (Aug 19, 2015, 53(32):7108-23). The author, M. Friedman, said this: “The reported health-promoting properties of the mushroom fruit bodies, mycelia, and bioactive pure compounds include antibiotic, anticarcinogenic, antidiabetic, antifatigue, antihypertensive, antihyperlipodemic, antisenescence, cardioprotective, hepatoprotective, nephroprotective, and neuroprotective properties and improvement of anxiety, cognitive function, and depression.”

 The U.S. Department of Agriculture has a helpful Web page listing Nutrient Content and Nutrient Retentionn of selected mushrooms.

 

 

The American Way of Health; The Links Between Big Pharma, the Medical-Educational System, Agribusiness, and the Food Industry


The title of this blog series draws from Jessica Mitford’s The American Way of Death published in 1963. The description on Amazon.com gives a preview of the approach this post will take.
“Before the turn of the century, the American funeral was simple “to the point of starkness,” says Jessica Mitford, the acclaimed muckraking journalist who published this investigation of the country’s funeral business in 1963. That the country went on to develop a tendency for gross overspending on funerals Mitford puts down to the greed and ingenuity of undertakers, whom she regards as salesmen guilty of pressuring families into agreeing to their excessive standards for burial.” 
 

Part Three. How Agribusiness and the Food Industry Work Together to Sabotage the Health of the American People.
Agribusiness
There has been a documented decrease in the nutritional quality of foods in America. Although interest in this become more evident in the past decade or two the decrease has been going on according to some at least since the 1950s. Probably, there has been a slow progression even since the end of the 18th century, which took on rapid acceleration with the move to industrialized farming.
A writer to one of the columns in the ScientificAmerican “Earthtalk,” asked, “What’s the nutritional difference between the carrot I ate in 1970 and 180 today? I’ve heard that there’s very little nutrition left. Is that true?” While the answer explained that it would be overkill to say there’s very little nutrition in today’s carrots, “It is true that fruits and vegetables grown decades ago were much richer in vitamins and minerals in the varieties most of us get today.” The writer went on to identify the main culprit in the trend as soil depletion. Agribusiness reliance on intensive farming methods strip more and more nutrients in the soil which are no longer available in the food products. On top of this soil erosion continues to be a major problem in the farmland in the United States (and other countries as well).
A study published in the December 2004 issue of theJournal of the American College of Nutrition compared data between 1950 and 1999 from the U. S. Department of Agriculture and found that 43 different fruits and vegetables showed notable declines in the amount of vitamin C Vitamin B, iron, phosphorus, calcium and protein. Besides the focus on intensive farming the article noted that more and more agricultural practices focused on improving salability—for example the size the resistance to pass in the rate of growth—rather than nutrition. Putting it another way the driving force since at least the 1950s, and most likely for decades prior was not the health of the American people but the “bottom line” of gigantic farming companies—Agribusiness. Other studies have found similar drops in nutritional quality, for example, 12 fresh vegetables and fruits dropped in calcium level by 27% between 1975 in 1977. The iron levels in these products fell 37% and vitamin C levels dropped 30%. The same kind of nutrient data emerges from studies of British farming as well.
According to an article in Mother Earth News, the U.S. government’s involvement in this process did not help our health at all when by about 2004 the USDA decided for what many consider political reasons to claim that organic foods are not superior nutritionally or even safer than conventional foods. This even though there was evidence that, for example, organic eggs from free range hens had more vitamin E, folic acid, and B12 than intensively raised eggs from massive chicken raising operations. You might notice if you’re eating organic eggs that probably the yolks are bright orange, indicating high levels of carotene antioxidants. On the other hand, eggs produced in a factory operation yolks are much lighter unless the owners feed marigold flowers to the eggs to make the yolks brighter. Adding fertilizer high in nitrogen (often higher than is actually needed for nutrition) in the interest of promoting faster growth by forcing the vegetables to take out more water is not only not particularly healthy but it also means that were eating vegetables and paying more for them that have more water in them.
To further complicate the picture, there is a multiplicity of federal agencies involved in the U.S agriculture and food system, introducing a bureaucrat’s heaven of regulation.
Consumer Product Safety Commission
Federal Trade Commission
U.S. Department of Agriculture
U.S. Department of Commerce
U.S. Department of Defense
U.S. Department of Energy
U.S. Department of Health and Human Services
U.S. Department of Homeland Security
U.S. Department of Housing and Urban Development
U.S. Department of the Interior
U.S. Department of Justice
U.S. Department of Labor
U.S. Department of Transportation
U.S. Department of the Treasury
U.S. Environmental Protection Agency
As the Union of Concerned Scientists points out, the modern system of industrial agriculture now dominant United States is “characterized by large-scale monoculture, heavy use of chemical fertilizers and pesticides, and meat production in CAFOs (confined animal feeding operations).”  The costs in human health and safety, society and economy:
·       Toxic pesticides
·       Water pollution
·       Increasing antibiotic resistance
·       Farmland damage from soil depletion and soil erosion
·       Lost biodiversity
·       Society and our economy:
·       Loss of midsize farms
·       Runoff pollution from agriculture that damages areas hundreds of miles away resulting in added costs for remediation. 
FoodIndustry
Once upon a time a relatively honest U. S. Senate committee tried to do the right thing. In 1977 the committee on Nutrition and Human Needs, known as the McGovern committee, published a document titled Dietary Goals for The United States. This document was based on significant research that found coronary heart disease could be reversed by eating a plant-based diet. The intent of the publication was to encourage Americans to stop eating so much animal-based foods and to increase foods based on plants. The benefits had been known in medical circles for decades. Then what happened? According to what one Harvard university professor remembers “the meat, milk and egg producers were very upset.” The government, following heavy pressure from industry, not only removed the recommendation to decrease meat consumption but disbanded the senate nutrition committee completely. Supposedly several prominent senators lost their reelection bids because they supported the report. 
According to an article in the Food and Law Journal by Jeff Herman, “Saving U.S. Dietary Advice from Conflicts of Interest,” some years later—surprise, surprise—the U.S. Dietary Guidelines Advisory Committee turned out to have a number of members with financial ties to “everything from candy bar companies to entities like McDonald’s counsel on healthy lifestyles and Coca-Cola’s beverage Institute for health and wellness.” Falling in line with industry wishes in 2012, the American Dietetic Association changed its name to the Academy of Nutrition and Dietetics but kept on taking millions of dollars every year from processed junk food meat dairy soda and candy bar companies. By the way this Association or Academy is the one involved when you see “registered dietitians.” It is a closed circle, as you can see.
In closing this bittersweet tale, here are what one authority considers the top 11 biggest lies of the food industry (be sure to read the detailed explanations).
  1. Low-Fat or Fat-Free 
  2. Trans Fat-Free 
  3. Includes Whole Grains
  4. Gluten-Free
  5. Not That Much Sugar
  6. Calories Per Serving
  7.  Fruit-Flavored
  8. Small Amounts of Healthy This and That
  9. Calling Harmful Ingredients Something Else
  10. Low-Carb Junk Foods
  11. Zero Calorie Beverages
For the possible conspiracy enthusiasts among my readers . . .


The American Way of Health; The Links Between Big Pharma, the Medical-Educational System, Agribusiness, and the Food Industry

Part Two. Wooing New Graduates of Medical Schools and Practicing Physicians

 In this post the number of similar articles in both popular and medical literature is copious and the length threatens to grow excessive. For this reason, I encourage the reader to treat the linked articles not just as academic citations, but as further recommended reading. Beyond this, it hardly seems necessary to do more than let a small sampling of words from reports and exposés speak for themselves. The samples are presented in chronological order.

The Truth About the Drug Companies: How They Deceive Us and What to Do About It. (Book, 2005)

 

Dr. Marcia Angell, of the Harvard Medical School, wrote The Truth About the Drug Companies: How They Deceive Us and What to Do About I in 2005. Angell joined the editorial staff of The New England Journal of Medicine (NEJM) in 1979. She served as interim Editor-in-Chief after the resignation of the former editor over a controversy. She was a finalist for the permanent post of Editor-in-Chief, but withdrew as a candidate explaining she was retiring to write a book on alternative medicine.
In the January 15, 2009 issue of The New York Review of Booksshe wrote an article titled, DrugCompanies & Doctors: A Story of Corruption.” A single paragraph best sums up her writing. “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.
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HarvardMedical School in Ethics Quandary (March 2, 2009) [Just One School’s Example]
 The students argue, for example, that Harvard should be embarrassed by the F grade it recently received from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money. . . . Under the school’s disclosure rules, about 1,600 of 8,900 professors and lecturers have reported to the dean that they or a family member had a financial interest in a business related to their teaching, research or clinical care. The reports show 149 with financial ties to Pfizerand 130 with Merck.”
If you think things may have improved since 2009, see “The Pharmaceutical Industry’s Role in U.S. Medical Education” below.

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How Corrupted Drug Companies Deceive and Manipulate Your Doctor (May 18, 2010)
After pointing out how heavily the National Institute of Health (NIH), the second-highest funder of drugs studies, is influenced by pharmaceutical money, this articles lists and explains in detail the biases found in medical journals. Since reading medical literature would seem to be an important part of a medical education, understanding these biases seems important. [The blog reader is encouraged to read the details of each of these items below plus what is likely to happen to any doctor who speaks out about them.]
Bias #1: Unwanted Results Are Not Published
Bias #2: Bad Results Are Submitted as Good
Bias #3: A Favorable Study Is Submitted Multiple Times
Bias #4: Follow-Up Reviews Done by Biased Experts
Bias #5: Ghostwriting
Bias #6: Journal Bias
Bias #7: Drug Companies Masquerading as Educators  
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Getting ‘Em Early: Pharma Reps Give Gifts to Most Medical Students (February 26, 2013)

 

. . . . more than half of medical students end up receiving gifts from pharmaceutical representatives by the end of their fourth year, according to an upcoming study.” 
$$$$$$$$$$$$$$$$
BigPharma Influencing Med Students and Doctors (November 6, 2014)

The collaboration between industry and academics is needed, but when does legitimate financing cross over into biased teaching, manipulated medical journals and untrustworthy prescriptions?” This article says that happens when the partnership between the two puts consumers in danger.
“In 2006, the New England Journal of Medicine, known as the best medical journal in the world, published a report that compared three diabetes drugs.” Their conclusion was that GlaxoSmithKline’s new drug Avandia was the best. Not one mentioned at the time was that all of the authors of this report (11) got money from GlaxoSmithKline or any possible safety concerns. Four of them actually worked for that company. “100,000 patients suffered heart attacks blamed on Avandia.” Lawsuits are still being processed.
$$$$$$$$$$$$$$$$

The Pharmaceutical Industry’s Role in U.S. Medical Education (April 3, 2016)
The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure stated that “diuretics and beta-blockers are the preferred choice for initial hypertension drug therapy” in 1993. From 1992 to 1995, diuretic prescriptions dropped by 50% and beta-blockers by 40%. Calcium channel prescriptions increased by 13%. Care to take a guess why this was? Perhaps because the pharmaceutical industry put $14 billion into marketing a new type of drugs, calcium channel blockers. Although these were described as “heavily-promoted, expensive, newly developed hypertension treatment” by 2001, one of the calcium Channel blockers, Norvasc,was among the top 5 selling drugs of any kind worldwide.
Medical students are prime targets for the pharmaceutical industry. “Medical students’ exposure to pharmaceutical marketing begins early, growing in frequency throughout their training.” Through gifts like free meals, textbooks and even drug samples, drug companies implant their message. “Forty to 100 percent of medical students reportexposure to the pharmaceutical industry, with clinical students being more likely than preclinical students to report exposure. The number of students recalling over 20 exposures to marketing rose from 33.3percent to nearly 72 percent as students entered their clinical training.”  

Next: Part Three. Agribusiness and the Food Industry.


The American Way of Health; The Links Between Big Pharma, the Medical-Educational System, Agribusiness, and the Food Industry


The title of this blog series draws from Jessica Mitford’s The American Way of Death published in 1963. The description on Amazon.comgives a preview of the approach this post will take.

“Before the turn of the century, the American funeral was simple “to the point of starkness,” says Jessica Mitford, the acclaimed muckraking journalist who published this investigation of the country’s funeral business in 1963. That the country went on to develop a tendency for gross overspending on funerals Mitford puts down to the greed and ingenuity of undertakers, whom she regards as salesmen guilty of pressuring families into agreeing to their excessive standards for burial.” 

Part One: Big Pharma (aka the Pharmaceutical Industry)

As it might be viewed by those who have fallen victim to the American way of profiting from drug sales, the growth of pharmaceutical companies can be viewed either as an example of unintended consequences or the result of intelligent design by a global conspiracy.

For example, in 1900, Pfizer, now one of the largest pharmaceutical, filed an official certificate of incorporation in the state of New Jersey, with authorized capital of $2 million divided into 20,000 shares of $100 each. In 2008, Pfizer had sales of $20.5 billion. The real value of that $2 million in 2008 dollars would be $137 million, but the sales alone in 2008 were 145 times that number. The latest revenue figures for Pfizer were $51.6 billion. How, you might ask, did a company become so big over the past century? It certainly is not just inflation!
The beginning of the answer lies in a particular action of the United States Government. In 1940, Pfizer was one of the smaller existing drug companies in America. Then came the war years. In 1941, the government contracted with a number of drug companies to produce penicillin for soldiers. Of these companies, Pfizer was the only one that used fermentation technology. Investing millions of dollars, Pfizer’s senior management put their own assets as Pfizer stockholders at stake to buy the equipment and facilities needed for the novel process of deep-tank fermentation. In just four months, Pfizer was producing five times more penicillin than originally anticipated.
Compare the growth in sales and net income from 1940 to 1950 for two of the companies involved in penicillin manufacture (Source: Moody’s Stock Survey 1947-1950):
Pfizer Inc.:
Merck & Co., Inc.
Sales (Million)
Sales (Million)
1940 – $7.0
1940 – $23.8
1941 – $10.3
1941 – $39.6
1942 – $11.4
1942 – $43.5
1943 – $16.7
1943 – $57.9
1944 – $24.4
1944 – $52.8
1945 – $27.5
1945 – $55.6
1946 – $43.6
1946 – $61.5
1947 – $39.2
1947 – $68.3
1948 – $47.7
1948 – $72.9
1949 – $47.5
1949 – $73.6
1950 – $60.8
1950 – $94.1
Net Income (Million)
Net Income (Million)
Pfizer, Inc.
Merck & Co., Inc.
1940 – $1.1
1940 – $2.5
1941 – $1.1
1941 – $3.2
1942 – $1.3
1942 – $2.8
1943 – $1.8
1943 – $3.6
1944 – $2.3
1944 – $2.2
1945 – $1.8
1945 – $2.3
1946 – $10.6
1946 – $6.0
1947 – $9.3
1947 – $6.3
1948 – $9.6
1948 – $8.5
1949 – $7.8
1949 – $7.0
1950 – $9.9
1950 – $11.3
Penicillin gave drug companies the start, but it took a lot more for them to get to the current level of income and profits. Some things that helped were spending millions of dollars on lobbying, getting useful control of the agencies that set threshold standards for specific diseases such as diabetes, wooing new graduates of medical schools and practicing physicians to prescribe their products and literally inventing new diseases.
Pfizer and Merck are not alone in these practices; these companies are used only as examples. The largest company, Johnson & Johnson, spends twice as much on sales and marketing (including lobbying) than on Research and Development—$17.5 billion compared to $8.2 billion.
Sales in billions USD for top pharmaceutical companies in the US (2004-2008)
Company
2004
2005
2006
2007
2008
Pfizer
31.1
27.3
26.8
23.6
20.5
GSK
19.1
20.2
22.2
20.7
18.4
AstraZeneca
11.5
12.7
14.7
15.5
16.3
Johnson & Johnson
16.7
16
16.1
16.3
16
Merck
15.3
15.4
16.7
17.6
15.5
Amgen
9.6
11.9
14.5
14.3
13.4
Hoffman-La Roche
6.2
8.2
10.4
12.4
13.1
Novartis
11.5
12.9
13.9
13.9
12.4
Lilly
8.2
8.7
9.2
10.3
11.4
Sanofi-Aventis
10.2
11.2
11
10.9
11
Total, Top 10
139.4
144.5
155.5
155.5
148
Total, US Market
239.9
253.9
276.5
287.6
291.5
Source: Standard & Poor’s Industry Surveys Healthcare 2009: Pharmaceuticals
Lobbying
What does it take to make an industry like pharmaceuticals successful given government regulation (Food & Drug Industry)?  In one word, MONEY.
Control the Standards for Disease Treatment
1.      The U.S. Preventive Services Task Force (USPSTF)

As self-described on their Web site, the USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The Task Force “works to improve the health of all Americans by making evidence-based recommendationsabout clinical preventive services such as screenings, counseling services, and preventive medications.” Supposedly free of influence by commercial interests, each member must disclose any such involvement. These reviewed by task force chairs and a determination made as to what restrictions should be placed on the members’ eligibility in specific actions. Three levels of disclosures (potential conflicts) exist—Level 1, 2, or 3, described on the USPSTF site (Emphasis in bold below added by this blog poster):

Level 1 disclosures include nonfinancial disclosures that would not affect the judgment of a Task Force member. These disclosures do not require any action.

Level 2 disclosures include financial disclosures of $1,000 or less and nonfinancial disclosures that are relevant to a topic but not anticipated to affect the judgment of the Task Force member for that topic. These disclosures are announced at the Task Force meeting, but do not limit the Task Force member’s participation in the topic process.
Level 3 disclosures include financial disclosures of a larger amount and significant nonfinancial disclosures that may affect the Task Force member’s view on the topic. Actions for Level 3 disclosures vary according to the nature of the conflict, and may include preventing the member from serving as lead of a topic or on the workgroup of a topic, preventing the member from serving as a primary spokesperson for a topic, or preventing the member from taking part in all topic activities. As all new Task Force members are reviewed for conflicts prior to joining the Task Force, Level 3 disclosures are extremely rare. 
Examples of Level Three Disclosures on the part of some current USPSTF members:
·        Kirsten Bibbins-Domingo:
·        Topic(s): Statin Use for the Primary Prevention of Cardiovascular Disease in Adults, Screening for Lipid Disorders in Children and Adolescents
·        Date of Disclosure:May 2015
·        Action: Dr. Bibbins-Domingo will not participate in the topic workgroup but may discuss and vote on the topic.
·        Francisco Garcia:
·        Topic(s): Screening for Cervical Cancer
·        Date of Disclosure:March 2016 
·        Action: Dr. Garcia will not participate in the topic workgroup. He may discuss the topic during topic deliberations but will be recused from voting.
·        Michael P. Pignone:
·        Topic(s): Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer
·        Date of Disclosure:January 2014
·        Action: Dr. Pignone may participate in the topic workgroup but will not be the primary lead. He may discuss and vote on the topic.
Readers may draw their own conclusions about panel objectivity.

2.     Health-Related Societies
Example: Diabetes and the American Diabetes Association
A reporton an article in the British MedicalJournalhad the following to say about diabetes and politics. Until the late 1990s, what is now called “pre-diabetes” was known as “impaired glucose tolerance.” Surprisingly, some 30 percent of those who failed the first test for this condition ended with perfectly normal results on a repeat.
The World Health Organization (WHO) lowered the criteria for diabetes in 1999. A year before this, the American Diabetes Association (ADA) recommended a similar reduction. Now you were diabetic with a fasting blood glucose level greater than or equal to 126 mg/dL (milligrams per deciliter). What before was simply an intermediate level was now called “impaired fasting glucose.” You fell in this category with a fasting blood glucose level of 110-125 mg/dL.
Then, in 2003, the ADA lowered the impaired level to 100 mg/dL. No other agency followed that step. Some experts noted the expansion at least doubled the number in the impaired category. Always seeking to improve health (even if in the process the drug companies got richer and the health organizations gained influence, a new test, HemoglobinA1c arrived in 2009.  Instead of an immediate read of current glucose level, HbA1c measured the effect over approximately the most recent three months, although somewhat weighted to the past two weeks. Now WHO said people with levels of HbA1c greater than 6.5 percent were diabetic. The intermediate or pre-diabetes level became 6.0 percent. More diabetic customers!
Finally, within a year, the ADA on its own, with no support from any other group, dropped the threshold for pre-diabetes to 5.7 percent. As a result of these changes, based on the ADA definitions, about one-third of adults between 20 and 65 are pre-diabetic and half of the adults older than 65 are in that category. We are talking about a potential market of more than 86 million people for treatment with a drug like Metformin that might prevent an unknown number of cases of Type 2 diabetes from developing! 
But, as authors John S Yudkin and Victor M Montori explain in depth, “a pre-diabetes diagnosis offers little value.” As previous research showed, half of people identified with “impaired glucose tolerance” and about two-thirds of people identified with “impaired fasting glucose” will not be diabetic 10 years later.  It seems that borderline HbA1c levels are no better at predicting who will and who won’t develop diabetes.
By this point, an announcement on an ADAWeb page headlined “Long-term Follow-up of Diabetes Prevention Program Shows Continued Reduction in Diabetes Development,” June 16, 2014should come as no surprise. The content notes that, “the study’s two interventions, a lifestyle program designed to reduce weight and increase activity levels and the diabetes medicine metformin (emphasis mine), decreased the development of type 2 diabetes.

Of course, significant beneficiaries of the new recommendations are the pharmaceutical companies. Their potential market suddenly got a lot larger. As one onlinesource notes, “It’s a good time to be a diabetes drug maker. The top 10 companies producing diabetes meds raked in about $62 billion in global sales in 2014, up 5.1% from the previous year. This is according to a report from data analytics firm GlobalData which says Novo Nordisk ($NVO), Sanofi ($SNY) and Merck ($MRK) lead the pack, posting solid gains for their products as they compete for a piece of a rapidly growing market.”
Just for metformin alone (and there are other similar drugs), 2013 salesby Merck and Bristol-Myers Squibb totaled $498 million. But wait! There is now research the metformin may extend life in non-diabetics! An entire new market! Although metformin is now remarkably cheap—as little as $.29/pill from online pharmacies, if you sell enough of anything, no matter how cheap, you can make a lot of money.

Next: Part Two. Wooing New Graduates of Medical Schools and Practicing Physicians

The Gift That Keeps on Giving: The American Way of Illness in a Digital Age


Go to the hospital for treatment for some serious form of cancer. Meet the American Medical Establishment with its “Cut (Surgery), Poison (Chemotherapy) or Burn (Radiotherapy” approach to disease. Then, just when you thought it couldn’t get any worse, months later you learn that your identity was stolen while you were in the hospital.
Did you know in 2014, hacking in the medical care field accounted for 42.5 percent of total hackings among all industries? This number keeps growing. A major health provider claims medical record/identify theft and fraud now has nearly more victims than retail, finance, and banking combined.
The Federal Trade Commission Consumer Information Web site points out that, “A thief may use your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.” Medical records often contain billing and payment details including credit card information and may include your Social Security number either directly or in the case of retirees, the Medicare number (Social Security number plus a suffix). 
The harm from this form of theft does not stop with potential financial problems; a thief may use your medical identity to obtain medical care and particularly drugs. You may find your medical history contains notes of conditions and prescriptions that are not yours. This can complicate your obtaining coverage under health and drug insurance—or even max out your coverage limits. Problems could even be dangerous or life threatening. For example, a wrong prescription might be sent to you for a drug to which you are allergic. 
What if your medical record, now digitally available practically anywhere, has been commingled with another person’s because of medical identity theft? You go to an emergency room because of an accident and need a transfusion, but the doctor pulls up your record with the other party’s s blood type listed. The possible dangers are real—not hypothetical and the ramifications practically unlimited. 
Correcting the problem is even harder than with stolen financial information because providers may be fearful of releasing a thief’s private medical information to you—which you might view as adding insult to injury. There is literally no end to the problems that could ensue. Here is just one horrendous example: “A pregnant woman stole the medical identity of a mother, and delivered a baby who tested positive for illegal drugs. Social workers tried to take away the real mother’s four children, falsely thinking she was the addict. She had to hire a lawyer to keep her family.”
If you still think medical identify theft only can happen to someone else, look at this data from a May 29, 2015 article in Forbes:“Ninety-one percent of health care organizations have had at least one data breach involving the loss or theft of patient data in the last two years, and 59% of their business associates experienced the same.” In scary numbers, by 2014, 2.3 million Americans had become victims of medical ID theft.
Additional Resources: