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Intermittent Fasting

fasting
Fasting can mean anything from total abstinence from food and beverages to restricting specific foods or the hours of food intake. Many religions have traditions of fasting, with various restrictions. There is a good summary of those traditions on Wikipedia. The reason for religious fasting is not to improve health, but for other reasons like improving discipline and demonstrating devotion.

There are many health claims for different fasting regimens. Daily calorie restriction has been demonstrated to prolong lifespans in several organisms, from yeast and worms to mice and monkeys, although the evidence for monkeys is equivocal and there is no evidence for humans. There is some evidence that intermittent fasting can forestall and even reverse cancer, cardiovascular disease, diabetes, and neurodegenerative disorders in mice. In humans, there is some evidence that it might help reduce obesity, hypertension, asthma, and rheumatoid arthritis. How good is the evidence? (more…)

Posted in: Nutrition

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Misinterpreting TACT: No, Chelation Does Not Outperform Statins for Heart Disease

chelation
Chelation with intravenous EDTA (disodium ethylene diamine tetra-acetic acid) has long been used for heavy metal poisoning. It binds the metal ions and facilitates their excretion from the body. In recent years it has been used for many other indications that are not evidence-based, such as autism and coronary heart disease.

The Trial to Assess Chelation Therapy (TACT) was done to assess the effectiveness and safety of EDTA plus high-dose oral vitamins for preventing second heart attacks in patients who had already had one. An article on The People’s Pharmacy website portrays the study as strongly positive. The Graedons, authors of the website, claim that science supports the use of chelation. They report that for every 12 patients undergoing chelation, one heart attack will be prevented over a five-year period. They cite a 5-year NNT (number needed to treat) of 16 for statin therapy and they conclude that:

EDTA chelation outperformed statins because fewer people needed to receive treatment to achieve a desirable outcome.

(more…)

Posted in: Clinical Trials, Science and Medicine

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Is Addiction a Disease? Yes and No

Yes, it's a disease

Yes, it’s a disease

No, it's a habit

No, it’s a habit


Addiction is a puzzling phenomenon. Why do addicts persist in self-destructive behavior even after it has lost them their jobs, their family, their health, and their self-respect? Do they have any control over their behavior? If so, why don’t they control it? If not, why not? Two recent books shed light on these questions: The Biology of Desire: Why Addiction Is Not a Disease, by Marc Lewis, and The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig.

Lewis is a neuroscientist and former addict; Heilig is a physician and addiction researcher. Lewis is convinced that addiction is not a disease, but a habit created by the neural circuitry of desire in the course of its normal functioning. Heilig is convinced that addiction is a chronic disease like diabetes that can’t be cured but that must be managed by lifelong treatment.

While they disagree about whether addiction is a disease, they actually agree about almost everything else. They agree that we should reject the stigma of addiction as a kind of moral failing. They reject the hypotheses that addiction is a matter of choice or self-medication. They think current diagnostic labels are inadequate. They both try to integrate two levels of information: the case histories of addicts and the scientific knowledge from research. They are both skeptical of AA and of conventional rehab programs. They both support evidence-based treatments. They both think addicts are not all alike and that individual addicts will respond better to individualized approaches. (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health

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Announcing: Video Lecture Course on Science-Based Medicine

A couple of years ago, the James Randi Educational Foundation commissioned me to develop a series of 10 video lectures on Science-Based Medicine. After a lot of work and many vicissitudes, it has finally gone live on YouTube. http://web.randi.org/educational-modules.html The lecture titles are:

  1. Science-Based Medicine vs. Evidence-Based Medicine
  2. What Is CAM?
  3. Chiropractic
  4. Acupuncture
  5. Homeopathy
  6. Naturopathy and Herbal Medicine
  7. Energy Medicine
  8. Miscellaneous “Alternatives”
  9. Pitfalls in Research
  10. Science-Based Medicine in the Media and Politics

The series is accompanied by a Course Guide that can be downloaded as a pdf.

 

 

Posted in: Announcements, Science and Medicine

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American Academy of Family Physicians Home Study Course Recommends Non-Science-Based Treatments

aafp

Strong medicine…along with a little nonsense

Since passing my board exams in family practice in 1979 I have relied heavily on the American Academy of Family Physicians for continuing medical education via the American Family Physician and the AAFP home study programs. The AAFP prides itself on its evidence-based approach to medicine. In general, it delivers. But the recent FP Essentials Number 432 on “Chronic Pain Management” fell short. It recommended treating chronic pain with acupuncture, chiropractic, touch therapy, and S-adenosyl methionine (SAM-e), presenting them in a way that misled readers into thinking that the recommendations were based on good scientific evidence. They were not.

With 6,500 peer reviewed journals and over two million papers published every year, it is easy to find a study to support pretty much any point of view. John Ioannidis taught us that most published research findings are false, with preliminary studies frequently being overturned by larger, better follow-up studies. When evaluating the evidence for a treatment, it is not enough to find one or two positive studies. It is essential to also look for negative studies and for systematic analyses that weigh all the published evidence, and to put all the available evidence into perspective. The authors failed to do that. (more…)

Posted in: Science and Medicine

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“The Truth About Cancer” Series Is Untruthful About Cancer

ty-bollinger
The Truth About Cancer: A Global Quest is billed as “the documentary series the mainstream media refused to air.” It consists of eleven episodes and is produced by Ty Bollinger, an outspoken supporter of natural treatments for cancer. Episodes 1 and 2 are currently available online.

Ty Bollinger started his quest because several of his family members had died of cancer despite conventional cancer treatment. He believed they had died not of the cancer but of the cancer’s “so-called treatments” and “false treatments.” He doesn’t explain which cancers they had, what the treatments were, or why he calls them “false.” He was angry, and he wanted his relatives’ lives to matter; he thought he could give their deaths meaning by seeking out alternative treatments that would have saved them and could save others. He was an accountant and bodybuilder, untrained in science or medicine. He started out with the conviction that conventional cancer treatment was a fraud, and confirmation bias had a field day. Instead of learning about cancer from reliable sources, he avoided mainstream cancer experts and researchers and only interviewed alternative practitioners from all over the world who agreed with his premise. He eagerly swallowed everything they told him.

He says, “You are about to learn the best treatments and preventions to cancer, protocols that won’t harm your body, from the world leading doctors across the globe.” He promises to show viewers science and documented evidence. He promises to expose the lies of conventional cancer treatment. He thinks he has information that will eradicate cancer once and for all. He couldn’t be more wrong. (more…)

Posted in: Book & movie reviews, Cancer

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This Book Won’t Cure Your Cancer, But It Will Help You Think More Clearly About It

cancerGideon Burrows has an inoperable brain cancer that is slow growing but is inevitably going to kill him. He has written a remarkable book about his experience, This Book Won’t Cure Your Cancer. A professional wordsmith, he is able to describe his experience of illness so vividly that the reader enters into his life, feels what he feels, and shares his suspense about what the next scan or doctor’s visit will reveal. Along with him, we suffer through the panic and fear, the chaos, the agonies of delays and uncertainty, the unpleasant hospital environment, and specialists with poor bedside manners. We follow him through difficult decisions about how to share the bad news with friends, relatives, and his young children; and we understand why this engenders guilt feelings. The story is as engaging as a detective story; we can hardly wait to see what the next scan will show and how the story of his illness will play out. It puts a human face on the cancer experience, and it would be valuable for that alone, but it is much more. The gradually unfolding episodes of his personal story are interwoven with what amounts to a primer on how to think critically about science-based medicine vs. alternative treatments. I can’t recommend this book highly enough.
(more…)

Posted in: Book & movie reviews, Cancer, Critical Thinking

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Breast Milk Testing: Scaremongering, Not Science

Breastfeeding_baby
New mothers, especially first-time mothers, tend to worry about whether they are doing what is best for their babies. A new service, Happy Vitals, will only add to those worries. We know that breast is best, but these folks make women question whether their breast milk is good enough. They say:

Happy Vitals provides families with the tools they need to monitor and improve the long-term health of their children. With our simple and easy-to-use tests, mothers can learn for the first time about the nutrient make-up of their breast milk, improve their diet and nutrition, and safeguard against exposure to heavy metals and other toxins that are harmful to a child’s growth and development.

After a crowdfunding/pre-sale campaign, they plan to start shipping kits this month. They offer various packages. For $149.95, they will analyze a sample of breast milk for four key nutrients: glucose, lactose, protein, and fat. For $559.95, they will also test for:

  • Four “indicators of immunity”: cortisol, IgA antibodies, IgG antibodies, IgM antibodies.
  • Eleven micronutrients: calcium, folate, iron, vitamin D, vitamin A, ferritin, magnesium, phosphorous, sodium, potassium, and vitamin B12.
  • Four heavy metal toxins: arsenic, lead, mercury, and cadmium (based on samples of infant’s hair and nails.)

(more…)

Posted in: Diagnostic tests & procedures, Nutrition

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Immunity: More Than Just Antibodies and Vaccines

immunitySince I graduated from medical school, new scientific developments in immunology have been occurring at a prodigious rate. I knew I could use a refresher course, and serendipity dropped one in my mailbox in the form of a review copy of the new book Immunity, by William E. Paul, MD, chief of the Laboratory of Immunology at the National Institute of Allergy and Infectious Diseases of the National Institutes of Health and a major player in many of the scientific discoveries he describes. It was just what I needed. It brought me up to date, and it left me in awe of the amazing things our bodies do to keep us alive.

We are bombarded with claims that something will “boost the immune system” but the people who say that have no understanding of how the immune system really works. We have anti-vaxxers who still deny the effectiveness of vaccines and the existence of herd immunity, and who imagine all kinds of hypothetical harms from vaccines, but who have little understanding of how vaccines actually work. This book itself could serve as a sort of vaccine to immunize readers against scientifically ignorant arguments. (more…)

Posted in: Basic Science, Book & movie reviews, Vaccines

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Willow Curve Device for Pain: Strong Claims, Weak Evidence

willow curveWillow Curve is advertised as the “world’s first digital anti-inflammatory device”, “a laser smart device” designed to relieve joint pain with thermal and photonic energy. It contains over 150 bio-sensory and bio-therapeutic components that continuously monitor the body’s thermal and electrical response to the device, and computer chips use that information to tailor a digital prescription on the fly. That prescription consists of “multiple energies” that change thousands of times a second.

It’s not clear exactly what the sensors sense, or how they work. It’s not clear how the device responds to information from the sensors to alter the output of heat and light, and it’s not clear how it chooses the appropriate dose for that patient. They don’t divulge information like intensity and wavelength for the various treatment protocols. They claim that the treatment “stimulates 15 bio-physiological processes for treating the joint and surrounding tissues.” Which 15 are those, exactly? They say that the Willow Curve dilates blood vessels, slows nerve response time (is that a good thing?), releases endorphins, blocks specific pain receptors, and detoxifies by removing toxic debris from the joints.

They offer no evidence in support of these claims. I tried to get clarification from the company, but they didn’t answer my inquiries.

(more…)

Posted in: Medical devices

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