I was intrigued to see this news article on the BBC website this morning: WHO warns against homeopathy use.

Quickly, throw open the door of your medicine cabinet and eject all those little white homeopathic tabs; the World Health Organization after careful consideration reflecting its singular position of authority has clearly at last come down firmly on the side of homeopath sceptics.

Except that is not really what the article says.

Firstly the article is not talking about homeopathy in general but is instead focused on the problem of homeopathic remedies being promoted as primary medication for developing world sufferers of TB, infant diarrhoea, influenza, malaria and HIV. Not even the Royal Homeopathic Hospital in London agrees with reliance on homeopathic remedies for such conditions, according to a comment by Dr Robert Hagan - a St Andrews University researcher quoted in the BBC article.

I am not particularly convinced that homeopathy works, and so I agree with the assertion that people with HIV, TB and the like should not RELY on homeopathy at the expense of readily available conventional medicine.

Even so, I detect more than the passing hand of the pharmaceutical industry behind this article.

The letter to the WHO by the young doctors concerned reliance on homeopathy at the expense of conventional medicine, but the headline suggests that the WHO has come out completely against the use of homeopathic treatments, full stop. The headline is sensationalist and incorrect in the breadth of its assertion.

Secondly, the article ignores the problem of access to conventional medicine even though it is focused on the developing world where the problem of the prohibitive cost of drugs is well documented. Homeopathy may be little more than a placebo for all I know, but better that in desperate situations where the patient has little hope of being able to get something that actually works.

The primary source for the story is Sense About Science which, a small amount of googling reveals, is a pharmaceutical industry-funded astroturfing unit whose main aim would indeed have been to get a headline suggesting incorrectly that the WHO has come down firmly against treatments competing with pharmaceutical drugs.

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Paranoia strikes deep in the heartland
But I think it's all overdone
Exaggerating this and exaggerating that
They don't have no fun

Paul Simon, "Have a good time"

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It would appear that the food industry knows precisely how to undermine even the most self-aware person's impulse control, by manufacturing food that contains exactly the right combination of sugar, fat, and salt to hit a preset "bliss point" in our brains.  So says Dr. David A. Kessler, in his new book "The End of Overeating." The former head of the FDA spent years fighting the tobacco industry, accusing it of deliberately manipulating nicotine levels in cigarettes to make them more addictive.  Now Kessler has turned his attention to the food industry:

"In “The End of Overeating,” Dr. Kessler finds some similarities [to tobacco] in the food industry, which has combined and created foods in a way that taps into our brain circuitry and stimulates our desire for more.

When it comes to stimulating our brains, Dr. Kessler noted, individual ingredients aren’t particularly potent. But by combining fats, sugar and salt in innumerable ways, food makers have essentially tapped into the brain’s reward system, creating a feedback loop that stimulates our desire to eat and leaves us wanting more and more even when we’re full."

This explains a number of things for me, for instance, why so many processed foods contain sugar, even where you'd never expect to find it.  It also explains why it's so much easier not to buy the Doritos in the first place than it is to buy them, bring them home, and not pig out on them. 

I don't think there's any way to regulate this aspect of the food industry--how do you tell an industry they're not allowed to make their product as appealing as possible?  Tobacco is a little different; it has been demonstrated to have extreme health risks with zero benefits.  But food, well, even if the food in question is unmitigated crap, it's hard to seriously argue for some sort of food police who will determine which foods are nutritionally acceptable.  So it appears that the only way to counter the chemically-engineered assault of the food industry is through consumer education about salt, fat, sugar, and neurobiology.

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From kitchen utensils to reclining chairs, a Scripps Howard News Service investigation has identified thousands of contaminated consumer products.

The actual quantity of products affected is unknown due to what the news service terms "haphazard screening, an absence of oversight and substantial disincentives for businesses to report contamination".

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A very good new site, Locavore Network, is building a national US database of local food producers to aid consumers in their growing quest for fresh, seasonal, local food, and to aid small farmers in promoting their produce in 21st Century style. 

It's not just about vegetables: the database includes producers of wine and meat, too.    The site also features user forums, classified ads, and blogs, and is actively soliciting correspondants and information about local food growers from around the country.   

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In a "tone-deaf" session before Congress, executives from major health insurance companies testified yesterday that they have no plans to stop their practice of rescinding the policies of sick people on the basis of whatever technicalities they can dig up.  For example, a woman with breast cancer found her policy was cancelled because she had failed to disclose a visit to a dermatologist for acne treatment when she took out her policy.  While rescision is a legitimate tool to fight fraud, insurers regularly seek out innocently omitted information in order to justify cancelling the policy of a patient whose care will be expensive.  When Congressmen asked the executives whether they would consider revamping their policies and limit their rescisions to clear cases of fraud, the executives answered that they would not. 

This development could be useful for those advocating a public health option, as it makes the position of the insurers unpalatable at best, if not downright dastardly.

From the LA Times: "Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them.

"This is precisely why we need a public option," Dingell said.

Proponents of a public plan seized upon the hearing, saying it showed why access to healthcare cannot be left to private insurance companies.

"This could reshape the debate," said Jerry Flanagan, a patient advocate with Santa Monica-based Consumer Watchdog.

"When insurance companies go under oath and admit they are canceling innocent patients when they get sick, it makes it very difficult for lawmakers to pass a law that requires every American to buy a policy or face a tax fine. It opens the way for a public option to hold the companies in check.""

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Here is a disturbing story for pregnant women worldwide and one to which I can personally relate. A new study, conducted by the University of Rochester Medical Center, suggests that dioxin pollution inhibits the natural proliferation of mammary cells during pregnancy thus decreasing a woman's ability to adequately breast-feed her infant.

Dioxins are a byproduct of incineration and are widely distributed throughout the atmosphere and thus the creatures living on the planet.  They are impossible to avoid. However, it is possible to decrease our intake. This article contains links to the FDA's site, Questions and Answers About Dioxins, which includes FDA dietary recommendations. Simply put, since dioxins accumulate in fats, consuming low- or non-fat dairy and lean meat products and increasing intake of vegetables, fruits and grains is recommended.

For a woman committed to breast feeding, being unable to produce enough milk for your newborn can be devastating. Having struggled with this myself, I can attest that the amount of shame and self-blame (what am I doing wrong, etc?) can be profound. While I will never know if dioxin "poisoning" was the culprit in my case, it does provide a reasonable explanantion. And for women who are currently pregnant or considering becoming pregnant, following the FDA dietary recommendations to limit dioxin exposure, after consulting your physician, could make a difference.

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Not surprisingly, organic dairy farmers and researchers are finding that when cows are given a diet more closely resembling their natural one (grass-like substances such as alfalfa and flaxseed) rather than soy or corn feed, they emit less methane. 18% less to be exact. If you're thinking, who gives a rip how much methane cows belch, you might want to think again. According to this New York Times' article, livestock is "one of the most serious near-term threats to the global climate." Apparently methane is second only to carbon dioxide in terms of its contribution to global warming and the production of cows for meat and milk is on the increase.

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   A nice little article reminding consumers to stay calm and listen to their physicians, not the advertisements they see promoting medical procedures and medications. The author uses achilles tendon tears and the pretty straightforward way they are diagnosed and treated to illustrate the point that consumers sometimes demand unnecessary treatments and doctors often relent to their patient's demands even thought the procedure is not indicated.

   I love reading medical-related articles written by physicians who can articulate issues for us lay people and give common sense advice. In this case, consumer beware; just because the commercial is pretty and convincing does not mean you need that particular thing. Educate yourself, talk with your doctor or pharmacist and consult your common sense.

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   Dr. Atul Gawande brings us  a fascinating and well written piece about the escalation of often unnecessary medical procedures in the United States. He insists that encouraging and rewarding ethical and patient-centered medical care in the US is vital to increasing the nation's health and to bringing down our raging health care costs.

   Gawande takes us to the town of McAllen, Tex., which has one of the highest per capita health care costs in the United States, in order to illustrate this explosive upward trend in American health care spending. Second only to Miami, Fla., the average income earned in McAllen is $12,000 per year. Medicare spends an annual per capita average of $15,000 here, twice the national average as well as $3,000 more than the average person makes. A quote from a surgeon he interviewed sums the issue up nicely, "Before it was about how to do a good job. Now it is about 'How much will you [a doctor] benefit?'"

   And more procedures and more spending does not necessarily mean better care or better results. In a several studies reviewed in this article the indications are the opposite, the more Medicare spends, the lower the state's quality ranking and more procedures tend to result in the same outcomes as fewer procedures and sometimes worse outcomes. Where does this focus on more, more, more come from? As Gawande says in the article, "About fifteen years ago, it seems, something began to change in McAllen. A few leaders of local institutions took profit growth to be a legitimate ethic in the practice of medicine... So here...a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers."

   On the other side of medical practice exists "accountable-care" organizations, medical facilities, such as the Mayo Clinic and groups of practioners such as those found in Grand Junction, Colo. who blunt harmful financial incentives and put the patient first in all aspects of care.

   In otherwords, ethical, appropriate and patient-centered care. Gawande asserts, and I agree, that rather than simply change our model of health care provision: single payor, expanding the role of public insurance, encouraging medical savings accounts, we also need to find inventive ways to reward those institutions and physicians already engaging in such practice and encourage others to do so.

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