Industry Funding may Bias Nutritional Health Research

Byoliveridley

Not a truly surprising finding, given the enormous profits at stake for the Nestle’s of the world.

PLoS Medicine – Relationship between Funding Source and Conclusion among Nutrition-Related Scientific Articles

Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding. Conclusions: Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors’ products, with potentially significant implications for public health.

Note the zero, as in, the number of unfavorable conclusions in wholly industry funded interventional studies.

interventional study—if humans consumed, or if human tissue was exposed to, a food or food component with the intention of measuring a biological response

Well, not surprising. You can exert much tighter control on an interventional study where you control most of the variables. Seems like there’s some predestination going on here!

What do the authors think is going on here?

(1) Industrial sponsors may fund only those studies that they believe will present their products in a favorable light, or their competitors’ products in an unfavorable light. In support of this possibility, all studies funded entirely by industry were characterized as “benefit” or “antagonism” with regard to the product under study (none were characterized as “no relationship”). That is, industrial organizations do not seem to sponsor articles about products in which they have no financial interest. (2) Investigators might formulate hypotheses, design studies, or analyze data in ways that are consistent with the financial interests of their industrial sponsors. (3) Industrial sponsors or investigators may choose to delay or not publish findings that have negative implications to the sponsor’s product. (4) Authors of scientific reviews may search and interpret the literature selectively, in ways consistent with the sponsor’s interests. (5) Scientific reviews arising from industry-supported scientific symposia, often published as journal supplements, may over- or under-represent certain viewpoints, if presenters whose opinions conflict with the sponsor’s financial interests are not invited to participate.

All good points. Remember next time you read an article in the paper about how exercise is much more important in determining obesity compared to your average sugary drink. Remember that a 12 Oz can of coke contains 39 grams of sugar, or 8 teaspoons worth!

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    Feds punt on Bisphenol A

    Byoliveridley

    By studiously ignoring all the subtle hormone disruption effects of bisphenol A and concentrating on easily observable neurological effects, the CERHR essentially does the industry’s bidding.

    Some risk linked to plastic chemical – Los Angeles Times

    A federal panel of scientists concluded Wednesday that an estrogen-like compound in plastic could be posing some risk to the brain development of babies and children.

    Bisphenol A, or BPA, is found in low levels in virtually every human body. A component of polycarbonate plastic, it can leach from baby bottles and other hard plastic beverage containers, food can linings and other consumer products.

    Culminating months of scientific debate, the decision by the 12 advisors of the Center for the Evaluation of Risks to Human Reproduction — part of the National Institutes of Health — is the first official, government action related to the chemical. Their recommendation will be reviewed for a federal report that could lead to regulations restricting one of the most used chemicals.

    The scientists ranked their concerns about BPA, concluding they had “some concern” about neurological and behavioral effects in fetuses, infants and children, but “minimal” or “negligible” concern about reproductive effects. The findings put the panel roughly in the middle — between the chemical industry, which has long said there is no evidence of danger to humans, and the environmental activists and scientists who say it is probably harming people.

    For a detailed look at how bisphenol research has been corrupted by industry sponsored “focused counter research” – where the goal is to show no effects and the experiment is tiled to ensure this goal, read this excellent article in the The Public Library of Science Biology Open Source Journal. Note, because it is Open Access, you can actually read it without selling a kidney! Some highlights…

    The moment we published something on bisphenol A, the chemical industry went out and hired a number of corporate laboratories to replicate our research. What was stunning about what they did,” vom Saal says with a mix of outrage and bemused disbelief, “was they hired people who had no idea how to do the work. Each of the members of these groups came to me and said, ‘We don’t know how to do this, will you teach us?’”

    More…

    The HCRA report, commissioned before Schwartz’s tenure, concluded that “the weight of the evidence for low-dose effects is very weak” [15]. Industry groups hailed the report as a comprehensive review by independent experts and quickly disseminated its findings. Yet the “comprehensive” report reviewed just 19 of 47 studies available in April 2002, and when it was published more than two years later, three panelists asked not to be listed as authors.

    What the hell, just read the whole article, especially the bit about the Harvard Center for Risk Analysis and its well documented industry shillness.

    The key to understanding bisphenol research is to realize that it is a hormone disruptor that works at low doses. At high doses, normal toxicological testing doses that is, it floods the hormone receptors and slows down the receptor pathways. So, the usual technique of testing in rats and mice at high doses and extrapolating will not work.

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    Lasers shooting into irises

    Byoliveridley

    I did not think my first minor surgery would involve someone shooting lasers to make holes in my iris. It sounds like more fun than it actually was, but was mostly painless and here I am, looking at a computer screen 3 hours later. My eyes feel like they’ve had about 5 hours of sleep, which is good considering they’re now sporting two brand new drain holes.

    Laser iridotomy is also performed prophylactically(preventively) on asymptomatic individuals with narrow angles and those with pigment dispersion. Individuals with a narrow angle are at higher risk of an acute angle closure, especially upon dilation of the eye

    http://www.surgeryencyclopedia.com/La-Pa/Laser-Iridotomy.html

    I also just started reading Bad Science by Ben Goldacre, which is about the use and misuse of the banner of science by a large group of people including nutritionists, pharmaceutical companies and “alternative” treatment specialists. It has a great chapter on the “placebo” effect, how much of it is culturally mediated, and how much doctor demeanour and confidence in their skills and outcome affects results. The doctor shooting holes in my eye was extremely confident in their skills and their results, and normally, my brain would be sending off all kinds of hubris warnings. In this case, their confidence reassured me a bit, and Bad Science definitely helped. It was also interesting to see a large section on homeopathy in the book, since I’ve written about my contact with homeopathy and felt that the cultural practices of a good homeopath can be of some use to people as long as they don’t go too far. The book confirmed some of that.

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    Chemical agency ties under review – Los Angeles Times

    Byoliveridley

    As I mentioned a couple of days back, Sciences International has some conflicts of interests in this bisphenol A issue. I am glad that NIEHS is taking note.

    Chemical agency ties under review – Los Angeles Times

    The National Institute of Environmental Health Sciences has begun a review of ties between a federal health center that evaluates the risks of chemicals to reproductive health and a consulting firm funded by companies that produce chemicals linked to reproductive disorders.

    The investigation follows a Times report on Sunday that Sciences International, an Alexandria, Va., firm funded by more than 50 industrial companies, helps manage the federal Center for the Evaluation of Risks to Human Reproduction.

    Among the firms with financial ties to Sciences International are two that produce bisphenol A, a chemical in polycarbonate plastic bottles that has been linked in animal testing to prostate and breast cancer and reduced fertility.

    Since 1998, Sciences International has helped manage the federal reproductive health center and prepared draft reports analyzing bisphenol A and 16 other chemicals. The company has a $5-million contract with the center.

    The center’s scientific advisory panel was scheduled to decide today whether bisphenol A endangers reproductive health in humans.

    But on Tuesday, director Michael Shelby announced that the panel, after two days of reviewing the 372-page report that Sciences International prepared on bisphenol A, known as BPA, still had too many unresolved questions and was postponing its decision for six weeks.

    Good investigative journalism still makes a big difference.

    As always, as I was writing this post, I noticed that the ever excellent folks at the pump handle read my mind and posted about it (2nd time in 3 days!), so I will stop writing (and thinking about Bisphenol A) and direct your attention to their post!

  • Melamine movin' on up the food chain

    Byoliveridley

    The FDA mentioned recently that the melamine suspected of poisoning many cats had gotten into pig feed in California, well, it gets worse…

    Tuesday: Uh-Oh — North Carolina Public Radio WUNC

    The FDA announced this afternoon that thousands of hogs in NC and four or five other states are now under quarantine because they were fed tainted rice gluten. Hogs here and in CA have tested positive for melamine. No one knows yet whether it poses any dangers to humans who ate the hogs, but the feds say they’re trying to find out.

    At this point in time, I would consider any animal feed from China suspect. Way out of control, because we have no procedure for being proactive about these things…

    It won’t amount to much because melamine apparently does not affect humans as much as it seems to affect cats, but it is the utter lack of control of ingredients and raw materials that scares me. What else can sneak through? What if the next one is actually deadly to humans?

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    What can the U.S learn from homeopathy?

    Byoliveridley

    Homeopathy was all around me growing up in India, so I read this article with interest as it jogged many memories of visiting the family homeopath with my parents.

    Faith Healing with Homeopathy — In These Times

    Homeopathy rests on three unproven tenets: First, “Like treats like.” Because arsenic causes shortness of breath, for example, homeopaths prescribe its “spirit” to treat diseases such as asthma. Second, the arsenic or other active ingredient is diluted in water and then that dilution is diluted again and so on, dozens of times, guaranteeing—for better and worse—that even if the dose has no therapeutic value, it does no harm. And third, the potion is shaken vigorously so that it retains a “memory” of the allegedly curative ingredient, a spirit-like essence that revives the body’s “vital force.”

    Fooey, the description of the science is hilariously pseudoscientific, but homeopathy is no laughing matter in India. It is estimated to be a Rs. 250 Crore (that is 2.5 billion rupees or about $58 million) industry as of 2002-2003.  I do not think this includes doctors and clinics. This website lists 158 colleges in India offering the  valid (it is like an MD!) degree of Bachelor of Homeopathic Medicine and Surgery, or BHMS. My parents swear by it, most of my family living in India has either visited, or regularly visit one. It is hugely popular for hepatitis and liver disease, more so than conventional medicine in India.

    What’s the deal? Why is it so popular? I think Terry Allen is on the right track, this sentence here, buried in the middle, hits the nail on the head…

    Part of the effect comes from the ritual of consultation with a practitioner who treats the patient like a person rather than a body part on an assembly line.

    Allen does not quite grasp the significance of this sentence and tracks away into placebo effects and evil pharma. But here’s the deal: A lot of Indians (who can afford $4-$5 consultation fee) visit their homeopath every month. When I tagged along with my parents, we would go on a Sunday afternoon at 2 PM to this homeopath’s office, which was a wing of his house (a big house, I might add!). It was a relaxed and leisurely time, he spent 10-15 minutes with each of us (yes, my parents made me!) talking about the previous month, what we were up to, how stressed we’d been, how our ailments from the previous month were doing, had we noticed any changes to our health over the month, etc. We would be interrupted occasionally by his little kid, or his assistant relaying a message from his wife, it was as far removed from a doctor’s visit as possible. And yes, he would take your blood pressure, run simple blood tests, etc. At the end of it, he would give you little sugar pills/sugar coated powder formulations to take home. The formulations were individually dosed, it was all categorized and labeled for you.

    This is like having a mini physical every month. Surely, just the act of talking to someone made you feel better, the act of ritually opening up little packets of “medicine” and following detailed instructions for 5 days helped, surely the homely and relaxing atmosphere of visiting a family friend helped, I don’t know.

    Metrics? both my parents occasionally had their hypertension treated with homeopathy. This worked as long as they were borderline, and simple stress management would get the numbers down. This doctor was/is very good at stress management because he talked calmly, yet firmly, he would listen and tease their little everyday stressors out of them and that was probably good for a 10 point reduction. But I remember the homeopath sending mom off to a doctor for a more conventional treatment regimen as soon as she hit 160.

    It never ever worked for me because I was way too sceptical to buy into the process, so I would not listen, or relax enough to talk. I would take my pills, but it would make absolutely no difference whatsoever. Of course, he was trying to treat me for severe sinus related issues probably brought on by pollution, and by sleepless nights spent on a beach looking for turtles!

    I am sure that for every good homeopath, there were two bad ones who just handed out pills of sugar. But my parents’ homeopath was, and continues to be part Dr. Phil, part candyman, part cheerleader!

    Homeopathy probably “works” because it makes people take the time to think about their life and what’s ailing them. It’s a lesson that American primary care providers could do well to learn.

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    Lead from toys not the real problem

    Byoliveridley

    Here’s what happens when you make a long verbal rant to someone about how the risk of lead exposure from water and air probably exceeds the risk from toys with lead paint, and then don’t blog about it because that means doing an hour or two of research and you don’t find the time… Someone else has the same notion, and actually writes about it AND gets published in a mainstream website!

    The lingering danger to children from lead. – By Darshak Sanghavi – Slate Magazine

    While tainted toys are in the news now, kids historically have gotten lead from two sources: the atmosphere and house paint. Roughly a quarter-million tons of lead compounds entered the atmosphere annually beginning in 1922, after a General Motors scientist developed a lead-based gasoline additive that prevented auto knocking. Lead’s chemical durability, recognized centuries ago, also made it an attractive paint additive. Toddlers are particularly susceptible to eating lead paint because it has a sugary taste; ancient Romans used lead powder to sweeten wine. By 1980, more than half a million American children—4 percent of all toddlers—had quite toxic blood lead levels from these sources.

    Lead is a serious problem in the US, and the bulk of exposure is from crumbling infrastructure, the inability (or unwillingness) to fix and replace decaying lead pipes, and the still ubiquitous presence of lead paint layers in older houses.

    The article doesn’t still give you exposure comparisons or numbers, so I guess I still have to do the work.