June 30th 2016, 16:53 | busterwddty
We’ve not only been built to move; like a dog needing to be walked every day, our bodies need to move in order to function properly.
Somewhere during the 20th century, though, we forgot about this essential purpose and designed lifestyles in which hours of movement punctuated by short bouts of stillness have been replaced by hours of stillness—at a desk, in our daily commute, during evenings in front of the TV—punctuated by a few furious rounds of movement.
Last month, WDDTY was saddened to learn of the passing of Dr Annemarie Colbin, one of its panel members, a visionary in the natural-food movement and a dear friend. In 1977, in need of income to support her young daughters, Dr Colbin started the Natural Gourmet Cookery School in the kitchen of her Upper West Side apartment. As the school likes to advertise, she was teaching kale and quinoa before the general public had ever heard of it.
Nearly 40 years later, the Natural Gourmet Institute for Health and Culinary Arts, as it's now known and which long ago moved to its own premises in Manhattan, became one of the top schools in America for natural cookery, and the first and only natural-foods cooking school accredited by the New York State education department to offer a chef's training programme in the subject, graduating to date more than 2,500 natural gourmet chefs from 45 nations.
In 1992, after rediscovering a network of neurotransmitters in the gut that act in a similar way to ordinary neurons, Dr Michael Gershon, chairman of the department of anatomy and cell biology at New York-Presbyterian Hospital/Columbia University Medical Center, an expert in the new field of neurogastroenterology,christened this phenomenon 'the second brain'.
He and others have since found that theenteric nervous system, as its technically known, consists of some 30 neurotransmitters and vast sheaths of neurons embedded all along the nine meters of our alimentary canal-100 million of them in all, more than are present in either the spinal cord or peripheral nervous system. In fact, the self-same genes involved in the formation of synapses between neurons in the primary brain are also involved in the formation of synapses in the gut brain.
We are a society gripped by constant pain of one sort or another-and life appears to be getting more painful by the year. In the UK alone, according to government statistics, at least a third of all households-representing some eight million of us-have one or more members suffering from moderate-to-severe persistent pain of some variety. This is two to three times more than the number of such sufferers in the 1970s.
Matters are even worse in the US. According to the American Pain Foundation, more than 26 million Americans ages 20 to 64 experience frequent back pain alone. Almost a third of all adults aged 65 or over report some variety of knee pain, and more than one-sixth report having hip pain or stiffness. Staggeringly, some 25 million cases of pain have to do with migraine, or lower facial pain or jaw pain such as a temporomandibular joint (TMJ) disorder.
The scene would not look out of place in Breaking Bad. Special Forces in camouflage gear and night-vision goggles stealthily break into a house and hold up its terrified owner, still in his dressing gown, shining a light in his face as they catch him holding a bottle of what appears to be illegal contraband.
"Guys, GUYS," says the terrified owner, who turns out to be Mel Gibson, "it's only vitamins." The SWAT team are unimpressed. Gibson is still trying to get them to see sense as they arrest him and clamp on the cuffs: "Vitamin C, you know, like in oranges?"
Since January, all of us in the West have been horrified by the spectacle of Islamic fanatics storming into the offices of the French satirical magazine Charlie Hebdo and assassinating 10 of its staff, including its editor,St'ephane Charbonnier, and his police bodyguard.
It shocks us precisely because we believe that one of our most fundamental freedoms, the right to free speech, is presently under threat by the most militant of political extremists, and preserving it has now become a life-or-death matter.
We are fat and getting fatter by the day.Several years ago, Johns Hopkins University did a study showing that, if obesity trends continue, in four years, an astonishing three-quarters of all Americans will be overweight. In Britain, according to an Oxford University epidemiologist, who wrote a government report on the subject, in less than 15 years, 86 per cent of UK men will be overweight and, in 20 years, 70 per centof UK women will reach the same level of obesity.
As fatness becomes the norm, increasing thinness becomes the ideal. Two decades ago, the average model weighed 8-per-cent less than the average woman; today's models weigh 23-per-cent less than today's average woman. With such a dysmorphic body ideal, it's small wonder that we're addicted to dieting.
The biggest headache for any drug-company executive is the placebo, or 'sugar pill', used in controlled trials to show that a drug in question works. Patients are divided into two groups, one of which is given the active drug, while the other takes the placebo, but no one knows who got what, not even those giving the pills. The idea is that far more patients will improve with the drug than with the placebo. Upon this assumption is built the entire edifice of modern medicine.
In practice, so many patients receive the same relief and even the same side-effects with a placebo as with the drug itself that a placebo is not a true control. Indeed, placebo power was best illustrated in patients with Parkinson's disease, where the body's system for releasing the brain chemical dopamine is faulty. The standard treatment for Parkinson's is a synthetic form of dopamine. Yet, in one study, doctors at the University of British Columbia in Vancouver showed on PET scans that, when patients given inert placebos were told they had received dopamine, their brains substantially increased the release of their own stores of the chemical (Science, 2001: 293: 1164-6).
The placebo problem-the subject of this month's News Focus-was raised to another degree of complexity when Harvard's professor of medicine Ted Kaptchuk ran a double-blind trial in which patients with irritable bowel syndrome were given a placebo, but told that they were taking a sugar pill, while the other patients were given nothing at all (PLoS ONE, 2010; 5: e15591). The placebo group were also told that placebos have been shown to create powerful mind-body self-healing.
Kaptchuk found that nearly two-thirds of his placebo group reported symptom improvement-even more than had improved with the powerful IBS drug alosetron in a recent trial (Clin Ther, 2008; 30: 884-901).
This raises the very basic question I've been wrestling with for some time: do pharmaceutical drugs ever work? Is it ever the drug itself that heals, or is the mental expectation of healing enough to marshal the body's healing mechanisms?
Other research bolsters the idea that the 'healer' may be more powerful than any agent. A recent study of 83 rheumatoid arthritis patients attended by a homeopath concluded that the consultation with a sympathetic practitioner-rather than the remedy itself-was the cause of the physical improvements reported by the patients (Rheumatology, 2010; doi: 10.1093/rheumatology/keq234).
There's also the power of healing rituals-the idea of 'taking some-thing', even when that something is known to be fake. Of 46,000 heart patients, those taking a placebo fared as well as those using the heart drug. The only survival factor appeared to be the belief that the therapy would work and a willingness to follow it religiously. Those who tended not to survive were those who had been lax with the regimen-whether active drug or placebo (BMJ, 2003; 326: 841-4).
Such studies suggest that what we take doesn't matter; the connection with the healer, the healing words and practices, the expectation of healing-in other words, our thoughts about healing-are always what turns out to be the true healer.
Nearly a year ago, Hollywood was shocked when actress Brittany Murphy, just 32, died from pneumonia, which she contracted after taking over-the-counter drugs. Within five months, her doting husband, British screenwriter Simon Monjack, aged 40, was also dead from a cardiac arrest-his heart had literally broken.
This phenomenon, called 'stress cardiomyopathy', is extraordinarily common; an emotional upset, such as the loss of a loved one, causes heart dysfunction and failure in people without previous heart disease.
Our dog Ollie, as a small, tricolored Cavalier King Charles spaniel, was bred by royal decree and born with a peculiar sense of regal entitlement and a permanent look of disdain. He belongs in a Peanuts cartoon-the curmudgeonly dog whose thought balloon continuously registers exasperation with his clueless owners. He refuses to eat except when it's inconvenient, and is extraordinarily picky, even when fresh organic meat is his for the taking.
Consequently, it's fascinating to see what Ollie eats in the wild, especially when he's out of sorts. Invariably, he heads for certain grasses or leaves and, after feasting on bunches of them, is completely cured.
Animal behaviourists realize that animals, across species, appear to have a natural instinct for determining which plants can heal different diseases. Stories abound of animals eating just the right things to heal themselves. After witnessing sick bears eating Ligusticum roots and getting better afterwards, Native Americans dubbed the plants with a name that means 'bear medicine'.
In her book, Wild Health, animal behaviorist Cindy Engel offers scientific evidence that animals instinctively know how to maintain optimum health. Given a smorgasbord of choice, even animals like rats will choose a nutritionally balanced diet.
Perhaps more extraordinary is the evidence that animals know how to self-medicate against a host of problems, including parasites, infection, skin conditions and accidental poisoning. Scientific evidence shows that animals are somehow able to differentiate among the thousands of toxic secondary compounds in plants that kill internal parasites. A number of species, including rhinoceroses and wild bison, feast on a specific bark known to be toxic to the microbes that cause dysentery.
Even animals in captivity often show a native sense of self-medication superior to their doctors. A captive capuchin monkey with a severe skin infection didn't get better until given access to tobacco leaves, which cured its skin condition permanently.
All this is relevant to two features in this month's issue. In our Special Report (pp 10-4), WDDTY publisher Bryan Hubbard has amassed extra-ordinary evidence that the contents of your fridge or larder not only can protect against illness, but may also cure disease once it takes hold. Cancer, asthma, Alzheimer's, dementia-and a host of other serious and even life-threatening illness-is vanquished by the likes of apple juice, rhubarb, brussels sprouts and blueberries.
Yet, we're eating less and less real food (p 5). A team that recently analyzed McDonald's Chicken McNuggets found that barely half of it is chicken-the rest is taste enhancers and other chemicals, including a compound used in Silly Putty and another used in lighter fluid.
The medicine we take is also increasingly dangerous, even contaminated, as was the case of millions of drugs produced by GSK, for which it has been fined by the American Food and Drug Administration (p 6).
Considering an animal's natural instinct for the healthy, one wonders what animals like Ollie would make of our tendency to consume toxic junk as food and toxic chemicals as medicine.
All of us at WDDTY are shaken to the core by the recent disclosures that most studies in the medical literature are marketing dressed up as research. For as many as 90,000 published drug trials, a drug company hired a PR firm-a 'medical education and communication company' (MECC)-to carry out its clinical trials, engaged a 'ghost' to write an article with a positive spin, enlisted a prominent academic to put his name to the paper he's had nothing to do with-and then succeeded in getting it published in a peer-reviewed journal.
This widespread practice came to light a few months ago during the discovery process of a class-action lawsuit against drug manufacturer Wyeth by 14,000 women who developed breast cancer after taking HRT.
The 1500 documents afford an unprecedented glimpse into the underworld of pharmaceutical marketing. The paper trail reveals how an MECC called DesignWrite, hired by Wyeth, launched a major damage-limitation exercise after a major study demonstrated an unequivocal link between HRT and life-threatening illness.
Wyeth's HRT products had reached annual revenues of $2 billion, but nose-dived by 65 per cent in 2002, when the Women's Health Initiative (WHI) study found that hormone replacement therapy-specifically Wyeth's version-increased the risk of breast cancer, ovarian cancer, stroke and heart disease.
DesignWrite proceeded to flood the professional press with positive reports of Premarin, cast doubt on the WHI, downplayed the cancer-causing potential of HRT and claimed cardiovascular benefits, while promoting unproven uses of HRT such as for preventing dementia.
A few months later, the German Institute for Quality and Efficiency in Health Care, which produces evidence-based consumer-health information, encountered "serious obstacles" in trying to wrest all sponsored published and unpublished studies from Pfizer on its antidepressant reboxetine. Eventually, it emerged that the company had withheld three-quarters of its patient data from unpublished trials. After these hidden data were finally handed over, the Institute concluded that the drug was "overall an ineffective and potentially harmful antidepressant".
There's no way to determine the full extent of such dirty research, although one review concluded that as much as three-quarters of every journal is ghosted. As Dr Joseph S. Ross of New York's Mount Sinai School of Medicine put it: "It's almost like steroids and baseball. You don't know who was using and who wasn't; you don't know which articles are tainted and which aren't."
These disclosures undermine the entire edifice of modern medicine. The BMJ now plans to encourage efforts to "re-evaluate the integrity of the existing base of research evidence"-in other words, virtually the whole of existing medical research needs to be done all over again.
The most insidious aspect of this story is the topic of this month's special report-that the extraordinary disease-fighting power of a simple nutrient like vitamin C has been virtually ignored by the modern medical press. The published medical evidence was promising 70 years ago-long before MECCs were around to tinker with the data.
Dr Bruce Moseley, an orthopaedic specialist at Methodist Hospital in Houston, TX, was convinced of the powerful effect of the human mind on healing. He recruited 180 patients with severe knee osteoarthritis and divided them into three groups, two of which underwent true surgery to clear out degenerative tissue and debris. The third group underwent a sham operation: they were surgically prepared, put under anaesthesia and wheeled into the operating room, where incisions were made in their knees, but no procedure was carried out.
Over the next two years, none of the patients knew who had received the real operations and who had received the placebo treatment, yet all three groups reported moderate improvements in pain and joint function. In fact, the placebo group reported better results than some of those who had received the genuine operation.
The mental expectation of healing was enough to marshal the body's healing mechanisms. The intention, brought about by the expectation of successful surgery, led to physical change (N Engl J Med, 2002; 347: 81-8).
The role of the mind in healing-the subject of Bryan Hubbard's cover story this month-completely baffles the medical community. Yet, it is well documented that belief in a placebo will bring about the same physiological effects as an active agent-so much so that it causes the drug industry enormous difficulty when designing trials; as so many patients report the same relief and even the same side-effects with a placebo as with the tested drug itself, a placebo is not a true control.
How can belief-and, in this case, a wrongheaded belief-affect the outcome of healing? Some clues come from intriguing brain studies showing that the electrical activity within the brain, and between the brain and other parts of the body, is identical whether we are merely thinking about doing something or actually doing it.
In weightlifters, for instance, the EEG patterns in the brain that are activated to produce specific motor skills become activated while the skill is only being simulated mentally. Indeed, just the thought is enough to produce the neural instructions to carry out the physical act.
In the case of placebos, our bodies don't distinguish between a chemical process and the thought of a chemical process.
According to a major review, the only factor for survival appears to be a belief that the therapy will work and a willingness to follow it religiously. Patients who stick to their doctor's orders fared equally well whether taking a drug or a sugar pill. In contrast, those who tended not to survive were those who were lax with their regimens, regardless of whether it was a placebo or an actual drug (BMJ, 2006; 333: 15-9).
Such studies suggest that our beliefs-about our medicine, about the outcome of a health crisis, about our connections to our place in the world-are a more powerful healer than any diet or exercise programme; they protect us against the worst toxins and the greatest adversity.
Knowing this, every doctor now has a duty to never give a negative diagnosis, and every patient has a duty to follow only the regime that he truly believes in. The thought it generates in us-whether positive or negative-is our most potent medicine. May we always use it wisely.
Just occasionally, I come across a doctor willing to break the conspiracy of silence on the damage caused by their tools. My hero of the hour is American psychiatrist Grace E. Jackson, who is utterly and refreshingly horrified by psychiatric and most other forms of pharmaceutical medicine. In fact, so incensed was Jackson over the current state of affairs that she felt compelled to self-publish a whistle-blowing book-Drug-Induced Dementia-that painstakingly catalogues the vast amount of scientific proof that modern medicine is the primary culprit behind all forms of dementia, one of the more rampant epidemic conditions of our time.
One of her more outrageous snippets of information is that, in the 1950s, doctors discovered that synthetic-dye and rocket-fuel derivatives had what they considered to be medicinal effects on psychiatric patients. Chlorpromazine, the first antipsychotic agent, was born.
In 2002, WDDTY learned of plans within the European Union to radically restrict natural medicine across all member countries, starting with laws to create a very low ceiling of 'safe upper limits' in vitamins.
Although the laws were ostensibly to create a 'level playing field' within the European supplement market, the proposals bore the heavy hand of Big Pharma.
In these austere times, President Obama's Congress and the fledgling UK coalition government are casting around furiously for ways to trim their bloated deficits. Yet, in the midst of all this slashing and burning, healthcare is the area that clearly remains a no-go zone.
In the UK, although Prime Minister David Cameron has been combing through the UK's lb156 billion budget deficit for savings, he remains committed to apportioning even more money to the UK's National Health Service. Spending is expected to rise every year for the NHS, commensurate with inflation, during his government.
It's reassuring to think that there are big organizations out there so wedded to our best interests that they are beyond reproach, impossible to buy or sell. The premiere organization with this kind of impeccable reputation the world over is the World Health Organization, one of original agencies set up by the newly formed United Nations. Its objectives were lofty; as described in its founding constitution, it was intended to "combat disease, especially key infectious diseases, and to promote the general health of the people of the world".
The WHO, as it's commonly known, was set up three years after the end of World War II, and its headquarters-as if to underscore its even-handed mandate-were in formerly neutral Switzerland.
Early in my career, I worked in the editorial department of a newspaper syndicate in New York, editing a variety of columnists, one of whom was the renegade medical columnist Dr Robert Mendelsohn.
Bob introduced me to the dangers of modern medicine. In particular, I remember his stark warnings about what he maintained were the most dangerous and unproven new drugs on the market. Top of Bob's list were a new class of new painkiller, the non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin. These, their manufacturers claimed, would take down inflammation without the use of steroids.
Bob was almost alone in his criticism of these so-called miracle drugs, warning that they also happened to cause serious, life-threatening stomach ulcers and bleeding.
That clarion call burned in my consciousness. So, it was particularly shocking for me to learn, a few decades later, that US and UK regulatory agencies had approved Motrin and other me-too drugs like it-albeit in slightly diluted form-as over-the-counter (OTC) drugs.
The drug in question was ibuprofen-a drug now considered so tame that we're routinely advised to give it to children. Bob's nemesis had been watered down, repackaged and sanitized: same drug, virtually the same side-effects, but with most of the warnings taken away.
In our cover story this month, publisher Bryan Hubbard has shone a bright light on the dark side of medicine: the burgeoning OTC business.
After the success of Motrin and other drugs with OTC status, many other drug companies have followed suit. Tired of years of regulatory red tape, many companies are creating a 'lite' version of their best-seller drugs to sell directly to consumers. The advantages are legion: the OTC version of the drug manages to remain completely under the radar, with little regulation, no post-marketing follow-up, no consumer awareness of potential dangers and no accountability. A pharmaceutical company is obliged to disclose far less about the potential dangers of an OTC drug than a drug that requires a prescription.
Yet, as many OTC drugs have the same deadly side-effects as their big brothers, the likelihood is that untold millions of people are being harmed, and even killed, by OTC drugs.
Nevertheless, because no one writes out a prescription for these products, there's no one to monitor where the bodies are buried.
What is most worrying about the exodus of 'Rx to OTC', as it's termed, is the complete abdication of responsibility by regulatory agencies such as the US Food and Drug Adminstration (FDA).
Back in Motrin's early days, the FDA had an entire agency committed to rooting out fraud in drug-testing. These days, any semblance of that watchdog activity has all but disappeared, as the FDA and its counterpart in the UK become increasingly chummy with Big Pharma and increasingly lax about drugs being sold directly to consumers.
The entire balance of the evidence has shifted. A drug-and the testers themselves-used to be considered dangerous until proven safe. Now, the only regulatory requirement is the market share.
The US and UK governments and the press are exulting in the recent highly public hanging of Dr Andrew Wakefield, found guilty of misconduct by the British General Medical Council (GMC). Wakefield, you may recall, is the British gastroenterologist who first raised the alarm bells over the measles-mumps-rubella vaccine (MMR).
In the minds of many medicos and in the press, the MMR vaccine now stands fully vindicated. The scientist who claimed that the MMR vaccine causes autism has been discredited. Order has been restored.
Someone finally bothered to ask the question: does breast screening work? The answer is a damning and resounding no, as our cover story this month makes clear. No breast screening programme anywhere is making the slightest impact on cancer mortality.
According to the prestigious Cochrane Collaboration, which carried out one of the most extensive and unbiased reviews of the literature to date, mammograms not only don't work as a screening tool, but also increase your risk of cancer and unnecessary treatment.
Most of us assume that if we're lucky enough to exceed our threescore and ten-the Biblical estimate of our lifespan-we do so at the expense of our bodies. We've come to expect that the long path to our demise is accompanied by an inevitable decline in our physical health. And perhaps our most terrifying fear is of growing feeble, forgetful and immobile.
The latest evidence-disclosed by WDDTY publisher Bryan Hubbard in this month's special report-suggests that this perception of old age is largely the result of the interfering hands of modern medicine. The fact is that old people are drowning in unnecessary medication. The over-60s make up just 8 per cent of the population, but they are prescribed more than one-third of all medicines dispensed by doctors. In fact, the average 60-plus person is prescribed at least six drugs, all of which are interacting to unknown effect.