Big Tobacco’s Poisonous Legacy

tobacco

The comments below were taken from a recent blog by my cousin, Sheila Kennedy, (http://www.sheilakennedy.net/2016/12/big-tobaccos-poisonous-legacy/) and it corresponds closely to what I have been long maintaining: In essence, the strategy of climate science denial is taken directly from tobacco’s playbook! I was on the front lines in this battle at the time fighting as a volunteer for the American Heart Association and saw how extremely difficult it was to counter the political effects of big tobacco money!

In the years when tobacco companies were fighting emerging medical evidence of the links between smoking and deleterious health consequences, including cancer, they developed a diabolically effective strategy; rather than arguing that the science was wrong, they claimed it was inconclusive, that no one really knew whether cigarettes were the cause of people’s illnesses. The research was inconclusive.

That tactic worked for a long time, and as Senator Sheldon Whitehouse (D-RI) recently wrote, it has been the playbook for efforts by fossil fuel interests to delegitimize scientific consensus about climate change. In an essay for Inside Higher Ed, Whitehouse called upon universities to confront the tactic.

The threat is simple. The fossil fuel industry has adopted and powered up infrastructure and methods originally built by the tobacco industry and others to attack and deny science. That effort has coalesced into a large, adaptive and well-camouflaged apparatus that aspires to mimic and rival legitimate science. The science that universities support now has an unprecedented and unprincipled new adversary…

The science-denial machinery is an industrial-strength adversary, and it has big advantages over real science. First, it does not need to win its disputes with real science; it just needs to create a public illusion of a dispute. Then industry’s political forces can be put into play to stop any efforts to address whatever problem science had disclosed, since now it is “disputed science.” Hence the infamous phrase from the tobacco-era science denial operation — “Doubt is our product.”

Doubt is aided and abetted by the absence of universally trusted news sources (Where have you gone, Walter Cronkite? A nation turns its weary eyes to you…), increasingly sophisticated propaganda purveyors, and the very human tendency to engage in confirmation bias.

As Whitehouse says, the fossil-fuel apologists and climate-change deniers don’t waste their time in peer-reviewed forums. Instead, they go directly to Fox News and talk radio, to committee hearings and editorial pages. “Their work is, at its heart, PR dressed up as science but not actual science. So they go directly to their audience — and the more uninformed the audience, the better.”

Our universities and other organizations engaged in the enterprise of science struggle for funding. Not so for the science-denial forces. You may think maintaining this complex science-denial apparatus sounds like a lot of effort. So consider the stakes for the fossil fuel industry. The International Monetary Fund — made up of smart people, with no apparent conflict of interest — has calculated the subsidy fossil fuels receive in the United States to be $700 billion annually. That subsidy is mostly what economists call “externalities” — costs the public has to bear from the product’s harm that should be, under market theory, in the price of the product. These $700-billion-per-year stakes mean that the funding available to the science-denial enterprise is virtually unlimited… Make no mistake: in every dispute that this denial machinery manufactures with real science, it is determined to see real science fail. That is its purpose.

As Whitehouse points out, given the strong connections between the incoming Trump Administration and the fossil fuel industry, we can no longer depend on government to be an honest broker and a defender of legitimate science. Hence his plea to universities and other scientific organizations — to join together and step up a common defense.

Or, as these deniers are usually apt to say, “I’m not a scientist myself, but I’ve heard from some real scientists (who and how many?) that the issue is not settled”.

Sometimes, it all seems like a bad dream…..

 

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HOW WE CAN PREVENT ALZHEIMER’S DISEASE

alzheimer

Contrary to popular belief, many studies suggest that Alzheimer’s disease can be prevented, or at least delayed in onset. As I have previously presented, regular exercise diminishes the likelihood of developing this condition.  In addition, food intake such as Mediterranean diets can be helpful. Finally, regular mental stimulation of most types (note the picture above) can also retard the deterioration of brain function.

DIETARY FACTORS

     Let’s examine first the diets that can be helpful. Researchers have found that people who stuck to a diet that included foods like berries, leafy greens, and fish had a major drop in their risk for memory-sapping disorders, which affect more than 5 million Americans over age 65. This eating plan is called the MIND diet. Here’s how it works. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It’s similar to two other healthy meal plans, i.e., the DASH diet and the Mediterranean diet. This approach specifically includes foods and nutrients that medical literature and data show to be good for the brain, such as berries, but extending to these 10 food groups:

  • Green leafy vegetables (like spinach and salad greens): At least six servings a week
  • Other vegetables: At least one a day
  • Nuts: Five servings a week
  • Berries: Two or more servings a week
  • Beans: At least three servings a week
  • Whole grains: Three or more servings a day
  • Fish: Twice or more a week
  • Poultry (like chicken or turkey): Two times a week
  • Olive oil: Use it as your main cooking oil.
  • Wine: One glass a day

Foods to avoid:

  • Red meat: Less than four servings a week
  • Butter and margarine: Less than a tablespoon daily
  • Cheese: Less than one serving a week
  • Pastries and sweets: Less than five servings a week
  • Fried or fast food: Less than one serving a week

                  The Benefits

One study showed that people who stuck to the MIND diet lowered their risk of Alzheimer’s disease by 54%. That’s big. But maybe even more importantly, researchers found that adults who followed the diet only part of the time still cut their risk of the disease by about 35%.

Scientists need to do more research on the MIND approach, but it’s a very promising start. It shows that what you eat can make an impact on whether you develop late-onset Alzheimer’s, which is the most common form of the disease.

Simply reducing cholesterol, at least by the commonly prescribed “statin” drugs can also produce a similar desirable result.

One recent study showed that, based on a sample of 399,979 Medicare beneficiaries, men and women who took statins two years or more lowered their risk of Alzheimer’s in the period spanning 2009 to 2013. The incidence of Alzheimer’s disease was reduced for beneficiaries frequently prescribed statins (high users), compared to low users, USC and University of Arizona researchers found. Among women who were high users, the incidence rate was 15 percent lower. Among men, the rate was 12 percent lower.

These data further support the idea that many sufferers of Alzheimer’s disease may share a common origin with arteriosclerosis (hardening of the arteries), which likely means that controlling the various known risk factors provides a likely way to avoid not only Alzheimer’s disease, but also to reduce cardiovascular diseases such as heart attacks and strokes.

PUTTING IT ALL TOGETHER: Multifactor lifestyle modification

A recent study from Finland showed that an intervention that targets nutrition, exercise, and metabolic and cardiovascular risk factors can improve cognition and memory in older adults, and prevent them from developing Alzheimer’s disease. Most striking, this program produced the greatest change in those who carried the highest risk, i.e., those subjects with a strong hereditary predisposition for this disease.

The randomized, controlled FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial was designed to show how a multimodal lifestyle intervention might not only slow or prevent cognitive decline, but help improve cognition among patients who are already experiencing decline. It enrolled 1,260 participants aged 60-77 years who were cognitively normal at baseline but at increased risk for decline.

All participants were followed for two years and randomized to 1) a control group provided with usual care by their regular physicians, or 2) the intervention group, which consisted of the following::

  • Dietary counseling with recommendations to consume increased amounts of fruit, vegetables, whole grains, lean protein, and healthy fats.
  • Progressive aerobic exercise and weight training, conducted by physical therapists, several times each week.
  • Cognitive training several times a week with a computer program that targeted executive processes, working memory, episodic memory, and mental speed.
  • Managing metabolic and cardiovascular risk factors, including blood pressure, weight, and body mass index. This was addressed in group sessions and with visits to participants’ own physicians.

The primary endpoint was change in mental function, which was conducted at baseline and at months 12 and 24. Also assessed were memory and processing speed.

By the end of the study, subjects in the intervention group experienced a significant, 25% greater improvement on the overall score than did those in the control group. Improvements on the secondary measures were significant for the intervention group as well: 150% better than the control group in processing speed, and 40% better in short-term memory. Measures of cognitive decline increased by 30% in the control group, whereas subjects in the intervention group experienced no deterioration.

This study also included preliminary data on how the intervention improved overall function and quality of life. Although there was some decline after 2 years in the control group, the intervention group remained stable or showed a significant improvement in general health. Moreover, although general daily function was good for all subjects at baseline, by the end of the study, significant differences had emerged, for the control group actually had a 50% increased risk for at least one new difficulty with activities of daily living.

The program was not associated with any serious adverse events. The results also appeared to have a lasting impact, which boded well for better sustained later outcomes. At the end of the study, the intervention group participants had decreased their body weights by about 4-5 lbs, which was significantly more than for control group subjects. Most of the former group reported that they were still eating fish and vegetables every day, and exercising at least twice a week.

This was the first long-term trial to show that a multidomain intervention like this one can maintain and improve not only cognitive decline but also more robust physical outcomes and quality of life. Of special importance, it carries no risks.

WHAT NATIONAL TRENDS CAN TELL US

   Over the past 20 years, we have witnessed a gradual reduction of prevalence of cardiovascular disease in the U.S., attributable to lifestyle improvements mentioned above.  Also fitting well with this concept, a corresponding reduction in cognitive impairment was identified in a National Health and Retirement Study (HRS) surveyª. Although these latter trends were less clear, they seem to provide further optimism that we may have the means to ward off much mental deterioration in the future.

 

ª Rocca WA, et al. Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011 Jan; 7(1): 80–93. doi:  10.1016/j.jalz.2010.11.002

 

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HEALTH TIPS FOR THE HOLIDAY SEASON

holidays

Mashed potatoes and gravy, Grandma’s apple pie, and other holiday favorites can be a joyous part of any celebration. But to feel your best, you know you need to eat in moderation and stay active. How can you avoid temptation when delicious foods and calories abound?

From Halloween through New Year’s, there’s always a decision to make about food. . Tasty treats tend to appear more often at work and festive gatherings, and to come as gifts. They may also tempt you when grocery shopping. Thus as the holidays approach, it’s important to think ahead and make a plan.

Consider your health goals for the holiday season, whether it’s preventing weight gain through overeating, staying active, connecting with others, or reducing stress. You can plan to make time for buying healthy groceries, cooking at home, scheduling regular physical activity, and setting aside a little quiet time for yourself.

Begin by adopting a flexible mindset. Many people have an attitude of all or nothing: either I’m on a diet or I’m not on a diet.  This “either-or” thinking can lead to negative self-talk, or being hard on yourself for small indulgences, overeating, or weight gain.

Unfortunately most people just throw their plan out the window when they think they’ve slipped up once. Celebrations don’t have to derail your lifestyle. You’ll have plenty of opportunities to follow your plan and eat healthy and feel good about it. Small choices really can make big changes. Each moment that you put something in your mouth or choose to exercise adds up over time, which can be true for weight loss or weight gain.Around the holidays, we often find ourselves with too many food options, for too many days in a row. It can be challenging to decide what to eat and when to say no.

Eat what you love—but in moderation. Consider choosing items that are unique to the season, instead of eating foods you can have any time of the year. When you feel the urge to splurge in unhealthy ways, try something else first, like drinking a glass of water, eating a piece of fruit, or climbing a few flights of stairs. You might even consider walking around your house or office for 5 minutes or more. Such diversions might be enough to help you resist unhealthy temptations. You could also try eating more deliberately. Slow down to really taste and enjoy your food. Eating more slowly also allows your body time to signal your brain when you’re full, which takes about 20 minutes. If you eat too much too quickly, it’s easy to gobble up as much as twice what your body needs before your brain even gets the message. Also it’s a good idea to identify and avoid any “trigger foods”—foods that may spur you to binge or eat more than usual. Overeating can bring feelings of bloating, reflux, indigestion, and nausea. Some people can eat less healthy foods in moderation and be fine, or have “cheat days” where they allow themselves to eat whatever they want for a day and stay on track for the rest of the week.. Others may have to avoid certain “trigger foods” completely, or they’ll spiral into unhealthy eating patterns for the rest of the week or abandon their plan altogether. Everyone is different. Because of these differences, it’s important not to force food on other people. Even if you don’t have an issue with food, be aware of other people around you, and respect their choices.

What if you do fall to temptation?  Happily every day is a new day when it comes to eating. If you overeat one day, work to get back on track the next meal or next day.

While food is a big part of the holidays, remember that there are other paths to staying healthy. Don’t make the holidays be just about food. The key is not only what you eat, but how much you’re moving. Even little bits of extra exercise can be very helpful for everyone over the holidays.

Plan ahead for how you’ll add physical activity to days that might otherwise involve a lot of sitting. When possible, get the whole family involved. You have to make an effort to incorporate exercise into days of big eating. Otherwise the day will come and go.Sign up to walk or run a community race. Enjoy catching up with family or friends on a walk or jog instead of on the couch. In between meals, take a family hike at a nearby park or stroll around your neighborhood..

The emotions of winter celebrations come into this picture, too. Joy, sadness, and stress are often associated with overeating during the holidays. People who are emotional eaters may be particularly vulnerable to such temptations around the holidays. If holiday stress causes you to derail your healthy plans, consider ways to reduce stress and manage emotions. These might include talking to a trusted friend, meditation, physical activity, or just getting outside. If you know you have a difficult time during holidays, plan outings once or twice a week with people who make you feel happy. If it’s in your best interest, also feel okay about declining invitations without feeling guilty.

Support your family and friends, too. Encourage them to eat healthy during celebrations and throughout the year. If you’re serving dinner, consider baking, broiling, or grilling food instead of frying. Replace sour cream with Greek yogurt, and mashed potatoes with mashed cauliflower. Make take-home containers available ahead of time, so guests don’t feel they have to eat everything in one sitting.

So you needn’t adopt a defeatist attitude around the holiday season. Be proactive, and fight the flab at the same time.

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DOES IT EVER PAY TO BE FAT?

overweight-scale


During the past several years, a misconception—the so called “obesity paradox”—has been creeping into the medical literature. This paradox is a medical hypothesis which holds that obesity (and even high cholesterol), counter intuitively, may be protective and associated with greater survival in certain groups of people, such as very elderly individuals or those with certain chronic diseases. It further postulates that normal to low body mass index or normal values of cholesterol may be detrimental and associated with higher mortality in asymptomatic people.

But is there any truth to this hypothesis? As we note below, the answer to this question is, no!

    A large international study that included Harvard researchers links a high body mass index (BMI)-a calculation used to determine if a person is overweight-to a risk of early death, and contradicts the idea that it’s possible to be fat and fit. Researchers pooled the data from 239 studies of more than 10 million people in 32 countries. They excluded people who had smoked, had a chronic condition, or died within five years of follow-up, leaving about four million people. Of those, researchers analyzed people’s BMIs (Body Mass Indices). A healthy BMI (non-obese) is considered to be in the range from 18.5 to 24.9. Researchers observed that study participants with a BMI of 20 to 24.9 were the least likely to die during the study period; people with a BMI above that were significantly more likely to die during the study period, especially men with high BMIs. The findings, published Aug. 20, 2016, in The Lancet, don’t prove that high BMIs cause early death, but they do suggest being overweight matters.

The bottom line: Extra fat puts you at risk for developing diabetes, heart disease, and cancer, so make weight control a priority, and avoid making phony excuses for being fat!

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