Food, Drugs, Water, Air and Government

For several years I have been railing against those who wish to restrict the FDA from exerting proper control over the many so-called “nutritional supplements” that are promoted with exaggerated hype to unsuspecting consumers. As a result of limited or absence of vetting of these products, all sorts of mischief has been visited on our public, ranging from toxicity that is inadequately reported to this agency, surreptitious inclusion of illegal components, and even inclusion of virtually nothing but sawdust or grass (unfortunately, not the fun kind!) into many of their products. But the power of the FDA has been hamstrung by those who wish to restrict government—which, to many, is a dirty word—from providing the public with adequate protection. Legislators accomplish this through limiting the funding, size, and powers of the FDA, allowing many unscrupulous “supplement” producers to literally run amuck and produce untold misery and financial burden on an unsuspecting public, all for the latters” monetary gain. A few examples of such malfeasance are presented in one of my recent posts: http://www.mortontavel.com/2015/10/22

But spelling this out on a more global scale, I quote a recent post by my cousin, Sheila Kennedy, a modern day muckraker, who makes the following comments with which I could not agree more:

For the past 30+ years, self-described “small government” conservatives have waged a propaganda war on the legitimacy of the state. While that war has rarely been as explicit as Grover Norquist’s famous threat to make government “small enough to drown in a bathtub,” or as intentional as the campaign I blogged about yesterday, the constant focus has been on what government does badly and the constant refrain has been that “we don’t need no stinkin’ government telling us to [fill in the blank].

Let’s stipulate that, yes, there are many things government at all levels does badly, and yes, we need to monitor its operations and correct its mistakes. Yes, there are good forms of government and oppressive forms, and thoughtful citizens should opt for—and attempt to institute— the former. But that is very different from the irresponsible attacks on the very existence of established political authority.

The shock that has accompanied the water crisis in Flint, Michigan demonstrates the extent to which even the most anti-government among us depend upon a well-functioning bureaucracy—not to mention the extent to which ill-considered ideological decision-making poses a very real threat to the well-being of citizens. (Especially citizens who lack the means to remove themselves from the polity and retreat into privileged enclaves where they can pay for clean water and other “amenities.”)

There’s a lot that might be said about Flint’s situation, and a lot of blame to go around, but  the lesson to be learned goes well beyond the idiocy of “penny wise, pound foolish,” stubbornly ideological policies, or even official misconduct.

America is no longer a country of family farmers and small merchants scattered along the eastern seacoast. The overwhelming majority of Americans no longer grow and preserve our own food or draw our water from a pristine nearby creek. Cars and factories discharge pollutants into our air, airplanes criss-cross the skies, and we live in densely populated cities where—among other things— we can’t just toss our garbage out the back door. The list is endless.

American citizens are utterly dependent on the institutions of government to provide services we cannot effectively or efficiently provide for ourselves. We expect government to assign air lanes so our planes don’t crash into each other, to inspect the foods we buy at the local grocery so we don’t get ill, to prevent the local factory from discharging its toxic waste into our waterways so we don’t drink contaminants, and much more.

The private sector cannot protect even the richest gated communities from polluted air.

There are certainly areas of our communal life where government need not and should not intervene. Debates about the necessity and/or propriety of programs and initiatives is entirely appropriate, as is criticism of poor performance of government agencies or officials.

But.

When self-serving political rhetoric encourages our dimmer citizens to fear a “government invasion” of Texas, when the slightest effort to curtail gun violence sets off hysterical accusations of “confiscation,” when loony-tunes cowboys try to “take back” land held in trust for the benefit of all citizens, when efforts to ensure equal treatment of the nation’s more marginalized groups is rejected by zealots who claim exemption from the laws of the land “because God,” we have not only weakened the bonds of citizenship, we have endangered our own safety and well-being.

If we don’t retreat from our bipolar “government bad/private good” approach to complicated issues, there will be a lot more people drinking brown, lead-filled water and breathing toxic air.

Among other things.

These comments, and many others, can be found on her website: http://sheilakennedy.net/2016/01/food-water-air-and-government/

 

 

 

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DIETARY SUPPLEMENTS: SOME GOOD, SOME USELESS, AND SOME DANGEROUS

During the past 25 years dietary supplements have rocketed in popularity in the U.S.A., reaching over $25 billion yearly in sales. Contributing to a misguided air of authenticity, they are offered in drugstores, supermarkets, and health-food stores. But what do we actually know about these products in terms of both safety and efficacy? In a  2013 Consumer Reports survey, 55% of respondents thought the government required supplement makers to include warnings about potential dangers and side effects on their products. They don’t, meaning that safety issues are often ignored!

   So let’s run down a list of highly popular supplements, and the pros and cons for each:

Multivitamins: Many people believe they can promote general health and ward off serious conditions such as cardiovascular diseases and cancer. But the facts don’t support these contentions. Clinical trials repeatedly fail to show benefit of multivitamin supplements to healthy people. But even worse, they can, under certain circumstances, be risky: Both vitamin A and calcium can be dangerous if taken in excess, especially when added to a normal diet. Adult males and females should not ingest a daily total of over 3,000 mg. of vitamin A. Total daily calcium intake should not exceed 2,500 mg. So check to see how much you are getting in your regular diet and avoid supplements that cause the totals to exceed these levels.

Vitamin E: Originally touted to prevent cardiovascular disease, later studies have totally debunked this premise. More recently, supplements of vitamin E were suggested in the hope of preventing prostate cancer, but actual study pointed in the opposite direction: This vitamin actually increased prostate-caner risk in men age 50 and older.

B vitamins: Often thought to promote healthy metabolism and energy, the evidence refutes this contention in most circumstances. A normal diet contains an excess of B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (Pyridoxine), B12 (cobalamin), and folic acid. Unless your diet is deficient (see below), then supplementation is a waste of money. Vegetarians, and people (especially the elderly) having difficultly with absorbing B12, may benefit from supplementation of this vitamin. Moreover, women who are or may become pregnant should consider supplementation with folic acid, 0.8 mg daily. The oral form of supplemental folic acid is usually absorbed better than that found naturally in food. One caveat, however, is that high doses of folic acid can mask B12 deficiency that can lead to serious physical problems.

Vitamin K:Believed to promote healthy blood clotting and protein synthesis and prevent cancer. The reality: Leafy greens and other vegetables provide more than enough to satisfy the body’s need for this vitamin. Moreover, the normal bacteria that inhabit the bowel synthesize vitamin K and can make up any possible shortfall. There is no evidence that supplemental doses can prevent cancer. But there is a downside risk: Too much vitamin K can make the anticoagulant (blood thinning) drug warfarin (CoumadinR) less effective, a serious potential danger.

Fish Oil:  This supplement is widely used with the intent to prevent and/or treat cardiovascular diseases. Although the evidence indicates that two or more servings of fish weekly is capable to reducing heart attacks and strokes, linking fish oil supplements to these diseases is less clear. Some evidence suggests that they may help, but the better choice is in the dietary consumption of the fish itself.

Calcium: An important mineral constituent of the body, calcium is often taken with the intent of building healthy bone, thus preventing osteoporosis and fractures. But the evidence does not support such claims. Even with supplemental consumption of over 1,000 milligrams daily, calcium has not been shown to prevent fractures in either premenopausal or postmenopausal women. Among the possible risks of high calcium intake, some studies suggest that it may increase the risk of heart disease.

Vitamin C: For many years high doses of this vitamin have been used for preventing and treating colds, heart disease, and cancer. Despite numerous studies, however, the actual evidence fails on all these counts.  Although generally safe, a possible risk of high doses of supplemental vitamin C can lead to unhealthy buildup of iron in body tissues and organs, posing a risk to the occasional individual suffering from iron storage disease

(hemochromatosis).

Vitamin D: This vitamin is important in bone and muscle health, nervous and immune system function, cell growth and reproduction, and moderating inflammation. Although controversial, its administration is alleged to ameliorate certain types of heart disease, hypertension (high blood pressure), diabetes, and possibly multiple sclerosis. Some research suggests it may prevent colon cancer, and—although controversial—other cancers as well. It’s also associated with a reduced rate of depression in older people, and greater immunity against some infections. So far, however, few controlled prospective trials have investigated the potential benefits of vitamin D supplementation in preventing any of these problems.

      Normally we obtain vitamin D through sun exposure and dietary intake. It is manufactured by the body, but the process requires exposure to ultraviolet light. Given the widespread use of sunscreen, however, to prevent skin cancer, up to 36 % of Americans are low on this vitamin. Food sources for this vitamin are limited, although some products such as milk are fortified. Natural sources include fatty fish such as catfish, salmon, mackerel, sardines and tuna; eggs; beef liver; and cod liver oil. Your doctor can perform a blood test to determine whether you are deficient of this vitamin. If you are found to be deficient, instead of risking sun exposure, dietary modification and/or supplemental vitamin D should be considered.  

     The latest US recommendations for the minimum daily requirement of vitamin D, or cholecalciferol—vitamin D3, the preferred formare 600 IU (international units) for those under 70, and 800 IU for those older. These quantities appear to retard bone loss. Persons infrequently exposed to the sun, especially the elderly, and postmenopausal women may need 800–1000 IU daily. From a review of available information, I conclude that people who get at least 700 IU of vitamin D daily and take calcium supplements have denser bones, have better muscle strength, and are likely to suffer fewer falls and fractures than those who don’t. The only caution is to avoid exceeding the government’s safe daily upper limit of 2,000 IU.

Glucosamine/Chondroitin:  This supplement is widely used in the effort to help repair cartilage and relieve suffering from degenerative joint disease (osteoarthritis).  After many conflicting studies, however, a recent, more definite large study showed that glucosamine was unable to relieve knee pain or cartilage loss in people with osteoarthritis. Although generally safe, this product would pose some risk to some people with shellfish allergies.

                  SOME SUPPLEMENTS DEFINITELY TO AVOID

      Unless there is compelling evidence of efficacy—which is seldom the case—all supplements should be avoided. Three especially egregious products linked to serious dangers are the following: 1)  Kava, which is taken to relieve stress and anxiety, is capable of producing serious liver disease, 2) Yohimbe (yohimbine hydrochroride), used to treat erectile dysfunction, is risky because the impure ingredient present in over-the counter preparations, can cause unpredictable effects on blood pressure, rapid heart rate, and other problems,.and 3) Aconite, touted to relieve inflammation and joint pain, can cause nausea, vomiting, low blood pressure, respiratory system paralysis, heart-rhythm disorders, and even death.

                          IS ANYTHING WORTH TAKING?

    In general, normal diets contain more that enough to preclude the need for supplementation. If one has a demonstrated deficiency of any, then, upon the advice of a physician, supplementation may be justified. As noted above in the case of vitamin B12, folic acid, and Vitamin D, supplementation can be useful.

 

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