Positive Health Online
Your Country
Letters to the Editor Issue 194
listed in letters to the editor, originally published in issue 194 - May 2012
Obesity, Gastric Surgery, Brain Scans and Harm
by Dr Edwin Salter
Major surgical procedures for the obese are costly, dangerous and require scarce facilities and skills. Some are irreversible and impose on patients a lifelong prevention of normal eating and social life. They are often undertaken without any adequate therapeutic attempt at the mental or behavioural change that would enable patients to take enduring responsibility for themselves.
There is almost an encouragement to the passivity of over-eating in the promise of rescue. The attractions of this surgery to medicine include, obviously, lots-of-money and the glamour of ‘final solution’ procedures that claim to save the lives of people who have no other options.
It is being asserted, for example, that the value of gastric bypass is proved by subsequent changes in brain function. Scans (fMRI) some months after surgery show reduced brain response to images of fattening foods.
However there are simpler explanations for these effects. First, patients have made a difficult and seemingly brave decision, and they have survived a dramatic and fearful trial. Such ritual, conceived as transforming, has great psychological power.
Second, the scanned patients have experienced a prolonged period of very minimal eating, and that in unnatural ways. It is predictable that this large change of behaviour shows as a corresponding adjustment of brain function. The relationships between mental awareness, practical action and neurophysiology are two-way processes.
Even if gastric surgery is effective on narrow grounds of individual weight control, the penalties are profound. Fundamentally, the whole enterprise is almost irrelevant to the immense public health issue of bad nutrition and abnormal body weight. But these interventions are touted as conclusive and with the gloss of celebrity.
It is bizarre to have created a society in which the poor are fat. A high-tech medical response to the symptoms of social and economic pathology is inappropriate, even harmful. It merely adds another twist to the exploitive (and psychologically cunning) industry that maintains a cycle of unsuitable foods and treatments.
Dr Edwin Salter kl.humanfactors@virgin.net
The Swiss Government's Exceedingly Positive Report on Homeopathic Medicine
by Dana Ullman
The government of Switzerland has a long history of neutrality, and therefore, reports from this government on controversial subjects need to be taken more seriously than other reports from countries that are more strongly influenced by present economic and political constituencies. Further, when one considers that two of the top five largest drug companies in the world have their headquarters in Switzerland, one might assume that this country would have a heavy interest in and bias toward conventional medicine, but such assumptions would be wrong.
In late 2011, the Swiss government's report on homeopathic medicine represents the most comprehensive evaluation of homeopathic medicine ever written by a government and was just published in book form in English (Bornhoft and Matthiessen, 2011). This breakthrough report affirmed that homeopathic treatment is both effective and cost-effective and that homeopathic treatment should be reimbursed by Switzerland's national health insurance program.
The Swiss government's inquiry into homeopathy and complementary and alternative (CAM) treatments resulted from the high demand and widespread use of alternatives to conventional medicine in Switzerland, not only from consumers but from physicians as well. Approximately half of the Swiss population have used CAM treatments and value them. Further, about half of Swiss physicians consider CAM treatments to be effective. Perhaps most significantly, 85 percent of the Swiss population wants CAM therapies to be a part of their country's health insurance program.
It is therefore not surprising that more than 50 percent of the Swiss population surveyed prefer a hospital that provides CAM treatments rather to one that is limited to conventional medical care.
Beginning in 1998, the government of Switzerland decided to broaden its national health insurance to include certain complementary and alternative medicines, including homeopathic medicine, traditional Chinese medicine, herbal medicine, anthroposophic medicine, and neural therapy. This reimbursement was provisional while the Swiss government commissioned an extensive study on these treatments to determine if they were effective and cost-effective. The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this new study, the Swiss government's health insurance program once again began to reimburse for homeopathy and select alternative treatments. In fact, as a result of a national referendum in which more than two-thirds of voters supported the inclusion of homeopathic and select alternative medicines in Switzerland's national health care insurance program, the field of complementary and alternative medicine has become a part of this government's constitution (Dacey, 2009; Rist, Schwabl, 2009).
The Swiss Government's Health Technology Assessment
The Swiss government's Health Technology Assessment on homeopathic medicine is much more comprehensive than any previous governmental report written on this subject to date. This report carefully and comprehensively review the body of evidence from randomized double-blind and placebo controlled clinical trials testing homeopathic medicines, plus they also evaluated the “real world effectiveness” as well as safety and cost-effectiveness. The report also conducted a highly-comprehensive review of the wide body of preclinical research (fundamental physio-chemical research, botanical studies, animal studies, and in vitro studies with human cells).
And still further, this report evaluated systematic reviews and meta-analyses, outcome studies, and epidemiological research. This wide review carefully evaluated the studies conducted, both in terms of quality of design and execution (called "internal validity") and how appropriate each was for the way that homeopathy is commonly practised (called "external validity"). The subject of external validity is of special importance because some scientists and physicians conduct research on homeopathy with little or no understanding of this type of medicine (some studies tested a homeopathic medicine that is rarely used for the condition tested, while others utilized medicines not commonly indicated for specific patients).
When such studies inevitably showed that the homeopathic medicine did not ‘work’, the real and accurate assessment must be that the studies were set up to disprove homeopathy... or simply, the study was an exploratory trial that sought to evaluate the results of a new treatment (exploratory trials of this nature are not meant to prove or disprove the system of homeopathy but only to evaluate that specific treatment for a person with a specific condition).
After assessing pre-clinical basic research and the high quality clinical studies, the Swiss report affirmed that homeopathic high-potencies seem to induce regulatory effects (e.g., balancing or normalizing effects) and specific changes in cells or living organisms. The report also reported that 20 of the 22 systematic reviews of clinical research testing homeopathic medicines detected at least a trend in favour of homeopathy.* (Bornhoft, Wolf, von Ammon, et al, 2006)
The Swiss report found a particularly strong body of evidence to support the homeopathic treatment of upper respiratory tract infections and respiratory allergies. The report cited 29 studies in Upper Respiratory Tract Infections/AllergicReactions, of which 24 studies found a positive result in favour of homeopathy. Further, six out of seven controlled studies that compared homeopathic treatment with conventional medical treatment showed homeopathy to be more effective than conventional medical interventions (the one other trial found homeopathic treatment to be equivalent to conventional medical treatment). All of these results from homeopathic treatment came without the side effects common to conventional drug treatment. In evaluating only the randomized placebo controlled trials, 12 out of 16 studies showed a positive result in favour of homeopathy.
The authors of the Swiss government's report acknowledge that a part of the overall review of research included one negative review of clinical research in homeopathy (Shang, et al, 2005). However, the authors noted that this review of research has been widely and harshly criticized by both advocates and non-advocates of homeopathy. The Swiss report noted that the Shang team did not even adhere to the QUORUM guidelines which are widely recognized standards for scientific reporting (Linde, Jonas, 2005). The Shang team initially evaluated 110 homeopathic clinical trials and then sought to compare them with a matching 110 conventional medical trials. Shang and his team determined that there were 22 "high quality" homeopathic studies but only nine "high quality" conventional medical studies. Rather than compare these high quality trials (which would have shown a positive result for homeopathy), the Shang team created criteria to ignore a majority of high quality homeopathic studies, thereby trumping up support for their original hypothesis and bias that homeopathic medicines may not be effective (Ludtke, Rutten, 2008).
The Swiss report also notes that David Sackett MD, the Canadian physician who is widely considered to be one of the leading pioneers in ‘evidence based medicine’, has expressed serious concern about those researchers and physicians who consider randomized and double-blind trials as the only means to determine whether a treatment is effective or not. To make this assertion, one would have to acknowledge that virtually all surgical procedures were ‘unscientific’ or ‘unproven’ because so few have undergone randomized double-blind trials.
For a treatment to be determined to be ‘effective’ or ‘scientifically proven’, a much more comprehensive assessment of what works and doesn't is required. Ultimately, the Swiss government's report on homeopathy represents an evaluation of homeopathy that included an assessment of randomized double blind trials as well as other bodies of evidence, all of which together lead the report to determine that homeopathic medicines are indeed effectiv
The next article will discuss further evidence provided in this report from the Swiss government on the effectiveness and cost-effectiveness of homeopathic care.
References
Bornhoft, Gudrun, and Matthiessen, Peter F. Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs. Goslar, Germany: Springer, 2011. http://rd.springer.com/book/10.1007/978-3-642-20638-2/page/1 (This book is presently available from the German office of the publisher, and it will become available via the American office as well as select booksellers in mid- to late-February, 2012.)(NOTE: When specific facts in the above article are provided but not referenced, this means that these facts were derived from this book.)
Bornhoft G, Wolf U, von Ammon K, Righetti M, Maxion-Bergemann S, Baumgartner S, Thurneysen AE, Matthiessen PF. Effectiveness, safety and cost-effectiveness of homeopathy in general practice - summarized health technology assessment. Forschende Komplementarmedizin. 13 Suppl 2:19-29. 2006. www.ncbi.nlm.nih.gov/pubmed/16883077
Dacey, Jessica. Therapy supporters roll up sleeves after vote. SwissInfo.ch, May 19, 2009. www.swissinfo.ch
Linde K, Jonas W. Are the clinical effects of homeopathy placebo effects? Lancet 36:2081-2082. DOI:10.1016/S0140-6736(05)67878-6. http://download.thelancet.com
Ludtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analysed trials. Journal of Clinical Epidemiology. October 2008. doi: 10.1016/j.jclinepi.2008.06/015. http://www.jclinepi.com/article/S0895-4356(08)00190-X/abstract
Rist L, Schwabl H: Komplementarmedizin im politischen Prozess. Schweizer Bevolkerungstimmt uber Verfassungsartikel ?Zukunft mit Komplementarmedizin? ab. Forsch Komplementmed 2009, doi 10.1159/000203073.
(Translation: Complementary medicine in the political process: The Swiss population votes on the Constitutional Article "The future with complementary medicine") www.ayurveda-association.eu
*Although this Swiss government report was just published in book form in 2011, the report was finalized in 2006. In light of this date, the authors evaluated systematic reviews and meta-analyses on homeopathic research up until June 2003.
About the Author
America's leading advocate for homeopathic medicine and author of The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy (Foreword by Dr. Peter Fisher, Physician to Her Majesty Queen Elizabeth II). Learn more about homeopathy and Dana's work at www.Homeopathic.com or watch Dana's videos at http://naturalnews.tv/Browse.asp?memberid=6958
Dana has authored 9 other books, including Homeopathy A-Z, Homeopathic Medicines for Children and Infants, Discovering Homeopathy, and (the best-selling) Everybody's Guide to Homeopathic Medicines (with Stephen Cummings, MD).
Learn more: www.naturalnews.com/035499_homeopathic_medicine_Swiss_report.html#ixzz1rTKNpNZ0
www.naturalnews.com/035499_homeopathic_medicine_Swiss_report.html
Source: Chris Woollams chris@canceractive.ccsend.com
The Press and the Public Hoodwinked by Recent Red Meat Research
by Simon Shawcross and Georges Philips
On 12 March 2012 the World media began releasing headlines, which included “Red meat increases death, cancer and heart risk, says study” (BBC News), and “Red meat is blamed for one in 10 early deaths” (The Daily Telegraph). This is shocking and potentially scary information for the public to have to digest, if these headlines were based on fact rather than speculation, assumption and an unproven hypothesis. Fortunately, as we shall show, this is just a case of sensationalism and we can breathe easy and continue to enjoy regular consumption of red meat for all of its known health benefits, as recommended in The ONE Diet (ISBN 1904928013).
The headlines mentioned above and hundreds of others like them arose because of the publication of research titled “Red Meat Consumption and Mortality Results From 2 Prospective Cohort Studies” Frank B Hu, MD et al, in the Archives of Internal Medicine. This newly published study is in fact, based on data from two older studies: the “Nurses’ Health Study” and the “Health Professional’s Follow-up Study”.
The controversial suggestion of this recent study is that a single daily serving of unprocessed red meat was associated with a 13% increased risk of death and a single daily serving of processed red meat was associated with a 20% increased risk of death. Again, terrifying information if this were actual scientific fact rather than just hypothesis.
The diet data used to create this hypothesis was self-reported (problematic in itself) by participants, by way of Food Frequency questionnaires filled out [only] once every four years between the 1980s and 2006. Research carried out in this manner is actually an “observational study”; observational studies can only suggest hypotheses they cannot ‘prove’ anything.
Only double or triple-blinded randomized controlled trials (RCT) can actually prove causation. So the BBC’s headline “Red meat increases death, cancer and heart risk, says study” is inaccurate; there is a small but critical word missing, the word “may”. A hypothesis is a long way from fact; it is only the first step up the ladder of scientific enquiry, and a hypothesis has to be repeatedly proven through RCTs to become fact.
There are real and great dangers from assuming anything from observational studies, as history bears witness. Researchers have previously made very serious errors when assuming too much about observational study data, including when data previously mined from the Nurses’ Health Study (yes the same one as used in the red meat research above). In 1991, the New England Journal of Medicine published an observational study that stated, “Current estrogen use is associated with a reduction in the incidence of coronary heart disease as well as in mortality from cardiovascular disease”; this was used to back the claim that hormone replacement therapy and women taking estrogen decreased their risk of heart disease by 50%.
When the results of real RCTs were published on Hormone Replacement Therapy (HRT) a few years later, it was discovered that the reverse was true and HRT increased the risk of heart disease by 29%. Taking observational studies seriously and reporting them as fact may well damage the health of the public.
There are other major problems particular to the red meat study by Hu et al. Despite the headline grabbing “20% increased risk of death” statement, the reality is this research’s numbers are incredibly small: the overall risk of dying was less than one person in a hundred over the entire 28-year study period.
Furthermore there were many other variables within the research that also showed a correlation with death rates (activity levels, alcohol intake, BMI and many others), and yet these were not factored out of the equation to isolate red meat as the determining risk factor.
Other variables also went unaccounted for, for some reason the “unprocessed meat” category included pork sandwiches, hamburgers and lamb curries. How ammonia-treated hamburger meat can be passed off as unprocessed meat is incredulous. And as the study didn’t track refined grains that would be included in sandwiches and hamburger buns, it is scientifically impossible to claim that it is the red meat in isolation that correlates with risk of death, it is just as possible to suggest that the unaccounted for refined grains were the real risk factor hidden within the statistics.
To demonstrate the lack of value in drawing any significant conclusions from the research in question we would point you to research carried out at the Harvard School Of Public Health and published in Circulation in 2010 titled, “Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis.” Micha R, Wallace SK, Mozaffarian D which, although it is a meta-analysis that included the data of observational trials, at least also included data from genuine randomized trials too and found that red meat consumption was NOT associated with coronary heart disease or diabetes mellitus - the opposite hypothesis from that presented on March 12th.
The March 12th media storm over the red meat study was poorly and dangerously reported even by some of the most respected international news outlets. The authors of The ONE Diet continue to wholeheartedly endorse the regular consumption of grass fed red meat for all its well known and established health benefits as detailed in The ONE Diet. The authors of The ONE Diet do not endorse or recommend the consumption of processed meat of any type due to the poor quality meat and chemical additives used to produce industrial processed meat.
About the Authors
Georges Philips is a change architect who has been working in the corporate world for many years as an educator, trainer and corporate coach. As a therapist for over 25 years he has written several books on subjects that include hypno-analysis, belief restructuring, neuro linguistics, stress, meditation and rapid cognitive therapy. His companion book to The ONE Diet Change Directions with a foreword by Dr. Edward de Bono is also available now. He is in private practice in London.
Simon Shawcross is a nutrition expert, personal trainer, wellbeing presenter and author. Since 2000, he has helped individuals and corporations achieve their weight loss, fitness and wellbeing goals. He has personally supervised over 6,500 sessions and presented numerous seminars. Simon has also written articles on health for several newspapers and magazines. He currently lives and works in London.
Further Information
Please contact Simon Shawcross on Tel: 07944866854; info@theonediet.com www.theonediet.com
Comments:
-
No Article Comments available