Monday, June 19, 2017

Science Bits and Bits and Bits

(written 2013)
Here are a collection of a few quick items you may find interesting.

Ear Candling

Ear candling is procedure often used by alternative medicine practitioners for reasons they claim including:  removing toxins, relieving sinus pressure, curing ear infections, helping with vertigo, improving hearing, purifying blood and much more.  There is no scientific evidence to support any of those claims.  Proponents often show some nasty discoloured gook in the candle after a session as proof.   This stuff actually is the residue from the candle itself.   Just burning one without use on an ear has the same exact effect as with use on an ear.  Tests have shown that there is not enough suction created from ear candling to cause ear wax to be pulled from the ear.

Health Canada considers ear candles to be Medical Devices and as such require licenses for the sale of them.  Since they are considered dangerous, Health Canada has not issued any licenses and therefore, the sale, and import of any ear candle is illegal.   They recommend if you do have compacted wax to seek a health care professional who will use proper equipment to remedy the problem.  http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/ear-oreille-eng.php


Foot Detox Baths

Another item often used by the alt-med industry.   You place your feet into a shapely water-filled bucket.  A special cleansing formula is added and the unit is turned on.  Soon an orangey-brown colour is visible in the water.  The practitioner providing this service has told you that this is toxins from your body exiting through your feet.

Here’s the reality.  Toxins in the body (and the practitioners always seem to forget to mention exactly what toxins) do not exit through the feet, or the skin for that matter, in any significant amount.  We already have a body system that does that (visit any bathroom to see it at work).   Also, the rusty colour you see in the water is just that…rust!   It is actually the oxidation of the metal components (electrodes) through a process called electrolysis.   This happens even without your feet in the unit (see this video http://youtu.be/hbqYOw9I38w ).  This is just like the ear candling in that the claimed “proof” of it working, occurs without any body parts being utilized.



Hologram Bracelets

These are bracelets (usually made out of rubber) with a hologram sticker embedded into them.   Proponents claim that these help increase energy, strength and balance among other things.  They often do a couple of demonstrations to show you how well they work.

There is no scientific evidence that they work as claimed, but I am more interested in the demonstrations you can often find some of the sales people utilizing.  These particular “provings” are a collection of old sideshow strength stunts and old snake-oil salesmen techniques recycled for modern audiences.  They use little known principles of leverage and a lack of knowledge of the body to make it seem like the bracelets are working.  By watching this video of magician Brian Brushwood (http://youtu.be/XpLt0oUWfOk),
you can see how subtle the changes in the demos are from not wearing a bracelet to wearing one.  Save your money and just keep practicing.

Honey I Suppressed the Kids

(written 2013)

You may have been hearing a lot the past few years about the wonderful effects honey can have on coughs.   Media, nutritionists, social networking and various other sources have been very effective in spreading the news that was issued in a 2007 press release by Penn State University (PSU) and the Journal of the American Medical Association (JAMA).  This study was funded by an unrestricted grant from the National Honey Board, an industry-funded agency of the United States Department of Agriculture. Unfortunately, as the Hip Hop group Public Enemy has said, “Don’t Believe the Hype.”

The press release from PSU (http://news.psu.edu/story/192001/2007/12/03/honey-proves-better-option-childhood-cough-otcs ) states that:
“The study found that a small dose of buckwheat honey given before bedtime provided better relief of nighttime cough and sleep difficulty in children than no treatment or dextromethorphan (DM), a cough suppressant found in many over-the-counter cold medications.”

While this statement is not untrue, it is a little misleading once one reads the published study. (http://archpedi.jamanetwork.com/article.aspx?articleid=571638).  In the study it states:
“Notably, however, direct comparison between honey and DM yielded no statistically significant differences.” and “much of the improvement can also be attributed to the natural history of URIs (Upper Respiratory Infection), which generally improve with time and supportive care.”

Well this is getting a little confusing.  Where did the PSU get the idea about honey being better?   Well, it also states in the study:
“Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. “

OK, so now we know where the supportive information came from.   But wait a minute!   Do you see it?  If honey is significantly better than no treatment, and DM is no better than no treatment, then how can the comparison between honey and DM show no significant differences?  So what’s going on here?

Looking at the First Night and Second Night comparison scores (figure 2 in the JAMA study), you can see honey does fare better overall compared to DM and no treatment.  Upon closer examination, you will notice though, that the advantage it has is less than 1 point.  Most seem to show just a .5 difference between No Treatment and Honey with DM in between those two.   So really, it shows no significance and is suggesting that a child having no treatment will experience pretty much the same relief as those taking a cough suppressant with DM or honey.

The authors suggest that the cause for the slight increase in effectiveness of honey may be due to some of its antimicrobial and antioxidant effects.  They also suggest that sweetened liquids may cause salivation and airway mucus to be secreted and thus provide a soothing demulcent effect.   Although, taken with a grain of sugar, when you again compare the relatively unimpressive results of honey over DM and no treatment with these explanations, it’s not really saying much.

Ideally, I would say that this study really shows that attentive and supportive care and time is the most important medicine in helping a child with a cough, which the authors also support by saying:
“much of the improvement can also be attributed to the natural history of URIs, which generally improve with time and supportive care. “

So just make sure that you show your child love and care for them.  If your child’s cough persists, see your doctor immediately.

Supple Risk

(written 2013)

“Use at your own risk” has become a common cliché, used as a layperson’s quick and easy legal disclaimer.   It’s been used to great comedic effect in many comic and late night TV host’s monologues.  It seems that our governments may be taking a similar weak approach in matters of our health, and that is no laughing matter.

I would think that consumers want safe and accurately labelled products.  They should consult medical health professionals and be able to make their own decisions on the effectiveness of a product.  Product safety is paramount, as well as quality, and efficacy statements should be based on good science.

Health Canada and the FDA (USA Food and Drug Administration) are very similar and share information with each other readily.  Their purpose is to protect the public health by regulating drugs, vaccines, medical devices, our nation’s food supply, cosmetics and dietary supplements.   The last one is where I have some concern.  Dietary supplements can include vitamins, homeopathy and natural herbs.

A recent (October 2012) Department of Health and Human Services Office of Inspector General’s (OIG) report (https://oig.hhs.gov/oei/reports/oei-01-11-00210.pdf) on FDA’s ability to regulate said:
“Overall, substantiation documents for the sampled supplements were inconsistent with FDA guidance on competent and reliable scientific evidence. FDA could not readily determine whether manufacturers had submitted the required notification for their claims.  Seven percent of the supplements lacked the required disclaimer, and 20 percent included prohibited disease claims on their labels. These results raise questions about the extent to which structure/function claims are truthful and not misleading.”

This obviously suggests that there are a lot of products on the market that may be misused due to improper labelling.  It goes on further to state:
“DSHEA [Dietary Supplement Health and Education Act] does not require manufacturers to submit dietary supplements to FDA for safety or approval prior to sale. As a result, FDA has no comprehensive list of dietary supplements on the market. Dietary supplement manufacturers must ensure that their products are safe, they have evidence to substantiate structure/function claims, and that product labels are truthful and not misleading.”

This is troubling as the FDA does not conduct surveillance of supplements sold in retails stores.   It does conduct limited surveillance on the internet and monitors adverse event reports, consumer complaints and visiting manufacturing facilities.   I find that this leaves a big loophole for products to slip into the market that are unsafe.  A lot of what the FDA is doing seems to be reacting to the issues instead of solving the issues beforehand.  It’s not totally their fault though as legislature in the US and in Canada has opened those holes in the past decade or two.

Since the FDA no longer has exclusivity in determining the efficacy of products.  Therefore, certain statements not evaluated by the FDA contain a disclaimer on the label such as “not been evaluated by the FDA, and that the product is not intended to diagnose, treat, prevent or mitigate any disease”.  You may or may not have seen these statements as they are usually very small thus leading to consumer confusion on whether the product works as stated.  A paper from CIRST (Centre Interuniversitaire de Recherché sur la Science et la Technologie)
( http://www.cirst.uqam.ca/Portals/0/docs/note_rech/2006_05.pdf) in Quebec has stated
 “Opponents of such regulation have argued that the disclaimer policy strips the FDA of the authority is needs to adequately protect consumers dupery and unsafe products,”
 referring to Bruce H. Schindler’s  1998 publication “Where There’s Smoke, There’s Fire: The Dangers of the Unregulated Dietary Supplement Industry.”

With Health Canada, items under NHP regulations can, if randomized, double-blind, placebo-controlled trials are not conducted,  make efficacy claims based on “traditional uses”, i.e., anecdotal evidence of use and efficacy.  This is an unsettling thought since anecdotes are clearly not considered strong evidence in science.

Also, since Health Canada has allowed exemptions (http://www.hc-sc.gc.ca/dhp-mps/prodnatur/legislation/acts-lois/exemption/index-eng.php ), there is a backlog of thousands of product on the market still remaining registered.  Health Canada and the Competition Bureau have done very little except giving notices to the manufacturers of these products.  The weak enforcement of protective policy, I feel, does little to help create a status quo that should be maintained.

So what to do?

If one is to consider taking a dietary supplement or natural health product, consult a medical health professional (like a family/general practitioner) to discuss the risk/benefits.  Also, Health Canada does provide an easy to remember way to see if a product has been evaluated by them (http://www.hc-sc.gc.ca/dhp-mps/prodnatur/faq/question_consum-consom-eng.php) .   A product that has a Natural Product Number (NPN  123456 for example) is a safer bet.  Ones that have been on the Exempted list have a number start with EN (EN-123456 for example).  These have not been fully evaluated.   A product with no NPN number, has not been evaluated or approved by Health Canada.

Stay Safe and informed.

Sun-gazing or Sun-thing Else?

(written in 2013)
You may have seen a number of memes and articles floating around the internet and social media these last few weeks, all talking about sun-gazing.  You may have also seen the terms sun-eater and Breatharian.  Besides the obvious looking at the sun action, what exactly is this you ask?

Sun-gazing, as postulated by its followers, is the act of looking at the sun and being able to live off of it.   They say you can rid yourself of diseases, become clear in the mind, sustain life with no food (like a plant) and also acquire super-human abilities.  It supposedly takes a lot of discipline and gradual dosage increases over months and years to obtain the highest levels.

Although its meditative aspects might be quite calming, what I’m really interested in is the safety of the practice.   The first concern is the most obvious.   It requires looking at the sun.  Doctors, opticians and optometrists regularly recommend not looking directly into the sun
(http://www.ncbi.nlm.nih.gov/pubmed/11419039 , http://www.ncbi.nlm.nih.gov/pubmed/15575813 ).  The practice of sun-gazing suggests 10 seconds the first day, while slowly increasing after that to over 40 minutes after 90 days.  Even though they suggest doing the gazing during dusk and dawn, damage is still possible and increases with prolonged gazing.  Developing cataract problems is of great concern (http://www.ncbi.nlm.nih.gov/pubmed/14569187 ).

The second and most important concern is the reduction or complete avoidance of food.  I think the idea of living only off the solar energy of the sun to be unattainable.   Sun-gazers claim that it is like plants, but just like plants, our bodies also need nutrients and water.  These nutrients provide much more than energy that our bodies use.  Nutrients also help in the multitude of bodily processes and also as part of the building blocks of our bodies themselves.  Without calcium, for example, we wouldn’t have bones.

There have been a few cases of persons having severe complications because of this and also death.  Recently, a Swiss woman succumbed to the perils of this practice (http://www.torontosun.com/2012/04/25/woman-living-only-on-sunlight-dies ).  A woman named Jasmuheen, who is a self-proclaimed expert on the practice, fell ill to the effects of dehydration, stress and high blood pressure within 48 hours during an episode of Australia’s 60 Minutes (http://en.wikipedia.org/wiki/Jasmuheen).  After 4 days, the doctor cancelled the test due to weight loss, dilated pupils, slowed speech, and the risk of kidney failure.  It is because of these two concerns, that this practice is something that I would say is not worth the risk.