Tuesday, January 19, 2010

Whose health is it anyway?

Susan gave me a book for Christmas. Bad Science, by Ben Goldacre, based on his regular Grauniad column of the same name, deals with how the media reports science. Specifically the British media, and mostly medical science, but the principles are fairly generalisable.

This fine read has taught me a bit about experimental design and medical ethics, and quite a lot about the placebo effect. One factette that lodged in my mind: when a new drug is released, older drugs that treat the same condition actually become measurably less effective. That is to say: if they previously had a 60% chance of curing the condition within a certain time, that chance may drop to 40% when the new drug becomes available.

No-one is quite sure why this should happen. Could be something to do with experimental design or sample selection. But Goldacre's money is on the placebo effect - the doctors themselves, being subject to the ferocious marketing tactics of drug companies, have more faith in the newer treatment.

Another case is the story of fish oil. Thanks to the charlatanry of "nutritionists", most journalists now accept as Proven Scientific FactTM that fish oils are good for the brain, and feeding fish-oil capsules to children makes them perform better in class. All over the country, to hear Goldacre tell it, parents are shovelling pills into their children daily; in some schools, not doing so is considered tantamount to child abuse. And yet there's not a shred of clinical evidence to support this superstition.

Big-time win for the drug companies. They've successfully persuaded a whole generation that "taking pills" is a normal activity for healthy people.

I thought of this today when I saw this story in today's paper. "Wear gloves to avoid cancer in the car" says the headline. Even by the Herald's standards, that's a pretty opaque headline - is there some nasty type of cancer that affects drivers, carcinogens in that rubber-like material that coats the steering wheel perhaps? But no. The story turns out to be about exposing your skin to sunlight while driving. Glass, it transpires, doesn't stop all UV radiation.
Plain, clear vehicle glass blocks only 37 per cent of UV-A radiation. The main risk comes from long or frequent trips exposed to sun through side windows.
Intrigued, I did a little more research into UV-A and UV-B.

UV-B is the stuff that causes sunburn, and plain ol' glass stops nearly all of that. But that nasty UV-A gets through, and according to the Cancer Society, that too is dangerous, even though it doesn't burn. I'm not qualified to comment on the health risks of UV-A, but my suspicions were aroused when I came to this line in the story:
The issue was highlighted by sunscreen maker Oasis Beauty, which urged drivers to apply sunscreen before driving.
The Cancer Society, to its credit, is leery of that suggestion. It recommends instead long sleeves and, optionally, gloves. (In summer, no less.) But, I had to wonder, what sort of weight should we apply to health advice from a company that's selling a product?

Even these measures are only necessary if you're driving long distances, because UV-A takes a good long exposure to do harm, and laminated windscreen glass stops 80% of it - it's only exposure through the un-laminated side windows that's really dangerous. So long sleeves should pretty much eliminate the risk, at no real cost.

But as with pretty much everything health-related, there's another side to this story. No UV-B means no vitamin D. And if you're of the male persuasion, no vitamin D is a recipe for, among other things, prostate cancer.

Over 200 people die of skin cancer in New Zealand every year. But roughly 600 men die of prostate cancer. In other words, as a man, I'm approximately six times more likely to die of too little UV-B than too much. So why is all the public-health propaganda telling me to get less sun?

The obvious answer is: sunscreen is bottled, marketed and profitable. Whereas sunlight is, as yet, still free. It's a lot harder to make money by telling people to use less of a product.

And this is why our health advice is so confusing: because it's all coming from people who have a product to sell. Nobody is disinterested. Nobody is on our side.

Health advice I believe in: eat fresh vegetables, don't get too fat or too thin, don't smoke or drink to excess, and last but not least, don't let the bastards grind you down. Everything beyond that, I'm now convinced, is guesswork based on information that is partial in every sense of the word.


Cian said...

Very sensible health advice! One of the things that I like to ask myself when eating is - Is it actual food? Would I have the ingredients in my kitchen cupboard? Does my body need those ingredients?

Our bodies are living organic creatures so why do we put unusual chemicals into them. Our bodies do not need Stabilizers, Emulsifiers etc., so should we really be eating them? - When I buy food, I actually want to buy food!

I know that for many people it is fairly unavoidable. For me it is fairly easy as 97% of the food I eat is organic and I rarely eat processed foods.

But yet I do not apply those rules to skincare! I know that I should but have not found replacements I like yet. I really must search harder.

Liked your post - Nobody is on our side really summed it up for me.

vet said...

I admire people who can avoid all that crap. I can do it about 50% of the time. So far this week I don't think I've had any food with additives - unless you count the nice Esk Valley Chardonnay I used to cook in last night - but I'm planning to change that tonight.

Cian said...

It is pretty difficult to get away from sulfites in wine, so they are an exception. I do not think that will change any time soon.

I am envious of the fact that you have some great wines on yourstep. We normally try to keep our intake to old-world countries due to food miles. I know that Britain (not so much Ireland) are producing some pretty good wines now, but still very limited on the organic front.