Excerpt from Unhealthy Distrust

The following is an excerpt from an article I recently published at Medium. The full article can be read here.

Anti-vaccination misinformation

The anti-vaxxers are without a doubt the low-hanging fruit here. The fact of the matter is that they are a very small, but very loud minority of zealots who use exaggerated methods to push their agenda. However, while their methods may be exaggerated, one should keep in mind that similar methods of misinformation are employed by other peddlers of pseudoscience on a regular basis, though oftentimes with more subtle execution.

It’s hard to pinpoint where to start with anti-vaccination arguments because there are just too many, and in true conspiracy theory fashion, if you were to take them all and hang them on a wall you would find contradictions abound. So let’s start with the very common tactic of evoking chemophobia. This usually starts with using either: (1) the most scientific — and thus unfamiliar — names someone can find for certain ingredients (e.g. aluminum phosphate, thimerosol); (2) very familiar sounding ingredients that have become buzzwords due to unwarranted bad press or negative ‘common knowledge’ (e.g. MSG, formaldehyde); or (3) the weirdest or most transgressive sounding ingredients (e.g. mouse brain, aborted fetuses).

Chemophobia works because it is the most honest way to misinform laymen. In most cases that I have come across, the ingredients that anti-vaxxers like to name are, in fact, technically true. It’s the way in which they are presented that is disingenuous and misleading. Memes and ‘infographics’ are passed around the internet identifying certain ingredients as neurotoxins, for example. What they don’t mention, though, is that there are thousands of known neurotoxins, many of which humans ingest rather safely every day (wine, anyone?). It is the dose that makes the poison, and all of the ingredients that are currently used in vaccines have been tested to insure that they are at levels considered safe for human consumption.

Another common trope from anti-vaxxers is quoting doctors or other perceived authority figures that are also anti-vaccination. The truth is, anyone can find an “expert” in a field who holds beliefs considered unconventional by their peers. Climate scientists have climate change deniers, biologists have creationists, historians have holocaust deniers…the list goes on. A classic example of this in the anti-vaxx community is the citing of Andrew Wakefield’s research purporting a link between the MMR vaccine and autism. Despite the paper being retracted in light of cherry-picking data and conflict-of-interest issues (Wakefield’s research was funded in-part by lawyers involved in suits against vaccine manufacturers), this unfounded link between vaccines and autism is still touted by many anti-vaxxers as gospel.

What is especially noteworthy about anti-vaxxers’ appeal to authority is that it is highly selective, and often contradictory. For example, I came across two images on an anti-vaxx Pinterest board, side by side with two very different messages. The first one states:

“Just so we’re clear, I get my vaccine information from the following: Center for Disease Control, Food and Drug Administration, Environmental Protection Agency, American Academy of Pediatrics, National Institute of Health, World Health Organization, immunologists, toxicologists, accredited scientists. ALL PUBLIC RECORDS.”

The image next to it read:

“Imagine if…Thousands of people were diagnosed with e. coli after eating at McDonald’s. But McDonald’s was allowed to investigate itself and claimed there was no link. Would you still trust McDonald’s after this? THAT’S HOW WE FEEL ABOUT THE CDC.”

I’m getting mixed signals here. Should I trust the CDC and the other organizations mentioned in the first image? All of whom, by the way, stress the safety and importance of vaccination. Or should I go with the McDonald’s analogy and reject them because they’re all just shills getting paid by big pharma? The answer from anti-vaxxers is simple. If it’s a doctor or organization making a statement against vaccines, clearly we should accept their authority on the subject. However, when any doctor or organization claims that vaccines are safe, we should remember that they are all conspirators being paid off by vaccine manufacturers to do their bidding.

Of course, when all else fails, if you can’t scare people with ingredients or convince them there is a global conspiracy, you can always double-down and just flat out lie. Ever hear the claim that doctors make big bonuses just for vaccinating your kids? Well, they don’t. This ‘fact’ is so often repeated that even some pro-vaccination folks believe it and actually try to craft arguments of justification. It’s a perfect example that if you say something enough times, people will stop questioning and just accept it.

The truth is that there is incentive for doctors to vaccinate children, but it’s not coming from vaccine manufacturers. The incentive to vaccinate children comes from insurance providers through a form of fee schedule payout for routine, preventative care. So why would insurance companies incentivize vaccination? Because vaccines work! Insurance companies don’t want you to get sick. When people get sick, they have to pay out more money, and that is not good for profits. So it is in the insurance companies’ best interests that you stay healthy. This means providing incentives for doctors to do regular preventative care including weight assessments, counseling, breast cancer screenings, and yes, vaccinations.

Artificial Fear

A short story

As most of my readers know by now, much of my interest in health and nutrition stems from my past employment with General Nutrition Center. For roughly 8 years I worked in a retail store that promoted a healthy lifestyle through the aid of mostly questionable advice and supplemental products. In due time I came to realize just how dubious the claims of many of GNC's products were, and ultimately made the decision to get out of that industry completely (unfortunately, only to find myself in the evermore sleazy industry of corporate dentistry...but that story is for another time). Despite GNC's constant peddling of bogus claims and alternative medicine, there were still plenty of customers coming through the door everyday who could somehow always find a way to one-up the bullshit we were selling .

One encounter that I remember quite vividly was really rather short and benign, but it left a lasting impression on my mind about the food and nutrition 'truths' that many people believe without a second thought. As a sales associate my job was to sell, and one great way to get a product in to a customer's basket is to provide them a free sample. With that said,  I was expected to offer different samples to every customer that walked through the door, depending on what was the spotlight product at the time. Featured in this particular instance was a chewable calcium and vitamin D supplement that GNC was promoting as a part of their newest women's health line.

One of the few people who actually accepted one of my free samples was a young woman wearing medical scrubs and looking for a multivitamin. She commented that the chew was very good, and we continued to talk about her options for a multivitamin. At the register (where we kept the actual product) I made sure to mention that we had the chews she had just enjoyed on sale. She had another sample and said, "These things are too good to actually be good for you," then proceeded to pick up a bag and read the ingredient list. After a short review she smiled and said, "I knew it! You guys put sucralose in these." She then dropped the bag on the counter and began to lecture me about how she could not believe that a store dedicated to being healthy would put something as "dangerous" as sucralose - or any other artificial sweetener - in its products.

Now, working in retail you get used to this kind of self-righteous behavior from customers, but something about this incident in particular stuck in my head to this day. I had heard plenty of complaints and off-the-wall claims about artificial sweeteners before, but many of them have always been very weak, citing dismissed studies on rats or correlation studies, if they cite anything at all. This particular customer was bold enough to cite herself. "As a nurse", she claimed that she knew that sucralose causes dementia and stated should would not let anyone of her friends or family ever come near the stuff. Her argument from authority ensured there would be no need for further debate, and she completed her purchase and left.

As I said before, this incident was not out of the ordinary for my typical day working in the health and wellness field, but I am continually reminded of it anytime I come across some social media, health and fitness guru promoting any type of 'natural' alternatives for dieting. At the base of many anti-artificial sweetener claims is the idea that simply being 'unnatural' is enough to warrant absolute avoidance. I will get back to the fallacy of this argument later, but for now let's just go through a very brief review of the most common artificial sweeteners on the market today and the common claims against them.

Sucralose

Since my opening story revolved around sucralose, lets start there. Sucralose is one of the most commonly used artificial sweeteners available, found in thousands of products and sold as a stand-alone ingredient known as Splenda. Sucralose is derived from natural sugar, undergoing a process that ultimately makes it up to 700 times sweeter than sugar while simultaneously contributing no dietary calories. Due to the fact that it has less of a bitter aftertaste than some other artificial sweeteners, it is a common ingredient in diet sodas especially. Its prevalence in that market has made it an easy target for anti-artificial naysayers with claims that it has been linked to dementia and even shrinking of the brain.

What is true it that the consumption of diet soda in general has shown to have a correlative link to a heightened risk of the onset of dementia in some individuals. What is not true is that the consumption of diet soda or sucralose have been shown to cause this increase in risk. The studies suggesting such a link are a perfect example of how correlation does not necessarily mean causation. In fact, all attempts to establish a cause-and-effect relationship between sucralose and dementia have returned negative results. Similar claims regarding sucralose and increased cancer risk have been made, however with over 100 peer-reviewed, scientific studies demonstrating its safety, it seems that the FDA has got it right with approving sucralose for regular consumption.

Aspartame

Next on the list is another commonly vilified artificial sweetener - aspartame. Aspartame is about 200 times sweeter than table sugar, and does yield some dietary calories. However, because of the extremely low quantity needed to improve flavor, the calories consumed from aspartame are negligible. Since its inception aspartame has been the target of numerous negative claims, many of which originated from conspiracy theories promulgated by email messages claiming to link aspartame to everything from multiple sclerosis, to seizures and depression, and even death (for more on conspiratorial thinking in alternative medicine click here).

Despite such claims, aspartame - one of the most rigorously tested food ingredients in the United States - has not been linked to any major adverse events among those who consume it regularly, with one exception. Among those who have been diagnosed with phenylketonuria (PKU), aspartame can be potentially hazardous. Due to aspartame's higher levels of the essential amino acid phenylalanine, those with PKU have to be aware and cautious regarding their consumption of the ingredient. PKU affects the body's ability to properly metabolize phenylalanine and adverse reactions can occur if someone who is diagnosed ingests high levels of aspartame.

Aside from the risks to phenylketonurics, aspartame has been shown time and time again to be safe for regular consumption by the general population. As with other artificial sweeteners, much of the claims against aspartame are either backed with a small number of questionable studies, or not at all, with anti-aspartame advocates often falling back on the 'everybody knows it's bad for you', argumentum ad populum.

Saccharin

Though not quite as prevalent as sucralose or aspartame, saccharin has been another common enemy of the anti-artificial crowd. Saccharin's popularity was a product of war-time rationing during the first and second world wars. However, in the 1970s the FDA actually considered banning the substance outright after a single study surfaced linking it to bladder cancer in rats. For some time, saccharin-containing products actually even carried a warning label stating that the product may be hazardous to one's health, and that it had been shown to cause cancer in laboratory animals.

Further research, however, has proven that saccharin is generally safe for human consumption on a regular basis, and epidemiological studies show no link or associations with cancer in humans. As for the rats, it was discovered that male rats actually have a particular pH factor that contributes to a predisposition to developing bladder cancer. Despite this later discovery, the rat study is still often cited by those attempting to demonize saccharin, as well as other artificial sweeteners in general.

Where does the fear come from?

While the initial attacks on aspartame in particular demonstrate the influence that conspiracy theories can have over the way people think about health, there is a more prominent and recurring theme among nearly all of the criticisms of artificial sweeteners: It's simply not natural. This type of argument is known in the skeptic community as the 'appeal to nature' fallacy, and it is a favorite tactic of many of the health and fitness gurus mentioned above. Common buzzwords employed by these personalities include 'organic' and 'all natural', and their rhetoric tends to disparage anything man-made as not being 'real food', while offering little to nothing in the way of a coherent and useful definition of such terms.

Even if we decide to ignore the particulars and accept the most general, common sense definitions of what is natural and what is artificial, the premise of the appeal to nature argument is fallacious in itself. Just because a substance occurs in nature does not make it unquestionably safe to eat. In contrast, just because something is man-made does not automatically render it harmful for ingestion. Regarding health and toxicity specifically, Dr. Bruce Ames of UC Berkeley has conducted research finding that "...in high-dose tests, a high proportion of both natural and synthetic chemicals are carcinogens, mutagens, teratogens, and clastogens". Furthermore, Dr. Ames writes, "Several chemicals that have been shown to be carcinogens at high doses in rodents have also been shown to be anticarcinogens in other animal models at lower doses [emphasis added]". Dr. Ames, and countless other scientists, have regularly pointed out that all chemicals - natural and synthetic - can be toxic. It is not the substance that is toxic, but the 'dose makes the poison'.

Final thoughts

Artificial sweeteners have their place in the average person's diet, especially with the rising rates of obesity, diabetes, and other illness related to the over-consumption of sugar. Still, opting for a Diet Coke so you can still enjoy and extra piece of cake can easily be counterproductive. This may be why there is little research positively linking diet soda consumption with weight loss. Nevertheless, if one is content on keeping their sugar intake low, they should not be inundated with fear-mongering and food-shaming because they opt to use an artificial alternative.

Finally, as with any other food, there can and will always be the possibility of adverse reactions associated with some individuals. Everyone's biochemistry and DNA are a little different, and for some, that extra packet of Sweet'N Low might bring on unwanted side effects (headaches, nausea, etc.) However, when discussing the general safety of artificial sweeteners as a whole and for the general population, there is no strong evidence to support any of the common claims purported by the dogmatic, anti-artificial tribe.

'Food Evolution' Trailer

It has been a busy couple of months for me with work and so I have not had as much free time to stay up to date on health and nutrition news.  With that said, I have learned that 'Food Evolution', a documentary narrated by Neil deGrasse Tyson about the science of GMOs, is now available on Amazon Prime for less than $5.  While I am hoping to watch it very soon and eventually comment on it here, in the mean time I felt like I would just share the trailer here and encourage everyone to check it out themselves.

Combating the Religion of Alternative Wellness

The New York Times recently published an article discussing the differences between the concepts of medicine and wellness, and it is full of wonderful points to consider.  In an effort to not simply re-hash the article in my own words, I will focus on one point in particular, that of the relationship between medicine and religion.  As the author, Dr. Gunter notes, "Medicine and religion have long been deeply intertwined, and it’s only relatively recently that they have separated. The wellness-industrial complex seeks to resurrect that connection."

In the context of this article, the 'wellness-industrial complex' seems to be limited only to the vitamin and supplement industry, with it's many products claiming to 'cleanse' and 'purify' our supposed self-destructive habits of everyday life.  However, I would contend that much of the arguments made in the article could logically be applied to the alternative medicine community at large.  Indeed, many alternative therapies require suspending our understandings of realty and accepting religious or otherwise mystical beliefs.  From the 'memory' of water that homeopathy purports, to the 'meridians' expounded by traditional Chinese healers, there is no shortage of unscientific nonsense within alternative medicine.

The Times article also discusses how conspiratorial thinking shapes support for the wellness-industrial complex, which I believe could also be extended to the whole range of alternative medicine.  This should be no surprise as both religious thinking and conspiracy theories have a common bond of providing a sense of order and control, in an otherwise chaotic world.  As Dr. Gunter writes:

"Belief in medical conspiracy theories, such as the idea that the pharmaceutical industry is suppressing 'natural' cures, increases the likelihood that a person will take dietary supplements. So to keep selling supplements and earthing mats and coffee enema kits and the other revenue generating merchandise, you can’t just spark fear. You must constantly stoke its flames.

There can be no modern wellness industry without medical conspiracy theories."

Indeed, 99% of the entire alternative medicine market relies on fear or distrust of patients who are often times already in a very vulnerable state.  In fact, this kind of misinformation and conspiratorial theorizing are at the heart of the anti-GMO, anti-vaccination, and pro-organic movements as well.  My argument is that the cult-like following of these alternatives is precisely what makes it so hard to convince their practitioners and followers that there is simply no science (or at most, very little science) to back up their claims.  

Additionally, it is also this cult-like adherence that causes so many consumers of alternative treatments to get overly emotional and even offended when they are told that they have been duped.  In my opinion, this is the major propagator of all anti-science movements.  It is a vicious cycle of leaders and followers, where once a follower has 'bought in', they then become leaders in their own right, constantly expounded the evils of big pharma, medical associations, corporations and anyone else who encourages conventional treatments.  Unfortunately, this means that in order to combat such pious thinking, those in favor of encouraging evidence-based wellness are going to have to ruffle quite a few feathers in doing so.

More Added Sugar Confusion

The last post I made here back in 2016 (just before my 2 year hiatus to finish grad school) was titled "Added Sugar, or Added Confusion?", and was an argument against the FDA's newly imposed changes to the 'Nutrition Facts' labels on foods in the United States.  The two major changes that have been made include increasing the overall size of the calories per serving, and the inclusion of a new line item disclosing the amount of 'added sugars' underneath the 'total sugars' listing.  As stated in the aforementioned post, there's nothing inherently bad about providing more information.  My concerns stemmed from the politics of the decision and the ambiguity of terms such as "added sugar".

Little to my surprise, those concerns have surfaced in my news feed in the form of an article over at The New Food Economy entitled, "The FDA's Great Maple Syrup Fiasco".  According to the article, the FDA recently made a decision to require that maple syrup products contain the 'added sugar' label, despite the fact that adding sugar to maple syrup is actually prohibited by federal law.  Clearly, this would not merely be confusing for consumers, but would actually be misleading (or not - depending on how you look at it - read the full article, and decide for yourself).

The confusion around how to properly label maple syrup stems from the FDA's lack of a clear definition of what exactly constitutes 'added sugar'.  From the article:

"Basically, FDA is trying to define added sugar as both sugar that has been added to your food and sugar that you might add to your food later—though at the moment you buy it, it hasn’t been added. When you look at a package of Rice Krispies Treats and read on the nutritional facts panel that a bar has 8 grams of total sugar including 8 grams of added sugar, you will conclude that 8 grams of sugar has been added to the product, and you will be correct. When you read that your maple syrup has 54 grams of sugar per 60 milliliters of syrup, including 54 grams of added sugar, you might reasonably conclude that 54 grams of sugar has been added to the syrup. And, of course, you’d be wrong."

The article goes on to explain that what the FDA's original intent appears to be was to help consumer identify "sneaky sugars", and in turn make smart decisions that prevent over-consumption.  Unfortunately, it is too subjective to define and label "sneaky sugars" and so the FDA was forced to work with what it had - namely, 'added sugars'.  To further illustrate the absurdities contained within the FDA's arbitrary definition of 'added sugars', the goes on to explain that:

"The federal standards of identity for jelly include added sugar. You can’t call a product jelly if it doesn’t have added sugar. So the sugar added to jelly doesn’t count as added sugar. Savor that for a moment: Jelly has to have added sugar, so it doesn’t have to declare any added sugar; maple syrup isn’t allowed to have added sugar, so it has to declare its entire content as added sugar."

So what's the takeaway here?  Simply put, the FDA's attempt to inform the public of what foods contain sneaky, excessive, added sugars is falling flat on its face.  It seems that money and time might have been better spent on actually educating the public on how to make informed decisions on their overall sugar consumption, rather than targeting a boogeyman buzzword.

California's Coffee Conundrum

I have a love-hate relationship with The Golden State.  On one hand, it is home to some of the most beautiful areas you can find in nature.  It is vast and interesting, with an abundance of gorgeous deserts, forests, beaches, and everything in between.  The city of Los Angeles is just plain cool and is a cultural circus worthy of a weekend visit from time to time.  But California is also home to some of the dumbest laws on the books, especially concerning public health.

One of those stupid laws in the news recently is commonly known as Proposition 65, and requires the labeling of anything accessible to the public that may contain even trace amounts of any of the 900+ chemicals on its master list.  If you have ever picked up a packaged food or supplement and saw a label warning you that the product in question contained chemicals known in the State of California to cause cancer or birth defects, then you have witnessed firsthand what Prop 65 created.  In recent news, a California court ruled that coffee be added to the portfolio of products that bear a carcinogen warning label, much to the chagrin of reasonable scientists and nutritionists.

What's wrong with the court's ruling - and Proposition 65 as a whole - is two-fold.  First, as many scientists and nutritionists have already shown numerous times, coffee does not cause cancer.  Although there is evidence that acrylamide may be carcinogenic (so far only to non-human animals, and only when exposed to large doses), and coffee does contain trace amounts of this chemical due to the process of roasting coffee beans, there is no substantial evidence that drinking coffee produces any increased risk of cancer.  Requiring a label that unnecessarily scares consumers away from something that is harmless, and may actually even have some health benefits to it, is nonsensical and only further empowers those on the fringes (see GMO labeling and laws in Europe for further examples).

Second, slapping a warning label on anything containing one of 900 different chemicals is onerous, excessive, and will only lead to people slowly becoming less and less sure of what is really harmful, and what is not.  When everything is highlighted, nothing is highlighted. 

Warnings should be real.  They should inform individuals of an actual threat to their safety and an increased risk of harm.  The key word there is "increased".  We all deal with risk every day, but when we see a warning label on something, we understand that our chance of something bad happening to us will probably increase if we don't heed its advice.  However, as we become more and more inundated with warning labels it is likely that we will actually become less and less inclined to pay attention to them, especially when the labels themselves seem to become increasingly frivolous.

As for me, right now I am waiting for a scientific study that shows that Disneyland visitors actually are at an increased risk for cancer, birth defects, or other reproductive harm compared to non-Disneyland visitors.  Maybe then, I will change my mind about Proposition 65.  Until then, I will continue to drink my coffee and visit with Mickey whenever I can.

Sources:

Cancer warning labels on coffee? California ruling 'crazy', scientists say

Stop freaking out about acrylamide in your coffee

The Proposition 65 List | OEHHA

Dr. Oz Goes to Washington

For those who remember, a few months back there was a short-lived call from her fans for Oprah to run for President in 2020.  It did not take long for her to downplay any rumors that she might run for office, and since that time there has been little else to mention of it.  But for those who were disappointed in her decision, it seems as though you will still be able to get a little taste of what an Oprah presidency would be like.  That's because according to a number of media outlets, President Trump has appointed a long-time Oprah favorite, Dr. Oz, to sit on the Presidential Council on Sports, Fitness, and Nutrition.

Appointing a well-known quack and peddler of pseudoscience is no surprise from a president who has his own ways with half-truths, lies, and dishonest misdirection.  Nevertheless, such a nomination should be a red flag to anyone in the health or science fields who weren't already dissatisfied with the current administration.  Though the position Oz will hold will be mostly symbolic, to an anthropologist like myself, there is a great deal of appreciation for the importance of such political symbols.

By putting Dr. Oz on an even greater pedestal, the Trump administration is giving credence not only to Oz as an individual, but to the entire movement of anti-science quacks and fear-mongers that he endorses.  From homeopathy to anti-GMO to anti-vaxxers, Dr. Oz has made himself an enabler - if not an outright supporter - of ineffective and sometimes even dangerous ideas.  It is already bad enough that our government gives low-key recognition of homeopathic treatments via the  'Homeopathic Pharmacopeia of the United States', but with the appointment of someone so vocally pro-pseudoscience as Dr. Oz there is a message sent that the government will not just let bad medicine exist passively, but actively endorse it.

Once again, the appointment and the position itself are clearly symbolic forms of political posturing by Trump.  Still, it stands as a useful reminder that dogmatic purveyors of misinformation and pseudoscience are going nowhere, and should be kept in constant check.  Lest we return to the days of snake-oil, leeches and bloodletting.