Archive for the ‘The Media Blows It Again’ category

Just because a chemical is present doesn’t mean you have to worry about it

July 31, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

Advocacy groups have been busy lately with their fancy-pants chemicalz detection science instruments, and their press releases have made it into the news. But is there news here, and are these chemicals something parents really need to worry about?

First it was a big lead from the New York Times called “The Chemicals in your Mac and Cheese.” The article started:

Potentially harmful chemicals that were banned from children’s teething rings and rubber duck toys a decade ago may still be present in high concentrations in your child’s favorite meal: macaroni and cheese mixes made with powdered cheese.

Oh noes, not high levels! The chemicals they’re talking about are from a family called “phthalates,” which sounds scary and difficult-to-pronounce. (Words shouldn’t start with four consonants. On this we should all agree.) Phthalates have been in wide use for over 80 years in plastics and other compounds. Though they’re not added to cheese, they’re on the coatings of tubes and platforms and whatever else is used in the machinery to make Magic Orange Cheese Powder. Foods with a high surface area (like a powder) are going to come in more contact with it, and a teeny bit of a trace of a few molecules are going to transfer over.

Important point: these chemicals have been in our food for many, many years. What’s changed is that we’ve now got fancy equipment to measure it. The Times story is quoting a kind of press release – not a medical study, or even anything published in the medical journal. It’s a “study” done by a consortium of food advocacy groups. It’s being promoted by an organization called “KleanUpKraft.Org” (Cutesy misspellings are at least as bad as starting words with four consonants, K?) And their “high levels” are in tiny parts per billion, at levels that are very low compared to amounts that cause adverse effects in animal studies.

Just because you can detect a chemical as present doesn’t mean there’s enough of it to hurt you. Mercury and arsenic are part of the natural world around us, and any food tested with equipment that’s sensitive enough will find at least traces of these and many other chemicals. It is not possible to get the values of phthalates or arsenic or many other chemicals down to zero in our foods.

Speaking of chemicals, this week another food advocacy organization announced that they’d found traces of an herbicide (glyphosate, found in Round-Up) in Ben & Jerry’s Ice Cream. And in every flavor tested, too, except Cherry Garcia, which is kind of nasty-tasting anyway (I’m sticking with Chunky Monkey, which wasn’t even tested.) But: their press release didn’t even reveal the levels that they found, only that they found it. Maybe it was one part in a zillion. Who knows? But: Do you think if the value were genuinely high they’d hide it like this? No way. It’s there in some kind of teeny amount, and they’re trying to scare you.

Don’t fall for all of this “The Sky is Falling, There’s Chemicals in My Food” hype. Just because something is hard to pronounce doesn’t make it dangerous, and just because something is present doesn’t mean it’s going to kill you. We’ve all got enough to worry about without being scared of Mac and Cheese and Ice Cream. In fact, a little comfort food in these troubled times would probably be good for all of us. Maybe even the grumps at KleanUpKraft.org.

By the way, I don’t disagree with one thing – homemade Mac n Cheese is at least as good as that boxed orange stuff. Though sometimes, I won’t deny it, the orange stuff sure does hit the spot…

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Homemade slime isn’t hurting your child

March 20, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

Another day, another internet scare. This time it’s about that homemade slime, and all the toxins and poisons in it – the ones that are pretty much killing our kids. Except there aren’t any toxins, and kids aren’t getting sick.

This rumor started with an article from the Daily Mail, a British “newspaper” that Wikipedia has deemed “generally unreliable.” In the fine tradition of crappy supermarket tabloids, the Daily Mail is on a par with the National Enquirer, the Star, the Sun, and Weekly World News – it’s a site that makes stuff up, or blows things crazy out of proportion to sell newspapers. Admit it – you were tempted to buy that cheap paper that proclaimed that Hillary was from Venus, or that there’s a Miracle Cream that Allows People to Grow a Sixth Toe. The story was amplified by a blog post at “This talk ain’t cheap”, where the author points out in the second sentence that she’s “not a doctor or a scientist or a chemist.”

As is the manner of clickbait about things hurting children, this one has been posted -n- reposted on Facebook and parenting blogs. In an effort to make sure the barn door is firmly bolted shut now that the horses are long gone, let me give you the quick version: there’s nothing in homemade slime that’s likely to hurt anyone, as long as it’s “used as directed.” Don’t eat the stuff, rub it in your eyes, or lie in a bathtub of it for an hour. Other than that, it’s safe.

We’ve still got an unopened box of borax and bottles of glue downstairs from my youngest’s “slime phase” last year. You mix up a bunch of chemicals (See! Chemicals! That’s your first warning, right there!!) to make a sort of gooey, hand-clinging, squishy mess. It even makes comical sounds when you squarsh it around between your hands. Harmless fun?

The Daily Mail article focuses on one ingredient in homemade slime, pointing out that boric acid (Borax) is labeled by the European Chemicals Agency as ‘toxic to reproduction’, and potentially irritating to eyes and lungs. The box in my basement says those things, too. Don’t eat it, and don’t rub it in your eyes, and don’t stick your face in the box and whiff it. If your children are too young to handle this on their own, they probably shouldn’t be making slime without supervision. Apart from the breathless and frightening tone, The Daily Mail’s critique of Borax is at least reasonably close to the truth. It’s conceivable that an unsupervised or particularly reckless child could get hurt by the stuff. It’s also possible that some kids could have more-sensitive skin, and could end up with a rash or the itchies (do I need to say: if your child gets irritated skin after playing with slime, he or she should stop playing with slime. The same is true if your child gets itchy skin after petting a cat or eating finger-fuls of cookie dough.)

But the blog post goes a step further, heading off the rails of the worry train. The blogger points out imaginary dangers of other ingredients, like glue. She says white glue – essentially, Elmer’s – can cause anxiety, convulsions, seizures (both convulsions AND seizures!), respiratory failure, and loss of appetite. Except none of this is true. In the manner of googlers-who-call-themselves-researchers everywhere, the author mistakes one kind of glue for another. Elmer’s white glue causes sticky hands, but is otherwise non toxic. What she’s quoting are side effects of huffing industrial glue or model cement, which is a different product entirely, and is not an ingredient in homemade slime.

There’s also shaving cream – which the blogger implies contains carcinogens and “very controversial” ingredients. I think of it as something people rub on their faces (men, typically), legs (often women), or all over the walls of the shower (children). If you’re afraid of your children touching shaving cream, I cannot help you.

By the way, homemade slime also contains water (AKA deadly dihydrogen monoxide) and often food coloring (I believe green is best, but mixing green and purple makes a hideous and wonderful color called “ocky” that has a certain charm.) A complete recipe is here. You can also make it with other, non-borax compounds like cornstarch or laundry detergent.

Parents, if your kids are taking a break from their iPhones to do something fun and icky with their hands, let them enjoy themselves. It may get messy, and you don’t want them (or the dog, or even the cat) eating their homemade slime. But it’s pretty much harmless fun. Today’s lesson: don’t let the internet scare you.

Fight the Fearmongers: MTHFR variants are nothing to worry about

March 13, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

Another day, another scare. Honestly, if you take Facebook and The Interwebs seriously, we’d all be dead three times over already.  (By the way: Facebook and the Interwebs would make a good name for a 2000’s cover rock band.)

Here’s one that’s come up a few times at my office this month: parents worried about MTHFR “mutations” that are making themselves and their children sick and vulnerable to all kinds of diseases. It’s another example of alarmists taking advantage of a tiny speck of science to scare you and sell things. Don’t believe any of it.

Background: MTHFR stands for…. Ah, forget it. Who cares what it stands for. It’s a shorthand name for a gene that encodes a protein that does important things involving the metabolism of the vitamin folic acid.

It turns out that there are hundreds of variations in the MTHFR gene we all carry. Genes, actually, with an “s” – we all carry two copies. Some variations work more or less efficiently, and a few very rare ones don’t work well at all. But the important thing to remember is that these are examples of the normal variation of our species. Having a different MTHFR gene from your neighbor doesn’t make you strange or broken.

In fact, having these variations is very common – so common, that variation is the rule, not the exception. As we learn more about these variations, the percentage of people with “variants” continues to go up – maybe about 60% of us, now, have at least 1 copy of a “variant.” And since almost all of the variants work just fine, this doesn’t matter at all.

 Part of the problem comes from the language of genetics, and the way gene science is depicted in the media. Use the term “mutant” and you think Patrick Stewart lifting things with his mind. A mutant is changed gene – and in science, that term is used for one-time or rare events. These MTHFR things are NOT mutants, at least not in the way a genetic scientist would use the word. Having one of them will not give you a tail, allow you to change the weather, or make lasers shoot out of your eyes. It also won’t make you or your child more likely to get sick.

The correct, more-specific word for what I’ve been calling “variants” is “polymorphisms.” These are genes that are different in subtle ways, and have become fairly common in a population. Hint: if a polymorphism made you sick, people with it wouldn’t reproduce, and the polymorphism would become rarer. Polymorphisms that don’t change health (like these MTHFR polymorphisms) can spread and linger in a population, like blue eyes or the ability to taste a tiny speck of cilantro.

Nonetheless, there are scads of web sites out there pushing MTHFR testing, and trying to sell books and products to people with these polymorphisms (which, as I mentioned, are most of us.) This is called “fear-mongering” –creating fear of a non-existent disease to get attention and make money. I’m not going to link to any of these sites, but here’s a sampling of some of the headlines and what the sites are pushing:

  • The MTHFR Gene Mutation And How To Rewire Your Genetics – Note the use of the scare-word, mutation. And, of course, you cannot rewire your genetics. Nonetheless, this site pushes worthless genetic testing, suggests treating non-existent yeast infections, encourages the use of a dozen supplements you don’t need, and suggests “detoxing” with coconut charcoal. Absolute, bat-shit nonsense – all for a made-up health scare.
  • Someone calling themselves “Your Functional Medicine Expert ®” (followed by 16 letters – do not trust anyone who has more letters in their “degrees” than in their own name) has her own top ten list of things to do for what she calls your “mutation.” Some of these are perfectly healthy for all of us: get exercise, eat leafy greens, spend time in the sauna. But she goes off the rails, too, referring people to a “trained biologic dentist” and “dry skin brushing” to detox da chemicalz dat’ll killz ya.

There are also alt-med freakshow sites that somehow link MTHFR variants as a warning against (of course) vaccines. This is an absolute crock.

Bottom line: genuine medical geneticists do not recommend MTHFR testing. Just because something sounds sciency doesn’t mean it’s something that is going to kill you. Don’t worry about things because you read about them on the internet. Go hug your kids, enjoy some sunshine, and take a break from Facebook and the Interwebs. Their show is starting to get old, and you’ve got better and healthier things to do with your time.

Protect yourself from cell phone radiation journalists

May 31, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

The media is agog over a new study, one tailor made for clickbaiting. Staid, boring old Wall Street Journal proclaimed “Cellphone-cancer link found in government study.” Mother Jones called the study “Game Changing”, and NaturalNews’s headline screams “Massive government study concludes cell phone radiation causes brain cancer.” (They also say “On all of these issues, Natural News has always been right!” Google it if you want. I’m not providing a link.)

The new data is from a preliminary release of data from 2,500 rats and mice. It hasn’t been peer-reviewed yet, or scheduled for publication. We have no idea what happened to the mice involved in this study – they weren’t mentioned. Maybe they were busy.

The rats were kept in an underground bunker (which protected them from the sun, a much larger source of radiation exposure.) Special enclosures exposed the experimental rat volunteers to cell phone radiowaves starting at gestation, through the first two years of their lives. Intense radiowaves bathed their entire bodies for 10 minutes on, 10 minutes off, 18 hours a day. For two years. Extrapolating from rat lifespans, that’s equivalent to about 50 human years. Think about that exposure: 50 years, starting before birth, using cell phones mashed up against your entire body for 9 hours a day. I get it, they want to use an absolutely maximal exposure to find even a small signal of increased risk. But does that sound remotely realistic?

Compared to the control rats, male (but not female) exposed rats had small numbers of cancers in their brains and hearts – in most groups, 1 or 2 out of 90. The control rats had zero across all of the subgroups, which is itself a surprise – these were lab rats bred to develop cancers, so cancer-causing exposures could be studied. The control (unexposed) rats also had a weirdly high early death rate (remember, this group didn’t have cell phones. They were bored to death, maybe.) In all seriousness, that seems to be a big flaw. Since cancer takes time to develop, rats in a shortened-lifespan group would almost certainly have fewer cancers at autopsy. Still – zero? Were they looking hard enough?

The new study certainly raises some good questions. How could radiowaves contribute to cancer? There’s no established plausible mechanism at these levels. Why were the results only seen in male rats? What about the mice, were they similarly affected? Why did the non-exposed rats die off early, and could that explain the effect? How do these exposures compare to a typical human way of using a cell phone, holding it in your hand to text or use an app? These are good questions. Too bad journalists covering the study didn’t try to answer them.

Ironically, just a few days earlier, a much larger study (of 45,000 people) showed exactly the opposite. What, you didn’t hear about the huge Australian study that showed no increased risk of brain cancers since the introduction of cell phones 29 years ago? Perhaps the science media is more concerned about rats than Aussies. They’re certainly more eager to get your clicks than to provide accurate or useful information.

A rat.

Whole milk best for children? Not so fast

April 25, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

A flurry of recent reports has supported the health benefits of whole-fat milk. Increased dairy fat has been linked to lower rates of diabetes, and to improved cardiovascular health. The traditional advice – that low-fat or skim milk can help reduce weight, and help improve health – may have been based on faulty assumptions about the way ingested dairy fat affects metabolism. These new studies of dairy fit in with a shift away from the “fat is bad” story to a more nuanced “some fat is bad, but other fat is good, and it’s complicated” way of looking at things.

But it’s important to remember that none of the studies driving this change were done in kids. We don’t really know the long-term health impact of full- versus low- versus no-fat milk in infants or children, and there are still some good reasons to think that lower fat dairy might be a good choice for many families.

Until about ten years ago, the AAP recommended full-fat milk starting at age 1. That changed in 2008, when a position statement about cardiovascular health supported the use of reduced-fat dairy products starting at 12 months of age if there were any concerns about overweight or a family history of obesity or heart disease (that would include just about everyone.) This recommendation was based on research showing three things: (1) growth and neurologic function was the same in children raised on low-fat milk (ie, extra fat was not needed for brain and body development); (2) lipid profiles and weights were healthier in children raised on low-fat milk; and (3) children who consumed low-fat milk tended to have healthier diets, overall, than kids drinking whole milk.

That position statement “expired”, as all AAP statements do, 5 years after it was published. Currently, the AAP officially has no position on the relative merits of these varieties of milk. (They do have a position vaguely endorsing chocolate milk in schools, and another position strongly discouraging unpasteurized milk. All AAP policies can be searched here. There are a lot of them.)

The bottom line, now: there really isn’t any solid, new information from studies in children since that 2008 AAP position. Though I agree that the adult studies are compelling, adults and children are very different, especially when looking at metabolism, growth, and the long-term health consequences of dietary choices. For example, milk constitutes a much higher proportion of caloric intake in kids than in adults (children drink more milk, and they’re smaller. Usually.) They need proportionally more calcium and vitamin D and phosphorus for growing bones. And we know overweight children are very likely to continue to struggle to maintain a healthy weight as adults.

The best current evidence in children supports the use of reduced fat milk. If that changes, I’ll let you know.

Edward Elric does not like milk

 

Resistant “superlice” cause outbreak of poor journalism

February 29, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

You’ve seen it on Facebook, Drudge, Yahoo News, and just about everywhere else—headlines like “Superlice outbreak hits 25 states” or “Super lice spreading across the US.” Makes you itchy just thinking about it, right?

But “the news” has gotten it wrong. They’re relying on an advertising piece written on behalf of a company that – guess what? – treats lice. Web sites are just regurgitating the same “story”, as if it’s news.

So what’s the story, really? The original spate of headlines began in August, 2015, right about the time when school started. The root of those stories, then, was a press release from the American Chemical Society, “Lice in at least 25 states show resistance to common treatments.” Researchers had collected lice from all over the country, and examined them for genetic changes that are linked to resistance to one of the most common over-the-counter lice treatments (pyrethrins, the active ingredient in “Rid”.) Sure enough, many of the samples included lice with one or more resistance factors. But there were some important caveats:

  • It’s not clear just how resistant the lice were, in practice. Knowing the genetics doesn’t predict what happens in real life.
  • Pyrethrin isn’t the only OTC lice treatment, just one of them.
  • The study itself hadn’t been published yet, and (as far as I can tell) is still not actually published.
  • The study was funded by Sanofi, a company that makes a prescription product that kills lice.

The excitement over that press release, and the dozens of news stories published in August about it, seemed to settle down until last week. Then, a fresh round of headlines appeared. These stories (for instance, here and here and here) all use very similar language, and segue in the second paragraph to talk about one specific alternative treatment for lice, highlighting the name of the product and place that sells it.

Is there any actual new news about this, since August? No. But a tag at the bottom of one of those stories gives us a clue – copyright “Frankly Media”, which is a public relations firm. These news stories, reappearing in dozens or maybe hundreds of places, are almost all word-for-word copies of what was a press release by an advertising agency for a specific product. The story, here, isn’t a new one. It’s just that someone wants to use unpublished research to scare you into buying something.

Lice themselves are a nuisance, yes, but keep in mind that they don’t spread disease, and don’t cause any symptoms other than an itchy scalp. There are several reasons why treatment of lice might not work:

  1. The child doesn’t actually have lice. This is very common. We know that many children who are diagnosed by school nurses or parents don’t actually have lice. If their scalps are itching for some other reason, lice therapy won’t “work.”
  1. Treatments aren’t used correctly, or aren’t repeated correctly. Some lice treatments need to be left on overnight, or applied to dry hair; almost all of them must be repeated in about 9 days. If the directions aren’t followed, lice treatments won’t be effective.
  1. Children get re-infested. Even after successful treatment, if a child returns to play with another kid with lice, the infestation will recur.
  1. Some lice really are resistant. We don’t know the exact percentage, but some lice aren’t responding as well to time-honored medications. We’ve known about this for at least 20 years. It’s not news. And there are both OTC and prescription alternatives, as well as non-medication based treatments that work very well.

All of this talk of “superlice” is overblown. Resistant lice don’t cause worse or “super” cases, and are easily treated with alternative approaches. Most lice can still be treated with any of a number of inexpensive OTC products, if used correctly. The only thing that’s spreading quickly are industries eager to make money off worried parents, and lazy websites re-publishing advertising copy in place of actual journalism.

toby determined

More water means slightly less weight in New York schools

February 1, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

A simple, safe, and cheap intervention looks like a good way to help fight obesity in our schools. But not by very much.

A study published January 2016 in JAMA Pediatrics, “Effect of a school-cased water intervention on child body mass index and obesity”, looked at the effects of installing new water dispensers in New York City school cafeterias. 1227 schools, including 1 065  562 students,  participated in the observational study, which tracked student weights and BMIs, comparing trends before and after the new equipment was installed.

Those new dispensers are called “water jets” in the study, and I *think* they’re just those typical water cooler things that offices use, with a big jug of water on top and a little flappy valve to get cooled water into a cup below. The study description says they both chill and oxygenate the water “to keep it tasting fresh”, and cost about $1000 bucks each. Furthermore, they “are relatively easy to use” (pretty clever, those New York kids.) The authors pointed out that participants were weighed and measured by PE coaches, whose scale-using skills have “previously been found reliable” (pretty clever, those New York coaches.)

The results: after these water jets became available, there was a statistically significant drop in BMI of about 0.025 points (it was just a touch more effective in boys than girls), and the percentage of children in the schools who were overweight dropped by .6-.9%. (from about 39% to about 38%).

I know, not very impressive. The statistics are solid—whether the authors looked at trends over entire schools, or at trends among individual students before and after water jet availability, these weight parameters did drop. And the drop is, technically, statistically valid and real. That’s how it’s been reported in the media. The New York Daily News said “Water machines available in schools can help kids lose weight.”

But the drop really wasn’t very much. Going from 39% to 38% overweight is good, but I think we ought to try to do better. You can lead a student to water, but studies like this show it’s hard to make them actually lose weight.

What should we do with all of this yellow paint?