Last week, a Texas woman named Michelle Kimzey made headlines when she suggested that Gardasil, the Merck vaccine for human papillomavirus (HPV), had caused her 14-year-old daughter to develop epilepsy. Kimzey claimed that she found some 5,000 other reports of adverse side effects in the federal government’s vaccine safety surveillance database, the Vaccine Adverse Event Reporting System (VAERS).

This is not the first time VAERS has been invoked in news stories about the safety of the HPV vaccine. Last year, the National Vaccine Information Center published an analysis of VAERS data suggesting that Gardasil could cause serious side-effects including the development of an autoimmune disorder, Guillain-Barre Syndrome (GBS). While VAERS is a valuable tool for monitoring vaccine safety—both the Centers for Disease control and Prevention (CDC) and the Food and Drug Administration (FDA) analyze information in the database—the reports can cause alarm when taken out of context.

The public should know that VAERS collects only unverified reports of health events. The CDC and FDA encourage parents, vaccine manufactures, health care providers and others to report all adverse events following vaccinations, regardless of whether the vaccination is the suspected cause. Thus some of the purported vaccine side-effects actually reflect underlying diseases or conditions completely unrelated to the vaccination. VAERS does not keep tabs on groups who have not received vaccinations, so there are no control groups to compare incidence rates of various health events.

Given these issues perhaps the government should revamp the database to prevent the VAERS reports from being misconstrued as verified cases of vaccine deaths and complications. What do you think?

Posted by Coco Ballantyne at 02:40 PM | Permalink | Comments (1)

They say that knowledge is power, and some 15 US states are poised to apply that philosophy in tackling the obesity epidemic. These states are considering legislation that would require fast food chains and certain restaurants to provide consumers with nutritional information such as calorie, fat and sodium content of food items. New York and California may be the first to pass laws mandating statewide menu labeling, which could set the trend for other states to follow. The public seems to be embracing the idea, particularly in New York, where a recent poll found that 80 percent of people want nutritional tables posted in fast food eateries. The point of these laws is to encourage consumers to make informed – and thus presumably healthier – decisions about what they are eating. Ultimately, the new laws aim to curb America’s obesity epidemic – which is at an all-time high (34% of adults are obese, and 32% of school-aged children are overweight or obese) – and lower the rate of diseases associated with obesity, such as diabetes, hypertension, and certain types of cancer.

But will people actually use the information to modify their eating habits? Perhaps the best place to inquire is New York City, where a menu-labeling rule is already in place (ahead of the possible statewide regulations). In January, the city’s Board of Health voted in favor of a regulation requiring restaurant chains (businesses with more than 15 units nationally) to prominently list calories on menus and menu boards. The industry group New York State Restaurant Association has challenged the regulation, and the 2nd US Circuit Court of Appeals will probably deliberate the case for another few weeks, according to a Restaurant Association representative. Meanwhile, the FDA has sided with New York City.

I conducted an informal survey in lower Manhattan and found that, although people seem to be noticing these calorie counts, they way it drives their behavior is variable.

“For me personally, it doesn’t change what I do,” said a man I met in a fast food chain, noting that he is not concerned about his weight. “But I think with other people it does.”

“I don’t pay attention to it,” said a woman sitting nearby. “I don’t believe that a plain bagel has 300 calories,” she added, referring to the posted calorie content.

But according to the employee working behind the register, the nutritional tables are deterring customers from buying high-calorie foods—to the detriment of business. "The people, when they ask about the muffins’ calories, they don’t buy them,” said the employee, pointing at the 400-calorie ‘reduced fat’ item. “It’s affecting my sales.”

A few blocks away at a fast-food restaurant where king-sized chocolate milkshakes pack over 840 calories, patrons stopped to scan the nutrition table on the wall before approaching the register. One young woman studied the information but claimed that it would not influence her decision; she would have that bacon-double-cheeseburger no matter what. But a traffic policeman said he would chosse menu items based on caloric and fat content. “It’s very important to know the nutritional value of the food,” he told me. A couple from Argentina agreed; they used the nutritional tables to avoid the excessive amount of carbohydrates that characterizes the North American diet.

I could not help but notice that the people who said they used nutritional tables to make decisions appeared lean and fit. All this made me wonder whether menu-labeling will simply reinforce good eating habits in those who already have healthy lifestyles, rather than reform those who most need it. Critics of menu labeling have pointed out that Americans have continued to get more obese despite two decades of nutritional labeling on packaged food. Perhaps better calorie labeling will not change things. What do you think?

Image by ebruli

Posted by Coco Ballantyne at 11:30 AM | Permalink | Comments (4)

A dear friend of mine sent me a link to this page, which shows the "h indices" of what the author of the page refers to the "best Spanish scientists". The page is a bit difficult to navigate if you don't know Spanish, but it doesn't matter; I'm sure that if you have the time and inclination, you will find a similar page in your language and for the nationality of your choice.

The reason for bringing it up has to do with the raison d'etre of the h index -- to quantify an individual's scientific research output. The h index was originally introduced by J. E. Hirsch, from UCSD, in this paper and, briefly, his proposal was that a scientist has an index of h if h of his/her papers have at least h citations each, and the rest of his/her papers have no more than h citations each. In his paper, Hirsch argues why this measure is preferable to other criteria, and ends up suggesting that "this index may provide a useful yardstick to compare different individuals competing for the same resource when an important evaluation criterion is scientific achievement, in an unbiased way".

I don't know how many people have bought into this index, but needless to say, as any of these metrics, it has limitations. For example, if you're the technician of a lab that has a bunch of highly cited papers and you're always including in the middle of a long list of authors, does your massive h index turn you into one of those "best scientists"?

In any case, its limitations notwithstanding, I thought I would share it in order to stimulate our unsatiable appetite for ways to measure the quality of what we publish. Ready to go check if yours is larger than your neighbor's?

Image by Brett L.

Posted by Juan Carlos Lopez at 12:08 PM | Permalink | Comments (2)

Not unexpectedly, the news media embraced and eagerly reported the latest revelation about the health benefits of red wine. The study, published in the online journal PLoS One this week, hinted that resveratrol, an antioxidant compound found in the skins and seeds of wine grapes, can boost cardiovascular health and slow aging in mice at lower doses than previously thought. Earlier studies have suggested that resveratrol helped mice run farther, stay slender, and stave off diabetes and cancer.

This buzz about red wine reminds me of the media’s enthusiastic coverage of dark chocolate's effects. Several studies have suggested the antioxidant flavanols in dark chocolate can improve blood vessel function and reduce blood pressure.

Any story about red wine or dark chocolate, especially one that gives people an excuse to indulge, is going to be well-received. As I write this, the New York Times article on the recent red wine study has been hovering near the top of the newspaper’s list of most popular online stories.

But as we swash down red wine and gobble bon bons, we may be inclined to forget that, along with all those antioxidants comes a good dose of alcohol and saturated fat. Excessive alcohol consumption (more than two daily drinks for men or more than one daily for women) can lead to liver disease, according to the Centers for Disease Control and Prevention (CDC). And recent studies suggest that one or two drinks a day may increase the risk of breast cancer.

And don’t forget the caveats associated with some of these studies. In most of the resveratrol studies (a notable exception being the recent PLoS study) mice were given massive quantities of compound. A human would have to guzzle at least several bottles of red wine a day to obtain a similar amount. And to reap the benefits of cocoa, you have to eat dark chocolate (preferably containing 70 percent cocoa), which tends to be bitter. With creamier chocolate the milk binds to the antioxidant compounds, making them unavailable to the body.

Finally, it is worth noting that the recent red wine study was partially financed by the Swiss DSM Nutritional Products, “the world's leading supplier of vitamins, carotenoids and other fine chemicals to the feed, food, pharmaceutical and personal care industries,” according to the company’s website. Similarly, several studies on cocoa flavanols have been funded by Mars Inc., the maker of chocolate products. So while it's tempting to toast to the promising results from these studies, the bottom line is more bittersweet.

By Coco Ballantyne
Photo by miss karen

Posted by Coco Ballantyne at 04:47 PM | Permalink | Comments (0)

You might have noted that the previous entry on this blog was written by Coco Ballantyne, who recently joined the journal as our News intern. I'm confident she will blog about far less frivolous things than the one I'm going to write about today, so please join me in giving her a warm welcome.

Now, check out this entry from The Wall Street Journal's Health Blog. In a nutshell, companies are beginning to restrict the freebies they give away at meetings, keeping them from doctors who work in specific parts of this country. For example, Lilly won't give you a cup of frozen yogurt if you have prescribing authority in Minnesota or if you are a government employee in New York.

This priceless initiative, of course, finds its origins in the criticisms that pharma companies have received for giving doctors expensive gifts, which have been regarded as an attempt to bias the choice of drugs that physicians prescribe. As the pharma industry seems to want to comply with state regulations that limit the gifts that they can give to doctors in some places, it seems that companies are pulling all the stops (no matter how silly) to make sure they remain on the safe side. I'm sure that some pundits who are obsessed with transparency in biomedicine are celebrating this victory of what I call "CFI fundamentalism".

Anyway, Minnesota docs, don't worry. Our marketing department just created some very neat Rubik cube-like toys to advertise the different journals that NPG publishes on cancer. They may not be as tasty as that frozen yogurt but, if you come to come by our booth at a future meetings, you'll be very welcome to take one of them home with you.

Posted by Juan Carlos Lopez at 12:40 PM | Permalink | Comments (3)