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The Fallacy Of Relying On Anecdotes In Medicine

Dr. Ian Gawler, a veterinarian, suffered from osteogenic sarcoma (a form of bone cancer) of the right leg when he was 24 in 1975. Treatment of the cancer required amputation of the right leg. After completing treatment he was found to have lumps in his groin. His oncologist at the time was confident this was local spread from the original cancer, which is highly aggressive. Gawler later developed lung and other lesions as well, and was given 6 months to live due to his metastatic disease.

Gawler decided to embark on an alternative treatment regimen, involving coffee enemas, a vegetarian diet, and meditation. Eventually he was completely cured of his terminal metastatic cancer. He has since become Australia’s most famous cancer survivor, promoting his alternative approach to cancer treatment, has published five books, and now runs the Gawler Foundation.

At least, that is the story he believes. There is one major problem with this medical tale, however – while the original cancer was confirmed by biopsy, the subsequent lesions were not. His oncologist at the time, Dr. John Doyle, assumed the new lesions were metastatic disease and never performed a biopsy. It was highly probable Read more »

*This blog post was originally published at Science-Based Medicine*

Improving Your Diet In The New Year

If healthier eating is on your list of resolutions for 2012, look no further. The January 2012 issue of the Harvard Women’s Health Watch offers 12 ways to break old dietary habits and build new ones.

For many years, nutrition research focused on the benefits and risks of single nutrients, such as cholesterol, saturated fat, and antioxidants. Today, many researchers are exploring the health effects of foods and eating patterns, acknowledging that there are many important interactions within and among nutrients in the foods we eat.

The result is a better understanding of what makes up a healthy eating plan. Here are five food- or meal-based ways to improve your diet that we list in the article (you can see all 12 on the Harvard Health website):

Pile on the vegetables and fruits. Their high fiber, mineral, and vitamin content make fruits and vegetables a critical component of any healthy diet. They’re also the source of beneficial plant chemicals not found in other foods or supplements.

Go for the good fats. Read more »

*This blog post was originally published at Harvard Health Blog*

The Truth About Weight Gain

Consuming excess calories increases body fat, regardless of how many calories come from protein. High-protein diets do affect energy expenditure and storage of lean body mass, just not body fat storage.

To evaluate the effects of overconsumption of low-, normal-, and high-protein diets on weight gain, researchers conducted a single-blind, randomized controlled trial of 25 healthy, weight-stable adults in an inpatient metabolic unit in Baton Rouge, La. Patients were ages 18 to 35 with a body mass index between 19 and 30. The study was headed by George A. Bray, MD, MACP.

After consuming a weight-stabilizing diet for 13 to 25 days, participants were randomized to diets containing 5% of energy from protein (low protein), 15% (normal protein) or 25% (high protein). Only the kitchen staff who supervised participants while they were eating knew the assignments. There was no prescribed exercise, and alcohol and caffeine were restricted.

Patients were Read more »

*This blog post was originally published at ACP Internist*

Majority Of California Children’s Hospitals Found To Offer Unhealthy Meals

A study published in the journal Academic Pediatrics reveals that 93% of California children’s hospitals offered unhealthy food to outpatients, visitors and staff in the cafeteria and snack bars.  Said another way, only 7% offered healthy food.  What did these foods consist of to be called “unhealthy”?  Try fried food, sweetened beverages, burgers and lots of sugary sweets.

The study found that 81% of the cafeterias placed high-calorie, high-sugar items like ice cream right by the cash register, a well known marketing plan to tantalize and increase selection.  Forty four percent didn’t even offer low calorie salad dressing and fewer than 1/3 had no nutrition information.

Health care workers, like the rest of America, suffer from increasing obesity.  One study showed over 54% of Read more »

*This blog post was originally published at EverythingHealth*

Modern Snake Oil: Physician Touts Baseless Cures For Rheumatoid Arthritis

There’s an old saying in medicine: “Use the new medicine while it still works.” This is more than just a cute quip. The saying encompasses a few different phenomena. When a drug is tested on a few thousand people, the luck of the draw may show a greater effect than would be seen in a larger, more diverse population. Also, less common side effects will become more evident in a larger sample. Once several million people take the drug, it may turn out that the drug isn’t as spectacular in a large, diverse population, and that certain side effects, though rare, are serious.

This is one of the reasons I’m a very conservative and skeptical physician. Today’s miracle drug may be tomorrow’s Vioxx. Less conservative doctors may make much more enthusiastic recommendations. I found one physician promoting pomegranate juice for rheumatoid arthritis (or at least linking to the article on Joe Mercola’s site without comment). It sounds harmless enough, but what’s the evidence? (You can hunt for the page yourself; I’m not linking to Mercola.)

The statement is based on a pilot study out of Israel consisting of data from six patients. The measures used seem quirky, but are irrelevant anyway. There are no conclusions that can be drawn from such a small sample. Despite this, the authors conclude (and Mercola and the doctor who posted the link presumably endorse) that, “Dietary supplementation with pomegranates may be a useful complementary strategy to attenuate clinical symptoms in RA patients.”

Really? Based on what? Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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