Science versus public health

Back in January, I wrote about the research that shows that being overweight does not increase mortality risk and may reduce it. This has been shown many times and a large meta-analysis of 97 studies, put together by Katherine Flegal et al. and published in JAMA, appeared to confirmed it.

Cue panic from the public health lobby who feared that the 'obesity epidemic' and all its limitless possibilities for social engineering were in jeoprady. In an astonishing outburst against a fellow academic, the longtime foe of 'Big Food', Dr Walter Willett, said:

"This study is really a pile of rubbish and no one should waste their time reading it."

As I said at the time...

How heartening it is to see the spirit of intellectual enquiry thriving at the Harvard School of Public Health. Perhaps Dr Willett and his friends will make a bonfire out of copies of the Journal of the American Medical Association and dance around it.

Willett and friends did not quite build a bonfire but, as Nature reports this week, they did go to the effort of organising a kangaroo court at which Flegal was tried for her crimes against public health hysteria.

Willett later organized the Harvard symposium—where speakers lined up to critique Flegal's study—to counteract that coverage and highlight what he and his colleagues saw as problems with the paper.

The problem for the Willetts of the world is that Flegal's study was pretty sound and a growing number of non-fanatical scientists are coming to accept that being overweight is not a serious health problem. There are potential confounders, including the fact that smokers tend to weigh less than nonsmokers, but—as with the 'sick quitter hypothesis' and alcohol consumption—the theory has stood up to every challenge and remains robust.

More and more studies show that being overweight does not always shorten life — but some public-health researchers would rather not talk about them.

...the most contentious part of the debate is not about the science per se, but how to talk about it. Public-health experts, including Willett, have spent decades emphasizing the risks of carrying excess weight.

Studies such as Flegal's are dangerous, Willett says, because they could confuse the public and doctors, and undermine public policies to curb rising obesity rates.

“There is going to be some percentage of physicians who will not counsel an overweight patient because of this,” he says. Worse, he says, these findings can be hijacked by powerful special-interest groups, such as the soft-drink and food lobbies, to influence policy-makers.

Just take that in for a moment. What kind of scientist talks like this? The truth will undermine our political activity! The food industry will use scientific facts to oppose us! Too bad, Walter. Policy is supposed to be based on the facts, remember?

But many scientists say that they are uncomfortable with the idea of hiding or dismissing data — especially findings that have been replicated in many studies — for the sake of a simpler message.

That's reassuring, up to a point. It's kind of worrying that a scientific journal needs to point that out to its readers, but that's what thirty years of 'public health' research has done to science. And I'd be more reassured if it said "most scientists" rather than "many scientists".

Willett says that he is also concerned that obesity-paradox studies could undermine people's trust in science. “You hear it so often, people say: 'I read something one month and then a couple of months later I hear the opposite. Scientists just can't get it right',” he says.

Once again, too bad. Zealots decide what to believe early in life and then stick to it regardless of the facts. Scientists don't (or, as Nature says, "many scientists" don't). As Keynes said, when the facts change, I change my mind. Are we supposed to seal the scientific consensus of 1990 in concrete just so you could fight your childish battle with the soda industry?

“We see that time and time again being exploited, by the soda industry, in the case of obesity, or by the oil industry, in the case of global warming.”

Boo-hoo.

Be under no illusions about what these people are up to. They are prepared to defame academics and misrepresent data in a conscious bid to mislead politicians and manipulate the public. They are not just prepared to do this, they have already done so.

This is the problem with mixing science and politics and it is endemic in the sordid oxymoron of 'public health'. Science wants to inform. Public health wants to manipulate, control and socially engineer. The two aims are incompatible. Public healthists believe they are fighting a war, and truth is always the first casualty.

I recommend reading the Nature article in full as well as the accompanying editorial. It gives an insight into how laughable is the idea of evidence-based public health policy.

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The curse of The Spirit Level strikes again

In August 2011, there were three nights of rioting in London with cars set alight, police officers attacked and shops looted. It was triggered when the police shot a man dead in Tottenham but rapidly became a riot for its own sake as it spread to other UK cities.

This orgy of disorder gave every chin-stroking intellectual an opportunity to speculate about its "root causes". Whatever they blamed—bad parenting, "austerity", poor education, unemployment, 13 years of Labour misrule, one year of Tory misrule or Mrs. Thatcher—the "root cause" was invariably the thing that the intellectual had been warning about for years.

For Wilkinson and Pickett, authors of The Spirit Level, that thing was income inequality...

The poison of inequality was behind last summer's riots

A year on from the riots, the government is still failing to identify their underlying causes

... But how does this social poison work? It makes some people look as if they are worth much more than others – not just a little bit more, but anything from supremely important to almost worthless.

Wilko and Pilko said that some CEOs are paid 300 times more than junior employees and that this creates "fears of inadequacy" which lead to violence. It is, therefore, impossible for Britain "to tackle the social ills contributing to the riots without reducing inequality."

Basically, antisocial societies cause antisocial behaviour. Greater inequality weakens community life, trust gives way to status competition, family life suffers, children grow up prepared for a dog-eat-dog world, class divisions and prejudices are strengthened and social mobility slows.

If only we lived in an egalitarian paradise like Sweden, this sort of thing wouldn't happen, eh?

From the BBC...

Riots grip Stockholm suburbs after police shooting

Rioters have lit fires and stoned emergency services in the suburbs of Stockholm for the third night in a row after a man was shot dead by police.

Incidents were reported in at least nine suburbs of the Swedish capital and police made eight arrests.

On Sunday night, more than 100 cars were set alight, Swedish media report.

... On Tuesday night, cars were torched in western and southern Stockholm, and stones were thrown at police officers and firefighters. One area affected, Rinkeby, saw similar rioting in 2010.

Kjell Lindgren of the Stockholm police told Aftonbladet newspaper that the unrest had spread from the original rioting in Husby.

"It feels like people are taking the opportunity in other areas because of the attention given to Husby," he said.

Earlier on Tuesday, Prime Minister Reinfeldt said: "We've had two nights with great unrest, damage, and an intimidating atmosphere in Husby and there is a risk it will continue."

And, alas, this carbon copy of the London riots has continued...

Stockholm restaurant torched as riots spread

A fourth night of unprecedented riots in Stockholm has seen unrest spread, with a restaurant and up to 40 cars burnt, police told the BBC.

... The Stockholm police spokesman said rioting had occurred in both deprived parts of the city and parts that would be considered "normal".

"My colleagues say the people on the streets are a mixture of every kind of people you can think of," he added.

"We have got Swedes, we have got very young people, we have got people aged 30 to 35. You can't define them as a group.

"We don't know why they are doing this. There is no answer to it."

Swedish sociologists are no doubt already claiming that this could have been averted by higher taxes and more generous welfare payments.


UPDATE

I have no idea who or what "community activists" are but they're blaming it on inequality already...

...community activists blamed high youth unemployment and recent cuts to public services in Husby and the other affected areas.

"This is the kind of reaction when there isn't equality between people, which is the case in Sweden," said Rami al-Khamisi, a law student and founder of Megafonen, a community rights organisation.

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Alcohol Con bites the hands that feeds it

This is rather wonderful from Alcohol Concern. Less than two weeks after minimum pricing was dropped from the Queen's Speech, the fake temperance charity has decided to have a pop at the politicians.

MPs admit to unhealthy drinking culture in Parliament, new survey reveals

New data released today by Alcohol Concern reveals a quarter (26%) of MPs believe there is an unhealthy drinking culture in Parliament.

That's an interesting interpretation of the statistic. Another—more honest—interpretation would be that a large majority of MPs don't think there is an unhealthy drinking culture in Parliament, but that wouldn't really serve the cause, would it?

Either there is an unhealthy drinking culture in Parliament or there isn't. Alcohol Con have put it to a vote and most MPs don't think there is. End of story.

Eric Appleby, Chief Executive of Alcohol Concern said:

“It’s surprising that only a quarter of MPs believe there is an unhealthy drinking culture in Parliament."

Considering the place is riddled with purse-lipped crypto-socialists like Sarah Wollaston and lemon-sucking busybodies like Diane Abbot, maybe Appleby has a point. Or maybe he's just disappointed that so few of them gave him the answer he wanted. Either way, women and Labourites were disproportionately more likely to complain about a "drinking culture".

A third (36%) of female MPs agreed with the statement that there was an unhealthy drinking culture in Parliament.

Labour MPs (31%) are more likely than MPs from either of the Coalition parties (20% Conservative and 19% Liberal Democrat) to believe that there is an unhealthy drinking culture in Parliament.

I also note that only the left-wing media bothered to report this non-story (see BBC, Guardian, Independent, Mirror). What is it with leftists and temperance?

Appleby continues...

"If a quarter of employees reported an unhealthy drinking culture in any other organisation it would provoke immediate action by bosses."

Firstly, they're not reporting it to their bosses, they're responding to a leading question in a poxy survey.

Secondly, there are plenty of bosses who would tell them to shut up or sod off.

Thirdly, MPs aren't air traffic controllers. Their job is to have long lunches with various rent-seekers and lobbyists while waiting to be told how to vote.

"Surely it’s time for Parliament to rethink its drinking culture and lead by example.”

Surely it's time for Parliament to rethink its culture of giving public money to groups like Alcohol Concern. Even after the Department of Health withdrew its funding, most of their income comes from the state. What do you say, MPs? Surely it's time to rid yourselves of this turbulent pressure group.

PS. Maybe Alcohol Concern has found some non-state funding at last. As the press release notes, "Alcohol Concern partnered with pharmaceutical company Lundbeck Ltd to commission and communicate the findings of the survey." Lundbeck have just brought out a stop-drinking drug.

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Angelina Jolie and BBC spin

Michelle Roberts. Not a clue.

Michelle Roberts, the BBC's worst health journalist, has taken to the airwaves to talk about Angelina Jolie's double mastectomy. Jolie decided to undergo the operation because she has inherited genes that make her very prone to breast cancer. Her mother died of the disease at the age of 56 and doctors say her DNA means that she has an 87 per cent chance of developing the disease.

I have written before about the BBC's determination to portray smoking, drinking and obesity as the leading causes of breast cancer, despite these being, at most, quite modest risks for the disease. Michelle Roberts was personally responsible for a particularly awful piece of journalism in 2011 which claimed, quite wrongly, that obesity was the "leading driver" of breast cancer.

Roberts could not allow the Jolie story to pass without bringing "lifestyle factors" into it and so appeared on camera—carefully flagged up as "a qualified doctor"—to talk her nonsense.

"In [Jolie's] case, DNA she inherited from her mum meant she was at 87 per cent increased risk of developing the disease in her lifetime and that's why she decided to have a double mastectomy."

No, no, no. She did not have an increased risk of 87 per cent. She had an absolute risk of 87 per cent, as the BBC themselves reported:

She said her doctors estimated she had an 87% risk of breast cancer and a 50% risk of ovarian cancer... Her chances of developing breast cancer have now dropped from 87% to under 5%, she said.

It beggars belief that the BBC's online health editor does not understand the difference between relative risk and absolute risk. Having made this pitiful error, she then moves on to her pet belief that "the vast majority of breast cancers" are caused by "behaviours such as smoking and conditions like obesity".

"Most cases of breast cancer are not caused by faulty genes such as these. Many more cases of breast cancer are caused by things like smoking and obesity—things that we all have the power to prevent."

There are lots of risk factors for breast cancer, including delayed childbirth and not breastfeeding (as this more considered BBC article points out). So why specifically mention smoking and obesity? It is questionable whether smoking increases the risk of breast cancer at all. The NHS doesn't include it in its list of risk factors and a comprehensive meta-analysis of 53 studies published in the British Journal of Cancer concluded that "smoking has little or no independent effect on the risk of developing breast cancer" (results shown below).

A relationship between obesity and breast cancer has been found more regularly, but the risk seems to be relatively small. This meta-analysis found that obesity was associated with a 25 per cent increase in postmenopausal breast cancer and this meta-analysis found a 15 per cent increase in postmenopausal breast cancer and no association with premenopausal breast cancer.

Even if the 87 per cent risk Roberts mentions was relative rather than absolute it would still be much larger than the 15-25 per cent increased risk associated with obesity and obviously much larger than the "little or no" risk associated with smoking. But since the 87 per cent risk is absolute, Jolie's breast cancer risk was off the scale compared to smokers and fatties.

The guiding principle of the Beeb's health reporting is that people shouldn't engage in bad habits so it's okay to misrepresent the facts in an effort to make us change our ways. If that means downplaying major risk factors and exaggerating minor risk factors, then so be it. It is the triumph of morality over medicine. It is not journalism. It is propaganda.

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Politics as it should be done

If only we had more politicians like Chris Davies MEP. He knew that the Tobacco Product Directive was being revised, but he knew nothing about e-cigarettes. So he decided to ask people to educate him. Now he knows a lot about e-cigarettes and will be responding to the European Commission accordingly.

Until a few months ago I had never heard of e-cigarettes. Since then I have had many letters and e-mails from users, have met with manufacturers, and have read widely on the subject. I am convinced that they can play a very effective role in helping confirmed smokers reduce or eliminate their dependence upon tobacco. Although the long term effects of using e-cigarettes has yet to be established it seems very likely to me that their use, rather than the continued smoking of cigarettes, is likely to be much less harmful to health and will prolong lives.

I am opposed to the introduction of restrictions on the sale and use of e-cigarettes by adults.

The European Commission has emphasised that it does not wish to ban the products but only to require them to be classified as medicines. However, this route involves significant costs and potential restrictions on their development and sale. It is true that e-cigarettes can be used as a medicinal nicotine replacement therapy but they can also be considered as a recreational drug like alcohol or tobacco cigarettes, albeit one which appears to be very much less harmful. It is the fact that they are said to be pleasurable to use that makes them so effective as a means of combatting addictive use of tobacco. I cannot see any value in allowing it to be easier for conventional cigarettes to be sold than e-cigarettes.

I am also opposed to the introduction of restrictions on the nicotine content of e-cigarettes. The user is the best person to judge what level of nicotine is appropriate to meet their needs, although clear information should be provided and the purity of the contents guaranteed.

I have tabled a series of amendments along these lines. I do believe that the Commission should review the properties of e-cigarettes and, if necessary, put forward separate proposals at a later date, and I do believe that the products should be labelled to point out that nicotine is addictive and may harm health, but this amounts to light-touch regulation not the heavy handed approach currently being pursued.

Well done, sir.

Other politicians take note. Representative democracy is not rocket science.

Go read the whole thing.

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Forbidden dissent

A couple of weeks ago, a bunch of medical temperance types held a meeting in the European Parliament to push for minimum pricing. I nearly fell off my chair when I read this comment attributed to a representative from the Royal College of Physicians...

When mentioning the Scottish MUP scheme he explained that the measure was part of the Scottish Nationalist Party Manifesto and that, as a rule, it was forbidden to oppose the Manifesto once voted on. Thus, he highlighted that the current debates were actually profoundly anti-democratic.

What fresh jackbootery is this?! I realise that Scotland is going to hell in hardcart, but I didn't know it was "forbidden to oppose the Manifesto" of the ruling party.

Perhaps he was misquoted? Let's ask someone who was there, namely EU sock-puppet supremo Monika Kosinka of the European Public Health Alliance...

Ms. Kosinka was born in a communist country. Can you tell? There is, of course, a massive difference between a democracy and an elected dictatorship.

The charmers of public health aren't very keen on free and open discussion, as you might expect from people whose arguments are wafer-thin. For example, the National Rifle Association recently referred to the debate about gun control as a "culture war". You don't have to be a gun nut to see that they the right to say that, but not if you're the editor of the Lancet, Richard Horton...

Horton wrote a book called Health Wars. Book him, Danno.

Kosinka has form for wanting the authorities to pounce on anyone she disagrees with. The Commentator recently reported her excitement about post-Leveson newspaper regulation. All it took was for them to report the results of a survey for her to want to unleash the hounds...

And journalists are not the only people who she wants to see clapped in irons...

Like 77% of Scots, I didn't vote for the SNP. Nor did I vote for the EU, the Royal College of Physicians, the EPHA, the Alcohol Health Alliance or any of the other state-funded authoritarian creeps who think they know better than me how to live my life. But even if the whole world went insane and I was the only person who didn't vote for them, I would not be "forbidden" from opposing their ridiculous ideas.

As John Stuart Mill put it: "If all mankind minus one were of one opinion, mankind would be no more justified in silencing that one person than he, if he had the power, would be justified in silencing mankind." That's not "profoundly anti-democractic". It's called civilisation.


UPDATE

 
In the topsy-turvy world of public health, quoting someone's exact words constitutes "smearing", apparently. Glibly describing someone as a 'lapdog apologist for corporate interests', on the other hand, is perfectly reasonable. Go figure.

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The wages of failure

That's all sorted then. The Queen's Speech contained no mention of minimum pricing or plain packaging so it is likely that both of these ill-considered policies have been kicked into the long grass until after the next election. Well done to the government for seeing sense. Let's hope the puritanical, prohibitionist juggernaut is starting to turn in this country.

Let's also hope that the government takes a closer look at the Department of Health's countless astroturf groups who have squandered millions of pounds of taxpayers' money on these two campaigns. They will be crying into their mineral water today, as will a certain Australian sociologist (be sure to read Nannying Tyrants' investigation into Simple Simon, by the way).

Some of the DoH's sockpuppets may even miss out on a bonus because of the coalition's refusal to capitulate. How tragic that would be, but at least they know that the money will still keep rolling in for the time being...

The future of Fresh and Balance, the North-East's two public health campaign groups, has been secured for at least the next two years.

Until recently Fresh - which campaigns for a reduction in the use of tobacco products - and Balance - which campaigns for a reduction in the consumption of alcohol - had been funded by NHS primary care trusts in the region.

But when PCTs were abolished, both agencies had to appeal to local authorities to provide funding.

Colin Shevells, director of Balance, said: "The funding we have secured from the 12 North-East local authorities is the same as before but for the first time we have got a two year contract."

There's nothing easier than spending other people's money, is there? And we're not talking pennies here...

The agreement means that Fresh has an annual budget of £713,000 and Balance has a budget of £680,000 per annum.

Guess what they're going to be lobbying for...

The main priority for Fresh is to secure plain-packaging for tobacco products and Balance is pushing for a minimum price per unit of alcohol to be introduced in England.

You read that right. £1.4 million* of taxpayers' money has been awarded to two astroturf groups to campaign for policies that the government has just rejected. This is both absurd and outrageous. How about some joined up government? Is central government even aware of this?


* £2.8 million really, since the funding is secure for two years.
 

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