spinline.net: The Blog

The latest Vitamin D Council newsletter, by Dr. John Cannell, is a must-read. (No, really.) His correspondent, “Kathryn,” is an African-American mother who faces child abuse charges following of the discovery of unexplained fractures in her infant following an x-ray. She had been following medical advice by breast-feeding and keeping her daughter out of the sun. But people with dark skin are particularly susceptible to vitamin D deficiency, and breast-fed children are in particular danger, as a vitamin D deficient mother produces deficient breast milk. She writes:

Well, a child abuse expert was called in and we were accused of abuse and they took our baby away, saying we had beaten her. I can’t forget Marissa screaming when they tore her out of my arms. We were shocked. We could never do such a thing. Even though they could not find any evidence of abuse except these broken bones, the DA tells me if I don’t plead guilty and testify against my husband and say he did it, I will be prosecuted as well and never see my baby again. Our lawyer says I can be forced to testify against my husband in child abuse but he would never hurt Marissa. I don’t know what to do. My husband is ready to plead guilty to save our baby from foster care but I don’t think I can let him do that.

I have learned of other African American parents in the same situation. Neither of us would ever abuse our child, it took seven years of trying and then infertility treatment to have her. The reason I am writing is because I have read about cases of rickets where unexplained fractures are common, especially in African Americans like us, that are being called child abuse. I breast fed Marissa but I now know that breast milk doesn’t have enough Vitamin D. We should have given it to her but our pediatrician never said anything about it and La Leche league says breast milk is all infants need.

When we learned Vitamin D may be involved, I asked my doctor to test me and my level was 5 at first. [The Vit. D council recommends 50-80 ng/ml as optimal.] He prescribed Drisdol and now it is 18 after taking 50,000 IU per week for two months. When our lawyer brought up rickets and Vitamin D deficiency the DA had Marissa x-rayed for rickets and tested for Vitamin D; her x-rays were normal and her blood level is now 21, but the child abuse doctors never tested her for Vitamin D when they first took her away from us and she had been on 400 IU formula in foster care for five months when they finally tested her.

Dr. Cannell writes:

The issues you raise about Vitamin D deficiency being misdiagnosed as child physical abuse are so common they were recently the topic of four papers in Pediatric Radiology. First, Drs. Kathy Keller and Patrick Barnes, both pediatric radiologists, published four cases reports. The course of each child was similar. Concerned parents took their child to the doctor for leg bumps, well baby checks, or even the flu. X-rays showed multiple skeletal fractures that were asymptomatic. No mention of bruises, skin abrasions, retinal hemorrhages, parental drug abuse, parental sociopathy, nor evidence the child was frightened of their parents. The children had been seen previously by physicians, nurses, lactation consultants, day-care workers, audiologists, family and friends with no suspicions of abuse. Such parents often have a reputation of being the most protective and concerned parents on the block. Drs. Keller and Barnes thought all four children had rickets. Keller KA, Barnes PD. Rickets vs. abuse: a national and international epidemic. Pediatr Radiol. 2008 Nov;38(11):1210–6.

The key here is the history as much as x-rays. These are often black children, living above latitude 35 degrees, usually breastfeeding without Vitamin D supplementation, often born in the late winter or early spring. The key on exam is that the fractures are painless, unlike traumatic fractures, and there are no bruises. A common finding in the neonatal medical record is craniotabes, or softening of the skull. About 20% of “normal” newborns have soft bones as evidence by craniotabes; of course these newborns are not normal, they are simply the newest additions to the Vitamin D deficiency pandemic.

…

Professor Russell Chesney, Chairman of the University of Tennessee Health Science Center Department of Pediatrics, went next, warning readers we are currently in the “third wave” of rickets; the first caused by air pollution during the industrial revolution, the second wave occurred during the 1980s mainly due to La Leche League-type breast-feeding among heavily clothed immigrants, and the current third wave. (The current wave of rickets is the gift of the sun-scare academic dermatologists, who, in turn, are gifted multi-million dollar grants from the cosmetic and sun-screen industry.) Professor Chesney points out that asymptomatic fracture from Vitamin D deficiency is not uncommon, adding that similar fractures have been noted in young arctic foxes, alpacas, and polar bears kept in zoos, all who apparently suffer such fractures during normal play—unless arctic foxes abuse their kids. I suspect arctic fox infants will get adequate Vitamin D long before African American infants.

It doesn’t look good for Kathryn.

We have no way of knowing how many innocent African American families have been, and will be, destroyed when child abuse experts misdiagnose the fractures and pseudo-fractures (Looser’s zones) of rickets as child abuse. In a recent report of two such cases, Dr. Senniappan of Saint Mary’s Hospital in England gave some good advice that was ignored in your case: “Clinicians have the duty to exclude the possibility of an underlying medical disorder associated with skeletal fragility,” and they have to do so at the time the diagnosis of child abuse is considered, not six months later after the child has been given Vitamin D and calcium in formula. Senniappan S, Elazabi A, Doughty I, Mughal MZ. Case 2: Fractures in under-6-month-old exclusively breast-fed infants born to immigrant parents: nonaccidental injury? (case presentation). Diagnosis: Pathological fractures secondary to vitamin D deficiency rickets in under-6-months-old, exclusively breast-fed infants, born to immigrant parents. Acta Paediatr. 2008 Jul;97(7):836–7, 992–3.

In Scotland, Dr. Colin Patterson of the Ninewells Hospital in Dundee reported on a case of unexplained fractures and warned, “A mistaken diagnosis of abuse can lead to irreparable damage to both family and child.” Paterson CR. Vitamin D deficiency rickets simulating child abuse. J Pediatr Orthop. 1981;1(4):423–5.

Kathryn, as far as the deal the DA is offering (having you plead guilty, dropping abuse charges against you, having your husband plead guilty and go to prison, and giving you your child back if you enter testimony against your husband), this is usually how the DA gets a conviction of “confirmed” child abuse. It is an unusual woman who would risk both prison and her child to defend the truth—not to mention a husband.

This is pretty messed up.

People over 30, do you remember a short-lived soda from the early 80s called Like Cola? Despite heavy TV advertising it failed dismally. I was trying to remember the jingle for some reason so I scrounged up some YouTubes of their ads.

I remember these commercials for the “flavored by the cola nut” angle they pushed. Duly programmed, I’m pretty sure I (unsuccessfully) lobbied my parents to buy this stuff, insisting that we experience the delicious genuine flavor that only real Brazilian cola nut extract can provide, or something.

Anyway, what I did not remember until I saw these was how heavily the caffeine-free aspect was played:

(See also Pepsi Free.) What the heck is going on here — was there some kind of anti-caffeine health scare going on the 80s or something? Well, if it isn’t our old friends at the Center for Science in the Public Interest, America’s Greatest Public Health Menace!

A quick Google search returns these two snippets — the first, from the book Junk Science Judo:

The CSPI petitioned the U.S. Food and Drug Administration in November 1979 to label coffee and tea for caffeine content and, once again, issue warnings to pregnant women. …

The FDA soon caved, issuing a 1980 warning to pregnant women to minimize their consumption of coffee, tea, and colas — even though, the FDA acknowledged, the evidence wasn’t conclusive. … Baby rats had been born with missing parts of toes when their mothers were force fed caffeine at the human equivalent of 24 cups of coffee per day.

The CSPI’s campaign unraveled soon enough, though. In June 1981, a review panel at the National Institute of Environmental Health Sciences concluded that the pregnant rats may simply have been poisoned by the high doses of caffeine. This caused them to lose weight and the weight loss itself affected the development of the baby rats.

And there’s this from a book called Uncommon Grounds:

More consumers … were switching to decaffeinated coffee as health concerns peaked in the early 1980s. … health fears escalated, so that even the average coffee drinker worried about what his morning cup might be doing to him.

Throughout the late 1970s, Michael Jacobson of the Center for Science in the Public Interest (CPSI) had hammered away at the U.S. Food and Drug Administration to remove caffeine from the list of drugs “Generally Recognized as Safe” (GRAS). … In November 1979 Jacobson filed a petition with the FDA asking for warning labels on coffee and tea packages reading: “Caffeine May Cause Birth Defects.”

Remember that this Michael Jacobson of CSPI is the same anti-meat douchebag who bullied fast food restaurants into ditching delicious and nutritionally benign beef tallow as their frying oil in favor the dangerous hydrogenated vegetable oils that they are only now abandoning.

Anyway, it’s kind of weird to think that the health-conscious were so fastidious about avoiding caffeine back then. These days your average organic tofu-eater would take double espressos through an IV if he could.

Worried about the swine flu epidemic that’s going to ravage the nation any minute now? Of course you are!

So click over to the Heart Scan Blog for the lowdown on vitamin D’s protective effects against influenza. Free sample:

In 2006, Dr. Cannell reports noticing that the patients in his psychiatric ward in northern California were completely spared from the influenza epidemic of that year, while plenty of patients in adjacent wards were coming down with flu. Dr. Cannell proposed that the apparent immunity to flu in his patients may have been due to the modest dose of 2000 units vitamin D per day he had prescribed that the patients in other wards had not been given. …

A similar conclusion was reached in a recent analysis of the National Health and Nutrition Examination Survey demonstrating that the higher the vitamin D blood level, the less likely respiratory infections were.

Personally, I used to suffer through 2 or 3 episodes of a runny nose, sore throat, hacking cough, fevers and feeling crumby every winter. Over the last 3 years since I’ve supplemented vitamin D, I haven’t been sick even once. The past two years I didn’t bother with the flu vaccine, since I suspected that my immunity had been heightened: no flu either winter.

And so it has been with the majority of my patients. Since I began having patients supplement vitamin D to achieve normal blood levels (we aim for 60-70 ng/ml), viral and bacterial infections have become rare.

New research is uncovering myriad new ways that vitamin D enhances natural immune responses to numerous infections, including tuberculosis, bacteria such as those causing periodontal disease and lung infections, and viruses like the influenza virus. Enhanced immunity against cancer is also an intensive area of research on vitamin D.

Following Kaus’s First Rule of Journalism, “Always generalize wildly from your own personal experience,” I would just add that since I’ve been supplementing with Vitamin D about a year and a half ago with a dose varying from 2000 to 6000 IU per day, I haven’t had so much as a sore throat. Case closed!

There’s a post on the NYTimes Well blog that points to a study that purports to show that encouraging children to drink water leads to good health outcomes:

Adding school water fountains, distributing water bottles in classrooms and teaching kids about the health benefits of water can lower a child’s risk for becoming overweight, a new study shows.

… At the beginning of the study, there were no statistical differences in the prevalence of overweight kids in the different groups. By the end of the school year, however, children in the schools where water drinking was encouraged were 30 percent less likely to be overweight.

Then, later, this:

Why the water intervention influenced weight risk among the schoolchildren isn’t entirely clear. Overall, the study didn’t show statistically meaningful differences in body mass index scores or overall consumption of sugary beverages. However, juice consumption did appear to drop slightly in the water group.

Well, that’s probably it right there. The way the study measured “consumption of sugary beverages” was from self-reporting by the kids, so you can throw that right out the window. But fruit juices, like soft drinks, are pretty much the worst thing you can consume, metabolically speaking. And it seems likely that if children are being pumped full of water they’re less likely to be drinking other beverages.

So my take, in short, is that if this study has any validity, the water project worked because the excess drinking of water meant that these kids drank less of everything else, most of which is bad.

Also, the study doesn’t mention what it was, exactly, that they were telling the children about “the health benefits of water.” I’d love to know.

Rather than propagandizing them on the supposed benefits of excess water consumption, how much easier would it be just tell kids to avoid fruit juice and soft drinks?

(And yeah, I know that “eight glasses a day” and the like was already a health fad. But this looks like this could shape up to be a separate albeit related childhood health fad.)

Hi, everyone! Have you all missed my blogging? Hello? Well, I’m back with a little roundup of some health tidbits culled from the healthblogosphere (by which I mean the three or so blogs I visit).

• Dental roundup! Tooth decay is a disease of civilization, following the modern diet, says Stephan of Whole Health Source. And Jenny at Diabetes Update writes on the connection between periodontal disease, elevated blood sugar, diabetes, and heart disease. It seems that gum disease may be a cause for the latter conditions. Insane!
• Getting out in the cold is good for your health! Apparently it promotes “brown” (versus “white”) fat. And who wouldn’t want that? Cold baths for everyone! UPDATE: After posting this item, I decided to try to take a cold shower for these purported health benefits and to see if I could stand it. It was really horrible for about three seconds but then it became bearable, pleasant even, probably because that’s when I turned on the hot water. What kind of idiot takes a cold shower? Afterwards I knocked a bottle of moisturizer into the toilet. That had nothing to do with the experment. It was just an accident. END OF UPDATE
• Another couple of posts from Whole Health Source — these on omega-6 fats. Much of the omega-3/omega-6 advice out there concerns increasing the former, but it seems like omega-6 fats (like corn and soybean oil) may have harmful effects independent of the amount of omega-3′s consumed. See here and here.
• This excellent John Schwenkler piece on the war on raw milk should be read in tandem with this Junkfood Science post on same. spinline.net The Blog executive summary: The federal government is a bunch of jackbooted thugs for trying to prevent people from consuming raw (unpasteurized) milk if they want it. Then again, raw milk doesn’t confer any health benefit versus pasteurized, and, of course, might contain pathogens. Then again, factory farms are pretty filthy places, pasteurization notwithstanding. Guess you can’t win…
• That’s all for now.

Not really, but a blog called Fanatic Cook points to a study by a group called EWG on contaminants in ten brands of bottled water shows that they may not be as pure as they’re assumed to be.

A study purporting to show that taking statins (Crestor, specifically) can benefit even healthy people over 50 has been trumpeted uncritically by various MSM outlets.

Not so fast, say Sandy Szwarc at Junkfood Science, Michael Eades, Jenny from Diabetes Update, and Derek Lowe.

Do MSM science journalists only know how to regurgitate press releases?

From the New York Times:

The old-fashioned school bake sale, once as American as apple pie, is fast becoming obsolete in California, a result of strict new state nutrition standards for public schools … They require that snacks sold during the school day contain no more than 35 percent sugar by weight and derive no more than 35 percent of their calories from fat and no more than 10 percent of their calories from saturated fat.

Outrageous! Now, I’m all for healthy eating, and I would be delighted if parents were less wont to load their kids full of sugary snacks and soft drinks. But these people need to lighten up!

In Chula Vista, Calif., near San Diego, sales plummeted at Hilltop High School’s multicultural food fair, an annual fund-raising event for the foreign language and global studies departments that has traditionally featured bratwurst, breadsticks with marinara sauce, apple pie and root beer floats. “This year was really hard,” said Jade Wagner, a senior, referring to the half-bratwursts and nondairy diet root beers.

Half-bratwursts!? Save the children!

A multicultural food fair without the food is just a multicultural fair. And folks, that’s just boring.

What’s more, under these nanny-state brownshirts’ regime, the life-giving, healthful saturated fat in a bratwurst is banned, but a glass of apple juice and a bagel—no added sugar, right?—would be the ideal healthy meal, even if it’s basically the nutritional equivalent of eating pure table sugar. Makes sense!

And the NYT might have mentioned that similar programs have been shown to be useless. The Junkfood Science blog recently had a look at some recent studies which failed to show any benefit from school sugar bans:

… we heard little about the intensive two-year study published earlier this year that was to provide evidence for the effectiveness of the School Nutrition Policy Initiative in reducing childhood obesity. This comprehensive program included every initiative popularly believed to reduce obesity and all of the interventions were in accordance with the CDC’s “Guidelines to Promote Lifelong Healthy Eating and Physical Activity” that are being incorporated into school wellness policies across the country. The program was a total failure. Not only had the children’s “healthy eating” behaviors slightly dropped, but it had no effect on the incidence, prevalence or remission of obesity…

… Given the massive resources, and increasingly intrusive interventions for students and families as school and government officials attempt to monitor and control what young people eat in schools, parents and tax paying consumers might begin insisting on some evidence before continuing to support these programs.

And one last thing: how can you trust anyone who can’t spell “McDonald’s?”

(When I originally sat down to write this, I somehow ended up watching ten minutes of The Price is Right online. How does that happen? But I’m happy to report that Drew Carey is doing a fine job, and that Taylor won the yellow Mustang.)

Stephan at Whole Health Source has reviewed twelve major trials that purport to “evaluate the relationship between saturated fat and risk of death,” and finds the following:

The first study to show an increase in deaths from replacing saturated animal fat with polyunsaturated vegetable fat was the tragically named Anti-Coronary Club study. After four years, despite lowering their cholesterol substantially, the intervention group saw more than twice the number of deaths as the control group. Amazingly, rather than emphasizing the increased mortality, the study authors instead focused on the cholesterol reduction. This study was not properly controlled, but if anything, that should have biased it in favor of the intervention group.

The second study to show an increase in deaths from replacing saturated animal fats with polyunsaturated vegetable fats was the Sydney Diet-Heart study. This was one of the larger, longer, better-conducted trials. After five years, the intervention group saw about 50% more deaths than the control group.

…

Overall, the data from controlled trials are clear: replacing animal fat with vegetable oil does not reduce your risk of dying! The same is true of reducing total fat. … Proponents of the theory that saturated fat is unhealthy have the burden of proof on their shoulders, and the data have failed to deliver.

Measuring heart disease mortality specifically, rather than total mortality, also yields unimpressive results.

So not only do the best data not support the idea that saturated fat increases the overall risk of death, they don’t even support the idea that it causes heart disease!

In sum,

Eat the fat on your steaks folks. Just like your great-grandparents did, and everyone who came before.

Whooo!

Way back when, Dr. Eades had some informed speculation on the subject of saturated fat and health.

What about saturated fat? How does a decrease in saturated fat cause obesity? First, the decrease in saturated fat has tracked with the increase in vegetable oils, which are typically rich in omega-6 fats. Omega-6 fats have been shown in numerous studies to be proinflammatory. They have also been shown to worsen alcoholic fatty liver disease, and, one would assume, [non-alcoholic fatty liver disorder] as well. …

Saturated fat is a healthful food. Read this article by Mary Enig that describes in detail the health benefits that come from eating saturated fat. …

So how does avoiding saturated fats lead to obesity. In my opinion in a couple of ways. First, indirectly, by having them replaced by vegetable oil, particularly hydrogentated vegetable oil, i.e., trans fat. Due to their stability, saturated fats have cooking properties that no other natural fats have. Food chemists have created trans fats to have the same cooking properties – and in some situations even better cooking properties – as saturated fats. But the addition of trans fats to the diet creates a host of other problems. The medical literature is crawling with studies showing that trans fats drive the development of obesity.

The other reason is that saturated fats compose the lion’s share of normal membranous fats and of the brain. When membranes don’t work as well, especially mitochondrial membranes, our energy storage and regulation system doesn’t work as well. Anything that impairs membrane functioning impairs signaling function. If signaling function falls off, then various hormones, neurotransmitters, etc. lose function. As insulin loses function, more insulin is required, more insulin leads to more downregulation of receptors, all of which ultimately leads to obesity.

Meanwhile, over at Animal Pharm, there’s a post that I must admit I understood little of but it’s entitled “Saturated Fats as Potent Anti-Atherogenic Drugs” which has got to be a good thing, right?