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.

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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.

I interrupt this brief blogging hiatus to bring you this important news. Scientists estimate that the effort to produce a live woolly mammoth will cost only $10 million. At that price, we can’t not do this. Just think of it. Mammoths!

This is an important national priority. I assign the task of securing funding to Hank Paulson. No one will notice if a measly $10 million is whisked away from that $700 billion TARP fund.

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?

Pretty neat, Google has launched a site called Google Flu Trends that uses patterns in flu-related search terms to track outbreaks.

On a whim, I decided that it would be good to know what, besides The Monkees and Huey Lewis and the News, happened in 20th century music, so I queued up a Philip Glass station on my Pandora Radio.

Based on under two hours of listening, I officially declare avant-garde music to have gotten a bad rap. Glass is eminently listenable!

I’m also struck by how a lot of movie scores seem to have been influenced by Glass or minimalism in general. I’m thinking of music from The Remains of the Day and Jon Brion’s score for Magnolia.

In other news, a lovely Debussey track called Arabesque No. 1 came up, but I couldn’t keep from being reminded of Jack Horkheimer, Star Hustler, a cheesy old public television show that used that piece as its theme. It ran on our PBS station in the 80s. Does anybody else remember that show? No? OK.

‘Cause here it is again! Man, I love YouTube.

Now, I was going to try to head off any needling about the geekiness of having ever watched this show with the defense that I have only ever seen it because it came on right after… Doctor Who.

(Sigh.)

There’s a nice article on the joys (and benefits) of eating fat over at a site called Table Matters. (h/t Blowhards.)

Lard is also natural. “Tub of lard” is now a derogatory phrase, but I wish I had one. Pork fat, fat back, bacon, lard, and leaf lard (for that flaky pie crust) are all good fats containing approximately 11 percent polyunsaturated fat. Wrap almost anything in bacon and voila — ecstasy. It is not for nothing that pork belly is the cutting-edge chef’s new favorite.

Goose, duck, even chicken fat are also good (with between 11 and 13 percent polyunsaturated fat). What makes a terrine de foie gras transporting? Fat. Pork rillettes? Fat. A duck deprived of its fat would fall flat. Cook potatoes in duck or goose fat and you’ll never want them any other way.

However, the article disappointingly ends with this old canard:

… in the end, it’s calories that make you fat. Too many in and not enough expended. We may be a nation of fatties, but it is not because of an overindulgence in glorious gorgeous fat: It’s overindulgence in general. Eat a little less; eat much better.

What Nonsense!

We’re one step closer to producing a live, cloned woolly mammoth.

This can’t happen soon enough. Get cracking, scientists!

(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?

A recent study showing a correlation between vigorous exercise and long life is being hyped by the press as showing that exercise leads to longevity. Michael Eades of Protein Power fame has some worthwhile comments and urges us to remember that correlation does not equal causation.

The conclusion of this study, which is absolutely accurate, is that running is associated with longevity and reduced disability. The two are associated or correlated. The study does not prove that running increases longevity or decreases disability. Correlation is not causation.

But you wouldn’t know that from the press coverage of this study. If you run a Google search, you will find the study reported as proving causality. See here, here and here for just a few instances.

…

We don’t know and can’t possibly determine from this study whether it is the running that increases longevity or whether there is some facet of personality or physiology that drives one to run that increases longevity. Maybe people who are destined to live longer take to running or other forms or aerobic exercise. People who are depressed typically have shorter lives, and people who are depressed tend not to join groups or exercise. Perhaps a number of the people in the control group are depressed, leading to an increase in early deaths in that group. It could be that the people who have the time to join a running group and spend the time running are more financially stable and are happier. Both of those conditions are correlated with longevity. There are far too many factors separating the two groups to dissect out the one and attach the benefit to it. But our culture firmly believes that exercise promotes longevity, so this experiment seems to bear that out, and most people accept it without looking to deeply.

Good stuff.