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Lifestyle and habits

The FDA and Supplement Regulation

by Jen Jenkins, Market Analyst

Although we see the topic wending its way in and out of the media spotlight, the Federal Drug Administration remains quietly under fire for its lack of effectively enforcing laws within the supplement industry. A rather surprising and intriguing reason for this lack of enforcement has been traced to a cross-contamination of the hierarchy of the FDA and industry officials in the supplement industry. However, this is disputed by a current chief executive of the Natural Products Association, Dr. Daniel Fabricant, who was formerly running the FDA’s division of dietary supplement programs up until last year. “I did more there in three and a half years than was done in the 16 years prior,” Dr. Fabricant has said.

At the beginning of April of this year, 14 state attorneys general insisted Congress provide the FDA with more power to regulate supplements. More attention has been paid in the last few years to supplements invading shelves that have dangerous hidden ingredients “with amphetamine-like chemicals” labeled only under obscure plant names. BMPEA is a chemical nearly identical to amphetamine that is currently causing the most concern. Canadian health authorities pulled all supplements containing the chemical from their shelves this past December. Meanwhile, the FDA has been aware of nine specific supplements containing the dangerous chemical for the past two years but chose to never make the names of those supplements public.

The biggest concern for consumers is that BMPEA is not listed as being an ingredient in many products that are still on store shelves. Many large retailers of supplements, such as the Vitamin Shoppe, are supportive of the FDA using the authority it has to regulate supplements the way it does other drugs in order to keep the industry safe. As suggested by the linked New York Times article, it remains in the best interest of the public to remain wary when incorporating new weight-loss and workout supplements into any diet: until we can fully trust that supplements are being properly regulated by the FDA, the safe bet is to stick to products that have familiar ingredients or to run it by a doctor.

See this New York Times article for a list of current supplements that are known to contain BMPEA.

Big Soda, Big Problems

by Angela Sams

What is your daily beverage of choice — do you guzzle water throughout the day, or prefer a soda with every meal? If you chose the former, then you are part of a growing trend that has many Americans sipping from their water bottles rather than going to the vending machine for a Coke. According to a recent New York Times article, soda is the new “toxic product to be banned, taxed and stigmatized,” similar to tobacco decades ago. While soda consumption boomed from 1960-1990, the last twenty years have seen a dramatic shift, with U.S. sales of full-calorie soda decreasing by more than 25%. The popular replacement? Bottled water.

The decline is most obvious among the affluent, white population, but will likely spread to the poorer minorities in society, as time goes on. The change is evident among younger generations, as well. Children are consuming fewer calories from sugary beverages, and an overall decrease in kids’ calorie consumption has brought some positive news with it—school-age children’s obesity rates are leveling off. Habits are established at a young age, so the fact that today’s kids aren’t turning to soda as their drink of choice means that they are less likely to suddenly start drinking it consistently as adults.

Why the sudden decrease in consumption? This can be attributed to a shift towards a healthier lifestyle and a desire to eat and drink better. Additionally, the media has helped draw attention to anti-obesity campaigners and proposed soda taxes. Though it may be difficult for officials to pass such a tax, the recent publicity around the debate is still causing people to think twice before popping open carbonated, sugary drinks.

Obviously, this creates a challenge for beverage companies, and they have responded by advertising that their drinks contain “real sugar” and by reducing the size of the cans to 7.5 oz. Even diet soda is taking a hit, as consumers are starting to become wary of artificial ingredients.

While drinking soda every once in a while is not likely to cause any major health problems, it is important to remember that one can may contain at least 17 teaspoons of sugar. This time around, following societal trends has far-reaching health benefits. Let’s raise a glass of water and toast to that!

To read more, check out this recent New York Times article.

 

Hospitals Are Getting Bigger (And Not Just In Texas)

by Jen Jenkins, Market Analyst

Parkland Hospital in Dallas, Texas is gaining exposure, and it isn’t due to its plush newness, updated equipment, sophisticated technology, or a tragic event of 1963 (for readers who are familiar with the name “Parkland Memorial.”). Instead, Parkland is getting attention because each room in the hospital has been specifically designed to more effectively treat overweight patients, or more accurately, “the bariatric population.” This population is made up of patients who typically have a body mass index of 40 or higher and as the need to accommodate these patients has grown, so has the trend to redesign hospital rooms across the country.

According to Nancy Connolly, a senior executive at a hospital consulting group, “Most hospitals we are building are providing an increasingly larger percentage of rooms that can accommodate the larger person.” These changes are necessary due to the unique challenges obese patients tend to face: beds, wheelchairs, and other equipment need to be larger and sturdier which also means that door frames and the rooms themselves need to designed differently. This is now routinely kept in mind as old hospitals are updated and new hospitals are built.

Regardless of what this new trend may indicate, the overall idea moving forward is for hospitals to be designed with the “universal patient” in mind so that every single person may feel comfortable and accounted for. Many arguments can and are being made about what this means about our society, food consumption, economic issues, etc. However, in this scenario hospitals are simply doing what is necessary to be in a better position to care for patients in every way possible – which is undoubtedly their most pertinent responsibility.  According to an article featured in The New York Times, although this trend is being seen across the country, Parkland has done an especially remarkable job in its new design, which will likely be replicated here on out.

 

The Great Sugar Anomaly

by Jen Jenkins, Market Analyst

Sugar is a familiar substance to all of us, but the history of its unnatural counterpart may be less so. The first artificial sweetener, saccharin, was discovered by accident in 1879; due to sugar rationing during WWI and WWII the artificial sweetener found fame. It wasn’t until 1965 that Aspartame, the second major artificial sweetener, was developed.

Controversy began when Canada banned saccharin in 1977 because of studies indicating it caused cancer in rats. The FDA considered banning the sweetener as well but due to large demand a moratorium was placed on the ban and then extended seven different times. In 1991 Congress withdrew the ban completely. The bottom line in that decision: numerous studies have been done on these artificial sweeteners since questions were first raised in 1977 and none have been able to prove a correlation between human consumption and cancer. Thus, artificial sweeteners remain prevalent in the diet of many Americans today.

For a long time, since sugar was deemed “bad,” diet enthusiasts touted artificial sweeteners to be the holy grail of dieting without giving up a sweet tooth. However, as is the tendency with many fads, the tables turned and a new battle has been waged. Which is worse: Sugar or its artificial equivalent? Opinions are vast and varied. This article by a professor of pediatrics at Indiana University School of Medicine argues that despite having been attacked for decades as “harmful chemicals” there is no scientific link showing humans are harmed by consuming artificial sweeteners, whereas there has been significant scientific evidence that sugar is harmful to humans and their health.

No matter where you stand in the debate it is interesting to scroll through the comments section of these articles to view the different stances people are taking (many of them volatile). Due to an overwhelming response to the article mentioned above, the author responded to some questions here. Whether you are team sugar or team artificial sweetener the key word seems to be moderation, or not at all, so what’s with all the hostility?

Americans Are Drinking Less Soda – and Starting to See Results

There’s no precise way to measure calorie consumption across a general population, but according to several major data sources which track trends in the United States, American calorie consumption is declining.

Barry Popkin, a University of North Carolina professor who has studied food data extensively, described the development as a “turning point.” There is no single moment when American attitudes toward eating changed, but researchers point to a 1999 study as a breakthrough. That year, researchers from the Centers for Disease Control and Prevention published a paper in The Journal of the American Medical Association that turned into something of a blockbuster.

In the intervening years the anti-obesity public health campaigns have focused on one subject more than any other: beverages. This seems to be working. Soda consumption in the US has fallen from an average of 40 gallons per year per American in 1998 to 30 gallons/person/year in 2014.  Interestingly, that 30 gallon average is the same rate of soda consumption in 1980, when the obesity rates started to climb. Though food trends haven’t radically changed — the drop in soda consumption isn’t accompanied by a rise in vegetable consumption, for instance — this is a clear stop in the right direction. Read more… 

The Age of Oblivobesity

by Jen Jenkins, Market Analyst, MCN

It’s never a good sign when a health condition prompts new buzz words, in this case “oblivobesity.”  This latest addition to the national discussion on the childhood obesity epidemic introduces this term while shedding some light on the series of (mis)conceptions and (mis)communications that have led to this problem and are continuing to compound it.

Just what is “oblivobesity” referring to? It is a term coined by Dr. David L. Katz, Director of Yale’s Prevention Research Center, to indicate parents’ inability to identify that their children are overweight. A grave review of recent studies published in Childhood Obesity showed some shocking results: Percentages of parents who inappropriately perceived their overweight child as just about the right weight was 96.6% and 94.9% for the [two studies in question]. As high as 78.4% of parents perceived their obese child as just about the right weight in the recent survey. This information helped bring this term to life taking special note of the fact that comparing this 2012 study to a similar study done in 1994 children are not only significantly heavier now but parents are also 30% less likely to notice that there is a problem.

The reasoning behind these revelations spans from the idea that children generally being heavier is considered the “new normal” to, in the words of Dr. Katz, “willful, genuine denial” on the part of the parents. The scary thing is that there is no hope of fixing the issue if the serious health threats that accompany obesity are being ignored or denied. Many different factors come into play when this discussion arises but the important takeaway here is that this growing issue is being swept under the rug in the very place that it must be addressed: American homes.

 

MCN Softball – Meet the Team!

SQUADby Jen Jenkins, MCN Market Analyst

For the first time in MCN history we are excited to introduce our very own softball team! Dedicated players from both the Corporate and Seattle offices are banding together to compete at Maplewood Playfield on Thursdays. The first game takes place tomorrow 6/4 and the season will run through 7/30, giving teams the opportunity to play six regular season games plus playoff games if/when we  qualify.

Yesterday marked the very first practice for some team members that were able to attend (photo proof provided above left). They’re looking pretty fierce out there! Lea Dilling remarked that there were a handful of them that had never played softball before but by the end of the practice were looking like really promising players. Oh what practice can do! One of the team’s original founders Russell Blount deserves special thanks for organizing the practice and has been officially coined “The Softball Man.” Another big thank you goes out to Albert Jennings for coaching the team like it was a paid gig. Based on how #PracticeOne went some highlights to look out for are: Kyle Brady and Dave Tucker tearing up the outfield; Lea Dilling diving for grounders; Amy Belete taking balls for the sake of the team; and Brianna Bean (former softball champion), Kierra Neher and Caitlin Jacques doing whatever it takes to get that win.

Along with the aforementioned players the roster for this season includes:  Jeremy Behrens, Barbara Bulichi, Jacob Burger, Ryan Clarry, Raul Gutierrez, Erik Madrid, Oscar Meza, Evan Shustoff, and Heather Vasquez. 

We are looking forward to bringing you updates about the team and the standings as the season progresses. Details for tomorrow’s game are below and we encourage anyone not playing and in the area to come out and help root our team on! Go Marmots!

Game I Details: 

Date: 6/4/2015

Time: 7:30 PM

Location:  Maple Wood Playfield – 4801 Corson Ave S, Seattle – Field 1

 

A Changing Landscape: America’s Opiate Epidemic

by Jen Jenkins, MCN Market Analyst

Many Americans have developed an expectation for something that on the surface appears harmless but in reality has proven rather dangerous: the quick fix. This expectation falls into a variety of categories but the dangers here tend to lurk around seemingly magical solutions that directly involve our health.

During the 1990’s there was a surge in pain medication being prescribed freely as an easy fix for chronic pain sufferers over the use of other types of rehabilitation. Prescribers were outspoken about their belief that these drugs were not addicting when used in these scenarios and pain medication was not only being freely prescribed but done so in enormous excess. Between 1999 and 2010 the US saw sales quadruple for opioids such as Percocet, Vicodin and OxyContin. These names probably sound familiar as they have readily become household names, yet we are only more recently being warned about the dangers of using these drugs.

On the other hand, heroin is widely known to be illegal and highly addictive. Fatal heroin overdoses in this country have almost tripled in the past three years, claiming the lives of more than 8,250 people per year. As horrifying as that is, it may not be all that surprising since the dangers of heroin are so well known.  In a shocking comparison, around double that number of people are dying every year from prescription opioid painkillers, which are molecularly similar to heroin. If that statistic is news to anyone it’s probably because overdoses due to prescription medications are far less scrutinized and rarely publicized. The victims of these overdoses are overwhelmingly white, financially well-off, and young; a very different demographic from what we have come to know in relation to other types of drug abuse.

This article in The New York Times provides a snapshot of the new heroin landscape and why it is more dangerous than ever before. Use of this addictive drug had been on decline since the 1980’s but was revitalized thanks to prescription opioid addicts who are more readily turning to heroin as a less expensive and more accessible alternative for a similar high. The article goes on to look at how this change of demographic has also brought about a new kind drug dealer, in particular highlighting the business practices of the group of traffickers dubbed “The Xalisco Boys.”

Although low-profile and anti-violent, The Xalisco Boys are drug dealers to fear because they are going after their customers instead of the old standby of waiting for customers to come to them. They also rely on marketing instead of perpetuating street crime and have devised a system resembling pizza delivery for selling heroin across the United States. Interestingly, they even keep business hours between 7am and 7pm to instill a “safe” sort of atmosphere along with reliable delivery and balloons of heroin that have been properly dosed out by weight and potency. Free samples given out at methadone clinics, discount pricing, and free hits delivered to customers showing signs of quitting are cited all examples of their entrepreneurial take on drug sales.

So what do we do in this ever-changing landscape?  Do we look for resolution on the street or in our clinics and hospitals? Especially now that “street crime is no longer the clearest barometer of our drug problem; corpses are.”

The Problem of Unnecessary, No-Value Care

By Brian L. Grant MD

Atul Gawande, MD once again hits a bull’s eye in this incisive New Yorker article on the massive problem and challenge of unnecessary “no-value” care.

In truth, “no value” is generous, since care with no value removes value from the system by diverting resources from the economy that could be creating value, and by increasing morbidity and occasional mortality that is inherently part of health care but is accepted as part of the risk benefit calculation.

When there is no benefit, one only encounters risk. Gawande cites a 2010 Institute of Medicine Report that 30% of health care spending, or 750 billion per year in the US, is wasted. Spread across the population of patients, this would mean that 30% of the care received offers no value (while carrying risk), and 30% of the care provided by hospitals, doctors, pharmaceutical manufacturers, physical therapists and so on, are wasted. Of course, human nature being what it is, the average patient likely thinks that it is someone else receiving such wasted care and the average health professional may believe, or at least profess publicly, that all which they do or prescribe on behalf of patients is necessary and appropriate.

If we were to accept this 30% statistic and were somehow able to curtail waste without shifting or increasing costs we would not be in the crisis of cost that we find ourselves in. Our 18% or so of GDP spent on health care would be a more moderate, but a still substantial, 12%. By any reasonable standard, Gawande is describing a situation that ought to outrage every citizen. How much of our many other crises could be abated if 750 billion dollars were allocated to them? Education, poverty, social justice, homelessness, child abuse, and neglect? Or for those with more libertarian views, if this money were redistributed to the 319 million Americans for their own spending, we would each by richer by $2,351.00 per year! What would such wealth unleashed on the economy accomplish?

Why does this problem exist? I believe it is a combination of factors including ignorance, greed, and indifference. The ignorance is preventable but is largely driven by the indifference of a consuming population who have little economic motivation to be mindful of what they receive since others are paying the costs via private and public insurance. Greed speaks for itself and takes the form of deliberately doing the unnecessary or a deliberate denial of the potential that a particular intervention is not needed by ignoring the evidence or not asking the right questions. The patient population in the presence of motivation is capable of making informed decisions by asking tough questions of their physicians and doing their own research.

Fortunately, as the article describes, there are systemic alternatives that can lead to change in this pattern of behavior when one is willing to acknowledge and confront the problem.

Consensus on Coffee: It’s Good for You!

A review of studies shows that coffee’s reputation as being unhealthy is undeserved, with the potential health benefits surprisingly large.

Aaron E. Carroll, professor of pediatrics at Indiana University School of Medicine, has looked at a number of studies and assembled some interesting news for those of us who love coffee but have long been told that it is bad for us:

  • Low risk of stroke: 11 studies totaling about 480,000 participants showed a lower risk of stroke for those consuming 2-6 cups per day vs. non-consumers
  • Heart failure: it’s not until the 10+ cups per day level of consumption that an increase in heart failure is indicated
  • Cancer: in some cases, such as prostate cancer, higher coffee consumption is not associated with negative outcomes; with breast cancer the link with drinking coffee is “statistically insignificant”; and with lung cancer outcomes are hard to parse out due to the influence of smoking
  • Cirrhosis of the liver: Drinking coffee is associated with “better laboratory values” in those at risk

More good news:

Is coffee associated with the risk of death from all causes? There have been two meta-analyses published within the last year or so. The first reviewed 20 studies, including almost a million people, and the second included 17 studies containing more than a million people. Both found that drinking coffee was associated with a significantly reduced chance of death. I can’t think of any other product that has this much positive epidemiologic evidence going for it.