July 2009

For those who thought taking off most of your clothes, climbing into a coffin-shaped box and exposing your body to a bombardment of ultraviolet rays was all part of maintaining a healthy lifestyle and appearance, comes this shocker from Europe: Tanning beds may cause cancer.

A study published this week in the medical journal Lancet Oncology prompted the World Health Organization (WHO) to categorize tanning beds as “definitely carcinogenic.”

Researchers said using tanning beds resulted in a 20 percent increase in the risk of developing melanoma, which is the deadliest kind of skin cancer.

Other studies have found young people who use tanning beds are eight times more likely to get melanoma than those who have never used them. They are a particular no-no for people under age 18, according to WHO, but 29 states have restrictions on use of tanning beds by minors.

As one might imagine, this has turned out to be a bad week for folks who run and work for tanning bed trade associations. Americans spend $5 billion on tanning, according to the St. Louis Post-Dispatch.

The Indoor Tanning Association, based in Washington, DC, published a $50,000, full-page ad in the New York Post yesterday slamming “media hype over tanning beds.”

“The Indoor Tanning Association will not stand by and allow some members of the media to unfairly malign our product and the thousands of small business owners who are our members, by grossly exaggerating the risks associated with tanning beds,” Dan Humiston, the group’s president, said in a news release.

“Because tanning beds produce the same UV light as the sun, OVEREXPOSURE and abuse of our product — just like OVEREXPOSURE to sunlight — is associated with an increased risk for some types of skin cancer. Other items in this category are red wine and salted fish.

“Scientific studies suggest that drinking red wine or other alcoholic beverages carries a greater cancer risk than tanning. It is completely irresponsible to compare indoor tanning with mustard gas or arsenic as so many media reports today have done.”

Right. Always remember, when you see studies like this, to keep turning so you can get the other side.

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The bitter truth of our modern world continues to crash down around us. First, we learned that bottled water isn’t any healthier for you than the stuff that comes out of the tap. And now we find out that organic food is apparently just another waste of money.

Boys and girls, you may as well buy a box of Cap’n Crunch and drown a bowl of it in hormone-laced, pesticide-soaked milk produced by cows that consume chicken intestines and pork-related byproducts.

The latest assault to our long-treasured assumptions comes from The London School of Hygiene & Tropical Medicine, where researchers unmasked the hard, cold realities about that expensive stuff in the fancy packaging.

When my wife saw the study, she shrieked: “How could that be?”

But as Elaine Benes told Jerry: “Oh, it be.”

The study, commissioned by the British government and published in the American Journal of Clinical Nutrition, reviewed 162 scientific papers over a 50-year span.

The conclusion: “A small number of differences in nutrient content were found to exist between organically and conventionally produced foodstuffs, but these are unlikely to be of any public health relevance.

“Our review indicates that there is currently no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority.”

The researchers noted that some previous reviews did show superior nutritional components to organic food, but there was never a comprehensive look at the issue. Some of the differences that were found were due to the ripeness of the fruit or vegetable, or the type of fertilizer used.

Organic food consumption has fallen, by the way, but not because of this study, or studies like it. The recession has affected shopping habits, with consumers returning to cheaper, mass produced foods. The organic market had been seeing phenomenal growth – 26 percent per year – until recently. Sales growth in Britain slowed to 1.7 percent in 2007, according to a Reuters report.

Actually, this doesn’t’ mean I’d never buy organic. I like the idea, for example, of buying eggs from chickens that are running around a real yard, having the time of their lives hunting for worms, bugs and other assorted chicken delicacies.

And there-in lies the salvation of the organic food industry. Some consumers will continue to believe that higher production standards are of some benefit, to themselves or the environment. But it may be that the double-digit growth the business enjoyed for so long is coming to an end.

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A fresh approach to treating depression is taking root in California, cultivated by mental health professionals who believe that many of our problems can be traced to losing touch with nature.

Ecotherapy addresses stress, depression and anxiety by encouraging people to interact with the great outdoors – plants, other animals and fresh air. The concept is explored in the new issue of Time Magazine.

“It’s psychotherapy — as if nature really mattered,” said marriage and family therapist Linda Buzzell-Saltzman, founder of the International Association for Ecotherapy. The organization, based in Santa Barbara, has about 500 members.

“Ecotherapy is the reinvention of psychotherapy as if nature mattered,” Buzzell-Saltzman explains on her Web site. “It takes into account the latest scientific understandings of our universe and the deepest indigenous wisdom.

“This perspective reveals the critical fact that people are intimately connected with, embedded in and inseparable from the rest of nature, which shifts our understanding of how to heal the human psyche and the currently dysfunctional human-nature relationship.”

It’s easy to scoff at this movement and call advocates a bunch of tree huggers.

But the problem is that humans have been hard wired over millions of years to be in tune with natural surroundings. It was only in the last two centuries, first with the introduction of industrialism, and now with the flood of new technology and communication services, that people became alienated from nature.

We now spend more time in front of Blackberries, cell phones, lap tops and plasma TVs than we do admiring the agility of squirrels scampering up an oak tree, or listening to morning song birds on the banks of a lake.

Ecotherapists recommend people start keeping a journal of their time spent interacting with nature. They are sometimes shocked to find that total time outside amounts to 15 to 30 minutes a day, usually walking to and from their car.

The short answer is to put aside the remote control and get out more often. An hour walk every day can make a difference in your attitude toward life.

“People were embedded in nature once,” Buzzell-Saltzman told Time. “We’ve lost that, and we’re paying the price.”

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The real obstacle to health care reform is becoming clearer by the day. It’s the country’s patchwork system of services, a hodge-podge of private for-profit entities with their own special interests to protect.

And here’s the kicker: Much of it has nothing to do with actual delivery of medical care.

Insurance companies have been spending millions of dollars lobbying Congress, particularly the Senate, to kill the public option plan. The U.S. Chamber of Commerce would like to see a proposal mandating employer insurance coverage shot down. Both objectives are now in sight as “moderate” Democratic senators cave in to their demands.

But it’s not over. Pharmaceutical companies have yet to weigh in. Look for their campaign – and it’s going to be a big one – to begin when Congress gets back from their recess in September.

See Bloomberg’s report today on drug companies’ $100 million ad campaign on health overhaul.

Not surprisingly, pharmaceutical companies don’t like the idea of allowing Medicare – or a government-based public option plan – to negotiate lower drug prices. Nor do they appreciate an option that wold allow the purchase of prescription meds from Canadian companies.

Watch for hard and sharp attacks on both of these proposals.

The campaign is being run by The Pharmaceutical Research & Manufacturers of America (PhRMA), the Washington-based lobbying arm representing 28 drug makers, including Pfizer and GlacoSmithKlein.

The industry did cut a deal with the Obama administration to discount brand-name drugs for Medicare recipients who fall into coverage gaps. It will supposedly lower drug costs by $80 billion over 10 years.

PhRMA will be trying to get two basic messages across. One is that re-importation of drugs is “a safety issue” that could put patients in the U.S. in jeopardy.

“We will have to fight that because we think that is the wrong thing to do from a patient standpoint,” Merck & Co. CEO Richard Clark told Bloomberg.

We should find it comforting that it has absolutely nothing to do with money, making sure investors get their 10 percent, and guaranteeing that execs get their multi-million-dollar bonuses. It’s purely a safety issue.

The second message is that negotiating lower prices will lead to fewer research projects and therefore negatively impact medical progress.

This is why real health care reform is falling victim to a thousand cuts.

If 10 people are holding a document, and each one is pulling in a different direction, it gets torn apart. It’s beginning to sound like that will be the fate of the country’s latest, greatest effort to give everybody access to health care.

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I mostly agree with Paul Krugman on economic issues. He also tends to be on the right side of the health care debate. But I believe that The New York Times’ columnist has been overly optimistic about getting a meaningful health care reform plan through Congress.

In his column published yesterday, he cuts to the chase and puts the onus on Blue Dog Democrats, the conservative group that organized in 1995 to tout their own brand “more financially responsible” Democratic values.

Note that the Blue Dogs backed President Bush’s tax cuts for the wealthy early on in his term – and the financial and economic implications of that didn’t seem to bother them then. The fact that we’re flooded with government debt is partially a result of that tax cut and yes, you can blame last year’s inappropriate and unwise bailouts as well.

But Krugman thinks this group of Democrats will still come around: “These are Democrats who, despite their relative conservatism, have shown some commitment to their party and its values,” he wrote on Sunday.

“Now, however, they face their moment of truth. For they can’t extract major concessions on the shape of health care reform without dooming the whole project: knock away any of the four main pillars of reform, and the whole thing will collapse — and probably take the Obama presidency down with it.”

Elected officials, Blue Dogs included, seem to agree on mandatory insurance coverage for everybody. If they follow the Massachusetts plan, people who can afford insurance but don’t get it would be penalized on their income taxes the following year.

Naturally, the only way this would work would be to force insurers to offer policies to people with pre-existing conditions.

But the real question Blue Dogs should be asking is, what’s affordable? Because if they back a bill that doesn’t include a pubic option, or some other innovative way to slash premium costs, the Washington version of affordability is likely to be at odds with Main Street’s version.

For a family that brings home $50,000 a year, for example, forking out $12,000 for a family health insurance policy is not realistic. They would probably opt to pay the income tax penalty instead because let’s face it, a lot of family budgets are already stretched to the limit.

If Blue Dog Democrats think people will be furious over the cost of a government option, wait until anger bubbles up over individual tax penalties. They may bring down the Obama presidency, as Krugman says, but also themselves as well.

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There was another boost for telemedicine this month as UnitedHealth Group announced a partnership with Cisco to build a national telehealth network.

Called Connected Care, the program uses video technology, along with an audio component, to help serve rural patients. UnitedHealth, one of the country’s largest health care insurers, was vague on the price tag but said it was investing “tens of millions of dollars” on the venture.

Connected Care was tested by Cisco employees in San Jose, California over a recent seven-month period, with a 90 percent approval rating, according to UnitedHealth. Other pilot programs were run in Scotland and New Zealand, and a fourth is nearing start-up in Minneapolis, the UnitedHealth home base.

“Connected Care is the house call for the 21st century and is our latest innovation providing people with greater access to quality care,” said Stephen Hemsley, UnitedHealth CEO. “The combination of Cisco’s technology and our national health care resources will make it easier for people to receive care where distance has been an obstacle.”

In its introductory phase, the company is using mobile clinics to hook patients up to medical services in rural areas. The program will be available in New Mexico in the first quarter of 2010.

Telehealth services make sense because they can provide basic care at a fraction of the cost. It’s an issue that Congress and the White House should be moving to the front of the health care reform debate.

See my June 15 post for more on the potential of long-distance health care. Maine recently began requiring insurers to cover distance care, as has Kentucky.

Watch for other states to follow suit. As telemedicine evolves, the key will be to make sure that dollars saved are used to expand services and cover more people – not just to boost investor and insurance company profits.

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Second graders should be analyzed for signs of depression that may show up later in life, a University of Washington study says.

The study funded by the National Institute on Drug Abuse followed 1,000 students in grades two through eight in the Pacific Northwest. Researchers found five patterns that may suggest problems later on in school.

“Some children are reporting that they don’t have as many friends, feel lonelier and are more anxious than their peers,” said James Mazza, a UW professor of educational psychology and lead author of the study. “They are telling us that they feel different from the typical happy- go-lucky second grader.

“We can start to build a profile of children’s mental health in the second grade. This is important because children who are experiencing depression symptoms early on may be at greater risk for mental health concerns during adolescence, based on other research studies.

“We want to reassure parents that everyone, including children, may feel sad or depressed once in a while, but that doesn’t mean they will go on to develop depression. We are trying to understand how depression starts and evolves in childhood so that we can develop interventions to help children.”

The five categories Mazza and colleagues found were:

– Low stables (26 percent). Children showed no or few signs of depression in second grade and the rate didn’t change through the eighth grade.

– Low risers (30 percent). No symptoms, or few symptoms in the second grade. But the number increased by small amounts.

– Mild stables (24 percent). Few symptoms that increased yearly by small amounts.

– Moderate changers (11 percent). A few more symptoms than the previous category. The number rose through elementary school and then dropped in middle school.

– Moderate risers (9 percent). The group started off with a similar number of symptoms as the moderate changers, but symptoms didn’t drop in middle school.

About 5 percent of children and teens suffer from depression, according to the American Academy of Child and Adolescent Psychiatry. But it’s often not identified because the symptoms are different than those seen in adults.

They include boredom and low energy; low self-esteem; difficulty maintaining relationships; poor concentration skills and destructive behavior.

Cognitive behavioral therapy can help, as well as psychotherapy. My personal comment: Tread lightly when you’re analyzing and treating kids as young as second graders.

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