March 2010


Most people understand, by now, that texting while driving, or engaging in a conversation on your hand-held cell phone while behind the wheel, is a safety hazard.

Here’s a conclusion that’s bound to generate some controversy: Even using a hands-free device dramatically increases the chances of a crash.

The National Safety Council, a century-old organization supported by private industry, issued a 22-page “white paper” on Friday taking an in-depth look at hands-free cell phone use in the car.

While public opinion has tilted in favor of laws regulating texting and hand-held cell phone use in the car, the assumption is that a hands-free conversation is the logical alternative and is perfectly safe, according to the NSC.

Not so, the organization says. “A third type of distraction can occur when using cell phones while driving – cognitive, taking your mind off the road,” the NSC contends. “Hands-free devices do not eliminate cognitive distraction.”

The paper begins with an account of a crash in Grand Rapids, MI in January 2004. A 20-year-old woman ran a red light while talking on a cell phone, killing a 12-year-old boy. She was traveling 48 mph and hit the third or fourth car – not the first – going through the intersection.

“The police investigation determined the driver never touched her brakes,” according to the NSC report. “Witnesses told investigators that the driver was not looking down, not dialing the phone, or texting.

“She was observed looking straight out the windshield talking on her cell phone as she sped past four cars and a school bus stopped in the other south bound lane of traffic. Researchers have called this crash a classic case of inattention blindness caused by the cognitive distraction of a cell phone conversation.”

The problem, according to these researchers, is multi-tasking. Multi-tasking is great when you’re at work, sitting in front of your computer and trying to seal a deal on the phone. But driving is another matter – it requires complete attention.

Yes, I know what you’re thinking. Aren’t drivers equally distracted by a chatty passenger or while listening to music?

Although studies show mixed results, NSC researchers claim that “adult passengers often actively help drivers by monitoring and discussing traffic. Passengers tend to suppress conversation when driving conditions are demanding.”

And: “Talking on cell phones has a different social expectation because not responding on a cell phone can be considered rude. In addition, callers cannot see when a driving environment is challenging and cannot suppress conversation in response.”

The conclusion is that talking on a cell phone, whether it’s hand-held or hands-free, boosts the risk of a crash by a factor of four.

What’s the solution? As you may expect, states and municipalities have been passing laws governing cell phone use in cars. In particular, texting is now illegal in many jurisdictions.

A more intriguing possibility is creating cell phone technology that actually blocks incoming and outgoing signals in moving vehicles.

These days, a lot of business is conducted via cell phones by drivers en route from one office to another. It will be interesting, over the next several years, to see how safety issues are balanced with the needs of business and personal communication.

Photo: http://www.flickr.com/photos/swanksalot/345450382/

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Cleanliness has become an obsession in the United States, with antibacterial soap dispensers in every bathroom, and hand sanitizers set up in supermarkets, libraries and other public places.

Homes, especially those with kids, are bathed in disinfectant. Here’s a commercial in which a mother douses her kid’s teddy bear with Lysol.

But there’s new evidence that exposing kids to germs early in life boosts their immune system and also reduces cardiovascular inflammation in adulthood, cutting the chances later of heart attack and strokes.

“It raises the intriguing possibility that higher levels of exposure to infectious microbes early in life may, in some way, protect you against cardiovascular disease,” study author Thom McDade, an associate professor of anthropology at Northwestern University, told the Chicago Tribune.

The study, which will appear in next month’s edition of the British scientific journal, Proceedings of the Royal Society, measured the levels of certain protein biomarkers in 1,700 Filipinos whose health had been tracked from birth to age 21.

McDade and his colleagues discovered that people who had had greater exposure to infectious microbes, and even animal feces, as infants had lower levels of the biomarker, called CRP, as adults.

Although McDade’s study focused on heart disease and cardiovascular issues, there’s a new line of thinking that radically reduced exposure to germs and bacteria may compromise developing immune systems.

The immune system can then begin to attack itself, causing allergies, asmtha and other problems in adulthood.

The hypothesis remains controversial. But McDade practices what he preaches – letting his kid romp around in the dirt. He adds: “If our son drops something on the floor, we don’t really care if he picks it up and eats it.”

Off topic: While I was reviewing the Proceedings of the Royal Society journal online, I couldn’t help noticing a study entitled: Multiple signals and male spacing affect female preference at cocktail parties in treefrogs.

Here’s the abstract. However, you’ll be disappointed if you expect to see frogs sitting around sipping martinis and mimosas.

Photo: At play in Nicaragua, http://www.flickr.com/photos/craigcloutier/3821425912/

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Most landmark legislation is defined by what it does, or what it will do. Antitrust laws, Social Security and Medicare fall into this category.

But for now at least, the new health care “reform” package, signed by President Obama today, may be best described not by what it is, but what it isn’t.

First of all, it isn’t health care reform, even though you’ll see the term used in every headline of every newspaper in the country. Yes, I know there are provisions that prevent insurers from pursuing some of the anti-consumer shenanigans practiced over the years. But the basic structure of the system remains in place.

Instead, this is a 2010 car body slapped on top of a 1960 Corvair chassis, with a few modifications and patches. The salesmen will tell you it’s new and improved, but it’s actually built on the flawed foundation of the for-profit health care insurance system. Drive it down the road at your own risk.

I should explain again, as I have in the past, that I don’t necessarily disagree with a system based on free market competition. But this package doesn’t increase competition, nor does it move us toward health care as a social benefit, as they have in many other countries.

Second, this is not a government takeover of health care. I realize that this is the mantra repeated daily by the Republican opposition, but that doesn’t make it so.

If an interviewer would ask House Minority Leader John Boehner: “How’s the weather in Washington today?” he’d say: “The weather would be fine if it weren’t for the fact that the government is taking over health care.”

Ask Sen. Mitch McConnell if he thinks we should add more troops in Afghanistan, and he’d say: “Well, that’s up to the generals on the ground. But right now they’re very upset about the government takeover of health care.”

Under the plan, anyone who accesses health care – unless they can afford to pay out of pocket – must go through a private insurer. In what way does that constitute a government takeover of health care?

Quite the contrary, the government is delivering 32 million new customers to private insurers, most or all of them companies in which stockholders can reap the benefits. I’d be surprised if, after Obama signs the bill, employees of UnitedHealth and Aetna don’t form a congo line around their respective headquarters.

Third, this is not universal health care. The name of this bill is not, “No Patient Left Behind.” Tea Partiers need not worry. There will still be about 5 percent of the population that falls through the cracks, one way or another.

And consider this: The legislation may actually discourage people from purchasing coverage. Say you’re 30, and healthy. Since insurers can’t exclude customers because of pre-existing conditions, why not wait until there’s actually something wrong before you purchase coverage? Remember, penalties for not buying a policy have been whittled down so far that for many people they won’t even be a factor.

And finally number four: The new health care law will not be a magic carpet for Republican control of Congress in fall. Do you really think that a law that mostly takes effect in 2014 is going to be the central issue in November?

The Democrats are vulnerable, yes. On unemployment, for sure. Or the botched attempt at financial reform. But health care legislation? Doubtful.

My prediction: Memories of the contentious debate will fade like last year’s Oscar nominations.

Photo: President Obama sells the health care package in Ohio. (White House photo)

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One of the arguments for health care reform is that costs are spiraling out of control. But just how bad is it?

The Government Accounting Office put the issue into some context with a report on pharmaceutical price increases. Hundreds of drugs have doubled in price between 2000 and 2008, the GAO says. A 100 percent increase is so far above the inflation rate, you would be tempted to conclude that the whole price structure has become unhinged from reality.

The report includes a chart of medications that had an “extraordinary price increase” over the eight-year period. They include well-known meds like Ambien, Lunesta, Lipitor, Levaquin, Prozac, and Cipro.

Some of the drug prices quoted involved brand-name products that are repackaged by other companies and then sold to hospitals and physicians. The rest were priced by the manufacturers.

More than 300 medications fell into this “extraordinary” price category and the GAO concluded that the biggest factor in the increases was lack of competition or available generic alternatives.

The report also blamed corporate mergers for the lack of competition.

Not surprisingly, the Pharmaceutical Research and Manufacturers Association PhRMA was unhappy with the GAO report and called it misleading.

“Unfortunately, the GAO report focuses only on a small number of selected brand medicines rather than the entire prescription drug market,” the organization said in a news release. “When looking at recently released national health care spending data for 2008, there was a sharp decline in retail prescription drug spending growth, leaving medicines as one of the slower growing areas of health care expenditures.”

PhRMA points out that companies have no control over middlemen who repackage their products for resale, and that’s true. But it’s also true that it doesn’t really matter who or what is to blame for the problem.

When drug prices escalate beyond the reach of average Americans, the issue needs to be addressed legislatively. Bulk Medicare purchases, and opening up foreign markets, have to be on the table. I also wonder why hospitals can’t buy directly from manufacturers and repackage the medications themselves.

As I’ve said before, when you decide to run health care like a business, you need to treat it like any other business.

A separate issue, but an interesting one, involves the use of Twitter and other social media by pharmaceutical companies to promote their products. The problem is, with 140 character-posts required, how do they sufficiently disclose side-effects and other warnings?

The FDA was concerned enough about it to hold a public hearing last November. Subsequently, drug companies have been submitting their ideas on how the problem should be handled.

Most companies say tweets should include links for more information, where readers could find the (sometimes lengthy) descriptions of drug risks. But not everyone clicks on links. And as in the case of pharmaceutical ads on TV, I often wonder why prescription drugs need to be promoted at all.

Photo: http://www.flickr.com/photos/blmurch/2455163495/

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As we sail into St. Patrick’s Day, I’m reminded of something I often hear when I go into an Irish pub for a refreshment and/or a wedge of shepherd’s pie. And that is, that not only does a cool glass of Guinness taste good, it’s actually good for you as well.

I’ve read, on various occasions, that Guinness is high in antioxidants, and is a good source of iron and other minerals. I looked into these claims and found differing opinions.

I tracked down an article in the UK Guardian, written by a British dietician who says many mothers-to-be insist their physician recommended a glass of Guinness for its iron content.

Setting aside, for the moment, the fact that the dangers of alcohol in pregnancy are widely accepted, the writer, Catherine Collins, says the iron content benefits of Guinness are a myth.

“You’d need to drink three pints of Guinness to provide the same amount of iron as a single egg yolk,” she says.

Health claims for Guinness go all the way back to an ad campaign in the 1920s, in which drinkers said they felt good after downing a pint. No kidding. But the company subsequently drummed up the slogan, “Guinness is Good For You,” which still finds its way in poster form to American bars even though the company was told to stop using it decades ago.

The brewer now says: “We never make any medical claims for our drinks.”

But the issue bubbles to the surface every once in a while, and no one study has ever helped it come to a head.

The BBC published an article in 2003 quoting a University of Wisconsin study claiming that Guinness reduces clotting in the arteries. The antioxidants it contains also slow down the deposit of cholesterol on artery walls, the BBC said.

Lager doesn’t have the same effect, the researchers concluded. The results were announced at a meeting of the American Heart Association in Orlando.

On the other hand, some researchers maintain that alcohol in any form helps reduce clotting. The benefits of small amounts of red wine have been well publicized.

Let the debate continue, I say. My own conclusion is that I’m willing to tap a cool glass of Guinness, but only because it stands on its own flavorful merit.

Photo: http://www.flickr.com/photos/nikonvscanon/439843801/

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For an activity that takes up a third of our lives, sleeping gets scant attention. Work and employment issues are endlessly hashed out in every blog, newspaper column and research project.

But even though we are all supposed to devote equal time to sleep – in theory, at least – the topic seems to get short shrift.

This week, the National Sleep Foundation published a comprehensive survey that goes into minute detail about the sleep habits of average Americans. The data analyzes race, gender, sleeping habits, the use of sleep aids and the impact on sleeplessness on daily lives.

The NSF concluded that most Americans have trouble sleeping, with significant differences among ethnic groups. However, all of the groups associated poor sleep habits with health problems, and many reported missing work or family functions because they didn’t get enough shut eye.

Only about 40 percent said they got a good night’s sleep every night or almost every night.

Not surprisingly, Americans are kept awake at night by financial concerns, job worries, relationship problems and health issues. Almost a third of the respondents in all groups surveyed related their sleep problems to at least one of these areas of concern.

In the hour before hitting the sack, the most popular activity was watching TV. Other common activities were working on the computer or surfing the Internet; praying; doing household chores and reading. Sex took a backseat, with mostly single digit percentages showing up on survey results across the board.

There were some strange ethnic differences between groups when it comes to specific bed-time habits, the NSF found. For example, whites were much more likely to sleep with their pet than other groups (16 percent vs. 4 percent among Asians and Hispanics and 2 percent among African Americans.)

Whites were also much more likely to have been diagnosed with insomnia by a doctor than other ethnic groups.

Use of sleep aids is also common, the NSF found. About a third of respondents said they used them, although Asians (25 percent) were the least likely to fall into this category.

A PDF of the survey is available online for those interested in the nitty-gritty details of American sleep habits. Charts and graphs show everything you’d ever want to know – and some things you would have probably preferred not to know.

The survey, called the 2010 Sleep in America poll, questioned 1,007 adults age 25 to 60.

Photo: The sleeping eye, http://www.flickr.com/photos/publicdomainphotos/3294552073/

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“Raw foodists” are people who eat 75-100% of their meals uncooked. This has become trendy in the last several years, promoting weight loss and overall good health, according to advocates.

But it’s not just a fad diet. It’s a social movement. There’s the Raw Spirit Festival, for example, in which raw food fans gather to celebrate “dynamic health-eco-peace.”

“This is more than a raw vegan food festival,” according to a promotional blurb on the organization’s Website. “Our vision is to integrate Healthy Living, Eco-Sustainable Solutions and World Peace because together these comprise a comprehensive strategy for addressing current global challenges. We feel that our Raw Spirit Fest non-profit organization belongs to the entire ever-expanding, international community.”

(This year’s Raw Spirit Festival will be held in a spectacular location in northern Arizona and will feature musical performances and, of course, raw vegan demo chefs.)

This lifestyle came to mind when I recently ran across research by Harvard professor Richard Wrangham on the importance of cooking in human evolution. As a professor of biological anthropology, he’s been making the case that cooking food was a key ingredient in helping humans separate from their pre-human ancestors.

“There’s this huge fantastic mystery: Where did humans come from? I think we came out of the kitchen,” Wrangham told the Harvard Gazette in January. Wrangham is author of the book, Catching Fire: How Cooking Made Us Human.

“People think that animals eat raw food, people are animals, so people can eat raw food. But humans are different kinds of animals. Nobody has appreciated how absolutely vital cooking is. We need it. We absolutely need it.”

Most physical evidence shows that humans started using fire about 800,000 years ago. But Wrangham believes it was far earlier than that – possibly almost 2 million years ago.

He bases his theory on the biology of early humans, who had developed shorter guts because they were able to extract more nutrients out of food faster. Nutrition extracted from raw foods is about half what can be absorbed from cooked food, he says. The extra energy is what’s needed for the human brain, which consumes a quarter of the body’s energy intake.

Freed from the ordeal of gathering and chewing, chewing and gathering all day long, early humans could turn their attention to other pursuits.

There are other biological advantages to cooking food, too, like killing bacteria and detoxifying some poisons.

On top of that, cooking helped humans evolve socially, Wrangham contends. It helped create a division of labor model in which men hooked up with women to have someone to cook their food, and women in turn needed someone to protect the food. The family was born.

I don’t think Wrangham or anyone else is saying don’t eat raw food. But if he’s right – and I think the argument is pretty credible – cooking is not only part of our various cultures but is actually incorporated into our biology.

In any case, it’s just as natural as eating a fresh salad or a raw vegetable plate. And depending on who’s in the kitchen, maybe a whole lot tastier.

Photo: When it comes to food, fire may be our friend. Flickr: http://www.flickr.com/photos/edbrambley/4259761361/

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