Thursday, January 29, 2009

Mercury in High Fructose Corn Syrup ---Autism: What If!

The Cockroach Catcher was an accidental resident of Barbados for nearly two years and saw the tail end of the sugar cane industry there. Alas, high labour cost and the general switch over to sweetening with High Fructose Corn Syrup (HFCS) means that cane sugar produced in the traditional manner can only remain as a novelty item that is sold in souvenir shops at a high price and probably never consumed by the purchaser.

What is little known is that High Fructose Corn Syrup is produced by a complex chemical process involving enzymes and chemicals such as caustic soda and hydrochloric acid.

In the
Washington Post yesterday:

Study Finds High-Fructose Corn Syrup Contains Mercury


“Almost half of tested samples of commercial high-fructose corn syrup (HFCS) contained mercury, which was also found in nearly a third of 55 popular brand-name food and beverage products where HFCS is the first- or second-highest labeled ingredient, according to two new U.S. studies.

“HFCS has replaced sugar as the sweetener in many beverages and foods such as breads, cereals, breakfast bars, lunch meats, yogurts, soups and condiments. On average, Americans consume about 12 teaspoons per day of HFCS, but teens and other high consumers can take in 80 percent more HFCS than average.

"Mercury is toxic in all its forms. Given how much high-fructose corn syrup is consumed by children, it could be a significant additional source of mercury never before considered. We are calling for immediate changes by industry and the [U.S. Food and Drug Administration-FDA] to help stop this avoidable mercury contamination of the food supply," the Institute for Agriculture and Trade Policy's Dr. David Wallinga, a co-author of both studies, said in a prepared statement.

“In the first study, published in current issue of Environmental Health ,researchers found detectable levels of mercury in nine of 20 samples of commercial HFCS.

“And in the second study, the Institute for Agriculture and Trade Policy (IATP), a non-profit watchdog group, found that nearly one in three of 55 brand-name foods contained mercury. The chemical was found most commonly in HFCS-containing dairy products, dressings and condiments.” The Washington Post reported.

Abstract
here; PDF of the full text here.

This is serious matter, considering that most food items sold in the US that are vaguely sweet contain HFCS, from so called fruit juices to tomato ketchups to health granola bars, jams and cereals, not to mention soda drinks.

The frightening part of the story was that the FDA knew about this since 2005, yes 2005.

One of the lead authors, Renee Dufault, was working for the FDA when she reported her findings that mercury was detected in 45% of HFCS products. No explanation was given as to why the FDA kept quiet. In March 2008 she retired from the FDA and decided to conduct further research for Environmental Health, using fresh samples randomly taken off shelves in retail shops in the latter part of 2008.

The discovery of the complex chemical process for converting corn starch into HFCS came at a time when corn based oil product was in commercial decline because of health concerns raised. Despite the highly complicated process involving three enzymes (believed to be genetically modified and therefore highly stable) , the cost of producing HFCS is still much lower than that of producing sugar from cane.


Where did the mercury come from?

The Institute for Agriculture & Trade Policy (IATP) report
is very educational and is worth a read here.

I quote from the Executive Summary:

“We live in a truly global food system. Our system typically is geared more toward producing lots of cheap calories, and then selling those calories to consumers, than it is toward meeting other goals like reducing fossil fuel use or producing food that is healthy.

“In stark relief, new science shows just how blind to healthfulness some processed food makers have been. Just published online in the journal, Environmental Health
, is a science commentary reporting that mercury was found in 9 of 20 samples of commercial high fructose corn syrup (HFCS), a common sweetener of foods and beverages. The HFCS came from three different manufacturers.

“Mercury is a potent brain toxin that we know accumulates in fish and seafood, although diet is not the only route by which we are exposed. When babies are exposed to elevated mercury in the womb, their brains may develop abnormally, impairing learning abilities and reducing IQ. For these youngest children, the science increasingly suggests there may be no “safe” level of exposure to mercury. And yet for decades an increasingly common ingredient in processed foods, HFCS, has been made using mercury-grade caustic soda.”

“……. In fact, we detected mercury in nearly one in three of the 55 HFCS-containing food products we tested. They include some of the most recognizable brands on supermarket shelves: Quaker, Hunt’s, Manwich, Hershey’s, Smucker’s, Kraft, Nutri-Grain and Yoplait.

"No mercury was detected in the majority of beverages tested. That may be important since sweetened beverages are one of the biggest sources of HFCS in our diets.

"On the other hand, mercury was found at levels several times higher than the lowest detectable limits in some snack bars, barbecue sauce, sloppy joe mix, yogurt and chocolate syrup.”…..

Caustic soda and hydrochloric acid can be manufactured cheaply from sea water using an electrochemical process aided by mercury cells.

A longtime enigma of these plants has been their “missing mercury.” The nine mercury cell plants operating in 2003 reported consuming 38 tons of mercury, but emitting only eight tons into the environment. What happened to the other 30 tons? The plants could not account for that. This month’s Environmental Health study suggests that the missing tons of mercury may have ended up as impurities in the plants’ products such as caustic soda that are then added to the food supply.

It is scientifically possible to use a non-mercury based method and in fact one senator tried to introduce legislation some time back to force the industry to stop using the mercury method. He unfortunately failed.

That senator happened to be Barack Obama, now president of the United States. Could that be why the papers were published soon after his inauguration? I will leave it to you to draw your own conclusion.

In the report it was pointed out that despite major concerns over the years that fructose, being only metabolised by the liver, may have serious health implications, HFCS is favoured by manufacturers because the products sweetened by HFCS have a long shelf life. Could this in fact be due to the preserving property of the mercury? Even microbes do not like mercury!

The corn lobby has always been very strong in the US and the FDA even allows food sweetened with HFCS to be labelled natural. Natural?

Here is the table extracted from the
Institute for Agriculture & Trade Policy report. It indicates the food products for which total mercury was detected, highest to lowest. (Measurements are in parts per trillion.)




What if the Cockroach Catcher was wrong?! Perhaps the level of mis-diagnosis of Autism in the United States in recent years might not have been high as speculated. There was just too much mercury in the food and drinks consumed by the American people! So even removing mercury from vaccines was not much help. Mercury readily passes from mothers to babies in breast milk.

Perhaps corn should be reserved for bio-fuel and Barbados could start growing sugar cane again. Of course non-mercury method could be used but the cost would be much higher.

What if the rate of Autism would begin to level off and even decline! What if indeed!

Autism posts:Autism: Leo Kanner

Autism: Somalis in Minnesota and Sunshine

Autism: Gene Disruption?

Autism, the Brain and Tiger Woods

Autism and Money

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Saturday, January 17, 2009

Alaska Zyprexa: DOJ at last.

A follow up to my earlier posts:

Alaska, Good Friday Earthquake and Zyprexa
Alaska Zyprexa: Follow Up

Alaska

In the final days of any government, there is a need to settle matters as the new administration may indeed have totally different ideas. Is Eli Lilly lucky in having a settlement with the Department Of Justice (DOJ) on the 15th of January 2009, just five days before the new President is sworn in? Only time will tell.


The settlement amounts to $1.415 billion: largest amount paid in the history of the DOJ.

The detail of the settlement is here.

Zyprexa (Olanzapine) is only approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia and certain types of Bipolar Disorder. Unfortunately this is in competition with a number of other so called atypical antipsychotics.

According to the
New York Times:

“Among the charges, Lilly has been accused of a years-long scheme to persuade doctors to prescribe Zyprexa to two categories of patients — children and the elderly — for whom the drug was not federally approved and in whom its use was especially risky.
“In one effort, the company urged geriatricians to use Zyprexa to sedate unruly nursing-home patients so as to reduce ‘nursing time and effort,’ according to court documents. Like other anti-psychotics, Zyprexa increases the risks of sudden death, heart failure and life-threatening infections such as pneumonia in elderly patients with dementia-related psychosis.
“The company also pressed pediatricians and family practitioners to treat disruptive children with Zyprexa, court documents show, even though the medicine's tendency to cause severe weight gain and metabolic disorders is particularly pronounced in children. In the past decade, Zyprexa's use in children has soared.”


Eli Lilly must have spent some good money as they have catchy slogans like:

“5 at 5″: to promote the drug’s side effect of sedation to nursing-home doctors: 5 milligrams of the drug at 5 p.m would help patients sleep

“Viva Zyprexa”: a campaign way back in 2000 to make the drug an “everyday agent in primary care” despite the fact that primary care doctors don’t typically treat schizophrenia and bipolar disorder. And this is long before the “Viva Viagra” campaign years later.

Off-label use in many ways makes a mockery of the role of the FDA, as safety of the drug thus used cannot be guaranteed. Yet for medicine to move forward, off-label use has its place. In my traditional way of thinking that may be tried at teaching hospitals and other centres of excellence, but only if they can be truly independent of the influence of drug firms. The truth of the matter is that the “off-label” period should only be brief as there is no reason why the usefulness of any drug’s so called side effect should not become part of any approved status.

But off-label for over ten years? Well!

Again according to the
New York Times:

“In the United States, most of Zyprexa’s sales are paid for by government programs because so many of those taking Zyprexa are indigent or disabled. Zyprexa had sales of $4.8 billion in 2007, making it the biggest seller by far for Lilly, whose revenue that year was $18.6 billion. Depending on dosage, the drug can cost as much as $25 for a daily pill.
“Zyprexa has generated more than $39 billion in sales since its approval in 1996, making it one of the biggest-selling drugs in the world.”


The $1.415 billion settlement seems like a small percentage of nearly $40 billion of revenue.

The big question is: will its off-label use continue?

Wednesday, January 14, 2009

Did You Catch These: 2008

There are not many Child Psychiatry Blogs out there and the Cockroach Catcher feels compelled to fill in the gap and bring you the latest in the world that concerns child psychiatry.

Today happens to be a year since I published my book The Cockroach Catcher and first started venturing into the blogosphere. Below is my personal review of the year’s postings.

Child Psychiatry seems to prefer the As:

There are of course the notable Bs:
Two of the longest blogs were:
Adoption Adoption Adoption, which highlighted the plight of a young child dumped in Hong Kong by her Dutch adoptive parents, who happened to be diplomats;


and Asperger's Syndrome, Libel and Thalidomide, which summarised a number of notorious cases, including the plot of Gordon Brown to tax the compensation for thalidomide patients.

One of my personal favourites is:


Anorexia Nervosa: What If!


Medicine blogging is a world wide phenomenon and generally ethical which offers a glimmer of hope to a profession that is being sidelined in the U.K. But we will fight on.

And for those who have not yet discovered the world of Medical Grand Rounds, check these out:
Grand Rounds

On looking back at my year’s Medicine blog, I find my all time favourite to be: Teratoma: One Patient One Disease? A thirty year puzzle finally got answered.


This is best read as a follow-up to Teratoma: An Extract, which is in fact a chapter from my book.


Nobel Prize: Morality and Medicine is worth reading for the morality question that was raised. On the question of morality, let the blog Chiropractic: Strokes and Class Action be a warning to those who seek to remove the primacy of medical discipline.

There is a very useful contribution from a colleague:

A Brief History of Time: CPR (Cardiopulmonary Resuscitation) A quick read may help you to save someone’s life at a wedding or some other social event.

To counter balance the more serious postings, try the more light hearted:


A surprisingly large number of readers searched and looked at:




Golf, Cholera and Tiger Woods.

However, who would have guessed that the posting that won the highest number of hits was: Picasso and Tradition?

Is this proof that culture is not completely dead?

Of the postings about food, you will be surprised at the material presented in: Quinoa: the super grain

My personal favourite and that of FOODIES:
Chinese New Year and the Goose


Chinese New Year, the Year of the Ox, will be arriving soon, time for another dose of quality meat and fat.

Wine buffs should take a good look at:
Pleasure Principle and Wine, which is of course my very personal view.


Now on to something close to my heart: Cockroaches

Of these, the most popular blog seems to be: Seroxat and Ribena,

about two school girls taking on a giant.

Others worthy of another look include:
Bipolar Disorder in Children

ADHD: Why?

Alaska Zyprexa: Follow Up

It Pays To Be A Taditionalist: Seroxat

Bipolar and ADHD: Boys and Breasts

Antipsychotics: Really?

Those regular readers of The Jobbing Doctor, Dr Rant and NHS Blog Doc will realise the significance of:

Hemlock: Biology, Shakespeare, Socrates, House, M.D.

Additional coverage of this can be found in: Ward 87, Chez Sam, Witch Doctor, NHS Exposed and Dr Grumble. The cover-up was rather sad for medicine and for mankind. It would be sadder still if the powers were to try to control blogging.

Important links in the year:
NHS Blog Doc
Mental Nurse
Jobbing Doctor
And of course Huffington Post.

If you need more clues, you can find some earlier blogs in:
Did you catch these?
Did you catch the May Blogs
Blogging Addiction Disorder (BAD)

Finally, may I take this opportunity to thank all past readers for their support and encouragement. Do please keep the comments coming and the debates going!

Sunday, January 11, 2009

Can They Draw: From Picasso to Matisse

EBA-Evidence Based Art Critique

It was in a BBC documentary a few years ago about the Turner Prize when the obvious question was asked: "Can xxxxxx xxxx (one of the nominees that year) draw?" The art experts participating in the discussion were all artful dodgers who managed not to give a straight answer.

A couple of years back I was in The Hermitage Museum in St Petersburg and saw their famous Matisse collection amongst a host of other treasures.


The Dance Hermitage St Petersburg

Matisse’s poster-like presentations led a few fellow travellers to ask the same question: Can Matisse draw?

Picasso is one of the artists that I have featured on this blog.

Juggler with Still Life 1905 NGA

Yes I am a great fan of Picasso but if anyone should ask me that same question of Picasso, I know what my answer would be and I would produce my evidence.




Earlier this year I was visiting some old school friends in Washington D.C., where in a few days time the world's media will descend to witness history in the making: the inauguration of Barack Obama.



National Gallery of Art Washington D.C.

At the National Gallery of Art (NGA) there, the answers to both the Matisse and Picasso questions can be easily found.

For the occasional museum visitor Picasso may be synonymous with cubism and paintings like this one:




The NGA had these as well.



Picasso Family of Saltimbanques, 1905


Tragedy, 1903

Read more about these here and here.

Now Henri Matisse:

We saw the paper cut-outs:

Mmmm: Can Matisse Draw?

Then we saw these paintings by Matisse:


Lorette with Turban, Yellow Jacket., 1917


La Coiffure, 1901

Can Matisse draw?!

Grand Rounds : 5:18: Ten Suggestions For Healthcare Reform in Medpage By Val Jones, MD Inauguration day issue.

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