Five Articles from Recent Medical Journals
Food Industry Buys Nutrition Research—
Threatening Your Family’s Health
between Funding Source and Conclusion among
Articles by Lenard I. Lesser in the open
access journal PLOS Medicine concluded,
“Industry funding of nutrition-related
scientific articles may bias conclusions in
favor of sponsors’ products, with potentially
significant implications for public health.”
The main finding of this study is that
scientific articles about commonly consumed
beverages funded entirely by industry were
approximately four to eight times more likely to
be favorable to the financial interests of the
sponsors than articles without industry-related
funding. Of particular interest, none of the
interventional studies with “all industry
support” had an unfavorable conclusion.
The authors state
further that, “When
an industry is the major sponsor of research on
its own product, unfavorable effects of that
product are less likely to be investigated. The
next step down the slope is adjustment of
designs. The dosage of the product and the
nature of control treatments may be adjusted so
as to increase the chance that the study will
demonstrate benefits of the product or that
adverse effects will not reach statistical
significance. Also, unfavorable data may be
deemed less relevant and may be left out of the
abstract and the press release, or out of the
paper itself. Finally, the whole publication may
be cancelled or seriously delayed when the
outcome is disappointing to the sponsor.”
articles about soft drinks, juice, and milk
published between January 1, 1999 and December
Ways That Industry
May Influence Outcomes of Studies
Fund only those studies that they
believe will present their products
in a favorable light, or their
competitors’ products in an
Formulate hypotheses, design
studies, or analyze data in ways
that are consistent with the
financial interests of their
Choose to delay or not publish
findings that have negative
implications to the sponsor’s
product. Researchers sign contracts
that allow the sponsor to veto
Search and interpret the literature
selectively, in ways consistent with
the sponsor’s interests.
Scientific reviews arising from
symposia, often published as journal
supplements, may over- or
under-represent certain viewpoints.
Presenters whose opinions conflict
with the sponsor’s financial
interests are not invited to
When I read a
scientific study in a medical journal, I first
look for the source of funding. This nugget of
information foretells what I am likely to read
in the article and why the researchers have
reached their conclusions. Contamination of the
research is so great that I trust no paper
published with industry funds—such as from food,
pharmaceutical, testing, or device industries.
When the funding sources are not clearly
identified in a suspicious paper, I will look at
other papers written by the authors to see if
they have worked for an industry favored by the
article in the past.
about knowing the truth about human nutrition
and working from a solid foundation of knowledge
needs to read the basic research on protein,
fat, carbohydrates, oils, milk and meat that was
performed from the late 1800s to the 1970s; at a
time when researchers did not have their hands
in the pocketbooks of big business. Much of
this research is cited in my first 2 books: The
McDougall Plan and McDougall’s Medicine—A
Challenging Second Opinion. Both can be
purchased in our store as downloadable e-books.
medications, tests, and surgical treatments
published since the early 1970s is so
contaminated by money that I do not know the
true benefits and risks of the treatments I am
asked to prescribe. Even under these
compromised circumstances, I have to make the
best decisions possible for my patients. When
tests and treatments seem indicated, I choose
the ones with the greatest safety and efficacy
record; which are also the simplest and least
expensive. In the case of medications this
usually means older and generic drugs. My
November 2004 newsletter discusses the few
medications I commonly prescribe.
LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS.
Relationship between Funding Source and
Conclusion among Nutrition-Related Scientific
Vol. 4, No. 1, e5
How Long to
Take Plavix and Aspirin after a DES (Heart
and long-term clinical outcomes after
drug-eluting stent implantation by Eric L.
Eisenstein published in the January 10, 2007
issue of the Journal of the American Medical
Association found, “The extended use of
clopidogrel (Plavix) in patients with DES (drug
eluting stent) may be associated with a reduced
risk for death (by 3.3%) and death or MI (by
4.5%) (at 24 months). However, the appropriate
duration for clopidogrel administration can only
be determined within the context of a
large-scale randomized clinical trial.”1
Of the 1501
patients in one group evaluated over the study
period of almost 5 ½ years, “…14 patients
receiving drug-eluting stents died or had a
nonfatal MI, and none of these 14 patients was
in the drug-eluting stent with clopidogrel
editorial pointed out that,
without contraindication, clopidogrel therapy
should be continued through at least 1 year and
possibly indefinitely until the time course of
vulnerability for stent thrombosis in patients
treated with drug-eluting stents is better
see many patients who have had these
drug-eluting stents (DES) placed in their heart
arteries and are very worried about dying from a
complication of very
late stent thrombosis (blood clot formation
closing down the artery). This often fatal
complication occurs 9 to 12 months after surgery
in about 0.5% of patients with DES—and can occur
as late as 3 to 4 years after surgery. My
patients want to know what to do. Based on this
research my best recommendation at this time is
to take the Plavix and aspirin as prescribed,
indefinitely. This treatment is not without
events requiring transfusion were observed in
2.1% of patients followed up for a similar
duration (approximately 2 years) to that of the
The reason DES may
have this complication is the cancer
chemotherapy drugs imbedded in the stent prevent
healing after the surgery—stopping the cells of
the artery lining from covering up the stent.
The exposed stent is highly reactive and causes
the blood to suddenly and tragically clot.
If you are at risk
of having heart surgery (angioplasty) then you
need to become fully informed quickly—read my
Hot Topics section from my home page on heart
I have discussed angioplasty therapy in detail
September 2006 newsletter.
Eisenstein EL, Anstrom KJ, Kong DF, Shaw LK,
Tuttle RH, Mark DB, Kramer JM, Harrington RA,
Matchar DB, Kandzari DE, Peterson ED, Schulman
KA, Califf RM. Clopidogrel use and
long-term clinical outcomes after drug-eluting
stent implantation. JAMA. 2007 Jan 10;297(2):159-68.
Kereiakes DJ. Does clopidogrel each
day keep stent thrombosis away? JAMA.
2007 Jan 10;297(2):209-11.
Tubes—Another Money Maker’s Benefits Disproved
Tubes and Developmental Outcomes at 9 to 11
Years of Age by Jack L. Paradise in the
January 18, 2006 New England Journal of
Medicine found that, “In otherwise healthy
young children who have persistent middle-ear
effusion, as defined in our study, prompt
insertion of tympanostomy tubes does not improve
developmental outcomes up to 9 to 11 years of
young son, Patrick, at age 5 developed chronic
fluid accumulation in his inner ears—most likely
from abundant molds growing in the moist
Hawaiian climate where we lived. The doctor I
took him to 25 years ago recommended the
placement of tubes in both ears to drain this
fluid. He threatened me with his prediction that
Patrick would lose his hearing and could become
developmentally impaired with future speech,
language, mental, and social difficulties. I
went to the medical library and discovered this
was not true and that there were great risks
from the surgery. He had no ear surgery and
today he is a doctor (PhD) of organic chemistry
and working at Stanford University in Palo Alto,
California. Few parents stand a chance of
defending their children against unnecessary
surgery; especially when their doctors threaten
permanent brain damage of their child if they
refuse the ear tubes.
The placement of
tympanoplasty tubes, also known as ventilation
tubes, is one of the most common procedures
performed on children. These tubes, open at both
ends, are inserted into incisions made in the
eardrums during a surgical procedure (myringotomy).
They are left in place until they fall out by
themselves or until removed by the doctor.
Common complications include: chronically
draining ears, infection, and hearing loss.
The condition that
is usually being treated is chronic otitis media
(an inflammation of
the middle ear) and is accompanied by an
accumulation of fluid in the inner ear (behind
the eardrum). The cause of this inflammation
with fluid is usually allergy to substances
present in the air and the food. Dairy proteins
are the most common cause of food allergy and
this condition.2,3 A change in diet
is often all that is needed to stop the
inflammation and reverse the fluid accumulation.
If a change in
diet does not stop the fluid and hearing loss
becomes a problem, then the inner ears can be
ventilated by using a bulb syringe, called a
Politzer device. Air is blown through the nose
into the eustachian tubes which temporarily
opens the inner ear and drains the fluid.
Hearing returns in 90% of cases.4
This simple cost-free treatment is done at home
by the child or the parents. We used the
Politzer device on our son with great success.
1) Paradise J,
Feldman, H, Campbell T, Dollaghan C, Rockette H,
Pitcairn D, Smith C, Colborn K et
al.Tympanostomy Tubes and Developmental Outcomes
at 9 to 11 Years of Age. N Engl J Med
Bernstein JM. The role of IgE-mediated
hypersensitivity in the development of otitis
media with effusion. Otolaryngol Clin North
Am. 1992 Feb;25(1):197-211.
Juntti H, Tikkanen S, Kokkonen J, Alho OP,
Niinimaki A. Cow's milk allergy is
associated with recurrent otitis media during
childhood. Acta Otolaryngol.
Silman S, Arick DS, Emmer MB.
Nonsurgical home treatment of middle ear
effusion and associated hearing loss in
children. Part II: Validation study. Ear Nose
Throat J. 2005 Oct;84(10):646, 648, 650
Promote Hip Fractures
proton pump inhibitor therapy and risk of hip
fracture by Yu-Xiao Yang published in the
December 29, 2006 Journal of the American
Medical Association found “Long term PPI
therapy, particularly at high doses, is
associated with an increased risk of hip
fracture.” (PPI, or proton pump inhibitors, are
powerful inhibitors of stomach acid
production.) The authors hypothesized that this
increased hip fracture risk may be due to
calcium malabsorption caused by the drug or by
inhibition of bone cell activity.
compared 13,556 people with hip fractures to a
control group of people. People taking PPI
antacids for more than one year had almost twice
the risk of hip fracture. Higher doses and
longer use increased the risk of hip fractures.
The authors suggested doctors prescribe the
lowest effective doses to patients with
Doctors prescribe PPIs to treat people with
heartburn, GERD (acid reflux disease), ulcers of
the stomach or intestine, or a condition of
relentless stomach acid overproduction, known as
Zollinger-Ellison Syndrome. Common examples of
these medications are Prilosec, Nexium, Prevacid,
AcipHex, and Protonix.
especially animal protein, in foods is a
powerful stimulant for acid overproduction.2
Therefore, not surprisingly, indigestion is a
very common problem for people eating the
Western diet—just walk down the aisles of your
local drugstore and see the multitude of
intestinal remedies for sale. This same animal
protein is also the primary cause of bone loss,
leading to osteoporosis, and to hip fractures.3,4
Therefore, it is likely that the association
between PPI use and hip fractures has a common
link to diet—in other words, people who eat a
lot of animal protein develop osteoporosis and
also have lots of indigestion, which leads to
The solution to
both problems is to eat an alkaline diet—one
consisting of fruits and vegetables. I must add
a few precautions. Grains and legumes are
slightly acidic and may need to be minimized in
the diet of people who have any tendency towards
osteoporosis—however, these foods do not usually
cause any stomach upset. Indigestion is
aggravated by raw vegetables, especially onions,
green peppers, cucumbers, and radishes. Fruit
juices (but not the whole fruits) commonly cause
severe stomach burning, and so do spicy foods.
Beer and wine (but not distilled spirits)
contain acids that cause indigestion. Just by
changing their diets almost all of our patients
throw away their antacids the first day.
Additional benefit comes from raising the head
of the bed 4 to 6 inches in order for gravity to
pull the acid out of the esophagus and back into
the stomach at night. Wafer antacids (like
TUMS) are a better choice. They relieve acid
indigestion and their alkaline makeup actually
helps the bones maintain their strength by
neutralizing very powerful dietary acids from
hard cheeses, meat, poultry, eggs, fish, and
shellfish. For more information see the new
Dr. McDougall’s Digestive Tune-up.
Yang YX, Lewis JD, Epstein S, Metz DC.
Long-term proton pump inhibitor therapy and risk
of hip fracture. JAMA. 2006 Dec
McArthur KE, Walsh JH, Richardson CT.
Soy protein meals stimulate less gastric acid
secretion and gastrin release than beef meals.
Gastroenterology. 1988 Oct;95(4):920-6.
3) Maurer M.
Neutralization of Western diet inhibits bone
resorption independently of K intake and reduces
cortisol secretion in humans. Am J Physiol
Renal Physiol. 2003 Jan;284(1):F32-40.
4) Remer T.
Influence of diet on acid-base balance.
Semin Dial. 2000 Jul-Aug;13(4):221-6.
Are Common from Colonoscopy
of colonoscopy in an integrated health care
delivery system by Theodore B. Levin
published in the December 19, 2006 issue of the
Annals of Internal Medicine found, “…that
perforations occurred nearly once in every 1000
colonoscopies and that serious
complications occur in 5 of every 1000. Removal
of polyps through biopsy with a snare or forceps
increases the risk for a serious complication
nearly 9-fold compared with colonoscopy without
biopsy. Postpolypectomy bleeding was the most
The study of
16,318 Kaiser patients who were over the age of
40 years at the time of testing found:
Eighty-two serious complications occurred.
Serious complications occurred in 0.8 per 1000
colonoscopies without biopsy or polypectomy.
Serious complications occurred in 7.0 per 1000
colonoscopies with biopsy or polypectomy.
Perforations occurred in 0.9 per 1000
Postbiopsy or postpolypectomy bleeding occurred
in 4.8 per 1000 colonoscopies with biopsy.
Biopsy or polypectomy was associated with an
increased risk for any serious complications.
Ten deaths (1 attributable to colonoscopy)
occurred within 30 days of the colonoscopy.
is a test performed by specialty-trained
gastrointestinal doctors and used to look at the
interior lining of the colon (large intestine).
A thin, flexible 4 to 6 foot-long viewing
instrument, called a colonoscope is used to
detect ulcer, polyps, cancers and areas of
inflammation or bleeding. During the procedure
tissue samples can be collected (biopsy) and
polyps can be removed. Colonoscopy is the most
common test recommended for screening for colon
cancer. Intervenous sedation is usually given.
Patients are often told that the risks from the
procedure are very few and minor, and that the
benefits far out-weigh the risks. This study
shows that in real-life medical practice (such
as at Kaiser) the complications are not so
uncommon and can be very serious.
The alternatives are a barium enema and sigmoid
exam or a virtual colonoscopy when necessary to
evaluate problems of the lower intestine and to
look for precancerous polyps (screening). Don’t
overlook the fact that almost all problems of
the intestines are caused by the foods you put
in it and most of these disorders are quickly
solved with a change to the McDougall Diet.
For more information see the new book,
Dr. McDougall’s Digestive Tune-up.
Levin TR, Zhao W, Conell C, Seeff LC, Manninen
DL, Shapiro JA, Schulman J.
Complications of colonoscopy in an integrated
health care delivery system. Ann Intern Med.
2006 Dec 19;145(12):880-6.