Losing is weight “twice as hard as previously thought”, according to media reports. Government weight-loss guidelines “mislead” overweight people about the effort needed to lose weight and dieting rules “don’t take into account changes in metabolism that occur when you lose weight”, several newspapers said.
The reports are based on a recent conference presentation in which obesity researchers reportedly said that current weight-loss guidelines fail to take into account the changes in metabolism the researchers identified. They said that this means weight loss takes twice the time predicted by current guidelines.
However, there is as yet no officially sanctioned way to work out a bespoke weight-loss programme for yourself, which is why if you’re worried about your weight it’s a good idea to have a chat with your GP.
The Independent said that there was a “slim chance” of the weight falling off with a reduction in calories. While this pun may have been hard to resist, it’s not particularly accurate; nor is the Financial Times’ assertion that “obesity experts [have] change[d] fat-loss guidance”.
What is the news based on?
The news reports stem from a presentation by Dr Kevin Hall, a researcher with the National Institutes of Health (NIH in the US, at the annual meeting of the American Association for the Advancement of Science (AAAS in Vancouver, Canada. Dr Hall reportedly said that dietary changes spark complex processes that alter the body’s metabolism and body composition and that this has made it difficult to assess the relationship between diet and weight changes. In a nutshell, he suggests that weight loss is not a straight line towards one’s target weight, but a downward curve that plateaus the closer you come to your goal.
Dr Hall’s presentation appears to be based on earlier work from the NIH in which a mathematical model was used to predict what happens when people of varying weights, diets and exercise habits try to change their weight. This model suggests that a reduction in energy intake of 100 kilojoules (about 24 calories a day for each person would eventually lead to a reduction in body weight of about 1kg. Half the weight loss would be achieved in about a year and 95% in about three years. The NIH says this is only half the weight loss claimed for calorie reduction in current guidelines. This is important because it “leads to unrealistically large weight-loss expectations”, Dr Hall is reported to have told the AAAS conference.
The NIH has developed an online tool designed to calculate the level of dieting needed to achieve a weight loss target, taking numerous factors into account including metabolism. It allows users to adjust their calorie intake as well as activity levels and see how much their weight, body fat and other measures are predicted to change over time if they stick to the tool’s plan.
Is there evidence for this model?
In a paper published in the Lancet in August 2011, NIH researchers, including Dr Hall, described a mathematical model for what happens when people of varying weights, diets and exercise habits try to change their weight. The NIH also developed an accompanying weight-simulation tool. The paper concluded that:
- Body-weight response to a change of energy intake is generally slow and depends on individual body composition and individual metabolic changes.
- Generally, an average overweight adult who reduced their energy intake by 100 kilojoules a day would eventually lose about 1kg. Half the weight change would be achieved in about a year and 95% of the weight change in about three years.
- Adults who are heavier have a larger expected weight loss for the same change of energy intake, although reaching a stable body weight will still take them longer.
It should be noted that this is not a clinical trial looking at real weight loss in people. It is a mathematical model that has been validated by comparing it to some actual changes in people. An NIH clinical trial comparing the effects of reducing fats and carbohydrates in obese adults is currently recruiting participants in the US.
What do current guidelines say?
In the UK, general guidance on losing weight for overweight or obese adults does not make detailed calculations of the relationship between calories in diet and weight change. Dietitians can help someone calculate the calorie loss needed to achieve a target weight over a certain period, but they would tailor this to the individual.
Overweight and obese adults are usually advised to follow a low-fat diet or one where the food eaten each day provides about 600 fewer calories than the body needs to stay the same weight. This is recommended by the National Institute for Health and Clinical Excellence (NICE based on thorough appraisal of the evidence available, rather than being a “rule of thumb” as suggested in several newspapers. Very low-calorie diets are sometimes recommended by professionals for short periods of time in specific circumstances.
Getting enough physical activity (150 minutes a week for adults is also usually crucial for most people who need to lose weight.
Do I need to change the way I diet?
This paper uses a mathematical model to advance the theory that for most people weight loss through dieting takes far longer to achieve than has previously been calculated. It doesn’t provide any evidence on the topic of specific diets and weight loss or advise specific changes to how people diet.
However, the news stories serve to remind us to set achievable weight loss goals, be realistic about our chances of reaching them and be determined in our efforts to do so.
Can I try the weight simulator?
The NIH online weight simulator tool allows people to input their age, sex and body weight and then calculate how many calories they’d need to cut from their diet in order to achieve their target weight loss. However, it is primarily a research tool. It includes no advice on diet or exercise and is not a substitute for personal medical advice on diet and weight loss. While the general principles of weight loss apply to all humans, this has been developed in the US, presumably for a US audience where the incidence of obesity is greater than that of the UK. As yet, it is not known whether a UK version will become available.
Where can I get weight loss advice?
If you think you need to lose a bit of weight, there’s a lot that you can do to help yourself. The key things you might consider are:
- Commit to changing your behaviour to lose weight.
- Understand calories and how the energy balance in your diet works.
- Follow these eight simple healthy eating tips.
- Find out how to get your recommended 150 minutes of activity every week. For example, you could try the NHS Couch to 5K running plan.
- Try to maintain a safe level of weight loss.
If your weight is becoming a real health problem for you, it’s best to see a healthcare professional such as your GP or a nurse at your GP surgery. He or she can measure your BMI and provide information and support about losing weight, the benefits of a healthier diet and doing more physical activity. They can also tell you about local organisations that can help people to lose weight.
For most overweight people, losing just 5% of your body weight can have health benefits such as lowering blood pressure and reducing the risk of diabetes.
Analysis by Bazian.
Links To The Headlines
Why the weight is so hard to shift: guidelines have been wrong all along. The Guardian, February 21 2012
Losing weight 'twice as difficult as diets claim'. The Daily Telegraph, February 21 2012
Losing weight is twice as hard as you may think... cutting calories slows down your body's metabolism. Daily Mail, February 21 2012
Obesity experts change fat-loss guidance. Financial Times, February 21 2012
Links To Science
AAAS Meeting 2012: The Calculus of Calories: Mathematical Modeling of Body Weight Dynamics. Kevin Hall, February 20 2012
Selective Reduction of Dietary Carbohydrate Versus Fat: Effects on Metabolism, Endocrine Physiology, Brain Activity and Reward Circuitry. NIH Clinical Research Studies
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On the day the Prime Minister called a health “summit” at No 10 to try to create the impression of support for the floundering Health and Social Care Bill, demonstrators outside Downing Street made their case against the Bill. (See BBC footage
here . Meanwhile
the e-petition calling for the Bill to be dropped attracted more than 150,000 signaturesand is about to become the best supported of any on the Cabinet Office website.
The demonstrators handed in a letter to the Prime Minister, which pointed out that the summit invitation list
“pointedly excluded key organisations that represent the views of over half a million health professionals. In so doing you make it clear that you are not willing to listen to the views of the very people who you yourself have said are to be significant beneficiaries of the Bill and whose support is key to its implementation.”
Among the excluded groups are the Royal College of GPs and the Faculty of Public Health.
The letter goes on to say that what the excluded organisations have in common is that they believe the Bill will
“transform the NHS from a public service with a duty to provide a universal, comprehensive and equitable service to a market based system of competing private providers with greatly increased risks to patients.”
The loss of the Secretary of State for Health’s legal duty to provide and secure free and comprehensive healthcare for the public, combined with the sheer size and complexity of the Bill, will cause chaos and leave the health system wide open to charging for health care, means testing for public health services and state subsidy for private provision.
Before the General Election, David Cameron repeatedly promised “no more top down reorganisations” of the NHS. He promised that "with the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS", and this pledge was also included in the Coalition agreement.
The Prime Minister does not seem to be listening to public or professional opinion on the Bill. As the letter points out:
“If you were serious about safeguarding and improving the NHS you would listen to these critical voices, all telling you to abandon the bill … But doctors, along with the nurses and allied health professionals are more united each day in their opposition to the bill.”
The No 10 summit has put Mr Cameron at the centre of the row over the Health Bill. The demonstration outside Downing Street is one more sign that he may pay a heavy political price if he continues to give the Bill his support.
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KWAME HOLMAN: The U.S. Supreme Court will revisit the issue of affirmative action in college admissions in arguments this fall. The court agreed today to hear a case filed by a white student who was denied entry at the University of Texas in 2008.
She contends the school's race-conscious policy is unconstitutional. The high court last ruled on the issue in 2003, when it upheld the use of race in admissions at the University of Michigan Law School.
Federal regulators moved today to ease critical shortages of two cancer drugs. The Food and Drug Administration announced it's allowing temporary imports of a replacement drug for Doxil, used to treat ovarian cancer. The agency also approved new suppliers of methotrexate, a drug to treat children with leukemia.
An official at the American Cancer Society said patients need the relief.
DR. LEONARD LICHTENFELD, American Cancer Society: The current drug shortage has become a daily nightmare for cancer patients, their families, and those who treat them, with no clear understanding of when drugs currently in shortage will become available and an uncertainty of when additional drugs may go into shortage.
KWAME HOLMAN: FDA officials said there currently are 283 prescription drugs in scarce supply or simply unavailable in the U.S.
On Wall Street, the Dow Jones industrial average broke 13000 for the first time since May of 2008, but it could not hold. Instead, the Dow ended with a gain of just 15 points to close at 12,965. The Nasdaq fell three points to close at 2,948.
A team from the U.N.'s nuclear watchdog agency held new talks in Iran today on the country's nuclear program. The group is supposed to gauge whether Iran is getting closer to developing a nuclear weapon, but the Foreign Ministry said the U.N. team will not be visiting any nuclear facilities.
RAMIN MEHMANPARAST, Iranian Foreign Ministry spokesman (through translator : The titles of the members of the visiting delegation are not inspectors. This is an expert delegation from the International Atomic Energy Agency, led by the vice president of the director general of IAEA. The purpose of the visit is not inspection. The goal is negotiation and talks on cooperation between Iran and IAEA to create a framework for further talks and cooperation.
KWAME HOLMAN: Also today, the head -- the deputy head of Iran's armed forces warned the regime could launch a preemptive strike if it feels threatened. He did not name a target.
In Syria, opposition groups claimed up to 100 people were killed in fighting across the country. Many of the deaths, they said, were in the opposition stronghold of Homs. There, the neighborhood of Baba Amr came under a heavy new artillery barrage by the Syrian military. Rebel sources said shells rained down at a rate of 10 per minute, but activists said President Bashar Assad's troops had been stymied in efforts to launch a ground attack.
In Washington, State Department spokeswoman Victoria Nuland appeared to open the door slightly to arming the opposition.
VICTORIA NULAND, State Department spokeswoman: We don't believe that it makes sense to contribute now to the further militarization of Syria. What we don't want to see is the spiral of violence increase. That said, if we can't get Assad to yield to the pressure that we are all bringing to bear, we may have to consider additional measures.
KWAME HOLMAN: U.S. officials also supported a call by the International Red Cross for a daily cease-fire to allow deliveries of humanitarian aid.
Protests erupted in Afghanistan today after Korans inadvertently were burned last night at a U.S. military base. More than 2,000 Afghans demonstrated outside the facility. Some in the crowd shouted "Die, foreigners" as they set tires ablaze and threw stones at the main gate.
A Western military official said the Muslim holy books were removed from a nearby jail because detainees wrote extremist messages in them.
The NATO commander in Afghanistan said emphatically they shouldn't have been added to trash meant for incineration.
LT. GEN. JOHN ALLEN, International Security Assistance Forces: We are thoroughly investigating the incident. We are taking steps to ensure this doesn't ever happen again. I assure you, I promise you, this wasn't intentional in any way. And I offer my sincere apologies for any offense this may have caused.
KWAME HOLMAN: Afghan President Hamid Karzai denounced the burning, and he ordered a separate inquiry into the incident.
Separately, three NATO soldiers were killed today in a roadside bombing in Southern Afghanistan; 47 NATO service members have died in Afghanistan so far this year.
Those are some of the day's major stories.
“Not sleeping enough can damage your immune system and make you ill,” according to the Daily Mail.
This somewhat sweeping statement is based purely on an animal study looking at how mice body clocks affected their immune systems. The study found that levels of an infection-detecting protein called TLR9 fluctuated throughout the day and that the exact level of this protein influenced how effective a vaccine was in mice. It also influenced the mice’s response to a type of serious infection.
Differences between man and mouse mean more research will be needed to determine if these findings apply to humans. If they do, then it may be possible that certain vaccinations could be administered at specific times of day to make them more effective. However, this approach would need to be tested in humans to be sure that it actually made a meaningful difference to the effectiveness of the vaccines.
The immune system is a complex area, and while this research shed some light on one aspect of the body’s immunity and its ties to the body clock, there’s still much to learn.
Where did the story come from?
The study was carried out by researchers from Yale University School of Medicine and the Howard Hughes Medical Institute in the US. It was funded by the US National Institutes of Health and published in the peer-reviewed scientific journal, Immunity.
When reporting this study both BBC News and the Daily Mail stated that this research was in mice, and gave good summaries of the findings. However, the Mail’s headline claimed that “not sleeping enough can damage your immune system and make you ill”, which the current research does not support. The results of this research in mice should not be interpreted as providing proof that amount of sleep affects illness in humans.
What kind of research was this?
This was animal research looking at exactly how the body clock affects the function of the immune system in mice. The researchers say that previous studies have shown that certain immune system functions and chemicals vary naturally in relation to light and daily rhythms in humans and mice. They say that studies have also suggested that disruptions to normal daily rhythms, such as jet lag or sleep deprivation, may also affect the immune system.
This type of early research will usually use animals such as mice to carry out in-depth investigation of the interaction of basic biological functions, which might be difficult to carry out in humans. Generally, it’s only once researchers have built up a picture of these interactions in mice that they can then carry out further studies to test the findings in humans.
What did the research involve?
The researchers first looked at a group of mice genetically engineered to have defective body clocks and a group of normal mice to identify any differences between the two groups in how their white blood cells (immune cells responded to invading microorganisms. They found that the differences identified related to a protein called Toll-like receptor 9 (TLR9 . This protein recognises DNA from bacteria and viruses, and plays a role in signalling to the immune system to mount an attack on these invading organisms. The researchers then looked at whether the production and function of TLR9 in normal mice varies throughout the day as a result of the body clock cycle (known as the “circadian cycle” .
The researchers then gave mice vaccinations containing molecules that would activate TLR9 and looked at whether mice responded differently to the vaccine according the time of the day it was given. They also looked at whether time of day affected how mice responded to being infected with bacteria in a process known to involve TLR9. The method used involves allowing bacteria from the mouse’s intestines to invade its body cavity. This leads to a condition called sepsis, a strong inflammatory immune system response throughout the body that is harmful to the mice.
What were the basic results?
The researchers found that levels of the protein TLR9 in mice did fluctuate naturally through the day, peaking at set times over a 24-hour cycle.
They found that when they gave mice vaccines that would activate TLR9, the vaccination produced a greater immune response if given at a time of day when TLR9 levels were at their highest. The researchers found that if the mice were infected at a time when TLR9 was at its highest, the mice showed worse signs of sepsis and died earlier than mice infected at the time when TLR9 was at its lowest.
How did the researchers interpret the results?
The researchers concluded that their findings showed a direct link between the body clock and one aspect of the immune system in mice. They said that this may have important implications for how vaccination and immune-system-related therapies are administered in humans.
They also noted that some studies have found that people with sepsis are more likely to die between 2am and 6am. They say that further studies are needed to determine if this may be related to levels of TLR9, and if so whether giving certain therapies during this period could reduce this risk.
Conclusion
This study identifies one way in which the body clock and immune system interact in mice, via a protein called TLR9. The researchers found that fluctuations in this protein throughout the day influenced how effective a certain form of vaccination was in mice, and also influenced the mice’s response to one type of serious infection.
Differences between the species mean more research is needed to determine if these findings also apply to humans. If they do, then vaccinations could be given at specific times of day when they would be most effective. However, this theory needs testing in humans to ensure that it makes a meaningful difference to the effectiveness of the vaccine.
There has also been media speculation that researchers could develop infection-fighting drugs based on these findings. However, this suggestion is premature as researchers first need to confirm that the mechanism identified in this study also applies in humans. Even if it is confirmed, it would still take a great deal of research to develop and test a drug that could capitalise on it.
It’s also worth remembering just how complex the immune system is, and although this research improves our understanding of one aspect (how it is affected by the body clock there is still much to learn.
Analysis by Bazian
Links To The Headlines
Body clock 'alters' immune system. BBC News, February 17 2012
Not sleeping enough can damage your immune system and make you ill, says study. Daily Mail, February 17 2012
Links To Science
Silver AC, Arjona A, Walker WE, Fikrig E. The Circadian Clock Controls Toll-like Receptor 9-Mediated Innate and Adaptive Immunity. Immunity, February 17 2011
The food industry had been concerned that EPA would set exposure recommendations below what some Americans are already exposed to via their diet, which could cause some people to radically change their eating habits. But the report released by EPA instead touted the reductions in dioxin exposure. According to the agency air emissions of dioxins have decreased 90 percent since the 1980s.
"Today's findings show that generally, over a person's lifetime, current exposure to dioxins does not pose a significant health risk," said EPA on Friday. "Most Americans have low-level exposure to dioxins. Non-cancer effects of exposure to large amounts of dioxin include chloracne, developmental and reproductive effects, damage to the immune system, interference with hormones, skin rashes, skin discoloration, excessive body hair, and possibly mild liver damage."
The agency said consumers should not be worried about exposure: "Most Americans have low-level exposure to dioxins. Most dioxin exposure occurs through the diet with small amounts of exposure coming from breathing air containing trace amounts of dioxins and from inadvertent ingestion of soil containing dioxins. While we all likely have some level of dioxin in our bodies, the levels are low and findings show that low-levels of exposure do not pose a significant health risk."
Dioxins are released into the air during certain industrial processes, like cement production and are also naturally occurring. According to new government data, air releases of dioxin rose 10 percent between 2009 and 2010. Dioxins are ingested by food animals, via grazing and contaminated feed, and are bioaccumulated -- a reality that has concerned regulators and public health authorities because dioxins are linked to reproductive and developmental problems, immune system damage and cancer.
The World Health Organization (WHO estimates that 90 percent of human exposure to dioxins is via food, particularly meat, dairy, fish and shellfish. The food industry worries that the EPA reassessment would have recommended an exposure threshold that is lower than the level of exposure many Americans already face through their daily diet.
The EPA's new assessment sets a reference oral dose -- more information here: http://www.epa.gov/iris/subst/1024.htm
According to one advocacy groups, some Americans may be close to the reference dose.
"The key finding of EPA's new report is that EPA has published a reference dose for dioxin and that the daily intake of dioxin in food is close to this level," said Mike Schade, a spokesman for the Center for Health, Environment & Justice. "It shows that the average background exposure of the American public to dioxin in food is very close to or above the EPA new reference dose."
Can some children simply “grow out” of autism? The Daily Mail certainly thinks so, and today reported that new research by a “prestigious American university” claims that “not only is this possible, it’s also common.”
The Mail’s claim is misleading and may offer a false impression to the parents of children with autism. It centres on a piece of research which looked at a completely different aspect of autism. The study assessed how the presence of other developmental conditions related to the diagnosis of autism. To do this, researchers looked at parent survey data relating to children with a current diagnosis of autism and children who had previously been diagnosed but no longer met criteria for diagnosis. It generally found that children who have a current diagnosis of autistic spectrum disorder (ASD were more likely to also have certain other conditions than those who no longer met the diagnostic criteria.
Diagnosing ASD is challenging, especially since the condition is often accompanied by other developmental disorders. Specialists also recognise that children who once met diagnostic criteria for an ASD may no longer do so at a later point, possibly because of care and management or because of an initial misdiagnosis. However, this study only suggests that conditions which occur at the same time may complicate the diagnosis of ASD, and does not support the claim that many children will simply “grow out of it”.
Where did the story come from?
The study was carried out by researchers from the Johns Hopkins Bloomberg School of Public Health, Maryland, and Massachusetts General Hospital for Children. There is no information about external funding. The study was published in the peer-reviewed medical journal Pediatrics.
The Daily Mail’s report misleadingly linked the study with the case of a boy who was diagnosed with severe autism at the age of three but who, according to the paper, had undergone a “transformation by the age of nine”. While the article described improvements in the boy’s symptoms, it did not reveal whether the child has a current diagnosis of autism.
The newspaper said that, according to the study, this type of transformation is “far from unique”, and that 453 of the 1,366 sets of parents questioned during the study said their children had “grown out of” a previous diagnosis of ASD. It also quoted one of the study’s authors as saying “there’s a lot of moldability of the developing brain.”
Despite suggestions otherwise, the study did not look at whether children grow out of the condition. Instead it, looked at how common multiple other developmental and psychological problems are among children with an ongoing diagnosis of ASD. It then compared these children with autism to children who reportedly had one of these developmental or psychological conditions in the past but who were no longer considered to have one.
The Mail did report the opinion of independent experts at the end of its story.
What kind of research was this?
The authors say previous studies have shown that children with ASDs have higher rates of co-occurring developmental and psychiatric conditions, compared with children who show typical development. For children diagnosed with ASD, different co-occurring conditions are found in different age groups. For example, children and adolescents with an ASD have shown higher rates of learning disability, while adolescents and adults with ASD are frequently diagnosed with co-occurring depression.
The authors also point out that the stability of a diagnosis of ASD can vary over time . The 2007 US National Survey of Children’s Health (NSCH showed that 40% of children aged 3-17 who had been diagnosed with ASD at any point were no longer considered to have a diagnosis when their parents later completed a survey on their symptoms.
Differentiating between autistic spectrum disorders and other co-occurring neurodevelopmental disorders (such as ADHD and learning disabilities and psychiatric conditions can be challenging for doctors. This can lead to confusion with diagnoses, which can delay appropriate diagnosis and lead to missed opportunities for effective interventions, say the authors.
Their cross-sectional study examined the cases of 1,366 children whose parents reported an ASD diagnosis when they completed the 2007 NSCH. This group included children with a current diagnosis and children who had a diagnosis in the past but did not currently have one. The researchers investigated the extent to which commonly co-occurring developmental, psychiatric and behavioural conditions differentiate children with a current ASD diagnosis from children who no longer met the criteria for diagnosis.
What did the research involve?
The authors obtained cross-sectional data on 1,366 children who had a parent-reported diagnosis of ASD (current, or past but not current from a US national survey of children, the NSCH. The data were collected from parents by phone interview between 2007 and 2008. Households with at least one child between the ages of 0 and 17 were eligible to participate. Questions included the child’s physical and mental health and any medical diagnoses. The 2007 data comprised 91,642 completed surveys.
For this study, researchers focussed on parents’ responses to questions about whether they had ever been told by a doctor or other healthcare provider that their child had a form of ASD and whether the diagnosis was current. They then created two study groups based on their responses: parents who reported a current ASD diagnosis and those who reported a past diagnosis.
For the purposes of their analyses, they then spilt the children into three developmental stages: young children (3-5 years , children (6-11 years and adolescents (12-17 years .
The final data set used in the study included details of 1,366 children:
- 154 young children, 373 children and 386 adolescents were reported to have a current ASD diagnosis
- 453 children 53 young children, 189 children and 211 adolescents were reported as having a former ASD diagnosis
Those who reported a past diagnosis made up 33.2% of the study sample.
The researchers looked at whether children in the two groups were also reported as having co-occurring conditions, including ADHD, learning disability, developmental delay, speech problems, hearing problems, anxiety, depression, behavioural problems and seizures/epilepsy. They divided responses into the following categories: a past diagnosis, current mild diagnosis, current moderate or severe diagnosis, and never diagnosed.
They analysed the data using standard statistical methods and took account of factors such as sex, race, education, income and whether the child had a current “individualised education plan” (IEP .
What were the basic results?
The researchers found that, after they adjusted for sociodemographic factors, children whose parents reported a current diagnosis of ASD were more likely to have co-occurring conditions than those who no longer met diagnostic criteria for an ASD (those who had a past diagnosis .
- Young children with a current ASD diagnosis were 11 times more likely to have current moderate/severe learning disability, and over 9 times more likely to have current moderate/severe developmental delay than those with a past diagnosis.
- Children with a current ASD diagnosis were 3.85 times more likely to have past speech problems, and 3.51 times more likely to have current moderate/severe anxiety than those with a past diagnosis (but less likely to have a past hearing problem .
- Adolescents with a current ASD diagnosis were 3.91 times more likely to have a current moderate/severe speech problem, and 10.48 times more likely to have current mild epilepsy than those with a past diagnosis (but less likely to have a past hearing problem .
How did the researchers interpret the results?
According to the researchers, their findings suggest that the presence of co-occurring psychiatric and neurodevelopmental conditions is associated with a change in ASD diagnosis, although the mechanisms that underlie this change are unclear.
They point out that core features of ASDs, such as communication problems, are often similar to the signs of conditions that commonly occur alongside ASDs. They say it is possible that a child may have been diagnosed with ASD because of the presence of common co-occurring conditions, but may later be reclassified as not having ASD. There may be many reasons for this, including developmental improvements or because a child no longer meets the diagnostic criteria as a result of early interventions to support their development.
Conclusion
Contrary to what readers of the Daily Mail’s article might think, this study did not look at whether children “grow out” of autism, nor does it support suggestions that they do. Instead, this research looked at the relationship between diagnoses of autism and the presence of other developmental conditions with similar, and sometimes overlapping, symptoms. Interpretations from this study should be made with care. It cannot tell us how the course of autistic spectrum disorder (ASD may progress over time or whether it is possible to grow out of ASD.
Though the study found some significant associations, and children with a current ASD diagnosis were more likely than children with a past diagnosis to have certain co-occurring conditions, these results need corroboration. While certain associations were significant, the risk figures tended have very wide confidence intervals (a type of measure used in statistical analyses to express the precision of an estimate . For example, the study found that young children with current ASD were 9 times more likely to have current moderate or severe developmental delay, but the confidence intervals around this result suggest that the association was likely to be anywhere between 1.9 and 44.4 times more likely. With such wide confidence intervals, we can have less confidence in the reliability of the calculated association.
Another important limitation of the study is its reliance on parents to self-report their children’s diagnoses through interviews carried out on the phone, which introduces the possibility of error.
Diagnosing an ASD is challenging, especially since the condition is often accompanied by other neurodevelopmental disorders with overlapping symptoms. Specialists also recognise that children who once met diagnostic criteria for an ASD may no longer do so at a later point, possibly because of care and management or because they were misdiagnosed initially.
The findings of this study are certainly of interest and indicate that other developmental, behavioural or psychiatric conditions occur among children with ASD. However, the study mainly highlights that the presence of other conditions is likely to make diagnosing ASD complicated, as experts already recognise.
Links To The Headlines
Can some children simply 'grow out' of autism? One mother tells how her son's life has been transformed. Daily Mail, February 22 2012
Links To Science
Close HA, Lee LC, Kaufmann CN, Zimmerman AW. Co-occurring Conditions and Change in Diagnosis in Autism Spectrum Disorders. Pediatrics Vol. 129 No. 2 February 1, 2012 pp. e305 -e316
Pediatrics Digest Summary: Co-occurring Conditions and Change in Diagnosis in Autism Spectrum Disorders. Pediatrics Vol. 129 No. 2 February 1, 2012 pp. X21
Politics can seem strange to historians. Governments make so many profound and elementary errors that one would think that the storehouse of previous policies would allow them to avoid some of the more egregious. But no: they blunder on regardless. A.J.P. Taylor once argued that the only thing statesmen learn from the past is how to make novel mistakes. But the situation actually looks worse than his joke implied: they learn, it seems, to make the
same
mistakes.
The present administration is set on a very large programme of public spending reductions to please ‘the markets’ –
essentially, bond holders. Previous occasions on which this has been Whitehall’s aim, for instance at the opening of the Great Depression in 1929-31, do not augur well for this policy. The post-war era of modest inflation and fast growth, on the other hand, which certainly did deliver rapid relief from Britain’s debts, is ignored.
The Secretary of State for Health is
pressing ahead with a very unpopular and politically risky ‘decentralisation’ of the National Health Service – which will actually pile layers of bureaucracy, rules and costs onto general practitioners and hospitals. Previous reorganisations, for instance Keith Joseph’s disastrous management-orientated reshaping of the Service in the 1970s, have left chaos and confusion in their wake. It’s another lesson that’s being ignored.
University fees are being ratcheted up, with little thought for the popularity or credibility of either British governance as a whole, or the future of our (in general very successful universities. By the early 1980s, Keith Joseph as Education Secretary had learned from a few of his past ‘big bang’ mistakes, and retreated from just such a suggestion before the Thatcher government was dragged into the quagmire. One could go on and on, and a list would become wearisome.
All of these so-called ‘reforms’ are dominated by one particular and orthodox view of economics, which posits that public spending crowds out private investment; that choice, especially within quasi-markets, must be better than the ‘bureaucracy’ and statism of collective provision; that these mechanisms will introduce competition and efficiency into the public sector; and that money will therefore be saved.
All of these presumptions are, of course, highly questionable, and deficit reduction, health care reorganisation and university marketisation are often going to cost the taxpayer more, not less, in the long run. More theoretically, the market is a human, a contingent and above all rule-bound and law-encrusted creation like any other way of life.
It is as questionable on the same basis as any trope. Certainly there is nothing ‘natural’ or
necessarily
efficient about its operation.
But if we leave that important caveat to one side, what’s also notable about present views of public spending and choice is that they are so
ahistorical
. As I argue in my new book,
Governing Post-War Britain: The Paradoxes of Progress
, what politicians really lack is a sense of time – or, rather, a critical sense of time passing and change occurring. This has been evident since at least the ‘Year Zero’ approach of New Labour and probably since the supposedly constant or permanent administrative revolution of the 1980s, both of which phenomena attempted to defy or deny the Conservatives’ previous accommodations with Labour, or that latter party’s prior history as a socialist or even social democrat grouping. But it has recently become even more acute under a government which seems to think that it must progress swiftly if it is to make any headway at all. Ministers such as Michael Gove (at Education and David Willetts (Minister for Higher Education and Skills paradoxically understand the very short time span during which they will possess the political initiative, but not the much larger and overarching narratives of British governance – of which they are becoming a part.
What did post-war governance demonstrate to its practitioners? For one thing, it became absolutely clear the past is critical when thinking about the future. When governments tried to import policy solutions – ‘Scandinavian’ national wage negotiations, ‘French’ industrial planning, ‘American’ plant level efficiency – they usually failed utterly. Had they possessed more confidence in building on more particularly
British
examples, the soil in which new ideas were supposed to take hold and flourish, they would have been more successful.
The next thing that became clear was the tyranny of unintended consequences. Step by step, and sequentially, many policy initiatives ran into the sand. Defence spending, that was supposed to make the Anglo-American alliance powerful, undermined the two countries’ currencies; consumer spending ended up buying continental Europeans’ goods, leaving those countries holding many billions of dollars and pounds that allowed them to dictate terms within NATO and the EEC. Above all, they learned the importance of the policy environment: not the simple inputs-in and outputs-out of our present managerialist and technocratic reformers, but the conduct of policy as a discretionary art that had to take account of the world around them – temporally, as well as geographically.
All developed world governments might profit from a little of this realism at the moment. But there seems little chance of this changing in the short term. Many mainstream economists’ models do not allow for time. There’s a supply line and a demand line on their graphs, and where they meet – not when – that’s the price and the quantity of the most ‘efficient’ goods and services. The fact that both producers and consumers are coming from somewhere – that they have stories and preferences – remains (in the jargon ‘exogenous’ and outside their ken.
The best studies of politicians’ and officials’ use of academic history reveal their engagement with the discipline to be spotty and inconsistent at best, and downright mendacious at worst.
Virginia Berridge of the London School of Hygiene and Tropical Medicine has asked NHS policymakers about this, and
what she found [pdf] was rather unsurprising, if depressing. Academics that knew nothing about modern healthcare history were invited to seminars; PhD students from Oxbridge who sometimes worked as MPs’ researchers were asked to help with speechwriting; top officials were aware of policy entrepreneurs’ and popular writers’ books, which drew on history but did not present new research findings. If we want to find a reason why politicians constantly reinvent the NHS, doing damage every time before practitioners can build capacity anew, we might do worse than look to this lack of institutional memory.
But time and the role of inherited practices, those ‘icebergs’ that make up more than ninety per cent of policy at any one time, are in fact one of the most important insights of the new economics of the late twentieth century, which has re-emphasised the importance of inheritances, institutions and language. From the ‘butterfly economics’ of
Paul Ormerod to the post-modern emphasis on language and perception of the economic historian
Deidre McCloskey, there is in fact a reaction well underway against timeless ways of thinking. This should be expected, of course.
Even during the years when what was known as the ‘
New Classical Synthesis’ ruled economics during the 1950s and 1960s, propounding its own particular form of bastardised or ‘steam’ Keynesianism that in practice involved politicians using government spending to regulate economic activity, an underground counter-revolution singing the praises of more traditional and neo-classical thinking was well underway in think tanks and universities. It eventually emerged into the public sphere, and was politically successful, in the form of Thatcherism and Reaganomics, slashing state spending and bearing down on inflation through high interest rates.
So today, in a mirror-image of the intellectual revolution of the 1970s, long-standing intellectual trends obvious since the 1990s are only now beginning to make themselves felt at the level of actual policy. Economists such as the Indian development economist
Amartya Sen and the liberal American Keynesian
Paul Krugman alike have long argued that temporal and social context should be much more important to economics than they have been hitherto. In the first instance, and as Sen has always maintained, that means that equality and inequality are key issues even in terms of traditional economic success measured in terms of growth and productivity. For Krugman, the increasing centralisation and concentration of financial firepower since the 1970s helps to explain the scale and sheer speed of our present financial crisis. Economists have, in short, been waking up to the importance of time and history for a good many years.
In so doing, all these authors have brought the past and the future – and an understanding of sequencing – back to social choice and economics. They have, in short, brought history (and History back in. Marx argued that ‘the dead grasp the living’; that we cannot escape our pasts. But it would be just as apposite to retort, with D.H. Lawrence, that ‘the dead don’t die. They live on and help’. A sense of the deep past is a necessary corrective to the idea that our present establishment economics is – always and forever – the economics that we must adhere to, and should alert us to the importance of our own institutions’ ‘rootedness’, the radical
number of Nobel Laureates opposing British deflation and Greece’s expert-led descent into chaos demonstrates. What we need to ask ourselves now is: why aren’t policy-makers listening?
Dr Glen O’Hara
is Reader in the History of Public Policy at Oxford Brookes University. His latest book,
Governing Post-War Britain: The Paradoxes of Progress
, will be published by Palgrave Macmillan in April of this year. He blogs, in a personal capacity, at
PublicPolicyPast.
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Listen to the Audio
JEFFREY BROWN: On this Presidents Day, the Republicans who would be president drove home their points in key upcoming primary states. And the latest seeming front-runner drew crowds and criticism.
Rick Santorum's rise in the polls continued today heading into next week's primary contest and two weeks before Super Tuesday. The new Gallup tracking poll showed Santorum leading with 36 percent of Republican voters. Mitt Romney is eight points back at 28 percent. Next is Newt Gingrich at 13 percent. And Ron Paul comes in fourth at 11 percent.
Polls out yesterday showed Santorum ahead in Oklahoma and in Ohio, an upcoming Super Tuesday state where he grabbed support from the state's attorney general, who previously endorsed Mitt Romney.
In Ohio today, the former Pennsylvania senator continued a line of attack against President Obama which he had begun yesterday, arguing that global warming is -- quote -- "not climate science, but political science."
RICK SANTORUM (R : They have nothing to do with real cost-benefit analysis, real understanding of how we have to value both the environment and its impact on man and the world. They have radical ideas.
JEFFREY BROWN: Over the weekend, Santorum also drew attention for how he described -- quote -- "the president's agenda" at a rally in Columbus, Ohio.
RICK SANTORUM: It's about some phony ideal, some phony ideal, some phony theology, oh, not a theology based on the Bible, a different theology.
JEFFREY BROWN: Yesterday, on ABC's "This Week," Obama campaign strategist Robert Gibbs said the comments went too far.
ROBERT GIBBS, Obama campaign strategist: I can't help but think that those remarks are well over the line. It's wrong. It's destructive. It makes it virtually impossible to solve the problems that we all face together as Americans.
BOB SCHIEFFER, "Face the Nation": He's the man of the hour in Republican politics.
JEFFREY BROWN: But that same day, on CBS's "Face the Nation," Santorum defended his remarks.
RICK SANTORUM: I wasn't suggesting the president is not a Christian. I accept the fact that the president is a Christian. I just said that when you have a world view that elevates the Earth above man and says that we can't take those resources because we're going to harm the Earth by things that are -- that frankly are just not scientifically proven. . .
JEFFREY BROWN: Meanwhile, Santorum's Republican opponents continue to campaign in crucial Super Tuesday states.
In Ohio today, former Massachusetts Gov. Mitt Romney insisted he's the only candidate capable of beating President Obama in November.
MITT ROMNEY (R : I have had the experience of leading. I have led four different enterprises. I happen to think that one of the criteria for selecting a president ought to be, has this person led something before? Our current president had not. And I think we've seen the consequence of that in some of the errors he's made.
JEFFREY BROWN: In Tulsa, Okla., former House Speaker Newt Gingrich said he's not planning on drop out of the race any time soon. And continuing to focus on states with caucuses, Texas Rep. Ron Paul turned his attention on North Dakota.
Today, his campaign said it had raised $4.5 million in January. Nonetheless, most attention today was on Santorum, who has seen his stock rise since winning contests in Colorado, Minnesota and Missouri three weeks ago. That scrutiny will only increase as his numbers rise in Romney's home state of Michigan, site of one of next week's two key primary contests.
And late today, the newest Gallup poll was released showing Santorum up by 10 points over Mitt Romney.
And we take a closer look now at Rick Santorum's rise with Susan Page, Washington bureau chief of USA Today, and from Harrisburg, Pennsylvania, Terry Madonna, director of the Center for Politics and Public Affairs at Franklin and Marshall College.
Susan, start with some context here. Who is Rick Santorum speaking to or reaching out to? And what kind of reception is getting on the trail?
SUSAN PAGE, USA Today: He's getting a great reception among Republican primary voters. This is a group of voters that is very conservative, lots of Tea Party supporters. A majority of them in some states like Michigan say they are evangelical or born-again Christians.
So when he talks about public education or about global warming in the way that he's doing, this has really drawn him big crowds and brought him to a standing in the poll and sustained a standing in the poll that is pretty remarkable.
On the other hand, there are big risks for him in audiences that are also hearing what he's saying. And that would be more moderate Republicans and especially the people who you turn to when you're the nominee in a general election, like independent voters and women voters. They may be hearing some of the things he's saying and thinking, is this someone I would really feel comfortable with in the Oval Office?
JEFFREY BROWN: I'm also wondering after so many months where the economy was the main focus of all this, to turn to these kinds of issues -- you just named some of them -- but also in the past couple of days prenatal care, you mentioned public school education, birth control, health care mandate, does he see these as these issues in a sense, as opposed to economic issues?
SUSAN PAGE: The social conservative issues have been his calling card at the beginning, have sort of made him different, say, from Mitt Romney.
But he has been trying to look like a more three-dimensional candidate, to talk about foreign policy, for instance, policy toward Iran, to talk about manufacturing policy. I was with him in Detroit last Thursday when he addressed the Detroit Economic Club, talking about the deficit, talking about economic policy, talking about the manufacturing sector and how to encourage it.
And he's had some appeal in his home state of Pennsylvania, as I'm sure Terry will talk about, with the kind of voters, the kind of blue-collar voters that predominate in places like Michigan and Pennsylvania and in Ohio.
JEFFREY BROWN: Well, Terry Madonna, let me bring you in there. You've followed Santorum for a long time. Is this -- the appeal to conservatives and talking about social issues, has that been part of who he is for as long as he's been in politics?
TERRY MADONNA, Center for Politics and Public Affairs, Franklin and Marshall College: Yeah. Well, Susan is exactly right.
I mean, when he started, for example, in 1980, when he defeated an incumbent Democrat, no one gave then Senator Santorum -- or then Rick Santorum, lawyer Santorum, a chance to win that race in a Democratic district. And he amassed lots of volunteers, many of whom were pro-life.
Then he won his Senate seat in 1994 with the help of the Christian coalition. And he was solidly pro-life. But the fact of the matter is, until you get to the late 1990s, it doesn't become sort of an overarching, overreaching issue, compelling issue, the way it certainly has become in the last decade.
He talked about fiscal matters, government reform, tax policies. That's what got him elected in 1990 to the House and what got him elected in 1994 in the Senate. The other thing that Susan points out that is, I think, very important, he's the only one of the four Republican candidates who had the niche among social conservatives.
He could always sort of rely on them. And in the polls that I have done and others have done, Tea Party activists are overwhelmingly social conservatives. So, he could reach that blend of fiscal conservatism, small government, limited government, get rid of the deficits. at the same time, he could talk about social issues.
JEFFREY BROWN: And, Terry, what about as a legislator in the state and then in the Senate? What became the key sort of issues that he worked on or became associated with? One was welfare reform, right?
TERRY MADONNA: Oh, absolutely. Yeah, he was the floor leader for welfare reform.
By the way, that's the first time we really see this aspect of sort of the religious issues, moral issues come to play, when he fought for and insisted on faith-based grants and tax cut -- you know, use of the money in welfare to go to faith-based organizations.
As a senator he did -- and his critics are accurate -- he did fight and brought home hundreds of millions of dollars for Pennsylvania projects. He supported minimum wage. He was never cozy or close to the unions, but he was certainly helpful to U.S. Steel. He had worked on projects for the pharmaceutical and technology industries in the southeastern part of the state.
He was a typical sort of light-blue, if I can, senator who could not ignore the interests of the state.
JEFFREY BROWN: Okay.
Well, now, Susan, you talked about some of the risks of getting into some of these issues. Now you have, of course, the other Republicans hitting back. You have, I guess what you would call the Republican mainstream sort of expressing some worry, some publicly, some, you know, behind the scenes. What are you hearing there?
SUSAN PAGE: I think there's tremendous concern among Republicans in Washington, among elected officials, including members of the House who are going to run, be running with whoever the presidential nominee is in November, about Rick Santorum and his ability to appeal to a broader electorate than the electorate we see in, say, the Iowa caucuses.
I think there is talk about whether -- if Rick Santorum wins in Michigan next Tuesday, that would be a catastrophic event for Mitt Romney and raise questions about a rather smooth path to the nomination perhaps for Rick Santorum. And would the Republican elites then try to step in, in some way, draft somebody new to get into this race?
Or could you get to a convention where no one had a mathematical clinch on the nomination and you might have negotiations about who was going to get that prize?
JEFFREY BROWN: Well, Terry Madonna, I suppose one thing that Republican leaders would be worried about is exactly what happened to Rick Santorum in 2006. He lost, and he lost real big, right, in his home state. What happened there?
TERRY MADONNA: Yes, by -- yes, by -- well, yes, in 2006 by 18 points to Bob Casey.
Well, it was the -- no doubt about it, the Democratic wave, the Iraq war election. There was also his social conservatism hurt him -- back to Susan's pointing, really hurt him in the southeastern part of Pennsylvania, in the suburbs of Philadelphia, where -- Now, Sen. Casey was pro-life, just as Rick Santorum was, but I think Sen. Santorum's outspokenness and some of the provocative things that he had said about gays, about abortion and Supreme Court decisions, and about women's role in the work force, very provocative.
Sen. Casey used some of that against him in the campaign. And then there was his residency. He had a home in Virginia. Sen. Casey made the argument that he wasn't a resident of Pennsylvania anymore and his kids were going to school, paid for by the taxpayers of Pennsylvania while they lived in Virginia. It was a cyber-school.
All in all, I mean, it wasn't a good year for Santorum. It's like the revolution had simply run away from him. And he lost in the vital areas of the states, in Pennsylvania and Virginia and Florida and Missouri, that -- that Republicans are going to have -- a Republican candidate is going to have to win or he's not going to win the electoral votes of those swing states.
JEFFREY BROWN: And, Susan, just briefly, what about President Obama and his advisers? Do you sense they're taking Rick Santorum a little more seriously now?
SUSAN PAGE: Well, taking him a little more seriously because he looks a little more serious.
But I have got to say that they continue to think that Mitt Romney is the stronger general election candidate. And the longer Rick Santorum stays in this beating up on Mitt Romney, that's fine with them. If he ends up being the nominee, I think they think that would all right as well, although of course there is some history for watching out what you wish for.
I remember the first campaign I covered in 1980 where the Carter people were so pleased that Ronald Reagan had the nomination. That didn't turn out the way they had hoped.
JEFFREY BROWN: All right, Susan Page, Terry Madonna, thank you both very much.
SUSAN PAGE: Thank you, Jeff.
That Friday recall and others raised questions about whether the timing of recall notices could potentially leave consumers uninformed about unsafe food over a weekend.
That
preliminary look did not show any significant differences in the daily publication of recall notices, but with the close of 2011, I decided to take a longer look.
This more comprehensive look included recalls going back to 2005 for USDA and Food and Drug Administration (FDA monitored foods. The USDA data also detailed whether there was a specific pathogen found in the foods (or epidemiologically linked to an outbreak , if any illnesses were associated with the recalled item, and the class of the recall as designated by the USDA's Food Safety and Inspection Service (FSIS . The FDA does not specify classes in its recall notices, so only the first two categories could be assessed.
The conclusions of this more detailed analysis show a different story from the earlier one.
USDA-FSIS Recalls
On the USDA front; from 2005-2011 there were more recalls announced on Fridays than would be expected by random chance (p
<.001 . Indeed, 2006, 2007, 2009, 2010 and 2011 all had significantly higher numbers of recalls on Fridays (p<.05 .
The total number of Class I recalls on Fridays were also higher from 2005-2011 (p=.003 . Class I recalls, by definition, are for dangerous or defective products that could cause serious health problems or deaths.
While on a per year basis, only 2006 and 2011 have significantly higher number of Class I recalls on Fridays than expected, 2007 and 2009 are very nearly significantly higher (p=.055 and p=.062, respectively .
The red line indicates the expected number of recalls if equally distributed throughout the week. A proportion significantly higher than expected of p
<.01 indicated by *.
In addition, if weekend recall dates are excluded, the pattern holds for total recalls with a greater number on Fridays than other weekdays (p=.002 . For Class I recalls, there was no significant difference in the number of Friday recalls compared with the number expected for weekdays, but there were still more alerts published on that day than any other day of the week (p=.086 .
The red line indicates the expected number of recalls if equally distributed throughout the week. A proportion significantly higher than expected of p
<.01 indicated by *.
There was no trend in any day of the week having more pathogen or illness related recalls than any other day in the seven years analyzed. This was true when only weekdays were analyzed, as well. This indicates that recall notices related to outbreaks of foodborne illness and due to specific pathogens found in food have been evenly spaced throughout the week.
While this is the case, when taken as a whole there were more Class I and Class II recalls on Fridays than would be expected. The significance of this difference for Class I recalls was eliminated when analyzing only weekdays, but held true for Class II notices, perhaps showing a propensity for putting out more urgent recalls on Fridays.
One particularly interesting finding was an observable pattern in an increasing number of Class II and Class III recalls during the time period studied, while Class I recall numbers remained relatively static. There was a significant difference in the number of Class II recalls starting in 2008 the percentage that Class II recalls make of the total number of recalls has continued to increase (P
<.05 . Class III recalls remain rare and, as such, there is little statistical power in any observations made.
The increasing number of Class II and slightly Class III with the stagnant number of Class I led to an overall increase in the number of recalls per year by the USDA from 56 in 2005 to 108 in 2011.
FDA Recalls
The previous article on this topic did not evaluate FDA recalls. This oversight has been amended this time around, and the findings are similar to those for FSIS recalls.
A glance at the total recalls per day chart shows that between 2005 and 2011 a significantly higher number of recalls were issued on Fridays than would be expected (P
<.01 .
The red line indicates the expected number of recalls if equally distributed throughout the week. A proportion significantly higher than expected of p
<.01 indicated by *.
This holds when excluding the weekends that had so few recalls.
The red line indicates the expected number of recalls if equally distributed throughout the week. A proportion significantly higher than expected of p
<.01 indicated by *.
The FDA data again points to a bias toward publishing recall notices on Fridays over other days of the week and, if anything, the tendency is more pronounced with this agency than with the FSIS. Indeed, recall announcements related to foods testing positive for pathogens and those associated with illnesses were also more common on Fridays, compared to the whole week or just the work week, a trend not seen in FSIS recalls.
Fridays have consistently seen significantly more than an expected number of recall notices for both the whole week and weekdays only for the entire seven years examined. However, due to the low number of recalls related to illnesses in all the years, statistical tests cannot be performed on a per year basis. This is also true of pathogen-related recalls prior to 2009.
There was again a pattern of certain types of recalls increasing over the years, as well as the overall number of FDA recalls increasing. The total number of recalls in 2005 was 145 and this reached a max of more than 800 because of multiple peanut butter-related recalls in 2009. Excluding that outlier, there was still a steady increase in the number of FDA recalls from 2005 to the end of 2011.
Why Fridays?
This tendency toward releasing recall statements on Fridays, more than on other days of the week, is likely not intentional but could be problematic, because people who do not consume media over the weekend might be less likely to be informed in a timely manner and, as a result, could eat recalled food. On the other hand, Friday recall notices may be the result of a sense of urgency to get make the information public before the work week ends.
Indeed, processes within the regulatory agencies may be causing an inordinate number of recall notices to be issued on Fridays. Such factors could include laboratory procedures to find contamination in samples, communication delays between the lab, regulators and the companies voluntarily recalling their products, and the general timeline of work in the offices. These, along with other processes, including political pressures, could lead to significantly more recalls on Fridays.
Importantly, recalls are initiated by private companies once the potential for hazard is found. The company distributing or producing the food recalls the products in coordination with the regulatory agency, but the company is ultimately responsible for when the recall is initiated.
It could take days before information regarding potential hazards makes it from a lab or other area of initial discovery, through the regulatory agency to the producer, and then for a recall alert to be issued. Thus, the high number of Friday recalls could be seen as an attempt to get the information out before the weekend, while people are still likely to be tuned into the news.
While the causes leading to the high number of Friday recalls cannot be determined with this small look into the past few years, what can be seen is a potential for lack of communication between the consumer and the food regulators. Easy access to information regarding potentially dangerous foods should be an issue of primary importance for both the USDA and FDA, and these agencies can work to ensure that the information is not going out when people are less likely to get it.
Submitted by
Chris Martenson
Dangerous Ideas
We are at a key turning moment in history.
The actions that we will soon decide to take will be determined by the beliefs we hold. At a time like this, holding the wrong set of beliefs can destroy your wealth, sap your joy, and even prove to be life-shortening.
Knowing the 'right' sets of beliefs to hold is never easy, but it is especially difficult at large turning points because, by definition, most people are holding onto old beliefs. Running against the crowd is difficult for everyone and impossible for many.
“If you think you can or think you cannot, you are correct.”
~ Henry Ford
Beliefs matter. A lot.
One’s experiences in life and one’s beliefs are closely connected, an idea that we explore in depth in our seminars. (The next ones are coming up in
March and
June . For instance, s
imply believing in the likelihood of success vastly improves the chances of good things happening to us and our accomplishing difficult tasks.
Whether it is the case that our beliefs help to shape reality, or merely how we experience it, is a distinction without a difference.
The tricky part is that our beliefs are usually hidden from us. Without conscious examination, they escape notice: lurking, shaping, and coloring our daily lives. Worse, beliefs quite often are not ‘ours’ in the sense that we create them by our individual thoughts and experiences. Instead, they are gifted to us by our society, culture, and media. Of course, when such beliefs are cynically shaped by those wishing to influence us (advertisers and big media come to mind , ‘gifted’ might not be the appropriate word.
Two very obvious efforts at shaping beliefs are currently being run in the US by various parties wishing to shape our collective beliefs to their liking. One is around the ‘necessity’ and desirability of going to war with Iran. The second, which we will examine closely in this report, concerns Peak Oil.
Whether or not Peak Oil is true cannot possibly be in doubt. Within anything other than a geological frame of time, oil is a finite substance. When it is burned, it is gone. Without stretching our brains very far, it is easy to conclude that anything that is finite and consumed will someday be gone.
Peak Oil, then, is really an observation, not a theory.
It draws upon and has at its disposal decades of experience with individual oil fields, producing basins, and entire countries all repetitively experiencing the exact same behavior: Oil production increases up to a point, and then it decreases afterwards. This is not theory; it is a related set of facts and careful observations.
It's odd that so many people will trust a psychiatrist to administer psychoactive drugs, about which so little is actually known, yet distrust Peak Oil, an idea about which so much is definitively known. As you can see, I am of the opinion that for some people, information (or data and beliefs have an awkward relationship at best, and a non-existent one at worst.
The only aspect of Peak Oil that is
theory is the precise moment at which the world will experience its final peak in flow rates.
When the peak will happen is a theory; Peak Oil itself is not. Because of this, it is flow rates that we care
most
about, which constitute a description of quantity. But we need to also concern ourselves with the net energy returned from the oil we expend effort to obtain, which is a matter of the quality of the oil.
Those are the two "Q's" that matter.
Quantity
and
quality
.
Given all this, note the headlines of the next two linked articles that recently appeared in the news media. Ask yourself,
What sorts of beliefs are they reinforcing?
And which ones they are minimizing, if not attacking?
The End of the Peak Oil Theory
Feb 16, 2012
If you haven't noticed, the oil apocalypse has been delayed -- again -- and the doomsday predictors are undoubtedly eating crow while they concoct another mega disaster. "Peak oil," the theory that oil production will soon hit a peak and begin declining, sending the world into an economic disaster, failed to live up to its hype again.
It's amazing how fast perceptions of our energy future can change. One day prevailing wisdom tells us that energy costs are going to rise uncontrollably as oil production declines and new energy sources fail to live up to their promise. The next, our problems are solved, and our reliance on foreign oil appears to be evaporating before our eyes.
(
Source
Citigroup Says Peak Oil Is Dead
Feb 17, 2012
Citigroup announced to the world Thursday that peak oil is dead. The controversial idea that world crude oil production is almost at its peak and will soon begin an irrevocable long-term decline has been laid to rest in the highly productive shale oil formations of North Dakota, with potentially big consequences for oil prices, the bank said.
“The belief that global oil production has peaked, or is on the cusp of doing so, has helped to fuel oil’s more than decade-long rally,” Citigroup said in a note to clients. “This is now all changing because of what is happening in North Dakota,” where new technology has led to a large and unexpected surge in oil production from shale rock.
After decades of decline, “U.S. oil production is now on the rise, entirely because of shale oil production,” said Citigroup. Shale oil could add almost 3.5 million barrels a day to US oil production between 2010 and 2022 and has already slashed 1 million barrels a day from U.S. oil imports. One day it may allow the U.S. and Canada to be self-sufficient in oil, it said.
(
Source
Obviously the idea of Peak Oil as a concept is directly under attack in these articles, but there are a host of underlying beliefs in play as well. One concerns the ability of the US (once again to become self-sufficient in oil by applying a bit of good old-fashioned ingenuity and a healthy slathering of high technology.
Another seems to be the belief that we might not have to change our ways after all; that the energy will be there in sufficient quantity (and
quality
! to support an indefinite continuation of past consumption and growth far into the future.
Don't worry, be happy
is the message.
Avoiding Propaganda
The definition of propaganda is
"a form of communication that is aimed at influencing the attitude of a community towards some cause or position."
It usually involves the selective use of facts or the avoidance of appropriate context, coupled with loaded messages and words, in order to elicit an emotional rather than rational response.
Whether the goal is to lead an otherwise unwilling populace towards war or to drive the purchase of a new car, propaganda is not only alive and well, but getting steadily better. Consider it a technology; like any technology, it is constantly being refined using the latest and greatest research, studies, and testing.
If you'd like to parse the articles further, go back and re-read them, looking for 'shaping' words that create impressions and are designed to elicit confidence, exude authority, or in other ways bypass the reader's own critical thought processes. Examples of such words and phrases would be 'controversial,' 'concoct,' and 'laid to rest.' These are not neutral words, but heavily biased ones, and we are so surrounded by them in what otherwise appear to be (and should be, ideally informational articles that they often escape notice.
The emotions being evoked possibly include: feeling silly for holding the wrong ideas (a form of social shame , anger (at being grievously misled by those nasty "Peak Oilers" , and elation ("Yay! No changes necessary!" .
These same sorts of emotional devices are constantly at work in the fields of finance, politics, investing, and advertising. Propaganda is a means to an end, and some argue that it can be beneficial if it moves us towards a better future and/or outcome.
But the risk here is that we are faced with propaganda that is sending the exact wrong messages at a very critical time.
What Could Possibly Go Wrong?
For a moment, let's accept the emotional premise of the above articles and shape our decisions around the idea that Peak Oil has been debunked and is a failed concept. What would change?
For starters, we can drop our concerns about the implications of steadily rising energy prices. Instead of buying smaller cars, more efficient homes, and placing our investments in those sectors that will prove resilient to higher energy costs, we can just go back to ignoring energy costs as a factor, content with knowing that they will be going down, not up.
Next, we can dispense with any concerns we might have had about how we will grow the economy going forward. Because you need energy -- especially oil -- to grow an economy, we can wholeheartedly invest in the stock market, confident that growth will once again emerge as it always has, unchanged and unfettered. 10% real, annualized returns are coming back!
The relief at being able to count on the future resembling the past, only bigger and presumably better, is palpable and seductive.
The only problem here is,
what if that view of the future is wrong?
Then what?
Everything.
All your plans for happiness, safety, wealth, and comfort go right out the window.
And the odd part is that adjusting to the idea of Peak Oil when it can nudge you towards using less energy more efficiently is just good business and good wealth preservation practice under any circumstances, with high oil prices or low. It really makes no sense to internalize any messages that seek to belittle Peak Oil. In fact, it makes sense to spot them and reject them as rapidly as possible. The risks are just too asymmetrical
Is Peak Oil Really Dead?
Okay, now it's time for a little data to put the above claims of Peak Oil being dead into proper context. In
Part II of this report we'll examine the data more closely, but for now this chart from the US Department of Energy should suffice to show where we are in terms of the US oil production story.
Yes, the Bakken could produce as much as 2 million barrels per day (bpd up from roughly 500 thousand bpd, maybe as much as 3 million bpd, but the US imports roughly 8 million bpd today under even severe economic conditions, and as much as 10 million bpd under happier economic conditions.
The Bakken and other shale plays are simply not going to replace
all
of that -- ever. Note, too, the slope of the line before the 'Bakken bump,' and observe that whatever gains are realized from shale oil will be fighting depletion losses from the rest of the tired fields under production.
And the Bakken will someday peak, too, and then where will we be? In the same place as before, wondering where we are going to get our next fix.
A Better Narrative
I would not mind the excitement over the Bakken as much as I do if it came along with a suitable narrative that made sense. Something along the lines of,
"The Bakken is very exciting because it offers us the chance to use domestic supply to begin to move away from our national oil dependence and towards a more sustainable energy future, one where we are not shackled to the need for endless production increases to fuel exponential economic growth. This transition will even make our monetary system much more healthy and robust."
But it is never packaged that way. Instead the message is always something like,
"Don't worry, be happy (and just get back to whatever it is you do, and be sure to shop a lot !"
At the very least, the Bakken should be telling the authors of the above articles and positions something quite different than what they are relating. For one thing, the amount of technology and constant expertise involved in squeezing the oil out of the formation clearly tells us that the easy, cheap oil is gone.
The complexity is on display if one just bothers to look. Here's a prime example relating to new attempts to squeeze more oil out of the tight shale formation:
While PetroBakken is bullish on dry natural gas injection, the company isn't ruling out the possibility of injecting water-or other fluids-for future projects in other areas of the Bakken.
PetroBakken is using the pilots to test different concepts or well configurations. For example, in the second pilot-which will inject natural gas at a rate of about two million cubic feet per day-gas will be injected along the entire horizontal section of the injection well, so the flood front will hit the toe of each of four perpendicular producing wells.
"As gas breaks through at the toe of each well, we have the ability to simply plug off the toe area of the producing horizontal well and mitigate the cycling of the gas at that port," LaPrade explains.
"The front would continue to move along the horizontal producing leg to the next port, where we would again plug that port off as the gas breaks through."
Typical wells in the Bakken come in at an average 200 barrels of oil per day and decline about 70-75 per cent in the first year before flattening out at 30-40 barrels per day.
(
Source
I think this is incredible ingenuity, and I admire the creativity and engineering on display. But all of this effort to fight the natural tendency of a Bakken well to produce at 30-40 bpd clearly is not the same thing as chunking a vertical well a thousand feet down and getting 1,000 to 10,000 bpd flow rates. The cost to produce a unit of energy is much higher in the Bakken case than in traditional, historical oil plays.
That is, net energy is lower than in the past, which cycles us back to the
quality
argument. The difference between cheap and expensive oil is important and clearly on display here, but that subtlety has somehow eluded the authors of the above articles.
Conclusion
Efforts are underway to convince the general populace that our energy concerns are a thing of the past and that the new energy discoveries in the Bakken and other shale formations have proven Peak Oil to be a mistaken idea. Some efforts go even further and flatly state that energy independence is right around the corner.
Nothing could be further from the truth.
There is a very clear relationship between economic growth and sufficient
quantities
of high
quality
energy. A crude measure of energy quality is its price. The lower the price for a unit of energy, the higher its quality (or net energy , but this is a very crude measure that can and often is heavily distorted by subsidies, market pressures, and other factors. As we squint at the world price for oil and note that Brent today is trading at $120 per barrel, it is clear that this high price is signaling that energy is now more expensive than it used to be.
By adopting the belief that Peak Oil has been debunked, one runs the risk of missing the larger story that our current economic model is unsustainable. And that stocks and bonds and other traditional investments that derive a large portion of their current value from expectations of future growth simply may not perform anything like they have in the past. And worse, that recent and continuing efforts to revive the old economy by printing money risk the destruction of the money system itself.
Given this all-too-human tendency to attempt to preserve the status quo, in this case by printing money, I must reiterate my advice to be sure that gold forms a significant portion of your core portfolio.
In
Part II: Preparing for a Future Defined by Peak Oil, we do the math to show that even using the rosiest estimates, there is no way for the Bakken field to get the US anywhere close to "energy independence" nor stave off the arriving society-changing impact of Peak Oil.
If that's the case, then what's to be done?
Now, more than ever, is the time to develop a full understanding of what the arrival of Peak Oil will do to world economies, financial investments like stocks and bonds, and our energy-indulgent way of living. As I have been writing for some time now, the next twenty years are certain to be quite different from the past twenty. Use the time you have now to invest in the pursuits -- and there are many -- that will reduce your vulnerability to the effects of rising energy costs, and learn that prosperity in such a future is possible if we lay the groundwork for it now.
Click here to access Part II of this report
(free executive summary; enrollment required for full access .
 |
Nassau, Bahamas - Dr. Gerarda Eijkemans the new PAHO / WHO Representative in The Bahamas paid courtesy calls on both the Prime Minister the Rt. Hon. Hubert Ingraham and His Excellency,
Governor General Sir Arthur Foulkes on
February 17th, 2012.
The Pan American Health Organization (PAHO is an international public health agency with more than 100 years of experience in working to improve health and living standards of the countries of the Americas...
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Created: 2/21/2012 10:05:00 AM
Last Editorial Review: 2/21/2012
Category: Health News
Created: 2/20/2012 6:06:00 PM
Last Editorial Review: 2/21/2012
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Created: 2/20/2012 2:05:00 PM
Last Editorial Review: 2/21/2012
Category: Health News
Created: 2/20/2012 6:06:00 PM
Last Editorial Review: 2/21/2012
Category: Health News
Created: 2/20/2012 2:05:00 PM
Last Editorial Review: 2/21/2012
Category: Health News
Created: 2/20/2012 6:06:00 PM
Last Editorial Review: 2/21/2012
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