What the Health – an awful documentary

If anyone fancies watching the documentary ‘What the Health’ on Netflix I’ll save you the trouble.

This is a documentary that supposedly exposes some concealed truths about diets and health. Their main conclusion seems to be that eating meat causes diabetes, and eating sugar does not. They propagate the common myth that eating fat makes you fat (it doesn’t). And they will cause more diabetes if people watch it and eat more sugar as a consequence.

Their agenda is undoubtedly to promote veganism and meat-free diets. Reducing meat consumption is hugely important, as animal agriculture is a massive contributor to climate change. And over-consumption of processed meats in particular can have detrimental health impacts, but this film unnecessarily spreads abundant false information. It has a worthy cause but totally misrepresents the science and evidence in trying to pursue its goals. This can not only lead to less trust of scientists, experts and health organisations, but can actively push people towards unhealthy choices.

Therefore, I don’t recommend it. And it provides a perfect example of why you can’t believe everything you see or read, just because it has quality production value and some Dr’s in lab coats.

For a full debunking please see the link below.

https://robbwolf.com/2017/07/03/what-the-health-a-wolfs-eye-review/

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Vaccines Do Not Cause Autism

vaccine baby

You may have heard the worrying suggestion that the MMR vaccine causes autism. Thankfully, this is most certainly not true. So why exactly is it suggested?

Bad science

In 1998, a paper was published in a scientific journal called The Lancet, authored by Andrew Wakefield, in which he argued that 12 children with autism had developed the condition from the MMR vaccine. This paper was later retracted by the journal as it provided no actual evidence for a link between autism and the vaccine, included falsified data, and Wakefield had failed to declare a massive conflict of interest. Before the study started, the parents of some of the children were trying to sue MMR manufacturers, because they believed the MMR vaccine had caused their children’s autism, and Wakefield was recruited and paid by lawyers to find that link1.

Consequently, Wakefield was struck off the medical register for his deeply unethical actions, although many would suggest that his punishment was not great enough. Wakefield is responsible for initiating the deeply troubling anti-vaccination movement, which is allowing infectious diseases that we were doing quite well to control, to kill more and more people. Even today, he continues to publish books and “whistle-blowing” documentaries which claim to reveal an institutional cover-up of the link between MMR vaccines and autism.

In response to this, the international medical community has invested huge amounts of time and money over the past 19 years, to find out if there really is any increased risk of autism from having the MMR vaccine. As a result, after all of the controversy and fear-mongering, the MMR vaccine is now the one thing which we can be most certain does not cause autism, because so much money has been spent, on study after study, looking for this alleged link2. But this has all come at a cost – fewer studies researching the true, still mostly unknown, causes of autism.

The scientific method

In science we can never say anything with absolute, 100% certainty, because as the weight of evidence grows larger and larger, we simply make it less and less likely that an alternative is true. But when all of the evidence points overwhelmingly in one direction, we allow ourselves to think of things as facts. Evolution is a fact. Climate change is a fact. “The MMR vaccine does not cause autism” is a fact.

The reason so many people put their trust in science, is that they know that one or two studies, or even half a dozen, could get things wrong for one reason or another, but eventually, with lots of different ways of looking at a problem, we will find the right answer. Nothing is ever taken for granted, everything builds upon previous work, and nothing is left unchallenged. The reason scientists feel comfortable accepting that evolution is true, is because every possible attempt to disprove it has been unsuccessful. And the UK’s National Autistic Society is clear “that there is no link between autism and the MMR vaccine”, because unbelievably, unnecessarily large amounts of time and money have been spent looking for this link, and found none3.

So what are the dangers?

Vaccines are effective because of herd immunity. If 95% of a population (for example) are vaccinated, a disease can be all but eliminated as there are not enough hosts for it to jump between. So the 5% who do not get vaccinated are also reasonably well protected from the disease. However, if more and more people forego vaccination, then there are suddenly enough hosts for the disease to spread between, and new outbreaks can occur. In 1996, 92% of people in the UK were MMR vaccinated, and there were just 56 reported cases of measles. 12 years later, the number of cases hit 1,348, after the number of people vaccinated had dropped to around 80%4. Wakefield’s falsified paper was quite clearly to blame, although equally responsible were the media, with their scaremongering and inaccurate reporting of this story. Media coverage was typically very poor – many outlets reported on Wakefield’s tiny anecdotal study whilst ignoring the enormous weight of quality evidence pointing to the safety of MMR.

Vaccines have enabled us to fight back and even wipe out infectious diseases which were killing people in their millions. Smallpox was the first human disease to be eradicated globally in 1980, and it was responsible for killing 2 million people as recently as the year 19675. Subsequently, vaccines have allowed us to eradicate a second disease, Rinderpest, which was a mass killer of livestock. Without vaccines, each of us, and each of our children, would be susceptible to horrendous, life-threatening diseases. And that is the very real danger that this anti-vaccination movement is amplifying. Just look at news reports from the past few years and you can see evidence of measles outbreaks in parts of the world that we thought had brought it under control – London in 2016, California in 2015 and Swansea in 2013. In the developing world, huge numbers of people are still dying from infectious diseases every day, and it is vital that we provide vaccines to protect people from these diseases.

So why does anyone believe it?

People like conspiracies. They like believing that mainstream science has got something completely wrong, and that government is secretly harming or controlling its people. It would not surprise me if many of the people who are anti-vaccination are also climate change deniers, or even evolution deniers. But there is no doubt that many bright, well-meaning people out there have simply got the wrong end of the stick, and that desperately needs to change.

After a turbulent 2016, it seems we are now living in the post-truth era, where made up, non-sensical, “alternative facts” can be given as much time as legitimate truths. They might sound harmless, but when decision makers use “alternative facts” as justifications for their actions it is simply a tactical way of deceiving the public, and outright ignoring the established evidence. This is an incredibly dangerous situation, and can only be avoided by ensuring that the voices of our respected experts are being heard, particularly when bad science or made up shit hits the headlines. Experts owe it to us to stand up and speak out, and we would be wise to listen carefully. 

 

Picture credit: Amanda Mills, USCDCP

References

  1. Brian Deer – “Revealed: MMR Research Scandal” Reprint of The Sunday Times
  2. University of Oxford – Vaccine Knowledge Project
  3. The National Autistic Society: Our position – MMR vaccine
  4. BBC News – Q&A: Measles 28th November 2008
  5. World Health Organisation – Smallpox

 

Cancer Misconceptions

There are a number of misconceptions I believe some people have about cancer, which I thought I would attempt to clear up.

  1. All cancers are alike
  2. We should find a cure for cancer soon
  3. Getting cancer is unlucky
  4. Cancer is a man-made disease

 

1. All cancers are alike

By using the term cancer we tend to think of it as a single illness, with a range of risk factors, such as smoking, eating unhealthily, drinking alcohol to excess and being exposed to radiation. But from a biological standpoint, cancers vary hugely, with over 200 types of cancer, and subtypes that vary drastically. All cancers are the result of abnormal cell growth. Normally, growth of our cells is controlled by oncogenes, promoting it, and tumour suppressor genes, inhibiting it. But occasionally a mutation will arise in a critical gene, which various safeguard mechanisms attempt to identify – so they can correct the mistake or else instruct the cell to self-destruct. However, very occasionally a mutation is missed by the safeguards (or the mutation is in a gene for the safeguards themselves!) and the abnormal cell can start growing uncontrollably; replicating, spreading, mutating and evolving as cancerous tissue1.

Almost all cancers are caused in this way, but the precise genetic fault that causes the cell to start growing abnormally and avoid self-destruction can be one of many thousand, or even million! As with any existing complicated system, the vast majority of changes will be detrimental to its function. Even in the same tissue type, there can be numerous different kinds of cancers, with very different causes. But cancers can start to grow in any tissue type in the body, and these usually differ substantially from one another. This brings us on to misconception number 2.

 

2. We should find a cure for cancer soon

Cancers vary widely in their causes and this means that there will never be a ‘cure for cancer’. Compared to most diseases cancers are incredibly difficult to treat because the cause is the body’s own cells, growing uncontrollably. Once it has begun there is almost no stopping it, as the body is unable to recognise the cancerous tissue as being a threat, as it has the “self” marker that foreign pathogens causing other diseases lack. Attempts at fighting the cancer by doctors are similarly thwarted – it is difficult to target the abnormal cells alone, hence why chemotherapy typically causes harmful side effects.

On top of this, a single cancer tumour has a whole succession of mutations, varying by location in the tumour, plus a tendency to mutate rapidly. Treatments can be aimed at the genetics of a sample unrepresentative of the entire tumour, and drug resistance can quickly emerge if a drug fails to destroy every cell quickly enough. As with other diseases that can evolve resistance to antibiotics, cancers can quickly mutate and overcome our most effective treatments2. Doctors compensate by administering a huge dose and combination of different drugs during chemotherapy, reducing the odds that the tumour will become resistant to the treatment. Unfortunately, the large dosage also contributes to the severe side effects that many cancer patients experience.

It is likely that many cancers will prove to be incurable, but by concentrating our efforts on the most common killers, we may hopefully be able to cure some of them in future. However, I think it is unlikely that cancers will ever stop being a leading cause of death. If you look at causes of death over the past couple of hundred years you can see that cancers have increased hugely. This rise in cancers can be attributed to people living longer due to improved sanitation, nutrition and medical care. No longer are infants lucky to make it to their teenage years, and no longer are adults lucky to make their 60th birthday. But unfortunately cancers become much more likely in old age, and this leads us on to misconception number 3.

 

3. Getting cancer is unlucky

The average life expectancy in the UK today is 81, which by the standards of any of our ancestors is incredibly long! While we are no longer likely to die from infectious diseases like diarrhoea, pneumonia and tuberculosis, which killed many of our ancestors, we are now more prone to developing a cancer. The reason for this is simple; cancers are caused by genetic mutations and these accumulate over time from mistakes in DNA copying (in cell cycles) and exposure to environmental risk factors. Now that we are lucky to live longer lives, we are much more likely to get and die from cancer.

According to Cancer Research UK, 1 in 2 people in the UK born after 1960 will develop cancer in their lifetime2. So getting cancer is just as unlucky as losing a coin toss. However, it should be recognised that lifestyle and environmental risk factors play a vital role too. Behaviours such as smoking, drinking, failing to exercise, eating a poor diet and getting sun burnt can vastly increase your chances of developing a cancer. So you obviously shouldn’t think of cancer as inevitable and throw caution to the wind!

While cancer is terrible as it takes many of us to our graves, it is actually a sign that we are living long lives in the first place. It should be noted that some cancers do strike people while they are young, but these are quite rare cases (less than 2% of all UK cancer cases are in under 25’s2). Why are cancers more common when we are older? Because there was a strong selective pressure for people to live to rear offspring, and to care for those offspring until they reached reproductive age in turn. So there was a strong pressure for people not to get cancer and die at a young age, before passing on their genes – those that failed left no offspring and those that succeeded were our ancestors. In contrast, the selective pressure on our ancestors to stay alive and be free of disease into old age was very relaxed. If a genetic disease doesn’t strike until we are 50, then it won’t be rapidly selected out of the population, as our children will already be passing on our genes!

All organisms face a trade-off in allocating energy to different aspects of their lives – growth, reproduction and maintenance (immune system and repair). Natural selection has led to strategies that produce optimal allocations of their resources, on average, resulting in a maximum possible number of strong, healthy offspring (biological fitness). The body spends energy defending itself against environmental, as well as genetic, factors that can trigger cancer, such as sunlight, viruses, bacteria and carcinogens. It pays to invest large amounts of energy supressing mutations that could lead to cancer in early and reproductive years, but the payoff to this maintenance reduces dramatically post-reproduction3.

There are so many different possible forms of cancer that we could get, and our chances increase rapidly as we age. Unfortunately, it is not bad luck if you get cancer and die from it in old age; that is how many of us can expect to die. Improved nutrition and medicine are allowing us to live longer and longer lives, and it is estimated that a third of all babies born today in the UK will live to be over 1004. However, even with great advances in genetic therapies, cancers will always be a huge difficulty to overcome; one that we may never be able to beat. So it is possible that many of us will live for over 100 years, but it is not very likely that we’ll be able to stay free of cancer forever.

 

4. Cancer is a man-made disease

This is absolute nonsense. The entirety of multi-cellular life has the ability to get cancer, and many other animals do get cancer; if they are lucky enough not to get injured, diseased or eaten before they get old.

A more accurate statement is that cancer is more common in modern times. Some environmental risk factors for cancer such as smoking, drinking alcohol, eating unhealthily and air pollution are no doubt more common in modern society. But the main reason cancer is more common is that we live longer lives; our bodies deteriorate with exposure to carcinogens and our cellular defences against cancer can’t protect us forever.

 

Special thanks to Jonathan Lockett, my cancer expert, for his technical knowledge and tips.

 

  1. Casás-Selves, M., & DeGregori, J. (2011). How cancer shapes evolution, and how evolution shapes cancer. Evolution4(4), 624–634. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660034/
  2. Cancer Research UK http://www.cancerresearchuk.org/cancer-info/cancerstats/keyfacts/Allcancerscombined/
  3. Aktipis, C., & Nesse, R. M. (2013). Evolutionary foundations for cancer biology. Evolutionary applications6(1), 144-159. http://www.athenaaktipis.com/Home_files/AktipisNesse2013.pdf
  4. Office for National Statistics http://www.ons.gov.uk/ons/rel/lifetables/historic-and-projected-data-from-the-period-and-cohort-life-tables/2012-based/sty-babies-living-to-100.html