Sunday 22 June 2008

Latest Attempt to Discredit Vitamin Therapies: Is it Criminal?

Managers of the I.G. Farben pharmaceutical and chemical cartel, sitting in the dock at the WWII Nuremberg war crimes tribunal. Charged with crimes including mass murder and crimes against humanity, thirteen of them were given prison terms ranging from eighteen months to eight years.

(Source)

In August 1947, two years after the end of the Second World War, twenty-four managers of the I.G. Farben pharmaceutical and chemical cartel appeared before an international war crimes tribunal in Nuremberg, Germany, to be charged with crimes including mass murder and crimes against humanity. The tribunal’s verdicts, delivered 11 months later, resulted in thirteen of the Farben defendants being given prison terms ranging from eighteen months to eight years.

Jump forward sixty years, to April 2008, and we find that much of the world’s media is awash with stories claiming that taking vitamin supplements could lead to a premature death. According to a review conducted on behalf of the Cochrane Collaboration by researchers at Copenhagen University in Denmark, studies using beta-carotene, vitamin A and vitamin E showed “significantly increased mortality”, whilst trials of vitamin C “found no significant effect.”

Read on to discover what the world’s media didn’t tell you about this Cochrane review, including its potential historical parallel with crimes committed by the managers of the I.G. Farben cartel.

Predetermined conclusions
with potentially genocidal results

With the World Health Organization attributing 15.3 million deaths to cardiovascular disease and 6 million deaths to cancer annually, it is clear that the genocidal potential of the Cochrane researchers’ recommendations – were they to be implemented into national health policies via restrictions on the sale of vitamin supplements – could ultimately exceed the total number of deaths caused by the I.G. Farben managers, above, by an order of magnitude.

The first thing that one needs to understand about the recent Cochrane Collaboration review is that it was not a clinical study but a meta-analysis. This distinction is an important one in that whilst a clinical study is a scientific test of how a treatment works in people, a meta-analysis is merely a statistical evaluation of the data taken from several hand-picked existing studies, pooled together and presented as a separate piece of work.

This meta-analysis utilized 67 randomized trials with antioxidant supplements (vitamins A, C, E, beta carotene and selenium) and concluded that vitamins A, E and beta carotene increase mortality risk by up to 16%. However, despite the extensive media coverage it received, very little attention was given to the fact that this analysis was not even a new one. In fact, the same topic, the same studies and the same authors from Serbia, Denmark and Italy, were published a year ago in the Journal of the American Medical Association (JAMA). Predictably therefore, and as has similarly been the case with this year’s version, the JAMA meta-analysis attracted much criticism from scientists, nutritionists and the dietary supplement industry. As a result, the authors later admitted that their paper contained errors and JAMA subsequently published corrections to it.

Now, however, we find that the same study has been “massaged” again and republished as “new”.

Moreover, and as the following article will show, this meta-analysis is simply the latest in a growing succession of anti-supplement publications by the same authors. In all of these publications, it is clear that the conclusions reached were essentially predetermined before so much as a single word had even been typed. As such, we are confident that the evidence we present here shows beyond reasonable doubt that the authors concerned are intent upon convincing national governments and the medical establishment that urgent political action should be brought to regulate vitamins as dangerous drugs.

However, with Cellular Health research having clearly identified the optimum daily intake of vitamins as a basic preventive and therapeutic measure against cardiovascular disease, cancer and many other health conditions, and the World Health Organization attributing 15.3 million deaths to cardiovascular disease and 6 million deaths to cancer annually, it is clear that the genocidal potential of these researchers’ recommendations – were they to be implemented into national health policies via restrictions on the sale of vitamin supplements – could ultimately exceed the total number of deaths caused by the aforesaid I.G. Farben managers by an order of magnitude.

Conclusions not consistent
with those of the studies analyzed

From a total of 815 vitamin studies considered for evaluation, the authors selected a mere 68 of them for their analysis in the 2007 JAMA publication and 67 for this year’s Cochrane review. As such, it is interesting to note that while the researchers were studying the effects of selected antioxidants on mortality, they failed to include any studies in which no one died during either the trial period or the follow-up period. In addition, the selected studies differed vastly from each other in a number of important aspects that have impact on the results:

  • The meta-analysis included 20 trials conducted on healthy subjects and 47 studies in which vitamins were taken by people suffering from a variety of diseases, such as Alzheimer’s; heart disease; macular degeneration; various cancers and other diseases. The analysis did not investigate the details of the causes of death, which not only included heart disease, cancer and broken hips, but also accidents, suicides and other causes. It is likely that deaths occurred due to previously diagnosed diseases, not antioxidant supplementation. If a true risk of mortality was apparent in any of the trials with antioxidants, the study would have been stopped. None, in fact, were stopped and such conclusions were not even indicated by the authors of the trials.
  • In many studies, the participants were taking not only tested nutrients but also a long list of other supplements and pharmaceutical drugs. It is apparent that the underlying health problems, as well as various medical interventions, drug and supplement treatments could all interfere or mask the effects that the authors attributed to one or a selected combination of chosen antioxidants.
  • The doses of supplements in different trials used for the analysis were significantly different. For example, vitamin E was used in doses of 10 IU (U.S. RDA is 22IU) and 5,000 IU per day. Similarly, vitamin A was used in the amounts of 1333 IU daily (U.S. RDA is 2333 IU for women and 3000 IU for men) as well as in doses of 200,000 IU (well above the upper tolerable limit of 10,000 IU). It is known that mega-doses of vitamin A, taken for a long period of time, can cause side effects. Worse still, the duration of supplement use varied widely: in some trials it was 28 days in others, 12 years.

It is a well-known principle that the more similar the chosen studies are, the more valid the meta-analysis. It’s rather like saying that one gets more accurate results when comparing apples with apples instead of apples with oranges, for example. In this meta-analysis however the studies analyzed were very divergent and the conclusions drawn by the authors are not consistent with the findings of the actual studies.

As such, it is particularly notable that only after the authors divided these 67 studies into groups of “high risk bias” and “low risk bias,” using their own criteria, did they observe a statistically significant effect on mortality. Otherwise there was no effect. The authors even acknowledged that their results are in conflict with observational studies, which show benefits of antioxidant supplementation and with secondary prevention trials, such as cancer prevention studies published in journals such as Nutrition and Cancer, the Journal of the National Cancer Institute, and Diseases of the Colon & Rectum. This exemplifies how the conclusion reached (antioxidant supplements increase mortality) was predetermined and that the authors just conducted a search for a method to support it.

Conclusions not consistent with real-world evidence

Statistical research shows that consumers of vitamin supplements have more chance of dying from being struck by lightning or from a wasp or bee sting than they have from dying as a result of ingesting their vitamin tablets.

Photo: Axel Rouvin, "CG lightning strike"
Some rights reserved.
Source: www.piqs.de

Statistics show that the conclusions reached in this meta-analysis bear no relation whatsoever to real-world evidence.

For example, data from the 2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System, published in the American Journal of Emergency Medicine in September 2004, states that in 2003 there were a total of only 4 deaths in the United States from the ingestion of vitamin supplements.

To put this number into perspective, a review published in the American Journal of Clinical Nutrition in 2005 estimated that approximately 70 percent of the US population uses dietary supplements at least occasionally, with around 40 percent using them on a regular basis. Given that the US population currently numbers 300 million people, this means that with 210 million Americans using dietary supplements occasionally and 120 million using them on a regular basis, dietary supplements are extraordinarily safe.

Moreover, setting aside the issue as to whether or not vitamins were even responsible for these 4 deaths – and in our opinion, in at least two of them, this is questionable - it is highly significant that none of them occurred due to the ingestion of either beta carotene, vitamin A or vitamin E – all three of which nutrients the Cochrane review claims increase mortality when ingested as supplements.

Statistical data from New Zealand and Canada provides still further confirmation that the risk of death from supplements relative to other factors is astonishingly small. In both of these countries, the research shows that consumers of vitamin supplements have more chance of dying from being struck by lightning or from a wasp or bee sting than they have from dying as a result of ingesting their vitamin tablets.

As such, in response to the claim that antioxidant vitamin supplements increase mortality, we must therefore ask a simple question: where are the bodies?

Clearly, our hospitals are not full of people suffering and dying from the effects of vitamins and other natural therapies. Instead, with adverse drug reactions being known to cost the British National Health Service £2 billion ($4 billion / €2.5 billion) annually and research showing that such reactions are now between the fourth and sixth leading cause of death in hospitalized patients in the United States and the seventh most common in Sweden, it can be seen that the global pharmaceutical industry’s sales of toxic patented synthetic chemical drugs are already responsible for mass murder on a scale almost unprecedented in human history.

And yet, if the researchers responsible for this Cochrane review get their way, it is scientifically-researched vitamin supplements, not the pharmaceutical industry’s deadly drugs, that would be the subject of political action to enact draconian restrictions upon their free availability. Without any doubt therefore, the deaths that resulted from such restrictions would be a crime against humanity of truly unimaginable proportions.

Given this potential outcome, and with leading pharmaceutical and chemical industry managers already having been found guilty of mass murder in the past, we find ourselves wondering whether the Cochrane researchers’ seeming attempts to aid the modern-day multi-trillion dollar pharmaceutical industry in its efforts to ban non-patentable vitamin therapies might ultimately lead to them, too, being found guilty of such a crime?

Why the review was conducted in Denmark

It was no accident that the Cochrane Collaboration chose the Knowledge and Research Centre for Alternative Medicine (ViFAB) in Denmark, and the Copenhagen Trial Unit’s Centre for Clinical Intervention Research, located at the Copenhagen University Hospital, Rigshospitalet, also in Denmark, as its sources of support for this meta-analysis.

Danish legislation covering food supplements is notorious for being harsh and restrictive. So much so, in fact, that, in recent years, Danish pro-natural health campaigners have been voicing concerns that their government’s totalitarian assaults on free choice and liberty - disguised as “consumer safety” - will ultimately eliminate the concept of supplements entirely in that country.

Notably therefore, the two supporting Danish organizations concerned have a number of conflicts of interest - both in terms of their sources of funding and their institutional bias – that raise serious questions regarding the outcome of this meta-analysis.

For example, the Knowledge and Research Centre for Alternative Medicine’s operational expenditure is funded by an appropriation stipulated in the Danish Finance Act. Its board members include representatives of the Danish Medical Association; the Danish National Board of Health and the Danish Ministry of Health and Prevention.

As for the Copenhagen University Hospital , it is notable that its specialist units include the Finsen Laboratory, which specialises in cancer research; a Department of Radiation Biology , whose research is carried out with support from state funds, cancer societies, and private foundations; the Bartholin Institute, which hosts research groups within Cancer/Immunology and Diabetes; a Department of Haematology, which treats disorders including malignant lymphoma, multiple myeloma, acute leukaemias as well as chronic lympho and myeloproliferative disorders; and a Laboratory of Gene Therapy Research; amongst others.

As such, far from being independent and non-biased, it can be seen that the funders of this study have a strong bias towards pharmaceutical medicine and a close affiliation to the decidedly anti-supplement Danish government.

Drummond Rennie, a director of the Cochrane Center in San Francisco and a deputy editor of the Journal of the American Medical Association, has long recognized the dangers that result from conflicts of interest of this nature. In 2004, for example, quoted in the British Medical Journal, he described it as “naive to think that those who have a financial conflict of interest will not be influenced when they do a review.” More to the point, he added that “there are avalanches of studies showing that studies and reviews are influenced by financial conflicts of interest, always in the direction that favours the commercial sponsor’s view.”

As we shall see next therefore, in the case of at least one of the authors of the Cochrane meta-analysis, Christian Gluud, MD, it turns out that Rennie’s observations are highly relevant.

Cochrane reviewer Christian Gluud’s conflicts of interest

Cochrane reviewer Christian Gluud’s scientific focus area is pharmaceutical research and development. Given that he is also an Ambassador and Member of the Scientific Advisory Board of Biologue, a Danish organization that is closely integrated with the Danish Pharma Consortium and whose members include pharmaceutical companies such as AstraZeneca, is it any wonder that he wants antioxidant supplements to be regulated as drugs?

Whilst media interest has tended to centre around Goran Bjelakovic, MD , the leader of the team authoring the anti-supplement meta-analysis, we find it unfortunate that far less attention has been paid to his main co-author, Christian Gluud, MD - especially so given that the latter would appear to have numerous conflicts of interest and connections to organizations having a strong institutional bias towards orthodox (i.e. pharmaceutical) medicine.

Along with his work at the Copenhagen University Hospital, for example, Gluud is an Ambassador and Member of the Scientific Advisory Board of BioLogue, where his scientific focus area is listed as being pharmaceutical research and development. Closely integrated with the Danish Pharma Consortium, the BioLogue network consists of several academic, governmental and regulatory partners; member companies - including pharmaceutical companies such as AstraZeneca Denmark; and the vast majority of biomedical researchers in Denmark. The members of BioLogue’s Steering Committee include representatives of the Danish Association of the Pharmaceutical Industry and the Danish Medicines Agency, amongst others. Significantly therefore, so far as the JAMA (2007) version of the meta-analysis is concerned, Gluud is stated as having been responsible for having obtained the funding for it. Moreover, and as we shall discover later, some sources even appear to infer that Gluud, rather than Bjelakovic, is the Cochrane review’s main author.

The Cochrane Collaboration’s conflicts of interest

The Cochrane Collaboration published a review of the migraine drug Eletriptan that was funded largely by Pfizer, Eletriptan’s manufacturer, at a time when Pfizer’s then president and chief executive officer, Henry McKinnell, above, was simultaneously a director of the Cochrane Library’s publishers, John Wiley and Sons.

The Cochrane Collaboration describes itself as an “independent organisation”, saying that it was established “to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide.” It also states that its central functions are funded by royalties from its publishers, John Wiley and Sons Limited, and that these come from sales of subscriptions to The Cochrane Library. The individual entities of The Cochrane Collaboration, meanwhile, are stated as being funded by a large variety of governmental, institutional and private funding sources, bound by an organisation-wide policy limiting uses of funds from corporate sponsors.

As we shall see however, behind these claims lie a number of important and uncomfortable facts that Big Media - in its apparent eagerness to inform us that taking vitamin supplements could lead to a premature death - has curiously neglected to make mention of.

Regarding Cochrane’s widely-trumpeted claim to be “independent,” for example, it turns out that the validity of this assertion has long been highly questionable. As long ago as October 2003, the British Medical Journal (BMJ) pointed out that the Cochrane website contains two reviews of migraine drugs - Eletriptan and Rizatriptan – that were funded largely by Pfizer, the manufacturer of Eletriptan.

Whilst the lead researcher on both these reviews, Andrew Moore, has been quoted as saying that he “strongly defends” their sponsorship by Pfizer, the fact is that both he and another of the Eletriptan reviewers have worked as consultants for pharmaceutical companies and other bodies, and have received research grants from industry, government, and charities. As such, there is clearly an argument to be made that Moore’s defence of the two migraine drug reviews is anything but independent.

To make matters even worse however, Cochrane published the review of Eletriptan at a time when Pfizer’s then president and chief executive officer, Henry McKinnell, was simultaneously a director of the Cochrane Library’s publishers, John Wiley and Sons.

Nevertheless, despite these serious conflicts of interest, at the time of writing (May 2008) both the Eletriptan and the Rizatriptan reviews remain available on the Cochrane website.

By November 2003 therefore, with the BMJ having openly stated that Cochrane had reached a crossroads over its drug company sponsorship, and Cochrane participants sharing stories of being offered cash for good reviews by drug companies, Cochrane’s leadership had no alternative but to announce that it was acting to allay fears over the influence of industry.

However, although the drug company sponsorship issue subsequently dominated Cochrane’s 2003 annual conference in Barcelona – the key sponsors of which included the drug makers Merck Sharpe & Dohme, Novartis, and AstraZeneca, whose logos were prominently displayed on the first page of the conference’s programme booklet - the Cochrane leadership failed to make a decision and opted instead for a complex consultation with its members.

Limits on commercial funding were subsequently proposed in February 2004, resulting in a new policy being issued in April 2004. Nevertheless, close examination of Cochrane's current policy on commercial sponsorship reveals that several highly significant anomalies remain.

For example, people who are employed by a pharmaceutical company are still not prohibited from taking part in reviews relating to the products of that company. Just as crucially, there is nothing to prevent people employed by pharmaceutical companies, people working as consultants for pharmaceutical companies, or people who have received research grants from pharmaceutical companies from taking part in reviews of competing products or systems of medicine such as vitamin therapies.

In addition, Cochrane’s current policy specifically states that government departments, not-for-profit medical insurance companies and health management organizations are not defined as commercial sources. As such, despite the fact that the vast majority of these have close links to, and tend to be strongly supportive of, the pharmaceutical industry, they are still permitted to sponsor Cochrane reviews. So, for example, although it is widely known that the US Food and Drug Administration has a close relationship with the pharmaceutical industry, Cochrane’s policy does not prevent it – or its counterparts in other countries – from sponsoring reviews. Revealingly therefore, Cochrane’s Report and Financial Statements for the year ended 31 March 2006 show that fully 79 percent of its funding for the preparation of reviews comes from “National and transnational government funding (including EU), typically from health and related ministries.”

As such, Cochrane’s stated claim that it was “established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide” has to be balanced against the fact that the majority of its funding comes from bodies with close links to, and strong support for, the pharmaceutical industry. In light of this, it seems hardly surprising that the majority of its reviews deal with the evaluation of drug-based therapies. Indeed, bearing this in mind, it is particularly notable that the members of the Cochrane Collaboration’s Steering Group, who direct its activities, are themselves virtually all employed by either university medical departments, hospitals or government health departments, all of whom by their very nature have extremely close connections to the world of orthodox (i.e. pharmaceutical) medicine.

As a result, given that natural therapies such as vitamin supplements are increasingly now coming under heavy attack worldwide from governments and their health-related ministries, it is not difficult to imagine that the Cochrane Collaboration would not want to bite the hands that feed it financially – especially so given the revealing statements in its Report and Financial Statements that “a significant number” of the Cochrane Collaboration’s Review Groups and Centres “are facing severe financial pressures” and that “others are struggling to maintain all or part of their funding.”

Pharma and chemical interests of the
Cochrane Library’s publishers, John Wiley & Sons Ltd.

The Cochrane Collaboration states that its central functions are funded by royalties from its publishers, John Wiley and Sons Ltd., which come from sales of subscriptions to The Cochrane Library. Even here however, it turns out that things are not quite as simple as they might initially seem.

For instance, Wiley's scientific, technical, medical, and scholarly business is known as Wiley-Blackwell and publishes over 300 medical journals, examples of which include: Cancer, the flagship journal of the American Cancer Society; Cancer Science, the official journal of the Japanese Cancer Association; the European Journal of Cancer Care; Diabetic Medicine, the journal of Diabetes UK; HIV Medicine, the official journal of the British HIV Association (BHIVA) and the European AIDS Clinical Society (EACS); the International Journal of Gynaecological Cancer, the official journal of the International Gynaecologic Cancer Society and the European Society of Gynaecological Oncology; and the Journal of Interventional Cardiology.

Moreover, it is also notable that Wiley’s acquisition in 1996 of VCH Publishing Group, the publishing arm of the German Chemical and Pharmaceutical societies, made it one of the largest chemistry publishers in the world.

As such, there is clearly an argument to be made that Wiley, as the Cochrane Library’s publisher, has a vested interest in the promotion of pharmaceutical and chemical medicine. From its perspective, any promotion of natural non-patentable alternatives - such as vitamin therapies – could likely be seen as a threat to its future profits.

The Cochrane reviewers’ ultimate aim:
“urgent political action” to bring in stiffer regulation of antioxidant supplements

Surprisingly, amidst the predictable media frenzy that resulted from the publication of this Cochrane review, there was very little attention paid to the reviewers’ ultimate aim.

Quoted in a Medical News Today article however, the reviewers made a "plea for urgent political action" to bring in stiffer regulation of antioxidant supplements. Even more interestingly, the Medical News Today article appears to infer that Christian Gluud - rather than Goran Bjelakovic – was the review’s main author and specifically quotes Gluud as saying “in no uncertain terms” that: "We should request that the regulatory authorities dare to regulate the industry without being financially dependent on the very same industry."

Of course, had Gluud’s criticism been levelled at pharmaceutical companies – in that regulatory agencies virtually the world over are highly dependent on licensing fees and other income from the drug industry - then it would clearly have been a reasonable one. By comparison, however, in most countries vitamin companies have traditionally contributed either very little or next to nothing, financially speaking, to the government agencies that regulate them. Notably therefore, Gluud neglected to make any mention of this important fact.

As such, enterprising journalists – and by this we mean journalists who prefer to do their own research, as opposed to those who took the lazy option and merely used the Cochrane Collaboration’s press release as the basis for their articles – should further take note that the call by these reviewers for stiffer regulation is not even a new one as they have been making similar statements for some four years now.

In an earlier Cochrane review, published in October 2004, for example, the same reviewers similarly contrived to show that there was no convincing evidence that antioxidant supplements have a beneficial effect on the occurrence of gastrointestinal cancers or on overall mortality and that beta-carotene, vitamin A, vitamin C, and/or vitamin E increase overall mortality. Significantly therefore, they were openly of the opinion in this review that “antioxidant supplements should be regulated as drugs.” Similarly, that very same month, Bjelakovic, Gluud and two of the other members of their team had a study published in the Lancet in which they claimed they “could not find evidence that antioxidant supplements can prevent gastrointestinal cancers” and that “on the contrary, they seem to increase overall mortality.

The timing of these two October 2004 publications was highly significant, as they were brought to the attention of the worldwide media only weeks before a crucial meeting of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU), whose agenda on which occasion included consideration of a proposed restrictive global guideline on vitamin and mineral supplements. Sponsored by the World Health Organization and the Food and Agriculture Organization of the United Nations, the main functions of Codex committees revolve around drawing up standards and guidelines for the global food and food supplement industries. Codex texts carry binding authority under the World Trade Organization (WTO), which uses them as the benchmarks when adjudicating on international trade disputes involving food products. Because of this, WTO member countries almost invariably base their domestic food laws upon Codex’s standards and guidelines, not only as a means of promoting international trade but also to avoid having expensive trade dispute cases brought against them at the WTO.

Significantly therefore, the proposed Codex vitamin and mineral supplement guidelines had been subject to vehement worldwide protests for many years, and, as a result, their adoption had essentially been stalled since the mid-1990s. Nevertheless, perhaps due in no small part to the efforts of Bjelakovic, Gluud and their team, the CCNFSDU’s 2004 meeting resulted in the guidelines being advanced for final adoption at Step 8.

Finally, with respect to the Cochrane reviewer’s ultimate aims, it is also notable that Bjelakovic and Gluud wrote a particularly revealing editorial in the May 16, 2007 issue of the Journal of the National Cancer Institute. Discussing a study claiming that taking multivitamins may be associated with an increased risk for advanced or fatal prostate cancers, they stated that the study’s authors "add to the growing evidence that questions the beneficial value of antioxidant vitamin pills in generally well-nourished populations and underscore the possibility that antioxidant supplements could have unintended consequences for our health." In their editorial’s conclusion, Bjelakovic and Gluud suggested that supplements should be tested for benefits and harms before they come to the market and infer that they should be treated in the same way as pharmaceutical drugs. Predictably, of course, in doing so they neglected to mention that such testing would be prohibitively expensive for non-patentable substances such as vitamins and that only patentable substances, i.e. synthetic chemical drug medicines, offer the possibility of recouping the huge costs involved.

As such, bearing in mind Gluud’s absurd inference that regulatory authorities are “financially dependent” upon “the [vitamin] industry”, as opposed to the multi-trillion dollar patented synthetic chemical drug industry, it would appear that both he and Bjelakovic are developing something of a habit of ignoring not only relevant studies, but also relevant facts.

The influence of Big Media

Journalist Rachel Johnson wrote an article entitled ‘Not so vital vitamins’ for the Sunday Times in the UK in which she cited the Cochrane review, stated that vitamins are a waste of money and claimed that taking them may shorten life expectancy. She later confessed however that she “knew there was something fishy” about the Cochrane review but that she “was under pressure to back it” even though she “thought it was simply impossible to pin any of the outcomes on taking vitamins.”

Following the storm of protest that erupted after the recent Cochrane review’s publication, it didn’t take long for evidence to emerge that certain newspaper editors had put their journalists under pressure to back it .

The British journalist and writer Rachel Johnson, for example, had written an article entitled ‘Not so vital vitamins’ for the Sunday Times in which she cited the review, stated that vitamins are a waste of money and claimed that taking them may shorten life expectancy.

Subsequently however, upon being presented with an article – citing research published in the International Journal of Cancer – showing that a researcher who claimed vitamins can speed up the development of cancer has essentially admitted she got it wrong, Johnson confessed that she “knew there was something fishy” about the Cochrane review but that she “was under pressure to back it” even though she “thought it was simply impossible to pin any of the outcomes on taking vitamins.”

But why might Johnson have been put under pressure? Could it have anything to do with the fact that recent advertisers in the Sunday Times’ magazines have included companies such as Garnier, a division of L'Oréal – the latter of which is the world's largest cosmetics firm and currently holds an 8.7 percent stake in one of the world’s largest pharmaceutical companies, Sanofi-Aventis; Boots, the UK’s dominant pharmaceutical retailer and wholesaler; and BUPA, the UK's leading provider of private health care insurance?

Conclusion


If people are prevented from accessing safe natural health therapies, pharmaceutical-based medicine will essentially be the only option left available to them.

As was similarly the case with the 2004 Cochrane review and Lancet study, the publication of this latest Cochrane meta-analysis comes at a critical time in the global battle to maintain free access to non-patentable vitamin therapies.

The European Commission, aided and abetted by the European Food Safety Authority (EFSA), is currently in the final stages of setting maximum permitted levels for vitamins and minerals in supplements. At present, it is currently expected that these levels will be announced sometime before January 2009 and that in many cases the permitted dosages will be far less than those that are necessary to prevent chronic diseases and promote optimum health.

Meanwhile, in Canada, New Zealand, the United States and many other countries, similar regulatory efforts are also underway to enact restrictions upon the availability of natural health therapies. Clearly therefore, should these actions be successful and patients subsequently be forced to worship at the deadly alter of pharmaceutical medicine, countless millions of deaths will occur that could otherwise have been prevented by the application of Cellular Health research.

Bearing all of this in mind, the question has to be asked as to whether the deliberate actions of the Cochrane researchers - in aiding and abetting those who want to bring in draconian regulations for vitamin supplements - are potentially criminal.

In considering this question, let us briefly summarize the evidence.

Firstly, we know that Cellular Health research has the potential to save millions of lives. Similarly, we also know that most prescription drugs don't work for most people and that adverse drug reactions are now between the fourth and sixth leading cause of death in hospitalized patients in the United States. And yet, if people are ultimately prevented from accessing safe natural health therapies, pharmaceutical drugs will essentially be the only option left available to them.

As regards the recent Cochrane meta-analysis, we know that the two organizations who supported it - the Knowledge and Research Centre for Alternative Medicine (ViFAB) in Denmark, and the Copenhagen Trial Unit’s Centre for Clinical Intervention Research, located at the Copenhagen University Hospital, Rigshospitalet, also in Denmark - have a strong bias towards pharmaceutical medicine and a close affiliation to the decidedly anti-supplement Danish government.

In addition, we also know that the majority of the Cochrane Collaboration’s funding comes from bodies with close links to, and strong support for, the pharmaceutical industry and that Wiley, the Cochrane Library’s publishers, has a vested interest in the promotion of pharmaceutical and chemical medicine.

Finally, and perhaps most seriously of all, we know that the scientific focus area of Christian Gluud, one of the leading authors of the Cochrane meta-analysis, is pharmaceutical research and development and that he has numerous conflicts of interest and connections to organizations having a strong institutional bias towards orthodox medicine.

As such, given all of the above, when Gluud and his colleagues make their pleas for “urgent political action" to bring in stiffer regulation of supplements, what are we to conclude? Are we supposed to believe that the various conflicts of interest described above are all merely coincidental and that the ongoing efforts of Gluud and his colleagues to discredit non-patentable vitamin therapies are somehow not intended to protect the interests of the multi-trillion dollar global pharmaceutical industry and its Investment “Business With Disease”?

Frankly, we think that the evidence presented here is already too strong for any reasonable person to dismiss out of hand. So much so, in fact, that we are confident the organizers of the “vitamins lead to a premature death” campaign will eventually be called to account for their actions.

Justice will prevail - the health and lives of countless millions of people are depending on it.

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Monday 16 June 2008

Why Oil Prices Are So High

A Weak Dollar, Bad Fed Policies and Hedge Fund Speculators
By Paul Craig Roberts
6-14-8
How to explain the oil price? Why is it so high? Are we running out? Are supplies disrupted, or is the high price a reflection of oil company greed or OPEC greed. Are Chavez and the Saudis conspiring against us?

In my opinion, the two biggest factors in oil's high price are the weakness in the US dollar's exchange value and the liquidity that the Federal Reserve is pumping out.

The dollar is weak because of large trade and budget deficits, the closing of which is beyond American political will. As abuse wears out the US dollar's reserve currency role, sellers demand more dollars as a hedge against its declining exchange value and ultimate loss of reserve currency status.

In an effort to forestall a serious recession and further crises in derivative instruments, the Federal Reserve is pouring out liquidity that is financing speculation in oil futures contracts. Hedge funds and investment banks are restoring their impaired capital structures with profits made by speculating in highly leveraged oil future contracts, just as real estate speculators flipping contracts pushed up home prices. The oil futures bubble, too, will pop, hopefully before new derivatives are created on the basis of high oil prices.

There are other factors affecting the price of oil. The prospect of an Israeli/US attack on Iran has increased current demand in order to build stocks against disruption. No one knows the consequence of such an ill-conceived act of aggression, and the uncertainty pushes up the price of oil as the entire Middle East could be engulfed in conflagration. However, storage facilities are limited, and the impact on price of larger inventories has a limit.

Saudi Oil Minister Ali al-Naimi recently stated, "There is no justification for the current rise in prices." What the minister means is that there are no shortages or supply disruptions. He means no real reasons as distinct from speculative or psychological reasons.

The run up in oil price coincides with a period of heightened US and Israeli military aggression in the Middle East. However, the biggest jump has been in the last 18 months.

When Bush invaded Iraq in 2003, the average price of oil that year was about $27 per barrel, or about $31 in inflation adjusted 2007 dollars. The price rose another $10 in 2004 to an average annual price of $42 (in 2007 dollars), another $12 in 2005, $7 in 2006, and $4 in 2007 to $65. But in the last few months the price has more than doubled to about $135. It is difficult to explain a $70 jump in price in terms other than speculation.

Oil prices have been high in the past. Until 2008, the record monthly oil price was $104 in December 1979 (measured in December 2007 dollars). As recently as 1998 the real price of oil was lower than in 1946 when the nominal price of oil was $1.63 per barrel. During the Bush regime, the price of oil in 2007 dollars has risen from $27 to approximately $135.

Possibly, the rise in the oil price was held down, prior to the recent jump, by expectations that Democrats would eventually end the conflict and restrain Israel in the interest of Middle East peace and justice for the Palestinians.

Now that Obama has pledged allegiance to AIPAC and adopted Bush's position toward Iran, the high oil price could be a forecast that US/Israeli policy is likely to result in substantial supply disruptions. Still, the recent Israeli statements that an attack on Iran was "inevitable" only jumped the oil price about $8.

Perhaps more difficult to understand than the high price of oil are the low US long-term interest rates. US interest rates are actually below the rate of inflation, to say nothing of the imperiled exchange value of the dollar. Economists who assume rational participants in rational markets cannot explain why lenders would indefinitely accept interest rates below the rate of inflation.

Of course, Americans don't get real inflation numbers from their government and have not since the Consumer Price Index was rigged during the Clinton administration to hold down Social Security payments by denying retirees their full cost of living adjustments. According to statistician John Williams, using the pre-Clinton era measure of the CPI produces a current CPI of about 7.5%.

Understating inflation makes real GDP growth appear higher. If inflation were properly measured, the US has probably experienced no real GDP growth in the 21st century.

Williams reports that for decades political administrations have fiddled with the inflation and employment numbers to make themselves look slightly better. The cumulative effect has been to deprive these measurements of veracity. If I understand Williams, today both inflation and unemployment rates, as originally measured, are around 12 per cent.

By pumping out money in an effort to forestall recession and paper over balance sheet problems, the Federal Reserve is driving up commodity and food prices in general. Yet American real incomes are not growing. Even without jobs offshoring, US economic policy has put the bulk of the population on a path to lower living standards.

The crisis that looms for the US is the loss of world currency role. Once the dollar loses that role, the US government will not be able to finance its operations by borrowing abroad, and foreigners will cease to finance the massive US trade deficit. This crisis will eliminate the US as a world power.

Paul Craig Roberts was Assistant Secretary of the Treasury in the Reagan administration. He was Associate Editor of the Wall Street Journal editorial page and Contributing Editor of National Review. He is coauthor of The Tyranny of Good Intentions.
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Saturday 14 June 2008

Water-fuel car unveiled in Japan

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The Fluoride Glut: Sources of Fluoride Exposure

"Dental and Public health administrators should be aware of the total fluoride exposure in the population before introducing any additional fluoride programme for caries prevention." - World Health Organization. (1994). Fluorides and Oral Health. WHO Technical Report Series 846.


Contents of Page

I. Current Sources of Fluoride

II. Increase in fluoride exposure & dental fluorosis

III. Current dental fluorosis prevalence

IV. Adding Poison to the Wound: EPA's Fluoride Pesticide Tolerances

V. Warnings & recommendations (from dental community)

VI. Current fluoridation policy outdated

VII. Complexities with prescribing fluoride in today's environment


I. Current Sources of Fluoride (Back to top)

Note: To find out how much fluoride is in the following products, click here.

TOOTHPASTE
For data on how much fluoride children ingest from toothpaste, click here .

"Virtually all authors have noted that some children could ingest more fluoride from dentrifice alone than is recommended as a total daily fluoride ingestion." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

FLUORIDATED TAP WATER
For data on the water fluoridation status of each state in the US, click here

"Since [the 1940s], the percent of individuals consuming fluoridated water (in the US) has steadily increased. The increase in percentage of communities with fluoridated water has resulted in an increase in the mean content of fluoride not only in soft drinks and fruit juices, but in canned goods (notably soups), leading to increased intake of fluoride by individuals in communities with nonfluoridated water." - Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60(3):131-9.

"Because the main component of most beverages is water, the fluoride content of these products closely parallels the fluoride content of water used in their processing." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"We cannot... ignore water fluoridation as a major source of ingested fluoride." - Heller KE, et al (1997). Dental Caries and Dental Fluorosis at Varying Water Fluoride Concentrations. Journal of Public Health Dentistry 57: 136-143.

INFANT FORMULA
For further information on fluoride exposure from infant formula, click here

"[I]nfant formulas reconstituted with higher fluoride water can provide 100 to 200 times more fluoride than breastmilk, or cows milk." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"Our analysis shows that babies who are exclusively formula fed face the highest risk; in Boston, for example, more than 60 percent of the exclusively formula fed babies exceed the safe dose of fluoride on any given day." - Environmental Working Group, "EWG Analysis of Government Data Finds Babies Over-Exposed to Fluoride in Most Major U.S. Cities", March 22, 2006.

"[M]ore than 50 percent of infants are currently formula fed by 1 month of age, and these infants are likely to be continuously exposed to high intakes of fluoride for 9 or 10 months - a circumstance quite rare in the 1960s and early 1970s." - Fomon SJ, Ekstrand J. (1999). Fluoride intake by infants. Journal of Public Health Dentistry 59(4):229-34.

"Fluoride is now introduced at a much earlier stage of human development than ever before and consequently alters the normal fluoride-pharmacokinetics in infants. But can one dramatically increase the normal fluoride-intake to infants and get away with it?" - Luke J. (1997). The Effect of Fluoride on the Physiology of the Pineal Gland. Ph.D. Thesis. University of Surrey, Guildford. p. 176.

"Parents should therefore be advised that they may be able to protect their children from dental fluorosis by breastfeeding their infant and by extending the duration for which they breastfeed. When infants are formula-fed, parents should be advised to reconstitute or dilute infant formula with deionized water (reverse osmosis, distilled, or low-fluoride bottled water) in order to reduce the amount of systemically ingested fluoride." - Brothwell D, Limeback H. (2003). Breastfeeding is protective against dental fluorosis in a nonfluoridated rural area of Ontario, Canada. Journal of Human Lactation 19: 386-90.

“Breastfeeding of infants should be encouraged, both for the many documented, general health benefits and the relative protection against ingestion of excessive fluoride from high quantities of intake of fluoridated water used to reconstitute concentrated infant formula early in infancy.” - Levy SL, et al. (1995). Sources of fluoride intake in children. Journal of Public Health Dentistry 55: 39-52.

PROCESSED CEREALS

"[F]ood processing often concentrates fluoride, and foods processed with fluoridated water typically have higher fluoride concentrations than foods processed with non-fluoridated water... A study that found marked differences between cereaals processed in fluoridated and non-fluoridated areas showed that cereals processed in a fluoridated area had fluoride concentrations ranging from 3.8 ppm to 6.3 ppm..." - Warren JJ, Levy SM. (2003). Current and future role of fluoride in nutrition. Dental Clinics of North America 47: 225-43.

"[D]uring manufacturing, infant dry cereals are processed in a slurry and placed in a revolving drying drum. The water from the slurry evaporates, and the fluoride from the water remains in the cereal. Thus, the fluoride concentration of the water used during processing can substantially affect the final fluoride concentration... Infants who eat large quantities of dry infant cereals reconstituted with fluoridated water could ingest substantial quantities of fluoride from this source." - Heilman JR, et al. (1997). Fluoride concentrations of infant foods. Journal of the American Dental Association 128(7):857-63.

JUICE
For published data on fluoride levels in juice, click here

"Our data suggest that young children who regularly or frequently drink substantial quantities of [juice] possibly should not receive dietary fluoride supplements, since they might be at increased risk of developing dental fluorosis." - Kiritsy MC, et al. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association 127(7):895-902.

SODA

"Seventy-one percent of the [sodas] had fluoride levels exceeding 0.60 ppm, which is considered to contain sufficient fluoride so that dietary fluoride supplements are contraindicated."- Heilman JR, et al. (1999). Assessing fluoride levels of carbonated soft drinks. Journal of the American Dental Association 130(11):1593-9.

"Schulz (1976) found that nearly all soft drinks then manufactured in optimally fluoridated Baltimore (1.10 ppm) had fluoride concentrations of 0.8 ppm or greater. Shannon (1977) tested soft drinks manufactured in Houston, Texas... He found that fluoride concentrations... closely matched the fluoride concentrations of the bottling plants' water supplies. This conclusion was also reached in other studies, including the authors' published and unpublished analyses of fluoride concentrations in 332 soft drink products." - Warren JJ, Levy SM. (1999). Systemic fluoride: Sources, amounts, and effects of ingestion. Dental Clinics of North America 43: 695-711.


TEA

For USDA data on fluoride levels in US tea, click here (pdf file).

"Appropriate regulation of the fluoride content of tea commodities should be an urgent matter for public food safety policy." - Cao J, et al. (2004). Fluoride in newer tea commodities. Fluoride 37: 286-300.

"Instant tea, one of the most popular drinks in the United States, may be a source of harmful levels of fluoride... The researchers found that some regular strength preparations contain as much as 6.5 parts per million (ppm) of fluoride, well over the 4 ppm maximum allowed in drinking water by the Environmental Protection Agency." - 'Potentially harmful fluoride levels found in some instant tea'', Washington University School of Medicine, January 25, 2005.

"Another important source of fluoride ingestion is tea...[T]he fluoride content of tea has been found to range from 0.1 to 4.2 ppm fluoride, with an average of about 3 ppm." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"[M]ost of the iced teas studied contained considerable fluoride concentrations. If infants ingest larger amounts of them because of their sweet taste, there is a risk of uncontrolled overdosing as a result of additional fluoride intake from other sources at the same time. " - Behrendt A, Oberste V, Wetzel WE. (2002). Fluoride concentration and pH of iced tea products. Caries Research 36(6): 405-410.

"The average fluoride concentration of infusions prepared from decaffeinated (green & black) tea in this study is 3.19 ppm and ranged from 1.01 to 5.20. This is unexpectedly higher than caffeinated tea and such a difference is statistically significant. If decaffeinated tea were prepared with optimally fluoridated water, the fluoride content would be increased by 1 ppm and would reach an average of 4.19 ppm." - Chan JT, Koh SH. (1996). Fluoride content in caffeinated, decaffeinated and herbal teas. Caries Research 30:88-92.

WINE
For USDA data on fluoride levels in Californian wines, click here.

"[A]nalyses of nineteen California wines revealed fluoride concentrations ranging from 0.23 to 2.80 ppm (mean 1.02 ppm, with seven samples above the international limit of 1 ppm)." - Burgstahler AW, et al. (1997). Fluoride in California wines and raisins. Fluoride 30: 142-146.

"Researchers from California State University in Fresno conducted a 5 year study (1990-1994) on vineyards throughout the San Joaquin Valley. They found that '[m]ultiple applications of Cryolite during the growing season significantly increase fluoride in wines.' Notably they found fluoride levels between 3 - 6 ppm in Zinfandel, Chardonnay, Cabernet Sauvignon, Chenin Blanc, Thompson Seedless, Barbera, Muscat Candi, Ruby Cabernet; and levels between 6 - <9>At 6 ppm one glass of wine (175 ml) would have delivered as much fluoride as about a liter of optimally fluoridated water!" - Connett E, Connett P. (2001). Fluoride: The Hidden Poison in the National Organic Standards. Pesticides and You 21: 18-22.

BEER

"Beers brewed in locations with high fluoride water levels may contribute significantly to the daily fluoride intake, particularly in alcohol misusing subjects and this may contribute to alcohol-associated bone disease." - Warnakulasuriya S, et al. (2002). Fluoride content of alcoholic beverages. Clinica Chimica Acta 320: 1-4.

"Soda pop and beer bottled with fluoridated water contain 0.7 to 1 ppm fluoride; consumption of these beverages is almost certainly more variable among individuals than consumption of water... If beer contains 0.7 ppm fluoride, heavy beer-drinkers may ingest more than 4 mg daily from beer alone." - Groth, E. (1973), Two Issues of Science and Public Policy: Air Pollution Control in the San Francisco Bay Area, and Fluoridation of Community Water Supplies. Ph.D. Dissertation, Department of Biological Sciences, Stanford University, May 1973.

MECHANICALLY DEBONED CHICKEN

"[F]oods made with mechanically separated chicken have the potential to be a major contributor to total fluoride intake... Fluoride contributed by foods made with mechanically separated chicken could increase the risk of mild dental fluorosis for children less than eight years of age when combined with other sources of fluoride exposure." - Fein NJ, Cerklewski FL. (2001). Fluoride content of foods made with mechanically separated chicken. Journal of Agricultural Food Chemistry 49(9):4284-6.

"[W]e found that infant foods containing chicken were high in fluoride. Thus, any infants who regularly eat more than a couple of ounces of infant foods containing high-fluoride-content chicken would be at elevated fluorosis risk." - Heilman JR, et al. (1997). Fluoride concentrations of infant foods. Journal of the American Dental Association 128(7):857-63.

FISH/SEAFOOD

"Food categories with the highest mean fluoride levels were fish [2.118 ppm], beverages [1.148 ppm], and soups [0.606 ppm]. Individual samples with the highest fluoride levels were tea [4.97 ppm], canned fish [4.57 ppm], shellfish [3.36 ppm], cooked veal [1.23 ppm], and cooked wheat cereal [1.02 ppm]." - Agency for Toxic Substances and Disease Registry (ATSDR) (2001). Toxicological Profile for Fluorides: Draft Profile for Public Comment. U.S. Department of Health & Human Services, Public Health Service.

TEFLON PANS

"Teflon-lined cookware may contribute to the fluoride ingested by humans. Full and Parkins boiled fluoridated water at a moderate rate until a one-third or one-half reduction in volume was attained, then determined the fluoride content of the residual water... In Teflon-coated ware, the concentration of fluoride ion increased to nearly 3 ppm. This result requires confirmation; but, if it is correct, then the release of fluoride into foods during cooking in plastic-coated wares requires investigation." - Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081.

FLUORIDATED SALT

The use of fluoridated salt is becoming increasingly widespread across the globe. While the US & Canada do not yet have salt fluoridation programs, it is currently estimated that more people in the world are exposed to fluoridated salt than fluoridated water. Thus, this source of fluoride exposure is becoming increasingly important and insidious. Fluoridated salt usually contains about 250 ppm fluoride, which would result in a daily intake of 2.5 mg of fluoride per day for people consuming 10 grams of salt. Countries with extensive salt fluoridation programs include: Austria, Bolivia, Columbia, Costa Rica, Dominican Republic, France, Germany, Honduras, Nicaragua, Panama, Switzerland, and Venezuela. To learn more, click here


ANAESTHETICS (Enflurane, Isoflurane & Sevoflurane)

"In the 1960s, the widespread use of the inhalational anaesthetic methoxyflurane was associated with a significant occurrence of postoperative renal dysfunction. This was attributed to hepatic biotransformation of methoxyflurane and subsequent release of inorganic fluoride ions into the circulation. Based upon the clinical experience with methoxyflurane, serum fluoride concentrations exceeding 50 mumol/l were considered to be nephrotoxic... Enflurane and even isoflurane may, when used during prolonged operations, also yield anorganic fluoride levels in excess of 50 mumol/l. " - Nuscheler M, et al. (1996). [Fluoride-induced nephrotoxicity: fact or fiction?]. Anaesthesist 45 Suppl 1:S32-40.

"Sevoflurane administration can result in increased serum inorganic fluoride ion concentrations, which have been associated with inhibition of renal concentrating ability." - Goldberg ME, et al. (1996). Sevoflurane versus isoflurane for maintenance of anesthesia: are serum inorganic fluoride ion concentrations of concern? Anesthesia and Analgesia 82(6):1268-72.

"[T]here were significant increases in the serum fluoride in group I (isoflurane) at 5, 10, 24 and 48 hours. The peak serum fluoride was 35.4 (8.5) µmol/L at 10 hours. Group S (sevoflurane) also showed similar significant increases in the serum fluoride concentration compared to baseline at all times of the study. The peak serum fluoride in the group S was 71.2 (19.3) µmol/L at 24 hours... After prolonged anaesthesia, metabolism of sevoflurane to inorganic fluoride is of a greater magnitude than that of isoflurane and exceeds the nephrotoxic threshold." - Abdel-Latif, MM, et al. (2003). Serum fluoride ion and renal function after prolonged sevoflurane or isoflurane anaesthesia. Egyptian Journal of Anaesthesia 19: 79-83.

CIGARETTES

"Cigarettes may be another significant source of fluoride intake by humans." - Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081.

II. Increase in fluoride exposure (Back to top)

"Fluoride is a persistent bioaccumulator, and is entering into human food-and-beverage chains in increasing amounts." - Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081.

"Based on this review, we conclude that fluoride intakes of infants and children have shown a rather steady increase since 1930, are likely to continue to increase, and will be associated with further increase in the prevalence of enamel fluorosis unless intervention measures are instituted." - Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60(3):131-9.

"[T]he prevalence of dental fluorosis in the United States has increased during the last 30 years, both in communities with fluoridated water and in communities with nonfluoridated water." - Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60(3):131-9.

"The increase in [dental fluorosis] suggests that the total systemic fluoride exposure for children during dental development has changed since the 1940s." - Pang D, et al. (1992). Fluoride intake from beverage consumption in a sample of North Carolina children. Journal of Dental Research 71: 1382-1388.

"[A] few cases of more severe fluorosis can be found now in some communities. Because the prevalence of fluorosis is now higher than 50 years ago, we can conclude that fluoride availability... has increased in North American children." - Rozier RG. (1999). The prevalence and severity of enamel fluorosis in North American children. Journal of Public Health Dentistry 59(4):239-46.

III. Current dental fluorosis prevalence (Back to top)

"The majority of children in this research study drank water witih the optimal fluoride level (0.7-1.2 ppm) and overall 34.5% had definitive fluorosis on at least two teeth. This result is generally consistent with most contemporary prevalence studies of fluorosis in North America." - Levy SM, Hong L, Warren JJ, Broffitt B. (2006). .Use of the fluorosis risk index in a cohort study: the Iowa fluoride study. Journal of Public Health Dentistry 66(2):92-6.

"Current studies support the view that dental fluorosis has increased in both fluoridated and non-fluoridated communities. North American studies suggest rates of 20 to 75% in the former and 12 to 45% in the latter." - Locker, D. (1999). Benefits and Risks of Water Fluoridation. An Update of the 1996 Federal-Provincial Sub-committee Report. Prepared for Ontario Ministry of Health and Long Term Care.

"[S]everal reports of prevalence for mostly mild fluorosis are in the 20 percent to 80 percent range." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

IV. Adding poison to the wound: EPA's fluoride pesticide tolerances (Back to top)

Despite repeated warnings that humans, particularly children, are currently receiving too much fluoride from their diets (see section V), fluoride pesticides continue to be added to the food supply under extremely lax regulations from the US Environmental Protection Agency (EPA).

Currently, the main fluoride pesticide used in the US is cryolite (sodium aluminum fluoride). The EPA currently allows up to 7 ppm of fluoride on over 30 fruits and vegetables treated with cryolite. This 7 ppm fluoride tolerance applies to: apricots, beets, blackberries, broccoli, brussel sprouts, cabbage, cauliflower, citrus fruits, collards, cranberries, cucumbers, eggplants, grapes, kale, lettuce, melons, nectarines, peaches, peppers, plums, pumpkins, radishes, raspberries, squash, strawberries, tomatoes and turnip.

A 2 ppm standard has also been established for potatoes, which are second to grapes for total cryolite usage.

The EPA's standard of 7 ppm for fluoride residues is over 5 times greater than the standard set by the US Department of Agriculture (USDA) in 1933. In 1933, the USDA established the maximum level for fluoride residues on fruits and vegetables at 1.2 ppm, which was the same standard the USDA established for arsenic. While arsenic pesticides have since been phased out of use in the US, fluoride pesticides remain.

In fact, the current tolerance levels for fluoride pesticides could become even higher - if the US EPA, under intense pressure from DOW Chemical, approves sulfuryl fluoride as a replacement fumigant for methyl bromide.

If EPA approves sulfuryl fluoride (an indoor fumigant that has never before been used on food) as the replacement for methyl bromide, there will be a substantial increase in the fluoride contamination of the food supply.

In a recent petition (February 15, 2002) to the EPA, DOW Chemical asked for extremely high fluoride tolerances on a wide number of common foods, including, 98 ppm for wheat germ, 40 ppm for wheat bran, 31 ppm for rice bran, 30 ppm for a variety of nuts, 28 ppm for corn meal, 26 ppm for corn flour, 25 ppm for millet grain, 25 ppm for wild rice grain, 25 ppm for sorghum grain, 25 ppm for wheat grain, and 17 ppm for oat grain!

V. Warnings & recommendations (from dental community) (Back to top)

Minimize Ingested Fluoride

"'In consideration of the currently understood mechanisms of cariostasis and fluorosis, our efforts should be focused on minimizing levels of ingested fluorides. The control of fluoride levels in infant formulas, the recent reductions in the fluoride supplement schedule, and the calls for lower fluoride pediatric toothpastes are all laudable efforts. We cannot, however, ignore water fluoridation as a major source of ingested fluoride." - Heller KE, et al (1997). Dental Caries and Dental Fluorosis at Varying Water Fluoride Concentrations. Journal of Public Health Dentistry 57: 136-143.

Do Not Use Fluoridated Water to Reconstitute Infant Formula

“When infants are formula-fed, parents should be advised to reconstitute or dilute infant formula with deionized water (reverse osmosis, distilled, or low-fluoride bottledwater) in order to reduce the amount of systemically ingested fluoride.” - Brothwell D, Limeback H. (2003). Breastfeeding is protective against dental fluorosis in a nonfluoridated rural area of Ontario, Canada. Journal of Human Lactation 19: 386-90.

“[W]e recommend use of water with relatively low fluoride content (e.g. 0 to 0.3 ppm) as a diluent for infant formulas and recommend that no fluoride supplements be given to infants.” - Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60: 131-9.

“Breastfeeding of infants should be encouraged, both for the many documented, general health benefits and the relative protection against ingestion of excessive fluoride from high quantities of intake of fluoridated water used to reconstitute concentrated infant formula early in infancy.” - Levy SL, et al. (1995). Sources of fluoride intake in children. Journal of Public Health Dentistry 55: 39-52.

“Use of powder concentrate would be recommended only for those with low-fluoride water.” - Levy SL, et al. (1995). Sources of fluoride intake in children. Journal of Public Health Dentistry 55: 39-52.

"to limit fluoride intakes to amounts <0.1> - Buzalaf MA, et al. (2001). Fluoride content of infant formulas prepared with deionized, bottled mineral and fluoridated drinking water. ASDC Journal of Dentistry for Children 68(1):37-41, 10.

“Our results suggest that the fluoride contribution of water used to reconstitute formulas increases risk of fluorosis and could be an area for intervention... Supporting long-term lactation could be an important strategy to decrease fluorosis risk of primary teeth and early developing permanent teeth.” - Marshall TA, et al. (2004). Associations between Intakes of Fluoride from Beverages during Infancy and Dental Fluorosis of Primary Teeth. Journal of the American College of Nutrition 23:108-16.

“The recommendation is that bottled or deionized water be used instead (of fluoridated water) to dilute the formula." - Ekstrand J. (1989). Fluoride intake in early infancy. Journal of Nutrition 119(Suppl 12):1856-60.

Ingestion of Fluoride from Toothpaste should be Reduced

"To reduce the risk of fluorosis, it has been suggested that use of higher concentration of fluoride dentrifices by preschool children be avoided, that only small quantities of paste be used under parental direction and supervision, that further development and testing of lower concentration fluoride dentrifices be encouraged, and that dentrifice tubes dispense smaller quantities so that inappropriate eating of fluoride dentrifice is avoided." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"WARNING: Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately." - FDA Mandated Warning on Fluoride Toothpaste Labels Sold in U.S.

Uniform Dosages Should be Reconsidered

"[W]e recommend that uniform dosages of fluoride supplementation should be reconsidered... The FDA should examine the testing and labeling of [juices and sodas] with respect to fluoride concentration so that practictioners and consumers can make an informed choice. Thorough washing of grapes should occur to eliminate any insecticide contamination of the juice. Manufacturers and bottlers should identify sources of fluoride within their products, and when necessary reduce fluoride levels to age-appropriate levels, as recommended by the American Dental Association and the American Academy of Pediatric Dentists." - Stannard JG, et al. (1991). Fluoride levels and fluoride contamination of fruit juices. Journal of Clinical Pediatric Dentistry 16(1):38-40.

Some Children Receive More Fluoride Than 'Optimum' from just One Source of Exposure

"[I]n most reports, a smaller proportion of children, often 10 percent to 20 percent of the study population, received several times as much exposure as the mean. Because of this finding, most authors commented that some children in their studies probably ingested sufficient quantities of fluoride from only the single source or category being studied to exceed the 'optimal' fluoride intake and be at increased risks of dental fluorosis." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"Virtually all authors have noted that some children could ingest more fluoride from dentrifice alone than is recommended as a total daily fluoride ingestion." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

Greater Attention Needs to be Paid to Total Fluoride Exposure

"When considering fluoride recommendations on a group basis, all major sources of fluoride ingestion, such as diet, dentrifice, and fluoride supplements, must be considered so that total daily intake of fluoride can be estimated. To this end, efforts should be renewed to determine and regularly monitor the fluoride levels of beverages and foods and have their fluoride levels made available to the profession and the public. If necessary, fluoride levels of infant formulas and other products should be modified. In addition, attempts must be made to avoid excessive ingestion of fluoride dentrifice and further investigate the cariostatic effect of lower fluoride concentration dentrifices." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"The amount of infant foods containing chicken consumed should be considered when assessing the total fluoride intake, as it could contribute a substantial amount of fluoride. Children who regularly consume quantities of infant foods containing chicken should also be monitored to make sure that they do not ingest too much fluoride from other sources such as fluoride dentrifice, dietary fluoride supplements or fluoridated water." - Heilman JR, et al. (1997). Fluoride concentrations of infant foods. Journal of the American Dental Association 128(7):857-63.

"[W]e recommend that dentists who are considering prescribing dietary fluoride supplements for those with nonfluoridated water inquire about young children's fluoride exposure from all important sources, including dentrifice, infant formula (type, brand, and quantity), water (sources, quantities and filtration system) and beverages (including specific juices and juice-flavored drinks)." - Kiritsy MC, et al. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association 127(7):895-902.

VI. Current fluoridation policy outdated (Back to top)

"The early recommendations concerning 'optimal levels' of fluoride in water have not been reviewed since [water fluoridation began], despite developments which could drastically alter the underlying assumption that fluoride intake from sources other than drinking water is relatively low. For example, as fluoridation has become widespread, more and more food processing plants have used fluoridated water, with generally unknown effects on the fluoride content of processed foods. Also, dehydrated and reconstituted food products, virtually unknown to consumers in the 1940s when most of the fluoride surveys were done, are today commonplace. As a result, although orange juice and potatoes are inherently poor sources of fluoride, this is no longer so if they have been concentrated and reconstituted with fluoridated water." - Prival M, Fisher F. (1974). Adding Fluorides to the Diet. Environment 16(5): 29-33.

"Current standards for water fluoridation in the United States have stood since 1962. Many things have changed since then, however, and these data suggest that perhaps it is time to reconsider these standards." - Heller KE, et al (1997). Dental Caries and Dental Fluorosis at Varying Water Fluoride Concentrations. Journal of Public Health Dentistry 57: 136-143.

VII. Complexities with prescribing fluoride in today's environment (Back to top)

"[P]recisely estimating total fluoride intake is quite difficult in research studies and clearly not feasible in clinical practices." - Kiritsy MC, et al. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association 127(7):895-902.

"If fluoride supplements are to be used, then accurate information on not only fluoride content of the residential water source, but on background levels of fluoride intake from food and beverages, type of feeding, kind of water used in reconstituting foods and beverages, use of beverages versus water at home or at child care, the possibility of a diffusion effect, and the use and ingestion of dentrifice and even mouthrinses and gels may need to be considered in making recommendations for appropriate dosages of fluoride supplements in children. These complex sets of data are difficult to obtain even on a research basis, much less in daily dental and medical practice." - Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23.

"With no fluoride levels marked on the soft drink products or easily available from the manufacturers, it is not possible for clinicians or consumers to directly estimate fluoride ingestion from carbonated beverages.Therefore, to reduce the risk of dental fluorosis, dental and medical practitioners should be cautious about prescribing dietary fluoride supplements to preschool-aged children in nonfluoridated areas who consume large quantities of carbonated soft drinks." - Heilman JR, et al. (1999). Assessing fluoride levels of carbonated soft drinks. Journal of the American Dental Association 130(11):1593-9.

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