Big Azz Sodas. What’s The Big Whoop?

Welcome to my Sunday obsession. Since early March, I’ve heard many debates on The Soda War: is the banning of sodas greater than 16 oz an effective way to fight obesity? Here I will present a few of the issues in this debate and the great difficulty I’ve experienced in finding primary sources of information.

I listened last week to a Slate’s Table To Farm episode that debated about whether banning of extra-large sodas is an effective way to limit calorie intake and obesity. They had two guests on the show representing both sides of the debate. I personally found the anti-soda ban argument a bit weak—this guest said that policies are unfair because they are targeting low income people’s pleasure foods; you don’t see anyone limiting the intake of brie, chips, beer or wine, for example, which are also not particularly healthy. The failing of this argument is that one product is sold as a single serving (extra-large sodas) versus products that are meant to be multiple servings (though I suppose people do eat a whole bag of chips in a sitting)—but it’s not like you go to the movie theatre to buy a large wheel of cheese for yourself.

Their debate has stayed on my mind, so I started to look for good sources of information. After doing a preliminary Google search for “public health news,” I was lead to American Public Health Association’s website. At first glance, I was impressed by the breadth of topics covered: click on the “Topics” tab, you will see the broad range of public health news topics they are reporting on (Child Health, Environment, Funding, Health Reform, HIV, Nutrition, etc).

Once I got into the articles, however, I was disappointed by the lack of primary sources. On the “soda ban” page, it said in the first paragraph, “New research shows that prompting beverage makers to sell sodas in smaller packages and bundle them as a single unit actually encourages consumers to buy more soda — and gulp down more calories — than they would have consumed without the ban.”

It went to on to list how this topic was being portrayed in a couple of city newspapers, but it failed to cite the original paper it was talking about. I would like to see the article showing how it can encourage more soda drinking. It did have links to the Jon Stewart show and his mention of this topic (or rather heckling). Why not cite the original source so we can decide for ourselves if the research is good?

In trying to track down the original study, I discovered that many media sources had been referencing this study and using it as concrete evidence against the soda bans, ie “Study shows that limiting size makes us want to gulp more.” However, most of the articles I read, including a New York Times article, did not provide links to this study. Also, I could not find the original study on Pubmed (I searched for “Brent Wilson” “Limiting Sugary Drinks” “Wilson soda”). I could not easily find it by going to PLOS website. I finally found a link to it here (KPBS, affiliated with San Diego State University).

The author of the study is Brent Wilson, a psychology doctoral student at University of California San Diego. How many people were studied? 100 college students. Aren’t you glad that policy makers (and media sources and the public) are relying on this one study (by a student with undergraduate student participants) to make public health decisions? I haven’t personally decided yet what is the most effective way to fight obesity. But I won’t be making my decision based on this single, small study by a student.

Another part of this debate has to do with the ‘anti-Bloomberg laws.’ According to the New York Times, the State of Mississippi has passed a law mandating that any policy that restricts food or drink must be passed at the state level. This means that cities or counties cannot form their own policies on a large range of nutrition issues: limits to soda size, salt content, shortening in cookies, toys in fast-food meals for children, how a menu is written or just about any other daily dining experience. However, this has had an unexpected backlash. Local governments are upset, not because they wanted to ban large-sized drinks, but they see this as a limit on their local authority to decide what is right for their region. Others are upset, like restaurant owners, because they want the choice to be up to them. Because restaurants and other vendors are driven by consumer demand, more and more restaurants are taking up healthier options already, not because the government demands it of them, but because consumers want these options. Restaurants should therefore be able to cater to the demands of the consumers.  The ironic part of this, is that Mississippi, according to NPR, has the highest rate of obesity in the country (1 in 3). So if restaurants are catering to consumers, should we be focusing our efforts on educating these consumers and influencing them to want healthy options?

The biggest lesson from my weekend reading is that the major news providers seem to have a couple of pieces of knowledge that they are all reporting. They lack real evidence and, worse, make it difficult to track down the ‘real’ evidence they present. It took me a lot of motivation and time to track down the primary sources. There has to be a better way to access information that is cited in the top media sources. I want to be able to look at these primary sources, see what real evidence is out there for or against of proposed public health intervention, and decide for myself. If I had not taken the time to hunt the original sources down, I could easily have made important decisions based on very flimsy evidence.

What about you? What public health interventions do you think we should be focusing on to fight obesity? Policies? Education? And where can we go for reliable public health information on this?


Functionally Cured: HIV cleared from child after receiving early drug therapy – by Nick Wohlgemuth

HIV causes a chronic viral infection, meaning that our bodies aren’t able to get rid of the virus like with cold or “flu” viruses. Thankfully for HIV patients, antiretroviral therapy is usually able to control viral replication, and patients are able to live long, healthy lives and drastically delay the onset of AIDS. However, antiretrovirals have bad side effects, and virus levels usually rise quickly once treatment is stopped.

In March, scientists presented a report of an infant that has been functionally cured of HIV. What the heck does that mean?

To be functionally cured of HIV, an individual has to have previously had a confirmed infection with the virus. Then, usually through the use of antiretroviral therapy, the virus is driven to such low levels that when the treatment is no longer administered, the virus levels don’t increase.

In this case, the baby was born to a mother with HIV and given antiretroviral therapy 30 hours after birth. Scientists confirmed that the child had virus in her blood and continued to monitor the virus levels. Soon, they couldn’t detect virus by using the normal clinical detection methods. The baby was taken off antiretroviral therapy when she was 18 months old, and virus levels remained undetectable up to the time of the report when she was 26 months old.

When scientists look with more sensitive methods, they can still detect virus in the child’s body, but the normal clinical screens are all negative. The child remains symptom free.

This is the first time there was been a well-documented case of a child being functionally cured of HIV. This case stresses the importance of starting antiretroviral therapy as soon as possible. The broader implications are limited at this time, but this seems to prove, in principle, that if we are able to get good antiretroviral drugs to infected individuals soon enough, then we might be able to functionally cure many more people with HIV.

-Nick Wohlgemuth

Conference Abstract

PHU News Analysis 1: Sources of News, H7N9, and West Nile Virus

News Analysis Episode 1 is now available!

Right click to download or click to stream

Nick, Nina, and guest Stephanie Porter discuss where they go for sources of information about science and health, the recent outbreak of avian influenza H7N9, West Nile Virus, and the One Health Initiative.

Links for the Episode:

H7N9 ProMED Mail Story

Steve’s H7N9 Blog Post

ProMED Mail

This Week in Virology

Virology Blog

Slate’s Political Gabfest

Science Friday

Ira Flatow

Center for a Livable Future

More information about the infant functionally cured of HIV

Recommended Twitter Follows

Why Snails Matter (a plea to Stephen Moore)

On a recent episode of “Real Time with Bill Maher”, Stephen Moore of the Wall Street Journal mockingly asserted that the government shouldn’t be funding research on snail mating habits. In response, fellow guest Zack Kopplin shot Moore down by telling him “you’re not a scientist!” The exchange got a big laugh, but it was a debacle for the advocacy of basic science research.

Kopplin is right, and wrong. There are extremely good reasons for funding snail research; we’ll get to those in a second. Kopplin’s answer to Moore, while good for laughs on a comedy show, is just as arrogant as Moore’s dismissive attitude towards basic science. Whether Moore knows why the government funds snail research or not is irrelevant. Most viewers probably don’t, and so Moore’s mocking of such research sounds right. Studying snail mating absolutely sounds ridiculous on its face. The fact is that this is taxpayer-funded research and the public deserves a better explanation than “but you’re not a scientist!!”

As a self-described science-education activist, Kopplin had an obligation to explain to Moore why he was wrong rather than shout him down. Since he didn’t, we will. Freshwater snails are the intermediate host of schistosomiasis, a parasitic worm that infects over 200 million people a year worldwide. The worms infect humans by burrowing their way out of the snails, and then into the skin of a nearby person. If you’re interested in where the worm goes from there, here’s a good depiction of the lifecycle.

Long-term infection with these worms causes severe liver damage and is a leading cause of bladder cancer in many parts of the world. Unfortunately, it’s also been an extremely difficult disease to control. One of the primary means of control is through killing the snail hosts. The snails are capable of reproducing extremely rapidly and to devise more effective control measures we need to better understand their lifecycle.

If you’re interested in learning more about schistosomiasis control research, the link for the study referenced by Stephen Moore is here. The CDC also has an extensive page on schistosomiasis, truly one of the world’s most important, and destructive parasites.


The Future of Cancer Treatment

Talk of “curing cancer” is often overly simplistic. Every cancer is unique in terms of the location and the individual. This is highlighted by recent possible breakthroughs in cancer therapy designed around educating a particular patient’s immune system to attack the cancer, rather than using drugs that as we all unfortunately know, can be extremely toxic!

This past weekend University of Pennsylvania researchers announced very exciting Phase I clinical trial results for a new cancer vaccine that may save women with advanced ovarian cancer. Two weeks ago Episode 1 guest Steven Salzberg wrote on his blog, Fighting Pseudoscience, about an extremely promising experimental treatment for acute adult leukemia that uses similar principles. These therapies are still experimental, but are part of an exciting new type of cancer treatments that may offer hope in the future to people with very advanced cancers.


A new bird flu? by Steve Goldstein

Yes, it does appear that a new type of bird flu has emerged in humans in southern China. What is meant by “bird flu” as opposed to our normal seasonal flu viruses or the pandemic H1N1 virus of 2009 fame? Avian flu viruses usually don’t infect people and when they do, transmission is almost always directly between birds and humans, as avian flu viruses typically don’t transmit well between people.

This H7N9 virus may be causing more severe disease than seasonal flu or similar avian flu viruses have caused in the past, and so has caught the attention of the World Health Organization, which is reporting 16 cases and 6 deaths so far. Fortunately for us, the virus does not seem to be transmitted from person-to-person. Therefore, measures already taken by the Chinese government, such as the culling of birds sold in local “wet markets”, have an excellent chance of stopping the outbreak.

The media has been kind enough to largely avoid the sensationalistic, inaccurate reporting that colored the debate about H5N1 research last year. Excellent articles about the current outbreak can be found here, here, and here.

The concern with avian flu viruses is that they might mutate and become more transmissible person-to-person. That’s certainly a possibility, which is why some of the world’s best scientists at the U.S. Centers for Disease Control and Prevention have already begun work on a vaccine to prevent H7N9 infection, just in case that happens.

The WHO FAQ page on H7N9 is an excellent resource, and you can also follow CDC Flu on Twitter. If you have questions for us feel free to post them in the comments, and if we can’t answer them ourselves we’ll get an answer for you from Dr. Andy Pekosz, who was featured in episode 1 of our podcast.


An Exciting Week For News Analysis!

Steve is working on updating us with some public health news. Check back here soon!

Also coming up: Nick & Nina are recording the first News Analysis episode with guest Stephanie Porter, MHS Candidate. They will be discussing good sources of public health news and communication, The West Nile Story, & One Health.

Episode 1: Public Health Miscommunication

Episode 1 is now available!

Right click to download or click to stream

Episode 1 Summary:
How often do we feel like we are public health experts after seeing a five minute blurb on CNN/NPR, or worse, reading a summary on Wikipedia? We then feel confident to go out into the world and spout our knowledge and make health decisions. The power of the press is mighty, especially now that anyone with access to the Internet commands more public health information than ever before. But of course, not all of the information is accurate, even information from high profile institutions like CNN. On the flip side, scientists are not often communicating directly with the public, but leave media sources to interpret and summarize highly technical scholarly articles. These media sources are experts at making science into an exciting news story, but how accurate is this relay of information? How can we tell the good from the bad? And what is our role as public health researchers in the dissemination of good public health information?

Episode 1 was recorded on 3/27/13 and features Nina Martin, Dr. Andrew Pekosz, Dr. Steven Salzberg, and Dr. Photini Sinnis.

Guest Info:
Andrew Pekosz, PhD is an Associate Professor of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health. He is most known for his work on flu vaccines and has been interviewed by many news shows (i.e. CNN, BBC, CSPAN, NPR, Discovery Channel) to dispell common misinformation about the flu vaccine.

Website          Bio

Steven Salzberg, PhD is a Professor of Medicine at Johns Hopkins University. He is the director of Johns Hopkins’s Center for Computational Biology. He also blogs at the Forbes column Fighting Psuedoscience and Genomics, Medicine, and Pseudoscience.

Website          Bio          Blog          Column

Photini Sinnis, MD is an Associate Professor of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health and a Member of the Malaria Research Institute at Hopkins. Her research focuses on the early events in malaria infection. Dr. Sinnis’s training as a physician has made her think a lot about communication with the public.

Website          Bio


Saving Lives With Better Science Communication