Dr Caroline Leaf – The Christian church’s anti-vaxxer

Well, this is my first post for the new year.  2016 was certainly historic!

In 2016, the Oxford Dictionaries Word of the Year was “post-truth”.  Post-truth describes the concept “in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief”.

While the popularity of the word rose in step with the popularity of the US President-Elect, post-truth as an idea has been building more and more over the last decade or so.  It’s the driving force behind other cultural phenomena of our modern world, like the alternative health and the anti-vaccination movements.

It’s also the secret to the success of Caroline Leaf.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She’s been riding the wave of our post-truth culture for years.  Dr Leaf has a set of slickly spoken mistruths that form the basis of her ministry, and are repeated constantly (including, but not limited to):

The mind controls the brain
75-98% of all physical, mental and emotional illnesses come from our thought life
The heart is a mini-brain
Our mind changes matter through quantum entanglement
ADHD and depression aren’t diseases
Anti-depressant medications are dangerous placebos

There is no scientific evidence to support any of these claims, but that hasn’t stopped her claiming, because Christians and the leadership of the Christian church believe her without question.

In the last twenty-four hours, Dr Leaf put up two separate social media posts which follow the same pattern – repeated mistruths with no basis in fact.

“What an honor to be speaking at the annual Noiva humanitarian foundation conference in Winterthur, Switzerland, which works actively with the Syrian refugees seeking to broker peace in the Middle East.  I spoke about how showing compassion and helping others improves brain health and increases physical and mental healing by around 63%!”

screen-shot-2017-01-07-at-10-01-34-pm

Showing compassion and helping others improves brain health and increases physical and mental healing by around 63% hey?  I’m assuming she’s referring to the study by Poulin et al [1], because she’s posted this to her social media feed before, and there aren’t any other studies out there that show compassion and helping others increases physical and mental health so much … not that the Poulin study showed it either (not even close – https://cedwardpitt.com/2016/10/27/dr-caroline-leaf-credit-where-credits-due/ and https://cedwardpitt.com/2016/01/16/does-helping-others-help-you/)

On the photo she put up on social media to gloat about her little jaunt to Switzerland, the Powerpoint in the background reads, “Can the mind change the brain?”  Again, the answer is a clear ‘No’!  She tried to argue the same nonsense in her TEDx talk in early 2015 (https://cedwardpitt.com/2015/03/26/the-tedx-users-guide-to-dr-caroline-leaf/).  It was wrong then, and it’s still wrong now.

Unless Dr Leaf’s found some better resources, NOIVA should ask for their money back.  They could have fed a lot of refugees for the wasted cost of hosting Dr Leaf at their conference.

Dr Leaf’s second social media post was even more egregious.

“Our genetic makeup fluctuates by the minute based on what we are thinking and choosing.”

WRONG!  Absolutely wrong.  There is NO scientific evidence that supports this statement at all (https://cedwardpitt.com/2014/09/27/dr-caroline-leaf-and-the-genetic-fluctuations-falsehood/).  DNA is stable.  It doesn’t “fluctuate by the minute”.  It’s not influenced by our thoughts or our choices.

We may be stuck in a post-truth world but science is not, and will never be, post-truth.  Your belief in the cancer-fighting properties of turmeric doesn’t make turmeric cure cancer.  Your opinion that the MMR vaccine causes autism doesn’t change the concrete scientific evidence that it doesn’t.

By the same token, Dr Leaf might believe that our thoughts and choices change our DNA, but it doesn’t matter how many times Dr Leaf repeats the same fiction, it still doesn’t make it fact.  She can repeat ad nauseum her belief that the mind controls the brain, or our mind changes matter through quantum entanglement, or depression isn’t a disease, or all of our illnesses come from thoughts.  None of them were true the first time she made each outrageous claim, and they still aren’t true now. Scientific truth doesn’t change depending on what suits your opinion.

In fact, all Dr Leaf is doing by continually perpetuating her stock of mistruths is to disempower her audience.  Rather than encourage people to follow the facts, they are sucked into a vortex of wasted money and time.  Precious resources are spent chasing wild geese instead of putting them towards something more meaningful.  NOIVA diverting funds to support Dr Leaf’s fees instead of feeding refugees is a perfect case in point.

Worse, Dr Leaf’s teaching discourages people from taking effective medications and seeking effective treatments which can only lead to greater suffering in those who are vulnerable.

In this sense, Dr Leaf is like the anti-vaxxer of the Christian church, discouraging her followers from seeking scientifically sound treatments in favour of belief in erroneous and invalid actions with no proof of efficacy and a real risk of harm.

When will the leadership of the Christian church stand up for their parishioners and stop Dr Leaf’s fictions from infecting their churches?  The answer should be ‘now’, and that’s a fact.

References
[1]        Poulin MJ, Brown SL, Dillard AJ, Smith DM. Giving to others and the association between stress and mortality. Am J Public Health 2013 Sep;103(9):1649-55.

Advertisements

Gardasil – saves your cervix, does nothing to your ovaries

Vaccine myths are like the fart smell that somehow gets trapped in your air-conditioning in your car.  They both seem to keep going around and around, reappearing at random, and are both similarly fetid.

Doing the rounds of the social media sites this week is the old chestnut that Gardasil, the human papilloma virus vaccine, caused a teenage girl’s ovaries to implode, and that Merck, that rich powerful conglomerate of evil, conveniently forgot to investigate the effects of the vaccine on the female reproductive system.

Actually, this is old news.  I wrote a couple of blogs in in the past about Gardasil conspiracy theories, including one about the whole Gardasil-kills-ovaries thing (and another here).  In the last couple of years, nothing much has really changed, well, except that the benefit of the HPV vaccine has become much clearer, and the hysteria of the anti-vaxxers has become more pronounced as a result.

For example, the article that’s recently been making the rounds is a 2013 article by Jonathan Benson at Natural News.  This particular article was discussing a paper published in the highly esteemed British Medical Journal [1] (which you can read for yourself here). Benson’s opening paragraph shows how ignorant and/or biased anti-vaccine proponents can be.

“A newly-published study has revealed that Merck & Co., the corporate mastermind behind the infamous Gardasil vaccine for human papillomavirus (HPV), conveniently forgot to research the effects of this deadly vaccine on women’s reproductive systems. And at least one young woman, in this case from Australia, bore the brunt of this inexcusable failure after discovering that her own ovaries had been completely destroyed as a result of getting the vaccine.”

There are a couple of big errors here.  First, the article in the BMJ isn’t a study, merely a case report.  There’s a big difference, namely the fact that a case report is just that, a report of a single case.  It’s not a study that proves that one thing causes another, but merely raises the possibility that there might be something going on that other peers should be aware of or further investigate.  The lack of definitive proof didn’t stop Benson from making his other big error, leaping to a rather tenuous conclusion that this girl’s ovaries imploded because of Gardasil.

In actual fact, Premature Ovarian Insufficiency (or POI), was known about long before the Gardasil vaccine was invented.  In 1986, the known incidence was about 1 in 10,000 young women between the ages of 15 and 29 [2], and there’s no known cause in more than 90% of the cases.

So, if Gardasil was one cause of ovary implosion in young women, then it stands to reason that the rate of ovary implosion would be much higher after the introduction of Gardasil.  Is that the case?

As it turns out, the answer is no.  A big fat no.  According to the Therapeutic Goods Administration in Australia, the number of Gardasil doses that have been administered in Australia has been more than 9 million.  The number of reports of ovary implosion? Three.  Just three.

That works out to be a rate of 0.003 per 10,000.

That’s quite a lot less than the rate of ovary implosion before Gardasil was invented.  Maybe Gardasil protects your ovaries rather than destroys them.

So Gardasil isn’t rendering anyone’s daughters infertile.  The TGA has reviewed this issue a number of times and reached the same conclusion every time … there is NO link between Premature Ovarian Insufficiency and the HPV vaccine.

What the HPV vaccine is doing is reducing the incidence of genital warts and gynaecological cancers.  For example, in the years leading up to the introduction of the HPV vaccine, the number of women presenting with genital warts was about 1 in 10.  In the four years after the vaccine was introduced, the rate of genital warts had fallen between 70 to 90% depending on the age group.  The effect was especially obvious in the women under the age of 21, whose rate of genital warts dropped from over 1 in 10 to less than 1 in 100 after the introduction of the vaccine.

The rate of cervical cancer changes also fell, with a study by Gertig and colleagues in 2013 showing that a full three doses of the HPV vaccine decreased the risk of high-grade (that is, nasty pre-cancerous) pap smear changes by nearly 50% [3].

So you won’t hear this from the Natural News team or others of their ilk, but vaccination with the HPV vaccine decreases your risk of genital warts by over 90%, decreases your risk of nasty cervical cancer changes by about 50%, and increases your risk of ovarian implosion by about 0%.

Don’t let the repugnant hot air of the anti-vaxxers put you off.  Vaccination with the HPV vaccine is safe and effective, not harmful like the vaccine myths would have you believe.

References

[1]        Little DT, Ward HR. Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination. BMJ Case Rep 2012;2012.
[2]        Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol 1986 Apr;67(4):604-6.
[3]        Gertig DM, Brotherton JM, Budd AC, Drennan K, Chappell G, Saville AM. Impact of a population-based HPV vaccination program on cervical abnormalities: a data linkage study. BMC medicine 2013;11:227.

Why all the anger?

One of the latest vaccination memes to go viral on social media is an article by Arizona “paleo-cardiologist”, Dr Jack Wolfson.

Dr Wolfson did an interview with one of his local TV stations in January, during which he gave his opinion about the outbreak of measles centred around Disneyland.

He said, “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it. We do not need to inject chemicals into ourselves and into our children in order to boost our immune system. I’m a big fan of what’s called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years. That’s the best way to protect.” (http://www.azcentral.com/story/news/12-news/2015/01/23/12news-doctor-dont-vaccinate/22200535/)

His follow up article, the one going viral, is titled, “Why All the Anger?” Uh … how about because you’re a douche?

Let’s start by looking at his comments in January on Arizona’s Channel 12 News:

  1. “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it”.
    Or in other words, by stopping our children getting sick, we’re depriving them of their rights. That’s a patently stupid statement. Our children have a right to expect care. We give them shelter, protection, education and good nutrition so that their lives can flourish. Vaccinations are part of that care. Sure, there are side effects of vaccines, but they are nothing compared to the abject cruelty of the diseases they prevent.
  1. “We do not need to inject chemicals into ourselves and into our children in order to boost our immune system.”
    Our immune systems do an amazing job at keeping us alive. Our immune systems will eventually fight off measles, chicken pox, or any other number of pathogens, but vaccines stop the “collateral damage”, the children who are overwhelmed by the full-blown infection and die, or are permanently disabled by it. Even for the children that come through ‘unscathed’ (i.e. not dead), illnesses like measles inflict weeks of suffering with high fevers, aching joints and muscles, severe fatigue, and any other number of symptoms, then there are the ongoing illnesses like shingles and the associated severe chronic nerve pain from viruses like chickenpox, all of which can be prevented by routine childhood vaccinations.
  1. “I’m a big fan of what’s called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years. That’s the best way to protect.”
    Really? The Palaeolithic population were hunter-gatherers, and we know that the mortality of hunter-gatherer children is in the order of 40% (http://cast.uark.edu/local/icaes/conferences/wburg/posters/sara_stinson/stinson.html). That’s not what I would call ‘protective’. Besides, palaeontologists have shown that the food promoted as ‘paleo’ is nothing like the food that our ancestors ate (https://www.youtube.com/watch?v=BMOjVYgYaG8) so paleo-nutrition is just another baseless fad.

I’m guessing that the response he received after publically sharing his heterodox views wasn’t particularly favourable. In reply, he offered this article, which is the article now going viral on social media (http://healthimpactnews.com/2015/arizona-cardiologist-responds-to-critics-regarding-measles-and-vaccines/).

It seems to me like he has unsuccessfully tried to dig himself out of his own grave. Sure, those people who are also currently drinking the antivaccine-paleo Kool-Aid will take his side and point to this brave martyr standing up to the establishment, but ultimately his come-back is nothing more than diversionary blame-shifting.

Here’s what he had to say about who the real enemies are:

“1. Be angry at food companies. Sugar cereals, donuts, cookies, and cupcakes lead to millions of deaths per year. At its worst, chicken pox killed 100 people per year. If those chicken pox people didn’t eat cereal and donuts, they may still be alive. Call up Nabisco and Kellogg’s and complain. Protest their products. Send THEM hate-mail.
2. Be angry at fast food restaurants. Tortured meat burgers, pesticide fries, and hormone milkshakes are the problem. The problem is not Hepatitis B which is a virus contracted by drug users and those who sleep with prostitutes. And you want to inject that vaccine into your newborn?
3. Be angry at the companies who make your toxic laundry detergent, fabric softener, and dryer sheets. You and your children are wearing and breathing known carcinogens (they cause cancer). Call Bounce and Downy and let them know. These products kill more people than mumps, a virus which actually doesn’t cause anyone to die. Same with hepatitis A, a watery diarrhea.
4. Be angry at all the companies spewing pollution into our environment. These chemicals and heavy metals are known to cause autism, heart disease, cancer, autoimmune disease and every other health problem. Worldwide, these lead to 10’s of millions of deaths every year. Measles deaths are a tiny fraction compared to pollution.
5. Be angry at your parents for not breastfeeding you, co-sleeping with you, and stuffing your face with Domino’s so they can buy more Tide and finish the laundry. Breastfeeding protects your children from many infectious diseases.
6. Be angry with your doctor for being close-minded and not disclosing the ingredients in vaccines (not that they read the package insert anyway). They should tell you about the aluminum, mercury, formaldehyde, aborted fetal tissue, animal proteins, polysorbate 80, antibiotics, and other chemicals in the shots. According to the Environmental Working Group, newborns contain over 200 chemicals as detected by cord blood. Maybe your doctor feels a few more chemicals injected into your child won’t be a big deal.
7. Be angry with the cable companies and TV manufacturers for making you and your children fat and lazy, not wanting to exercise or play outside. Lack of exercise kills millions more than polio. Where are all those 80 year olds crippled by polio? I can’t seem to find many.
8. In fact, be angry with Steve Jobs and Bill Gates for creating computers so you can sit around all day blasted with electromagnetic radiation reading posts like this.
9.Be angry with pharmaceutical companies for allowing us to believe living the above life can be treated with drugs. Correctly prescribed drugs kill thousands of people per year. The flu kills just about no one. The vaccine never works.

Finally, be angry with yourself for not opening your eyes to the snow job and brainwashing which have taken over your mind. You NEVER asked the doctor any questions. You NEVER asked what is in the vaccines. You NEVER learned about these benign infections.

Let’s face it, you don’t really give a crap what your children eat. You don’t care about chemicals in their life. You don’t care if they sit around all day watching the TV or playing video games.

All you care about is drinking your Starbuck’s, your next plastic surgery, your next cocktail, your next affair, and your next sugar fix!”

Yes, it’s all your fault. You’re all too selfish to see how you’ve been conned by centuries of scientific evidence, and that only those who follow the doctrines of paleo-nutrition are truly enlightened.

It would be funny if it wasn’t so serious. This so-called man of science would have us believe that measles, chickenpox, diphtheria, polio and other vaccine preventable diseases are benign. Tell that to the 2.5 million children who die every year from vaccine-preventable diseases around the world (De Cock, Simone, Davison, & Slutsker, 2013).

“At its worst, chicken pox killed 100 people per year.” According to the CDC, his figure is correct – the average number of deaths from chickenpox from 1990-1996 was about 103 per year in the USA though he failed to mention the 11,000 hospitalisations per year caused by chickenpox (http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf). Measles, on the other hand, kills two people for every thousand that are infected by it (http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#complications). The 2013 US road toll was 0.107/1000 (http://www.cdc.gov/nchs/fastats/accidental-injury.htm), making measles 18 times more deadly than road transportation.

“Where are all those 80 year olds crippled by polio? I can’t seem to find many.” Well, it’s hard to find anything when you’re closed minded. Polio caused paralysis in about 1 in 100 cases, and death in up to 30% of those (http://www.cdc.gov/vaccines/pubs/pinkbook/polio.html). Again, those figures are worse than the road toll.

“Be angry with your doctor for being close-minded and not disclosing the ingredients in vaccines (not that they read the package insert anyway). They should tell you about the aluminum, mercury, formaldehyde, aborted fetal tissue, animal proteins, polysorbate 80, antibiotics, and other chemicals in the shots”. Guess what, your doctor doesn’t tell you about aluminum, mercury, formaldehyde, aborted fetal tissue, animal proteins, polysorbate 80, antibiotics etc in vaccines because they’re either not there, or they’re there in amounts so tiny that you would have a greater exposure to them by simply eating. For example, Thiomersal (which contained mercury) has been removed from childhood vaccines since the year 2000 as a precautionary measure, even though there was never any evidence it caused any harm. Aluminium from vaccines is lower than everyday exposure from intake from diet or medications, such as antacids, and is well below the levels recommended by organisations such as the United States Agency for Toxic Substances and Disease Registry. And there is no aborted foetal tissue in vaccines (http://www.health.gov.au/internet/immunise/publishing.nsf/content/uci-myths-guideprov)

And the rest … more of the usual rhetoric of the paleo-minded – sugar, “tortured meat” burgers, “pesticide” fries, and “hormone” milkshakes, laundry detergent, pollutants that “cause autism, heart disease, cancer, autoimmune disease and every other health problem”, computers that bombard you with electromagnetic radiation … he even goes a little Freudian by blaming mothers for not breast feeding and co-sleeping enough. It’s all a bit of a stretch.

So why all the anger? Maybe it has something to do with the fact that people are sick and tired of so-called experts trying to debase solid science with some tarted up pseudoscientific fad. The public know more than what most snake-oil salesmen think they do, and they’re sick of being treated like idiots. People know that immunisation works, and trying to sell the idea that ‘paleo-nutrition’ is better than vaccination just makes you look like a douche.

References

De Cock, K. M., Simone, P. M., Davison, V., & Slutsker, L. (2013). The new global health. Emerg Infect Dis, 19(8), 1192-1197. doi: 10.3201/eid1908.130121

Dr Caroline Leaf and the 98 Percent Myth

Dr Caroline Leaf believes that nearly all our diseases come from our thoughts.

Dr Caroline Leaf believes that nearly all our diseases come from our thoughts.

In the hustle and bustle of daily life, most people wouldn’t stop to consider what makes people sick.  In my profession, I get a front row seat.

In the average week, I get to see a number of different things.  Mostly “coughs, colds and sore holes” as the saying goes, although there are some rarer things too.  And sometimes, people present with problems that aren’t for the faint of heart (or stomach – beware of nail guns is all I can say).

Normally, the statistics of who comes in with what doesn’t make it beyond the desk of the academic or health bureaucrat.  The numbers aren’t as important as the people they represent.

But to Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist, the numbers are all important.  To support her theory of toxic thoughts, Dr Leaf has stated that “75 to 98% of mental and physical (and behavioural) illness comes from one’s thought life” [1: p37-38].  She has repeated that statement on her website, on Facebook, and at seminars.

As someone with a front row seat to the illnesses people have, I found such a statement perplexing.  In the average week, I don’t see anywhere near that number.  In general practices around Australia, the number of presentations for psychological illnesses is only about eight percent [2].

But Australian general practice is a small portion of medicine compared to the world’s total health burden.  Perhaps the global picture might be different?  The World Health Organization, the global authority on global health, published statistics in November 2013 on the global DALY statistics [3] (a DALY is a Disability Adjusted Life Year).  According to the WHO, all Mental and Behavioural Disorders accounted for only 7.2% of the global disease burden.

You don’t need a statistics degree to know that seven percent is a long way from seventy-five percent (and even further from 98%).

Perhaps a large portion of the other ninety-three percent of disease that was classified as physical disease was really caused by toxic thoughts?  Is that possible?  In short: No.

When considered in the global and historical context, the vast majority of illness is related to preventable diseases that are so rare in the modern western world because of generations of high quality public health and medical care.

In a recent peer-reviewed publication, Mara et al state, “At any given time close to half of the urban populations of Africa, Asia, and Latin America have a disease associated with poor sanitation, hygiene, and water.” [4] Bartram and Cairncross write that “While rarely discussed alongside the ‘big three’ attention-seekers of the international public health community—HIV/AIDS, tuberculosis, and malaria—one disease alone kills more young children each year than all three combined. It is diarrhoea, and the key to its control is hygiene, sanitation, and water.” [5] Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years (DALYs)), and poor-quality drinking water is an important risk factor for diarrhoea.” [6]

Diarrhoeal disease in the developing world – the second most common contributor to disease in these countries, afflicting half of their population – has nothing to do with thought.  It’s related to the provision of toilets and clean running water.

We live in a society that prevents half of our illnesses because of internal plumbing.  Thoughts seem to significantly contribute to disease because most of our potential illness is prevented by our clean water and sewerage systems.  Remove those factors and thought would no longer appear to be so significant.

In the same manner, modern medicine has become so good at preventing diseases that thought may seem to be a major contributor, when in actual fact, most of the work in keeping us all alive has nothing to do with our own thought processes.  Like sanitation and clean water, the population wide practices of vaccination, and health screening such as pap smears, have also significantly reduced the impact of preventable disease.

Around the world, “Recent estimates of the global incidence of disease suggest that communicable diseases account for approximately 19% of global deaths” and that “2.5 million deaths of children annually (are) from vaccine-preventable diseases.” [7] Again, that’s a lot of deaths that are not related to thought life.

Since 1932, vaccinations in Australia have reduced the death rate from vaccine-preventable diseases by 99% [8].  Epidemiological evidence shows that when vaccine rates increase, sickness from communicable diseases decrease [9: Fig 2, p52 & Fig 8, p67].

Population based screening has also lead to a reduction in disease and death, especially in the case of population screening by pap smears for cervical cancer.  Canadian public health has some of the best historical figures on pap smear screening and cervical cancer. In Canada, as the population rate of pap smear screening increased, the death rate of women from cervical cancer decreased.  Overall, pap smear screening decreased the death rate from cervical cancer by 83%, from a peak of 13.5/100,000 in 1952 to only 2.2/100,000 in 2006, despite an increase in the population and at-risk behaviours for HPV infection (the major risk factor for cervical cancer) [10].

And around the world, the other major cause of preventable death is death in childbirth.  The risk of a woman dying in childbirth is a staggering one in six for countries like Afghanistan [11] which is the same as your odds playing Russian Roulette.  That’s compared to a maternal death rate of one in 30,000 in countries like Sweden.  The marked disparity is not related to the thought life of Afghani women in labour.  Countries that have a low maternal death rate all have professional midwifery care at birth.  Further improvements occur because of better access to hospital care, use of antibiotics, better surgical techniques, and universal access to the health system [11].  Again, unless one’s thought life directly changes the odds of a midwife appearing to help you deliver your baby, toxic thoughts are irrelevant as a cause of illness and death.

Unfortunately for Dr Leaf, her statement that “75 to 98 percent of mental, physical and behavioural illnesses come from toxic thoughts” is a myth, a gross exaggeration of the association of stress and illness.

In the global and historical context of human health, the majority of illness is caused by infectious disease, driven by a lack of infrastructure, public health programs and nursing and medical care.  To us in the wealthy, resource-rich western world, it may seem that our thought life has a significant effect on our health.  That’s only because we have midwives, hospitals, public health programs and internal plumbing, which stop the majority of death and disease before they have a chance to start.

Don’t worry about toxic thoughts.  Just be grateful for midwives and toilets.

References

1.         Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:

2.         FMRC. Public BEACH data. 2010  [cited 16JUL13]; Available from: <http://sydney.edu.au/medicine/fmrc/beach/data-reports/public%3E.

3.         World Health Organization, GLOBAL HEALTH ESTIMATES SUMMARY TABLES: DALYs by cause, age and sex, GHE_DALY_Global_2000_2011.xls, Editor 2013, World Health Organization,: Geneva, Switzerland.

4.         Mara, D., et al., Sanitation and health. PLoS Med, 2010. 7(11): e1000363 doi: 10.1371/journal.pmed.1000363

5.         Bartram, J. and Cairncross, S., Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med, 2010. 7(11): e1000367 doi: 10.1371/journal.pmed.1000367

6.         Hunter, P.R., et al., Water supply and health. PLoS Med, 2010. 7(11): e1000361 doi: 10.1371/journal.pmed.1000361

7.         De Cock, K.M., et al., The new global health. Emerg Infect Dis, 2013. 19(8): 1192-7 doi: 10.3201/eid1908.130121

8.         Burgess, M., Immunisation: A public health success. NSW Public Health Bulletin, 2003. 14(1-2): 1-5

9.         Immunise Australia, Myths and Realities. Responding to arguments against vaccination, A guide for providers. 5th ed. 2013, Commonwealth of Australia, Department of Health and Ageing, Canberra:

10.       Dickinson, J.A., et al., Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC Public Health, 2012. 12: 992 doi: 10.1186/1471-2458-12-992

11.       Ronsmans, C., et al., Maternal mortality: who, when, where, and why. Lancet, 2006. 368(9542): 1189-200 doi: 10.1016/S0140-6736(06)69380-X

Gardasil and the Deadly Scam

Making the rounds of Facebook is an article published on The Daily Sheeple (“Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam,” 2014) about Gardasil, the Human Pappilloma Virus vaccine.

If what Sheeple are saying is correct, then Gardasil is a deadly scam!  We’ve all been conned into believing that Gardasil and other HPV vaccines were safe, and useful in protecting our children from cervical cancer, when really it doesn’t do anything but make money for Merck, that multi-billion dollar global tyrant, while our children wither and die.

True to the form of paranoid extremists everywhere, Sheeple uses hysterical accusations and mistruths in a breathless promotion of fear and ignorance.  The only deadly scam going on here is Sheeple’s.

Lets break down the article by Sheeple a little, then lets look at the facts from the peer-reviewed literature, not misquotes from misquotes.

Sheeple quotes an article on a similarly extreme blog, which took the quotes from another extremist blog.  It alleges that Dr Harper believed that Gardasil was pointless, and harmful, even more harmful than cervical cancer which it was designed to prevent.  The article alleges that there were 15,037 adverse reactions and 44 deaths.  They quote Harper to CBS stating that, “‘The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC’s Dr. Barbara Slade) were 3.4/100,000 doses distributed,’ Harper tells CBS NEWS.  ‘The rate of serious adverse events on par with the death rate of cervical cancer.’”

The truth is that the rates of serious adverse reactions to the HPV vaccine are incredibly small.

The CDC Morbidity and Mortality Weekly report from the 26th July 2013 states that, “From June 2006 through March 2013, approximately 56 million doses of HPV4 were distributed in the United States … During June 2006–March 2013, the Vaccine Adverse Event Reporting System (VAERS) received a total of 21,194 adverse event reports occurring in females after receipt of HPV4” (Centers for Disease Control and Prevention, 2013).  That’s an adverse events rate of 0.04%.

The vast majority of vaccination side effects are a red, sore arm and fainting, which are not exclusive side effects to HPV vaccinations, but to all vaccinations in adolescents (Centers for Disease Control and Prevention, 2013; Harper & Vierthaler, 2011).  In large trials, the rate of vaccine side effects was comparable to the rate of side effects from the placebo (Centers for Disease Control and Prevention, 2013; Gee et al., 2011; Lu, Kumar, Castellsague, & Giuliano, 2011; Rambout, Hopkins, Hutton, & Fergusson, 2007).  So the vaccine is not the problem, it’s the histrionic teenagers.

In terms of deaths from the HPV vaccine, there aren’t any.  Rambout et al. (2007) wrote, “The meta-analysis demonstrated that, overall, the incidence of serious adverse events and death was balanced between the vaccine and control groups … Most deaths were reported as accidental, and none of the deaths was considered attributable to the vaccine.”  National Centre For Immunisation Research and Surveillance (2013) states that, “HPV vaccines are approved for use in over 100 countries, with more than 100 million doses distributed worldwide … No deaths reported in safety surveillance systems data in Australia or overseas, have been determined to be causally related to either of the HPV vaccines.”

Compare that to the current Australian road toll, which currently stands at 5.2/100,000 (Road Deaths Australia, December 2013).  It’s safer to have a HPV vaccination than it is to drive a car.

The Sheeple article also fails to correctly report the benefits of the HPV vaccine, which has already shown a dramatic drop in the rate of HPV infection (Lu et al., 2011) and the incidence of genital warts (Ali et al., 2013).

Given all of this, did Dr Harper really suggest that the HPV vaccine was useless and harmful?  I doubt she said anything of the sort, since in 2011 in a formal paper in a peer-reviewed journal, she said, “Should vaccination be an option that women choose for their cervical cancer protection, Cervarix is an excellent choice for both screened and unscreened populations due to its long-lasting protection, its broad protection for at least five oncogenic HPV types, the potential to use only one-dose for the same level of protection, and its safety.” (Harper & Vierthaler, 2011)

One final word about every woman’s favourite health check, the pap smear.  Australia does have a low death rate from cervical cancer, compared to the rest of the world, even before the introduction of the HPV vaccine.  The national co-ordinated approach to cervical screening with pap smears is the reason why.  “Vaccination is not an ‘alternative’ to Pap tests; together these two approaches provide optimal protection. The National Cervical Screening Program recommends routine screening with Pap tests every 2 years for all women between the ages of 18 (or 2 years after first sexual intercourse) and 69 years.” (National Centre For Immunisation Research and Surveillance, 2013)

Is there a giant deadly scam behind the Gardasil vaccine?  Only from those who oppose it.  The same people wouldn’t think twice about letting their teenagers in a car, which is far more dangerous.  When it’s their turn, I’ll have no hesitation in having my children vaccinated for HPV.  If you disagree, that’s ultimately your choice.  But examine all the facts first.  Don’t let your children’s health rest on a baseless Internet meme.

References

Ali, H., Donovan, B., Wand, H., Read, T. R., Regan, D. G., Grulich, A. E., . . . Guy, R. J. (2013). Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ, 346, f2032. doi: 10.1136/bmj.f2032

Centers for Disease Control and Prevention. (2013). Human papillomavirus vaccination coverage among adolescent girls, 2007-2012, and postlicensure vaccine safety monitoring, 2006-2013 – United States. MMWR Morb Mortal Wkly Rep, 62(29), 591-595.

Gee, J., Naleway, A., Shui, I., Baggs, J., Yin, R., Li, R., . . . Weintraub, E. S. (2011). Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink. Vaccine, 29(46), 8279-8284. doi: 10.1016/j.vaccine.2011.08.106

Harper, D. M., & Vierthaler, S. L. (2011). Next Generation Cancer Protection: The Bivalent HPV Vaccine for Females. ISRN Obstet Gynecol, 2011, 457204. doi: 10.5402/2011/457204

Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam. (2014). The Daily Sheeple.  Retrieved Jan 17, 2014, from http://www.thedailysheeple.com/lead-developer-of-hpv-vaccines-comes-clean-warns-parents-young-girls-its-all-a-giant-deadly-scam_012014 – sthash.lDJcsFRt.dpuf

Lu, B., Kumar, A., Castellsague, X., & Giuliano, A. R. (2011). Efficacy and safety of prophylactic vaccines against cervical HPV infection and diseases among women: a systematic review & meta-analysis. BMC Infect Dis, 11, 13. doi: 10.1186/1471-2334-11-13

National Centre For Immunisation Research and Surveillance. (2013). Human papillomavirus (HPV) vaccines for Australians | NCIRS Fact sheet: March 2013.   Retrieved Jan 17, 2014, from http://www.ncirs.edu.au/immunisation/fact-sheets/hpv-human-papillomavirus-fact-sheet.pdf

Rambout, L., Hopkins, L., Hutton, B., & Fergusson, D. (2007). Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials. CMAJ, 177(5), 469-479. doi: 10.1503/cmaj.070948

Road Deaths Australia, December 2013. (2014).  Canberra, Australia: Commonwealth of Australia. Retrieved from http://www.bitre.gov.au/publications/ongoing/rda/files/RDA_Dec13.pdf.

Autism Series 2013 – Part 3: The Autism “Epidemic”

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

It seems that autism is on the rise.  Once hidden away in institutions or just dismissed as odd, society is now faced with a condition that it is yet to come to grips with.  Some out in the community believe that it must be a toxin, or vaccines or mercury.  Others accuse doctors of simply giving in to the unreasonable demands of pushy parents to defraud the system of money – “Things have reached the point these days where any kid that’s not a charming little extrovert will be accused of being, ‘on the spectrum.’”[1]

So is there an epidemic of kids who are “not charming little extroverts”?  It depends on who you ask.

Take, for example, two articles written in the year 2000.  In the first, titled “The autism epidemic, vaccinations, and mercury”, Rimland said,

“While there are a few Flat-Earthers who insist that there is no real epidemic of autism, only an increased awareness, it is obvious to everyone else that the number of young children with autism spectrum disorders (ASD) has risen, and continues to rise, dramatically.”[2]

The other, written by Professor Tony Attwood, a world authority on Aspergers Syndrome, said,

“… is there an epidemic of people being diagnosed as having Asperger’s Syndrome? At present we cannot answer the question, as we are unsure of the diagnostic criteria, the upper and lower levels of expression and the borders with other conditions. Nevertheless, we are experiencing a huge increase in diagnosis but this may be the backlog of cases that have been waiting so long for an explanation.”[3]

I don’t think it’s very often Prof Attwood is lumped with ‘flat-earthers’.  But you can see the change in perspective from one side looking objectively to the other who need for there to be an “epidemic” of autism in order to strengthen their case.

So who’s right?  To see if this autism “epidemic” hypothesis has any real merit, we need to delve into some numbers.

First, some basic epidemiology – because part of the confusion in looking at the autism numbers is defining exactly what those numbers represent.  Here are some important epidemiology terms from the “Physicians Assistant Exam for Dummies”[4]:

Incidence: For any health-related condition or illness, incidence refers to the number of people who’ve newly acquired this condition.

Prevalence: Prevalence concerns the number of people who have this condition over a defined time interval.

Most autism figures are for prevalence, or often more specifically, point prevalence – “the number of people who have this condition at any given point in time.”

The other thing to remember from my last blog is that initially autism was only diagnosed on the strict rules of Kanner, and was considered to be a single disease caused mainly by bad parenting [5].  So through the 1960’s and 1970’s, only the most severe children were diagnosed as having autism because the high-functioning autism would not have met Kanners criteria, and even if they did, most parents didn’t want the label for fear of the social stigma.

So then, what are the numbers?  The early prevalence was estimated to be less than 5/10,000 or 1 in 2000[6], although in surveys done after 1987, the numbers began to rise past 7/10,000[7].  In the 1990’s, Autism prevalence climbed into the teens and the latest prevalence has been documented for autism is 20.6/10,000[7].

But that’s only about 1 in 485.  The CDC estimated a prevalence of 1 in 88 (113/10,000)[8].  Where did the other 400 people go?

This is where the importance of definitions is highlighted.  Autism is considered part of a spectrum, and at the time of the surveys reviewed by Fombonne, DSM III then DSM IV considered conditions like Pervasive Developmental Disorder and then Aspergers Disorder to be part of that spectrum.  Adding in the rate of PDD and you have a figure of 57.7/10,000 and adding in Aspergers gives you a combined rate of 63.7/10,000, or 1 in 157 people surveyed[7].

And yet even then, who you measure and how you measure makes much more of a difference, because a recent, rigorous study targeting all 7 to 12 year old children in a large South Korean populous found a prevalence of 2.64%, which is 264/10,000 or 1 child in every 38.  The authors noted that, “Two-thirds of ASD cases in the overall sample were in the mainstream school population, undiagnosed and untreated. These findings suggest that rigorous screening and comprehensive population coverage are necessary to produce more accurate ASD prevalence estimates and underscore the need for better detection, assessment, and services.”[9]

So if there has been a fifty-fold change in prevalence (from 5 to 264 cases per 10,000 people) in just thirty years, isn’t that an epidemic?

Well, no.  As much as some might ignorantly deny it, there is no real evidence for it.  Remember the definitions from the “Physicians Assistant Exam for Dummies”[4]:

Incidence: For any health-related condition or illness, incidence refers to the number of people who’ve newly acquired this condition.

Prevalence: Prevalence concerns the number of people who have this condition over a defined time interval.

It’s the rapid rise in the number of new cases diagnosed that defines an epidemic, which is the incidence and not the prevalence[10].  While the prevalence has changed a lot, the incidence has been fairly stable.  From Nature, “Christopher Gillberg, who studies child and adolescent psychiatry at the University of Gothenburg in Sweden, has been finding much the same thing since he first started counting cases of autism in the 1970s. He found a prevalence of autism of 0.7% among seven-year-old Swedish children in 1983 and 1% in 1999. ‘I’ve always felt that this hype about it being an epidemic is better explanation’, he said.”[11]

Fombonne agrees. “As it stands now, the recent upward trend in estimates of prevalence cannot be directly attributed to an increase in the incidence of the disorder.”[7]  He said later in the article that a true increase in the incidence could not be ruled out, but that the current epidemiological data which specifically studied the incidence of autism over time was not strong enough to draw conclusions.

While there’s no epidemic, there is the real issue of the genuinely increasing prevalence.  Why the rise in those numbers?  Fombonne went on to explain, “There is good evidence that changes in diagnostic criteria, diagnostic substitution, changes in the policies for special education, and the increasing availability of services are responsible for the higher prevalence figures.”[7]  Nature published a graph from the work of Professor Peter Bearman, showing that 54% of the rise in the prevalence of autism could be explained by the refining of the diagnosis, greater awareness, an increase in the parental age, and clustering of cases in certain geographic areas.

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4. (Adapted from King, M. and Bearman, P., Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 2009. 38(5): 1224-34 AND King, M.D. and Bearman, P.S., Socioeconomic Status and the Increased Prevalence of Autism in California. Am Sociol Rev, 2011. 76(2): 320-46.)

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4. (Adapted from King, M. and Bearman, P., Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 2009. 38(5): 1224-34 AND King, M.D. and Bearman, P.S., Socioeconomic Status and the Increased Prevalence of Autism in California. Am Sociol Rev, 2011. 76(2): 320-46.)

From Nature: “The fact that he still cannot explain 46% of the increase in autism doesn’t mean that this ‘extra’ must be caused by new environmental pollutants, Bearman says. He just hasn’t come up with a solid explanation yet. ‘There are lots of things that could be driving that in addition to the things we’ve identified,’ he says.”[11]

There is no autism epidemic, just medical science and our population realising just how common autism is as the definition becomes more refined, people become more aware, and some other biosocial factors come into play.

What can we take from the numbers?  That we’re being overtaken by Sheldon clones?  That soon there will be no more “charming little extroverts”?  If the CDC figure is accurate, then one person in every hundred is on the spectrum, so the world is hardly being overtaken by autism.  But the take home message is that Autism Spectrum Disorders are more common that we ever thought, and there are more people on the spectrum “hiding in plain sight”.  If the study from South Korea is accurate then one person in every thirty-eight is on the spectrum, but two thirds of them are undiagnosed.

Should there be more funding, more resources, or more political representation for people on the spectrum?  Perhaps, although the public and research funds are not unlimited, and other health concerns should also be treated fairly.  But since autism is life long and impacts on so many areas of mental health and education, understanding autism and managing it early could save governments billions of dollars into the future.

Rather, I think that the climbing prevalence of ASD is a clarion call for understanding and tolerance.  If we learn to tolerate differences and practice discretionary inclusion, then both the autistic and the neuro-typical can benefit from the other.  That’s a world which we’d all like to live.

REFERENCES

1. Bolt, A. If the autistic don’t get full cover, where’s the money going? 2013  2013 May 11]; Available from: http://blogs.news.com.au/heraldsun/andrewbolt/index.php/heraldsun/comments/if_the_autistic_dont_get_full_cover_wheres_the_money_going/.

2. Rimland, B., The autism epidemic, vaccinations, and mercury. Journal of Nutritional and Environmental Medicine, 2000. 10(4): 261-6.

3. Attwood, T., The Autism Epidemic: Real or Imagined, in Autism Aspergers Digest2000, Future Horizons Inc: Arlington, TX.

4. Schoenborn, B. and Snyder, R., Physician Assistant Exam For Dummies. 2012: John Wiley & Sons.

5. Pitt, C.E. Autism Series 2013 – Part 2: The History Of Autism. 2013  [cited 2013 2013 Aug 15]; Available from: https://cedwardpitt.com/2013/08/15/autism-series-2013-part-2-the-history-of-autism/.

6. Rice, C.E., et al., Evaluating Changes in the Prevalence of the Autism Spectrum Disorders (ASDs). Public Health Reviews. 34(2).

7. Fombonne, E., Epidemiology of pervasive developmental disorders. Pediatric research, 2009. 65(6): 591-8.

8. Baio, J., Prevalence of Autism Spectrum Disorders: Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 61, Number 3. Centers for Disease Control and Prevention, 2012.

9. Kim, Y.S., et al., Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry, 2011. 168(9): 904-12.

10. “Epidemic vs Pandemic”. 2013  [cited 2013 Sept 03]; Available from: http://www.diffen.com/difference/Epidemic_vs_Pandemic.

11. Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

 

Dr Caroline Leaf – Contradicted by the latest research

This is my most popular post by far.  I truly appreciate the support and interest in this post, but I’ve discovered and documented a lot more about Dr Leaf’s ministry in the last two years.  I welcome you to read this post, but if you’d like a more current review of the ministry of Dr Caroline Leaf, a new and improved version is here:
Dr Caroline Leaf – Still Contradicted by the Latest Evidence, Scripture & Herself

* * * * *

Mr Mac Leaf, the husband of Dr Caroline Leaf, kindly took the time to respond to my series of posts on the teachings of Dr Leaf at Kings Christian Centre, on the Gold Coast, Australia, earlier this month. As I had intended, and as Mr Leaf requested, I published his  reply, complete and unabridged (here).

This blog is my reply.  It is heavily researched and thoroughly referenced.  I think it’s fair to say that while Dr Leaf draws her conclusions from some scientific documents, there is more than enough research that contradicts her statements and opinions.  I have only listed a small fraction, and only on some of the points she raised.

In fairness, the fields of neurology and neuroscience are vast and rapidly expanding, and it is impossible for one person to cover all of the literature on every subject.  This applies to myself and Dr Leaf.  However, I believe that the information I have read, and referenced from the latest peer-reviewed scholarly works, do not support Dr Leaf’s fundamental premises.  If I am correct, then the strength and validity of Dr Leaf’s published works should be called into question.

As before, I welcome any reply or rebuttal that Dr Leaf wishes to make, which I will publish in full if she requests.  In the interests of healthy public debate, and encouraging people to make their own informed decisions on the teachings of Dr Leaf, any comments regarding the response of Mr Leaf, Dr Leaf or myself, are welcome provided they are constructive.

This is a bit of a lengthy read, but I hope it is worthwhile.

Dear Mr Leaf,

Thank you very much for taking the time out to reply to some of the points raised in my blog.  I am more than happy to publish your response, and to publish any response you wish to make public.

ON INFORMED DECISIONS

I published my blog posts to open up discussion on the statements made by Dr Leaf at the two meetings that I attended at Kings Christian Centre on the Gold Coast.  As you rightly point out, people should be able to make informed decisions.  A robust discussion provides the information required for people to make an informed choice.  Any contributions to this discussion from either yourself or Dr Leaf would be most welcome.

I apologise if you interpreted my blogs as judgemental, or if you believe there are any misunderstandings.  You may or may not have read my final two paragraphs from the third post, in which I acknowledged that I may have misunderstood where she was coming from, but that I would welcome her response.  If there were any misunderstandings, it is likely because Dr Leaf did not make any attempt to reference any of the statements she made on the day.  You may argue that she was speaking to a lay audience, and referencing is therefore not necessary.  However, I have been to many workshops for the lay public by university professors, who have extensively referenced their information during their presentations.  A lay audience does not preclude providing references.  Rather, it augments the speakers authority and demonstrates the depth of their knowledge on the subject at hand.

YOUR DEFENCE

It’s interesting that you feel the need to resort to defence by association, and Ad Hominem dismissal as your primary counter to the points I raised.

Can you clarify how attending the same university as Dr Christaan Barnard, or a Nobel laureate, endorses her arguments or precludes her from criticism?  I attended the University of Queensland where Professor Ian Frazer was based.  He developed the Human Papilloma Virus vaccine and was the 2006 Australian of the Year.  Does that association enhance my argument?

Can you also clarify why a reference from a colleague was preferred to letting Dr Leaf’s statements and conclusions speak for themselves?  Dr Amua-Quarshie’s CV is certainly very impressive, no doubt about that, although he doesn’t list the papers he’s published.  (I’m assuming that to hold the title of Adjunct Professor, he’s published peer-reviewed articles.  Is he willing to list them, for the record?)

Whatever his credentials, his endorsement means very little, since both Dr Leaf and Dr Amua-Quarshie would know from their experience in research that expert opinion is one of the lowest forms of evidence, second worst only to testimonials [1].  Further, both he and Dr Leaf are obviously close friends which introduces possible bias.  His endorsement is noteworthy, but it can not validate every statement made by Dr Leaf.  Her statements should stand up on their own through the rigors of critical analysis.

On the subject of evidence, disparaging your critics is not a substitute for answering their criticism.  Your statement, “By your comments it is obvious that you have not kept up to date with the latest Scientific research” is an assumption that is somewhat arrogant, and ironic since Dr Leaf is content to use superseded references dating back to 1979 to justify her current hypotheses.

DR LEAF’S EVIDENCE

In the blog to which you referred, Dr Leaf makes a number of statements that are intended to support her case.  These include the following.

“A study by the American Medical Association found that stress is a factor in 75% of all illnesses and diseases that people suffer from today.”  She fails to reference this study.

“The association between stress and disease is a colossal 85% (Dr Brian Luke Seaward).”   But again, she fails to reference the quote.

“The International Agency for Research on Cancer and the World Health Organization has concluded that 80% of cancers are due to lifestyles and are not genetic, and they say this is a conservative number (Cancer statistics and views of causes Science News Vol.115, No 2 (Jan.13 1979), p.23).”  It’s good that she provides a reference to her statement.  However, referencing a journal on genetics from 1979 is the equivalent of attempting to use the land-speed record from 1979 to justify your current preference of car.  The technology has advanced significantly, and genetic discoveries are lightyears ahead of where they were more than three decades ago.

“According to Dr Bruce Lipton (The Biology of Belief, 2008), gene disorders like Huntington’s chorea, beta thalassemia, cystic fibrosis, to name just a few, affect less than 2% of the population. This means the vast majority of the worlds population come into this world with genes that should enable the to live a happy and healthy life. He says a staggering 98% of diseases are lifestyle choices and therefore, thinking.”  Even if it’s true that Huntingtons, CF etc account for 2% of all illnesses, they account for only a tiny fraction of genetic disease.  And concluding that the remaining 98% must therefore be lifestyle related is overly simplistic.  It ignores the genetic influence on all other diseases, other congenital, and environmental causes of disease.  I will fully outline this point soon.

Similarly, “According to W.C Willett (balancing lifestyle and genomics research for disease prevention Science (296) p 695-698, 2002) only 5% of cancer and cardiovascular patients can attribute their disease to hereditary factors.”  Science is clear that genes play a significant role in the development of cardiovascular disease and most cancers, certainly greater than 5%.  Again, I will discuss this further soon.

“According to the American Institute of health, it has been estimated that 75 – 90% of all visits to primary care physicians are for stress related problems (http://www.stress.org/americas.htm). Some of the latest stress statistics causing illness as a result of toxic thinking can be found at: http://www.naturalwellnesscare.com/stress-statistics.html”  These websites not peer-reviewed, and both suffer from a blatant pro-stress bias.

You’ll also have to forgive my confusion, but Dr Leaf also wrote, “Dr H.F. Nijhout (Metaphors and the Role of Genes and Development, 1990) genes control biology and not the other way around.”  So is she saying that genes DO control development?

EVIDENCE CONTRADICTING DR LEAF

Influence Of Thought On Health

Dr Leaf has categorically stated that “75 to 98% of all illnesses are the result of our thought life” on a number of occasions.  She repeated the same statement in her most recent book so it is something she is confident in.  However, in order to be true, this fact must be consistent across the whole of humanity.

And yet, in a recent peer-reviewed publication, Mara et al state, “At any given time close to half of the urban populations of Africa, Asia, and Latin America have a disease associated with poor sanitation, hygiene, and water.” [2]  Bartram and Cairncross write that “While rarely discussed alongside the ‘big three’ attention-seekers of the international public health community—HIV/AIDS, tuberculosis, and malaria—one disease alone kills more young children each year than all three combined. It is diarrhoea, and the key to its control is hygiene, sanitation, and water.” [3]  Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years [DALYs]), and poor-quality drinking water is an important risk factor for diarrhoea.” [4]

Toilets and clean running water have nothing to do with stress or thought.  We live in a society that essentially prevents more than half of our illnesses because of internal plumbing, with additional benefits from vaccination and population screening.  If thoughts have any effect on our health, they are artificially magnified by our clean water and sewerage systems.  Remove those factors and any effects of thought on our health disappear from significance.  Dr Leaf’s assertion that 75 to 98% of human illness is thought-related is a clear exaggeration.

Let me be clear – I understand the significance of stress on health and the economy, but it is not the cause of 75-98% of all illnesses.  I’m not sure if there is a similar study in the US, but the latest Australian data suggests that all psychological illness only counts for 8% of visits to Australian primary care physicians [5].

In terms of cancer, I don’t have time to exhaustively list every cancer but of the top four listed in the review “Cancer Statistics 2013” [6] , here are the articles that list the gene x environment interactions:

  1. PROSTATE – There are only two risk factors for prostate cancer, familial aggregation and ethnic origin. No dietary or environmental cause has yet been identified [7].  It is most likely caused by multiple genes at various loci [8].
  2. BREAST – Genes make up 25% of the risk factors for breast cancer, and significantly interacted with parity (number of children born) [9].
  3. LUNG/BRONCHUS – Lung cancer is almost exclusively linked to smoking, but nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. COLORECTUM – Approximately one third of colorectal cancer is genetically linked [11].

So the most common cancer is not linked to any environmental factors at all, and the others have genetic influences of 25% to more than 50%.  This is far from being 2% or 5% as Dr Leaf’s sources state.

Also in terms of heart disease, the INTERHEART trial [12] lists the following as significant risk factors, and I have listed the available gene x environment interaction studies that have been done on these too:

  1. HIGH CHOLESTEROL – Genetic susceptibility accounts for 40-60% of the risk for high cholesterol [13].
  2. DIABETES – Genetic factors account for 88% of the risk for type 1 diabetes [14].  There is a strong genetic component of the risk of type 2 diabetes with 62-70% being attributable to genetics [15, 16].
  3. SMOKING – nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. HYPERTENSION – While part of a much greater mix of variables, genetics are still thought to contribute between 30% and 50% to the risk of developing high blood pressure [17].

So again, while genes are a part of a complex system, it is clear from the most recent evidence that genetics account for about 50% of the risk for cardiovascular disease, which again is a marked difference between the figures that Dr Leaf is using to base her assertions on.

Atrial Natriuretic Peptide

I am aware of research that’s studied the anxiolytic properties of Atrial Natriuretic Peptide.  For example, Wiedemann et al [18] did a trial using ANP to truncate panic attacks.  However, these experiments were done on only nine subjects, and the panic attacks were induced by cholecystokinin.  As such, the numbers are too small to have any real meaning.  And the settling is completely artificial.  Just as CCK excretion does not cause us all to have panic attacks every time we eat, ANP does not provide anxiolysis in normal day to day situations.  Besides, if ANP were really effective at reducing anxiety, then why do people suffering from congestive cardiac failure, who have supraphysiological levels of circulating ANP [19] , also suffer from a higher rate of anxiety and panic disorders than the general population? [20]

The Heart As A Mini-Brain

As for Heartmath, they advance the notion of the heart being a mini-brain to give themselves credibility.  It’s really no different to an article that I read the other day from a group of gut researchers [21] – “‘The gut is really your second brain,’ Greenblatt said. ‘There are more neurons in the GI tract than anywhere else except the brain.’”  The heart as a mini-brain and the gut as a mini-brain are both figurative expressions.  Neither are meant to be taken literally.  I welcome Dr Leaf to tender any further evidence in support of her claim.

Hard-Wired For Optimism

As for being wired for optimism, the brain is likely pre-wired with a template for all actions and emotions, which is the theory of protoconsciousness [22].  Indeed, neonatal reflexes often reflect common motor patterns.  If this is true, then the brain is pre-wired for both optimism and love, but also fear.  This explains the broad role of the amygdala in emotional learning [23] including fear learning.  It also means that a neonate needs to develop both love and fear.

A recent paper showed that the corticosterone response required to learn fear is suppressed in the neonate to facilitate attachment, but with enough stress, the corticosterone levels build to the point where amygdala fear learning can commence [24].  The fear circuits are already present, only their development is suppressed.  Analysis of the cohort of children in the Bucharest Early Intervention Project showed that negative affect was the same for both groups.  However positive affect and emotional reactivity was significantly reduced in the institutionalised children [25].  If the brain is truly wired for optimism and only fear is learned, then positive emotional reactivity should be the same in both groups and the negative affect should be enhanced in the institutionalised cohort.  That the result is reversed confirms that neonates and infants require adequate stimulation of both fear and love pathways to grow into an emotionally robust child, because the brain is pre-wired for both but requires further stimulation for adequate development.

The Mind-Brain Link

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do anti-depressant medications correct depression or anxiety disorders?  There is high-level evidence to show this to be true [26-28].  The same can be said for recent research to show that medications which enhance NDMA receptors have been shown to improve the extinction of fear in anxiety disorders such as panic disorder, OCD, Social Anxiety Disorder, and PTSD [29].

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do some people with acquired brain injuries or brain tumours develop acute personality changes or thought disorders?  Dr Leaf has done PhD research on patients with closed head injuries and treated them in clinical settings according to her CV.  She must be familiar with this effect.

One can only conclude that there is a bi-directional effect between the brain and the stream of thought, which is at odds with Dr Leaf’s statement that the mind controls the brain and not the other way around.

FURTHER CLARIFICATION

One further thing.  Can you clarify which of Dr Leaf’s peer-reviewed articles have definitively shown the academic improvement in the cohort of 100,000 students, as you and your referee have stated?  And can you provide a list of articles which have cited Dr Leaf’s Geodesic Information Processing Model?  Google Scholar did not display any articles that had cited it, which must be an error on Google’s part.  If her theory is widely used as you say, it must have been extensively cited.

I understand that you are both busy, but I believe that I have documented a number of observations, backed by recent peer-reviewed scientific literature, which directly contradict Dr Leaf’s teaching.  I have not had a chance to touch on many, many other points of disagreement.

For the benefit of Dr Leaf’s followers, and for the scientific and Christian community at large, I would appreciate your response.

I would be grateful if you could respond to the points raised and the literature which supports it, rather than an Ad Hominem dismissal or further defense by association.

Dr C. Edward Pitt

REFERENCES

1. Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107.

2. Mara, D., et al., Sanitation and health. PLoS Med, 2010. 7(11): e1000363.

3. Bartram, J. and Cairncross, S., Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med, 2010. 7(11): e1000367.

4. Hunter, P.R., et al., Water supply and health. PLoS Med, 2010. 7(11): e1000361.

5. FMRC. Public BEACH data. 2010  16JUL13]; Available from: <http://sydney.edu.au/medicine/fmrc/beach/data-reports/public&gt;.

6. Siegel, R., et al., Cancer statistics, 2013. CA Cancer J Clin, 2013. 63(1): 11-30.

7. Cussenot, O. and Valeri, A., Heterogeneity in genetic susceptibility to prostate cancer. Eur J Intern Med, 2001. 12(1): 11-6.

8. Alberti, C., Hereditary/familial versus sporadic prostate cancer: few indisputable genetic differences and many similar clinicopathological features. Eur Rev Med Pharmacol Sci, 2010. 14(1): 31-41.

9. Nickels, S., et al., Evidence of gene-environment interactions between common breast cancer susceptibility loci and established environmental risk factors. PLoS Genet, 2013. 9(3): e1003284.

10. Berrettini, W.H. and Doyle, G.A., The CHRNA5-A3-B4 gene cluster in nicotine addiction. Mol Psychiatry, 2012. 17(9): 856-66.

11. Hutter, C.M., et al., Characterization of gene-environment interactions for colorectal cancer susceptibility loci. Cancer Res, 2012. 72(8): 2036-44.

12. Yusuf, S., et al., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004. 364(9438): 937-52.

13. Asselbergs, F.W., et al., Large-scale gene-centric meta-analysis across 32 studies identifies multiple lipid loci. Am J Hum Genet, 2012. 91(5): 823-38.

14. Wu, Y.L., et al., Risk factors and primary prevention trials for type 1 diabetes. Int J Biol Sci, 2013. 9(7): 666-79.

15. Ali, O., Genetics of type 2 diabetes. World J Diabetes, 2013. 4(4): 114-23.

16. Murea, M., et al., Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabet Stud, 2012. 9(1): 6-22.

17. Kunes, J. and Zicha, J., The interaction of genetic and environmental factors in the etiology of hypertension. Physiol Res, 2009. 58 Suppl 2: S33-41.

18. Wiedemann, K., et al., Anxiolyticlike effects of atrial natriuretic peptide on cholecystokinin tetrapeptide-induced panic attacks: preliminary findings. Arch Gen Psychiatry, 2001. 58(4): 371-7.

19. Ronco, C., Fluid overload : diagnosis and management. Contributions to nephrology,. 2010, Basel Switzerland ; New York: Karger. viii, 243 p.

20. Riegel, B., et al., State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 2009. 120(12): 1141-63.

21. Arnold, C. Gut feelings: the future of psychiatry may be inside your stomach. 2013  [cited 2013 Aug 22]; Available from: http://www.theverge.com/2013/8/21/4595712/gut-feelings-the-future-of-psychiatry-may-be-inside-your-stomach.

22. Hobson, J.A., REM sleep and dreaming: towards a theory of protoconsciousness. Nat Rev Neurosci, 2009. 10(11): 803-13.

23. Dalgleish, T., The emotional brain. Nat Rev Neurosci, 2004. 5(7): 583-9.

24. Landers, M.S. and Sullivan, R.M., The development and neurobiology of infant attachment and fear. Dev Neurosci, 2012. 34(2-3): 101-14.

25. Bos, K., et al., Psychiatric outcomes in young children with a history of institutionalization. Harv Rev Psychiatry, 2011. 19(1): 15-24.

26. Arroll, B., et al., Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev, 2009(3): CD007954.

27. Soomro, G.M., et al., Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev, 2008(1): CD001765.

28. Kapczinski, F., et al., Antidepressants for generalized anxiety disorder. Cochrane Database Syst Rev, 2003(2): CD003592.

29. Davis, M., NMDA receptors and fear extinction: implications for cognitive behavioral therapy. Dialogues Clin Neurosci, 2011. 13(4): 463-74.