Friday, September 16, 2011

The Idiot Behind the Curtain

There’s been a bit of a hubbub around Dr. Oz the past day or so for his comments implying that the levels of arsenic in apple juice are unsafe based on his test of a couple samples.  The FDA got wind of the story and explained their conclusion for the safety of apple juice.  Yet Dr. Oz went ahead and spread misleading information that has caused a scare in apple juice.
The only question that should matter in this discussion is what does the scientific evidence say on the subject?  Here are a couple important facts to consider:
Arsenic occurs organically and inorganically. 
Only the inorganic arsenic compounds are toxic. 
Any compound in high doses is toxic (yes, even water), so the amount of inorganic arsenic matters as well. 
Given that Oz’s non-clinical “experiment” doesn’t even attempt to distinguish between organic and inorganic arsenic, you can’t reasonably draw the conclusion as Oz does that “The FDA should not allow more arsenic in our apple juice than we allow in our drinking water”.  This is obviously silly since the threshold of toxicity will be lower for water than for apple juice: water is two hydrogen atoms and an oxygen - any arsenic found in water is a residual contaminant, whereas apples juice carries arsenic produced by the apple.  Even backing out the inorganic arsenic, you would expect the threshold to be lower for water since water is consumed and used at much higher levels than apple juice.

Often, the nuances of such subjects are lost on people.  It is so easy to fall into thinking driven by a false dichotomy - either a substance is good or bad.  But the dose matters.  A single atom of arsenic consumed in a lifetime will likely be of no consequence, which I think most people would concede.  The question is: how much arsenic (or any other substance) can you consume before it has a quantifiable health outcome?  This is where the FDA comes in - to test this in rats and to do epidemiological (observational of existing behavior and outcomes rather than prospective) studies of humans.
I noticed some people are pulling the ‘big applejuice’ gambit by trying to call into question the FDA’s objectivity by virtue of the supposed fact that they are lobbied.  Whether the FDA is lobbied or not is beside the point.  Every politician in Washington is lobbied by interests that are directly conflicted.  There are lobbying efforts to accept global warming and those against it.  So by the fact that there is lobbying involved make them both wrong?  Of course not.  Simply observing that lobbying occurs doesn’t address the factual value of the claims.
It really isn’t a surprise that Dr. Oz would mangle the science since he has been promoting so called Complimentary and Alternative Medicine (CAM) for quite a while.  Among other things Dr. Oz has promoted a number of scientifically bogus modalities:
Homeopathy – small doses of a drug (or really anything…seriously) diluted to the point where there’s literally no chance you’ll get any measurable dose of the drug.  But somehow (magic) homeopathy is supposed to cure you of the symptom the undiluted drug would cause.  Makes sense right?  Not to mention the fact that it has completely failed clinical trials
Reiki – this is nothing more than faith healing and it doesn’t work.  Instead of being wrapped up in religious dogma, this is the eastern mysticism version that tries to ‘align’ ones’ ‘energy field’ and such nonsense by the practitioner waving her hands over the patient. Pure BS.
Acupuncture – This is another idea from eastern mysticism that is supposed to align the body’s Chi by inserting small needles at particular points in the body.  There are a number of well designed clinical trials of acupuncture and they show that it is no better than a placebo.  In addition, not only has it been shown not to matter where you put the needles, but it has been shown that you don’t even need to insert the needles (a simple non-puncturing poke will do) to induce a placebo response.  This leaves acupuncture practitioners with nothing. 


In conclusion, I'm not really surprised to see Dr. Oz once again promoting pseudo-science and misinformation.  Though it does give me hope that the former CDC Director, Dr. Richard Bressler, was direct and unequivocative in his criticism of Dr. Oz on the Good Morning America show.  This is a good example how experts in a field should respond to inaccurate information and communicate why the information is wrong. 

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