Steve Kass

More delicious reasons here.

On the other hand, there’s no reason in the latest salvo against sugar, which popped up offensively in the pages of Nature today.

It’s an opinion piece in Nature’s COMMENT section. It’s not peer-reviewed science, it’s silly, and it’s got this CHART inside that make it look all science-y if you don’t look close.

A chart of what? A chart of who the fuck knows what, that’s what.

The caption says: Global sugar supply … excluding fruit and wine.

The article says: “In many parts of the world, people are consuming an average of more than 500 calories per day from added sugar alone (see ‘The global sugar glut’).”

I say: Global sugar supply and added sugar consumption are two different things. Which is it, supply or consumption? Which is it, all sugar or just added sugar? According to the sideways writing, the chart or its data came from the FAO, but a frenetic half-hour and scores of searches at their web site (without a break for gummies) yielded no answer.

Incidentally, why on a map that appears to provide by-country data is Hawai’i shaded a different color than Alaska and the Lower 48? Would a map of per capita calorie consumption or production — whether of all food or just added food, not only of sugar or just added sugar — look any different? Is 500 calories of who the fuck knows what a lot of who the fuck knows what, or at least enough to justify regulating who the fuck knows what?

Pity the children and the bears.

News this week of an Adderall shortage, and this report, which draws into question the widely-held belief that methamphetamines cause brain damage and cognitive impairment, prompt me to rescue an old statistical parody I wrote (and posted on my now-moribund Drew web page) in 2003, a few years before I had this soapbox. The news links above are also well worth visiting.

Cocaine’s brain effects might be long term [“news”]

Insulin’s metabolic effects might be long term [parody]

BOSTON, March 10, 2003 (UPI) — Cocaine and amphetamines
might cause slight mental impairments in abusers that
persist for at least one year after discontinuing the
drugs, research released Monday reveals.

MADISON (NJ), March 16, 2003 — Insulin might cause metabolic
disorders in abusers that persist for at least one year after
discontinuing the drug, research released Monday reveals.

However, experts outside the study said the findings were inconclusive
and pointed out although cocaine has been widely abused for decades,
impaired cognitive function is not seen routinely or even known to exist in
former abusers.

"Overall, the abusers were impaired compared to non-abusers on the function of attention and motor skills," Rosemary Toomey, a psychologist at Harvard
Medical School and the study’s lead investigator, told United Press International.

“Overall, the abusers were impaired compared to non-abusers
on tests of sugar metabolism,” Rosemary Toomey, a psychologist
at Harvard Medical School and the study’s lead investigator,
told United Press International.

Previous studies have yielded inconsistent findings on whether
cocaine abuse led to long-term mental deficits. Some studies found
deficits in attention, concentration, learning and memory six months
after quitting. But a study of former abusers who were now in prison
and had abstained from cocaine for three years found no deficit.

Few studies have looked at the long term effects of insulin
abuse, although doctors and scientists generally believe
the drug is harmful. One study of former abusers who
were now in prison and had abstained from insulin for
three years found a higher than normal death rate.

To help clarify these seemingly conflicting results, Toomey’s team,
in a study funded by the National Institute on Drug Abuse, identified
50 sets of male twins, in which only one had abused cocaine or
amphetamines for at least one year. Amphetamine abusers were
included because the drug is similar to cocaine and could have the
same long-term effects on the body.

To address the lack of careful studies, Toomey’s team, funded by
the National Institute on Drug Abuse, identified 50 sets of male
twins, in which only one had abused insulin for at least one year.

Most of the pairs were identical twins, meaning they share the exact
same genetic pattern. This helps minimize the role biological
differences could play in the findings and gives stronger support to the
mental impairments being due to drug abuse.

Most of the pairs were identical twins, meaning they
share the exact same genetic pattern. This helps minimize
the role genetic differences could play in the findings and gives
stronger support to the impairments being due to insulin abuse.

The abusers, who averaged age 46 and had not used drugs for at least
one year, scored significantly worse on tests of motor skills and
attention, Toomey’s team reports in the March issue of The Archives
of General Psychiatry.

The abusers, who averaged age 46 and had not used
insulin for at least one year, scored significantly worse
on tests of sugar metabolism, Toomey’s team reports in
the March issue of The Archives of General Metabolism.

The tests all were timed, which indicates the abusers have
"a motor slowing, which is consistent with what other investigators
have found in other studies," Toomey said.

The tests all were performed after fasting, which indicates the abusers
have “an impaired metabolism unrelated to diet, which is consistent
with the consensus in the medical community,” Toomey said.

Still, the abusers’ scores were within normal limits and they actually
performed better on one cognitive test, called visual vigilance, which
is an indication of the ability to sustain attention over time. This
indicates the mental impairment is minor, Toomey said. "In real life,
it wouldn’t be a big impact on (the abusers’) day-to-day functioning
but there is a difference between them and their brothers," she said.

The finding is significant, she added, because given that the study subjects
are twins and share the same biological make-up, they would be expected
to have about the same mental status. This implicates the drug abuse
as the cause of the mental impairment.

The finding is significant, she added, because given that the study
subjects are twins and share the same biological make-up, they would
be expected to have about the same metabolic status. This
implicates the drug abuse as the cause of the impairment.

Among the abusers, the mental test scores largely did not vary in
relation to the amount of cocaine or amphetamine used. However,
on a few tests the abusers did score better with more stimulant use.

Among the abusers, poorer test scores were consistently associated
with increased levels of insulin abuse. Among the heaviest abusers,
not one scored better than his non-abusing twin.

"The results seem to me to be inconclusive," Greg Thompson,
a pharmacist at the University of Southern California’s
School of Pharmacy in Los Angeles, told UPI.

“The results seem to me to be conclusive,” Greg Thompson,
a pharmacist at the University of Southern California’s
School of Pharmacy in Los Angeles, told UPI.

This is "because both twins are within a normal range
(and) sometimes the cocaine-abusing twin did better than the
non-abusing twin and sometimes not," Thompson said.

This is “because almost without exception, only the non-abusing
twin is within a normal range (and) the insulin-abusing twin did
worse than the non-abusing twin,” Thompson said.

In addition, cocaine has been abused by millions of people, going
back as far as the 1930s and before, he said. "You’d think you’d be
seeing this as a significant clinical problem and we are not," he said.

In addition, insulin has been abused by millions of people,
and poor sugar metabolism among former insulin abusers
has been reported by physicians going back as far as the 1930s
and before, he said. “This is a significant clinical problem,” he said.

Of more concern to Thompson is the effect stimulants such as Ritalin,
which are used to treat attention deficit disorder, are having on
children. "This would be a much bigger problem I would think if
it’s true stimulants impair cognitive function," he said.

Of more concern to Thompson is the effect daily insulin injections
are having on children. Insulin is commonly prescribed to control
diabetes (frequent urination, weight gain, and fatigue syndrome).
“Many of these children will become former insulin abusers, and
poor sugar metabolism will be a major healthcare issue for
them in the years to come,” he said.

"Before I’d worry about the 46 year-old abuser, I’d want to know about the
3 year old being treated for ADD (attention-deficit disorder)," Thompson said.

“Before I’d worry about the 46 year-old abuser, I’d want to
know about the 3 year old being treated for diabetes,” Thompson said.

The Soda Police are getting noisier lately, but their concern for public health is a subterfuge. When it comes down to brass tacks (and I doubt brass’s slight lead content is going to kill you when used judiciously in plumbing, by the way), the S.P. don’t care most about the public health or about overweight kids at risk for diabetes and heart disease. They’re hell-bent on demonizing soda, especially soda made by Big Food and sold by the Big Chain Store and Restaurant Corporation.

Demon or not, it probably won’t hurt Americans to drink less soda on average than we do now. It will definitely help the environment if we drink less of anything that comes in individual single-use containers — even water — if there’s an environmentally friendly alternative already in place.

Here’s a simple two-part proposal to bring back running water.

BBRW Part 1. Require public water fountains everywhere.

Schools, parks, subway stations, airports, shopping centers, offices, stores, and more. We already require a lot of things, sensible and otherwise, so the means is in place. Require enough of them so no one has to wait in line. These water fountains (bubblers in Wisconsin and parts of New England) should have good water pressure, and they should be designed so they can fill up a bottle, too — or there should be some faucets for that. Simply making it possible to fill a personal water bottle in an airport — and yes, you can carry one through security so long as it’s empty — will reduce heart disease.

No flow restrictors, either; use spring-loaded knobs to conserve. (I’m not going to say a word about those infrared hand-wavy travesties.) Restrictors belong in kitchens and showers, if anywhere. It doesn’t need to take ten minutes to deliver half a cup of water. ADA compliant, but otherwise basic and solid. Call me nostalgic, but I like porcelain-coated cast iron.

Room-temperature, pure water is already available from every municipal water system. Only a little effort makes it ubiquitous. (If you’re afraid it will give you cancer, carry your own personal PET-free container full of home-purified water.)

BBRW Part 2. Require water to be available everywhere soda is available, for less.

If a restaurant offers a meal that includes soda, require it to offer the same meal with the same size tap water for less money. Less by at least half the restaurant’s own à la carte price for the included soda. Except during water emergencies, require restaurants to offer tap water when patrons are seated.

Stop the endless debates over soda vs. fruit juice, sugar versus high-fructose corn syrup, artificially-sweetened beverages vs. sugary ones, and aspartame vs. stevia extract. Bring back running water.

Year after year, thousands of Americans are devastated to discover that their community has been stricken by a disease cluster. Some rare and frightening disease of unknown cause has visited their community like a plague. Residents are afflicted at rates many times the national average.

Despite years of study, billions of dollars, massive lawsuits and at least two Hollywood movies, little progress has been made towards understanding, let alone preventing, disease clusters.

The general public continues to suspect and blame environmental causes, especially chemicals with names that are hard to pronounce. The real reason for most disease clusters is likely something else.

Math.

Yes, math. Look at this map.

This map shows the 2009 rate of aleatorum gravis, an emerging and debilitating disease that currently affects only one American in 5,000. In some communities, however, the disease is rampant. Counties with rates more than five times the national average are shaded in red, and those with more than twice the national rate are shown in the darkest shade of green. [Click on the image or here for the full U.S. map.]

Nebraska.

Clusters of a. gravis are concentrated in the nation’s heartland, especially Nebraska and neighboring states. Why? If you wanted, you could look for and find potential causes alarmingly close to each cluster. A gas pipeline, a chicken farm, a power plant, a landfill. Or you could have a lawyer look for you.

Look as hard as you want, but the fact is that the cause of these disease clusters is mathematics. There is no such thing as a. gravis. The map shows the result of randomly giving each U.S. resident the disease with a 1-in-5,000 chance. (Mathematica notebook and links to population and geographic data files available on request.)

Math, indomitable math, caused these clusters.

Randomness.

Cases of non-communicable disease come in clusters just by chance. So do bags of M&Ms that have more blues than average, but it’s hard to drum up fear about them. Randomness and uniformity are not the same thing.

By chance alone, some counties will end up with higher rates of any randomly-occurring disease than other counties. The Central Limit Theorem proves it. Which counties is anyone’s guess, but because of the Law of Large Numbers (not subject to repeal), small counties are more likely than large ones to end up with unusually high (or low) rates. Sanity check: When was the last time you read about a disease cluster the size of a large city, as opposed to a census tract, county, or neighborhood?

Science.

Do some diseases have non-random environmental causes? Sure. Cholera, to give a famous example. That’s why local and national governmental agencies like the CDC and the National Cancer Institute take reports of disease clusters seriously. But the good scientists there also understand the math, and I trust their advice about public health policy more than what I hear on the local newscast, on Oprah, or from yet another celebrity non-scientist.

Reminder: John Snow was a scientist. (He also drew a map to make his point, which was a darn good idea.)

By the way, you don’t even have to be in a red county to jump on the bandwagon of fear and woo. You can still decide your neighborhood is a disease cluster (when it’s not), get everyone riled up, and make a scary video. Or you can write for a shameful woo-purveying media giant. For free. Specifically, the one behind the recent stench of pseudoscience in the air about disease clusters, and who’s getting no link from here. If the miasma theory of disease were true, scientists would be dropping like flies from what they read.

Pseudoscience and pandering to unjustified fear waste society’s resources and sidetrack scientists from research that might make the world a better and less scary place.

The American Stroke Association is having a conference in Los Angeles (near Hollywood) this week. The disease-ridden news coming out of that conference is full of numbers, so reporters are cooking up bigger-than-usual batches of scare.

Yesterday’s stroke news was an unjustified scare about stroke and younger people.

Today’s stroke news: “Is The Oscar Ticket to Heart Attack, Stroke?”

According to a recent study by UCLA researchers, 7.3% of 409 Oscar nominees for best actor or actress since 1927 had strokes, according to public records, a number senior study author cautions is “sure to be an underestimate.” Scary?

ABC News wants their article to be scary, so they imply a wrong answer to the questioning headline with this wrong statistic: “The lifetime risk of stroke in the United States is roughly 2.9 percent, according to a 2010 report from the American Heart Association.” Oscar nominees’ higher-than-7.3% stroke rate is now officially scary. It’s several times the average!

Except that it’s not. The 2.9% figure ABC quotes is wrong. The number 2.9% does appear in the American Heart Association report, but it’s not the lifetime risk of stroke among Americans. It’s the prevalence of (having had a) stroke among American adults, young and old combined — the percentage of Americans who had had a stroke before the data-gathering took place, not who will have a stroke before they die. Many of the 97.1 percent who hadn’t had a stroke when surveyed will have a stroke later in their lives.

According to the same AHA report, stroke accounted for about 137,000 deaths in 2006, or one of every 18 deaths in the United States in 2006. One out of 18 is more than 5%, and that’s just the stroke deaths. The lifetime risk of stroke must then be at least 5%, and it’s probably a lot higher. Only about 1 in 6 strokes is fatal, so the lifetime incidence of stroke could be as high as 30%. In any case, it’s considerably higher than 2.9%, the figure ABC gives.

So. The real news is “Like Other People, Actors Sometimes Have Strokes.” In fact, that’s more or less what the authors of the study set out to say. They wanted to increase public awareness about stroke prevention. When famous people get this or that disease, the general public’s awareness of the disease increases (at least for a while), and those who go to big disease conferences may want more visibility for the specific disease they study.

In scary news today: Stroke Patients Getting Younger, Stroke Rising Among Young People, and so on.

Apparently some researchers reported that some number went up recently, and the number that went up had something to do with stroke and something to do with 15-44 year-olds.

Sounds like a good excuse for a rousing chorus or two of Fire in the Theater! Obesity! Diet Soda! You’re Gonna Die!, no?

No.

The number reported to have gone up recently is not the total number of strokes among 15-44 year-olds, nor is it the rate (per 10,000 people, for example) of strokes among people that age.

The number that went up recently is the rate of strokes in 15-44 year-olds as a fraction of all hospitalizations for that age group. Not an easy quantity to conceptualize. But when a quantity is hard to conceptualize, you aren’t automatically allowed to grab a “you may pretend it’s something else.” pass and lie with impunity. (Do these same journalists give up and write “Boxer” if they can’t spell “Feinstein”?)

Maybe the stroke rate among 15-44 year-olds is not going up.

It could be that hospitalizations of 15-44 year-olds for reasons other than stroke are going down. Maybe hospitals are more and more likely to list multiple reasons for hospitalization than in the past. Maybe many former headaches are now deemed strokes (thanks to the proliferation of imaging tests). Either of these trends would make the numerical rate of stroke diagnoses per 10,000 hospitalizations go up without reflecting an increase in stroke.

Maybe a lot of things. Maybe the rate of stroke is going up among young people. Which might be scary. Or not. It’s possible more and more diagnoses of stroke are insignificant — no worse than a bad headache. Just because “stroke” sounds scary doesn’t mean there can’t be innocuous kinds of stroke.

Unfortunately we don’t know from today’s irresponsible scramble to turn numbers into fear.

Internet news aggregator robots never leave me alone. Internet news aggregator robots, never leave me alone.

Every day or more, one of the news aggregator robots gets both my attention and my goat. Here’s one of today’s missiles: “CDC: Most Teens Choose to Abstain,” at cbn.com. The first paragraph:

A recent study shows that most teenagers are virgins, contradicting claims from family planning groups that most young people do not abstain from sex and more sex ed should be taught in schools.

Image by Kelley Boone, some rights reserved (CC-BY-SA 2.0)

This kind of blabbery drives me nuts. They might has well have said, “A recent study shows that the earth is flat, contradicting claims from Unitarians that the planets revolve around the sun and astronomy should be taught in schools instead of the Bible,” when in fact a recent study showed no such thing, and even if it had, it wouldn’t contradict what the Unitarians supposedly said. Maybe if I’d been on the debate team I’d know how to respond more effectively.

If I were a fundamentalist Christian who wanted to justify abstinence education, I wouldn’t quote or misquote studies, nor would I attempt to use logic. I’d be honest: “According to my church, the world is flat, most young people abstain from sex, and abstinence should be taught in schools right after study hall and before creationism. That’s what I believe, because faith in the church is my guiding light.”

Studies be damned, science be damned, the church is the ultimate authority. I might have more respect if they put it that way more often. (I would still object if it got to the point of the Constitution be damned and laws be damned.) Why should fundamentalists care a whit about the fact that science is consistent, well-founded, and predictive? Why should they care about evidence from studies and measurements, if faith, not intelligence, is their life’s compass? I can disagree, disapprove, and be dismayed, but I have no appeal. We live on different planets; we grew up in different universes.

Anyway, for readers who might appreciate facts and figures, let me explain the CBN’s vulpigeration.

What is “sex,” anyway? For its study, the CDC defined “sex” to be heterosexual vaginal sexual intercourse¹ only (though the boy need not stay on top). Many English speakers would call a bunch of other things people do naked with others sex, but the CDC’s restrictive definition should suit the Christian Broadcasting Network in two ways. First, this definition doesn’t infringe on the way CBN might define another word, “sodomy.” They might prefer it for that bunch of other things people do naked with each other. Second, it yields higher virgin percentages. As far as the CDC and CBN.com are concerned, you’re a virgin if you haven’t been part of any penis-in-vagina hanky-panky, even if you’ve gotten plenty naked and nasty with one or more hims or hers.

Fact: Most young people do not abstain from sex. (Or “sex.”) Not during their entire youth, which is what CBN.com suggested. According to the CDC study, most (65% of) boys aged 18-19 and most (60% of) girls in the same age group have had heterosexual vaginal sexual intercourse. The CDC numbers suggest that most young people do abstain from sex “sex” until about age 17 or 18, but abstaining until you stop abstaining is not the same thing as abstaining. Using the CBN.com logic, you could say that all people abstain from sex, ’cuz they all do — until they stop, and most stop, as we know from all the babies being born and abortions being performed. Few babies (or aborted fetuses) are incarnate nowadays.

¹ Additional information available on the internet.

For the record, I’m not particularly fond of small parties, either.

On Monday, CBS News leapt (or leaped, if you wish) onto the alarm bandwagon, writing (emphasis mine):

So far, the biggest outbreak has taken place on Vancouver Island in British Columbia, but the fungus has since spread past the order [sic] into Oregon where it’s become a "a major source of illness in the region," according to the online journal PLoS Pathogens.

Not to be snarky (translation: Imma snark (translation: sarcasm coming)), but besides misspelling “border,” the CBS News writer failed to read either my previous post here (highly forgivable) or my comment on the PLoS Pathogen article’s discussion page (less forgivable, being that there are only two comments on the article).

It’s interesting to think about where in the scientific peer review process a clinker like “major source of illness” should have been caught. (I’ll think to myself.)

For the record, a publications assistant at PLoS Pathogens who handled my comment deserves thanks. He offered helpful feedback on a first draft of my comment, and he followed up to suggest that PLoS Pathogens cares when their articles are misinterpreted.