Food, Inc.: Taking a closer look at the food you eat

Tonight, my wife and I watched Food, Inc., a highly informative 90-minute documentary that takes a close look at the food we eat and where it comes from. We were expecting to see many revolting pictures of animals being butchered. There certainly were a fair amount of butchering scenes, although the creators of the film constantly focused on presenting useful information rather than trying to shock the viewer. This video was not made to appeal unfairly to the emotions. It was made to present compelling information about an important series of food-related issues. Watching this video reminded me of something that was quite disturbing. The mainstream media and our own government do not starkly peel back the happy veneer of the food production industry. Thus, Food, Inc. also serves as a meta-indictment of those failed institutions of government and the media. Each of the eleven topics covered was compelling, and each of them was presented with a fair amount of balance, despite the fact that most of the corporations running factory farms refused to appear in the video. Consider that Wal-Mart (and a few other companies) was presented as a corporation that was actually trying to make some changes that would benefit the health of Americans-it was not presented as a perfect corporation, but it was given credit for trying to make some changes in the right direction. One corporation in the video was presented as notoriously evil: Monsanto, based in my hometown of St. Louis Missouri. What else could you say about a corporation that refuses to allow farmers to use seeds from their crops, and surreptitiously watches farmers with a team of 75 intimidating investigators, bringing many of them to court for daring to reuse their seeds. This has never before happened in the history of the world that a farmer has lost the right to use his or her own seed crop as he or she wants. If you're thinking, "Well, they should never have signed up to buy that genetically modified seed in the first place," the video will have you thinking again. Some of the victims are non-Monsanto-customer farmers in nearby fields, who were forced to defend themselves in court at great expense after Monsanto accused them of illegally using Montana's product, whereas the seeds often blow onto their property from neighbors' fields. The episode about the seed-washer sued by Monsanto is heartbreaking. After watching Food Inc., you'll never think the same way about corn. I'm not talking about enjoying a fresh meal of corn on the cob--get that image out of your head. I'm talking about highly processed corn. Almost anything you might purchase at a typical grocery store is pumped full of empty calories and questionable substances derived from processed corn (and soybeans). If you're wondering why corn-based sodas and chips are so cheap, and broccoli and peas are so expensive, the answer lies in federal subsidies controlled by huge agribusinesses. Imagine a world where healthy foods were cheap and where foods injected with corn fructose were not subsidized-- that's certainly not the world in which we live. The video reveals that many of the purportedly great variety of fast foods are actually dressed up processed corn. One of the most memorable lines for me was uttered by an especially articulate man who raises organic meat (you know, where animals were not confined in small dark spaces and forced to eat corn, but are actually allowed to eat grass and to graze). He suggested that if huge meat factories (chicken, hogs and beef) were forced to make their factories with transparent walls, people would stop buying their products. It was interesting that the only footage from inside the factory farms was through the use of hidden cameras. The big factory farms refused to give tours to the producers. One exception was a woman farmer who had had enough of it, and went on camera to give a tour of her chicken farm, which was actually run in a much more humane way than most of the dark enclosed factories where the great majority of America's chickens are raised and slaughtered. Even her operation, considerably more humane than most factory farms (it actually was open to sunlight) still wasn't a pretty sight. Another thing I found revolting was the way that it illegal immigrants work hard to produce food for the rest of America, some of them for a dozen years or more, but they are unceremoniously rounded up from their trailers up in a constant stream of police raids. All of this while the companies that have made constant use of the hard labor of these undocumented people are left unscathed. There are very few raids for illegal immigrants at the factory farms-this would interfere with the profitable assembly line. Image by Raman at Flickr (with permission) Image by Raman at Flickr (with permission) There's a lot more to Food, Inc. then I've described in this brief post. I highly recommend that you watch Food Inc. if you care about what you're putting in your stomach. Even if you think you have a cast-iron stomach, take a look at Food Inc. and you'll be primed to start eating more smartly. Although much of the information presented in this video is disturbing, the video is full of good suggestions for what you can do about these problems. So is the movie's website (with regard to each of these topics, simply click the "Learn More" link).

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Stop Discriminating against Sick People!

Stop Discriminating against Sick People! Jonathon Alter was a guest on "the Ed Show" tonight on MSNBC. In a noisy debate with Ed, he said that the goal of healthcare reform should be "to end discrimination against sick people". He said that the path to reform was largely irrelevant. That whether or not there was a public option was largely irrelevant. That healthcare reform is a civil rights issue, and that reform had nothing to do with the mechanics of that reform. To be clear, Mr Alter stated that he was personally very much for a public option. But he was also very clear that regardless of the public option, this reform needed to pass. I agree with Jonathon. Discrimination against sick people must stop. Discrimination against people with 'pre-conditions' must stop. Discrimination against people, must stop. It's time to act. Call your congressman. Enact healthcare reform.

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Huffington quackery

Over at Salon.com, Rahul K. Parikh, M.D. makes a strong case that the Huffington Post is not strong on vetting their health and wellness contributors:

But when it comes to health and wellness, that diverse forum [Huffpo] seems defined mostly by bloggers who are friends of Huffington or those who mirror her own advocacy of alternative medicine, described in her books and in many magazine profiles of her. Among others, the site has given a forum to Oprah Winfrey's women's health guru, Christiane Northrup, who believes women develop thyroid disease due to an inability to assert themselves; Deepak Chopra, who mashes up medicine and religion into self-help books and PBS infomercials; and countless others pitching cures that range from herbs to blood electrification to ozonated water to energy scans.

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Health-less

The boogeyman of Socialized Medicine is being dragged onto the field of rhetorical combat to block the move toward anything smacking of Single Payer Health Care in the United States. The argument is old and hoary by now, that adopting a system like that available in Canada or the United Kingdom would lead to a collapse of American health care. Somehow the fact that expenses might be shared and disbursed through the government will render the world’s best health care system somehow crippled inside a generation is not seriously questioned by most people. Because most people don’t know. You can find case after case of anecdotal evidence to support the notion that British health care is worse than ours. Someone knows someone who, as the argument goes. And there is something to that. The waiting periods alone, the pigeonholing of treatment—horror stories abound which we glimpsed here when HMOs were instituted and accountants seemed to be in charge of medicine. There is, in fact, too much information for the average American to digest much less make sense of. Technologically, the United States has an extraordinary medical system. Unmatched in the world, despite some annoyingly negative statistics. That we achieve what we do in a country peopled by citizens who do the least for their own health than in any other country comparably empowered is amazing. Americans eat too much. Medicine can only do so much against a rising tide of obesity related illnesses. The tradition of the doctor giving you a physical and then telling you to eat right and get some exiercise is not a quaint leftover from an age that didn’t know as much as we do—that is sound advice and more than half the battle in maintaining good health. The explosion of Type 2 diabetes in children has been alarming, and this can be tied directly to diet and exercise. We also work longer hours under higher stress than almost anywhere else in the developed world. The need for vacations and long weekends is acute. This may sound sarcastic, but the link between stress and several major illnesses is no joke. We are also a violent society. If one looks at emergency room statistics, it becomes quickly clear that we are a people who like to beat, stab, and shoot each other at higher levels than almost anywhere else. What makes all these factors so overwhelming is that we have the means to do all this. Because a certain percentage, a significant percentage, of the population can afford to go to the doctor and have the consequences of all these lifestyle disasters “taken care of.” I put all this out front because the one factor that is muted in the national debate over the rising cost of healthcare is the fact that we are, collectively, idiots. We do not do, statistically, the simplest things to avert the need for medical intervention. The last detail in this litany has nothing to do with idiocy but with sentiment and perspective. It has been said for decades and it is true—80% of individual health expense in this country is spent in the last two years of life. We are, as a people, loathe to die and we will direct our health services to do absolutely everything to give us another day. In Europe, such people are told to go home and die. That sounds cold, I know, and I’m sure there are people in France and Germany and Italy with the resources to reject this advice. But the nations as a whole are not expected to pay for it. Here we are. Through health insurance.

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Statistical illiteracy afflicts health care professionals and their patients

Over at Scientific American Mind Gerd Gigerenzer and his colleagues have published a terrific article documenting the statistical illiteracy that sometimes runs rampant in health care fields. The article, "Knowing Your Chances," appears in the April/May/June 2009 edition. The authors point out numerous medical care fallacies caused by statistical illiteracy , including Rudy Giuliani's 2007claim that because 82% of Americans survived prostate cancer, compared to only 44% in England, that he was lucky to be living in the United States and not in England. This sort of claim is based on Giuliani's failure to understand statistics. Yes, in the United States, men will be more quickly diagnosed as having prostate cancer (because many more of them are given PSA tests), and then many more of them will be treated. Despite the stark differences in survival rates (the percentage of patients who survive the cancer for a least five years, "mortality rates in the two countries are close to the same: about 26 prostate cancer deaths per 100,000 American men versus 27 per 100,000 in Britain. That fact suggests the PSA test

has needlessly flagged prostate cancer in many American men, resulting in a lot of unnecessary surgery and radiation treatment, which often leads to impotence or incontinence. Because of overdiagnosis and lead-time bias, changes in five-year survival rates have no reliable relation to changes in mortality when patterns of diagnoses differ. And yet many official agencies continue to talk about five-year survival rates.

Gigerenzer and his colleagues give a highly disturbing as example regarding mammogram results. Assume that a woman just received a positive test result (suggesting breast cancer) and asks her doctor "What are the chances that I have breast cancer?" In a dramatic study researchers asked 160 gynecologists taking a continuing education course to give their best estimate based upon the following facts:

A.) the probability that a woman has breast cancer (prevalence) is 1% B.) if a woman has breast cancer the probability that she tests positive (sensitivity) is 90% C) if a woman does not have breast cancer, the probability that she nonetheless tests positive (false-positive rate) is 9% The best answer can be quickly derived from the above three statements. Only about one out of 10 women who test positive actually has breast cancer. The other 9/10 have been falsely diagnosed. Only 21% of physicians picked the right answer. 60% of the gynecologists believed that there was either an 81% or 90% chance that a woman with a positive test result actually had cancer, suggesting that they routinely cause horrific and needless fear in their patients. What I found amazing is that you can quickly and easily determine that 10% is a correct answer based upon the above three statements--simply assume that there are 100 patients, that one of them (1%) actually has breast cancer and that nine of them (9%) test false positive. This is grade school mathematics: only about 10% of the women testing positive actually have breast cancer. As the article describes, false diagnosis and bad interpretations often combine (e.g., in the case of HIV tests) to result in suicides, needless treatment and immense disruption in the lives of the patients. The authors also discuss the (tiny) increased risk of blood clots caused by taking third-generation oral contraceptives. Because the news media and consumers so often exhibit innumeracy, this news about the risk was communicated in a way that caused great anxiety. People learned that the third-generation pill increased the risk of blood clots by "100%." The media should have pack is aged the risk in a more meaningful way: whereas one out of 7000 women who took the second-generation pill had a blood clot, this increased to two in 7000 women who took the new bill. The "absolute risk increase" should have been more clearly communicated. Check out the full article for additional reasons to be concerned about statistical illiteracy.

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