Can You Fill In The Blank?

"______ have been the most profitable product in the most profitable industry in the most profitable country in the world."

I'll be back with a clue.

Clue: The quotation is from a book I'm reading. The author says that the profit margin for the industry above in 2006 was 18%.

In contrast, the profit margin for the:

• Construction industry was 2%.
  
• Automotive industry was 1%.
  
• Even oil industry profits, in 2006, were around 9%.

Update: See my next post for the answer.
________

Homeopaths: "Put Up Or Shut Up," Says Author Of "Big Bang"

There are many effective alternative therapies. In my mind, homeopathy is not one of them. Nor is it effective in the minds of Edzard Ernst, professor of complementary medicine at the University of Exeter, UK (whose family doctor was a homeopath), and science author Simon Singh.¹ They've just offered 10,000 pounds (about $19,734 as of today) to anyone that can show homeopathy good in a randomized, double-blind clinical trial:

Competition Puts Homeopathy On Trial

A hollow bet.
________¹ Singh is author of Big Bang: The Origin of the Universe (P.S.).
From Publisher's Weekly: "There's no better account of the big bang theory than this."

Ernst and Singh's new book is Trick or Treatment: The Undeniable Facts about Alternative Medicine.

Thank you, B.

Sickening Tomatoes

Yesterday the CDC reported that 383 persons have been infected with Salmonella Saintpaul since April. They likely became infected by eating raw tomatoes. Where those tomatoes came from remains a mystery.

Those 383 persons are only the ones whose symptoms were bad enough to land them in a doctor's office, which doctor was keen enough to order a stool sample, which lab's protocols were keen enough to detect the correct pathogen and report the finding, and which tracking system was keen enough to collect and synthesize that data.

How many people were infected but not counted? This study¹ says:

"We estimated that there were 38.6 cases of Salmonella infection for each culture-confirmed case."

So, 383 x 38.6 = 14,784 persons not counted.

If I add the counted 383 to the uncounted estimate of 14,784, I get 15,167 persons.

That's a lot of sick people.
________¹Foodnet Estimate Of The Burden Of Illness Caused By Nontyphoidal Salmonella Infections In The United States, Clinical Infectious Diseases, 2004

Photo of red plum tomatoes from Recipe Girl, who dished up a fantastic recipe for Slow Roasted Plum Tomatoes.

Eating Potatoes

I've been eating all kinds of potatoes this year. Having a blast.

Here's a little purple one I found recently. It's from Peru. The orange one was sold as a Garnet Yam, but it's technically a sweet potato. I wish I could find some of these colorful varieties grown locally.


The sweet potato was roasted yesterday then refrigerated. It makes a great snack. The purple one is uncooked, although I'll have to cook it now that I cut it for you to see inside. Funny how different in color they look from different angles.


B just sent this photo stream from the BBC. He knows I'm on a potato kick:

________Photos: Homegrown

Sundays Won't Be The Same

________

Heart Surgery Can Damage The Brain, Probably Won't Prolong Life

I ran across this:

Is Heart Surgery Worth It?, Business Week, July, 2005

Excerpts... First, setting the stage:

"You start breathing hard after climbing stairs, and your chest hurts. You go to your doctor. Scans reveal that arteries feeding your heart are severely narrowed. Your doctor sends you to the hospital for coronary bypass surgery or angioplasty to restore the blood flow to your heart. Despite the trauma of surgery, you're glad the blockage was caught in time, saving you from a potentially fatal heart attack."

Now, the questions...

"There's just one problem with this happy tale of modern medicine: More and more doctors are questioning whether such heart procedures are actually extending patients' lives."

"The data from clinical trials are clear: Except in a minority of patients with severe disease, bypass operations don't prolong life or prevent future heart attacks. Nor does angioplasty, in which narrowed vessels are expanded and then, typically, propped open with metal tubes called stents."

So, why are we doing 400,000 bypass surgeries and one million angioplasties a year?

"The heart-surgery industry is worth an estimated $100 billion a year."

$100 billion. Just for heart surgeries. Just in 1 year. That's a lot of money.
But heart surgery relieves angina ... or does it. Enter the placebo effect:

"Recent studies even raise questions about whether surgery causes the symptom relief. In June, Harvard Medical School associate professor of medicine Dr. Roger J. Laham reported on follow-up results of a randomized trial looking at laser surgery to improve blood flow. Patients who got the surgery had significantly less pain and improved heart function. But so did patients who had a sham operation -- the equivalent of a placebo."

"After 30 months the placebo effect was still there. Scans and other tests showed physiological gains in blood flow among only those who thought they had been operated on. A similar large placebo effect might explain "most of the benefits that we've seen so far with balloon angioplasty and bypass surgery," Laham says."

________
I ran across the article above after reading about Bill Clinton, and why he's been acting odd:

'Bypass Brain': How Surgery May Affect Mental Acuity, Wall Street Journal, June 10, 2008

The following implies that the reason our former President has been perhaps a little less predictable is due to microscopic strokes:

"When a patient's blood is pumped through a heart-lung machine during bypass, tiny air bubbles, fat globules and other particles may enter the bloodstream. The pump can also damage platelets, which form clumps, and clamping the aorta loosens bits of plaque. That debris can travel to the brain and clog tiny capillaries, forming microscopic strokes."

How many people does this effect? Over half of patients in a cited NEJM study had significant cognitive decline upon discharge. Here's a more recent study that suggests more than that may suffer brain damage:

"Researchers at Johns Hopkins School of Medicine have been following 152 bypass patients, another 92 treated with medication or stents and a group of healthy controls. They reported in the Annals of Neurology last month that after six years, all the patients with coronary-artery disease had cognitive decline -- no matter how they were treated. The healthy patients didn't."

Hard to say whether surgery, or heart disease itself led to that decline, since everyone who had heart disease also had intervention.

Proponents of those $100 billion-a-year heart surgeries, most of which won't prolong life or prevent another heart attack, say "cognitive decline should be viewed as a minor and transient risk." (That quote is from Timothy Gardner, cardiothoracic surgeon and president-elect of the American Heart Association. The same American Heart Association that recommends someone improve their health by eating 0.5 ounces less of a fast-food sausage egg biscuit.)
________

Diet Analysis Software

Three sources for analyzing nutrients in foods that are free and good (the software, not the foods):

USDA Nutrient Database
Online or offline.

Pros:

• Free, sort of ... Our taxes pay for this. It's one government service worth tapping. It's the foundation (in terms of foods listed and their breakdown) for most other food databases in this country - both free and for a price.

Cons:

• Does not analyze individual diets, only individual foods.
  
• Stark. No charts, graphs, or judgments about consumption. (Some may consider these aspects a plus.)

________
NutritionData
Online.

Pros:

• Free. (Owned by Condé Nast.)
  
• Analyzes individual diets, in addition to individual foods.
  
• Uses the USDA database, plus a few more inputs from restaurants and food manufacturers.
  
• Lots of charts and graphs.
  
• Lots of additional tools, calculators, and widgets.
  
• Lots of additional commentary on nutrition - recipes, articles, a blog.
  
• Promotes "healthy" eating. (Some may consider this a drawback.)

Cons:

• All the additional bells and whistles make this a busy and not altogether user-friendly site.

________
CRON-O-Meter
Offline. Program must be downloaded.

Pros:

• Free. Open source. Created by a small team in their spare time.
  
• Analyzes individual diets, in addition to individual foods.
  
• Can track multiple users.
  
• Of the 3, I think this is the easiest to use. Very intuitive.
  
• Uses the USDA database, but adds a better interface.

Cons:

• Not accessible when away from your computer.
  
• Uses a nice chunk of computer memory to run.

If you've used any of these, or others, feel free to comment about them.
________
Update: A few more...
My Pyramid Tracker, Online (free)

• Family Nutritionist reminded me of this one. Based on the USDA 2005 Dietary Guidelines.

FitDay, Online (free) and Offline ($29.95)

• Free version has limited analysis.

________

American Heart Association's My Fats Translator

The American Heart Association (AHA) has an online tool called:
My Fats Translator

"A calculator that translates our fat recommendations into daily limits just for you."

The calculator returns:

• Daily calorie needs (including BMI, and where it falls on an underweight-overweight scale)
  
• Recommended range for total fats
  
• Limits for bad fats: saturated and trans

I tried it. Below were some recommendations. (The same examples were given for all my various entries.)


 

I can see right off the bat the AHA doesn't go in for behavior modification. Pizza for pizza, fries for fries, burger for burger.

In this next one, a biscuit instead of a croissant, I included some breakdown to show that this substitution provides the same number of calories as the original ... and 3 grams of trans fat, where the original had none. (If there was one fat everyone might agree is worth limiting.)

 

Next they throw sense to the wind and recommend the same exact item, but 0.5 ounces less of it. Both contain the same amount of saturated fat and cholesterol, fats the AHA call "bad" and need replacing.

 

You may as well tell someone they don't have to change anything about their fast food diet, just eat 1 or 2 bites less of it. Okay, I'm being hard on them. They did include an "Or Even Better" substitution that occasionally broke trend.

These types of substitutions aren't going to dent the health profile of someone with heart disease. For an organization that brought in close to a billion dollars last year, you'd think they could come up with something a little more pronounced. If I was more cynical I'd say the AHA had an interest in keeping Americans fat ... or at least dependent on a highly-processed, fast food diet, requiring drugs to tweak lab values.

Out of curiosity, I checked to see who some of their big contributors were, who they might in some way be beholden to. Here's the list for those who gave between $1,000,000 – 4,999,999 last year: ¹

AstraZeneca Bristol-Myers Squibb The Bugher Foundation Campbell’s Soup John K. Castle ConAgra Foods (Healthy Choice) The Michael and Susan Dell Foundation GlaxoSmithKline Kellogg’s Kenneth L. Mink Co. King Pharmaceuticals KOS Pharmaceuticals

Macy’s Merck & Co. Merck/Schering-Plough Merrill Lynch Employee Giving Campaign Novartis Pharmaceuticals Pfizer Pharmaceuticals The Robert Wood Johnson Foundation Ross Stores, Inc. Subway® Restaurants Takeda Walgreens

Ten of the top 23 donors are drug companies, 11 if I count the pharmacy Walgreens. Big commercial food manufacturers (Campbell's, ConAgra, Kellogg's, and Subway) also contribute a sizable portion. I really don't want my cynicism to win out here.
________ ¹ You can see the rest of their donors in their 2007 annual report (pdf).