Hundreds of Supplements Tainted With Hidden Drugs

This is why people should use caution when taking supplements, and it also shows the risk of inadequate corporate oversight. Unlike pharmaceutical drugs, the American supplement industry is barely regulated at all.

The labels promise miracles: Fast Weight Loss! Eliminates Hunger! Burns Calories!

Now new research highlights how hundreds of brands of dietary supplements deliver so much kick from a modest blend of vitamins and herbs. The answer is many labels leave out one important ingredient: a hidden payload of pharmaceutical drugs and experimental chemicals.

A new analysis of 10 years of FDA records reveals that from 2007 to 2016, almost 750 dietary supplements were found to be contaminated with secret doses of totally unregulated drugs, including prescription medicines, banned and unapproved chemicals, and designer steroids.

Over 20 percent of these offending products contained more than one unapproved drug ingredient, and numerous contained a cocktail of clandestine chemicals – in two cases, as many as six unlisted ingredients.

For a US$35 billion industry patronised by about half of American adults, it’s possible this data could be just the tip of the iceberg, too.

“The drug ingredients in these dietary supplements have the potential to cause serious adverse health effects owing to accidental misuse, overuse, or interaction with other medications, underlying health conditions, or other pharmaceuticals within the supplement,” researchers from the California Department of Food and Agriculture, Sacramento, explain in their paper.

Given that supplement use is associated with some 23, 000 ER visits and 2,000 hospitalisations in the US each year, it’s clear we’re looking at a big problem here, but what’s even more shocking than the brazen selling of these illicit additives is how tame and toothless the FDA’s official actions were.

Of 746 products identified as adulterated by the FDA, just 360 (48 percent) were subsequently recalled, leaving more than half of the contaminated supplements available for sale.

“The agency’s failure to aggressively use all available tools to remove pharmaceutically adulterated supplements from commerce leaves consumers’ health at risk,” writes general internist Pieter Cohen from Harvard Medical School in a commentary on the new research.

Many of the tainted supplements analysed in the study contained sildenafil (the active ingredient of Viagra) to boost their powers of sexual enhancement. Another erectile dysfunction drug, tadalafil, was also common.

Other chemicals included hidden antidepressants, a withdrawn weight loss drug called sibutramine, and undeclared anabolic steroids or steroid-like substances.

It’s been argued however that since almost 75 percent of the offending supplements were sold online or through international mail order, they don’t represent the ‘mainstream’ of the supplements industry.

“These come from dark corners of the internet,” president of the Natural Products Association, Daniel Fabricant, told the San Francisco Chronicle.

“They’re not what you get at your health food store.”

Still, given that none of these products are actually subjected to the same stringent tests reserved for pharmaceutical drugs, it’s possible any supplement could contain anything – which is why Cohen advises choosing products that only contain a single ingredient and avoiding products that purport to offer spurious, medical-sounding benefits.

Why? Because as this research shows, many supplements turn out to be medicine after all – only it’s an unknown drug, potentially a banned one, and there’s no way of measuring your dose.

“If the company is saying it works like Viagra or you’re going to gain muscle like you’re on steroids – that’s not a supplement. That’s a drug,” Fabricant says.

“Dietary supplements are meant to maintain health, not to take 30 minutes before sex.”

The findings are reported in JAMA Network Open.

Good Immunotherapy is Amazing at Treating Cancer — And It’s Unnecessarily Expensive

Drugs are cheap to produce — it’s things like unjust government-granted patent monopolies that allow pharmaceutical companies to charge exorbitant prices that make drugs expensive.

To quote economist Dean Baker’s latest October 2018 paper:

“Many items that sell at high prices as a result of patent or copyright protection would be free or nearly free in the absence of these government granted monopolies. Perhaps the most notable example is prescription drugs where we will spend over $420 billion in 2018 in the United States for drugs that would almost certainly cost less than $105 billion in a free market. The difference is $315 billion annually or 1.6 percent of GDP. If we add in software, medical equipment, pesticides, fertilizer, and other areas where these protections account for a large percentage of the cost, the gap between protected prices and free market prices likely approaches $1 trillion annually, a sum that is more than 60 percent of after-tax corporate profits.”

On to the article though.

Last week, researchers James Allison and Tasuku Honjo were awarded this year’s Nobel Prize in medicine for their work on cancer immunotherapies, heralded by the Nobel committee as “seminal discoveries” that “constitute a landmark in our fight against cancer.”

Immunotherapies like those developed on the basis of Allison and Honjo’s work are indeed an important step towards a whole new way to treat cancer, as well as a host of other chronic diseases. However, this Nobel award should remind us that these innovative therapies are out of reach for so many patients in the United States due to the exorbitant prices drug companies charge for them.

Just weeks before the Nobel announcement, oncologist Ezekiel Emmanuel wrote in a Wall Street Journal essay, “We Can’t Afford the Drugs That Could Cure Cancer,” that “a cure for cancer has become possible, even probable” with immunotherapies, but that our health system cannot afford their price tag. Just after the Nobel announcement, Vox reporter Julia Belluz reminded us that “the average cost of cancer drugs today is four times the median household income” (emphasis added).

Immunotherapies constitute a part of the class of drugs called biologics (as opposed to chemical pharmaceuticals) that have shown very promising results in treating many previously intractable conditions, such as multiple sclerosis, asthma, chronic pain, and Crohn’s disease, due to their ability to more precisely target individual diseased cells. Therefore it’s no surprise that currently most of the top 10 best-selling drugs worldwide are biologics.

[…]

If biologics really are the future of medicine, we must change the way prescription drugs are priced in the United States, or millions of patients will be left behind. One way to do that is to invest in public pharmaceuticals that can assure an adequate supply of and equitable access to essential medications.

Is Brazil About to Become a Brutal Militaristic Regime?

Brazil may soon become a brutal regime reminiscent of its past atrocities, and the far-right will probably impose crippling austerity (it wants to freeze real government spending for decades, which will worsen public health and make recessions much worse) that will do significant harm to the working class.

For the past thirty years, Congressman Jair Bolsonaro was a fringe extremist in Brazilian politics, known mostly for outlandish, deliberately inflammatory quotes in which he paid homage to the most notorious torturers of the 1964-1985 military regime, constantly heralded the 1964 coup as a “defense of democracy,” told a female socialist colleague in Congress that she was too ugly to “deserve” his rape, announced that he’d rather learn that his son died in a car accident than was gay, and said he conceived a daughter after having four sons only due to a “moment of weakness.”

[…]

His primary solution to the nation’s crime epidemic is to unleash the military and police into the nation’s slums and give them what he calls “carte blanche” to indiscriminately murder anyone they suspect to be criminals, acknowledging many innocents will die in the process. He has criticized monsters such as Chile’s Pinochet and Peru’s Fujimori – for not slaughtering more domestic opponents. He has advocated that mainstream Brazilian politicians be killed. He wants to chemically castrate sex offenders. In all respects, the hideous Brazilian military dictatorship that took over Brazil and ruled it for 21 years – torturing and summarily executing dissidents, with the support of the US and UK in the name of fighting Communists – is his model of governance.

As a result of last night’s truly stunning national election in Brazil, Jair Bolsonaro has been instantly transformed from marginalized clown into the overwhelmingly dominant force in the country’s political life. Bolsonaro himself fell just short of winning the 50% needed to win the presidency without a run-off.

But given the margin of victory, he is the overwhelming favorite to win on October 28 against the second-place candidate, ex-São Paulo Mayor Fernando Haddad. Haddad is the previously unknown, hand-picked successor anointed by Lula, the ex-two-term President who had been leading all polls until he was convicted on dubious corruption charges and quickly imprisoned so as to bar his candidacy, then silenced by Brazil’s right-wing judiciary with a series of remarkable prior restraint censorship orders barring all media outlets from interviewing him.

[…]

In sum, it is virtually impossible to overstate the threat level posed to democracy and human rights in the world’s fifth most-populous country as a result of last night’s election. And unlike in the U.S. or in the UK, which have old, strong, long-established democratic institutions that can limit the excesses and worst abuses of demagogues and authoritarians, Brazil has none of that. Spiraling from multiple crises – suffocating economic inequality, an epidemic of violence worse than many war zones, and a corruption scandal so sweeping that it has infected the core of almost every faction of the ruling class – this is a country with little to no ability to impose limits on what Bolsonaro wants to do.

Add to that the sheer youth of Brazilian democracy – only 33 years old: the temporal equivalent of the U.S. in 1820 or so – and it’s remarkably easy to envision a quick return to the military rule that imposed so many atrocities on so many segments of the population. That all of this has been ushered in democratically should be, but likely will not be, another warning sign to western democracies that are confronting similar dynamics, albeit ones that are unfolding somewhat more gradually.

To be sure – as is true of Trump, Brexit, and the rise of right-wing extremism throughout Europe – some substantial minority of Bolsonaro voters are motivated by classic bigotry, racism, anti-LGBT animus, resentment toward the indigenous population, and just a general tribal anger that seeks scapegoats for their plight. But many, probably most, are none of those things.

Many, instead, are motivated by legitimate grievances toward an establishment ruling class that has failed them on all levels, that expresses indifference if not outright contempt for their suffering and loss of hope, that they blame, often with good reason, for enacting policies that have destroyed their futures while refusing to accept any responsibility for it. And once that framework is adopted, any perceived enemy of that ruling class becomes their friend, or at least someone whose vows of destruction become more appealing than vows to preserve the system they justifiably despise (the reality is that Bolsonaro (like Trump), with his Chicago-trained neoliberal economic guru, will serve the economic interests of the establishment with great devotion at the expense of his working-class voters, but the perception of his anti-establishment animus is what matters).

The standard establishment reaction in the face of rising demagogues like Bolsonaro is to denounce those who support them, to call them names, to heap scorn on them, to sanctimoniously lecture them that their choices are primitive, retrograde, ignorant and illegitimate. That only serves further to exacerbate the dynamic.

Some context for the 21st century:

The world is watching Brazil’s elections, probably as never before. “Latin America’s latest menace: Bolsonaro Presidente,” screams the headline on the cover of The Economist. This conservative UK magazine would love to see the Workers’ Party (PT) disappear from Brazilian politics, but even they cannot stomach Bolsonaro, who in 2016 dedicated his vote to impeach President Dilma Rousseff to the colonel responsible for her torture.

[…]

By 2014, under the presidencies of Lula and Dilma, poverty had been reduced by 55 percent and extreme poverty by 65 percent, and unemployment hit a record low of 4.9 percent. Some of these gains were lost when the economy then went into a deep recession that year, and the right took advantage of that downturn to seize what it could not win at the ballot box in four consecutive elections.

They impeached Dilma and removed her from office without even accusing her of an actual crime; and then Judge Moro sent Lula to prison for a “bribe” he never accepted, in a “trial” without material evidence. The US government sent experts from its Justice Department to “help” with investigations, and quietly showed support for the removal of Dilma.

But the bulk of the Brazilian electorate could see that although all the major political parties were infected with corruption, the decapitation of the Workers’ Party was not about justice. Lula retained a commanding lead in the polls even after his conviction. And so it became necessary to bar Lula from running for president, to jail him, and restrict his access to the media.

[…]

For the first time in decades, the threat of a military dictatorship is surfacing. No responsible journalism should ignore this threat, nor legitimize the extremism that strengthens it. And anyone who cares about democracy in Brazil would have to support Bolsonaro’s opponent in the second round of the election.

Mental Health Disorder Rates Rising Globally

This is a sign of regression or stagnation, not progress, and it suggests that there needs to be a shift in the general direction human societies are on. Outside of the economic impacts of lost productivity, there are many collateral effects (e.g., worsened interpersonal relationships) that are associated with widespread mental health problems continuing as well.

The “Lancet Commission” report by 28 global specialists in psychiatry, public health and neuroscience, as well as mental health patients and advocacy groups, said the growing crisis could cause lasting harm to people, communities and economies worldwide.

While some of the costs will be the direct costs of healthcare and medicines or other therapies, most are indirect – in the form of loss of productivity, and spending on social welfare, education and law and order, the report’s co-lead author Vikram Patel said.

The wide-ranging report did not give the breakdown of the potential $16 trillion economic impact it estimated by 2030.

“The situation is extremely bleak,” Patel, a professor at Harvard Medical School in the United States, told reporters.

He said the burden of mental illness had risen “dramatically” worldwide in the past 25 years, partly due to societies ageing and more children surviving into adolescence, yet “no country is investing enough” to tackle the problem.

“No other health condition in humankind has been neglected as much as mental health has,” Patel said.

The World Health Organization (WHO) estimates that around 300 million people worldwide have depression and 50 million have dementia. Schizophrenia is estimated to affect 23 million people, and bipolar disorder around 60 million.

The Lancet report found that in many countries, people with common mental disorders such as depression, anxiety and schizophrenia routinely suffer gross human rights violations – including shackling, torture and imprisonment.

Richard Horton, editor-in-chief of the medical journal the Lancet, which commissioned the report, said it highlighted the “shameful and shocking treatment of people with mental ill health around the world”.

It called for a human rights-based approach to ensure that people with mental health conditions are not denied fundamental human rights, including access to employment, education and other core life experiences.

Statistics on the Undercurrent Societal Problem of Loneliness

Now there is evidence that loneliness itself is directly harmful to human health, and that’s not to mention the indirect damage it causes. How UK doctors are prescribing people social activities also seems like a refreshingly progressive way at combating the problem.

Everyone feels isolated sometimes, but with one in five Americans chronically lonely, has loneliness reached epidemic proportions? In 1988, the journal Science published a landmark study suggesting isolation was as strong a risk factor for morbidity and mortality as sedentary lifestyle, high blood pressure and smoking or obesity. Since then, loneliness has become an increasing public health concern and health officials are now taking the idea of an epidemic seriously. As the population ages, the burden of social isolation on public health will only increase.

Loneliness is one aspect of interrelated conditions such as isolation due to illness, disability or age; the social and language-based isolation of being an immigrant; depression; poverty; discrimination, etc.

This past summer, two surveys made news, marking the extent of loneliness in the U.S. and other economically developed countries. Since these and other studies are new, we can anticipate learning more about the interrelationships of factors that contribute to loneliness over time. That shouldn’t stop us from addressing the problem now, but may help provide better perspective.

The most recent survey, from The Economist and the Kaiser Family Foundation, finds that 9 percent of adults in Japan, 22 percent in America and 23 percent in Britain “always” or “often” feel lonely or lack companionship. Another study of 20,000 U.S. adults, 18 and older, published in May by Cigna and market research firm Ipsos, reveals nearly half of American adults reported “sometimes” or “always” feeling alone (46 percent) or left out (47 percent); more than one in four Americans (27 percent) “rarely” or “never” feel that people understand them; and 43 percent of Americans “sometimes” or “always” feel their relationships lack meaning and they are isolated. One finding stands out: Generation Z (22 years and younger) scored the lowest of every age-group and appears to be more prone to experiencing significant loneliness. Gen Z may be the loneliest generation.

Regarding health impacts, several recent studies have found that loneliness is a risk factor for decreased resistance to infection, cognitive decline and conditions such as depression and dementia.

A UC San Francisco 2010 study found loneliness to be a predictor of functional decline and death among adults 60 and older. Over six years, lonely subjects were more likely to experience decline in activities of daily living (24.8 percent vs. 12.5 percent); develop difficulties with upper extremity tasks (41.5 percent vs. 28.3 percent); experience decline in mobility (38.1 percent vs. 29.4 percent) or climbing (40.8 percent vs. 27.9 percent); and face increased risk of death (22.8 percent vs. 14.2 percent). It appears that without social interaction, we languish and decline, though it’s possible that greater longevity, coupled with functional decline, leads to social isolation.

At the other end of the spectrum are challenges faced by young adults. Two 2017 national surveys of adolescents, in grades eight to 12, found among lonely individuals, especially females, depressive symptoms and suicide rates increased between 2010 and 2015. The studies found adolescents who spent more time on social media and devices such as smartphones more likely to report mental health issues, though it’s not clear if the self-directed isolation of screen time leads to or results from loneliness.

While we need to know more about causes to stanch this epidemic, many studies identify ways to minimize the effect of loneliness. Socializing with friends and family and increasing meaningful face-to-face interactions decreases loneliness. Those with active social lives report better health. Strong social affiliations — such as being part of a religious group, hobbyist circle or exercise group — have positive effects. Doctors in the United Kingdom make “social prescriptions,” specifying patients take part in structured social activity.

Slowing the Aging Process by Eating Fruits and Vegetables

Why fruits and vegetables are important — they contain a chemical that reduces some of the negative effects of aging, something that’s obviously valuable. The research is trying to use the chemical in a drug, but it’s good that it demonstrates that point.

Previous research published earlier this year in Nature Medicine involving University of Minnesota Medical School faculty Paul D. Robbins and Laura J. Niedernhofer and Mayo Clinic investigators James L. Kirkland and Tamara Tchkonia, showed it was possible to reduce the burden of damaged cells, termed senescent cells, and extend lifespan and improve health, even when treatment was initiated late in life. They now have shown that treatment of aged mice with the natural product Fisetin, found in many fruits and vegetables, also has significant positive effects on health and lifespan.

As people age, they accumulate damaged cells. When the cells get to a certain level of damage they go through an aging process of their own, called cellular senescence. The cells also release inflammatory factors that tell the immune system to clear those damaged cells. A younger person’s immune system is healthy and is able to clear the damaged cells. But as people age, they aren’t cleared as effectively. Thus they begin to accumulate, cause low level inflammation and release enzymes that can degrade the tissue.

Robbins and fellow researchers found a natural product, called Fisetin, reduces the level of these damaged cells in the body. They found this by treating mice towards the end of life with this compound and see improvement in health and lifespan. The paper, “Fisetin is a senotherapeutic that extends health and lifespan,” was recently published in EBioMedicine.

“These results suggest that we can extend the period of health, termed healthspan, even towards the end of life,” said Robbins. “But there are still many questions to address, including the right dosage, for example.”

One question they can now answer, however, is why haven’t they done this before? There were always key limitations when it came to figuring out how a drug will act on different tissues, different cells in an aging body. Researchers didn’t have a way to identify if a treatment was actually attacking the particular cells that are senescent, until now.

Even Brief Workouts Quickly Improve Memory Function

Exercise has numerous benefits, and more and more continues to be found about how valuable consistent exercise is. Having a stronger memory will often improve performance in a variety of ways, and thus this research should give people more motivation to workout more.

People who include a little yoga or tai chi in their day may be more likely to remember where they put their keys. Researchers at the University of California, Irvine and Japan’s University of Tsukuba found that even very light workouts can increase the connectivity between parts of the brain responsible for memory formation and storage.

In a study of 36 healthy young adults, the researchers discovered that a single 10-minute period of mild exertion can yield considerable cognitive benefits. Using high-resolution functional magnetic resonance imaging, the team examined subjects’ brains shortly after exercise sessions and saw better connectivity between the hippocampal dentate gyrus and cortical areas linked to detailed memory processing.

Their results were published today in Proceedings of the National Academy of Sciences.

“The hippocampus is critical for the creation of new memories; it’s one of the first regions of the brain to deteriorate as we get older — and much more severely in Alzheimer’s disease,” said project co-leader Michael Yassa, UCI professor and Chancellor’s Fellow of neurobiology & behavior. “Improving the function of the hippocampus holds much promise for improving memory in everyday settings.”

The neuroscientists found that the level of heightened connectivity predicted the degree of recall enhancement.

Yassa, director of UCI’s Center for the Neurobiology of Learning and Memory and the recently launched UCI Brain Initiative, said that while prior research has centered on the way exercise promotes the generation of new brain cells in memory regions, this new study demonstrates a more immediate impact: strengthened communication between memory-focused parts of the brain.

“We don’t discount the possibility that new cells are being born, but that’s a process that takes a bit longer to unfold,” he said. “What we observed is that these 10-minute periods of exercise showed results immediately afterward.”

A little bit of physical activity can go a long way, Yassa stressed. “It’s encouraging to see more people keeping track of their exercise habits — by monitoring the number of steps they’re taking, for example,” he said. “Even short walking breaks throughout the day may have considerable effects on improving memory and cognition.”

Yassa and his colleagues at UCI and at the University of Tsukuba are extending this avenue of research by testing older adults who are at greater risk of age-related mental impairment and by conducting long-term interventions to see if regular, brief, light exercise done daily for several weeks or months can have a positive impact on the brain’s structure and function in these subjects.