More on Guns

More on Guns - What Happened in Australia

The NRA defends its position on guns by pointing out that gun ownership has increased, but gun deaths have decreased. I do not know if that is true, but it may be.

However, we are looking at two issues. One is guns used in homicides, the other is mass shootings and accidental shootings.

A recent review in JAMA addresses this.

Australia has experienced no mass fatal shootings since it banned rapid-fire long guns in 1996, a JAMA study finds. The ban included guns already owned by citizens and mandated government buyback of all prohibited firearms.

Using national government statistics and news reports, researchers compared firearm deaths during two decades before the ban (1979 through 1996) and two decades afterward (1997 to May 2016). Before Australia's ban, there were 13 mass fatal shootings, with 104 deaths — versus none afterward.

Total firearm deaths also declined after the ban, from 3.6 per 100,000 population to 1.2 per 100,000. However, at the same time, non-firearm suicides and homicides also declined, so the reduction in total firearm deaths could not be directly attributed to the gun ban.

Separately, New England Journal of Medicine editorialists call for "universal background checks ... for every gun sale in every setting" in the U.S., as well as a ban on "assault weapons." I couldn't agree more.

JAMA. Published online June 22, 2016. doi:10.1001/jama.2016.8752

Disease Prevention - Be careful of Cause and Effect

Lowering cholesterol prevents heart disease - right? Actually no. Although drugs like lipitor, and activities such as exercise have been shown to decrease coronary artery disease, there are other drugs (Zetia and some experimental ones) that have been very effective in lowering cholesterol, even LDL, and increasing HDL, yet have no effect on heart disease.

We need to understand the difference between an association and a cause. Heart disease is ASSOCIATED with high cholesterol, but this does not seem to be the actual cause. Drugs like lipitor, and activities like exercise not only lower cholesterol, but also decrease inflammation in the coronary arteries. This seems to be much more important. On the other hand, smoking directly causes heart disease; perhaps by increasing inflammation.

Recently there was some publicity on a drug that might decrease amyloid in the brain. Since this is associated with Alzheimers, there is hope this could be preventative. However we really don't know if the amyloid is a result of the dementia or a cause. So we need to wait and see if this drug actually prevents Alzheimers, or just amyloid. Or if it has other side effects. Studies are ongoing.

In another study, researchers found that replacing saturated fats with linoleic acid–rich vegetable oils lowers cholesterol but not deaths. " Ramsden CE et al. BMJ 2016 Apr 12. Veerman JL. BMJ 2016 Apr 12."

Although there were some minor issues with this review, it is clear that we need to be extremely careful in evaluating associations versus causes. Unfortunately the common press does not generally distinguish these issues.

Cancer Prevention - Easier Than You Thought

I read about vitamins and supplements, coffee, red wine, and chocolate that may prevent cancer. The studies that support these show very small decreases in cancer risk.

But there is a "simple" way to decrease cancer mortality by close to 50%!

In a recent observational study, researchers studied 28,000 healthcare professionals who met four healthy lifestyle criteria: never or past smoking, moderate or no alcohol consumption, no obesity, and regular physical activity. These participants were compared with over 100,000 participants who didn't meet all four criteria.

The researchers calculated that 25% of cancers in women and 33% in men might not have occurred if everyone adopted the healthy lifestyle. Similarly, 48% of cancer deaths in women and 44% in men might have been averted. When comparing the healthy group to the U.S. white population in general, the reductions were even greater. Lung and esophageal cancers saw the greatest reductions.

So while great breakthroughs have been made in treatment, we need to embrace these common sense values.

JAMA Oncol. Published online May 19, 2016. doi:10.1001/jamaoncol.2016.0843

Should Everyone Have Guns?

In this country there is considerable controversy about whether gun ownership should be more restrictive. Interestingly, in every country where gun laws have been strengthened there has been a decrease in gun related deaths. Personally, I cannot imagine why someone would want to own an assault rifle unless they lived in Iraq or a similar violent country.

Gun advocates argue that the evidence, although obvious, is not real.

Researchers in Lancet examined gun related deaths and determined 3 laws which seemed to have the most beneficial effects and extrapolated how these laws, if enacted nationally, would affect these deaths. Interestingly, although this was published in March, even after Orlando there seems to be continuing ignorance.

Researchers examined 25 gun laws in force in the states, finding the three laws most associated with lower rates of firearm-related mortality: universal background checks for firearm purchases, background checks for ammunition purchases, and identification requirements for firearms (i.e., microstamping or ballistic fingerprinting).

The authors then calculated the effect on firearm mortality if the three laws were mandated nationally. With background checks for firearm purchases, the death rate would decline from 10.35 per 100,000 population to 4.46; with ammunition background checks, to 1.99; and with firearm identification, to 1.81.

I do not find this surprising. I just hope that this country can enact some sensible legislation without party bickering and more deaths.

The Lancet, Volume 387, Issue 10030, 30 April–6 May 2016, Pages 1847-1855

What does "Healthy" mean on a food label?

Many foods market themselves as healthy. The current FDA requirements for "healthy" means a food is low in fats and has vitamins. In other words, according to the FDA Pop-Tarts are healthy, while many granola bars (which include fats from peanuts) are not.

Kind, a granola bar producer appealed this (successfully) to the FDA and now van label their bars as healthy. However this has prompted the FDA to start a review process.

So read the ingredients of your foods; and try and avoid high fructose sugars, corn syrup, and processed foods in general!

https://www.yahoo.com/news/fda-reevaluate-definition-healthy-124650906.html