Can anything be done about the appalling Joe Mercola?

[Asolepius]

I cannot understand why you bothered with the OP if this is how you feel.

.

No, I am just playing devil's advocate . I do want to do something, but not sure what's going to be effective. I am looking for evidence of effectiveness!

 

[Ivor the Engineer]

I've just looked at the Pubmed links in the Wiki article on Coconut oil, and the 1997 one does not make it sound particularly bad:

http://www.ncbi.nlm.nih.gov/pubmed/9021429

Saturated fat intake appears to be a risk factor of insulin resistance which is important in the pathogenesis of diabetes and cardiovascular disease. This study aims to demonstrate whether saturated fat intake may be a risk factor of hypertension. Cross-sectional survey in six randomly selected streets in Trivandrum city in south India was conducted to study 1497 randomly selected subjects (737 males and 760 females) of 25-64 years of age. The prevalence of hypertension by Joint National Committee V criteria (> 140/90 were 34.6% (n = 255) in males and 30.7% (n = 234) in females. The consumption of food groups showed that they were within desirable limits. However, the intake of fruit, vegetable, legume and coconuts was lower and saturated fat intake higher (> 10% kcal/day), although total fat intake was within desirable limits. Total and saturated fat intake, and the consumption of coconut oil and butter, flesh foods, milk and yogurt as well as sugar and jaggery were significantly associated with hypertension. Total visible fat (> 20 g/day) intake was positively associated whereas fruit, vegetable, legume and coconut intake (< 400 g/day) was inversely associated with hypertension. Salt intake (> 8 g/day), smoking and illiteracy were not associated with hypertension. Multivariate logistic regression analysis showed that saturated fat intake, age and body mass index were independently and strongly associated with hypertension whereas fruits, vegetable, legume and coconuts, coconut oil and butter and alcohol (males) intakes were weakly associated with hypertension. The odds ratio indicate higher risk of hypertension due to higher intake of saturated fat in both sexes (mean: odds ratio, 1.07, 95% confidence interval 1.05-1.09; women, 1.08, 1.06-1.12, P < 0.01). Significant determinants of hypertension were higher saturated fat, particularly coconut oil, and lower fruit, vegetable, legume and coconuts, particularly legumes and coconuts in the diet, apart from conventional risk factors.

[anecdote]
My mother had a TC of about 6, but her doctor said not to worry because she had a good LDL:HDL ratio.

But she decided to use Flora margarine, and a recent blood test showed a TC of 4.2, but the LDL:HDL ratio was much worse, such that he has told her to go back to her original diet.
[/anecdote]

As for what you can do, if Mercola's claims for coconut oil are false, report him to the relevant agency and get him to correct his advertisement.

 

[Asolepius]

I've just looked at the Pubmed links in the Wiki article on Coconut oil, and the 1997 one does not make it sound particularly bad:

http://www.ncbi.nlm.nih.gov/pubmed/9021429

This study is only looking at hypertension. CV disease is much broader than that, and I am thinking of coronary heart disease in particular. The recommendation of cooking with an oil that's 90% saturated is dangerous rubbish.

As for what you can do, if Mercola's claims for coconut oil are false, report him to the relevant agency and get him to correct his advertisement.

The FDA has already warned him about this. I suppose I could tip them off again.

 

[Dymanic]

Is that called "argument from arrogance"?

My claim is that the available evidence does not support the "antivax" position, taking that to mean the broadly applied opposition to vaccination in general, a position which appears to be gaining in popularity. If that's an arrogant position, help me out with that by explaining what's arrogant about it, because I'm not seeing it as having much to do with ME.

What about people who want some but not all the vaccines?

I think such an approach can make good sense for some people under some circumstances. To explore it any further would seem to require more specifics. If you'd like to discuss the scientific basis for regarding a particular vaccine as either safe and effective or not safe and effective, please provide an example.

Is downhill skiing irrational? Is running a marathon irrational?

I think "rational" versus "irrational" would be as much a false dichotomy with regard to those activities as it would for vaccination. As with anything, there are risks, and there are (or may be) benefits, but they won't be the same for every person, or under all circumstances. For a person with severe osteoporosis, downhill skiing would be a bad idea, as would running a marathon for a person recovering from a recent heart attack. In a similar sense, for some individuals, recieving a particular vaccine might be either risky or lacking in any significant benefit.

I make decisions all the time that are more intuitive than logical. But I see the antivax position (again, in the broadest sense) as trying to use logic and evidence to affirm truths that were aquired intuitively, and something about that strikes me as fundamentally dishonest.

 

[Jekyll]

I've just looked at the Pubmed links in the Wiki article on Coconut oil, and the 1997 one does not make it sound particularly bad:

http://www.ncbi.nlm.nih.gov/pubmed/9021429

You forgot to highlight this bit:

Significant determinants of hypertension were higher saturated fat, particularly coconut oil

The only way I can see to make sense of the abstract is to assume that, although Coconut oil is a very good indicator of hypertension, its use by the general public is fortunately so scarce that there is only a weak correlation running the other way from hypertension to coconut oil.

 

[Blue Wode]

I do want to do something, but not sure what's going to be effective. I am looking for evidence of effectiveness!

Asolepius, you recently thought that “blog-bombing” was quite a successful tactic in dealing with the very dubious Joseph Chikelue Obi:
http://www.internationalskeptics.com/forums/showpost.php?p=3365218&postcount=89

As we currently have a ‘Skeptics Circle’ every fortnight…
http://skepticscircle.blogspot.com/
…perhaps some sort of “blog-bombing” event could be organised on a weekly/monthly basis in which willing bloggers write critically on the same subject (e.g., Mercola, Kevin Trudeau, Dana Ullman, Prince Charles, etc.) They could all then link to each other and re-post their articles at pre-agreed regular intervals just to keep the momentum going. Hopefully, in time, some influential people in the media would start to pick up on the problems and publicise them to a wider audience.

Co-incidentally, just today, the Science Based Medicine blog produced a post related to your OP:

I could go on ad nauseum examining Google search engine hits on skeptical subjects, but in looking at three popular alternative practices it’s clear that the sheer number of practitioners and marketers out there simply crushingly outnumber those of us that care about critical thinking and worry about the possible negative effects of these belief systems. I think the best thing we can do is to attack at the point of the media and do our best to educate those with a loud voice (by this I mean those who are heard by millions) about the facts relating to alternative medical practices and the power and fallaciousness of the anecdote.

http://www.sciencebasedmedicine.org/?p=47

 

[Ivor the Engineer]

My claim is that the available evidence does not support the "antivax" position, taking that to mean the broadly applied opposition to vaccination in general, a position which appears to be gaining in popularity. If that's an arrogant position, help me out with that by explaining what's arrogant about it, because I'm not seeing it as having much to do with ME.

Ok, I misunderstood what you were saying. I agree with your above statement.

I think such an approach can make good sense for some people under some circumstances. To explore it any further would seem to require more specifics. If you'd like to discuss the scientific basis for regarding a particular vaccine as either safe and effective or not safe and effective, please provide an example.

Are they the only categories allowed? What about the personal benefit of a particular vaccination? What about the potential for unforeseen consequences?

As for a specific example, I think it seems to be fairly pointless for most people to have a vaccination against Hep A.

I think "rational" versus "irrational" would be as much a false dichotomy with regard to those activities as it would for vaccination. As with anything, there are risks, and there are (or may be) benefits, but they won't be the same for every person, or under all circumstances. For a person with severe osteoporosis, downhill skiing would be a bad idea, as would running a marathon for a person recovering from a recent heart attack. In a similar sense, for some individuals, recieving a particular vaccine might be either risky or lacking in any significant benefit.

Apart from excitement, enjoyment, a sense of control or achievement, the health benefits from downhill skiing or marathon running can be obtained much more safely and efficiently on (say) a treadmill or exercise bike. Spending time taking a lift up a mountain and then sliding down on skis seems pretty irrational to me given the risks, as does running continuously for 26 miles leading to injured feet and chafing of other body parts.

While no one questions these irrational choices (except in the cases you gave where an existing health problem puts the individual at particular elevated risk), someone making the irrational choice not to get vaccinated (or have their children vaccinated) against generally harmless and/or rare illnesses is seen as not acceptable to many people here.

I make decisions all the time that are more intuitive than logical. But I see the antivax position (again, in the broadest sense) as trying to use logic and evidence to affirm truths that were aquired intuitively, and something about that strikes me as fundamentally dishonest.

That’s a valid criticism, but the situation has probably been created partly by them constantly being forced to defend an intuitive decision against a scientific argument.

 

[Dymanic]

While no one questions these irrational choices (except in the cases you gave where an existing health problem puts the individual at particular elevated risk), someone making the irrational choice not to get vaccinated (or have their children vaccinated) against generally harmless and/or rare illnesses is seen as not acceptable to many people here.

As disease incidence decreases in response to widespread vaccination, a point is reached at which the optimal locus in the payoff matrix is to opt out of the vax and fall back on herd immunity -- just as the most "rational" choice may be to let others clean up your mess, refrain from placing yourself at risk to aid another, or graze your stock on the commons. It depends a lot on how you define "rational". When a person does these things, and others object, they aren't necessarily being irrational either; it may just be that they obtain better payoffs by attempting to discourage such selfish behavior.

That’s a valid criticism, but the situation has probably been created partly by them constantly being forced to defend an intuitive decision against a scientific argument.

I can't buy that. They choose to defend it. And they don't stop there. They go on the attack with it. In doing so, they tend to use a similar approach to the one taken by creationists in attempting to discredit evolution. It's based on a simple principle: it's easier to throw mud than it is to catch it.

 

[godless dave]

Chicken pox is not "generally harmless". Also, diseases are contagious. Refusing to vaccinate your children not only puts your children in danger, it puts others in danger.

Don't any of the anti-vaxers have older relatives who lived through the polio years?

 

[Dymanic]

Chicken pox is not "generally harmless".

I think there is some room to consider that it is, for some values of "generally". Non-vaxers often advocate "CP parties" as a means of aquiring immunity for their children, and while tragic outcomes are certainly possible, they appear not to be very frequent. A potentially much more serious problem arises when the concept is extrapolated to, say, measles. With chicken pox, about 1 in 10 unvaccinated children who get the disease will (according to the CDC) have a complication serious enough to require a visit to a health-care provider. With measles, about the same number will have a complication serious enough to require a visit to an undertaker. And a similar number will develop encephalitis, which not infrequently leads to permanent brain damage. I suppose there might still be some room to consider even measles to be "generally harmless" (for some values of "generally") -- but you sure don't want your kid to be among the exceptions.

As for "rare"; there may be some room to consider many vaccine preventable diseases to be that. Measles is a good example. In the U.S., measles cases are front-page news, while in some countries measles deaths are counted in hundreds of thousands (mostly children) accounting for nearly half of the VPD deaths, and 5% of all deaths among children less than 5 years of age. Ask any staunch anti-vaxer to explain the disparity, and you'll get a clear answer: it's because a difference in living conditions; nutrition, sanitation, etc. Point out that there have been dramatic declines in mortality rates in countries where measles vaccination programs have been implemented even when living conditions remain poor, and you'll get the same clear answer. Just as if they had never heard you. It's amazing.

 

[Ivor the Engineer]

I think there is some room to consider that it is, for some values of "generally". Non-vaxers often advocate "CP parties" as a means of aquiring immunity for their children, and while tragic outcomes are certainly possible, they appear not to be very frequent. A potentially much more serious problem arises when the concept is extrapolated to, say, measles. With chicken pox, about 1 in 10 unvaccinated children who get the disease will (according to the CDC) have a complication serious enough to require a visit to a health-care provider. With measles, about the same number will have a complication serious enough to require a visit to an undertaker. And a similar number will develop encephalitis, which not infrequently leads to permanent brain damage. I suppose there might still be some room to consider even measles to be "generally harmless" (for some values of "generally") -- but you sure don't want your kid to be among the exceptions.

As for "rare"; there may be some room to consider many vaccine preventable diseases to be that. Measles is a good example. In the U.S., measles cases are front-page news, while in some countries measles deaths are counted in hundreds of thousands (mostly children) accounting for nearly half of the VPD deaths, and 5% of all deaths among children less than 5 years of age. Ask any staunch anti-vaxer to explain the disparity, and you'll get a clear answer: it's because a difference in living conditions; nutrition, sanitation, etc. Point out that there have been dramatic declines in mortality rates in countries where measles vaccination programs have been implemented even when living conditions remain poor, and you'll get the same clear answer. Just as if they had never heard you. It's amazing.

1 in 10 measles infections causing to death!? In the developing world maybe, but the figure for the developed world before the introduction of the vaccine was between 1 in 1000 and 1 in 7000 died, depending on the country and data you look at.

Currently, about 1 in 100,000 die from chickenpox in the developed world and about 1 in 200 to 1 in 500 are hospitalised. Just because some doctors and others who favour the introduction of the varicella vaccine suddenly decide to start claiming it's not usually a mild disease does not change the reality of the situation which is for the vast majority of children it is.

It's a bit rich to complain about Mercola and other anti-vaccination proponents lying to promote their point of view when the other side appears to be willing to do the same to frighten people into compliance.

 

[Asolepius]

1 in 10 measles infections causing to death!? In the developing world maybe, but the figure for the developed world before the introduction of the vaccine was between 1 in 1000 and 1 in 7000 died, depending on the country and data you look at.

Currently, about 1 in 100,000 die from chickenpox in the developed world and about 1 in 200 to 1 in 500 are hospitalised. Just because some doctors and others who favour the introduction of the varicella vaccine suddenly decide to start claiming it's not usually a mild disease does not change the reality of the situation which is for the vast majority of children it is.

It's a bit rich to complain about Mercola and other anti-vaccination proponents lying to promote their point of view when the other side appears to be willing to do the same to frighten people into compliance.

To settle this, let's have a link to where it says this on the CDC site.

 

[Ivor the Engineer]

As disease incidence decreases in response to widespread vaccination, a point is reached at which the optimal locus in the payoff matrix is to opt out of the vax and fall back on herd immunity -- just as the most "rational" choice may be to let others clean up your mess, refrain from placing yourself at risk to aid another, or graze your stock on the commons. It depends a lot on how you define "rational". When a person does these things, and others object, they aren't necessarily being irrational either; it may just be that they obtain better payoffs by attempting to discourage such selfish behavior.

I was going to make a similar point (I was thinking about ESS's).

I can't buy that. They choose to defend it. And they don't stop there. They go on the attack with it. In doing so, they tend to use a similar approach to the one taken by creationists in attempting to discredit evolution. It's based on a simple principle: it's easier to throw mud than it is to catch it.

Which is why I'm thinking it might better to just say "whatever, don't have yourself/your children vaccinated." rather than try to debate them. Promote your position honestly, don't slag them off and don't force them to do something they don't want to do, unless it really is a matter of public health.

I could of course be totally wrong.

 

[Asolepius]

Which is why I'm thinking it might better to just say "whatever, don't have yourself/your children vaccinated." rather than try to debate them. Promote your position honestly, don't slag them off and don't force them to do something they don't want to do, unless it really is a matter of public health.

But surely this is the point? It really is a matter of public health. Polio is virtually unknown in Britain now, although I knew a victim in the 1960s. This change was brought about by vaccination. How else did it happen? Having said that, I do have misgivings about compulsory vaxing, because it just gives the anti-vaxers another excuse to object. On the other hand, I agree with water fluoridation on a risk-benefit basis. I do try to be logical but it's difficult

 

[Ivor the Engineer]

To settle this, let's have a link to where it says this on the CDC site.

IIRC, last time this was discussed the most inflated figure the CDC could muster was 1 in 300 children dying from measles.

I've found this link from the CDC site which is putting it at 1 in 500 to 1 in 1000:

http://0-www.cdc.gov.pugwash.lib.wa...vac/measles/downloads/pg_why_vacc_measles.pdf

Measles
Measles is a viral illness that causes a rash all over the body. It also
causes fever, runny nose and cough. About 1 out of 10 children with
measles also get an ear infection, and up to 1 out of 20 get
pneumonia. About 1 out of 1,000 get encephalitis, and 1 or 2 out of
1,000 die. While measles is almost gone from the United States, it
still kills about half a million people a year around the world.
Measles can also make a pregnant woman have a miscarriage or
give birth prematurely.
Measles spreads through the air by breathing, coughing or
sneezing. It is so contagious that any child who is exposed to it and
is not immune will probably get the disease. Before measles vaccine,
nearly all children got measles by the time they were 15. Each year
about 450 people died because of measles, 48,000 were hospitalized,
7,000 had seizures, and about 1,000 suffered permanent brain damage or
deafness. Today there are only about 50 cases a year reported in the
United States, and most of these originate outside the country.

Now try and tie the above with this graph:

http://www.healthsentinel.com/graphs.php?id=14&event=graphs_print_list_item

and one from the UK:

http://www.healthsentinel.com/graphs.php?id=28&event=graphs_print_list_item

This graph shows the decrease in mortality from measles from 1838 to 1978. What is striking is the massive decrease in mortality from measles prior to the use of the measles vaccine. The decrease was from a high of 70.49 per 100,000 down to 0.11 per 100,000 in 1968 when the measles vaccine came into use.

Even multiplying the death rate by 15 (to account for most people having measles in childhood before the age of 15, thus the proportion of the population at risk being about 1/15th of the total), you cannot get up to 1 in 500 cases resulting in death.

 

[Dymanic]

1 in 10 measles infections causing to death!? In the developing world maybe, but the figure for the developed world before the introduction of the vaccine was between 1 in 1000 and 1 in 7000 died, depending on the country and data you look at.

Yes, it depends on what country and data you look at. In developed countries, the case fatality rate is often quoted at roughly one in a thousand. An increase in vaccine coverage tends to produce an upwards shift in age distribution of measles cases, and a corresponding reduction in CFR is just what you'd expect. In undeveloped countries, where vaccine coverage is poor (or nonexistent) measles remains primarily a disease of young children, and case fatality rates can be even higher than ten percent:

"During 1989--1991, a population-based study in rural Ghana found a measles CFR of 15%, even in an area with vitamin A supplementation."
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5302a2.htm

It can also vary with factors such as household size, as indicated by this study in Eastern Niger:

"The CFR was highest in infants aged <1 year (15.6%). Households with 2 case patients had a higher CFR (10.8%) than that of households with only 1 case patient (6.0%). Households consisting of 8 members had a CFR of 12.8%, whereas the CFR of smaller households was 7.1%. This investigation suggests that the measles CFR in the Mirriah district may be 2-fold higher than the WHO regional estimate and 20-fold higher than the estimate derived from routine surveillance."
http://www.journals.uchicago.edu/doi/abs/10.1086/499240

Just because some doctors and others who favour the introduction of the varicella vaccine suddenly decide to start claiming it's not usually a mild disease does not change the reality of the situation which is for the vast majority of children it is.

If you look closely at my last post, you may see that I pretty much already agreed to that. How "scary" a thing is ultimately ends up being rather subjective.

Which is why I'm thinking it might better to just say "whatever, don't have yourself/your children vaccinated." rather than try to debate them. Promote your position honestly, don't slag them off and don't force them to do something they don't want to do, unless it really is a matter of public health.

I don't know how things are where you live, but as far as I know, all but two U.S. states provide for exemptions on religious or philosophical grounds, and all of them provide for medical exemptions, so complaints about being "forced" to vaccinate tend to be overstated. I often attempt to get some idea of the vax status of people I'm in contact with, when it can be done tactfully. I may even go so far as to make gentle and polite suggestions. But most people aren't interested enough in the science to get into much of a debate about it anyway. It's a personal decision, and I can respect that. At the same time, personal decisions cannot always be made without considering what implications they may have for others in a community, and I don't consider it unreasonable to ask them to respect that.

Hardcore anti-vaxers are another matter. Simply not vaccinating themselves and their children isn't good enough for them, any more than not eating meat and boycotting zoos is good enough for PETA. For them, it's not a personal decision; it's a crusade. They write books, maintain websites, and run full-page ads in newspapers to spread the word. To me, that is an open invitation to debate. And there is plenty to debate, both scientifically and ethically.

 

[robinson]

Indeed. Another reason there is a debate, in part perhaps, is because we just don't have scientific evidence to show the benefits of forced vaccinations. Every time the subject comes up, we can't simply talk about the evidence based medicine, evidence that shows, without a doubt, that vaccines are safe, effective and have made a huge difference in populations that receive them.

If you disagree with that statement, please show us the evidence. It would be a great tool to counter false claims and nonsense about vaccines and such.

 

[Dymanic]

Another reason there is a debate, in part perhaps, is because we just don't have scientific evidence to show the benefits of forced vaccinations.

Maybe you can clarify what you mean by "forced vaccinations" and provide examples of places which enforce such policies.

 

[robinson]

In the US, unless you use the religion excuse, children have to have vaccinations in order to attend school, and they have to attend school.

The interesting things is, some people choose the religious excuse, and don't have their kids vaccinated. This has been going on for a long time.

So we have two populations, that live in the same areas. Both children and adults at this point. One group has had all the vaccines. The other has had very few, or none at all. (I know, hard to believe, I was surprised to discover this as well).

So it is basic evidence based medicine to study the two groups, and show what the difference is between them. I know, I know, you would think this has already been done. There is no debate.

But of course there is a huge debate, controversy, all kinds of stuff. Because both sides don't have the evidence.

Why is that? It seems impossible. In all the worlds advanced countries, why has this not been done?

 

[Dymanic]

In the US, unless you use the religion excuse, children have to have vaccinations in order to attend school, and they have to attend school.

Actually, they don't. Nearly two percent of children in the U.S. are homeschooled, and this surely includes many for whom the decision was heavily influenced by a desire to avoid vaccination. I suppose you might consider this such an undesirable alternative to the high quality of public education in the U.S. as to render the immunization requirement effectively "forced"; but based on my observation both as a parent of a child currently in that system and as a member of a society comprised primarily of its final products, I'm not so sure I'd be very quick to do so.

The interesting things is, some people choose the religious excuse, and don't have their kids vaccinated. This has been going on for a long time.

Further underscoring my point.

So we have two populations, that live in the same areas. Both children and adults at this point. One group has had all the vaccines. The other has had very few, or none at all. (I know, hard to believe, I was surprised to discover this as well).

There's an interesting little study presently ongoing in San Diego involving measles in unvaccinated children. Basically, it involves taking some measles-infected kids and running them through the same clinic as a bunch of other kids, in a community which contains a high number of unvaccinated kids, and seeing which ones get sick. I don't know if you like the way it was designed, but the results seem pretty clear. The scope of the study is currently being expanded to include cohorts in Hawaii.

So it is basic evidence based medicine to study the two groups, and show what the difference is between them. I know, I know, you would think this has already been done.

Just drop "unvaccinated cohort" into a google search bar, and you can know it too. Your chief complaint seems not to be that it hasn't been done, but that it hasn't been done the way you think it should, which (I presume) would be to study all of the effects of all of the vaccines taken together over an indeterminate period of time. If you ever try to really get down with the details of what such a study would look like, you might realize why the results would be such a hopeless mess. Then again, you might not. There is a reason why epidemiological studies are usually designed by persons trained in statistical analysis rather than by seat-of-the-pants laymen.