Paul Howard is a senior fellow at the Manhattan Institute Center for Medical Progress and the editor of the blog Medical Progress Today. In this Washington Post op-ed, Howard addresses the potential danger to public health of indulging in the current wave of trendy skepticism toward vaccinations:

Sadly, too many parents have lost faith in vaccines. Partly, this is because of a “generation gap.” In 1940, U.S. infant mortality rates stood at 40 deaths per 1,000 live births. Tens of thousands more children would go on to be killed or maimed by measles, polio and chicken pox. Today, infant mortality averages about 7 deaths per 1,000 live births, and those other diseases have been largely vanquished by vaccines. A childhood free of serious illness is now taken for granted.
When mysterious disorders like autism strike seemingly healthy children — at about the same age when childhood vaccines are typically administered — frustrated parents lash out at doctors and pharmaceutical companies. And today’s vaccine inventors must contend with a powerful force that had yet to arise when Jonas Salk created his revolutionary polio vaccine — mass litigation.
The birth of “liability without fault” in pharmaceutical litigation in 1958 — captured in Dr. Paul Offit’s riveting book The Cutter Incident — set the dangerous precedent that vaccine companies would be held liable for side effects even when their products were made using the best available science and according to government regulations. [. . .]
The debate over vaccine litigation has thus shifted from a presumption of innocence to a presumption of guilt. While the number of major studies that have failed to find any substantive link between vaccines and developmental disorders or autism is now in the double-digits (including a September 27th CDC study in the New England Journal), critics are effectively demanding that scientists prove that thimerosal does not cause illness — an impossible standard.
The very success of vaccines has become their downfall. As Dr. Offit writes in Vaccinated, “When [vaccines] work, absolutely nothing happens. Parents go on with their lives, not once thinking that their child was saved.”

The entire op-ed is here. This earlier post addresses the devastating impact that the Cutter Incident had on the production of vaccines and public health.

NY Times nutrition columnist Gina Kolata (previous posts here) reviews Gary Taubes’ new book, Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control and Disease (Knopf September, 2007), which was previewed earlier here. Kolata observes:

His thesis, first introduced in a much-debated article in The New York Times Magazine in 2002 challenging the low-fat diet orthodoxy, is that nutrition and public health research and policy have been driven by poor science and a sort of pigheaded insistence on failed hypotheses. As a result, people are confused and misinformed about the relationship between what they eat and their risk of growing fat. He expands that thesis in the new book, arguing that the same confused reasoning and poor science has led to misconceptions about the relation between diet and heart disease, high blood pressure, cancer, dementia, diabetes and, again, obesity. When it comes to determining the ideal diet, he says, we have to ìconfront the strong possibility that much of what weíve come to believe is wrong.î [. . .]
Taubes convincingly shows that much of what is believed about nutrition and health is based on the flimsiest science. To cite one minor example, thereís the notion that a tiny bit of extra food, 50 or 100 calories a day ó a few bites of a hamburger, say ó can gradually make you fat, and that eating a tiny bit less each day, or doing something as simple as walking a mile, can make the weight slowly disappear. This idea is based on a hypothesis put forth in a single scientific paper, published in 2003. And even then it was qualified, Taubes reports, by the statement that it was ìtheoretical and involves several assumptionsî and that it ìremains to be empirically tested.î Nonetheless, it has now become the basis for an official federal recommendation for obesity prevention.
But the problem with a book like this one, which goes on and on in great detail about experiments new and old in areas ranging from heart disease to cancer to diabetes, is that it can be hard to know what has been left out. [. . .[
. . . I kept wondering how he would deal with an obvious question. If low-carbohydrate diets are so wonderful, why is anyone fat? Most people who struggle with their weight have tried these diets and nearly all have regained everything they lost, as they do with other diets. What is the problem?
On Page 446, he finally tells us. Carbohydrates, he says, are addictive, and weíve all gotten hooked. Those who try to break the habit start to crave them, just as an alcoholic craves a drink or a smoker craves a cigarette. But, he adds, if they are addictive, that ìimplies that the addiction can be overcome with sufficient time, effort and motivation.î
Iím sorry, but Iím not convinced.

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If so, and even if not, check out these 100 Web Resources for Medical Professionals.

Gary Taubes, a writer for Science magazine, is the author of the soon-to-be-released book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control and Disease (Knopf September 25, 2007). He provides a don’t miss preview of his book in this past Sunday’s New York Times:

Many explanations have been offered to make sense of the here-today-gone-tomorrow nature of medical wisdom ó what we are advised with confidence one year is reversed the next ó but the simplest one is that it is the natural rhythm of science. An observation leads to a hypothesis. The hypothesis (last yearís advice) is tested, and it fails this yearís test, which is always the most likely outcome in any scientific endeavor. There are, after all, an infinite number of wrong hypotheses for every right one, and so the odds are always against any particular hypothesis being true, no matter how obvious or vitally important it might seem. [. . .]
The dangerous game being played here, as David Sackett, a retired Oxford University epidemiologist, has observed, is in the presumption of preventive medicine. The goal of the endeavor is to tell those of us who are otherwise in fine health how to remain healthy longer. But this advice comes with the expectation that any prescription given ó whether diet or drug or a change in lifestyle ó will indeed prevent disease rather than be the agent of our disability or untimely death. With that presumption, how unambiguous does the evidence have to be before any advice is offered? [. . .]
Richard Peto, professor of medical statistics and epidemiology at Oxford University, phrases the nature of the conflict this way: ìEpidemiology is so beautiful and provides such an important perspective on human life and death, but an incredible amount of rubbish is published,î by which he means the results of observational studies that appear daily in the news media and often become the basis of public-health recommendations about what we should or should not do to promote our continued good health. [. . .]
All of this suggests that the best advice is to keep in mind the law of unintended consequences. The reason clinicians test drugs with randomized trials is to establish whether the hoped-for benefits are real and, if so, whether there are unforeseen side effects that may outweigh the benefits. If the implication of an epidemiologistís study is that some drug or diet will bring us improved prosperity and health, then wonder about the unforeseen consequences. In these cases, itís never a bad idea to remain skeptical until somebody spends the time and the money to do a randomized trial and, contrary to much of the history of the endeavor to date, fails to refute it.

Read the entire article.

As noted in previous posts here and here, the myth that endurance training and long-distance running are good for one’s health remains firmly entrenched among most Americans, despite sad reminders such as this. In this timely article, Mark Sisson lucidly explains why endurance training is hazardous to one’s health. Here is a snippet:

The problem with many, if not most, age group endurance athletes is that the low-level training gets out of hand. They overtrain in their exuberance to excel at racing, and they over consume carbohydrates in an effort to stay fueled. The result is that over the years, their muscle mass, immune function, and testosterone decrease, while their cortisol, insulin and oxidative output increase (unless you work so hard that you actually exhaust the adrenals, introducing an even more disconcerting scenario). Any anti-aging doc will tell you that if you do this long enough, you will hasten, rather than retard, the aging process. Studies have shown an increase in mortality when weekly caloric expenditure exceeds 4,000. [. . .]
Now, what does all this mean for the generation of us who bought into Ken Cooperís “more aerobics is better” philosophy? Is it too late to get on the anti-aging train? Hey, we’re still probably a lot better off than our college classmates who gained 60 pounds and can’t walk up a flight of stairs. Sure, we may look a little older and move a little slower than we’d like, but there’s still time to readjust the training to fit our DNA blueprint. Maybe just move a little slower, lift some weights, do some yoga and eat right and there’s a good chance you’ll maximize the quality of your remaining yearsÖ and look good doing whatever you do.