Does Nutella cause cancer?

nutellaOn a recent cycling trip in Canada, I ate an obscene amount of Nutella. It works as a great lunch, and dipping fresh bread in it is a delicious snack. When you are exercising all day every day, a tasty, spreadable, dippable energy source like this is extremely useful. Don’t get me wrong, it is a very unhealthy food, but despite this, I’m a fan.

Which is why I was surprised this week to see Ferrero (the makers of Nutella) defending their product against claims that it causes cancer. A quick internet search revealed the problem. As the Tech Times put it: “Nutella Can Cause Cancer, Study Warns”. The Huffington Post ran with: “Stores Are Pulling Nutella After Report Links It To Cancer”, while the Daily Mail asked “Could Nutella give you CANCER?”. So what is this all about, and should you stop eating Nutella? Continue reading

Conspiracy thinking and the US election

Shortly before the election in November a story did the rounds that claimed Hillary Clinton and her former campaign manager, John Podesta, ran a child sex ring at a pizzeria in Washington DC. This was an extremely complex conspiracy theory that was based on the fact that Podesta had emailed the owner of the pizzeria regarding fundraising. And it gained a shocking amount of attention on the internet.

Think about that. Millions of people were willing to share this, and numerous other fake news stories and conspiracy theories online. In fact, one of the things that defined this election was the prevalence of such conspiracy theories. Presumably only a minority of people (one hopes) fell for stories as extreme as that above, but their presence in the discourse suggests that something larger has happened. The theories may be a symptom of something else, a change in the way that people think, and it seems that Donald Trump and the Brexiteers have tapped that change to great effect. Continue reading

What happens when we don’t publish clinical trials

The last blog I posted emphasised the importance of publishing all clinical trials. The story of Lorcainide is a stark warning of what happens when we don’t.

In 1980 a cardiologist in Nottingham named Alan Cowley carried out a small clinical trial of a drug called Lorcainide. It was known at the time that heart attacks could cause irregular heartbeats in patients (known as arrhythmia), and these arrhythmias often lead to early death. Lorcainide had been shown to suppress arrhythmia, so it made sense that patients who came to hospital with a heart attack should be treated with the drug. Cowley and his colleagues carried out a small trial with 95 patients, and tested them to see whether they were getting more or fewer arrhythmias. The drug worked, lowering the frequency of serious arrhythmia.

The doctors noticed something else however. Of the 48 patients on the drug, 9 had died, compared to only 1 patient on the placebo. This was a very small trial, so the doctors weren’t overly alarmed. It’s not surprising that 10 patients died in the study; these are patients who are presenting with heart attacks after all. It was just worrying that there was such an imbalance between the groups. The doctors chalked it up to bad luck, and viewed their trial as a success.

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Problems with clinical trials

Clinical trials are at the heart of our progress in medicine. If we have a new therapy, clinical trials tell us whether it is better than the current one. They measure outcomes, but also look out for side effects and unexpected consequences of taking the therapy. They are absolutely essential to our progress, and it is vital that they are carried out properly and transparently. Continue reading

Correlation vs Causation

The following headline caught my eye recently:

“Migraines could be caused by gut bacteria, study suggests”

The Guardian – 18/10/16

To anybody who suffers from migraines, this is very interesting; at the moment, we really don’t understand what causes them. If a study has figured this out, then we may be able to help the estimated 15% of the population who are sufferers.

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Hot drinks and cancer

You may have seen a frankly terrifying headline this week:

“Hot drinks probably cause cancer, warns World Health Organisation”

Telegraph, 15th June 2016

Almost every news source carried this story, and the headlines were universally similar to the one above. This story comes from a report by the WHO, which looked at the association between coffee and mate (a South American herbal tea) and various forms of cancer. In short, they found that there was no association between coffee or mate and cancer, but that the temperature of the beverage may be linked to oesophageal cancer. Continue reading