Saturday 21 December 2013

Why aren't apples more tempting? Adam speaks

It’s so simple if you look at the research. An Oxford University study, published in the British Medical Journal, has concluded that eating an apple a day could save as many lives in the over 50s as a daily statin.
Regular readers of Danger Man’s Doctor will already be aware of our interest in brocolli, and apple is as noble a variety of vegetation. Readers will also be aware of our curiosity that, while everyone bemoans the nation’s stubborn refusal to eat more of said brassicas and fruits, no one stops to ask why we won’t do as we’re told. 
The Oxford University study is a case in point. “We could all benefit from simply eating more fruit,” says study author Dr Adam Brook wistfully, in the face of evidence that one in ten of us can’t even manage one portion of fruit and veg a day.
If people did ask why we aren’t listening, they might find some answers quite quickly. Strong clues came in two news stories published in the past fortnight.
First, a study in the Journal of Consumer Research found that we remember the least when we feel most threatened. If information makes us worried, our brain’s first response is to blank it. 
The researchers used the example of breast cancer awareness campaigns: an advertisement dwelling on women’s vulnerability to the disease is likely to make them feel threatened, and the prevention message is more likely to be forgotten.
As we’ve said before on this blog, scaring people about health doesn’t work. We freeze like rabbits in the glaring headlights of our impending mortality, and can only move on by forgetting we ever heard the message.
The second enlightening news story was that drug giant GlaxoSmithKline has announced it will stop paying doctors to promote its drugs at medical conferences. Amazing that it ever happened at all isn’t it? 
What this tells us is that getting an accurate picture of what’s good for us – not a simple prospect in itself – is made much more difficult by commerce weighting the answers we get. Industry funds research about industry’s products – which is why there’s a wealth of evidence showing the benefits of statins, but hardly any research showing the benefits of apples. Why would drug companies fund research into apples? Why would multinational food companies for that matter? Until someone comes up with a body of research about apples that compares with the vast amount invested in for statins, doctors are not going to be prescribing fruit.
It’s not really our fault that we don’t behave sensibly when it comes to our health. It’s the result of health information campaigns being based on how we’d like humans to be, rather than how we actually are. And it’s the result of industry simply having too much clout in determining what doctors tell us and what foods are allowed to seduce us.  

Wednesday 4 December 2013

Bad gen on the antigen

I’m a loyal follower of The Times: I worked for it for 14 years. I’m also a great supporter of prostate cancer support and research: my father died of the condition.
So you’d have thought I’d be rejoicing about the fact that this year The Times Christmas Appeal is supporting Prostate Cancer UK. But I’m not. Why?
Because it seems the charity is using this wonderful opportunity to raise money for research, to promote messages about prostate cancer which are unhelpful and possibly damaging.
This week the journal Biomarkers in Medicine pointed to the shortcomings of the PSA (prostate specific antigen) test in diagnosing prostate cancer or indicating its aggression. It highlighted the need to find new biomarkers that would provide doctors with a genuinely useful test – one that wouldn’t throw up vast numbers of false positives, and expose men to tests and treatments that could leave them unnecessarily impotent, incontinent or in pain. Such a test currently does not exist.
The prostate specific antigen. Pic: EAS 
Yet here in the same week is Owen Sharp, Chief Executive of Prostate Cancer UK, quoted in an article in The Times to launch the appeal:
“Low awareness of the PSA test means that lives may be lost every single day because men don’t know what is already available to them,” he said.
“We know that GPs are turning men away and talking them out of it. It’s not the majority but it’s about one in eight. Some of them don’t believe in the PSA test. We have calls from men about this all the time and I spoke to a man last week who had a stand-up row with his GP to get the test. We need to be very clear that having had the conversation, it is men’s choice and they shouldn’t be turning men away.”
A more responsible approach might be to support GPs who are not rushing men into having a potentially damaging test; to make clear that the PSA test is the bluntest of instruments; to stress that this is exactly why all of us need to support the quest for a new test.
Thankfully, Rosemary Bennett, the Times journalist who wrote the piece, had the sense to put Sharp’s words into context with comment from GPs about the dangers of PSA testing.
And they say it’s journalists who over-simplify...