They engineered a better salmon, so why can't I eat it?

What happened to genetically modified salmon? A few months back I was looking forward to my first taste of the new AquaBounty salmon, which grows to maturity twice as fast as wild salmon. Will it taste just as good? Better? I thought I'd know soon. But then politics intervened.

It's almost always bad when politicians meddle in science. Usually they do so because they just don't like what they're hearing, as they have done time after time with global warming. Now it's genetically modified salmon. What happened? The FDA was ready to approve the new salmon until two weeks ago, when Congressman Don Young from Alaska, under heavy lobbying pressure from the Alaskan fisheries industry, simply stepped in to block it. The FDA had already found that the fish was safe to eat, but hadn't yet issued final approval. So Congressman Young and his pals decided to pass legislation to halt the process.

I wrote about AquaBounty's salmon last year, when the FDA was holding hearings to approve it for human consumption. Ironically, the FDA doesn't get to approve genetically modified crops, and our food supply is filled with GM corn, soy, and other plants. But thanks to the vagaries of U.S. law, the FDA gets to weigh in on salmon.

The science is pretty cool: AquaBounty took two genes from other fish and added them to Atlantic salmon. They added a growth gene from Pacific Chinook salmon, and another gene from a fish called ocean pout (Trisopterus luscus). Together, these genes allow AquaBounty's new salmon, called AquAdvantage ®, to grow to maturity in 18 months rather than 3 years. This promises to make salmon farming much more efficient, if we ever allow it.

Better fish farming is incredibly important for the future of wild fish on our planet. Wild fish populations have plunged 90-99% all over the planet, and many fish populations have been completely wiped out. Here on the east coast of North America, wild cod populations completely crashed in the 1990s, and by 2004 the World Wildlife Fund predicted that wild cod would disappear completely in 15 years. The situation isn't any better for Atlantic salmon, which are at "perilously low levels." The U.S. declared Atlantic salmon an endangered species in 2000, and added more salmon populations to the endangered list in 2009.

The solution, obviously, is to farm our fish, just like we do with every other food we eat. As I wrote last year:

"We farm all the other animals that we eat. Imagine that we only ate wild cows, or chicken, or pigs. The human race can't be fed by wild animals alone - we're too numerous and too hungry. Sooner or later, we will drive wild fish to extinction, unless we make the switch to farmed fish."

To make fish farming more efficient, we need to apply new genetic technologies to increase yields the way we have with our crops and with domesticated animals.

These new salmon are nothing to be afraid of, but anti-GMO activists have labelled them "Frankenfish" as a transparent scare tactic. I'm neither a fan nor an opponent GMO foods, but knee-jerk opposition to all GMOs doesn't make any sense. Modifying crops to make them more resistant to pesticides, as Big Agriculture firms (Monsanto in particular) have done, strikes me as a terrible use of the technology. "Roundup Ready" corn and soy allow Monsanto to sell more of their herbicide, and make farmers dependent on it. If anti-GMO forces want to boycott this type of genetically modified organism, I'm on their side.

But not with salmon. AquaBounty salmon doesn't promote the use of pesticides or other industrial chemicals. It just makes salmon farming more efficient. The genes added to the salmon are naturally-occurring ones from other fish, so they are still 100% fish. (In contrast, GM crops have genes injected into them from bacteria and other foreign species.) Furthermore, the farming operations by AquaBounty are all inland farms, so there's almost zero chance of the fish escaping into the wild. (I went to one of the FDA hearings last fall and heard a detailed description of the farms.) And even if they did escape, it wouldn't matter because the AquAdvantage salmon are sterile, and couldn't breed with wild fish.

Despite these facts, environmental organizations such as Food and Water Watch are waging a campaign to "Stop Frankenfish,", and spreading misinformation about the science. I was particularly disappointed by the comments from the Union of Concerned Scientists at last September's FDA hearing. Jane Rissler from the UCS compared GM salmon to the massive BP oil spill in the Gulf of Mexico, a ridiculous bit of overstatement. I thought the UCS were the good guys! I agree with their stances on many issues, but they do not speak for me on this one.

I can't resist pointing out that Republicans such as Alaska's Rep. Young claim to hate regulation, and favor the free market - except when they don't. Here we have Young stepping in and imposing regulation to halt the free market under pressure from lobbyists. Not surprisingly, Young is joined by Alaska Senator Lisa Murkowski, but his efforts are also supported by Democratic Senator Patty Murray from Washington, who also has a salmon industry to protect. As happens all too often, politicians are in favor of science only when they agree with it. They're all too happy to pass laws on behalf of special interests, even if it goes against with their supposed political positions on government regulation.

Sadly, environmentalists who oppose GM salmon don't seem to realize that they are acting against their own interests. The same is true of the fishing industry. If they win, the result will be the eventual extinction of many wild fish species, with unpredictable consequences for the ocean's ecosystem. The arguments about the threat posed by GM salmon haven't stood up to scientific scrutiny, so these groups have turned to politics instead. It looks like they might win, in the short term. But if we insist on taking so many of the ocean's fish for our dinner plates, the wild fish will soon be gone.

Strychnine for your child's cold - courtesy of your friendly homeopath

I was in the pharmacy section of my local grocery store last week, looking for children's ibuprofen, when I stumbled upon Children's ColdCalm, a homeopathic product from Boiron.

This stuff isn't cheap - it's $12.49 at RiteAid, and the price is similar at my local grocery stores (Giant Foods and Whole Foods). If you follow the instructions, you'll give half the package (40 pills) to your child in the first 12 hours.

Not only is it expensive, but it doesn't work - or at least there's no evidence that it does. Boiron is selling parents sugar pills and telling them that it will cure their children of colds. Here's what the package says, right on the front: "Multi-Symptom Cold Relief, Sneezing, Runny Nose, Nasal Congestion, Minor Sore Throat."

Since it's in the "Colds" section of the pharmacy, most parents probably assume this is just like any other medicine. But it's not. It's a homeopathic drug.

The manufacturer, Boiron, makes very specifc claims on their website. Here's a partial list of ColdCalm's ingredients with their claimed benefits:

Belladonna 6C HPUS * Relieves colds with a sudden onset

Eupatorium perfoliatum 3C HPUS * Relieves sinus pain

Gelsemium sempervirens 6C HPUS * Relieves headaches associated with colds

Kali bichromicum 6C HPUS * Relieves nasal discharge

Nux vomica 3C HPUS * Relieves sneezing attacks

Phytolacca decandra 6C HPUS * Relieves sore throat associated with colds

Pulsatilla 6C HPUS * Relieves colds with a loss of taste and smell

What the heck are these? Belladonna sounds familiar - oh yes, that because it's an extremely toxic plant, also called Deadly Nightshade, one of the most poisonous plants in the Western hemisphere.

And "nux vomica": that sounds suspicious. Maybe that's because it is actually strychnine! Yes, that's right, strychnine, once used as rat poison, which is fatal to adults in doses as small as 30 milligrams. I wonder how much Boiron recommends that we give to children?

According to the American Cancer Society:

"Strychnos nux-vomica has not been proven effective for the treatment of any illness. Since the seeds contain strychnine, which is poisonous to humans, conventional medical practitioners do not recommend it as a medicine. Some research has shown that the level of poison in nux vomica preparations may depend greatly on how the seeds are processed."

Need I say more? Pulsutilla, another ingredient in ColdCalm, is a poisonous plant that produces toxins that slow the heart and can cause convulsions.

Is this how they want to cure my child's cold?

But wait, these are homeopathic medicines, which means they've been diluted down to nothing. So perhaps there's so little strychnine in the pills that it won't hurt your child, at least not too much. In ColdCalm, though, the dilutions aren't as tiny as the ones used in typical homeopathic preparations: 3C is one part in 1 million, so there might be some strychnine left in these tablets. We really don't know. A huge problem here is that none of these claims have been tested, so no one (including Boiron) knows what strychnine at these dilutions does to a child. Nor can they say precisely how much strychnine is in each tablet.

You might have noticed the abbreviation HPUS in that ingredient list: this refers to the Homeopathic Pharmacopoeia, a list of homeopathic drugs. HPUS drugs cannot be regulated by the FDA. Yes, you read that right. Homeopathic drugs are approved automatically as long as the homeopaths themselves list them in their "pharmacopoeia." No evidence of efficacy is required. We have Congress to thank for this - specifically, the Food, Drug and Cosmetics Act of 1938, which granted a special exception to homeopathic drugs. The Act was authored primarily by a Senator who believed in homeopathy.

I wrote about Boiron's ridiculous Oscillococcinum flu "cure" last year, but I didn't realize they have a whole line of bogus treatments for colds and flu. And Boiron isn't some small mom-and-pop operation: it's a huge multi-national company selling nothing but homeopathic products, making huge profits selling treatments that don't work.

So parents, if you see "homeopathic" on that package in the pharmacy, you might want to look a little harder at what they're selling you.

Alternative medicine debate at The Atlantic

Over at The Atlantic, one of my favorite monthly magazines, there's a feature article by David Freedman in which I'm quoted at some length, titled "The Triumph of New-Age Medicine." As readers of this blog might guess, I have some disagreements with the title and with many of the points in Freedman's otherwise very well-written piece.

Rather than blogging about it here, The Atlantic invited me to post a response in an online debate they are having. My response, which just appeared today (June 16), is titled "A 'Triumph' of Hype Over Reality" and you can read it here. I encourage you to post comments at the Atlantic site.

Several more experts' responses will appear on this page at The Atlantic over the next few days, if you want to follow the debate. I know I will.

Chronic fatigue syndrome hypothesis collapses further

Two years ago, a team of scientists announced with great fanfare that they'd found the cause of chronic fatigue syndrome: a mouse retrovirus called XMRV. There were many media reports and much excitement, and at least a dozen studies were launched to look for this virus in more patients. Unfortunately for patients, the findings turned out to be seriously flawed.

New results published this week seem to be the final nail in the coffin for the XMRV hypothesis. The editors at Science have taken the unusual step of publicly asking the authors of the 2009 study to retract their findings. As reported in the Wall St. Journal, Science sent a letter to the authors stating:

"At this juncture, Science feels that it would be in the best interest of the scientific community'' for the co-authors to retract the paper."

In addition, the editors published an "expression of concern" this week, which is their way of warning everyone that the results are wrong. Judy Mikovits, the leader of the study, steadfastly insists that she is right and all the others are wrong.

Despite Mikovits' claims, the evidence is very clear that she is wrong. Study after study has found no trace of the virus in CFS patients. Where Mikovits' original study found 67% of the patients had XMRV, followup studies found 0%. A set of three papers in the journal Retrovirology, published in December, showed conclusively that the finding was due to laboratory contamination. The XMRV virus turned up as a contaminant in cancer cell lines that are widely used in laboratory research. As I wrote in January:

"It turns out that a common tumor cell line called 22Rv1 is infected with MLV-X. It also turns out that all the XMRV sequences from human patients are far more similar to the exact same strain of MLV-X that is in the mouse cell line. The tumor cell line was in the lab doing the experiments: ergo, it's contamination. Elementary, my dear Watson."

Two new papers in Science this week found the same thing. One of them, titled "No Evidence of Murine-Like Gammaretroviruses in CFS Patients Previously Identified as XMRV-Infected" looked at patients who had tested positive for the XMRV virus, and found that they didn't have it all. The second study provides new detail on how the XMRV virus got into the cancer cell lines.

So why does Mikovits cling so fiercely to her claims? (She posted a long letter defending herself at the Whittemore Peterson Institute, where she works.) What she doesn't say is that she has gone far beyond her original findings: she and her institute are actively promoting the use of anti-retroviral therapies for CFS patients. As Nature News reported in March,

"The WPI owns a company that charges patients up to $549 to be tested for XMRV, and Mikovits believes that patients who test positive should consult their doctors about getting antiretroviral drugs normally prescribed to those with HIV."

This is a blatant conflict of interest, and it perhaps explains some of Mikovits' stubbornness.

It gets worse. As Trine Tsouderos reported last summer in the Chicago Tribune, Mikovits claimed at the Autism One conference that XMRV also causes autism. She has no evidence to support this startling claim. Mikovits stated to the Tribune that "unless we do something now this (XMRV) could be the worst epidemic in U.S. history."

Mikovits also believes there is a conspiracy against her. In March, she told Nature "I had no idea there was that much bias against this disease." Nonsense. The collapse of the evidence about XMRV and chronic fatigue syndrome is just science doing what it is supposed to do: when a study cannot be replicated, then the hypothesis is abandoned and we move on.

This is a classic tale of a scientist gone bad. Unfortunately for CFS patients, Mikovits is distracting attention from efforts to find the real cause. By speaking at the Autism One conference, she has joined the ranks of pseudoscientists and anti-vaccinationists. It's pretty clear now that she will never retract her findings, despite the pressure from the editors at Science. I can only hope that CFS patients, who are understandably desperate for a treatment, won't be fooled into taking ineffective and possibly harmful therapies based on the failed XMRV hypothesis.

Test your kids' genes for sports ability: hype or reality?

A company called Sports X Factor recently announced that it's selling a genetic test that will reveal your potential to be a sports star. They're marketing it as a way to predict what sports your kid will excel at. Is this real, or just another over-hyped attempt to cash in on parents' aspirations for their children?

Sports X Factor, which sells the test for $180, stated in a press release a few weeks ago that the test

"can make workouts more effective, children’s sports choices more appropriate and trainers’ awareness of potential risk factors more precise. It can even save a life."

Wow, sounds impressive. But is it true?

In some ways, this is nothing new. Another company, Atlas Sports Genetics, started offering a similar test in 2008. They make similar promises, claiming that their test

"Gives parents and coaches early information on their child’s genetic predisposition for success in team or individual speed/power or endurance sports."

Unlike some of the rank pseudoscience I often blog about, this claim actually has some real science behind it. Back in 2003, Kathryn North and colleagues at the University of Sydney published a paper in a leading genetics journal about a gene called ACTN3. They found that mutations in this gene were associated with elite sprinters, both male and female. Superficially, it's easy to take this association and turn it into a "speed gene," but it's not.

The science is much more nuanced. (Isn't it annoying when things aren't so simple?) ACTN3, which affects muscle fibers, has three common genotypes. Let's call them Red, White, and Blue.* Elite-level sprinters are usually Red or White: 92% of male sprinters and 100% of female sprinters in the original study were one of these. In the general population, 30% of people are Red and 52% are White. For elite endurance athletes, there tendency is the opposite: slightly more of them are Blue, but the difference isn't significant.

The advice from Atlas Sports Genetics is a gross over-generalization of the science. Here's how they interpret the test results:

Blue: Predisposition to endurance events

White: Equally suited for both endurance and sprint/power events

Red: Predisposition to sprint/power events

The science simply isn't this clear. The only thing you might say is that Blue genotypes are not likely to be Olympic sprinters. But that's true of 99.999% of us anyway. There's no "predisposition" to particular sports.

The newer test from Sports X Factor looks at 9 genes, not just ACTN3. Although a broader test might sound superior, the genes they test include ApoE4, which is associated with a slightly higher risk of Alzheimer's disease. This raises serious ethical questions. Do you really want your child to know that he/she might be pre-disposed to Alzheimer's? As Hank Greely, a Stanford lawyer and bioethicist, said in the Washington Post, “I think this company is a good advertisement for the need for more regulation of genomic testing,”

I suggest that parents save their money, and instead take a test that I'm offering right here, for free, to determine your child's sports potential. Just follow these two easy steps:

1. Ask your child, "do you want to play soccer?"
2. If the answer is yes, sign your child up for a kids' soccer team.

Wasn't that easy? And it works for almost any sport! Just replace "soccer" by your kid's favorite sport. Oh, and then you have to go to the games. That's the hard part.

*For science geeks only: the genotypes Red, White and Blue are RR, RX, and XX respectively. The mutation is R577X, where the X is mutation that introduces a premature stop codon at position 577 that shortens the ACTN3 protein. RR means that both copies of the protein are full-length. RX means one copy is shortened, and XX means both are. About 18% of the population is XX ("Blue").

Measles invades U.S.: anti-vaccine movement scores again

How can we keep unvaccinated people from bringing infectious diseases into the U.S.? These diseases are a real threat to public health, and while we're spending billions on national security, almost all that money goes towards "security theater," such as full-body scanning equipment at airports, which does almost nothing to protect the public. We'd be much better off spending those scarce funds on detecting infections at the border.

In the most recent invasion, the measles virus has snuck in thanks to a single unvaccinated student from Utah, who picked up the disease in Poland. The junior high student traveled to Poland with his family to pick up his sister, who was there as a Mormon missionary. As reported by the Associated Press, up to 1000 people have already been exposed, and the circle could easily spread beyond that.

Measles is a dangerous and incredibly infectious virus, transmitting easily between people. According to the CDC:

"About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. For every 1,000 children who get measles, one or two will die."

This is not a disease to take lightly. Fortunately, the vaccine is highly effective, which means the real challenge is getting people to take it.

Utah requires measles vaccinations for public schools, but (as in many other states) parents can refuse vaccines for personal or religious reasons. California now has about 2% of parents refusing vaccines for their children for personal beliefs. This gaping hole in our public health system needs to be closed: if parents refuse to vaccinate their children, they are putting the rest of us at risk, and these children need to be kept out of public schools.

Most of the parents refusing vaccines for the children are doing so out of fear that vaccines cause harm. Despite countless studies showing that vaccines are safe (and in particular, that vaccines do not cause autism), these rumors persist, amplified greatly by the anti-vaccine movement, which seems impervious to evidence or reason.

Meanwhile, anti-vaccine groups such as Age of Autism are fighting to keep or even expand these exemptions. Other sites such as ThinkTwice.com http://www.thinktwice.com/laws.htm and Internet quacks Joseph Mercola and Sherri Tenpenny advise parents to refuse vaccination and use whatever loopholes they can to enroll their kids in school. Parents who follow this advice rely on the immunization of others to protect their own children, but they appear unconcerned about the risk they forcing on the rest of us. They also neglect to consider that vaccines are never 100% effective, so even those of us who vaccinate our kids are still bearing a greater risk by allowing the unvaccinated to attend school.

Europe has its own problems with vaccine coverage, and measles is spreading rapidly this year, having hit 24 countries so far. France had 3749 cases and one death in the first two months of this year. Many of the victims are children too young to be vaccinated, but the disease is often spread by people who simply refuse to get the vaccine.

The latest measles outbreak in Utah could have been avoided if the student involved had simply been vaccinated. Realistically, though, we will always have citizens traveling abroad and bringing infectious diseases back. If the U.S. really wants to use its security dollars wisely, we should implement greater screening at the border to keep these disesases out. We could start by telling people to get vaccinated before they leave the country. If they refuse, we could require them to be tested for infections when they return. We could implement this using funds we'd save when we stop telling everyone to take off their shoes at the airport.

Bad medicine at the University of Maryland

Pseudoscience is insinuating itself into our medical schools across the nation, going by the name "Integrative Medicine." Integrative medicine is just the latest buzzword for a collection of superstitions, myths, and pseudoscience that has gone by various names over the years. First it was Holistic medicine, and once that fell out of favor, it became Alternative medicine, followed soon after by Complementary and Alternative medicine (CAM), and lately Integrative medicine. These names can't disguise the fact that many of the practices lumped together are bad medicine. What disturbs me particularly, as a professor, is that CAM is moving into the medical curriculum at respectable medical schools, including the University of Maryland.

Perhaps the best way to reverse this trend is to call attention to it. Academic freedom allows professors to proclaim all sorts of wild ideas, including nonsensical ones, but we don't have to allow them to teach courses with no basis in reality. That same academic freedom, incidentally, allows me to criticize bad science wherever I find it, including my own university.

So what's going on at Maryland's medical school? UMM is home to one of the nation's premier "integrative medicine" programs, which promotes a wide range of questionable practices. Its clinical services include:

• Acupuncture
• Homeopathy
• Reflexology
• Reiki
• Qi Gong

Although each of these has a different history, all of them are, well, nonsense. Let's take a closer look homeopathy, which is perhaps the most ridiculous pseudoscience on the list. Homeopathy is based on two ideas: that "like cures like", and that vanishingly small quantities of medicine are stronger than larger quantities. Both ideas were invented by Samuel Hahnemann in the late 1700s, back when most medicine was pretty bad for you. Unfortunately for Hahnemann, his ideas were no better.

The idea that "like cures like" is used to justify treating (for example) itchiness with extract of poison ivy. I'm not making this up: this is a standard homeopathic preparation, promoted on many homeopathic sites, even (sorry, cycling fans) on Lance Armstrong's Livestrong website.

The second idea is that you dilute these substances so much that instead of causing the symptom, they cure it. Alas, Hahnemann was unaware that when you dilute a substance to the degree that he recommended, you end up with nothing left. Typical dilutions used today go by the abbreviations 10C, 20C, or 30C. One "C" is a dilution of 1 in 100, and 20C means that you dilute the active ingredient 100-fold, and then repeat the process 20 times over. This is a dilution of 100 to the 20th power, a ridiculously large number. If you had a single molecule immersed on a sphere of water the size of the entire planet, it would still not be dilute enough.

That's right: homeopathic treatments are just water. Or rather, water dropped onto a sugar pill, and sold at stores such as Whole Foods, which has a section devoted to homeopathic remedies. And offered up as medicine by the University of Maryland's Center for Integrative Medicine through their clinical services. (Why isn't this malpractice? I haven't figured that out yet.)

The other treatments offered by the UMM Center are no better. Their Qi Gong brochure explains that

"sickness, pain or physical disorders are the result of qi blockage, or unbalanced qi in the body. Qigong practice helps to balance the qi system in the body and break the qi blockage(s) to recover health."

There's no scientific basis for qi - it is simply magical thinking. The brochure, though, claims that Qigong will give you "an increased resistance to illness through a stronger immune system." None of these claims have any good science to back them up.

But it gets worse. The Center for Integrative Medicine is offering lectures and courses in all four years of the medical school curriculum, and it boasts that the "integrative medicine elective has become a top choice for fourth year medical students." How unfortunate that this pseudoscience has infiltrated its way into the medical curriculum, and that the UMM Center is, in essence, mis-training medical students at one of the nation's oldest medical schools.

By providing a respectable home for these pseudoscientific practices, UM Medicine is undermining its own scientific and educational missions. But when the money is coming in, the administration seems quite happy to support it. Last August, the Dean of Medicine issued a glowing press release about the Center, after its Director published a very poor study (see my earlier blog about that one) arguing for the use of acupuncture. I don't know if the Dean believed that press release, but someone ought to tell him that Integrative Medicine has no place in a 21st century medical curriculum. I guess I just told him.

Note: why do I pick on U. Maryland? Primarily because it's my own institution (although I noted previously that UM Medicine is a separate campus from the main campus at College Park where I work). There are plenty of other Integrative Medicine programs at reputable medical schools, most of them just as deserving of criticism.