An Apple A Day

Over time we have gotten used to the idea that some things we cannot see, can still cause us harm.  In fact, much longer ago, say 1,500 years, people were concerned about vaporous humors floating out of swamps and causing illnesses.  Those ethereal malefic influences often proved to be tiny creatures like mosquitoes carrying invisible ones like bacteria.  Since Rachel Carson proved that DDT was ruining our world despite its invisibility, we have learned to be skeptical about all kinds of things.

Most of us, including me, would rather not have to worry about something else, especially another invisible but ever present hazard.  A new study dealing with electromagnetic radiation provides an unpleasant jolt to our complacency.  Given the strength of the study and the potential impact of the finding, I am more than a little surprised by the lack of media attention.  Maybe that is because no one really wants to believe it, especially electronic media workers and their bosses?

Whatever else anyone has to say, good or bad, about Kaiser, clinical records of Kaiser patients are a goldimine for researchers.  Dr. De-Kun Li is a researcher working for Kaiser, specializing in reproductive and hormonal health studies.  Years ago, this group found that exposure to electromagnetic fields (EMF) doubled the risk of miscarriage for pregnant women.  This time they studied pregnant Northern California patients, looking for an association between EMF exposure and asthma.  The study design was particularly strong for this kind of research.  They gave over 800 pregnant women monitors to wear, measuring EMF exposure during pregnancy.  The children were tracked until age 13 to learn which of them developed asthma.

Children of women with the highest levels of EMF exposure during pregnancy were three times more likely to develop asthma than children of the least EMF exposed mothers.  The greatest EMF exposure came from home appliances (hair dryers, microwave ovens and vacuum cleaners).  The meters used did not measure radio frequency energy, so this study teaches us nothing about smart meters, cellphones and the wireless networks all around us.  Dr. Li, however, has also expressed his concern about radio-frequency exposure.

Forgive me for rattling on about vitamin D, but it is VERY important. The latest news is even more important than usual, and it is notable for at least three reasons, maybe four, if we count the fact that Mother’s Day is fast approaching.

The most meaningful studies are designed as interventional trials, where people are divided into groups, each receiving different treatments, and then their responses analyzed statistically to determine if the treatment had any effect. This study was designed in that way, with women who were pregnant for 12 weeks or more randomly assigned to receive either 400, 2,000 or 4,000 iu of vitamin D a day. Researchers then tracked their risk of major complications of pregnancy, including premature labor, premature birth and infections. The highest dose of vitamin D, 4,000 iu/day, was clearly associated with the lowest rate of complications.

First, this is important because pregnancy complications are serious and common.

Secondly, because showing that doing something has an effect demonstrates cause not just association.

FInally, given official warnings that taking 2,000 iu/day of vitamin D is the safe upper limit, I am impressed that they were able to get the study approved. Human Subjects Committees at research institutions are mandated to block research that endangers the subjects of the trial. For example, 15 years ago, when I conducted the first national survey of alternative medical instruction in US medical schools and family practice residency programs, the Human Subjects Committee at UCSF refused to allow me to resend questionnaires to schools that did not respond to the first one, as they felt that I would be harming them by such a request. Seriously. Thankfully, the particular HSC involved in this case was courageous enough to approve this vitamin D study. As such research is needed and human subjects committee can be ridiculously conservative, this is not a minor event. I find that most patients need well more than the “safe limit” of 2,000 to bring their blood levels up to normal. This “safe limit” is completely wrong and unscientific. It must be changed, and the sooner the better.