Consumer Health Digest #18-32
Your Weekly Update of News and Reviews
August 12, 2018
Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H., with help from Stephen Barrett, M.D. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making. Its primary focus is on health, but occasionally it includes non-health scams and practical tips.
Homeopathy commissioning in England ended. Homeopathic pills or consultations can no longer be funded with money from England's National Health Service (NHS). The Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (CCG) has become the last of England's CCGs to end the commissioning of homeopathic remedies. This action marks the culmination of a four-year campaign by the Good Thinking Society to persuade NHS England to stop wasting money on homeopathy. [Marsh. NHS Bristol ends funding for homeopathy, ending all homeopathy commissioning in England. Good Thinking site. Aug. 7, 2018]
Evidence mounting against fish-oil supplementation. For many years it has been suggested that omega-3 polyunsaturated fatty acids from oily fish, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as well as alpha-linolenic acid (ALA) from plants benefit cardiovascular health. Last year an American Heart Association science advisory suggested that omega-3 fatty acid supplementation was reasonable for patients with coronary heart disease. However, two recent reviews express doubts about supplementation. One encompassed 79 randomized controlled trials that followed a total of 112,059 patients—some healthy and some with existing illnesses—for 1-6 years. [Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews, July 18, 2018] The other meta-analyzed ten large trials that followed a total of 77,917 high-risk participants for at least a year. (The average was 4.4 years.) [Aung T and others. Associations of omega-3 fatty acid supplement use with cardiovascular disease risks. JAMA Cardiology 3:225-234, 2018] Taken together, the reviews concluded:
- EPA and DHA slightly reduce serum triglycerides and raise HDL However, increasing their intake has little or no effect on all-cause deaths and cardiovascular events and probably makes little or no difference in the rates of llnesses or deaths due to coronary artery disease, stroke, or heart irregularities.
- Eating more ALA (for example, by increasing walnuts or enriched margarine) probably makes little or no difference to all-cause or cardiovascular deaths or coronary artery disease but probably slightly reduces cardiovascular events, coronary mortality, and heart irregularities. The effects of ALA on stroke are unclear as the evidence was of very low quality.
- While oily fish is a healthy food, it is unclear from the small number of trials whether eating more oily fish is cardioprotective.
A news article published in JAMA notes that four more large randomized trials are under way. [Abbasi J. Another nail in the coffin for fish oil supplements. JAMA 319:1851-1852, 2018]
Vaginal ring contraceptive approved. The U.S. Food and Drug Administration has approved Annovera™ (segesterone acetate and ethinyl estradiol vaginal system), the first contraceptive to provide an entire year of protection against unintended pregnancy while fully under a woman's control. The product is a soft, flexible, donut-shaped 2¼ inch silicone ring that is designed to be placed in the vagina for three weeks followed by one week out of the vagina, at which time the woman may experience a menstrual period. The ring is washed and stored in a compact case during each seven-day withdrawal period. It does not require refrigeration, which is important for distribution and use in low-resource settings. The four-week schedule can be followed thirteen times to provide a year of protection, during which the hormones delivered by the ring can prevent ovulation. Based on clinical trial data, two to four women out of 100 women may get pregnant during the first year of use. Annovera's physical risks are related to its hormonal effects. The most common side effects are headache and nausea. Similar to other combined hormonal contraceptives, the product carries a boxed warning that women over 35 who smoke should not use it because cigarette smoking increases the risk of serious cardiovascular events from hormonal contraceptive use. [FDA approves new vaginal ring for one year of birth control. FDA News Release, Aug 10, 2018]
The Population Council, the global nonprofit research organization that developed Annovera has a license agreement with TherapeuticsMD to make it available with significantly reduced pricing at federally designated Title X family planning clinics that serve lower-income women. The product is expected to be commercially available by 2020. However, the council notes that it has not been adequately evaluated in women with a body mass index (BMI) greater than 29. [FDA approves the first one-year contraceptive fully under a woman's control. Population Council press release, August 10, 2018].
Position statements attack facilitated communication and the rapid prompting method. The American Speech-Language-Hearing Association has issued position statements discouraging the use facilitated communication and rapid prompting techniques because they lack scientific validity and do not foster independent communication by people with autism and other disabilities. [ASHA discourages use of facilitated communication, rapid prompting method. ASHA press release, Aug 8, 2018] Stuart Vyse has described the battle to discourage their use in a recent article. [Vyse S. Autism wars: Science strikes back. Skeptical Inquirer, Aug. 7, 2018]
Aromatherapy scrutinized. Professor William London's latest column is an overview of aromatherapy that focuses on the lack of well-controlled clinical trials supporting claims that it is effective in treating human diseases. [London WM. Essential considerations about aromatherapy. Skeptical Inquirer. Aug. 9, 2018]
This page was posted on August 12, 2018.