Author: jgscott2008

Measles: An Old Bad Disease Returns

JOHN G. SCOTT

FEB 28, 2026

Epidemiology of Measles

Measles is the world’s most infectious disease. It has a basic reproductive number (R₀) of 12-18. That means that each infected person infects 12-18 other non immune people. As a result, 90% of susceptible people will get measles from exposure to 1 person with measles. The measles virus can linger in the air for 2 hours after a person with measles has left a room. Any susceptible person who enters that room during the 2 hour time period can be infected with measles. Here is a picture of a child with a typical measles rash.

Most US doctors have never seen a case of measles like this child. That, unfortunately is about to change.

For comparison of infectivity let’s look at the R₀ for other diseases we consider very contagious. R₀ for Ebola is 1.5-2.5, R₀ for COVID is 2.2-3.6 and R₀ for influenza is 1.2-1.4. As you can see none of these diseases comes even close to being as infectious as measles.

There are only two other diseases that are closer to being as contagious as measles. The R₀ for pertussis (whooping cough) is 5-17 (see my recent post on pertussis). The R₀ for varicella (chicken pox) is 10-12.

History of Measles in the US Prior to Measles Vaccine

Prior to the introduction of the measles vaccine in 1963, virtually all children in the US had measles by age 15. Having measles (and surviving it) provides lifetime immunity to measles, so adults born before 1954 have had measles and are already immune. People born before 1954 do not need to be vaccinated for measles.

Symptoms of Measles

Here is a description of measles symptoms from the Mayo Clinic

“Measles symptoms show up around 7 to 14 days after contact with the virus.

The first symptoms usually are:

  • Fever, which may be as high as 105 degrees Fahrenheit (40.6 degrees Celsius).
  • Dry cough.
  • Runny nose.
  • Red, watering eyes, called conjunctivitis.

About 2 to 3 days after the first symptoms, you also may see tiny white spots inside the mouth, called Koplik spots.

About 3 to 5 days after symptoms first start, or about 14 days after you come into contact with the virus, it’s common to see a rash. The rash is made up of large, flat spots and small raised bumps. The rash starts on the face or neck and spreads down the body from the chest to the arms and legs. A person with measles can spread the virus four days before the rash appears and four days after.”

Measles is obviously not a pleasant disease to have. Fever of 104-105 is pretty scary. All children with measles are miserable, but most children without complications recover from measles in about 10 days.

Complications of Measles

This information comes from the CDC.

Ear Infections

1 in 10 children with measles get bacterial ear infections that may need antibiotics

Hospitalization

About one in 5 children and adults with measles have to be hospitalized,

Pneumonia 

One out of every 20 children with measles gets measles pneumonia. pneumonia is the most common cause of death from measles in children.

Encephalitis

One child out of every 1000 will develop encephalitis (inflammation of the brain). This condition can also cause death, but children who survive may have deafness and/or intellectual disability.

Death

Three children out of every 1000 children with measles will die from their disease, either from respiratory or neurological complications.

Subacute Sclerosing Pan Encephalitis (SSPE)

This is a uniformly fatal brain disease that can occur 7-10 years after a measles infection. Fortunately it is rare, but children who get measles before age 2 are at higher risk of SSPE.

Herd Immunity to Measles

The recommended regimen for MMR (measles, mumps and rubella) vaccination that gives the most protection is to be vaccinated at age 1 year and a second dose at age 4-5. This regimen gives lifelong 97% protection against contracting measles. This means that children under 1 year of age are protected only by everyone around them being immune to measles. Measles is a live vaccine (a weakened strain of the measles virus). People who have weakened immune systems because of chemotherapy or other causes of immune deficiency cannot receive live virus vaccines. Their only protection from measles is herd immunity. Herd immunity means that enough people are vaccinated or immune that a susceptible person who cannot be vaccinated is protected by the “herd” of people who are vaccinated.

Measles is so contagious that 95% vaccination rate is necessary to prevent measles entirely. Outbreaks start to occur if vaccination rates fall below 95%. Large outbreaks occur at vaccination rates below 90%.

In 2025 MMR vaccination rates ranged from a low of 75% in Idaho to 98% in Connecticut. Only 10 states had MMR vaccination rates above 95%.

MMR Side Effects

There are occasional side effects to MMR vaccine but the vast majority of those are mild. They include pain and swelling at the injection site, fever, a mild rash about 10 days after vaccination and some joint stiffness. When they happen these side effects disappear completely in a day or two. There are some very rare more serious reactions including febrile seizures (8 in 10,000 vaccinations), bruising or bleeding from low blood platelets (1 in 20,000 vaccinations) and severe allergic reactions (1 in 1 million vaccinations. Febrile seizure is scary for parents but does not recur and has no long term effects on the child. The other rare side effects are manageable. There are no known deaths from side effects of MMR vaccine. It is also important to point out that all of these side effects are much more common with measles infections.

MMR Vaccination Resistance 

Worry about side effects of MMR vaccine has led to parents refusing MMR for their children. The main reason for vaccination resistance is worry that MMR vaccine causes autism. Very large well designed research studies have shown definitively that there is no connection between MMR vaccine and autism. The misinformation about MMR vaccine and autism unfortunately persists. This vaccination resistance has decreased the vaccination rate below the 90% threshold for serious outbreaks of measles in large parts of the US.

Current Outbreaks of Measles

I think the best way to show the resurgence of measles in the US is graphically. Below is a graph from the Johns Hopkins Bloomberg School of Public Health.

As you can see from this graph, measles cases started to rise after 2019 and went through the roof in 2025. 2026 is on track to have even more cases than 2025.

Deaths from Measles

Worldwide in 2025 95,000 children died from measles almost entirely from lack of measles vaccination. Three of those deaths were in the US. Given the resurgence of measles outbreaks across the US, we will undoubtedly see more deaths from measles.

Bottom Line

Measles is the most contagious disease in the world. Most children recover, but complications occur in 20% (one in five) children with measles. Complications include ear infections, hospitalizations, pneumonia, encephalitis and death. Vaccination rates must be at least 95% for complete herd immunity. Once vaccination rates fall below 90% large outbreaks of measles occur Vaccination rates are below 90% for large parts of the country and large outbreaks continue to occur in those communities with low vaccination rates. Measles is back with a vengeance!

The New Food Pyramid – Confusing and Not So Healthy

I am starting to use Substack for blog posts. My Substack address is drjohngscott.substack.com. I will continue to post on this site also for the time being, but I will eventually switch over completely to Substack. Substack is more flexible (and also free!). Try it out.

FEB 11, 2026

New dietary guidelines were released in January by the USDA and Department of Health and Human Services titled Dietary Guidelines for Americans 2025–2030. In this post I’m going to illustrate the clear deficiencies of the new guidelines by comparing them to two older versions of Dietary Guidelines for Americans. I will begin the description of each guideline with the visual diagram used to summarize the guideline.

Dietary Guidelines for Americans 1995. These guidelines introduced the image of the food pyramid. The pyramid suggests daily servings for each of the food groups. Serving size is defined in the full text of the guidelines. The most servings are at the base of thy pyramid (bread cereal rice and pasta group) and the least number of servings at the third level of the pyramid, which include dairy and proteins. Note that the very top of the pyramid, which includes fats, oils and sweets, does not include serving sizes but just advises to use sparingly. 

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The full version of the guidelines is 40 pages long and includes the names of a 12 member expert advisory committee. This committee included many famous experts in nutrition, especially Marion Nestle.

Dietary Guidelines for Americans 2020-2025

By 2020 a lot more information was available about foods that increased or decreased the risk of chronic diseases such as diabetes, heart disease and stroke. The image was changed from a food pyramid to an image of a healthy eating plate. The generic image did not include serving sizes except suggesting no more that 1-2 servings a day for dairy products. 

The guidelines included a My Plate Plan calculator that makes calorie recommendations and serving sizes based on age, gender, height, weight and average activity level. Try out the calculator using the above My Plate Plan link. It’s fun to see how many calories you should eat and how they should be distributed.

Note the proportions of food groups on the Healthy Plate image. Vegetables (not including potatoes and french fries) and fruits make up half of the daily calories. Whole grains and protein make up the other half at roughly 1/4 each. Healthy protein emphasizes fish, poultry, beans and nuts with advice to limit red meat and cheese.

That does not mean you should eat no red meat at all, it just should not be your main source of protein. An excellent guide to limited healthy meat and poultry eating is a book by Matthew Evans titled On Eating Meat: The truth about its production and the ethics of eating it.

The guidelines also recommend eliminating processed meats like bacon and cold cuts. Limited quantities of healthy oils (both olive oil and vegetable oils) were recommended for salad and for cooking. It recommended avoiding trans fats

The full text of the 2020-2025 guidelines is 140 pages long. As with the previous guideline it lists the names of a 20 member advisory committee. It also includes a detailed description of how the guidelines were developed. Here is a particularly relevant quote from that description:

“The Guidelines must be grounded in the body of scientific and medical knowledge available at that time, not in individual studies or individual expert opinion.”

2025-2030 Dietary Guidelines for Americans

The new image for the 2025-2030 is an upside down version of the 1995 food pyramid. Things you should eat the most of are at the top and things to eat the least of are at the bottom. This image says nothing about actual quantities of the foods recommended. It has red meat (including an image of a steak), cheese and poultry at the top and whole grains at the bottom. This is the complete reverse of the 1995 pyramid, which had whole grains at the base of the pyramid with meat and poultry and dairy limited at the top. It is also almost the reverse of the 2020 Healthy Eating Plate. The 2025-2030 inverted pyramid does at least have vegetables at the top, but fruits are somewhere in the middle. 

The full version of the new guidelines consists of only nine pages. there is no listing of an advisory committee or any scientific reviewers. The only authors listed are Robert F. Kennedy Jr (Secretary of HHS) and Brooke Rollins (Secretary of Agriculture).

The 2025-2030 guidelines have a little good advice (eat mostly unprocessed foods and avoid added sugar ), and a great deal of very questionable advice. See below

Fats

The 2026 guidelines advise eating (or drinking) full fat dairy (all saturated fat), They advise that healthy fats include beef tallow and the fat in red meat (all saturated fats). Here is a quote from the 2025-2030 guidelines:

“Healthy fats are plentiful in many whole foods, such as meats, poultry, eggs, omega-3–rich seafood, nuts, seeds, full-fat, dairy, olives, and avocados. When cooking with or adding fats to meals, prioritize oils with essential fatty acids, such as olive oil. Other options can include butter or beef tallow.”

Note that meats, poultry and eggs are listed before nuts, seeds olives and avocados and full fat dairy is mentioned in the middle of those much healthier polyunsaturated fats.

Another interesting quote from the 2025-2030 guidelines: 

“More high-quality research is needed to determine which types of dietary fats best support long-term health.” 

This is absolutely not true. There is plenty of research showing polyunsaturated oils and fats lower the risk of cardiovascular disease. I suspect this statement is a veiled reference to Kennedy’s completely unsubstantiated idea that seed oils, which are polyunsaturated oils are bad for you. Seed oils are polyunsaturated oils and have been shown to lower the risk of cardiovascular disease. Even polyunsaturated fats should account for no more than 20-35% of daily calories.

The 2025-2030 guidelines do say that saturated fats should be limited to no more than 10% of total daily calories. This is the same as recommended in the 20020-2025 guidelines. It is not clear how you would do that by eating full fat dairy, using beef tallow for cooking, and eating red meat for protein. We know that eating too much saturated fat increases the risk of heart disease and stroke. The American Heart Association recommends limiting unsaturated fat to only 5-6% of total daily calories.

Protein

The 2026 guidelines suggest protein intake of 1.2 to 1.6 grams of protein per kilogram of body weight. This is the amount of protein recommended for very active people (i.e. long distance runners and weight lifters. People who are more sedentary need only 0.8 grams of protein per kilogram and moderately active people only need about 1 to 1.5 grams of protein per kilogram of body weight.

The average American eats about 20% more than the recommended amount of protein (see this link from BBC Science Focus). Not only do we eat more protein than we need, two thirds of that protein comes from animals (Department of Agriculture Food Surveys Research Group).

Alcohol

Previous versions of the Dietary Guidelines for Americans have recommended a maximum of 1 drink a day for women and 2 drinks a day for men. A change to 1 drink per day for both men and women was proposed for the 2020-2025 guidelines, but any change in this recommendation was actively opposed by the alcohol industry so the advice remained unchanged. 

The best current science shows that there is no totally safe level of alcohol intake. Alcohol at any level increases the risk of cancers of the GI tract, high blood pressure, cardiomyopathy, sleep disturbance, and dementia. The more alcohol consumed, the bigger the risk. Another problem is that “drink” means different things to different people 

The UK national health service uses a measure called a “unit” of alcohol. A unit is 10 ml (about 1/3 oz) of pure alcohol. That is the amount that most people can metabolize in 1 hour. The NHS recommendation is that no more than 14 units per week is a low (not zero) risk level of alcohol consumption. Here is a chart showing what 14 units of alcohol is in common alcoholic drinks:

A shot of spirits is 25 ml (.8 oz) of 80 proof alcohol, which is equal to 1 unit. 

The 2025-2030 guidelines recommendations just say “Consume less alcohol for better overall health.” This guidance is not very helpful.

Bottom Line

The 2025-2030 Dietary Guidelines for Americans are poorly researched and contain much advice that is contrary to current nutritional science. I strongly recommend that you ignore them. The 2020-2025 Dietary Guidelines for Americans remain the most comprehensive and well researched nutritional advice and I would advise that everyone continue to use them.

Alcohol intake recommendations are not current in either guideline. Although there is no absolutely safe level of alcohol intake, the UK NHS alcohol guidelines using units of alcohol as the measure make the most sense.

Pertussis (Whooping Cough): Resurgence of a Deadly Disease

A recent article in the journal Pediatrics reported a surge in cases of pertussis, commonly known as whooping cough. Unfortunately the article is only available to subscribers to the journal. Here is a link to a description of that article in a medical news service called Medscape. Pertussis is a bad disease. See below.

History of pertussis

Pertussis is caused by a bacterium, Bordatella Pertussis. Prior to the advent of pertussis vaccines, pertussis was one of the leading US causes of death of children under 5 years of age. There were over 200,00 cases and 9000 childhood deaths in the US from pertussis every year (a rate of 4.5 deaths per thousand children). Pertussis was especially lethal in infants, and was probably the leading cause of death in this age group. Worldwide, pertussis prior to vaccines was just as bad as in the US or worse. Worldwide there were 24.1 million cases and 160,700 deaths in children under five every year.

Epidemiology of pertussis

In un-immunized people pertussis is extremely infectious, almost as much as measles. One infected person on average infects 12-18 other people. In adolescents and adults pertussis is unlikely to cause death or hospitalization, but it is an extremely unpleasant disease. Older children and adults have paroxysms of coughing, followed by a loud, wheezing inspiration (the whoop of whooping cough). These symptoms can last for weeks or months. The coughing is sometimes so severe that people break ribs or develop hernias. Treatment with antibiotics is used to prevent transmission. Antibiotics are also given to contacts to prevent them from getting infected. Antibiotics do not have any effect on the length or severity of the disease. Those who have symptomatic pertussis just have to wait for it to go away. Here is an audio file of a child with pertussis. You should listen to it realize what a severe disease pertussis is. Let me warn you that it is distressing to listen to.

Pertussis vaccines

Whole cell pertussis vaccines

Whole cell pertussis vaccine combined with vaccines for tetanus and diphtheria was widely introduced and given to infants and children in the 1940’s. This was a highly effective vaccine. It not only prevented disease, but also prevented colonization and therefore stopped transmission of pertussis. It reduced the cases of pertussis by 75%. Unfortunately, the whole cell vaccine had rare but concerning side effects.These iincluded persistent crying, febrile seizures and hypotonic-hypoeresponive episodes (HHE). Children with HHE had sudden onset of reduced muscle tone, decreased responsiveness to verbal or other stimuli, and change in skin color (pallor or cyanosis) that occurred shortly after vaccination. These adverse events, though temporary were obviously distressing to parents. There were also rare cases of encephalopathy (Inflammation of the brain) that caused permanent disability. These cases were so rare that it was impossible to know whether these permanent disabilities were caused by the vaccine, or were simply associated but not causal. Controversy over whether the vaccine had any role in these cases continues even today.

Acellular pertussis vaccine

Because of the rare but distressing side effects of whole cell pertussis vaccine, a new vaccine was developed that had components of the pertussis bacterium, but not whole cells. This was called the acellular vaccine. This acellular vaccine had far fewer and milder adverse reactions than the whole cell vaccine. The combination vaccine is abbreviated DTaP (diptheria-tetanus-acellular pertussis). This is the vaccine used for children today. Unfortunately the acellular pertussis vaccine is less effective than the previous whole cell vaccine. It does prevent children from getting ill with pertussis, but it does not prevent colonization of the nose and throat. Children who are colonized in this way are not sick, but they are infectious and can pass on the virus to other children and adults. This keeps the bordatella pertussis bacteria circulating in communities.

Waning Immunity

Neither the whole cell nor the acellular vaccine provides lifetime immunity, unlike the Measles-Mumps-Rubella vaccines, which do provide lifetime immunity. Even people who have pertussis do not get lifetime immunity. Immunity from vaccines and infection wane over time. It appears that the acellular pertussis vaccine gives good protection from getting sick from pertussis for about 4 years, and starts to wane after that. The result is that we still see pertussis even in fully immunized children and adults starting about 5 years after the last routine immunization, which occurs at between 4 and 6 years of age. A booster TDaP is also recommended at around 12 years of age. This means that the most vulnerable children, that is children 5 or under are protected from getting ill from pertussis. Infants below 2 months of age (too early for vaccination) are protected by the recommendation that all pregnant women get a booster TDaP vaccine in the third trimester of every pregnancy. Anyone who is going to have extended contact with an infant under 2 months should also get a booster TDaP.

Risk of resurgence of severe pertussis

Bordatella pertussis continues to circulate in communities because of colonization of immunized children. Resistance to vaccinating children with DTap can quickly cause a resurgence of pertussis in infants and young children. This would be disastrous and is already happening. In 2024, there were 35,435 documented cases of pertussis across the U.S., including 655 in Colorado. That was a huge jump over the 7063 cases in all of 2023. Large states, including New York and California, logged high numbers of pertussis infections in 2024. So did some less-populated states like Idaho, Washington and Oregon, each of which reported more than 1,000 cases of pertussis. There were 10 deaths from pertussis in 2024. Cases are on track to be even higher in 2025.

Research on new pertussis vaccines

The search is on for a new pertussis vaccine that prevents colonization but that also does not cause the distressing side effects that happened with the whole cell pertussis vaccine. The best candidate at the moment is a live vaccine that has been genetically modified to eliminate the toxins produced by the bacterium. If and when approved this vaccine will be administered nasally. In rhesus monkeys it prevented colonization with bordatella pertussis and had no significant side effects. It is currently in phase 3 trials in humans.

Bottom Line

Pertussis is a serious disease and is life threatening to infants and young children. The severity and duration of pertussis are not affected by antibiotics that are given to limit the spread of the disease. The only effective treatment of pertussis is prevention through immunization. Acellular pertussis vaccine is much safer but also less effective than the old whole cell vaccine. It allows bordatella pertussis to continue to circulate in communities. Resistance to immunization of children has led to a marked increase in serious pertussis infections in 2024 with 10 deaths reported. Pertussis cases are on track to be even higher in 2025. A promising new attenuated live pertussis vaccine is in phase 3 trials and may soon be approved assuming research funding is not withheld by the Trump administration.

Assault on Science

I recently read a very interesting book called Science Under Siege. The authors are Peter Hotez, pediatrician and vaccine researcher at Texas Children’s Hospital in Houston, Texas and Michael Mann, the prominent climate researcher who found strong evidence for manmade global warming. It is an excellent book and I highly recommend reading it. Public confidence in science has significantly declined since the pandemic, but the majority of polls continue to show strong support for science (see this link to the Pew Research Center). On the other hand, there is a well funded, sophisticated effort to discredit science and scientists. Many people do not understand how science is done, how it is funded, and its contributions to society. In this post I will write about all of those things, as well as the people and groups who are funding the assault on science and scientists.

What is the Scientific Method?

The scientific method is a systematic way to advance knowledge. Here are the steps of the scientific method: This excellent formulation is copied from a webpage from American Journal Experts.

  1. Define a question: Constructing a clear and precise problem statement that identifies the main question or goal of the investigation is the first step. The wording must lend itself to experimentation by posing a question that is both testable and measurable.
  2. Gather information and resources: Researching the topic in question to find out what is already known and what types of related questions others are asking is the next step in this process. This background information is vital to gaining a full understanding of the subject and in determining the best design for experiments. 
  3. Form a hypothesis: Composing a concise statement that identifies specific variables and potential results, which can then be tested, is a crucial step that must be completed before any experimentation. An imperfection in the composition of a hypothesis can result in weaknesses to the entire design of an experiment.
  4. Perform the experiments: Testing the hypothesis by performing replicable experiments and collecting resultant data is another fundamental step of the scientific method. By controlling some elements of an experiment while purposely manipulating others, cause and effect relationships are established.
  5. Analyze the data: Interpreting the experimental process and results by recognizing trends in the data is a necessary step for comprehending its meaning and supporting the conclusions. Drawing inferences through this systematic process lends substantive evidence for either supporting or rejecting the hypothesis.
  6. Report the results: Sharing the outcomes of an experiment, through an essay, presentation, graphic, or journal article, is often regarded as a final step in this process. Detailing the project’s design, methods, and results not only promotes transparency and replicability but also adds to the body of knowledge for future research.
  7. Retest the hypothesis: Repeating experiments to see if a hypothesis holds up in all cases is a step that is manifested through varying scenarios. Sometimes a researcher immediately checks their own work or replicates it at a future time, or another researcher will repeat the experiments to further test the hypothesis.

This is clearly not an easy process. There must be transparency at every step so that other researchers can evaluate the methods and repeat the experiments to be sure they get the same results.

How are scientific findings published?

Once results are obtained from a scientific study, a paper describing the results is prepared by the authors. There are usually several authors for any scientific paper. The principal investigator prepares the initial draft and sends it to his/her colleagues. There are usually many drafts and modifications before a final paper is ready to submit. The final paper as agreed upon by the authors is submitted to a peer reviewed scientific journal. The paper is first reviewed by the editor of the journal. If the editor feels there is significant problem with the paper or if he/she thinks it is not appropriate for readers of the journal then the editor can reject the paper. If the paper passes editorial review, then it is sent to at least 3 scientists in the same field for evaluation. These are called peer reviewers. Each reviewer writes a review of the paper, which are sent to the editors of the journal and to the authors of the paper. The reviewers often suggest modifications to the paper. The journal editor may reject the paper based on the reviewers comments, may suggest that modifications be made and the paper be resubmitted, or much more rarely may accept the paper for publication based on positive reviews from the peer reviewers.

As I can attest from my own numerous scientific publications, the acceptance of a paper by a peer reviewed journal is a long and rigorous process. I have also had papers rejected by the editor and after review by peer reviewers.

Very rarely, investigators publish papers based on fraudulent data. This is usually discovered eventually and the editors then publicly retract the paper. This happened to Andrew Wakefield with his publications about a connection between MMR vaccine and autism in the medical journal the Lancet. All of these papers were found to be based on fraudulent data and were retracted. He actually lost his medical license in the UK because of this. Subsequent large very well designed studies showed no connection between vaccines and autism. This is an example of how the scientific method advances knowledge.

Double blind randomized controlled trials

This kind of trial is the gold standard of scientific research. Subjects for the research are recruited and are randomly assigned to either the experimental group or the control group. Great care is taken to be sure that the selection for either group is completely random. The size of the two groups has to be large enough to ensure that any factors that might bias the results should be balanced out in the two groups by the random selection. The intervention being tested (usually a medicine or other treatment) is given to the experimental group and an identical placebo (inactive) pill or intervention is given to the control group. The investigators administering the treatment don’t know whether they are administering the experimental treatment or the placebo, and they also don’t know which people are in the experimental or the control group. That’s why this kind of trial is called “double blind.” The code for which patients got the experimental treatment and which got the placebo treatment is not broken until the end of the trial. Double blind randomized controlled trials give the most reliable bias free results, but they are very expensive to conduct. There are other kinds of trials as well, because not every research question lends itself to a randomized controlled trial. Almost all well designed research is expensive to conduct. In the next section I will write about how research is funded.

How research is funded

Most research is conducted at academic institutions. Funding for research has to cover the salaries of the researchers and their staff, and the research infrastructure of the institution. All of that is very expensive. Almost all research is funded by grants, either federal (National Institutes of Health (NIH) or National Science Foundation (NSF) or private foundations. Most large grants are federal.

Grant application process

Some grants are designed for application by institutions themselves but most grants are applied for by research scientists. Application for a scientific grant is a major involved process. There is a 12 page limit for the main application for an NIH grant, but supplementary documents required like budgets and investigator bio sketches can run to 150 pages. Each federal grant application is evaluated by a study section composed of eminent scientists in the field. Funding is only available for a small number of grants so most grant applications are rejected. If the study section gives the grant a good score the grant may be awarded to the institution or the investigator. Even if the grant is awarded to the investigator, the grant money is administered by the institution. It never goes directly to the investigator. A percentage of each grant is used by the institution to pay for its research infrastructure. The rest is used by the institution to pay the investigator’s salary and to pay for the costs of the research. Private foundations each have their own rules for grant applications, but they are also difficult to get. Grants from private foundations are usually, but not always smaller than federal grants.

Are scientific results truth?

Science is a systematic way to search for truth about how the world works and how we can successfully manipulate it to get desired results. It is a mistake to put too much emphasis on the results of one study. When many studies find the same or similar results, we have increasing confidence that the results represent truth, but never absolute. Scientific results are always to some degree provisional. That does not mean they are not useful.

Benefits of science to society

Rather than enumerate the benefits, here is a link to a University of California website that explains the benefits much better than I can. As the webpage points out, the benefits of science to society are substantial.

Attacks on science and scientists

Because science is a systematic search for knowledge, the findings of some scientific studies are often inconvenient for certain groups or individuals with ideological beliefs. Some scientific findings also threaten some wealthy people whose wealth comes from industries that scientific results threaten. The fossil fuel industry, for example, has created huge wealth for companies and individuals. Climate science has clearly shown that CO2 emissions from fossil fuels is causing rapid global warming that will be catastrophic if CO2 emissions are not drastically reduced. Scientific research has also been instrumental in developing alternative energy sources such as solar, wind, and others that have become economically viable. The fossil fuel industry has invested tremendous amounts of money to attack these findings. They work at creating the idea that these well validated scientific results are controversial. They hire people with academic credentials who question that CO2 emissions are causing climate change. This kind of opposition research is rarely published in peer reviewed journals. Front groups are created as well as PACs to lobby legislators that are funded without revealing the source of those funds. This is so-called dark money, but it has been shown to come primarily from people who get their wealth from fossil fuels. Koch industries is a good example. There also is a large industry that promotes supplements, vitamins, and alternative medicines that have no basis in science. This industry attacks legitimate health research as well as proven preventive treatments, particularly vaccines for children and adults.

These attacks on science are sophisticated, coordinated, and so far unfortunately very effective. In addition prominent scientists have been subpoenaed to appear before hostile congressional committees, harassed and threatened with arrest and/or bodily harm. These things are well documented in the book by Hotez and Mann.

Bottom Line

Science is a systematic way to advance knowledge. As results are validated by multiple well designed studies we find out more about the world and how to manipulate it to our benefit. Publication of scientific results in peer reviewed journals is a difficult and rigorous process. Almost all science is done in academic institutions and is almost entirely funded by federal grants and grants from private foundations. Obtaining grant funding is also a very rigorous process. Grants are administered by institutions and grant money is never given directly to investigators.

Wealthy people who stand to lose money because of scientific findings are conducting a sophisticated, well funded campaign to attack scientific results they don’t like and to discredit, harass, and threaten legitimate scientists.

Autism: Is There An Epidemic?

HHS Secretary Robert F. Kennedy Jr has declared that there is an epidemic of autism and that there must be some environmental toxin that is causing it. The evidence says otherwise. I will review the evidence in this post.

Increased diagnosis of autism

There is no question that autism is being diagnosed more frequently than in the past. According to the CDC, in 2000 the prevalence of autism was 7 per thousand 8 year old’s and by 2024 was 32 per thousand, a 4.5 times increase.

Evolution of diagnostic criteria for autism

Up until 1980, autism was considered a form of schizophrenia in children. It was thought to be rare, probably because many of these children were institutionalized. Over the various versions of the DSM (Diagnostic and Statistical Manual) criteria over the years, the criteria to diagnose autism have been constantly expanded, resulting in a progressive increase in the frequency of the diagnosis of autism. In the most recent version of the DSM all the subcategories of autism including Asperger’s disease were combined into one diagnosis – autism spectrum disorder. This resulted in a marked increase in the diagnosis of autism, because it included all the less severe forms of autism. There is an excellent description of this evolution on the Arizona Autism United blog: How the Autism Diagnosis Has Evolved Over Time.

Has the frequency of severe autism increased?

Severe or profound autism includes children who have no or little speech, are intellectually disabled, and some have challenging behavior that interferes with safety and well being. According to the CDC, people with severe autism make up about 26% of people with autism. Kennedy says that severe autism has markedly increased. According to Christine Ladd-Acosta, who is the vice director of the Wendy Klag Center for Autism and Developmental Disabilities, the data show that severe or profound autism has increased little or none in the last 10 years. Maureen Durkin, another well known autism researcher, divided autism cases up into different buckets. She found that severe autism has not increased at all, and in fact has decreased a little.

Screening for autism spectrum disorder

The American Academy of Pediatrics began recommending screening children for autism spectrum disorder in 2006. Screening is recommended at well child visits. There is some controversy about the benefits of screening children with no symptoms, but it is clear that screening has increased the diagnosis of autism spectrum disorder, especially milder forms of autism. Screening has also resulted in earlier diagnosis of children with more severe autism. Earlier intervention improves the outcomes in these children.

Causes of Autism Spectrum Disorder

Genetic Causes

Multiple studies including identical twin studies have shown the cause of 80% of autism spectrum disorder cases are genetic. Here is a link to an NIH article that summarizes these studies. Genetic causes are both hereditary and caused by genetic mutations.

Environmental causes

There are certain environmental factors associated with slightly increased risk of autism spectrum disorder. All of these factors account for a very small increase in the incidence of autism spectrum disorder, each less than 1%.

  • Advanced parental age
  • Prenatal exposure to air pollution or certain pesticides
  • Maternal obesity, diabetes or immune system disorders
  • Extreme prematurity or very low birth weight
  • Birth complications leading to periods of oxygen deprivation to the baby’s brain

Do childhood vaccines cause autism spectrum disorder?

The answer to this is a definite no. Multiple large well designed studies have shown no association of vaccines, or any component of vaccines including thimersal and aluminum that have any association with autism spectrum disorder. Here is a link to an article from the CDC summarizing these studies.

Does taking Tylenol (acetaminophen) during pregnancy cause autism?

Once again the answer is no. There were a few small studies that showed an association of acetaminophen during pregnancy and development of autism spectrum disorder. Larger, better designed studies have shown no association of acetaminophen use during pregnancy and subsequent development of autism spectrum disorder in children born from those pregnancies.

Autism spectrum as neurodiversity

Many people with milder forms of autism spectrum are fully functional and live independently. They view themselves as on a spectrum of neurodiversity rather than having a disorder. Here is a link to an article from Autism Speaks describing the idea of neurodiversity.

Bottom Line

The increase in the incidence of autism spectrum disorder is almost entirely due to increased diagnosis and increased awareness. The cause of 80% of autism spectrum disorder is genetic. There are a few environmental causes that have increased over time, but these account for only a tiny portion of the increase. There are many well designed studies that show that vaccines do not cause autism spectrum disorder. There are also similar large well designed studies that show that taking acetaminophen during pregnancy does not cause autism spectrum disorder in the babies born from those pregnancies.

Many people on the autism spectrum are fully functional and live independently. They view themselves as people with neurodiversity rather than people with a medical disorder.

There is a very good podcast called Science Versus that reviews all of the evidence that I have outlined above. It is worth listening to. Here is a link to the transcript of the podcast. You can listen to the episode on your normal podcast app. The show notes for the episode has all the references that are used in the episode.

mRNA Vaccines – Truth vs Misinformation

Robert F Kennedy Jr has stopped funding for research to develop new mRNA vaccines because he says they don’t work well for respiratory diseases. He also claims that mRNA vaccines induce mutations in respiratory viruses. He says that even one mutation makes mRNA vaccines ineffective. Here is a link to his video post on X where he makes these claims. He also claims that he has consulted science experts who agree with him about mRNA vaccines.

In this post I will review the real science about mRNA vaccine technology, how mRNA vaccines differ from traditional vaccine technology and also discuss how viruses mutate and why (spoiler alert: they don’t mutate because of mRNA vaccines). Here is a link to a STAT news article that deconstructs Kennedy’s arguments: Kennedy’s case against mRNA vaccines collapses under his own evidence.

Traditional vaccines

There are two types of traditional vaccines, live vaccines and killed vaccines. Both types require growing the target virus in tissue culture. In a live vaccine, the virus is weakened so that infection does not cause the disease when injected into people with healthy immune systems. The MMR vaccine is an example of a live vaccine. It contains weakened strains of measles virus, mumps virus and rubella virus. Killed vaccines use some proteins from the virus to sensitize the immune system to kill the virus when it detects those proteins. the DPT vaccine is an example of a killed vaccine. It contains protein fragments from the diphtheria virus, pertussis (whooping cough) virus and tetanus virus. It is very labor intensive to create a vaccine using these traditional methods. To make enough weakened virus or virus protein fragments to immunize a large population takes a lot of tissue culture and a long time. It usually takes 10-15 years of research and development before new traditional vaccines are ready to use. Manufacturing those already approved vaccines is still very labor intensive.

What is mRNA?

The m in mRNA stands for messenger RNA. The genes in your DNA can’t do anything by themselves. They don’t directly make proteins. Instead they code for messenger RNA. Messenger RNA does the work of making proteins that determine hair color, eye color and all other genetic traits. Each type of messenger RNA is specific for a particular protein. Messenger RNA does not last very long in animal (or human) cells. It lasts from a few minutes to a few hours and then it disappears. The DNA makes more messenger RNA as needed.

How does an mRNA vaccine work?

The advantage of an mRNA vaccine is that the body does all the work of manufacturing the virus protein fragment. No intensive tissue culture is required. mRNA is synthesized in a laboratory. The synthesized mRNA codes for a specific virus protein. In the case of the COVID mRNA vaccine, the mRNA codes for the spike protein. When that mRNA is injected into a muscle, the muscle cells start to make many copies of the spike protein. The immune system recognizes this as a foreign protein and makes antibodies against it as well as sensitizing killer lymphocytes so that they recognize the protein too. Just like the body’s own mRNA, the injected mRNA only lasts for a few minutes to a few hours and then disappears. It never changes the DNA in the cell, because DNA makes mRNA, not the other way around.

How does mRNA vaccine speed up the vaccine development process?

We now have the technology to rapidly determine all the genetic code of a new virus. That sequencing can happen within a few weeks of discovering a new virus. That genetic code allows us to determine which proteins make up the virus particle. We can then decide which viral protein is the best to stimulate immunity to the virus and synthesize an mRNA molecule that will make that protein in human muscle cells. That process is much faster than the traditional method. We had an effective mRNA COVID vaccine within a year of the beginning of the pandemic. That is an absolutely unprecedented time scale in new vaccine development.

Do mRNA vaccines induce mutation in viruses

This is what Kennedy claims and it is absolutely not true. Some viruses, like COVID and flu virus mutate frequently and some like measles virus and polio virus are stable and do not mutate or mutate rarely.. The mutation rate depends on the nature of the virus, not on the vaccine. All vaccines, not just mRNA vaccines for viruses that mutate frequently lose some efficacy over time and the vaccine has to be modified. The viruses that mutate frequently would continue to do that whether a vaccine is available or not. Vaccines do not make viruses mutate faster. Most mutations make the virus less infectious, but the occasional mutation makes the virus more infective. The mutations that are more infective become more frequent and crowd out the older versions of the virus. Measles and polio vaccines prevent infection because the measles and polio viruses stay exactly the same over time.

Safety of mRNA vaccines

The only mRNA vaccine that we have extensive experience with are the ones developed for COVID. Mild reactions were common (sore arm, fever. myalgias) more commonly with the second dose. Rare cases of myocarditis (inflammation of the heart muscle) were reported in younger people. All of these were transient and completely resolved. There is a very tiny chance of having a severe allergic reaction to the vaccine. Out of 8 billion doses administered death due to allergic reaction occurred in 14 people. That is a risk of death of 1.75 x10-9 (1.75 preceded by 9 zeros!).That risk is much, much smaller than the risk of being killed in an auto accident. The risk of death from COVID in unvaccinated people is of course much higher. mRNA vaccines are safe with a minuscule risk of severe side effects.

Why do people still get influenza or COVID even after they have been vaccinated.

Antibodies induced by flu and COVID vaccines are in the blood stream and not as much on the mucus membranes. Although vaccinated people are less likely to get infected with influenza or COVID, the protection rate from infection is less than 100%. Vaccinated people can still get infected with influenza or COVID. The vaccine induced antibodies immediately start fighting the infection. This means that vaccinated people who get infected are much less likely to get severe infections, much less likely to be hospitalized and are much more likely to have mild symptoms. You get a great deal of protection from the vaccine even if you get infected with the virus. Kennedy asserts that if you get infected with the virus, then the vaccine does not work. That is poppycock!

Research into new mRNA vaccines

Researchers can now use AI to develop universal mRNA vaccines for COVID and influenza that could develop immunity to multiple genetic variants at the same time. This technology would mean that new vaccines don’t have to be developed every year to deal with new genetic variants. This technology also might make it possible to develop vaccines for malaria and leptospirosis. It may also be possible to use this technology to develop vaccines that sensitize the immune system to destroy cancer cells.

All of the federal funding for research using this promising technology has been blocked by HHS secretary Robert F Kennedy Jr.

Bottom Line

mRNA vaccines can be developed much faster than traditional vaccines. They are safe and effective at both preventing disease and making disease much milder when infection does occur. mRNA technology has the potential to make universal flu and COVID vaccines, vaccines for malaria and leptospirosis and even vaccines to prevent cancer. It is unconscionable that federal funding for this important research has been halted.

Empathy vs Compassion

I recently read a fascinating book by psychologist Paul Bloom called Against Empathy: The Case for Rational Compassion. In this post I will discuss this book in more detail as well as review other evidence about the difference between empathy, theory of mind, and compassion. I will also discuss how Bloom’s book has been misused by some right wing Christians.

Empathy

Definition of Empathy

Most definitions of empathy include vicariously feeling the same emotions as another person and understanding another person’s perspective. Psychologists separate these two things. Vicariously feeling another person’s emotions or pain is called emotional empathy. It is neurologically distinct from understanding another person’s perspective, which is called cognitive empathy or theory of mind. Bloom focuses his critique on emotional empathy, not theory of mind.

Emotional Empathy

Emotional empathy is hard wired into us. It is a mostly unconscious response to another person’s distress. It can motivate us to be kind and helpful to the person or people who elicit this response. It can also lead to harm and even violence. Much more about that later in this post. Emotional empathy is a system 1 response. I’ll explain what that means below.

System 1 and System 2 modes of thinking

System 1 and system two are descriptions of of two ways that our minds operate. It is a somewhat simplified model, but it is consistent with current neuroscientific research. The best accessible description of system 1 and system 2 is a book by Daniel Kahneman called Thinking, Fast and Slow. I highly recommend reading it.

System 1 is what we use for most routine tasks in our lives. It is our fast, automatic, intuitive and emotional mode of thinking. It operates without conscious awareness and relies on mental shortcuts to make quick judgments and decisions. System 1 is essentially our brain’s “autopilot” mode, constantly monitoring our surroundings and making rapid assessments. It is essential to our lives, but , it’s also important to be aware of its limitations. It can sometimes lead to errors in judgment, particularly when dealing with complex or unfamiliar situations. 

System 2 thinking is a deliberate, conscious, and effortful process used for complex tasks and decisions. It is characterized by logical reasoning, careful analysis, and consideration of multiple factors. Unlike System 1 (fast, intuitive thinking), System 2 requires focused attention and effort.

Emotional empathy as a system 1 mode of thinking

Emotional empathy happens without our conscious awareness. It is contextual. Bloom cites research that emotional empathy is influenced by what we think about the person we are empathizing with and how we judge the situation that person is in. In one study subjects were shown videos of people in pain said to be suffering from AIDS. Some of the people in the videos were described as having gotten AIDS from intravenous drug use and some were described as having gotten AIDS from a blood transfusion. Subjects showed much more empathy for the people who were described as having gotten AIDS from a blood transfusion than those described as having gotten AIDS from intravenous drug use.

Emotional empathy is also influenced by the group to which the other person belongs. Is it one of Us or one of Them? There was a study of a painful shock to the hand in European soccer fans. One person was shocked while others witnessed the person who was shocked. Subjects showed more empathy if the person was a fan of the subject’s team and much less empathy if the person was a fan of the opposing team. All of these responses were shown to be below the level of consciousness. When subjects were asked about the reason for the difference in their empathy scores, they denied that there was any bias.

Does high emotional empathy correlate with good behavior?

People do vary in how empathic they are. On one end of the spectrum are people who have a high emotional empathy response, and on the other end of the spectrum are people who have very little emotional empathy. We would expect that people with a high emotional empathy response would be more likely to take action to help. People with high emotional empathy feel peoples’ distress more strongly and this should motivate them to help if for no other reason than to reduce their own distress. Another way that they could reduce their distress, however, is to escape rather than help. We would also expect that people with very low emotional empathy would have more cruel or violent behavior.

It turns out that there is almost no correlation with empathy and good or bad behavior. A meta-analysis of all the studies showed that low empathy has no association with aggression, and high empathy has minimal to no effect on good behavior. To quote Bloom, “Being high in empathy doesn’t make one a good person and being low in empathy doesn’t make one a bad person.”

Emotional empathy as a spotlight

Emotional empathy acts like a spotlight. To quote Bloom again, “making visible the suffering of others making their troubles real, salient and concrete.” The spotlight effect is a weakness as well as a strength. When you point a spotlight at something, everything else is in darkness. What you see depends on where you point the spotlight. This focus effect makes you more vulnerable to bias. It also leads to something called “the identifiable victim effect.” This sets up a situation where one identifiable victim elicits more emotional empathy than than a thousand victims. Stalin once said “One death is a tragedy; one million deaths is a statistic.” We also see this effect in deaths from the COVID pandemic. Eighty percent of Americans do not know anyone who died from COVID, though over a million Americans died from the COVID pandemic. The people who died were disproportionately elderly, black or poor. For people outside of those groups there was no emotional empathy spotlight effect. That is likely why so many people were not convinced that COVID was a serious disease.

The dark side of emotional empathy

Emotional empathy where there is conflict between groups can exacerbate conflict, even wars. People on one side feel empathy for members of their group who feel they have been harmed by the other side. Empathy with your side leads to the desire to punish the perpetrators. Of course people in the group on the other side of the conflict feel emotional empathy for the people on their side and therefore want to punish the other group. In these kind of situations emotional empathy exacerbates rather than mediates conflict between groups.

Burnout

People in the helping professions (doctors, nurses, therapists) do not do well when they experience high emotional empathy with all their clients. Experiencing the pain and suffering of patients, even though empathic suffering is not as severe as the suffering of the patient, is not pleasant. Over time, symptoms of burnout can develop. These include fatigue, poor concentration, lack of energy and effectiveness, cynicism and detachment.

Manipulating emotional empathy

The emotional empathy response can be manipulated for good causes, but also for things that are morally suspect or wrong.

Charities

Charities understand that eliciting emotional empathy will increase donations. They do this by showing images of individual people or animals who are obviously in distress. Stories go with the images about the suffering of this individual person or animal. Since we have an increased emotional empathy response to children in distress, the charity ads often use images of children. The emotional empathy response is not a good way to decide which charities should get your donations. Some charities do much more good for a lot more people than others. All charities, both good and not so good use the same techniques to manipulate emotional empathy. There is a better way to decide which charities should get your donations. More about that later in this post.

Politicians

Politicians often highlight individual people to manipulate the emotional empathy response to recruit people to vote for them or to take one side or the other in political and policy battles. Once again, this is not a good way to choose which politician or which policies you want to support.

The Christian right

There have been several recent books by right wing Christian authors who have cherry picked Paul Bloom’s critique of emotional empathy. Essentially anything or anyone that elicits empathy that contradicts their view of Christianity is termed “toxic empathy.” This is just another manipulation of empathy in a negative sense that promotes a particular religious viewpoint.

Compassion

Definition of compassion

Psychologist Paul Gilbert defines compassion as basic kindness with a deep awareness of the suffering of oneself and of other living things coupled with the wish and the effort to relieve that suffering.

Compassion as system 2 thinking

Understanding (rather than feeling) the suffering of a person or group of people uses system 2 thinking. That understanding facilitates the desire to help in the most effective way possible. Determining the most effective way to help requires logical reasoning, analysis, and consideration of multiple factors. These are characteristics of system 2 thinking.

Awareness of the vast amount of suffering in the world does not mean that an individual person can help relieve the suffering of all sentient beings. Compassion involves choosing both how and whom one can help the most.

Compassion in the helping professions

As noted above, emotional empathy alone can lead to burnout. It can also lead to less than ideal doctor-patient relationships. Patients are not interested in doctors or nurses feeling their pain. They want compassionate competent care. Doctors, nurses and therapists must of necessity maintain a certain emotional distance from their patients in order to provide that compassionate care. Compassionate care clearly involves mostly system 2 thinking. Unlike emotional empathy, understanding and compassion lead to the opposite of burnout. Multiple studies have shown that compassionate care is good for both patients and their clinicians. Here is a link to a review of a book by Dr. Anthony Mazzarelli and Dr. Stephen Trzeciak: Wonder Drug: Scientific evidence that serving others is best medicine.

Compassion training

It is possible to enhance compassion through training. For over a thousand years buddhists have practiced a form of meditation on compassion called “loving kindness” meditation. It involves both compassion for self and then expanding to family, friends, and eventually all sentient beings. Here is a link to a website that describes this kind of meditation: Metta Meditation: A Complete Guide to Loving-Kindness. There are many other ways to enhance one’s ability to be compassionate including cognitively based compassion training, Stanford multidisciplinary research based training, as well as many others. They have all been shown to increase compassion, which in turn leads to helping others. Once again compassion for self and others is as good for the helper as it is for the one who is helped

Bottom Line

You cannot turn off emotional empathy, nor should you even try. It is an automatic system 1 response. When combined with understanding and compassion it is always a good thing. It makes suffering visible and salient. The important thing is to learn to recognize your emotional empathy system 1 response and then engage your system 2 understanding and compassion. Emotional empathy by itself is not good or bad, but can be either. Your capacity for understanding and compassion (which is essentially kindness) can be enhanced by training. We definitely need more kindness in our world today.

MAHA Fact and Fiction

We have all lately heard a lot about MAHA (Make America Healthy Again) from Robert F Kennedy Jr. Some of the things he is advocating probably would improve the health of Americans, but many would not only not improve health, but would make it worse. In this post I’m going to try to identify the good parts and debunk the rest.

Food Dyes

Kennedy wants to eliminate “synthetic” food dyes except for “natural” ones. Food dyes have no nutritional value and many have never been adequately tested in humans. That does not mean they are toxic or cause disease. The only food dye that has been shown to be possibly toxic to humans is red dye #3 also known as erythrosine. It has already been banned in food and cosmetics. For other food dyes we simply do not know how safe they are for human consumption. . The FDA has recently approved 3 plant based food dyes:

  • Galdieria extract blue, a blue color derived from the unicellular red algae Galdieria sulphuraria.
  • Butterfly pea flower extract, a blue color that can be used to achieve a range of shades including bright blues, intense purple, and natural greens. This dye is produced through the water extraction of the dried flower petals of the butterfly pea plant
  • Calcium phosphate, a white color approved for use in ready-to-eat chicken products, white candy melts, doughnut sugar, and sugar for coated candies.

We don’t know any more about the safety of long term use of these plant-based dyes in food than we know about synthetic dyes. Just because they are extracted from plants does not make them safer. The drug digoxin was originally extracted from the foxglove plant. Taking too much of that can kill you. The most conservative thing to do is to ban food dyes, period. That would take congressional action, which is most unlikely in the current congress.

There is no evidence, by the way, that any currently used food dyes cause cancer or other diseases. There is just very little evidence about whether they are safe or not.

Emulsifiers

Emulsifiers are added to foods to prevent separation of oil and water in foods. They also can increase shelf life. Some are natural products like guar gum and some are synthetic. Emulsifiers are not new and have been used for hundreds of years. There is some evidence that certain emulsifiers may adversely affect the gut microbiome. Most of this work has been done in mice, so it is not clear whether emulsifiers have the same effect in humans. Emulsifiers are used most extensively in processed and ultra-processed foods. Unprocessed foods do not contain emulsifiers. Once again, the jury is out on whether emulsifiers have adverse effects in humans, but they might have an effect on the gut microbiome and promote inflammation and they might not. Kennedy is opposed to all emulsifiers in food. This is not exactly a nuanced perspective, as is the case with all his recommendations and obsessions.

Other Food Additives

There are hundreds of substances added to foods. Here is a link to an FDA list of all substances added to foods that are approved by the FDA or are GRAS (generally recognized as safe): Substances Added to Food. This list is 80 pages long! I have to say that I agree with Kennedy on this one. Already, all of these additives have to be listed on the contents label. If there are more than three things on the contents label that you don’t recognize, leave it on the shelf!

Seed Oils

Kennedy (who is a lawyer, not a health expert, by the way) parrots many so called “natural” food advocates who say that seed oils have toxic by products and the wrong ration of omega 6 to omega 3 fatty acids. They maintain that seed oils cause inflammation and thus increase the risk of heart disease and other conditions like obesity and diabetes. The evidence does not support these claims.

What are seed oils anyway?

  • Canola (rapeseed) oil
  • Corn oil
  • Cottonseed oil
  • Soybean oil
  • Sunflower oil
  • Safflower oil
  • Grapeseed oil
  • Rice Bran oil

All of these are polyunsaturated (as opposed to saturated oils like animal fats, palm oil and coconut oil , which are not good for you in more than moderate amounts). They are more refined than cold pressed oils and a chemical process is used in the refining process. These chemicals, including hexane are volatile and completely evaporate during the refining process. There are no toxic by products in refined seed oils.

Health effects of seed oils – The evidence

Seed oils contain linoleic acid which is an omega 6 fatty acid. Multiple studies show that linoleic acid intake decrease the risk of heart disease and decreases , not increases inflammation. The best way to use these or any oil as a beneficial part of a healthy diet is stir frying vegetables, oven roasting fish, or crafting homemade salad dressings.

The correct ration of omega 6 to omega 3 fatty acids is not clear. To get both eat omega 3 fatty acids which are found in high amounts in walnuts and fatty fish. A good summary of the evidence on the good health effects of seed oils can be found on this Massachusetts General website: Seed Oils: Facts and Myths.

Beef Tallow

Kennedy thinks that using beef tallow for frying is healthier than seed oils. While beef tallow does make for delicious french fries, it is 100% saturated fat. Saturated fat can be healthy as a small part of your total fat intake, but eating exclusively animal fat vs unsaturated fat markedly increases the risk of heart disease, obesity and diabetes. Multiple studies over the years have confirmed increased risk from eating exclusively or large quantities of saturated fats. Kennedy has a video of him frying a whole turkey in beef tallow while saying that this is cooking the MAHA way. Here is a link to that video. In my opinion this is the height of irresponsibility.

Water Fluoridation

Kennedy cites studies that show decreased IQ in children who are exposed to fluoridated water. I have a previous post about the safety of water fluoridation. See this link. The bottom line is that these studies were done in countries and locales that had very high natural fluoride levels. There was no effect in these studies on the very low fluoride levels that are used in water supplies to prevent cavities in children. Banning water fluoridation will lead to excess tooth decay in the most vulnerable children.

Limiting foods that can be purchased with SNAP benefits

SNAP stands for Supplemental Food Assistance Program. It used to be called the food stamp program. Benefits are applied to a card that can be used like a credit card to purchase food. As of now households whose gross income is 130% or less of the federal poverty and whose net income is below the federal poverty level are eligible for SNAP benefits. The amount is determined by the number of people in the household. The federal government pays all of the benefits and 50% the administrative costs. The state pays the other half of the administrative costs. The Big Beautiful Bill Act will make substantial cuts to the SNAP program. More about that later.

People can use their SNAP benefits to purchase food, but not alcohol or cigarettes. Texas and Louisiana have just passed laws that also prevent using SNAP benefits to purchase soft drinks or candy. Kennedy has praised these new state laws. While it is true that soft drinks and candy are not healthy foods, excluding these from SNAP benefits is just a way to make lawmakers feel virtuous about limiting the food choices poor people make. It is not going to improve their nutrition because like non-SNAP households foods households buy on SNAP benefits tend to be ultra-processed foods. Healthy unprocessed foods are more expensive and require time to prepare and cook as well as requiring working appliances and cooking equipment. Families at or below the poverty level, who are often renting sub-standard housing are unlikely be able to afford to purchase or to have the time, and equipment to prepare and cook unprocessed foods. Non-SNAP households don’t do much better. See this link from the USDA: Foods typically purchased by SNAP households .One more MAHA recommendation that will likely not improve health!

What makes this even worse are the cuts to the SNAP program in the Big Beautiful Bill Act. Here is a summary of the cuts and when they will kick in:

  • Shifting SNAP costs to states by:
    • Requiring states to pay a portion of SNAP benefits for the first time in program history, up to 15%, based on their payment error rates, beginning in October 2027. Final negotiations in the Senate resulted in a temporary implementation delay for up to two years for states with high error rates. 
    • Increasing the state’s share of administrative costs from 50% to 75%. 
       
  • Restricting future adjustments to the Thrifty Food Plan, which will include cuts to SNAP benefits as well as benefit levels for The Emergency Food Assistance Program (TEFAP), SUN Bucks/Summer EBT benefits, and the Nutrition Assistance Program block-grant to Puerto Rico. 
     
  • Increasing the number of individuals subject to time limits on their SNAP benefits, including, for the first time ever, parents of school-aged children over 14 and older adults age 55 through age 64 by expanding work requirements and restricting waivers. 
     
  • Adds a time limit on benefits for veterans, currently homeless individuals and former foster care youth.
  • Eliminating funding for the SNAP Nutrition Education program. 

SNAP is (or was) the most effective hunger relief program in the U.S.

All of the above information on the changes to SNAP benefits comes from the Harvesters Community Food Network .

Vaccines

With no evidence whatever, the MAHA report calls current childhood vaccination schedules “overmedication.” It emphasizes exceedingly rare adverse effects of vaccines and promises to do “randomized trials” of current vaccine schedules. Randomized trials are routinely done before new vaccines are approved and repeating them will be inordinately expensive and delay vaccine approval. The result of this MAHA policy will mean that we will see serious childhood diseases again, some of which will result in hospitalization and some totally avoidable childhood deaths. We have already seen a resurgence of measles cases in 40 states. See my previous post about Vaccine risks in perspective.

Bottom Line

Kennedy has legitimate concerns about the unhealthy ultra-processed foods that most Americans eat. The concerns about food additives are also reasonable but overblown. These legitimate concerns are mixed in with conspiracy theories about toxic byproducts in seed oils, health benefits of beef tallow, and vaccines as a cause of autism. He completely ignores the fact that most poor people cannot afford to buy, prepare or cook healthy unprocessed foods. He is overall a danger to public health.

Trump Administration Assault on Health Care and Research

The Trump administration along with its rubber stamp republican controlled congress is conducting an unprecedented assault on US health infrastructure and on medical research. In this post I will write about the details of that assault and the current and likely future effects on people in the US and around the world.

HIV Funding Cuts

Funding has been cut for current studies on HIV vaccines being carried out by Duke University, The Scripps Research Institute and Moderna’s clinical trials. These vaccines showed great promise for preventing HIV infection.

The administration has eliminated the CDC HIV prevention division

Funding for the Presidents Emergency Plan for AIDS Relief has been eliminated. This program, begun in 2003 during the George Bush administration, has delivered lifesaving treatment to 25 million people in 54 countries and had previously bipartisan support. Without this funding, thousands of people around the world, especially in African countries will die. Children born with HIV are especially vulnerable.

Center for Disease Control cuts

The CDC has historically held a strong reputation as a global leader in public health. It has been considered the “gold standard” for national health agencies. In April of this year 2400 CDC employees’ jobs were terminated, shuttering whole programs at the agency. About 460 of those employees have been rehired. The Trump administration 2026 proposed budget cuts CDC funding by 50%. Much of CDC funding goes to state health departments, so state health departments will struggle and public health programs like TB treatment, and STD treatment will be understaffed if not eliminated entirely.

Vaccines

Robert F Kennedy Jr was appointed by Trump as head of HHS. He has a long history of conspiracy theories about vaccines. He recently fired all 17 members of the CDC immunization advisory panel and appointed 8 new members, many of whom have been critical of mRNA vaccines as well as other vaccines. Vaccines recommended by the panel have to be covered by insurance. It seems likely that rare side effects of vaccines will be emphasized and that vaccination rates will continue to fall in the US. Prepare yourself for the return of measles, pertussis (whooping cough), and maybe even polio.

Cuts to Medicaid

It is clear that Federal Medicaid funding will decrease substantially, but we won’t know how much until a final budget is worked out between the House and Senate. The Senate version cuts Medicaid even more than the House version. Medicaid cuts will not only affect the health of Medicaid recipients but will have downstream severe effects on the entire US healthcare system. This will include hospitals, physicians, federally qualified health centers, certified nursing facilities, and even insured persons (because premiums will increase). There is an excellent viewpoint piece in JAMA detailing all the damage to US medical care caused by substantial cuts in Medicaid spending. Here is a link to that article. It is worth reading.

Effects of Medicaid Cuts on the Medical Care Ecosystem.

Medicaid Work Requirements

The vast majority of Medicaid recipients who are able to work are working.  in 2023, nearly two-thirds of adults ages 19-64 covered by Medicaid were working and nearly three in ten were not working because of caregiving responsibilities, illness or disability, or due to school attendance, reasons that counted as qualifying exemptions from the work requirements under previous policies (Understanding the Intersection of Medicaid and Work: An Update). Arkansas is the only state that has previously tried work requirements for Medicaid recipients. The documentation requirements were such that over 18,000 people lost their Medicaid insurance, despite the fact that the vast majority of them were already working. If Congress passes Medicaid work requirements, millions of people will lose Medicaid. That means more emergency room care, more untreated chronic illness and more deaths.

Reduced Subsidies for Affordable Health Care Insurance Marketplace

The premium tax credits for the ACA insurance marketplace are set to expire in 2025. The House budget bill does not extend those tax credits. Without those tax credits millions of people will lose their insurance because they will not be able to afford the increased cost.

Cuts to Research Funding

National Institutes of Health (NIH)

The Current Trump administration budget includes a 40% cut in funding for NIH! This is completely unprecedented. If that level of budget cut happens, the NIH will be unable to award any new research grants for at least 3 years!

Importance of NIH Funded Research on Health

NIH funded research has resulted in numerous health benefits in the US and the world. These include improvements in chronic disease treatment and prevention, cancer diagnosis and treatment, infant and maternal health, identification and treatment of immune diseases, and a host of other benefits. Here is a link to an NIH website documenting the health benefits of NIH funded research: Improving Health.

Long Term Effects on US Research

The quality of research in the US has long been among the very best in the world. The US has attracted talented researchers from all over the world. The NIH budget cuts along with the cancellation of existing research grants makes the US a much less attractive place for researchers. The Trump administration focus on limiting immigration also makes the US much less attractive to talented researchers from outside the US.

A recent survey of US scientists was carried out by the prestigious science journal Nature. The survey found that 75% of US scientists were considering leaving the US (The Hill).

Recruitment of US scientists by other countries

A number of countries are actively recruiting top US scientists. They are offering not only funding, but also emphasizing academic freedom (Economic Times).

Bottom Line

The cuts to HIV treatment and HIV vaccine research will result in thousands of preventable deaths from HIV. The One Big Beautiful Bill Act (that is the actual name of the budget bill) will result in millions of people losing both Medicaid and ACA insurance. It will decimate medical research as well as severely compromise the US Public Health Service (because of the CDC cuts). The lack of emphasis on vaccines by HHS will likely result in continued lower vaccination rates with return of measles, pertussis, diptheria and polio. All of this will be a health care disaster.

Feel free to share this post. Also write your congressional representative and your senators. It may not help, but it can’t hurt to do what you can to mitigate this disaster in progress.

Water Fluoridation

This is another post responding to misinformation promulgated by HHS Secretary Robert Kennedy Jr. Misinformation seems to proliferate faster that true science-based information. Perhaps one way to combat this is for readers of these blog posts to share them as widely as possible to people they know.

Secretary Kennedy is opposed to adding fluoride to public water supplies. He maintains that adding fluoride to public water supplies causes lower IQ’s in children. Two states, Utah and now Florida have already banned fluoridation of public water supplies, mostly in response to his claims about the evils of water fluoridation. I will examine the evidence for these claims in this post

Positive effects of water fluoridation

The US Public Health Service recommends public water fluoridation at a level of 0.7 mg per liter. This level of fluoride in water reduces tooth decay in children by 25% even in children who do not brush or floss regularly. This therefore most benefits poor and marginalized populations for whom dental hygiene can be difficult. Public water fluoridation at this level is one of the most effective public health interventions. Tooth decay can lead to chronic inflammation, which can lead to many other diseases including heart disease.

Sources of natural fluoride

Fluoride occurs naturally in almost all water supplies through the erosion of rocks and soil containing fluoride. The levels of natural fluoride are usually too low to prevent tooth decay, but some water supplies have much higher levels of natural fluoride up to as much as 50 mg per liter in some mountainous and volcanic regions.

Adverse effects of high natural fluoride

Fluorosis

Fluorosis has two components. At fluoride levels greater than 1.5 mg/L children who have growing teeth can develop brown discoloration of teeth. This is called dental fluorosis and is mostly a cosmetic problem. Long term exposure to fluoride levels greater than 10 mg/L can lead to skeletal fluorosis, which is a much more serious condition.  In skeletal fluorosis the bones are generally weaker than normal with stiffness and pain in the joints as the early symptoms. In severe cases, muscles are impaired and bones in the central skeleton are irregularly thickened.

Lower IQ in children

In January of 2025 JAMA (Journal of the American Medical Association) published an analysis of combined data from many international studies that showed lower IQ scores in children exposed to higher levels of fluoride from all sources: Fluoride Exposure and Children’s IQ Scores. The study found that the higher the exposure to fluoride, the lower were the children’s IQ scores. This finding was statistically significant for levels above 1.5 mg/L but not at or below this level. None of these studies were done in the United States. The US Public Health recommendation of 0.7 mg/L is well below the threshold for association of lower IQ in children.

Other sources of fluoride

The most significant other sources of fluoride are supplements, toothpaste and oral rinses. For children who have fluoride at 0.7 mg\l in drinking water, fluoride containing supplements should not be given. Most toothpastes contain fluoride, so children with fluoride in the water supply should use only a pea sized amount of toothpaste per brushing and should be encouraged to spit out the toothpaste after brushing. If the water supply has not been fluoridated and contains only trace amounts of natural fluoride, then supplements should be given to children.

Bottom Line

Fluoridation of public water systems at the recommended concentration of 0.7 mg/L is safe and effective at markedly reducing tooth decay in children. There is no evidence that fluoride in water at this level has any adverse effects. There is some evidence that concentrations of higher than 1.5 mg/L are associated with modest decreased IQ in children. Elimination of fluoride from public water systems will increase tooth decay in the most vulnerable populations and will not have any benefit. Children who live in communities with fluoridated water should not take fluoride supplements, should use only small amounts of fluoridated toothpaste, and should be encouraged to spit out toothpaste after brushing and not swallow it. Communities who have high natural levels of fluoride in drinking water can reduce fluoride to safe levels by reverse osmosis or charcoal filter systems.