Misinformation

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.

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.
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.
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.
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.
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.
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.
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.

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.

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.

Is Sugar Poison? Do Food Dyes Cause cancer and ADHD?

In a March 28 speech in West Virginia, HHS Secretary Robert F. Kennedy Jr. said “So the loneliness, the dispossession, the crisis that we have in mental health, in suicide, in ADD, ADHD, all of these are linked — and particularly to the dyes,” Kennedy also said in that same speech, given alongside Gov. Patrick Morrisey, “It’s very clear the dyes that Gov. Morrisey is banning, all of them are linked in very, very strong studies to ADHD and to cancers. So we’re seeing an explosion in cancers in this country.” At a recent press conference he also said “Sugar is poison”

As usual, there is almost no evidence to back up these claims. There are some reasons to eliminate food additives and limit sugar intake. In this post I will talk about those reasons without making up spurious associations that have no real evidence.

Sugar

It is clear that too much sugar is not good for you. It can lead to tooth decay in children (which water fluoridation helps prevent). It can also lead to liver disease, increased triglycerides, obesity and heart disease. A modest amount is fine. High fructose corn syrup is a bigger problem, which Kennedy does not even mention. See my previous post Sugar and High Fructose Corn Syrup. Sugar in excess is not good for you. Modest amounts are not associated with any health problems. Sugar is not poison!

Food dyes and food additives

There are a number of food additives that have been proven to be safe. These include:

Guar Gum: A thickening agent derived from guar beans, used in various food products like ice cream and yogurt.
Xanthan Gum: A thickening agent and stabilizer used in salad dressings, soups, and sauces.
Inulin: A fiber substitute derived from chicory root, offering a smooth and creamy texture and supporting gut health.
Vinegar: A natural preservative, used in pickling, canning, and other applications.
Ascorbic Acid: The synthetic form of vitamin C, used as an antioxidant and preservative, also beneficial for immune support and iron absorption.
Monosodium Glutamate (MSG): Used as a flavor enhancer, generally considered safe.
Citric Acid: Naturally found in citrus fruits and used as an acidity regulator and preservative.
Beta-Carotene: A natural colorant used in various foods.
Riboflavin: riboflavin is just vitamin B2. It is a food additive used for both fortification and coloring. It’s a yellow to orange-yellow crystalline powder that is naturally found in many foods and also produced synthetically for use as a food additive.

Most other food dyes and additives have not been tested adequately to prove they are not toxic. There is no real evidence that they cause cancer or any other health problem, but there is also not adequate evidence that they are safe. Removing these dyes and additives is a good idea, but is going to be difficult to accomplish because they are used in highly processed foods that are the biggest money maker for the big food industry.

Plastics

Microplastics and chemicals that leach from plastic containers are a much bigger health hazard than food additives. There is good evidence that chemicals from plastics cause harm, including affecting the endocrine development of children. See my previous post Toxic Chemicals We Regularly Consume and How to Stop Consuming Them. Secretary Kennedy has not even mentioned the health hazards of plastics.

“Explosion of Cancer”

In fact the incidence of most cancers, particularly lung cancer have decreased in recent years. The incidence of some cancers have increased minimally. See this report from the National Cancer Institute: Annual Report to the Nation 2025: Overall Cancer Statistics. There is not an explosion of cancer in the US as Secretary Kennedy claims.

Bottom Line

Sugar is not poison. Too much sugar is bad for you but modest amounts are not. You should avoid as much as possible foods that have added sugar or especially high fructose corn syrup. Quite a few food additives have been proven to be safe. Many others have not been adequately tested for toxicity in humans, but there is no evidence for a specific health hazard for any of them. There is no convincing evidence that they cause mental illness, cancer or ADHD. Removing these dyes and additives would be a good idea but will be difficult. Chemicals leached from plastics in food containers have proven health hazards. People should switch to glass containers where possible. There is no “explosion of cancer” in the US.