HEALTHY, WEALTHY, AND WISE (?)
Tylenol poisonings. AIDS. Rare killer viruses with no cures. Hamburgers that kill children and old people. Beef that makes you mad. Salmonellacontaminated chicken in the local grocery store. Pesticides on fruits and vegetables. Toxic shellfish. Milk pumped up with bovine growth hormones. Mexican food, Italian food, Chinese food, movie theater popcorn. According to media stories over the past few years, all of these are "harmful to your health"!
To add to the confusion, sometimes one piece of health news is followed within weeks by another that directly contradicts the first.
• In February 1995, the Centers for Disease Control told us that any kind of exercise improved life expectancy, even sporadic modest exercise. Then, two months later, a Harvard University study announced that only people who exercised strenuously and regularly enjoyed longer lives.
• A Danish study, published in the 6 May 1995 issue of the British Medical Journal, encourages the drinking of wine. According to the ten-year study, people who drink three to five glasses of wine a day live longer. However, other studies point out that the benefits of alcohol might not outweigh the risks.
• One study finds that eating fish doesn't prevent heart disease, as it is widely believed to do. Another study reports that reducing dietary fat to 30 percent of calorie intake doesn't help reduce the risk of heart disease--in spite of dozens of news stories to the contrary.
It's difficult to know what to embrace and what to fear. Questions cloud our attempts to apply the results of scientific research to our lives. We learn that food irradiation can kill potentially harmful bacteria, such as E. coli in beef and pork, and salmonella in chicken. But does irradiation carry unforeseen cancer risks?
Another example is caffeine. Eighty percent of Americans consume caffeine daily. However, a Johns Hopkins University report published in the Journal of the American Medical Association in October 1994 found that caffeine causes birth defects and is an addictive drug with classical psychoactive dependence. Other studies tell us that caffeine magnifies the risk of heart attacks and the effects of stress. Conversely, different researchers and food professionals assert that caffeine can protect against colon and rectal cancer, increase alertness and productivity, reduce suicidal tendencies, and increase sexual activity in the elderly. So what do we do, have that second cup of coffee or not?
And what is the difference between saturated fat, unsaturated fat, and polyunsaturated fat? Does fluoride help our teeth, or hurt our kidneys?
Help! We're continually bombarded with advice on health issues. A recent New York Times headline (10 May 1995) read, "Amid Inconclusive Health Studies, Some Experts Advise Less Advice"!
The overabundance of health advice can, itself, be harmful to our health. Dr. Donald Louria, chairman of preventive medicine and community health at the New Jersey Medical School in Newark, told the New York Times (10 May 1995) that "the danger of [overselling health advice to the public] is that they will not believe the stuff we have that's documented." In other words, the bona fide, scientifically sound health advice gets lost in the crowd. Another physician, Dr. Walter Willett of the Harvard School of Public Health, worries about the "lack of distinction between wishful thinking and solid facts in health advice. When a new study contradicts conventional wisdom, people throw up their hands and decide not to believe anything scientists say" (New York Times, 10 May 1995).
The good news is that our health has never been better in the history of mankind! According to the National Center for Health Statistics, as recently as 1890 the average life expectancy for Americans was just over 31 years old. By 1930, the average life lasted just under 60 years--almost doubling in only forty years. By 1990, the average life expectancy had reached 75.4, the highest in history. Infant deaths have dropped by half over the past twenty years, to just over 9 babies in every 100,000 born today (Los Angeles Times, 11 September 1994).
In addition, the death rate from heart disease (the No. 1 killer) has dropped27 percent since 1970. Deaths from stroke (the No. 3 killer) are down 44 percent. Smallpox is gone, and polio is almost gone. We can cure leprosy. Cancer deaths (the No. 2 killer) have increased, but this rise is mostly due to smoking and to the fact that we're living longer; other diseases don't get us first.
Nevertheless, in spite of this overwhelmingly good news, 78 percent of Americans still think that they face more risk than their parents did twenty years ago, according to researchers Marsh and McLennan in the Los Angeles Times (11 September 1994). Only 6 percent think that we face less risk. Why is this? It seems that we're scaring ourselves to death. The following information can help us sort through some of the many "scare stories" and the conflicting advice about our health.
BREAST CANCER SCARE
U.S. News and World Report describes "a breast-cancer epidemic": "Every three minutes, a woman is diagnosed, and every 11 minutes, a woman dies from the disease. It strikes one in eight women and kills 46,000 a year" (23 November 1992).
The National Breast Cancer Coalition sends a fundraising letter to millions of Americans. The letter reads, "We are at war. And our enemy is breast cancer. It attacks women brutally and indiscriminately. It has reached epidemic proportions in America ... . And if you think you're safe because breast cancer doesn't run in your family, think again. Three-quarters of new cases are diagnosed in women who have no family history of the disease."
The concerns about breast cancer being reported in the media are important. This dreaded disease is deadly, disfiguring, and physically and emotionally painful even if "cured." It's true that breast cancer is on the rise. At the same time, women can't walk around in terror of breast cancer. In fact, many studies have shown that anxiety predisposes people to diseases such as heart disease and even cancer.
Let's try to sort through the rhetoric on breast cancer to identify the real risks and arrive at an intelligent approach for women to prevent the disease.
Outlook (6 May 1995) reports on how the Women's Health Letter breaks down that famous "one in eight women" statistic. Those 1-in-8 odds refer only to women who live to be ninety-five. Three-quarters of diagnosed breast cancers occur in women over fifty. Breast cancer is primarily a disease of elderly women. Thanks to medical advances, we have more elderly people alive today in our society than ever before in history. If we have more casesof breast cancer, it's because we have more older women. That's the "epidemic."
It's true that there are more cases of breast cancer in young women than there were sixty years ago, because there are more younger women today, especially the baby boomers. Our population has increased. The number of cases has grown, but the rate of cases--the percentage of people in that group who get breast cancer--has not changed. The actual risk itself hasn't increased.
The Women's Health Letter (6 May 1995) stated that the 1-in-8 statistic doesn't describe a woman's immediate risk. Rather, women have different risks at different ages, with the risk increasing as a woman ages. Specifically, according to a chart developed by the National Cancer Institute, "A...