His health, her health

Medications affect women differently than men but you wouldn’t know it from prescribed drugs.

Take the sleep drug Ambien, for example.  After the drug had been placed on the market, it was found to have a dramatically different effect on women. The U.S. Food and Drug Administration found that five times as many women were experiencing driving impairment eight hours after taking the drug. As a result, doctors now prescribe “sex-specific” Ambien which is a lower dose. In Canada the drug is sold under the name Sublinox. But sex-specific prescriptions are the exception rather than the rule.

Doctors prescribe the same drugs for men and women even though they have only been tested on men. Researchers have known about this weakness of drug trials for a long time. Dr. Marcia Stefanick, professor of medicine at Stanford University explains:

“Indeed, drug metabolism, tolerance, side effects and benefits differ significantly between the average man and woman for many widely prescribed medications, with women having a 50 to 70 per cent higher chance of adverse reaction (Scientific American, September, 2017).”

Despite knowing of the difference, few women are included in trials. In a review of 258 trials of cardiovascular treatments, only 27 per cent of the participants were women, and of those only one-third were reported by sex.

Despite years of “Red Dress” campaigns, most people and many physicians still think heart disease is a man’s disease. They are surprised to learn that heart disease is the number-one killer of women, far exceeding deaths from breast cancer. Physicians are less familiar with the symptoms of heart disease in women. In men, the main symptom is chest pain, whereas in women symptoms can include back pain, nausea, headache and dizziness. Women’s symptoms are seen as “atypical” because men don’t report them.

Chauvinistic blindness excludes half the population.

Heart disease also involves the build-up of plaque in the arteries. Men, and older women, tend to suffer from a blockage in one location. Younger women are more likely to have diffuse plaque along the entire artery with the same effect. Because a local block is not found in a younger woman, she could be diagnosed as “free from of heart disease” even though at risk of a fatal heart attack.

The other sex is sometimes overlooked in trials. Men are often neglected in studies for ailments thought to be unique to women. Osteoporosis, characterized by reduced bone strength, is considered a woman’s disease because white women are twice as likely to suffer a bone fracture as white men. As a result, fracture prevention trials include few men. But one-third of hip fractures are in men –and they have worse medical outcomes than women

Men are more susceptible to viral, bacterial, parasitic and fungal infections than women; the exception being sexually transmitted infections such as HIV and herpes which is more prevalent in women. However, women’s resistance to infection comes at a price. Women constitute 70 per cent of cases where a robust immune system attacks her own body in autoimmune diseases.

Professor Stefanick lauds the Canadian Institutes of Health Research for promoting the inclusion of sex and gender in drug trials and wishes the U.S.  Government would do the same. She adds:

“We need further mandates, through policy and funding restrictions, to ensure that female biology makes it into textbooks and testing protocols.”

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How to market sugar water

There’s no doubt that consumption of pop is harmful, even deadly but you’d never know it from the soft drink industry. Professor Paulette Nestle, nutritionist at New York University, is blunt:

“The science is clear. Kids and adults who drink pop tend to be heavier and have a higher prevalence of obesity, type 2 diabetes, heart disease, and tooth decay.”

coca_cola_bubbles

Studies funded by the soft drink industry find the opposite: roughly 85 per cent of them find pop to be harmless. And if there is a problem, they say, it’s your fault. No one is holding a gun to your head and forcing pop down your throat. The problem lies on the shoulders of individual consumers. It’s a matter of choice. If only consumers would exercise more.

However, consumers make choices on what they perceive about a product and the sugar water industry is persuasive. They spend millions of dollars on Super Bowl ads that avoid the product itself. Instead, they market deep emotional connections to friends and family. If I can find happiness in a can of Coke, why wouldn’t I drink it?

And if I can find my identity in a can of pop, all the better. Coke sells cans with my name on it and words such as Love and Superstar. Who wouldn’t want to support a corporation that supports the arts, community projects, and cleaning up the environment?

“When Philadelphia was considering a soft-drink tax, Coke offered to give the Children’s Hospital of Philadelphia $10 million. It’s that kind of thing,” says the author of eight books in a newsletter from the Centre for Science in the Public Interest.

It’s a standard tactic used by the merchants of misery. You see it used by proponents of Ajax mine in Kamloops. They don’t address the problems that the mine will create: like toxic dust, groundwater contamination, potential sludge spills, the environmental headache created by the mountain of tailings when they leave.

No, Ajax mine tells us how important copper is to our daily lives, how they will create jobs, how they support our university and the arts. To oppose the mine is to oppose family and community, they would have us to believe.

The sugar water industry has learned from the tobacco industry that you can counter science by creating doubt. Sure, 99 per cent of studies might find that consumption of tobacco causes cancer but if only one study is inconclusive, then maybe tobacco is not that bad. It’s human nature to hope that something we want will be OK despite mounting evidence to the contrary, something we are addicted to or feel a deep emotional connection to, something that will create jobs.

Another tool in the toolbox is to fund groups like the Global Energy Balance Network. The group employed scientists of considerable stature who found that lack of exercise, not diet, was responsible for the obesity epidemic. Then a reporter for the New York Times discovered that these scientists had been taking millions of dollars in research grants from Coca Cola including funding of the website.

One of these scientists said not worry about eating less, gobbling junk food, drinking pop. Just be more active. Would it were true.