Consumer Health Digest #01-52
Your Weekly Update of News and Reviews
December 24, 2001
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
Chiropractic VA legislation passes. The Department of Veterans Affairs Health Care Programs Enhancement Act of 2001 (H.R. 3447) requires the Department of Veterans Affairs to offer chiropractic services at many of its facilities. The bill was introduced on December 11th following an agreement by leaders of the Veteran Affairs committees of both houses of Congress. It passed the House that day and the Senate on the 20th. The American Chiropractic Association has stated that the measure was championed by a bipartisan coalition led by House Veterans Committee Chairman Chris Smith (R-NJ); Congressmen Jerry Moran (R-KS), Lane Evans (D-IL), and Bob Filner (D-CA); Senate Majority Leader Tom Daschle (D-SD); and Senators Strom Thurmond (R-SC) and Tim Hutchinson (R-AR). Its provisions include:
- The program shall be carried out at sites designated by the Secretary of Veterans Affairs for purposes of the program. The Secretary shall designate at least one site for such program in each geographic service area of the Veterans Health Administration. The sites so designated shall be medical centers and clinics located in urban areas and in rural areas.
- The chiropractic care and services available under the program shall include a variety of chiropractic care and services for neuro-musculoskeletal conditions, including subluxation complex.
- Establishment of a chiropractic advisory committee to advise the Secretary on protocols governing referral to doctors of chiropractic, direct access to chiropractic care, scope of chiropractic and other issues.
"Subluxation complex" is a not a medically recognized term. Chiropractors do not agree on what "subluxations" are or how they should be diagnosed. They also differ about how to find them and where they are located. In addition to seeing them on x-ray films, many chiropractors say they can find them by: (a) feeling the spine with their hand, (b) measuring skin temperature near the spine with an instrument, (c) concluding that one of the patient's legs is "functionally" longer than the other, (d) studying the shadows produced by a device that projects a beam of light onto the patient's back, (e) weighing the patient on special scales, and/or (f) detecting "nerve irritation" with a device. Undercover investigations in which many chiropractors have examined the same patient have found that the diagnoses and proposed treatments differed greatly from one practitioner to another.
Revised book blasts "subluxation" theory as hoax. Ludmil.A. Chotkowski, M.D., FACP, a retired specialist in internal medicine, has published a second edition of Chiropractic: The Greatest Hoax of the Century? The 208-page book, edited by Stephen Barrett, M.D., features case reports plus personal observations at two chiropractic schools, a chiropractic office, and a chiropractic lecture. Its central premise is that "subluxation" theory is a hoax that encourages chiropractors to do inappropriate spinal manipulations. Copies can be purchased for $15 from New England Books,1143 Chamberlain Highway, Kensington CT 06037.
Dietary advice for hypertensive patients. A study supported by the National Heart, Lung, and Blood Institute (NHLBI) suggests that the Dietary Approaches to Stop Hypertension (DASH) diet plus reduced dietary sodium can lower blood pressure for most people. [Vollmer WM. Effects of diet and sodium intake on blood pressure: Subgroup analysis of the DASH-sodium trial. Annals of Internal Medicine 135:1019-1028, 2001] NHLBI news release, Dec 17, 2001.] The diet emphasizes fruits, vegetables, low-fat dairy foods, whole grains, poultry, and fish and allows smaller amounts of red meat and sweets than does the typical U.S. diet. An accompanying editorial cautioned:
Although many studies have suggested that salt-restricted diets have beneficial effects, most [studies] measured surrogate end points, such as blood pressure or left ventricular hypertrophy [enlargement], rather than clinical outcomes, such as myocardial infarction and stroke. Vollmer and colleagues' trial advances knowledge concerning the magnitude and certainty of short-term effects of low-salt and very-low-salt diets on blood pressure. But given the difficulty of achieving and maintaining very-low-salt diets, the uncertain clinical benefits of either low-salt or very- low-salt diets, and the fact that other therapies have clearer proven clinical benefits, these findings do not give clinicians reason to move salt restriction to the top of the list of items to be discussed with hypertensive adults. On the other hand, it is easy to identify people who consume high-salt diets with a few simple questions. Such people may benefit from and are unlikely to be harmed by the following simple, sound advice: Eat fresh fruit and vegetables, don't add salt during food preparation or at the table, and avoid preprocessed prepared foods. [Mulrow M. Sound clinical advice for hypertensive patients. Annals of Internal Medicine 135:1084-1086, 2001.]
Drkoop.com files for bankruptcy. LifeCare Corp., which does business as Dr.Koop LifeCare Corp, has announced that it has filed Chapter 7 bankruptcy and will cease operations. The company was founded in 1998 by former U.S. Surgeon General C. Everett Koop. In November 2001, it launched a private-label line of "natural products" that were sold through Shop NBC and The Vitamin Shoppe. Under Chapter 7, a trustee will liquidate the company's assets. Koop's Web site, which has more than 18,000 pages, is one of the most heavily trafficked health information sites.
Consumer Health Digest changes distribution schedule. Starting with the next issue (1/1/02), this newsletter will usually be issued on Tuesdays rather than Mondays.
This page was posted on December 25, 2001.