Tuesday, February 17, 2009

What is Bill Maher's Religion?

Larry King interviews Bill Maher, February 14, 2009:

KING: From our blog, Chris writes, "Bill, what is your silver bullet for health care?"

MAHER: Well, eat right would be a good start. Stop eating that crap in the supermarket. I think most health problems are from lifestyle choices. This is something no politician ever talks about, because no politician is going to say, get off the couch; you're fat; you know, ask the doctor if getting off your ass is right for you. But that really is the key to it. People don't catch a cold, they hatch a cold by things they put in their body. We have way too much toxicity and too few nutrients.

KING: Do you get a flu shot?

MAHER: Never. Never.

KING: It's a vaccine against the flu?

MAHER: First of all, that's a huge scam. Even if it worked, and I don't believe it does, by the time the actual flu came around, it would have mutated from whatever they shot into you. That is a good example of the corruption --

KING: You eat nothing in a box or in a can?

MAHER: Things that are in boxes or cans generally are not good. But have some peanut butter tonight if you like, Larry.

Here Bill Maher manages to deny the pathogenic cause of disease, as well as blame victims for acquired viral infections, stating that people "hatch a cold." Does Maher feel the the same way about Dengue Fever? Polio?

This is an example of hyperbole gone wild. Is Maher correct that people with suppressed immune systems are more susceptible to suffer an illness? Yes. Do people develop weaker immune systems by eating unhealthy foods? Perhaps. But Bill Maher's misleading statements imply that dietary intake is the primary cause, or at least an extraordinarily significant cause, of developing viral rhinopharyngitis.

In fact, the extensive National Health and Nutrition Examination Survey suggests that, while obesity is responsible for numerous pathological phenomena, overweight and obesity seem to be protective from death via infections1. (The researchers used a COX model to account for the fact that the obese tend to die earlier from other diseases, before getting a "chance" to die from infections). While one randomized controlled trial (RCT) in mice showed that genetically ob/ob obese rodents were more likely to die from influenza virus than "slim" rodents2, another RCT demonstrated that ob/ob obese mice were more resistant to death from the malarian parasite, Plasmodium berghei3. Thus, the research relating to the link between obesity and infectious disease is insufficient to be considered conclusive, and additional studies should be performed on this topic. However, Maher's conjecture that acute coryza (common cold), or other infectious diseases, are largely "hatched" from dietary choices, is invalid.

Even if we were to discover a causal link between eating habits and symptomatic coryza infection,4how does Maher know that "toxins" are the culprits, rather than excess fat? Which specific toxins are responsible? Additionally, on what basis does Maher believe that "nutrients" inoculate people from the common cold?

Indeed, many Americans ought to lose weight for other reasons, so at least this embellishment likely has mild consequences.

But then Maher moves on to vaccines.

An estimated 20,000 Americans die from influenza every year. So, if Maher convinces people to avoid a efficacious inoculant, he is behaving very irresponsibly.

Several randomized controlled trials demonstrate the effectiveness of the flu vaccine in children and non-elderly adults, and no scientific study seems to have refuted this. For example, according to the CDC:

A 4-year randomized, placebo-controlled trial of children aged 1-15 years found vaccine effectiveness ranging from 77% to 91%, following only one dose of vaccine given to previously unvaccinated children3."

There is a bit of controversy regarding the efficacy of the flu vaccine in the elderly population. While most well-designed cohort studies have shown that the flu vaccines reduce incidence of influenza infection and death for this demographic 4, these data has been contested in a few other studies 5. However, let's say we did discontinue vaccination of the elderly. We should then employ even greater care to vaccinate children, in order to decrease the probability of elderly exposure to the virus. (The authors of the Canadian study that challenges the usefulness of vaccination for the elderly, indeed noted, "Placebo-controlled randomised trials show influenza vaccine is effective in younger adults.")

Even if Maher, for some wacky reason, does not recognize the validity of such studies, why does he believe that the findings published in these journals amount to a "huge scam," a fabrication intended to hoodwink the public, and an example of "corruption"? These articles all seem to me like the expected process that takes place to advance scientific knowledge, rather than some large conspiracy. In order to save lives, we rely on the best evidence we have, concerning the costs and benefits of every preventative measure and treatment.

We already know that Maher views religious people unfavorably, and that he maintains staunch views on a whole gamut of topics. However, if Maher distrusts both theological doctrine and scientific research, which Higher Authority does he rely on as his arbiter of truth?

1. Katherine M. Flegal and Barry Graubard, et. al. "Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity" JAMA. 2007;298(17):2028-2037. http://jama.ama-assn.org/cgi/content/full/298/17/2028

2.Alexia Smith, Patricia Sheridan, et. al. "Diet-Induced Obese Mice Have Increased Mortality and Altered Immune Responses When Infected with Influenza Virus." Nutritional Immunology137:1236-1243, May 2007

3. Vincent Robert, Catherine Bourgouin, et. al. "Malaria and obesity: obese mice are resistant to cerebral malaria" Malaria Journal 2008, 7:81

4. Please note that infection with the Influenza virus is always the primary etiology. By "causal link" I mean that dietary habits might lead to increased rate of clinical disease from infection, or decreased ability to kill off the virus.

5. Kathleen Neuzil and William Dupont, et. al. "Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: The Pediatric Experience." The Pediatric Infectious Disease Journal:Volume 20(8)August 2001pp 733-740
CDC link that review some of the evidence about flu vaccines is at http://www.cdc.gov/FLU/PROFESSIONALS/VACCINATION/effectivenessqa.htm

6. Most of the research in this area seems to have been

Peter A. Gross, Alicia W. Hermogenes, et. al. "The Efficacy of Influenza Vaccine in Elderly Persons: A Meta-Analysis and Review of the Literature." Annals of Internal Medicine. Volume 123 (7) October 1995 pp. 518-527

See also a randomized controlled trial at http://jama.ama-assn.org/cgi/content/abstract/272/21/1661

One study involved a Swedish cohort study of 260,000 age 65 or older. The researchers state, "The relative risks of mortality among vaccinated versus unvaccinated individuals were estimated using Cox's proportional hazards regression adjusted for, and stratified by, demographic factors and comorbid conditions." They found that they needed to vaccinate 297 in 1998/1999, 158 in 1999/2000 and 743 in 2001/2002 (the vaccine was not so great that year) in order to prevent one vaccine related death among the group, let alone prevent incidence of developing an influenza infection.
a. Ortqvist, F. Granath. "Influenza vaccination and mortality: prospective cohort study of the elderly in a large geographical area." Eur Respir J. 2007 Sep;30(3):407-8.

7. Lone Simonsen, Roberty Taylor, et. al. "Mortality benefits of influenza vaccination in elderly people: an ongoing controversy."
The Lancet Infectious Diseases, Volume 7, Issue 10, Pages 658 - 666, October 2007. http://www.annals.org/cgi/content/full/123/7/518.


Ren said...

Wow! I had no idea he'd gone off the deep end like that... Here's a guy that pushes science as the end-all, be-all of all things, and then he denies the science?

Maybe he doesn't know the science? Or he knows as much about it as he knows about God?

Thank you for a wonderfully well-thought article.

Heal Spieler said...

Hi Ren,
I know, it seems pretty strange. He is such a champion of theory of evolution, so I don't know why he suddenly puts down scientific research.
My guess is that he'd probably just say "I was being comical," which a frustrating tactic that comedians sometimes use when they are called out on their statements about factual matters. But, people are influenced by his opinions, and I wouldn't doubt that some people may have forgone their flu shots because of his statement.
Thanks for reading!

Ren said...

Adina, some would argue that there is less evidence of evolution as there is that the flu vaccine prevents the flu. Oh, well... Another celebrity making health policy, and bad one at that.

Having said that, this is no better on his part than religious leaders who prohibit medical treatment because it goes against their teachings.

I believe in living for our faith/beliefs rather than dying because of them.

Orac said...

Sadly, this is old news. Maher's been spewing nonsense like this for years:




Heal Spieler said...

Thanks Orac!
You're like the pseudoscience encyclopedia.