Eight feminist ways to love your body | Van Badham

A young woman from Perth has declared next month to be Weigh Free May. I am so in

I always end up feeling like shit when I look at Instagram, said Selena Gomez, who has 133 million Instagram followers, when she was interviewed by Vogue last year.

Selena. Freakin. Gomez.

Of course, shes not the only one. In 2017, the UKs Royal Society for Public Health released a survey of 1,479 young people analysed on their attitudes to social media and found that Instagram, where personal photos take centre stage, received the worst scores for body image and anxiety.

Instagram easily makes girls and women feel as if their bodies arent good enough, admitted a respondent.

But blaming social media for womens poor body image is easy. Harder to face is that Instagram is just the latest platform for the insidious syndrome of relentless body-hating our culture encourages in women. On this subject, a Glosswitch piece in the New Statesman exhorted feminists to remember the analysis in older tracts like Susie Orbachs Fat is a Feminist Issue and Naomi Wolfs The Beauty Myth, that oppression was structural and bodies were real.

Once upon a time, we may have been angry about this, she despaired.

Is feminism failing in the fight for the female body? The $160bn global beauty industry is growing at up to 7% a year, more than twice the rate of the developed worlds GDP.

My own belief is that its hard to escape a cage with a shape that keeps changing. Feminism may have accepted Naomi Wolfs 1990 dictum that dieting is the most potent political sedative in womens history but in 2018 #cleaneating and #fitspo dont admit to being diet cults, even 37m or 54m Instagram posts later. In her latest book, Natural Causes, Barbara Ehrenrich criticises the recent paradigm shift in which now, health is indistinguishable from virtue. The last decade has witnessed the emergence of orthorexia an eating disorder in which a fixation for healthy eating is what causes one harm.

However the propaganda message redesigns itself, we cant we must not abandon a feminist imperative to own our bodies as sites of our unconditional love.

Its an activist mission thats inspired Grace Ritter to declare Weigh Free May. The 24-year-old student from Perth is now in recovery from an eating disorder that dominated her life for 10 years. Shes created a website and Facebook group, encouraging others to let go of obsessive, aesthetic self-assessment for just one month.

Her campaign requires no donation, there are no events beyond your own commitment: I just wanted to start up a way to get people talking and thinking about ways they could be valuable and things they could do, she says, that werent about shrinking themselves.

Grace, I am so in. And in the belief that bodily comfort is a feminist act, Id thought Id share my own super scientific recommendations for simple ways to celebrate your body in a weigh-free May.

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A poster from Grace Ritters Weigh Free May campaign. Photograph: https://www.weighfreemay.com/

My eight feminist ways to love your body again

Take an Epsom salt bath. You can buy box of magnesium crystals for about five bucks (2.50) in the supermarket, and poured into a bathtub of warm water they make a sound like fairy magic. The Epsom Salt Council claims the magical properties of a long soak include relaxing muscles, nursing bruises, softening skin and relieving irritations like sunburn. At the very least, you can relax in the tub safe in the knowledge that somewhere in the world theres an Epsom Salt Council.

Wear comfy slippers. A fancy pair of slippers not only make your feet feel like kissed princesses, they also decrease your risk of catching colds and flu by keeping you warm. Changing into slippers stops you from traipsing gross germs from outside to inside, keeps your carpets cleaner, reduces risk of foot infections, prolongs the life of your socks, prevents floorbound slips, and makes you more productive. Relaxed workers as it turns out get more work done.

Cuddle a puppy. Puppies are fluffy bombs of love and adoration that keep you warm and cosy and live for your physical presence. Theyre also powerful chemical weapons that activate oxytocin in the brain, reducing bodily stress, improving the immune system and lessening the impact of pain.

Enjoy casual sex. Researchers from NYU and Cornell University concluded that if you want to have casual sex, you definitely should as doing so lowers stress and raises overall emotional wellbeing. Only when people bring their hangups to hookups do they become problematic. And theres a really easy way not to get emotionally hung up on a sex partner. Have a shower and leave, deleting their number on the way out. What you experienced can live on forever in your own smug smile.

Share a cake. Cake is delicious. And according to researcher Penny Wilson from ANU, the consumption of cake also connects us to its social role as a symbol of joy and celebration; the conveyor of history, culture and tradition; as a token of love, belonging and social occasion. These are lovely feelings to share with another person. So get someone over and have another piece.

Get around in bamboo underpants. Theyre so soft! Theyre made from sustainable material! They hug your bum like a baby blanket all day and even better discourage the proliferation of vaginal thrush. No, they do not resemble any costume of a Vegas showgirl but, girls, anyone who kicks you out of bed for being comfortable is not gonna provide you much comfort in bed.

Have a cup of tea. Sure, tea reduces risk of heart attack and stroke, may help protect your bones, can alleviate depressive symptoms and studies suggest it can diminish cancer-risk, but the main reason to have a tea is that its tasty. Its dreamy flavours and perfumes are transportive. If you brew a quality teabag of black tea in boiling water for no less than three minutes, no more than five, remove the bag and add milk to taste, take a deep sniff and sip … hating anything is really hard.

And, remember, Celeste Barber is good for you. If ever there was an antidote for the body hating blues, it would have to be the Australian comedian. Her legendary Instagram account doesnt only mock the falsity of Instaperfection, but inspires a vision of female experience in every way superior for a failure to live up to it.

Because we can starve ourselves, measure our pieces, work ourselves into the metal of the gym-machines, suck in our cheeks and become obsessed with our own shame for doing so.

But maybe May is a good month to put on our slippers, get comfortable, watch Celeste and observe that eating chips off the floor, dancing around in your pants and spraying yourself in the face with a hose really does look a lot more like fun.

  • Van Badham is a Guardian Australia columnist

Read more: https://www.theguardian.com/commentisfree/2018/apr/13/eight-feminist-ways-to-love-your-body-without-even-leaving-the-house

Johnson & Johnson accused of failing to warn patients at higher risk from vaginal mesh

Company allegedly knew devices posed added risk for patients with compromised immune systems

The pharmaceutical giant Johnson & Johnson allegedly failed to warn women that its vaginal mesh devices posed a particular risk for patients with compromised immune systems, despite it being well known before they were first sold in Australia.

The federal court is currently deliberating on a landmark class action involving hundreds of women who have sued the multinational giant over the impact of its vaginal mesh devices.

The mesh was surgically implanted to treat stress urinary incontinence and pelvic organ prolapse, common complications of childbirth. It was marketed to surgeons as a simple, safe and affordable implant, which would boost their profits and speed up operations considerably.

But the devices left many women in debilitating pain and unable to have sex, ruining lives and causing long-term impairment.

Over a six-month hearing, the federal court heard allegations that Johnson & Johnson either knew of the risks or failed to properly test the devices before launching them on the Australian market.

On Monday, the women won the right to add a new allegation to its case: that Johnson & Johnson knew the devices posed an added risk for patients with compromised immune systems but failed to warn women.

Kathryn Gill, the lead applicant in the case, was among those who were not warned, the court heard.

Gill suffered from psoriasis but says she was not told of the added risk she faced in undergoing the surgery. She said she never would have gone ahead with the procedure had she known.

It was not until after Gills operation that warnings about immune problems were added to the instructions for a number of the mesh devices.

The warning read: In patients with compromised immune systems or other conditions that would compromise healing, the risks and benefits should be carefully weighed.

The court was also told that US regulators wrote to the manager of regulator affairs at Ethicon, Johnson & Johnsons product development arm, in October 1990, well before the products were first sold in Australia. The letter adverted to potentially delayed wound healing in patients with compromised health due to a number of factors, according to the federal court.

The court also heard from a biomaterials expert, Prof Paul Santerre, who said it was well known that immune system problems made it more difficult for biomaterials to integrate with tissue. Santerre cited a 1997 report on the issue.

Mesh was not sold in Australia until after 1997.

The allegations about the immune system response were not initially included in the class action against Johnson & Johnson. But lawyers for the women launched a late bid to have them included in their formal pleadings, which was opposed by the company.

Federal court justice Anna Katzmann allowed the pleading to be changed in a judgment handed down on Monday afternoon. She rejected the arguments that doing so would put the company in an unfair position, having already argued its case.

Having given careful consideration to the points raised by both parties, I am not satisfied that the amendments would cause any injustice to the respondents, she said.

Katzmann has also allowed the women to seek an injunction that would prevent the mesh devices being sold or marketed in Australia without a comprehensive warning about the risks.

The company had attempted to argue that was a role best left to the Therapeutic Goods Administration (TGA), an argument Katzmann rejected.

Katzmann has reserved her full judgment in the case and it will be handed down at a later date.

Read more: https://www.theguardian.com/australia-news/2018/apr/10/johnson-johnson-accused-of-failing-to-warn-patients-at-higher-risk-from-vaginal-mesh

Every single teacher on a crowd-funding site just got their wishes fulfilled

(CNN)When it comes to educating America’s children, how much of a difference could $29 million make? Could it send a second grader on a school trip to the museum, or provide updated equipment to a class of budding scientists?

Ripple, a cryptocurrency and international payment company, has donated $29 million in cryptocurrency to DonorsChoose.org, a donation platform that connects people to classroom needs across the country. With the money, Donors Choose was able to fulfill every single classroom project request on its site — 35,647 requests in all, from 28,210 teachers at 16,561 public schools.
“It’s fair to say there’s never been a day that this many classroom dreams have come true,” Donors Choose founder Charles Best told CNN.

    The Colbert bump

    The massive donation is the culmination, or grand finale, if you will, of the site’s #BestSchoolDay project. Two years ago, Stephen Colbert, who is a member of the Donors Choose board of directors, announced he was going to pay for every school project request in his home state of South Carolina.
    His act of kindness set off a movement that became known as #BestSchoolDay.
    “More than 50 actors, athletes and philanthropists were inspired to fund classrooms in their states,” Best told CNN. “Together, those 50-plus people gave more than $14 million, and to use, that represented the idea of a best school day.”
    Best says the response has been overwhelming — in a good way.
    “An outpouring of joy would not be an overstatement,” he said.

    The Ripple effect

    Best says when the organization connected with Ripple, the cryptocurrency management company was “inspired to think of the impact” of such a significant gift.
    “At Ripple, we care about giving back to our community and we collectively value the importance of quality education in developing the next generation of leaders,” Ripple’s SVP of Marketing Monica Long said in a statement.
    “DonorsChoose.org’s track record speaks for itself — they are highly effective at improving the quality of education and the experience of teachers and students across America. We’re proud to work with them to support classroom needs across the country.”
    According to Ripple’s company site, the donation will affect approximately 1 million public school students.
    Best says the “classroom projects” requested on the site represent specific missions or activities that teachers have for their students.
    “It’s a public schoolteacher requesting a classroom library. A field trip. A set of art supplies. A pair of microscopes. It’s about requesting experiences or tools to provide a student learning experience,” he said.
    “We believe in the wisdom of the front lines,” Best added. “Hardworking, passionate teachers know their students’ needs better than anyone else in the school environment. If we can tap into their needs, we can unleash smarter solutions and empower those people on the front lines.”

    Read more: https://www.cnn.com/2018/03/29/health/donors-choose-ripple-donation-stephen-colbert-trnd/index.html

    Meet the tech evangelist who now fears for our mental health

    Belinda Parmar was a passionate advocate of the digital revolution but has started keeping her familys smartphones and laptops locked away to protect her loved ones. Is she right to be so worried?

    In Belinda Parmars bedroom there is a wardrobe, and inside that wardrobe there is a safe. Inside that safe is not jewellery or cash or personal documents, but devices: mobile phones, a laptop, an iPod, chargers and remote controls. Seven years ago, Parmar was the high priestess of tech empowerment. Founder of the consultancy Lady Geek, she saw it as her mission both to make tech work better for girls and women and to get more girls and women working for tech. Now she wants to talk about the damage it can cause to our mental health, to family life and to children, including her son Jedd, 11, and daughter Rocca, 10.

    Parmar made her living and lived her life through these devices, so what happened to make her lock them up? Why did this tech evangelist lose her faith?

    Strong women run in Parmars family. She tells me her mother raised her and her sister alone after separating from their father when Parmar was two (shes now 44 and recently separated herself), while her grandmother, who had four children, ran her own business, a recruitment firm in Mile End, east London. She grew up believing anything was possible, which is why she felt driven to start Lady Geek when she was 35, after a man in a phone shop tried to sell her a pink, sparkly phone. That was the way technology was sold and I thought: This is ridiculous. I was so angry that I went home and started a blog, she says.

    The blog was called Lady Geek, and it launched a national conversation about sexism in the tech industry. Parmar left her job in advertising to turn it into a business, advising tech companies how to make their products better for women, and going into schools to encourage girls to go into the industry, for which she was awarded an OBE. For me, tech was a leveller, she says. You didnt need money, you didnt need status; it was an enabler of a more equal and more diverse society. This tiny bubble that most of us lived in had been popped and that was wonderful. That still is wonderful.

    But certain aspects of her relationship with technology were not so wonderful. Id wake up and look at Twitter, she says. I had two small children, and the first thing I should have been doing was going to see the kids, but Id be looking at Twitter. She realised she was using social media for validation, to feed her ego. She began to think: If technology is an enabler, why am I just using it for things I dont like about myself?

    As her children grew up, she started to be disturbed by her sons apparent compulsion to play video games. Technology takes parents out of control. I cant compete with an amazing monster, that level of dopamine. He doesnt want to eat with us, to be with us, because its not as exciting, she says. She bought a Circle, a device that allows you to manage the whole familys internet access, controlling which devices are online at which times and what they can view. My son hid it, she says. She tried to turn the wifi off, but he stood guarding it, blocking her way. She still does not know where the Circle is. In theory, she says, if youve got compliant children, this would be perfect. Perhaps that is why her combination to the safe, with his devices and hers, is 12 digits long.

    Safe
    Safe keeping … Parmar locks her devices in for the night. Photograph: Teri Pengilley for the Guardian

    She has reason to worry. When a friends 12-year-old son showed signs of being addicted to video games, Parmar at first shrugged it off. Then he refused to go to school because he wanted to play all day, and then he spent eight weeks in a psychiatric institution. Hes 15 now. Nothings changed. He still wont go to school, she says.

    Professor Mark Griffiths, a psychologist and director of the International Gaming Research Unit at Nottingham Trent University, has spent 30 years studying technological addictions; he was the first to use that phrase in 1995, to describe excessive person-machine relationships. All behaviour is on a continuum from absolutely no problems at all, he says, through to recreationally enjoying something, to excessively enjoying something, to problematic and then addictive and pathological at the far end. For someone to be genuinely addicted to technology, that technology has to be the single most important thing in their life they do it to the neglect of everything else and very few people fulfil that.

    He is prolific (helped, he says, by having given up his mobile phone), publishing more than 100 papers last year alone his most recent was on Instagram addiction. But he has his doubters. There are academics wholl say this is complete nonsense, that if it doesnt involve ingestion of a psychoactive substance it cant possibly be an addiction. To that he retorts: what about gambling? What is good for me is the established bodies are catching up, he says. This year, the World Health Organization added gaming disorder to its list of mental health conditions in ICD-11, the International Classification of Diseases.

    Griffiths is careful to articulate the difference between believing that technological addictions are real, and believing that they are ubiquitous. Addiction is defined not by the amount of time spent doing the activity, but by the context in which you do it. Parents tend to pathologise behaviour that isnt pathological its the technological generation gap, he says. Every week, concerned parents email him to say their daughter or son is addicted to social media, and when he asks if their children do their homework and chores, take exercise and have a wide network of friends, nearly always the answer is yes. But, they say, the kids are wasting three hours a day online. What were you doing when you were their age? Because I was watching TV for three hours a day when there were only three channels. And then there are the parents who use social media just as much as their kids, and who shouldnt be surprised when kids end up copying exactly what they are doing.

    While it may be reassuring that few of us would qualify as addicts by Griffiths definition, the fashion for tech detoxes, and a recent survey that found that 75% of those aged 25 to 34 feel they use their phone too much, suggests many of us remain disturbed by our increasingly entwined relationship with technology. Richard Graham, a child and adolescent psychiatrist who runs the Tech Addiction Service at Londons private Nightingale hospital, tells me: Were psychologically cyborgs now, whether we like it or not. Were integrating these devices into our mental functioning, into our social and emotional lives. He quotes Chief Justice Roberts of the US supreme court: The proverbial visitor from Mars might conclude they were an important feature of human anatomy.

    While Graham feels the addiction model has its uses, he also draws on other ways of thinking about what is going on when we cant look away from a screen. He tells me about the student who decided to wind down one evening by playing a game of League of Legends, which would take about 40 minutes; the next time he looked at the clock, it was 5.30am. To explore this, Graham turned to flow psychology, a way of understanding the process of getting into the zone around a piece of work, which can be positive but can also make you lose track of space and time. This is not escapism: A lot of gamers are thinking strategically, in a very deep way. He is also interested in the idea of hyperfocus, which some people with ADHD experience, as not so much a problem of not being able to concentrate, but of not being able to shift concentration.

    He was influenced, too, by the work of Sherry Turkle, a social psychologist who has been researching the relationship between people and technology for three decades. Some of the participants in her studies, he says, were so attached to their consoles that they even found winning upsetting because it disrupts the connection with the machine. Theres a sense that they keep going because they dont want that connection to be lost. A psychoanalyst might compare this to the unconscious desire to be back in the womb, in a state of absolute connection.

    For young people on the brink of or enduring the horrors of adolescence, like Belindas son, Graham feels there could be something else going on: an identity crisis, trying to find a place in the world of near-adults. For these young people, games and social media arent just fun theyre business. Whether they monetise their YouTube channel or not, this is a way to succeed, to harness digital capital and turn it into self-esteem. Griffiths suggests that screens might even be one of the reasons for the drop in youth crime over the past 25 years: More youth are spending more time in front of technology, so they havent got time to go out and commit acquisitive crime. Being very engrossing isnt necessarily bad.

    These experts agree that abstinence is not the way forward: instead, we need to build what they call digital resilience, and learn to use technology in a measured, controlled way. If someone goes diving and is deeply immersed in the ocean, Graham says, you cant just bring them up quickly without significant effect. So rather than talking about digital detox, we need to think about digital decompression.

    He recommends the American Academy of Pediatrics family media plan, which tells you how much sleep you need, and schedules a period of no-screen time an hour before bed, as well as clean periods in your day and clean zones in your home. I think it can really help if everyone does it together. But adults can be more slippery than young people. Theyll say: I need my phone for work, for my alarm. Unfortunately, with adolescents, anything like that smacks of hypocrisy and is incredibly damaging.

    Young people can be responsive when adults change their own behaviour, he says. I had quite a nice discussion with a young man and his mother. She told me she only has a Kindle, and I replied that the later models will disrupt your sleep as much as anything else. This absolutely thrilled the adolescent, who was much more willing to change his behaviour because Id caught his mum out. And she was up for changing, too.

    Parmar realises she has to set an example. I love technology, but my own behaviour has changed because Im more self-aware, she says. Hence her devices being in the safe, along with her sons. But looking around her sunlit bedroom, I see a laptop on the desk, a tablet next to her pillow. So your bedroom isnt screen-free, then, I say. She looks reflective, perhaps a little sheepish, and acknowledges that she likes to watch things on her tablet once the kids have gone to bed. Shes still figuring things out, still coming to terms with the tough decisions we all need to make if we want to be more in control of our relationship with technology.

    These are the conversations Parmar wants us to have, which is why she is launching a campaign and website, TheTruthAboutTech.com (no relation to a similarly named American campaign), that will offer practical tips and a space for people to share their stories. This is my new mission. And I tell you what: dealing with my son every day, it reminds me, this is personal. This is really personal.

    She also wants to hold to account the tech giants who are profiting from our over-engagement. She raises her voice: I want to say, youve got to be more responsible. You can still make billions, but you should be thinking about how can you bring all the human values we want as a society into your products. She is furious with Reed Hastings, the CEO of Netflix, who last year said the companys main competitor was not Amazon Video or YouTube, but sleep. That is disgraceful. He should be saying: My No 1 mission is to unite families in their living room around great content.

    These companies, she says, are the most powerful brands in the world, more powerful than governments. Imagine if a government had said that. Theyre digital dictators, and part of this campaign is getting them to stand up and be accountable. And what does that mean? It means rethinking Snapchats streaks, which track how long users have been in daily communication, keeping them checking in for fear of losing out; it means rethinking YouTubes Up next queue, which automatically plays video after video; it means addiction ratings on video games. And thats barely scratching the surface.

    How does she feel about her previous work, spreading the benefits of tech with no mention of its dangers? I think I was naive, she says. I didnt know enough. I feel good about the fact that I got more women into technology, but if I did it again, I would do it in a way that is more realistic, balancing the good and the bad.

    I cant stop thinking about that safe. After all, a safe is built to protect our most precious possessions or to lock up our most dangerous weapons. It feels extraordinary that something so everyday, so anodyne as a mobile phone could have such unnerving value, such threatening power. With their influence and wealth, why would the tech giants change from digital dictators to enlightened despots?

    Parmar believes commercial pressures will compel them two influential Apple shareholders are already threatening to sue the company for not limiting screen time. Graham proposes a darker alternative: We could edge towards the equivalent of a parasite that drains its host so much that it kills itself, along with the host. He doesnt mean that these technology companies and their products will actually kill us, of course. But if its this relentless, the so-called attention economy will fall down, because well all be too exhausted.

    Build your digital resilience

    Four tips from addiction expert Richard Graham.

    1 Be united as a family. Use the American Academy of Pediatrics family media plan but remember: The whole family needs to buy into this.

    2 Plan activities outside the home. Go to the cinema, for example. Its a shared experience, and theres a narrative to stoke the imagination.

    3 Vary your digital diet. People get stuck in very simple diets of media consumption, using the same platforms, games and messaging apps. Using different platforms is important its about moving between them and having a sense of ease of being able to do something, then stop and move on.

    4 Live healthily. Sleep enough, eat well, drink enough water and do some physical activity every day.

    Read more: https://www.theguardian.com/technology/2018/mar/15/meet-the-tech-evangelist-who-now-fears-for-our-mental-health

    Australia investigates implants that left some women with ‘rotting pelvises’

    (CNN)Like more than 100,000 Australian women, Linda Schulz had a pelvic mesh implant to treat complications from childbirth that resulted in her bowel and bladder prolapsing.

    The mesh was meant to be a quick fix, but the aftermath was worse.
    Her right leg went numb almost immediately after the procedure, and after a few weeks the mesh was like a knife constantly cutting her up from the inside.
      “The mesh cut through my vagina wall and came through my skin,”Schulz said. “Any movement, whether I moved my legs or not, felt like a serrated-edge knife was cutting me.”
      In the last year, Schulz, 48, along with hundreds of women experiencing similar complications, petitioned the Australian Senate to investigate their use, hoping for an outright ban and recourse for past procedures.
      After a yearlong inquiry, the Senate released a report Wednesday, recommending that the implant be a “last resort” and raised concern that medical practitioners had not adequately informed their patients and “overused” the procedure “without considering alternative treatment options.”
      The report went on to outline vital recommendations for improved treatment guidelines and medical training, prevention of financial inducements for practitioners, a registry of high-risk implantable devices and an audit of past procedures. It also outlined concern that it is not possible to identify accurately the number of women who have received transvaginal mesh implants in the country.
      “Women that have had those implants, who have those outcomes … have been failed in a monumental way by the system and by certain people in the medical profession who they trusted,” saidSen. Rachel Siewert when she introduced the report Wednesday to the Senate. “I hope that we never have to have another inquiry where we see such suffering from the witnesses.”
      Senate involvement all started when Sen. Derryn Hinch heard stories such as Schulz’s, and was moved to startan inquiry in February 2017.
      “I hope our report convinces them they have been listened to and more importantly they have been believed,” Hinch said at the Senate meeting introducing the report.
      Hearings were held across Australiain 2017, interviewing both patients and mesh manufacturers. Hundreds wrote in to the Senate, sharing a range of stories about living with pain after the operation — from not being able to walk, sit or drive to puncturing their partner during intercourse with a splinter that broke off the implant.
      Schulz said she hopes the report will go past recommendations into action, and she hopes no woman has to go through what she did: “It changes your whole life. You don’t feel like a woman anymore. They just take everything in one fell swoop.”

      ‘Horror stories’ in consumer group’s survey

      Clocking in at 20 minutes, the mesh implant is a quick fixaimed at repairing common complications from childbirth and menopause.
      The mesh is implanted to support weakened or damaged tissue to treat poor bladder control and organ prolapse. But the procedure can be risky because of the methods and materials used. According to various studies, complications can include organ perforation, infection, hemorrhage and sexual dysfunction.

      About half of women between 50 and 79 may have prolapse, according to the American Urogynecologic Society. When muscles and ligaments in the pelvic floor get too stretched, for reasons such as childbirth, they fail to hold up the pelvic organs: the bladder, rectum and uterus. The organs can drop into the cavity, making urination and sex painful.
      One in five women has incontinence, or poor bladder control, from childbirth, according to the Journal of Prenatal Medicine.
      Part of the problem in the past, Schulz said, is that there were no hard statistics and records of how many procedures are done and their effects.
      In April 2017, the Health Issues Centre — an Australian consumer advocacy group — conducted its own survey. After asking on Facebook for stories, it heard from 2,500 women in six weeks.
      “We heard horror stories, lives that were completely destroyed,” said Danny Vadasz, head of Health Issues Centre, who also wrote to the Senate, asking for reform. “We were shocked and barely believed something like this could happen in what we considered the world-class health system of Australia.”
      The Australian health care system offers universal health care insurance, paid through taxes, as well as private insurance.
      Based on his survey, Vadasz estimates that in the past two decades, there have been 120,000 to 150,000 mesh implants in Australia, and around 70% of the stories his group heard involved a lack of fully informed consent. Many women, he said, were not even told that a mesh would be implanted into their bodies.

      ‘Mine was badly fitted’

      “As these devices were to be permanent, we are meant to live with rotting pelvises forever,” said Justine Watson, a Sydney resident who submitted her mesh photos to the Senate as part of the inquiry and joined more than 700 Australian women last year in a suit against Johnson & Johnson over claims of flaws in its mesh devices.
      In January, the pharmaceutical giant withdrew its mesh products from the Australian market. That same month, Australia’s medical devices regulator, the Therapeutic Goods Administration, removed mesh products for prolapse.
      Watson’s pain was so severe that she tried to take her own life after being hospitalized multiple times. Doctors didn’t believe her, she said, referring her to psychiatrists instead.
      “Mine was badly fitted,” said Watson, who spent her life savings to travel in October from Australia to the United States to remove the mesh that was first implanted in 2010. “It broke into the wall of my bladder and skewered my urethra.”
      After giving birth to two boys, both weighing more than 8 pounds, Watson struggled with incontinence.
      But within three months of the procedure, Watson was incontinent again and after suffering multiple medical problems,such as fibromyalgia, chronic pain and fatigue, she had the mesh removed. At 47, the procedure left her with the body of an 80-year-old: unwell, overweight and unable to walk more than 100 meters.

      The need for more action

      Both Watson and Schulz said they felt that Wednesday’s Senate report was full of guidelines rather than concrete rules.
      “This (report) feels somewhat ambiguous and can be interpreted several different ways. … It’s very unlikely that it’ll make any difference,” Watson said.
      And eight Australian pelvic mesh implant support groups agreed, saying in a joint statement: “There are a few glimmers of hope for mesh-injured women in the report – but the wording used in the recommendations are so weak that it could, if not followed up by robust policy change, give Australian health authorities, specialists and primary carers permission to carry on as usual. We are disappointed that the recommendations are not stronger, mandating a change in treatment, monitoring and care – especially considering that the report found that: Women are not having their mesh complications identified, or believed, by primary or specialist doctors.”
      Now Schulz, along with others who have been affected, are now looking into a Royal Commission, an official investigation that they hope can fully ban the practice and even offer financial restitution.
      Schulz wants more recognition of the problem. She represents more than 1,600 women in the Australian Pelvic Mesh Support Group, an advocacy organization that warns women about the risks of the procedure.
      In response to the Senate study, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said, “more needs to be done to protect the safety of women.”
      “It was very clear in the report that women who have experienced adverse complications as a result of a mesh implant have endured long-term pain and reduced quality of life,” said President Professor Steve Robson from RANZCOG, which trains and accredits doctors in Australia and New Zealand.
      Along with agreeing with the recommendation for a registry for high-risk medical devices, he added in his statement: “We support our members by offering clinical guidance and ensure that our College communications and information hubs reflect current national standards.”
      A 2016 study, which compared the results of women across 35 UK hospitals who had surgery with and without mesh, concluded that there was “no benefit to women having their first prolapse repair from the use of transvaginal synthetic mesh.”
      More than 1 in 10 in their study suffered complications, with 3 in 10 needing another operation, leading thestudy authors to recommend the more standard approach, without mesh, where organs are repositioned to their original areas and the supportive tissue surrounding them is repaired and stitched. The Mayo Clinic consistently uses this method.
      There are also less invasive treatments, recommended by some researchers, such as pelvic floor muscle training to strengthen the weakened tissue.
      But for many women, such as Schulz, no other option is given.

      A global issue

      The surgical mesh procedure is controversial and has led to many class-action suits across the United States, UK and Australia.
      In the UK, the National Health Service estimates that over the past two decades, more than 100,000 women have had surgery involving a mesh implant and 3% to 5% have had complications. But a recent study suggested higher figures, estimating that 1 in 15 women had to have her implant surgically removed in the UK.
      Edward Morris, vice president for clinical quality for the Royal College of Obstetricians and Gynaecologists, highlights that based on current evidence, the mesh may be effective to treat incontinence but is not advised for organ prolapse.
      There is still a small subset of women for whom it might be beneficial, he added, given the “appropriate information and counseling about the risks and benefits.”
      The college has a mesh webpage dedicated to information and advice on mesh implants to help women be informed about the procedure.
      In December, the National Institute for Health and Care Excellence — the UK’s health watchdog — withdrew its recommendation for the procedure to treat pelvic organ prolapse, and the Department of Health and Social Care is auditing cases dating to 2005.
      In January, New Zealand banned all vaginal mesh procedures to treat organ prolapse.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      In the United States, the Food and Drug Administration has not taken steps to ban vaginal mesh. However, in 2016, it reclassified the device from class II (moderate risk) to class III (high risk), providing the agency with more oversight over the manufacturing of mesh products.
      The FDA estimated that there are 75,000 procedures involving pelvic mesh implants each year in the United States. A 2011 report by the FDA also reported 2,874 cases of injury, death or malfunction related to the use of vaginal mesh between 2008 and 2010, including three deaths: two from bowel perforations and one from hemorrhage.

      Read more: https://www.cnn.com/2018/03/28/health/pelvic-mesh-implant-australia-senate-intl/index.html

      Yoga with Adriene’s founder won YouTube with her message of self-love — and self-deprecating humor

      Adriene Mishler isn't the only star of Yoga with Adriene. Her fans love her sidekick, Benji the blue heeler, almost as much as they love downward dog.
      Image: yoga with adriene/Mashable composite

      Adriene Mishler exudes plenty of mushy-gushy spiritual thinking, but the yoga evangelist embraces something else, too: self-deprecating humor.

      That’s part of what has made her so accessible to her 3.2 million YouTube subscribers. When she mentions self-love or chakras, she bookends it with “Okayyyy, Adriene,” or when she directs you to sit in a cross-armed-cross-legged pretzel of a pose as you lift your head, she mumbles, “This is like Ariel on the rock, speaking to my generation, a little mermaid joke.” 

      It’s why her fans call her goofy and authentic, an overused cliche in the YouTube world, but they really mean it. They insist! There’s just something about Adriene. 

      If you’re already rolling your eyes, take a deep, cleansing breath. It’s worth trying to wrap your head around why this particular woman has the top six videos when you search “yoga” on YouTube and dominates Google search.

      Adriene has been hosting free yoga videos on Yoga with Adriene since 2012.

      Image: Yoga with Adriene

      At the moment, Adriene is taking mental notes about Peru. When the 33-year-old tells me she rearranged her schedule to take adult Spanish classes so she can teach yoga when she visits Spanish-speaking countries, I mention one of her fans in Peru already translates her videos into Spanish. A Peace Corps volunteer there leads about 25 students, ages 5 to 84, in an hour-long flow, Monday through Friday.

      “Wow, I just got the chills,” Adriene says.

      You see, one of Adriene’s other fans from the Netherlands, who followed her yoga classes on a European tour like a Deadhead, recently quit her job as a vice principal and moved to Peru, where she founded a nonprofit teaching yoga to underserved children, with Yoga with Adriene’s motto, “Find What Feels Good,” at the core. It’s called Con Pazion, and Adriene’s sponsor, Adidas, donated $10,000 to the budding organization on her behalf. Yoga with Adriene fans have also donated, with some now sitting on Con Pazion’s board.

      “It’s all starting to fall into place somehow,” Adriene says. 

      Leonie van Iersel, the Yoga with Adriene fan who founded Con Pazion (center), and her students.

      Image: COn Pazion

      Although her mother is Mexican-American, Adriene never learned Spanish as a child. She jokes that she probably knows more Sanskrit, the ancient Indian language used in yoga practice, than Spanish. When she was in high school, she took American Sign Language instead because she had deaf friends. 

      While she’s excited to learn, it means she has to give up something she’s done for a decade, even after her meteoric YouTube rise: teach yoga, IRL, on Saturday mornings. 

      For yoga instructors, a Saturday morning studio slot means you’ve made it. And moving on fills her with bittersweet nostalgia. 

      “I used to joke that the only people who would come to my classes are my friends and my mom, and of course I would never let any of them pay.”

      “Yoga with Adriene” was the most googled workout in 2015. She won a 2016 Streamy Award in the Health and Wellness category, and in January of this year Google searches for “Yoga with Adriene” reached an all-time high — spiking by 40 percent since November 2017. 

      But she didn’t start out intending to be an internet sensation. When she was 19, she’d sub, teach kids’ classes, and lug around a jam box and burnt CDs all over her hometown of Austin — anything to teach yoga.

      “I used to joke that the only people who would come to my classes are my friends and my mom, and of course I would never let any of them pay, and then I’d end up paying rent at the studio where I was teaching and not making any money,” she said. 

      She wouldn’t disclose her YouTube revenue, but according to analytics firm SocialBlade, Yoga with Adriene pulls in anywhere from $3,000 to $45,000 a month. (It’s a big range, but YouTube estimates are often like that due to complicated ad schemes.) That doesn’t include intake from her subscription video service, Adidas sponsorship, events, or merchandise. She’s currently writing a book about her relationship with yoga and planning her own yoga teacher training program.

      Yoga with Adriene encourages viewers to “find what feels good.”

      Image: Yoga with Adriene

      Back when Adriene was losing money on her yoga classes, she taught children drama and acted on the side. It was on an indie movie set where she met Chris Sharpe, the film’s director, who’d later become her business partner and the Greg to her Dharma.  The movie was about a girl band in a post-apocalyptic world. At first Adriene passed on it — she had auditioned for Juilliard, she had trained in New York, she wanted to do theater — but was convinced when she heard her friend was part of the cast. That friend later married Sharpe and now has her own YouTube cooking channel. 

      “It never got finished and I do thank god for that because we had quite the get-ups,” Adriene says, giggling.

      After the movie fell apart, Chris emailed Adriene in 2010, pitching a yoga YouTube channel. But the idea just sat there, gestating for two years until the duo made Yoga with Adriene’s first video. The actor in Adriene wanted to nail every moment, but Chris encouraged her to relax and act like Mr. Rogers inviting people into her home. After that, it clicked. 

      All Adriene wanted to do was provide free at-home yoga for the masses when most classes cost between $15 and $20. It took her awhile to warm up to the social media circus and SEO-focused video titles. Her library of under 30-minute videos is diverse, to say the least: There’s yoga for mornings, bedtime, teachers, depression, golfers, disasters, a broken heart. You name it, she’s probably got it. And her blue heeler, Benji, is often seen lounging around, sometimes snuggling up on the mat as she maneuvers around him.

      “I was nervous to take yoga out of its sacred space and slapdash it into this digital space,” says Adriene. “That’s why it took forever for me to title any video ‘Yoga for weight loss’ or ‘Yoga for flow.’”

      But it’s titles like those that likely pushed her to the top of Google and YouTube search.  

      “It’s very savvy how she structured it,” said Allon Caidar, a YouTube metadata expert and founder and CEO of TVPage, a video commerce platform. Adriene focuses on keywords and has more than one video about highly-searched topics, he points out. Despite multiple high-profile YouTuber scandals (ahem Pewdiepie, ahem Logan Paul), Caidar predicts that marketing budgets focused on influencers like Adriene, especially in the lifestyle and health sectors, will grow this year.

      Adriene jokes that one April Fools’ Day she wants to upload the same video with two titles: one focused on self-love and another on weight loss to test which gets more views. 

      “Just to kind of prove a point,” she says. “With the titles, I’m using the platform to bring more people to the mat.”

      Yaiza Varona, a 39-year-old in the UK, found Adriene because of her high ranking. She was browsing for a yoga video on YouTube, clicked the first one, and now she’s a Yoga with Adriene disciple. 

      “If she said paint yourself blue, I’d do it. At this moment, I trust whatever she says because it feels so right,” the music composer says. “I’m not that much into yoga as a philosophy, but she brings it down to Earth. She focuses so much on enjoying being in your body.”

      Megan-Eileen Waldrep, the Peace Corps volunteer in Peru, says it may sound silly, but to her, Adriene feels like a friend. 

      “She makes jokes or weird references and then says under her breath, ‘I don’t know why I said that,’ which is hilarious. It’s an unedited flow of her stream of consciousness and yoga,” the 25-year-old from Chicago says.

      There are critics who deride Adriene for being “that YouTube yogi,” though. 

      “They’re judging a book by its cover, and they don’t understand that I’ve poured my whole little heart and soul into trying to be mindful of how I share this information,” she says. 

      Adriene is used to pouring her heart and soul into things. She’s been doing it since she was a kid. Over Christmas, she was laughing with her dad about how she spent hours as a child recording her own theater and dance shows on VHS. Decades later, she’s still filming her own productions, only now she has a core staff of four.

      Adriene’s been in some indie movies, she plays a journalist in Rooster Teeth’s Day 5, and has voiced characters like Lois Lane and Supergirl for DC Universe Online. She’ll keep acting even as she expands her yoga business, she says. It’s a dream she can’t shake.

      You may see her at an event with hundreds of people doing yoga in a cavernous room — she uses a special mic because she had two vocal cord surgeries due to a benign tumor — but you’ll also still get a free video on YouTube every week. And if you watch those videos, you’ll be in on the joke when the floor creaks beneath your feet, just like Adriene’s does at home.

      “I would love for us to look back and go, ‘Remember when yoga was this thing you went to at the gym, and now it’s like brushing your teeth, washing your vegetables, taking a shower, something that you do in your home regularly,'” she says. “We’re not far from that. I’d like to look back and know that I did my part to trailblaze that offering.”

      Read more: https://mashable.com/2018/03/07/yoga-with-adriene/

      Period tracker apps’ obsession with pink is a problem

      It's time to draw some blood.
      Image: Getty Images/CSA Images RF

      My period is a dark, viscous, murderous red. Yet tech companies keep selling me products to control it, all cast in that mellow-cool shade of my generation: millennial pink.

      I’m frequently served ads for period tracker apps and other forms of reproductive health monitoring and pregnancy management on social media. And I’ve noticed among the subtly cute icons, the minimalist san-serif fonts, and clean lines, a beige-pink palette that looks nothing like what comes out of me once a month.

      Tech companies: Please stop marketing my vagina to me in a color that reeks of stale marketing meetings, approachability, and tranquility. I’m not afraid of my period, and your app can’t tame it.

      I was reminded of this cliché color scheme with the release of Fitbit’s new smartwatch, the Versa. It will feature, for the first time, a menstrual-cycle tracker. 

      Starting this spring, women can enable the feature during setup. Period days will show up in the Versa’s calendar tracker in a chic light pink. The blue days are fertile ovulation days. Baby blue.

      Pink is for periods, blue is for baby-making.

      Image: Fitbit

      For what it’s worth, Fitbit also incorporates other shades of pink: a fat, hot pink droplet indicates days of heavy flow, a few hot pink circles mean spotting.

      The functionality itself provides more than just a calendar. There are also options to track fluids, and other symptoms some women may get, like headaches and cramps. Plus, Versa users can access educational and editorial content about women’s health or join women’s health-oriented communities.  

      Aside from whether or not you buy into any period app’s general value proposition — that “tracking” one’s period helps you have safer sex, pregnancy wise; or that mentally and physically preparing for your period by putting it in a calendar somehow makes your life better? — there’s something else, um, fishy, going on.

      The gateway to all this reproductive knowledge is painted in millennial pink. 

      Does this palette — Pantone’s 2016 color of the year — look familiar to a certain period vs. ovulation calendar?

      Millennial pink, also called “Tumblr pink,” is the muted pink hue that’s dominated runways, interior design, home goods, and book and magazine covers galore. It’s not just one color of pink, it’s a spectrum of matte pinks and beiges that have a somewhat subdued vibe. The Cut aptly describes millennial pink as running the gamut “from salmon mousse to gravlax.” 

      If you’ve seen it, you know it. And it often comes with a side of hot pink or orange-y red, or is complimented with a tranquil blue-gray or a vibrant green. Pantone’s Laurie Pressman, vice president of the Pantone Color Institute, says it has to have a tinge of orange to it, too.

      Put our clocks forward and dreaming of #grapefruitweather ⏰😴

      A post shared by THINX (@shethinx) on

      Many publications have opined about the prevalence of this color and its supporting characters: what it means, why we like it, why it just won’t go away. In an exhaustive timeline of millennial pink from its origins to its hegemony, The Cut notes that what makes millennial pink so appealing is its nod to femininity, with a dose of ironic distance; or, as they call it, “ambivalent girliness.” 

      “With Millennial Pink, gone is the girly-girl baggage; now it’s androgynous,” writes The Cut.

      Pantone points to the sense of calm millennial pink conveys. It writes in its 2016 color of the year announcement: 

      As consumers seek mindfulness and well-being as an antidote to modern day stresses, welcoming colors that psychologically fulfill our yearning for reassurance and security are becoming more prominent. Joined together, Rose Quartz and Serenity demonstrate an inherent balance between a warmer embracing rose tone and the cooler tranquil blue, reflecting connection and wellness as well as a soothing sense of order and peace.

      Unsurprisingly, these sorts of pinks also connote youthfulness.

      “The grouping of pinks that fall under the Millennial Pink umbrella are engaging,” Pressman told Mashable over email. “Playful and innocent, they carry with them a suggestion of a sweet taste or scent. They have a lightness, romantic sensibility and this attitude of carefree youthfulness.” 

      This is the color — the de-feminized signifier of youthful nostalgia and order over chaos — that period trackers and women’s health apps choose for the design and marketing of their product. It represents more than just a use of a popular color; coded into these design choices is a sense of bridling.

      And, it’s everywhere.

      I first noticed the not-so-bright-pink in an advertisement to freeze my eggs. The multiple shades of pink weren’t the only thing I found problematic about the ad, but it was what got my attention.

      I also noticed it in ads served to me for rhythm method period tracking and vaginal bacterial analysis.

      But the period app is where 20-somethings’ favorite pinks really rules the day. The top three menstrual tracker apps in the Apple app store use it in their branding. There is even a tracker app called Pink Pad whose use of pink runs the salmon spectrum from mousse to smoked. In addition to the actual UI of Pink Pad, their social media branding features funny and inspirational quotes on a background of, you guessed it, light pink.

      Image: pinkpad in the app store

      Image: eve. in the app store

      You know what’s missing from most of these ads? Red. Rusty or scarlet, nearly black or a waterier apple color, red is almost entirely absent from the UI and marketing materials of period tracking and women’s health apps and tech services. Maybe it’s too on the nose. Maybe it’s off-putting, sexy, powerful, or scary. In any case, the color of blood is not the color of period apps.

      Red’s absence in place of the loaded millennial pink is disappointingly predictable. It doubles down on the association of periods with death, injury, and fear.

      “The main reason designers and marketers of women’s health product would want to avoid the color red is because of its association with blood,” Pressman said. “Red can also signify danger, evil and anger, probably not the feelings one wants to engender when trying to promote health.”

      But red’s exclusion in place of the much friendlier pink is a bit ironic, and more than a little problematic. 

      If pink signifies restrained girliness and order, the prospect of a period tracker app, especially one branded in pink, belies a misunderstanding of periods. 

      Now, I do not love my period. It is mostly just an inconvenient fact of life. But during my period, I’m nicer to myself, without feelings of guilt and debilitation. That’s because periods help women understand ourselves; they don’t work against us (although it may feel that way sometimes). So an app, colored to convey a sense of control, that purports to master one of the powerful biological markers of being a woman, misses the role that periods actually play in women’s lives.

      Plus, using a color associated with “youthfulness” to market a product that monetizes the period — the traditional marker of the end of childhood and the beginning of sexual maturity — denies, shushes even, the full-fledged womanhood that a period represents.  

      Both through apps and their marketing, the tech industry’s approach to women’s health is to turn an internal rhythm into a digital record, to transform a bright and messy reality into a clean and muted one. Millennial pink represents more than just an aesthetic choice: It’s prudish, and infantilizing.  

      Period trackers may be helpful to some women. But to the companies making and marketing these apps, please, don’t elide this aspect of womanhood by painting it with a trendy, approachable color that turns femininity into ironic girlishness, a period of bodily and emotional rawness into tempered calm. You might be afraid of our periods. But we’re not. 

      Let it flow.

      Read more: https://mashable.com/2018/03/14/millennial-pink-period-apps/

      CNN Exclusive: California launches investigation following stunning admission by Aetna medical director

      (CNN)California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.

      “If the health insurer is making decisions to deny coverage without a physician actually ever reviewing medical records, that’s of significant concern to me as insurance commissioner in California — and potentially a violation of law,” he said.
      Aetna, the nation’s third-largest insurance provider with 23.1 million customers, told CNN it looked forward to “explaining our clinical review process” to the commissioner.
        The California probe centers on a deposition by Dr. Jay Ken Iinuma, who served as medical director for Aetna for Southern California from March 2012 to February 2015, according to the insurer.
        During the deposition, the doctor said he was following Aetna’s training, in which nurses reviewed records and made recommendations to him.
        Jones said his expectation would be “that physicians would be reviewing treatment authorization requests,” and that it’s troubling that “during the entire course of time he was employed at Aetna, he never once looked at patients’ medical records himself.”
        “It’s hard to imagine that in that entire course in time, there weren’t any cases in which a decision about the denial of coverage ought to have been made by someone trained as a physician, as opposed to some other licensed professional,” Jones told CNN.
        “That’s why we’ve contacted Aetna and asked that they provide us information about how they are making these claims decisions and why we’ve opened this investigation.”
        The insurance commissioner said Californians who believe they may have been adversely affected by Aetna’s decisions should contact his office.
        Members of the medical community expressed similar shock, saying Iinuma’s deposition leads to questions about Aetna’s practices across the country.
        “Oh my God. Are you serious? That is incredible,” said Dr. Anne-Marie Irani when told of the medical director’s testimony. Irani is a professor of pediatrics and internal medicine at the Children’s Hospital of Richmond at VCU and a former member of the American Board of Allergy and Immunology’s board of directors.
        “This is potentially a huge, huge story and quite frankly may reshape how insurance functions,” said Dr. Andrew Murphy, who, like Irani, is a renowned fellow of the American Academy of Allergy, Asthma and Immunology. He recently served on the academy’s board of directors.

        The Gillen Washington case

        The deposition by Aetna’s former medical director came as part of a lawsuit filed against Aetna by a college student who suffers from a rare immune disorder. The case is expected to go to trial later this week in California Superior Court.
        Gillen Washington, 23, is suing Aetna for breach of contract and bad faith, saying he was denied coverage for an infusion of intravenous immunoglobulin (IVIG) when he was 19. His suit alleges Aetna’s “reckless withholding of benefits almost killed him.”
        Aetna has rejected the allegations, saying Washington failed to comply with their requests for blood work. Washington, who was diagnosed with common variable immunodeficiency, or CVID, in high school, became a new Aetna patient in January 2014 after being insured by Kaiser.
        Aetna initially paid for his treatments after each infusion, which can cost up to $20,000. But when Washington’s clinic asked Aetna to pre-authorize a November 2014 infusion, Aetna says it was obligated to review his medical record. That’s when it saw his last blood work had been done three years earlier for Kaiser.
        Despite being told by his own doctor’s office that he needed to come in for new blood work, Washington failed to do so for several months until he got so sick he ended up in the hospital with a collapsed lung.
        Once his blood was tested, Aetna resumed covering his infusions and pre-certified him for a year. Despite that, according to Aetna, Washington continued to miss infusions.
        Washington’s suit counters that Aetna ignored his treating physician, who appealed on his behalf months before his hospitalization that the treatment was medically necessary “to prevent acute and long-term problems.”
        “Aetna is blaming me for what happened,” Washington told CNN. “I’ll just be honest, it’s infuriating to me. I want Aetna to be made to change.”
        During his videotaped deposition in October 2016, Iinuma — who signed the pre-authorization denial — said he never read Washington’s medical records and knew next to nothing about his disorder.
        Questioned about Washington’s condition, Iinuma said he wasn’t sure what the drug of choice would be for people who suffer from his condition.
        Iinuma further says he’s not sure what the symptoms are for the disorder or what might happen if treatment is suddenly stopped for a patient.
        “Do I know what happens?” the doctor said. “Again, I’m not sure. … I don’t treat it.”
        Iinuma said he never looked at a patient’s medical records while at Aetna. He says that was Aetna protocol and that he based his decision off “pertinent information” provided to him by a nurse.
        “Did you ever look at medical records?” Scott Glovsky, Washington’s attorney, asked Iinuma in the deposition.
        “No, I did not,” the doctor says, shaking his head.
        “So as part of your custom and practice in making decisions, you would rely on what the nurse had prepared for you?” Glovsky asks.
        “Correct.”
        Iinuma said nearly all of his work was conducted online. Once in a while, he said, he might place a phone call to the nurse for more details.
        How many times might he call a nurse over the course of a month?
        “Zero to one,” he said.
        Glovsky told CNN he had “never heard such explosive testimony in two decades of deposing insurance company review doctors.”

        Aetna’s response

        Aetna defended Iinuma, who is no longer with the company, saying in its legal brief that he relied on his “years of experience” as a trained physician in making his decision about Washington’s treatment and that he was following Aetna’s Clinical Policy Bulletin appropriately.
        “Dr. Iinuma’s decision was correct,” Aetna said in court papers. “Plaintiff has asserted throughout this litigation that Dr. Iinuma had no medical basis for his decision that 2011 lab tests were outdated and that Dr. Iinuma’s decision was incorrect. Plaintiff is wrong on both counts.”
        In its trial brief, Aetna said: “Given that Aetna does not directly provide medical care to its members, Aetna needs to obtain medical records from members and their doctors to evaluate whether services are ‘medically necessary.’ Aetna employs nurses to gather the medical records and coordinate with the offices of treating physicians, and Aetna employs doctors to make the actual coverage-related determinations.
        “In addition to applying their clinical judgment, the Aetna doctors and nurses use Aetna’s Clinical Policy Bulletins (‘CPBs’) to determine what medical records to request, and whether those records satisfy medical necessity criteria to support coverage. These CPBs reflect the current standard of care in the medical community. They are frequently updated, and are publicly available for any treating physician to review.”
        Jones, the California insurance commissioner, said he couldn’t comment specifically on Washington’s case, but what drew his interest was the medical director’s admission of not looking at patients’ medical records.
        “What I’m responding to is the portion of his deposition transcript in which he said as the medical director, he wasn’t actually reviewing medical records,” Jones told CNN.
        He said his investigation will review every individual denial of coverage or pre-authorization during the medical director’s tenure to determine “whether it was appropriate or not for that decision to be made by someone other than a physician.”
        If the probe determines that violations occurred, he said, California insurance code sets monetary penalties for each individual violation.
        CNN has made numerous phone calls to Iinuma’s office for comment but has not heard back. Heather Richardson, an attorney representing Aetna, declined to answer any questions.
        Asked about the California investigation, Aetna gave this written statement to CNN:
        “We have yet to hear from Commissioner Jones but look forward to explaining our clinical review process.
        “Aetna medical directors are trained to review all available medical information — including medical records — to make an informed decision. As part of our review process, medical directors are provided all submitted medical records, and also receive a case synopsis and review performed by a nurse.
        “Medical directors — and all of our clinicians — take their duties and responsibilities as medical professionals incredibly seriously. Similar to most other clinical environments, our medical directors work collaboratively with our nurses who are involved in these cases and factor in their input as part of the decision-making process.”

        ‘A huge admission’

        Dr. Arthur Caplan, founding director of the division of medical ethics at New York University Langone Medical Center, described Iinuma’s testimony as “a huge admission of fundamental immorality.”
        “People desperate for care expect at least a fair review by the payer. This reeks of indifference to patients,” Caplan said, adding the testimony shows there “needs to be more transparency and accountability” from private, for-profit insurers in making these decisions.
        Murphy, the former American Academy of Allergy Asthma and Immunology board member, said he was “shocked” and “flabbergasted” by the medical director’s admission.
        “This is something that all of us have long suspected, but to actually have an Aetna medical director admit he hasn’t even looked at medical records, that’s not good,” said Murphy, who runs an allergy and immunology practice west of Philadelphia.
        “If he has not looked at medical records or engaged the prescribing physician in a conversation — and decisions were made without that input — then yeah, you’d have to question every single case he reviewed.”
        Murphy said when he and other doctors seek a much-needed treatment for a patient, they expect the medical director of an insurance company to have considered every possible factor when deciding on the best option for care.

        See the latest news and share your comments with CNN Health on Facebook and Twitter.

        “We run into the prior authorization issues when we are renewing therapy, when the patient’s insurance changes or when an insurance company changes requirements,” he said.
        “Dealing with these denials is very time consuming. A great deal of nursing time is spent filling and refilling out paperwork trying to get the patient treatment.
        “If that does not work, then physicians need to get involved and demand medical director involvement, which may or may not occur in a timely fashion — or sometimes not at all,” he said. “It’s very frustrating.”

        Read more: http://www.cnn.com/2018/02/11/health/aetna-california-investigation/index.html

        Yes, bacon really is killing us

        The long read: Decades worth of research proves that chemicals used to make bacon do cause cancer. So how did the meat industry convince us it was safe?

        There was a little cafe I used to go to that did the best bacon sandwiches. They came in a soft and pillowy white bap. The bacon, thick-cut from a local butcher, was midway between crispy and chewy. Ketchup and HP sauce were served in miniature jars with the sandwich, so you could dab on the exact amount you liked. That was all there was to it: just bread and bacon and sauce. Eating one of these sandwiches, as I did every few weeks, with a cup of strong coffee, felt like an uncomplicated pleasure.

        And then, all of a sudden, the bacon sandwich stopped being quite so comforting. For a few weeks in October 2015, half the people I knew were talking about the news that eating bacon was now a proven cause of cancer. You couldnt miss the story: it was splashed large in every newspaper and all over the web. As one journalist wrote in Wired, Perhaps no two words together are more likely to set the internet aflame than BACON and CANCER. The BBC website announced, matter-of-factly, that Processed meats do cause cancer, while the Sun went with Banger out of Order and Killer in the Kitchen.

        The source of the story was an announcement from the World Health Organization that processed meats were now classified as a group 1 carcinogen, meaning scientists were certain that there was sufficient evidence that they caused cancer, particularly colon cancer. The warning applied not just to British bacon but to Italian salami, Spanish chorizo, German bratwurst and myriad other foods.

        Health scares are ten-a-penny, but this one was very hard to ignore. The WHO announcement came on advice from 22 cancer experts from 10 countries, who reviewed more than 400 studies on processed meat covering epidemiological data from hundreds of thousands of people. It was now possible to say that eat less processed meat, much like eat more vegetables, had become one of the very few absolutely incontrovertible pieces of evidence-based diet advice not simply another high-profile nutrition fad. As every news report highlighted, processed meat was now in a group of 120 proven carcinogens, alongside alcohol, asbestos and tobacco leading to a great many headlines blaring that bacon was as deadly as smoking.

        The WHO advised that consuming 50g of processed meat a day equivalent to just a couple of rashers of bacon or one hotdog would raise the risk of getting bowel cancer by 18% over a lifetime. (Eating larger amounts raises your risk more.) Learning that your own risk of cancer has increased from something like 5% to something like 6% may not be frightening enough to put you off bacon sandwiches for ever. But learning that consumption of processed meat causes an additional 34,000 worldwide cancer deaths a year is much more chilling. According to Cancer Research UK, if no one ate processed or red meat in Britain, there would be 8,800 fewer cases of cancer. (That is four times the number of people killed annually on Britains roads.)

        The news felt especially shocking because both ham and bacon are quintessentially British foods. Nearly a quarter of the adult population in Britain eats a ham sandwich for lunch on any given day, according to data from 2012 gathered by researchers Luke Yates and Alan Warde. To many consumers, bacon is not just a food; it is a repository of childhood memories, a totem of home. Surveys indicate that the smell of frying bacon is one of our favourite scents in the UK, along with cut grass and fresh bread. To be told that bacon had given millions of people cancer was a bit like finding out your granny had been secretly sprinkling arsenic on your morning toast.

        Vegetarians might point out that the bacon sandwich should never have been seen as comforting. It is certainly no comfort for the pigs, most of whom are kept in squalid, cramped conditions. But for the rest of us, it was alarming to be told that these beloved foods might be contributing to thousands of needless human deaths. In the weeks following news of the WHO report, sales of bacon and sausages fell dramatically. British supermarkets reported a 3m drop in sales in just a fortnight. (It was very detrimental, said Kirsty Adams, the product developer for meat at Marks and Spencer.)

        But just when it looked as if this may be #Bacongeddon (one of many agonised bacon-related hashtags trending in October 2015), a second wave of stories flooded in. Their message was: panic over. For one thing, the analogy between bacon and smoking was misleading. Smoking tobacco and eating processed meat are both dangerous, but not on the same scale. To put it in context, around 86% of lung cancers are linked to smoking, whereas it seems that just 21% of bowel cancers can be attributed to eating processed or red meat. A few weeks after publishing the report, the WHO issued a clarification insisting it was not telling consumers to stop eating processed meat.

        Meanwhile, the meat industry was busily insisting that there was nothing to see here. The North American Meat Institute, an industry lobby group, called the report dramatic and alarmist overreach. A whole tranche of articles insisted in a commonsense tone that it would be premature and foolish to ditch our meaty fry-ups just because of a little cancer scare.

        Nearly three years on, it feels like business as usual for processed meats. Many of us seem to have got over our initial sense of alarm. Sales of bacon in the UK are buoyant, having risen 5% in the two years up to mid-2016. When I interviewed a product developer for Sainsburys supermarket last year, she said that one of the quickest ways to get British consumers to try a new product now was to add chorizo to it.

        And yet the evidence linking bacon to cancer is stronger than ever. In January, a new large-scale study using data from 262,195 British women suggested that consuming just 9g of bacon a day less than a rasher could significantly raise the risk of developing breast cancer later in life. The studys lead author, Jill Pell from the Institute of Health and Wellbeing at Glasgow University, told me that while it can be counterproductive to push for total abstinence, the scientific evidence suggests it would be misleading for health authorities to set any safe dose for processed meat other than zero.

        The real scandal of bacon, however, is that it didnt have to be anything like so damaging to our health. The part of the story we havent been told including by the WHO is that there were always other ways to manufacture these products that would make them significantly less carcinogenic. The fact that this is so little known is tribute to the power of the meat industry, which has for the past 40 years been engaged in a campaign of cover-ups and misdirection to rival the dirty tricks of Big Tobacco.


        How do you choose a pack of bacon in a shop, assuming you are a meat eater? First, you opt for either the crispy fat of streaky or the leanness of back. Then you decide between smoked or unsmoked each version has its passionate defenders (I am of the unsmoked persuasion). Maybe you seek out a packet made from free-range or organic meat, or maybe your budget is squeezed and you search for any bacon on special offer. Either way, before you put the pack in your basket, you have one last look, to check if the meat is pink enough.

        Since we eat with our eyes, the main way we judge the quality of cured meats is pinkness. Yet it is this very colour that we should be suspicious of, as the French journalist Guillaume Coudray explains in a book published in France last year called Cochonneries, a word that means both piggeries and rubbish or junk food. The subtitle is How Charcuterie Became a Poison. Cochonneries reads like a crime novel, in which the processed meat industry is the perpetrator and ordinary consumers are the victims.

        The pinkness of bacon or cooked ham, or salami is a sign that it has been treated with chemicals, more specifically with nitrates and nitrites. It is the use of these chemicals that is widely believed to be the reason why processed meat is much more carcinogenic than unprocessed meat. Coudray argues that we should speak not of processed meat but nitro-meat.

        Parma
        Prosciutto di Parma has been produced without nitrates since 1993. Photograph: Stefano Rellandini/Reuters

        Pure insane crazy madness is how Coudray described the continuing use of nitrates and nitrites in processed meats, in an email to me. The madness, in his view, is that it is possible to make bacon and ham in ways that would be less carcinogenic. The most basic way to cure any meat is to salt it either with a dry salt rub or a wet brine and to wait for time to do the rest. Coudray notes that ham and bacon manufacturers claim this old-fashioned way of curing isnt safe. But the real reason they reject it is cost: it takes much longer for processed meats to develop their flavour this way, which cuts into profits.

        There is much confusion about what processed meat actually means, a confusion encouraged by the bacon industry, which benefits from us thinking there is no difference between a freshly minced lamb kofta and a pizza smothered in nitrate-cured pepperoni. Technically, processed meat means pork or beef that has been salted and cured, with or without smoking. A fresh pound of beef mince isnt processed. A hard stick of cured salami is.

        The health risk of bacon is largely to do with two food additives: potassium nitrate (also known as saltpetre) and sodium nitrite. It is these that give salamis, bacons and cooked hams their alluring pink colour. Saltpetre sometimes called sal prunella has been used in some recipes for salted meats since ancient times. As Jane Grigson explains in Charcuterie and French Pork Cookery, saltpetre was traditionally used when brining hams to give them an attractive rosy appearance when otherwise it would be a murky greyish brown.

        In earlier centuries, bacon-makers who used saltpetre did not understand that it converts to nitrite as the meat cures. It is this nitrite that allows the bacteria responsible for cured flavour to emerge quicker, by inhibiting the growth of other bacteria. But in the early 20th century, the meat industry found that the production of cured meats could be streamlined by adding sodium nitrite to the pork in pure form. In trade journals of the 1960s, the firms who sold nitrite powders to ham-makers spoke quite openly about how the main advantage was to increase profit margins by speeding up production. One French brand of sodium nitrite from the 60s was called Vitorose or quick-pink.

        Nitro-chemicals have been less of a boon to consumers. In and of themselves, these chemicals are not carcinogenic. After all, nitrate is naturally present in many green vegetables, including celery and spinach, something that bacon manufacturers often jubilantly point out. As one British bacon-maker told me, Theres nitrate in lettuce and no one is telling us not to eat that!

        But something different happens when nitrates are used in meat processing. When nitrates interact with certain components in red meat (haem iron, amines and amides), they form N-nitroso compounds, which cause cancer. The best known of these compounds is nitrosamine. This, as Guillaume Coudray explained to me in an email, is known to be carcinogenic even at a very low dose. Any time someone eats bacon, ham or other processed meat, their gut receives a dose of nitrosamines, which damage the cells in the lining of the bowel, and can lead to cancer.

        You would not know it from the way bacon is sold, but scientists have known nitrosamines are carcinogenic for a very long time. More than 60 years ago, in 1956, two British researchers called Peter Magee and John Barnes found that when rats were fed dimethyl nitrosamine, they developed malignant liver tumours. By the 1970s, animal studies showed that small, repeated doses of nitrosamines and nitrosamides exactly the kind of regular dose a person might have when eating a daily breakfast of bacon were found to cause tumours in many organs including the liver, stomach, oesophagus, intestines, bladder, brain, lungs and kidneys.

        Just because something is a carcinogen in rats and other mammals does not mean it will cause cancer in humans, but as far back as 1976, cancer scientist William Lijinsky argued that we must assume that these N-nitroso compounds found in meats such as bacon were also carcinogens for man. In the years since, researchers have gathered a massive body of evidence to lend weight to that assumption. In 1994, to take just one paper among hundreds on nitrosamines and cancer, two American epidemiologists found that eating hotdogs one or more times a week was associated with higher rates of childhood brain cancer, particularly for children who also had few vitamins in their diets.

        In 1993, Parma ham producers in Italy made a collective decision to remove nitrates from their products and revert to using only salt, as in the old days. For the past 25 years, no nitrates or nitrites have been used in any Prosciutto di Parma. Even without nitrate or nitrite, the Parma ham stays a deep rosy-pink colour. We now know that the colour in Parma ham is totally harmless, a result of the enzyme reactions during the hams 18-month ageing process.

        Slow-cured, nitrate-free, artisan hams are one thing, but what about mass-market meats? Eighteen months would be a long time to wait on hotdogs, as the food science expert Harold McGee comments. But there have always been recipes for nitrate-free bacon using nothing but salt and herbs. John Gower of Quiet Waters Farm, a pork producer who advises many British manufacturers of cured meats, confirms that nitrate is not a necessary ingredient in bacon: Its generally accepted that solid muscle products, as opposed to chopped meat products like salami, dont require the addition of nitrate for safety reasons.

        Bacon is proof, if it were needed, that we cling to old comforts long after they have been proven harmful. The attachment of producers to nitrates in bacon is mostly cultural, says Gower. Bacon cured by traditional methods without nitrates and nitrites will lack what Gower calls that hard-to-define tang, that delicious almost metallic taste that makes bacon taste of bacon to British consumers. Bacon without nitrates, says Gower, is nothing but salt pork.

        Given the harm of nitro-meat has been known for so long, the obvious question is why more has not been done to protect us from it. Corinna Hawkes, a professor of Food Policy at City University in London, has been predicting for years that processed meats will be the next sugar a food so harmful that there will be demands for government agencies to step in and protect us. Some day soon, Hawkes believes, consumers will finally wake up to the clear links between cancer and processed meat and say Why didnt someone tell me about this?


        The most amazing thing about the bacon panic of 2015 was that it took so long for official public health advice to turn against processed meat. It could have happened 40 years earlier. The only time that the processed meat industry has looked seriously vulnerable was during the 1970s, a decade that saw the so-called war on nitrates in the US. In an era of Ralph Nader-style consumer activism, there was a gathering mood in favour of protecting shoppers against bacon which one prominent public health scientist called the most dangerous food in the supermarket. In 1973, Leo Freedman, the chief toxicologist of the US Food and Drug Administration, confirmed to the New York Times that nitrosamines are a carcinogen for humans although he also mentioned that he liked bacon as well as anybody.

        The US meat industry realised it had to act fast to protect bacon against the cancer charge. The first attempts to fight back were simply to ridicule the scientists for over-reacting. In a 1975 article titled Factual look at bacon scare, Farmers Weekly insisted that a medium-weight man would have to consume more than 11 tonnes of bacon every single day to run the faintest risk of cancer. This was an outrageous fabrication.

        But soon the meat lobby came up with a cleverer form of diversion. The AMI the American Meat Institute started to make the argument that the nitrate was only there for the consumers own safety, to ward off botulism a potentially fatal toxin sometimes produced by poorly preserved foods. The scientific director of the AMI argued that a single cup of botulism would be enough to wipe out every human on the planet. So, far from harming lives, bacon was actually saving them.

        In 1977, the FDA and the US Department of Agriculture gave the meat industry three months to prove that nitrate and nitrite in bacon caused no harm. Without a satisfactory response, Coudray writes, these additives would have to be replaced 36 months later with non-carcinogenic methods. The meat industry could not prove that nitrosamines were not carcinogenic because it was already known that they were. Instead, the argument was made that nitrates and nitrites were utterly essential for the making of bacon, because without them bacon would cause thousands of deaths from botulism. In 1978, in response to the FDAs challenge, Richard Lyng, director of the AMI, argued that nitrites are to processed meat as yeast is to bread.

        The meat industrys tactics in defending bacon have been right out of the tobacco industrys playbook, according to Marion Nestle, professor of nutrition and food studies at New York University. The first move is: attack the science. By the 1980s, the AMI was financing a group of scientists based at the University of Wisconsin. These meat researchers published a stream of articles casting doubt on the harmfulness of nitrates and exaggerating the risk from botulism of non-nitrated hams.

        Does making ham without nitrite lead to botulism? If so, it is a little strange that in the 25 years that Parma ham has been made without nitrites, there has not been a single case of botulism associated with it. Almost all the cases of botulism from preserved food which are extremely rare have been the result of imperfectly preserved vegetables, such as bottled green beans, peas and mushrooms. The botulism argument was a smokescreen. The more that consumers could be made to feel that the harmfulness of nitrate and nitrite in bacon and ham was still a matter of debate, the more they could be encouraged to calm down and keep buying bacon.

        A
        A bacon sandwich at a diner in Michigan. Photograph: Molly Riley/Reuters

        The botulism pretext was very effective. The AMI managed to get the FDA to keep delaying its three-month ultimatum on nitrites until a new FDA commissioner was appointed in 1980 one more sympathetic to hotdogs. The nitrite ban was shelved. The only concession the industry had made was to limit the percentage of nitrites added to processed meat and to agree to add vitamin C, which would supposedly mitigate the formation of nitrosamines, although it does nothing to prevent the formation of another known carcinogen, nitrosyl-haem.

        Over the years, the messages challenging the dangers of bacon have become ever more outlandish. An explainer article by the Meat Science and Muscle Biology lab at the University of Wisconsin argues that sodium nitrite is in fact critical for maintaining human health by controlling blood pressure, preventing memory loss, and accelerating wound healing. A French meat industry website, info-nitrites.fr, argues that the use of the right dose of nitrites in ham guarantees healthy and safe products, and insists that ham is an excellent food for children.

        The bacon lobby has also found surprising allies among the natural foods brigade. Type nitrate cancer bacon into Google, and you will find a number of healthy eating articles, some of them written by advocates of the Paleo diet, arguing that bacon is actually a much-maligned health food. The writers often mention that vegetables are the primary source of nitrates, and that human saliva is high in nitrite. One widely shared article claims that giving up bacon would be as absurd as attempting to stop swallowing. Out of the mass of stuff on the internet defending the healthiness of bacon, it can be hard to tell which writers have fallen under the sway of the meat lobby, and which are simply clueless nutrition experts who dont know any better.

        Either way, this misinformation has the potential to make thousands of people unwell. The mystifying part is why the rest of us have been so willing to accept the cover-up.


        Our deepening knowledge of its harm has done very little to damage the comforting cultural associations of bacon. While I was researching this article, I felt a rising disgust at the repeated dishonesty of the processed meat industry. I thought about hospital wards and the horrible pain and indignity of bowel cancer. But then I remembered being in the kitchen with my father as a child on a Sunday morning, watching him fry bacon. When all the bacon was cooked, he would take a few squares of bread and fry them in the meaty fat until they had soaked up all its goodness.

        In theory, our habit of eating salted and cured meats should have died out as soon as home refrigerators became widespread in the mid-20th century. But tastes in food are seldom rational, and millions of us are still hooked on the salty, smoky, umami savour of sizzling bacon.

        We are sentimental about bacon in a way we never were with cigarettes, and this stops us from thinking straight. The widespread willingness to forgive pink, nitrated bacon for causing cancer illustrates how torn we feel when something beloved in our culture is proven to be detrimental to health. Our brains cant cope with the horrid feeling that bacon is not what we thought it was, and so we turn our anger outwards to the health gurus warning us of its hazards. The reaction of many consumers to the WHO report of 2015 was: hands off my bacon!

        In 2010, the EU considered banning the use of nitrates in organic meats. Perhaps surprisingly, the British organic bacon industry vigorously opposed the proposed nitrates ban. Richard Jacobs, the late chief executive of Organic Farmers & Growers, an industry body, said that prohibiting nitrate and nitrite would have meant the collapse of a growing market for organic bacon.

        Organic bacon produced with nitrates sounds like a contradiction in terms, given that most consumers of organic food buy it out of concerns for food safety. Having gone to the trouble of rearing pigs using free-range methods and giving them only organic feed, why would you then cure the meat in ways that make it carcinogenic? In Denmark, all organic bacon is nitrate-free. But the UK organic industry insisted that British shoppers would be unlikely to accept bacon that was greyish.

        Then again, the slowness of consumers to lose our faith in pink bacon may partly be a response to the confusing way that the health message has been communicated to us. When it comes to processed meat, we have been misled not just by wild exaggerations of the food industry but by the caution of science.

        On the WHO website, the harmfulness of nitrite-treated meats is explained so opaquely you could miss it altogether. In the middle of a paragraph on what makes red meat and processed meat increase the risk of cancer, it says: For instance, carcinogenic chemicals that form during meat processing include N-nitroso compounds. What this means, in plain English, is that nitrites make bacon more carcinogenic. But instead of spelling this out, the WHO moves swiftly on to the question of how both red and processed meats might cause cancer, after adding that it is not yet fully understood how cancer risk is increased.

        The
        The typical British sausage does not fall into the processed meat category. Photograph: Julian Smith/AAP

        This caution has kept us as consumers unnecessarily in the dark. Consider sausages. For years, I believed that the unhealthiest part in a cooked English breakfast was the sausage, rather than the bacon. Before I started to research this article, Id have sworn that sausages fell squarely into the processed meat category. They are wrongly listed as such on the NHS website.

        But the average British sausage as opposed to a hard sausage like a French saucisson is not cured, being made of nothing but fresh meat, breadcrumbs, herbs, salt and E223, a preservative that is non-carcinogenic. After much questioning, two expert spokespeople for the US National Cancer Institute confirmed to me that one might consider fresh sausages to be red meat and not processed meat, and thus only a probable carcinogen. (To me, the fact that most sausages are not processed meat was deeply cheering, and set me dancing around the kitchen with glee thinking about toad in the hole.)

        In general, if you ask a cancer scientist to distinguish between the risks of eating different types of meat, they become understandably cagey. The two experts at the National Cancer Institute told me that meats containing nitrites and nitrates have consistently been associated with increased risk of colon cancer in human studies. But they added that it is difficult to separate nitrosamines from other possible carcinogens that may be present in processed meats like bacon. These other suspects include haem iron a substance that is abundant in all red meat, processed or not and heterocyclic amines: chemicals that form in meat during cooking. A piece of crispy, overcooked bacon will contain multiple carcinogens, and not all are due to the nitrates.

        The problem with this reasoning, as I see it, is that it cant account for why processed meat is so much more closely linked to cancer than cooked red meat. For that, there remains no plausible explanation except for nitrates and nitrites. But looking for clear confirmation of this in the data is tricky, given that humans do not eat in labs under clinical observation.

        Most of what we know about processed meat and cancer in humans comes from epidemiology the study of disease across whole populations. But epidemiologists do not ask the kind of detailed questions about food that the people who eat that food may like answers to. The epidemiological data based on surveys of what people eat is now devastatingly clear that diets high in processed meats lead to a higher incidence of cancer. But it cant tell us how or why or which meats are the best or worst. As Corinna Hawkes of City University comments, The researchers dont ask you if you are eating artisanal charcuterie from the local Italian deli or the cheapest hotdogs on the planet.

        I would love to see data comparing the cancer risk of eating nitrate-free Parma ham with that of traditional bacon, but no epidemiologist has yet done such a study. The closest anyone has come was a French study from 2015, which found that consumption of nitrosylated haem iron as found in processed meats had a more direct association with colon cancer than the haem iron that is present in fresh red meat.

        It may be possible that epidemiologists have not asked people more detailed questions about what kind of processed meats they eat because they assume there is no mass-market alternative to bacon made without nitrates or nitrites. But this is about to change.


        The technology now exists to make the pink meats we love in a less damaging form, which raises the question of why the old kind is still so freely sold. Ever since the war on nitrates of the 1970s, US consumers have been more savvy about nitrates than those in Europe, and there is a lot of nitrate-free bacon on the market. The trouble, as Jill Pell remarks, is that most of the bacon labelled as nitrate-free in the US isnt nitrate-free. Its made with nitrates taken from celery extract, which may be natural, but produces exactly the same N-nitroso compounds in the meat. Under EU regulation, this bacon would not be allowed to be labelled nitrate-free.

        Its the worst con Ive ever seen in my entire life, says Denis Lynn, the chair of Finnebrogue Artisan, a Northern Irish company that makes sausages for many UK supermarkets, including Marks & Spencer. For years, Lynn had been hoping to diversify into bacon and ham but, he says, I wasnt going to do it until we found a way to do it without nitrates.

        When Lynn heard about a new process, developed in Spain, for making perfectly pink, nitrate-free bacon, he assumed it was another blind alley. In 2009, Juan de Dios Hernandez Canovas, a food scientist and the head of the food tech company Prosur, found that if he added certain fruit extracts to fresh pork, it stayed pink for a surprisingly long time.

        In January 2018, Finnebrogue used this technology to launch genuinely nitrate-free bacon and ham in the UK. It is sold in Sainsburys and Waitrose as Naked Bacon and Naked Ham, and in M&S as made without nitrites. Kirsty Adams, who oversaw its launch at M&S, explains that its not really cured. Its more like a fresh salted pork injected with a fruit and vegetable extract, and is more perishable than an old-fashioned flitch of bacon but that doesnt matter, given that it is kept in a fridge. Because it is quick to produce, this is much more economically viable to make than some of the other nitrate-free options, such as slow-cured Parma ham. The bacon currently sells in Waitrose for 3 a pack, which is not the cheapest, but not prohibitive either.

        I tried some of the Finnebrogue bacon from M&S. The back bacon tasted pleasant and mild, with a slight fruitiness. It didnt have the toothsome texture or smoky depth of a rasher of butchers dry-cured bacon, but Id happily buy it again as an alternative to nitro-meat. None of my family noticed the difference in a spaghetti amatriciana.

        Nitrite-free bacon still sounds a bit fancy and niche, but there shouldnt be anything niche about the desire to eat food that doesnt raise your risk of cancer. Lynn says that when he first approached Prosur about the fruit extract, he asked how much they had sold to the other big bacon manufacturers during the two years they had been offering it in the UK. The answer was none. None of the big guys wanted to take it, claims Lynn. They said: It will make our other processed meats look dodgy.

        But it also remains to be seen how much consumer demand there will be for nitrite- or nitrate-free bacon. For all the noise about bacon and cancer, it isnt easy to disentangle at a personal level just what kind of risk we are at when we eat a bacon sandwich. OK, so 34,000 people may die each year because of processed meat in their diet, but the odds are that it wont be you. I asked a series of cancer scientists whether they personally ate processed meat, and they all gave slightly different answers. Jill Pell said she was mostly vegetarian and ate processed meats very rarely. But when I asked Fabrice Pierre, a French expert on colon cancer and meat, if he eats ham, he replied: Yes, of course. But with vegetables at the same meal. (Pierres research at the Toxalim lab has shown him that some of the carcinogenic effects of ham can be offset by eating vegetables.)

        Our endless doubt and confusion about what we should be eating have been a gift to the bacon industry. The cover-up about the harm of meat cured with nitrates and nitrites has been helped along by the scepticism many of us feel about all diet advice. At the height of the great bacon scare of 2015, lots of intelligent voices were saying that it was safe to ignore the new classification of processed meats as carcinogenic, because you cant trust anything these nutritionists say. Meanwhile, millions of consumers of ham and bacon, many of them children, are left unprotected. Perhaps the most extraordinary thing about this controversy is how little public outrage it has generated. Despite everything, most of us still treat bacon as a dear old friend.

        In an ideal world, we would all be eating diets lower in meat, processed or otherwise, for the sake of sustainability and animal welfare as much as health. But in the world we actually live in, processed meats are still a normal, staple protein for millions of people who cant afford to swap a value pack of frying bacon for a few slivers of Prosciutto di Parma. Around half of all meat eaten in developed countries is now processed, according to researcher John Kearney, making it a far more universal habit than smoking.

        The real victims in all this are not people like me who enjoy the occasional bacon-on-sourdough in a hipster cafe. The people who will be worst affected are those many on low incomes for whom the cancer risk from bacon is compounded by other risk factors such as eating low-fibre diets with few vegetables or wholegrains. In his book, Coudray points out that in coming years, millions more poor consumers will be affected by preventable colon cancer, as westernised processed meats conquer the developing world.

        Last month, Michele Rivasi, a French MEP, launched a campaign in collaboration with Coudray demanding a ban of nitrites from all meat products across Europe. Given how vigorously the bacon industry has fought its corner thus far, a total ban on nitrites looks unlikely.

        But there are other things that could be done about the risk of nitrites and nitrates in bacon, short of an absolute veto. Better information would be a start. As Corinna Hawkes points out, it is surprising that there hasnt been more of an effort from government to inform people about the risks of eating ham and bacon, perhaps through warning labels on processed meats. But where is the British politician brave enough to cast doubt on bacon?

        Follow the Long Read on Twitter at @gdnlongread, or sign up to the long read weekly email here.

        Read more: https://www.theguardian.com/news/2018/mar/01/bacon-cancer-processed-meats-nitrates-nitrites-sausages

        Spread of breast cancer linked to compound in asparagus and other foods

        Using drugs or diet to reduce levels of asparagine may benefit patients, say researchers

        Spread of breast cancer linked to compound in asparagus and other foods

        Using drugs or diet to reduce levels of asparagine may benefit patients, say researchers

        Read more: https://www.theguardian.com/science/2018/feb/07/cutting-asparagus-could-prevent-spread-of-breast-cancer-study-shows