Fluoridation and ADHD: A new round of statistical straw clutching

“To clutch at straws – the act of reaching for a solution no matter how irrational or inconsequential.” Source: Advanced Vocabulary for English Language Learners

Anti-fluoridation activists are promoting a number of new scientific papers they argue support their campaigns. But one has only to critically read these papers to see they are clutching at straws. Their promotion relies on an unsophisticated understanding of statistics and confirmation bias.

I will look at one paper here – that of Bashash et al., (2018) which reports an association between maternal prenatal urinary fluoride and prevalence of child ADHD.

The paper is:

Bashash, M., Marchand, M., Hu, H., Till, C., Martinez-Mier, E. A., Sanchez, B. N., … Téllez-Rojo, M. M. (2018). Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years of age in Mexico City. Environment International, 121(August), 658–666.

I discussed an earlier paper  by these authors – Bashash et al., (2016) which reported an association between maternal neonatal IQ fluoride and child IQ – (also heavily promoted by anti-fluoride activists) in a number of articles:

Promotion of the new paper by anti-fluoride activists suffers from the same problems I pointed out for their promotion of the earlier paper. In particular it ignores the fact that the reported relationships (between maternal neonatal urinary fluoride and cognitive measure for children in Bashash et al., 2016, and prevalence of child  attention deficit hyperactivity disorder – ADHD – in Bashash et al., 2018) were very weak and explain only a very small amount of the variation. This raises the possibility that the reported weak relationships would disappear if significant risk-modifying factors were included in the statistical analyses.

Bashash, et al., (2018)

Whereas the earlier paper considered measures of cognitive deficits in the children the current paper considers various measurements related to ADHD prevalence among the children. These include parent rating scales (CRS-R). Three were ADHD-related scales from the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Inattention Index, Hyperactivity-Impulsive Index and Total Index [inattentive and hyperactivity-impulse behaviours combined]). They also include several other indexes related to ADHD.

A number of computer-assisted indexes (CPT-II) were also determined.

Most indices were not significantly associated with maternal prenatal urinary fluoride. However, the authors reported statistically significant (p<0.05) relationships for indices of Cognitive Problems + Inattention, ADHD Index, DSM Inattention and DSM ADHD Total.

The data and the relationships were provided in graphical form – see figure below – taken from their Figure 2:

There is obviously a wide scatter of data points indicating that the observed relationships, although statistically significant, explain only a small part of the variation in the indices.

So, just how good are the relationships reported by Bashash et al., (2018) in explaining the variation in these ADHD-related indices? I checked this out by digitally extracting the data from the figures and using linear regression analysis.

Index

% Variance explained

Cognitive problems + Inattention 2.9%
ADHD Index 3.1%
DSM Inattention 3.6%
DSM ADHD Total 3.2%

In fact, these relationships are extremely weak – explaining only a few per cent of the observed variation in the ADHD related indices. This repeats the situation for the cognition-related indices reported on the Bashash et al., (2016) paper (see Maternal urinary fluoride/IQ study – an update).

The fact these relationships were so weak has two consequences:

  1. Drawing any conclusions that maternal neonatal fluoride intake influences child ADHD prevalence is not justified. There are obviously much more important factors involved that have not been considered in the statistical analysis.
  2. Inclusion of relevant risk-modifying factors in the statistical analysis will possibly remove any statistical significance of the relationship with maternal urinary fluoride.

Credible risk-modifying factors not considered

Bashash et al., (2108) do list a number of possible confounding factors they considered. These did not markedly influence their results. however, other important factors were not included.

Nutrition is an important factor. Malin et al., (2108) reported a signficant effect of nutrition on cognitive indices for a subsample of the mother-child pairs in this study (see A more convincing take on prenatal maternal dietary effects on child IQ).

Their statistical analyses show that nutrition could explain over 11% of the variation in child cognitive indices indicating that nutrition should have been included as a possible risk-modifying factor in the statistical analyses of Bashash et al., (2016) and Bashash et al., (2018). I can appreciate that nutrition data was not available for all the mother-child pairs considered in the Bashash et al., papers. However, I look forward to a new statistical analysis of the subset used by Malin et al., (2108) which includes prenatal maternal urinary fluoride as a risk-modifying factor and tests for relationships with child ADHD prevalence.

Could the reported weak relationship disappear?

Possibly. After all, it is very weak.

The problem is that urinary fluoride data could simply be a proxy for a more important risk-modifying factor. That is, urinary fluoride could be related to other risk modifying factors (eg. nutrition) so that the relationship with urinary fluoride could disappear when these other factors are included.

I illustrated this for a earlier reported relationship of child ADHD prevalence with extent of fluoridation in US states (see Perrott 2017 – Fluoridation and attention deficit hyperactivity disorder – a critique of Malin and Till (2015)). In  that case the relationship was much better than those reported by Bashash et al., (2016) and Bashash et al., (2018) – explaining 24%, 22% and 31% of the variance in ADHD prevalence for the years 2003, 2007 and 2011 respectively. The relationships are illustrated in their figure:

Relationships between water fluoridation (%) and child ADHD prevalence for 20013 (red triangles), 2007 (blue diamonds) and 2011 (purple circles). Malin & Till (2105)

Yet, when other risk-modifying factors (particularly mean state elevation) not considered by Malin & Till (2015) were included in the regression analyses there was no statistically significant influence from fluoridation prevalence. In this case fluoridation prevalence was related to altitude and was simply acting as a proxy for altitude in the Malin & Till (2015) regression.

Conclusion

As the authors admit, this study:

“was not initially designed to study fluoride exposure and so we are missing some aspects of fluoride exposure assessments (e.g., detailed assessments of diet, water, etc.).”

However, they do say these “are now underway” so I look forward with interest to the publication of a more complete statistical analysis in the future.

There are other problems with the data (for example the paucity and nature of the urinary fluoride measurements) and these are the sort of issues inevitably confronting researchers wishing to explore existing data rather than design experimental protocols at the beginning.

Readers should therefore always be hesitant in their interpretations of the results and the credibility or faith that they put on the conclusions of such studies. The attitude should be: “that is interesting – now let’s design an experiment to test these hypothetical conclusions.”

The problem is confirmation bias – the willingness to give more credibility to the findings than is warranted. Scientists are only human and easily succumb to such biases in interpreting their own work. But this is even more true of political activists.

The reported relationships are weak. Important risk-modifying factors were probably not included in the statistical analyses. The observed relationships may simply mean that urinary fluoride is acting as a proxy for a more important risk-modifying factor (like nutrition) and the weak relationship may disappear when these are considered.

So scientific assessment of this study will be extremely hesitant – interpreting it, at best, as indicating need for more work and better designed research protocols.

But, of course, political activists will lap it up. It confirms their biases. Political activist organisations like the Fluoride Action Network are heavily promoting this paper – as they did with the earlier Bashash et al., (2016) paper.

But they are simply clutching at straws – as they often are when using science (or more correctly  misrepresenting and distorting the science) to support their political demands.

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September ’18 – NZ blogs sitemeter ranking

A view of the Montserrat Monastery, Catalonia, from above. Views from the mountaintop were amazing

Apologies for the delay this month. But my excuse is excellent – a Wine, Tapas and Walking Tour in Spain. I have come back both exhausted and refreshed, but with a better understanding of Spanish wine.

I notice a few regulars no longer allow public access to the site counters. This may happen accidentally when the blog format is altered. If your blog is unexpectedly missing or the numbers seem very low please check this out. After correcting send me the URL for your site meter and I can correct the information in the database.

Similarly, if your blog data in this list seems out of whack, please check your site meter. Usually, the problem is that for some reason your site meter is no longer working.

Sitemeter is no longer working so the total number of NZ blogs in this list has been drastically reduced. I recommend anyone with Sitemeter consider transferring to one of the other meters. See  NZ Blog Rankings FAQ.

This list is compiled automatically from the data in the various site meters used. If you feel the data in this list is wrong could you check to make sure the problem is not with your own site meter? I am of course happy to correct any mistakes that occur in the automatic transfer of data to this list but cannot be responsible for the site meters themselves. They do play up.

Every month I get queries from people wanting their own blog included. I encourage and am happy to respond to queries but have prepared a list of frequently asked questions (FAQs) people can check out. Have a look at NZ Blog Rankings FAQ. This is particularly helpful to those wondering how to set up sitemeters. Please note, the system is automatic and relies on blogs having sitemeters which allow public access to the stats.

Here are the rankings of New Zealand blogs with publicly available statistics for September 2018. Ranking is by visit numbers. I have listed the blogs in the table below, together with monthly visits and page view numbers. Meanwhile, I am still keen to hear of any other blogs with publicly available sitemeter or visitor stats that I have missed. Contact me if you know of any or wish help adding publicly available stats to your bog.

You can see data for previous months at Blog Ranks

Subscribe to NZ Blog Rankings Subscribe to NZ blog rankings by Email Find out how to get Subscription & email updates Continue reading

September ’18 NZ blog ranking – delayed

Gaztelugatxe on Gulf of Biscay coast, Spain

An apology

I am on holiday so will be a few weeks late with this month’s blog rankings.

Flight MH17 tragedy in Ukraine – new evidence

New evidence presented at Russian Ministry of Defence press conference, 17 September 2018.

In July 2014 the Malaysian Airline Flight MH17 was shot down over eastern Ukraine. All 283 passengers and 15 crew died. A Dutch-led international Joint Investigation Team (JIT) has been investigating the tragedy with the aim of determining criminal blame.

Update: Facebook took it upon themselves to censor my timeline and remove the Facebook post of my article. It seems their fact-checkers at the Atlantic Council have judged this information as “not following community standards”

Bit of a lesson there.

 

The JIT produced a preliminary report in 2016 (see But will it stand up in court?) and updated this with new evidence at a press conference last May 24. At the conference they revealed the serial number of the missile which shot down the plane and made a general appeal for people who might have information on this to come forward. At a Press Conference this week the Ministry of Defence (MOD) of the Russian Federation has responded with information from the manufacturer’s log books about this specific missile.

This appears to be the most concrete evidence to date which could be used to lay credible blame for the tragedy.

The JIT reveals serial numbers of the missile and appeals to the public for information about it.

While the JIT May 24 statement laid the blame on the Russian Federation, their evidence was rather subjective – relying on subjective interpretation of markings on vehicles in videos available online. “Open source” evidence. In contrast, the Russian MOD was specific and taken from archived information from the missile manufacturer.

In a way, this is rather unique because this information was understandably classified. Presumably, Russian officials have been active in the period between May and September locating the log books, interviewing relevant staff members from the time of production and going through the bureaucratic procedures required to declassify the material.

The new evidence

The video of the Russian MOD press conference above summarises three pieces of evidence the Russians have made available:

1: The most convincing evidence is the date of manufacture of the specific missile (December 1986) and its transport to the military unit where it was deployed. The records show it was deployed to a unit based near Lvov in the then Ukrainian Socialist Republic. It had never been returned to Russian territory.

I think that evidence is solid. The MOD spokesperson said the information has been passed onto the JIT and if they ask to inspect the archives they will be invited to Moscow to do so. He also made the point that the Russian side has asked the JIT to request the log books of the Ukrainian military unit which has been in possession of that missile and reveal its movements and location during July 2014.

2: Analysis of the video material the JIT had relied on to support their conclusion that the missile came from the Russian 53rd Anti Aircraft Missile Brigade based near Kursk in the Russian Federation. That video material had initially been compiled by Bellingcat, a suspect internet group now allied with NATO. The JIT conclusion relied on subjective tracking of markings on a BUK unit and its transporter and claimed to track it through its journey.

JIT open source video evidence supporting their conclusion that the BUK unit came from Russia

Russian experts have analysed these videos and shown problems with lighting and perspective indicating they have been faked. Something as simple as placing an image of a BUK unit into an existing video.

Their analysis seems credible, but obviously, this is the sort of thing which could be debated between experts in a court.

3: A recording of a telephone conversation made in 21016 where Ukrainian Armed Forces Col. Ruslan Grinchak refers to the tragedy in a way that implied it was caused by the Ukrainian armed forces. This person was in charge of airspace over the Donetsk region at the time of the tragedy.

This evidence relies on interpretation so is less convincing by itself.

Conclusion

The new evidence resulting from the discovery of the missile serial numbers by the JIT looks conclusive. As Russian Lieutenant General Nikolai Parshin told reporters the archives show:

“the missile was assembled on December 24, 1986, and delivered by rail to the military unit number 20/152, officially named the 223rd Air Defense Missile Brigade. It was deployed to the Ukrainian Soviet Socialist Republic’s Ternopol Region, which was part of the Subcarpathian Military District.”

Unless archive evidence in the possession of the Ukrainian armed forces can show that the missile was subsequently exported back to the Russian Federation there seems no doubt that Flight MH17 was shot down by a Ukrainian missile.

However, much more has to be done to apportion blame. There is still the possibility that this particular BUK unit was in the hands of the separatist forces in the Donetsk or Lugansk regions (although Dutch Intelligence reports at the time indicated any BUK units in the hands of separatists were not functioning -see Flight MH17 in Ukraine – what do intelligence services know?).

What is clear is that the ball is now back in the hands of the JIT, and more specifically, the Ukrainian armed forces. The JIT should now demand archived information on the locations, servicing and possession of this specific missile in the period between 2086 and July 2014.

Of course, as in other aspects of this investigation, the Ukrainian side may claim that records do not exist or have been destroyed. I do not think that is good enough and such lack of cooperation has already damaged the reputation and reliability of the JIT. Ukraine, as possibly one of the suspects, should never have been given membership of the JIT where it can influence the investigation and exert veto power over the dissemination of findings.

Perhaps reporters should now be asking the Ukrainian military to go away and find this specific missile and hold their own press conference where they can expose the serial number of the one they have in their possession.

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Novichock detection and the Salisbury tourists

Image credit: EU Today.

The Salisbury novichok poisonings are a real can of worms. Media coverage is obviously politically, rather than scientifically, driven. Social and mass media reporting is highly partisan and the scientific components and reports (which are mostly classified) can become slaves to the particular political masters. I find the whole drama a mystery and certainly do not want to tie myself to any of the conspiracy theories, official or otherwise, that are floating around. It’s probably a subject to keep well away from.

However, one aspect intrigues me – the claimed identification of novichock residues in the London hotel room used by the Russian duo, Alexander Petrov and Ruslan Boshirov. In particular, is the identification of the material reliable and, further, is the reporting of this identification factual and reliable?

Media reporting: This generally assumes a positive identification, although at trace levels. The Sun, for example, reported:

“Petrov and Boshirov stayed in the City Stay Hotel in Bow, East London, during their time in the UK.

Cops searching their room two months later on May 4 are said to have discovered minute traces of Novichok, a high-grade military nerve agent created by Soviet scientists.”

And later:

“police found traces of Novichok in the hotel room in which the pair stayed for two nights.”

Similarly, the Independent reported:

“Investigators later found traces of novichok in their room at the City Stay Hotel.

They said the amount was too low to present a health risk but are appealing for any hotel guests who stayed there between 4 March and 4 May to contact investigators.”

Since Petrov and Boshirov surfaced and were interviewed the media coverage has become even more partisan and the discovery of these traces of novichock is being portrayed as even more definite.

The police reportIn the absence of an official scientific report of the analyses this is the best we have to go on:

“On 4 May 2018, tests were carried out in the hotel room where the suspects had stayed. A number of samples were tested at DSTL at Porton Down. Two swabs showed contamination of Novichok at levels below that which would cause concern for public health. A decision was made to take further samples from the room as a precautionary measure, including in the same areas originally tested, and all results came back negative. We believe the first process of taking swabs removed the contamination, so low were the traces of Novichok in the room.

Following these tests, experts deemed the room was safe and that it posed no risk to the public.”

This raises more questions, for the scientifically inclined, than the answers, seemingly, provided:

  • How many samples were taken – 2 positives is probably a low proportion of the total measurements?
  • Where were the sample sites located in the room
  • How do the low levels reported compare with the detection limits for the methods used?
  • Was the decision to take further samples based on lack of confidence in the results form the first sampling?
  • Again, how many further samples were taken and from what sites in the room?

I suspect that the two positive detections were probably false positives which the analyst had low confidence in. It is likely many samples were taken from the room so that two positives near, or at, the level of detection is not a good result. I suspect experts would challenge this evidence in court.

Absence of evidence is not proof of innocence

I should stress that in questioning the results I am not trying to argue for the innocence of the two guys. After all, a true professional would not have contaminated the hotel room. If the evidence is genuine, though, it may be more suggestive of a non-professional or non-state actor than a professional hitman.

The problem, though, at this stage is that all the other evidence made public is circumstantial and unlikely to stand up in court. The claimed positive detection of novichock-type compounds in the hotel room could be the key to a successful conviction so any doubts should be removed.

Novichock compounds

The following presents my views on the problems of detecting novichock compounds at low levels and why I think we should not accept the current media reports as positive evidence. A court would have to look very critically at the actual data and detection methods used. At the moment the political and police statements could be expressing far more confidence in the reported findings than is actually warranted by the real evidence.

An Iranian paper from two years ago, Hosseini et al., (2016) provides information on the synthesis, structure and detection of novichock-type compounds. It is probably the most up-to-date information publicly available and its citation is

Hosseini, S. E., Saeidian, H., Amozadeh, A., Naseri, M. T., & Babri, M. (2016). Fragmentation pathways and structural characterization of organophosphorus compounds related to the Chemical Weapons Convention by electron ionization and electrospray ionization tandem mass spectrometry. Rapid Communications in Mass Spectrometry, 30(24), 2585–2593.

The paper describes the micro-synthesis of two compounds that are listed under Schedule 2.B.04 of the Chemical Weapons Convention. These are:

  • Compound 3: N-[Bis(dimethylamino)methylidene]-P-methylphosphonamidic fluoride, and
  • Compound 4: O-alkyl N-[bis(dimethylamino)-
    methylidene]-P-methylphosphonamidate Novichok derivatives

The figure shows the chemical structures of these compounds.

The F atom in compound 3 is replaced by an organic group (R) to form the novichok derivative. As this can be either of a wide range of organic groups (the authors list nine different groups for derivatives they synthesised) the novichock-type compounds include a range of different chemicals with differing levels of toxicity.

This is why more official reports on the Salisbury poisonings refer to novichock-type nerve agents and not just novichock.

Before any clever reader decides to use this paper to synthesize their own samples of these or similar compounds I must stress the warning provided by the authors:

“It should be noted that, due to the extreme toxicity of these materials, the separation and purification of CWC-related chemical are very difficult and therefore should be carried out only by a trained professional in an efficient fume cupboard equipped with an active charcoal filtration system.”

Detection of novichok-type compounds

Mass spectrometry methods are used for detection. This involves breaking up the molecules into fragments using an electron ionizer (EI). These molecular fragments are then separated according to mass and charge and the amounts of each detected in a mass spectrometer (MS) to produce an EI-MS spectrum.

Each compound has its own “fingerprint” – a pattern of peaks defined by the mass/charge (m/z) of each molecular fragment and the relative intensity of each peak. The figure below shows the EI-MS “fingerprints” for compound 3 and the O-ethyl derivative of compound 4.

We can see why the detection of a compound relies not only on a single peak but also other characteristic peaks and their relative sizes.

For example, the largest peak (H) at m/z = 71 occurs in both compounds. This is because the molecular fragment (see the chemical structure to the right) responsible for it is produced by ionization of both compounds. So that peak cannot be used alone to differentiate between the two compounds. Identification of a specific compound requires locating all the major characteristic peaks and ensuring their relative intensities are correct.

This is straightforward where the compounds are available at relatively high concentrations and the combination of mass spectroscopy with gas or liquid chromatography helps to remove some of the background chemicals. The ability of UK experts to conclude that the type of novichok used to poison the Skripals is the same as that in the fake scent bottle used by the second victims (Dawn Sturgess and Charlie Rowley) means that they were able to recover samples containing the nerve agent at sufficiently high concentrations.

But, at low concentrations one may simply not be able to find all the characteristic peaks, and identification using just the most intense peaks is not so reliable. For example, compounds 3 and 4 could not have been differentiated at low concentrations if all that could be detected were very small peaks at m/z =  71, 135 and 150. Yet that is the situation when searching for trace levels and one is always conscious that the peaks that are detected could be due to low levels of a completely different compound.

Conclusions

I suspect the description of the two possibly positive samples in the London Hotel as trace levels or “at levels below that which would cause concern for public health” were interpretations driven by “wishful thinking” and exaggerated confidence and not surety. After all, scientists often face such pressures when their political masters are looking for results to fit a preconceived narrative. It is easy to be persuaded in such situations. And it is tempting for both scientists and police to describe their findings in a more confident way when presenting to the media than they would during peer discussions in the laboratory or office.

My suspicions are supported by the fact that the total number samples taken from this hotel room must have been quite large so that makes the reliability of the positive values at such low levels for only two samples quite suspect (although information on locations of sampling sites would help this interpretation).

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A more convincing take on prenatal maternal dietary effects on child IQ

Image credit: Nutrition and Pregnancy: Choline For Baby’s Development

Prenatal maternal nutrition is more likely to influence child cognitive abilities than fluoride. A new paper shows this by considering the effects of good or bad prenatal nutrition for the women in the Basash et al., (2016)  study that anti-fluoride campaigners promote. The new data shows that nutrition is more important than fluoride.

The Bashash et al. (2016) reported a weak relationship between prenatal maternal urinary fluoride and child cognitive outcomes or IQ (see Fluoridation: “debating” the science?). Anti-fluoride campaigners latched on to the paper because it seems to offer critical “evidence” for their claims that community water fluoridation lowers IQ. They argue that IQ, rather than the risk of dental fluorosis, should be the main consideration when considering community water fluoridation.

But a new study shows that prenatal maternal nutrition is a better predictor of neurodevelopmental outcomes for children than is urinary fluoride. This study used data from the same set of Mexican women/child pairs as Bashash et al., (2016).

Here is the citation for the new study:

Malin, A. J., Busgang, S. A., Cantoral, A. J., Svensson, K., Orjuela, M. A., Pantic, I., … Gennings, C. (2018). Quality of Prenatal and Childhood Diet Predicts Neurodevelopmental Outcomes among Children in Mexico City. Nutrients, 10(8), 1093.

Misrepresentation  of the Bashash et al., (2016) study

I have dealt with this in a number of articles. Basically my argument was not with the study itself (although it obviously lacks consideration of important risk-factors in it statistical analysis) but with the way anti-fluoride activists use it to draw unwarranted conclusions.

A key problem they ignore is that the relationships reported by Bashash et al., 2016 can explain only about 3% of the variation in the cognitive measurements. This strongly suggests that the relationship with prenatal urinary fluoride would probably disappear if more important risk-modifying factors were included in the statistical analysis. My article “Predictive accuracy of a model for child IQ based on maternal prenatal urinary fluoride concentration.”  explains this and is available online.

The new Malin et al., (2108) study now provides some risk-modifying factors, specifically diet, which explains the data better than does urinary fluoride.

Readers wishing to refer back to my earlier posts on misrepresentation of the Bashash et al., (2106) study can read:

Diet as a predictor of neurodevelopmental outcomes

The statistical analyses in this new paper are quite complex because the authors considered nutrient mixture and not simply each nutrient in isolation. Their argument for this is that we consume nutrients as mixtures and that interactions between nutrients is always possible.

The study, therefore, looked at the relationship of different neurodevelopmental outcomes in the children with prenatal maternal diet. Initially the authors considered the predictive ability of nutrition by considering “good” or “bad” diets based on U.S. dietary guidelines.

A bad diet during pregnancy may harm your future child’s neurodevelopment. Credit: © ivanmateev / Fotolia

Good maternal prenatal nutrition had a significantly positive effect on all the neurodevelopmental outcomes measured. In contrast, poor nutrition had a significantly negative effect on all the outcomes (see table below). Weighted Quartile Sums (WQS) were used to create indices for the individual diets.

I compared the predictive ability of prenatal maternal nutrition used here with the prenatal maternal urinary F approach used by Bashash et al., (2016) using data digitally extracted from their supplemental figures (S1 and S2 – see below). This was for the verbal development score of the children. Unfortunately, this was the only individual data presented.

Clearly, there is a lot of scatter in the data – to be expected where a number of risk-modifying factors are involved. However, the data showing a positive effect of good maternal prenatal nutrition on the verbal score of the children explains 7.1% of the variation. The data for poor prenatal nutrition explains 11.2% of the variation.

Compare this with the predictive ability of the data present by Bashash et al., (2016) where maternal prenatal urinary fluoride could only explain 3% of the variation of the child cognitive scores (see Maternal urinary fluoride/IQ study – an update).

Malin et al., (2018) were able to show which nutrients contributed most to the positive or negative neurodevelopmental outcomes of the children. They concluded:

“mothers who consumed more nutritious diets during pregnancy tended to have children with more favorable neurodevelopmental outcomes, while mothers who consumed less nutritious diets and/or higher levels of sodium, saturated fat, and/or sugar during pregnancy tended to have children with poorer neurodevelopmental outcomes. This suggests that the consumption of more comprehensively nutritious prenatal diets favorably affects child  neurodevelopment, while the consumption of less comprehensively nutritious prenatal diets may hinder it.”

Individual nutrients affected specific neurodevelopmental factors but they reported that prenatal dietary thiamine, vitamin B6, monounsaturated fats, fibre and calcium had beneficial effects. In contrast, lower monounsaturated fat, lower thiamine, lower fibre and higher saturated fat were associated with lower neurodevelopmental scores for the children.

Conclusions

If anti-fluoride activists are really concerned about child IQ and other aspects of child neurodevelopment then they should be campaigning on the importance of nutrition during pregnancy and stop diverting us by scaremongering about community water fluoridation.

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Fluoridation: “debating” the science?

How the anti-fluoride activist envisages their debate challenge – their hero standing up against the might of the health authorities. Image credit: From the Coliseum to the Cage

New Zealand last week saw another “debate challenge” from anti-fluoride activists. But are their regular challenges serious? And do gladiatorial “debates” before partisan audiences have any value in science anyway?

These people often back away when their bluff is called. Their challenges have more to do with political tactics than any elaboration or clarification of the science. They appeal to the macho and combative attitudes of the intended audience.

One thing for sure, such “debates” do not advance scientific knowledge one iota – nor are they meant to.

The anti-fluoride hero is always victorious in the eyes of the partisan and faithful audience. Image credit: The Real Lives of the Gladiators of Rome – The Unfathomable Sport of Life and Death

Three Wise Men – the anti-fluoride activists Paul Connett, Declan Waugh and Vivyian Howard – visited New Zealand last week. Fluoride Free NZ (FFNZ) advertised these activists as “international experts . . .  “sharing the latest research.” Of course, the implications that these activists actually do any original research on fluoridation or what they were sharing was their own research were completely false.

 

This was just another one of those annual visits from Paul Connett (head of the US Fluoride Action Network) and his mates with the aim of misrepresenting and distorting the science so as to promote the political campaigns of the local anti-fluoridation brigade.

Anti-fluoride campaign puts all its eggs in the IQ basket

New Zealanders are rather tired of this sort of activism but the visit does represent an escalation. This year Three Wise Men, a few years back Two Wise men (Paul Connett and  Bill Hirzy) and before that just one wise man (Paul Connett). Is this a sign of increasing desperation as New Zealand moves ever so slowly to handing over decisions on community water fluoridation to District Health Boards? Or is it a sign of increased funding of the Fluoride Action Network and associated activist groups by the “natural”/alternative health industry? After all, it must cost a bit to send three spokespersons around the globe for just two meetings.

One thing I take from this activity is that the anti-fluoride movement has decided to put all its eggs in one basket – the IQ story. They won’t stop blaming fluoridation for all the ills of the world – from obesity to gender confusion. But they are deliberately making a determined effort to bring their IQ story onto centre stage.

The real experts and all the research indicate the main possible negative health effect which must be considered when planning introduction of fluoridation is mild forms of dental fluorosis. In contrast, anti-fluoride activists in the USA and NZ are attempting to present the main health effect that must be considered is a claimed decline in IQ.

The FFNZ advert shows this is the message the Three Wise Men were promoting in New Zealand. But the “latest research” they were “sharing” was not theirs but that of Basash et al., (2016). Or, rather, they were sharing a misrepresentaion and distortion of that research to fit their scarmongering claims.

I won’t repeat my analysis of the Bashash et al., (2016) paper and its misrepresentation here – readers can refer back to my articles:

A draft of my article critiquing the Bashash et al., (2016) paper, “Predictive accuracy of a model for child IQ based on maternal prenatal urinary fluoride concentration.” is also available online.

The predictable debate challenge

No visit by Paul Connett would be complete without a challenge to debate the science with him. He is frustrated with the fact that his audiences are almost completely faithful anti-fluoride activists. The academics, experts and health authorities did not turn up to his meeting at Otago University so he claims “they don’t feel any obligation whatsoever to debate the science” and ”to simply ignore us is unacceptable” (see Anti-fluoride campaigner invites university debate).

Similarly, he blamed others and claimed his anti-fluoride message was being ignored when only three MPs turned up for his meeting at the NZ Parliament Building last February. That was disingenuous as he had been given plenty of time for a presentation to the Health Committee during the consultations on the Fluoridation Bill last year. And MPs are regularly bombarded with huge amounts of propaganda from anti-fluoride activists. Obviously, MPs feel so inundated with such propaganda that they see no need to attend yet another meeting to hear the same old message.

Connett’s challenges to “debate the science” in front of a partisan audience have more to do with political propaganda and enthusing activists than with science. He knows scientific knowledge does not progress by holding gladiatorial circuses. It progresses by long, careful and detailed research, publication and peer review.

Neither of these Three Wise Men has performed any original research on community water fluoridation but they can still make their input via the peer review process – which include post-publication peer review via critiques of published papers.

To be fair, Connett and other members of the Fluoride Action network have occasionally presented such critiques. Two examples come to mind – the studies of  McLaren et al., (2016) and of Broadbent et al., (2015). These were critiqued in responses published in these same journals by a number of opponents of fluoridation. The original authors responded in the same journals. Arguments and extra data were presented in the responses and the science is better off for those critiques.

But science does not gain one iota from Connett’s attacks on the New Zealander Broadbent and other researchers in the media or in his meetings with the faithful. Such attacks and macho comments, often bordering on ad hominem, only discredit the attacker. They are not the way to discuss science and yet Paul Connett and his supporters challenge genuine scientists to participate in such “debates’ which are nothing more than testostorone-laden slanging matches.

A farcical example of a debate challenge

This time around I got personally involved because I called the bluff of activists making yet another debate challenge. It came out of an online discussion where I was attempting to correct some mistaken claims made by anti-fluoride activists. Here is the challenge:

Screenshot of my invite – just as well a have this as this Facebook page subsequently deleted the invitation and all comments I had made. I am officially a nonperson there.

A game of chicken followed where I attempted to get Fluoride Free NZ (FFNZ) and Paul Connett to formally stand behind the challenge. Chicken because I recognised it was a game. I had a scientific exchange (“debate”) with Paul four years ago – I think it was useful and I believe this is how good faith scientific discussions should take place (see Connett & Perrott, 2014: The Fluoride Debate for the full exchange). But Paul had made clear to me some time ago that he wanted no further contact with me.

Sure enough, FFNZ very quickly retreated from the possibility they had offered of a one on one debate. I emailed FFNZ:

“I think a one on one exchange would be best and as Paul and I have similar expertise he would be the logical discussion partner.”

Their response:

“No we will only agree to two on two.”

Paul confirmed that he would not debate one on one with me. I accepted a two on two “debate” but pointed out it was their responsibility, not mine, to organise the speakers. If they were not prepared to do that I suggested a two on one “debate” (especially as being the only speaker on one side this would give me extra presentation time) but made clear that I would effectively ignore Vyvyan Howard because our expertise did not cross over. (Vivyan agree with me that as he is a pathologist “you are correct that a direct discussion between us would be unbalanced.”)

I also made clear I would not tolerate any attempt to use that format to argue that I was isolated and could not find anyone else in New Zealand to support my arguments (an implication Paul made in our email exchange, and, of course, a claim being parroted by his supporters on social media).

Paul then formally withdrew. A pity as I love Wellington and was looking forward to a visit at someone else’s cost.

So a farce, But wait. there is more. The Facebook page, Rethink Fluoride, deleted their invitation to this “debate.” They then followed by deleting all my comments on their posts. Rather ironic as I had a few days before congratulated them by allowing open comments, and in particular allowing scientific comments – something all other anti-fluoride Facebook pages refused to allow.

Conclusion

Debate challenges by anti-fluoride activists are never genuine. They do not wish to discuss the science – they are simply using the challenges to enthuse their true-believing supporters. It is a form of attack on genuine researchers and health experts.

There is a time and place for good faith scientific exchange – post-publication peer review, for example, can give a genuine avenue for any real critiques to appear and be considered. Testosterone-laden gladiatorial debates before partisan audiences do not.

Anti-fluoride activists are disingenuously using these “debate challenges” to imply that experts and researchers have no confidence in their science and are afraid. It’s simply a macho tactic which often descends into ad hominem attacks.

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Opportunities and problems for grassroots activism offered by the internet

Caitlin Johnstone is an amazing woman. Very literate and on the ball politically.

Her analysis of recent changes in information transfer offered by the internet and the reaction of mainstream media is important. This speech, “How to Win a Grassroots Media Rebellion,” is well worth watching.

It explains a lot of the recent history of the media, the control of information and the threats to media and internet access by ordinary people.

If you find her arguments interesting follow her on Facebook, Twitter, the Medium, and on Steemit.

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August ’18 – NZ blogs sitemeter ranking

Image credit: The Fine Line. Rob Cottingham.

I notice a few regulars no longer allow public access to the site counters. This may happen accidentally when the blog format is altered. If your blog is unexpectedly missing or the numbers seem very low please check this out. After correcting send me the URL for your site meter and I can correct the information in the database.

Similarly, if your blog data in this list seems out of whack, please check your site meter. Usually, the problem is that for some reason your site meter is no longer working.

Sitemeter is no longer working so the total number of NZ blogs in this list has been drastically reduced. I recommend anyone with Sitemeter consider transferring to one of the other meters. See  NZ Blog Rankings FAQ.

This list is compiled automatically from the data in the various site meters used. If you feel the data in this list is wrong could you check to make sure the problem is not with your own site meter? I am of course happy to correct any mistakes that occur in the automatic transfer of data to this list but cannot be responsible for the site meters themselves. They do play up.

Every month I get queries from people wanting their own blog included. I encourage and am happy to respond to queries but have prepared a list of frequently asked questions (FAQs) people can check out. Have a look at NZ Blog Rankings FAQ. This is particularly helpful to those wondering how to set up sitemeters. Please note, the system is automatic and relies on blogs having sitemeters which allow public access to the stats.

Here are the rankings of New Zealand blogs with publicly available statistics for August 2018. Ranking is by visit numbers. I have listed the blogs in the table below, together with monthly visits and page view numbers. Meanwhile, I am still keen to hear of any other blogs with publicly available sitemeter or visitor stats that I have missed. Contact me if you know of any or wish help adding publicly available stats to your bog.

You can see data for previous months at Blog Ranks

Subscribe to NZ Blog Rankings Subscribe to NZ blog rankings by Email Find out how to get Subscription & email updates Continue reading

Who is weaponising the vaccination debate?

Image credit: How To Win a Vaccination Debate

The  media are promoting a new scientific paper on the vaccination debate. Their interest is undoubtedly driven by the study’s conclusion that “Russian trolls” (and by implication the Russian state) are amplifying this debate to promote discord in the US. The title describes this as “Weaponization of Health Communication.”

I am very cynical. After all, the media loves to dramatise these matters – and scientists are not immune to the temptation of taking advantage of this and the current political environment. The data the authors present is weak and has a far more reasonable explanation than the one they assume.

Yes, I may well be called a “Russian troll” or one of “Putin’s Useful Idiots” (and it wouldn’t be the first time) for expressing these doubts. But I have read the paper and this was helpful as it provides sources enabling me to do my own checking.

The paper is:

Broniatowski, D. A., Jamison, A. M., Qi, S., AlKulaib, L., Chen, T., Benton, A., … Dredze, M. (2018). Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate. American Journal of Public Health.

That’s just the abstract but here is a link to the full text.

The paper summarises its main claim about “Russian trolls” as:

“Russian trolls and sophisticated Twitter bots post content about vaccination at significantly higher rates than does the average user. Content from these sources gives equal attention to pro- and antivaccination arguments. This is consistent with a strategy of promoting discord across a range of controversial topics—a known tactic employed by Russian troll accounts. Such strategies may undermine the public health: normalizing these debates may lead the public to question long-standing scientific consensus regarding vaccine efficacy.”

The sources

The analysis relies on subjective judgment for defining a twitter account as a bot, but it does use two publicly available lists of twitter accounts (and tweets from these accounts) defined as inauthentic or false “Russian trolls.”

These sources are:

  1. “Russian troll accounts identified by NBC news” which allegedly documented “Russian interference in the US political system” (see Twitter deleted 200,000 Russian troll tweets. Read them here), and
  2. “Accounts the US Congress identifies as Russian trolls” (see Twitter’s list of 2,752 Russian trolls).

The evidence supporting their main claim is given in their Figure 1: Bots’ Likelihood of Tweeting About Vaccines Compared With Average Twitter Users: July 14, 2014–September 26, 2017. See below:

Tweets from the “NBC Russian Trolls” contain a higher incidence of vaccination keywords than tweets from the average twitter user. To be clear – this is not evidence of promotion of an anti-vaccine message (“Content from these sources gives equal attention to pro- and antivaccination arguments”). It simply shows these collection of tweets contained a higher than average reference to this polarizing subject.

I suspect a similar analysis of this collection of tweets would also show a higher than average incidence for other polarizing subjects in this collection. It is the nature of the tweet selection not evidence of a specific motive.

In fact this claim of “promoting discord” is so commonly used nowadays that it seems to have lost any meaning. Politicians now attribute this motive to much of the Russian social media – and to Russian mainstream media (eg., RT and Sputnik) news reports.

We should note that the authors did not attempt to justify the highly political allegation. They simply aligned themselves with the political message, but the senior author Broniatoski admits “we cannot say that with 100% certainty, because we’re not inside their head.”

Unfortunately, they did not consider for one moment other possible explanations for their results (that is highly unscientific and reveals a bias). I think this illustrates the power of the controlling or prominent political narrative. Anti-Russian hysteria is widespread in the US at the moment.

But there are more innocent motives for such tweets which a more objective analysis would have considered (see below).

The “guilty” tweets

I have looked through the database listing the tweets identified as from“Russian troll accounts identified by NBC news.” The incidence of reference to vaccination in the tweets from“Accounts the US Congress identifies as Russian trolls” was not much different to that for the “average user” so I did not consider them.

There were 203,451 tweets in this collection and I found about 100 (about 0.05%) included a vaccine keyword (vacc*). The paper gives examples of both pro and anti-vaccine tweets from this collection and mine were similar. These were hardly remarkable – indeed most of them were retweets. For example:

  • RT @HealthRanger: Don’t miss this: #autism-vaccine link explained by doctors!   https://t.co/L9ziemow6o  #antivax #vaccines #adhd
  • RT @ActivistPost: States are rushing to pass vaccine mandates before everyone realizes that they’re completely unnecessary at best, harmful…
  • RT @HealthRanger: Danish #documentary exposes widespread damage caused by HPV vaccine https://t.co/nuQqQ1u0XZ  #health #vaccines #antivax #…
  • RT @HealthRanger: Never inject them. #antivax #vaccines #natural #health https://t.co/oY0XLqRkdH
  • RT @pakalert: The Scary TRUTH About Vaccines (Satanic illuminati Vaccines Agenda Exposed Full Documentary) https://t.co/fxs8zOwVnV
  • RT @WorldTruthTV: Robert De Niro To Produce Film Proving Vaccines Cause Autism | World https://t.co/telXZBWPRi https://t.co/VrApvqn62s
  • RT @CobraCommans: Canadian scientists to test promising HIV vaccine on 600 volunteers @ANCParliament @My_AfricanUnion @AfricaHealthFor
  • RT @GStein269: Perry talking about Drugs and Vaccines? https://t.co/lsxJN2Udcy
  • RT @SanJosePost: #politics California’s vaccine bill passes Assembly, next hurdle: Gov. Jerry Brown
  • RT @varadmehta: Having a vaccine truther chair a commission on vaccine safety is something that merits actual outrage. But media only has o…
  • RT @blicqer: Major HIV Vaccine Trial Set to Begin in South Africa  https://t.co/fPkW3XYV32 @TheRoot https://t.co/I5iRgU42Yn

The #VaccinateUS hashtag

The paper describes the #VaccinateUS hashtag as:

“designed to promote discord using vaccination as a political wedge issue. #VaccinateUS tweets were uniquely identified with Russian troll accounts linked to the Internet Research Agency—a company backed by the Russian government specializing in online influence operations.”

Again, it did not provide any evidence to support this allegation.

The authors claim these tweets “contain a combination of grammatical errors, unnatural word choices, and irregular phrasing.” I did not see this myself – the grammar in these tweets appeared to me to be far better than the average tweets I see. The authors did acknowledge that these “messages contain fewer spelling and punctuation errors than do comparable tweets from the general vaccine stream.”

Tweets with this hashtag are about evenly divided between pro- and anti-vaccination potions (“43% were provaccine, 38% were anti vaccine, and the remaining 19% were neutral”). It occurred rarely in the quarter million tweets.

While they appear to have been specifically written by the account holders or staff at the organisation behind them, rather than simple retweets, they hardly provide evidence for a motive of “sowing discord.”

Here are some examples:

  • what will you fill when you get a disease that you could’ve been protected from? #VaccinateUS
  • if we don’t have regular chek ups and get #vaccines-what’s the point of doctors’ work? #VaccinateUS
  • open your eyes, people! It’s all government conspiracy plan  #VaccinateUS
  • our government cares only about money so it’s profitable for them to say that #vaccination is necessary #VaccinateUS
  • the production of a #vaccine is disgusting #VaccinateUS
  • #VaccinateUS FDA  state that #vaccines are safe
  • #VaccinateUS For sure #vaccines work!
  • God bless big pharma. You fools #VaccinateUS

Amplification of the anti-Russian hysteria

Ironically the charge laid at the supposed “Russian trolls” (that they seek to sow discord by amplifying existing electoral or polarizing debates) is actually typical of much of the reaction in our media to stories like this. In fact these media reports are aimed at sowing discord and promoting Russophobia. And, unfortunately, such anti-Russian amplification, or weaponization to use the language of the paper, comes from people I would have thought should know better.

This example from March for Science – a social media group formed after Trump’s election and aimed at mobilising scientists against anti-science policies of the new administration.

They are reposting an article from the Guardian (which these days leaps onto any anti-Russian argument they find). But in doing so they add their own claim:
” Study finds that 93% of tweets about vaccines between 2014 and 2017 were planted by bots and Russian trolls with the aim of sowing division.”

The 93% is the invention of March for Science as neither the paper or The Guardian provided this figure. And the study did not “find” that Russian trolls were sowing divisions – that was the prevailing assumption they started with. March for Science is simply crudely (very crudely considering their invention of 93%) amplifying the anti-Russian narrative and contributing to weaponization of social media against the Russian Federation.

Bringing this home, the NZ Facebook page Science Community New Zealand reposted the March for Science claim. Here we have social media accounts claiming to be pro-science amplifying an outright lie on social media.

Update: Science Community New Zealand has now removed the offending post – a good sign perhaps.

I am disappointed at such a naively political falsification from organisations which is meant to be promoting science. It does show how persuasive the current anti-Russian hysteria is – but it is especially disappointing to see people who should know better succumbing to it. Or, perhaps, I have been fooled and the real motives of March for Science and Science Community New Zealand have been far more questionable right from the start.

A more realistic motive for these tweets

The motive given by the study’s authors, and usually promoted in the current mainstream media narrative (sowing discord to weaken US society), really does not hold water. That strategy could more legitimately be attributed to ordinary US twitter users who indulge in tweeting on controversial subjects in far larger numbers. Anything  added by these Russian trolls is minuscule. If the Kremlin genuinely has such a strategy it should be judged a pitiful failure.

But what about this shady company Internet Research Agency based in St Petersburg? I have no doubt it exists and that it is planting material in social media like Facebook and Twitter. Presumably it is also setting up non-authentic or fake accounts for this purpose.

However, the paper’s claim that it is “a company backed by the Russian government” is not supported by any evidence at all and is typical of the way our media continually falsely claims that Russian individuals and entities are connected to the Kremlin or “close to Putin” – simply because of their ethnicity.

While the company (and many similar companies indulged in similar activity) have no credible results in “sowing discord” (compared with the ordinary, authenticated users of Twitter and Facebook in the US) they do seem to be doing this for commercial purposes. These appear to be similar to the activity of the Cambridge Analytica company which acquired personal data from social media users which they then marketed to political users.

Using fake or inauthentic accounts to retweet messages, or plant original messages, in a polarizing political or health debates is one way of mining personal data. Authentic users who retweet, “like” or repost such messages reveal a preference or bias which is of interest to companies involved in marketing products and ideas. Even seeding social media with pictures and videos of cats and dogs which attract likes, retweets and reposts can help obtain information of use to commercial and political entities.

Hell, Google, Facebook and Twitter themselves are involved in mining account holder’s personal information and selling it to advertisers.

How else do we end up getting social media messages related to topics we have searched for information on, or have commented  on in social media. On the surface this appears harmless, even useful (although the continual  messages I still get offering travel insurance just because I researched the topic several months ago are rather tiring – and counter-productive as they turn me off the advertiser).

Conclusions

My main objection to this paper is its uncritical and unthinking acceptance of the prevailing political narrative. I think it shocking that a scientific study makes no attempt to question or validate the narrative it relies on.

The data is extremely weak – only someone intoxicated by the political narrative will seriously see the extremely small number of tweets and retweets they found as evidence of a “strategy of sowing discord.”

Finally, the authors make no effort to consider other more reasonable explanations for their data. That is a pity as mining personal data by Google, Facebook, Twitter, Cambridge Analytica, the Internet Research Agency and other commercial companies should concern us all. Targeted advertising is very intrusive and annoying. Targeted political influence is also no doubt occurring and should concern us.

But the old trick of blaming the Russians for these problems is diverting our attention away from the real culprits.

I guess this shows how a bad political climate and destructive prevailing narrative can influence even the most scientific researcher.

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