This is a very important argument, and it is essential for healthcare professionals, journalists and politicians alike to make a concerted and aggressive effort to kick these sugar-peddling companies out of the sphere of academic influence.
The more overt “More Doctors smoke…” advertisements of yesteryear are thankfully a thing of the past, but the covert influence of sugar-saturated food companies is no less a threat to our health. Aaron and Siegel (1) report that from 2011 to 2015, the Coca-Cola Company and PepsiCo were found to sponsor 95 national health organizations, many medical and public health institutions amongst them. They also lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition.
The British Nutrition Foundation, for example, lists amongst “Sustaining Members” Coca-Cola, PepsiCo, Kellogg, Nestle, Tate & Lyle and has “Corporate Members” British Sugar plc, Mars UK, KP Snacks, McDonalds, United Biscuits, Weetabix, Ocean Spray and many more. Although it is open to companies and corporations from a variety of backgrounds including healthcare and fitness, the actual members who have provided support read as a Who’s Who of Sugar Salesmen (2), making their promise of a “a focus on objective nutrition science interpretation and delivery” open to scrutiny. The American Society for Nutrition is no different, with an almost-identical list of names cropping up (3) for this group, which publishes the Journal of Nutrition.
Indeed, the editorial boards of top nutrition journals are littered by corporate affiliations with sweetie companies – The American Journal of Clinical Nutrition, for example, lists the likes of Mars, Coca-Cola, PepsiCo, Nestle, McDonald’s and Ferrero amongst companies who have a relationship with members of their board (4). The ambassador’s reception may also be overflowing with hazelnut-and-wafer spherical treats at many other nutrition journals, who often home of the Journal of Nutrition Education and Behavior, who have eight “corporate patron friends” and four “corporate sustaining friends. (5)
It would be interesting to note how these journals consider submissions which report a detriment to health from these companies’ products, but when some of the largest nutrition journals display such a conflict of interest it must become clear to all that the Honey Pot relationship between “Big Food” and academia is poisonous and needs to be dealt with.
(1) Sponsorship of National Health Organizations by Two Major Soda Companies. Aaron, Daniel G. et al. American Journal of Preventive Medicine , Volume 52 , Issue 1 , 20 – 30
On 24 April 2017, the Daily Mail published an article with the title statement “Going to the loo ‘just in case’? Don’t – it could wreck your bladder”. With a daily print circulation of 1.5 million (December 2016) and 100 million unique online visitors per month, the newspaper dispenses alarming and dangerous advice which may encourage people to hold in their urine, thereby risking urinary tract infections and renal impairment.
The article itself, apart from a number of lurid stock photos, is less sensationalist in tone than the headline. However, the focus is so scattershot (bouncing from the volume of urine that a bladder can hold, to a brief differential diagnosis of polyuria, the use of earplugs, men exercising their pelvic floor, and even David Cameron’s Brexit negotiations) that the only “take home message” risks being the first line for the newspaper’s readers. With an average reader age of 58, many of the Daily Mail’s readers will suffer from nocturia and take such advice to heart.
Dismissing tabloid medical journalism as beneath scrutiny is done at our peril, as many patients rely on newspapers to build their knowledge base and engagement can be significantly affected by what is understood to be true. When this message is dangerously incorrect, it should be confronted and disputed.
We don’t need the European Union, the National Health Service, or any other outdated monolithic organisation.
You see, Britain is special, and will ALWAYS remain so. It’s what makes us expats when we move overseas, whereas people who come here are foreigners. The respect that we have means that we will always be lucrative trading partners for Australia, New Zealand, Canada and all our former colonies. If Scotland and Northern Ireland don’t like it, then to hell with them. The union of England and Wales (Wangland) can form strong alliances with our friends overseas and we will once again rule the waves.
Happy Purim to all the Jewish people around the world, celebrating the day that Queen Esther saved the Jewish people by alerting King Xerxes to the Grand Vizier Haman’s evil plot.
Israel’s Prime Minister Benjamin Netanyahu referenced this whilst speaking to schoolchildren earlier this week:
“In Persia, they wanted to kill us but it didn’t work,” Netanyahu said. “Today, too, Persians are trying to destroy us, but today, too, it will not work.”
Bibi has spent much of the last week selling the lie that Iran’s ruler wanted to kill the Jews. Wrong! Haman was NOT the ruler. He was the vizier. He was an adviser. He was this guy:
Netanyahu’s rationale for amending history is logical: A persistent simmering frisson between Iran’s theocratic regime, which does not recognise Israel, and the hawkish Israeli prime minister consolidates the power of both parties. However, in making this statement, Netanyahu is crushing an important shared Jewish and Persian lore which has been mentioned in numerous historical manuscripts and holy books (The Torah, Bible and Quran).
Chief amongst this is Xerxes’ grandfather Cyrus The Great who liberated the Jewish people enslaved in Babylon, and announced an edict for the rebuilding of the Temple of Jerusalem.
This Persian ruler therefore ushered in a new epoch in the history of the Jewish people, culminating in the temple itself being completed during the reign of Darius II four generations later.
The Cyrus Cylinder, kept at the British Museum, describes how Cyrus allowed captives in Babylon to return to their native territories, which earned him an honoured place in the Jewish faith.
How about Xerxes, who was the grandson of Cyrus and the ruler during the events which are now celebrated in Purim? Does marrying a Jewish maiden, listening to her describe Haman’s plans and condemning the vizier to hang for his tricks mean that this was a ruler who wanted to “annihilate the Jews”. How about issuing a decree which authorized all Jews to defend themselves, and appointing Mordechai the first Jewish prime minister of the Persian Empire? These historical facts were, conveniently, rather missing from Netanyahu’s comments.
This contempt towards history is an insult to both Persian and Jewish History, two ancient cultures who have been intertwined for millenia despite the current challenges. This should be a time for celebrating cultures, and the deep bond which was cemented between Persia and the Jews following those events. Bonds which have persisted for many centuries, and still exist to this day, despite the rhetoric from Iran’s leaders, and perhaps the hawkish elements in Israel.
Abdol Hossein Sardari, known as the “Schindler of Iran” is an example. A diplomat who saved thousands of Iranian jews from deportation by the Nazi regime, he then began issuing hundreds of Iranian passports for non-Iranian jews to save them from persecution, dying in poverty two years after the Iranian Revolution in 1981. His actions do not fit into Netanyahu’s narrative either, but he exemplifies the courage and the principles of human rights that Cyrus the Great pronounced 25 centuries earlier.
Published on: https://iranwire.com/en/blogs/693/4344
In this guest blog, Dr Nima Ghadiri describes the harrowing experience of the end-of-life care his grandmother received in an Iranian hospital, and the betrayal of the principles of bioethics, which were first identified many centuries ago by Iranian polymaths, including Avicenna and Razi.
Avicenna (left) and Razi (right), Persian physicians and polymaths who helped define the principles of bioethics, used by healthcare professionals to this day
My beloved grandmother and closest friend Batool Sepassi died in an Iranian Hospital ICU (Intensive Care Unit) following a short illness.
During the course of a viral illness, she became increasingly short of breath and had to be admitted to a local private hospital. She had a chest infection and was taken to the intensive care unit accompanied by close family. At this point the family had separated to go to the payment desk, and my grandmother was taken to ICU, though no medical history was taken nor treatment started until payment was organized (the privilege of private healthcare).
There were some major flaws in treatment. Having been admitted with a chest problem, it took 30 hours for a chest consultant to see my grandmother, though not without a battle — we were told “this patient is not on my list” — and a serviceable X-ray was only taken the following day.
My family was only allowed an hour a day to visit my grandmother, which was extremely hard given that she thrived on closeness to family and friends. My close relatives stayed outside all day the ICU to be able to glance at my grandmother from a distance and hear her calling out for them. This was a traumatic experience, particularly when they heard the expressions “Saaket” or “Khafeh Sho” (“Shut up”) from my grandmother when she was undergoing procedures. My grandmother loved to communicate and form bonds with people, and appreciated having her close ones hold her hand during medical procedures. During all of her stay, her arm was outstretched to hold someone’s hand, but there was no one there and her hands were eventually fastened to the bed.
The course of the disease was unpredictable, and ultimately a poor prognosis was given, i.e. the chances of my grandmother’s survival diminished. During this period, interactions with nurses and doctors were punctuated by disregard and dismissal. For example, when one relative noticed that the nebulisers were inserted in my grandmother’s eyes rather than her nostrils (where they belong), this fact was dismissed with a “oh, her oxygen was high”. There were a few good doctors and nurses, but they were conspicuously outnumbered by the poor ones. When my cousin objected against intubation (insertion of a tube into the lungs) for the last few hours of life, instead of explaining the rationale, the doctor shouted at her “Do you want to kill your grandmother?” It took a lot of pressure to prevent the ICU team from doing a completely needless invasive procedure (kidney dialysis) with just a few hours of life remaining and kidney test results that had been unchanged for years.
Nevertheless, simple measures such as giving my grandmother something to drink were considered a luxury. When my grandmother was deteriorating, no provision was made to allow her to be close to loved ones. She and her family did not want her to be in an intensive care unit, and not only was she kept there against her will during the treatment phase, but she was kept there when she was about to die.
I asked my cousin to connect her to me by video call before her death during the one-hour visiting period. Her eyes were initially closed, but as soon as she heard my voice, they opened wide. Her mouth was entirely bandaged apart from a tube coming out of it, but I could see the outline of her lips moving briskly underneath all the bandages. She wanted to say something, and had never been stopped from talking to me before. She started vigorously shaking her tied arms in an attempt to communicate with me, but then realized her efforts were fruitless and her eyes started welling up with tears. In all my years of knowing her, I don’t remember her crying. She died just over an hour later, curtains drawn and no loved ones around her.
Nothing could have prepared me for this image, which remains traumatically imprinted in my mind. It will be a memory I will never forget. I keep wondering what she wanted to say – was she saying goodbye to me, or asking me to convey a message: to look after my mother, my brother, or help someone desperately in need? Finding the answer to this is a futile quest, but it is a rumination that will, sadly, remain.
Dying alone, with family not allowed to be with her is one thing, but my family were also denied the chance to see her after death. Only after begging were they able to get a brief glimpse of her in the corridor prior to entering the mortuary after challenging the comment, “She’s gone, why don’t you just go now”.
Passing away is an inevitable part of people’s existence, but the environment for this chapter of life is so important. As a doctor who works in the United Kingdom’s National Health Service, I have been well-versed in the importance of dignity in death. But in Iran, a country whose polymaths helped define the early principles of bioethics, it is unfathomable that core bioethical values were denied for such a sweet soul as my grandmother, and potentially for others. These principles include Non-Maleficence — not performing unnecessary procedures that serve just to prolong the patient’s life and often cause distress and pain to the patient — and Autonomy – respect for the desires and values of the patient, including how they want to be treated and how they want to die.
In my grandmother’s case this was with her family around her and without fruitless procedures. Denying someone’s spirit and character so manifestly in their final days and hours is criminal. These sentiments were shared by my family, and indeed being able to spend time with a loved one before and after their death to say goodbye should be a basic right, rather than just being able to observe this sorrowful moment from a distance. It should not be such as Sisyphean effort to spend time with a loved one and find out what happened during a hospital stay, hampered at all stages by a lack of sympathy and empathy alongside a degree of ageism against someone who is perceived as just a bed number rather than a human being.
A photo of Nima Ghadiri’s grandmother holding a pomegranate on Shab-e Yalda (An ancient Persian festival commemorating the Winter Solstice), three weeks before she died
I remain always indebted to my grandmother for looking after me as a child in the United Kingdom and being someone I could talk to and share my life with for so much of my existence. Even at her age, she had the spirit of someone many decades younger, was full of life and brought joy to so many. She shared all she had with charity and those less fortunate than herself. Strangers often commented on how sweet and bright she was and I used to talk to her about films, technology and current affairs. She remained a fountain of wisdom and I could not have dreamt of a better grandmother. Her grandchildren remain traumatized by the manner in which she has gone, and the suffering and abuse that she endured. Because she was such a positive and life-loving soul, I do not want the final page of her life to be negative. I am not sure how yet, but I know that I would be happy if the discussion arises for Iran, the country of Avicenna, Razi and numerous others, to re-discover what care, particularly at the end of life, means. Perhaps in the future, I will open a palliative care institute in her name.