Yesterday, an Oklahoma judge Thad Balkman, of Cleveland County District Court, ordered Johnson & Johnson to pay $572.1 million to the state for fueling an opioid epidemic with deceptive marketing practices.

The shares for Johnson & Johnson (JNJ.N) were up after the ruling because the sum is said to be substantially less than shareholders had expected. The state’s attorney general was seeking $17 billion.

The expectation was this was going to be a $1.5 billion to $2 billion fine. $572 million is a much lower number than had been feared.”

Jared Holz, healthcare strategist for Jefferies & Co.

The state’s lawyers said Johnson & Johnson is an opioid “kingpin,” arguing that the marketing efforts caused doctors to over-prescribe the addictive painkillers which lead to a surge in drug addiction and overdose deaths in Oklahoma.

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Judge Balkman said prosecutors did demonstrate J&J’s contribution to a “public nuisance” in its marketing.

Those actions compromised the health and safety of thousands of Oklahomans. The opioid crisis is an imminent danger and menace to Oklahomans.”

Judge Balkman

The payment is said to be used for the care and treatment of opioid addicts.

More than 2,000 additional opioid lawsuits are due to go to trial in Ohio in October unless the parties reach a settlement.

Of course, Johnson & Johnson vigorously denied wrongdoing and says it will appeal the decision.

In 2017 Johnson & Johnson was ordered to pay $417 million and then in 2018, they were ordered to pay $4.7 billion for asbestos in Johnson & Johnson talcum powder. Johnson & Jonhson is also one of the top five vaccine manufactures.

Glyphosate was added to California’s Proposition 65 list of carcinogens in July 2017. Products containing Glyphosate, like Monsanto’s RoundUp, were supposed to have warning labels on the packaging that stated potential cancer risks. The glyphosate cancer warnings were scheduled to be on the packaging of glyphosate products in summer of 2018 But in 2018 Monsanto challenged the law and a federal judge temporarily banned California’s plans to add cancer warning labels on glyphosate-based products. And now the EPA has stated they will “no longer approve product labels claiming glyphosate is known to cause cancer.”

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The EPA will not allow labels that indicate a link between glyphosate and cancer. Registrants selling products that contain glyphosate have 90 days from August 7th to show compliance removing the warning.

The State of California’s much criticized Proposition 65 has led to misleading labeling requirements for products, like glyphosate, because it misinforms the public about the risks they are facing.”

EPA Statement

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This means that while Costco bans glyphosate and Bayer/Monsanto is facing more than 10,000 lawsuits and losing millions of dollars in those lawsuits (maybe billions soon) for the damage glyphosate can do to one’s health, it won’t have a warning label, but coffee and supplements sold in California will have cancer warnings labels.

Due to the way they’re processed, many fish oil supplements contain synthetic fish oil. DHA and EPA from fish oil are triglycerides, which are highly bioavailable. In most fish oil supplements, the DHA and EPA have been converted to ethyl esters — a synthetic substrate with low bioavailability that comes with health concerns.

A study, recently published in Annals of Internal Medicine on July 9 of 2019, examined the effectiveness of supplements and diets to prevent cardiovascular disease. The study looked at reviews and trials that encompasses 277 trials and 992,129 participants. They found that Omega-3 products yielded “low-certainty” evidence that they were associated with reduced risk for myocardial infarction and coronary heart disease.

One of the many problems with such medical studies is the products used. Some studies have highlighted this issue with fish oils.

Other studies looking into what common fish oil supplements actually contain have found that they have lower amounts of omega-3 than specified on the label, variable content and unregulated purity, and potentially significant levels of saturated fat and rancid oils.

Scientific American

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A recent article from Dr. Mercola’s site explains this issue in depth.

Whittel estimates about 98% of the omega-3 products on the market are inferior (and perhaps even toxic) due to the way the fish are caught and processed — a summary of which is provided in the graphic below.

In short, in order to render the rancid fish safe for human consumption, it must be cleaned, and what’s left at the end of this process is a synthetic ethyl ester omega-3 oil. The reason why some brands are able to provide you with higher concentrations of DHA, for example, is also because of this deconstruction and reconstruction process, and this appears to be part and parcel of Amarin’s complaint.

The processing most fish oils undergo transforms the omega-3 fats from their triglyceride form into an ethyl ester form. In fish, the DHA and EPA occur in the form of triglycerides, which are the most bioavailable. In most commercial fish oil supplements, however, the DHA and EPA are delivered in the form of ethyl esters.

Mercola recommends making sure your fish oil contains DHA and EPA in their triglyceride form. The company needs to process the fish oil the right way. Cold-pressed, minimally processed fish oil with triglyceride DHA and EPA is more expensive to produce.

We recommend Carlson and Nordic Naturals. Green Lifestyle Market carries Nordic Naturals fish oil.

Mercola also recommends krill oil, which has greater bioavailability.

A new study from researchers at several American universities has found that long-term exposure to air pollution, especially ozone, leads to an increase in emphysema that mirrors that of smoking a pack of cigarettes a day for 29 years. Chronic lower respiratory illnesses like emphysema are the fourth leading cause of death in the United States, but the number of people smoking fell to its lowest recorded point in U.S. history in 2017.

Rates of chronic lung disease in this country are going up and increasingly it is recognized that this disease occurs in nonsmokers…We really need to understand what’s causing chronic lung disease, and it appears that air pollution exposures that are common and hard to avoid might be a major contributor…”

Dr. Joel Kaufman

Nuts and Bolts

Of the air pollution examined in this study, researchers found that ground-level ozone, or O3, pollution had the biggest effect on emphysema. The study took place over a period of 18 years in six different cities in the United States – Chicago, Winston-Salem, N.C., Baltimore, Los Angeles, St. Paul, Minnesota, and New York. It found that cities, where average ozone levels rose by 3 ppb (parts per billion), saw a corresponding rise in emphysema rates.

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We were surprised to see how strong air pollution’s impact was on the progression of emphysema on lung scans, in the same league as the effects of cigarette smoking, which is by far the best-known cause of emphysema…”

According to Dr. Kaufman

The United States and Europe have seen declining levels of ozone in cities over the past 30 years. However, countries like India and China have seen the opposite trend. In 2015, the average ozone levels in 74 major Chinese cities increased by 3.4 percent. India and China accounted for 79 percent of premature respiratory deaths attributed to ozone pollution in a 2010 study. That can have serious effects on public health.

The New Normal

In 2015, air pollution killed 6.5 million people worldwide. It’s likely those numbers will keep rising. In the United States, the Trump Administration has been dismantling EPA policies designed to keep air pollution in check. They have finished or are currently in the process of rolling back 22 regulations that govern air pollution and emissions, including changes to the Clean Air Act. Why are we going backward?

Sources:

• Air pollution can accelerate lung disease as much as a pack a day of cigarettes – University of Washington
• Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function – JAMA
• Increasing Air Pollution Causes Lung Disease Equivalent to Smoking Pack of Cigarettes a Day for 29 Years – Newsweek
• Ozone Pollution Grows, but It Can Be Fixed – Scientific American
• One million premature deaths linked to ozone air pollution – Phys Org
• 83 Environmental Rules Being Rolled Back Under Trump – New York Times

A recent study of eight different e-liquids sold by Juul found that some of those products formed chemical irritants called acetals when heated.

Juul is one of the biggest names in the emerging e-cigarette market, but this new study furthers the growing concern that these products may also be incredibly harmful to our health. The lack of knowledge has not been helped by the lack of regulation, as these products don’t require approval from the Food and Drug Administration (FDA). That freedom has allowed them to use compounds like vanillin, which is banned in regular cigarettes.

According to Hanno Erythropel, lead author of the study, this is bad news for consumers.

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“People often assume that these e-liquids are a final product once they are mixed…But the reactions create new molecules in the e-liquids, and it doesn’t just happen in e-liquids from small vape shops, but also in those from the biggest manufacturers in the U.S…”

He goes on to say…

“…you are breathing this in. We didn’t imagine people would be inhaling flavor compounds at the level they are now. We have very little information.”

Acetals and Ingredients

Acetals are formed when you eliminate water from alcohol and aldehydes, chemicals used to artificially flavor or perfume food. Exposing human cells to acetals causes human cells to exhibit an irritation response. Researchers noticed high acetal levels in one particular Juul flavor – creme brulee.

The creme brulee tested positive for high levels of vanillin acetals. Vanillin is a compound used for vanillin flavoring. It’s also been banned for use in regular cigarettes. But e-cigarettes contain them. Sven-Eric Jordt at Duke University is a co-author of this study…

We were surprised that levels in Juul vapor were already close to safety limits for workplaces where vanillin is used, such as in bakeries and the flavor chemical industry…”

As the FDA has yet to implement proper regulations or require companies to list the ingredients in their products, it is likely there could be more unpleasant surprises in store for e-cigarette users.

The FDA Calls for Regulation

The FDA is trying to remedy this oversight. The administration had previously set 2022 as the deadline for e-cigarette companies to submit applications to keep selling their products. That has been changed to May of 2020, after a U.S. District Court judge in Maryland ruled that the FDA had been acting outside of its legal authority in allowing e-cigarette companies to operate without proper regulation.

Although previous FDA commissioner Scott Gottlieb expressed doubts that e-cigarette manufacturers would find it difficult to get their products approved, it’s not very comforting to think that the only reason the FDA is enforcing rules strictly and in a timely fashion is that they are legally compelled to.

Sources:

• Irritating Compounds Can Show Up In ‘Vape Juice’ – NPR
• Juul vaporizer: What is it, why are teens addicted and is it safe? – CNET
• Juul users inhaling chemicals not listed – YaleNews
• Juul And Rivals, Given 10 Months To Submit FDA Application, Face Battle To Keep Selling E-Cigs – Forbes
• Federal Judge Rules FDA Acted Illegally in Delaying Required Review of E-Cigarettes, Cigars – American Lung Association

While restaurants are lining up to add Beyond Meat and Impossible Foods‘ products to their menus Chipotle Mexican Grill doesn’t want them.

Chipotle provides a menu that contains only 51 ingredients, less than every other major restaurant chain. Chipotle offers “Plant-powered Lifestyle Bowls” and they use sofritas as their meat substitute for their vegetarian customers, which is made from tofu. Chief Executive Officer Brian Niccol says that the fake meat products are too processed for their restaurant.

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We have spoken to those folks and unfortunately it wouldn’t fit in our ‘food with integrity’ principles because of the processing, as I understand it, that it takes to make a plant taste like a burger,” Niccol said in an interview. “If there’s a way for them to do this that would match our ‘food with integrity’ principles, I’m sure we would continue talking with them.”

Chief Executive Officer Brian Niccol

Beyond Meat’s CEO responded with an invitation, suggesting that Beyond Meat’s factory is much better than what they’d find visiting a factory-farm.

You can come to our facility anytime. Don’t call me, just knock on the door. I invite you to do the same with all of Chipotle’s meat-processing facilities. They won’t let you, and if they did, you wouldn’t want to see it.”

CEO Ethan Brown

Many consumers are looking towards more sustainable foods and becoming more aware of the environmental costs and animal cruelty involved with factory farming. But consumers are also becoming more concerned with health problems with processed foods and GMOs.

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Both Beyond Meat and Impossible Foods develop their faux meat with highly processed plant-based ingredients. Beyond Meat’s uses pea protein as their main ingredient. Impossible Foods GMO soy and heme which is made from genetically modified yeast.

According to a new report published The BMJ medical journal, more than 1 in 10 patients are harmed in the course of their medical care. Half of those injuries are said to be preventable. Of the preventable errors, 12 percent led to patients being permanently disabled or killed.

The study looked at 70 earlier reports and covered more than 300,000 patients.

Our study finds that most harm relates to medication, and this is one core area that preventative strategies could focus on.”

Maria Panagioti, a senior lecturer at the University of Manchester

While 49 percent of the medical injuries were considered “mild,” 36 percent were deemed “moderate,” and 12 percent classified as “severe.”

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This was an international study. Two decades ago a report from the Institute of Medicine showed that medical errors resulted in the death of 98,000 Americans each year. A recent Johns Hopkins study concludes 250,000 people in the U.S. die from medical errors yearly but other reports show numbers as high as 440,000 a year.

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If medical error was a disease, it would rank as the third leading cause of death in the U.S.”

The BMJ