COMMENT
Trials and tribulations All those interested in progress on chronic fatigue syndrome should unite in the hunt for therapies, says Esther Crawley FOR an illness that causes a lot of misery and suffering, we know very little about chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis (ME). Those affected by it include many children: one in 100 teenagers miss at least a day a week of school because of it, and probably 2 per cent are missing out on the normal stuff teenagers do. The people I see who are sick with it have disabling fatigue, problems with memory and concentration, and terrible pain. Yet progress is being hampered because some people dispute its cause and treatment. Some call it a non-illness, and others decry the use of psychological therapy. The result? Too few people are offered treatment and there is almost no research. Part of the difficulty is that it is not one illness. Both children and adults have different symptom clusters
that may represent different illnesses with different biology, requiring different approaches. This may explain why treatments only work for some. And although epidemiology shows that CFS/ME is distinct from normal fatigue, people still argue that it is not a real illness because everyone gets tired. But common fatigue is short-lived, has no other symptoms and does not stop you living a normal life. My patients would love to go to school or see their friends, but no longer can. CFS is poorly studied, but we do know it is heritable, usually triggered by an infection, and that children who get CFS are more genetically vulnerable to it. In teens, hormones are affected: for example, cortisol is low in the morning. We also know of changes that suggest metabolism is different, and that it isn’t an individual “bug” that is important
Sweet ‘n’ sour Industry-backed science that disputes sugar’s health risks is a problem, says David Miller THE sugar industry seems to have learned well from the tobacco industry. If you want to head off regulation arising from evidence that links your product to ill health, muddy the waters by creating the impression of a controversy where none exists. A US study highlights this approach, suggesting the 20 | NewScientist | 12 November 2016
“manufacture of scientific controversy” that casts doubt on the connection between sugary drinks, obesity and diabetes. Of 60 studies analysed, all 26 that failed to find a relationship had links to the sugary drinks industry. (Annals of Internal Medicine, doi.org/10/bsm8). This comes after a September
paper in JAMA claimed that the sugar industry “sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD [coronary heart disease]”. Earlier studies confirm the influence of industry funding on science in relation to sugary drinks and nutrition research. But it’s not just the sugar industry. There is an emerging
“ In the corporate world, managing science is simply a part of wider strategies… to protect profits”
and wide-ranging literature on the extent to which science is biased by industry funding in general – including in randomised controlled trials, considered the gold standard in medical research. In the corporate world, managing science is simply a part of wider strategies to influence government policies to protect profits. Manufacturing scientific controversy is, in other words, part of lobbying. An upcoming book I co-wrote, Impact of Market Forces on Addictive Substances and Behaviours, shows how science is viewed as a lobbying resource by the alcohol, tobacco and sugar