Anvin Mathew

[TheLiverDoc™ @theliverdoc]

I am sorry but Dr Pal Manickam, the Gastroenterologist from California, is becoming not just a health misinformation menace, but also a subtle "hate-monger" with his divisive attitude towards dietary choices in India, also known as Bharat, a Union of States and marriage of [dietary] cultures and traditions.

Claims:
1. Eating red meat (beef and pork) causes colon cancer
2. Nitrosamines (from nitrites/nitrates) in red meat causes colon cancer
3. Cancer screening in USA above age of 50, but not in India
4. Kerala has maximum number of colon cancers in India
5. Kerala has maximum number of colon cancers because Malayalees eat a lot of beef. A lot.

Response:
1. Eating red meat does not cause colon cancer
https://t.co/rHYLCtFnA0
Higher red meat consumption was shown to have a correlation with increased risk for colon cancer, but the evidence for independent association was weak and remains weak
https://t.co/lgtOetDajU
Eating red meat does not increase risk of colon cancer. Excessive consumption of red meat/ processed meat (excessive not yet fully defined across populations) was confusingly correlated with increased risk of colon cancer
https://t.co/QITFuHVvjd

2. Studies have only looked at nitrites and nitrates [and hence nitrosamine formation] causing stomach cancer and not colon cancer. The International Agency for Research on Cancer (IARC) also focussed on nitrosamines and stomach cancer, but the potential role for dietary nitrate/nitrite in colon cancer is not conclusively proven.

Meat-based diets (specifically processed meat, not fresh meat) have a well described higher risk for cancer, but it is not readily attributable to nitrite consistently in all studies. Most studies are on ground and well water and not meat. https://t.co/bWtn4mBkfl
And the strongest study to show cancer link and nitrite consumption is in mice, not humans
https://t.co/hRSk6hzFoJ
The biggest source of nitrate exposure is dietary consumption of certain types of vegetables that are naturally high in nitrate.
This is a clear case of investigator bias, looking at any possible way to force the data into a specific conclusion (like Dr. Pal is doing in the video).
The IARC maintains the tone of its conclusion, but only to reiterate its validity in a theoretical state, while acknowledging that the epidemiology does to support these conclusions.
https://t.co/bKVYSoJSSH

Nitrites are just one reason processed meats may contribute to bowel cancer, and their relative importance is uncertain. Other factors that may contribute include iron; PAHs (polycyclic aromatic hydrocarbons) which are formed in smoked meats; and HCAs (heterocyclic amines), which are created when meat is cooked over an open flame – and which also are tumour-promoting. So its not just red meat, but the cooking method signficantly affecting health outcomes.
https://t.co/fyCZWEBP8L

3. India does not have a national level screening protocol because the proportion of colon cancer among all cancers in India is only 3% which would lead to wastage of medical resources on a low-incidence cancer detection protocol. But in the USA, colon cancer is the second most common cause of cancer death. Overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 26 for women - which is much much higher compared to India and that is why they have screening protocols in place - not because they eat more red meat than Indians.
https://t.co/Axx8zRbxf0

4. Kerala has the highest crude incidence rate of all cancers followed by Mizoram. Not colon cancer. All cancers. https://t.co/h6eOAyA4mZ
Highest colon cancer rates and burden of colon cancer are observed in Goa and Orissa, not Kerala.
https://t.co/qWCjSpl9IX & https://t.co/I3RxMPANdq
While the discussion on beef and colon cancer is ongoing in the video, a segment of the clip shows a news item "concerning increasing cases of colon cancer in Kerala" - this is that news piece - https://t.co/OkMqZwDSkl - and read what it says: it talks about only younger age group and colon cancer. "Experts opine that underlying factors leading to the rise in cases, especially at this age, could be lifestyle, environment and genetic factors" - they do not mention beef at all. The report also says: "Though we have no authentic records to show the statistics of rising cases, we have been observing a trend here. Our changing lifestyle is most likely to blame for the rise in colorectal cancer cases amongst younger people, though hereditary reasons are also a major cause." - again, no mention of beef eating.

5. Lakshwadeep is India's biggest meat eater followed by north-east states such as Arunachal Pradesh, Mizoram, Nagaland and Manipur followed by Kerala.
https://t.co/ichOVum2rM
MEAT EATING. Not beef eating. Specifically looking at the largest beef consuming state - it is Meghalaya, where more than 80% of the population consumes this meat, not Kerala.
https://t.co/NrWcmggQEY
Kerala is the largest beef consuming state in the context of male population only. [https://t.co/LmroARDOs6]

6. Oh by the way, about pork and colon cancer --> the risk was not increased consuming high amounts of pork: https://t.co/oBT5mQJo78 and there is only one study showing colon cancer risk in women in Japan, not India and that too who consumed pork >/= 3 times/week compared to </=1 time: https://t.co/EtMWN9oAjp

Add-on: The risk for colon cancer is not red meat alone (with weak evidence), but more importantly (with stronger evidence), alcohol use, smoking, family history of cancer, presence of inflammatory bowel disease, obesity and polyps or adenoma of colon. These have been very conviniently ignored by the Gastroenterologist from California.

Summary - red meat causing colon cancer is not convincingly proven. Increased intake of processed red meat more than higher intake of unprocessed red meat is weakly linked from evidence point of view to colon cancer risk. Nitrosamine in red meat as cancer causing in humans is not proven. Kerala does not have the largest burden of colon cancer in India, nor it is the largest consumer of beef. There is no realistic evidence that eating pork increases risk of colon cancer.

These are actual facts. And I am not even a Gastroenterologist from California. I am a Hepatologist. From India.

[TheLiverDoc™ @theliverdoc]

The National Medical Commision of India, the apex "scientific" body that regulates medical education and medical professionals has silently dropped the Ashoka State Emblem from it's logo, replacing it with an image of the Hindu God Dhanvantri, the embodiment of pseudoscientific Ayurveda, thus signaling the shameless entry of India into the inner circle of pseudoscience Hell.

If the NMC Members in charge of this abomination has some shame, they'll change the logo to a more secular one...one that does not embrace pseudoscientific beliefs, driven by religion and faith, but by science and rationality. Some shame at least.

[BJS @BJSurgery]

Open Access in June's BJS: Watch and wait after neoadjuvant treatment in rectal cancer: International Watch &amp; Wait Database (IWWD) https://t.co/e1WpWg0c0j @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @paulo_sutt @robhinchliffe1 @young_bjs

[Anvin Mathew @mathewanvin]

@TVMohandasPai Now all the corporates started worrying about economy. They would be happy , if they receive corporate tax cut. Bigots

[Srinivas BV @srinivasiyc]

How many nationalist Indian media channels are debating prime-time on the big revelation made by former J&amp;K Governor &amp; BJP Leader Shri Satyapal Malik about the truth of the Pulwama attack?

Anyone??

[Anvin Mathew @mathewanvin]

BJS tweet on our article

[BJS @BJSurgery]

In March's BJS: Reconstructive techniques following low anterior resection for carcinoma of the rectum: meta-analysis https://t.co/MOUiwSaR2d @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @paulo_sutt @robhinchliffe1 @young_bjs

[BJS @BJSurgery]

In March's BJS: Reconstructive techniques following low anterior resection for carcinoma of the rectum: meta-analysis https://t.co/MOUiwSaR2d @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @paulo_sutt @robhinchliffe1 @young_bjs

[Saket Gokhale @SaketGokhale]

For the 1st time in 75 years, we have a PM who is literally fluorescent.

[Anvin Mathew @mathewanvin]

@USAndIndia I am a trainee doctor from India and received a chance to present my paper at prestigious DDW 22. But not being able to get an appointment for US Visa. Please open some interview slots for B1/B2 visa.

[Anvin Mathew @mathewanvin]

@qatarairways @qrsupport I ve received a promo code as part of special offer for healthcare workers .When I try to book tickets using the code ,it is showing ‘the code is no longer valid’. Plz look into it. I tried to contact via email, but no reply till now

[Anvin Mathew @mathewanvin]

Tried contacting email , but no reply as of now. Please look into this matter 2/2

[Anvin Mathew @mathewanvin]

@qrsupport I received a promo code to book complimentary return ticket as a part of special program for COVID frontline health workers. When I tried booking using the promo code , it is showing ‘the code is no longer valid’ 1/2

[Anvin Mathew @mathewanvin]

@flyspicejet That reply is not solving the problem. No alternate SpiceJet flight is available in the sector on the same day or any adjacent days

[Anvin Mathew @mathewanvin]

@flyspicejet booked a ticket from Dehradun to kochi on 1st aug…now flight was cancelled and no other SpiceJet flight available on that day or adjacent days..mailed cystomer relation , but no reply..

[Anvin Mathew @mathewanvin]

@flyspicejet if the airlines have the right to increase the charges per sector with time , refund shud also be according to market rate at the time of cancellation, else they should arrange alternate flight.. @MoCA_GoI @DGCAIndia @JM_Scindia. 2/2

[Anvin Mathew @mathewanvin]

@flyspicejet Airline cancel flights at last minute and no other service is available from SpiceJet in the entire wk. Now the prices in the sector are exorbitant..how can I manage with the refund amount. 1/2

[Anvin Mathew @mathewanvin]

PNR : S84DJI

[Anvin Mathew @mathewanvin]

#MeTooUrbanNaxal

[Anvin Mathew @mathewanvin]

@Airtel_Presence No reply or assistance from your side

[Anvin Mathew @mathewanvin]

@Airtel_Presence Still not working... Its showing still as disconnected... Kindly contact me in my no 8336833145