Industrial espionage

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Industrial_espionage 

Teapot with Actresses, Vezzi porcelain factory, Venice, c. 1725. The Vezzi brothers were involved in a series of incidents of industrial espionage. It was these actions that led to the secret of manufacturing Meissen porcelain becoming widely known.

Industrial espionage, economic espionage, corporate spying, or corporate espionage is a form of espionage conducted for commercial purposes instead of purely national security.

While political espionage is conducted or orchestrated by governments and is international in scope, industrial or corporate espionage is more often national and occurs between companies or corporations.

Forms of economic and industrial espionage

Economic or industrial espionage takes place in two main forms. In short, the purpose of espionage is to gather knowledge about one or more organizations. It may include the acquisition of intellectual property, such as information on industrial manufacture, ideas, techniques and processes, recipes and formulas. Or it could include sequestration of proprietary or operational information, such as that on customer datasets, pricing, sales, marketing, research and development, policies, prospective bids, planning or marketing strategies or the changing compositions and locations of production. It may describe activities such as theft of trade secrets, bribery, blackmail and technological surveillance. As well as orchestrating espionage on commercial organizations, governments can also be targets – for example, to determine the terms of a tender for a government contract.

Target industries

During testing, automakers commonly disguise upcoming car models with camouflage paint patterns designed to obfuscate the vehicle's lines. Padded covers or deceptive decals are also often used. This is also to prevent motoring media outlets from spoiling the model before its planned reveal.

Economic and industrial espionage is most commonly associated with technology-heavy industries, including computer software and hardware, biotechnology, aerospace, telecommunications, transportation and engine technology, automobiles, machine tools, energy, materials and coatings and so on. Silicon Valley is known to be one of the world's most targeted areas for espionage, though any industry with information of use to competitors may be a target.

Information theft and sabotage

Information can make the difference between success and failure; if a trade secret is stolen, the competitive playing field is leveled or even tipped in favor of a competitor. Although a lot of information-gathering is accomplished legally through competitive intelligence, at times corporations feel the best way to get information is to take it. Economic or industrial espionage is a threat to any business whose livelihood depends on information.

In recent years, economic or industrial espionage has taken on an expanded definition. For instance, attempts to sabotage a corporation may be considered industrial espionage; in this sense, the term takes on the wider connotations of its parent word. That espionage and sabotage (corporate or otherwise) have become more clearly associated with each other is also demonstrated by a number of profiling studies, some government, some corporate. The United States government currently has a polygraph examination entitled the "Test of Espionage and Sabotage" (TES), contributing to the notion of the interrelationship between espionage and sabotage countermeasures. In practice, particularly by "trusted insiders", they are generally considered functionally identical for the purpose of informing countermeasures.

Agents and the process of collection

Economic or industrial espionage commonly occurs in one of two ways. Firstly, a dissatisfied employee appropriates information to advance interests or to damage the company. Secondly, a competitor or foreign government seeks information to advance its own technological or financial interest. "Moles", or trusted insiders, are generally considered the best sources for economic or industrial espionage. Historically known as a "patsy", an insider can be induced, willingly or under duress, to provide information. A patsy may be initially asked to hand over inconsequential information and, once compromised by committing a crime, blackmailed into handing over more sensitive material. Individuals may leave one company to take up employment with another and take sensitive information with them. Such apparent behavior has been the focus of numerous industrial espionage cases that have resulted in legal battles. Some countries hire individuals to do spying rather than the use of their own intelligence agencies. Academics, business delegates, and students are often thought to be used by governments in gathering information. Some countries, such as Japan, have been reported to expect students to be debriefed on returning home. A spy may follow a guided tour of a factory and then get "lost". A spy could be an engineer, a maintenance man, a cleaner, an insurance salesman, or an inspector: anyone who has legitimate access to the premises.

A spy may break into the premises to steal data and may search through waste paper and refuse, known as "dumpster diving". Information may be compromised via unsolicited requests for information, marketing surveys, or use of technical support or research or software facilities. Outsourced industrial producers may ask for information outside the agreed-upon contract.

Computers have facilitated the process of collecting information because of the ease of access to large amounts of information through physical contact or the Internet.

History

Origins

The work of a European priest, Father Francois Xavier d'Entrecolles to reveal to Europe the manufacturing methods of Chinese porcelain in 1712, is sometimes considered an early case of industrial espionage.

Economic and industrial espionage has a long history. Father Francois Xavier d'Entrecolles, who visited Jingdezhen, China in 1712 and later used this visit to reveal the manufacturing methods of Chinese porcelain to Europe, is sometimes considered to have conducted an early case of industrial espionage.

Historical accounts have been written of industrial espionage between Britain and France. Attributed to Britain's emergence as an "industrial creditor", the second decade of the 18th century saw the emergence of a large-scale state-sponsored effort to surreptitiously take British industrial technology to France. Witnesses confirmed both the inveigling of tradespersons abroad and the placing of apprentices in England. Protests by those such as ironworkers in Sheffield and steelworkers in Newcastle, about skilled industrial workers being enticed abroad, led to the first English legislation aimed at preventing this method of economic and industrial espionage. This did not prevent Samuel Slater from bringing British textile technology to the United States in 1789. In order to catch up with technological advances of European powers, the US government in the eighteenth and nineteenth centuries actively encouraged intellectual piracy.

American founding father and first U.S. Treasury Secretary Alexander Hamilton advocated rewarding those bringing "improvements and secrets of extraordinary value" into the United States. This was instrumental in making the United States a haven for industrial spies.

20th century

East-West commercial development opportunities after World War I saw a rise in Soviet interest in American and European manufacturing know-how, exploited by Amtorg Corporation. Later, with Western restrictions on the export of items thought likely to increase military capabilities to the USSR, Soviet industrial espionage was a well known adjunct to other spying activities up until the 1980s. BYTE reported in April 1984, for example, that although the Soviets sought to develop their own microelectronics, their technology appeared to be several years behind the West's. Soviet CPUs required multiple chips and appeared to be close or exact copies of American products such as the Intel 3000 and DEC LSI-11/2.

"Operation Brunnhilde"

Some of these activities were directed via the East German Stasi (Ministry for State Security). One such operation, "Operation Brunnhilde," operated from the mid-1950s until early 1966 and made use of spies from many Communist Bloc countries. Through at least 20 forays, many western European industrial secrets were compromised. One member of the "Brunnhilde" ring was a Swiss chemical engineer, Dr. Jean Paul Soupert (also known as "Air Bubble"), living in Brussels. He was described by Peter Wright in Spycatcher as having been "doubled" by the Belgian Sûreté de l'État. He revealed information about industrial espionage conducted by the ring, including the fact that Russian agents had obtained details of Concorde's advanced electronics system. He testified against two Kodak employees, living and working in Britain, during a trial in which they were accused of passing information on industrial processes to him, though they were eventually acquitted.

According to a 2020 American Economic Review study, East German industrial espionage in West Germany significantly reduced the gap in total factor productivity between the two countries.

Soviet spetsinformatsiya system

A secret report from the Military-Industrial Commission of the USSR (VPK), from 1979–80, detailed how spetsinformatsiya (Russian: специнформация, "special records") could be utilised in twelve different military industrial areas. Writing in the Bulletin of the Atomic Scientists, Philip Hanson detailed a spetsinformatsiya system in which 12 industrial branch ministries formulated requests for information to aid technological development in their military programs. Acquisition plans were described as operating on 2-year and 5-year cycles with about 3000 tasks underway each year. Efforts were aimed at civilian and military industrial targets, such as in the petrochemical industries. Some information was gathered to compare Soviet technological advancement with that of their competitors. Much unclassified information was also gathered, blurring the boundary with "competitive intelligence".

The Soviet military was recognised as making much better use of acquired information than civilian industries, where their record in replicating and developing industrial technology was poor.

Legacy of Cold War espionage

Following the demise of the Soviet Union and the end of the Cold War, commentators, including the US Congressional Intelligence Committee, noted a redirection amongst the espionage community from military to industrial targets, with Western and former communist countries making use of "underemployed" spies and expanding programs directed at stealing such information.

The legacy of Cold War spying included not just the redirection of personnel but the use of spying apparatus such as computer databases, scanners for eavesdropping, spy satellites, bugs and wires.

Industrial espionage as part of US foreign policy

According to an article from news website theintercept.com, "potentially sabotaging another country's hi-tech industries and their top companies has long been a sanctioned American strategy." The article was based on a leaked report issued from former U.S. Director of National Intelligence James R. Clapper's office that evaluated a theoretical scenario on how intelligence could be used to overcome a loss of the United States' technological and innovative edge. The report did not show any actual occurrence of U.S. conducted industrial espionage, and when contacted the Director of National Intelligence office responded with, "the United States—unlike our adversaries—does not steal proprietary corporate information to further private American companies' bottom lines", and that "the Intelligence Community regularly engages in analytic exercises to identify potential future global environments, and how the IC could help the United States Government respond". The report, he said, "is not intended to be, and is not, a reflection of current policy or operations".

Former CIA Director Stansfield Turner stated in 1991 "Nevertheless, as we increase emphasis on securing economic intelligence, we will have to spy on the more developed countries-our allies and friends with whom we compete economically-but to whom we turn first for political and military assistance in a crisis. This means that rather than instinctively reaching for human, on-site spying, the United States will want to look to those impersonal technical systems, primarily satellite photography and intercepts".

Former CIA Director James Woolsey acknowledged in 2000 that the United States steals economic secrets from foreign firms and their governments "with espionage, with communications, with reconnaissance satellites". He also stated it is "not to provide secrets, technological secrets to American industry." He listed the three reasons as understanding whether sanctions are functioning for countries under sanction, monitoring dual-use technology that could be used to produce or develop weapons of mass destruction, and to spy on bribery to uphold the Foreign Corrupt Practices Act.

In 2013 The United States was accused of spying on Brazilian oil company Petrobras. Brazil's President Dilma Rousseff stated that it was tantamount to industrial espionage and had no security justification.

In 2014 former US intelligence officer Edward Snowden stated that America's National Security Agency was engaged in industrial espionage and that they spied on German companies that compete with US firms. He also highlighted the fact the NSA uses mobile phone apps such as Angry Birds to gather personal data.

In September 2019, security firm Qi An Xin published report linking the CIA to a series of attacks targeting Chinese aviation agencies between 2012 and 2017.

Israel's economic espionage in the United States

Israel has an active program to gather proprietary information within the United States. These collection activities are primarily directed at obtaining information on military systems and advanced computing applications that can be used in Israel's sizable armaments industry.

Israel was accused by the US government of selling US military technology and secrets to China.

In 2014 American counter-intelligence officials told members of the House Judiciary and Foreign Affairs committees that Israel's current espionage activities in America are "unrivaled".

Use of computers and the Internet

Personal computers

Computers have become key in exercising industrial espionage due to the enormous amount of information they contain and the ease at which it can be copied and transmitted. The use of computers for espionage increased rapidly in the 1990s. Information has commonly been stolen by individuals posing as subsidiary workers, such as cleaners or repairmen, gaining access to unattended computers and copying information from them. Laptops were, and still are, a prime target, with those traveling abroad on business being warned not to leave them for any period of time. Perpetrators of espionage have been known to find many ways of conning unsuspecting individuals into parting, often only temporarily, from their possessions, enabling others to access and steal information. A "bag-op" refers to the use of hotel staff to access data, such as through laptops, in hotel rooms. Information may be stolen in transit, in taxis, at airport baggage counters, baggage carousels, on trains and so on.

The Internet

The rise of the Internet and computer networks has expanded the range and detail of information available and the ease of access for the purpose of industrial espionage. This type of operation is generally identified as state backed or sponsored, because the "access to personal, financial or analytic resources" identified exceed that which could be accessed by cybercriminals or individual hackers. Sensitive military or defense engineering or other industrial information may not have immediate monetary value to criminals, compared with, say, bank details. Analysis of cyberattacks suggests deep knowledge of networks, with targeted attacks, obtained by numerous individuals operating in a sustained organized way.

Opportunities for sabotage

The rising use of the internet has also extended opportunities for industrial espionage with the aim of sabotage. In the early 2000s, it was noticed that energy companies were increasingly coming under attack from hackers. Energy power systems, doing jobs like monitoring power grids or water flow, once isolated from the other computer networks, were now being connected to the internet, leaving them more vulnerable, having historically few built-in security features. The use of these methods of industrial espionage have increasingly become a concern for governments, due to potential attacks by terrorist groups or hostile foreign governments.

Malware

One of the means of perpetrators conducting industrial espionage is by exploiting vulnerabilities in computer software. Malware and spyware are "tool[s] for industrial espionage", in "transmitting digital copies of trade secrets, customer plans, future plans and contacts". Newer forms of malware include devices which surreptitiously switch on mobile phones camera and recording devices. In attempts to tackle such attacks on their intellectual property, companies are increasingly keeping important information off network, leaving an "air gap", with some companies building Faraday cages to shield from electromagnetic or cellphone transmissions.

Distributed denial of service (DDoS) attack

The distributed denial of service (DDoS) attack uses compromised computer systems to orchestrate a flood of requests on the target system, causing it to shut down and deny service to other users. It could potentially be used for economic or industrial espionage with the purpose of sabotage. This method was allegedly utilized by Russian secret services, over a period of two weeks on a cyberattack on Estonia in May 2007, in response to the removal of a Soviet era war memorial.

Notable cases

British East India Company

In 1848, the British East India Company broke Qing China's global near-monopoly on tea production by smuggling Chinese tea out of the nation and copying Chinese tea-making processes. The British Empire had previously run a considerable trade deficit with China by importing the nation's tea and other goods. The British attempted to rectify the deficit by trading opium to the Chinese, but encountered difficulties after the Daoguang Emperor banned the opium trade and the First Opium War broke out. To avoid further issues in trading tea with China, the East India Company hired Scottish botanist Robert Fortune to travel to China under the guise of a Chinese nobleman and obtain Chinese trade secrets and tea plants for replanting. Infiltrating Chinese tea-making facilities, Fortune recorded the Chinese process for creating tea and smuggled tea leaves and seeds back to the East India Company. These tea plants were later introduced into India, helping it surpass China as the world's largest tea producer.

France and the United States

Between 1987 and 1989, IBM and Texas Instruments were thought to have been targeted by French DGSE with the intention of helping France's Groupe Bull. In 1993, U.S. aerospace companies were also thought to have been targeted by French interests. During the early 1990s, France was described as one of the most aggressive pursuers of espionage to garner foreign industrial and technological secrets. France accused the U.S. of attempting to sabotage its high tech industrial base. The government of France has been alleged to have conducted ongoing industrial espionage against American aerodynamics and satellite companies.

Volkswagen

In 1993, car manufacturer Opel, the German division of General Motors, accused Volkswagen of industrial espionage after Opel's chief of production, Jose Ignacio Lopez, and seven other executives moved to Volkswagen. Volkswagen subsequently threatened to sue for defamation, resulting in a four-year legal battle. The case, which was finally settled in 1997, resulted in one of the largest settlements in the history of industrial espionage, with Volkswagen agreeing to pay General Motors $100 million and to buy at least $1 billion of car parts from the company over 7 years, although it did not explicitly apologize for Lopez's behavior.

Hilton and Starwood

In April 2009, Starwood accused its rival Hilton Worldwide of a "massive" case of industrial espionage. After being acquired by The Blackstone Group, Hilton employed 10 managers and executives from Starwood. Starwood accused Hilton of stealing corporate information relating to its luxury brand concepts, used in setting up its Denizen hotels. Specifically, former head of its luxury brands group, Ron Klein, was accused of downloading "truckloads of documents" from a laptop to his personal email account.

Google and Operation Aurora

On 13 January 2010, Google announced that operators, from within China, had hacked into their Google China operation, stealing intellectual property and, in particular, accessing the email accounts of human rights activists. The attack was thought to have been part of a more widespread cyber attack on companies within China which has become known as Operation Aurora. Intruders were thought to have launched a zero-day attack, exploiting a weakness in the Microsoft Internet Explorer browser, the malware used being a modification of the trojan "Hydraq". Concerned about the possibility of hackers taking advantage of this previously unknown weakness in Internet Explorer, the governments of Germany and, subsequently France, issued warnings not to use the browser.

There was speculation that "insiders" had been involved in the attack, with some Google China employees being denied access to the company's internal networks after the company's announcement. In February 2010, computer experts from the U.S. National Security Agency claimed that the attacks on Google probably originated from two Chinese universities associated with expertise in computer science, Shanghai Jiao Tong University and the Shandong Lanxiang Vocational School, the latter having close links to the Chinese military.

Google claimed at least 20 other companies had also been targeted in the cyber attack, said by the London Times, to have been part of an "ambitious and sophisticated attempt to steal secrets from unwitting corporate victims" including "defence contractors, finance and technology companies". Rather than being the work of individuals or organised criminals, the level of sophistication of the attack was thought to have been "more typical of a nation state". Some commentators speculated as to whether the attack was part of what is thought to be a concerted Chinese industrial espionage operation aimed at getting "high-tech information to jump-start China's economy". Critics pointed to what was alleged to be a lax attitude to the intellectual property of foreign businesses in China, letting them operate but then seeking to copy or reverse engineer their technology for the benefit of Chinese "national champions". In Google's case, they may have (also) been concerned about the possible misappropriation of source code or other technology for the benefit of Chinese rival Baidu. In March 2010 Google subsequently decided to cease offering censored results in China, leading to the closing of its Chinese operation.

USA v. Lan Lee, et al.

The United States charged two former NetLogic Inc. engineers, Lan Lee and Yuefei Ge, of committing economic espionage against TSMC and NetLogic, Inc. A jury acquitted the defendants of the charges with regard to TSMC and deadlocked on the charges with regard to NetLogic. In May 2010, a federal judge dismissed all the espionage charges against the two defendants. The judge ruled that the U.S. government presented no evidence of espionage.

Dongxiao Yue and Chordiant Software, Inc.

In May 2010, the federal jury convicted Chordiant Software, Inc., a U.S. corporation, of stealing Dongxiao Yue's JRPC technologies and used them in a product called Chordiant Marketing Director. Yue previously filed lawsuits against Symantec Corporation for a similar theft.

Concerns of national governments

Brazil

Revelations from the Snowden documents have provided information to the effect that the United States, notably vis-à-vis the NSA, has been conducting aggressive economic espionage against Brazil. Canadian intelligence has apparently supported U.S. economic espionage efforts.

China

The Chinese cybersecurity company Qihoo 360 accused Central Intelligence Agency of the United States of an 11-year-long hacking campaign that targeted several industries including aviation organizations, scientific research institutions, petroleum firms, internet companies, and government agencies.

United States

A 2009 report to the US government, by aerospace and defense company Northrop Grumman, describes Chinese economic espionage as comprising "the single greatest threat to U.S. technology". Blogging on the 2009 cyber attack on Google, Joe Stewart of SecureWorks referred to a "persistent campaign of 'espionage-by-malware' emanating from the People's Republic of China (PRC)" with both corporate and state secrets being "Shanghaied" over the past 5 or 6 years. The Northrop Grumman report states that the collection of US defense engineering data through cyberattack is regarded as having "saved the recipient of the information years of R&D and significant amounts of funding". Concerns about the extent of cyberattacks on the US emanating from China has led to the situation being described as the dawn of a "new cold cyberwar".

According to Edward Snowden, the National Security Agency spies on foreign companies. In June 2015 Wikileaks published documents about the National Security Agency spying on French companies.

United Kingdom

During December of 2007, this was suddenly revealed that Jonathan Evans, head of the United Kingdom's MI5, had sent out confidential letters to 300 chief executives and security chiefs at the country's banks, accountants and legal firms warning of attacks from Chinese 'state organisations'. A summary was also posted on the secure website of the Centre for the Protection of the National Infrastructure, accessed by some of the nation's 'critical infrastructure' companies, including 'telecoms firms, banks and water and electricity companies'. One security expert warned about the use of 'custom trojans,' software specifically designed to hack into a particular firm and feed back data. Whilst China was identified as the country most active in the use of internet spying, up to 120 other countries were said to be using similar techniques. The Chinese government responded to UK accusations of economic espionage by saying that the report of such activities was 'slanderous' and that the government opposed hacking which is prohibited by law.

Germany

German counter-intelligence experts have maintained the German economy is losing around €53 billion or the equivalent of 30,000 jobs to economic espionage yearly.

In Operation Eikonal, German BND agents received "selector lists" from the NSA – search terms for their dragnet surveillance. They contain IP addresses, mobile phone numbers and email accounts with the BND surveillance system containing hundreds of thousands and possibly more than a million such targets. These lists have been subject of controversy as in 2008 it was revealed that they contained some terms targeting the European Aeronautic Defence and Space Company (EADS), the Eurocopter project as well as French administration, which were first noticed by BND employees in 2005. After the revelations made by whistleblower Edward Snowden, the BND decided to investigate the issue whose October 2013 conclusion was that at least 2,000 of these selectors were aimed at Western European or even German interests which has been a violation of the Memorandum of Agreement that the US and Germany signed in 2002 in the wake of the 9/11 terror attacks. After reports emerged in 2014 that EADS and Eurocopter had been surveillance targets the Left Party and the Greens filed an official request to obtain evidence of the violations.

The BND's project group charged with supporting the NSA investigative committee in German parliament set up in spring 2014, reviewed the selectors and discovered 40,000 suspicious search parameters, including espionage targets in Western European governments and numerous companies. The group also confirmed suspicions that the NSA had systematically violated German interests and concluded that the Americans could have perpetrated economic espionage directly under the Germans' noses. The investigative parliamentary committee was not granted access to the NSA's selectors list as an appeal led by opposition politicians failed at Germany's top court. Instead the ruling coalition appointed an administrative judge, Kurt Graulich [de], as a "person of trust" who was granted access to the list and briefed the investigative commission on its contents after analyzing the 40,000 parameters. In his almost 300-paged report Graulich concluded that European government agencies were targeted massively and that Americans hence broke contractual agreements. He also found that German targets which received special protection from surveillance of domestic intelligence agencies by Germany's Basic Law (Grundgesetz) − including numerous enterprises based in Germany – were featured in the NSA's wishlist in a surprising plenitude.

Competitive intelligence and economic or industrial espionage

"Competitive intelligence" involves the legal and ethical activity of systematically gathering, analyzing and managing information on industrial competitors. It may include activities such as examining newspaper articles, corporate publications, websites, patent filings, specialised databases, information at trade shows and the like to determine information on a corporation. The compilation of these crucial elements is sometimes termed CIS or CRS, a Competitive Intelligence Solution or Competitive Response Solution, with its roots in market research. Douglas Bernhardt has characterised "competitive intelligence" as involving "the application of principles and practices from military and national intelligence to the domain of global business"; it is the commercial equivalent of open-source intelligence.

The difference between competitive intelligence and economic or industrial espionage is not clear; one needs to understand the legal basics to recognize how to draw the line between the two.

Collusion

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Collusion 

Collusion is a deceitful agreement or secret cooperation between two or more parties to limit open competition by deceiving, misleading or defrauding others of their legal right. Collusion is not always considered illegal. It can be used to attain objectives forbidden by law; for example, by defrauding or gaining an unfair market advantage. It is an agreement among firms or individuals to divide a market, set prices, limit production or limit opportunities. It can involve "unions, wage fixing, kickbacks, or misrepresenting the independence of the relationship between the colluding parties". In legal terms, all acts effected by collusion are considered void.

Definition

In the study of economics and market competition, collusion takes place within an industry when rival companies cooperate for their mutual benefit. Conspiracy usually involves an agreement between two or more sellers to take action to suppress competition between sellers in the market. Because competition among sellers can provide consumers with low prices, conspiracy agreements increase the price consumers pay for the goods. Because of this harm to consumers, it is against antitrust laws to fix prices by agreement between producers, so participants must keep it a secret. Collusion often takes place within an oligopoly market structure, where there are few firms and agreements that have significant impacts on the entire market or industry. To differentiate from a cartel, collusive agreements between parties may not be explicit; however, the implications of cartels and collusion are the same.

Under competition law, there is an important distinction between direct and covert collusion. Direct collusion generally refers to a group of companies communicating directly with each other, usually to coordinate and/or monitor their actions, to cooperate through pricing, market allocation, sales quotas, etc. By contrast, tacit collusion is where companies coordinate and monitor their behavior without this direct communication. This is generally not considered illegal, so companies guilty of tacit conspiracy should face no penalties, even though their actions would have a similar economic impact as explicit conspiracy. Collusion is the result of less competition through mutual understanding, where competitors can independently set prices and market share. A core principle of antitrust policy is that companies must not communicate with each other. Even if conversations between multiple companies are illegal but not enforceable, the incentives to comply with collusive agreements are the same with and without communication. It is against competition law for companies to have explicit conversations in private. If evidence of conversations is accidentally left behind, it will become the most critical and conclusive evidence in antitrust litigation. Even without communication, businesses can coordinate prices by observation, but from a legal standpoint, this tacit handling leaves no evidence. Most companies cooperate through invisible collusion, so whether companies communicate is absolutely at the core of antitrust policy.

Collusion which is covert is known as tacit collusion, and is considered legal. Adam Smith in the Wealth of Nations explains that since the masters (business owners) are fewer in numbers, it is easier to collude to serve common interests among those involved, such as maintaining low wages, whilst it is difficult for the labor to coordinate to protect their own interests due to their vast numbers. Hence, business owners have a bigger advantage over the working class. Nevertheless, according to Adam Smith, the public rarely hear about coordination and collaborations that occur between business owners as it takes place in informal settings. Some forms of explicit collusion are not considered impactful enough on an individual basis to be considered illegal, such as that which occurred by the social media group WallStreetBets in the GameStop short squeeze.

Base model of (Price) Collusion

For a cartel to work successfully, it must:

• coordinate on the conspiracy agreement.

(Bargaining, explicit or implicit communication)

• Monitor compliance.
• Punish non-compliance.
• Control the expansion of non-cartel supply.
• Avoid inspection by customers and competition authorities.

Regarding stability within the cartel:

• Collusion on high prices means that members have an incentive to deviate.
• In a one-off situation, high prices are not sustainable.
• Requires long-term vision and repeated interactions.
• Companies need to choose between two approaches：

1. Insist on collusion agreements (now) and promote cooperation (future).
2. Turn away from the alliance (now) and face punishment (future).

• Two factors influence this choice: (1) deviations must be detectable (2) penalties for deviations must have a significant effect.
• Collusion is illegal, contracts between cartels establishing collusion are not protected by law, cannot be enforced by courts, and must have other forms of punishment.

Variations

• π（Pc）/n(1-ẟ) ≥ π（Pc） →1/n(1-ẟ)≥ 1
• 1 ≥ n(1-ẟ)
• 1 ≥ n-nẟ
• nẟ≥n-1
• ẟ ≥n-1/n

Suppose there are n firms in this market. At the collusive price, the firms are symmetric, so they divide the profits equally between the whole industry, represented as π(Pc)/n.If and only if the profit of choosing deviate is greater than that of sticking to collude, i.e

• π（Pc）/n(1-ẟ) ≥ π（Pc）(Companies have no incentive to deviate unilaterally)
• Therefore, when 𝛿 ≥ 𝑛−1/𝑛 is the case, i.e. the firm has no incentive to deviate unilaterally, the cartel alliance will be stable. So as the number of firms increases, the more difficult it is for The Cartel to maintain stability.

As the number of firms in the market increases, so does the factor of the minimum discount required for collusion to succeed.

According to neoclassical price-determination theory and game theory, the independence of suppliers forces prices to their minimum, increasing efficiency and decreasing the price-determining ability of each individual firm. However if all firms collude to increase prices, loss of sales will be minimized, as consumers lack alternative choices at lower prices and must decide between what is available. This benefits the colluding firms, as they generate more sales, at the cost of efficiency to society. However, depending on the assumptions made in the theoretical model on the information available to all firms, there are some outcomes, based on Cooperative Game Theory, where collusion may have higher efficiency than if firms did not collude.

One variation of this traditional theory is the theory of kinked demand. Firms face a kinked demand curve if, when one firm decreases its price, other firms are expected to follow suit in order to maintain sales. When one firm increases its price, its rivals are unlikely to follow, as they would lose the sales gains that they would otherwise receive by holding prices at the previous level. Kinked demand potentially fosters supra-competitive prices because any one firm would receive a reduced benefit from cutting price, as opposed to the benefits accruing under neoclassical theory and certain game-theoretic models such as Bertrand competition.

Collusion may also occur in auction markets, where independent firms coordinate their bids (bid rigging).

Deviation

Future collusive profits

Actions that generate sufficient returns in the future are important to every company, and the probability of continued interaction and the company discount factor must be high enough. The sustainability of cooperation between companies also depends on the threat of punishment, which is also a matter of credibility. Firms that deviate from cooperative pricing will use MMC in each market. MMC increases the loss of deviation, and incremental loss is more important than incremental gain when the firm's objective function is concave. Therefore, the purpose of MMC is to strengthen corporate compliance or inhibit deviant collusion.

The principle of collusion: firms give up deviation gains in the short term in exchange for continued collusion in the future.

• Collusion occurs when companies place more emphasis on future profits
• Collusion is easier to sustain when the choice deviates from the maximum profit to be gained is lower (i.e. the penalty profit is lower) and the penalty is greater.
• Future collusive profits − future punishment profits ≥ current deviation profits − current collusive profits-collusion can sustain.

Scholars in economics and management have tried to identify factors explaining why some firms are more or less likely to be involved in collusion. Some have noted the role of the regulatory environment and the existence of leniency programs.

Indicators

Practices that suggest possible collusion may include one or more actions such as:

• Uniform prices and setting of an unjustified high or an unjustified low price
• Kickbacks and blanket referral agreements between competing businesses
• Dividing territories and market allocation
• Tying agreements and anticompetitive Product bundling (although, not all product bundling is anticompetitive)
• Refusal to deal and Exclusive dealing
• Dumping (pricing policy)
• Vertical restraints
• Horizontal territorial allocation
• Bid rigging

Examples

Set higher prices

• In the example in the picture, the dots in Pc and Q represent competitive industry prices. If firms collude, they can limit production to Q2 and raise the price to P2. Collusion usually involves some form of agreement to seek a higher price.
• When companies discriminate, price collusion is less likely, so the discount factor needed to ensure stability must be increased. In such price competition, competitors use delivered pricing to discriminate in space, but this does not mean that firms using delivered pricing to discriminate cannot collude.

Collusion is illegal in the United States, Canada and most of the EU due to antitrust laws, but implicit collusion in the form of price leadership and tacit understandings still takes place. Several examples of collusion in the United States include:

• Market division and price-fixing among manufacturers of heavy electrical equipment in the 1960s, including General Electric.
• An attempt by Major League Baseball owners to restrict players' salaries in the mid-1980s.
• The sharing of potential contract terms by NBA free agents in an effort to help a targeted franchise circumvent the salary cap.
• Price fixing within food manufacturers providing cafeteria food to schools and the military in 1993.
• Market division and output determination of livestock feed additive, called lysine, by companies in the US, Japan and South Korea in 1996, Archer Daniels Midland being the most notable of these.
• Chip dumping in poker or any other card game played for money.
• Ben and Jerry's and Häagen-Dazs collusion of products in 2013: Ben and Jerry's makes chunkier flavors with more treats in them, while Häagen-Dazs sticks to smoother flavors.
• Google and Apple against employee poaching, a collusion case in 2015 wherein it was revealed that both companies agreed not to hire employees from one another in order to halt the rise in wages.

In the EU:

• The illegal collusion between the giant German automakers BMW, Daimler and Volkswagen, discovered by the European Commission in 2019, to hinder technological progress in improving the quality of vehicle emissions in order to reduce the cost of production and maximize profits.

There are many ways that implicit collusion tends to develop:

• The practice of stock analyst conference calls and meetings of industry participants almost necessarily results in tremendous amounts of strategic and price transparency. This allows each firm to see how and why every other firm is pricing their products.
• If the practice of the industry causes more complicated pricing, which is hard for the consumer to understand (such as risk-based pricing, hidden taxes and fees in the wireless industry, negotiable pricing), this can cause competition based on price to be meaningless (because it would be too complicated to explain to the customer in a short advertisement). This causes industries to have essentially the same prices and compete on advertising and image, something theoretically as damaging to consumers as normal price fixing.

See also: Disney litigation

Barriers

There can be significant barriers to collusion. In any given industry, these may include:

• The number of firms: As the number of firms in an industry increases, it is more difficult to successfully organize, collude and communicate.
• Cost and demand differences between firms: If costs vary significantly between firms, it may be impossible to establish a price at which to fix output. Firms generally prefer to produce at a level where marginal cost meets marginal revenue, if one firm can produce at a lower cost, it will prefer to produce more units, and would receive a larger share of profits than its partner in the agreement.
• Asymmetry of information: Colluding firms may not have all the correct information about all other firms, from a quantitative perspective (firms may not know all other firms' cost and demand conditions) or a qualitative perspective (moral hazard). In either situation, firms may not know each others' preferences or actions, and any discrepancy would incentive at least one actor to renege.
• Cheating: There is considerable incentive to cheat on collusion agreements; although lowering prices might trigger price wars, in the short term the defecting firm may gain considerably. This phenomenon is frequently referred to as "chiseling".
• Potential entry: New firms may enter the industry, establishing a new baseline price and eliminating collusion (though anti-dumping laws and tariffs can prevent foreign companies from entering the market).
• Economic recession: An increase in average total cost or a decrease in revenue provides the incentive to compete with rival firms in order to secure a larger market share and increased demand.
• Anti-collusion legal framework and collusive lawsuit. Many countries with anti-collusion laws outlaw side-payments, which are an indication of collusion as firms pay each other to incentivize the continuation of the collusive relationship, may see less collusion as firms will likely prefer situations where profits are distributed towards themselves rather than the combined venture.

Government policies to reduce collusion

Collusion is when multiple companies reach an agreement to increase prices and profitability, at the expense of consumers. So the government is trying to prevent this from happening, such as the following policies:

• Fines for companies convicted of collusion.
• Fines and imprisonment for company executives who are personally liable.
• Detect collusion by screening markets for suspicious pricing activity and high profitability.
• Provide immunity to the first company to confess and provide the government with information about the collusion.

Orthomolecular medicine

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Orthomolecular_medicine 

Orthomolecular medicine

Alternative medicine
Claims	Health effects of dietary supplements, particularly vitamin megadoses.
Related fields	Naturopathy
Original proponents	Linus Pauling (coined term)
MeSH	D009974

Orthomolecular medicine is a form of alternative medicine that aims to maintain human health through nutritional supplementation. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective for chronic disease prevention; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.

The approach is sometimes referred to as megavitamin therapy, because its practice evolved out of, and in some cases still uses, doses of vitamins and minerals many times higher than the recommended dietary intake. Orthomolecular practitioners may also incorporate a variety of other styles of treatment into their approaches, including dietary restriction, megadoses of non-vitamin nutrients and mainstream pharmaceutical drugs. Proponents argue that non-optimal levels of certain substances can cause health issues beyond simple vitamin deficiency and see balancing these substances as an integral part of health.

American chemist Linus Pauling coined the term "orthomolecular" in the 1960s to mean "the right molecules in the right amounts" (ortho- in Greek implies "correct"). Proponents of orthomolecular medicine hold that treatment must be based on each patient's individual biochemistry.

The scientific and medical consensus holds that the broad claims of efficacy advanced by advocates of orthomolecular medicine are not adequately tested as drug therapies. It has been described as a form of food faddism and as quackery. Proponents point to mainstream sources that have published research supporting the benefits of nutrient supplementation and to instances where conventional medicine uses vitamins as treatments for some diseases.

Some vitamins in large doses have been linked to increased risk of cardiovascular disease, cancer and death. The scientific consensus view is that for normal individuals, a balanced diet contains all necessary vitamins and minerals and that routine supplementation is not necessary outside of specific diagnosed deficiencies.

History and development

In the early 20th century, some doctors hypothesised that vitamins could cure disease, and supplements were prescribed in megadoses by the 1930s. Their effects on health were disappointing, though, and in the 1950s and 1960s, nutrition was de-emphasised in standard medical curricula. Riordon's organization cite figures from this period as founders of their movement, although the word "orthomolecular" was coined by Linus Pauling only in 1967.

Amongst the individuals described posthumously as orthomolecularists are Max Gerson, who developed a diet that he claimed could treat diseases, which the American Medical Association's 1949 Council on Pharmacy and Chemistry found ineffective; and Evan Shute and his brother, who attempted to treat heart disease with vitamin E. Several concepts now cited by orthomolecularists, including individual biochemical variation and inborn errors of metabolism, debuted in scientific papers early in the 20th century.

In 1948, William McCormick theorized that vitamin C deficiency played an important role in many diseases and began to use large doses in patients. In the 1950s, Fred R. Klenner also tried vitamin C megadosage as a therapy for a wide range of illnesses, including polio. Irwin Stone stated that organisms that do not synthesise their own vitamin C due to a loss-of-function mutation have a disease he called "hypoascorbemia". This term is not used by the medical community, and the idea of an organism-wide lack of a biosynthetic pathway as a disease was not endorsed by Stone's contemporaries.

In the 1950s, some individuals believed that vitamin deficiencies caused mental illness. Psychiatrists Humphry Osmond and Abram Hoffer gave people having acute schizophrenic episodes high doses of niacin, while William Kaufman used niacinamide. While niacin has no known efficacy in psychiatric disease, the use of niacin in combination with statins and other medical therapies has become one of several medical treatments for cardiovascular disease.

In the late 1960s, Linus Pauling introduced the expression "orthomolecular" to express the idea of the right molecules in the right amounts. Since the first claims of medical breakthroughs with vitamin C by Pauling and others, findings on the health effects of vitamin C have been controversial and contradictory. Pauling's claims have been criticised as overbroad.

Later research branched out into nutrients besides niacin and vitamin C, including essential fatty acids.

Scope

According to Abram Hoffer, orthomolecular medicine does not purport to treat all diseases, nor is it "a replacement for standard treatment. A proportion of patients will require orthodox treatment, a proportion will do much better on orthomolecular treatment, and the rest will need a skillful blend of both." Nevertheless, advocates have said that the right nutrients at the optimum dose for the individual concerned can prevent, treat, and sometimes cure a wide range of medical conditions. Conditions for which orthomolecular practitioners have claimed some efficacy are: acne, alcoholism, allergies, arthritis, autism, bee stings, bipolar disorder, burns, cancer, the common cold, depression, drug addiction, drug overdose, epilepsy, heart diseases, heavy metal toxicity, acute hepatitis, herpes, hyperactivity, hypertension, hypoglycemia, influenza, learning disabilities, mental and metabolic disorders, migraine, mononucleosis, mushroom poisoning, neuropathy & polyneuritis (including multiple sclerosis), osteoporosis, polio, a hypothesised condition called "pyroluria", radiation sickness, Raynaud's disease, mental retardation, schizophrenia, shock, skin problems, snakebite, spider bite, tetanus toxin and viral pneumonia.

Orthomolecular psychiatry

Main article: Orthomolecular psychiatry

Hoffer believed that particular nutrients could cure mental illness. In the 1950s, he attempted to treat schizophrenia with niacin, although proponents of orthomolecular psychiatry say that the ideas behind their approach predate Hoffer. According to Hoffer and others who called themselves "orthomolecular psychiatrists", psychiatric syndromes result from biochemical deficiencies, allergies, toxicities or several hypothetical contributing conditions which they termed pyroluria, histadelia and histapenia. These purported causes were said to be found during an "individual biochemical workup" and treated with megavitamin therapy and dietary changes including fasting. These diagnoses and treatments are not accepted by evidence-based medicine.

Principles

According to Abram Hoffer, "primitive" peoples do not consume processed foods and do not have "degenerative" diseases. In contrast, typical "Western" diets are said to be insufficient for long-term health, necessitating the use of megadose supplements of vitamins, dietary minerals, proteins, antioxidants, amino acids, ω-3 fatty acids, ω-6 fatty acids, medium-chain triglycerides, dietary fiber, short and long chain fatty acids, lipotropes, systemic and digestive enzymes, other digestive factors, and prohormones to ward off hypothetical metabolism anomalies at an early stage, before they cause disease.

Orthomolecularists say that they provide prescriptions for optimal amounts of micronutrients after individual diagnoses based on blood tests and personal histories. Lifestyle and diet changes may also be recommended. The battery of tests ordered includes many that are not considered useful by medicine.

Prevalence

Orthomolecular medicine is practiced by few medical practitioners.

A survey released in May, 2004 by the National Center for Complementary and Alternative Medicine focused on who used alternative medicine, what was used, and why it was used in the United States by adults age 18 years and over during 2003. The survey reported uses in the previous twelve months that include orthomolecular related uses: Nonvitamin, nonmineral, natural products 18.9%, Diet-based therapies 3.5%, Megavitamin therapy 2.8%.

Another recent CAM survey reported that 12% of liver disease patients used the antioxidant silymarin, more than 6% used vitamins, and that "in all, 74% of patients reported using CAM in addition to the medications prescribed by their physician, but 26% did not inform their physician of their CAM use."

Even though the health benefits are not established, the use of high doses of vitamins is also common in people who have been diagnosed with cancer. According to Cancer Research UK, cancer patients should always seek professional advice before taking such supplements, and using them as a substitute for conventional treatment "could be harmful to [their] health and greatly reduce the chance of curing or controlling [their] cancer".

Medical and scientific reception

Methodology

Orthomolecular therapies have been criticized as lacking a sufficient evidence base for clinical use: their scientific foundations are too weak, the studies that have been performed are too few and too open to interpretation, and reported positive findings in observational studies are contradicted by the results of more rigorous clinical trials. Accordingly, "there is no evidence that orthomolecular medicine is effective". Proponents of orthomolecular medicine strongly dispute this statement by citing studies demonstrating the effectiveness of treatments involving vitamins, though this ignores the belief that a normal diet will provide adequate nutrients to avoid deficiencies, and that orthomolecular treatments are not actually related to vitamin deficiency. The lack of scientifically rigorous testing of orthomolecular medicine has led to its practices being classed with other forms of alternative medicine and regarded as unscientific. It has been described as food faddism and quackery, with critics arguing that it is based upon an "exaggerated belief in the effects of nutrition upon health and disease."Orthomolecular practitioners will often use dubious diagnostic methods to define what substances are "correct"; one example is hair analysis, which produces spurious results when used in this fashion.

Proponents of orthomolecular medicine contend that, unlike some other forms of alternative medicine such as homeopathy, their ideas are at least biologically based, do not involve magical thinking, and are capable of generating testable hypotheses. Orthomolecular is not a standard medical term, and clinical use of specific nutrients is considered a form of chemoprevention (to prevent or delay development of disease) or chemotherapy (to treat an existing condition).

Despite a lack of evidence for its efficacy, interest in intravenous high dose vitamin C therapy has not been permanently extinguished, and some research groups continue to investigate whether it has an effect as a possible cancer treatment.

Views on safety and efficacy

In general, the vitamin megadoses advocated by orthomolecular medicine are unsupported by scientific consensus. Some vitamins are toxic in high doses, including niacin (B₃), cholecalciferol (D) and tocopherol (E). The view of the medical community is that there is no evidence for the efficacy of Orthomolecular medicine as a treatment for cancer, and that high vitamin doses may – on the contrary – increase overall mortality. Nutritional treatments are not generally accepted as being helpful for psychological health. Its claims have been criticized by most medical organizations, including the American Cancer Society, the American Psychiatric Association, the National Institute of Mental Health, the American Academy of Pediatrics, CHAMPUS, and the Canadian Paediatric Society. The American Medical Association describes as "myths" the ideas that adequate nutrition is not readily achievable with normal food, all food grown with pesticide is poisonous, all food additives are poisonous, vitamin and mineral deficiencies are common, that the cause of most disease is poor diet, which can be prevented by nutritional supplements. 

Similarly, the American Cancer Society comments that the current scientific evidence does not "support use of orthomolecular therapy for most of the conditions for which it is promoted." Some supplements have exhibited benefits for specific conditions, while a few have been confirmed to be harmful; the consumption of nutritious foods is the best recognized method to obtain vitamins, minerals, and nutrients crucial for good health. Barrie Cassileth, an adviser on alternative medicine to the National Institutes of Health, stated that "scientific research has found no benefit from orthomolecular therapy for any disease," and medical textbooks also report that there is "no evidence that megavitamin or orthomolecular therapy is effective in treating any disease."

A 1973 task force of the American Psychiatric Association unanimously concluded:

This review and critique has carefully examined the literature produced by megavitamin proponents and by those who have attempted to replicate their basic and clinical work. It concludes in this regard that the credibility of the megavitamin proponents is low. Their credibility is further diminished by a consistent refusal over the past decade to perform controlled experiments and to report their new results in a scientifically acceptable fashion. Under these circumstances this Task Force considers the massive publicity which they promulgate via radio, the lay press and popular books, using catch phrases which are really misnomers like "megavitamin therapy" and "orthomolecular treatment," to be deplorable.

In response to claims that orthomolecular medicine could cure childhood psychoses and learning disorders, the American Academy of Pediatrics labelled orthomolecular medicine a "cult" in 1976.

Proponents of orthomolecular medicine counter that some vitamins and nutrients are now used in medicine as treatments for specific diseases, such as megadose niacin and fish oil for dyslipidemias, and megavitamin therapies for a group of rare inborn errors of metabolism. A review in the Annals of Internal Medicine concluded that while some therapies might be beneficial, others might be harmful or interfere with effective medical therapy. A recent study of over 161,000 individuals provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women." A recent meta-analysis in JAMA suggested that supplementation with combinations of antioxidant vitamins (beta-carotene, vitamin A, and vitamin E) may increase mortality, although with respect to beta-carotene this conclusion may be due to the known harmful effect in smokers.

Safety

In the United States, pharmaceuticals must be proven safe and effective to the satisfaction of the FDA before they can be marketed, whereas dietary supplements must be proven unsafe before regulatory action can be taken. A number of orthomolecular supplements are available in the US in pharmaceutical versions that are sometimes quite similar in strength and general content, or in other countries are regulated as pharmaceuticals. The US regulations also have provisions to recognize a general level of safety for established nutrients that can forgo new drug safety tests. Proponents of orthomolecular medicine argue that supplements are less likely to cause dangerous side-effects or harm, since they are normally present in the body. Some vitamins are toxic in high doses and nearly all (with the possible exception of Vitamin C) will cause adverse effects given high levels of overdosing for prolonged periods as recommended by orthomolecular practitioners. Forgoing medical care in favor of orthomolecular treatments can lead to adverse health outcomes.

Health professionals see orthomolecular medicine as encouraging individuals to dose themselves with large amounts of vitamins and other nutrients without conventional supervision, which they worry might be damaging to health. Potential risks of inappropriate vitamin and supplement regimes include an increased risk of coronary heart disease, hypertension, thrombophlebitis, peripheral neuropathy, ataxia, neurological effects, liver toxicity, congenital abnormalities, spontaneous abortion, gouty arthritis, jaundice, kidney stones, and diarrhea. In their book Trick or Treatment?, Edzard Ernst and Simon Singh conclude that "The concepts of orthomolecular medicine are not biologically plausible and not supported by the results of rigorous clinical trials. These problems are compounded by the fact that orthomolecular medicine can cause harm and is often very expensive."

Example: vitamin E

Orthomolecular proponents claim that even large doses of vitamin E pose no risk to health and are useful for the treatment and prevention of a broad list of conditions, including heart and circulatory diseases, diabetes and nephritis. Initial hopes for the usefulness of vitamin E in orthomolecular medicine were based on epidemiological studies suggesting that people who consumed more vitamin E had lower risks of chronic disease, such as coronary heart disease. These observational studies could not distinguish between whether the higher levels of vitamin E improved health themselves, or whether confounding variables (such as other dietary factors or exercise) were responsible. To distinguish between these possibilities, a number of randomized controlled trials were performed and meta-analysis of these controlled clinical trials have not shown any clear benefit from any form of vitamin E supplementation for preventing chronic disease. Further clinical studies show no benefit of vitamin E supplements for cardiovascular disease. The current position of the American National Institutes of Health is that there is no convincing evidence that vitamin E supplements can prevent or treat any disease.

Beyond the lack of apparent benefit, a series of three meta-analyses reported that vitamin E supplementation is associated with an increased risk of death; one of the meta-analyses performed by the Cochrane Collaboration also found significantly increased mortality for the antioxidant vitamins A and beta-carotene. A subsequent meta-analysis found no mortality benefit from vitamin E, but also no increase in mortality either.

Use in AIDS

Several articles in the alternative-medicine literature have suggested that orthomolecular-related dietary supplementation might be helpful for patients with HIV/AIDS. A study using 250 mg and 1000 mg doses of vitamin C along with other antioxidants to treat people with AIDS did not find any benefit.

A meta analysis in 2010 (updated in 2017 with different results) found that micronutrient supplementation decreased the risk of death and improved outcomes in pregnant women with HIV in Africa. A 2017 Cochrane review found no strong evidence to suggest that micronutrient supplementation prevents death or is effective at slowing the progression of disease for adults with HIV. It is important for people living with HIV to eat a healthy adequate diet. For people with HIV that have clinically demonstrated deficiencies in micronutrients or for people who are not able to consume the recommended daily quantities of minerals and vitamins, supplementation is still encouraged. Vitamin A in children with HIV appears to be safe and beneficial. Vitamin A deficiency is found in children with HIV infection who may or may not have symptoms of AIDS. Vitamin A supplementation reduces morbidity and mortality in AIDS symptomatic children, but has no effect on asymptomatic children. It does not prevent HIV infection, cannot treat the chronic HIV infection, and will not cure AIDS.

Deaths resulting from illegal vitamin trials in South Africa

Main article: Matthias Rath

Matthias Rath has been extensively criticized for presenting his vitamin supplements as a treatment for AIDS and for testing them in illegal trials in South Africa. A former associate of Linus Pauling, Rath has promoted vitamins as a treatment for HIV infection, describing treatment with effective antiretroviral drugs as toxic and part of a global conspiracy serving the financial interests of the pharmaceutical industry. In a lawsuit that found against Rath, the South African Medical Association blamed his vitamin products for several deaths. The World Health Organization and two health agencies of the United Nations also described Rath's advertisements as “wrong and misleading” and “an irresponsible attack on ARV (antiretroviral) therapy.” The South African Centre for Social Science Research described the trials as "state sponsored pseudo-science". Rath's trials, conducted with the aid of AIDS denialist David Rasnick, were declared unlawful by the Cape High Court; Rath, Rasnick and their foundation were barred from conducting further unauthorised clinical trials and from advertising their products.

Alleged institutional bias

Advocates of orthomolecular medicine, including Pauling, Hoffer and Ewan Cameron have claimed that their findings are actively suppressed by the medical and pharmaceutical industry. Hoffer wrote "There is no conspiracy led and directed by a single person or by a single organization. There is no Mafia in psychiatry. However, there is a conspiracy led and directed by a large number of professionals and their associations who have a common aim to protect their hard-earned orthodoxy, no matter what the cost to their opponent colleagues or to their patients."

The Journal of Orthomolecular Medicine, founded in 1967 as the Journal of Schizophrenia, is a major publication of orthomolecular medicine. As Abram Hoffer wrote:

We had to create our own journals because it was impossible to obtain entry into the official journals of psychiatry and medicine. Before 1967 I had not found it difficult to publish reports in these journals, and by then I had about 150 articles and several books in the establishment press.

Other members of the medical community deny the existence of such an institutional prejudice. A review in the Journal of Clinical Oncology denied that physicians collude against unconventional treatments. Claims of conspiracy were limited to the now defunct Linus Pauling Institute of Science and Medicine. In its current iteration, the Linus Pauling Institute derives a significant amount of funding from the National Institutes of Health and other federal sources.

Genetics of obesity

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Genetics_of_obesity 

A 1680 painting by Juan Carreño de Miranda of a girl presumed to have Prader-Willi syndrome

Like many other medical conditions, obesity is the result of an interplay between environmental and genetic factors. Studies have identified variants in several genes that may contribute to weight gain and body fat distribution; although, only in a few cases are genes the primary cause of obesity.

Polymorphisms in various genes controlling appetite and metabolism predispose to obesity under certain dietary conditions. The percentage of obesity that can be attributed to genetics varies widely, depending on the population examined, from 6% to 85%, with the typical estimate at 50%. It is likely that in each person a number of genes contribute to the likelihood of developing obesity in small part, with each gene increasing or decreasing the odds marginally, and together determining how an individual responds to the environmental factors.  As of 2006, more than 41 sites on the human genome have been linked to the development of obesity when a favorable environment is present. Some of these obesogenic or leptogenic genes may influence the obese individual's response to weight loss or weight management.

Genes

Although genetic deficiencies are currently considered rare, variations in these genes may predispose to common obesity. Many candidate genes are highly expressed in the central nervous system.

Several additional loci have been identified. Also, several quantitative trait loci for BMI have been identified.

Confirmed and hypothesized associations include:

Condition	OMIM	Locus	Notes
leptin deficiency	164160	7q31.3
leptin receptor deficiency	601007	1p31
prohormone convertase-1 deficiency	600955	5q15-q21
proopiomelanocortin deficiency	609734	2p23.3
melanocortin-4 receptor polymorphism (MC4R)	155541	18q22
BMIQ1		7q32.3	near D7S1804
BMIQ2		13q14	near D13S257
BMIQ3		6q23-q25	near D6S1009, GATA184A08, D6S2436, and D6S305
BMIQ4		11q24	near D11S1998, D11S4464, and D11S912
BMIQ5		16p13	near ATA41E04
BMIQ6		20pter-p11.2	near D20S482
INSIG2		2q14.1
FTO		16q12.2	Adults who were homozygous for a particular FTO allele weighed about 3 kilograms more and had a 1.6-fold greater rate of obesity than those who had not inherited this trait. This association disappeared, though, when those with FTO polymorphisms participated in moderately intensive physical activity equivalent to three to four hours of brisk walking.
TMEM18		2p25.3
GNPDA2		4p13
NEGR1		1p31.1
BDNF		11p13
KCTD15		19q13.12	KCTD15 plays a role in transcriptional repression of AP-2α, which in turn, inhibits the activity of C/EBPα, an early inducer of adipogenesis.
KLF14		?	Although it does not play a role in the formation of fat itself, it does determine the location on the body where this fat is stored.
SH2B1		16p11.2
MTCH2		11p11.2
PCSK1		5q15-q21
NPC1		18q11-q12
LYPLAL1	616548	1q41	Disputed metabolic function of being either a lipase or a short-chain carboxylesterase.

Some studies have focused upon inheritance patterns without focusing upon specific genes. One study found that 80% of the offspring of two obese parents were obese, in contrast to less than 10% of the offspring of two parents who were of normal weight.

The thrifty gene hypothesis postulates that due to dietary scarcity during human evolution people are prone to obesity. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would more likely survive famine. This tendency to store fat, however, would be maladaptive in societies with stable food supplies. This is the presumed reason that Pima Native Americans, who evolved in a desert ecosystem, developed some of the highest rates of obesity when exposed to a Western lifestyle.

Numerous studies of laboratory rodents provide strong evidence that genetics play an important role in obesity.

The risk of obesity is determined by not only specific genotypes but also gene-gene interactions. However, there are still challenges associated with detecting gene-gene interactions for obesity.

Genes protective against obesity

There are also genes that can be protective against obesity. For instance, in GPR75 variants were identified as such alleles in ~640,000 sequenced exomes which may be relevant to e.g. therapeutic strategies against obesity. Other candidate anti-obesity-related genes include ALK, TBC1D1, and SRA1.

Genetic syndromes

The term "non-syndromic obesity" is sometimes used to exclude these conditions. In people with early-onset severe obesity (defined by an onset before 10 years of age and body mass index over three standard deviations above normal), 7% harbor a single locus mutation.