What’s All the Fuss about CBD?

As I was walking through the local mall, I had to steer around a large sign in front of the GNC store. It read: “CBD Products Available.” It did nothing to raise my opinion of GNC, which I consider to be the epitome of junk science, but I thought I should do some research to make sure my eye rolling was justified.

Cannabidiol (CBD) oil is an extract from industrial-grade hemp or the marijuana plant. It does not have the effect of getting the user “high” as the THC in marijuana does. It recently surged onto the market with a wide variety of health claims. What are the facts?

There is so much information, but it has to be sorted careful, as much of it is pure advertising, telling the stories of miracle cures. Many promises are unreliable to the point that in September the Federal Trade Commission (FTC) ordered three companies to stop making claims that they: relieve pain better than opioid painkillers and that they treat cancer, Alzheimer’s disease, multiple sclerosis (MS), fibromyalgia, cigarette addiction, colitis, autism, anorexia, bipolar disorder, PTSD, schizophrenia, anxiety, depression, Lou Gehrig’s Disease (ALS), stroke, Parkinson’s disease, epilepsy, traumatic brain injuries, diabetes, Crohn’s disease, psoriasis, and AIDS – while using the words miracle and magic to describe the effects. The following month both the FTC and FDA warned a Florida company marketing CBD products about making similar unsubstantiated claims. (These were only the ones that were caught.)

Stepping aside from the hype, Science News published a story earlier this year that is a little more down to earth. “A gaping chasm separates the surging CBD market and the scientific evidence backing it. While there are reasons to be excited about CBD, the science just isn’t there yet.” Trials are underway, but “much of the existing research was done with cells in the lab or in lab animals, with results that don’t necessarily translate to people.”

The next stop was a WebMD article, “CBD Oil: All the Rage, But Is It Safe & Effective?” They remind readers, “experts say the evidence is scant for most of these touted benefits” and it is being sold as a supplement, “produced without any regulation, resulting in products that vary widely in quality.” So far “only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.”

CBS recognized the quality problem in this piece from about three months ago with the warning that “without wide federal oversight, there is no way of really knowing what's inside CBD [products].” They commissioned lab tests of samples from all over the country and found no harmful chemicals but significant differences between the amount of CBD on the label and actual contents making proper dosage a big problem. In addition, “cannabinoids do interact with prescription drugs. But because we lack reliable controlled trials, we don't have enough detail to understand all the interactions.”

The same viewpoint comes from Harvard Medical School. “Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting.” The JAMA network notes that in studies to date "evidence of effectiveness was scarce," and that a California testing company found 85% of samples inaccurately labelled.

This Slate article makes the point clearly. As more and more products, from foods and beverages to creams and lotions, have CBD added “CBD is in everything, but it hasn’t been proven to do much of anything." Despite this, it is forecast to become a $22 billion industry by 2024.

In summary, with no scientific evidence of health benefits outside of the treatment of epilepsy, CBD oil has become all the rage with companies adding it to all sorts of products and selling it as a miracle cure. Some companies have crossed the legal line with their claims, but those that are more careful can easily imply that it’s curative powers are enormous without coming right out and saying it. Instead they rely on endorsements from beneficiaries of the placebo effect, as do many of the other supplements on the market. (In other words, my eye rolling was justified.)

Flashback - Ignoring The Facts

[This one comes from January 2012 and is still one of my favorites. People, who are involved in a test that proves that a $30 item is not effective, continue to insist on buying one. Note, they didn't just hear on TV or read on the internet that the item is bogus - they were actually involved in testing it and shown the results. It didn't work as advertised, but they still wanted one regardless of what their eyes were telling them because of all the hype they had heard elsewhere! Being swayed by marketing promotions and celebrity endorsements is not wise behavior.]

While looking for a different article on the Placebo Effect, I found this interesting video. As you know, the Placebo Effect causes people to recover or show improvement even when they are given only a fake remedy, the familiar sugar pill. The power of the mind is amazing.

I recall an article a number of years ago stating that the improvement within the control groups in certain drug studies increased as the power of the real medicines increased. They were getting the sugar pill but believed they were getting the latest, stronger medicine, so they experienced even better results. It was all psychological. It is easy to understand how this reaction could play into the hands of "snake oil" salesmen. They sell you a useless cure and let your mind do the rest. Then they get a few believers who help them sell more. That's why I always say, "Endorsements are not evidence."

Here is the  CBS News video testing the claims of a particular performance wristband, one endorsed by famous athletes, and touted to improve athletic performance. When test subjects were given the advertised wristband, their performance on physical and balance tests did improve. But when they were given a one-dollar replacement band and told it also was special, performance on physical and balance tests improved comparably. The video also explains how the bracelet company sets up tests to ensure the perception of improved performance.

The scariest part is the ending where, despite the fact that the $30-wristband claims had been debunked, shown to be no more effective than the $1 bands or even not wearing a wristband at all, the participants still wanted one!

This is not critical thinking! This is the kind of decision-making that leads people to spend money on worthless items instead of using it wisely. Then they wonder why they get into debt and can't afford to retire. It's the kind of thinking that leads us to vote for candidates based on endorsements or personal appearance or charisma instead of the leadership and ideas we need. It's the kind of thinking that contributes to the decline of America!

How Can Facts Compete With Fads?

A couple of years ago beet juice was all the rage. Promoters sold a powder to dissolve in water.  They called it a circulation super-food. They backed up their claim with a pile of testimonials but scant scientific evidence; except that beets are vegetables, and vegetables are healthy. Does that make any vegetable a super food?

Well, step aside beet juice. It’s time for celery to take a turn.

How do we know celery juice is the latest super food? – Testimonials, of course! Says one article, “Celery juice is everywhere. So much so, that the two New York Whole Foods locations I’ve gone to in the past two weeks have been out of celery” as people buy it in bulk to take it home and run it through the blender.

These are not ordinary testimonials. Apparently the fad start when the Medical Medium (MM not to be confused in any way with MD) told his thousands of on-line followers that celery juice was “one of the most powerful and healing juices we can drink.” Since then it has been “rising in popularity within the health and wellness world” with tens of thousands of personal endorsements on Instagram. Among them are celebrity/influencers including Gwyneth Paltrow, Kim Kardashian and Debra Messing.

When I looked up articles about celery juice, though, most that I found said that those claims are false. This one begins with a headline, “Celery Juice ‘Benefits’ Are Total B.S., According to Nutrition Science.” The claims of it reducing chronic inflammation are grossly exaggerated. It doesn’t necessarily help with weight loss, because juicing any vegetable “will yield a higher concentration of sugar.” Any mention of detox should automatically be a red flag for anyone with an ounce of nutritional common sense.

Another website mocks the whole idea of the detox claim saying, “this entire celery juice trend is the epitome of bullshit pseudoscience.” It’s all about being a member of the super cool crowd that crowed about kale until celery juice was declared the new kid in town. It’s more about a need to belong, than a desire to be healthier.

Another reason people are drawn to juice fads is the convenience. The answer to not having time for fruit and vegetables is to grab a bottle or tumbler of the liquid equivalent, but it’s not really equal. The process of juicing compromises some of the nutritional value because it loses the beneficial fiber you find in raw veggies.

And Americans don’t get enough fiber.

This BBC article argues, “people who eat more dietary fiber are actually feeding their gut microbiome,” and “fiber leads to greater satiety, less insulin secretion, and more short-chain fatty acids, which all amounts to one thing: less body weight.”

Studies show that “those who had the highest intake of fiber or total fiber actually had an almost 80 percent greater likelihood of living a long and healthy life over a 10-year follow-up, [and] were less likely to suffer from hypertension, diabetes, dementia, depression, and functional disability.” 

This fiber, that BBC calls a lifesaving food, is easily available. “You find it in fruit and vegetables, some breakfast cereals, breads and pasta that use whole-grains, pulses such as beans, lentils and chickpeas, as well as nuts and seeds.” That’s whole fruits and vegetables, not the ones that have been run through a blender.

Once again, that’s the truth about another so-called super food. But how does the truth compete with celebrities, influencers and self-declared wellness experts with thousands of Instagram followers but no formal training in nutrition or science? All these fad diets are based on testimonials and endorsements that appeal to the emotions without any scientific basis with the sole intent of selling to gullible people their books, products and other secrets of good health.

Food For Thought

Considering consistency by the news media: CBS This Morning has a regular series, "What’s Working," which investigates innovations in America that seem to be paying off. On one particular episode a few weeks ago they went to the University of Vermont to highlight a program to discourage the use of drugs and alcohol and move students toward more healthy activities.

Near the end of the piece the professor who designed the program explained that the brains of college students are not yet fully developed. "You couldn't come up with a worse age to send someone to college than when they're 18.” The reporter feeds back the notion, “The brains are not done developing at 18?” He responds, “Not even close.” 

This was not the only report emphasizing the immaturity of college students, and is not confined to CBS, with some saying the brain is not done developing until the early twenties. Some sources put the age of a fully developed frontal cortex closer to 25. Such statements have been fairly common when discussing various crimes and indiscreet tweets. Then why were these same reporters so excited just ten months ago about the apparent wisdom of a group of high school students lecturing the country on gun policy?

Considering income inequality: If we didn’t have rich people, there would be no designer goods. Nobody would be able to show off for their friends by buying the cheap knock-offs.

Considering trusting medical information based only on endorsements: Bloodletting was a common practice among doctors for thousands of years up to about one hundred years ago. Today bloodletting has been shown to be ineffective and mostly harmful. (A controlled variation is used today only in the treatment of a few very rare diseases.)

Since there would have been no opportunity for controlled experiments, the only way it could have continued to be practiced for so long would be through endorsements and by doctors hyping their own successes. “Marie-Antoinette, for instance, seemed to benefit from a healthy dose of bloodletting while giving birth to her first child, Marie-Thérèse, in 1778” – an endorsement from the Queen! 

Doesn’t this same practice of celebrity and friends’ endorsements and doctors hyping their own successes sound like anything we might see on TV or read on the Internet today for any number of miracle cures?

Considering the cancer conspiracy: Did you know that doctors, Big Pharma and the FDA are working together to suppress cancer research for fear that discovery of a cure will put them out of business? They also try to undermine real cures provided by alternative medicine. Many Americans do believe this conspiracy theory. Wired reported on a video that came out last July on the Internet about a miracle cancer cure derived from moss and available online. It “quickly racked up millions of views.” The video used the usual lure of “what the pharmaceutical companies don’t want you to know.”

The problem was the video was intentionally faked for the purpose of education, “teaching people to be skeptical of videos exactly like this one.” Do the same people who endorse this cancer-conspiracy myth also believe that firefighters want more fires and do not promote the use of smoke alarms and the practice of fire safety? Do they think dentists don’t want you to brush and floss? All this is equally hard to believe.

It doesn’t take much research (and critical thinking) to find obvious distortions and contradictions in the news and social media. As always the bad information flies around the world at lightning speed, while the truth struggles to catch up (often just in time to be slapped down by committed advocates or enterprising charlatans).

Science Education

I see so many cases of scientific misinformation and errors on TV, in the press and in advertising that I think it would be a good idea for someone or some organization (perhaps a university or  Consumer Protection Agency) to provide high school science teachers with a set of weekly topics.  The thrust would be how to protect yourself against fraud and misinformation – how people will try to use your lack of understanding of science to mislead, trick and cheat you.  If you don't understand science, no one will help you.

Here is a shocking example from a newspaper report from earlier this year (May 7, 2013) showing how sloppy journalists can be about science.  Dateline Cape Canaveral, “Two robotic U.S. rovers are back in business on Mars after a month long solar blackout that blocked communications with engineers back on Earth [due to] a solar conjunction [when the] sun in early April moved into an orbit directly between Earth and Mars, interfering with communications between the planets."  [Emphasis added].  Really?  The sun moved into an orbit between the planets?  Didn’t the columnist or his editor know better?  This is scary - reporting based on 15th Century science.  With this in mind, how much other, more damaging, bad information is passed along through the sloppiness or ignorance of the press? 

Many subjects, some covered in these posts over the past two years, would be helpful to young adults to keep them from wasting their time and money or becoming unnecessarily panicked.  Suggested topics include:  the placebo effect, pros and cons of dietary supplements, what to look for in properly designed experiments or tests for effectiveness, genetic engineering of food, the pros and cons of organic farming, a brief history of diet scams, the truth about vaccines and autism, fluoride in drinking water, understanding irradiated food, and common scientific myths.  Without an understanding of these subjects along with training in critical thinking as part of a science education, future generations will be vulnerable to deceptive advertising and the pleas from advocates for every crackpot idea that comes along.

What will happen when they step into high school chemistry class and find out that everything in the universe is made of chemicals and that "chemical" is not a bad word, nor is it the opposite of natural or organic – ideas that seem contrary to what they've encountered from family and the media?  It has almost come to the point where science is being replaced by religion in the public mind, not a standard religion, but a new quasi-religion where the truth is based more on what you believe or believe in than what can be scientifically tested.  Unless this behavior changes Americans will continue to waste money and energy supporting products and services backed only by scientific-sounding arguments and celebrity endorsements.  Let's change it early, before another generation is taken in.

Earthing - Keep Your Feet on the Ground

When I read about this last week, I could only think, “Where has people’s critical thinking gone?  Earthing, proclaimed as “the greatest health discovery ever” and “right up there with the discovery of penicillin,” is the practice of walking outside barefoot or in some other way increasing contact with the earth to allow us to absorb free electrons from the earth’s surface leading to improved health.  There is a detailed explanation of how this works along with – you guessed it! – lots of endorsements.

How many times have I repeated that endorsements or wonderful stories are not proof of effectiveness nor is selling supposed remedies as ancient wisdom, old knowledge rediscovered, or the unlocking of some secret?  When I read this, several questions immediately came to mind.  Why are the earth’s electrons any different from other free electrons?  Why did our ancient ancestors who had more contact with the earth have a much shorter life expectancy?  Why don’t our doctors tell us to walk outside barefoot more often – some kind of conspiracy to withhold the information or are they just tired of giving tetanus shots?  If electrons from the earth enter a body so easily, why can’t you slowly drain a flashlight battery by holding both ends between your fingers?  Where is the research?

I actually did find some research.  Here is one paper describing a particular study.  It had 12 participants.  The researchers grounded their beds and measured cortisol levels as well as participant reports of pain, stress and sleep dysfunction.  This seems like pretty shabby experimental design.  How were the 12 chosen?  Such a small sample size limits the statistical validity.  Where was the control group and “double-blind" setup to guard against placebo effect?  Self-reporting is prone to error.  This isn’t even in the same league as FDA requirements for any approved treatment.  It’s almost like getting 12 people together for an endorsement party.  Other studies are cited, but to what end?  Their website lists 13 bullet point benefits and implies that it's just the tip of the iceberg.  Snake oil, anyone?

The disclaimer on the site is most telling:  “Products and information on this site are not intended to diagnose, treat, cure, or prevent any disease.”  Of course not, that would probably be illegal.  (I don't doubt their sincerity, since everyone just walking around barefoot would fit their theory and not profit them a dime. but sincerity is never proof of validity.)  In any case, they strongly imply throughout that health benefits abound while making it easy to order their $60 mats, $200 kits and $300 bed sheets. 

One hundred dollars here, one hundred dollars there – it all adds up -- and a non-skeptical, non-critical thinking society then finds itself wondering how can I afford to retire or why am I part of a $1 trillion college debt crisis?