And Speaking of Sugar

Last Friday I flashed back to an entry from February 2012 where I showed how eager the media is to help us blame sugar for the obesity and the diabetes epidemics instead of the taking responsibility for our own choices.

Shortly after deciding to feature those comments I came across this related news report. “The Sugar Association is asking the Food and Drug Administration to require more detailed information about artificial sweeteners on packaging.”

The problem as they see it is that, because sweeteners do not provide nutrition or calories, they are not required to be listed on nutrition facts labels. Instead they are listed under ingredients in smaller print on the side of the package.

The industry argument is, “Consumers deserve to know what is in their food so they can make informed decisions for themselves and their families.” By making these changes, the FDA “will bring the complete transparency in sweetener labeling that we know consumers want, deserve and should expect.” 

They innocently portray themselves as merely calling for transparency by putting the information on food labels as “sweetener,” followed by the name. This is similar to the tactics of the anti-GMO crowd. By forcing producers to list an ingredient on the package, they hope that past misinformation will give shoppers the impression that a safe ingredient, because it is highlighted, is really dangerous. It’s a subtle scare tactic dressed up as transparency that they have pulled off elsewhere*, but it’s not based on science!

I referred to information sources I trust like WebMD and the Mayo Clinic rather than believing folks like Global Healing, Nutralegacy or Doctors Jocker and Axe. Here is what the real doctors at Mayo Clinic have to say. 

Under the heading of possible health benefits, they state, “Artificial sweeteners don't contribute to tooth decay and cavities. Artificial sweeteners may also help with: Weight Loss and Diabetes.”

As far as concerns: “according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women.”

So they are safe and sometimes beneficial, but the Sugar Association has for a long time believed, “Consumers Are Confused: Decoding Artificial Sweeteners,” as that headline from ten years ago stated. The article goes on to say, “August marks the five-year anniversary of the Food and Drug Administration’s (FDA) receipt of a petition to help clear up some of the confusion...." So this has been going on for 15 years, and they are taking another run at it. Why? Before you start feeling bad for the Sugar Association, follow the money.

“The U.S. Sugar program is the federal commodity support program that maintains a minimum price for sugar, authorized by the 2002 farm bill....” It was designed to “protect the incomes of the sugar industry-growers of sugarcane and sugar beets, and firms that process each crop into sugar.”

This Reason Magazine article from last year calls it welfare for the rich, saying that it costs Americans as taxpayers and consumers about $4 billion per year. It does this in several ways: 

1. “Subsidies when sugar prices fall below a certain level;
2. Protection from foreign competition (a limit on imports); and
3. A guarantee that prices stay high (the sugar program imposes quotas on how much sugar may be produced in America).”

They are willing to spend a lot of money lobbying to maintain this sweet deal.

This Market Watch story from 2018 confirms the $4 billion cost while pointing out, “On average, U.S. sugar prices are about twice as high as world prices.” 

So, Big Sugar is trying to subtly frighten more people into buying their product at twice the price, based on a false (but popular) notion that the alternatives cause cancer and other problems, while downplaying the truth about the health concerns around sugar itself. They are counting on only a tiny minority of critical thinkers to figure it out.

*Note how successful they have been in giving high fructose corn syrup an undeserved bad rap.

Flashback – Household Germs

[This piece from November 2014 has popped up as a favorite in the past. Perhaps it’s a good  reminder not to get out of the hand-washing habit.]

ABC asks the “shocking” question: What’s the most germ-infested place in your house? The answer, it turns out, is “the towels in your kitchen and bathroom.”

They go on to cite a Kimberly Clark-funded study whose author says, “towels are more likely to be bacteria-ridden than other household items because they are used to wipe hands and surfaces that may have been contaminated by raw meat products.” They are usually damp, a state that further encourages bacterial growth.  

If that's not disgusting enough, it is common knowledge that most home kitchens would not pass the kind of standard health inspection that cafeterias and restaurants are routinely subject to. We certainly don’t wear our hairnets when preparing dinner. How many people keep a thermometer in their refrigerator, clean all surfaces, assign different cutting boards to meat and vegetables or are diligent about chilling foods promptly at the end of each meal? These are standard food safety requirements. But the idea of handling raw meat and then wiping your hands on a kitchen towel before continuing with meal preparation is the kind of practice that would get your favorite eating establishment shut down.

This is not what really caught my attention in the article, though. What I noticed was the use of flu season and the Ebola scare in their introduction to set up the story. Flu and Ebola are viral diseases; they have nothing to do with the bacteria discussion that was the focus of the rest of the story. Like the writer, most people don’t seem to pay much attention to the difference between bacteria and viruses. Germs are germs. If I have a head cold, I call the doctor and ask for antibiotics – the fact that antibiotics act against bacteria and not viruses is not my concern. So we end up with germs that build a resistance to antibiotics, people don’t make the connection and then rely on “science” to fix the problem.

This is all unnecessary when we have easy access to a complete explanation of the differences between bacteria, viruses, fungi and protozoa written for kids! It points out that some bacteria are good, live in your body and help you digest food. It doesn’t mention that some fungi are good – like morel mushrooms. It closes with advice about hand washing with soap and water – nothing fancy needed, using tissues for coughs, sneezes and sniffles, and getting proper immunizations. Yes, it tells kids that immunizations are important and the smart choice. It closes with “eating well, exercising regularly, and getting good sleep” can keep you healthy.

This is great information and advice that many adults should heed. When a reporter for ABC news can so casually mix things up, then report on adults wiping, not washing their hands during food preparation, perhaps we need to take a step back and learn from the science that we expect our kids to understand.

[These issues call for critical thinking, but up in the first paragraph of the original piece, notice the use of the word “shocking.” Other news media favorites include "stunning," “staggering” and “catastrophic.” They can’t just address a question or pass along a fact. It has to be emotionally charged, controversial or both. In the process of presenting news that should call for critical thinking, they intentionally distract with emotional wording.]

Another Health Scam

With the coronavirus leading every news broadcast, the networks have begun also to highlight the prevalence of false claims, fake cures and scams. To make the point that this is not new, CBS Sunday Morning (4/26) addressed the history of fake medicines and cure-alls, but was disappointingly vague on some of the current scams, ones people fall for every day, probably from fear of offending both promoters and viewers. They did, however, include a few comments from Dr. Stephen Barrett who pulls no punches in his criticism of modern scams.

In one of his latest investigations into junk medical science, Dr. Barrett addressed a process known as bioresonance hair testing. Practitioners use a device "based on the pseudoscience of radionics to analyze hair samples mailed in by customers" to "detect nutritional deficiencies; overexposure to heavy metals; and food and environmental intolerances” to serve as a “roadmap to better health.” He calls the practice preposterous, in that “hair analysis is not reliable for evaluating the nutritional status of individuals” as well as giving several other reasons why it doesn’t work.

An earlier article on the same subject he warned its use by “chiropractors, nutrition consultants, physicians who do chelation therapy, and other misguided practitioners who claim that hair analyses can help them diagnose a wide variety of health problems and can be used as the basis for prescribing supplements.” 

Since bioresonance is based on radionics, it gets even more “preposterous.” These theories supposedly rely on quantum entanglement, a central principle of quantum physics where information can be transmitted instantaneously at a distance apparently violating the speed of light. Quantum physics is arcane and incomprehensible to non-scientists, yet many questionable products use it to explain action at a distance to add a scientific-sounding aura to their sales pitch. But it's all bogus.

Then it gets more unrealistic. According to this site, “Radionics can be used for humans, animals and agriculture by means of radionic instruments which amplify and 'balance' the subtle energy field of the subject” by using “a photograph, hair snippet or other biological sample.” It works best with a good quality digital photograph because “the image stores the information of the subject and a digital file cannot be contaminated like a biological sample can,” and the light “creates a crystallization of the energy matrix of the subject.” 

Another site says, it’s “a method of healing and diagnosing at a distance using the unique extra-sensory faculties of the operator supported and amplified by a physical instrument, device, geometric pattern, energy or substance.” Since “every person's energy patterns, frequencies, signatures, vibrations or rhythms are as unique to them as their fingerprints,” they can easily detect and help correct any type of “illness, injury, infection, stress, pollution, malnutrition, or poor hygiene.”

In summary, “patients” send a full digital picture or some strands of hair. "Doctors,” using their powers of ESP, run it through their energy detection machine, make a diagnosis based on an individual energy matrix, vibrations and rhythms and recommend supplements to cure what ails them, all using the magic of quantum physics. Remember, the same technique applies to their pets or their houseplants – with a separate charge for each.

But that’s not all! In some cases, their house may be causing the problem due to the presence of “geopathic stress,” which messes with the occupants’ health. That, too, can be cured at a distance by sending a photograph and using the above technique.

This seems so outlandish that I can’t help wondering who would be taken in by it. Then I see the statement that radionics can be a “supplement to other complementary and Subtle Energy therapies especially Homeopathy, Acupuncture, Reiki,” and it all becomes clear.

CBS might mock citizens of the nineteenth century for buying Stanley’s snake oil concoctions or for making a millionaire of Albert Abrams (1864-1924), developer of devices that were the precursors of today’s radionics, but they needn’t look far to find twenty-first-century parallels.

Arthur C. Clark wrote, “Any sufficiently advanced technology is indistinguishable from magic,” but come on, people! These scams are packaged as advanced technology and sold to people who want to believe in magic.

Why FDA Approval?

With the desperate search for a coronavirus vaccine and medicines to reduce the seriousness of the disease comes a lot of discussion about FDA approval. One side argues that speed is of the essence and we need to accelerate the process. The other side argues that we can never be sure of a drug’s effectiveness without proper testing. (This will reflect some of the information from last week’s entry, “Understanding Experiments.”) 

The FDA admits, “It takes on average 12 years and over US$350 million to get a new drug from the laboratory onto the pharmacy shelf.” The first step requires about three years of laboratory testing before testing on humans. “Only one in 1000 of the compounds that enter laboratory testing will ever make it to human testing.” 

Next comes a three-phase process. First they must test for safety. Next they need 100 to 300 volunteers to test for basic effectiveness. Finally 1000 to 3000 patients in clinics and hospitals are monitored for effectiveness and to identify adverse reactions. Each phase can easily take years to complete. (And some people wonder why drugs cost so much and why the companies fight and scheme to protect their patents.)

In the interim some drugs that have been previously approved for other diseases are being tested on coronavirus patients. This practice of prescribing drugs off-label is really quite common in the US. WebMD writes, “Off-label prescribing isn't necessarily bad. It can be beneficial, especially when patients have exhausted all other approved options.”

This is why FDA approval is so valuable and why makers of so many pills, salves, ointments and medical devices are so eager to try to take credit for having cleared this hurdle. Otherwise the law requires them to post the familiar disclaimer: “The statements made regarding these products have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.” (But the disclaimer is familiar only to those who bother to read the fine print.)

If companies fail to do this, it’s not the FDA but the Federal Trade Commission (FTC) that comes after them for misrepresentation, as they did in this case – one of many that show up almost weekly.

“Under a settlement with the Federal Trade Commission, the marketers of an electrical nerve stimulation device called Quell have agreed to pay at least $4 million and stop making deceptive claims that the device treats pain throughout the body when placed below the knee and is clinically proven and cleared by the Food and Drug Administration (FDA) to do so.” (From an FTC press release.)

I checked their website and found that they no longer show the device as FDA approved (to treat or cure), but still do try to give that impression through endorsements and research posters. They continue to mention the FDA at least twice on the site, referring only to registration, not approval – big difference. In summary, the “FTC alleged that the defendants lack scientific evidence to support widespread chronic pain relief claims…” but the site lists no such disclaimer. It’s big business and a $4 million fine pales in comparison to a $350 million development cost.

That it is “100% drug free and non-surgical” while it “stimulates sensory nerves with safe and precise electrical pulses to trigger a natural pain relief response” appeals to people with chronic pain trying to avoid addictive drugs. It’s understandable how such a device would tempt people, and if placebo does the trick it might be worth $300 plus an on-going expense for fresh electrodes.

Like so many other health and medical decisions, avoiding such questionable products is all about a little research and critical thinking.

Appropriately Skeptical

From time to time I see an ad from a local doctor promoting stem cell therapy for pain. It includes one endorsement telling how the office was so easy to work with and how the pain went away. For some time now I have been skeptical about the validity of this promotion. I thought stem cell research was not yet in the mainstream of medical practice, and I know that endorsements are not reliable evidence. It seemed suspicious, so I decided to look into it.

The promotional material on line states in part: “Stem cell therapy uses your body’s most powerful and flexible cells to promote natural regeneration in damaged joints.” It claims to be effective for a list of conditions: surgical wounds, tendon damage, severe muscle strain, arthritis, damaged cartilage, torn meniscus and many other joint and soft tissue injuries and conditions.

“The stem cells … come from your own body … a small quantity of bone marrow from your large hip bone.” (Using the recipient’s own stem cells avoids the need for FDA approval.) The on-site lab processes the harvested cells. The doctor then can “precisely inject your stem cell mixture where you need it … where they morph into new cell types” and provide “long-lasting relief” for “many [but not all] patients.”

My first stop was WebMD with a sub-headline reading: “Unproven, Risky Treatments Mislead Patients to Seek Cutting-Edge Therapy.” International Society for Stem Cell Research (ISSCR) “advises patients to seek only stem cell treatments being tested in clinical trials approved by the FDA”… or some approved smaller studies.

There is a lot of information on the site but it is summarized like this: “Every treatment has some risks. So the question comes down to whether the benefits outweigh the risks. And those studies haven't been done yet.” 

This Healthline report from about 18 months ago says that stem cell therapies are being promoted for a wide variety of conditions, but “very few of these applications have any scientific backing, [however] stem cell therapy for knees has been the subject of quite a few promising studies.” It would be a big improvement over knee replacement, but promising studies hardly qualify a procedure for routine outpatient application. They list the cost of this treatment at “approximately $3,000 to $5,000 per knee, depending largely on geographical location.” 

The FDA gives much of the same information. “Stem cell products have the potential to treat many medical conditions and diseases. But for almost all of these products, it is not yet known whether the product has any benefit—or if the product is safe to use.”

Consumer Reports chimes in with a sub-headline: “A new industry is booming. But critics worry that the treatments are ineffective and dangerous.” Here is a very brief summary: “Stem cells are special cells with the potential to repair damaged tissue and organs.” But “not all of them are possessed of equal power.” According to the current scientific consensus, the therapeutic potential of stem cells taken from fully developed tissues, adult cells, is believed to be much more limited. (Does this include marrow from hipbones? I wonder.)

That Consumer Reports piece is a long article with many warnings about the confusion in the field and the inability of regulators to keep up with the proliferation of clinics, both legitimate and otherwise.

Another reason I am skeptical is that the same doctor offers many other questionable services including platelet-rich plasma (PRP), calling it “one of the most powerful natural healing methods available today.” Some conditions include dry eyes, hair loss and erectile dysfunction.

The Pain Science website opinion published earlier this year describes it this way: “injections bathe troubled cells in a concentrated mixture made from your own blood. Hopefully this stimulates healing where it is otherwise failing … but no one really knows for sure yet.” Regardless, it’s not hard to find someone willing to do it for you, but it’s not cheap. “Without any clear evidence of benefit beyond placebo, PRP is now being marketed aggressively as a cure-all for sports injuries.”

I did this research not because I would consider going to a pain specialist unless I was referred by my primary care doctor. I did it just to show how careful we need to be to avoid spending a lot of money on dubious treatments. 

I didn't name this doctor because I'm sure there are similar ads running all over the country. I am not demonizing any doctor who may truly believe in such treatments, but it is a warning to patients everywhere. 

It is nearly always better and safer to be appropriately skeptical.

Don’t Be a Sucker

Last week I received an email where the subject line included the words “immune system.” There was something in the message about clicking on a link to unsubscribe. It was obviously either a promotion for a fake product or a phishing attempt. In any case, I sent it to the spam folder without opening it. 

Even if there were no link attached, it would have suffered the same fate. Anytime you see words like “boosting your immune system” or “promotes healing,” put your hand over your wallet and run away! It’s surprising how many people still don’t get it.

Marketing of these products has ramped up as the threat of the coronavirus pandemic hit the US. In fact according to this website, the airwaves and Internet are already overrun with bogus products and fake cures. “The Federal Trade Commission (FTC) and U.S. Food and Drug Administration (FDA) have sent warning letters to seven companies allegedly selling unapproved products that may violate federal law by making deceptive or scientifically unsupported claims about their ability to treat coronavirus (COVID-19).” 

These companies and others are pushing products, running the gamut from teas to essential oils to colloidal silver and other supplements, as being able to treat or prevent the disease. By law all such substances must state in their advertisements that they have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. Most do, but some, like the ones in the article, get into trouble when they fail to comply. 

In any case, there are not yet any treatments for coronavirus nor is there a vaccine to prevent it. Even without the disclaimer, it should be clear that these are scams. Here, for example, is what Mayo Clinic says about colloidal silver. “Colloidal silver isn't considered safe or effective for any of the health claims manufacturers make.” It doesn’t work for coronavirus or any other condition and may be harmful.

It takes almost no effort for critical thinkers to find flaws with the products and supposed health services listed. The truth should be common knowledge by now. (See any of my many previous entries debunking the benefits of dietary supplements, starting here.) References in the above article to a “naturopathic doctor” or to renegade chiropractors falsely claiming some power against the virus should raise red flags. 

But instead panic buying of supplements, or what this site refers to as “immune products,” in the wake of the coronavirus scare is leading to supply shortages and higher prices.

The expression “There’s a sucker born every minute” is often attributed to P.T. Barnum, but there is no evidence that he ever said it. It may have been said by any number of other people and is commonly heard and understood in the 21^st century.

I have no respect for these companies pushing fake remedies. They all should be sent to the spam mailbox. The ones that fail to post the disclaimer deserve their problems with the government. The ones that post the disclaimer but still imply some medicinal power for their products are no better than modern day snake-oil salesmen looking for the next sucker. Those who still believe in what NPR calls the Vitamin C myth or rely on other supplements, essential oils, reiki or other alternative medicine for their health needs may as well be handing their money to a witchdoctor for all the good it will do them.

Wise up. Don’t be a sucker.

Added Note: It is helpful to remember we are all in this together, except apparently for the news media, doing all they can to highlight the negative aspects of the disease and the efforts to combat it to promote fear and anxiety.

Coronavirus Fears

The fears, more so than the virus, are leading people to do strange things. The toilet paper and bottled water hoarding is just one example. I stopped by the grocery store today and it was packed at 1:30 in the afternoon. Schools announced they would shut down for 2 weeks to disinfect, and apparently what you do when the schools are closed to keep the kids from infecting each other is take them to a crowded grocery store instead.

And what the schools are disinfecting is a mystery, since there have been no reported cases of coronavirus (COVID-19) in this or any of the surrounding counties. But I guess the schools will be as germ-free as they have ever been.

I don’t think the Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, Dr. Anthony Fauci, is doing anyone any favors. He is undoubtedly very knowledgeable on the subject, but his bedside manner leaves something to be desired. With the country in a panic he told Congress, “things will get worse than they are right now. ”

That is the direct truth, perhaps a little too direct. It is understandable from a purely clinical point of view that diseases spread, especially in a population without immunity, but words like that don’t do anything to get people to calm down. They have the opposite effect (to the great delight of the news media). 

So here is another way to think about it. America is very likely better at dealing with such a problem than China. The first case in China was traced to November 17 of last year.

By February 29, we were seeing headlines like this from NPR: “As New Coronavirus Cases Slow In China, Factories Start Reopening.” They were still having some economic problems, but the future seemed brighter.

By March 12 Reuters was reporting: “The Chinese city of Wuhan, ground zero of the coronavirus outbreak, reported just five new cases on Friday, the second day in a row the tally has been less than 10, while no locally transmitted infections were reported in the rest of the country.” Less than four months after the initial outbreak they seemed to be getting a handle on the problem.

That should be encouraging for the rest of us. Though it will likely get worse as Dr. Fauci stated, the first case of coronavirus was already detected in the US just about two months ago. “On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever.”

Now extrapolation can be a little dangerous, and no one can guarantee that we will be out of the woods less than two months from now. But judging from progression of the disease in China and subsequently in Italy, it seems like a decent assumption. Whether it is or not remains to be seen, but taking that point of view is certainly more comforting (and realistic) than listening to the evening news and then hauling the kids off to the store to buy more toilet paper. 

Flashback – Why So Much Bad Advice

[This message was originally posted over six years ago, but since then the dynamic of bad information driving out the good has only gotten stronger with more fake news, advertising weasel words, political spinning, echo-chamber exchanges, media bias and health fads without any scientific basis.]

Why do bad ideas and bad advice seem to persist in a society with easy access to good science? One reason may be the tendency to cling to beliefs then look for evidence to support them, instead of accepting the conclusions of well-designed experiments. In his book The Righteous Mind Jonathan Haidt proposes that feelings and emotions come first, and that most reasoning works to justify rather than to test beliefs, that our “intuitions tend to drive our later reasoning.”  John Stuart Mill presented the same thought more than 150 years ago:  (paraphrasing) the more you argue, even while making clear, rational points, the deeper others dig in to protect long-held beliefs. Adding to the sad situation are the effects of scientists and doctors who would rather become famous as authors or TV stars by promoting popular beliefs than risk challenging them, as they should, with the truth.

One case that comes to mind is the persistent belief that artificial sweeteners are dangerous. Simple research is reassuring, but the belief is ingrained in our culture. The National Cancer Institute states clearly and unequivocally: “There is no clear evidence that the artificial sweeteners available commercially in the United States are associated with cancer risk in humans.” The Mayo Clinic’s view is that “there's no sound scientific evidence that any of the artificial sweeteners approved for use in the U.S. cause cancer or other serious health problems.” So who do Americans trust, these authoritative sources or a Facebook friend who watched some guy in a halloween costume on YouTube with scary stories?

Likewise folk remedies of all kinds continue to circulate. One longstanding belief is that magnetism has magical healing powers, leading people to buy bracelets, insoles and other magnetic devices. This is odd because over the past 15 years the FTC has ordered Magnetic Therapeutic Technologies, among others, to stop advertising magnets as a cure for numerous diseases or even as a pain reliever. No credible evidence exists of healing powers, and none can be claimed in their advertising. One recent well-designed test of such devices confirms this fact concluding: “Wearing a magnetic wrist strap or a copper bracelet did not appear to have any meaningful therapeutic effect, beyond that of a placebo, for alleviating symptoms and combating disease activity in rheumatoid arthritis.” Does that slow the sale of magnetic shoe insoles? – Not for people who don’t let the facts get in the way of a good story, a persuasive ad or a celebrity endorsement.

It’s your money to use as you please. You can save it for college and retirement, give it away to companies selling you magnetic health devices, or even flush it down the toilet. Two of those choices make the same amount of sense, but as Paul Simon sang, “A man hears what he wants to hear and disregards the rest."

Opposing Views on Alternative Medicine

The Association to Protect the Sick of Pseudoscientific Therapies (APETP in Spanish) was formed by victims of those therapies along with scientists, doctors, nurses, physiotherapists, computer scientists, lawyers, and many other credentialed health professionals to fight against the rise of unproven alternative medical practices in Europe. They recently published a manifesto to “raise awareness in the media about the problem of pseudo-therapies and the position of the scientific community against them.”

They feel strongly about the dangers and deception of these practices. “More than 150 pseudo-therapies have been identified as being in use throughout Europe. Thousands of citizens’ lives depend on this being prevented. In fact, according to a recent research, 25.9 % of Europeans have used pseudo-therapies last year. In other words, 192 million patients have been deceived.”

They do not list all 150 in the manifesto, but summarize a few. “Homeopathy is the best known pseudo-therapy, but it is not the only one nor the most dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology, biomagnetism, orthomolecular therapy and many more are gaining ground.” They claim that these are not only unproven, but they distract patients from seeking professional help when desperately needed. They are calling for legislation in countries around the world to combat their spread. 

In the US, practitioners of these therapies are not allowed to advertise or otherwise imply that their products can “diagnose, treat, cure or prevent any disease or any other medical condition,” but the government has not considered consumer protection legislation. In fact, the FDA and other agencies are easier on these products and practices than they are on prescription medicine in terms of testing requirements for safety and efficacy.

Meanwhile, from halfway around the world comes another example of what that group is fighting against. 

In response to the Coronavirus outbreak and WHO’s warnings, a branch of the Indian government, the Ministry of AYUSH, issued an advisory based on traditional medicine.

The first part of the release gives the typical good advice on how to behave in this environment: maintain personal hygiene; wash hands frequently; drink enough water; avoid touching your eyes, nose, and mouth; avoid close contact with sick people; stay home when sick; cover your face if you cough or sneeze; and use a mask in public places.

But next they recommend “ways and means of prevention of Coronavirus infection through Homoeopathy” and use of a variety of Unani medicines for “symptomatic management of Coronavirus infection.” (This would be illegal in the US but it is government-sponsored in India.)

Unani medicine, not common in the West, is “a form of alternative medicine, which is based on the belief that the human body contains four humors, and that imbalance of these four humors is the cause of disease,…created by the ancient Greek physician Hippocrates, which later spread to the Islamic empires...during the Middle Ages. While this belief has no scientific basis, contemporary adherents still try to propagate these beliefs as science.” [Source: Wikipedia]

 An editorial in the Times of India decried the government advisory: “When all the authorities including World Health Organization claim there is neither any vaccine nor any treatment for coronavirus, the government is promoting unproven therapies to lull people into a false sense of security that they can be safe if they consume such concoctions.” Dr. Misba Hul Bashier added on Twitter that “loads of patients developed acute liver and kidney failure due to alternative medicines.”

Of course, recommendation of useless or even dangerous steps driven by fear of the virus is not limited to the Indian government. A Canadian news story cites “quack remedies and vaccine conspiracies – a global deluge of misinformation” including a recommendation on Facebook to drink a household disinfectant and another source claiming that a saline solution, salty water, can cure it.

What can we do when misinformation abounds – petition the government for new regulations like the Europeans? Critical thinking would be a lot easier and less intrusive by trusting real evidence rather than endorsements and recommendations.

Diet Soda Still Under Attack

People using social media too often read headlines and don’t look at the rest of the story or, perish the thought, do a little research to find out the truth. We see articles posted where an event happened in another country but the comments read as if it happened right next door. (I highlighted an example of some of the dangers of this kind of behavior, blindly reposting stuff, earlier this month.)

That is why I wasn’t surprised to run across another condemnation of diet soda being spread on Facebook a few weeks ago when the original news story came out last February 14. (Does the American Heart Association (AHA) always release a story on Valentine’s Day or was that just a coincidence?) This story presented a good example of how a headline can be very misleading, and how 15 minutes of research leads to a different conclusion.

Multiple news outlets reported it, but the Fortune headline was typical: “Drinking Two or More Diet Sodas a Day Increases Likelihood of Strokes, Heart-Attacks, American Heart Association Says.” Although they have been seen as a healthier alternative to sugary drinks, the study shows that “immoderate drinking of the low-calorie drinks is associated with a greater risk of strokes or heart attacks.” 

They go on to say that over 82,000 women participated, which is a very large sample, but it means the findings can apply only to women. Furthermore, and not mentioned in the Fortune article, they were post-menopausal women between the ages of 50 and 79.

Part of the findings correctly reported was that the women “who drank two or more artificially sweetened drinks had a 23% higher risk of strokes in general.”

A more thorough report came from Science Daily. They also report the 23% figure, but add near the beginning of the piece an important reminder for non-statisticians. “While this study identifies an association between diet drinks and stroke, it does not prove cause and effect because it was an observational study based on self-reported information about diet drink consumption.” Also researchers can determine no mechanism by which the ingredients in diet drinks could cause the associated ailments.

A further question arises: How bad is a 23% increase in risk? That depends not on the size of the sample, but on the size of the risk. If, for example, the overall risk of something bad happening is 60%, a 23% increase brings the risk up to almost 75% - a big difference. On the other hand, if the risk is small, say 2% such an increase brings the risk to less than 2.5%. Without specifying the original size of the risk, the unanswered question is: how much behavior should I change to try to avoid it?

The percentage increase says nothing about the real size of the increased risk. To find out how serious it was I went to the AHA Journal article cited in those news stories. I found the data in Table 2 of the study.

The data showed that the risk of a stroke over the twelve years of follow up was about 3% for the group that drank almost no diet drinks and 3.7% for those who regularly drank two or more. Remember, this very small risk applies only to post-menopausal women. And also mentioned in the conclusion of the AHA study, those women in the higher-risk group “were more likely to be obese, had lower levels of exercise, had … lower diet quality… [and] were more likely to be a current smoker.”

A different study with a smaller sample asking the same question was published two years earlier by Harvard Health. It concluded that the risk from diet soft drinks is small. They also referred to a larger study that “detected a slightly higher risk of stroke in people who drank more than one soda per day, regardless of whether it contained sugar or an artificial sweetener.” (That flies in the face of the aspartame urban myth that won't seem to go away.) And agreeing with the conclusion in the AHA study, for people drinking diet sodas, “heightened stroke risk may result from their health problems rather than their beverage choice.”

An honest headline should have read: "Postmenopausal women who drink two or more diet drinks a day seem to have a slightly higher risk of strokes but what they drink might have nothing at all to do with it" - not exactly click-bait.

It takes just a little critical thinking and research to uncover the misrepresentations in so many headlines. If you don’t care enough about the issue to do the research, ignore the headlines. If you do, don’t repost them on social media until you've looked into the matter.

Flashback - Health Advice

[Here is a combination of a flashback and an example of how easy it is to predict future news. In November 2013 I wrote the below essay with the title "Secrets to Good Health." This month the BBC ran an article about a BMJ (British Medical Journal) report that men can live an extra 7 years, 10 years for women, of quality life by adopting five healthy habits: never smoking, healthy diet, exercise, body mass index (BMI) between 18.5 and 24.9 and moderate alcohol use. That's substantially what I told readers over 6 years ago in the following flashback.]

As I read this information from Johns Hopkins on how to maintain good eyesight, it occurred to me that products advertised as the secret to good health must be a scam.

This article from a group of medical experts tells that other than regular checkups, to maintain good eyesight “many lifestyle factors that protect our heart health may also help keep our eyes healthy, including being active; getting enough sleep; controlling blood pressure and diabetes; not smoking; maintaining a healthy weight; and eating a diet rich in fish and leafy, green vegetables like spinach and kale. Wow, that’s almost the same advice for every other health concern, not only heart health, but also improving the effects of arthritis, preventing chronic illness , promoting memory and general mental health.

The real secret to good health is that there is no secret.  Health authorities have not been trying to hide anything from us. There is no big secret "doctors don't want you to know."  In fact they have been shouting from the rooftops at every opportunity. We are told over and over on a number of issues that if we want to avoid problems and just generally feel better we should: get enough sleep, eat healthy, drink alcohol only in moderation, stop smoking, get plenty of exercise, drink enough liquids, use sunscreen, wear work gloves or protective eyewear as appropriate, learn relaxation techniques to reduce stress, brush and floss, wash your hands and get a flu shot. This should come as a surprise to no one. We have heard all this advice or subsets of it many times for many years.

The problem with advice like this is that no one wants to hear it. Americans are looking for the easy way, one that requires little discipline. So every time a new diet book is published or the doctors on TV tell us about a miracle cure or another health secret, people want to sign up for the program (and send in their money). They can’t hold an audience by saying the same things over and over, especially when we are so desperate for secrets, so the authors and television personalities must give us secrets.

The real secret is the boring truth – that there is no secret. Like every other endeavor in life, staying healthy requires a little luck and a lot of discipline to stick to the best course of action. The rest is distraction.

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.)

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.

Ancient Chinese Folly

There is something fascinating about ideas that are ancient and Chinese. They are in the same category as all-natural, sustainable and organic. People take them on faith, feeling that research is unnecessary, while risking the loss of time and money; and sometimes putting themselves at risk.

Take acupuncture for example. I am always skeptical of treatments that boast a cure or relief from multiple conditions. Just one example is listed here. “Health benefits of acupuncture include relief from chronic pain, arthritis, anxiety, insomnia, depression, migraine, nausea, postoperative pain, and obesity.” 

This other website adds to the list: nausea, sciatica, sinus congestion, stress, tinnitus and tobacco addiction. But then they go on to describe several recent research results in not very glowing terms. In 2017 authors reported limited evidence that acupuncture is modestly effective for acute low back pain. A 2016 review of 22 previously published trials concluded that adding acupuncture to standard treatments for migraines “may reduce the frequency of episodes, however the size of the effect is small when compared to a sham acupuncture treatment.” A 2016 review of 12 trials found that it may help people with frequent tension headaches. And another analysis “it appeared to provide only short-term(up to 13 weeks) relief” for people with chronic knee pain.”

One puzzling comment was that after the treatment “some people feel relaxed (or even sleepy), while others feel energetic.” One treatment with opposite outcomes may indicate a strong placebo effect.

Not many sources list the side effects of acupuncture. Since it’s ancient and Chinese many will automatically assume that it is only beneficial. But the treatment “can cause serious adverse effects, such as infections, nerve and blood vessel injury, complications from needle breakage or remnant needle pieces, punctured organs, central nervous system or spinal cord injury, hemorrhage, and other organ and tissue injuries resulting in death. Punctured pleural membranes around the lungs can lead to collapsed lungs.”

A study from China in 2015 claiming acupuncture is effective for treating the symptoms of angina was published only a few weeks ago. It received a harsh critique based on the time delay, lack of studies replicating the result, failure to use a double-blind design, the subjective nature of the results and that all authors were affiliated with schools of acupuncture or Traditional Chinese Medicine.

A report from 2013 states that “after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant.” Since then as we see above, evidence of effectiveness continues to be weak.

I always wonder why so many people, who mock those that don’t agree with them on climate change as being as unscientific as flat-Earthers, unquestioningly put their faith in these treatments and cures, some even crazier and more dangerous than acupuncture.

The BBC reports on a case from the Journal of Obstetrics and Gynaecology Canada of a 62-year-old woman who, on the advise of her traditional Chinese doctor, sustained severe burns when she tried vaginal steaming in an attempt to avoid surgery for a prolapsed vagina. “Vaginal steaming, which involves sitting over a hot water and herb mix, has seen a growth in popularity” and is “now available at some salons and spas.”

The practice began to gain popularity in 2010 and has been endorsed by Gwyneth Paltrow as a detox and cleansing treatment – those two words alone should scare off clear thinking Americans. Last year Chrissy Teigen, who tweeted under a picture of herself trying it, “no I don’t think this works but it can’t hurt right?” No, wrong! Ask a doctor rather than a model or movie star and you will get the opposite answer on all claims.

Once again, lapses in critical thinking are so obvious. There is no such thing as alternative medicine. There is only medicine that works and medicine that doesn’t. In the war between science and fairy tales, the fairy tales are winning.

The Latest Big Thing – CBD Oil

I began to wonder about CBD oil when I saw on the local television news a very non-critical report about a new store in town. It was like a press release from the store that the reporters used as an excuse to fill airtime with a very positive interview of the owner, but without questioning any of the exaggerated claims about the its curative powers. I knew that it had been until recently illegal, making good scientific research very difficult and sparce, and that researchers generally look at only one effect at a time when testing any treatment. How could this substance arise out of the blue with so many promises?

This webpage, for example, lists seven benefits including: relieving pain, reducing depression and anxiety, alleviating cancer related symptoms, reducing acne, having neuroprotective properties and benefiting heart health. Of course the last three are conditioned with “may," “might” and “could.” It warns: “Although CBD is generally considered safe, it can cause adverse reactions like diarrhea and fatigue in some people. It may also interfere with certain medications.”

Based on such reviews, it appears to fall into the familiar too-good-to-be-true category. So I was not surprised to find the headline: “FDA warns company marketing unapproved cannabidiol products with unsubstantiated claims to treat cancer, Alzheimer’s disease, opioid withdrawal, pain and pet anxiety.” And if you are going to advertise in the realm of too good to be true anyway, why not throw in that it counteracts the growth of [and/or] spread of cancer, kills breast cancer cells, treats Parkinson’s disease, reduces the severity of opioid-related withdrawal, addresses symptoms of chronic pain, anxiety and ADHD, and helps with PTSD, schizophrenia, fibromyalgia and eating disorders. The FDA objects to all these claims (and more) as “unsupported and unapproved.”

 WebMD calls it “all the rage” but warns that “experts say the evidence is scant for most of these touted benefits." Like many other over-the-counter products and supplements, it is “being produced without any regulation, resulting in products that vary widely in quality.” Dosages vary from one product to another, possibly from one production run to another and from one brand to another. “Only one purported use for cannabidiol, to treat epilepsy, has significant scientific evidence supporting it.”

Last April the USA Today piled on, asking: “Is this hemp plant derivative snake oil or a legit remedy?” In addition to all the powers listed above, they add that it’s also hyped as a cure for inflammation, stress, unsatisfying sex and PMS.  But it's sold at local pharmacies (including the one that stopped selling cigarettes because they care so much about our health) in the form of creams, lotions, oils, tinctures, pills, powder or liquid. But this story also comments that the marketers' therapeutic claims are "rarely supported by medical evidence that CBD is significantly better than a placebo.”

Again from USA Today in a different story: “The head of the National Institute on Drug Abuse said there’s no evidence that marijuana [or CBD] weans people from opioid addiction – and promoting such treatment might deny people a chance at recovery.”

The Mayo Clinic sums it up: “While CBD is being studied as a treatment for a wide range of conditions, …research supporting the drug's benefits is still limited." It can cause more serious side effects than those mentioned above and “can interact with other medications” such as blood thinners.

And remember that part about it being unregulated? “Another cause for concern is the unreliability of the purity and dosage of CBD in products. A recent study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than labeled. In addition, THC [the psychoactive ingredient found in marijuana] was found in 18 products.” But don’t sweat those pesky details – it’s all-natural and I heard on Facebook…!

Save Your Vitamin Money

At least once a month we see reference to one or another survey or report about people being unable to afford retirement. They haven’t saved enough money, but may not be able to keep working either. But now just when it’s needed, along comes a reliable tip on how to save a little more: Don’t waste your money on vitamins. 

This is not the first time I have written about the waste and potential dangers of dietary supplements. The last entry on the subject of supplements in general was about two years ago where I quoted from the New York Times saying that annual spending in America averages about $100 per person. I focused on vitamin and mineral supplements as recently as last September. I was hoping after many attempts to have wrapped it up, but it’s good advice, so I will give it another shot based on some fresh headlines.

About two weeks ago researchers from West Virginia University School of Medicine published a study in the journal Annals of Internal Medicine showing “that although reduced salt intake and certain supplements may lower the risk of cardiovascular diseases, most nutritional supplements do not improve the risk for heart disease or death.”

An article reviewing that study quotes the lead researcher: “The reason we conducted this study was that millions of people in the United States and across the world consume supplements or follow certain dietary patterns, but there was no good-quality evidence to suggest that these interventions have any effect on cardiovascular protection." 

The study itself was not a clinical trial but a review of 277 other studies with a total of nearly one million subjects. It looked at the effectiveness of many popular nutritional supplements and 8 diets. “Findings show that of the 16 dietary supplements, only two showed beneficial effects on heart health, namely omega-3 long-chain fatty acids and folic acid….[whereas] selenium, vitamin B6, vitamin E, vitamin C, iron, and vitamin A, among others, show no significant effect on heart health.” 

Other important findings were that some supplements by themselves, not just the tainted ones that appear in the news from time to time, are potentially harmful. Another surprising finding was that “most diets, like modified fat intake, the Mediterranean diet, and reduced saturated fat intake, had no effect on the heart at all.”

Some other sources reporting on the same study had more watered down headlines. This one says, “For Heart Health, Some Popular Supplements Aren't as Helpful as We Thought.” But the sub-headline is more direct: “Consumers should ‘stop wasting their money on these products.’ ”

Another one is even more careful in its wording: “Nutritional supplements and diets not always protective, research suggests.” But they did provide a link to another study from 14 months ago that also came to the conclusion that “most commonly consumed vitamin and mineral supplements provide no consistent health benefit.”

The final conclusion as always is “only eating a healthy balanced diet is the key to overall health.” That shouldn’t come as a surprise to anyone who has been paying any attention to and looking into health news over the years. Once again, it’s looking for the easy, magical answers that cause us to waste time and money on pills and fad diets. Avoiding that mindset is, though, an easy way to come up with some extra money for that problematic retirement savings plan.