Snake oil, water and acid – a very sad mix

A fiasco over a ‘Natural Therapy Clinic’ at Wanganui Hospital was finally resolved satisfactorily – but for the wrong reasons.

The attempted introduction of ‘natural therapy’ to Wanganui Hospital has been yet another appalling demonstration of the failed leadership, governance and management structure of the Whanganui District Health Board.

Whilst clearly recognising all our rights to pursue personal and spiritual health, wellbeing, happiness and pleasure, my view is this: New Zealand hospitals, established with public funds and administered by the Ministry of Health, must follow the principles of evidence-based care.

I have a high level of interest and involvement in things spiritual and religious. I am an ardent advocate of patient and broader human rights and strongly support and respect our indigenous people and the Treaty of Waitangi.

However, and a big however, as a trained scientist, specialist General Surgeon and third term elected member of the Whanganui DHB, I have been appalled at what has unfolded in the attempted introduction of ‘natural therapies’ to our public hospital here.

I think I understand the sentiments that might have driven this initiative. Indeed I also have a degree of sympathy with its proponents, who almost certainly meant well.

The arrogance of thinking within Western medicine that excludes possible benefits of other modalities of healing is not warranted. An environment lacking in empathy and caring is all too common in our public hospitals and also needs to be dealt with. So too, the awful health statistics of our under-privileged population – in which Maori are sadly over-represented.

However, even a cursory examination of what has transpired in this failed process reveals serious and very worrying realities of the state of stewardship of the provision of medical care in New Zealand.

The initiative to establish a ‘Natural Therapy Clinic’ at Wanganui Hospital saw the formal establishment of the service via an early morning blessing at Te Piringa Whanau on Monday 23 July at 7.45am. The service was led by local kaumatua John Maihi and Wanganui Hospital chaplain Rev Graham Juden.

Despite obvious months of planning and detailed preparation, this was announced via a press release of 19 July1, just three days before the formal launch.

This was the first word of this initiative breathed to members of the Whanganui District Health Board. Not a single mention of it was made by the CEO Julie Patterson to her board – not even a hint in her weekly email updates to board members, the last one appearing just days before the launch. For a board that runs on the premise of ‘no surprises’ from its CEO, this is disturbing.

This is especially concerning since the media release in January 2012 suggesting (with the blessing of local obstetric specialists) that Wanganui might soon have no obstetric service was also never formally discussed at a board meeting. This created six months of chaos and anxiety for our community.

Termination

Fortunately, like the absurd idea of not providing an acute obstetric service to a city of 45,000 people, the ‘Natural Therapy Clinic’ idea has been terminated.

Interestingly, the scheme was cancelled just days before it was to be presented to the board. The only way I was able to get it to the board table at all was to link the idea of allowing non-accredited ‘practitioners’ loose on our patients with the recent case of alleged sexual abuse of one of our patients by a mental health care assistant in our organisation.

The CEO reported at the time2:

” Almost 12 months ago we received a complaint from a young woman, one of our mental health clients. The complaint alleged that she had been raped by a Health Care Assistant (HCA). The staff member was immediately suspended and the complaint investigated. It was found that the staff member had had inappropriate contact with the woman (texting and meeting her away from the unit) and a strong suspicion that there had been a consensual sexual relationship. The staff member resigned but was informed in writing that the outcome of the investigation was that he would have been dismissed. As this person was part of the unregulated workforce, we had no other levers.”

How much more blatant a lesson does one need to realise the obvious pitfalls of not only allowing, but encouraging, unregulated workers access to our patients?

The ‘paper’ which was finally presented to the board was the usual inept documentation supplied for board members and was lacking in even the rudiments of scientific form or rigour.

The claim that the pilot programme received “overwhelmingly positive feedback from staff”3, is perhaps one of the more obvious areas of deception in all this.

A survey of the 75 staff members who chose to use the service at its pilot stage apparently showed a positive response. However, of course, this is a self-selected group of less than seven percent of hospital staff members who wanted to avail themselves of the service in the first place. The views of the other 93 percent of staff are not canvassed or recorded.

But this is characteristic of DHB doublespeak.

The first media release of 19 July concerned me on a number of levels. The fact that the board had not been consulted was one. Board sets policy; management is tasked with implementing it.

All too often in our fragile district, management has implemented unjustifiable actions and then looked to the board for support after the fact. That support has understandably and correctly for the most part not been forthcoming.

An open-ended field

The second concern was the lack of definition of ‘Natural Therapy’ and the open-ended inclusion of all comers, including traditional Maori healing, Christian prayer, massage, Reiki and meditation training, as treatment modalities.

More recently, and again without prior notification, we learn through the media3 that ‘colour therapy’ was also included in this array.

None of these can seriously or accurately be considered to be therapies any more than a warm bubble bath or hairdressing could be. That does not mean that they necessarily infer harm – of course the latter two do not. Furthermore, it does not mean that hairdressers and bubble bath are not allowed or even encouraged in our hospitals: of course they are. They simply are not therapies. They are nice things and we can choose to use them in or out of hospital if we wish at our own whim.

The provision of Traditional Maori Health is already recognised by our Ministry of Health and appropriately funded and provided outside of hospitals. One could well argue that this is a legitimate part of the history and culture of New Zealand and like the Maori language is worthy of respect and support. I agree. This is a noble sentiment, and one supported by our government, but any serious practitioner of traditional Maori healing would no sooner practise his art in a backroom of Wanganui Hospital then I would perform a laparotomy in the staff canteen.

Confusion

It is curious that the reported formal line of the organisation as to why the project was shelved was to “avoid confusion and anxiety in the community which we are here to serve”. That confusion, however, has been created by the management team of what is supposed to be a first-world public hospital formally suggesting through one of its most prominent specialists that the likes of ‘colour therapy’, prayer and body rubs might have any serious therapeutic benefit.

Indeed, in a study of some 1200 patients published in the American Heart Journal4 prayer clearly has been tested and shown to have no such effect.

My greatest concern, until recently, was that this project was initiated and sustained by a medical specialist colleague Dr Chris Cresswell, who is a Fellow of the Australasian College of Emergency Medicine (FACEM) and boasts vocational registration with the New Zealand Medical Council.

Code of Ethics

Our own Medical Association of New Zealand code of ethics requires us to “[a]dhere to the scientific basis for medical practice while acknowledging the limits of current knowledge.”5

It is entirely inappropriate for us to use our acquired medical positions and titles to actively promote in a formal way practices that clearly are not evidence based.

The issue is not that these modalities have no value. For individuals they clearly do. It is not that they might do harm; they probably will not. The issue is a gross breach of our commitment to our patients to apply best practice and evidence-based models to their care.

Furthermore, the notion that individuals who are essentially unaccountable and unrecognised by professional bodies and standards should be unleashed on our patients is at best irresponsible. That one of our senior doctors &#8212 Dr Cressell &#8212 in his professional capacity was using his medical qualifications and status to promote these people and suspect modalities should be a matter for the Medical Council to act on. These are not acceptable treatment options. They might well be nice and comforting and like hand-holding and hairdressing, patients are at liberty to use them at their own behest even in our hospitals. They are not to be formally prescribed by doctors using their medical credentials to promote snake oil. These are not therapies; these are not credentialed practitioners. These are at best warm fuzzies and do not require ‘clinics’ endorsed by our doctors. They have no place in our hospitals any more than homeopathy, devil worship or nail painting does.

I was surprised that the hospital CEO, Clinical Board and Association of Senior Medical Staff supported this poorly conceived idea at the outset. They did. They most certainly did.

Not one of my medical colleagues locally spoke out against this plan. Not one spoke out in support of high-quality, first-world, evidence-based medical care of which we should be unambiguously proud.

Common sense?

Then suddenly, the idea was dropped. I thought some common sense had prevailed.

The real and greatest concern, though, is this. Our CEO and board chair refused in the public section of our board meeting to properly explain why the project was so suddenly stopped in its tracks.

The answer lies not in medical ethics, science, patient concern or professionalism. Astoundingly, it seems, it lies not in a rational, scientific concern for evidence-based practice and a concern for who precisely we allow to have access to our patients. It lies, rather, in religiously based paranoia and bigotry.

A Wizard at the hospital

On 6 September 2012 an advertisement article appeared in the Wanganui River City Press titled ‘Dreams, magic, healing and medicine’6.

This promoted a talk to be given by Dr Cresswell on a number of topics including the ‘Natural Therapy Clinic’ and his proud introduction of it to Wanganui Hospital.

Sadly for Dr Cresswell and the ‘Natural Therapy Clinic’ the article disclosed the fact that Dr Cresswell is an ordained Wizard in the Whanganui School of Witchcraft and Wizardry, a clearly unchristian organisation and the meeting was part of Theosophy Wanganui.

I guess that degree of open mindedness, free spirit and lateral thinking on the part of Dr Creswell is what led him on his natural therapy crusade. I must confess to a degree of admiration, kinship and support for his wide raging interests, but alas, like business and pleasure, some things are best not mixed.

We can deduce it was the wizardry of Dr Cresswell that drove the medical professionals to object to the scheme. Not science, not ethics, not professionalism. Rather, we are told, “it was contrary to their religious beliefs”.

I’ve been told more than once my problem is that I think too much.

That’s probably true, but what has happened is not only mind boggling and sad, but frighteningly revealing on a whole number of levels.

A well-meaning ‘good guy’ doctor probably crossed the bounds of professionalism by formally elevating feel-good modalities to therapies. An ill-informed management team jumped on the bandwagon and Maori health was usurped in an attempt to ooze credibility over other unrelated claptrap practices.

The Health Board members were never consulted and some well-deserved bad press followed. Sadly, the Medical Council of New Zealand and the Ministry of Health provided no guidance and remained silent whilst all this unfolded. Happily, some very influential Wanganui senior doctors killed the project after previously supporting it. Sadly, it seems it was because of their own religious and personal bigotry that a silly idea was ended.

Great result, bad motivation. Very bad motivation.

Medical ethics

Vicki Hyde of the NZ Skeptics7 points out:

“It’s rare for public figures to come out against these ‘soft’ services. It´s easier to ignore the ethical and evidential issues associated with claims that these kinds of practices actually help to treat illness or disability beyond exploiting the well-recognised placebo effect.”

It is imperative that as doctors, our first responsibility must be to our patients. Of course, we need to be cognisant of our limitations, humble, not arrogant and open to all the needs of our patients. But we are trusted as a profession and that trust can only be maintained if we adhere to defined standards based on evidence and ongoing re-evaluation and scrutiny. We should not promote, via our medical qualifications, unproven modalities at the level of treatment modalities. But neither can we allow our own specific religious affiliations to affect our professional conduct with respect to our colleagues who might hold different or indeed no religious affinities.

As trained medical practitioners we must boldly uphold the scientific basis of our profession and never be compromised by political correctness or political claptrap and doublespeak.

Saving grace?

The supposed saving grace in all of this is that ( we are told) no taxpayer money was spent on this project. My Official Information Act application will shed some light on that. But note, apart from the media releases, the following occurred8:

  • A credentialing committee was established, including Dr Cherryl Smith (Co-Director of Te Atawhai o Te Ao), Dr Chris Cresswell, Gilbert Taurua and Runesu Masaisai (WDHB Clinical Therapies Manager).
  • Dr Chris Cresswell was to extend his professional development on natural therapy as part of his credentialing requirements as recommended by the clinical board.
  • An independent legal opinion was sought which resulted in the WDHB’s insurance company providing approved cover for the pilot.
  • Therapists were required to become honorary DHB staff ensuring compliance with all WDHB expectations, policies and procedures.
  • Systems were established to obtain confidentiality agreements from all therapists.
  • Therapists were required to be police checked.
  • Therapists were referee checked and cleared by both steering committee and credentialing committee.
  • A memorandum of understanding was developed specific to the therapists collective.
  • Informed patient consent expectations and documentation were established.
  • The orientation programme for therapists included: WDHB purpose, values and behaviours, fire and emergency evacuation, infection prevention and control, manual handling, patient safety and service quality including complaints, privacy and the code of rights, CPR and smoking cessation.

That appears to be a lot of taxpayer funded work to me.

Some appointed members of the Whanganui DHB tried to excuse this whole debacle by suggesting that this was all just a staff benefit scheme and never intended for patients. They clearly never read their press releases and have been patently out of touch with this important process, or worse, have compromised their own integrity in order to cover for a failing and flailing management.

To add insult to all these injuries, in an attempted justification of the failed project, Julie Patterson made the public comment that “in areas like ‘chronic pain’, Western Medicine has nothing to offer.” Really?

With views like that from high earning health bureaucrats, doctors, nurses, the Medical Council and the Ministry of Health have sure got a lot of work to do.

In the face of all of this nonsense, we cannot and should not remain silent.

References
1. Whanganui District Health Board Press Release 19th August 2012.
2. Weekly update, CEO Whanganui District Health Board 21st May 2010.
3. Wanganui Chronicle 26th September 2012. Hospital Ditches Natural Therapy, Anne-Marie Emerson.
4. Benson H et al. 2006: Am Heart J. 2006 151(4):934-42.
5. Medical Association of New Zealand Code of Ethics. www.nzma.org.nz/sites/all/files/CodeOfEthics.pdf
6. River City Press Sept 6th 2012 Dreams, magic, healing and medicine.
7. NZ Skeptics press release 24th August 2012,www.scoop.co.nz/stories/AK1208/S00554/consumer-wins-bent-spoon-again.htm
8. Wanganui District Health Board Meeting 28th September 2012 Item 10.2.
Clive Solomon is a Consultant General Surgeon, elected member of the Whanganui DHB (third term) and a Wanganui District Councillor. [Editor’s note: Organisations referred to in this article differ in their preferred spelling of Wanganui or Whanganui.]

Newsfront

How to raise a psychic child

All children are psychic, according to one of the stranger items to appear in the NZ Herald (30 May) for a while.

Sue Bishop is described by writer (I hesitate to say journalist) Nicky Park in the paper’s Life & Style section as “one of Australia’s top intuitives” – a phrase Bishop herself uses in her promotional material. She says children are tuned in to their abilities more than ever, but parents need to know how to nurture their kids’ skills without discouraging or being too pushy.

Bishop, who is currently promoting her recent book Psychic Kids, says we’re starting to see little kids who can see spirits, and actually validate who it is. “It’s different to a child saying, ‘I’ve got a monster on top of my bed’ [how, exactly?]. We know that’s imagination.”

The “level of awareness” kids have today is different to the kids of the 80s, she says, partly because the topic is less taboo now so children are free to explore their psychic abilities. Then there’s “soul evolution”.

“I believe that each evolution carnates to bring a new gift, a new awareness to help us grow and expand also to deal with the problems created from the former generation.”

But at the age of seven the soft part of the skull fully closes (this is in the NZ Herald, remember, so it must be true), and the age of reason begins.

“It’s when children go through this phase that they start to fear death and fear separation from a parent … they start to focus more on being logical and analytical. They start to doubt their intuition, they shut that part of themselves off.”

But don’t worry, the Herald has some useful tips to help you prevent your child from becoming logical and analytical. You must recognise you and your child have a sixth sense, and set safe boundaries for using these abilities. But don’t indulge them too much: “Some kids will go too far and let their imagination take over.”

‘Medicine man’ offside

A self-styled Woodville ‘medicine man’ has found himself offside – with the country’s other medicine men (Dominion Post, 18 June).
Karys Woodcock, a 65-year-old part-time actor raised in England, says he is entitled to be a shaman because his father had Crow Indian heritage. He is legally changing his name to Laughing Bear, and says he has attracted a strong following for his ‘medicine readings’ and other services. He charges for those services, but according to Joseph O’Connor, 81, genuine shamans don’t charge.

O’Connor says he is a third-generation psychic and shaman, while “Laughing Bear” is an actor living in a world of fantasy. “Renting out rooms to unregistered psychics must be stamped out. There are so many so-called psychics robbing the public. He is doing a great injustice to the unsung heroes and healers that have made this country.”

Woodcock charges $60 to $70 an hour for medicine card readings, as well as charging for teaching groups, and takes donations for ghost and spirit house cleansing. He admits there is a big argument about shamans receiving money. “People fall in love with understanding living holistically, but forget that in order for me to practise as a shaman, I have to get petrol, have a mortgage to pay.

“My tepee is bigger than what I used to have. I don’t really want to go and live in the bush. People give us a gift of dollars instead of a leg of elk or deerskin. If [the] creator wants you to do something, you have to be alive to do it.”

Animals vie for psychic fame

Remember Paul the psychic octopus? The late lamented mollusc who correctly picked the outcomes of all seven of Germany’s matches plus the final in the 2010 Football World Cup now has plenty of competition (Stuff, 8 June).

None have the form of the eight-legged marvel, however, says Joe Crilly, a spokesman for British bookmaker William Hill. “And with so many to follow, there are undoubtedly going to be a few who get it wrong.”

Citta, a 33-year-old female Indian elephant at Krakow Zoo, was given the gig for the 2012 Euro Cup after correctly picking Chelsea would win the Champions League final, heading off a donkey, a parrot, and another elephant. But her first two predictions of Polish victories – made by choosing a marked melon – have been astray, with both matches drawn.

Meanwhile a “psychic pig” in the Ukraine predicted four of six results in the first round correctly. Other contenders are a ferret called Fred, Kharuk the Russian reindeer, Sissi the German dachshund, Nicholas the English llama and Huat the Singaporean arowana – that’s a large freshwater fish. Information is limited on how well any of these are doing, which probably says something in itself.

Snake test of faith fatal

A West Virginia preacher who handled venomous snakes to prove his faith in God has died after being bitten (NZ Herald, 1 June).

Mark Wolford’s own father died of a snakebite in 1983 aged 39, and he himself had been bitten before and survived. On this occasion witnesses say a timber rattler bit the 44-year-old on the thigh during a Sunday service at Panther State Forest.

Ralph Hood, a religion professor at the University of Tennessee at Chattanooga, said his friend Wolford would want people to remember him as “a Christian who was living his beliefs and being obedient.”

“A common misunderstanding is that handlers believe they can’t get bit or it won’t kill them,” Hood added. “What they’ll tell you is, vNo one will get out of this alive.’ They’ll also tell you it’s not a question of how you live; it’s a question of how you die … This is how he would have wanted to die.”

Although most Appalachian states have outlawed snake handling, it remains legal but rare in West Virginia.

UFOs buzz Northland … or not

Ufocus NZ are claiming many sightings of UFOs in the Northland region in recent months, but none has been reported to the police, a police spokeswoman says (Northern Advocate, 23 May).

Suzanne Hansen, who is research network director for the UFO-watching group, said one man had reported seeing a UFO land in Northland in April, but she was not revealing where at this stage. “He’s a very credible source. He saw an object that had landed and said it was definitely not an aircraft or like anything else he had seen.”

After a story on the sightings appeared in the Northern Advocate on May 19 several more reports of recent UFO sightings from the region had come in, while others had contacted the group to report historical sightings in Northland.

NZ Skeptics spokeswoman Vicki Hyde said there were a huge number of possible explanations for UFO sightings – and none of them involved visits from extraterrestrials.

Ghost haunts university

Residents at Otago University’s Cumberland College have taken to sleeping with the lights on following a sighting of a ghost (Otago Daily Times, 22 May).

The ghost has been linked to the Grey Lady, who allegedly haunted a nurse at the college after the nurse, working at the now-closed Queen Mary maternity hospital nearby, took her baby for being an unfit mother.

College resident Mareck Church said the “ghost sighting” happened on the night of Saturday, 5 May, when two female health science students noticed a weird smell and a chill in the air as they walked down the hallway after coming back to the college from studying. Weird smells in a hall of residence? Cold in Dunedin? Definitely something odd here.

“One of the girls saw a black figure beside the fire hydrant, turned to the other girl to point it out and as they both turned round, they felt a cold whoosh of air pass them,” Mr Church said.

Some students, Mr Church included, then played pranks on other residents, including going around the corridors with pillowcases over their heads.

The situation had calmed down since staff arranged a blessing by a chaplain and a kaumatua on May 10. Good to see our universities are bastions of rationality.

Could coconut oil be an option for treating Alzheimer’s?

A new alternative treatment for Alzheimer’s doing the rounds seems to be based on a misunderstanding of the underlying science.
The title of this piece is a question posed by the ‘health correspondent’* in one of our local rags. It was inspired by a video doing the rounds on the internet of an American doctor who is using coconut oil to treat her husband’s Alzheimer’s. The doctor’s name is Mary Newport and she also has a book out: Alzheimer’s Disease: What If There Was a Cure? The Story of Ketones.
So what are ketones and could coconut oil be the new wonder cure for Alzheimer’s? Normally carbohydrates in the diet are converted into glucose which is then used by the body as fuel. However, when facing starvation, the body can burn fats in place of carbohydrates. The liver converts the fats into ketones which can be used in place of glucose. Where it gets interesting is that a particular high-fat diet is being used to successfully treat another brain disease – epilepsy. The ketogenic diet is a strictly controlled, high-fat, adequate protein, low-carbohydrate diet, which has been shown in numerous peer-reviewed scientific studies to be effective for controlling seizures in the group of children that don’t respond to medical treatment (so-called drug resistant epilepsy). Unfortunately studies have shown that it is less effective in adults.

So the ketogenic diet is more than just supplementing the diet with coconut oil. And it isn’t without side effects either, which can include weight loss, kidney stones, and constipation. While these are not insurmountable, the diet can be fatal for people with genetic disorders of fat metabolism. People like these will not be able to use the fats provided in the diet and if insufficient protein and carbohydrate are given, they will start breaking down their own protein stores for fuel, which can lead to coma and death.

So what about ketones and Alzheimer’s? Well it turns out that there are a number of studies looking at raising ketone levels in people with mild to moderate late onset Alzheimer’s. And it looks like they are doing it without the strict ketogenic diet. In a randomised, double-blind, placebo-controlled, multicentre trial1, subjects were given a daily drink of a ketogenic compound called AC-1202 on top of their normal diets (and prescribed Alzheimer’s medication), and assessed for changes in cognitive performance.

But there was also a little twist to this story. One of the major risk factors for late onset Alzheimer’s is possession of one or more copies of the epsilon 4 variant of the apolipoprotein E gene (APOE4). The more copies of APOE4 you have, the higher your risk of developing the disease. So did AC-1202 improve cognitive performance? Yes, but only for people who didn’t carry any copies of APOE4. What this means is that your genes affect whether or not you respond to ketones. Interestingly, about 10 percent of subjects got a little better without any treatment too.

So what is AC-1202? It is NeoBee 895®, a common food ingredient made using glycerin from vegetable oil and fatty acids from, you guessed it… coconut oil! Although palm kernel oil is also often used. But before you race off to check your APOE4-type and stock up on coconut oil, let’s return to Mary Newport and her husband for a moment. Mary blogs2 about their life with Alzheimer’s, and despite being on coconut oil since 2008, all is not rosy. So if you started this article thinking that adding a little coconut oil to your diet would be the answer, I’m sorry to disappoint you. As Ben Goldacre would say, I think you’ll find it’s a little more complicated than that!

*A Vitamin and supplement peddler, so I am always a little sceptical of his claims !

  1. Henderson ST, Poirier J (2011). BMC Medical Genetics. 12:137.

  2. coconutketones.blogspot.co.nz

3000 km for skepticism

Gold takes a long walk.

Some time back I noticed that I was getting the first signs of Repetitive Strain Injury (RSI). I’m a web developer and spend way too much time in front of a keyboard and mouse. It’s a common enough thing among people in my industry. From what I can tell one of the best ‘treatments’ for it is to just stop for a bit. So I am.

In order to do something productive, or at least worthwhile, during this time I’m going for a sponsored walk to raise funds for the Christchurch Earthquake Appeal Trust, Woman’s Refuge and our own NZ Skeptics Society. I’ve built a half-way decent website for it (intentionallyhomeless.org) and it’s able to take pledges for distance covered. Providing I finish the full trail I have already raised over $2000 as I write this.

The trail I’m following is called Te Araroa (The Long Pathway) and it was only recently completed and opened. It runs for 3000 km from Cape Reinga to Bluff, although I’m starting in the south and fleeing the (potentially) foul weather instead of heading into it.

I’ll be maintaining a journal on the website where you can follow the journey and, should you choose, you can pledge money to the charities or sponsor me personally.

I’m also looking for supply drops, couches and interesting things along the walk. One way to check the track would be to install Google Earth and load the trail using the .kmz file available at the official site (teararoa.org.nz). If you, as a resupply drop or couch, or the point of interest are close enough to the trail I’ll definitely make the stop.

The best way to contact me would be via the contact form on the Intentionally Homeless site or via [email protected]

New woo for you

Alison Campbell learns how to fine-tune the universe with a didgeridoo.

Recently a commenter on Orac’s Respectful Insolence blog ( scienceblogs.com/insolence) mentioned the therapeutic use of didgeridoos for various health issues. Surely this is a joke, I thought. But no: it seems that didgeridoo sound therapy (Http://www.didgetherapy.com) is indeed alive and well.

Apparently it works by:

(a) producing ultrasound frequencies that have a massaging effect (no, really!);

(b) clearing “emotional and energetic stagnation”; and

(c) allowing” meditation and mind-body healing”. And of course “[m]editation can also be used to quantum manifest healing and the co-creation of our universe.”

Wow! Who’d have thunk it? Every time someone meditates, they’re fine-tuning the universe (if not actually remaking it anew).

So, we have all the signs of classic ‘woo’ here. Quite apart from the (mis) use of words like ‘quantum’ (in the words of Inigo Montoya, “you keep using that word. I do not think it means what you think it means”), we have information-poor statements like this (original grammar but I’ve emphasised a phrase):

“This low frequency producing characteristic of the didgeridoo creates a no touch “sound massage” and has been reported to provide similar results as conventional ultra sound treatments and relieve a wide range of joint, muscular and skeletal related pain.”

“reported”… By whom, to whom, and where? In other words, show us the data. Without that, we are simply dealing with anecdote and testimonial.

And there’s the energy cleansing: here the website blurb refers to both TCM and Ayurvedic ‘medicine’, and gushes that the effects of playing a didgeridoo are as follows;

“The most basic description one could give for the energetic clearing power of the didgeridoo is “it is like a reiki or qi gong power washer.” It has been reported that the energetic clearing effects are similar to traditional five-element acupuncture.”

This might be fine if reiki actually did anything… And there’s that “reported” again. Plus, how was the similarity to the results of acupuncture measured, and for which ailments? (There’s quite a list of health issues for which didgeridoo therapy is supposedly useful, on that website. At least they don’t claim that it actually cures cancer.(

One testimonial, featured on the website, describes didgeridoo music as an “Ancient Vibrational medicine” (it would be interesting to know how Australian aborigines view this), which fits with the statement that:

“Sound Therapy is based on the theory* that all life vibrates at various frequencies and specifically the human body has multiple vibrational frequencies that can slip ‘out of tune’ due to emotional or energetic stagnation. When these frequencies are ‘out of tune’ they can lead to physical and emotional health issues.”

This vibration thing has been around for a while – Orac has taken several looks at the various claims made about it (including the truly bizarre claim that DNA produces sound waves, that these can be recorded, and that those recordings can be transmitted to someone else and change their DNA in turn!( However, the idea’s longevity doesn’t actually mean that it’s in any way an accurate reflection of biological reality.

And finally, we have this:

“Didgeridoo Sound Therapy & Sound Healing is not an Aboriginal Australian tradition or practice, though love and respect is given to them for sharing this amazing instrument with the world.”

So – not an “Ancient Vibrational medicine” at all, then …

  • Not ‘theory’ in the sense of ‘strong, scientific explanation for a large number of observations/measurements’, but rather, in the sense of ‘some idea I’ve** come up with.’

** Not me personally!

Newsfront

‘Suckers’ feed on alternative health patients – literally

The NZ Herald (10-14 January) must have been having trouble filling its pages during the silly season, looking at its recent series on alternative therapies.

Each day for the best part of a week, the paper sent its reporters out to try a range of “alternative relaxation and remedies”.

Reporter Andrew Koubaridis must have drawn the short straw – while others in the series got to try out Japanese and Korean variants of spa therapies, he had two leeches sucking blood from his arm for more than an hour.

“I couldn’t take my eyes off the little suckers,” he said.

Mehdi Jaffari, who runs the Life Clinic Hirudotherapy centre on Auckland’s North Shore, says he learned the practice from his Iranian father and that the art had been passed down for generations in his family. Leeches can treat problems ranging from arthritis, diabetes, endometriosis, hepatitis and high blood pressure to bronchitis, he claims. They can even help reduce wrinkles, apparently.

“Their saliva has enzymes that helps break blood clots, and widens blood vessels to stop bacteria growth and prevent inflammation. It also helps blood circulation and flow,” Jaffari says.

The article refers to the UMR Research survey on the beliefs of New Zealanders (see Editorial, p 2), which found a majority believed in alternative remedies. Nearly three out of four believed arnica reduces bruising and slightly over half believed that homeopathic remedies are scientifically proven.

In the same series, Lincoln Tan and Amelia Wade checked out Ayurveda, a traditional Indian system of medicine.

“The human body is made up of five basic elements,” says Ayurveda specialist Priya Punjabi, “and whenever there is any disorder, these elements become imbalanced and they affect bodily channels and tissues, creating illnesses in the system.”

The elements are earth, water, fire, air and sky. This is obviously a huge advance on the traditional western view that there are only four elements.

Paranormal investigators open for business

A paranormal investigation team has been given front page coverage by the Waikato Times (10 December).

The group, who call themselves the Quantum Foundation (what is it with that word quantum?) say they’re not ghost hunters, but are called in to “paranormal hot spots” where they try to put clients’ minds at rest. Nor are they ghostbusters. “We don’t get rid of whatever’s there.We can call in people to do that,” said co- founder Tracey Royce.

Royce and fellow investigator Lisa Austen said they took a scientific, research- based approach to the supernatural, and sought natural explanations for alleged hauntings.

They use equipment such as cameras, digital recorders and electromagnetic field readers and spend up to eight weeks reviewing content. They have carried out 10 investigations in 16 months, and do not charge for their services.

Most of what they collect is mundane, and they seemed to recognise that ‘orbs’ are artifacts caused by dust particles reflecting light through a camera lens (NZ Skeptic 94(. But both say they have had experiences they can’t explain, including a sighting of a “full-blown apparition” of a ghostly figure, that drive them on.

Recently they investigated Diggers Bar in central Hamilton, where they captured “electronic voice phenomena”, including laughing, a voice saying “it’s coming”, and one instance of aggressive swearing. Someone swearing around a bar late at night in central Hamilton? How could there be a natural explanation for that?

David Riddell (who’s he?v) of the NZ Skeptics reportedly said gullible people were often suckered in by folks with fancy equipment, though I have it on good authority he said no such thing. But he did suggest that we are awash with electromagnetic fields, and a recorder is likely to pick up all sorts of things if left on overnight. Even if something couldn’t be explained it didn’t mean it was from another world. “A lot of people, when faced with something they can’t explain, automatically say [it] must be something supernatural. But sometimes it is okay to say you simply don’t know what it is.”

Conspiracy theorists get a roasting

Also in the Waikato Times (19 December), freelance writer Joshua Drummond has got stuck into conspiracy theorists with a nice piece of old-fashioned debunking. The three most terrifying words in the English language, he says, are “Did you know?”

“‘Did you know,’ said an idiot to me one day, ‘that 9/11 was an inside job?'”

Over the next half-hour, says Drummond, he was subjected to a sloppy paraphrasing of an internet documentary called Loose Change. This alleges a government conspiracy which was somehow, “as these things commonly are, both tremendously competent and massively incompetent at the same time.”

He goes on to list a number of other currently popular conspiracy theories, including “the ever-popular primate change denial, courtesy of creationists, who may not like being labelled conspiracy theorists,but that is what they are.”

Drummond says conspiracy theorists waste their time on nonsense when far better examples of true wrongdoing lie right in front of their unseeing eyes. Drug companies, for example, may act in highly questionable ways in their endless quest for higher profits – “but it doesn’t follow that vaccination doesn’t work.”

Vitamin supplements unnecessary

A major study of vitamin supplements has found taking the pills does nothing for people’s health (NZ Herald, 27 December).

The study, by researchers at Nancy University in France, followed 8000 people for more than six years. Those taking supplements were just as likely to have developed cancer or heart disease as those who took an identical-looking dummy pill. There was hardly any difference in how healthy members of the treatment and control groups reported themselves feeling.

Catherine Collins, chief dietician at St George’s Hospital in London, said it was the worried well who were taking these pills to try and protect themselves against Alzheimer’s disease, heart attacks and strokes.

“But they are wasting their money. This was a large study following people up for a long period of time assessing everything from their mobility and blood pressure to whether they were happy or felt pain.”

Other recent studies have indicated that, for some people, vitamin supplements could actually be harmful. One last year found pills containing vitamin E, ascorbic acid, beta-carotene, selenium and zinc increased the risk of malignant melanoma four-fold.

Another discovered women on a daily multi-vitamin pill increased their risk of breast cancer by up to 20 percent.

While the evidence that vitamins can do harm is still limited, the latest study seems to confirm that many people are at the very least taking them unnecessarily.

Split for Scientology?

Scientology has had a rough few years, and now a schism seems to be opening up within the so-called ‘church’ (NZ Herald, 7 January).

Debbie Cook, a former senior member of Sea Org, Scientology’s equivalent of the clergy, has circulated an email severely criticising the management style and financial policies of the group’s current leader, David Miscavige. She says Miscavige’s dictatorial leadership style is at odds with the doctrines laid down by the church’s founder, science-fiction author L Ron Hubbard, and that he has become obsessed with fundraising. His regime is now “hoarding” a cash reserve of more than US$1 billion, she claims, and has spent tens of millions more on a portfolio of large, upmarket buildings which largely sit empty.

Cook left the Scientology payroll in 2008, but says she remains “completely dedicated” to its beliefs. Her criticisms strike a chord with many disaffected recent defectors, but her highly respected status within the usually secretive world of Scientology may give her views weight among more active members, the article says.

Pseudoscience for profit

Proponents of alternative therapies often throw around charges of vested interest when challenged. But often their own interests don’t bear scrutiny.

As this is the first of what I hope will be a regular column in the NZ Skeptic, I thought I would take the opportunity to tell you all a little bit about who I am and what has motivated me to write this column (besides David twisting my arm…). I am a research scientist with two obsessions: bioluminescence (the production of light by living organisms – think glow worms and fireflies), and nasty microbes. I feel immensely privileged to have made a career out of combining these two passions: in a nutshell, I make bacteria glow in the dark for a living.

After many years working in the UK, I was awarded a fellowship from the Health Research Council of New Zealand and relocated to the University of Auckland. Shortly after arriving in Auckland I joined Skeptics in the Pub and a fellow skeptic lent me a copy of Trick or Treatment. This fantastic book, written by Dr Simon Singh and Prof Edzard Ernst, reviews the evidence for the effectiveness of complementary and alternative medicine. I’m sure I don’t need to tell this audience that despite very little evidence for their success, these treatments are widely used.

In the final chapter, Singh and Ernst list some reasons why this might be. Surprisingly, scientists are on their list. Singh and Ernst argue that alternative health practitioners are highly vocal and many of their claims go unchallenged. They believe scientists have a responsibility to make their voices heard too. I found Singh and Ernst’s call to arms inspirational and took up blogging and writing letters to the editor as a result.

A very rich source of ire comes from a free monthly 150-page glossy A4 advertising magazine called the Ponsonby News, distributed to over 16,000 homes and businesses in Auckland. The Ponsonby News has a couple of ‘health correspondents’: John Appleton, who has a website selling vitamin and other supplements, and ‘Dr’ Ajit, an Ayurvedic practitioner with a couple of spas in Auckland. For those unfamiliar with Ayurvedic ‘medicine’, it is a system of traditional medicine that originated in India. Mr Ajit’s column is usually pretty funny, like urging people with hay fever not to eat stodgy food in winter for fear it will clog them up.

But John Appleton’s column usually worries me. A couple of months ago, he was inspired by an article he read in the Listener assessing the risks and benefits of hormone replacement therapy, which advised readers to avoid the internet and talk to their doctors instead. Unsurprisingly, Mr Appleton was somewhat horrified by this suggestion having “found the internet to be a fabulous resource” for researching topics like hormone replacement therapy.

Indeed, what he went on to write about was ‘bio-identical’ hormones which he implied are a safe and effective alternative to hormone replacement therapy. I wrote a letter to the editor to point out that the benefits of ‘bio-identical’ hormones were at best overhyped and at worst pseudoscientific nonsense1, which prompted a reply both through his column and in person. In it, I was accused of being part of the medical establishment, locked away in my ivory tower, only interested in “science for profit”, unlike those in the complementary and alternative medicine field, who he believes are doing “science for people”. He has since sent me an envelope full of reading material to show me just how bad evidence-based medicine is.

It was really interesting to read the propaganda material which has shaped Mr Appleton’s views on evidence-based medicine and the medical establishment. Needless to say, they are all non-peer reviewed articles posted on natural health websites.

I found one article in particular quite fascinating, as it trumpeted Andrew Wakefield, the disgraced gastroenterologist who insists there is a link between autism and the measles-mumps-rubella (MMR) vaccination. As a microbiologist, I am very familiar with Wakefield’s work, which is just plain old bad science (see NZ Skeptic 100). But Wakefield continues to be held up as a shining example of how a good doctor trying to do the best for his patients has been vilified by the medical establishment. If this kind of material is what Mr Appleton is using as his evidence base then I’m definitely alarmed!

I am left contemplating Mr Appleton’s concept of “science for profit” versus “science for people”. I have never thought of myself as doing science for profit. True, I make a decent living being a scientist but it is nothing like the money I imagine some of those involved in alternative medicine make. It is worrying that the alternative health field has successfully propagated the belief that it is purely motivated by improving people’s health and wellbeing, completely glossing over the fact that it is an extremely lucrative industry.

Indeed, one of the pieces of evidence that Mr Appleton used to back up the claims he made about ‘bio-identical’ hormones was a review paper written by a medical doctor called Kent Holtorf and published in an obscure peer-reviewed journal. Interestingly, Dr Holtorf declared no conflicts of interest despite the fact that he is founder of the Holtorf Medical Group which has offered ‘bio-identical’ hormone therapy for over 10 years. Science for people? More like ‘pseudoscience for profit’, if you ask me.

1‘Bio-identical’ was a phrase coined to describe plant-derived molecules believed to be identical to human hormones. No evidence has ever been presented to verify this. Many of the conventional treatments include similar plant-derived molecules. The difference is that the conventional therapies have been studied over many years so doctors know what the side effects and risks associated with them are. There is no evidence that ‘bio-identical’ hormones are safer or more effective; it is likely they have the same side effects and risks. As for it being pseudoscience, ‘bio-identical’ hormone treatment often involves blood or saliva testing to determine which hormones are deficient and hence tailoring treatment to the individual. While this sounds like a good idea, there is no scientific basis or indeed evidence that such a strategy is useful or relevant. In fact, hormone levels in the blood and saliva vary from day to day and are unlikely to reflect the actual biological activity in specific tissues.

Amber teething beads: something to chew on

A ‘natural’ way to manage teething pain has no plausible mechanism.

Parents, especially new parents like myself, are a vulnerable group. We tend to be full of anxiety that we are doing the ‘right thing’ by our children. Wherever you find a vulnerable group like this you also tend to find those who prey on such fears.

Being a new parent and a skeptic I have been on guard regarding dubious advice and practices, but so far I have actually been pleasantly surprised: I have not, as far as I’ ve noticed, been subjected to any dubious advice. But recently I was confronted by a practice of a fellow new parent that I found a little disturbing. I’ m taking about using necklaces of amber beads to reduce the pain of teething for babies.

Teething can be an especially stressful time for parents and children. The child may be experiencing pain as the new teeth break through the gums; this means an irritable child and frazzled parents. Anything that promises to relieve or prevent this harrowing time is gratefully embraced.

On to the amber beads. This practice disturbs me for several reasons. First is safety. The necklace, if left on the baby for long periods, may pose a strangling hazard if it becomes caught on something. Most advertise that they are made to break easily to prevent this and that the beads are individually knotted onto the necklace to prevent scattering on breakage. However, this still seems to leave a broken string of beads in reach of a baby, and as most people know – anything a baby can get its hands on goes straight into the mouth. So choking is also a concern.

Now, I’m not one to be a worry wart over every little potential hazard; used correctly under parental supervision I suspect that the likelihood of a tragedy of this kind is low. But not zero. This, coupled with the low probability that the necklace actually does anything, is what worries me. The second disturbing thing is that parents are accepting that the necklaces work via word of mouth, and apparently not consulting their doctors before subjecting their child to an intervention of unknown safety and efficacy.

I have three main points I believe parents should consider before trying these beads (in addition to the physical safety above). The first relates to basic plausibility. There are several explanations for how the beads are supposed to work floating around the intertubes, many of the tinfoil hat brigade variety ([… it generates pain relieving magnetic field[). Only one explanation I have found makes biological sense so that’s the one I’ll be focusing on.

Baltic amber is known to contain between three and eight percent succinic acid. According to proponents this is released from the beads and into your baby. The succinic acid then allegedly has an analgesic effect and so reduces the pain of teething. Here is where my first point regarding plausibility comes in.

Amber is tough. Really tough. This is a material that has persisted for thousands and in some cases millions of years unchanged. Suffering through innumerable climatic cycles of heating and cooling. Yet this same tough unchanging material will happily give up its chemical components upon the gentle heating it receives on being placed next to your baby’s skin? Colour me unconvinced. I found a 2010 paper on volatile degradation products from Baltic amber that doesn’t mention succinic acid as an identified component. Related to this point, amber has a hardness on the Mohs scale of between 1 and 3. Baltic amber, which is usually touted as the therapeutic variety (because of the high succinic acid content), is at the high end of this scale at 2 – 2.5. To put this in perspective, Tin has a hardness of about 1.5 and Gold is 2.5-3. But let’s say for argument’s sake that clinically relevant amounts of succinic acid are released by the amber and absorbed by your baby’s skin.

My second point then, relates directly to the claims made for succinic acid. Succinic acid is made in the body (and in plants) as part of the citric acid cycle (aka the Krebs cycle). It is also used in the food and beverage industry as a food acid (additive #363 to be precise). Interestingly, in this capacity there are recommendations from some quarters to avoid the substance ([avoid it, banned in some countries[, warnswww.foodreactions.org).

Even so, apart from its early use as a topical treatment for rheumatic pain, there is no evidence that I could find (searching Pubmed at least, where I would expect a decent study to be referenced) that it is effective as either an anti-inflammatory or general analgesic. Let me be clear on that. I don’t mean low-quality evidence, I don’t mean small, poorly designed trials with equivocal effects, I mean nothing. Zip. Nada. In fact if anyone knows of any let me know because I find this complete lack quite surprising. I’m open to the idea that I was looking in the wrong place or was using incorrect search terms. So, unless there is late breaking news, it fails on that count as well. But what do we care about evidence of efficacy anyway? Let’s throw this point out too, and move on to my final point to consider.

Let’s say that (a): the beads do indeed release succinic acid into your baby and (b): this succinic acid has an analgesic effect once it enters your baby’s body. Doesn’t the very fact that an unknown amount of a drug is being put into your baby’s body bother you? (If it has biologic activity that can be used in a therapeutic fashion, it’s a drug, no quibbling on that point please.)

What is that I hear? It’s natural? Oh, well, that’s okay then. No wait, it’s not. I don’t care what the origin of a compound is, the question is what are its effects on the body and do the benefits outweigh the risks. Let’s replace succinic acid with some other naturally occurring substance, salicylic acid. This is a compound with known anti-inflammatory properties. Would you be happy with a product that introduced unknown levels of this compound into your baby? What if I said that overdoses with this compound could lead to a one percent chance of death (emedicine.medscape.com/article/818242-overview#a0199)? It’s natural; it’s also the precursor to acetylsalicylic acid, otherwise known as Aspirin.

Now, lest I be accused of unnecessary fear-mongering and drawing false comparisons I would like to admit that at present there is no evidence to suggest that succinic acid is hazardous, nor even that it is potentially hazardous. This does not detract from my main point however. It isn’t whether this particular compound is safe or not but that the reasoning around its use (ie [It’s got to be good, it’s natural[) is faulty and cannot be used as a substitute for evidence.

Based on the complete lack of plausibility on any level of efficacy any potential for harm, however small, must tip the balance of the equation away from the use of this product. But don’t trust me; talk to your doctor. I suspect though that given the complete lack of reliable information on this topic they will be left to rely on their own philosophy of harm vs benefit. In the final analysis, there are not always clear answers, but developing good critical thinking skills will at least provide you with a small light in the darkness.

Forum

Homeopathic ‘vaccines’ on sale in New Zealand

The website www.endohealth.co.nz is selling such items as homeopathic immunisation and travel kits . On offer are such remedies as Natrium Muriaticum 200C which, it is claimed, will protect against all types of Malaria and Haemophilus 200 for protection against H I B (this abbreviation is for Haemophilus influenzae type B which causes severe pneumonia and meningitis in infants).

The site’s owners say:

Endo Health Limited provides accessible and experienced health care based on Homoeopathic principles as defined by Dr Samuel Hahnemann in the Sixth edition of The Organon of Medicine. We also manufacture and supply a full range of homoeopathic products, both classical and complexes, in a number of different presentations. We provide Homoeopathic prophylaxis for childhood diseases, and individualised kits for travel to areas where there is risk of exotic diseases, as well as kits to alleviate the medical dangers of travelling by aircraft. We provide information on vaccines used in the prevention of childhood diseases. Unless stated otherwise, all this information is sourced from Medical journals and has been available to all Medical Practitioners and Medical authorities.

One of the homeopaths claims to have been a pharmacist for many years and to be President of the Homoeopathic Association of New Zealand, an organisation which appears to be non-existent.

I’ve been aware for a while that some people have sourced and used these homoeopathic immunisations , so as an individual I’ve sent an email off to Medsafe’s Compliance Unit stating that I believe that these homoeopaths and their website’s sales could be harmful to people, and that the site would likely contravene the Medicines Act as they are making therapeutic claims (as per New Zealand Regulatory Guidelines for Medicines Edition 6.13, March 2011).

They also attempt to circumvent the section 34 provision which allows natural therapists and others to supply after being requested by or on behalf of that person to use his own judgment as to the treatment required . They do this by saying the Medicines Act requires that there must be an exchange of information and this consultation (really an order for the product) may be by email. This would also be likely to be actionable under advertising standards, as they have requirements under their therapeutic product and service codes regarding advertising and therapeutic claims.

Unfortunately I suspect even if this is found to be correct and some action is taken, this will be dealt with by the old slap with a wet bus ticket (probably a cease and desist letter asking for them to remove the claims as to therapeutic purpose and/or asking for the withdrawal of the products), if any of the other examples I’ve seen over the years (eg adulterated supplements) are any guide. I’m not aware of anything happening other than withdrawal of the unsafe product after Medsafe has done testing, even though the product(s) may have been supplied and sold for quite a period of time and would pose a risk to the consumer.

That being said, it may help if other individuals or the society consider taking some action, as well such as contacting relevant agencies to express concern or even sending out a press release addressing the anti-vaccine stance of those in the alt med industry. The consumer is being exploited by sale of homoeopathic vaccines and homoeoprophylaxis products that claim to prevent diseases such as malaria, typhoid and cholera. Consumers could become seriously ill if they come into contact with these diseases and haven’t used proven interventions.

This could be another opportunity to call on homeopaths to do the right thing and come out in support of conventional vaccines and against the practice of homeopathic vaccination . As the Ministry of Health says, There is no evidence that homoeopathic ‘immunisation’ provides any protection against infectious diseases. The UK Faculty of Homoeopathy supports conventional immunisation.

Opening a Dore?

A learning difficulties programme that claims to re-train the cerebellum makes some impressive claims which don’t stand close scrutiny.

DORE is an organisation that claims to treat learning difficulties without drugs. Their programmes supposedly

“… tackle the root cause of learning difficulties by improving the efficiency of the cerebellum – the brain’s ‘skill development centre’ – and the part of the brain now understood to play a significant role in learning, coordination, emotional control and motor skills.”

Recently the company held a series of information sessions to coincide with the opening of a new Dore centre in Lower Hutt, to go with their existing centres in Auckland and Christchurch. I attended a session to see what it was all about.

As we entered the room, video testimonials were playing, showing parents and their children claiming dramatic results for a range of learning disabilities and conditions, such as Asperger’s syndrome. An information pack was handed out, which included newspaper clippings and another testimonial. It claimed that Dore gets to the “core of learning difficulties”, “actively improves ability to learn”, is drug-free, based on scientific principles, is personally tailored and is not a “quick fix” or “soft option”. A FAQ stated that people who successfully complete the programme did the exercises accurately and consistently and if improvements don’t occur this is mainly because people are not sticking to the routine.

A video introduced Wynford Dore, who stated his daughter had learning problems, for which he searched for a solution. Then a mother and her son related how the son had dyslexia and behavioural problems at school which the mother was only made aware of after a few years when a teacher spoke to her. The child was already on a three-year programme with SPELD when the family discovered Dore; they followed this programme for a year concurrently with SPELD. They claimed significant improvement about three months after starting Dore.

The presentation went on to claim that approximately 16 percent of the New Zealand population had learning difficulties, with only four percent diagnosed; these were said to affect one in six New Zealanders. It was difficult to locate comparative figures, but SPELD estimates that seven percent of children have a specific learning disability, which would equate to about 50,000 school children.

The Dore programme claimed to assist with dyslexia, ADD/ADHD, dyspraxia (motor skills) and Asperger’s syndrome, and is targeted at people aged seven and over. The presenter briefly went over the typical feelings of those struggling with learning difficulties, and described how they thought these conditions manifest – as a multitude of literacy, numeracy, memory, attention, coordination, social and emotional problems. This was all claimed to be due to an inefficient cerebellum. Dore, they said, addresses underlying causes rather than symptoms (where have I heard that before I wonder?).

The conditions treated all allegedly have a physiological basis and nothing to do with other factors. Figures were presented, said to be from the Otago University longitudinal study and purporting to show that dyslexics were significantly disadvantaged compared with peers (with the consequent implication that treatment would help prevent this disadvantage).

Dyslexic students were more likely to leave school with no qualifications, much less likely to have a Bachelors degree, and none achieved Masters/Doctorate levels. Average income was more than $10,000 less than their peers. However, there was no word on whether this lack of achievement could be generalised to all people suffering dyslexia, given the long time period of the study and the considerable changes in educational services over that time.

In a further video presentation a Dr Sara Chamberlain claimed the cerebellum governs the automatic performance of simple tasks, and that this facility can be enhanced through exercise. We then heard about Dore’s assessment process. Following an initial phone consultation, prospective clients fill out a questionnaire, and there are a variety of tests and a medical assessment. Posture and ocular-motor skills are tested, and then dyslexia is screened for, apparently using a standard tool. Other conditions such as ADD/ADHD are assessed using the DSM-IV manual; the whole initial appointment takes three to four hours. The programme, it appears, is not suitable for everyone. Clients then have 1.5-hour interviews at three-monthly intervals and on completion of the course.

It was claimed that many scientific papers link the cerebellum with learning, attention, etc; these can be found on their website. They say they have done research themselves and written papers, and will provide details on request. They mentioned ongoing studies into ADHD at Ohio State University and by another US office; the Ohio State University testing appears to be a pilot study, but I couldn’t find any references to the other. A testimonial was introduced from a Dr Edward Hallowell, presented as an expert in ADD and ADHD. When I checked on this later, he appears to be involved with the Dore programme and would hardly be an unbiased commenter.

We were presented with figures from self-evaluation claiming to show 86.5 percent of children and 88.5 percent of adults showed progress in literacy and numeracy after taking the Dore programme. For coordination the respective figures were 81 percent and 75.4 percent, and for social skills 78.1 percent and 72.6 percent. The exercise programme was claimed to be individualised, unlike other programmes like ‘Brain Gym’ that aren’t (for more information on Brain Gym see Ben Goldacre’s Bad Science blog(.

The regime

The exercises take 10 minutes twice daily, with a mandatory four-hour break between; they have 400 exercises and 16 levels that could be completed. These involve such things as using a wobble board, or an exercise ball, or throwing and catching mini bean bags. Again, the cerebellum was claimed to be receiving, processing and automating sensory information from somatosensory, visual and vestibular inputs. The cerebral cortex (the thinking part of the brain) is apparently supposed to integrate all of this but with the conditions Dore say they treat, it is claimed the cerebellum isn’t working with the cerebral cortex.

The idea that defects in the cerebellum cause learning difficulties would seem to be a classic case of correlation not necessarily equating with causation. As noted by Oxford University psychologist Dorothy Bishop in her 2007 paper “Curing dyslexia and ADHD by training motor co-ordination: Miracle or myth?”, cause and effect would seem to be not so simple as presented at the session.

“The notion that the cerebellum might be implicated in some children’s learning difficulties is not unreasonable: both post-mortem and imaging studies have reported cerebellar abnormalities. Furthermore, some studies have reported behavioural deficits involving balance and automatisation of motor skills in a subset of people with dyslexia, consistent with a cerebellar deficit hypothesis. However, it is premature to conclude that abnormal cerebellar development is the cause of dyslexia, rather than an associated feature. Many people with dyslexia do not show any evidence of motor or balance problems. Furthermore, the cerebellum is a plastic structure which can be modified by training, raising the possibility that cerebellar abnormalities might be a consequence of limited experience in hand-writing in those with poor literacy.”

The programme used to use a book, but is now web-based. Exercises are carried out and then “marked” according to their criteria. They stressed that compliance was key, along with parental support. Times for completion vary, but are usually 12-14 months, with a weaning process at the end of the programme where the exercises are gradually wound down. The course is expensive, costing almost $5,400 or a little less for a one-off payment. They did say that they gave three “sponsored” places per month, but didn’t describe what exactly this entailed, outside of mentioning that it was for low income families and that children with a medical diagnosis could apply for a disability allowance through WINZ which could be used to access their programme.

A few questions

During question time, they were asked how they could be sure the child in the video testimonial had improved because of Dore and not the other programme he was on. The answer was fudged: they said they didn’t diagnose but looked for “sensory processing problems” and it was those they treated, which then enabled the person to learn. In other words, if there was improvement, it was Dore, not any other intervention specifically targeted at helping the person learn to overcome their disability and learn to read.

Another questioner asked why it was so costly given that the programme is mostly self-directed. They equivocated, talking about staffing costs, the website, and having support available. They said that braces cost much more and that that is basically cosmetic, when their programme “benefited a person for life” so was worth the investment. Yet another question was about the doctors – why wouldn’t they use paediatricians and other suitably qualified professionals? They stated that for their purposes, the level of medical expertise was sufficient.

Dore has obviously learned from experience following actions taken by overseas advertising standards authorities, and no longer make claims of “100 percent cure” and “miracle cure” for the conditions they claim to treat. In fact they seemed to be reasonably realistic in introducing caveats such as “it doesn’t work for everyone”. Despite this, they still claim to be proven to help overcome learning difficulties even though the evidence base is weak to non-existent. Although they make many claims to be “scientific” and have an extensive list of papers on their website, when the UK Advertising Standards Authority considered a complaint against Dynevor, Dore’s parent company, they assessed the studies submitted in support as poor, lacking control groups, and not supporting the treatment claims made:

“The ASA noted Dynevor’s interpretation of the ad. We considered, however, in the absence of any qualifying text to the contrary, that consumers were likely to understand the claim “Need help with Dyslexia, ADHD, Dyspraxia or Asperger’s?” to mean that the DORE programme could help treat the named conditions. We also considered that we would need to see robust, scientific evidence to support the claim. We noted that the two studies provided by Dynevor assessed the effect of the exercise-based DORE programme on children with reading difficulties and children and adults with ADHD respectively…

“… As neither the first nor second study referred to Asperger’s syndrome and only two participants in the first study had dyspraxia, we considered that the evidence was inadequate to support claims to treat those conditions. With regards to dyslexia and ADHD, we did not consider that the studies were sufficiently robust to support the treatment claims for those conditions, and we therefore concluded that the claim was misleading…”

The average person would have trouble verifying claims about the role of the cerebellum and the ability of an exercise programme to improve function. If it really was that easy everyone would be using Dore’s exercises. Their claim that dyslexia, dyspraxia, ADD/ADHD and Asperger’s syndrome have one cause, one cure, is insufficient. The conditions they claim to treat are disparate and cause and effect is not established. There was little discussion of how cerebellar function or dysfunction is assessed, or of the relevance of their testing of such things as eye tracking, and no discussion at all of how the exercises impact on the cerebellum or how outcomes are measured. Bishop says:

“The gaping hole in the rationale for the Dore Programme is a lack of evidence that training on motor-coordination can have any influence on higher-level skills mediated by the cerebellum. If training eye-hand co-ordination, motor skill and balance caused generalized cerebellar development, then one should find a low rate of dyslexia and ADHD in children who are good at skateboarding, gymnastics or juggling. Yet several of the celebrity endorsements of the Dore programme come from professional sportspeople.”

There is little real involvement from the company once the programme has commenced, with only a few appointments to follow up after the initial assessment. Many who join the programme don’t apparently have a formal diagnosis of the conditions Dore claims to treat, and they won’t get that from the company, as they state they don’t diagnose anything other than the alleged cerebellar problems.

It’s not surprising that some would see benefits though – the commitment and parental support required to do the programme would alone benefit some children. Then there is regression to the mean, the Hawthorne effect (subjects modify an aspect of their behaviour being experimentally measured simply in response to being studied) and natural improvements with growing maturity. On retesting later, there may appear to be improvements due to the client having done the test before and being aware of what is required. Many would concurrently use other services such as reading recovery, and Dore themselves recommend that if the child has spare time, that it is spent practising reading and writing. That extra practice reading could be extremely beneficial.

The high cost of the programme is concerning, especially when they acknowledge that not everyone will benefit. Despite this, they had parents travelling from the Wellington region to undertake assessments in Auckland – hence the opening of an office in the region. There may also be a financial risk to participants; Dore UK and Australia have both failed, leaving clients out of pocket. In New Zealand Dore was placed in liquidation in 2009 and the Companies Office states: “This Company currently has Liquidators, Receivers or Voluntary Administrators appointed” with the liquidators due to report again in May 2011.

Manipulation, chiropractic, and the idols of Francis Bacon

Chiropractic has had a colourful history since its invention in the 19th Century.

Chiropractic has had an extraordinary history, but the vehement response of its practitioners to criticisms of its claims is nothing if not human. These unwelcome aspects of human behaviour – a readiness to believe and a violent reaction to well-founded criticism – were recognised and categorised by Francis Bacon 400 years ago.

Chiropractic has been defined as “a system of treating bodily disorders by manipulation of the spine and other parts”.1 The Oxford English Dictionary gives a number of meanings for manipulation, including “The act of operating upon or managing persons or things with dexterity, especially with disparaging implications, unfair management or treatment”. Manipulate, among other meanings, is “to manage by dexterous contrivance or influence, especially to treat unfairly or insidiously for one’s own advantage”.

[Until 1818 English dictionaries gave only one meaning for manipulation: the method of digging for silver ore.]

The practice of chiropractic began in the US in 1885. It is one of a number of strange behaviours and belief systems which have had their origins in that country, including osteopathy, craniosacral manipulation, applied kinesiology, scientology, creationism science, Christian Science, and Mormon beliefs. It was in that country too that homeopathy received its greatest support after its invention in Europe. Why this should have happened is an interesting question. An American friend says that it springs from an overwhelming desire to avoid the perceived errors of Europe with its suppression of religious freedom.

David Daniel Palmer was born in Ontario in 1845, and brought his family to the US where by 1865 they were living in Davenport, Iowa. He was a grocer, and a bee-keeper, and had a deep interest in spiritualism. He practised ‘magnetic healing’ and called himself ‘Doctor’. 2, 3, 4

He later said that the idea of chiropractic came to him as ‘received wisdom’ at a séance in 1885, from a certain Dr. Jim Atkinson, deceased at that time. Shortly after this, on 18 September, 1885, he treated a man who had been deaf for 17 years. He said: “I examined him and found a vertebra racked from its normal position – I racked it into position by using the spinous process as a lever, and soon the man could hear as before.” He went on: “There was nothing crude about this adjustment; it was specific, so much so that no chiropractor has equalled it”.

Palmer called the spinal irregularity he had found a “subluxation”, a term borrowed from orthodox medicine where it means a partial dislocation of a joint. Only chiropractors can find, feel, or see their patients’ abnormalities, which they proceed to correct.

Palmer decided there must be a single cause for all diseases: “I then began a systematic investigation for the cause of all diseases and have been amply rewarded.” He had a friend coin the word ‘chiropractic’ from the Greek ‘cheir’, hand, and ‘praxis’, action. He said that the free flow of the body’s ‘innate intelligence’ (or ‘psychic energy’) to all parts of the body was interrupted by spinal vertebral subluxations, and this was the cause of 95 percent of all illnesses.

He said: “I occupy in chiropractic a similar position to Mrs [Mary Baker] Eddy in Christian Science. Mrs Eddy claimed to receive her ideas from the other world and so do I. I am the fountainhead.”

Palmer was hugely successful. In 1897 he opened the ‘Palmer School of Care’ in Davenport. Admission was by payment of tuition fees and no other qualification. In 1905 it was renamed ‘The Palmer School of Chiropractic’ and it has gone on to occupy a large campus on what is now called Palmer’s Hill, in Davenport.

His son, Bartlett Joshua (‘BJ’), took over the business in 1906, while his father was in prison for practising osteopathy and medicine without a licence. DD and BJ fell out and DD opened a rival school.

By 6 August 1908, the US congress was considering a bill to regulate the practice of chiropractic and to licence chiropractors.

David Daniel Palmer died in 1916 a short while after being run over by BJ in an automobile. The death certificate said ‘typhoid fever’.

Bartlett Joshua Palmer made a fortune, and promoted chiropractic in Canada, Australia, and the United Kingdom. He stressed salesmanship as he taught, and his classrooms were decorated with such slogans as:

“The world is your cow, but you must do the milking”

and

“Early to bed and early to rise, work like hell and advertise”.

BJ marketed a patented machine called the Neurocalometer which he said could detect subluxations, whether or not the patient had symptoms. It is still sold today as the Nervoscope and costs about $US799.

BJ founded a radio station, WOC (Wonders of Chiropractic) in 1924.

In 1926, HJ Jones in Healing by Manipulation stated there were more than 8000 chiropractors in the US and Canada.

BJ died a multimillionaire in 1961.

This story is one of extremely successful entrepreneurship in the best tradition of American showmanship. It has nothing to do with science, and a lot to do with evangelical know-how.

In 2007 there were 19 colleges of chiropractic in the US, two in the UK, at least one in Australia and one in New Zealand.

Repeated examinations of x-rays, MRI scans and autopsy material have failed to show any evidence for existence of the ‘subluxation complex’. The American Association of Chiropractic Colleges states that “the subluxations are evaluated, diagnosed, and managed through the use of chiropractic procedures”.

Because of Palmer’s initial dogma, many chiropractors reject the role of infectious agents in disease and hence deny the value of vaccination.5 Chiropractic neck manipulation is associated with an increased risk of vertebro- basilar vessel damage.6 Chiropractors insist on spine x- rays even when the risk of unnecessary exposure to radiation is raised, and this despite the absence of x- ray changes consistent with a ‘subluxation’.

A careful examination of all the scientific evidence7 has resulted in the conclusion that chiropractic offers some help for low back pain but otherwise has no more effect than that of a placebo for any other complaint.

In 1999 an American chiropractor, Samuel Homola, published Inside Chiropractic: a Patient’s Guide8. He supported manipulation for back pain, but rejected what he described as chiropractic dogma. He confirmed that the chiropractic profession had little tolerance of dissent.

“Its nonsense remains unchallenged by its leaders, and has not been denounced in its journals. Although progress has been made, the profession still has one foot planted lightly in science, and the other firmly rooted in cultism.”

He was labelled a ‘heretic’ by his colleagues.

Some commentators divide chiropractors into ‘straight’ dogmatists and ‘mixers’ who will use some science.

Chiropractors and defense by legal action: the American Medical Association Saga

In the US, doctors encouraged the arrest of chiropractors for practising medicine without a licence. By 1940 it is said that 15,000 prosecutions had been brought. However 80 percent of these had failed, with the United Chiropractors’ Association, encouraged by BJ Palmer, giving financial support to the defendants.

The AMA Committee on Quackery lobbied in 1963 to have chiropractors relegated to a non- medical status. The committee argued that chiropractic should not be recognised by the US Office of Education, citing the lack of scientific evidence, the denial of germ theory, the claim to be able to treat 95 percent of all diseases, and the use of the ‘E- meter’.

In 1976 the Chiropractors’ Association, having become aware of further action planned by the AMA, brought a suit against the association on the grounds that it planned to limit chiropractors’ practice, and this was in breach of anti- trust legislation as it was anti-competitive.

In 1987 the Court found in favour of the chiropractors, and an appeal by the AMA in 1990 failed.

The chiropractors had shifted the issue from science to rights of commercial practice. This was totally in keeping with their history of astute business acumen – and lack of scientific evidence.

The 1978 NZ Royal Commission of Inquiry into Chiropractic

In a context of legal and political mechanisms, the NZ Chiropractors’ Association with its supporters, and the NZ Medical Association and its supporters, battled for and against official recognition of chiropractic as a national health resource, and the access of its practitioners to the rewards from the Accident Compensation scheme.

The chiropractors bolstered their position with hundreds of letters to the commission from satisfied customers, and the NZMA responded by scathing and dismissive comments as to the worth of such letters, and by decrying the lack of science in the practice of chiropractic.

Kevin Dew9 suggests that the result was a negotiated settlement exchanging a proposal by chiropractors to restrict their practice to musculoskeletal conditions, in return for official Government recognition, and the addition of chiropractic to New Zealand’s health resources.

The controversy was resolved without any resolution as to the scientific validity of the claims of chiropractic. It was thought there were only 100 chiropractors in New Zealand at that time.

Recent publications6show that the majority of chiropractors in the English- speaking world continue to make claims for their treatment which extend well beyond the realm of musculo- skeletal disorders.

There were 391 chiropractors advertising in the Yellow Pages in New Zealand in August, 2010.

Simon Singh and the British Chiropractors’ Association

In 2008, Simon Singh and Edzard Ernst published a book called Trick or Treatment.7

On 19 April 2008, Singh wrote an article in The Guardian, pursuing the topic canvassed in the book, that chiropractic was alternative medicine and there was no evidence for any effect except on lower back pain.

“The British Chiropractors’ Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections and prolonged crying even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession, yet it happily promotes bogus treatments”.

The BCA quickly sued him for libel, and on 7 May 2009 the court handed down a verdict in favour of the chiropractors.

Meanwhile in New Zealand

On 25 July 2008, the NZ Medical Journal published a paper by Andrew Gilbey reporting evidence that some chiropractors in NZ were using the title ‘Doctor’ in a manner which could mislead the public. In the same issue an editorial by David Colquhoun appeared, critical of chiropractic, and the qualifications of its practitioners. He wrote:

“For most forms of alternative medicine, including chiropractic and acupuncture the evidence is now in. There is now better reason than ever before to believe that they are mostly elaborate placebos, and at best are no better than conventional treatment.”

In the next issue of the NZMJ the editor published a letter from a lawyer, Paul Radich, representing the NZ Chiropractors’ Association, threatening legal action under the NZ Defamation Act, against the journal, Gilbey, and Colquhoun. The letter demanded apologies from all parties, and outlined the financial penalties for all.10 The tone was intimidatory.

In his comments about the position of the NZMJ as a scientific publication, the editor, Frank Frizelle, invited the chiropractors to an evidence- based debate with these words: “Let’s hear your evidence, not your legal muscle”.

The NZMJ published an invited response from the NZ College of Chiropractic in its next issue11 and I understand there has been no further correspondence from the lawyer (personal communication from the editor, NZMJ, September 2010).

Back to London

A month after the initial court procedure in London, Simon Singh announced his intention to appeal the finding in favour of the BCA.

On 1 April 2010 the Appeal Court handed down its verdict. The Lord Chief Justice of England and Wales, The Master of the Rolls, and Lord Justice Sedley stated that Singh(s comments were not libellous, and that they were matters of opinion backed by evidence. They went on to quote an American judge, Judge Easterbrook, now Chief Justice of the US 7th Circuit Court of Appeals.

In Underwager v Salter 22 Fed.3d 730 (1994):

“Plaintiffs cannot, by simply filing suit and crying ‘character assassination’ silence those who hold divergent views, no matter how adverse those views may be to the plaintiff’s interests. Scientific controversies must be settled by the methods of science, rather than by the methods of litigation. More papers, more discussion, and more satisfactory models – not larger awards of damages – mark the path toward superior understanding of the world around us.”

Back to New Zealand

As it happens, nine days after Singh’s appeal was upheld, Ernst and Gilbey authored a paper in the NZMJ: “Chiropractors’ Claims in the English-speaking World”.5 They examined 200 individual chiropractors’ websites and nine chiropractic association sites in Australia, Canada, New Zealand, the UK and the US. They concluded:

“The majority of chiropractors and their associations in the English-speaking world seem to make claims which are not supported by sound evidence. We suggest the ubiquity of the unsubstantiated claims constitutes an ethical and public health issue.”

On 11 June 2010, Shaun Holt and Andrew Gilbey wrote a letter to the editor of the NZMJ12 drawing attention to the wider public scrutiny of chiropractic claims and nature following the success of Simon Singh’s appeal.

Francis Bacon and his ‘idols’

Francis Bacon (1561-1626) lived at a time when the new empiricism was disturbing the security and comfort taken in accepting the opinions of established authorities. He was a lawyer, a legal theorist, a judge, and a writer. He became Lord Chancellor, but was charged by Parliament with corruption, and having taken bribes from those appearing before him in court. He pleaded guilty and wrote: “I was the justest judge that was in England these fifty years, but it was the justest censure in Parliament these two hundred years.”13

Bacon wrote a series of ‘Axioms’ towards the end of his life. I would like to use some of these to examine aspects of human behaviour that the history of chiropractic reveals. It has been a considerable surprise to me to realise the prescience of this man.

He used the term ‘idols’ to list aspects of human behaviour.

Axiom 41: “The Idols of the Tribe”

These have their foundation in human nature itself.

“For it is a false assertion that the sense of man is the measure of things. On the contrary, all perceptions, as well of the sense as of the mind, are according to the measure of the individual, and not according to the measure of the universe.”

We are all subject to our nature, and seek security and certainty, and believe the evidence of our eyes. If we get better after manipulation, then clearly the manipulation made us better. Emma Young says: “We are causal determinists – we assume that outcomes are caused by preceding events”.14

Axiom 42: “The Idols of the Cave”

These are the idols of the individual man, due to our own peculiar natures, our education, our own experiences, or to reading from authorities we admire. “The spirit of man is in fact a thing variable and full of perturbation”. If we are told by our parents or teachers that someone else is better after manipulation, then we will believe that it is a ‘true’ relationship.

Axiom 43: “The Idols of the Marketplace”

“Formed by the intercourse and association of men with each other. For it is by discourse that men associate, and words are imposed according to the apprehension of the common understanding. The ill and unfit choice of words wonderfully obstructs the understanding. Words plainly force and overrule the understanding, and throw all into confusion and lead men away into numberless empty controversies and idle fancies.”

The choice of the word ‘subluxation’ for example, to describe an undemonstrable change! Or the claim for the existence of ‘psychic energy’. A radio station extolling the “Wonders of Chiropractic” is a wonderful Idol of the marketplace.

To take legal action and gain the publicity which is sure to follow with extensive argument about the meaning of, for example, ‘happily’ has great appeal in the marketplace.

Axiom 44: “The Idols of the Theatre”

“Which have migrated into men’s minds from various dogmas, and the wrong laws of demonstration. All the received systems are but so many stage plays – many more plays of the same kind may yet be composed.”

How well aware of this human trait are all showmen and charlatans. The Palmers, father and son, exploited this behaviour. To claim that new knowledge has come from beyond the grave is wonderful ‘theatre’, full of drama and mystery. To maintain the dogma of the wonderful in the face of evidence to the contrary is so much easier than to examine the evidence.

All these human behaviours can be seen in the history of chiropractic, and in so many other catastrophes such as the anti- vaccination campaign, the Peter Ellis trial, the Cartwright affair, the anti- fluoridation campaign and so on and on.

The history of chiropractic, and the response of chiropractors to criticism about the absence of science in their beliefs, illustrate the profound insights of Francis Bacon about our nature. It is our nature which results in the persistence of the perverse, and which resists the truth.

The responses of those without objective evidence for their personal beliefs often include ad hominem attacks, threat of legal action and financial injury, professional ridicule, and public invective. All these are seen in the chiropractors’ responses.

References

  1. Collins’ Concise Dictionary of the English Language (1988).
  2. Shapiro, R 2009: Suckers: How Alternative Medicine Makes Fools of Us All. Vintage Press, London.
  3. Carroll, RT 2003: The Skeptics’ Dictionary; A Collection of Strange Beliefs, Amazing Deceptions and Dangerous Delusions. John Wiley & Sons, NJ.
  4. Goldacre, B 2008: Bad Science. Fourth Estate, London.
  5. Ernst, E; Gilbey, A 2010: NZMJ, 123(1312) 36-44.
  6. Ernst, E 2007: J. R. Soc. Med. 100(7) 330-338.
  7. Singh, S; Ernst, E. 2008: Trick or Treatment: Alternative Medicine on Trial. Transworld Publishers, London.
  8. Homola, S 1999: Inside Chiropractic: A Patient’s Guide.
  9. Dew, K 2000: Sociology of Health & Illness, 22(3) 310-330.
  10. Editorial, 2008: NZMJ, 121(1279) 16-18.
  11. Roughan, S 2008: NZMJ, 121 (1280)72-74.
  12. Gilbey, A 2010: NZMJ, 123(1316) 126-127.
  13. Hollander, J; Kermode, F 1973: Oxford Anthology of English Literature. OUP, London & New York.
  14. Young, E 2010: New Scientist 2720.

Oxygenated food for the brain?

Alison Campbell finds some claims about raw foods hard to swallow.

I was reading a couple of articles about ‘raw foods’ today. This is ‘raw foods’ as in ‘foods that you don’t heat above 40°C in processing them.’ It’s also as in, a vegetarian diet. (I do rather enjoy vegetarian food, but I don’t think I could eat nothing but, all the time; I like meat too much.) Anyway, what caught my eye wasn’t so much the diet programme itself but the mis-use of science to promote it. That did rather get my goat broccoli.

Apparently you should get your kids to eat their greens (along with the rest of the diet) by telling them that plants do this wonderful thing: they turn sunlight into chlorophyll and – when you eat it – it will give you extra oxygen. Sigh&#8230 This concept was repeated in the second article, which told me that raw (but not cooked) foods are ‘oxygenated’ and thus better for your brain, which needs to be fully oxygenated to work properly.

Well, yes, and so do all your other bits and pieces, and they don’t get the oxygen from food. As Ben Goldacre once said, even if chlorophyll were to survive the digestive process and make it through to the intestine, it needs light in order to photosynthesise, quite apart from the fact that you don’t normally absorb oxygen across the gut wall. And it’s kind of dark inside you.

The second shaky claim related to digestive enzymes. Because raw foods are ‘alive’ then they are full of enzymes. And so we’re told that eating them will help you to digest your meals better.

Er, no. First, because when said enzymes – being proteins – hit the low pH environment of your stomach they are highly likely to be denatured. This change in shape means that they lose the ability to function as they should, and in fact they’ll be chopped up into amino acids like any other protein in your food, before being absorbed and then used by your cells to make their own enzymes.

And second – the raw foods diet is plant-based. Yes, plants and animals are going to have some enzymes in common. I’d expect that those involved in cellular respiration and DNA replication/protein synthesis would be very similar, for example, because these are crucial processes in any cell’s life and any deviations in form and function are likely to be severely punished by natural selection. But we already have those enzymes; they’re manufactured in situ as required. In other words, even if the plant enzymes somehow made it into cells intact and capable of functioning, they’d be redundant.

However, with a very few exceptions, plants aren’t in the habit of consuming other organisms so, in regard to plant cells being a good source of the digestive enzymes required for the proper functioning of an omnivore’s gut – no, I don’t think so. No.

Some might ask, why on earth do I bother about this stuff? After all, it’s not doing any harm. But the thing is – science is so cool, so exciting; it tells us so much about the world – why do people have to prostitute it in this way? Kids (and others) are fascinated by the way their bodies’ organ systems work, and I can’t see why there seems to be a need to provide ‘simple’ – and wrong! – alternative ‘explanations’ when the real thing is so wonderful.