Having our say on natural health

As part of the Memorandum of Understanding between the National and Green parties, the Ministry of Health has been developing proposals for a natural health products scheme to regulate such products on the New Zealand market. To kick this process off the ministry has produced a consultation paper setting out high-level proposals for the scheme and called for submissions on it. The NZ Skeptics were among those who sent in a submission in time for the closing date on 17 May. Vicki Hyde and Michelle Coffey were the principle authors, with contributions from several other society members.

In general, the NZ Skeptics support the scope, purpose and principles of the proposed legislation. We think it’s important that the industry has some regulatory oversight to support consumer protection, particularly in the area of claims and proof of efficacy, as well as safety, marketing material and labelling. The use of terms such as ‘natural’ concerns us as it is used to imply benign, which is not a supportable claim.

In addition we are concerned that there appears to be very little in the way of supervisory oversight or quality control in this industry, particularly with regard to imported products. This is potentially of major concern as, on the rare occasion when such checks have been made, product quality has been found to be severely compromised.

Some ‘natural health products’ have been found to have significant levels of contaminants such as heavy metals, or to contain pharmaceutical products, such as viagra and paracetamol, deliberately introduced to give the product a measurable effect not obtainable from the ‘natural’ products.

We believe that informed choice for the consumer is critical in this area, as in all areas relating to health. Labelling requirements need to be clearly defined to ensure that the natural health industry does not use archaic, misleading or inappropriate terminology to boost its claims to the detriment of consumer understanding.

Also, the definition of ‘natural health product’ needs careful deliberation. This industry has been seen in the past as quick to claim any and all modalities that suit their business. ‘Natural health’ should be regarded as a marketing term, not a scientific one. The extension of this business into ‘synthetic equivalents’ gives this industry even more scope for misleading consumers (cf the claims of BZP as providing a ‘herbal’ high).

There is a link to the full submission on the NZ Skeptics home page (www.skeptics.org.nz).

Newsfront

Female ‘sorcerers’ tortured and murdered

Four Papua New Guinea women, believed by fellow villagers to have used sorcery to cause a fatal road crash, were tortured with hot metal rods to confess, then murdered and buried standing up in a pit (Stuff, 25 January).

A local newspaper said that police had only recently uncovered the grisly murders, which occurred last October near the town of Goroka in the jungle-clad highlands some 400km north of the capital, Port Moresby. Black magic is widespread in the South Pacific nation where most of the 5.1 million population live subsistence lives. Women suspected of being witches are often hung or burnt to death.

Local police commander Chief Inspector David Seine told the newspaper that people in the village of Kamex accused the four women of sorcery after a road crash killed three prison officers. The women were reportedly tortured into admission by being stabbed with hot metal rods, said Seine.

It appeared the women were blindfolded with thick sticky tape strapped across their faces and mouths and their hands had been tied before they were murdered, he said.

Commander Seine said the women were buried in an old narrow toilet pit in the standing position. The pit was then covered with soil and two old vehicle tyres placed on the top.

“They planted a banana tree on top of the pit with fresh grass making it difficult for anyone to discover the site, but police got to it with the help of some elders from the village,” he said.

Red netting benefits ‘a myth’

A retired scientist is questioning the effectiveness of red horticultural shade cloth which is being erected on a growing number of orchards around the Nelson region (Nelson Mail, 17 March).

Orchardists use the red cloth because it is thought to enhance pipfruit crops. But the bright red netting has run into a storm of controversy with lobby groups and neighbouring land owners who say it is visual pollution.

Now Rob James of Motueka, who was involved in tobacco research at the Department of Scientific and Industrial Research for 18 years, claims the benefits of red netting are a myth.

Mr James said he had been in touch with scientists in New Zealand and at Cornell University in New York and none of them knew of any research that proved that red netting was better than any other coloured netting.

“There’s no published research on the use of red netting in the world. If there was, we would have found it.”

If people did have scientific evidence on the benefits of the netting on pipfruit he would like to see it.
Pipfruit New Zealand chairman Ian Palmer agreed there was no scientific proof of the benefits of red netting, but said that was irrelevant. Fruit grown under red netting was “elite”, he said. “The evidence is in the fruit itself.

“It had the sort of appearance that made it some of the best fruit I’ve seen.”

Mr Palmer said the red netting seemed to enhance the colour of the fruit, giving it a pinkish finish. He said he had not seen the results of fruit grown under white netting.

Vitamins ‘do more harm than good’

Proponents of Intelligent Design (ID) may be attracting a lot of attention, but they have yet to convince anyone who counts that their ideas should be taken seriously. In the latest setback, school authorities in Kansas have deleted language from teaching guidelines that challenged the validity of evolutionary theory, and approved new phrasing in line with mainstream science (Guardian Weekly, 23 February).

The 6-4 vote by the state board of education is seen as a victory for a coalition of moderate Republicans and Democrats, science educators and parents who had fought for two years to overturn earlier guidelines. It reverses the decision taken by the same authorities two years ago to include language undermining Darwinism on the insistence of conservative parents and the ID movement. The board removed language suggesting key concepts, such as a common origin for all life on Earth and for species change, were seen as controversial by the scientific community. They have since received a petition of nearly 4000 signatures opposing the new decisions.

Herbal medicine perceptions studied

The perceptions that consumers of alternative medicines have about the treatments they use are to be studied by a Waikato University psychology student (Hamilton Press, 21 March). Kirsty Bell is concentrating her research on depression, and she is seeking people who are interested in sharing their experiences.

The World Health Organisation estimates that 75 percent of the world’s population uses some form of alternative medicine, and New Zealand statistics show that one in four New Zealanders over the age of 15 use them.

Alternative health industry setback

A letter from Tertiary Education Minister Michael Cullen has quashed the alternative health industry’s hopes of establishing a New Zealand Qualifications Authority (NZQA)-approved industry training organisation (Sunday Star Times, 23 February).

The Health Training Organisation (HTO) is now considering removing itself from the national qualifications framework. HTO executive officer Roger Booth said responsibility for setting standards in the industry was held by the NZQA, but it stepped down from this role on February 28. The HTO wanted to take on responsibility itself, but its application to establish itself as an Industry Training Organisation (ITO) had been turned down. The NZQA wanted the organisation to align itself with another ITO, Mr Booth said.

NZQA deputy chief executive, quality assurance, Mike Willing said alternative health standards and qualifications would eventually be removed from the framework if no ITO took over standard-setting for the sector.

Mr Booth said discussions with several ITOs had found no natural partner.

‘Used car salesman’ a ‘fraud of the worst kind’

John of God got short shrift in the Sunday Star Times (25 February). Described as a “faith healer and used-car salesman” by journalist Ruth Hill, the Brazilian otherwise known as Joao Teixeira de Faria was holding a four-day event in Lower Hutt.

He claims to cure cancer, Aids, and other conditions including ‘spiritual desperation’ by channelling 36 ‘spirit doctors’. New Zealanders are the biggest single group of foreign visitors per capita to his çheadquarters in southwest Brazil, largely through tours promoted by Wellington naturopath Peter Waugh.

NZ Skeptics chair-entity Vicki Hyde said she was unimpressed by what she had seen of his performance, which consisted of “old carnival tricks”.

“If it looks like a duck and quacks like a duck, it’s probably a quack.”

She said the Skeptics were concerned the ‘healer’ was preying on vulnerable, desperate people. Victims of failed faith healings were often reluctant to speak out because they blamed themselves for not having enough faith-“another nasty piece of psychological manipulation” on which faith healers relied, said Hyde.

US stage magician James Randi, best known as a debunker of pseudoscience, is convinced John of God is “a fraud of the worst kind, making money from other people’s suffering. To any experienced conjuror, the methods by which these seeming miracles are produced are very obvious.”

Haden sticks to his guns

The passing of long-standing NZ Skeptics member Frank Haden was widely reported. Perhaps the best tribute came from Tom Scott’s cartoon in the Dominion Post (March 9). A voice booms from the clouds: “What’s all that swearing at the gate?” St Peter, standing at the Pearly Gates, replies: “Crusading journalist Frank Haden is refusing to come in. He says he didn’t believe in this place before and isn’t about to change his mind now…”

www.stuff.co.nz/281630a17218.html

Hokum Locum

Debunking debriefing

It has become a cliché that whenever something bad happens, a horde of counsellors descend on the survivors to make their lives a misery. It’s true. Counselling does make you more sick compared to doing nothing.

A child is run over and killed. Instead of teachers and parents rallying around and doing what they have done for hundreds of years, ‘professionals’ are now called in to make things worse. In a study, survivors were randomly allocated to “emotional ventilation debriefing” (whatever that is), educational debriefing or nothing and were followed up at two weeks, six weeks and six months. The only difference in outcome was that at six months the first group had significantly more emotional distress.

Not only are these forms of counselling useless they are harmful and the relevant authorities should face up to this by not inflicting it on people. People have always coped with death and disaster and feelings naturally settle with time. Ordinary people underestimate their own ability to just be there for their friends and family and support them. No fancy talk is necessary. bjp.rcpsych.org/cgi/content/abstract/189/2/150

More on Placebos

It can easily be argued that the history of complementary and alternative medicine (CAM) is intimately involved with the history of the placebo effect. The placebo effect is also intimately involved with the practice of medicine although attempts are made to control for it.

The placebo effect is poorly understood, even by doctors, and if you interview specialists they generally discount the placebo effect in their own specialty and attribute it to their colleagues in other specialties. Orthopaedic surgery is rife with placebo procedures such as arthroscopic washout of arthritic knees. At least two good trials have shown that it is worthless yet orthopaedic surgeons continue to inflict this useless procedure on their patients. I confronted one such specialist and he argued that “in my experience it makes the knee feel better.” This is the typical feeble appeal to authority which is the lowest and most contemptible form of evidence. This refusal to accept the evidence is not unusual and in the past other placebo operations have been performed for years until such time as there is a critical mass of peers crying stop.

With respect to homeopathy, there are wide variations in the results of placebo controlled trials because, as someone put it, not all placebos are equal. One wag suggested that “double strength placebos” were needed.

In an interesting study subjects were given placebo analgesia and subjected to painful stimuli. The painful stimuli were then surreptitiously reduced to make the analgesia appear even more effective. This enhanced learned response lasted up to seven days and the authors concluded that this effect “may explain the large variability of the placebo responses that is found in many studies.”

My conclusion from all of this is that my own profession fails to use the placebo effect in a positive way. It is viewed instead as a nuisance to be controlled or minimised. The CAM industry has shown no such reluctance and the placebo effect is behind most of these treatments. Perhaps this explains the public fascination with quackery?

www.chaser.com.au/index.php?option=com_content&task=view&id=1182&Itemid=26

Medical Journal of Australia Vol 179 18 Aug 2003

Pain Vol 24 Issues 1-2, Sep 2005 Pg126-133

Traditional Chinese Medicine (TCM)

Advocates of TCM argue that it cannot be evaluated by clinical trials because TCM has a different philosophical basis to western medicine. This is a typical argument known as the ‘plea for special dispensation’ and is a hallmark of quackery.

TCM evolved in China in the same manner as western medicine under the teachings of Galen. Authoritative teachings were gospel and anyone who dissented was criticised. In many respects this process has some of the features of a religion where beliefs are more important than scientific facts.

Galen solved the problem of the circulation of the blood by proposing that blood got from one side of the heart to the other through tiny pores in the heart. No one was ever able to demonstrate these pores but it was taken as fact. When Harvey described what actually happened in the circulation of the blood (ie arteries to capillaries to veins and back again) based on his anatomical studies he was treated as a heretic. TCM is a placebo-based philosophy and every time there is a scandal such as herbs adulterated with western drugs, for example Viagra and steroids, this strengthens the argument that such products and practices should be banned as being consumer fraud.

Occupational Health Delusions

Unhappy people in boring jobs can escape their stressful situation by attributing some mythical illness to the workplace. This entitles them to compensation from ACC. Many such people become extremely litigious and unpleasant if there is any suggestion that their illness is psychosomatic. Complaints and symptoms are out of all proportion to any evidence of an actual injury.

A recurring theme in the occupational health literature is the statement that “psychological factors might be important.” There is seldom any suggestion that a condition has nothing to do with work. Conditions such as railway spine and miners’ nystagmus were compensated when we now know that these conditions were a delusion, a folie a deux between plaintiffs and their gullible doctors.

Sick building syndrome (SBS) is a modern example of this delusional thinking. I recall an earlier study where symptoms bore no relationship with building ventilation. This experiment involved varying the ventilation rate without the workers’ knowledge. If the air was being changed at a very high rate there should have been a corresponding drop in symptoms.

Another recent study has found “symptoms of SBS are more strongly associated with job demands, workload, social stressors, and support at work than with the physical environment.” Occupational and Environmental Medicine 2006;63:283-289

More on Goji Juice

I revisited the goji juice site www.best-goji-juice.com and decided to investigate Dr Earl Mindell. He has a legitimate Bachelor’s degree from the University of North Dakota and a PhD from a diploma mill, the University of Beverly Hills. Quackwatch has some good information about his vitamin industry and the goji juice industry is a good example of multilevel marketing similar to Amway. Has anybody tried the stuff? I would be interested to hear.

The ideal marriage?

Consider an iridologist married to a reflexologist. The iridologist can look into her partner’s eyes and tell him what’s wrong with his feet. The reflexologist can look at her feet and tell her what’s wrong with her eyes. Many thanks to whoever it was who passed that on at the conference and thanks to Dr Keith Davidson for passing on a half page advertisement devoted to reflexology from the Christchurch Press, 26 September. It’s clearly a growth industry with their own website www.reflexology.org.nz. You can train at a reflexology school or even gain a diploma from the Canterbury College of Natural Medicine.

Hokum Locum

Now that Terri Schiavo has been allowed to die peacefully there is an opportunity to reflect on the matter free from the hysteria and religious arguments advanced as an excuse to maintain her in a vegetative state. When discussing the ethics of the situation with a local surgeon he commented that the main problem was that the feeding tube should never have been inserted in the first place. A feeding tube is surgically inserted into the stomach through a hole in the abdominal wall. Once such medical interventions have been made it is very hard to reverse them. In this case the debate appears to have been hijacked by Catholic pressure groups.

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