Consumer Health Digest #02-39
Your Weekly Update of News and Reviews
September 24, 2002
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
FTC blasts weight-loss advertising. The U.S. Federal Trade Commission has published a 48-page staff report on current trends in weight-loss advertising. [FTC releases report on weight-loss advertising. FTC news release, Sept 17, 2002] The report noted that nearly 40% of the ads made at least one representation that is almost certainly false and 55% made at least one representation that is very likely to be false. Many ads promised weight-loss results beyond what is possible, and nearly half claimed that the users could lose weight without diet and exercise. The promotional techniques included testimonials; alleged before-and-after photos; promises of fast, guaranteed, and/or permanent results; claims that the product is "natural," "medically approved, and/or "clinically proven"; and warnings about excessive weight loss. The report concludes that false and misleading claims are widespread and appear to have increased over the last decade. However, it fails to mention that the U.S. Postal Service, which has jurisdiction over mail-order advertising, has ignored fraudulent health-related ads since 1991.
Acupuncturists offer inconsistent diagnoses and treatment. A 40-year-old woman with chronic back pain who visited seven acupuncturists during a two-week period was diagnosed with "Qi stagnation" by 6 of them, "blood stagnation" by 5 , "kidney Qi deficiency" by 2, "yin deficiency" by 1, and "liver Qi deficiency" by 1. The proposed treatments varied even more. Among the six who recorded their recommendations, the practitioners planned to use between 7 and 26 needles inserted into 4 to 16 specific "acupuncture points" in the back, leg, hand, and foot. Of 28 acupuncture points selected, only 4 (14%) were prescribed by two or more acupuncturists. [Kalauokalani D and others. Acupuncture for chronic low back pain: Diagnosis and treatment patterns among acupuncturists evaluating the same patient. Southern Medical Journal 94:486-492, 2001] The study appears to have been designed to make the results as consistent as possible. All of the acupuncturists had been trained at a school of traditional Chinese medicine (TCM). Six other volunteers were excluded because they "used highly atypical practices," and three were excluded because they had been in practice for less than three years. TCM claims that illness is the result of imbalances in the flow of nonmaterial energy (Qi) through invisible channels called meridians. Whereas science-based methods are thoroughly studied to ensure that they are reliable, this appears to be the first published study that examines the consistency of TCM diagnosis or treatment. Critics suspect that larger studies would show that TCM diagnoses are meaningless and have little or nothing to do with the patient's health status. The study's authors state that the diagnostic findings showed "considerable consistency" because nearly all of the practitioners found Qi or blood stagnation. However, the most likely explanation is that these are diagnosed in nearly everyone. It would be fascinating to see what would happen if a healthy person was examined by multiple acupuncturists.
Fast food companies sued for "causing" obesity. Samuel Hirsch, a New York City attorney, has filed two class action suits on behalf of clients who would like to hold fast-food companies responsible for their health problems. In July, 56-year old Caesar Barber sued McDonald's, Wendy's, Kentucky Fried Chicken and Burger King, claiming that their food has contributed to his obesity, diabetes, and heart disease. In August, Hirsch filed suit on behalf of obese teenagers. The suits allege that the companies failed to adequately warn that eating food products with high levels of fat, salt, sugar, and cholesterol could have adverse health effects. FindLaw has published two commentaries on the legal theories involved. [Sebok AJ. The "big fat" class action lawsuit suit against fast food companies. Part I || Part II]
Colorectal screening recommendations updated. The U.S. Preventive Services Task Force (USPSTF) has updated its recommendations for detecting colon and rectal cancer. The methods include home fecal occult blood testing (FOBT); flexible sigmoidoscopy; the combination of home FOBT and flexible sigmoidoscopy, colonoscopy; and double-contrast barium enema. Each option has advantages and disadvantages. The task force report concludes:
- Screening should be started at 50 years of age for people at average risk. In persons at higher risk (for example, those with a first-degree relative who receives a diagnosis with colorectal cancer before 60 years of age), initiating screening at an earlier age is reasonable.
- The choice of specific screening strategy should be based on patient preferences, medical contraindications, patient adherence, and available resources for testing and follow-up.
- The optimal interval for screening depends on the test. Annual FOBT offers greater reductions in mortality rates than biennial screening but produces more false-positive results.
- A 10-year interval has been recommended for colonoscopy because the cancers usually arise in benign polyps that take many ten years to become malignant.
- Shorter intervals (5 years) have been recommended for flexible sigmoidoscopy and double-contrast barium enema because of their lower sensitivity, but there is no direct evidence with which to determine the optimal interval for tests other than FOBT.
- Sigmoidoscopy every 10 years may be as effective as sigmoidoscopy performed at shorter intervals, but this question needs further study.
- The appropriate age at which colorectal cancer screening should be discontinued is not known.
Anti-quackery WebRing launched. Paul Lee has set up an Anti-Quackery WebRing to link sites whose purpose is to "combat health-related frauds, myths, fads, and fallacies, and which are more concerned with scientific proof than the unproven anecdotes of so-called alternative medicine." The ring now has 17 members.
FDA warns against importing drugs. The U.S. Food and Drug Administration has published a lengthy description of the potential health risks of imported drugs. The problems include lack of quality assurance; counterfeit products; presence of untested substances; risk of unsupervised use; labeling and language issues; and lack of appropriate directions. [Meadows M. Imported drugs raise safety concerns. FDA Consumer 36(5):18-23, 2002]
This page was posted on September 24, 2002.