An article entitled "Murder by Faith," written by Edward Dolnick, appeared in the January-February, 1990, issue of In Health (formerly Hippocrates) magazine. Dolnick presents detailed information on the death of 7-year-old Amy Hermanson, the child of devout Christian Scientists, who died of untreated diabetes. More than that, he reviews the psychodynamics of how people come to accept the teachings of Christian Science and the sensitive legal issues involved. Those who wish to understand this complex problem will benefit from reading this piece.
Comment: There is no situation more instructive to antiquackery activists than the psycho-social-legal-political interactions involved in the current conflict between Christian Science and children's right to protection under the law. Contained are insights into how belief systems function; why seemingly intelligent people get hooked by cults, and how far they will go in devotion to their faiths; how group dynamics reinforce delusional thinking; how political leverage can circumvent the U.S. Constitution; and, how reasonable public relations people can make these issues appear if one is willing to set aside fundamental scientific demands of proven, verifiable safety and effectiveness and accept philosophical rhetoric in its place. The arguments used to defend Christian Science are no different--but more potent because of the highly sensitive religious freedom component--than those used to justify abandoning regular cancer therapy for laetrile or the freedom to market dubious AIDS remedies.
Dr. Michael Mogadam of Georgetown University's School of Medicine says "misconceptions and disinformation have clouded the relevance of nutritional practices in cancer prevention...no convincing evidence exists to incriminate any dietary factor. The relevance of fiber and excess energy intake to the risk of colorectal cancer is also far from established. It is concluded that the significance of dietary factors in cancer prevention is exaggerated. Even if an association does exist between nutrition and the risk for certain cancers, it is very small. ...we should not allow nutritional misconceptions, fads, and belief systems, to mislead the public into wasting billions of dollars for ineffective dietary practices and 'nutritional' supplements, in the false hope of cancer prevention." Am J Gastroenter, 83:1346-51, 1988.
After increasing its pesticide testing by 25%, FDA reports that it is finding fewer pesticide residues in the foods we eat. Nearly two-thirds of raw foods had no residues, and less that 1% have levels above the tolerances set by the EPA (Consumer News, January, 1990).
FEDERAL ORGANIC FOODS CERTIFICATION ACT PROPOSED
Senator Patrick Leahy of Vermont has proposed a bill outlining a national standard for organic food production. Leahy stated in his introductory remarks: "Since goods labeled organic often sell at premium prices, the temptation to misuse the word is great." Leahy believes that a national organic food certification program will ease problems in interstate commerce, and give farmers a commercial incentive to alter the way in which they farm. The Senate Agriculture Committee, chaired by Leahy, will hold hearings on the bill in February. Comments on the bill are welcomed and should be sent to Kathleen Merrigan at Room 328 Russell Office Bldg, U.S. Senate, Washington, DC 20510.
Steven Hassan's book Combating Cult Mind Control (Park Street Press, 1988) is an insightful look at the bizarre and dangerous world of cults. Hassan, himself a former member of the Unification Church (Rev. Moon), draws from both an insider's perspective as well as from his expertise in his current role as an exit-counselor in his account of how people get into cults--and how people may or may not get out. In spite of his anti-cult stance, Hassan is both fair and realistic. He does not condemn all groups which might be deemed "cults" by objective criteria. Rather, it is destructive cultism (ie, that which results in mind control) which concerns him. He also stays within the bounds of established American freedoms in the solutions he recommends for the problem. This is admirable because it would be very easy for one who was victimized to become an extremist on the topic. Particularly interesting to quackbusters are comparisons that can be drawn between the psychodynamics of cult mind control and the allegiance commonly seen by victims of quackery to their medical messiahs. Although parallels between cultism and quackophilia (ie, "lovers of quackery") have long been noted by quackologists (recall that Victor Herbert titled one of his books Nutrition Cultism) no book we have seen has provided such a clear basis for comparison. What Hassan provides is a look into human vulnerability and some of the failings of our modern society's ability to cope with the role of belief in the human experience. The book can be ordered from Park Street Press, One Park St., Rochester, VT 05767. Price: $16.95.
The folly of allowing a double-standard to exist for dietary supplements and drugs has been dramatically demonstrated by the recent outbreak of Eosinophilia-Myalgia Syndrome. Well over 1000 new cases have been reported with at least a dozen deaths. Public health statisticians traditionally acknowledge gross under reporting of any type of disease, so it is not inappropriate to suggest that the incidence is several magnitudes greater than the data on hand. Handicapping the efforts of investigators attempting to determine the exact cause of this new disease is the fact that dietary supplements are not subject to the same manufacturing and distribution standards as drugs despite the fact that they may be prescribed or self-inflicted for medicinal purposes. The reason they are not is due to the Proxmire law passed in 1976. Senator Proxmire's ill-conceived law exempts dietary supplements from efficacy requirements and greatly limits FDA's ability to monitor them for safety. Interestingly, the Proxmire law is the only federal legislation passed in the 20th Century that reduced rather than enhancing basic requirements of safety and effectiveness for health-related products. NCAHF has always taken issue with this misbegotten law and believes that it is time to undo the setback to consumer protection that its existence represents.
Brian Goldman's report of Victor Herbert's presentation to the Ontario Allergy Society ("American crusader brings message about health care fraud to Canada," Can Med Assoc J 140:1189-1191, 1989) prompted a defensive rebuttal by Zoltan Rona, MD, President of the Canadian Holistic Medical Association. Herbert and Tod McNeely, MD, both responded to Rona, who was permitted the final word, in the Letters section of the October 15, 1989 issue of CMAJ. The series is a classic confrontation of informed people, and can be instructive to anyone interested in evaluating apparent conflicts between regular medicine and self-proclaimed "holistic health." Available from NCAHF for $2 and a double-stamped, self-addressed business-sized envelope.
On December 4, 1989, the U.S. Supreme Court denied an appeal by two Chicago naprapaths who charged that a 1987 Illinois law threatens the continued practice of their profession. The law requires that any person who "holds themselves out to the public as being engaged in the diagnosis or treatment of ailments of human beings" be licensed. The naprapaths complained that the state's 200, or so, naprapaths would have to be graduates of a medical school or chiropractic college "regardless of their prior training or expertise." They argued that the law was an attempt by the Illinois Medical Association to "prohibit the existence of (a) competing practice" and "grant themselves a monopoly in the field of healing arts." (Chicago Tribune, 12/5/89).
Comment: Naprapathy is "a system of therapy employing manipulation of connective tissue (ligaments, muscles and joints) and dietary measures; said to facilitate the recuperative and regenerative processes of the body" Dorland's Illustrated Medical Dictionary (ie, therapeutic massage). A reading of the massage therapy literature reveals two distinct types of masseurs. The rational practitioners who provide comfort, symptomatic reliefs of musculoskeletal problems and sound advice on rest and exercise. The second group is made up of zealots who extol massage therapy, reflexology, Rolfing, Hellerwork, and other manual therapies beyond reason. As empirics they use subjective responses as evidence of benefit and practice a widely-ranging form of pseudomedicine. Their rhetoric is indistinguishable from that of others who want to practice medicine but do not want to go to medical school. This Court decision is significant in light of attempts by nonscientific health care providers to gain legal recognition through the use of the Sherman Antitrust Act.
Masseurs of a third type, massage parlor operators, have usurped the field in some states, much to the chagrin of rational, ethical masseurs who now find themselves assailed by quackery on one hand and prostitution on the other.
The Exercise Standards and Malpractice Reporter (4:1, 1990) states that the Pennsylvania Supreme Court has upheld a lower court decision which dismissed a death suit against the publisher of Robert Linn's Last Chance Diet. The book was responsible for promulgating the liquid protein diet associated with more than fifty deaths. The report states that "as a result of various settlements and dismissals, only the publisher remained before the trial court, and... only those issues dealing with the publisher were examined..." The defendant was granted dismissal on the grounds of freedom of speech. The plaintiff appealed but was denied. The report states that although the book's advice was deemed to be protected by the constitution, claims and suits may be brought where harm results to a patron.
K.N. Prasad is a professor in the Department of Radiology and Director of the Center for Vitamins and Cancer Research at the University of Colorado Health Sciences Center in Denver. He is an active researcher and has published in reputable journals. Nevertheless, his book, Vitamins Against Cancer (Rochester, VT: Healing Arts Press, 1989) has received a "cannot be recommended" verdict by Current Diet Reviews (Nov-Dec, 1989). The book promotes the notion that megadosing on certain supplements is wise despite the lack of scientific support in humans. Animal research data is deemed sufficient for action. Although dietary recommendations are consistent with those of the American cancer Society, its bold recommendations of supplements are in opposition to those of the National Research Council and others.
Obesity & Health newsletter has named six "Clipped Fleece Awards" for "the Worst of 1989" in fraud and exploitation in the weight-loss business:
The Sunrider Corporation paid $175,000 in penalties to settle a civil suit in which the Los Angeles district attorney's office had charged false advertising of diet and health products. Nutrien Whole Food Concentrate and a weight-management regime called Vitalite were involved. Labels on Nutrien claimed that the product contained vitamin B-8, a non-existent substance. The firm also falsely claimed that Nutrien would help people with heart disease and pneumonia (San Francisco Chronicle, 12/27/89).
Charles E. DuVall, Sr., MT, DM, DC passed away on January 13 following a stroke. Dr. DuVall was an ardent supporter of science and consumer protection. He worked hard to bring badly needed reforms to his profession. He was often maligned by DCs who cringed when he exposed the shortcomings of chiropractic. They wanted professional silence; he wanted professional standards of conduct, integrity and accountability. He was apparently more confident than his "mum-is-the-word critics" that spinal manipulative therapy has value and can stand scientific scrutiny. He was willing to accept whatever limitations upon SMT or DCs that scientific investigation might bring. He placed the public's interest above that of the chiropractic guild. Dr. Duvall distinguished himself by becoming the first chiropractor elected to the NCAHF Board of Directors in 1988. He was also a founder and director of the Ohio Council Against Health Fraud. His son, Charles E. DuVall, Jr., DC, will serve out the remainder of his term on the NCAHF board.
"True herbalism encompasses scientific testing, honest reporting of the results, and the safe use of effective herbs by informed practitioners and the public. It also includes the production and ethical marketing of herbal products." So begins the best article on herbalism we have seen yet, "False tenets of paraherbalism," (Nutrition Forum, Nov-Dec 1989) by Varro E. Tyler, PhD. Dr. Tyler is Vice President for Academic Affairs at Purdue University (formerly Dean of the Schools of Pharmacy, Nursing and health Sciences at Purdue). Tyler employs "paraherbalism" in reference to herbal pseudoscience, and compares herbalism and paraherbalism to Dr. Jekyll and his evil self Mr. Hyde. The good of herbalism can be destroyed by the evils of paraherbalism, says Tyler. Paraherbalism is characterized by a least 10 false tenets:
Tyler elaborates upon each of these false tenets in the article which is recommended as basic reading for every health consumer and provider. He warns herbal advocates that adherents to the false tenets are creating an image of herbalism that could prevent the development of scientific herbalism in America.
[Dr. Tyler is author of The New Honest Herbal (JB Lippincott Co., 1987), a superb consumer's guide on herbs; coauthor of Pharmacognosy, 9th Edition (Lea & Febiger Co., 1988), a standard reference for medical botany; and a member of NCAHF's Task Force on Herbal Remedies.]
A satellite symposium on "Diet and Health: Combating Misinformation" will be offered on Friday, May 11 by the University of California Cooperative Extension. Nutrition and health professionals in education, business, government, and medical facilities as well as colleges and universities can host this professional development program for a site fee of $200. The 4-hour symposium will air on a C-band satellite from 9 am to 1 pm Pacific time and will be available for registered downlink sites across the nation. Videotapes will be available for the same fee at a later date. The professional development program is aimed at dietitians, home economists, nutritionists, educators and health care personnel. The symposium will focus on why people are vulnerable to health and nutrition-related misinformation and quackery; and deal with combating misinformation about obesity and weight control, dietary fiber and fat, and nutrient supplements. Applications for continuing education credits have been made for both the satellite broadcast and the videotaped program for registered dietitians, dietetic technicians, certified home economists, dietary managers, nurses, physicians and health educators. Speakers include Wayne Callaway, MD, George Washington University Medical Center; Barbara Schneeman, PhD, University of California; Janet McDonald, PhD, RD, US Food & Drug Administration; and William Jarvis, PhD, NCAHF president. For more information about the program, how to register as a site, and multi-site discounts, contact Karen Berjem, Agricultural Communications, University of California, Davis, CA 95616; or phone (916)757-8949.
The "Cho Low Tea" scam reported in the July-August, 1989 issue turned out to be a noteworthy classical fraud. It turns out that the mail order firm didn't even have a tea product on hand. Promoters apparently intended to simply repackage a common Chinese black tea. The story has been documented in the FDA Consumer (12/89-1/90) and Nutrition Forum (Nov-Dec, 1989).
NCAHF has been asked to review and comment upon the American Heart Association's logo program HeartGuide, which is in trouble with the FDA. After a close look, we do not doubt that AHA has the best of intentions, but believe that the program should be withdrawn for several reasons:
Nature's Sunshine Products, Inc., of Spanish Fork, Utah, with a 56% increase in net income--$3.3 million on $44.5 million in sales--was featured as one of America's 100 top growth companies in 1989 by Business Week magazine (5/22/89). According to the story, NSP began when housewife, now company chairman, Kristine Hughes, began putting cayenne pepper, garlic, and other herbs into capsules and selling them after relieving her husband's ulcer with cayenne on a neighbor's advice. NSP reportedly has 45,000 door-to-door salespeople on a multilevel marketing sales structure. Like most multilevel companies, NSP appeals to naive, well-intended people who are motivated to help themselves financially while allegedly helping to improve the health of their friends and neighbors. Testimonials and unsubstantiated claims are the hallmark of this type of promotion. Distributors, who are themselves users, generally are unable to separate personal perceptions of benefits experienced with the products from their enthusiasm as salespeople. According to research, this type of person-to-person marketing is very effective for health products. The fact that thousands of people participate in these operations creates a constituency that generates additional testimonials, provides a grass-roots responses to media attacks, and political power to influence legislators to protect their self-interests.
NSP has strong links with the National Health Federation (see The Unhealthy Alliance: Crusaders for "Health Freedom" A Special ACSH Report, 1988). Among those praised and presented as health authorities are NHF Board Chairman, Kurt Donsbach, DC, and NHF board member, Bernard Jensen, DC (the iridology guru). Another NHF board member, naturopath Jack Ritchason, is highly placed in NSP. Company newsletters encourage distributors to join, and donate money to NHF. Ritchason was once Associate Director of "Dr. Donsbach's Herbal Institute" and received a "Ph.D." from dubious "Donsbach University" (as did Jensen). Field courses for distributors on herbology are taught at NHF regional conventions. NSP spouts platitudes about "health freedom" identical to NHF's perverted view, which confuses the right of consumers to buy with the privilege of providers to sell health products and services--a distortion which disdains requirements that providers be competent, truthful and accountable.
Most disturbing is NSP's formal training program for "Natural Health Counselors" in "Phase II" of the Company's "expanded educational program." Salespeople are taught how to employ worthless methods such as iridology, muscle-response testing, foot reflexology, and "crystal patterning observation" (a method used to prescribe herbs). Company literature extols 19th Century Thomsonian medicine, a system of medical herbalism. Natural Health Counselors are supplied with a detailed catalog which serves as a kind of pharmacopeia of herbal preparations and their alleged specific benefits to health and healing of specific organ systems.
Natural Health Counselors are told to say that they are practicing "education, not medicine." This clearly implies a recognition on NSP's part of possible wrongdoing. It also misrepresents the fact that the dubious health assessment methods taught to Natural Health Counselors are intended to create a belief in customers that they have special health needs which will be met by using Nature's Sunshine products. Regardless of what NSP dubs them, such practices constitute diagnosis and prescription which constitutes the practice of medicine in most states. NCAHF believes that Attorney's General across the nation should investigate NSP's operations to stop its misguided, deliberate pseudomedical education program, and prosecute salespeople engaged in the unlicensed practice of medicine.
Curiously, NSP seems to be advanced through the informal "grapevine" of the Mormon church. Mormons have an anti-medicine tradition founded upon a justifiable condemnation of 19th Century medical practitioners encountered by Mormon pioneers. According to Smith ("Why are Mormons so susceptible to medical & nutritional quackery?" J Coll Aescl, 12/83) Thomsonian doctors extolled today by laypeople promoting herbalism were precisely the types of practitioners condemned by Mormon pioneers.
An "exclusive" headline story in the Medical Tribune (12/28/89) proclaimed that a recently completed National Toxicology Program study has found a link between high doses of fluoride and bone cancer (osteosarcoma). Newsweek flashed "The Fluoride Risk: Evidence of a Link to Cancer" on the cover of its February 5 issue. Both reports are based upon partial information that has been leaked to individuals in the EPA--a full report is not due until April. Without having the study to carefully analyze, objective critics are held at bay. This lack of information will not stop antifluoridationists from attempting to arouse public hysteria. We can only provide some background information and comments on what has been reported thus far (also see Science, 247:276-7, 1990).
Background. The NTP study was an outcome of the 1977 Congressional hearings on prima anti-fluoridationist John Yiamouyannis' claim that cancer rates were significantly higher in fluoridated v. nonfluoridated cities. Follow-up studies by qualified epidemiologists in the USA and abroad did not confirm Yiamouyannis' claims. However, laboratory evidence that very high doses of fluorides had been associated with tumor growth and genetic damage was also presented. No investigator inferred that results with high fluoride doses were relevant to the 1-ppm levels used in fluoridation, but further study was called for regarding the carcinogenicity of fluoride.
Reports of Findings. Newsweek states that the study involved a two-year feeding of rats and mice with varying levels of fluoride. No animals drinking fluoride-free water or the lowest level (11-ppm) developed cancer. But, one of 50 male rats consuming 45-ppm water, and 4 of 80 male rats on 79-ppm water, developed osteosarcoma (no female rats developed bone cancer). Whether or not these results were statistically significant was not reported, but the greater number of cancers at the higher fluoride dose was said to possibly indicate a dose-response effect, which would support a possible cause-effect relationship.
No reason to panic. This is not the first time very high doses of fluoride have been linked to adverse reactions--even tumor growth. Fluoride is a potent trace element. The mere fact that adjusting the level found in water from .3-ppm to 1.0-ppm can result in dramatic improvement in dental caries is evidence of fluoride's biological power. Fluoride is not the only trace element to exhibit paradoxical effects. Selenium deficiencies have been associated with reduced cancer and excesses with excess cancer, and simply increasing calories in rodent diets will increase tumors. The theory that high doses fed to small numbers of rodents for a short period will yield valid data on the effect of small doses on large numbers of humans over the long term is highly questionable. Yet this is the reasoning when testing for carcinogenicity. For toxicity, the fundamental tenet that "the dose makes the poison," is followed (most trace minerals required for human health are toxic at high levels), but no safety threshold is recognized for carcinogenicity.
Questionable reporting. The Newsweek report reflected either bias or shallow investigation by referring to the 1988 Chemical & Engineering News report as "balanced," and claimed that the furor it generated was simply "emotional responses" from scientists who had "lost their objectivity." Anyone informed on the history of antifluoridationism was fully aware that the issues raised by C&EN had been refuted by careful study long ago (see NCAHF Newsletter, May-June, 1989). This unwarranted attack on the objectivity of those who complained about the C&EN report (included was U.S. Surgeon General Koop) is itself indicative of biased reporting. Such a suspicion is supported by the headlining of a report before it is available for careful analysis. Further, the overall tone of the article demeans fluoridation as "not doing much good anyhow." This statement is refuted by the National Preventive Dentistry Demonstration Project that found fluoridation to be the most effective and most economical method of caries prevention available. The NPDDP was the most carefully done study ever of the effectiveness of various preventive dental procedures.
What should be done. Whether or not fluoride is linked to osteosarcoma in humans should not be hard to test. Fluoride exposure of the roughly 2100 new cases annually, and fluoride bone levels in cases and controls should be easily measured. This should be done. Responsible health scientists must follow every new lead regarding possible cause-effect associations in disease etiology.
It is clear that the current political emphasis upon the environment has created a favorable atmosphere for the advancement of "organic farming." Being against pesticides and other noxious chemicals in farming is like being for motherhood and the flag. NCAHF, like everyone else, supports the elimination of pesticides from agriculture, if it can be done without serious damage to food production. Many with insight into agricultural technology believe the notion that eliminating agrichemicals would have only a minor impact upon the food supply, such as merely a 10-15% increase in food prices, is naive.
NCAHF board member, Harold Loeffler, PhD (retired food technologist) says: "My experience of more than forty years in the marketing of frozen foods makes me believe that many fruits and vegetables would disappear from the fresh produce market. Included are apples, apricots, and peaches. Growers who have missed spraying report having lost almost 100% of their crops. Winter vegetables such as broccoli and brussels sprouts could not be grown without pesticides. Growers in Watsonville and Half-Moon Bay (Calif) hoped they could achieve this during November and December when cold rain and foggy weather might discourage aphids, instead the aphids prospered. When the brussels sprouts were cooked, a scum of dead aphids had to be skimmed off of the cooking water. The Agricultural Marketing Service set an unofficial limit of 100 aphids per 10 oz. package of frozen sprouts! Broccoli suffered in the same manner. Every second head had a grey, cheesy core of aphids at least 1/2 inch in diameter at the top. This had to be cut out or the whole head discarded. There are reports that high pressure water sprays are being tested for aphid removal. I doubt if this will be practical given the immense quantities of water this would require and California's short supply."
NCAHF has always supported the concept of labeling products as "free of pesticide residues" because it is a testable claim, and consumers could expect to get what they are paying for. The mere fact that pesticides have not been applied to a crop is no guarantee that they will not bear residues. An important aspect of organic food fraud has long been for growers to take over a plot of land that has been treated against pests (worms, bugs, fungi) and raise marketable crops until the soil residues are used up. When produce becomes too unsightly to sell, growers then move on to other previously treated fields.
The real issue involves public trust. In California, Cal Health tests for residues and has taken strong action in the past (recall the year the state's watermelon crop was condemned). Nevertheless, to calm public hysteria, a private company (Nutriclean) tests produce and client stores exhibit placards stating "No pesticide residues detected." It would be noteworthy news if the company found significant pesticide residues that Cal Health had missed. One wonders, if consumers do not trust Cal Health to do its job, why should they trust a private company to do the job instead. Independent studies of organic foods marketing have consistently revealed misrepresentations. Fear-mongering may sell for awhile, but in the long-run it is counterproductive. Food marketers had better start educating consumers about the merits of modern food production.
[NCAHF recommends the ACSH Report Pesticides and Food Safety (June, 1989) for insight into this important topic. Order from: ACSH, 1995 Broadway, 16th Floor, NY, NY 10023-5860; $3 + SSAE with $.75 postage]