In an effort to cash in on the reality that food is superior to vitamin pills, vitamin companies are going to market veggie pills.
This is not the first time a pill company has tried this approach. Daily Greens, a capsule of dehydrated veggies, were charged by the FDA for claiming that their product could prevent cancer. The amount of dehydrated veggies that can be crammed into a pill small enough to swallow is very limited. One could do as well by mixing up a package of Soup Time.
The new products will try to avoid regulatory action by making no health claims. Marketers seem to be trying to take advantage of a source of cognitive dissonance in society. This is the fact that nearly everyone agrees that they should be eating more veggies, but they don't. Reasons given are convenience and taste. However, the real problem seems to be that people simply haven't developed the habit of shopping for, buying and preparing veggies. Promoters will point to phytochemicals which are present in veggies that have been found to inhibit some forms of cancer. They do not want to prove that their dehydrated versions are up to the task in terms of their quality or quantity. Whether veggie pills are really helpful or just another factor to help people avoid difficult lifestyle changes remains to be seen.
The computer Internet is extolled as the "information highway," but just as in the days of stagecoaches, the road seems to be plagued by highwaymen who are out to rob the passengers. Even worse may be the harm done by well-meaning people who spread the word about the latest health fad that they have tried with imagined success.
A case-in-point involved an obscure epilepsy drug, Neurontin, that was touted on a Prodigy data service used by patients with Lou Gehrig's disease (aka, ALS). Of 19 ALS Prodigy subscribers who claimed that they had improved on Neurotin, three died within 12 weeks and none showed lasting improvement. Breathing, talking, and swallowing became harder for most. [Kenosha News, 3/1/95]
Dr. Abdul Alim Muhammad, a nonpracticing surgeon turned minister in Louis Farrakhan's Nation of Islam, is promoting Low Dose Oral Interferon Alpha (LDOIA), an AIDS remedy first touted by Davy K Koech, health minister of Kenya.
Both Dr. Muhammad and Farrakhan preach that the AIDS virus was created by the U.S. government for the purpose of committing genocide against non-white people all over the world. LDOIA is offered as the remedy to this terrible plague.
Church members are asked to contribute money so that LDOIA can be distributed among those infected. Muhammad and Farrakhan claim that LDOIA was developed by a black doctor in Africa, but the remedy actually was developed by veterinary researcher Dr. Joseph Cummings in Amarillo, Texas, as a medicine to bolster the immune systems of cows. In 1988, he reported in a biology journal that LDOIA had increased the survival time of cats with leukemia.
LDOIA, which is unlicensed in the USA, is being manufactured by a pharmaceutical company not listed in FDA records. Muhammad operates the Abundant Life Clinic in Washington DC where his dispenses LDOIA as part of his AIDS patient management program. His clinic has received US government grants totaling $571,521.
[Chicago Tribune, 3/14/95]
Louis Bass, Inc, which does business as Crestwood Company (Glendale, Wisc) and Abovo Inc (Chicopee, Mass), settled FTC charges that its Crestalk and Canon Communicator devices enable autistic individuals to communicate through Facilitated Communication (FC).
Under the final orders, Crestwood and Abovo are prohibited from misrepresenting that any communication aid will assist autistic and/or mentally retarded individuals to communicate through FC, or to claim that any such aid will assist any individual with a disability to communicate through FC unless they have competent and reliable scientific evidence to substantiate such a representation.
The consent agreement was finalized on 3/13/95. Consent agreements do not constitute an admission of guilt, but violation of the agreement can result in civil penalties.
[FTC press release, 3/27/95. Media contact: Brenda A. Mack, Office of Public Affairs, 202-326-2182]
An E. coli outbreak associated with raw milk consumption in 1993 has prompted a legislative proposal to require pasteurization of all milk sold in Oregon (House Bill 2358).
In December 1993, the state's agriculture department began requiring labels on raw milk that declared that raw milk "may contain disease-producing organisms," and that coliform bacterial counts for raw milk must be the same as for pasteurized milk (no more than 10 organisms per milliliter). There are 535 dairy farms in Oregon. Only 3 still sell raw cow's milk and one sells raw goat's milk. Only 120 of the state's 95,000 cows are owned by farms licensed to sell raw milk. Raw milk advocates claim it to be more healthful and say that the heat process destroys nutrients*. [The Oregonian, 2/15/95]
*Modern high-temperature, short time pasteurization barely affects nutrients, diminishing only the most fragile vitamins, thiamine and ascorbic acid, by about ten percent; the process has no detrimental effects upon other nutrients or their absorption.
A 59-year-old Sioux City, Iowa woman died, and another was hospitalized and nearly died, after drinking kombucha tea. Both women suffered from severe acidosis. Like many such cases, it is difficult to prove conclusively that the tea is the culprit, but is the leading suspect.
A kombucha marketer's attorney in California is quoted as saying that it is "ridiculous" to blame kombucha because "its been around for centuries, and hundreds of millions of people have drunk it." Such a statement is unwarranted. Anyone familiar with the history of public health knows that it is near-impossible to link cause and effect in common experience.
Recall the deaths from cholera due to drinking contaminated water, a problem solved by John Snow, the father of modern epidemiology. Sickness and death followed quickly but no one made the association. Given the nature of the kombucha culture and dangers of contamination, it is very possible that the kombucha culture the victims used differed from others. Iowa's public health officials warn people not to drink the tea until the cause of these problems are determined. (Des Moines Register, April 13, 1995)
Freedom of Choice vitamins are marketed by the Foundation for the Advancement of Innovative Medicine (FAIM). An ad says that a substantial portion ($3.50 per bottle) of the sale price of each bottle of vitamin E goes to support the lobbying efforts of FAIM to gain insurance reimbursement for "alternative" medicine, continue OTC sales of nutrients, herbs and homeopathic medicines, and protect the practitioners of nonstandard medicine. (Innovation 1995;1:13)
Cancer patients are denied access to existing scientific information on "alternative" cancer therapies assembled under a publicly-funded research grant.
The National Cancer Institute (NCI) paid Grace Monaco and associates $500,000 to develop the Evaluative Database on Unproven and Untested Cancer Remedies. The idea was to make the information available for PDQ (Physician's Data Query) and the NCI hotline 1-800-4-CANCER. Compilers of the database included information on the methods' scientific validity, costs, therapists' credentials, clinic locations, and evaluations by scientific and medical groups--the type of information cancer patients searching for answers need to have.
The database remains unused in Monaco's files. She can't even give it away. Why not? (1) Fears of lawsuits by those it evaluates, despite the fact that no such lawsuit has ever been successful in the past. (2) Political pressure from influential people in Congress. It is clear that medical alternativists do not want patients to have freedom of choice, rather, the freedom to market anything they wish. (Probe (1/1/95).
[Saul Green, PhD, used information from the database in his JAMA articles on Antineoplastons (1992;267:2924-8), Gerson therapy (1192;268:3224-7), and Immuno-augmentative Therapy (1993;270;1719-23).]
The California AIDS Fraud Task Force (CAFTF) is asking publications that carry advertising for health products post a warning to their readers to wit: #WARNING
Protect yourself! This publication has no way of determining the integrity of those placing ads. Consult your health care professional before using any treatment. There is not yet a cure for HIV/AIDS. Any claim to the contrary is fraudulent. For more information, contact the California AIDS Fraud Task Force at 1-800-459-4503.
To help us get an idea of how much cooperation the CAFTF gets from publishers, please send a sample of any posted warnings you see to NCAHF. A Stop AIDS Health Fraud pamphlet is available; write: CAFTF, c/o FDA, 1431 Harbor Bay Pkwy, Rm 207, Alameda, CA 94502-7070.
Washington University researchers found that the highly publicized aminophylline-containing thigh cream does not work.
Dr. Leroy Young, professor of plastic and reconstructive surgery, studied 17 women who massaged either the cream or a placebo into one thigh and one side of their stomach for a period of four weeks. Eleven women completed the study (4 of the dropouts did so when they saw no improvement). Curiously, one woman was convinced that the cream worked for her even though her weight and measurements were unchanged! "Some people just believe in miracles," said Young. For more information contact Mary Carollo at 314-362-4950.
The 1994 Dietary Supplements Health Education Act (DSHEA) does not please health food industry attorneys, the FDA, or consumer advocates.
Health food attorneys wonder if the requirement that balanced information be made available means that books that are negative on supplementation must be present with advocate books. They wonder how far apart "physically separate" books must be from the products they promote. They worry that the FDA now has greater enforcement power with respect to "structure and function" claims, wondering if the FDA could declare any risk to be "unreasonable."
Irreconcilable conflicts are thought to exist between the 1990 Nutrition Labeling & Education Act (NLEA) and DSHEA. These and other issues were discussed in Food Labeling News (2/2/95 & 2/9/95). It was also reported that the Dietary Supplements Guidelines Committee was not going to advocate the widespread use of supplements [FLN, 2/9/95}.
FDA field workers are confused by the new law as well. They are finding new ways to enforce standards of quality that will meet consumer expectations. Good Manufacturing Practices (GMPs) is a tool that seems to cover many potential problems. From here it looks like it will be a question of how hard the FDA wants to fight in the present political climate.
Will the present attacks on the agency increase its resolve, or cause its leaders to run for cover? We'll see. Consumer advocates are probably the most disappointed in the DSHEA. Probe pointed out how the law diminishes consumer protection and responsible marketing. Its views parallel those of NCAHF. Both are based upon the evaluation by Donna Porter of the Congressional Research Service of the Library of Congress (see Nutr Today, Mar-Apr, 1995).
So far only the American Dietetic Association seems unconcerned about DSHEA. It dubbed the law "consumer friendly" (JADA, 1994;94:1370).
We're not sure which group of consumers they were referring to!
The Foundation for the Advancement of Innovative Medicine (FAIM), a New York based organization made up of maverick doctors and others who promote dubious medicine, is organizing a campaign to attack insurance companies that refuse to reimburse for unapproved and nonstandard procedures.
The lever FAIM intends to use is the New York State Alternative Medical Practice Act (NYSAMPA). FAIM contends that the law "conveys the message that conventional and alternative therapies are equal" and that "it should logically follow that all of these therapies should be considered equally for reimbursement benefits from insurance companies." FAIM is surveying its constituency for information on policyholders who have been denied reimbursement to build its case.
Legally, insurance policies are contracts between companies and policy-holders to reimburse for health care expenses as defined by the contract. Whether of not a procedure qualifies for reimbursement depends upon the exclusions of the policy. If a company wants to pay for quackery, it can (at least one company is already doing so). FAIM may be putting more fait h in the NYSAMPA than is warranted. The law protects:
The physician's use of whatever medical care, conventional or nonconventional, which effectively treats (emphasis added) human disease, pain, injury, deformity, or physical condition.
FAIM focuses on "nonconventional," which is ill-defined. However, key words are "effectively treats" which have legal precedent. There are established legal standards for determining effectiveness. Such standards are used not only in approving medications, but in deciding false advertising, mail fraud, and wire fraud cases that involve health claims. NCAHF believes that a savvy prosecutor could require a nonconventional practitioner to provide scientifically sound evidence of effectiveness. Whether or not someone tries will depend upon their commitment to medical quality assurance.
Jack Raso provides the most thorough analysis yet of outfits that provide dubious nutrition credentials. His title "School daze: the fast track to nutrition 'credentials'," is instructive.
The diversity found among unconventional sources of nutrition "credentials" is great, and not all are bogus. Raso provides useful information on 16 of 50 "credentialing" organizations that he tried to contact. Included are the American College of Natural Health (Clayton School of Natural Healing, American Holistic College of Nutrition); American College of Nutripathy; American Institute of Holistic Theology; California College for Health Sciences*; Greenwich University; Institute of Educational Therapy; International Society of Naturopathy; LaSalle University; Lesley College; Life Science Institute (American College of Health Science, and others); National Institute of Nutritional Education; North American University; St. Martin University; Walden Univ.*
*seem to be all right
[Nutr Forum 1995;12(2):13-19]
Wu Xianghong, a doctoral candidate in philosophy and science at Renmin University of China, Beijing, writes about the popularity of paranormal beliefs in China in Skeptical Briefs March, 1995.
Unsophisticated scams of a simplemindedness not seen in the USA since the 1920s, such as claiming to turn water into gasoline and electronic "growth pads" in shoes to help short men grow taller, are rampant there. It wasn't until November, 1994, that China had a truth in advertising law. Since then fraudulent ads have diminished, but Wu says that "pseudoscientific businesses, especially in the field of medicine, haven't been contained." He says that although new medicines are required to pass a clinical test "the necessary control group is usually neglected, or it is not under rigorous control." He adds that the effectiveness of Chinese medicine cannot be tested by scientific standards because the theory behind them is not empirical.
Several examples of current flim flam practices are detailed. Among them is the "China Soft Shell Turtle Extract" alleged to be the "secret formula" used by China's winning team of long distance woman runners. Their coach, Ma Junren, sold the formula to a financial group in Chang Zhou. An inspection of the production line failed to find any trace of turtles. Ma is also connected to another company that sells a product called Life Atomic Energy. Wu says that China is so concerned that widespread ignorance and superstition are holding back progress that in December, 1994, a proclamation was issued which stated:
Public education in science has been withering in recent years, at the same time activities of superstition and ignorance have been growing and antiscience and pseudoscience cases have frequently been happening. Therefore, effective measures must be applied as soon as possible to strengthen public education in science. The level of public education in science and technology is an important sign of national scientific accomplishment, and is a matter of overall importance relating to the promotion of the economy, the advancement of science, and the development of the society. We must pay attention and carry out the public education with consideration of a strategy to modernize our socialist country and to make our nation powerful and prosperous. Ignorance is never socialist nor is poverty.
Wu says that it is planned to advocate education with the three aspects of science: scientific knowledge, scientific method, and scientific ideas. His fear is that the government will suppress the paranormal by political power instead of persuasion. This approach is likely to result in more cases of paranormal claims.
Wu's report is important to thinking people for several reasons. First, China has been the source of a considerable amount of quackery in North America. Curtailing it there may help reduce this. Second, this discussion supports NCAHF's contention that the idea of eastern and western science is bogus. Thirdly, the recognition of the importance of rational thinking to society at large and the installation of a national program to bring this about in a totalitarian society should trouble thought leaders in our free society.
Not only are paranormal ideas treated as entertainment by both Hollywood and the media information networks, but scientists are regularly portrayed as Jekyll and Hyde, or Dr. Frankenstein characters. Most of the nutty paranormal medical ideas Wu describes has a following in North America. Unlike China, the U.S. government is currently encouraging belief in nonscientific medicine through such entities as the NIH Office of Alternative Medicine, the U.S. Department of Education's recognition of accrediting agencies for chiropractic and naturopathy, and recognition of the homeopathic pharmacopeia by the Food, Drug and Cosmetic Act.
In December, 1994, the U.S. Agency for Health Care Policy and Research (AHCPR) issued clinical practice guidelines for the treatment of most acute, painful, low back problems. Among the recommended treatments was spinal manipulation "especially during the first four weeks." The clinical studies that led to this recommendation was essentially the same data reviewed by the RAND corporation (see NCAHF Newsletter, Sept-Oct, 1993, "RAND scolds chiropractors...")
Although the AHCPR report recommended manipulative therapy, it did not mention chiropractic. Nevertheless, the Associated Press used "chiropractors" as its opening word proclaiming:
Chiropractors get a boost and surgeons a setback in new, government guidelines on how to treat low back pain .
When asked by Dr. Stephen Barrett why he had mentioned chiropractors when the report did not, AP reporter Christopher Connell said that it was because they were best known for doing manipulative therapy. Apparently, Connell did not realize that chiropractic is not synonymous with either manipulative therapy or with the rational treatment of back pain.
John Badanes, a licensed chiropractor and acupuncturist, says:
Chiropractors are more like "back fetishists" than back specialists. Most offer only one treatment modality, the "Adjustment," which varies from office to office depending on the specific Chiropractic Technique paradigm adhered to by the practitioner. These Chirodigms, if you will, are self-referential algorithms applied to every patient regardless of entering complaint.
Chiropractors' relationship to the spine is not comprehensive. They can't offer drug therapy or surgery and are not even in a position to have a useful opinion as to how these options might be beneficial (or not). After all, these medical interventions are not part of a DC's training or their dogmatic and pervasive Vitalistic chiropractic "philosophy." These are hardly the characteristics of an expert.
DCs can be capable manipulative and physical therapists if they work at it, but the absence of research by DCs in the literature attests to their failure to have made a contribution to scientific knowledge about treating back pain. Replying to an accolade that DCs were "good physical therapists," Peter Modde, DC, retorted, "chiropractors are lousy physical therapists. We are good psychologists. Our success is based upon the instilling within patients the belief that they have a spinal bone 'out-of-place,' and that we chiropractors can 'put it back in place.' We pop their spines and let nature take its course" . Modde was referring to chiropractic manipulation as suggestive therapy. Sam Homola, DC, agrees:
The "popping sound" associated with "putting bones back-into-place" (though it may be accomplished by manipulating a normal joint) is one of the cleverest that most effective forms of suggestive therapy ever devised. (p.47) This has a tremendous psychological influence over the mind. While the popping sound itself is quite meaningless, this influence mig ht possibly be used to advantage in curing psychosomatic conditions—provided the patient is informed that the bone is "back-in-place" and will stay there. By the same token, however, such treatment can cause a great deal of harm; that is by perpetuating a psychosomatic condition or even creating a new psychological illness. (p.95) 
The public relations image of chiropractic as having become a more trustworthy profession is misleading. Many DC leaders are becoming more proactive in promoting the irrational "subluxation" hypothesis. Too many DCs believe and practice pseudo-scientific nonsense to justify the general recommendation that people patronize DCs. Also, a general recommendation cannot be made because consumers select health care providers at their own risk.
If things go badly DCs are judged in court by chiropractic, not medical, standards. Too many DCs advise against antibiotics for children's ear infections, discourage immunization, or may persuade patients to give up needed medications. The best news is that there are now pro-science groups among the diverse factions that make up the DC guild, but their numbers are relatively small.
Citations. (1) Connell. "Surgery, many tests out for back pain," AP, Washington, 12/9/94; (2) E-mail communication, 4/16/93; (3) Homola. Bonesetting, Chiropractic, and Cultism. Critique, 1963.