A survey of 1,500 American adults conducted in November, 1997 found the highest levels of use of nonstandard methods yet recorded in a national study. Forty-two percent of the sample said that they had used some form of alternative care in the past year.
Herbal therapy was the most widely used (17%), 85% of which was self-care. Chiropractic was second with 16% reporting use, 99% of which was professional care.
This reflects a substantial increase in chiropractic utilization which has been at 7-10% for many years. The third most used was massage (14%), 84% of which was professional care. Vitamin therapy was fourth (13%), 79% of which was self-care.
Other forms of alternative care were not widely used. Most interesting was the lack of enthusiasm for acupuncture. Despite the fact that respondents were most aware of acupuncture, only 2% reported using it. Only 10% said that they were likely to use it in the future, and 58% said that they would not. This was considerably more negative a rating than other forms of alternative care, and only yoga and hypnotherapy were as poor.
Of those who used acupuncture, 57% reported being "very satisfied." This was the lowest of three types of practitioners (80% of massage, and 73% of chiropractic users were "very satisfied"). Satisfaction was not reported with the other forms of alternative care. Only 15% of users said that their use replaced standard care.
The increased use of alternative care appears to be due to successful public relations. The leading reason for positive attitudes toward alternative care was having "learned more about it" (47%). No information is given on the sources. It is a safe guess that the respondents learned more about alternative care from noncritical sources because those of us who track the sources know that they have been overwhelmingly noncritical. Twenty-two percent stated that the "media made me more open-minded." Forty-one percent and 23% respectively became more positive as a result of their own personal experience, or the positive experience of a friend.
Providers of nonstandard care have a long history of emphasizing patient satisfaction in their practices, so the findings are not surprising. True efficacy, the real measure of the value of health care, is not a factor in studies of this type of study. We conclude that this survey has revealed that the flood of propaganda about nonstandard "alternative" and "complementary" health care has increased its use because people with health problems are known to try anything that they hear about. Especially if the method does not have the strong stench of quackery.
The record shows that the desperate sick will even try quackery, but only 4% of the study's population considered their current health status to be "poor." Eighty-three percent rated their health as "excellent" (32%) or "generally good" (51%). Most respondents (55%) were not willing to have their insurance premiums increased to have access to alternative care; 30% would pay $10 or less a month for access; and 15% would pay $11 or more per month for coverage.
The study was conducted by InterActive Solutions of Grand Rapids, Michigan for Landmark Healthcare Inc of Sacramento, California.
The Scientific Review of Alternative Medicine brings a badly needed skeptical approach to alternative-complementary medicine. To date, every journal we have seen has taken an open, but empty-minded perspective ie, (a) ignores the available information that has found little value in the methods being advanced under the banner of alternativism; or, (b) ignores what has been learned in the past about the pitfalls of subjective personal experience in producing clinical illusions that fooled patients and practitioners alike until doctors learned to control expectations and psychological reactions by double-blind clinical trials.
We are pleased that 9 of the 53 members of The Council for Scientific Medicine sponsoring the journal are NCAHF board members. Its editor is Wallace Sampson, MD, past chairman of the NCAHF board of directors.
The journal is published biannually. Cost: $50 for individuals in the US & Canada; $90 for institutions and overseas. Order from: Prometheus Books, 59 John Glenn Drive, Amherst, NY 14228-2197; tel: 800-421-0351.
According to an industry report, sales of Ginkgo and St. John's Wort surged following feature stories in national news weeklies and television magazine news shows. In the last quarter of 1997 the two herb-drugs became number one and number two in sales at $29.5 and $28 million respectively.
Ginkgo is supposedly good for mental deterioration and St. John's Wort has antidepressant effects. One reason people like herbs is because they have the romantic aura of naturalness that people equate with safety, but another is the availability of such items without a prescription and at lower cost than standard drugs. Ease of access probably plays as powerful a role as perception in the growing marketplace success of herbal remedies.
The Ergogenics Edge: Pushing the Limits of Sports Performance by Melvin H. Williams, PhD provides a comprehensive discussion of the nutritional, physiologic, pharmacologic, biochemical, and psychological methods used to enhance sports performance. This 327-page softcover book includes ratings of more than 60 "ergogenic aids" (ergos=work) with respect to effectiveness, safety, legal aspects, and ethical concerns. It can be ordered from NCAHF Books, POB 1747, Allentown, PA 18105. Price including postage: NCAHF members $18.70; Nonmembers $20.50; add $1 to Canada orders, $3 to overseas orders.
Consumers are sure to take to products containing the new fat replacers. The Center for Science in the Public Interest (CSPI) is engaged in a crusade against Olestra, which has made the whole matter a public issue, but the final proof of the pudding will be in the eating.* People who find such products objectionable won't use them. CSPI seems to be getting a lot of self-serving publicity for its role as the "food police" more than anything else.
Readers who want to be well-informed should obtain the scientific status summary Fat Replacers, (March, 1998), from The Institute of Food Technologists, 221 N. LaSalle St., Ste 300, Chicago, IL 60601-1291; Tel. 312-782-8424; fax. 8348; e-mail. email@example.com.
*Cheskin et al (JAMA;1998:279:150-2) found no increase in the incidence or severity of GI disturbances following one sitting of ingesting olestra prepared potato chips.
The American Council on Science and Health has periodically evaluated popular magazines for the accuracy of the nutrition information they provide. ACSH has just released its evaluations for 1995-96. Consumer Reports led the field. Women's magazines such as New Woman and Cosmopolitan again were ranked at the bottom but are doing better.
For a copy of the complete report contact ACSH directly at: 1995 Broadway, 2nd Floor, NY, NY 10023-5860; Tel 212-362-7044; fax 4919; e-mail firstname.lastname@example.org. Price: $5.
The Quebec Court of Appeals in Canada has ruled that only licensed physicians are allowed to practice homeopathy. If this rule were to be applied in the United States, thousands of chiropractors would be outside the law.
According to the 1993 Job Analysis of Chiropractic, 37% of more than 50,000 USA chiros practice some form of homeopathy. That calculates to over 18,500 practitioners. Naturopaths also practice homeopathy, but there are fewer than 1,500 practicing nationwide, and there are only about 500 homeopaths (many are fringe MDs). Apparently chiros are the most prevalent homeopathic practitioners.
Newsweek featured the story of Dean Ornish, MD in its March 16, 1998 issue. Ornish has been a hero among preventive medicine adherents since he demonstrated a significant reduction in heart disease among patients who followed his strict regimen of diet, exercise, meditation, and group psychotherapy.
Ornish's story is an all-too-familiar one of conversion from a depressed and suicidal young man to a zealot influenced by a swami. It helps explain why Ornish included meditation along with the more conventional ideas of dietary restriction and exercise in his program. Ornish, himself, comes across as a kind of guru as he motivates his patients to follow his monastic program of self-denial.
Ornish's personal example, with his ideological commitment, may be the key to the success of the program. This may explain why we have not seen anyone replicate his results. If this is so, then we have learned something useful. We have learned that highly-motivated patients and a highly-committed doctor-teacher can combine to produce an effective preventive medicine program.
Such a program may not be suitable for everyone, but it is worthwhile to know that it can work. Some may wince at the need for a doctor to be so strongly committed because ideology generally subverts the scientific method.
Ornish comes across as more a guru than a doctor of medicine in the Newsweek story, but maybe that's what it takes for people to succeed in the lifestyle approach to preventive medicine.
On January 20, the Healthy Weight Journal and the NCAHF Task Force on Weight Loss Abuse presented their 9th Annual Slim Chance Awards for those items that they believe to be the worst weight loss products of the year.
This year's announcements were presented in the shadow of the tragic fen-phen fiasco that involved prescription diet pills. And, although these "legitimate" products may have caused more documented harm, they differ from products outside of the medical and health community in that legitimate producers track unanticipated harm and remove products from the market when it is warranted. Nonmedical product promoters generally not only do not track harm, they engage in denial and cover-ups when their products are implicated.
The Healthy Weight Journal is published six times a year by Decker Periodicals, 4 Hughson Street South, P.O. Box 620, LCDI, Hamilton, Ontario, Canada. The 1997 subscription rates are: US & Canada individual $59US; institution $89US; student $27 US. Elsewhere add $15 to each category. Tel: 800-568-7281.
Venastat, by the Ginsana USA Corp, is being marketed to relieve leg swelling due to varicose veins. It doesn't get rid of the varicose veins but helps improve symptoms of leg swelling and pain. The product contains horse chestnut seed extract which is thought to work by inhibiting enzymes that weaken the vein and allow fluid to leak out. The product is said to work about as well as wearing compression stockings. Although natural horse chestnut seeds are toxic, the extract in Venastat has been purified to remove the toxins.
[Pharmacist's Letter, March, 1998]
The Presidential Commission on Dietary Supplement Labels dropped its earlier recommendation that makers of dietary supplements need to prove the efficacy of their products--which NCAHF applauded--and now suggests that consumers do their own homework on these products.
The Commission turned its report over to HHS Secretary Donna Shalala who was to decide whether to propose its recommendations as formal rules. The problem with the Commission's position is that there simply isn't enough information available to make such judgments, especially when it comes to herbal remedies.
The ill-conceived 1994 Dietary Supplements Health & Education Act made its gravest error when it permitted herbal remedies to be marketed as dietary supplements. This created an unregulated medicine industry which markets products that are as dangerous as prescription drugs with less oversight than is given common nonprescription medications. The Commission's final report appeared to be largely a sell-out to the dietary supplement industry.
The promotion of Noni juice (ie, the juice of the tropical plant Morinda citrifolia) is growing as more and more hucksters become involved in multilevel marketing schemes that sell the product.
According to The Lawrence Review of Natural Products, (Oct. 1997) no information is available on side effects. We note that several studies on mice found that the juice can inhibit the growth of some cancer cells. Although proponents claim that this is accomplished by "enhancing the immune system," they do not specify the aspects of the immune system that are allegedly affected.
Frankly, we doubt that this is the case because immune system enhancement is an unlikely mechanism for inhibiting cancer.a When a substance inhibits the growth of cancer cells it is much more likely that it is "cytotoxic" (poisonous to cells). Just as with chemotherapeutic agents, fast-growing cancer cells are more strongly affected by toxic substances than are normal cells. The cancer cells are poisoned to death while normal cells are mildly poisoned but recover once the therapy is stopped.
In the case of Noni, it appears that the substance is biologically active. This means that it may have medicinal value. However, it also means that it can have negative effects such as interfering with other medications. People who take other medicines should be cautious with Noni.
Don't expect your doctor to know if it is safe. There simply is no good information. Consumers who have decided to become guinea pigs should watch carefully for side-effects, and should not allow themselves to be misguided by naturopaths, homeopaths, or chiropractors who claim that adverse side effects are "the poisons coming out." In fact, these side-effects are due to poisons going in!
Contrary to what the hucksters would like their potential customers to believe, it is not comforting to learn that an herbal remedy does, in fact, have biological activity. This is because any substance that can alter physiology has the potential for both good and ill, depending upon the nature of the individual, his problems, the dosage, how it is administered, and more. Benign, useless herbal products are less a problem because their benefits are due to the placebo effect and no harm can be done.
A review of original articles and abstracts published in the last 30 years on the use of chelation therapy in cardiovascular disease, with emphasis placed upon the most recent placebo-controlled studies, concluded that "more controlled studies are required to determine the efficacy of chelation therapy in cardiovascular disease before it can be used broadly in the clinical setting." Studies of three different chelating agents were reviewed (these are named in the title).
[Elihu, et al. "Chelation therapy in cardiovascular disease: ethylenediamine-tetraacetic acid, deferoxamine, and dexrazoxane," J Clin Phamacol, 1998;38:101-05.
The media has been agog recently with speculative reports on the power of intercessory prayer to heal the sick. Studies with flawed designs and weak, albeit statistically significant, findings are trumpeted as having provided scientific evidence of a mysterious benefit to healing prayer.
Such vague and subtle findings pale in the face of the solid evidence of the killing power of faith healing, much of which involved intercessory prayer, documented in the journal Pediatrics (1998;101(4):625-9). Rita Swan, PhD and Seth Asser, MD, examined the deaths of 172 children from families who relied upon faith healing from 1975 to 1995.
Four out of every five sick children who died after their parents put their trust in faith healing would most likely had survived if they had received medical care. Eighty-one percent (140) of the deaths were caused by conditions that had a chance of survival exceeding 90% when treated medically. Eighteen more of the children died of conditions with better than a 50% survival rate with medical care. All but three children would have benefitted in some way from medical care.
Twenty-six percent of the deaths have occurred since 1988 when the American Academy of Pediatrics called for an elimination of laws that exempt parents from legal accountability for medical neglect for religious reasons. Evidence that the elimination of such laws would save lives is found in the fact that Christian Science church members in Canada are permitted by the church to seek medical help for their children because the law does not provide a refuge as it does in many U.S. states.
The Christian Science church is probably the largest denomination that is opposed to medical care. The group with the most fatalities was the Faith Assembly (64). Christian Science was second with 28 deaths. The authors note that their data cannot be used to establish rates, however. Reporting of such deaths is not systematic.
Curiously, despite the sympathy that Americans normally exhibit to the plights of children, very few cases of death due to religion-motivated medical neglect have received national press coverage, and reports in the medical literature are also rare.
The authors have shown by their investigation that child deaths due to religion-motivated neglect are not only preventable, they are predictable and they will continue to occur as long as good people do nothing to stop them. The U.S. Supreme Court is clear on whether or not requiring parents to obtain medical care for children is constitutional. It has stated:
The right to practice religion freely does not include the liberty to expose the community or child to communicable disease, or the latter to ill health or death... Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion. (Prince v. Massachusetts, 321 U.S. 158 (1944)
Rita Swan is president of Children's Healthcare Is a Legal Duty, and Seth Asser is Coordinator of the NCAHF Task Force on Children's Health Threats.
Most readers are aware that 11-year-old Emily Rosa has caused enormous embarrassment to the proponents of Therapeutic Touch (TT) through the publication of an experiment that she performed for a junior high school science project when she was nine [JAMA, 1998;279:1005-10.].
Emily's simple experiment was aimed at the most basic assumption of TT, which is that there exists an "energy field" around the body that can be sensed, and favorably altered, by a TT practitioner. If there is no energy field, or if it cannot be sensed, there is no basis for the sequential notion that the field can be altered by hand-waving. Emily simply tested whether or not 21 experienced TT practitioners could sense an energy field if they could not see whether or not anyone was actually within close proximity. They couldn't, which showed that their perception of an energy field was a product of their imaginations, not reality.
Emily's test reminded those knowledgeable about the history of medicine and pseudoscience of the test done on "animal magnetism" practitioners in 18th-century France. Patients and practitioners attested to being able to sense feelings of discomfort or heat emanating from objects that had been "magnetized." A 12-year-old boy who believed himself to be sensitive to magnetism was selected. His eyes were bandaged (blindfolded) and he was led successively to four trees that, unbeknown to him, had not been magnetized and made to embrace each for two minutes. He felt strong symptoms and reacted dramatically at each. Through this and other tests it became obvious to the Franklin Commission that the feelings sensed by believers was a product of their imaginations [Crabtree A. From Mesmer to Freud. Yale University Press, 1993, p.27.] Innocent children were involved in both instances. In 1784 a child was the subject, in 1996, a child did the test. The French boy was selected because of his innocence, and Emily is believable for the same reason.
It is impossible to learn of this story without recalling the fairy tale of the Emperor's New Clothes. The story was that a deluded Emperor was tricked into wearing imaginary clothes. He was stark naked but viewers were told that only sophisticated people could see the clothes. Everyone wanted to be sophisticated so they deluded themselves into thinking that they could see the invisible clothes. When the Emperor went on parade it was a child who exclaimed that the "Emperor has no clothes." Suddenly everyone was aware of the delusion. Such tales reveal ancient wisdom about human nature. TT is a delusion that thousands of practitioners, mostly Registered Nurses, have accepted only to now be exposed by a child.
The reaction of the believers has only made their delusions more apparent. Part of the TT delusion is that practitioners are empowered by their "intention to heal." This idea is rooted in radiesthesia (ie, "the sensitive radiance"), the notion that the vitalistic Life Force produces a resonance via thought processes which can be discerned by people possessing a "sixth sense" (aka "Sensitives"). TT apologists say that the TT practitioners Emily tested were not "intending to heal."
They also accuse Emily of blocking their powers with negative thoughts. This reminded me of the excuse offered by a psychic healer who had been caught faking a cure. When confronted with the fact that there had been no real healing by an undercover skeptic who has disguised himself for the investigation, the psychic declared that the reason the healing had not occurred was because of the presence of the skeptic's negativism--which the psychic now declared he could sense during the meeting. This is why James Randi referred to deluded believers as "unsinkable rubber duckies." Society's hope lies in a sensible public that will now laugh TT off of the scene. One report from Eugene, Oregon involved comments by the family of a patient observing TT being done by a nun at Sacred Heart Hospital. Snickering, they were overhead commenting about "rattles" in an apparent reference to the dance of a witch doctor.
Emily is the daughter of Linda Rosa, RN, Coordinator of the NCAHF Task Force on Questionable Nursing Practices. The publication of her study distinguished her as the youngest author ever to have been published by the Journal of the American Medical Association. Emily had heard her mother talk a lot about TT around the house, and came up with this simple test on her own.
High level research methodologists are sure to be able to find flaws in her test, or design a stronger test, but they look pretty silly arguing with a kid who has exposed adult folly. To the TT proponents we say, where is your evidence that an energy field in fact exists? Her success is sure to inspire more kids to become active skeptics. Emily will appear on the cover of the premier issue of Junior Skeptic to be included with vol 6, #2 of Skeptic later this year by the Skeptics Society, P.O. Box 338, Altadena, CA 91001.
In addition to Emily's test, the article
provides a thorough description of TT history, popularity, theory,
claims, practice, and scientific status.