Monday, July 22, 2019

Snake Oil Sellers and Health

Someone discovered that I'm a fifty something male so every day my inbox fills up with news of miracle cures for low testosterone and erectile dysfunction. I also get emails about the health benefits of lemon juice, baking powder and apple cider vinegar for conditions from arthritis to diabetes to indigestion. Some of these miracle cures are already in your kitchen, but the majority are potions concocted in a laboratory in Taiwan - and they are going to cost.
I should say at this point, that I am not a medical practitioner and the opinions I express here are based on a dose of common sense mixed with a dram of scepticism rather than on any expert knowledge or extensive research into medical issues.
When I open one of these emails, the typical pitch goes like this:
1. You can't trust the medical establishment - they're in cahoots with Big Pharma to make you ill and keep you ill - type 2 diabetes being the crowning example.
2. Most if not all prescription medicines have dreadful side effects, some of which are worse than the condition you started with.
3. Surgery is a drastic way to make your back/shoulder/knee pain worse.
4. There are various natural remedies for almost every illness known to humanity, but because of pesticides, poor quality control etc you can't just get your medicine from the supermarket. You need supplements. And ours happen to be the best.
5. If we don't have a supplement to sell, we'll sell you a cookery book or a set of DVDs
The same applies to exercise. These health gurus are now telling us that everything we thought was true about exercise is false. Far from keeping you lithe and young, conventional "cardio" and "carb burning" exercise clogs your body with free radicals that accelerate the aging process. Ditch the running, cycling and gym classes and buy our miracle exercise programme: four extremely intense minutes a day and you'll have a physique to die for...
Some of the promises are clearly overblown and result in fairly swift use of the delete button. But the most effective messages are carefully crafted, with references to rigorously controlled trials published in respected medical journals and "case studies" of people like you and me with "before" and after "photos" to seal the deal.
The most pernicious aspect of these emails, though, is the claim that the medical establishment wants to keep you ill so they can make big bucks from your misfortune. Medical practitioners in the US, where almost all my emails originate, may have incentives - for billing purposes - to tell you you're really ill and you need a battery of medications, surgery, physio etc. though I doubt it. But the situation in the UK is very different Here, because of NHS funding and resourcing issues, medical practitioners have more incentive to ration treatment. For example, patients with long-term conditions such as diabetes or hypertension can claim free prescriptions, so what's in it for GPs in keeping patients drug-dependent for life? There is every incentive to minimise the use of surgery and other therapies because of long waiting lists. The NHS even has gate-keeping services to limit demand by offering telephone or online advice. The NHS certainly has no incentive in keeping you ill.
Similarly, because of lower food standards in the US, it might be difficult for many consumers there to access good quality food. That is not the case in the UK at the moment (though post-Brexit things may be different). Here food production and labelling standards mean that consumers can be confident that a pound of carrots will contain reasonable levels of whatever vitamins and minerals are associated with them.
Some gurus are out to sell the benefits of complementary therapies: reiki, reflexology, acupuncture. These may be helpful - or at worst harmless - for minor ailments or for pain relief for osteo-arthritis. However, the danger comes when they are peddled as cures for cancer and heart disease.
Other gurus alert you to the dangers of eating certain foods: "Never eat these five foods!" they scream. Wheat phobia is a fairly common one and seems to stem from the paleo community, who teach that farming is the worst human activity ever. The fear of wheat is now spreading to other grains that were still benign yesterday: oats, rye, barley. Rice and potatoes are also pure poison for the paleos.
Some gurus tell tales of remote Tibetan villages where everyone lives to be 150 because they use some mysterious herb in their tea. It's true that there are "blue zones" where a significant proportion of people live to a ripe old age and in fine fettle. However, all the research indicates that this is never due to a single factor but to a combination of factors such as genetics, diet and lifestyle. For example, remaining physically active and being part of a close community appear to be crucial. You can't replicate these factors in a bottle.
Some advice looks innocuous because there doesn't seem to be any selling going on. For example, drinking warm water, lemon juice and honey every morning. However, to get the "free report" on the miracle that is lemon juice you have to provide your email address, which is then sold to other snake oil sellers, so that like me, you're soon inundated with pseudo-medical advice.
Remember, most of these gurus have no formal medical training at all, and the minority who do have opted for a comfortable living as medical heretics.
When you see a claim for the benefits of taking magnesium or L-Arginine, check it out on a reputable website like WebMD. You will generally find:
1. The claims are overblown, i.e. there is little or no evidence that the herb, spice or mineral has any appreciable impact on serious conditions such as cancer, heart disease etc.
2. A clinical trial on a small group of patients showed some impact on a minor or rare condition - this is the "kernel of truth" that makes the claim defensible in case of litigation.
3. Overall though, the list of proven uses is much shorter than is claimed.
4. There are risks, for example, for pregnant women, the elderly or people using other medications.
If the sales blurb refers to clinical trials carried out at a university or research institute, check directly on the institution's website. Did such a trial take place, and if so, what were the results?
Similarly, check with your country's food and drug regulator. What advice are they giving about this miracle potion?
Always be wary of the snake oil seller's call to action, which usually rounds off a long and tedious email or video presentation:
1. A stark reminder that your condition is wrecking your life.
2. Orthodox treatments are dangerous or ineffective.
3. You have to take responsibility for your health because your doctors and their mates in Big Pharma don't give a damn about you.
4. The answer to your problems is available at a massive discount but you need to buy within the next 15 minutes.
5. Get your credit card ready.
Of course, if you don't buy the miracle cure there and then, you'll get reminder emails for several days afterwards saying the discount is still available for you alone because "we really care about your glaucoma/rheumatism/varicose veins etc."
When I get emails from the gurus, my approach is:
1. Never accept claims for miracle cures unless or until there is clear evidence to support such claims i.e. rigorous clinical trials conducted by a reputable institution such as a university.
2. Never use any supplements without checking that you really need them, and they work. Then check the ingredients and quality control. Read independent reviews wherever possible.
3. Be wary of paying for any diet or exercise programme until you have seen it in action: be sure that you can commit to it and that it will work for you - physically and mentally. Where possible read independent reviews before parting with any cash.
4. Avoid fads such as therapies, lifestyles or superfoods that have no proven efficacy.
In my family, our approach to health issues is:
1. Have regular check-ups with an orthodox medical practitioner. Increase the frequency as you get older or if you have a long-term condition.
2. Only take supplements if you really can't get the vitamins and minerals you need from your diet, such as Vitamin D in the winter, or if your doctor recommends it because of a medical condition or other issue.
3. Use complementary therapies where there is a proven medical benefit and/or where you feel some tangible benefit, such as pain relief, relaxation or de-stressing. Do not use these therapies instead of orthodox medicine, particularly for serious conditions such as cancer or heart disease.
4. If you want to follow a diet or eating plan, find one that suits your likes and life-style. If you want to lose or gain weight, or if you have a condition such as diabetes or coeliac disease, follow proven medical advice for your condition.
5. Follow an exercise plan that suits you, whether it be walking to the shops or running marathons. Exercise should be fun, so find an activity that you can enjoy and commit to. If you can afford it, find a personal trainer who can help you design an exercise programme that works for you and keeps you motivated.
6. If you don't want to eat healthily or do any exercise, be mindful of the potential consequences.
7. If you are a parent or carer, follow this approach for your child or the person you are caring for, as well as for yourself.
If you see an email offering you the elixir of eternal youth, applying a bit of common sense and scepticism could save you £s - and more importantly, do wonders for your health and well-being.
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