Diets fail. Not just often, but almost always—90% of the time. If diets worked we wouldn’t have a worldwide obesity problem. And obesity is a problem that needs to be solved. The prevalence of obesity has doubled since 1980. As a public health issue, there are few determinants of illness that are more destructive, as obesity contributes to the growing rates of diabetes, heart disease, and even cancer. There’s no “one true cause” of all illness, but obesity comes pretty close. When people ask me for the single most important thing they can do for their health, my advice (after quitting smoking) is to (1) ensure you keep your weight under control and (2) exercise in any way possible.
Despite its tremendous impact on health, I’ve only blogged about obesity in an indirect way—by pointing out what doesn’t work. Dr. Oz is my perpetual source of bad health information with his regular promotion of bogus “weight loss” supplements like the green coffee bean “miracle”. I’ve also criticized eating programs like the fads of “Eating Clean”, gluten “intolerance”, or harmful diet delusions like “detox”. It’s the typical skeptical science blogger approach—spot pseudoscience, debunk it, and hope you did something good. But none of my posts have focused on what one should do—just what you shouldn’t. Over at Science-Based Medicine (where I also blog) Dr. Mark Crislip recently commented that what science-based medicine advocates support manifests in what we oppose. He’s right, because that’s the easy approach. Using the principles of science-based medicine, there’s an awful lot to oppose in the current writing and popular opinion on how to treat obesity. And my professional advice in the role of a pharmacist has been limited to steering people away from supplements, and then giving some basic advice about dietary planning. Anecdotes and platitudes. I admit that I’ve told patients to “eat less and exercise more”. I haven’t seen pharmacists do much more, though I like to think that pharmacists can and should be playing a much larger part in obesity management and treatment.
Continue reading ‘The Diet Fix: A Science-Based Weight Loss Guide’
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Tags: diets, Dr. Yoni Freedhoff, nutrition, obesity, The Diet Fix, weight loss
One of the encouraging shifts I’ve seen in health journalism over the past few years is the growing recognition that antivaccine sentiment is antiscientific at its core, and doesn’t justify false “balance” in the media. There’s no reason to give credibility to the antivaccine argument when their positions are built on a selection of discredited and debunked tropes. This move away from false balance and towards a more accurate reflection of the evidence seems to have started with the decline and disgrace of Andrew Wakefield and his MMR fraud. And there is now no question that antivaccine sentiment has a body count: Simply look at the resurgence of preventable communicable disease. Today, antivaccinationists are increasingly recognized for what they are – threats to public health. It seems less common today (versus just 5 years ago) that strident antivaccine voices are given either air time or credibility in the media.
But false balance on topics like influenza can occur without giving a voice to groups like antivaccinationists. A more subtle technique to shift perceptions is both widespread and hard to detect, unless you’re aware of it: the naturalistic fallacy, known more accurately as the appeal to nature. In short, it means “It’s natural so it’s good” with the converse being “unnatural is bad.” In general, the term “natural” has a positive perception, so calling a product (or a health intervention) “natural” is implying goodness. The appeal to nature is so common that you may not even recognize it as a logical fallacy. Unnatural can be good, and natural can be bad: Eyeglasses are unnatural. And cyanide is natural. Natural doesn’t mean safe or effective. But the appeal to nature is powerful, and it’s even persuasive to governments. If we believe that health interventions and treatments should be evaluated on their merits, rather than whether or not they’re “natural”, then decisions to regulate “natural” products differently than the “unnatural” ones (like drugs) makes little sense. Yet the Dietary Supplement Health and Education Act was a legislative appeal to nature, introducing a different regulatory and safety standard for a group of products while drawing a fallacious distinction with “unnatural” products like drugs. Canada fell for the appeal to nature too: It has the Natural Health Products Regulations which entrenched a lowered bar for efficacy and safety for anything a manufacturer can demonstrate is somehow “natural”. Continue reading ‘False “Balance” and an Appeal to Nature in the Globe and Mail’
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Tags: Appeal to Nature, Globe and Mail, influenza, logical fallacies, naturalistic fallacy
Regulators like Health Canada have tremendous power. They alone decide whether a drug or health product can be legally sold in Canada. With that power they have the authority to compel manufacturers to generate data to support their health claims, and they have the final word on the marketing statements a manufacturer can make about their product. If you don’t satisfy their requirements, you may not sell your product in Canada. Health Canada claims to have a rigorous review process, and they assure Canadians that their approval means (in their words) that a product is “safe, effective, and of high quality.” The system is designed for consumer protection purposes – regulations and rules for companies have developed over decades based in part on regulatory disasters like the thalidomide tragedy. So when you see a product that is approved by Health Canada that claims “Helps the body to metabolize fats and proteins”, then you might expect that claim to be backed by good scientific evidence. You’d be wrong. Regrettably, Health Canada has effectively eliminated regulatory requirements for anything that can be called a “Natural Health Product”. It’s a regulatory double standard that has allowed hundreds of useless and sometimes potentially dangerous products on to the Canadian marketplace. Continue reading ‘Is there anything the Natural Health Products Directorate won’t approve? The Antioxidant Edition’
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Tuesday’s post on Target’s decision to sell homeopathy for the treatment of asthma stirred a lot of questions towards Target, given their decision to market the a product that has no proven medical benefit. There were also supporters of homeopathy in the comments, from a pharmacy student who said homeopathy works because of radiation, and another that suggested that if I don’t believe in homeopathy, I can’t believe in the warmth of the sun. To be absolutely clear, homeopathy is not only unproven, it’s disproven. There is no serious scientific debate about this fact. The best evidence demonstrates that homeopathy is exactly what we expect – an inert placebo with no therapeutic effects. Homeopathy is not “alternative medicine”, it is an alternative TO medicine, and to consumers who may not understand what “homeopathic” means, it’s highly misleading to package and sell this on pharmacy shelves alongside products that actually contain medicine. Continue reading ‘Looking for the medicine in Target’s asthma remedy’
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Tags: asthma, homeopathy, Target
I can’t think of anything more appalling than selling water to someone and telling them it will treat their asthma. This pic via Ryan Melyon on Twitter, was taken at a Target pharmacy in Chicago:
I’ve said it before but it’s worth repeating: Homeopathy is an elaborate placebo system where the “remedies” are inert. It’s reckless endangerment of life to sell a product for treating the acute symptoms of asthma when there is no medication in the bottle, even if there is a caution on the front of the box. And it should be obvious, but placebo has no meaningful effects in the treatment of asthma. The sale of homeopathy in pharmacies is not only misleading to consumers, it is fundamentally unethical behavior from a health professional. Target and its pharmacists have a ethical and moral responsibility to pull this product off the shelf immediately.
January 16: Here’s an update on Target’s fake asthma “remedy”. And a petition has been started asking Target to stop selling this product.
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Tags: homeopathy, pharmacy practice, target pharmacy
Happy 2014 Everyone! It’s been a while since the last weekend reading update. Here’s some links and posts for your reading pleasure. The picture above is from the Toronto ice storm that we’re still recovering from. Continue reading ‘Weekend Reading’
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Tags: anaphylaxis, canadianisms, drug safety, gluten, homeopathy, natural health products, naturopathy, pharmacy compounding, pharmacy practice, quackery, supplements, vaccines
Happy New Year to my regular readers! Today’s post revisits some old material, repackaged and updated.
New Year, New You, right? 2014 is the year you’re finally going to get serious about your health. You’re winding down from a week (or more) of celebrations and parties. You’re pretty much recovered from New Year’s Eve by now. It’s time to make some resolutions. Conveniently, there is no shortage of solutions being advertised to absolve you of your sins while overhauling your body and soul for 2014: What you need to do is “detox”. You’ll see the detox kits at your local Whole Foods (or even your local pharmacy). Books, boxes or bottles, with some combination of “detox”, “cleanse” or “flush” in the product name. Supplements, tea, homeopathy, coffee enemas, ear candles, and footbaths all promise detoxification. The advertising suggests you’ll gain a renewed body and better health – it’s only seven days and $49.95 away. Or try to cleanse yourself with food alone: Dr. Oz is hyping his Holiday Detox plan. Bon Appetit is featuring their 2014 Food Lover’s Cleanse. Or what about that old standby, the “Master Cleanse”? It’s the New Year – wouldn’t a purification from your sins of 2013 be a good idea to start the year? After all, the local naturopath sells detoxification protocols, including vitamin drips and chelation. There must be something to it, right? Continue reading ‘The Detox Myth: What your alternative health provider isn’t telling you’
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Tags: chelation, cleanse, cleansing, coffee enemas, detox, detoxification, homeopathy, naturopathy, nutritionist, quackery