Evaluating Nutritional Claims - Separating Fact from Fiction
by Galen O. Ballard
(Published in the Dec/Jan 1998 Issue of Chiropractic Products Magazine)

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The 90's witnessed the rapid rise of alternative health care as millions of Americans became disenchanted with mainstream medicine. The growth of nutritional and herbal medicines has likewise enjoyed rapid growth and acceptance as a viable alternative to drugs and surgery in many instances. Nutrition's "golden age" began in earnest when prestigious Time magazine devoted its April 6, 1992 issue to a cover story entitled "The Real Power of Vitamins".

As with any hot new growth industry, the nutrition field has attracted unscrupulous individuals and organizations out to capitalize on "what's in" to make a fast buck. These callous schlockmeisters prey on people's hopes, fears, illnesses, and lack of knowledge - especially older individuals who usually have at least one chronic condition.

Your patients are bombarded daily with misleading or outright fraudulent advertising urging them to make serious decisions about nutritional products. Some companies even recruit your patients to sell nutrition, thereby placing nutritional counseling into the hands of total amateurs.

The Doctor of Chiropractic should logically be the provider of sound nutritional therapy as both modalities stress that the body has the inherent ability to heal itself with the proper resources and treatment procedures. "Nutritional supplementation should be prescribed and supervised by the Doctor of Chiropractic," emphatically states the American Chiropractic Association. Oftentimes, however, the D.C. is not prepared to assume this role. And this could prove disastrous in the very near future.

As a Doctor of Chiropractic, you need to protect your patients from misleading advice and marginal products that may prove dangerous. You need to be able to evaluate nutritional claims and separate fact from fiction. You need to ascertain the difference between reality and puffery in sales pitches made by nutritional hucksters.

If you and your peers shirk this responsibility, it is my belief the profession will have blown a once in a lifetime opportunity to become - as Stephen Seater, the former director of the FCER, so eloquently put it - "the wellness doctors of the new millennium".

Separating fact from fiction in nutritional claims is not difficult if you know the warning signs and "red flags" to watch for. Here are several "real world" examples of current advertising claims for products which, upon examination, constitute little more than nutritional scams. I have altered individual and product trade names as many D.C.'s have wittingly or unwittingly become involved in promoting them. Lets examine each one up close:

From the self published advertorial magazine Miracle Healings by Dr. Julius Feelgood is a testimonial from Frances M. who states that after taking glucosamine sulfate, barley grass and fish oil, the terrible pain she had been experiencing from rheumatoid arthritis completely disappeared in three days. What's wrong with this picture?

For starters, glucosamine sulfate is utilized for the relief of osteoarthritis, not rheuma-toid arthritis. Second, clinical studies have shown that glucosamine sulfate exhibits no direct pain relieving effects. Third, glucosamine sulfate usually takes 4 to 8 weeks to exert a protective effect against joint destruction. Fourth, barley grass and fish oil have not been clinically determined to have any affect on rheumatoid arthritis which is a multifactorial autoimmune disease with no known cure.

Knowing the above facts, would you recommend prescribing a concoction of glucose-amine, barley grass and fish oil to a patient suffering from rheumatoid arthritis? I would hope not! However, even if you were totally ignorant of the above nutritional facts, you could still readily conclude the above arthritis formula was hogwash by applying the following primary "red flag" in evaluating nutritional claims:

Red Flag One: The testimonial is one of the most obvious clues to a scam that you can find!

At best, a testimonial only indicates that a given product, ingredient or therapy worked on a specific person. Let's face facts, the "placebo effect" is extremely powerful. I remember as a small boy I would often get a cut or bruise. My mother would kiss it to make it better. And the pain did immediately go away, which is proof of the power of a mother's love, not a miracle cure!

By way of example, one hundred individuals are given Product A to ameliorate their arthritis. One person desperately wants to believe the product will work and, sure enough, that particular person's arthritic pain is alleviated. Of the remaining 99 individuals, 95 of them experience increased pain while the other 4 die!

The testimonial for this marvelous product would read, "Francis M's arthritic pain completely disappeared by using Product A!" The clinical study would reveal that Product A exacerbated the pain in 95% of the test subjects, ameliorated the pain in one subject and was a contributing factor in the death of four others.

If you were considering prescribing Product A to your patient, which information would you prefer the manufacturer/promoter to provide you - Francis M's testimonial or the results of the clinical study? Which brings us to the second most important "red flag" in evaluating nutritional claims:

Red Flag Two: Never rely on claims that are not supported and documented in the scientific literature!

Lose Weight! Tone Muscle! Gain Energy! Reduce Pain! All While you Sleep touts the half page ad in a well known chiropractic publication. "Show me the proof!", I say. But they can't. Because there isn't any. Only wonderful glowing testimonials from grateful customers such as "After taking CorpusAid I lost 23 pounds in 60 days and noticed an increase in energy". Or how about "I have been taking Nitroglycerin every day for my heart but have not had to take a tablet since I started taking CorpusAid. One more, "I am a 74 year old male with rheumatic arthritis. Within 8 days of taking CorpusAid, I no longer wear magnetic knee supports". Which brings us to the third "red flag" in evaluating nutritional claims:

Red Flag Three: Never rely on a product that claims to cure almost every human ailment and disease. (This is the original snake oil ploy utilized for over 100 years)

Let's review a list of the ailments and diseases that this fantastic new product called CorpusAid has been used to treat. They include weight lose, carpal tunnel, fibromyalgia, chronic fatigue, ear ringing, arthritis pain, multiple extremity pain, lowered blood pressure, cholesterol, psoriasis, urinary incontinence, and, of course, etc., just in case the promoters may have missed something such as baldness, hemorrhoids, and hoof-and-mouth disease.

There are other clues that "something is rotten in Demark", or in this specific case, Canada. In reviewing hundreds of nutritional products and claims I have observed that Canada now appears to have overtaken Europe, the Orient, and even Outer Mongolia as the location of numerous and "miraculous" new nutritional discovers. This is often referred to as the mystique factor. Many of us seem to think that products from somewhere else - anywhere else - are inherently better than those found in the USA. It reminds me of the classic definition of an expert - someone from more than 50 miles away. I suspect the real reason many of these miraculous products are manufactured out of the country is it makes it difficult to check on the company, its reputation, its founders, and the product itself.

In this specific instance, CorpusAid comes to "U.S." via British Columbia, Canada, where we are told it has been in use for over 10 years at several exclusive medical health facilities, none of which are named. The product was discovered by a brilliant Canadian scientist who whipped up a formula to mix with chicken feed that would cure the chickens from an ailment known as fatty liver syndrome and help build lean muscle. The result was very happy chickens and the product CorpusAid. (I swear I'm not making this up! I couldn't make this up! My imagination isn't that good!). This brings us to "red flag" number four in evaluating nutritional claims:

Red Flag Four: Be suspicious of nutritional products developed by a brilliant scientist or doctor as the result of an important discovery or breakthrough.

The most abused phrase in the nutrition industry today is "miraculous discovery", by a brilliant scientist or doctor. This usually indicates an idea the promoters haven't thought of before. The one sure way to making a fast buck is to have a new product or ingredient that sounds impressive and hasn't been around long enough to be debunked. Nutrition is not about discovering new "fad" products. Rather, it is knowing the systems of the body and what kind of nutritional ingredient or formulation is required.

Another interesting advertisement catches my attention in yet another chiropractic publication. End Arthritis Pain Forever! the headline screams. One bottle of 100 cap- sules will cure arthritis. The product was discovered over 25 years ago "by a brilliant research scientist from Canada". The active ingredient is cetyl myristoleate which is synthesized from cetyl alcohol and myristic acid. (Myristic is a saturated fatty acid shown to elevate cholesterol). It is sold under various trade names by various promoters.

The claim made for this product is based upon a single published rodent study in which cetyl myristoleate isolated from Swiss albino mice was an apparent protective agent against adjuvant arthritis in rats. Advertising literature also touts that a clinic study was conducted on humans. In the "study", an M.D. gave 42 arthritic patients the recommended product dosage and reported the favorable results achieved. The "study" was not peer reviewed nor published.

According to various advertising and literature, this amazing product appears to have the ability to erase the memory from T-cells which have been programmed to attack the cartilage which, according to the literature, is why arthritis is referred to as an autoimmune disease. "Your practice will be overwhelmed with orders when your patients discover this product!!" the promoters promise. A bottle of 100 capsules retails for approximately $300.00. (Ouch)

As if curing arthritis was not sufficient to justify the product's outrageous cost, testimonials were provided by folks stating the product ameliorated their cancer, liver disease, lupus, etc.

The above product claims transgress so many "red flag" warnings that I hardly know where to begin! For starters, it violates all four of the warnings outlined previous. The legitimate clinical study conducted on rodents never addressed the issue of curing arthritis in humans, and never claimed to do so! The human "clinical study" to which the promoters refer is nothing more than the personal opinions of 42 individuals who were given the product by their doctor. No control group was used. The individuals knew they were being given a product on the belief it would cure their arthritis so the "placebo effect" negated honest results. No tests or examinations were conducted prior, during or following the "study" to ascertain the results. If this "doctor" had attempted to publish his "clinic study" he would have been laughed out of practice as a buffoon!

Of course, this product was also developed by a brilliant scientist in Canada as the result of an important discovery and alleviates numerous unrelated conditions and diseases. To the "red flag" warnings above, lets add a few more, beginning with warning number five:

Red Flag Five: Nutritional products that claim to cure any incurable disease are frauds.

If cetyl myristoleate was discovered 25 years ago as claimed, and assuming it really could cure the over 100 various forms of arthritis, don't you suppose this incredible ingredient would have been published in every medical journal in the world by now? With over 200 million Americans suffering from osteoarthritis and another several million from rheumatoid arthritis, don't you imagine every health practitioner would be prescribing it? Which brings us to "red flag" number six:

Red Flag Six: The medical profession doesn't want you to know about this!

With the repression of alternative cancer and cardiovascular treatments, it is easy to believe that the medical community really does have a conspiracy against alternative health treatments. However, most health results and benefits from new product ingredients are published in scientific journals after careful peer review. This serves to weed out experiments and discoveries that have been carelessly conceived, performed, or analyzed.

If a conspiracy truly does exist, I suspect it is between the pharmaceutical industry and the FDA to have all "natural medicine" declared prescription drugs. The stated position of this consortium would be "to protect the health of the American public by taking nutritional medicine out of the hands of hucksters, faddist, and unscrupulous holistic practitioners. Of course this position will also enable them to control the lucrative and rapidly growing alternative health care market, but that, of course, is an incidental consideration. (Believe that and I have a bridge in Brooklyn I would be happy to sell you!) Which leads us to red flag number seven:

Ref Flag Seven: Nutritional companies that claim their products are "FDA Approved" or Regulated.

Again I scan a chiropractic trade journal and see a well known nutrition company advertising their products as being "FDA-regulated". Horse manure! The FDA regulates drugs. The Food, Drug and Cosmetic Act only requires that foodstuffs and nutritional products not contain rat droppings, insect parts, metal filings, or be otherwise contaminated or adulterated. The FDA does not test or approve the efficacy of nutritional products which is what such advertising implies.

The words "FDA approved" or "FDA regulated" on a nutritional or dietary product implies nothing more than the FDA's failure to do its job concerning the fraudulent usurpation of its authority by hucksters.

Con men (and women) focus on the following "big three" human conditions because so many Americans are affected by them and desperately want to be cured - ARTHRITIS, OBESITY, and CANCER.

Con artist also focus on the big three vanity conditions afflicting the human race - BREAST ENLARGEMENT, PENILE ENLARGEMENT and WRINKLE AVOIDANCE by promising such conditions can be achieved or corrected without surgery.

If government regulators would do nothing more than concentrate on shutting down the hucksters involved in peddling fictitious cures for the above six "human conditions and frailties", fully 80 percent of all nutritional fraud would be eliminated and the parasites promulgating these scams could go back to peddling swamp land in Florida or portraits of Elvis at flea markets. Unfortunately, this common sense approach doesn't appear to be the focus of government regulators at this point in time.

I am looking at a brochure and related product flyers on Boobs R' Us, an herbal breast enhancement product which I picked up at a recent Florida Chiropractic Association convention in Orlando. (Chiropractic conventions are fertile ground for the con artist to ply his trade). The ingredient in this dietary product include hops, barley, wild oat, yam, wheat, corn and egg white which, when taken as directed over a two month period, will "enlarge and firm up a woman's breast". (The last time I encountered a formula similar to this one was years ago when Grandpa made homemade beer in the bathtub).

The promoters of Boobs R' Us offer no clinical studies to support the product's claims other than stating the formula was tested "with 2,000 eager women (I bet!) at the University of Munich" and the results were "over 95% of the women had successful nipple and breast growth, firmness, and fullness". No explanation was offered as to how the formulation achieved these remarkable results.

Just for fun, and perhaps because I am of German descent, I phoned the medical and science center at UM. After all, the University would certainly have a record of a controversial study of this magnitude, especially one with a 95% success rate. The research librarian I spoke with - once she stopped laughing - indicated both she and her daughter "would be most interested in such a product", however, the University of Munich had no record of such a study ever being conducted there.

The retail price of a two month supply of this product is $480, but the Doctor of Chiropractic can purchase 5 boxes for $350 each for resale to his "clients". Support materials included copies of written personal testimonials. After reviewing the claims and pricing on this nutritional product, it becomes obvious why the word "boob" is also a slang term for "gullible fool".

Gullibility is what the scam artist relies upon to peddle basic nutrition concoctions at outrageously inflated prices. Tahitian Zulu Juice, Liquid Elixir-of-Life, Blue-Green Pond Scum, Liquid Lumumba Fruit from Bora Bora. The list of ordinary juice drinks from far off exotic lands is endless. (The "mystique factor" at work again). For example, the advertising claims for Tahitian Zulu Juice state that the product "works in the body at the cellular level, giving it the ability to affect all body systems". No kidding!! All nutrition works at the cellular level to affect all body systems unless its excreted, even junk food!

So why are these hucksters telling us something that every high school freshman in Biology 101 already knows? Because they need to justify why you should pay $25 or more for a bottle of Liquid Lumumba Fruit from Bora Bora when you or your patients could be receiving similar (or superior) nutritional benefits from drinking a bottle of Wisconsin Apple Cider. Or, if you prefer, how about orange juice, or grape juice, or a glass of V-8 (It's great!). Every one of these fine American products provide your body with nutritional benefits at considerably less cost than the exotic blends peddled by scam artists.

The fact that all of the above examples of nutritional fraud were gleaned from literature and sales pitches at major chiropractic conventions or advertisements in chiropractic trade journals should serve as a wake up call to the profession. Nutritional
scam artists now man booths at all major chiropractic conventions and their ads are repeated each month in the trade press. The reason is simple. Hucksters always gyrate to where the action is!

It's no secret that most individuals in the health care field, including chiropractors, have been financially hurt by the managed care industry. It is also no secret that many D.C.'s have been forced by economic necessity to expand their practice beyond spinal manipulation.

As pointed out by a Trends Research Institute Study, the most promising professional opportunities for chiropractors to expand their practices and their incomes lie within the $30 BILLION dollar nutritional and weight management markets.

I don't know how many D.C.'s have read Trends' The New Millennium Chiropractor but I will venture a guess that every huckster who ever sold a bottle of snake oil knows this particular report inside and out! I believe it may be one reason why the profession has been targeted by a rash of phony nutritional "get-rich-quick" schemes. It's easy to be swayed by dollar signs and adopt a "hear-no-evil, see-no-evil, speak-no-evil" mentality when your income plummets and your lifestyle appears to be in jeopardy. Scam artists thrive in such an environment.

Chiropractors must be able to spot and avoid becoming involved with fad products and nutritional hype. The profession simply cannot afford to prescribe marginal or worthless products that drain their patients' financial resources and may even endanger their health. At a time when the profession is finally on the threshold of achieving the recognition it so justly deserves as bonafide health practitioners, it cannot afford to compromise its status by aligning itself with hucksters.

If the Doctor of Chiropractic fails to assume his or her professional responsibility for prescribing safe and effective nutrition, it is only a matter of time before the FDA - in cooperation with the pharmaceutical industry - will ensure that you are forever relieved of this chore!

The clock is already ticking in that direction. The January 97 issue of Retail Pharmacy News, a professional journal for pharmacists, ran a feature article encouraging pharmacist to "avoid stocking trendy or unproven products and stick with basic nutritionals supported by science-based information". Don't promote marginal nutritional products as so many pseudo health practitioners are currently doing, the article stresses.

It is unfortunate the above article did not appear in chiropractic trade publications as well. National polls continually show that the pharmacist is ranked as the most trusted health professional in the United States. It is a ranking that pharmacists jealously protect. Nutritional supplementation and herbal medicine is becoming big business and the pharmacy profession would like to preempt alternative health care practitioners. And many chiropractors are giving them the ammunition to do so! It is time for the chiropractic profession to police itself or see its hard won credibility destroyed.

Clinical studies reveal the average American has deficiencies in various vitamins, minerals and enzymes. However, I know of no studies or scientific research indicating that Americans are experiencing deficiencies in glorified nutritional tonics and fruit juices from Pago Pago or other far away places. In fact, the body may experience allergic reactions to exotic nutrients and foods it is not accustom to assimilating.

Herbs and herbal based formulations can relieve or ameliorate many human conditions and illnesses, and such herbs have been known to mankind for centuries. None of these herbs are "new". Rather, it is only recently that modern man has newly rediscovered these natural medicines.

There are a multitude of reputable nutrition companies that wholesale proven and reliable products exclusively to chiropractic professionals. Most of them offer money back guarantees. All of them support chiropractic through donations and memberships in various national chiropractic organizations and state associations. None of them rely on testimonials, "fad" ingredients, or advertising hype. All of them have been in business for many years and stand ready to assist the Doctor of Chiropractic in expanding his practice and enhancing his income. Remember, they have a vested interest in chiropractic and in seeing that you succeed. They will be here long after the scam artists have "taken the money and run". The Doctor of Chiropractic who aligns himself with reputable vendors and prescribes what is best for his patients will always prosper.

The "Magnificent 7" red flag warnings to avoid falling prey to a product scam -even if you know nothing about nutrition.

1. The personal testimonial - "I lost 50 pounds (of water weight) in 15 days (and now I'm dehydrated)!

2. Any health claims not supported or documented in the scientific literature "Studies done in Munich, Berlin, Tokyo and Moldavia show our product cures arthritis but we're not giving you the information to check it out for yourself. Just trust us!"

3. Claims that a product can cure a multiple of unrelated human ailments and diseases - Known worldwide as the Snake Oil Ploy.

4. Products developed by a brilliant scientist or doctor as a result of an important discovery - "While working for a major, big, huge research lab somewhere in the Swiss Alps, brilliant research scientist, I. Cheatham Good, discovered a new ingredient that enables the lame to walk and the blind to see!"

5. Nutritional products that claim to cure incurable diseases - "This miracle product cures cancer, arthritis and hoof and mouth disease within minutes while you sleep, and for only a mere $500 a bottle. Such a deal!"

6. The medical profession doesn't want you to know about this - "Dr. Zog was developing a wart remover for hogs when he suddenly realized he had discovered a cure for cancer, but the medical profession doesn't want you to know about this!" (The old conspiracy ploy).

7. Any nutritional company that claims its products are FDA-approved or FDA-regulated - Call the FDA at 1-800-238-7332. They will want to know the name of this company since the FDA only approves and regulates drugs!