Respectful Insolence

Woo: The future of American medicine?

i-e7a12c3d2598161273c9ed31d61fe694-ClassicInsolence.jpgAfter chilling out for part of the weekend, yesterday I became so engrossed in writing my part of a training grant for my postdoc that, before I knew it, it was way too late to provide you with the Insolence you crave for today. Oh, well. Tomorrow for sure; there’s a lot that has been waiting for my attention. Besides, I haven’t even really taken a vacation this summer; so I deserve a day or two (or three) off from time to time. In the meantime, I’ll post a couple of bits of “classic” (if you can call it that) Insolence. This particular bit of insolence dates back nearly four years, all the way back to November 2006. Remember, if you haven’t been reading at least four years, it’s new to you! Besides, it’s always fun (or disturbing) to me to see how well some of my older material has aged. See you tomorrow. Unfortunately, nothing appears to have changed since I first banged this out on my keyboard. Maybe I should do an update.

If you’re a physician, there comes a certain point in your career when you start caring a lot more than you did about the next generations of physicians in the training pipeline. While you’re in the middle of training, you are the next generation; besides, you’re too worried about just getting through medical school, residency, and Board certification to be all that concerned about those behind you in the pipeline, anyway. Then, when you’re early faculty, you’re concerned about establishing yourself, getting your career on track, and, if you’re in academics, getting promoted. True, physicians who aren’t interested in education wouldn’t be in academics in the first place, but most of us tend to be far more concerned about resident education, because these are the people who will be replacing us one day in our own specialties. At some point, however, one starts wondering about the next generation of doctors that will not just be replacing one’s own specialty, but will be becoming the next generation of primary care doctors, internists, and other specialties aside from one’s own. Part of this interest in self-interest. After all, we’re all getting older, and aging physicians will need doctors too. More importantly, though, most physicians like to think that their profession is improving and that the next generation of physicians will surpass the present generation, thus insuring continued improvements in the science and art of medicine. We like to see our generation leaving a legacy of improved patient care and part of that legacy is the training of medical students.

Unfortunately, I have seen what may be the future of American medicine, and now I’m very concerned. Dr. R. W. has shown it to me. The American Medical Student Association (AMSA), an organization that should be committed to advocacy of the finest training and the best scientific medicine, is deep into promoting woo among medical students.

Dr. R. W. was concerned about this pushing of pseudoscience as an instance of hypocrisy, given that AMSA is promoting a national “Pharm Free Day” on November 16, in which AMSA urges hospitals and medical schools to restrict access by pharmaceutical representatives to students, residents, and physicians, with a sanctimonious statement in which they seem to claim they are doing this in the name of evidence-based medicine:

AMSA members believe in providing the highest quality care through evidence-based medicine. Here’s how.

I’m less concerned with the hypocrisy (although Dr. R. W. is perfectly correct to point it out) and more concerned with the woo that AMSA is actively promoting among medical students. Indeed, AMSA publishes a Complementary Therapies Primer, which is full of credulity towards many forms of woo. It wouldn’t be so bad if it were just herbal medicine being promoted. After all, some herbs do indeed contain active compounds that definitely do have pharmacological activity and can be used to treat disease. (Just ask Abel Pharmboy.) It is almost certain that we will continue to find new natural products and plants that harbor substances that can be used as drugs to treat disease. The stuff on yoga, meditation, and other relatively innocuous woo doesn’t bother me too much either, as long as it doesn’t claim to treat disease. But AMSA goes way, way beyond that. Some examples follow.

AMSA on traditional Chinese medicine (p. 5):

Traditional Chinese Medicine (TCM) is an ancient method of health care that combines the use of medicinal herbs, acupuncture, food therapy, massage and therapeutic exercise. It has proven helpful for many conditions, including chronic degenerative disease, cancer, infectious disease, allergies, childhood ailments, heart disease and AIDS.

Really? How? Based on what evidence? AMSA doesn’t say. It simply goes on:

TCM also introduces a major component of the body, qi, that Western medicine does not even acknowledge. Qi is what is called the life force, and it is all inclusive of the many types of energy within the body as well as being essential for life itself. This vital life energy flows through the body following pathways called meridians. These meridians flow along the surface of the body and through the internal organs, with each meridian being given the name of the organ through which it flows, such as “liver” or “large intestine.” Organs can be accessed for treatment through their specific meridians, and illness can occur when there is a blockage of qi in these channels. Therefore it is essential in TCM to keep the qi flowing in order to maintain health. The healthy individual has an abundance of qi flowing smoothly through the meridians and organs. With this flow, the organs are able to harmoniously support each other’s functions.

Again, there’s no evidence presented for qi or any of the other mystical mumbo-jumbo discussed without skepticism. And, most outrageous of all:

TCM is well suited to anyone looking for safe healing, answers he or she can understand in everyday human terms, and involvement in and responsibility for his or her own healing.

On what studies or evidence does AMSA base these assertions, particularly the last one, in which AMSA explicitly states that TCM is “well-suited” to a certain group of patients? None whatsoever. The references are all books on TCM and acupuncture. There’s not a single peer-reviewed scientific study or clinical trial listed in the references for TCM. There’s not discussion of the lack of scientific evidence even for the existence of qi (and scientists have looked and continue to look; I’ve seen grant applications in which the applicants propose trying to measure qi without success or hope of success). Moreover, there is little or no skepticism or critical thinking. It’s all warm and fuzzy acceptance. Don’t believe me? You can read the whole thing yourself, or you could check out a couple of more examples.

AMSA on reflexology (p. 9):

Reflex areas in the hands and feet are believed to correspond to every part of the body, which may in turn be affected by stimulating the associated reflex areas. Reflexology is useful in relief of stress and tension, stimulation of relaxation, improving blood supply and unblocking of nerve impulses, thereby normalizing and balancing the entire body. Precise pressure is applied to release blockages inhibiting energy flow and causing pain and disease. Nerve endings in the feet are felt to connect with all areas of the body. Although medically unproven, there is a wealth of anecdotal evidence as to the effectiveness of this approach.

In other words, there is no good evidence other than the testimonials of the adherents of reflexology that it does any good treating disease. Certainly none of the references cited are in the peer-reviewed literature. They don’t even appear to be attempts at a critical evaluation of this technique. In fact, they don’t appear to be anything more than tomes written by advocates, and not even a single example of this so-called “anecdotal” evidence is cited or listed.

Before I go on, I can’t resist citing one more example from p. 18:

Fasting has been used as a means of physical, mental, and religious purification for centuries. Modern holistic medical practitioners are now recognizing its value in health maintenance and promotion.

Fasting eliminates the work required to digest and metabolize food, and allows the body to use stored fats as fuel. While fasting, fewer toxins are absorbed by the body, yet toxin elimination continues at the normal rate. Food allergens are eliminated, allowing the GI system to rest. After four days of fasting, serum fats are lowered, and the thinner blood circulates more effectively, leading to greater oxygenation and better immune function. Fat burning allows the release and elimination of fat-stored toxins such as pesticides.

Fasting has been used to benefit hypertension, headaches, allergies, arthritis, fibrocystic breast disease, schizophrenia, and, of course, obesity. Fasts may vary from two days to several months, depending on the condition to be treated. Fasting longer than a few days can be dangerous, however, and should only be done under the care of a health professional.

Fasters should consume an adequate amount of liquid. Experts are divided as to whether pure water or vegetable juice is the ideal replacement. Juice fasts are better suited to patients with poor dietary habits, who will undergo a vigorous detoxification phase of the fast. Patients may take a “detoxifying cocktail” of garlic, lemon, grapefruits and olie oil to flush out the liver at bedtime. Many practitioners encourage use of enemas while fasting.

I refer readers to the following old posts by yours truly for discussions of this sort of “detoxification” woo, which is an altie staple that is not only not supported by science but creates the appearance of “success” by producing the very “stones” that the “liver flush” claims to eliminate:

Would you like a liver flush with that colon cleanse?
Mere regularity is not enough
The Orange Man

Even worse is, though, the credulous treatment of homeopathy on p. 19 (yes, I couldn’t resist just one more example):

The Law of the Infinitesimal Dose was formulated by Dr. Hahnmann when he experimented with dilute solutions, seeking to avoid toxicities, and found them to be more effective than full strength preparations. Homeopathic remedies are repeatedly mixed with water or alcohol and shaken (succussion), often diluting the substances to such a degree that no amount of the original medication can be found in the remedy. Some believe that the remedies retain their
effect because of electromagnetic frequency imprinting, changing the structure of the diluent subtly.

Initially, as a patient is treated by a homeopathic physician, he or she may actually worsen. This is know as a “healing crisis.” As the presenting, most recent, symptoms are treated, older, underlying disorders come to the surface. Dr. Constantine Hering, the father of American homeopathy, believed that healing progresses from recent diseases to chronic maladies, from emotional imbalances to physical disorders, from superior to inferior, and from the deep structures to the superficial. This is known as Hering’s Laws
of Cure. By following Hering’s Laws when treating a patient, a practitioner can successively unravel many layers of pathology, eventually recreating internal order and achieving a more permanent cure.

Homeopathy is used to treat diabetes, arthritis, asthma, epilepsy, rashes, allergies, mental and emotional imbalances, and the common cold, as well as many other conditions. Homeopathic remedies are very inexpensive and nontoxic, and many reports document their success in a variety of situations. Homeopathy, while popular in the early twentieth century, has lost favor with the medical establishment in the US.

There’s a reason that homeopathy has “lost favor” with the medical establishment. (Actually, it never really had much favor with the medical establishment in the first place.) That’s because it’s utter bunk. Indeed, even physicians of the 19th century, physicians like Oliver Wendell Holmes, could quite convincingly show why homeopathy is utter bullshit. (Sorry, there’s just no other word for it that describes homeopathy as well.) It makes me despair for our medical education system that AMSA, an organization run by medical students is publishing such a credulous treatment of pseudoscience like homeopathy. Didn’t they learn anything in undergraduate and medical school? Apparently not. Our medical schools seem to have failed to teach them basic chemistry, physiology, and pharmacology, leading to statements like this regarding the evidence supposedly supporting woo:

Proponents of CAM therapies argue that unconventional treatments often cannot be tested effectively by the traditional, double-blind, controlled format that is the hallmark of conventional scientific studies. According to Manuel J. Avancena, L.Ac., an acupuncturist in Reston, Virginia, acupuncture points are different for every patient. If five patients present with the same primary complaint, the treatment will be different for each patient depending on coexisting symptoms or problems. This holistic component of the treatment would not be effectively measured by a study that demands that each patient have the same points treated in order to control variability.

People more skeptical of CAM demand nothing less than the double-blind, controlled study with objective results before they consider CAM. To some, the very argument that CAM cannot be evaluated using the controlled, double-blind study indicates that CAM is equivalent to quackery. In addition, scientists and physicians often remain doubtful if a therapy works but little evidence is available regarding the mechanism of its effects.

Guilty as charged, with one exception. (I’m funny that way. I’m alway skeptical of treatments that don’t appear to have any physiological or scientific basis for “working.” In fact, I’m even more skeptical when the evidence that such treatments actually “work” is so flimsy.) The above is nothing more than a typical altie strawman that skeptics require “nothing less than the double-blind, controlled study with objective results.” True, that is the gold standard towards which we strive when evaluating a therapy, but evidence-based medicine does not demand only double-blind, randomized, placebo-controlled clinical trials before it will consider a treatment, as I have explained before. When weaker evidence is all that is available, evidence-based medicine must synthesize it as best it can and come up with recommendations. AMSA does get one thing right, though. If an advocate of a treatment claims that it can’t be evaluated by the scientific method, I become suspicious of quackery–and rightly so, I argue. Even if, as claimed, “every patient requires a different treatment” under this system, it should still be possible to determine using the scientific method exactly why and to identify the criteria upon which the “individualized” treatments should be based. Conventional medicine “individualizes” treatments too, but it doesn’t have the temerity to claim that such individualization can’t be studied scientifically. In conventional medicine, no treatment is assumed to be impossible to study scientifically, and CAM should be treated no differently than “conventional medicine.” It is true that certain treatments may be very difficult to apply the scientific method to, but that does not mean that we should throw up our hands, give up, and just take the alties’ word for it that their treatments work. We should treat their claims exactly the same as any claim by academic physicians or big pharma.

But AMSA’s promotion of woo goes beyond even this. AMSA is going so far as to hold what it refers to as a “Leadership Training Program for CAM.” Here’s the goal:

The LTP is an experience of a lifetime. 20 medical students from across the country will gather on the campus of the Omega Institute for a weeklong, intensive retreat dedicated to complementary and alternative medicine and leadership skills training. Our expectation is that these 20 students will go on to become the future generation of leaders in CAM education in their medical schools and beyond.

During the LTP, students will learn from expert facilitators about a number of CAM topics- everything from acupuncture to research to mind-body medicine to the latest in regulation and licensing standards for CAM. Stress reduction, wellness, and nutrition will also be emphasized throughout the week as students will enjoy healthy meals and will have opportunities to take classes in meditation, Yoga, and movement. To enhance leadership skills, LTP facilitators will host sessions on public speaking, interpersonal skills, teamwork, and other activities designed to make YOU a more effective advocate for CAM.

In addition, each participant will plan a project to increase CAM awareness at his or her school. The LTP facilitators will host sessions throughout the week to help you make your project a success!

Great. Just what we need, a project promoting the credulous acceptance of the claims of alternative medicine by future generations of doctors. But that’s not all. In April, AMSA is sponsoring a woo-filled four week elective in in communal living, alternative medicine, and activism. Yes, we’re talking about a group bonding experience largely based on the credulous acceptance of the claims of alternative medicine (plus a some left-wing activism thrown in for good measure) in future generations of doctors. (The left wing activism doesn’t bother me that much, but I do find the emphasis on woo highly disturbing.)

There are a couple of truly ironic aspects of this credulous support of alternative medicine by AMSA. Perhaps the most amusing is the frequent claim by alties that the AMA “suppresses” the “truth” about alternative medicine. Yet, here we have AMSA, the premiere organization for medical students, swallowing the altie line, hook, line, and sinker. True, AMSA is not a branch of the AMA. However, it is the largest organization representing medical students, and consequently the leaders of AMSA are likely to be the leaders in medicine in general in the next 10-20 years. After all, any medical student who would be willing to go through what it takes to become a leader in a national society like AMSA will also be likely to become a leader in various local, state, and national medical societies and organizations after he or she becomes a physician.

The most ironic aspect of all, however, is that, while a major medical student organization in the U.S. is accepting traditional Chinese medicine and medical schools themselves rush to embrace it, the Chinese themselves, particularly Chinese youth, appear to be early in the process of rejecting TCM in favor of scientific medicine:

Traditional Chinese Medicine (TCM) is losing out to western medicine in the popularity stakes in China, according to an online survey.

Only 28 percent of the 14,677 respondents to the survey by China Youth Daily and Tencent.com said they would turn to TCM first even though 87 percent said they still had faith in the centuries-old practice.

Half of the respondents who voiced their support for TCM believe it is an effective cure for many diseases but 27 percent only trust it because it is “the quintessence of China”. As for the future of TCM, more than 60 percent said they were not optimistic.

A nationwide debate erupted over TCM after an online proposal was submitted by Zhang Gongyao, a professor at Central South University, urging China’s health authorities to remove TCM practices from its national health service. It attracted both support and outrage from thousands of netizens.

Supporters of the proposal labeled traditional Chinese medicine “unscientific and untrustworthy” and opponents lambasted supporters for ignoring history.

Indeed, one prominent Chinese physician has dared to speak out:

Mr. Zhang, a professor at Central South University in Hunan province who has been studying medical history for more than 30 years, is urging the government to stop promoting traditional medicine. He has launched an online petition to seek its removal from the constitution and the official medical system. And he wants China’s traditional-medicine practitioners to get mainstream medical training.

“From the viewpoint of science, Chinese traditional medicine has neither an empirical nor a rational foundation,” he wrote in an article that ignited a furor when it found its way onto China’s Internet. “It is a threat to biodiversity. And it often uses poisons and waste as remedies. So we have enough reasons to bid farewell to it.”

Although he has been largely vilified, he has also garnered a surprising amount of support:

The professor won a surprising amount of support on some Chinese websites. One person commented that traditional medicine needs to prove itself scientifically, or else it should be dismissed as witchcraft. Another person, a medical student, said she wished her university would stop teaching traditional medicine, which she regarded as mythology.

Chinese newspapers pointed out that China has about 270,000 traditional-medicine practitioners today, far fewer than 800,000 in the early 20th century. Meanwhile, the number of physicians trained in Western medicine has soared from 87,000 in the early 20th century to about 1.75 million today.

“If the government wants people to trust traditional medicine, it must make a greater effort to prove the reliability and scientific basis of traditional medicine,” the respected newspaper Southern Daily commented. “Otherwise, traditional medicine will keep declining every day.”

So, in China, the number of practitioners of evidence-based medicine is increasing, while the number of practitioners of TCM is decreasing. The exact opposite seems to be occurring in the U.S. Wouldn’t it be sad if, just as China is starting to subject even its most deeply respected medical traditions to the scientific method and becoming willing to discard therapies that have no scientific basis, we in the U.S. start embracing the very same unscientific therapies that the Chinese are starting to reject in favor of evidence-based medicine? Yes, I will concede that parts of the literature on alternative medicine that AMSA publishes stresses that alternative medicine should be used in addition to conventional evidence-based medicine, but it doesn’t reassure me much. I’m still having nightmares in which I picture myself old and with cancer, faced with a chipper young doctor, fresh out of residency, assuring me that I’ll be just fine if I take the recommended homeopathic medicine and go through a “detoxification” regimen.

I fear for the future of my profession. My only hope is that AMSA is not representative of the vast majority of medical students. (I suspect that this is the case.) Even so, by claiming to be advocates of evidence-based medicine on the one hand while promoting unproven and unscientific therapies such as homeopathy and reflexology on the other hand, AMSA can’t help but have a pernicious effect on the education of the current generation of medical students.

Comments

  1. #1 James Sweet
    September 7, 2010

    Playing devil’s advocate for a moment… AMSA’s constituency are the medical students themselves, right? i.e. it is the students’ interest to which they are beholden, not the students’ future patients or anyone else.

    With insurance companies increasingly willing to cover this sort of nonsense, one could almost make the argument that AMSA is serving their mission by promoting woo among medical students. After all, it could make their future practices more lucrative, eh?

    Not that I would endorse such a cynical and self-serving approach, of course. I’m just sayin’…

    One thing that always cracks me up:

    Reflexology is useful in relief of stress and tension, stimulation of relaxation

    Wait wait wait… so you are saying that getting a foot rub can be relaxing? STOP THE PRESSES!

  2. #2 Desdemona
    September 7, 2010

    I don’t have a lot of time.. but wanted to point out that “westernized” Chinese medicine is different than the “real” thing. There is a lot of biology behind it. The Chinese were doing biopsies and things long before western medicine. You can correlate the words with nerves and blood.. not magic mojo like the Westerners had with Humors and whatever.

    Of course there is a huge push for the fruity side of in the US, but don’t down the science because of a bunch of Americans wanted to feel like Asian mystics.

    That being said, I’m not saying to ignore modern medicine for it, but you can find scientific explanation behind the authentic thing and why some of it actually works. (They beat us on life expectancy back in the day by 20 or 30 years so it couldn’t be that much hocus pocus).

  3. #3 Desdemona
    September 7, 2010

    Here is a link related to my above post, it would be interesting to hear what you guys have to say on it.

    http://thehealthyskeptic.org/chinese-medicine-demystified-part-i-a-case-of-mistaken-identity

  4. #4 Scott
    September 7, 2010

    Can you expand on the point you’re trying to make? Certainly, acupuncture as understood today was effectively invented by Mao and has little to do with anything more ancient than that. Reiki is of a similarly recent provenance. The only connection “TCM” has to antiquity is to claim one in an attempt to sound good.

    So while it’s fair to say that the medicine practiced in China way back when had a certain amount of connection to real science, what’s called “TCM” today does not. And indeed has little connection to “the medicine practiced in China way back when.”

    I’ll agree that it would be unfair and inaccurate to say that the Chinese of, say, the 1st century BC had no understanding of biology and physiology, or didn’t use that understanding in medicine. But it is fair and accurate to say that they had much less understanding than we do today (hence the invalidity of the appeal to antiquity), and it’s also fair and accurate to say that today’s “TCM” is mystical BS with no scientific validity. And it’s the latter of these of which Orac speaks here.

  5. #5 Chris
    September 7, 2010

    Gah! The Healthy “Skeptic” is into functional medicine. Woo is strong with that “skeptic”!

  6. #6 Desdemona
    September 7, 2010

    I skimmed earlier and didn’t see any differentiation of the two. I still didn’t see any. I do agree that homeopathy has no science and just seems to be a really good placebo (for those whom claim it works for them).

    Anyways, I am not for completely ignoring all “natural” methods and ONLY using medicine. Which is what we seem to do a lot and with a price (like the whole antibiotic problem, they gave me a booster the last time I was suppose to take one, which I declined since I’m nursing and healed without it).

    I like “some” of Healthy Skeptic’s stuff since he does use references and doesn’t just blow steam like other foodies do. But, like with everything… I don’t just “drink the Koolaid.” I think completely discounting anything that isn’t modern could be a bad thing. Some things can be controlled with food/natural methods and they should be (ie mild forms of ADD and diabetes) and drugs should be used when natural is not possible. Why risk the side effects when you don’t have too? (getting off topic with the Chinese Medicine thing).

  7. #7 Militant Agnostic
    September 7, 2010

    For me the idiocy of TCM is best represented by a picture P.Z. Meyers had on Pharyngula. It showed a rhino that had bled to death after poachers sedated it and sawed it’s horn off. That is “real” TCM – where is the science behind that Desdemona? TCM isn’t just superstitious bullshit, it is evil superstitious bullshit. I think medical students need to see pictures like this as part of their exposure to alternative medicine.

  8. #8 Desdemona
    September 7, 2010

    I am missing the point of the Rhino image.. was he saying that is modern medicine? I haven’t heard of a TCM practitioner sedating someone and then chopping off a limb. Though I can’t claim to be an expert. I just wanted to throw out other ideas because that is what I do best :)

    BTW I like your name Militant Agnostic, though for a VERY off topic reason :)

  9. #9 Militant Agnostic
    September 7, 2010

    Ground up Rhino horn as well as bear bile and tiger paws/penises are TCM remedies that use parts of endangered species. That was my point.

    Coincidentally Christie Wilcox has a post at Observations of a Nerd on modern woo driving sharks to extinction.

    http://scienceblogs.com/observations/2010/09/ocean_of_pseudoscience_sharks.php#more

  10. #10 Desdemona
    September 7, 2010

    OH, ok, I can understand that. What about religious cultures that use similar things (ie in Voodoo and I’m sure there are others). Are we going to start denying them as well? I can say that I’m starting to lean toward the “done being nice just because they call it a religion” thing, but I like to hear what other people think.

  11. #11 Scott
    September 7, 2010

    I skimmed earlier and didn’t see any differentiation of the two.

    Not explicitly, but he was pretty clear about defining the subject and it was definitely “what is currently called TCM” as opposed to “what was practiced in China 2000 years ago.”

    Also, don’t read too much into “natural.” Normally what that really means is “untested and unregulated.” In particular, “natural” methods don’t have fewer side effects (unless they do nothing at all) and quite often have more. Herbs are a prime example. Realistically, the term “natural” is mainly useful as a BS detector. It certainly doesn’t tell you anything meaningful about how safe and effective the product/method/whatever is.

    Eating a balanced diet, getting plenty of exercise, etc. OTOH are legitimate and could theoretically be termed “natural.” But the “natural” label has nothing to do with why or how well they work.

  12. #12 LovleAnjel
    September 7, 2010

    Desdemona- @6 that’s one of the biggest, flamiest straw men. Science-based medicine is all about non-drug therapies. Where do you think all those studies on diet and exercise come from?

    I don’t know your experience, but every doctor I have had has gotten into diet & exercise with me. *Warning: anecdotal evidence follows* When I was diagnosed with irritable bowel, the first thing out of my doc’s mouth was “Eat fiber cereal and yogurt every day. And exercise at least 20 minutes most days of the week”. Drugs weren’t even mentioned until after I spent a month with Fiber One as my best friend.

    Scientific medicine doesn’t “deny” active pharmacological agents just because someone in a rural location grinds up a leaf to get them. It investigates such things to isolate, study and purify them for controlled dosing. When there is no proof that something works or solid reason to believe that it may, then people have doubts.

  13. #13 CRM-114
    September 7, 2010

    “Traditional Chinese Medicine (TCM) is an ancient method of health care ….”

    Not really. There are to my knowledge no records from ancient times, for one. Oral traditions are unreliable transmissions from generation to generation. For another, TCM is still in development: it is continually being invented by current practitioners.

    If a new endangered species turns up, that too will be sacrificed for TCM.

    The only part of TCM that is truly ancient is the part about ‘making stuff up’.

  14. #14 Desdemona
    September 7, 2010

    “flamiest straw me” do you mean The Healthy Skeptic or something else?

    By natural I don’t mean the food or supplement label by any means. And of course there are plenty of cases where you do need the chemical drug. I am talking more diet and exercise, but there don’t seem to be a lot of Dr.’s who say, “don’t eat sugar, HFCS, artificial flavors, simple carbs,” the whole list. If you have Diabetes then of course that is an exception since its hard to ignore that food relation. I’m more about healing by avoiding man made food substances (when it’s possible) than trying to use herbs as drugs. It seems hardly no one uses that, but maybe I’m just talking to the wrong Drs. Military Drs really don’t seem to use that (which is who I mostly see). My son’s father goes to a shrink and while she did tell me that diet will make a difference on his depression he says that she never said anything to him about it. My son’s first pedi told me to give him gator-aide once, as a 6 month old infant. I declined that suggestion because I had a strong no refined sugar rule with him at that age (he does get some now).

    I think Dr.’s are all over the spectrum, my son’s current Pedi says she uses meds as last resort, which is why he see’s her now.

  15. #15 Calli Arcale
    September 7, 2010

    Desdemona @ 10:

    OH, ok, I can understand that. What about religious cultures that use similar things (ie in Voodoo and I’m sure there are others). Are we going to start denying them as well?

    If they’re killing endangered species, hell yes. (Note: some groups have been permitted strictly limited use of endangered species, e.g. certain Native American tribes being permitted to gather fallen eagle feathers for their ceremonies, or certain subsistence Inuit groups permitted to take a limited number of whales, but all were required to obtain permission.)

    But that’s a red herring. We’re not talking about religion or culture here. We’re talking about *medicine*. TCM does not represent itself as a religion, and it is not using rhino horn for any sort of spiritual purpose. It’s selling it for medicinal purposes. So here we have a substance which is not only ineffective for what they’re claiming (it will not treat impotence, except possibly by boosting confidence — the placebo effect) but is actively harmful for the biodiversity of this planet. A whole species may go extinct because people sell it as a cure.

    Contrast this with so-called mainstream medicine. When Taxol was discovered, they didn’t strip forests of Pacific Yew. They worked out a different way of getting the substance. Driving a species into extinction isn’t wise even for something that actually does work. After all, even if you ignore the environmental plea, what will you do when that species is gone and you have no other source for the drug?

  16. #16 jay.sweet
    September 7, 2010

    I don’t think Desdemona’s lamentation of mainstream medicine’s preference for drug-based solutions deserves a “flamiest strawman” characterization :) In fact, I think you’ll find that most people working within mainstream medicine admit this is a problem!

    It’s just that it’s a complex problem that isn’t solved by just saying, “Let’s all prescribe less drugs.” For one thing, patient compliance is a big issue. Every doctor I’ve had has told me to get an exercise regiment going, but I’ve never done it, for example. If there were a pill they could give me that would have similarly beneficial effects as thrice-weekly exercise, though with a small risk of side-effects, it might well make sense to prescribe it — even though in theory I just need to get off my lazy ass and go to the gym, which could potentially be both cheaper and safer.

    Also one needs to factor in recent data showing that doctors are influenced by pharma advertising and gifts and such, even if they think they aren’t. Docs are human too, after all.

    Mainstream medicine is “working on it”, and there have been some improvements. We could improve faster by imposing more restrictions on how pharmaceutical companies can market their product.

    But hell, Orac has written in the past about how frustrating it is that woo is able to appropriate diet and exercise as somehow being “alternative” medicine, even though it ain’t… just because mainstream medicine has been remiss in emphasizing non-interventive solutions to a sufficient degree does not mean that they stop being part of science-based medicine!

    That all out of the way, I’m still confused about what Desdemona was talking about at #2 up there. Besides eating well and exercising more, what “natural” therapies are you referring to exactly? Herbal therapies can work (though most on the market don’t) but Scott eloquently addresses the problems with this at #11. Yoga, etc., are legitimate means of getting exercise, but there’s no magic to it. What exactly are you referring to???

  17. #17 Pablo
    September 7, 2010

    there don’t seem to be a lot of Dr.’s who say, “don’t eat sugar, HFCS, artificial flavors, simple carbs,”

    Really? Man, I must be hearing/talking to the only ones then, because I hear that all the time from doctors.

    Then again, I actually listen to a lot of doctor talk (on doctor radio (sirius and xm)), so get to hear doctors give out general recommendations. And proper nutrition is among the things they harp on – to the point where I get tired of it.

    Similarly, my doctor talks about eating right all the time when I go to see him.

  18. #18 Calli Arcale
    September 7, 2010

    My insurance company’s on the bandwagon now; they have a program where a nurse calls me to discuss my chronic conditions, and mostly they ask about exercise and diet. They also make sure I’m taking time for myself and not letting myself get too stressed out. Whoa! Big mainstream medical corporation that isn’t pushing drugs! Stop the presses!

  19. #19 Pablo
    September 7, 2010

    But hell, Orac has written in the past about how frustrating it is that woo is able to appropriate diet and exercise as somehow being “alternative” medicine, even though it ain’t..

    Shoot, it almost seems the case that the wooeys are as or more likely to say, “Here, take these pills.” They just couch them as “supplements.” All we need to do is to take fish oil, niacin, flaxseed, etc, etc, etc.

    Doesn’t Jenny McCarthy give her kid something like 50 pills a day? Or was that Suzanne Sommers who does that?

    Go to the “supplement” section of your pharmacy and look at the shelves, filled with bottles.

  20. #20 Scott
    September 7, 2010

    there don’t seem to be a lot of Dr.’s who say, “don’t eat sugar, HFCS, artificial flavors, simple carbs,” the whole list.

    None of these can be justified as a blanket ban. Indeed, if you tried then you couldn’t eat, well, virtually anything. Certainly no fruits or vegetables (which all contain sugars, which are simple carbohydrates, and indistinguishable from what’s in HFCS).

    Whether or not something is a “man made food substance” is really quite irrelevant to anything. If something can be shown to be bad, then it’s bad regardless of “natural” or “man made”. If it’s good, then it’s good regardless. A simpleminded division into “natural=good, manmade=bad” is quite counterproductive.

  21. #21 Scott
    September 7, 2010

    And while we’ve gotten off on a diet tangent anyway…

    The really important problem with respect to modern diets is not “natural” vs. “artificial.” It’s that our instincts about food evolved to deal with conditions of scarcity, and hence don’t work well with conditions of plenty. “Eat as much fat and sugar as you can lay your hands on” is a good plan when calories are scarce and storing up some extra may be the difference that allows you to survive the winter. When they’re as easy to obtain as oxygen, that same instinct leads to obesity, heart disease, diabetes, etc.

    So eating healthy today calls for going against our instincts. Hard to call that “natural.”

  22. #22 Bronze Dog
    September 7, 2010

    Go to the “supplement” section of your pharmacy and look at the shelves, filled with bottles.

    And note how many have the “Quack Miranda Warning” about how the claims haven’t been evaluated by the FDA or how they really don’t mean to say it does anything. At least not on the bottle itself.

    Good old sloth combined with wishful thinking is the reason for the idea that you can just pill pop your way to health. Big Placebo, however, is extraordinarily interested in marketing the idea, since it’s easier to fill a plastic bottle with useless mulch than give someone a personal trainer. But if the pills don’t do the job, they can still blame the customer for not exercising instead of, you know, showing that their pills actually do anything.

    The pharmaceutical companies have to jump through far more extensive hoops to put their pills in bottles. (Unless, of course, they let one of their subsidiaries label those pills as “supplements.”) And they run the risk of lawsuits and recalls if their pills don’t perform as well as their tests show. Good doctors, after all, try to keep tabs on what they prescribe to their patients as well as how it affects them.

    I’m very much in favor of removing the double standard: Supplements should be tested and regulated just like the rest of the stuff.

  23. #23 LovleAnjel
    September 7, 2010

    “I’m more about healing by avoiding man made food substances (when it’s possible) than trying to use herbs as drugs.”

    Confused – are those substances making you ill? Of course you should stop taking them. I don’t think any doctor would disagree. Are you sick with something not linked to nutrition? Probably not going to help you then. Diabetics shouldn’t eat much sugar, but I have a hard time seeing the distinction between “man-made” sugar and “natural” sugar– saccharides are saccharides. And many diabetics could not cure themselves with diet and exercise anyway.

    At what point does something become “man-made”? Is my steak man-made because the meat was butchered and cooked? Is my pesto man-made because I processed the basil and garlic with olive oil? Is my milk man-made because it’s been pasteurized and de-fatted? Is honey man-made because it is removed from the hive and processed to remove wax and dead bees? Is maple syrup man-made because it has been removed from the plant and concentrated? Is corn syrup man-made because it has been removed from the plant and concentrated? Where do you draw the line?

  24. #24 Desdemona
    September 7, 2010

    The two “natural” remedies I can think of are both for stomach or allergy issues and I’ve heard people who would swear by them. There is the GAPS diet for stomach problems. Basically give your stomach a very basic/easy to digest food and slowly introduce in more difficult foods. They use bone broth for the start and add in cooked vegies and go from there. A lot of people swear its cleared up allergies, etc. The most recent one I heard of was using raw milk to do the same, but while GAPS usually takes a month+ (because of the slow introduction of new foods) the milk diet only takes 10 days. My aunt knows a guy who did the raw milk bit. Since I’ve read a LOT about breast milk I can believe the raw milk one because raw human milk does the same thing to infants (per studies).

    While you can argue on the safety of raw milk you can also argue the safety of popping pills on a daily basis for the rest of your life. If a food fix didn’t work (and it wasn’t a emergency case of course) you could always go to the medicine. Again, I’m not saying this is for EVERY ailment.

  25. #25 Bronze Dog
    September 7, 2010

    Good way to put it, Anjel. I’ve had to make similar points in regard to quantum nonsense: Humans are not separate from nature.

    When a human manufactures a molecule of a chemical, it’s exactly the same as if a plant or animal manufactured it. It’s the properties of the chemical, not its origin that determines how it’ll affect our bodies.

    Humans just happen to be very good at manufacturing yummy molecules and very bad at moderating their intake. You need fat and protein in your diet, but think twice before eating another triple bacon cheeseburger.

    For the quantum nonsense, we’re made out of the same particles as the ones we’re experimenting with. To observe something requires that you interact with it. You can’t just draw a line between experiment and experimenter and demand that the universe care about the distinction.

  26. #26 Desdemona
    September 7, 2010

    There are chemicals put in your food as additives, there is even a global additive industry that is worth 23 Billion dollars (just read that a couple of days ago). If it’s completely chemical in substance (food colorings fall into that category)then of course it is 100% in that category.

    There are some things that are borderline, they start out as unaltered foods.. ie sugar cane, etc but are processed extensively, heated, bleached, etc and by the end usually have little to no nutritional value. At least a fruit has nutrients, white table sugar does not. I don’t buy it and avoid most things that sell it (I do indulge at times, not a total purist, I believe in balance not stress).

    The best foods, plants from the ground, animals that are not processed, grains that are not bleached and turned into empty calories.

  27. #27 Chris
    September 7, 2010

    Actually, there is a possibility that drinking raw milk can lead to popping pills every day of your life. Sometimes E-coli infections can lead to permanent organ damage.

    When I read Desdemona say “I am missing the point of the Rhino image.. was he saying that is modern medicine?”, I definitely knew she does not have a clue to what goes into TCM. But then she may not actually read about the psychiatrist from Japan charged with poaching bears in the Pacific Northwest (quote from paper: “Convinced Shigemura was attempting to smuggle bear gallbladder — a prized aphrodisiac sold at premium prices”).

  28. #28 Desdemona
    September 7, 2010

    No, I haven’t read that particular article. My original post was to say that not ALL of it is completely BS. Not that it’s ALL good. At least one person read that in my post.

    I’ve read the raw vs. not raw debate and decided that I would simply pick my dairy wisely and enjoy my raw milk. I don’t like the taste of pasteurized milk unless it’s skim.. the fat is what seems to change taste wise. Cooking kills nutrients, there are plenty of articles that will say that and you are cooking at a high rate of heat. Why eat half a food when you can eat the whole food? It’s about keeping the dairy sanitized.

  29. #29 RevolutionWillNotBeTelevised
    September 7, 2010

    I know this is off topic for this article, but I want to say thank you to someone who posted a link to this site over at CrooksAndLiars for allowing me to find this place.

    Todays current fiasco over there has devolved into a ‘Genetically Modified Food is the Devil!’ and I find it hard to be keep reading that site anymore.

    So to that poster(I forget your name),

    Thank You

  30. #30 Desdemona
    September 7, 2010

    I should probably add (since I plan on frequent this blog a lot, though will probably lurk more so than post.. we will see.. I do have a hard time keeping my fingers “quite sometimes) that I have read a lot of the less main stream “health” thoughts in the last year or so, the super “crunchy” organic, nothing processed, and even some paleo vs vegan stuff. I don’t follow it all, but after reading some of the crazy anti-vac stuff I decided I needed to get back to reading the other side on more than just the vac issue. So, most of my posts are testing past theories I’ve read, not really me saying, “this is how it is,” though I know I have a bad habit of coming across that way. But, it is the easiest way to get people to challenge your way of thinking (which I do really enjoy).

    So, I am enjoying this blog and it’s comments very much.

  31. #31 Chris
    September 7, 2010

    “Cooking kills nutrients”, while that is sometimes true. It can also release nutrients. You should avoid generalizing, and learn to balance the risks. A book suggestion: Catching Fire.

  32. #32 Desdemona
    September 7, 2010

    If I stopped drinking raw milk then I’d have to stop eating hamburger, raw spinach, tomatoes, and the many other foods that have been recalled. I also gladly eat large amounts of sushi which is, raw fish, and could have parasites. Risks I’m more than happy to take.

    I have never heard of pasteurizing as releasing nutrients in milk. I don’t eat EVERYTHING raw.

  33. #33 AnthonyK
    September 7, 2010

    Look Desdemona – eat what you like, and enjoy it, but mmost of the so-called health benefits of “raw” foods don’t really exist. I mean I don’t eat food with loads of artificial additives because I prefer to make it myself and I don’t like the taste of highly processed food, but I wouldn’t say there are any real health benefits in it.
    TCM’s different though – it makes magical claims, resists then fails proper testing, and is very deliterious to the natural remedies (e.g rhino horn/tiger penis for virility) and, of course, it simply doesn’t work.
    Viagara does though – “2000 years” and more of all stripes of traditional medicine and modern medicine cracks it. The holy grail of woo: we made it.
    See, that’s the difference. Medicine works; magic doesn’t.

  34. #34 Chris
    September 7, 2010

    “I have never heard of pasteurizing as releasing nutrients in milk.”

    Where did I say that?

    (by the way, my stepmother spent the most grueling summer of her life when she was fifteen after getting brucellosis, she also spent the rest of her life with kidney issues — all from raw milk, sure drink it yourself, but never give it to children)

  35. #35 LovleAnjel
    September 7, 2010

    Desdemona – If a batch of food is recalled for health concerns, I strongly suggest you get your money back and go buy a different brand. Just because some spinach was recalled doesn’t mean it’s all bad. Just the recalled stuff. Cooking kills deadly bacteria. Cook your burgers & enjoy them thoroughly (I LOVE raw meat, so don’t get me wrong, I eat it whenever I can).

    I went 25 years eating raw cookie dough without ever getting sick. Then, I got Salmonella. BAD Salmonella. Nothing is worth the pain and agony I went through. I hope you never have to experience something like that, but consuming unpasteurized/uncooked animal products increases the likelihood a lot. Good luck.

  36. #36 jenbphillips
    September 7, 2010

    Re: the boogeyman of HFCS, I found Jim Laidler’s recent SBM post most enlightening:
    http://www.sciencebasedmedicine.org/?p=6501

  37. #37 Militant Agnostic
    September 7, 2010

    A lot of the spinach that was recalled was “organic”.

  38. #38 Fuzzzone
    September 7, 2010

    “It’s about keeping the dairy sanitized.”

    As someone with some experience in dairies and ranches, I don’t for a moment imagine that the suggestion above is easily feasible. You may as well tell a farmer to keep his soil sanitized. There are simply too many possible vectors in a dairy. Obviously you clean and sterilize the milking equipment and lines and tanks etc, you can wipe down the teat pre-milking, but there’s no way you’re going to get everything. Cows are dirty.

  39. #39 Chris
    September 7, 2010

    “It’s about keeping the dairy sanitized.”

    Ooooh, I read to fast and missed this gem. Obviously written by someone who has never been to a dairy. Though the trip we did with preschoolers was truly fun, with one kid who kept wanting to investigate the manure pit. Then there was a trip to the Oregon coast, Tillamook is a very aromatic town (yes, it does use local dairies, lots of local dairies!).

    The dairy of the preschool visit worked very hard to keep everything clean and sanitized, and even still the final product was pasteurized.

  40. #40 Calli Arcale
    September 7, 2010

    Militant Agnostic — but not all of it, IIRC. The trouble with spinach (and other foods typically served raw) is that it’s grown outside. Of course. And there are birds outside, and birds poop. Sooner or later, a bird infected with salmonella is gonna poop on some spinach (or other fruit or vegetable) close enough to harvest that it will make it into the food supply. It’s inevitable.

    The main advantage of buying from small local farmers isn’t organic produce. It’s outbreak containment. Produce bought at a farmer’s market generally hasn’t had a chance to contaminate anything else yet (or, conversely, *be* contaminated), but stuff from the big commercial farms is often shipped to a processing facility where there is the opportunity for cross-contamination. Unless we start irradiating our food, I’m not sure that’s really a solvable problem; it’s not practical to get *all* of our food from small farms, after all, and directly from the grower. Especially for those of us in northern states.

    Regarding raw milk tasting better . . .

    This is, of course, entirely subjective. There are no appreciable nutritional differences, and the immunological benefits of raw cow’s milk really only apply if you happen to be a calf. (I got edjumacated about that over at Science Based Medicine, where someone was explaining the differences in human and calf gut biology. It was fascinating, but the short version is that cow immunoglobulins do not survive the human digestive process, and essentially serve no more purpose to humans than a source of protein.) However, the flavor differences are significant. Be careful what you ascribe to pasteurization, though; homogenization also affects the flavor (and mainly the texture), and most raw milk is not homogenized.

    One commenter over at SBM said that he/she doesn’t not like American pasteurized milk but LOVES European pasteurized milk. It’s a different method, and while it’s just as good at killing harmful bacteria, it preserves the fat consistency and thus it ends up tasting almost identical to raw milk. You might want to look into that, Desdemona.

  41. #41 James Sweet
    September 8, 2010

    I was going to echo what Calli Arcale said about raw milk. Let’s get it out of the way: There are absolutely no health benefits to raw milk, not even minor nutritional benefits, and there are significant health risks.

    That said, if you are an adult and you prefer the taste and understand the risks, hey, go for it. We all do at least SOME dangerous stuff that we happen to enjoy, right? Or does nobody here go skiing?

    I had not thought to mention it, but Calli is also right about the homogenization affecting the taste. We found a place at a local farmer’s market that sells pasteurized-but-not-homogenized milk. It’s confusing though because they market it as “Cream on top” instead of as homogenized, and in fact I didn’t even realize it wasn’t homogenized until I got it home and looked at it, and then I could tell visually.

    The non-homogenized whole milk is too much for us (too much cream on top!), but the 2% is friggin’ delicious. We love it. And since it’s pasteurized I can give it to my son with a clear conscience.

  42. #42 Pablo
    September 8, 2010

    My problem with “raw milk” is not so much the health risks, which are true and all, but more the fact that people buying raw milk are getting ripped off!

    There’s no reason anyone should be paying more than store-price-for-non-raw-milk for raw milk. You should pay the farmer more than dairy price, but you should also get it for cheap, too. Everyone comes out ahead.

    Farmers that are charging $5, $8, $10 or even $15 a gallon for raw milk are laughing at the people buying it for being suckers. Let’s see, I can sell my milk to the dairy for less than $1 a gallon, or I can call it “raw milk” and sell it to suckers for $10…hmmm, what to do, what to do? Oh I know! I will sing the praises of raw milk!

    Now all I need to do is to get the government to outlaw it for me so I can charge blackmarket prices, and I got it made…

    Given the health risks, you should be paying the premium for having safe milk. Raw milk is in large supply (sans government restrictions) and very little demand. The rest of the cost is marketing (and blackmarket, where appropriate)

  43. #43 momkat
    September 8, 2010

    I also highly recommend Dr. Laidler’s post at Science-based Medicine, referenced above at #36. It greatly helped me sort the sugar thing out. Desdemona, if you haven’t visited that site, you should give it a look. Orac’s “friend” also posts there from time to time.

  44. #44 Bob Ellal
    September 8, 2010

    Employing the mind/body connection–in the form of qigong, Chinese mind/body exercises–helped me immensely in my successful battles with four bouts of supposedly terminal bone lymphoma cancer in the early nineties. I used it as an adjunct to chemotherapy, which is how it should always be used.

    Qigong kept me strong in many ways: it calmed my mind–taking me out of the fight-or-flight syndrome, which pumps adrenal hormones into the system that could interfere with healing. The deep abdominal breathing pumped my lymphatic system—a vital component of the immune system. In addition, qigong energized and strengthened my body at a time when I couldn’t do Western exercise such as weight-lifting or jogging–the chemo was too fatiguing. And it empowered my will and reinforced it every day with regular practice.

    I’m not saying it destroyed the lymphoma–the chemo did that. And “vitalism?” All I can say is that after several years of practice I felt electrical occurrences in my body that I cannot explain.

    One oncologist dismissed it as a placebo. I replied: “So I’m not really alive–I just think I’m alive?” My oncologist rolled her eyes when I told her about it. But when she saw I was strong after the high-dose chemo of my second bone marrow transplant she told me to “keep doing it,” as she and other oncologists couldn’t explain why I was still alive. Clear 14 years and still practicing.

    Bob Ellal

  45. #45 Scott
    September 8, 2010

    There are chemicals put in your food as additives, there is even a global additive industry that is worth 23 Billion dollars (just read that a couple of days ago). If it’s completely chemical in substance (food colorings fall into that category)then of course it is 100% in that category.

    A carrot just pulled out of the ground is “completely chemical in nature.” Water is “completely chemical in nature.” AIR is “completely chemical in nature.” Oxygen, nitrogen, cellulose, vitamin A, etc. are all chemicals.

    In other words, you have entirely failed to make any distinction at all here – much less a meaningful or useful distinction.

    I’m definitely getting the impression that you’ve drunk deeply of the “natural products” Kool-aid. Trying to draw a line between “natural” and “artificial” is meaningless and counterproductive. Bronze Dog, I think, put it the best of anyone in this discussion:

    When a human manufactures a molecule of a chemical, it’s exactly the same as if a plant or animal manufactured it. It’s the properties of the chemical, not its origin that determines how it’ll affect our bodies.

    If only I were so eloquent.

  46. #46 Desdemona
    September 8, 2010

    I do think there is a difference between raw and not raw. People with a mild lactose intolerance can drink raw, but not pasteurized. Do you think a person could go on a store bought milk diet and heal allergies? There is more to food than just it’s nutritional value. People have cleared up alleriges, stomach ailments, basically gut related things by drinking/eating probiodic, fermented, basically things with good bacterias in it. I know to many people who have seen results to believe it’s all fake. Maybe its really good placebo, but it’s a placebo that works then.

    I live in Cali so it’s a lot easier to access here (I wouldn’t do the black market thing, don’t care about it THAT much. I would just not drink a lot of milk) and the demand is higher since there are more “fringe” group health nuts here. I can tell the difference when I travel outside the state. There are health food stores everywhere here, hard to find in some locals.

    I have a hard time finding non-homogenized milk that is pasteurized (I have looked, though not with great effort) so I don’t know which process is changing the flavor. I have no clue where I’d find “European” processed milk and there is no way I’d try to ship it.

  47. #47 Pablo
    September 8, 2010

    People with a mild lactose intolerance can drink raw, but not pasteurized.

    Does raw milk not have lactose in it?

    Do you think a person could go on a store bought milk diet and heal allergies?

    No, but then I don’t know of any evidence that says they can do it with raw milk either. Perhaps you can enlighten me?

    (not assertions, but evidence, please)

  48. #48 LovleAnjel
    September 8, 2010

    “Do you think a person could go on a store bought milk diet and heal allergies?”

    If they are not allergic to milk and use an evidence-based method like slowly increasing exposure over time, yes. My friend is getting her three kids through some of their allergies at a specialized hospital clinic, no raw milk involved.

  49. #49 LovleAnjel
    September 8, 2010

    BTW, lactose intolerance is not an allergy. Intolerances happen because your body cannot digest a food. They make you feel sick. Allergies happen when your body mistakes food for an invading organism and mobilizes the immune system to destroy it. They can kill you in minutes.

  50. #50 James Sweet
    September 8, 2010

    It’s conceivable that raw milk could have a probiotic effect similar to yogurt, but… if that’s your goal, why not just eat yogurt, which is safe?

    Like I say, I don’t have a problem with an informed adult choosing to drink raw milk for the taste, but I really think you’re fooling yourself if you think there is a health benefit. There is zero evidence for that, y’know?

  51. #51 Chris
    September 8, 2010

    “People with a mild lactose intolerance can drink raw, but not pasteurized.”

    Absolutely false. Lactase does not magically appear in the stomach of a lactose intolerant person just because the milk is raw. They can consume some dairy products after being processed by rennet (turned into cheese).

    My sister is very lactose intolerant. She cannot even have a latte, but she can have a little bit of cheese. She was born two months premature (in the early 1960s, one of the few to survive without injury or blindness), and never even developed lactase, so she could not even have breastmilk.

    You continue to reveal that you really don’t what you are talking about.

    Bob Ellal, nice story. You still had chemo, the exercises made you feel better. Period. That is not magic.

  52. #52 Desdemona
    September 8, 2010

    Just read that the Standford Univ. is doing a study to see if lactose intolerant people can drink raw milk. It’s in the works right now though, so no results yet.

    There are humans who are lactose intolerant, ie they drink pasteurized milk and they get bloated, break out, etc.. but they don’t have that problem if they drink raw. They see the results on themselves. I’m sure you would not be able to convince them that it’s all hog wash. The allergy healing (food allergies, not milk allergies, ie fruit was one) was from my aunt’s friend. She tried raw milk the last time she visited after he told her his personal story. He drank raw milk for 10 days straight and consumed nothing else.

    You can still get e coli and such from pasteurized milk, though from the reading I did earlier (at work so its very intermittent) the outbreaks are a lot less. There is no 100% guarantee though. I checked out Ohio’s list of recalls, just out of curiosity and there was other fresh foods, alfalfa sprouts, obviously the recent egg thing, but most of the recalls were from manufactured products, which is of course how pasteurized milk usually gets contaminated… in the bottling or whatever after the pasteurization.

    Raw milk is more risky, I will not argue against that. I by no means think that nutritional science is perfect (it’s too new and for almost every pro article you can find a con) BUT I will agree that the raw milk thing is most based on “personal story” evidence (forgot the right word, sorry). There is one study for the allergy thing which was done in Great Britain (I really hope I am remember the right country) but they did say at the end that they don’t know if it was the raw milk itself that helped or the fact that the kids lived on farms and didn’t live in a very sterile environment.

    Part of the reason why I like my milk is because it’s simi-local (read the environmental impact of a typical grocery store visit, and yes I shop at farmer’s markets a lot). BUT, I do have access to another simi-local farm who does pasteurize. So, I am thinking about doing my own self experiment… I will switch and see if my stomach notices a difference.

  53. #53 Chris
    September 8, 2010

    Lots of claim, and yet not one shred of evidence.

  54. #54 Pablo
    September 8, 2010

    Hey, she’s HEARD about it.

  55. #55 Desdemona
    September 8, 2010

    So, do some of you believe that there are zero bad chemicals put into foods? I will look up and list studies that show otherwise. There is at least one (I think more though) food dye that causes behavior changes in kids (yes, based on a actual study) and if my memory serves me right it’s one of the Yellows. There are food additives that are allowed in the US that are banned in other countries because they have been deemed unsafe. Pepsi and Coke don’t even use the same soda formula in some of their imported products because HFCS is seen as a major problem by countries in England and their product wouldn’t sell if they did. So, they use sugar instead.

    I will add links if you want when lunch comes and I can “legally” be on here (bad employee I am sometimes).

  56. #56 Pablo
    September 8, 2010

    “So, do some of you believe that there are zero bad chemicals put into foods?”

    I don’t know what this means, on the whole.

    I do know that pasteurization doesn’t.

    (pasteurization doesn’t involve putting ANY chemicals in foods)

  57. #57 Todd W.
    September 8, 2010

    @Desdemona

    The problem that people are having with your posts is that you are arguing by assertion. The only things that you offer as evidence are anecdotes and hearsay, which are very poor quality and subject to many forms of bias.

    If you make a somewhat unusual claim (e.g., drinking raw milk can cure allergies), then you need to provide scientific evidence to support the claim. The reason for this is that scientific studies generally try their hardest to protect against the sorts of biases that make anecdotes and hearsay unreliable.

  58. #58 Vicki
    September 8, 2010

    Desdemona–

    There are chemicals in foods that are bad for certain people. They aren’t necessarily put there on purpose or by humans. For example, there are chemicals in peanuts and shrimp that can cause anaphylactic shock in certain people. Those are entirely natural. So is whatever it is in mushrooms that makes my husband sick.

    The link you’re trying to draw is arbitrary at best. Yes, I know someone whose daughter is sensitive to an artificial red dye. Is cochineal better? For her, maybe. For some people, it runs into religious or ethical restrictions, and there are probably people who are actually sensitive to that beetle extract.

    Nicotine is natural. Acetylsalicylic acid is artificial.

    Evaporated sugar cane juice is an “all natural sweetener.”

  59. #59 Calli Arcale
    September 8, 2010

    I read the study about food coloring causing behavioral changes; it was interesting, but not convincing. It would need to be replicated and show more impressive numbers before I can be sure they’re not just seeing an artifact. (It does happen.)

    Desdemona, there are actually more reasons why sugar is used than HFSC. Money is a major one; in the US, corn is heavily subsidized, and as we do not produce enough sugarcane to satisfy our cane sugar demand, we have to import it, and the imported stuff is taxed. That’s not true in other countries, especially those which produce their own sugarcane. In Europe, in fact, cane sugar and beet sugar are cheaper than corn syrup, which is the real reason the beverage manufacturers use them.

    You talk of a study to find out whether raw milk would be safe for the lactose intolerant. I have to wonder why any IRB would approve such a study; it seems highly unethical, since the established science suggests that raw milk will be just as bad for the lactose intolerant as pasteurized milk. After all, both contain lactose. Some website claim that raw milk contains bacteria which break the lactose down, but this seems unlikely to me; after all, if that were the case, you wouldn’t need rennet to make cheese.

    Allergies and intolerances are different things. You talk of people getting rashes, but that doesn’t happen from lactose intolerance. There are genuine dairy allergies, the most notable being allergy to bovine casein. As another poster mentioned, these tend to be more dangerous than lactose intolerance. Raw milk is no protection; the offending proteins are present both before and after cooking the milk. There are ways to desensitize the immune system to a protein, but they are not always effective and must be attempted cautiously.

  60. #60 Scott
    September 8, 2010

    So, do some of you believe that there are zero bad chemicals put into foods?

    Speaking for myself, I certainly believe that there are chemicals which should not be in food. What I do NOT believe is that an arbitrary division into “natural=good, artificial=bad” has any value whatsoever in determining which chemicals are beneficial, neutral, or harmful.

  61. #61 Calli Arcale
    September 8, 2010

    Vicki: yes, there are people allergic to cochineal, which is part of the reason there has been a push to compel manufacturers to list it as something other than just “natural coloring”. (Cochineal is kind of an interesting dye with a history going at least as far back as the Aztecs. It very much impressed the Spaniards.) Interesting your husband gets sick from mushrooms — so does mine!

  62. #62 Chris
    September 8, 2010

    Oh, oh, Desdemona! The vast ignorance you are showing in what compromises food, and how it is made to be eaten keeps growing.

    So what exactly are “bad chemicals”? What is the traditional method for making nutrients more available in blue corn? How are cassava roots processed to make tapioca, and why? Why will you never find raw cashew nuts in the store?

    How are toxins created by bacteria not “bad chemicals” when it comes to raw milk?

  63. #63 Desdemona
    September 8, 2010

    http://news.bbc.co.uk/2/hi/health/2984519.stm

    http://www.thelancet.com/journals/lancet/article/PIIS0140673607613063/abstract

    http://www.physorg.com/news155189152.html

    http://www.sixwise.com/newsletters/05/10/19/all-the-health-risks-of-processed-foods—-in-just-a-few-quick-convenient-bites.htm

    Those are the articles I have right now. I don’t know how a 85% positive rate is not convincing. Though the biggest problem with that study is that it was a cocktail and not a single ingredient. Maybe the rules for nutritional science are different than psychology, but in psychology if you have a 85% return on a study it is very significant.

    One of those articles is only with two kids, so not real solid in the scientific arena, but I could say if I was that mom I would alter the diet of the twin eating processed food. I noticed a significant change in my son when I changed our diet.. cut out most simple carbs/white sugars and went more basic (ie meat, veges, fruits). I also went less carb (not the faddy low carb) and more protein. I ate a really high carb diet though, prior too. His growth changed back to what it was when he only nursed and his mental/physical development picked up quite a bit. It may have just been a coincidence, but I sure as hell don’t plan on going back to the old diet.

    If I don’t directly mention raw milk then I’m not talking about it, so please don’t refer my non raw milk back to raw milk. I do change subjects sometimes.

    Since there is no health benefit to food additives I will continue to avoid them as a main staple in our diet. We do enjoy treats on occasion (like once every month type of occasion) but there is by no means any reason for me to consume them in large quantities.

  64. #64 New Med Student
    September 8, 2010

    You mention that our med schools may not be doing enough to teach us that some of these things can’t work after your example about homeopathy. Actually, as a new student (at a school you may be familiar with), I have lately been a little bit surprised and kind of disappointed. Not only are we not being encouraged to be skeptical, we are actually being taught that some of these things are valid medical treatments. We had a lecture this morning on CAM, which included comments on TT, acupuncture, chiropracty, but ran out of time to adequately inform us about hypnosis, homeopathy, and a long list other CAM therapies (including oh-so-many energy therapies). Only once did the presenter suggest that something might not work, saying that people just weren’t taking the herb in an effective way, and that if they simply took it as directed it could make a cold clear up in 7-10 days. The student groups are not far behind, though; there was an AIDS denialism movie shown by the HuMed group last week, and several members of the group told me about their experiences shadowing CAM professionals that dealt with people’s chakras.

    I’m not sure it’s a lack of basic science that’s to blame. Several of my fellow students don’t understand why I feel that our professors should at least be critical of these ideas. If it works, it works, but if there is no evidence, then that should at least be acknowledged when they present this to us. Instead, they are being introduced without any challenge or question. What do we gain from not being told that some of these ideas under scrutiny and remain unproven?

    Hopefully the segments on evidence-based medicine will help to clear things up, but I haven’t gotten the impression from my fellow students that it gets stressed very much.

  65. #65 LovleAnjel
    September 8, 2010

    Desdemona, it looks to me like you are very interested in learning about the science behind food and diet and it’s effects on people, but you are just beginning to learn about what constitutes acceptable scientific evidence and why. I think that is why some of the other posters are reacting the way they are to your posts – you’re not quite sure how to support your assertions in this particular arena.

    Some basic rules that may help you out:

    1. Anecdotal evidence is unacceptable. This is where statements about your aunt or your son or a friend of a friend fall. It’s a lone case with unknown, uncontrolled variables, so no one could actually tell what was causing the change you say there was.

    2. Case studies in the literature are not much better. This is where the article about the twins fall. Again, only a couple of subjects were involved. They can be great starting points for future studies, but do not constitute good evidence in and of themselves.

    3. Reliable studies need a high number of participants. There are mathematical ways of determining if an observed effect was real or chance, and in general they require a minimum of 20 subjects in each group. Below that number, there isn’t enough information to draw a conclusion.

    4. Reliable studies use a control. If one group of children gets a sugary drink, another group exactly like the first gets a non-sugary drink that is otherwise exactly like the other– color, taste, mouthfeel, temperature, setting, cups, people present, everything. This isolates the sugar as the variable being tested and removes other possible variables. If anything, even seemingly insignificant, differs between the groups, you can’t draw a conclusion (for example, in the old Pepsi vs. Coke taste tests, people tended to choose the cup labeled “O” instead of the one labeled “N”, regardless of what soda it contained).

    5. Reliable studies are double-blind. This means neither the subject nor researcher knows which group anyone is in. So neither the children, parents, nor researcher observing their behavior know which of the drinks the kids have. This is because expectations blur our observations. If you tell someone that sugar makes kid hyper and here’s a sugary drink, they will see hyperactive behavior, even if the drink had no sugar in it (there is a study and I don’t have the link **slaps own wrist**).

    Hopefully this will help you to sort through some of the articles you are reading.

  66. #66 LovleAnjel
    September 8, 2010

    “…if they simply took it as directed it could make a cold clear up in 7-10 days…”

    ROFLMAO Seriously? This is being taught in a med school class? Well, yes, and if you rub Gruyere on your feet twice a day and spin counterclockwise whilst whistling the Star Spangled Banner on the 12th hour after sunset, your cold should clear up in 7-10 days as well. Because that’s about how long it takes a cold to run it’s course.

    Are any other faculty sitting in on any of these lectures? That’s f-ing shameful. Tell me what school this is so I can tell my undergrads not to apply there.

  67. #67 Bronze Dog
    September 8, 2010

    A bit of expansion on Anjel’s post:

    1. Anecdotal evidence is unacceptable. This is where statements about your aunt or your son or a friend of a friend fall. It’s a lone case with unknown, uncontrolled variables, so no one could actually tell what was causing the change you say there was.

    The “unknown, uncontrolled variables” are what causes the uncertainty. The world is a messy place, and the human body is more complex than a toaster. If I ate X and got sick, I wouldn’t automatically assume X caused it. I could have gotten a germ from someone else. I could have scraped an infected surface. Some part of my body might have malfunctioned in some way or another. Any of those could have coincidentally occurred at the same time. When the world has billions of people on it, coincidences will happen.

    That’s why scientists use large groups of people in clinical trials: Any effect that happens could be the result of an external factor that was missed. With lots of people and methods to prevent known alternative causes, it gets less and less likely something else could cause the effects in question.

    Our perception of causality is inherently flawed, and to me, the excess use of anecdotes is a big red warning sign that says, “Danger: I think that I am an infallible, omniscient god.”

    Science is based on the idea that humans are flawed, knows a lot about what sorts of flaws we have, and gives us a guide on how to avoid making mistakes because of our flaws. Science is about people double-checking themselves and each other. The “authority” is in the rigorous error checking, not in the person.

    The alternative medicine gurus don’t like that message: They want to believe that they have some magical super sense for causation and thus they don’t need to double check their ideas against reality. It works in their heads because it works in their heads. If it ends up failing, they can just rely on their post-rationalization flaws to come up with an excuse, rather than bruise their ego by wondering if they might have been wrong.

    And corrupt businessmen like that arrogance: It’s a “go-getter attitude” that pushes the product right past all the safety and efficacy tests us cautiously optimistic people want to run.

  68. #68 Pablo
    September 8, 2010

    ROFLMAO Seriously? This is being taught in a med school class? Well, yes, and if you rub Gruyere on your feet twice a day and spin counterclockwise whilst whistling the Star Spangled Banner on the 12th hour after sunset, your cold should clear up in 7-10 days as well. Because that’s about how long it takes a cold to run it’s course.

    Boy, what a waste of good Gruyere…

    mmmmmmmm, gruyere…

  69. #69 Frameshift
    September 12, 2010

    This is disgusting.

    I poked my head up while finishing my applications and this is what I find. Blech. I am a card-carrying member of the AMSA, and while I dismissed some of their adverts about woo-trips, I didn’t realize the inanity went so deep.

    With your permission, Orac, I would like to send this blog post to my AMSA contacts and see what they say. I am deeply motivated to get involved in the leadership of this organization just so I can fight against this kind of idiocy.

    Slightly off-topic, here in San Francisco (admittedly a hippie bastion of woo) one of the largest medical centers, California Pacific Medical Center, has started advertising for their Center For Integrative Medicine. They have drunk the woo-laide, and I find it more than a little irritating.

  70. #70 William
    October 25, 2010

    As someone with a doctorate and experience conducting empirical research published in academic journals, I am well aware of the ways in which ‘science’ is used to promote the interests of the status quo. I am all too familiar with the way in which journals are controlled and research funded by those whose vested interests are at stake. Needless to say I can easily imagine the games that are played with t-statistics and other statistical measures. Give me a break. Or maybe you would like to show me how you got those ‘normal ranges’ for testosterone levels for my age group? I didn’t think so.

    There is a self-serving arrogance at work here whereby there can be only one type of medical ‘science’ and all alternative therapies must be evaluated by it. No surprise that this will serve the interests of the status quo, i.e. the big medicine establishment.

    I have taken Chinese herbs (either individually or in formulas, chosen by myself or chosen by herbalists) for decades because they work. This means that I know what to take and when. Do they always work? Of course not, but neither do prescription medications. So why in the world would I wait breathlessly for western medical ‘scientists’ to tell me that something works or not?

    It is my body and I know it better than any else ever will–this statement being laughable to MDs who routinely ignore what patients tell them about their medical history and write prescriptions that they neither ask for, want, nor (surprise, surprise) take.

    Most alternative therapies, TCM in particular, offer a model (or philosophy perhaps) that allows people to understand themselves. Most MDs, on the other hand, with all of their ‘scientific’ training clearly offer nothing other than a diagnosis based on purely mechanical considerations.

    The ugliest aspect of this is that western medical ‘science’ results in medical practicioners that cannot view patients as people. Rather patients are mechanisms with symptoms, some of which are psychological, etc. No wonder patients are looking for a different medical model.

    And now I will await all the smug replies about how I just do not understand science….

  71. #71 Chris
    October 25, 2010

    William:

    As someone with a doctorate and experience conducting empirical research published in academic journals,

    If this was true, why do you think that your anecdote on your use of herbs and/or medicine is a valid argument?

    And what exactly do you mean by “western” medicine? Are you happy with research from Japan?

  72. #72 Composer99
    October 25, 2010

    No need for smug replies, thread necromancer (quite appropriate in the run-up to Hallowe’en, I dare say).

    Your unsupported, unsubstantiated arguments by assertion and your willingness to accept uncontrolled anecdote over methodically rigorous clinical trial demonstrates your ignorance sufficiently for all to see.