White Coat Underground

Magic diet? Not so much

Alternative medicine practitioners love to coin magic words, but really, how can you blame them? Real medicine has a Clarkeian quality to it*; it’s so successful, it seems like magic. But real doctors know that there is nothing magic about it. The “magic” is based on hard work, sound scientific principles, and years of study.

Magic words are great. Terms like mindfulness, functional medicine, or endocrine disruptors take a complicated problem and create a simple but false answer with no real data to back it up. More often than not, the magic word is the invention of a single person who had a really interesting idea, but lacked the intellectual capacity or honesty to flesh it out. Magic is, ultimately, a lie of sorts. As TAM 7 demonstrates, many magicians are skeptics, and vice versa. In interviews, magicians will often say that they came to skepticism when the learned just how easy it is to deceive people. Magic words in alternative medicine aren’t sleight-of-hand, but sleight-of-mind, playing on people’s hopes and fears.


A reader has turned me on to another magic word I hadn’t known about. It’s called the “Inflammation Factor”, and is the invention of a nutritionist named Monica Reinagel. Like most good lies, this one builds on a nidus of truth.

Inflammation is a medical term that refers to a host of complex physiologic processes mediated by the immune system. Inflammation gets its ancient name from the obvious physical signs of inflammation: rubor, calor, dolor, tumor, or redness, heat, pain, and swelling. As the vitalistic ancient medical beliefs bowed to modern science, inflammation was recognized to be far more complex than just these four external characteristics. In addition to being a response to injury and disease, the cellular and chemical responses of inflammation can cause disease. For example, in asthma and food allergies, a type of immune reaction called type I hypersensitivity elicits a harmful type of inflammation. Coronary heart disease, the biggest killer of Americans, is believed to have a significant inflammatory component.

But nothing in medicine is perfectly simple. For example, corticosteroids, which can be used effectively to treat the inflammation in asthma are not effective against the inflammation in cororary heart disease. It’s just not that simple.

But while inflammation may not be that simple, people can be. People want easy answers, and quacks are happy to step in to provide them.

So Ms Reinagel has invented a diet, available for sale in a book called The Inflammation Free Diet Plan. Her premise is that inflammation is at the root of all major diseases, and that your diet can affect inflammation, thereby improving your health.

While the hypothesis is intriguing, each step of the argument has problems, leading to an invalid conclusion.

Inflammation is the root of all disease

No, it’s not. “Inflammation”, which is actually refers to a lot of different processes, plays an important role in many diseases. But not all inflammation is the same.

The most important factor in fighting inflammation is the food you eat every day.

Um, no. If you have a staph infection on your arm, your eating habits will not change the amount of heat, pain, swelling, or redness. The kernel of truth here is that diet can affect various measures of inflammation, such as C-reactive protein (here is one of many examples). There’s a long leap between this fact and the conclusion that diet can “stop inflammation”.

The benefits of reducing inflammation are immediate as well as long term. You’ll notice that your skin looks younger, your joints feel better, and your allergy symptoms improve. At the same time, when you reduce inflammation, you also reduce your risk of heart disease, Alzheimer’s disease, cancer, osteoporosis, diabetes, and other complications of aging.

It’s a very long walk from the claim that reducing inflammation is “a good thing” to proving that your particular diet reduces inflammation and thereby improves health . A hypothesis is not true simply because it sounds pretty.

Who wouldn’t love a magic book that would prevent and cure all illness? Perhaps you’ve noticed that these books come along every few months. None of them ever has the one true answer. Life is much more complicated and beautiful than any magic book. It may be a lot more difficult to commit science than to commit quackery, but in the end it’s a lot more satisfying and a lot more useful.

_________________________
*”Any sufficiently advanced technology is indistinguishable from magic.” –Arthur C. Clarke’s Third Law

Comments

  1. #1 Denice Walter
    July 23, 2009

    Not so unfamiliar to me.Many woo-based empires rest on inflammation 1. PBS pledge-break darling Nicholas Perricone has the whole “inflammation causes wrinkles”/”Eat salmon” schtick(see Quackwatch).2.About 2 years ago,I went to see (and question)the *other* PBS pledge-break fave,Gary Null,who took questions from the audience at a local bookstore;in response to queries about cancer, heart disease,M.S.,diabetes,menopause, arthritis, Alzheimers,and aging in general, he answered,”It’s all due to inflammation!Reduce inflammation”,by sticking to a pure, organic, vegan, low fat, mostly raw diet which will curtail said inflammation and “totally cure” the aforementioned illnesses.Oh, and take the supplements he sells.It’s all outlined in his books and videos .I didn’t ask my question (“Is your doctorate as real as your haircolor?”)because I feared retaliation by the highly excited groupies surrounding him, also I didn’t want to actually laugh out loud at him,having been taught better manners than that.

  2. #2 Jason Thibeault
    July 23, 2009

    With me, “all diseases come from” immediately rings alarm bells and sends big red flags straight up in the air. Doesn’t matter what comes after it, it’s probably crap.

  3. #3 T. Bruce McNeely
    July 23, 2009

    “Inflammation is at the root of all major diseases.”

    So, by that logic, if you take megadoses of corticosteroids, you should achieve perfect health.

  4. #4 T. Bruce McNeely
    July 23, 2009

    Denice, the answer to your usasked question is “Yes”.
    http://www.quackwatch.com/04ConsumerEducation/null.html

  5. #5 daijiyobu
    July 23, 2009

    BTW, lovin’ the Natty Bumppo canoe motif / pic.:

    “Stay alive, no matter what, and I will find you.”

    -r.c.

  6. #6 daedalus2u
    July 23, 2009

    Inflammation is like the canoe, with nitric oxide as the paddle. Sometimes you need inflammation to go one way, to fight an infection or parasite. Sometimes you need inflammation to go the other way after the infection is gone.

    The right nitric oxide level is like sitting in the middle with everything perfectly balanced. If you are not in the middle and perfectly balanced, you can still paddle the canoe, but it takes more effort. Too much effort and you get tired and sloppy. You can’t navigate as precisely, so you crash into rocks more often. The canoe is more tippy when the water is rough you take on more water and your cargo gets wet.

    Not having the right nitric oxide level is like being up the creek without a paddle. You can paddle with your hands, so long as you stay in very calm water. It is easy for even a weak current to drag you down stream. You can throw out an anchor to stop (corticosteroids), but that doesn’t help you get back upstream.

    If there was a magic diet, it would work like, well, magic. There is no diet that works like magic or it would be obvious and the people selling it wouldn’t need such high pressure sales tactics.

  7. #7 Katherine
    July 23, 2009

    Thanks for writing about this. Before I started reading a lot of skeptical blogs and resources on the internet, I encountered the concept of low-inflammitory diets. Wanting to know more, I tried to investigate, and found NO more information. Now that always makes me suspicious, but it’s nice to have one’s suspicions confirmed. :)

  8. #8 Donna B.
    July 23, 2009

    I know the cause of all diseases and suffering and I promise I can cure you of them.

    The ultimate cause of all disease is life.

    Unfortunately, the cure is illegal. It’s called murder. Or, probably manslaughter in most cases as the intent is not to kill but to make money.

    Why more “alternative” cures (and a very few of the supposedly medically sound ones, e.g. RNY bariatric surgery) are not illegal is what I really can’t quite figure out.

    But then I must ask myself if there are not some medical treatments that are now obviously beneficial that might have been thought useless in the past. Of course, washing hands is one of them. No one would have been jailed for washing their hands, but the thought of making it “illegal” to NOT wash ones hands would have been thought downright silly.

    So… I come down on the side of being careful what we make illegal, though I’d still like to knock a few heads together occasionally.

  9. #9 limes
    July 24, 2009

    Inflammation causes my depression and my friend’s anorexia nervosa? OKAY!

    All these diet sellers are really promising is the illusion of control. People want to believe that all their medical problems have simple, easy to fix causes and that they, personally, with no damn doctor telling them what to do, can fix everything. They don’t want to feel like they’re at the mercy of their GABA-A receptors or that they actually need the statins and can’t just will their arteries better.

  10. #10 Donna B.
    July 24, 2009

    Just another example of the toxin as sin, is it not?

    If only I eat the right things (not sin) the more my health is blessed.

    Or something like that.

  11. #11 Karl Schwartz
    July 24, 2009

    Nice job. Reminds of another magic phrase: “Supports immune function” to fight cancer, etc.

  12. #12 James Pannozzi
    July 24, 2009

    @PalMD, the wise, who pontificates that:

    “Alternative medicine practitioners love to coin magic words…”

    Oh… they do, do they…?

    And Allopaths don’t do this?

    Stick to tirades against Homeopathy, you do better at that, though your comments have worn a little thin lately… threadbare in fact.

  13. #13 daijiyobu
    July 24, 2009

    J.P., per “and allopaths don’t do this?”

    I think you mean “didn’t”, allopaths were the physicians of Hahnemann’s time.

    -r.c.

  14. #14 James Pannozzi
    July 25, 2009

    @daijiyobu

    No, I meant exactly what I said, “And allopaths don’t do this?”.

    “Allopathy” refers to the so-called “standard” medical physicians of our times – the standard system of medicine which relies on suppressive therapies and whose approach is grounded in reductionistic approaches. For example, in cancer treatments, the problem is treated as essentially a local problem (unless it has metastasized) to be excised, irradiated or poisoned away with chemotherapy.

    In modern times, “standard” medicine has amended its approach and started integrating more holistic approaches into their treatments.
    Nutrition has started to get some attention, and other aspects of the patient’s background have begun to be taken into account.

    Another designation, somewhat more pejorative in my opinion, is the Homeopathic reference to physicians of the “old school”, again this refers to allopaths.

  15. #15 Whitecoat Tales
    July 25, 2009

    MD’s don’t use the term Allopath. It’s similar to creationists labeling people who believe in evolution as “Darwinists”, the use of the term implies your opinion of it.

    Nutrition has always gotten attention, it’s revisionist history to somehow attribute this to complementary medicine being “integrated”. Similar gibberish is the phrase “holistic,” which is merely a buzzword. In medical school, I’m not taught “oh just treat this problem, ignore the rest of the body,” conventional medicine IS holistic, in a meaningful way. We treat the whole patient, and are willing to “integrate” any solution that works.

    On the other hand, most “holistic” practioners have an ideological position rather than a pragmatic position. Believer’s in the Marshall protocol believe vitamin D and “L form bacteria” are the problem. Accupuncturists believe in QI and meridians. Chiropractors in Innate Intelligence. Naturopaths in vitalism.

    In all these cases they oversimplify the incredibly complicated, and beautiful sum of human physiology to some unrealistic single cause of all problems.

    The exception is Homeopathy, the theory of which is explicitly a “treatment” of symptoms rather than primary causes.

    In most contexts, holistic means “we’ll ‘treat’ you based on our made-up a primary, unprovable cause of your problems, in a way that can’t be verified scientifically because um… we say so, but it’s really all very simple, don’t believe that it takes 4 years of college, 4 years of med school, and a residency to understand medicine, it doesn’t”
    …Sorry if this shows up twice.

  16. #16 James Pannozzi
    July 26, 2009

    @Whitecoat Tales

    “Nutrition has always gotten attention…”

    Pardon me for total disagreement, no revisionism needed.

    “On the other hand, most “holistic” practioners have an ideological position rather than a pragmatic position”

    Pardon me for disagreeing….again.

    “Naturopaths in vitalism. ” I thought the Homeopaths believed in vitalism and the Naturopaths in nutrition….I keep getting them mixed up.

    “In all these cases they oversimplify the incredibly complicated, and beautiful sum of human physiology to some unrealistic single cause of all problems.”

    Ah!!!! “unrealistic”!!!! And they are the ones oversimplifying complicated human physiology, eh?!!

    The exception is Homeopathy, the theory of which is explicitly a “treatment” of symptoms rather than primary causes.

    Completely incorrect! Here is a quote from Hahnemann (hey will somebody bring some coffee, I just forgot how to spell “Hahnemann”) himself from the Organon of Medicine, written over 150 years ago. ( I believe only experts should read Hahnemann because without specialized knowledge of terminology used in that era, much of it appears as utter nonsense, but the following passage is clear enough in indicating that your conception of Homeopathy theory is wrong.

    Section 81
    “From all this it is clear that these useless and misused names of
    diseases ought to have no influence on the practice of the true
    physician, who knows that he has to judge of and to cure diseases, not according to the similarity of the name of a single one of their
    symptoms, but according to the totality of the signs of the individual state of each particular patient, whose affection it is his duty carefully to investigate, but never to give a hypothetical guess at it.

    If, however, it is deemed necessary sometimes to make use of names of
    diseases, in order, when talking about a patient to ordinary persons,
    to render ourselves intelligible in few words, we ought only to employ them as collective names, and tell them, eg., the patient has a kind of St. Vitus’s dance, a kind of dropsy, a kind of typhus, a kind of ague; but (in order to do away once and for all with the mistaken notions these names give rise to) we should never say he has the St. Vitus’s dance, the typhus, the dropsy, the ague, as there are certainly no disease of these and similar names of fixed unvarying character. ”

    Right now I’ve got a case of “dropsy” of a different sort than he meant, so we’ll leave it there. (I don’t want to hear a peep out of you PalMD, no laughing or else you’ll get treated to more Organon!!)

  17. #17 Whitecoat Tales
    July 26, 2009

    Pardon me for total disagreement, no revisionism needed.[snip]Pardon me for disagreeing….again.

    You’re disagreeing… but on the basis of what? Have you studied medical education through the years? Have you performed an analysis of nutrition in medical practice in the 100 years since the flexner report? no? So you disagree on the basis of your google PhD, which is worth about what you paid for it.

    I thought the Homeopaths believed in vitalism and the Naturopaths in nutrition….I keep getting them mixed up.

    In that case you just don’t know what you’re talking about. Principle #2 of naturopathy is “Vis medicatrix naturae” which is explicitly vitalism.
    Homeopathy breaks the laws of physics, and the way homeopaths say it does so is a different form of vitalism.

    Ah!!!! “unrealistic”!!!! And they are the ones oversimplifying complicated human physiology, eh?!!

    …Yes, unrealistic. Where have conventional doctors oversimplified?

    Once you’ve hit 4 exclamation points, you need to have a cold shower or something

    To your quote from the organon I can only say:
    HAHAHAHHAHAHAAA!

  18. #18 Lucario
    July 26, 2009

    So what exactly is supposed to be in this anti-inflammatory diet, and does it resemble the diet of any ethnic group on Earth?

    I would’ve liked to see a more thorough fisking of the individual elements of the diet.

  19. #19 PalMD
    July 26, 2009

    One can’t fisk something that’s not even wrong

  20. #20 James Pannozzi
    July 27, 2009

    @Whitecoat Tales

    “You’re disagreeing… but on the basis of what? Have you studied medical education through the years? Have you performed an analysis of nutrition in medical practice in the 100 years since the flexner report? no? So you disagree on the basis of your google PhD, which is worth about what you paid for it.”

    Tsk tsk, Argumentum Ad Authoritatem…. to bolster one’s non-existent reasoning.

    You made some unsupported sweeping generalizations like this one:
    “”Nutrition has always gotten attention…” and you seem OK with that but when I respond with an opinion, equally undocumented, suddenly there is a …. problem? Go study some medical history.

    Here’s another generalization, unsupported by fact you’ve just made:
    “Homeopathy breaks the laws of physics, and the way homeopaths say it does so is a different form of vitalism. “.

    “Breaks the laws of physics”??? How could you possibly know that unless you knew, in advance, all the laws of physics?

    PalMD Statements, such as THIS one:
    “Alternative medicine practitioners love to coin magic words…”

    This is a typical PalMDian pejorative sweeping generalization typically designed to contemptously disparage practitioenrs of alternative systems of medicine. It is rather obvious that the masters of “magic” words most certainly included the MD’s themselves. Nomen est omen.

    It is, however, like your hastily written presumptions, only opinion.

    Opinion. Nothing more.

  21. #21 Monica Reinagel
    July 27, 2009

    PalMD implies that I claim that inflammation is the root of all disease. In fact, I titled an article “Inflammation: The Root of All Disease?” The question mark specifically alludes to and challenges some of the more breathless reporting on the topic from the mainstream media.

    If you read more than a line or two of what I’ve written on the subject (including punctuation), I think you’ll find my views to be a bit more nuanced:

    1. Of course I don’t suggest that inflammation is the root of all disease. That’s ridiculous. But I do believe that chronic low-level inflammation is a contributing factor to the most common degenerative diseases suffered by Western cultures—heart disease, cancer, dementia, diabetes, obesity, etc. This view is fairly mainstream.
    2. Of course I don’t claim that all inflammation is bad–or the same. Inflammation is a necessary and beneficial part of the immune response. Chronic, unproductive, systemic inflammation, however, is a problem and it is this latter variety that is primarily driven by diet and lifestyle. Again, a widely held view.

    If you accept the two previous statements, you might go looking for information on how to modify your diet to one less likely to provoke or exacerbate systemic inflammation. When you do, you’ll quickly find an unwieldy and contradictory set of injunctions: Omega-3 fats are good. Omega-6 fats are bad (sometimes.) Antioxidants are good. Sugar is bad. Fiber is good. Saturated fat is bad. And so on.

    These guidelines don’t address the fact that some foods are high in both sugar and antioxidants or both omega-3 and omega 6 fats. They also don’t say much about the effect of single foods in the context of a mixed and varied diet or how to combine “anti-inflammatory foods” into an otherwise balanced, nutritious diet. The rating system that I developed is a proposed solution to these difficulties.

    In a nutshell, I attempted to integrate the existing published research on the inflammatory or anti-inflammatory effects of various individual nutrients into a single computation, adding points for anti-inflammatory nutrients and ratios and subtracting points for inflammatory ones. The amount added or subtracted for a given nutrient is based on the amount of that nutrient present compared with the documented effects of various dosages of that nutrient on inflammation in humans.

    I’ll be the first to say that the formula is at least as much art as science but the idea was simply to draw an unwieldy set of research-based dietary recommendations together into a single integrated tool which could be objectively applied to a wide variety of foods and used to estimate the effects of combinations of foods as well as individual foods.

    At the very least, following the guidelines outlined in my book results in a healthful and balanced diet that conforms with widely held nutritional principles. In addition, evidence suggests that it may have the added benefit of reducing or avoiding excessive, inappropriate inflammatory responses–and that this may have both short and long-term benefits.

    No magic.

  22. #22 James Pannozzi
    July 27, 2009

    @Monica Reinagel

    Well said.

    I believe there is one inflammatory response you can safely ignore… PalMD’s comments!

  23. #23 Igor
    July 27, 2009

    Of course PAL’s inflammatory response is based on a easily identified diet of BS.

  24. #24 Igor
    July 27, 2009

    “Breaks the laws of physics”??? How could you possibly know that unless you knew, in advance, all the laws of physics?”

    Ha, so by implication homeopathy does not break the undiscovered laws of physics?

  25. #25 T. Bruce McNeely
    July 27, 2009

    James Pannozzi:
    I’m impressed. You cite the argument from authority in Latin, no less! We might take your claims a little more seriously if you actually knew what the argument from authority was.

    Also, I don’t anticipate any new Laws of Physics emerging in support of Homeopathy any time soon.

  26. #26 Lucario
    July 27, 2009

    “Can’t fisk something that isn’t even wrong?”

    Could you, at the very least, give out a few details of what foods are OK and what are forbidden in her diet? You said that her diet is wrong without going into details regarding the specific foods she says are supposedly anti-inflammatory.

    I’m not trying to antagonize you. I’d just want a few more details, especially from the medical literature, whether or not these supposedly anti-inflammatory foods are supposed to be good for us.

  27. #27 PalMD
    July 27, 2009

    The question is irrelevant as the premise of the diet is incorrect. The foods in the diet (i haven’t bought the book) may or may not be “good for you”, but it’s irrelevant viz whether a diet can “reduce inflammation” thereby fixing lots of diseases.

  28. #28 Tsu Dho Nimh
    July 27, 2009

    @14 Nutrition has started to get some attention

    No James, nutrition has always been getting attention. I have a collection of medical books going back to the 1790s, and attention was ALWAYS paid to the patient’s diet, recommendations made about the diet.

    What has changed, because of scientific research and experiments, are the recommendations and the reasoning behind them.

  29. #29 Lucario
    July 27, 2009

    OK, can someone who’s bought or otherwise read the book tell me what foods this lady recommends? That way, i can check out the claims myself and form my own opinion.

    And honestly, I really don’t think you can make a 100% opinion of a book until you’ve read it thoroughly.

  30. #30 Igor
    July 27, 2009

    Well we have a good sample of the claims on this website (see above). But what’s the point when so little is enough. For example, I may recommend the Secret and Law of Attraction, which, in a nutshell, claims that you make your own reality by wishing things into existence. Works every time too, except when it doesn’t but then you did something wrong. Don’t believe these claims? Well how can you criticize them without having wasted hours of your time reading this nonsense. The only lesson you get from those books are of human gullibility, but you don’t need to read the whole thing to figure that out.

  31. #31 daedalus2u
    July 28, 2009

    Inflammation is far too important for organisms to allow random dietary influences to control it. Inflammation is extremely well controlled by physiology, not by diet.

  32. #32 j.s.
    October 24, 2009

    Evil magic! Witches and demons! Typical. To those who inquired, for almost two months now I have been cooking my food based on recipes from a great naturopathic book. Now I feel like MAGIC! ;) Long story short – 6 months or so ago I saw two different doctors and they could find nothing wrong with me, so I went to a Chinese doctor (Vade Retro Satana!) who looked at my tongue (sure sign of witchcraft) and said “You have too much phlegm.” He gave me horrible tasting herb and plant based teas (was cheap too) and things started to get a bit better, until I discovered this book (this link contains much of the book except important “Chapter 5 – How to Use this Book” & “125 recipes”) I found it amazingly by overhearing a conversation. I was still weezing a bit at night though much less than before (only at night when my lungs literally swelled up from 11 pm to 4 am), I slept a bit better but woke up, was very allergic to dust, low energy, bowels were fine though, and swollen glands – neck, groin, adrenals, prostate – I do yoga so I could feel it during compression postures and pee was not flowing so easily). Anyhow (by now you may think I’m a wacko, but it’s ok) I FEEL GREAT. It was allergies obviously! Why didn’t the doctors spot that? I’m certain there are quacks out there misusing the anti-inflammation diet (just like any other thing online, although I’m sure all regular doctors are angels adorning a halo from the moment they take their oath), but to label all naturopaths, their ideas, fellow healers who are well educated, resourceful and honest, but want to do mainly prevention instead of mostly writing prescriptions, is WRONG! I think you should focus on helping people more and stop hurting your own practices. People are reading this and they are a lot smarter than you give them credit. You should try it before you knock it. Good luck!

  33. #33 Gerhardt J. Steinke, FHB
    December 2, 2009

    WOULD LIKE TO SEE MUCH MORE ON MONICA REINAGEL’S APPROACH.
    A short list of other “gurus” supporting her work would be nice. The rest of the ND website presents no problem. As a vegan, I see zillions of books consistent with veganism.

    Has anyone else written a book consistent with Reinagel?

    I found the ND (Nutrition Data) website very useful. If we had a government supporting no nonsense honest labels for foods it would contain the percentages of macronutrient calories very similar to what we see in the ND website. No more “less” or “reduced” or “low fat” obfuscation. And all foods in common use would be labeled consistent with ND.

    For example “1%” milk would be labeled as 21% fat. With the USDA in bed with the Dairy and Meat lobby, I can only dream.

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