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Olympic Pseudoscience

The Summer Olympics are coming up, which means that, in addition to world-class athletic performance, the public will be exposed to a variety of sports-related pseudoscience. This is not unique to the Olympics, of course. The world of sports competition is rife with pseudoscience, false claims, dubious products, superstitions, and magical charms. The most egregious example of this recently has been the energy bracelet scam – multiple companies have and are marketing little bits of rubber, plastic, or metal that you wear on your wrist and they claim (based on parlor tricks rather than evidence) will improve athletic performance. They give classically pseudoscientific explanations for the alleged effect, such as negative ions or energy frequencies. In fact the new icon of the entanglement of sports with pseudoscience is the Power Balance Stadium.

Occasionally the scientific community takes notice of such claims and bothers to review them. Also, in the internet age, the information is actually available to the public (rather than buried in an obscure journal). A recent joint investigation by BBC Panorama and the British Medical Journal (BMJ) recently found a shocking (to them) lack of evidence for many claims made to market performance-enhancing products. The BBC reports:

A team at Oxford University examined 431 claims in 104 sport product adverts and found a “worrying” lack of high-quality research, calling for better studies to help inform consumers.

High quality studies would be nice, but the article fails to ask the question – who is going to fund those studies? What incentive do manufacturers have in proving their products don’t work?

The researchers did learn a few things about how the game is played, how companies create the impression of scientific support for their claims without the substance of science. For example, regarding a popular sports drink:

Dr Heneghan and his team asked manufacturer GlaxoSmithKline (GSK) for details of the science behind their claims and were given what he said scientists call a “data dump” – 40 years’ worth of Lucozade sports research which included 176 studies.

GSK apparently pulled several classic pseudoscientific ploys. The first is to attempt to replace quality research with quantity. The assumption is, if you pile it high enough, you end up with compelling evidence (at least they hope the public will think so). A lot of low quality research does not add up to even a single rigorous study, however. Dr. Heneghan found that the studies were mostly of very poor quality, the kind of studies that are likely to generate some conveniently false positive results that are great for marketing (the goal is to slap the ubiquitous claim, “clinically proven,” onto the marketing).

Related to this is the problem of in house vs truly independent research. An in house study performed by researchers on the company payroll (not academics with reputations and careers to worry about) is less than worthless.  You can produce any results you wish with even subtle tweaking of a study. Transparency, replication, and peer-review provide at least some check (although imperfect) on researcher bias. A variation of the in house study, which is more deceptive, are the “independent” companies that perform product testing for other companies. This is essentially outsourcing in house studies, with the added benefit that the company can say that their claims were “independently tested.”

The second ploy is to tout “minuscule effects” as if they were significant. All that is necessary is for the study group using the sports-enhancing product to perform slightly, barely, teensy tiny bit better than the other group, and the company can tout an effect (while not mentioning the effect size). Of course such tiny effect sizes are not even reliably real – they are within the noise of such studies, especially those that are small or not tightly controlled.

The third marketing tactic is to claim a real effect, but not one that is specific to the product, and which can be obtained much more cheaply from everyday items. With regard to nutritional supplements the BBC article reports:

Nutrition expert Professor Mike Lean of the University of Glasgow described what little evidence there is that certain amino acids, which form part of proteins, may improve muscle strength as “absolutely fringe evidence and I think that that is almost totally irrelevant, even at the top level of athletics”.

The marketing of such products typically will talk about basic science facts that make their claims seem plausible. Proteins are made of amino acids, so if you want to build muscle you have to have sufficient amino acids in your diet. This is true, and it is easy to conceptualize the food you eat fueling the building of muscle. The real question is, however, is this process limited by your nutrition, and is the nutrition you are getting from the sports product any bed than regular food you can buy from the supermarket. Dr. Lean concludes that the fancy supplements are, essentially, just really expensive milk.

Running shoes are another example. Fancy and expensive shoes designed to reduce injuries or enhance performance simply do not work any better than regular sneakers. Any effect is tiny and insignificant.

A fourth marketing ploy commonly used is to cite evidence for a small benefit at the extreme end of athletic performance (like marathon running) and then use that to support claims for the average user. This is an example of misapplying evidence or the unjustified extrapolation. Effects that are apparent for professional athletes may not be significant for the average user. Further, products that may help compensate for an injury do not necessarily enhance performance in healthy individuals.

The BMJ authors set out to review evidence – and they found that the evidence is low quality, with insignificant effect sizes and non-specific effects that do not justify high prices for specialty items. The marketing of sports products, however, has been very successful (as the Power Balance Stadium attests). The usual strategy is to get high profile sports stars to use the product. They will likely perceive a benefit, simply because of the inherent biases in making such assessments. Further, there is a huge financial incentive for them to feel that the product helps their performance. They then endorse the product, and the average sports fan likely believes that a professional athlete must know what they are talking about when it comes to performance. Sprinkle in some dubious in-house studies and you have a marketing campaign.

There are other countless products not discussed in the BBC/BMJ article. For example, breathe right strips – those little white strips that began appearing across the noses of many athletes. The claim is that they enhance performance by opening the nasal passages and making it easier to breathe. There is some evidence that the strips at least do open the nasal passages a bit, and this is often the kind of evidence that is used to support such products. It seems to support the claims made for the product, but is not a direct test of performance. Studies looking at endurance performance, recovery from exercise, and the work of breathing during exercise have all found no benefit from such strips, however.

Now a new product, kinesio tape, is looking to become the next breathe right strips. This tape is applied over muscles to, allegedly, enhance performance, reduce injury, and reduce soreness and stiffness. So far the evidence is mostly preliminary, but a recent review concluded:

In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries

There is some evidence that taping an injured muscle may help it perform better, just like a brace, but there is no convincing evidence that there is anything special about kinesio tape over regular tape. This is therefore an example of marketing a non-specific effect that can be gained from cheaper products as if they were a special feature of an expensive product. It’s not even clear from the existing evidence that kinesio taping has a net positive effect. The same article notes, for example:

 KT had some substantial effects on muscle activity, but it was unclear whether these changes were beneficial or harmful.

There was also a study published since the review, looking at the effect of kinesio taping on the leg muscles of healthy women, which concluded:

 Application of KT to RF, VL and VM muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or electromyographic activity of VL muscle in healthy women.

Conclusion

Consumers should be very skeptical of claims made for products marketed as athletic performance enhancing. Given that the BMJ article looked at 104 such products and found no convincing scientific evidence to support their claims, it seems reasonable to conclude that this is a general feature of the athletic performance marketplace. Some common sense rules of thumb seem reasonable  - don’t believe the hype, don’t believe in magic, don’t be overly impressed by professional endorsements, be skeptical of claims for scientific support, and don’t waste money on expensive versions of products when cheaper versions are likely to be just as good.

Posted in: Herbs & Supplements

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38 thoughts on “Olympic Pseudoscience

  1. broadhead says:

    There’s an interasting article about the programme from a sports nutrition retailer:
    http://blog.predatornutrition.com/2012/07/20/the-truth-about-sports-products-programme-review/

    It’s pretty critical about the questions asked by the BMJ review, with no apparent separation between ‘average’ and ‘elite’ performance levels.

    Their best point is that supplement companies do not want successful trials showing big benefits, because then the supplements get banned or otherwise regulated.

  2. Scott says:

    Their best point is that supplement companies do not want successful trials showing big benefits, because then the supplements get banned or otherwise regulated.

    Actually, that’s an extremely strong point on the side of “the supplements are BS.” Because without those successful trials showing real benefits, selling them is frankly fraudulent.

  3. ConspicuousCarl says:

    On this subject, Power Balance’s new mouth gear (a sort of chiropractor for your mouth) lists a bunch of “scientific research” :
    http://www.powerbalance.com/mouthgear/how-it-works/

  4. rork says:

    I am curious about electrolytes in sports drinks in particular. Our docs don’t want us consuming more sodium, and I don’t see how ordinary people in the USA could consume too few electrolytes, yet it seems common knowledge that such additions improve performance. I see sports health experts giving advice about it as if they actually knew something.
    Where I live, native peoples consumed no extra salt at all.

  5. Jimmylegs says:

    @rork:

    If people believe that “electrolytes = better performance” they are mistaken. From my really amateur understanding of sports drinks and their properties, when you are playing or working out you lose sodium and other things, the sports drink (such as Gatorade) replaces what you lose. Compared to water, any sports drink is better, ONLY if you use it when needed, if you drink it as a normal drink that is when you have problems.

    So in a way the sports drink does improve performance, but not in a way people may think.

    It’s kind of sad that even with all this research done, people wont listen. Do people not like to admit to being wrong or scammed? Does anyone know of any research done on people being lied to, then revealing contradictory statements (which are true) and seeing the retention rate of the lies (or rejection of the truth)? If this has not been done I wonder what are the ethical implication of doing such studies.

  6. One of my acupuncture patients wore a Power Balance bracelet (I know, it’s surprising that more don’t…) and is looking for a new job. I had thought about it too much, and questioned her before. “At the mall when they pushed on my arm with the bracelet, I felt stronger and more balanced.” “All these pro basketball guys are wearing them.” “It’s not going to hurt me!” I suggested that for her next job interview she not wear it, as if the prospective employer didn’t believe in Power Balance bracelets, wearing it could give him the idea that she’s gullible or lacks critical thinking skills. Hmmm…. haven’t seen her since!

  7. Excuse me, I believe you mean clients, not patients, Mr. Acupuncturist.

  8. ConspicuousCarl says:

    Jimmylegs:
    “Compared to water, any sports
    drink is better, ONLY if you use it when needed,
    if you drink it as a normal drink that is when you
    have problems.”

    What sort of problems?

  9. LovleAnjel says:

    @ ConspicuousCarl – weight gain, for one. They have sugar and about 50 – 100 Cal per bottle, depending on the brand.

    I’ve heard that, unless you’re doing something like running a triathalon or performing heavy labor all day, the sports drink is a waste. You don’t lose enough salt from normal exercise to justify it – and a banana is far tastier anyway.

  10. Composer99 says:

    Skeptic North did an article in February (by SBM contributor Scott Gavura) discussing some of the literature surrounding rehydration (specifically pertaining to coconut water as a “natural” substitute for specially-prepared sports beverages).

  11. Jimmylegs says:

    LoveleAnjel is correct, I should have given examples, my opinion might actually not be as correct as it once was. The new Gatorade G2 has less sugar, approximately the same amount of sodium, and slightly less Potassium than the original.

    We don’t need to consume Gatorade (Powerade is roughly the same) as a regular drink because we get our salt, sugar, and Potassium from other sources (we shouldn’t drink soft-drinks but we do). So the old wisdom might not be as correct, but I would still advise against consuming Sports drinks as a regular drink.

  12. mousethatroared says:

    Regarding sports drinks… Our family caught the rotavirus (or rotavirus like illness) going around last winter. I’ve never used sports drink for sports, but when diluted by half, they do seem to be good for hydration during illness. To me (and the kids) they seem more palatable than water or pedialyte, electrolyte drinks. I find if you freeze the diluted version into a slushy consistency, one can tolerate some even when quite nauseous.

    Sports drinks like Gatorade were also recommended by my father-in-law’s doctor when he was struggling with dehydration due to chemo.

  13. DWATC says:

    @Rork…

    It’s not the electrolytes that “enhance” performance, it’s the carbohydrates (sucrose in particular). It doesn’t necessarily enhance performance but can prolong performance. Sodium triggers thirst which is why it’s placed in sports drinks. Nothing can replace water when it comes to hydration, and we generally get enough electrolytes in our diet. Gatorade was one of the first and picked all the good things to put in them and the others just wanted to put the rest of the electrolytes in their drinks even if they have no direct effect.

    As an athletic trainer, I use kinesio tape. I don’t use it for the proclaimed “performance enhancement”. Anytime I have seen it used in that manner, the athlete doesn’t perform beyond the norm. My anecdotal experience with KT is that it is beneficial for patellofemoral maltracking in acute injury to reduce pain during activity. I may use it during strengthening as well. I use it to reduce tension placed on muscle strains, in particular hamstring strains and low back. I’ve had success with SI Jt dysfunction during competition to reduce the likelihood of subluxation or dislocation of the joint. I use it to prevent glenohumeral dislocation. From my observation, in order to enhance performance using kinesio-tape, one would need to tape the entire limb to have noticeable effect. Again, all anecdotal, but it does have it’s uses. It’s unnecessarily expensive and, like many products, is mostly hype….. A friend of mine (also an ATC) is a “certified” kinesio taper and does all kinds of altmed tx including craniosacral therapy (I’ve had a few talks (debates) with him about that.) and some various TCM tx. Hes worked for a chiropractor for a while now, so I assume that was the gateway. As someone who tries to understand why I do what I do and whether it’s scientifically supported, I am weary of accepting any of these claims, or doing a treatment unless I’m positive it does no harm and I’ve explained it as much as I can to my patient. Everytime I tape an athlete, whether it’s regular athletic tape or KT, I always say “if it makes it worse, take it off.”

    @Dr. Novella… I am curious though, what other tape are you referring to? Athletic tape is restrictive (which it’s supposed to be), and it’s efficacy fades quickly. Elastic tape has few uses beyond covering athletic tape jobs and bandaids, although I’ve come up with some inventive uses for the elastic cohesive tape. KT is waterproof and semi-sweat proof, so its extremely beneficial in athletics. I’m not trying to be argumentative, just curious. I’m always open to finding new cheaper products that could be of use in my field.

  14. DWATC says:

    ….side-note…

    I’m not saying gatorade isn’t a good drink to use for hydration, but it’s shouldn’t be a primary drink. Mousethatroared made comment about it’s other uses. The main problem I’m seeing with the sports drinks, gatorade in particular, it’s this huge money-making “G Series”. I do like it because it gives people that easy quick fix for replenishing fluids and electrolytes, and gives them the sources of carbs and proteins for the prep and immediate recovery period, BUT again it’s that lazy expensive quick fix instead of teaching these athletes proper nutrition in the first place. Many athletes today are overloading the proteins when they don’t necessarily need them. It’s not the amount, it’s the timing. Anyway that’s off topic.

  15. DWATC says:

    ….I should rephrase, “prevent glenohumeral dislocation”. Many are freak accidents and can’t necessarily be “prevented” even with brace, so I guess I should have said it reduces the likelihood of dislocation depending on the mechanism.

  16. icarus4me says:

    One comment, the BMJ article looked specifically at *branched chain* amino acid supplementation, not supplementation with any sort of amino acid e.g. “protein shakes”. There’s pretty good evidence out there that for most average joes, protein intake is limiting in muscle gain if they want to build strength. The evidence for BCAAs is lacking, however, which is what they were referring to. Wasn’t entirely clear in your otherwise excellent article that you noticed this distinction.

  17. rork says:

    In Composer99′s link, Gavura warns against naturalistic fallacy, which is then repeatedly exhibited by crunchy commenters. Very entertaining. Thanks!

  18. Angora Rabbit says:

    Commenting on Icarus4me. The typical “average joe” (meaning westerner) is not limiting in protein intake. Protein requirements are 0.8 g/kg BW for non-athletes, 1.2-1.4 g/kg for endurance athletes, and 1.4-2.0 g/kg for strength athletes. However, since the typical western diet contains a considerable excess in protein, and because the typical athlete compensates by increasing their overall caloric intake including protein, the typical western diet of 10-15% calories as protein is more than adequate to meet needs.

    The BCAA supplements hinge on the Reality Grain that BCAA transamination is handled by skeletal muscle, not liver. About 70% of the AAs exiting the liver are BCAAs. That somehow has been transmutated into “muscle has a special need for BCAAs.” While it is true that BCAAs are the most abundant AAs in proteins including myofibrils, and there are some odd twists in BCAA metabolism involving energetics and muscle, the boost offered by BCAA supplements are generally less than the cost of the product, apart from certain elite athlete situations. Since one can easily meet that requirement with real protein (like an egg white), and because one cannot store protein the way carbohydrates and fat is stored, my students learn that these amino acid supplements are largely expensive pee.

    Great article. Athletic supplements are truly the Stuff that Dreams are Made of, since there is very little reality in the “edge” that most confer.

  19. Nope, Skeptical_Health, I mean patients, not clients. Much as it may nauseate some, my acupuncture license here in Oregon is regulated by the Oregon Medical Board, the same folks who oversee MDs. I have an insane scope of practice which explicitly covers diagnosis and treatment with acupuncture, herbs, exercise, massage, electrotherapy and nutrition. I’m not saying it makes perfect sense or is scientifically plausible, but it is the reality. If you can make a valid argument for why the people who pay me for my medical services aren’t “patients,” I’ll change my use of the word.
    Massage customers are “clients” as massage therapists are not medical practitioners and are specifically restricted from making diagnoses and treating diseases. But apparently, my scope of practice would let me diagnose someone with epilepsy as having “disturbed spirit” from “ghosts and demons,” and prescribe treatments such as acupuncture’s “13 Ghost Points” and possibly even Cinnabar (mercury sulfide) to treat it. Please note I do *not* use this approach in my own clinical practice of medicine. I mostly treat odd cases of pain which have not responded well to conventional care. Many of my patients are referred by local MDs or at least have been checked out by science-based methods before trying my ‘woo.’
    As I blog about regularly, I appreciate the skeptical movement and am concerned about the fraud in the TCM and CAM worlds. If I were 20 again instead of 40, I’d choose a career in scientific research instead. I may still pursue another degree or career, though my patients would be upset.

  20. Jimmylegs says:

    @skeptical_acupuncturist:

    You could be regulated by the strictest medical board in the world and you could still not distances yourself far enough from the implausibility of your practice. Your site does not say where you went to school.

    “I have an insane scope of practice which explicitly covers diagnosis and treatment…”

    No… no… you cannot diagnose because you are not a doctor, a nurse has more real medical training than you do. Also your treatments do NOTHING, I’m not sure how long you have been here but it’s been covered many times that acupuncture is placebo at best and at worst a detriment that delays real treatment.

    I don’t know where you went to school so I don’t know your training, but if you’re an acupuncturist you have to believe in life-energy (qi, which has yet to be demonstrated to be real) because if not then what the hell are the needles for?

    Also I see your ebay store contains some possible hogwash. Some items of which state a function of “Expels Wind & Clears Heat, Transforms Phlegm, Benefits Sinuses,” “Supplements Kidney Yin, Subdues Deficiency Fire, Drains Damp-Heat from the Lower Burner,” “Supplements Qi, Supports Healthy Digestion, Uplifts Sunken Yang,” and one of the best “Dispels Wind & Heat, Expels Toxic Heat, Transforms Phlegm, Benefits Nose, Supports Healthy Sinuses.”

    What the hell does all that crap mean? What the HELL is toxic heat? I’m sorry if I’m coming off rude or mean, but you cannot sit here and say you are helping people when you clearly sell the wooist of woo (not a big fan of “woo” word but I shall use it).

    It is total and utter nonsense.

  21. Janet Camp says:

    Well done Jimmylegs!

    ======

    So, Skeptical Acupuncturist, are you really saying that you know perfectly well that what you do is complete crap and that you only do it because you think you are too old to get out there and get real medical training? Is it some kind of catharsis for you to “confess” to us skeptics?

  22. @Jimmylegs,

    I graduated from the Oregon College of Oriental Medicine in 1997 with a Master’s Degree in Acupuncture & Oriental Medicine, funded largely by Sallie Mae. My site has been around for years and there are some older layers of material there, sorry you couldn’t find my license info easily (http://www.ancientway.com/Pages/AcuLicense.html). I don’t fit well into your (apparently) black and white world. I’m open to criticism and discussion, though my acupuncturist “colleagues” recently wore out my tolerance for ad hominem attacks with their response to my pointing out the exploitative fraud a particular herb company is marketing towards HIV/AIDS patients (http://ancientway.com/blog/?p=2309). I’ve pretty much had it with the TCM world, particularly since reading _Trick or Treatment_, _Snake Oil Science_ and related material over the past year.

    I understand your opinion is that I can’t diagnose anything, but the law in Oregon says otherwise:

    —begin law from http://www.leg.state.or.us/ors/677.html
    677.757 Definitions for ORS 677.757 to 677.770. As used in ORS 677.757 to 677.770:
    (1)(a) “Acupuncture” means an Oriental health care practice used to promote health and to treat neurological, organic or functional disorders by the stimulation of specific points on the surface of the body by the insertion of needles. “Acupuncture” includes the treatment method of moxibustion, as well as the use of electrical, thermal, mechanical or magnetic devices, with or without needles, to stimulate acupuncture points and acupuncture meridians and to induce acupuncture anesthesia or analgesia.
    (b) The practice of acupuncture also includes the following modalities as authorized by the Oregon Medical Board:
    (A) Traditional and modern techniques of diagnosis and evaluation;
    (B) Oriental massage, exercise and related therapeutic methods; and
    (C) The use of Oriental pharmacopoeia, vitamins, minerals and dietary advice.
    (2) “Oriental pharmacopoeia” means a list of herbs described in traditional Oriental texts commonly used in accredited schools of Oriental medicine if the texts are approved by the Oregon Medical Board. [1993 c.378 §1]
    —end law

    I’ve asked the Oregon Medical Board to clarify part A (specifically what diagnostic methods I can use) and also the list of texts in part 2 (which would seem to indicate that I can prescribe Cinnabar, Arsenic, or Opium Poppy Husks, as they are in the books my college used). They said the Board would have to talk about it in December as these are complex and new questions. Again, please note that I have no interest in using Pendulums in diagnosis or prescribing Cinnabar to epileptic children (as suggested in one “respected” Chinese herbal textbook).

    I also dispute your claim that my treatments do “NOTHING.” I often give exercise instruction and practical dietary advice to my patients, which I hope you do not consider to be without basis. Also, my acupuncture sometimes seems to have a lasting effect on certain types of pain, particular dermatome-based musculoskeletal syndromes. Often it appears to be more than a placebo effect, but many of my patients would be happy with the results they get even if it is comparable to a credible placebo. I try hard to encourage people to seek science-based diagnosis and care, and feel horrible if my services have delayed access to a more appropriate treatment. I regularly talk people out of trying to self-treat cancers with herbs or buy into the latest fad.

    While I understand your criticism about my inclusion of the TCM descriptions on some of the products I carry, I chose to include the manufacturer’s terminology which is, from what I can tell, legal. I am competing with sites which categorize things by disease category (i.e. Cancer, Alzheimer’s, etc.) and also do illegal medical consults via the internet/phone, which I do not do. My internet customers are people who are already looking for these products by name, not people looking to self-prescribe using the info I provide. The fact that the TCM terminology was confusing to you reassures me, though I am considering taking more off my site.

    I find your statement that if I’m an acupuncturist I have to believe in a vitalistic definition of Qi an incorrect oversimplification. While I spent far too much time and money memorizing esoteric BS and certainly hoped it was at least useful if not true, I no longer think in an astrological/vitalistic model of acupuncture meridians. To me the best definition of Qi is Oxygen, which fits most of the traditional descriptions (i.e. “the blood carries Qi”). Acupuncture produces a local capillary bed dilation, noticeable as a reddened area around the (sterile, single-use, increasingly shallowly inserted) needles. In addition to the endorphin (and placebo) effect, I feel acupuncture can help release spasmed muscles and thus quickly relieve some types of severe pain. I regularly use electroacupuncture, which I admit is not traditional acupuncture but is within my scope of practice. This is an example of how I’ve changed my practice approach based on scientific evidence. My intent is to provide safe, effective, evidence-based medicine within my scope of practice, and to be honest with my patients when there isn’t good supporting research. My income is correspondingly lower than the aggressive chiropractors in town, but that gives me more time to read and write.

    The “wooist of woo” is, unfortunately, far worse than I sell. Homeopathy, Black Salve, Astrological Tuning Forks, Essiac… The list goes on and on. Many Chinese herbal formulas are pharmacologically active, and some of them have been found to be relatively safe and effective, particularly for some chronic sub-clinical complaints (such as minor sinus allergies). I try hard to stay up on issues of toxicity, and pass that info along to inform my patients and customers. Again, my views have changed over the past few years, and were it easier to shift careers into something more science-based with comparable independence and pay, I’d likely change. However, at the risk of a fallacious ‘tu quoque’ argument, when I go to any supermarket pharmacy and see the illegal crap they are selling with impunity (detox foot pads, homeopathic eye drops, Weight Loss 3000, etc.), I realize I’m not such a demon. My sales are fairly low, partly because I don’t overpromote. Our local Wal-Mart probably sells more fake Hoodia in a year than all my sales combined.

    If I abandoned the Chinese Medicine world, it would go on without me. For now, I’m working from within to bring a more skeptical, ethical point-of-view about what I see as the worst and best of Chinese medicine. I am a reasonable scholar of Chinese medical history, Taoist esoteric practice, history of occultism and the New Age movement, and am constantly reframining it in a context of scientific skepticism. I hope to drag some more minds out of the gutters of Woo Street before I move on. As an acupuncturist, there is a segment of the population who may listen to me more than they’d ever listen to Dr. Novella or Dr. Gorski, as some minds are closed to mainstream medicine but look up to CAM artists. For me however, I am grateful for SBM, JREF, CSICOP, etc. for giving me stimulating reading materials which have made me yearn to be a science-based magician, not a woo-based occultist.

    I’m clearly open to criticism, or I wouldn’t be posting here. But to dismiss my world as “total and utter nonsense” is unlikely to encourage me to consider finer points of persuasive argument. There are something like 28,000 acupuncturists in the USA now, and there are perhaps 10 who have spoken out critically and skeptically about the delusions and dangers in the TCM world, including Ben Kavoussi, George Ulett, Sabio Lantz, Felix Mann, and me. That’s about 0.03%. You may insult and dismiss me if it helps you avoid cognitive dissonance, but if you help me refine my critical thinking skills, make new observations about science-based medicine, or show some support for my attempts to expose the worst frauds and fallacies in The TCM/CAM world, it will probably reach more people who are making important decisions about their healthcare and sway them in the direction of science and skepticism.

  23. broadhead says:

    Scotton 25 Jul 2012 at 11:01 am
    Actually, that’s an extremely strong point on the side of “the supplements are BS.” Because without those successful trials showing real benefits, selling them is frankly fraudulent.

    I don’t think you’ve thought it through properly. If a successful trial shows real benefits, the product becomes instantly more hassle to sell, with greater regulation and more controls on availablity and dosage.

    I’m not going to argue that steroids are good for you outside of specific circumstances, but let’s face it, they would sell a lot more if there hadn’t been the number of trials – if everyone ‘knew’ that they worked to build muscle from anecdotal recommendations and was able to buy them over the counter. The morality of it aside, in that situation a producer would have to be monumentally stupid to publicise a successful clinical trial. Golden egg, killing of goose etc.

  24. broadhead says:

    And of course I mean a “rational” producer in the strict economic sense, not one that had humans with a conscience involved.

  25. ambodave says:

    @jimmylegs
    “It’s kind of sad that even with all this research done, people wont listen. Do people not like to admit to being wrong or scammed? Does anyone know of any research done on people being lied to, then revealing contradictory statements (which are true) and seeing the retention rate of the lies (or rejection of the truth)? If this has not been done I wonder what are the ethical implication of doing such studies.”

    Here’s a resource that explores the extent to which people will hold onto “myths” even when presented with the reality, and methods for breaking through all the misinformation.

    http://www.shapingtomorrowsworld.org/Debunking-Handbook-now-freely-available-download.html

  26. @jimmylegs,

    Wait, are you telling me you aren’t familiar with kidney yin? Kidney yin is actually only on the right kidney, the left kidney gets the yang. If you align the two kidneys with the chakras, then the phlegm transforms into a heat dissipator which allows you to, umm, … ok, I’m not creative enough to write that kind of garbage! Some of those items you listed are absolutely hilarious. How do people come up with that crap?

    @skeptical_acupuncturist,

    Jimmylegs already said it all. Just because your “practice” is regulated by a government body doesn’t give it an ounce of scientific validity. If you use that completely fallacious argument to rationalize stealing money from the sick, well, that’s just sad.

  27. Scott says:

    If you can make a valid argument for why the people who pay me for my medical services aren’t “patients,” I’ll change my use of the word.

    Given that you cannot provide any legitimate non-placebo medical treatment, yet take money based on the claim that you can, might I suggest “marks?”

  28. Isn’t the name “skeptical acupuncturist” an oxymoron? It’s rather telling that he writes he provides “medical services.” I’d love to read the abundance of rigorous double-blind placebo-controlled trials supporting these treatments. I’d also appreciate reading the depth of research explaining the proven mechanism of action of such treatments. sCAM, sCAM, sCAM.

  29. icarus4me says:

    “Commenting on Icarus4me. The typical “average joe” (meaning westerner) is not limiting in protein intake. Protein requirements are 0.8 g/kg BW for non-athletes, 1.2-1.4 g/kg for endurance athletes, and 1.4-2.0 g/kg for strength athletes. However, since the typical western diet contains a considerable excess in protein, and because the typical athlete compensates by increasing their overall caloric intake including protein, the typical western diet of 10-15% calories as protein is more than adequate to meet needs.”

    Angora Rabbit, I’m aware of those figures, but I think your maths needs a little examination.
    Typical training weightlifter, 80kg, needs 160 grams of protein per day. That’s the equivalent of over four whole cans of tuna, and 80kg is pretty light for a weightlifter. I’d be surprised if that’s a typical western diet.

    A 24 y.o 80kg man of moderate exercise needs 2945 kcal/day, using the example on the wiki page for Harris-Benedict equation. Even using your upper limit of 15% protein for a typical western diet with a “considerable excess of protein”, that’s 441.75 kcal protein per day or 110 grams. So there’s already a substantial shortfall, not a “considerable excess”, for a weightlifter, and that’s just to MAINTAIN mass, not to gain it. Most people doing weights aren’t doing it to stay the same size, so they’ll need caloric excess above and beyond that.

    Most people who lift don’t have the time to prepare that much protein in meal format, so they supplement with whey protein instead. Bargain whey is also comparable in price to the cheaper sources of dietary protein, so it’s good if you’re on a budget and avoid the XXXNOS TurboBulk overpriced crap aside from the inconvenience of preparing and eating six egg white-only omelettes a day.

  30. Jimmylegs says:

    @skeptical_acupuncturist:

    I’m sure you’ve read the posts about placebo and it’s ethics. I think I posted in there, but my stand point is that “If the treatment is shown to be placebo (acupuncture has yet to be shown to be more than placebo) but is claimed not to be placebo (by the doctor) then it is unethical (unless this is a trial) because placebos do not treat the disease it only “treats” the symptoms.” I realize this is kind of an oversimplification but I’m sure you understand my point. Placebos don’t treat disease, therefore (in my opinion) they don’t “work.”

    “some of them have been found to be relatively safe and effective..” Which ones and where are the studies? Also have they been FDA approved? I know that there are a lot of things that sell in store that do not have FDA approval, but I’m skeptical of those also (like 5-Hour energy shot and ColonHealth) so don’t think I’m only attacking CAM.

    I do not have cognitive dissonance on any matter or at least I can think of. I take at your word (I have no reason to doubt) that you do direct people to more appropriate treatments (such as cancer patients), so I applaud you for that.

    But, I cannot agree with you selling the Chinese herb pills. When investigating the items, such as “Tian Wang Bu Xin Wan” I find sites that use woo words and non-specifics like “tranquilize[s] the mind,” “treating various diseases related to heart, kidney as well as lungs,” and “increase[s] the production of several important fluids in the body.” I understand keeping to the label, but I would like to have a detailed explanation in the items description.

    You say you are for science and skepticism but I do not see it, perhaps you can justify selling this products because I would like to hear the reasons. An unacceptable answer is “I’m not breaking the law.” Before anyone thinks that maybe unfair, keep in mind that Magnet Bracelets are legal to sell but we know they don’t work for any medical benefit.

  31. ZeGuimaraes says:

    Angora Rabbit, it isn’t easy and cheap to eat 150g-200g of protein without whey supplements.

  32. rdscptic says:

    The BBC, and Panorama in particular, (the program that aired the recent study mentioned) usually has high standards of factual accuracy. I was sadden to hear, in an otherwise balanced program, the presenter say (paraphrased) “We all know about the sugar rush we all get”. Sigh, debunk one set of myths and perpetuate another.

  33. elburto says:

    @rdskptc – actually, Panorama’s become a joke over the last few years. It’s gone from being a world-class beacon of investigative reporting, to a weak, biased consumer affairs show like Tonight , formerly known as Tonight with Trevor McDonald.

    Dispatches is on the up though (after a weak run), and as a bonus it has a 0% chance of being exposed to that hateful little man, John Humphries.

    To be honest, some of the best factual journalism is coming out of Al-Jazeera News. Birthright, Inside Story and other documentary strands on the channel are incredibly good. I really enjoyed the recent exposa of a UK power company destroying Native American fishing grounds. Sadly AJN isn’t a 24 hour channel on Freeview.

    Anyone else dead from the irony of a TCM-hawking quackupuncturist mocking Power Balance users? At least Power Balance is cheap and harmless.

  34. ConspicuousCarl says:

    LovleAnjel on 25 Jul 2012 at 2:05 pm

    @ ConspicuousCarl – weight gain, for one. They have sugar and about 50 – 100 Cal per bottle, depending on the brand.

    Compared to what? Juice and soda are double that. And no, a freaking banana is not going to satisfy most people who want to drink something.

    I’ve heard [...]

    How convincing!

  35. Janet Camp says:

    @Dr. Novella

    In light of all the tape (kinesio) seen on Olympic competitors (it seems to be everywhere, including big patches of something that looks like tape on the lower backs of most of the Chinese athletes). I wonder if you could comment further on the popularity of this product? Perhaps Scott Guvara would have some input as well?

    DWATC comments at length and professes professional knowledge, but it sounds like a lot of anecdotes to me.

    According to Wikipedia, beach volleyball player Kelli Walsh endorses a brand of this stuff and I noticed she was plastered with it in the final game.

    I fear we will soon be seeing this tape on anyone who ever has an ache or pain. I’m wondering if I should get some to apply to my forehead–to ease my aching brain.

  36. mousethatroared says:

    rdscptic “The BBC, and Panorama in particular, (the program that aired the recent study mentioned) usually has high standards of factual accuracy. I was sadden to hear, in an otherwise balanced program, the presenter say (paraphrased) “We all know about the sugar rush we all get”. Sigh, debunk one set of myths and perpetuate another”

    Actually, since we’re posting somewhat off topic questions, the sugar rush is one of mine.

    Is the sugar/hyper thing really a myth?

    I often get very jittery, hyper and sick feeling if I eat sugar on an an empty stomach (breakfast). I also sometimes get shaky, weak and nauseous when I skip lunch or eat a very late lunch. If I eat sugar at that time…very bad feeling.

    Non-medical folks have told me this is low blood sugar. I don’t really know, I mentioned it to my doctor in passing years ago, she seemed unconcerned, so I just don’t eat sweets on an empty stomach and don’t skip meals. But, if enough other people have these sensations, I wonder if that is the source of the sugar/hyper belief.

  37. BillyJoe says:

    Michelle,

    You are describing symptoms of hypoglycaemia.

    You would tend to get the symptoms if you haven’t eaten for a while. Or soon after a high sugar meal or snack. The theory in the second case is that the sugar is rapidly broken down to glucose which is then rapidly absorbed through the stomach wall producing high blood glucose levels initially. The pancreas overreacts to the excessively high blood glucose levels by secreting too much insulin which pushes the blood glucose levels below the normal range.

    “I often get very jittery, hyper and sick feeling if I eat sugar on an an empty stomach (breakfast).”

    I’m assuming there is a delay of at least 30 minutes between the ingestion of sugar and the symtoms.
    If not, my assessment might be wrong.
    Also, I defer to any experts out there….

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