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Green Tea: Panacea or Poison?

320px-Genmaicha_tea_brewed_and_unbrewed

In the news: a woman in Fort Wayne, Indiana is suing the Arbonne International company in Allen Superior Court, claiming that its product contained toxic levels of green tea extracts, causing her to develop acute liver failure.

Green tea accounts for 20% of tea consumption worldwide. It has become more and more popular because of its many reported health benefits; the consumption of green tea in the US has risen by 40% just since 2000. A less-processed form of tea, green tea contains higher levels of antioxidants and polyphenols than other teas. It was traditionally used to control bleeding, heal wounds, aid digestion, improve heart and mental health and regulate body temperature. More recently, research has suggested that it has many health benefits.

The evidence for health benefits

The University of Maryland Medical Center has a helpful webpage that summarizes all the relevant research and provides a long list of references. Green tea may reduce the risk of heart disease (but the FDA prohibits that claim on labels; they concluded there was no credible evidence to support it). Green tea lowers total cholesterol and raises HDL. Population studies suggest that it may help protect against several kinds of cancer, but the evidence is mixed: other studies suggest that it may actually increase the risk of some cancers, and it may interfere with cancer chemotherapy. It may help in inflammatory bowel disease, diabetes, liver disease, and weight loss. There is even preliminary evidence that it might prevent dental cavities, might be useful in arthritis, might help treat genital warts, and might even prevent symptoms of colds and flu. Studies show that drinking green tea is associated with reduced risk of dying from any cause. At first glance, it might sound like a panacea, but the evidence is still questionable. Much of it is from small, preliminary studies that have not been replicated or that contradict each other. (more…)

Posted in: Herbs & Supplements

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Mandatory breast density reporting legislation: The law outpaces science, and not in a good way

Over the years, our bloggers here at Science-Based Medicine have written time and time again about the intersection of law and science in medicine. Sometimes, we support a particular bill or law, such as laws to protect children against religion-inspired medical neglect; laws making it harder for manufacturers of homeopathic “medicines” to deceive the public; or California Bill AB 2109, a bill whose intent was to make it more difficult for parents to obtain nonmedical exemptions to vaccine mandates but whose implementation after being passed into law was profoundly sabotaged by Governor Jerry Brown. or, more recently, California SB 277, a bill currently wending its way through the California legislature that would eliminate nonmedical exemptions to school vaccine mandates and has, not surprisingly, engendered extreme resistance from the antivaccine crowd, including by Robert F. Kennedy, Jr. In the vast majority of cases we explain how the law lets us down when it comes to science in medicine, and, unfortunately, examples are many: Naturopathic licensing laws; supplement regulation (or, more appropriately, lack of regulation); misguided, deceptive, and patient-hostile “right-to-try” laws; state laws regulating medical practice that allow quackery to flourish unchecked; laws regulating pharmaceutical cost transparency that ask the wrong question.

The case I will discuss here is unusual in that it is a case of the law getting ahead of what the science says in a manner that will likely do little, if any, good for patients, cause a lot of confusion until the science is worked out better, and end up costing patients money for little or no benefit. I am referring to laws mandating the reporting of high-breast-density to women with dense breasts undergoing mammography. These laws are sweeping the country (albeit not as rapidly as “right-to-try” laws), with a total of 22 states having passed them as of today since Connecticut became the first to do so in 2009. The most recent of these laws went into effect in my own state of Michigan exactly one week ago:

Women with dense breast tissue — the sort that can hide potentially deadly tumors from routine mammograms — must be notified in writing and encouraged to consider additional tests under a new state law that is effective Monday.

While mammograms remain the gold standard for detecting breast tumors, they’re less reliable in almost half of women with dense breast tissue. Dense or fibrous tissue shows up as splotches of white on a mammogram — so do tumors.

That will likely surprise many of the millions of women who rely on mammography for catching the earliest signs of cancer, said Nancy Cappello. The Connecticut woman was shocked in 2004, when her gynecologist found a lump — advanced cancer that had already spread to her lymph nodes — just months after a mammogram deemed her cancer-free.

(more…)

Posted in: Cancer, Politics and Regulation, Public Health

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Chiropractic Manipulation of the Neck Linked to Stroke in a 6-Year-Old Child…

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The risk of suffering a stroke when undergoing aggressive chiropractic manipulation of the neck is not a new concern. We’ve discussed it several times on the pages of Science-Based Medicine over the years, most recently in November of 2014 when Steven Novella covered the death by chiropractor of 30-year-old Jeremy Youngblood, whose fatal brain injury occurred while seeking treatment for a sore neck. For a nice review of cervical manipulation in general, the evidence against its inappropriate use, and an assessment of the literature on this subject, check out prior posts by Dr. Hall and chiropractor Samuel Homola.

I believe that my take on the issue is in line with my fellow SBM authors. There is no role for high velocity, low amplitude (HVLA) thrust-type maneuvers that cause sudden and intense rotation of the neck in any patient, for any reason. It is not effective for neck pain, headache or any other complaint, and it is a proven risk factor for injury to the vertebral arteries and subsequent stroke. Some patients are at higher risk, such as the elderly or those with atherosclerosis or connective tissue disorders, but this type of injury can occur at any age and even in a perfectly healthy individual. (more…)

Posted in: Chiropractic, Science and Medicine

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Medicine doesn’t come from the hardware store: Don’t drink turpentine

This is not a health food. Don't drink it.

This is not a health food. Don’t drink it.

I enjoy feedback from readers. Yes, there’s the regular hate mail accusing me of being a Big Pharma Shill. But there’s the occasional appreciative comment from someone that found a post helpful or informative. The most gratifying feedback is when someone tells me that something I wrote led to a more informed health decision. Often it’s because I was able to answer a question that they couldn’t find a science-based answer to. I’ve answered thousands of questions in my pharmacy career, and have only blogged a handful of them (so far). One of my most fascinating experiences was a stint working evenings in a pharmacy that happened to have a large “natural” health focus. It’s there I began to scrutinize alternative medicine more closely, because it was virtually all the store sold. Homeopathy, ear candles, copper bracelets and salt lamps were all for sale. If it was unproven, proven ineffective, or defied some law of physics or chemistry, this pharmacy probably sold it. But the customers loved these products. I was dumbfounded. Some would buy dozens of supplements, costing hundreds dollars per month, on the advice of their naturopath, treating some vague or non-specific complaints. Others swore by homeopathic remedies, for themselves and their pets. It was common to meet people who were treating conditions that either didn’t exist, or hadn’t been properly diagnosed, like naturopath-diagnosed “food intolerances” or “hormone imbalances”. There were also the occasional “pH balancing” advocates that insisted I was misguided and uneducated for reassuring them that their body’s pH was just fine, despite what their urine test strips were telling them. (more…)

Posted in: Herbs & Supplements, Naturopathy, Science and Medicine

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Remembering Wallace Sampson

Wally Sampson, MD March 29, 1930 – May 25, 2015

Wally Sampson, MD
March 29, 1930 – May 25, 2015

I’m sad to report that Dr. Wallace (Wally) Sampson, one of the original authors at Science-Based Medicine, passed away on May 25th at the age of 85. Wally was a valued member of the SBM community, a mentor to many of us, and a tireless crusader against health fraud and pseudoscience in medicine. He carried the banner of defending science and reason within medicine for a generation, and his is one of the giant shoulders on which SBM currently rests. His contributions to this website can be found here.

Wally was fighting against health fraud back when it was still called health fraud, rather than “alternative medicine” or whatever the latest marketing term they have adopted is. I would often go to him for perspective on the long range trends in our struggle to promote science in medicine. He had put in the decades of service necessary to have such perspective.

I personally owe Wally a great deal for my own career battling medical pseudoscience. Wally was keen to identify and nurture new people interested in promoting science in medicine. As a much younger skeptic, prior to social media, when I was only running a new and obscure local skeptic group, Wally invited me to speak at conferences, and eventually to be one of the assistant editors for The Scientific Review of Alternative Medicine, a print journal of which he was the first editor (available online here). Such nurturing was not common in my experience. He gave me the experience and platform upon which I eventually built Science-Based Medicine.

(more…)

Posted in: Announcements, Health Fraud

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The Rosedale Diet: Here We Go Again

The Rosedale Diet

Ron Rosedale, MD has devised a “powerful program based on the new science of leptin.” “Finally — the ultimate diet for fast, safe weight loss, lifelong health, and longer life…” He suggests it will prevent or improve high blood pressure, diabetes, heart disease, osteoporosis, arthritis, and a host of other ills. He repeats the CAM canard that “doctors only treat symptoms” and claims that his diet corrects the underlying cause of obesity, premature aging, and many diseases. That underlying cause is hormone (leptin) dysfunction. His is essentially just another low carb diet, only with more fat and less protein than other versions. His recommendations are ridiculously elaborate and are not supported by good evidence. His diet extrapolates from basic science, is based on speculative hypotheses, and has never been tested to see whether it works and is safe, much less whether it is superior to other diets.

If this sounds vaguely familiar, it should. He is doing what so many proponents of fad diets have done in the past, and he does it poorly. His book is a puerile effort compared to Gary TaubesGood Calories, Bad Calories; Taubes at least marshaled an impressive mass of scientific data, presented a cogent argument, and ultimately acknowledged that more studies would be needed to test his recommendations. (more…)

Posted in: Book & movie reviews, Herbs & Supplements, Nutrition

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Let food be thy medicine and medicine be thy food? The obsessive worship of “medicinal foods”

Let food be thy medicine and medicine be thy food? The obsessive worship of “medicinal foods”

Let food be thy medicine and medicine be thy food.

– attributed to Hippocrates

Who said anything about medicine? Let’s eat!

– attributed to one of Hippocrates forgotten (and skeptical) students

 

Who hasn’t seen or heard Hippocrates’ famous quote about letting food be your medicine and your medicine your food? If you have Facebook friends who are the least bit into “natural” medicine or living, you’ve almost certainly come across it in your feed, and if you’re a skeptic who pays the least bit of attention to what’s going on in the quackosphere you will almost certainly have seen it plastered on a picture as a meme, either using a picture of Hippocrates or pictures of plates of green, leafy vegetables, or both. I like to view the fetishization of “food as medicine,” to cite Hippocrates, as one of the best examples out there of the logical fallacy known as the appeal to antiquity; in other words, the claim that if something is ancient and still around it must be correct (or at least there must be something to it worth considering).

Of course, just because an idea is old doesn’t mean it’s good, any more than just because Hippocrates said it means it must be true. Hippocrates was an important figure in the history of medicine because he was among the earliest to assert that diseases were caused by natural processes rather than the gods and because of his emphasis on the careful observation and documentation of patient history and physical findings, which led to the discovery of physical signs associated with diseases of specific organs. However, let’s not also forget that Hippocrates and his followers also believed in humoral theory, the idea that all disease results from an imbalance of the “four humors.” It’s also amusing to note that this quote by Hippocrates is thought to be a misquote, as it is nowhere to be found in the more than 60 texts known as The Hippocratic Corpus (Corpus Hippocraticum).

As Diana Cardenes argues:

But Hippocratic doctors clearly saw a difference between food and medicines. In fact, food was considered as a material that could be assimilated after digestion (e.g. the air was also food) and converted into the substance of the body. For example, food was converted into the different parts of the body such as muscles, nerves, etc. By contrast, the concept of medicines at the time was a product which was able to change the body’s own nature (in terms of humor quality or quantity) but not be converted into the body’s own substance. Thus a food wasn’t considered a medicine. A possible root of the food-medicine confusion is the following cryptic phrase found in the work On Aliment: “In food excellent medication, in food bad medication, bad and good relatively”.3 This text is nowadays attributed to the Hellenistic period, but was considered to be Hippocratic in Antiquity by Galenus in particular.

Now, it is certainly true that Hippocrates and his followers used diet to treat many illnesses, it’s not really clear what sort of success they had. However, this ancient idea that virtually all disease could be treated with diet, however much or little it was embraced by Hippocrates, has become an idée fixe in alternative medicine, so much so that it leads its proponents twist new science (like epigenetics) to try to fit it into a framework where diet rules all, often coupled with the idea that doctors don’t understand or care about nutrition and it’s big pharma that’s preventing the acceptance of dietary interventions. That thinking also permeates popular culture, fitting in very nicely with an equally ancient phenomenon, the moralization of food choices (discussed ably by Dr. Jones a month ago).
(more…)

Posted in: Cancer, Nutrition

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Chiropractic Nose Balloons

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Pictured: Hobbit condom. Yup, it’s gonna get weird again.

You can pick your friends. You can pick your nose. But you can’t pick your friends nose.

Unless you practice Nasal Cranial Release.

There are so many pseudo-medicines, it is hard to keep track. New variations appear, new combinations of old SCAMs occur, old pseudo-medicines wax and wane, although no pseudo-medicine ever dies. Except phenology? Maybe? I find a few phrenology sites on the web, but I cannot tell if they are real or satire.

There is an ongoing discussion in my family as to the greatest band of all time. The Who is THE correct answer, but really, bands do not have to follow the Pauli exclusion principle. There can be multiple greatest bands of all time, all existing simultaneously at the same place. Except that The Who is a little bit more greater than the others. Yes. More greater.

The same concept applies to SCAMs. Whose goofiness reigns supreme? Homeopathy? Reiki? Epigenetic Birth Control? They are all equally goofy, each in their own special way.

In my feeds I saw the announcement that “Anderson Chiropractic Announces Nasal Cranial Release Therapy“. I had never heard of Nasal Cranial Release Therapy. It sounds bad, turning humans into a PEZ dispenser, popping off the skull by way of the nose, a particularly horrific form of rhinotillexomania. It’s not that goofy. But close. (more…)

Posted in: Chiropractic

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Florida strikes out against Brian Clement

CBC interview with Brian Clement.

CBC interview with Brian Clement.

Brian Clement is a charlatan. Unfortunately, that doesn’t seem to be a problem for the State of Florida. I made two (which turned into three) attempts to get the state to take action against Clement or the Hippocrates Health Institute, where he serves with his wife Anna Maria Gahns-Clement as co-director. All of them failed. Brian Clement slithered through the cracks in Florida law each time.

Before we get into the details of Florida’s failure to act, a bit of history (and there is plenty of it) is in order.

In recent months, Clement’s sordid cancer quackery has been well-documented in the media as well as in the science “blogosphere”. (I’ve listed what I hope is a — but almost certainly isn’t — complete blog archive at the end of this post. Many of the Canadian Broadcasting Corporation [CBC] and other news reports are linked in these posts.) Most of the coverage has centered on two Canadian girls suffering from lymphoblastic leukemia whose parents pulled them from conventional cancer therapies, which gave them an excellent chance of survival, in favor of treatment at the Hippocrates Health Institute (HHI), a sprawling spa in West Palm Beach, Florida, licensed as a massage establishment by the state.

Clement gave a talk in Canada, in 2014, claiming “we’ve had more people reverse cancer than any institute in the history of health care.” (“We” is the operative word here, because it later served as Clement’s ticket to avoid prosecution by the Florida Board of Medicine, as you shall soon find out.) The girls’ families were impressed.

Sadly, one of the girls, Makayla Sault, died earlier this year. The other, identified only as “JJ” in the media because of a publication ban, has returned to conventional treatment. However, her mother apparently remains under the influence of Clement: JJ is restricted to a raw foods diet and is still being followed, if that is the right word, by HHI. (more…)

Posted in: Cancer, Health Fraud, Legal, Nutrition, Politics and Regulation, Science and the Media

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Attitudes Predict CAM Use

 From the US Food and Drug Association article "6 Tip-offs to Rip-offs: Don’t Fall for Health Fraud Scams

CAM: More branding than medicine.

One of the persistent themes of SBM is that CAM (complementary and alternative medicine, or integrative medicine) is nothing more than a marketing brand. Its recent popularity is not based upon new evidence or a changing paradigm of medicine as its proponents claim. Its popularity is increasing despite the lack of evidence for specific CAM treatments and despite a dedication to evidence-based medicine within the medical profession.

CAM is also modern mythology, which I guess all really effective advertising and branding is. It floats atop a number of demonstrably false marketing claims. One is that the popularity and use of CAM is surging. This is partly a self-fulfilling prophesy, and no doubt it is increasing, but the degree to which CAM is popular has been consistently exaggerated by proponents (largely as a way to justify its existence).

This myth is largely perpetuated by redefining CAM as needed, including things like prayer, massage, and taking vitamins. I suspect that praying for a sick loved-one has always been popular and doesn’t represent a trend toward CAM. When unequivocal alternative modalities are considered, their use is still tiny and not increasing. The most recent NIH survey found:

Use of acupuncture (1.1%), homeopathic treatment (1.7%) naturopathy (0.2%), and energy healing (0.5%) was miniscule.

(more…)

Posted in: Medical Academia, Science and Medicine

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