Science functions best when it is free from any bias or conflict of interest. All those engaged in the process should value what is actually true more than anything else. Unfortunately, there are many sources of bias in science.
Researchers may want their pet theory to be supported. Journal editors want to publish research that will have a high impact. And of course, corporations would prefer that the results of scientific research favor their products and services. A recent round of editorials accuses the Coca-Cola company of trying to put its thumb on the scale of science in order to deflect attention away from sugary drinks as a source of obesity and overweight. What are they doing and what does the science actually say?
According to The New York Times:
The beverage giant has teamed up with influential scientists who are advancing this message in medical journals, at conferences and through social media. To help the scientists get the word out, Coke has provided financial and logistical support to a new nonprofit organization called the Global Energy Balance Network, which promotes the argument that weight-conscious Americans are overly fixated on how much they eat and drink while not paying enough attention to exercise.
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 Taubes‘ Good 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…)
There was a half-page ad in my local paper, thinly disguised as a “Special Report” by a Health and Fitness Editor, for a new fat-melting pill that “could put diet industry out of business by 2016.” I have seen a lot of ridiculous ads for weight loss products, but this one takes the cake. It’s arguably even worse than the one that proclaimed “we couldn’t say it in print if it wasn’t true” and then proceeded to say things in print that weren’t true.
It’s called Shred360. Here are some of the claims:
- It shook up the fitness industry because it DOUBLES your fat-burning potential.
- It allows anyone to LOSE INTENSE AMOUNTS OF FAT without grueling workouts or tasteless diet foods.
- It breaks your fat cells apart and disintegrates them, even while you sleep.
- Speeds your metabolism by 43%.
- It vaporizes fat without effort.
- Its proprietary blend of 16 potent ingredients is scientifically proven.
- Burns stored fat through thermogenesis and lipolysis.
- Increases energy and mental clarity almost immediately – guaranteed.
- Fools your body into feeling full: the ultimate appetite suppressant.
- Unconditionally guaranteed to make every surplus bit of your unwanted fat disappear effortlessly.
- Analysts think it will put Jenny Craig and Weight Watchers out of business by 2018 (which doesn’t even make sense if it has already put the entire diet industry out of business by 2016).
- You can eat like a normal person, skip the gym, and lose the fat you want while you sleep.
- Produced under highly controlled environmental conditions in small batches, so supplies are very limited.
- Free samples available for 100 customers – don’t wait to call.
A screenshot from the Shred360 product website. Lots of claims!
The 2014 film Fed Up is an advocacy documentary. Its message:
- There is a worldwide epidemic of obesity.
- It is endangering our children.
- Increased sugar consumption is responsible.
- The food industry is responsible for our increased sugar consumption because it puts hidden sugar in processed foods, bombards us with advertising, favors profits over health, and lobbies against regulation.
- The government is responsible because it has failed to control the food industry.
The film has received mostly positive reviews and has been called the Inconvenient Truth of the health movement. It was written and directed by Stephanie Soechtig, whose earlier films attacked GMO foods and the bottled water industry, and narrated by Katie Couric, who “gave anti-vaccine ideas a shot” on her talk show in late 2013.
The film shows families struggling with childhood obesity and “experts” expressing their opinions. Their selection of “experts” is heavy on politicians and journalists and light on nutrition scientists.
As regular readers of this blog know, Dr. Mehmet Oz had a very, very bad day last week, in which he received a major tongue lashing from Senator Claire McCaskill (D-MO) for the scientifically unsupported and irresponsible hyperbole he dishes out day after day on his syndicated daytime television show. Personally, I was tempted to pile on myself, but had to content myself with enjoying a couple of posts from a super secret blog in the run-up to the hearing (inviting Dr. Oz to testify is “like asking Al Capone to testify about U.S. tax policy or Stanislaw Burzynski about clinical trial design and ethics”), right after the hearing, and looking at the fallout from the hearing. I had even thought of asking my “friend” to combine the last two into an SBM-worthy post, but by the time that thought had occurred to me, the moment had passed.
One of the best takes I’ve seen on the whole “Oz-fest” last week comes from John Oliver on his HBO show Last Week Tonight With John Oliver. It’s a really long segment that takes up the last half of his show and features—don’t ask why—George R. R. Martin and a tap dancing Steve Buscemi. It’s hilariously spot on:
Most SBM readers will enjoy it. I promise. Oliver even correctly identifies Sen. Orrin Hatch (R-UT) and Tom Harkin (D-IA) as tools of the supplement industry and explains why dietary supplements in the U.S. are largely unregulated and the FDA and FTC have such limited powers to do anything about them preemptively.
Isagenix is a wellness system sold by multilevel marketing. It consists of a suite of products to be used in various combinations for “nutritional cleansing,” detoxification, and supplementation to aid in weight loss, improve energy and performance, and support healthy aging. It allegedly burns fat while supporting lean muscle, maintains healthy cholesterol levels, supports telomeres, improves resistance to illness, reduces cravings, improves body composition, and slows the aging process. And makes millions for distributors who got on the bandwagon early and are high on the pyramid.
I have written about it before and have been roundly criticized by its proponents. It generated my all-time favorite insult: “Dr Harriet Hall is a refrigerator with a head.”
My biggest concern with Isagenix was that it had not been clinically tested. They claimed that clinical tests were in progress (funded by Isagenix). An e-mail correspondent recently told me I should take another look at Isagenix, since a clinical study had been completed. It had not yet been published, and I asked her to get back to me when it was. Ask and you shall receive (but you may be sorry!). She contacted me when the study by Kroeger et al. was published in the journal Nutrition and Metabolism. The full study is available online and I urge readers to click on the link and look at Table 2, which I will be referring to later. The journal is peer-reviewed but, as will become painfully obvious, the peer reviewers did not do a competent job. It is an open-access online journal with a low impact factor. The authors had to pay to get their article published: it cost them $1805.
Being fat is bad except when it’s good. It’s called “the obesity paradox.” (No, that isn’t a mis-spelling for “two physicians who treat fat people.”) The adverse health effects of obesity are well established, but there are exceptions. Obesity appears to confer an advantage in certain subgroups with conditions like heart disease and diabetes.
In the News
Casual consumers of some recent media reports might interpret them as an excuse to stop trying to lose excess weight, especially if they are diabetic. Others might think we have been lied to about the dangers of the obesity epidemic. The reality is more complicated. (more…)
I first wrote about Hoodia in my “SkepDoc” column in Skeptic magazine (Vol. 13, No. 1, 2007). The following is adapted from that column with an update from new research revealing that it doesn’t work and that it causes worrisome side effects.
I first heard of Hoodia in 2006, when a radio ad informed me that it was the new miracle weight loss pill. Shortly after that, I started seeing ads for Hoodia everywhere. Anna Nicole Smith took it. It was featured on Oprah. Lesley Stahl went to Africa to taste the plant on 60 Minutes. There are nearly 40 competing brands of pills, a patch version, and even a Hoodia lollipop. It seems to have taken the world by storm; but it’s not new.
Hoodia gordonii is a cactus that grows in the deserts of southern Africa, and the San people have traditionally used it as an appetite suppressant, thirst quencher and to treat severe abdominal cramps, hemorrhoids, tuberculosis, indigestion, hypertension and diabetes. The claim is that it banishes hunger and thirst. What is the evidence? At this point it’s strictly anecdotal. Skinny Bushmen report it relieves hunger pangs in starvation conditions on long hunts; we don’t know what happens if it’s used by lazy fat people with access to food. Before the new study, there hadn’t been a single published study in humans. (more…)
The American Society of Bariatric Physicians recently invited me to speak at their continuing medical education (CME) conference on obesity in Seattle. They got my name from Stephen Barrett of Quackwatch and asked if I could speak about questionable weight loss treatments like HGH, MIC (methionine, inositol and choline), and the HCG Diet. I seized the opportunity to discuss how to evaluate any medical claim, with examples from alternative medicine as well as from weight loss. My title was “Questionable Evidence for Questionable Treatments.” I talked about some of the things that can go wrong in clinical trials and why simply finding reports of positive randomized controlled trials (RCT) is not enough. I advocated rigorously science-based medicine and recommended the SBM website.
Several people came up afterwards to express their thanks and their agreement, but some of the questions from the audience were rather hostile. One man said he was a military doctor and he was using and teaching acupuncture (which I had criticized as a bad example of “tooth fairy science” in my talk). I asked for his opinion of battlefield acupuncture and he just said “No comment.” A couple of people thought science wasn’t enough and thought it was okay to prescribe questionable treatments when there was no proven effective treatment. I responded that I had no objection as long as the patient was told the facts and not given the false impression that the questionable treatment had been tested and shown to work.
I was glad for the chance to meet some of the ASBP members. I had never met a bariatric physician and was interested to learn about their practices and philosophies. I had never really thought about the fact that most obese patients had associated diseases like hypertension and diabetes, so their overall management could be very complex. I attended the whole obesity course: some of what I heard was educational, some of it was questionable, and some of it was frankly disturbing. (more…)
Over the last few months, I have had a truly surreal experience. It started when I noticed a two-page full color spread in TV Guide magazine advertising a product called Akavar 20/50. It contained the same claims that so many bogus weight loss products do: eat all you want and still lose weight. What attracted my interest was their highlighted statement: “We couldn’t say it in print if it wasn’t true!”
I laughed out loud. Anyone can say anything in print until they get caught. These diet ads all say things that aren’t true, and the FTC can’t begin to catch them all.
The ad describes research results they call “staggering.” They have scientific documentation that 23 out of 24 patients using Akavar’s active ingredient lost weight. They also described a controlled, randomized clinical trial of their actual product in which 23 out of 24 patients lost “a substantial amount of weight.” Two questions immediately came to mind: why were the numbers the same in both studies, and if a single active ingredient worked just as well, why was there any need to develop the Akavar formulation?
There was a toll-free number where I could call for further information. I called and asked for the citations of the two studies they referred to. The man who answered was flummoxed: “No one’s ever asked me that before.” He had to go for help. Finally he came up with the names of two journals and no further information.
I searched PubMed for anything in either of those journals that might even remotely be the studies they described, and I couldn’t find anything. I wrote the company’s customer service representative and asked for more information. And then the real fun began. Here are the actual e-mails for your delectation: (more…)