THANKS TO managed care, it's getting harder and harder to see doctors, and you're afforded less and less time with them when you do. Why does anyone express surprise that Americans spend more and more every year on help-yourself books, herbal remedies, and wonder drugs ordered from obscure Web sites in Oaxaca or Bimini?
In a way, our determination to get healthy in the teeth of the medical establishment's determination to let us languish is admirable. If only our judgment equaled our spunk. Because there's abundant evidence that 90—if not 99—percent of the $20 billion a year Americans spend on dietary supplements, herbs, and patent medicines is utterly wasted, if not actually harmful to health.
We're not the only people in the world who have a long history of suckerdom when it comes to patent remedies, but we're the only ones to institutionalize our predilection for snake oil in law (see Harris L. Coulter's Divided Legacy for a history of the development of America's medico-legalo-pharmaceutical complex).
As a consequence, it's almost impossible in this country to get the straight dope on medical questions from the sources we pay to provide answers: Call the county or state departments of health about health claims you've seen for some herb or other, and you'll be referred briskly to the U.S. Food and Drug Administration (FDA) for answers.
Unfortunately, thanks to the financial clout of the food-supplement lobby on Congress, since 1994 the FDA has been expressly forbidden by law to test, license, or even comment on any patent remedy, so long as its maker calls it a food supplement, not a medicine. So forget about federal scientists posting a list of products making phony health claims on the Internet. The best you'll get from a visit to the FDA Web page are some very general "Tips for Users": nearly 3,000 words of tips that basically boil down to "You're on Your Own."
Since they can't get reliable information— or, often, any information at all—from physicians or government, most people get their information from the media. And "reliable" is not exactly the word you'd want to use for what they get. Television talk shows and local news broadcasts are notorious for their willingness to publicize virtually anything or anyone claiming a health breakthrough—the more sensational the better. But the mainstream media don't do any better; they may even, if fast, do more damage by lending their credibility to the latest half-tested, half- understood "medical miracle."
But we have to work with what we have, and the mainstream media are at least willing to report countervailing evidence when it becomes available—though rarely admitting that any mistake was made in the first place.
Even on the World Wide Web itself, where all but a smidgen of the pages devoted to medicine, health, and nutrition are full of half-truths, commercial bias, and outright lies, there are a few sites devoted to detoxifying the miasma of misinformation surrounding them. If you use the Web at all to search for health-related information, you owe it to yourself to bookmark one of them: the trenchantly titled quackwatch.com.
The last year or so has brought a bonanza of backtracking on medical "breakthroughs" long thought to be well established. We list just a few here as a reminder that you can't believe everything you read in the papers—including this one.
Vitamin C helps stave off colds. The granddaddy of them all, longer running than The Fantasticks. In the 31 years since Linus Pauling announced its efficacy against colds, not one properly conducted study has shown any beneficial effect of taking vitamin C on a regular basis, and plenty of bad side effects, including bowel irritation, diarrhea, and (see below) kidney stones. But Pauling's legacy continues: Some even claim that vitamin C retards cancer. (There are too many sources to cite, but see the Web links at the end of this article.)
Cholesterol causes heart disease. Correction: Atherosclerotic plaques cause damage to, and congestion of, the arteries, thereby increasing blood pressure and possibly damaging heart tissue. But cholesterols (there are quite a number of them) are a major component of the outer wall of every cell in the body, so drugs or home remedies which purport to "lower cholesterol" had better be used with exquisite caution. As for dietary cholesterol, a connection between consuming cream, butter, eggs, etc., and excess system cholesterol has never been demonstrated, let alone proven. If you eat too much, particularly too much fat, your "bad cholesterol" count will most likely go up. But don't blame the chicken or the cow, my friends: It's the piggy doing the eating who's at fault.
Ibuprofen is better for you than aspirin. Maybe, if you take it for arthritis pain and your tummy can't tolerate aspirin. But if, like a lot of people, you also take a small dose of aspirin daily to reduce the risk of blood clots and subsequent stroke, you might as well not bother: Turns out ibuprofen-based pain relievers block aspirin's blood-thinning action (The New York Times, Dec. 20, 2001).
P.S.: A 1988 study suggests that steady use of any nonsteroidal pain reliever is a contributory factor in over 16,000 deaths annually in the U.S. from ulcer complications: about the same number who die from AIDS (Reuters, May 8, 1998).
A low-calcium diet helps prevent kidney stones. Sorry; just the opposite, actually. A five-year study at the University of Parma in Italy showed that men on a normal healthy diet were half as likely to suffer from kidney stones as those on a low-calcium diet (HealthScoutNews, Jan. 9, 2002).
Oat bran reduces the risk of colon cancer. Nope. Recent statistical studies show no significant correlation. Wheat bran does seem to help guard against colon cancer, but nobody so far has suggested why this might be, and there's no conclusive study of the subject, anyway (Cox News Service, March 15, 2001).
Mammograms improve a woman's chances of surviving breast cancer. Apparently not; a recent Danish study showed (according to The New York Times' Gina Kolata) that "women who had the tests ended up with more surgery, including mastectomies, more radiation and [more] chemotherapy treatment than women who were not screened," but they died just as often as their untested sisters (The New York Times, Dec. 30, 2001).
Lactose intolerance is a serious health problem in America. It sure is—if you're of Asian or African extraction. Otherwise, that gassy, replete feeling you've decided is due to genetic lactose intolerance is probably due only to overeating—or, just possibly, to "irritable-bowel syndrome," which is just as hard to pinpoint (and often just as imaginary) as chronic fatigue syndrome. Avoid milk products if you like, doctors say, but you'll likely be better off just eating less grease, more fiber, exercising, blah, blah, blah . . . (The New York Times, Jan. 14, 2002).
Echinacea boosts the immune system. Like many herbs from the traditional pharmacopia, echinacea (a variety of wild daisy) may turn out to contain compounds useful in treating medical conditions; but there is no evidence capable of standing up in court or lab that it improves immune response. None. Nada. Nitz. (There are innumerable sources; check out Nutrition Today, Sept. 2001.)
Glucosamine reduces pain and swelling from arthritis. Maybe it does, in some people, but the verdict of oral dosages in most studies is "nix" or "not proven." What's sure is that glucosamine, often with the cartilage derivative chondroitin, is useless when applied topically as a cream: Neither compound is capable of penetrating the skin (Journal of the American Medical Association, March 14, 2000).
If you're tired all the time, you're probably hypoglycemic. Unlike "chronic fatigue syndrome," which remains a hypothesis, hypoglycemia is a real condition, but it's about as rare as CFS and just as hard to pin down. "Low blood sugar" is not enough for a diagnosis; there has to be a persistent pattern of low blood sugar correlated with the symptoms and below-average thyroid activity, too.
Kava root is natural Prozac. So it is, in reasonable quantities: Pacific Islanders have been brewing it for thousands of years for its calming and mood-elevating effects. But that was before Western herb-pushers got hold of it: The dose of kava in many supplements is 10 or more times what you'd get in a natural decoction, and sure enough, it turns out persistent use at high levels screws up your liver (The New York Times, Jan. 16, 2002).
Jogging is the best all-round exercise there is. Oh, yeah? Talk to the physical therapists and orthopedists who have to deal with the consequences of careless or ill-advised jogging: the displaced and ruptured spinal discs, the eroded cartilage and frayed ligaments, the compromised hips and ruined knee joints. Some people can jog and run and flourish; others, probably a majority, should find another mode of exercise. Like swimming—the scenery may not be much, but you won't be looking into knee replacements, either.
Interferon cures colds . . . uh, make that bone cancer . . . no, multiple sclerosis. . . . Since its isolation in 1957, this family of anti-viral agents has been turned against any number of diseases; problem is, even today, nobody understands how the body produces them or how they work (when they do). But the biotech industry doesn't give up easily, and recently there's been some evidence that interferons are sometimes effective against hepatitis, leukemia, and MS. What's certain is that artificial interferons—produced outside the body by recombinant DNA and cloning procedures—are often acutely toxic, so that there's a serious risk in using them even against such life-threatening conditions (BIOWORLD Today, July 13, 2001).
Aromatherapy cleanses the body of impurities and toxins. Oh, please. . . .
For more information: www.quackwatch.com, an informational Web site maintained by volunteer doctors to inform the public of medical hazards and falsehoods; the Food and Drug Administration's public- information site for nonregulated substances, www.cfsan.fda.gov/~dms/ds-savvy.html#tips.
If you're even looking at this, you already know you're in lousy shape. But just how lousy? Wouldn't you like to know? Go on, try it; no one else has to know (but make sure you destroy the evidence afterward—remember Richard Nixon).
How many days since you walked or biked to the store?
How many days does a can of Danish butter cookies last in your home?
How many months since your last routine full-spectrum physical (i.e., not for a specific ailment)?
How many servings of vegetables or fruit have you eaten in the last 24 hours? (NB: Fried, chocolate-covered, or encased in pastry don't count.)
How many inedible vegetables are in your refrigerator right now?
How many of the six categories of the FDA's food pyramid can you name? (10 points extra if you can draw it correctly)
How many days has it been since you cooked dinner from scratch?
How many of the eight glasses of water doctors recommend you drink each day do you drink? (And if you drink eight or more, how often do you go to the bathroom? Just curious.)
How many prescription medications do you take routinely?
How many take-out meals a month do you eat?
To score yourself: Add up all the points of odd-numbered questions and subtract all the points for even-numbered questions.
If you scored between:
1 and 25, you're pretty close to the flabby all-American norm.
0 and -25, you're doing fine. Keep it up.
25 and 50, you're in serious need of an attitude check and a complete change of lifestyle.
-25 and -50, you're ridiculously healthy and probably ride a bike to work through heavy traffic.
Over 50: You're dead and just don't know it.
Under -50: You're lying.