Health Information: Separating Fact From Fiction
The days when people received all their health information from doctors have come and gone. The technology explosion of recent years has made health information more accessible to more people than ever before. Books, magazines, television, radio, supermarkets, health food stores, and the Internet are just a few places where health information and advice is available. But how can you know if the source is credible and the information accurate?
Prevalence and Dangers of Nutrition and Health Fraud
The federal government estimates that, of the $800 billion spent annually on healthcare, fraud and abuse account for $50 billion to $80 billion. Additionally, Americans spend an estimated $20 billion a year on unproven medical treatments.
This isn't to say that all unproven treatments are fraudulent. But without scientific evidence, medical professionals can't know for sure if the treatment actually worked or if there was a placebo effect involved. Potential dangers of unproven treatments include drug interactions and toxicities. The possibility also exists that using unproven remedies can delay the use of established treatments, thus allowing a disease to worsen.
The following are some areas that are particularly susceptible to misleading claims:
Because herbal supplements are considered foods rather than drugs, they are not subject to the same approval criteria by the Food and Drug Administration (FDA) as are drugs. Consequently, there is no governmental oversight of manufacturing or of herbal effectiveness.
Products from different manufacturers may be very different in potency and may not be directly comparable. Even if one brand of herb has been shown effective, this does not guarantee that a competitor’s product will perform equally well. An important misconception is that since they are "natural," they are harmless. This may not be the case, and indeed, as noted below, at least one herbal has been banned because of dangers that emerged after widespread use. Herbs and supplements can be very powerful and must be used with caution. Check the FDA's website for warnings and safety information on dietary supplements.
While herbal remedies have been used for centuries, only recently have studies been designed to test their efficacy. Searching for test results in legitimate sources is the best way to learn whether scientific studies support the use of a given herbal remedy. Natural and Alternative Treatment includes information on over 350 herbs and supplements.
The Internet is another flourishing area for nutritional information and misinformation.
"The Internet is going to flood us with more information than we can use," says John H. Renner, MD, of the Consumer Health Information Research Institute. There is no governing body or set of rules overseeing the content on the Internet. Therefore, there is nothing to prevent anyone from using it to peddle false information and promote fraudulent products.
Dr. Renner spends much of his time studying health and nutrition information on the Internet. He looks for accuracy, usefulness, credibility, and links in a website. A big mistake many credible sources make, he notes, is providing links to other sources without first checking their credibility. His main advice to consumers surfing the Internet for nutritional information is to "find out the source of the information."
Well-established and reputable sources include government agencies, such as the FDA and USDA, professional organizations such as the American Dietetic Association and the American Medical Association, and volunteer organizations, such as the American Heart Association, American Cancer Society, and the American Diabetes Association .
A Note About Credentials
Your doctor probably has a diploma hanging on the wall. You won't always find that when looking for nutritional advice, particularly when it comes from a source outside of the traditional healthcare setting. To be sure you are getting advice from someone who has training in a wide variety of nutrition topics, one option is to look for the credentials RD (registered dietitian). Registered dietitians must complete four years of undergraduate study in nutrition at an accredited university, a postgraduate internship, and then pass a national exam to receive the RD credential. If you are seeking a nutrition counselor, see the American Dietetic Association's website to locate a registered dietitian near you.
If you are investigating alternative therapies, you may want to look for people who have the initials ND after their names. This signifies that they have been trained as a naturopathic doctor, which usually includes four to five years in a program that emphasizes natural therapies. Naturopathic doctors are licensed in 16 US states, as well as Puerto Rico and the Virgin Islands.
Red Flags for Consumers
The Food and Nutrition Science Alliance (FANSA) is a coalition of food scientists, nutrition professionals, and researchers. To aid consumers in evaluating nutrition and health reports and advice, FANSA has issued a "list of red flags of junk science." "Any combination of these signs should send up a red flag about the accuracy of the information," says Janet Hunt, PhD, RD. Included in the list are:
- Recommendations that promise a quick fix.—We'd all like to lose 20 pounds in two days, but history (and biology) continue to prove that it's just not possible.
- Claims that sound too good to be true.—A claim that a particular product or diet can single-handedly cure an illness or work miracles on your metabolism is usually unfounded. Also, beware of claims of a "secret formula," another clue that quackery may be at work.
- Recommendations based on a single study.—A single study, no matter how well-designed, is not adequate as a basis for definite conclusions and recommendations.
- Dramatic statements that are refuted by reputable scientific organizations.—Manufacturers of fraudulent products often use anecdotes and testimonials from other consumers, as well as celebrity endorsements, to "prove" that a product works. These shouldn't take the place of scientific experiments or general consensus among scientists.
- Lists of "good" and "bad" foods.—Most reputable nutrition professionals agree that there really are no good and bad foods, just good and bad diets. One food alone won't make a person overweight or unhealthy, nor will one food alone bring about weight loss or better health.
- Recommendations made to help sell a product.—A registered dietitian may recommend a dietary supplement to you, but beware of any practitioner who gives dietary advice and then tries to sell you a product. That is a conflict of interest.
- Recommendations based on studies published without peer review.—Scientific studies published in reputable medical journals undergo a thorough review process before publication. If someone is quoting studies while promoting products, ask to see the studies. Check out where and when they were published.
What If You're a Victim?
If you think you've been the victim of nutrition quackery, you have several options. Most importantly, if you think a product has caused you physical harm, contact your doctor immediately. Otherwise, the National Council Against Health Fraud, the Consumer Health Information Research Institute, and the FDA Office of Consumer Affairs are good organizations to turn to with questions and complaints. If the product was ordered by mail, your local post office might be able to help. Ultimately, knowledge is your best defense. An informed consumer is much less likely to become a victim of nutrition quackery.
Food and Drug Administration
National Center for Complementary and Alternative Medicine
National Council Against Health Fraud
Dietitians of Canada
Barrett S, Herbert V. The Vitamin Pushers: How the "Health Food" Industry Is Selling America a Bill of Goods . Prometheus Books: Amherst, New York; 1994.
Dietary supplements: making sure hype doesn't overwhelm science. FDA Consumer Magazine. November 1993.
Licensed states and licensing authorities. The American Association of Naturopathic Physicians website. Available at: http://www.naturopathic.org/viewbulletin.php?id=118. Accessed July 18, 2008.
Last reviewed June 2008 by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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