Bullsh*t of the Day: Colon Cleansing

I think it's time to cleanse the world of colon cleansing.

Colon cleansing is where people go on special liquid diets or take special liquid or herbal supplements to "cleanse" the colon of any "toxins" that supposedly have accumulated in there.


First, the word "toxin" is always a red flag. Usually, "toxin" is pseudoscientific doublespeak that people use to get you to buy their product. The next time people tell you their product will get rid of toxins, ask them "Which toxins?" They usually can't tell you.

In fact, colon cleansing is based on the outdated 19th century theory of autointoxication....the belief that waste collects in the colon over time and stagnates there. Well, research as early as the 1920's showed that this isn't true. Doctors who regularly perform colonoscopies and literally look into hundreds of colons per year will tell you that stool does not collect in the colon at all.

There's also no evidence that stool is toxic to the body. If stool was toxic, then people who suffer from constipation would also suffer from more disease....but they don't.

If you take a close look at the ingredients of these "colon cleansing" products, you'll find that they're either simply a random collection of different types of fiber...

and/or a random collection of herbs...
 
 

 
...and there's no evidence that any of these herbs do anything for you, let alone "cleanse" your colon.


In fact, you have to be careful with some of the herbal colon cleansers, because they may contain powerful laxatives, such as senna leaves. While laxatives can occasionally relieve constipation, frequent use may have harmful effects, including dehydration and vitamin/mineral deficiencies.

Despite all the claims of the people who want you to take a colon bath, there's no need to cleanse your colon. It does just fine on its own.

For a healthy colon, what matters is what you put in your mouth. Make sure your diet is adequate in natural fiber from whole fruits and vegetables. Also, drink enough water....mild dehydration may result in constipation.

Basically, the only shit that needs to get cleaned up here is the bullshit surrounding colon cleansers.  If you ever use any these products, you're flushing your money right down the toilet...literally!

What Makes Bullsh*t.....Bullsh*t????

Judging by the comments on my Cobroxin blog post (as well as the comments on the follow-up post), it is apparent that some people don't understand what this blog is about.

It's also apparent that some people don't really understand why something can be considered bullshit.

Some people seem to think that this blog is about exposing scams.

That's only partly true.

The purpose of this blog is stated very clearly over in my disclaimer to the right.  Specifically, it states that the purpose "is to challenge the evidence-basis of many claims made in the health and wellness industry."

Just because I challenge the evidence presented for a product or claim, doesn't necessarily mean I think the product is a scam. 

So what makes me call something bullshit?

I consider something bullshit if the level of evidence being provided for a product doesn't match the claims being made about that product.

Let me repeat that.

I consider something bullshit if the level of evidence being provided for a product doesn't match the claims being made about that product.


Logic dictates that extraordinary claims require extraordinary evidence.

If I tell you that I went to the grocery store today, you probably wouldn't demand much evidence for me to support that.  Yes, I may be lying, but since people go to the grocery store every day, it is an ordinary claim and thus there is little reason for you to be skeptical of my claim.

Now, I tell you that I went to the grocery store and saw Bigfoot. 

Suddenly, my claim is not so believable.  People don't go to the grocery store and see Bigfoot every day.  In fact, you never hear about people going to the grocery store and seeing Bigfoot.  This is an extraordinary claim.  Thus, the level of evidence necessary to support that claim is beyond the level of evidence necessary to support a claim I went to the store.  You would require extraordinary evidence...other eyewitnesses, video, photos, hair samples, etc.

This holds true in the field of health and wellness.  This field is full of products with bold claims, but not bold evidence to support those claims.  The evidence generally doesn't come even close to the claims being made.

In other words, in the health and wellness industry, extraordinary claims are often accompanied by only ordinary evidence.

This is true with the Cobroxin product.  The claims being made about this product are quite extraordinary....that it causes significant pain relief for moderate to severe chronic pain, across a wide variety of medical conditions.  And this is all without major side effects.

That is quite a bold claim.  But, the level of evidence provided for that claim doesn't match up.  There are no published, double-blind, placebo controlled trials, published in major journals on Cobroxin.  The only evidence provided are numerous testimonials, as well as outdated, poorly designed studies on cobra venom components in mainly Chinese journals (which are notorious for bad science).

Compare that to your typical OTC or prescription pain reliever such as Tylenol.  There are numerous double-blind, placebo-controlled trials on OTC and prescription pain relievers, many of which are published in major journals.  Also, the claims being made for these products are certainly not as bold as that made for Cobroxin.  There are no magical claims of significant pain relief across a large number of medical conditions.  And there are also no unrealistic claims being made about a lack of side effects.

The fact is, the evidence provided for standard OTC and prescription pain relievers is quite good, and matches well with the claims that are made about these products.  Yet the Cobroxin believers claim Cobroxin is even better, on a lower standard of evidence.

And that's why Cobroxin is on the B.S. list....because the level of evidence doesn't meet the claims being made.

So my question for all the Cobroxin believers....why should Cobroxin be held to a lower standard evidence than OTC and prescription pain relievers, when the claims being made about it exceed the claims being made about OTC and prescription pain relievers?

Bullsh*t of the Day: Superfruit Juices

In honor of Alan Aragon's recent blog post on MonaVie, superfruit juices are today's bullsh*t.

At just about every fitness or nutrition expo I've walked through, there has been someone pushing a "superfruit" juice of some kind or another. Mangosteen, Acai berry juice, you name it….I've probably been pushed it.

When I walk past these Superjuice booths, the conversation goes something like this:

Pusher: "Hi."

Me (trying to keep on walking to avoid the product spiel): "Hi."

Pusher: "Have you tried our Supercalifragilisticexpialidocius Juice? It's made from a mixture of Mangosteen, Acai berry, and Goji juice. It has one billion times the antioxidant capacity of an orange. A teaspoon serving will give you the same number of antioxidants as 10,000 servings of fruits and vegetables."

Pusher pushes a small Dixi-cup sample in my face, stopping me in my tracks. To appease the Pusher, I take the sample and drink it.

Tastes like a really dry red wine without the alcohol. I restrain my face muscles from doing a yoga-like contortionist trick.

Me: "Ummm, thanks."

Pusher: "Do you feel it? Do you feel any different?"

I'm starting to feel annoyed, sure. And I feel an awful aftertaste in my mouth.

Pusher: "Ever since I started taking this, I can't believe how much different I've been feeling. I have more energy, I have more stamina, I've lost weight, my cholesterol is lower, my blood pressure is down…I feel great! And my mom started taking this and her cancer went away."

Will this juice help me lower my taxes too? Solve world hunger? Bring peace to the Middle East? Stop the explosion of reality TV shows?

Pusher: "And it's only $100 for a 1 Liter bottle. Imagine how much you would have to pay for 10,000 servings of fruits and vegetables."

Imagine how much I would pay to leave this conversation.

Pusher: "Here's a brochure showing all the benefits of our juice, and how you can order it."

Me: "Thanks"……but no thanks.

Walking away, I look at the brochure. On the front page is a smiling face of a hot chick who is holding a glass of this juice.

Yes, I'm sure the juice is what makes her look that way.

And testimonials by "Greg" and "Judy" and "Sally" and "Richard" abound. Apparently people that have tried this juice don't have last names. And Doctor Rosen Rosen says he recommends this juice to all his patients. And there are references to scientific studies that, upon closer inspection, have little to do with the product.

Obviously my story has been exaggerated for effect, but you get the point. These Superjuices are super hyped. The question is whether there is anything to the hype. Choice Online, an Australian consumer watchdog group, looked into these juices and published their results. They tested the Total Antioxidant Capacity (TAC) of many of these juices, and compared them to the TAC of fruit that you can get at your local grocery store. A single serving of these juices only had 9-34% of the TAC of a Red Delicious Apple!!!!! In fact, according to their tests, three servings of one brand of Mangosteen juice would fall short of the TAC of a cup of berries! So much for these juices being "super." And the prices of these juices was ridiculous…$24 to $85 per liter. You're better off eating the standard fruits and vegetables that you can get from your local supermarket.

Don't get me wrong. It's not that these juices have no health benefits. But their benefits don't even come close to the hype surrounding them, and their benefits actually don't match up to a plain ol' piece of whole fruit. Also, while there are studies showing some potential health benefits to the components of these exotic fruits, most of these studies have been done in vitro (in a test tube) or in animals. Very few clinical studies on humans have been performed. In addition, remember that many of these in vitro and animal studies look at either the whole fruit itself, or components or extracts of the whole fruit. These juices may not have the same composition as the whole fruit or fruit components/extracts.

The bottom line is that, rather than spending money on these expensive juices, you are better off eating a variety of whole fruits and vegetables. Not only will you get more antioxidants, but you'll also get the other benefits that juice can't provide….fiber, for example. And you'll be saving money while saving your health at the same time.

Guest Post: Bser or Liar?

Today's post is a guest post by Jamie Hale who I mentioned in a previous post:

Bser or Liar?

One of the most prominent features of our culture is the promotion of nonsense.  Two distinct groups, Bsers and Liars, perpetuate nonsense.  What’s the difference between Bsers and Liars?  Bsers have no connection to the truth; they have no idea if they are telling the truth , it’s not a concern.  Liars purposefully misrepresent what they believe to be true, although they accidentally tell the truth on occasion.

…essential nature of bullshit although it is produced without concern with the truth, it need not be false.  The bullshitter is faking things.  But this does not mean that he necessarily gets them wrong….He does not reject the authority of the truth, as the liar does, and oppose himself to it.  He pays no attention to it at all.

-          Harry G. Frankfurt, Moral Philosopher & Princeton University Prof., On Bullshit  

Are there more Bsers or Liars?  I would say there are more Bsers.  Why are there so many Bsers? There are two key reasons for so much Bs, 1- ego inflation 2- customary communication.

Most people like to impress others with their worldly knowledge.  The admiration of others increases self-esteem.  Many people pride themselves on being good Bsers, the type that can carry on a conversation with anyone, or wow people with their smarts.  Some of the most popular people I know are Bsers, the life of the party.  Personally, I don’t mind to hear a little Bsing, which I participate in on occasion, but I Hate Hate Hate Hate the over the top Bser.  The over the top Bser is sort of a bully. How do you shut down a bully?  Call the bluff, and ask to see evidence to support their claims. 

Society’s customary process of communication furthers the need for BS.  Consider the following, you and your significant other attend a dinner party for your boss.  After a few minutes of chitchat the conversation turns to politics.  The next thing you know your co-workers are in a heated discussion concerning stem-cell research, they seem to be rather knowledgeable about the subject, then they turn to you for your opinion.  You panic because you know very little about the subject, but you decide to express your opinion anyways.  You felt obligated to say something or else you may come off as rude or even worse stupid; this type of situation occurs on a regular basis.  Bullshit is unavoidable when someone is forced to discuss a topic that they know little about. 

Why are there so many liars?  It is impractical to list all of the reasons that people lie, but we can say people lie because they don’t want you to know the truth (what they believe to be the truth) at the time.  Contrary to the popular motto, “always tell the truth”, lying is not always a bad thing.  Everyone lies from time to time; anyone who says other wise is lying.  Of course, are there different types of lies?  No, there is lying under different circumstances.  Is there anything wrong with lying to cheer up a friend, to sooth someone dying, to boost your kid’s confidence?

Bsers and Liars are motivated by different things; both can be very bad, while both can be harmless, it just depends.

 What do you think, are there more Bsers or Liars in the fitness industry?

Visit Jamie Hale’s website @ www.maxcondition.com

Bullsh*t of the Day: Airborne

As I sit here battling the flu, I decided to write today's B.S. topic about a product that is marketed towards preventing upper respiratory tract infections:  Airborne

Not only did my current bout with the flu inspire me to write this, but recent comments over on my Cobroxin blog also inspired me.  On that blog, commenters seem to think that a lot of positive testimonials are somehow evidence of a product's efficacy.  What these commenters don't realize is that positive testimonials, by themselves, are worthless for supporting a product's efficacy.  Things like the placebo effect, regression to the mean, the cum hoc, ergo propter hoc ("with this, therefore because of this") fallacy, and other things can make a completely worthless product look like it does something.

Like Cobroxin, there are a lot of people who swear by Airborne.  But, like Cobroxin, Airborne is also bullshit.

If you look on the ingredient list, it's nothing more than an overpriced, overglorified multivitamin.  In fact, the doses of each vitamin and mineral are similar to what you would find in a typical multivitamin.  For example, here's a list comparing the ingredients of Airborne to the Kirkland brand Daily Multivitamin you can get from Costco.

Vitamin E
Airborne 30 IU     Kirkland Multivitamin   60 IU
Vitamin A
Airborne 2000 IU   Kirkland Multivitamin  3500 IU
Vitamin C
Airborne 1000 mg  Kirkland Multivitamin  120 mg
Riboflavin (Vitamin B2)
Airborne  2.8 mg    Kirkland Multivitamin  1.7 mg
Magnesium
Airborne 40 mg      Kirkland Multivitamin  100 mg
Zinc
Airborne 8 mg        Kirkland Multivitamin  22.5 mg
Selenium
Airborne  15 mcg    Kirkland Multivitamin  45 mcg
Manganese
Airborne  3 mg       Kirkland Multivitamin  2.5 mcg
Potassium
Airborne  75 mg     Kirkland Multivitamin  80 mg

In 5 out of these 9 micronutrients, the Kirkland multivitamin gives you more than Airborne does.  Nearly equivalent amounts are found in 2 more of the micronutrients.  Thus, Airborne gives you more in only 2 out of the 9 micronutrients.

What are the costs of these two substances?
Airborne:  62 cents per tablet
Kirkland Multivitamin:  3 cents per tablet

Can you say rip-off?

The product also contains glutamine, an amino acid that is used as a fuel source by your immune cells.  However, it contains less than 50 milligrams.  I published a study on glutamine in 2006, and I can tell you that 50 milligrams isn't going to do a thing for you.  We gave our subjects 20-30 grams of glutamine per day.  You need high doses of glutamine to see any potential immune benefit, and this benefit will only happen in conditions of extreme stress.  Now when I say extreme stress, I don't mean you've-got-5-exams-tomorrow-and-your-girlfriend-is-breaking-up-with-you type stress.  I'm talking trauma-ward, burn-patient, you-might-die extreme physical stress.
 
You get more glutamine out of food then you do from Airborne.

Airborne seems to make a big deal that it was designed by a schoolteacher.  I'm not quite sure how being a school teacher makes one an expert on nutrition and immune function.

That's not the end of it.  Airborne Health, the company that sells Airborne, had to fork out $23 million in a settlement agreement after the firm made false claims about its supplement.  It was found that the product was deceptively marketed.  Also, Airborne Health claimed that the product was supported by a clinical trial.  However, ABC News found that this was not a legitimate clinical trial run by doctors or scientists.  In fact, this "clinical trial" was done by a guy who never even graduated from school.

So why is this product so popular?  Well, this school teacher once appeared on Oprah! 

It must work, then, right????!!!

Man, all it takes is one appearance on Oprah and a product becomes an instant success...regardless of whether it's legit.

The fact is, there is no evidence that Airborne will help prevent upper respiratory illness.  I think the term "Airborne" is a very fitting name for this product...because its claims are more full of air than substance.

No B.S. Award November 1st: Alan Aragon & Jamie Hale

I'm giving out a couple No-B.S. Awards today to a couple of No-B.S. guys.

The first goes to Alan Aragon.

Alan has his own website, and he publishes an outstanding newsletter each month.  In this newsletter, Alan critically reviews recent studies in the health and fitness field.  He doesn't just talk about the studies and their results; he also explains how you can apply the study results to your own fitness goals.  It's not a bunch of scientific gobbledygook either; Alan does a good job of presenting the information in a manner easily understood by the layperson.  You can see a sample issue of his newsletter here.

Alan doesn't just have a newsletter.  He also does consulting and seminars.  He also has a great science-based book on building muscle and losing fat which you can find here.

Alan's primary goal is to deliver solid, evidence-based information, which is why he gets the "No-B.S." award for the day.

The second No-B.S. Award goes to Jamie Hale, AKA Coach Hale:

Like Alan, Jamie is a big believer in evidence-based information.  Jamie states that, "The only true authority in science is science itself."  Jamie his own website called MaxCondition.  Jamie has written a collection of excellent, evidence-based books, which you can see here.  One particularly noteworthy book is Knowledge and Nonsense.  In this 483-page, well-referenced book, Jamie discusses the science of nutrition and exercise.  He covers everything from popular diets, like South Beach, to hormones, to training for muscle growth.  He also has some excellent "Fact or Fiction" chapters which challenge the evidence-basis of many beliefs in the fitness and nutrition industry.

Jamie is available for consultation.  You can also find a large library of articles he has written here.

Because of Jamie's "No-B.S." approach, and the fact that he weighs his conclusions based on the evidence rather than ideology, he gets my "No-B.S." award of the day.

Bullsh*t of the Day: Cobroxin Again

In my blog yesterday, I wrote about how Cobroxin is a homeopathic medicine.  Most homeopathic medicines have been diluted to the point where there practically is no active ingredient in the product.  I assumed this was true regarding Cobroxin.

However, I was wrong.  According to the manufacturer, Cobroxin has a 5X dilution according to Homeopathic Pharmacopoeia of the United States.  This means that there is detectable cobra venom (or venom components) in the product.  The product has been diluted 1:100,000.

Cobra venom, at a 1:100,000 dilution, does have biological effects.  For example, this dilution has been shown to cause hemolysis (destruction of red blood cells) in dog blood.  However, these biological effects happen when the venom is injected, or tested in vitro.  This is radically different from applying something topically or orally.

There is evidence that cobra venom has components that may have analgesic effects when injected.  Cobroxin's manufacturer provides a list of studies that supposedly showed cobra venom or its components to have pain-relieving effects.  However, the majority of the studies they list involved injection of cobra venom or its components.  Only 7 out of the listed studies used oral delivery, and only 1 used topical delivery.  Of the 7 that used oral delivery, 6 of them did not report the dose used.  1 of them was only presented as an abstract at a conference and was never published in full form in a peer-reviewed journal.  There is no reference for another one (Xu et al, 2001).  2 more of them were presented in a Chinese journal (Journal of Snake), and there is no mention of placebo controls or blinding.  3 of these didn't even look at pain.


The fact is, the research presented that supposedly supports the use of Cobroxin is of extremely low quality (even the injection studies).  Many of the studies listed don't involve blinding, placebo controls, randomization, or any of the other things that are necessary for an adequate study.  Many of the studies presented are of so low quality, they would never be accepted in today's peer-reviewed journals (particularly in American or European journals, which are more stringent than Chinese journals).  Also, none of these studies involved Cobroxin itself; they are just studies on cobra venom and its components.


When it comes to pain relief, unblinded studies and studies that lack a placebo control are worthless.  It is well established that there is a significant placebo effect in analgesia studies.   Just the mere suggestion that a substance might relieve your pain will often actually reduce your pain, even if the substance has absolutely no biological effect.  There is evidence that the expectation of pain relief causes the release of dopamine and opioids, which, in turn, have an analgesic effect.


Another reason to be skeptical of Cobroxin is the long list of ailments that cobra venom or its components supposedly treat.  In this document, the manufacturer lists the treatment of everything from pain to diabetes to cancer to addiction.  Any time an ingredient is presented as a near "cure-all", it should be viewed with skepticism.

The fact is, there are no double-blind, placebo-controlled trials on Cobroxin published in peer-reviewed journals.  Until this happens, any claims regarding Cobroxin should be taken with a grain of salt, and Cobroxin remains on the B.S. list.