Bad Science (12 page)

Whenever a piece of evidence is published suggesting that the fifty-billion-dollar food supplement industry’s products are ineffective, or even harmful, an enormous marketing machine lumbers into life, producing spurious and groundless methodological criticisms of the published data in order to muddy the waters—not enough to be noteworthy in a meaningful academic discussion, but that is not their purpose. This is a well-worn risk management tactic from many industries, including those producing tobacco, asbestos, lead, vinyl chloride, chromium, and more. It is called manufacturing doubt, and in 1969 one tobacco executive was stupid enough to commit it to paper in a memo. “Doubt is our product,” he wrote, “since it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public. It is also the means of establishing a controversy.”

Nobody in the media dares challenge these tactics, where lobbyists raise sciencey-sounding defenses of their products, because they feel intimidated and lack the skills to do so. Even if they did, there would simply be a confusing and technical discussion on the radio, which everyone would switch off, and at most the consumer would hear only “controversy”: job done. I don’t think that food supplement pills are as dangerous as tobacco—few things are—but it’s hard to think of any other kind of pill for which research could be published showing a possible increase in death, and industry representatives would be wheeled out and given as easy a ride as the vitamin companies’ employees are given when papers are published on their risks. But then, of course, many of them have their own slots in the media to sell their wares and their worldview.

The antioxidant story is an excellent example of how wary we should be of blindly following hunches based on laboratory-level and theoretical data, and naively assuming, in a reductionist manner, that this must automatically map onto dietary and supplement advice, as the media nutritionists would have us do. It is an object lesson in what an unreliable source of research information these characters can be, and we would all do well to remember this story the next time someone tries to persuade us with blood test data, or talk about molecules, or theories based on vast, interlocking metabolism diagrams that we should buy his book, her wacky diet, or his bottle of pills.

More than anything it illustrates how this atomized, overcomplicated view of diet can be used to mislead and oversell. I don’t think it’s melodramatic to speak of people disempowered and paralyzed by confusion, with all the unnecessarily complex and conflicting messages about food. If you’re really worried, you can buy Fruitella Plus, which are nasty, chewy sweets but with added vitamins A, C, E, and calcium. In the last five years, even chocolate companies have jumped on the bandwagon, in the ultimate expression of how nutritionism has perverted and distorted our common sense about food.

Mars unveiled CocoaVia, a chocolate with extra antioxidants that they claimed was good for hearts and arteries. Hershey’s soon followed with “Natural Flavanol Antioxidant Milk Chocolate,” as part of its healthy “Goodness Line.”

If I were writing a lifestyle book, it would have the same advice on every page, and you’d know it all already. Eat lots of fruit and vegetables, and live your whole life in every way as well as you can: exercise regularly as part of your daily routine, avoid obesity, don’t drink too much, don’t smoke, and don’t get distracted from the real, basic, simple causes of ill health. But as we shall see, even these things are hard to do on your own and in reality require wholesale social and political changes.

So who are these people? The most important thing to recognize is that there is nothing new here. Although the contemporary nutritionism movement likes to present itself as a thoroughly modern and evidence-based enterprise, the food guru industry, with its outlandish promises, moralizing, and sexual obsessions, goes back at least two centuries.

Like our modern food gurus, the historical figures of nutritionism were mostly enthusiastic laypeople, and they all claimed to understand nutritional science, evidence, and medicine better than the scientists and doctors of their era. The advice and the products may have shifted with prevailing religious and moral notions, but they have always played to the market, be it puritan or liberal, New Age or Christian.

Graham crackers are a digestive biscuit invented in the nineteenth century by Sylvester Graham, the first great advocate of vegetarianism and nutritionism as we would know it, and proprietor of the world’s first health food shop. Like his descendants today, Graham mixed up sensible notions, such as cutting down on cigarettes and alcohol, with some other, rather more esoteric, ideas that he concocted for himself. He warned that ketchup and mustard, for example, can cause “insanity.”

I’ve got no great beef with the organic food movement (even if its claims are a little unrealistic), but it’s still interesting to note that Graham’s health food store—in 1837—heavily promoted its food as being grown according to “physiological principles” on “virgin unvitiated soil.” By the retro-fetishism of the time, this was soil that had not been “subjected” to “overstimulation”…by manure.

Soon these food marketing techniques were picked up by more overtly puritanical religious zealots like John Harvey Kellogg, one of the men behind the cornflake. Kellogg was a natural healer and health food advocate, promoting his granola bars as the route to abstinence, temperance, and solid morals. He ran a sanatorium for private clients, using “holistic” techniques, including that modern favorite colonic irrigation.

Kellogg was also a keen antimasturbation campaigner. He advocated exposing the tissue on the end of the penis, so that it smarted with friction during acts of self-pollution (and you do have to wonder about the motives of anyone who thinks the problem through in that much detail). Here is a particularly enjoyable passage from his
Treatment for Self-Abuse and Its Effects
(1888), in which Kellogg outlines his views on circumcision: “The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement.”

By the early twentieth century a man named Bernard Macfadden had updated the nutritionism model for contemporary moral values and so became the most commercially successful health guru of his time. He changed his Christian name from Bernard to Bernarr, because it sounded more like the roar of a lion (this is completely true), and ran a successful magazine titled
Physical Culture,
featuring beautiful bodies doing healthy things. The pseudoscience and the posturing were the same, but he used liberal sexuality to his advantage, selling his granola bars as a food that would promote a muscular, thrusting, lustful lifestyle in that decadent rush that flooded the populations of the West between the wars.
¹¹

More recently there was Dudley J. LeBlanc, a Louisiana senator and the man behind Hadacol (“I hadda call it something”). It cured everything, cost $100 a year for the recommended dose, and to Dudley’s open amazement, it sold in the millions. “They came in to buy Hadacol,” said one pharmacist, “when they didn’t have money to buy food. They had holes in their shoes and they paid $3.50 for a bottle of Hadacol.”

LeBlanc made no medicinal claims, but pushed customer testimonials to an eager media. He appointed a medical director who had been convicted in California of practicing medicine with no license and no medical degree. A diabetic patient almost died when she gave up insulin to treat herself with Hadacol, but nobody cared. “It’s a craze. It’s a culture. It’s a political movement,” said
Newsweek
.

It’s easy to underestimate the phenomenal and enduring commercial appeal of these kinds of products and claims throughout history. By 1950 Hadacol’s sales were over twenty million dollars with an advertising spend of one million dollars a month, in 700 daily papers and on 528 radio stations. LeBlanc took a traveling medicine show of 130 vehicles on a tour of thirty-eight hundred miles through the South. Entry was paid in Hadacol bottle tops, and the shows starred Groucho and Chico Marx, Mickey Rooney, Judy Garland, and educational exhibitions of scantily clad women illustrating “the history of the bathing suit.” Dixieland bands played songs like “Hadacol Boogie” and “Who Put the Pep in Grandma?”

The senator used Hadacol’s success to drive his political career, and his competitors, the Longs—descended from the Democrat reformer Huey Long—panicked, launching their own patent medicine called Vita-Long. By 1951 LeBlanc was spending more in advertising than he was making in sales, and in February of that year, shortly after he sold the company—and shortly before it folded—he appeared on the TV show
You Bet Your Life
with his old friend Groucho Marx. “Hadacol,” said Groucho, “what’s that good for?” “Well,” said LeBlanc, “it was good for about five and a half million dollars for me last year.” The point I am making is that there is nothing new under the sun. There have always been health gurus selling magic potions, and there always will be.

Let’s look at just one: Dr. Gillian McKeith—a prime-time TV celebrity in the U.K., now a rising star on BBC America, and a bestselling author with an empire of products. To some she is a guru. To me she is, as we shall see, a menace to the public understanding of science. She has a mainstream television nutrition show, yet she seems to misunderstand not nuances but the most basic aspects of biology, things that a schoolchild could put her straight on.

I first noticed Dr. Gillian McKeith when a reader sent in a clipping about her first series on Channel 4. McKeith was styled, very strikingly, as a white-coated academic and scientific authority on nutrition, a “clinical nutritionist,” posing in laboratories, surrounded by test tubes, and talking about diagnoses and molecules. She was also quoted here saying something a fourteen-year-old doing GCSE biology could easily have identified as pure nonsense: recommending spinach and the darker leaves on plants, because they contain more chlorophyll. According to McKeith, these are “high in oxygen” and will “really oxygenate your blood.” This same claim is repeated all over her books.

Forgive me for patronizing, but before we go on, you may need a little refresher on the miracle of photosynthesis. Chlorophyll is a small green molecule that is found in chloroplasts, the miniature factories in plant cells that take the energy from sunlight and use it to convert carbon dioxide and water into sugar and oxygen. Using this process, called photosynthesis, plants store the energy from sunlight in the form of sugar (high in calories, as you know), and they can then use this sugar energy to make everything else they need, like protein, and fiber, and flowers, and corn on the cob, and bark, and leaves, and amazing traps that eat flies, and cures for cancer, and tomatoes, and wispy dandelions, and conkers, and chilies, and all the other amazing things that the plant world has going on.

Meanwhile, you breathe in the oxygen that the plants give off during this process—essentially as a by-product of their sugar manufacturing—and you also eat the plants, or you eat animals that eat the plants, or you build houses out of wood, or you make painkiller from willow bark, or any of the other amazing things that happen with plants. You also breathe out carbon dioxide, and the plants can combine that with water to make more sugar again, using the energy from sunlight, and so the cycle continues.

Like most things in the story the natural sciences can tell about the world, it’s all so beautiful, so gracefully simple, yet so rewardingly complex, so neatly connected—not to mention true—that I can’t even begin to imagine why anyone would ever want to believe some New Age “alternative” nonsense instead. I would go so far as to say that even if we all are under the control of a benevolent God, and the whole of reality turns out to come down to some flaky spiritual “energy” that only alternative therapists can truly harness, that’s still neither so interesting nor so graceful as the most basic stuff I was taught at school about how plants work.

Is chlorophyll “high in oxygen”? No. It helps make oxygen. In sunlight. And it’s pretty dark in your bowels; in fact, if there’s any light in there at all, something’s gone badly wrong. So any chlorophyll you eat will not create oxygen, and even if it did, even if Dr. Gillian McKeith, Ph.D., stuck a searchlight right up your bum to prove her point, and your salad began photosynthesizing, even if she insufflated your guts with carbon dioxide through a tube, to give the chloroplasts something to work with, and by some miracle you really did start to produce oxygen in there, you still wouldn’t absorb a significant amount of it through your bowel, because your bowel is adapted to absorb food, while your lungs are optimized to absorb oxygen. You do not have gills in your bowels. Neither, since we’ve mentioned them, do fish. And while we’re talking about it, you probably don’t want oxygen inside your abdomen anyway. In keyhole surgery, surgeons have to inflate your abdomen to help them see what they’re doing, but they don’t use oxygen, because there’s methane fart gas in there too, and we don’t want anyone catching fire on the inside. There is no oxygen in your bowel.

So who is this person, and how did she come to be teaching us about diet? What possible kind of science degree can she have, to be making such basic mistakes that a schoolkid would spot? Was this an isolated error? A one-off slip of the tongue? I think not.

Actually, I know not, because as soon as I saw that ridiculous quote, I ordered some more McKeith books. Not only does she make the same mistake in numerous other places, but it seems to me that her understanding of even the most basic elements of science is deeply, strangely distorted. In
You Are What You Eat
(page 211) she says: “Each sprouting seed is packed with the nutritional energy needed to create a full grown healthy plant.”

This is hard to follow. Does a fully grown, healthy oak tree, a hundred feet tall, contain the same amount of energy as a tiny acorn? No. Does a fully grown, healthy sugarcane plant contain the same amount of nutritional energy—measure it in “calories” if you like—as a sugarcane seed? No. Stop me if I’m boring you, in fact, stop me if I’ve misunderstood something in what she’s said, but to me this seems like almost the same mistake as the photosynthesis thing, because that extra energy to grow a fully grown plant comes, again, from photosynthesis, in which plants use light to turn carbon dioxide and water into sugar and then into everything else that plants are made of.

This is not an incidental issue, an obscure backwater of McKeith’s work, nor is it a question of which “school of thought” you speak for: the “nutritional energy” of a piece of food is one of the most important things you could possibly think of for a nutritionist to know about. I can tell you for a fact that the amount of nutritional energy you will get from eating one sugarcane seed is a hell of a lot less than you’d get from eating all the sugarcane from the plant that grew from it. These aren’t passing errors or slips of the tongue (I have a policy, as it were, of not quibbling on spontaneous utterances, because we all deserve the chance to fluff); these are clear statements from published tomes.

If you watch McKeith’s TV show with the eye of a doctor, it rapidly becomes clear that even here, frighteningly, she doesn’t seem to know what she’s talking about. She examines patients’ abdomens on an examination couch as if she were a doctor and confidently announces that she can feel which organs are inflamed. But clinical examination is a fine art at the best of times, and what she is claiming is like identifying which fluffy toy someone has hidden under a mattress (you’re welcome to try this at home).

She claims to be able to identify lymphedema, swollen ankles from fluid retention, and she almost does it right; at least, she kind of puts her fingers in roughly the right place, but only for about half a second, before triumphantly announcing her findings. If you’d like to borrow my second edition copy of Epstein and de Bono’s
Clinical Examination
(I don’t think there were many people in my year at medical school who didn’t buy a copy), you’ll discover that to examine for lymphedema, you press firmly for around thirty seconds, to gently compress the exuded fluid out of the tissues, then take your fingers away and look to see if they have left a dent behind.

In case you think I’m being selective, and quoting only McKeith’s most ridiculous moments, there’s more: the tongue is “a window to the organs—the right side shows what the gallbladder is up to, and the left side the liver.” Raised capillaries on your face are a sign of “digestive enzyme insufficiency—your body is screaming for food enzymes.” Thankfully, Gillian can sell you some food enzymes from her website. “Skid mark stools” (she is obsessed with feces and colonic irrigation) are “a sign of dampness inside the body. If your stools are foul-smelling, you are “sorely in need of digestive enzymes.” Again. Her treatment for pimples on the forehead—not pimples anywhere else, mind you, only on the forehead—is a regular enema. Cloudy urine is “a sign that your body is damp and acidic, due to eating the wrong foods.” The spleen is “your energy battery.”

So we have seen scientific facts—on which Dr. McKeith seems to be mistaken. What of scientific process? She has claimed, repeatedly and to anyone who will listen, that she is engaged in clinical scientific research. Let’s step back a moment, because from everything I’ve said, you might reasonably assume that McKeith has been clearly branded as some kind of alternative therapy maverick. In fact, nothing could be further from the truth. This doctor has been presented, consistently, up front on television, on her website, by her management company and in her books, as a scientific authority on nutrition.