Stephen Barrett, M.D.
Victor Herbert, M.D., J.D.
1. When Talking about Nutrients, They Tell Only Part of the Story.Quacks tell you all the wonderful things that vitamins and minerals do in your body and/or all the horrible things that can happen if you don't get enough. Many claim that their products or programs offer "optimal nutritional support." But they conveniently neglect to tell you that a balanced diet provides the nutrients most people need and that government guidelines makes balancing your diet simple.
2. They Claim That Most Americans Are Poorly Nourished.This is an appeal to fear that is not only untrue, but ignores the fact that the main forms of bad nourishment in the United States are obesity in the population at large (particularly the poor) and undernourishment among the poverty-stricken. Poor people can ill afford to waste money on unnecessary vitamin pills. Their food money should be spent on nourishing food.
It is falsely alleged that Americans are so addicted to "junk" foods that an adequate diet is exceptional rather than usual. While it is true that some snack foods are mainly "naked calories" (sugars and/or fats without other nutrients), it is not necessary for every morsel of food we eat to be loaded with nutrients. In fact, no normal person following the Dietary Guidelines for Americans is in any danger of vitamin deficiency.
3. They Recommend "Nutrition Insurance" for Everyone.Most vitamin pushers suggest that everyone is in danger of deficiency and should therefore take supplements as "insurance." Some suggest that it is difficult to get what you need from food, while others claim that it is impossible. Their pitch resembles that of the door-to-door huckster who states that your perfectly good furnace is in danger of blowing up unless you replace it with his product. Vitamin pushers will never tell you who doesn't need their products. Their "be wary of deficiency" claims may not be limited to essential nutrients. It can also include nonessential chemicals that nobody needs to worry about because the body makes its own supply.
4. They Say That Most Diseases Are Due to Faulty Diet
This simply isn't so. Consult your doctor or any recognized textbook of medicine. They will tell you that although diet is a factor in some diseases (most notably coronary heart disease), most diseases have little or nothing to do with diet. Common symptoms like malaise (feeling poorly), fatigue, lack of pep, aches (including headaches) or pains, insomnia, and similar complaints are usually the body's reaction to emotional stress. The persistence of such symptoms is a signal to see a doctor to be evaluated for possible physical illness. It is not a reason to take vitamin pills.
and Can Be Treated with "Nutritional" Methods.
5. They Allege That Modern Processing Methods and
It is true that food processing can change the nutrient content of foods. But the changes are not so drastic as the quack, who wants you to buy supplements, would like you to believe. While some processing methods destroy some nutrients, others add them. A balanced variety of foods will provide all the nourishment you need.
Storage Remove all Nutritive Value from Our Food.
Quacks distort and oversimplify. When they say that milling removes B-vitamins, they don't bother to tell you that enrichment puts them back. When they tell you that cooking destroys vitamins, they omit the fact that only a few vitamins are sensitive to heat. Nor do they tell you that these vitamins are easily obtained by consuming a portion of fresh uncooked fruit, vegetable, or fresh or frozen fruit juice each day. Any claims that minerals are destroyed by processing or cooking are pure lies. Heat does not destroy minerals.
6. They Claim That Diet Is a Major Factor in Behavior.Food quacks relate diet not only to disease but to behavior. Some claim that adverse reactions to additives and/or common foods cause hyperactivity in children and even criminal behavior in adolescents and adults. These claims are based on a combination of delusions, anecdotal evidence, and poorly designed research.
7. They Claim That Fluoridation Is Dangerous.Curiously, quacks are not always interested in real deficiencies. Fluoride is necessary to build decay-resistant teeth and strong bones. The best way to obtain adequate amounts of this important nutrient is to augment community water supplies so their fluoride concentration is about one part fluoride for every million parts of water. But quacks usually oppose water fluoridation, and some advocate water filters that remove fluoride. It seems that when they cannot profit from something, they may try to make money by opposing it.
8. They Claim That Soil Depletion and the Use of Pesticides and
These claims are used to promote the sale of so-called "organically grown" foods. If an essential nutrient is missing from the soil, a plant simply doesn't grow. Chemical fertilizers counteract the effects of soil depletion. Quacks also lie when they claim that plants grown with natural fertilizers (such as manure) are nutritionally superior to those grown with synthetic fertilizers. Before they can use them, plants convert natural fertilizers into the same chemicals that synthetic fertilizers supply. The vitamin content of a food is determined by its genetic makeup. Fertilizers can influence the levels of certain minerals in plants, but this is not a significant factor in the American diet. The pesticide residue of our food supply is extremely small and poses no health threat to the consumer. Foods "certified" as "organic" are not safer or more nutritious than other foods. In fact, except for their high price, they are not significantly different.
"Chemical" Fertilizers Result in Food That Is Less Safe and Less Nourishing.
9. They Claim You Are in Danger of Being "Poisoned"
This is another scare tactic designed to undermine your confidence in food scientists and government protection agencies as well as our food supply itself. Quacks want you to think they are out to protect you. They hope that if you trust them, you will buy their "natural" food products. The fact is that the tiny amounts of additives used in food pose no threat to human health. Some actually protect our health by preventing spoilage, rancidity, and mold growth.
by Ordinary Food Additives and Preservatives.
10. They Charge That the Recommended Dietary Allowances (RDAs)
The RDAs have been published by the National Research Council approximately every five years since 1943. They are defined as "the levels of intake of essential nutrients that, on the basis of scientific knowledge, are judged by the Food and Nutrition Board to be adequate to meet the known nutrient needs of practically all healthy persons." Neither the RDAs nor the Daily Values listed on food labels are "minimums" or "requirements." They are deliberately set higher than most people need. The reason quacks charge that the RDAs are too low is obvious: if you believe you need more than can be obtained from food, you are more likely to buy supplements.
Have Been Set Too Low.
11. They Claim That under Everyday Stress, and in Certain Diseases,
Many vitamin manufacturers have advertised that "stress robs the body of vitamins." One company has asserted that, "if you smoke, diet, or happen to be sick, you may be robbing your body of vitamins." Another has warned that "stress can deplete your body of water-soluble vitamins . . . and daily replacement is necessary." Other products are touted to fill the "special needs of athletes."
Your Need for Nutrients Is Increased.
While it is true that the need for vitamins may rise slightly under physical stress and in certain diseases, this type of advertising is fraudulent. The average American—stressed or not—is not in danger of vitamin deficiency. The increased needs to which the ads refer are not higher than the amounts obtainable by proper eating. Someone who is really in danger of deficiency due to an illness would be very sick and would need medical care, probably in a hospital. But these promotions are aimed at average Americans who certainly don't need vitamin supplements to survive the common cold, a round of golf, or a jog around the neighborhood! Athletes get more than enough vitamins when they eat the food needed to meet their caloric requirements.
Many vitamin pushers suggest that smokers need vitamin C supplements. Although it is true that smokers in North America have somewhat lower blood levels of this vitamin, these levels are still far above deficiency levels. In America, cigarette smoking is the leading cause of death preventable by self-discipline. Rather than seeking false comfort by taking vitamin C, smokers who are concerned about their health should stop smoking. Suggestions that "stress vitamins" are helpful against emotional stress are also fraudulent.
12. They Recommend "Supplements" and "Health Foods" for Everyone.Food quacks belittle normal foods and ridicule the food-group systems of good nutrition. They may not tell you they earn their living from such pronouncements—via public appearance fees, product endorsements, sale of publications, or financial interests in vitamin companies, health-food stores, or organic farms.
The very term "health food" is a deceptive slogan. Judgments about individual foods should take into account how they contribute to an individual's overall diet. All food is health food in moderation; any food is junk food in excess. Did you ever stop to think that your corner grocery, fruit market, meat market, and supermarket are also health-food stores? They are—and they generally charge less than stores that use the slogan.
By the way, have you ever wondered why people who eat lots of "health foods" still feel they must load themselves up with vitamin supplements? Or why so many "health food" shoppers complain about ill health?
13. They Claim That "Natural" Vitamins are Better than "Synthetic" Ones.This claim is a flat lie. Each vitamin is a chain of atoms strung together as a molecule. With minor exception, molecules made in the "factories" of nature are identical to those made in the factories of chemical companies. Does it make sense to pay extra for vitamins extracted from foods when you can get all you need from the foods themselves?
14. They Suggest That a Questionnaire Can Be Used
No questionnaire can do this. A few entrepreneurs have devised lengthy computer-scored questionnaires with questions about symptoms that could be present if a vitamin deficiency exists. But such symptoms occur much more frequently in conditions unrelated to nutrition. Even when a deficiency actually exists, the tests don't provide enough information to discover the cause so that suitable treatment can be recommended. That requires a physical examination and appropriate laboratory tests. Many responsible nutritionists use a computer to help evaluate their clients' diet. But this is done to make dietary recommendations, such as reducing fat content or increasing fiber content. Supplements are seldom necessary unless the person is unable (or unwilling) to consume an adequate diet.
to Indicate Whether You Need Dietary Supplements.
Be wary, too, of questionnaires purported to determine whether supplements are needed to correct "nutrient deficiencies" or "dietary inadequacies" or to design "customized" supplements. These questionnaires are scored so that everyone who takes the test is advised to take supplements. Responsible dietary analyses compare the individual's average daily food consumption with the recommended numbers of servings from each food group. The safest and best way to get nutrients is generally from food, not pills. So even if a diet is deficient, the most prudent action is usually diet modification rather than supplementation with pills.
Diet quacks would like you to believe that special pills or food combinations can cause "effortless" weight loss. But the only way to lose weight is to burn off more calories than you eat. This requires self-discipline: eating less, exercising more, or preferably doing both. There are about 3,500 calories in a pound of body weight. To lose one pound a week (a safe amount that is not just water), you must eat about 500 fewer calories per day than you burn up. The most sensible diet for losing weight is one that is nutritionally balanced in carbohydrates, fats, and proteins. Most fad diets "work" by producing temporary weight loss—as a result of calorie restriction. But they are invariably too monotonous and are often too dangerous for long-term use. Unless a dieter develops and maintains better eating and exercise habits, weight lost on a diet will soon return.
The term "cellulite" is sometimes used to describe the dimpled fat found on the hips and thighs of many women. Although no medical evidence supports the claim, cellulite is represented as a special type of fat that is resistant to diet and exercise. Sure-fire cellulite remedies include creams (to "dissolve" it), brushes, rollers, "loofah" sponges, body wraps, and vitamin-mineral supplements with or without herbs. The cost of various treatment plans runs from a few dollars for a bottle of vitamins to many hundreds of dollars at a salon that offers heat treatments, massage, enzyme injections, and/or treatment with various gadgets. The simple truth about "cellulite" is that it is ordinary fat that can be lost only as part of an overall reducing program.
16. They Promise Quick, Dramatic, Miraculous Results.Often the promises are subtle or couched in "weasel words" that create an illusion of a promise, so promoters can deny making them when the "feds" close in. False promises of cure are the quacks' most immoral practice. They don't seem to care how many people they break financially or in spirit—by elation over their expected good fortune followed by deep depression when the "treatment" fails. Nor do quacks keep count—while they fill their bank accounts—of how many people they lure away from effective medical care into disability or death.
Quacks will tell you that "megavitamins" (huge doses of vitamins) can prevent or cure many different ailments, particularly emotional ones. But they won't tell you that the "evidence" supporting such claims is unreliable because it is based on inadequate investigations, anecdotes, or testimonials. Nor do quacks inform you that megadoses may be harmful. Megavitamin therapy (also calledorthomolecular therapy) is nutritional roulette; and only the house makes the profit.
17. They Routinely Sell Vitamins and Other
Although vitamins are useful as therapeutic agents for certain health problems, the number of such conditions is small. Practitioners who sell supplements in their offices invariably recommend them inappropriately. In addition, such products tend to be substantially more expensive than similar ones in drugstores—or even health-food stores. You should also disregard any publication or Web site whose editor or publisher sells dietary supplements.
"Dietary Supplements" as Part of Their Practice.
18. They Use Disclaimers Couched in Pseudomedical Jargon.Instead of promising to cure your disease, some quacks will promise to "detoxify," "purify," or "revitalize" your body; "balance" its chemistry or "electromagnetic energy"; bring it in harmony with nature; "stimulate" or "strengthen" your immune system; "support" or "rejuvenate" various organs in your body; "unlock your body's healing ability"; or stimulate your body's power to heal itself. Of course, they never identify or make valid before-and-after measurements of any of these processes. These disclaimers serve two purposes. First, since it is impossible to measure the processes quacks allege, it may be difficult to prove them wrong. Moreover, if a quack is not a physician, the use of nonmedical terminology may help to avoid prosecution for practicing medicine without a license—although it shouldn't.
Some approaches to "detoxification" are based on notions that, as a result of intestinal stasis, intestinal contents putrefy, and toxins are formed and absorbed, which causes chronic poisoning of the body. This "autointoxication" theory was popular around the turn of the century but was abandoned by the scientific community during the 1930s. No such "toxins" have ever been found, and careful observations have shown that individuals in good health can vary greatly in bowel habits. Quacks may also suggest that fecal material collects on the lining of the intestine and causes trouble unless removed by laxatives, colonic irrigation, special diets, and/or various herbs or food supplements that "cleanse" the body. The falsity of this notion is obvious to doctors who perform intestinal surgery or peer within the large intestine with a diagnostic instrument. Fecal material does not adhere to the intestinal lining. Colonic irrigation is done by inserting a tube into the rectum and pumping up to 20 gallons of water in and out. This type of enema is not only therapeutically worthless but can cause fatal electrolyte imbalance. Cases of death due to intestinal perforation and infection (from contaminated equipment) have also been reported.
19. They Use Anecdotes and Testimonials to Support Their Claims.We all tend to believe what others tell us about personal experiences. But separating cause and effect from coincidence can be difficult. If people tell you that product X has cured their cancer, arthritis, or whatever, be skeptical. They may not actually have had the condition. If they did, their recovery most likely would have occurred without the help of product X. Most single episodes of disease end with just the passage of time, and most chronic ailments have symptom-free periods. Establishing medical truths requires careful and repeated investigation—with well-designed experiments, not reports of coincidences misperceived as cause-and-effect. That's why testimonial evidence is forbidden in scientific articles, is usually inadmissible in court, and is not used to evaluate whether or not drugs should be legally marketable. (Imagine what would happen if the FDA decided that clinical trials were too expensive and therefore drug approval would be based on testimonial letters or interviews with a few patients.)
Never underestimate the extent to which people can be fooled by a worthless remedy. During the early 1940s, many thousands of people became convinced that "glyoxylide" could cure cancer. Yet analysis showed that it was simply distilled water!  Many years before that, when arsenic was used as a "tonic," countless numbers of people swore by it even as it slowly poisoned them.
Symptoms that are psychosomatic (bodily reactions to tension) are often relieved by anything taken with a suggestion that it will work. Tiredness and other minor aches and pains may respond to any enthusiastically recommended nostrum. For these problems, even physicians may prescribe a placebo. A placebo is a substance that has no pharmacological effect on the condition for which it is used, but is given to satisfy a patient who supposes it to be a medicine. Vitamins (such as B12 shots) are commonly used in this way.
Placebos act by suggestion. Unfortunately, some doctors swallow the advertising hype or become confused by their own observations and "believe in vitamins" beyond those supplied by a good diet. Those who share such false beliefs do so because they confuse coincidence or placebo action with cause and effect. Homeopathic believers make the same error.
20. They Claim That Sugar Is a Deadly Poison.Many vitamin pushers would have us believe that refined (white) sugar is "the killer on the breakfast table" and is the underlying cause of everything from heart disease to hypoglycemia. The fact is, however, that when sugar is used in moderation as part of a normal, balanced diet, it is a perfectly safe source of calories and eating pleasure. Sugar is a factor in the tooth decay process, but what counts is not merely the amount of sugar in the diet but how long any digestible carbohydrate remains in contact with the teeth. This, in turn, depends on such factors as the stickiness of the food, the type of bacteria on the teeth, and the extent of oral hygiene practiced by the individual.
21. They Display Credentials Not Recognized
The backbone of educational integrity in America is a system of accreditation by agencies recognized by the U.S. Secretary of Education or the Council on Higher Education Accreditation (CHEA), which is a nongovernmental coordinating agency. "Degrees" from nonaccredited schools are rarely worth the paper they are printed on. In the health field, no nonaccredited school can qualify people to give trustworthy advice.
by Responsible Scientists or Educators.
Unfortunately, possession of an accredited degree does not guarantee reliability. Some schools that teach unscientific methods (chiropractic, naturopathy, acupuncture, and even quack nutritional methods) have achieved accreditation. Worse yet, a small percentage of individuals trained in reputable institutions (such as medical or dental schools or accredited universities) have strayed from scientific thought.
Since quacks operate outside of the scientific community, they also tend to form their own "professional" organizations. In some cases, the only membership requirement is payment of a fee. We and others we know have secured fancy "professional member" certificates for household pets by merely submitting the pet's name, address, and a check for $50 . Don't assume that all groups with scientific-sounding names are respectable. Find out whether their views are scientifically based.
Some quacks are promoted with superlatives like "the world's foremost nutritionist" or "America's leading nutrition expert." There is no law against this tactic, just as there is none against calling oneself the "World's Foremost Lover." However, the scientific community recognizes no such titles. The designation "Nobel Prize Nominee" is also bogus and can be assumed to mean that someone has either nominated himself or had a close associate do so.
Some entrepreneurs claim to have degrees and/or affiliations to schools, hospitals, and/or professional that actually don't exist. The modern champion of this approach appears to be the lateGregory E. Caplinger, who claimed to have acquired a medical degree, specialty training, board certification, and scores of professional affiliations—all from bogus or nonexistent sources.
Even legitimate credentials can be used to mislead. The American Medical Association's "Physician's Recognition Award" requires participation in 150 hours of continuing education over a three-year period and payment of a small fee. Most practicing physicians meet this educational standard because it is necessary to study to keep up-to-date. Accredited hospitals require this amount of continuing education to maintain staff privileges, and some states require it for license renewal. However, most physicians who do this don't bother to get the AMA certificate. Since the award reflects no special accomplishment or expertise, using it for promotional purposes is not appropriate behavior.
22. They Offer to Determine Your Body's Nutritional State
Various health-food industry members and unscientific practitioners utilize tests that they claim can determine your body's nutritional state and—of course—what products you should buy from them. One favorite method is hair analysis. For $35 to $75 plus a lock of your hair, you can get an elaborate computer printout of vitamins and minerals you supposedly need. Hair analysis has limited value (mainly in forensic medicine) in the diagnosis of heavy metal poisoning, but it is worthless as a screening device to detect nutritional problems . If a hair analysis laboratory recommends supplements, you can be sure that its computers are programmed to recommend them to everyone. Other tests used to hawk supplements include amino acid analysis of urine, muscle-testing (applied kinesiology), iridology, live-cell analysis (also called dark-field video analysis, nutritional blood analysis, vital hematology, and biocytonics), genetic testing, blood typing, "nutrient-deficiency" and/or lifestyle questionnaires, and "electrodiagnostic" gadgets.
with a Laboratory Test or a Questionnaire.
23. They Diagnose Their Favorite Diseases in Virtually Everyone Who Consults.At least 25 diagnostic labels classifiable as fads have been in vogue during the past fifty years . Some unscientific practitioners apply one or more of these diagnoses to almost every patient they see. The common ones includde adrenal fatigue, candidiasis hypersensitivity, hypothyroidism, "leaky gut," chemical sensitivity, electrical hypersensitivity, amalgam toxicity, Lyme disease, "parasites," hypoglycemia, vertebral subluxation complex, and even "magnetic deficiency."  Some refer to actual disease (which the patients do not have), whereas others are not recognized by the scientific community. In many cases, nonstandard tests are used to "diagnose" them and recommend "dietary supplements," "detoxification," and/or various procedures to treat them. A small percentage of physicians and large percentages of chiropractors, naturopaths, and bogus "nutritionists" are involved in this process. Others may also profit by selling educational materials promoting these alleged conditions and supplement concoctions claimed to help them.
24. They Claim They Are Being Persecuted by Orthodox Medicine
The "conspiracy charge" is an attempt to gain sympathy by portraying the quack as an "underdog." Quacks typically claim that the American Medical Association is against them because their cures would cut into the incomes that doctors make by keeping people sick. Don't fall for such nonsense! Reputable physicians are plenty busy. Moreover, many doctors engaged in prepaid health plans, group practice, full-time teaching, and government service receive the same salary whether or not their patients are sick—so keeping their patients healthy reduces their workload, not their income.
and That Their Work Is Being Suppressed Because It's Controversial.
Quacks also claim there is a "controversy" about facts between themselves and "the bureaucrats," organized medicine, or "the establishment." They clamor for medical examination of their claims, but ignore any evidence that refutes them. The gambit "Do you believe in vitamins?" is another tactic used to increase confusion. Everyone knows that vitamins are needed by the human body. The real question is "Do you need additional vitamins beyond those in a well-balanced diet?" For most people, the answer is no. Nutrition is a science, not a religion. It is based upon matters of fact, not questions of belief.
Any physician who found a vitamin or other preparation that could cure sterility, heart disease, arthritis, cancer, or the like, could make an enormous fortune. Patients would flock to such a doctor (as they now do to those who falsely claim to cure such problems), and colleagues would shower the doctor with awards—including the extremely lucrative Nobel Prize! And don't forget, doctors get sick, too. Do you believe they would conspire to suppress cures for diseases that also afflict them and their loved ones? When polio was conquered, iron lungs became virtually obsolete, but nobody resisted this advancement because it would force hospitals to change. And neither will scientists mourn the eventual defeat of cancer.
25. They Warn You Not to Trust Your Doctor.Quacks, who want you to trust them, suggest that most doctors are "butchers" and "poisoners." They exaggerate the shortcomings of our healthcare delivery system, but completely disregard their own—and those of other quacks. For the same reason, quacks also claim that doctors are nutrition illiterates. This, too, is untrue. The principles of nutrition are those of human biochemistry and physiology, courses required in every medical school. Some medical schools don't teach a separate required course labeled "Nutrition" because the subject is included in other courses at the points where it is most relevant. For example, nutrition in growth and development is taught in pediatrics, nutrition in wound healing is taught in surgery, and nutrition in pregnancy is covered in obstetrics. In addition, many medical schools do offer separate instruction in nutrition.
A physician's training, of course, does not end on the day of graduation from medical school or completion of specialty training. The medical profession advocates lifelong education, and some states require it for license renewal. Physicians can further their knowledge of nutrition by reading medical journals and textbooks, discussing cases with colleagues, and attending continuing education courses. Most doctors know what nutrients can and cannot do and can tell the difference between a real nutritional discovery and a piece of quack nonsense. Those who are unable to answer questions about dietetics (meal planning) can refer patients to someone who can—usually a registered dietitian. Like all human beings, doctors sometimes make mistakes. However, quacks deliver mistreatment most of the time.
26. They Encourage Patients to Crusade for Their Treatment Methods.A century ago, before scientific methodology was generally accepted, valid new ideas were hard to evaluate and were sometimes rejected by a majority of the medical community, only to be upheld later. But today, treatments demonstrated as effective are welcomed by scientific practitioners and do not need a group to crusade for them. Quacks seek political endorsement because they can't prove that their methods work. Instead, they may seek to legalize their treatment and force insurance companies to pay for it. One of the surest signs that a treatment doesn't work is a political campaign to protect the practitioners who are using it.