Dr Robert Woodward. Scientific Adviser to the Society for the Promotion of Nutritional Therapy
The time has come to stop wasting resources on researching most areas of Complementary/Integratory Health. I am prompted to say this after reading reports that The Complementary Medicine (CAM) department at Exeter University may be forced to close because its results are not finding favour with benefactors.
Many areas of CAM such as Acupuncture, Homoeopathy, Radionics, Applied Kinesiology, Iridology are allied to religion not science. Scientific research into them will never be sufficiently positive to satisfy the establishment. Ernst has confirmed this and so potential benefactors have vanished. Healthwatch should ensure consumers are made aware of the religious aspect of many CAM practices rather than ask their followers to produce “evidence”.
Whilst the vast majority of CAM practice defies logic there are two areas of CAM which should be capable of scientific evaluation. However, I fear the unbridled power of vested interests ranged against them may be too great and resources insufficient to prove their value to the satisfaction of the medical establishment.
Herbalism and The Pharmaceutical Interests.
Traditional Herbal Medicines are about to be subjected to a new European Directive. Many consumers and manufacturers of herbal medicines think that the agenda for this directive has been set by the mainstream pharmaceutical and medical interests who they believe have a vested interest in the demise of traditional herbalism. Of course, the pharmaceutical industry has an interest in the active ingredients of herbs in order to make patentable analogues – herbalism in CAM terms requires use of the whole herb.
Very few herbs have been characterised in depth and can be prepared to consistent specifications likely to be demanded by the directive. At a recent seminar it was stated that there were six and one of those was Kava kava!(6) just banned in UK and Europe. Some herbal medicines are compounded of ten or more herbs which in turn may mean a thousand or more discrete chemical entities being present in the final product. At present, scientific standardisation of such products is impossible. Clinical trials using such items is a waste of time.
Professor Ernst has referred to these problems in his reviews of herbal trials in the journal Focus on Alternative and Complementary Therapies so he is well placed to pursue research in the area.
This research will require considerable investment of money as well as scientific and medical manpower. Costs might be at the levels currently expended by the pharmaceutical industry – billions of pounds for a herbal Industry currently selling product to a value in millions with little profit to fund research investment and without patent protection.
Until scientific standardisation is possible for herbs and products, the demands of the vested pharmaceutical interest must be rejected. The authorities should demand that herbs and herbal products are prepared in pharmaceutically approved premises with all product formulas compulsorily registered centrally. This would ensure that withdrawal of an unsafe herb could be achieved efficiently. Claims should carry caveats commensurate with traditional use.
Diet supplementation and the Food Industry Interests.
Media stories about the poor quality of people’s diets seem to be proliferating with the Food Industry being consistently criticised. Evidence that many people do not eat a wholesome balanced diet can be found from observing customers in motorway cafes, fast food restaurants and supermarkets. Colas, salty-snacks/cereals, sugary confectionery, refined flour based baked goods and convenience foods dominate. Substantial amounts of fresh fruit and vegetables are purchased by a minority. The “Balanced Diet” is accepted as established fact by experts with fervent certainty but I find no reliable evidence for the assumption that it is universally consumed by the UK population. Functional diet would be a better term as a contrast to dysfunctional diet and food.
The Food Industry, manufacturers and fast food chains, has a vested interest in the status quo. That their members might be capable of using deception to protect their market is open to question, but a series of events that took place in 1988 gave cause for concern.
In that year some research (1,2) demonstrated that, because some children were not eating a functional diet, known quantitative addition of well known discrete diet components had a beneficial effect that could be objectively measured through non-verbal IQ points. This was achieved using a pharmaceutically prepared dose form – it couldn’t be done with oranges for vitamin C, spinach for folic acid etc. This research as well as that on antisocial behaviour of prisoners(8) indicated the inadequacy of the diet of those benefiting and proves that steps need to be taken to put matters right. Pills were the research tool but diet is the answer. These findings mean that there is a need for dietary improvement in the whole population and puts in doubt the view that widespread consumption of the “balanced diet” is a fact.
Misreporting of this research led to great problems. A documentary TV programme in January 1988 that investigated the IQ/Diet research put emphasis on diet – yet the tabloid newspapers gave pills the star billing. No particular brand was ever mentioned and shelves were cleared of all vitamin pills by consumers. My old company did not initiate the publicity or the misleading angle although many thought we did. We were very small players in the market although I was interested in finding a scientific rationale for supplementation. IQ tests gave quantitative results – a bonus.
The same journalists all did a volte face in July 1988 when the negative results of another trial using a different formula pill (3) appeared in the media. The research seemed to have been hurriedly conducted—involving just one month’s trial compared to the nine in the original—and indeed at least one national newspaper was running the story even before the preliminary report had been published. The research department in question was partly funded by the World Sugar Research Organisation—a point which did not surface in press reports and interviews.
The new study used a different formula and method and so should not have stood comparison with the original four trials(2,4,5,7), all of which had been positive. For the sake of the consumer, repeat studies to confirm the results should have been conducted by an independent body, such as Exeter.
Exeter is already taking an interest in nutritional therapies. Supplement products can be made to consistent standards so that clinical investigations can be undertaken on standardised products. If research resources for herbs and food supplements are not found then the outlook is bleak for the public because all real resources will be vested in the multinational food and pharmaceutical industries, establishment medicine and Government here and in Brussels. Their agenda is open to question and rightly causing much disquiet among informed consumers and some health professionals. The stakes could not be higher.
1 Schoenthaler SJ, BierID.Vitamin-mineral intake and intelligence: amacrolevel analysis of randomised controlled trials.J,Alt Comp Med 1999; 5:125-34
2 Benton D,Roberts G Effect of Vitamin and mineral supplementation on intelligence of a sample of schoolchildren.Lancet 1988;1:140-143.
3. Naismith D,Nelson M,Burley V,Gatenby S.,Can Children’s intelligence be increased by vitamin and mineral supplements Lancet 1988;2:335.
4.Crombie S,Todman J,et al Effect of vitamin and mineral supplementation on verbal and non-verbal reasoning of schoolchildren .Lancet 1990; 335: 744-7.
5. Benton D,Cook R. Vitamin and mineral ssupplements improve the intelligence scores and concentration of six-year-old children. Personal Indi Diff 1991;12:1151-8.
6. Symposium on Quality of Herbal Drugs. Pharm.J., 21.9.02;269; 404-5.
7. Pilot study unpublished GR/ RJW 1986.
8.Gesch CB et al. Influence of supplementary vitamins etc on the anti-social behaviour of young adult prisoners. Randomised, placebo controlled trial. Br.J.Psychiatry 2002:181;22-28.
For further information read The Tandem IQ Story. R.J.Woodward, Roberts Publications 1994.