The Health Food Scam

Some breakfast food manufacturer hit upon the simple notion of emptying out the leavings of cart horse nosebags, adding a few other things like unconsumed portions of chicken layer's mash, and the sweeping of racing stables, packing the mixture in little bags and selling them in health food shops.
Frank Muir

'Natural' products

Many people believe that if a food is 'natural', it is safe and better for them. An indication of the strength of this belief is that in Britain we spent £150-million on 'health' foods in 1991. But the health food industry is in a far from healthy state, at least as far as the customer is concerned. For it has its deadly side.
For drugs to be used on the public, they have to be licenced by the Department of Health. To get that licence the drug must be shown to be safe, effective and of good quality. And to do that can mean years of testing, costing millions of pounds. Foods, on the other hand have a much easier passage. Under the Ministry of Agriculture's regulations, a food must not damage your health, but no proof is required.
So what decides whether a product is a drug or a food? You may be surprised to learn that it is not its effect on the body, but merely what it says on the label. (Many people believe, wrongly, that the Government is controlling what is on the labels. There are no such controls.) If the product claims to prevent, cure or treat something it is a drug; if it doesn't, it is a food. Because of this loophole, a number of products, which are decidedly unhealthy, have been sold in health food shops, even some known to be dangerous that have been banned for use as drugs.
One such was Tryptophan , a naturally occurring essential amino acid found in small quantities in milk, meat, eggs, nuts and cereals. In these it is safe. But tryptophan was sold in health food stores and chemists for use in place of tranquillisers. A 49-year-old woman, suffering from insomnia and not wanting to take tranquillisers, was advised to try the tryptophan sold in her local health food shop. She did. After a few weeks her speech became slurred; later her muscles were destroyed, she developed cramps, became increasingly disabled until she had to resort to a wheelchair. It was the tryptophan that had ruined her life. Tryptophan is also used as a food supplement to make the body stronger and Bruce Newlands, a British international weight lifter, took it for this reason. Within months his body was covered in a rash and his hair fell out. He lost 70 lbs in weight, became paralysed and, he too, is now confined to a wheelchair.
But they were lucky. Tryptophan can kill. In the USA more than 38 have been killed so far and an estimated 5,000 injured. The injuries caused by tryptophan are so severe that it is inevitable that many more will die.
It is true that the tryptophan that was to blame for all these tragedies was impure. The Japanese firm, Showa Denko, cut out many of the processing steps to save costs, ending up with an impure product. And the numbers who took it are so large because that one firm supplied nearly all the world's manufacturers. But even in its pure form, it should not have been sold. Tryptophan, as a drug, had already been banned because of fears over its safety. Tryptophan is an essential protein in our diet, and manufacturers who told us that we needed more promoted it. But tryptophan is found so widely in foods, and so little is needed, that deficiency is unknown. It is true that protein deficiency can occur, but giving tryptophan in such cases only makes things worse.
Comfrey, used to treat wounds and broken bones, and as an aid to digestion, is another 'natural' product which gives cause for concern. It has already failed safety tests and is not recommended by the Medicines Control Agency for use in licensed drug preparations. It can never be used in any drug preparation - but that doesn't stop it being sold in health food shops as a food supplement or a tea.
In one case a woman taking comfrey as an aid to digestion found that her feet began to swell. Over 15 days, her stomach filled with fluid and she gained 20 lbs in weight. Naturally she saw her doctor who was baffled, as were others, when she had to be hospitalised for tests and major surgery. They thought she had cancer or cirrhosis of the liver. Eventually, a specialist recognised the symptoms as those of Bush Tea poisoning. The comfrey had damaged her liver. Indeed, comfrey can cause cancer of liver.
Ginseng has been used in the East for centuries. Hundreds of millions of people are firm in their belief in the beneficial effects of ginseng. In the West too, its use at present is expanding.
This expansion is not as a result of newly discovered beneficial effects. Ginseng has been tested on animals and reports of these trials seem promising. But only one well-controlled trial, so far, has reported the effects of ginseng on humans. Using Korean ginseng in a placebo-controlled, double-blind trial on night-shift nurses, mood and body feelings were assessed. The results were less than impressive; the placebo improved as many aspects as did the ginseng.
Ginseng is not without side effects and can be dangerous if over-used. It can cause painful breasts, vaginal bleeding, skin eruptions, oedema, hypertension, depression, nervousness, sleeplessness and diarrhoea in the mornings. It is also addictive in the long-term.
But most of those symptoms are the result of taking too much. Surely, if it is used properly, there shouldn't be a problem, should there? The truth is that, as with most other herbs, we just don't know what the maximum safe dose is. There are many types of ginseng: American, Chinese, Japanese, Korean and Siberian. Each has different properties, discovered only recently with the advent of high-performance liquid chromatography. Labels on the products do not give amounts of the various active ingredients; they are not required to as ginseng is categorised as a food. And they cannot, as the amount of each ingredient in the plants themselves varies so much depending on when, where and how they are grown. High intake is not only possible but actually encouraged by the literature sold in the same health food shops as the ginseng.
For some women, ginseng can be dangerous even at low doses. It has oestrogen-like effects and should not be taken if they are suffering from cancer of the breast or uterus.
Kelp tablets don't specify on the label that they contain iodine (although many people take them for their iodine content), so one doesn't know how much one is taking. But there is an upper limit to the amount of iodine that it is safe to take. Follow the instructions and you will probably be taking too much.
Garlic . Garlic is part of the Mediterranean Diet which is supposed to be healthy. This is most people's motivation for taking garlic in this country. A number of trials have been conducted over recent years to try to determine whether the garlic is of benefit. In some it appears that it is, but others have shown the opposite and, as yet, there is no convincing evidence on which to base a recommendation one way or the other.
Two things are clear, however. Firstly, half a clove a day is unlikely to have any significant effect on health. A recent review of a number of trials where benefit was shown, found that to be of benefit the daily dose should be 7-28 cloves a day. And that is more than most could eat (or their neighbours tolerate). Secondly, in these trials where benefit was shown, it was the allicin in the garlic which was found to be the beneficial ingredient. But it is also allicin which causes the characteristic smell. Any product, such as a garlic capsule, which has been prepared so that there is no aroma, is likely to have had the active ingredient removed and, therefore, to be useless. And what do the health food shops tend to sell? The ones which don't cause the breath to smell.
St John's Wort is taken for depression. It has been taken for so long that it is generally thought to be very safe. But one must be careful if taking some prescription drugs: other antidepressants, drugs for blood pressure or heart disease, and antirejection drugs such as cyclosporin. It must also not be taken with foods containing the amino acid, tyramine. This is found in cheeses; yeast extracts, Oxo and Bovril; Bologna sausage; dried, salted or pickled herring and cod; Pepperoni; Chianti wine; broad beans (fava, Chinese pea pods); caffeine and chocolate if taken in large quantities; liver; pineapple, plums and raisins; and soy sauce. St John's wort can also makes the skin sensitive to sunlight.
Royal Jelly is produced by bees in relatively small quantities. Naturally, its supply is limited and it has to be sold at a high price. In her book, Royal Jelly , Irene Stein claims that it can cure 46 ailments: acne, AIDS, allergies, angina, arthritis, bronchitis, cancer, cold sores, . . .. She also makes miraculous claims about using royal jelly on animals; treating an anorexic tortoise, a dog with a slipped disc and bringing a cow back to life in Ireland! In an interview in 1989, Irene Stein was asked whether someone with cancer or Aids, reading her book, could get hope and might easily believe that taking royal jelly could help to cure them. She replied, 'I hope they do.'
In a television interview, Professor John Garrow of St. Bartholomew's Hospital, London called her attitude irresponsible saying, 'Imagine the situation of a patient or the relative of a patient who can't afford royal jelly and who is, therefore, put in the position that maybe they are not doing their best for their wife or husband or child or parent. I think that it is totally irresponsible and cruel. And I think that anyone who is going to make claims of that sort has a very, heavy responsibility to be sure that what they say is true. And far as I can see, that responsibility has been totally ignored.'
Now, several years later, Irene Stein's claims are still unproven. Although she no longer markets royal jelly herself, her book is still on the market and royal jelly may still be bought.
The Rio Summit of 1992 and Sean Connery's film The Medicine Man helped to put all sorts of 'natural' products from the Brazilian rainforest in the public eye. Two of them were Guarana and Lapacho . There was a large amount of media hype and health food shops boasted that they had bits of the rainforest within. But, when tested, Guarana's active ingredient turns out to be nothing more than caffeine; two guarana tablets a day being the equivalent of one medium-strength cup of coffee. And Lapacho, or 'the Tree of Life' claimed on the label to contain lapacol, which boosts the immune system. Actually, it contains none. When this fact was brought to the notice of the manufacturer, Rio Trading, they changed the label.
Bran. Bran is sold as a panacea for all kinds of disease from coronary heart disease to varicose veins. Not so long ago bran, which is the outer husks of wheat and other cereals, was a worthless by-product of the milling industry. It was thrown away. Today it can be bought in health food shops, pharmacies and supermarkets at great cost. But bran is not a food; there is no enzyme in our bodies which can break it down. But that doesn't mean that it is harmless. Bran is quite unlike vegetable fibre in that it contains phytate. Phytate binds with a number of minerals and vitamins, so that the body cannot absorb them, and it also depletes the body of a number of minerals. (For details of the harm bran can do, see The Cholesterol Myth ).
Another lucrative use that the manufacturers have found for bran is in the multi-billion pound slimming industry. Fibre tablets are sold as a slimming aid. One such tablet contains 0.2 g of bran and the dieter is instructed to take 5-6 tablets a day. She is told that the fibre will stay in her stomach and prevent her from feeling hungry. Let's examine the evidence. Firstly, the whole basis of the fibre hypothesis is that fibre goes through the gut faster; it does not remain in the stomach. Secondly the amount of fibre in 5-6 tablets at around 1 gram is about the amount of fibre found in one prune. But does it work? You won't be surprised that the answer is 'no'. A typical trial published in 1989 found that 'The effect of fibre was consistently not significant.' It went on: 'Although several mechanisms have been suggested by which fibre might work, none has yet proved acceptable.' It's hard to imagine that the eating of one prune a day would reduce hunger pangs significantly, either.

Herbal and Conventional drug interaction

Introduction

There is a concern in the medical world, about the flourishing use of dietary supplements, called "nutraceuticals", the reluctance of patients to let their doctors know what nutriceuticals they are taking and the possible occurrence of interaction between nutraceuticals and prescribed drugs:

Nutraceuticals (herbal medicines) are being used by an increasing number of patients who typically do not advise their clinicians of their use. Known or potential drug-herb interactions exist and should be screened for.

For the nutraceutical industry and for the consumers of nutraceuticals, the concern should be broader than the concern of the medical world. The nutraceutical industry is primarily concerned with possible interaction of nutraceuticals with each other, as well as possible interaction of hutraceruticals with prescrition drugs.

While I have no desire to stop people taking nutraceuticals, thenutraceutical industry has a responsibility to educate their customers about possible drug interactions with their products. User of these products should also always tell their doctors to ensure that they can also warn of any possible interactions.

Below, I have mentioned a few of the interactions between nutraceuticals and prescribed drugs. This list id not exhaustive.

Summary

Echinacea can cause hepatotoxicity and therefore should not be used with other known hepatotoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole.
Nonsteroidal anti-inflammatory drugs may negate the usefulness of feverfew in the treatment of migraine headaches.
Feverfew, garlic, Ginkgo, ginger, and ginseng may alter bleeding time and should not be used concomitantly with warfarin sodium.
Ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects.
St John wort should not be used with MAO inhibitors and serotonin reuptake inhibitors.
Valerian should not be used with barbiturates because of excessive sedation.
Kyushin, licorice, plantain, uzara root, hawthorn, and ginseng may interfere with digoxin pharmacodynamically and with digoxin monitoring.
Evening primrose oil and borage should not be used with anticonvulsants because they may lower the seizure threshold.
Kava when used with alprazolam has resulted in coma.
Immunostimulants (eg, Echinacea and zinc) should not be given with immunosuppressants (eg, corticosteroids and cyclosporine).
Tannic acids present in some herbs (eg, St John's wort and saw palmetto) may inhibit the absorption of iron.
Kelp as a source of iodine may interfere with thyroid replacement therapies.
Licorice can offset the pharmacological effect of spironolactone.
Numerous herbs (eg, karela and ginseng) may affect blood glucose levels and should not be used in patients with diabetes mellitus.
Ginseng and Ginkgo Biloba oppose each other and should not be used together

Herbal Teas

Many natural herbs are made into teas and drunk widely by intelligent people who take particular trouble to read the labels and check for adverse side effects. But many natural herbal teas, whose labels proclaim their health-giving properties seem to be potent sources of harm. Some of the more common ones, and the harm they can do are listed below:

Babchi causes photosensitivity, a condition where going out into sunlight can be painful.
Kavakava produces difficulty with hearing and vision.
Khat (Catha) can cause dependence and psychotic reactions, mania, insomnia, hypertension and 'running amok'.
Thorn Apple (Jimson Weed) produces thought disturbances and hallucinations.
Valerian , like comfrey, causes liver damage.
Alfalfa is responsible for enlargement of the spleen and can reduce the numbers of blood cells.
Coffee enemas can result in death.
Honey (from rhododendron pollen) causes nausea, vomiting, sweating, dizziness, hypotension (low blood pressure) and impairment of consciousness.
Karela produces hypoglycaemia (a deficiency of glucose in the bloodstream, causing muscular weakness, incoordination, mental confusion and sweating.).
Liquorice is responsible for hypertension, water and sodium retention.
Margosa Oil can cause constipation and promote respiratory infections.
Mistletoe and Senna both cause hepatitis - yet more liver damage.

Vitamin and mineral supplements

Another lucrative part of the health food business is the promotion and sale of vitamins and mineral supplements. Many books and magazine articles may be found extolling their virtues as a great way to stay healthy. But it is all unsupported hype to boost sales. No-one eating a normal diet of fresh fruit, vegetables and animal products such as meat, eggs, cheese, fish, etc, needs vitamin and mineral supplements. Beware processed foods if you want to avoid unnecessary expense – and ill-health. We have, today, a climate in which food companies sell us dysfunctional (junk) food that makes us ill – and then sells us 'functional foods' (a euphemism for vitamins and mineral supplements) to make up for the deficiencies in their products. You are paying them twice!
Vitamins may be a waste of money but most people think of them as relatively harmless. This isn't always the case. The government has issued warnings for a long time about taking vitamin A in high doses. It is particularly dangerous for a woman to take vitamin A if she is pregnant. In 1991, the health food industry agreed to ensure that warnings were displayed on the labels of vitamin A. Yet it is still possible, two years later, for anyone to buy vitamin A from health food shops and pharmacies in packets which do not carry such warnings. In a random check in Boots, for example, I found that their own combined vitamin A, C & D tablets carried no warning, and neither did Haliborange . In a health food shop, there was Healthilife Vitamin A . It stated that 1 tablet contained 100% of the recommended daily amount (RDA), yet said that up to three per day could be taken. The label on Lanes' Carotene claimed that each tablet provides nearly twice the recommended daily dose (180%) and Vitalia Selenium formula, A, C, E and Ginseng tablets contain 133% of RDA. None of them carried any warning of the dangers of overdose; indeed taking either of the last two products would ensure that an overdose was inevitable. The only one I found which did carry a warning was Adexolin .
Calcium tablets provide a good example of where manufacturers do not put as much effort into ensuring that their products work as they do into promoting them. Calcium supplementation is used to keep bones and teeth healthy. It is aimed specifically at women who are at risk of osteoporosis (although osteoporosis isn't caused by a lack of calcium but of protein). For the calcium to be of use to the body, the tablets must dissolve so that the calcium can be absorbed through the gut wall. And they must dissolve within a specific time otherwise they will have gone too far through a person to be absorbed.
Scientists at King's College, London, tested 10 brands of calcium tablet in a solution similar to that found in the stomach, to see how effective they were. The criterion used was that at least 50% of the tablet should have dissolved within 45 minutes. Of the ten products tested, only two passed. They were Health Aid Strong Calcium and Calcia .
Of the others, most had hardly started to dissolve at all within the 45 minutes. Professor Chris Marriott calls these tablets 'Bedpan Bullets' as, having gone in one end and out the other it is in the bedpan that they end up. He added 'if this is the quality of things that are sold in health food shops, I hope this isn't the tip of an iceberg, and the others are just as bad.' The test above is very simple. It could be done by the manufacturers, but they don't do it because they don't have to. All they have to show is that the tablets will break up into small pieces, and most will. But this does not prove that they will dissolve and, if they don't dissolve, they don't work.
Calcium tablets are very expensive and so represent extremely poor value for money. A pint of milk is not only more natural, it is much cheaper and far more effective.
Liquid Iron , if taken accidentally by a child, can have catastrophic results. Iron is corrosive and can do a great deal of damage to the intestine. Acute symptoms are abdominal pain and vomiting, progressing, in serious cases, to coma.
The list above is not exhaustive. No doubt there are other products as worthless or dangerous now and, no doubt, others will be devised in the future.
Health foods are big business. Their shops are everywhere offering pills and potions to alleviate all modern afflictions, to give us more vitality and arrest ageing in a 'natural' way. The phrase 'health food' lulls us into a false sense of security, and their products are marketed as being good for us. But the medical evidence to back such claims simply does not exist.
Pharmacists are forced into selling these products because of public demand. But they have serious misgivings. Unlike the proprietors of health food shops, pharmacists are trained in the prescription of drugs. But when asked for advice about herbal remedies they tend to be at a loss. What, for example, is the maximum safe dose? Do they interact with other drugs the customer may be taking? The answer is, they just don't know. Nobody does, and the consequences could be serious. Unless, that is, something is done to regulate the health food industry.
The health food industry is campaigning to prevent further regulation. It claims that if the rules are tightened, health food shops could be put out of business. But the regulations now are so full of holes that products:

Can be so impure that they kill.
Can be sold as foods although too dangerous to be used as drugs.
Can be sold without warnings on their labels.
Can make veiled and unsubstantiated medical claims.
Can be so badly made that they don't work.
May not even contain what they promise.

The European Commission is currently looking at the regulations surrounding the sale of vitamins, minerals and herbal remedies. We can only hope that it does its job quickly and thoroughly. And if it does put the health food shops out of business, that may be no bad thing. Even at best they are quite unnecessary.

References

D'Arcy PF. Adverse reactions and interactions with herbal medicines. Adverse Drug React. Toxicol Rev 1991; 10(4): 189.
Barna P. The case of ginseng. Lancet 1985; ii: 548.
Mansell P, Reckless J P D. Garlic: Effects on serum lipids, blood pressure, coagulation, platelet aggregation and vasodilatation. Br Med J 1991; 303: 379.
Pena M, Bacallao J, Barta L, Amador M, Johnston FE. Fiber and exercise in the treatment of obese adolescents. J Adolesc Hlth Care 1989; 10: 30.

Last updated 1 March 2000

"One must attend in medical practice not primarily to plausible theories but to experience combined with reason." Hippocrates

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