 Hi, I'm back. This is Dr. Harriet Hall with lecture 8 in a series of 10 lectures on science-based medicine. In previous lectures, I covered the big five major areas of alternative medicine, chiropractic, acupuncture, homeopathy, naturopathy, and energy medicine. But there are a lot of minor topics I haven't covered. In this lecture, I'm going to talk about some of the recurrent themes in alternative medicine, and then I'll cover some remaining odds and ends. Some of which are really odd and should be ended. First, I want to talk about zombies, recurrent means and myths that refuse to die. No matter how many times they're deep out to disprove, they keep coming back to haunt us. There are lots of them, but I'll focus on these seven examples. The bogus homunculus. Food as medicine. The idea that a proper diet will prevent all disease. The idea that superfoods have unique health benefits, that weight loss can be effortless, that detoxification is necessary for health, and that retained feces are poisoning the body. I'll start with zombie number one, the bogus homunculus meme. Homunculus means little man in Latin. It refers to any small scale representation of the human body. These are two real homunculi. They show the areas of the brain that correspond to sensation and movement in various parts of the body. The one on the left maps the sensory cortex. The one on the right maps the motor cortex. A disease or injury that has damaged these parts of the brain would cause a paralysis or a loss of sensation in the corresponding parts of the body. In lecture seven I talked about cargo occult science where people imitate science without understanding the principles involved. Alternative medicine offers lots of examples of cargo occult science where the homunculus is imitated in other parts of the body without any understanding of the underlying anatomy. These real homunculi in the cerebral cortex represent the true wiring of the nervous system as mapped by anatomists and neurophysiologists. Alternative homunculi represent nothing but wild imagination. I talked about ear acupuncture in lecture four. A doctor in France imagined that the ear looked like a fetus curled up in its mother's womb. This led to several versions of a bogus homunculus like this one. There are no anatomical connections between the ear and the areas of the body depicted here. Reflexology offers a lot of different bogus maps of regions on the foot that have no anatomical connections to the areas shown. And erudology offers yet another bogus map of the body on the iris of the eyes. Here's another bogus map on the hand from hand acupuncture. That was hand acupuncture. This one is from hand reflexology. Just press on the right spot to relieve pain in the corresponding areas of the body. Notice that this is entirely different from the hand acupuncture diagram. Notice the spine running along the outside edge of the thumb, the eyes on the middle finger, the arms on the index finger, and the heart at the top of the little finger. Even individual teeth are said to correspond to organs. According to this diagram, when I fell and broke my top two front teeth, it should have affected my kidneys. It didn't. Remember butt reflexology from the acupuncture lecture? It showed a homunculus on the periphery of the buttocks. It's no sillier than any of the other diagrams I've just shown you. Zombie meme number two is food as medicine. This is a really old one dating back to ancient Egypt. The ancient Egyptians thought that all diseases were caused by what people ate and that dietary regimens could cure. Hippocrates said, let food be your medicine and medicine be your food. Of course, he didn't really have much in the way of medicine, so food was probably the best he could do. Today, some people like Dr. Joel Furman are still echoing Hippocrates. He says, we must unleash the disease fighting artillery in our own kitchens. Should patients just be given drugs for diabetes, cholesterol, blood pressure and more? Or should they know they have the opportunity for a complete non-drug recovery? We don't need to find the cure. It's already been found and it's sitting there on the shelves of our grocery stores. Not in my grocery store, dude. You got to wonder where he shops. The cure for diabetes right there between the arugula and the artichoke? I don't think so. Mark Hyman agrees. He says, food cures everything. He says, scientists have discovered a powerful drug to cure all chronic illness. He says, food is the most powerful drug we have. The fastest acting with the most impressive results and no side effects. Really? If he had pneumonia, I wonder if he'd treat it with food instead of antibiotics. If he were in agony with a kidney stone, I wonder if he would refuse morphine and just eat something instead. The word nutraceuticals is a compound of the words nutrition and pharmaceutical. It's a marketing term that refers to foods sold as medicines. It includes dietary supplements and also foods that have been fortified with extra nutrients like iodized salt. QuackWatch lists the American Nutraceutical Association as a questionable organization. As far as science is concerned, foods can't be considered medicines unless they can be shown to treat diseases. Food can treat diseases caused by nutritional deficiencies. Scurvy is a disease caused by a deficiency of vitamin C. And citrus fruits are a good source of vitamin C, so they can be used as medicines to treat scurvy. Good nutrition is important to health in general, but I don't know of any specific food that can serve as effective medicine to treat any non-deficiency disease. Lots of claims are made. For instance, they'll tell you that cinnamon lowers blood sugar and can be used to treat diabetes. But studies have given conflicting results, and even those that showed lower blood sugar didn't find any improvement in hemoglobin A1C levels, which are the best measure of long-term diabetes control. The American Diabetes Association concluded that cinnamon doesn't work. Zombie meme number three. The idea that a proper diet will prevent all disease. You may have heard statements like these. If you eat right, you can't ever get sick. Or, a proper diet will prevent 100% of cancers and will cure cancers already present. That's simply not true. Some people think a proper diet is better than vaccines. Some anti-vaxxers claim that vaccines didn't make a difference. They point out that deaths from contagious diseases were already declining before vaccines were introduced. Well, they were because of better sanitation, better nutrition, and more effective medical treatment of sick children. Deaths were declining. But the incidence, the number of children who caught the diseases, wasn't declining. It only declined when vaccines were introduced. The idea that factors like sanitation or diet are more effective than vaccines is just nonsense. We've seen several natural experiments in both developed and underdeveloped countries, where the vaccination rate declined and the incidence of the disease increased. And then when the vaccination rate rose again, the incidence of the disease dropped again. In the same country with no change in nutrition or sanitation. Some people insist that a healthy child who's adequately nourished can't get sick. They are dreaming. Good nutrition may reduce the risk of catching an infectious disease, and it may reduce the risk of serious complications. But it certainly doesn't prevent the diseases. Some people think a proper diet will prevent cancer. And we know that can't be true. The majority of cancers, 58% of them, are due to bad luck and they're unavoidable. Some cancers are due to heredity. There are familial cancers and inherited mutations like the BRCA genes that cause breast cancer. The body's constantly copying DNA as cells divide. And the process is imperfect. Copying errors can lead to cancer and there are unavoidable random mutations. Only about 42% of cancers can be attributed to environmental or lifestyle factors. And nearly half of those are due to tobacco. Being overweight is associated with 5% of cancers. Exposure to radiation from all sources, sun, tanning beds, medical procedures and natural background radiation is associated with another 5%. You're more likely to get cancer if you live at a high altitude or live in a brick house or if you have radon in your basement. And eating too few fruits and veggies probably accounts for around 5%. Alcohol is associated with 3.5% of cancers. Chemical toxins like pesticides and workplace exposures account for a small percentage of cancers. And a few cancers are caused by infections like HPV and hepatitis B. But we have vaccines to prevent those. Different studies come up with different numbers. An estimate from the American Cancer Society is more optimistic. It says that as many as a third of cancers might be preventable with diet. But that includes dieting to prevent obesity. It's true that eating a healthy diet will reduce the risk of cancer, but there's no way it can prevent all cancers. There's no way diet could have any effect on the bad luck factors. Proper diet can't prevent all disease, but it can prevent deficiency diseases and it can reduce the risk of some other diseases. What can science tell us about proper diet? Science discovered vitamins and it has a pretty good handle on what nutrients we need. The best scientific knowledge is reflected in published nutrition guidelines. We need 6 categories of nutrients. Proteins, fats, carbohydrates, vitamins, minerals and water. The body digests what you eat and breaks it down into its component nutrients. The original source of the nutrients is not important. Throughout human history, people have eaten a wide variety of diets. Some rich in plant foods, some poor in plant foods and rich in animal foods. People can thrive on a wide variety of diets. Modern vegans eat no animal products. Eskimos live mainly on raw meat and blubber. The Maasai subsist mainly on raw meat, raw milk and raw blood from their cattle. People can live on raw meat alone. It has all the nutrients we need, even vitamin C, which is destroyed by cooking. A raw meat diet may be nutritious, but I wouldn't recommend it. Studying diet is problematic. Most studies are questionable because it's hard to control exactly what people eat and it's practically impossible to do double-blind studies. Researchers can ask people to follow a diet, but they can't very well enforce compliance. Even patients in controlled inpatient settings can cheat. Friends can smuggle in food or patients can sneak down to the gift shop for a candy bar. Most studies rely on self-reports and recall, and we know that memory is unreliable and estimates of portion size are unreliable. Nutrition recommendations change, but that's the value of science. It can change in response to better evidence. As we learned more about risk factors for heart disease, first we were told to avoid cholesterol in the diet, then total fat, then saturated fat, and now it seems everything's okay except trans fats. When experts recommended low-fat diets, people replaced the fats with high-calorie carbohydrates and they got fat, and then low-carb diets became popular. So what should we eat? Low-fat, low-carb, low-protein, no meat? We don't have any good answers yet. Some diets like the Mediterranean diet and the vegetarian diet have been shown to correlate with better health, but we don't know if they're ideal and they certainly don't prevent all disease by any means. Traditional Chinese medicine has a non-scientific view of nutrition. It classifies foods as warm, cool, moist, or dry. Here are some examples. Boiled spinach is cooling and moistening, so it would presumably treat warm, dry diseases. If there were really any such thing as a warm, dry disease. Roast beef and chilled wine are warming. Toast, while dry to the touch, actually moistens the body. Who would have guessed? They make a lot of health claims for these four categories of food, and it's all based on pre-scientific mythology. It's superstition and magical thinking, not science. Ayurveda, the ancient Indian system of medicine, is equally unscientific. In Ayurveda, diet recommendations are determined by your dosha, your mind-body type. To pacify kaffa, you should eat spicy foods and avoid sweet foods, except for honey, but don't eat the honey. Avoid tomatoes and nuts. Turkey is fine, but avoid rabbit and pheasant. To reduce vata, eat sweet, sour, and salty foods. Avoid spicy foods. Nuts are good, and so are dairy products. For excess pita, eat sweet foods and avoid the spicy. Eat nuts. I took Deepak Chopra's quiz, and I found out that my type is mixed vata and pita. Those two apparently agree that I should eat sweet food, avoid spicy foods, and eat nuts, but that left me confused as to whether I should eat sour and salty foods and dairy products. Everyone seems to want to tell us what to eat. Here are some of the diets people advocate that are not supported by evidence. The Paleo diet, based on what we think our ancestors ate. Raw food diet, based on the belief that cooking destroys the life force in food. The blood type diet. The alkaline diet. The maker's diet, which only allows foods that are mentioned in the Bible. Frutarians who eat only fruit. The tapeworm diet. The zodiac diet. There are so many of these fad diets. It seems like there's a new one every month. They not only want to tell you what to eat, but how to eat. Certain foods shouldn't be mixed. Food should be eaten in a certain order. Don't drink liquids with meals. Advocates of Fletcherizing even want to tell you how to chew. You must chew your food 32 times. Then you spit it out. The idea is that you would absorb the nutrients without the bulk and would lose weight. Fletcher's motto was, Nature will castigate those who don't masticate. There's a plethora of claims and a paucity of proof. So how can you choose the right diet? We still have a lot to learn, but the available evidence is converging on this diet advice. Eat a variety of foods, mostly plants, not too much. Get your nutrients from food rather than from pills. Most reputable sources of dietary advice emphasize plant-based foods. Your mom was right when she told you to eat your vegetables. Zombie meme number four is that certain foods have unique health benefits. Sometimes they're called superfoods. Good nutrition is important to health, but there are no special foods with unique health benefits. Gaylord Hauser discovered that these five wonder foods would add years to your life. Skim milk, Brewer's yeast, wheat germ, yogurt, and blackstrap molasses. He also claimed that he had cured himself of tuberculosis of the hip by eating 36 lemons a day for one to two weeks. I find that hard to believe. It makes me wonder why he didn't add lemons to his list of wonder foods. He wasn't a doctor or a scientist. He was a huckster who had several run-ins with the FDA for making false claims to sell products like anti-diabetes tea. Cider vinegar is promoted as a cure-all that keeps the body in balance, thins the blood, aids digestion, and gives you a longer, healthier, youthful life. The evidence for those claims? Zero. Wheatgrass juice allegedly has all these wonderful effects. It cleanses the body, neutralizes toxins, slows the aging process, and prevents cancer. The plant enzymes in wheatgrass are supposed to supplement body enzymes, but that doesn't seem likely since we know that enzymes are destroyed by digestion. There is no evidence that any of those claims are true. The stuff looks putrid, and they tell me it tastes even worse. One of the latest fads is anti-inflammatory foods. Inflammation is such a bugaboo that it even made the cover of time. These foods are supposed to be anti-inflammatory. Kelp, wild Alaska salmon, Turbaric, shiitake mushroom, green tea, papaya, blueberry, extra virgin olive oil, broccoli, sweet potato. They supposedly counteract heart disease, Alzheimer's, Parkinson's, age-related disorders, many cancers, and autoimmune diseases like rheumatoid arthritis. Evidence for these claims is lacking. There's a whole science of nutrigenomics. Now, it's true that nutrients affect gene expression, and genetic differences affect how we process nutrients. Some day we may be able to provide individualized diet advice based on the genome. But the companies that currently offer nutrigenomic testing and advice are pretty much a scam designed to tell you their brand of diet supplements. Acai is billed as the number one superfood in the world. Look at all these claims. Weight loss, increased energy, better digestion, improved sleep, enhanced mental health, stronger immune system, healthier skin, youthful appearance, detoxification benefits, improved circulation, healthier heart. Wow. The evidence? Zero. In fact, a study showed that the antioxidant content of acai berries was less than that of mangoes, strawberries, and grapes. Acai is one of the superfruits that are said to offer value beyond basic nutrition. Promoters typically hype a single, exotic, tropical superfruit, but all of these have been designated superfruits. Acai, baobob, macky, mangosteen, goji, sea buckthorn, jujube, cuckoo asu, pitayas, pomegranates, guava, dragon fruit, kiwi, lychee berries, yum berries. How could you decide which one to choose? Superfruits is a marketing term, and it's used mainly to promote exotic, tropical fruits that have to be imported and can be sold at exorbitant prices. They are high in nutrients, but they don't offer any special benefits that you can't get from other fruits. A lot of more common fruits have also been designated as superfruits, including choked cherries, lingonberries, blueberries, blackberries, raspberries, figs, apples, bananas, cantaloupe, cherries, citrus fruits, plums, strawberries, tomatoes, avocado, pumpkin and pumpkin seeds, watermelon and pineapple. Now, maybe an expensive fruit has more antioxidants per gram, but you can get the same amount of antioxidants if you eat enough of the cheaper fruits. Lists of superfoods contradict each other. Here are three different lists that I found on the internet. The one on the right is Dr. Oz's. There's very little overlap. Twenty-three items appear on only one of these three lists, and the only item that's common to all three lists is beans. All these foods are a good source of various nutrients, but there's nothing special about them. Oranges are usually considered a great source of vitamin C, but many other fruits have more than oranges. One medium orange has 70 milligrams of vitamin C. A cup of chopped red bell pepper has nearly three times as much, 190 milligrams. Two kiwi fruits have 137 milligrams. A serving of broccoli has 132 milligrams. Other foods that have more vitamin C than an orange include green bell peppers, mango, pineapple, Brussels sprouts, cauliflower, strawberries, papayas, kale, and chili peppers. A superfood may contain a high level of a nutrient, or even high levels of multiple nutrients, but if you're already getting enough of those nutrients in your regular diet, eating a superfood won't make you healthier, the excess will just be eliminated. You may have noticed that most of the claims of health benefits of foods are rather vague. Unless a product has been approved by the FDA as a medicine, it's illegal to claim that it can cure, treat, or prevent any disease. One company falsely advertised that elderberry juice could cure, treat, or prevent various disease conditions, including AIDS, diabetes, and flu. And their products were seized by the FDA. Zombie meme number five. There is an effortless way to lose weight. Don't you wish? Physics tells us that if you use up more calories than you take in, you will necessarily lose weight. It's simple in principle, but it's fiendishly difficult to put into practice, and it takes a lot of effort. People want a way to make it easy. If it sounds too good to be true, it probably is. ACAVAR 2050 advertised that you could eat all you want and still lose weight. They said, we couldn't say it in print if it wasn't true. But they did say it in print, and it wasn't true. They were using deceptive marketing tactics to sell an untested product. They claimed to have evidence from two clinical trials. But neither of those trials actually tested the product. One just tested caffeine. There is no evidence that ACAVAR 2050 aids weight loss, but if it does, it's probably because it contains a lot of caffeine. And frankly, coffee tastes better and is cheaper. Hoodia is a cactus-like plant that only grows in the Namib desert. It was traditionally used by skinny bushmen in the Namib desert as an appetite suppressant for population conditions on long hunts. Recently, it has been touted as a miracle weight loss pill for lazy fat people with plenty of access to food. That doesn't necessarily follow. It can't be cultivated. You have to go out and find it in the desert. Its popularity led to biopiracy. It was stolen from the San people. It's protected by law, and it can only be exported as part of the profits being returned to the sun. When several Hoodia products were tested, half of them contained less than a tenth of a percent of what the label said. And half of those contained no Hoodia at all. So if you buy it, you're probably not getting any. And if you are getting any, you're defrauding the San people. Either way, I'd say the customer was getting Hoodia weight. It hasn't been proven safe or effective. A pharmaceutical company worked on it for a while, trying to extract the active ingredient, but they gave up on it. Finally, in 2011, a study showed that it doesn't work and it causes side effects. Dr. Oz seems to have a new weight loss miracle every month or two. The latest one is Garcinia Cambogia. He calls it the weight loss holy grail. He's easily impressed and disregards the scientific studies that have shown either no effect or an effect too small to be clinically significant. Oh, and it is known to cause various side effects. Before this one, Dr. Oz recommended other miracles like green coffee bean extract, raspberry ketones, yerba mate, bilberry, hot pepper jelly, catechin and conjugated linoleic acid, acacia powder, pickles, red wine, and wet foods. Dr. Oz must have been eating a lot of wet foods because he's all wet. I wonder what his next miracle will be. Here's what the scientific evidence says about successful weight loss. Reduce calorie intake, stay physically active and keep a food diary. Most weight reduction diets are strategies that get you to eat fewer calories. Keeping a food diary has been shown to improve weight loss, and I think it's because people who write down everything they eat become more aware of what they're putting in their mouth and they eat fewer calories. Zombie meme number six, the idea that we need to be detoxified. These are the only science-based reasons to detoxify. Alcohol detox for alcoholics, drug detox for addicts, treatment of poison ingestion, dialysis for kidney failure, and chelation for heavy metal poisoning. Except in cases of poisoning, the body doesn't need any help in handling toxins. The liver and kidneys do a fine job by themselves. Toxins are constantly being ingested, and they're also being constantly created in the body by metabolic processes. The liver breaks down toxins and prepares them for excretion in bile or urine, and they're eliminated. Some of the bogus detoxification treatments that are used in alternative medicine, colon cleansing, infrared saunas, foot pads and foot baths, gersen therapy, oil pulling, Scientology's purification rundown, chelation, maple syrup, cayenne pepper and lemon juice, removal of dental fillings. Now, none of these will do you any good, and some of them are likely to harm you. Have you seen these detox foot baths? The water turns brown, and they tell you it's the toxins coming out through the skin of your feet. It's not toxins, it's rust. It's a process of electrolysis that removes ions from the metal electrodes. If you run the machine without putting your feet in it, you'll see the same color change. Have you seen ads for those detox foot pads? Kenokee is the best known brand. You leave these pads on your feet overnight, and in the morning, they've turned brown. And supposedly, the color change means that toxins have been removed from your feet. But guess what? They also turn brown if they're exposed to moisture without any skin contact. Zombie meme number seven. Retained feces are poisoning you. The mantra is, death begins in the colon. Almost every disease has been attributed to poisons that have been absorbed from the intestine. They say that decay, fermentation, and putrefaction in the colon are released into the blood, poisoning the entire body. This process is sometimes called auto-intoxication. There's a long history of people being overly concerned about bowel function and constipation. Those worries date back as far as ancient Egypt. A passage in the Ebers Papyrus suggests that undigested food causes poisonous substances that overflow into the body and initiate putrefaction in vital organs. The auto-intoxification myth was discredited by science early in the 20th century, but it persists as a popular belief. Heather Mills tells us, did you know that when you eat meat it stays in your gut for 40 years, putrefies, and leads to a disease that killed you? Others tell us over a period of years of faulty diet, the walls of the large intestine become coated with a thick layer of mucus and impacted food. The average North American is carrying around 9 to 12 pounds of impacted fecal material. Some people claim there are accretions of 5-year-old hamburgers stuck to the colon wall. Now, none of that can possibly be true, even in part. These are constantly looking inside the colon. Surgeons, radiologists, gastroenterologists doing endoscopies and pathologists doing autopsies. No doctor has ever seen any such accretions. And we know that the cells lining the colon are constantly being replaced every few days, so if anything were stuck to the wall of the colon it would fall off as the old cells sloughed off. Nevertheless, people who believe this rot subject themselves are also known as high colonics or colon hydrotherapy, often in one of these spa-like facilities. It's like an enema but with much more water. It can cause side effects like cramping, bloating, nausea and vomiting. It can be dangerous due to perforation, dehydration, infection, electrolyte imbalance, and removal of normal colon bacteria. There have been reports of kidney failure, pelvic abscesses, peroneal gangrene, septicemia, acute water intoxication, and deaths from amoeba infection transmitted by improperly cleaned equipment. There is no medical reason for colon cleansing except as a bowel prep for surgery, imaging procedures, or colonoscopy. And colon irrigation is not used for those bowel preps. Then there is coffee enemas said to be an important part of any detox. They say it stimulates the liver to excrete toxins in the bile. They say the caffeine is absorbed but claim it doesn't cause caffeine side effects. Which doesn't make any sense because once the caffeine is in your bloodstream, it can't remember how it got there and it can't act any differently. Coffee enemas are used for everything from general well-being to treatment of cancer. People take 4 to 10 enemas a day. It requires boiling the coffee for 15 minutes, lying on the floor for 15 to 30 minutes after the enema before excretion. That's a huge investment of time for something that has never been shown to do any good. There are even special coffees sold for the purpose. If Starbucks were selling it, they could call it star butts. Twice daily coffee enemas are part of the Gonzales Regimen. Promoted as a treatment for cancer. Patients also take freeze-dried pancreatic enzymes, nutritional supplements 130 to 160 doses a day. A special diet of organic foods, preparing fresh juices many times a day, skin brushing daily and liver flushes. The Gonzales Regimen has been tested, and it doesn't work. I'll be coming back to it in lecture 10. So, enough about zombies. Now for some more odds and ends. That reminds me of the old joke about the psychiatrist and the proctologist who decided to open an office together. They couldn't decide whether to call it nuts and butts, queers and rears, or odds and ends. One of the oddest alternative to both beliefs is breatharianism. This is Prahajani. He's 83 years old. He claims to have lived without food for seven decades, surviving on universal life force energy alone. The Indian Army is studying him because they want to teach their troops to go without food. They're so invested in believing his lie that they're not bothering to provide constant 24-hour surveillance of what's happening. The breatharian fad has come to the U.S. This woman tells us that the starving of the world would be just fine if they could only be reprogrammed. They starve to death because the mass media has tricked them into thinking they need food. Did you realize you were being tricked by the mass media? You don't need food. You can live on light or the holy breath or prana or something. Yup, you can live on it until you die, which will happen a lot sooner if you don't eat. Wouldn't it be nice if you could remove gallstones without surgery? So-called liver flushes claim to do just that. They use a variety of ingredients, mainly olive oil. You drink the flush solution and these objects appear in your stool. But the green object is not the quarter. That's just there to show the scale. These are not gallstones. Hope stones produced by the action of digestive juices on large volumes of olive oil. Here's another odd belief. Ear candles. A conical hollow cylinder coated with wax is inserted into the ear canal and lit. It supposedly removes wax buildup from the ear canal. After a treatment, the candle remnants are open to show that they contain debris like this. Patients are told that this is the ear wax that the candle removed by creating a suction. It isn't. Skeptics tried burning the candles without inserting them in the ear. They found the same debris. It comes from the candle itself, not from the ear canal. Some ear candlers have wised up enough to stop claiming that it removes wax, but they still claim it's a holistic way of treating ear aches. It's also sold as a relaxation technique that allegedly provides a whole laundry list of other health benefits. Ear candles have been banned by the FDA because they serve no medical purpose and they're risky. There have been reports of burns, perforated eardrums, complications requiring surgery, fires, and at least one death. Longevity clinics are springing up everywhere. In his book, Fantastic Voyage Live Long Enough to Live Forever, Ray Kurzweil predicts that in the future, everyone will live forever. He's trying to stay alive until science makes living forever possible. He follows a regimen that he devised in collaboration with Dr. Terry Grossman, who runs a longevity clinic. He takes 250 supplement pills every day. He spends a whole day every week at the longevity clinic getting IV vitamins, circulation, and acupuncture. He takes additional herbs that his wife gives him. He drinks 8 to 10 glasses of alkaline water a day, and 10 cups of green tea. I wish him luck, but none of the things he's doing have ever been shown to extend the human lifespan. Science-based preventive medicine can minimize the risk of premature death from disease, but the claims of the anti-aging clinics and patients go way beyond any evidence. Then there are claims about vitamins. 40% of Americans take vitamins mostly for the wrong reasons. Science says most of them are wasting their money. People take vitamins to boost their energy, to improve their memory, to fight fatigue, irritability, and poor concentration, to extend their lives, to lose weight, to relieve depression, to induce hair growth, to improve skin and other alleged beliefs. Newsflash! Vitamins don't do any of those things! Here are the only science-based reasons for people in the general population to take vitamins. Young women should take folic acid for prevention of birth defects. And the elderly, who may not be getting enough vitamin D or vitamin B12 in their diets, should probably take supplements. People should only take vitamins if their doctor tells them there's a specific medical reason to. For people who worry that they may not be getting enough vitamins in their diet, it's better to improve the diet than to take multivitamin pills. And vitamins can harm. Studies have shown that smokers who take beta-carotene, vitamin A, are more likely to die of lung cancer and heart disease. When people took vitamins A, C, E, beta-carotene and selenium to prevent intestinal cancers, it increased their death rate. Supplemental vitamin E, increased mortality, heart failure and prostate cancer. And one study showed that taking a daily multivitamin increased the risk of death. And there's the antioxidant paradox. Antioxidants can have both good and bad effects. When people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders. There are all sorts of bogus oxygen therapies based on the myth that disease is caused by a lack of oxygen. Hyperbaric chambers are recommended for everything from autism to insomnia. Ozone and intravenous hydrogen peroxide are used for AIDS and cancer. Diet supplement companies sell oxygen supplements like vitamin O that don't even contain any oxygen. Bogus magnet therapy is abound. Magnets are used mainly for pain, but also for other conditions. Everything from HIV to diarrhea. They've been put into everything from insoles to mattress pads. They supposedly work to increase circulation by attracting the iron in hemoglobin in red blood cells. That's not true. Hemoglobin is not ferromagnetic and oxygenated hemoglobin in plasma are actually slightly repelled by a magnet. If blood were attracted to magnets, patients would explode or bleed to death during MRI exams. The claims for magnets are pseudoscientific or simply ignorant. A magnetic mattress pad salesman once told me that negative magnetism is greater at night because the moon is out. Magnets have been tested. They don't improve the circulation and they don't even produce any significant magnetic field at or below the skin. Here are just a few of the many things I won't have time to cover. Aromatherapy Bach flower remedies which are like a cross between neuropathy and homeopathy. Psychic surgery. Neurolinguistic programming. Fake cancer cures. Shiatsu. EMDR. Eye movement desensitization and reprocessing. Facilitated communication. Water quackery. Urine therapy. And there are many, many more. It's what the French call an embarras de richesse. An embarrassing over-abundance of riches. If time permitted it would be fun to review all of these. It would be a bit like a visit to the zoo to see all the strange animals. There is no end to what the human imagination can invent. And no end to what gullible people will believe. If you want more you can find it on quackwatch science-based medicine in the skeptics dictionary. Those are all listed in the course guide. Now that's all the time I'm going to devote to CAM. In the next lecture I'll talk about pitfalls in clinical research.