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Dietary Fads And Frauds

The folklore and superstition of cultures throughout history have attributed healing or harmful properties to certain foods. This tendency has not disappeared with the advent of the sciences of nutrition and medicine. Food folklore continues today, although in many instances it is inconsistent with scientific evidence.

Nutrition fraud is a comprehensive term used by the US Food and Drug Administration (FDA) to describe the abuses that occur as a result of the misleading claims for traditional foods, dietary supplements, and dietary products and of the deceptive promotion of other food substances, processes, and devices.

Food faddism is a dietary practice based upon an exaggerated belief in the effects of food or nutrition on health and disease.

Food fads derive from three beliefs:

  1. That special attributes of a particular food may cure disease.
  2. That certain foods should be eliminated from the diet because they are harmful.
  3. That certain foods convey special health benefits.

Food faddists are those who follow a particular nutritional practice with zeal and whose claims for its benefits are substantially more than science has substantiated.

Until Einstein's equation, E=mc?, which may also be written Calories=mc? is invalidated the only way to reduce weight (m) is to reduce the amount of calories consumed (E). In other words, to lose weight it is necessary to eat less calories each day than you burn up, and the only way to gain weight is to eat each day more calories than you use. [Herbert, J., (Chief Hematology & Nutr. Lab. Bronx VA Medical Center) : Nutrition Cultism - Facts & Fictions. 1981.]

Food quackery, which involves the exploitive, entrepreneurial aspects of food faddism, is the promotion for profit of special foods, products, processes, or appliances with false or misleading health or therapeutic claims. A food quack is one who pretends to have medical or nutritional knowledge and who promotes special foods, products, or appliances with false or misleading claims, usually for personal financial gain.

Nutrition fraud flourishes today because of the diversity of cultures, the historical tradition of concern for health and the use of natural remedies, and the introduction of advanced communication technologies.

Food faddism has its roots in Great Britain, where patent medicines were advertised and sold by everyone from hawkers to goldsmiths. In the colonies, legal protection of consumers against fraudulent claims was first recorded in Massachusetts Bayin 1630. Nicholas Knopp, was whipped and fined five pounds for selling a cure for scurvy that had "no worth nor value" and was "solde att a very deare rate". [Young, J.H. The toadstool millionaires: a social history of patent medicines in America before federal regulation. 1961.]

One of the earliest nutrition faddists was Sylvester Graham, a "back to nature" reformer who was suspicious of any food altered from its "natural" condition, such as white flour. His legacy continues among those who question whether processed food of any type can provide adequate nutrition.

Although, it must be noted that processed foods should not necessarily be eliminated from a persons diet because of this belief, it is true that without fortification the more a food is processed and thus differs from its natural form the less nutrient dense it will be.

Some groups such as fruitarians actually go a step further, they don't eat processed or cooked foods. The reason being that when a food is cooked it is not able to be digested and becomes toxic. There is no scientific evidence to back this argument to its fullest extent.

Popular interest in nutrition, coupled with concern about food shortages during World War I, was fostered by the increasing promotion of the health properties of foods in the early 20th century. Vitamins, by the very nature of their discovery, became associated with the prevention or cure of disease and were soon promoted as curative agents.

Today the travelling patent medical man has been largely replaced by the highly skilled and organized use of electronic means to promote fraudulent marketing - computers, customized mailing lists, national advertisements, and other mass media. The medium and the details have changed, but the message and the goals remain. It is difficult for consumers to evaluate the validity of the health claims perpetrated by quacks and faddists.

Purveyors of nutrition fraud capitalize on people's desire to be healthy and on the lack of certainty in many areas of nutrition and health. No writer for a lay audience has any special insights into nutrition which are not known by a substantial part of the scientific community. Magic and sensational diets are nothing more than exaggerations of one facet of nutrition at the expense of another, often to the detriment of the willing victims.

Regulation of Nutrition Fraud

The first Federal legislation, the Pure Food and Drug act of 1906, made it unlawful to manufacture or introduce into interstate commerce adulterated or misbranded food or drug products.

Currently, numerous Government, medical and consumer-oriented organizations are responsible for preventing and controlling fraud. These agencies work cooperatively, and their antifraud activities have become more visible in recent years.

Private agencies and organizations such as the American Dietetic Association, the American Cancer Society, the American Medical Association, the National Council Against Health Fraud, and other health professional groups are also active against food fraud.

The Federal Food, Drug and Cosmetic Act empowers the FDA to prohibit the introduction of any food, drug, device or cosmetic that is adulterated or misbranded. Only factual and nonmisleading information is allowed on food labels. Most false promotional claims, therefore, are not made on labels. Instead, they appear in books, lectures, and mass media that are protected by constitutional rights. The FDA has the authority to use its food additive and drug approval processes to control food products allowed on the market and to remove fraudulent products.

Most fraudulent food products are classified as foods, but when therapeutic claims are made for them, they are also considered to be drugs. If a food product is also classified as a drug and is considered by the FDA to be ineffective for its claimed use, it will not have an approved New Drug Application. For example, if it is promoted for treating a disease that is not amenable to lay diagnosis, it cannot have adequate directions for use and will not be approved.

Health Consequences of Fraud

Nutrition fraud may lead to deleterious health consequences, caused by the failure to seek legitimate medical care, by potentially toxic components of foods and products, by nutrient toxicities and deficiencies, by diversion of monies from essential treatments, and by interference with sound nutrition education.

Public health and safety can be jeopardized by false promises that divert or deter individuals from pursuing sound forms of medical treatment or that encourage them to abandon beneficial therapy for a disease. Fraud may encourage people to reject legitimate medical advice and to practice inappropriate self-medication that is less likely to be helpful, and more likely to be directly harmful, than the medical technology based on a sound understanding of human biology and nutrition.

The FDAs annual reports document numerous instances of fraud-induced failure to obtain appropriate health care. Because early detection and treatment improve prognosis for many illnesses, unproven "nutritional" therapies may unnecessarily delay beneficial intervention. Some diet regimens recommended by health faddists to treat cancer, for example, are so nutritionally deficient or toxic that adherence to them has caused death or serious illness.

Public injury can occur when foods and unproven remedies are toxic. Just because a substance occurs naturally in food does not mean that it is necessarily safe. Many of the chemicals known to be present in herbs have never been tested for safety. Some plant foods contain potentially unsafe pharmacologically active ingredients such as aflatoxin, one of the most potent carcinogens known.

There has been a substantial increase in the use of herbal products that contain pharmacologically active ingredients that can possibly produce undesirable effects such as an increase in blood pressure. Occasional poisonings and clinical intoxications are reported after the use of herbal tea products. Ginseng, one of the most popular herbs, has been reported to produce oestro-like effects in some people. From present evidence, it cannot be concluded that all herbal products can be consumed safely over extended periods of time. [Larkin, T. Herbs are often more toxic than magical. FDA Consumer: 4-11, October, 1983.]

Potentially harmful ingredients have been identified in samples of other food supplements, such as an oestroic hormone in commercial alfalfa tablets, arsenic in kelp tablets, and cadmium in dolomite have caused the FDA to caution against use of these products, particularly by pregnant women and children.

Frauds and fads may induce nutrient toxicities or deficiencies. Many people take vitamins as self-medication for the prevention or treatment of health problems. The use of these products varies with such demographic factors as geographic region, education, income, and race. Women are more frequent consumers than men. Intakes range widely, extending up to 50 times the Recommended Dietary Allowance (RDA) for individual nutrients.

Nutrient supplements are usually safe in amounts corresponding to the RDA, but the RDA's are already set to provide maximum benefit consistent with safety. Thus, there is no reason to think that larger doses will improve health in already healthy people, and excess intake can be harmful. Mega-dose intakes can have seriously harmful effects. The toxicity of high dosages of vitamin A and D is well established. Because the margin is narrow between a safe and a toxic dose of most trace elements, excessive supplementation with these substances may be particularly hazardous.

Excessively restrictive dietary practices can also induce serious medical problems or even death. Popular weight reduction products often provide very low calorie intakes. Because such products have been associated with the deaths of some young women, the FDA now requires warnings on labels to alert consumers of such products.

Many popular diets are potentially harmful because they eliminate food groups or severely limit food variety. Examples include those that drastically reduce carbohydrate intake, or advocate excessive fruit consumption, and those that claim that a person cannot digest protein and carbohydrates at the same time. This is not true, as can be seen in the Chapter - The Digestive System, different parts of the digestive tract deal with different nutrients and will absorb those nutrients, besides most foods usually contain both protein and carbohydrates (eg. legumes which are often 50% protein and 50% carbohydrate).

Fad diets seldom produce long-lasting weight control. Highly restricted diets, such as the more extreme forms of Zen macrobiotics, have led to nutritional deficiencies, starvation, and even death in a few individuals. [Council on Foods and Nutrition, Journal American Medical Association. Zen macrobiotic diets. 218:397, 1971.] Such diets have also been associated with retarded fetal development and childhood growth or other nutritional problems in young children.

Commercial interests have capitalized on a heightened public awareness of nutrition and health issues, but much of the public cannot evaluate the validity of available weight reduction schemes, supplements, and services. Self-appointed health and nutrition advisors have expressed distrust of proven public health measures such as fluoridation and pasteurization and, instead, have promoted treatment alternatives that are not supported by accepted medical practice. The public also may be misled by extravagant claims of health benefits from the use of certain foods or nutrient supplements.

Economic Consequences of Fraud

People experience economic injury when purported remedies and cures do not work, are untrue, or are greatly exaggerated or when purchased products are not needed. Fraudulent products are known to be extremely profitable to those who sell them. Quackery has become big business and costs the deluded consumers in excess of $10 billion a year!

Most fraudulent products and services can be very costly yet are promoted as having nutritional or health benefits that have not been substantiated in scientific literature. [The Surgeon General's Report on Nutrition and Health,1988.]

A vast array of substances are available for a variety of different purposes. some of them may even appear to work owing to the power of the placebo effect - if you expect product X will make you feel better, then it probably will. But these supplements must not be dismissed as placebos in the sense of being inert pieces of chalk. These substances are what they say they are, and many of them have powerful pharmacological effects (though not necessarily those claimed for them). The dangers of hypervitaminosis is an obvious example. The effects of excess quantities of isolated amino acid supplements, minerals such asselenium and substances such as ginseng have never been fully explored and may be no less hazardous.

Even if consumed at a level which is not harmful, their use is still undesirable. In most instances they are unnecessary; either providing nutrients which are surplus to requirements or supposed nutrients which are probably not needed at all. Furthermore, those who are most susceptible to health food claims are perhaps those who can least afford to be. [Health Foods and Fad Diets, Manual of Dietetic Practice, British Dietetic Association. Pg 229. 1989.]

Table 2.6 Health food supplements and remedies

Product

Reason for use

Comments

Vitamins
Minerals
Amino Acids
Kelp
Spirulina
Aloe vera

To correct dietary deficiencies

Surplus to requirements in most cases. Considerable dangers with over-use

Vitamins - B13, B15, B17
Flavonoids
Inositol
Selenium
Lecithin

To supply "nutrients" deficient in a normal diet

No evidence that supplements of these are necessary. B17 (laetrile) has now been banned from sale in the U.K.

Ginseng
Honey
Kelp
Pollen
Bee's royal-jelly
Spirulina

To restore vigour, induce feelings of well-being

Ginseng has certain pharmacologic effects although these are variable and unpredictable. Extremely expensive. Problems with over-use have been reported. May provide traces of vitamins and minerals (at a price) but little in the way of magic

DNA and RNA

Rejuvenation and retard ageing

The body makes all the DNA and RNA it needs. Dietary excess can cause hyper-uricaea

Cider vinegar
Garlic

To "cleanse" the body of toxins

In the absence of severe liver or renal disease, the body is quite capable of doing this for itself

Enzymes

To aid digestion or metabolism

Cannot possibly act in this way. Are denatured on reaching the stomach and then treated as any other protein

Spirulina
Cider vinegar
Honey
Lecithin

As a slimming aid

Claims that substances can burn up fat or stimulate metabolism are nonsense; if true obesity would be a thing of the past. Honey and Lecithin are significant sources of calories

Aloe vera
Green lipped-mussel
Kelp

As a cure for arthritis and rheumatism.

It should be noted that chronic disorders such as rheumatism and arthritis have periods of partial remission in any case.

Herbal remedies

Healing

A skilled herbalist may well be able to relieve minor ailments via the pharmacologic effects of some plants. But these effects can be powerful, and some times toxic, indiscriminate use of these remedies by the uninformed can be dangerous

The public incurs other costs because many products labelled as "natural" or "organic" sell for higher prices than their "regular" counterparts, although their special benefits are not generally demonstrable. "Natural" vitamins often sell at double the price of synthetic products even though they are chemically identical. In some products labelled as "natural," only a minor fraction of the vitamin is actually derived from natural sources.

What is also very difficult to understand is why more natural foods, like whole wheat bread or unpolished rice, often cost more than their refined counterparts, white bread or par-boiled white rice, that have undergone costly processing and packaging which should make them more, not less expensive.

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