The Quackometer

The Advertising Standards Authority is one of the few regulatory bodies in the UK regularly prepared to tackle the untruthful and unsubstantiated claims made routinely in the alternative health industry. It is also one of the weakest regulatory bodies in the UK. Nothing could highlight that more than how Life Healthcare (trading under the url http://www.reverseageing.com/) dealt with an investigation.

Life Healthcare had made an advertising leaflet for a product called Thyroid Support Formula and had a heading on the front page that stated "New Scientific Studies Prove That There Is Hope, Read On, and You'll learn the Secrets That Your Doctor Might Not Be Telling You about an Under-Active Thyroid". Particularly worrying was the claim that,

But the truth is that conventional medicine does not have the best testing or treatment methods for an under active thyroid. Just because your test results have come back negative for an under active thyroid doesn't mean you don't have it.

A complainant to the ASA expressed concerns that a leaflet from Life Healthcare was

potentially harmful because it discouraged people from seeking proper medical treatment or from following the advice of their doctor

and doubted that,

the claims made in the ad for the product's efficacy could be substantiated

The ASA took a look a the advertisement and also challenged Life Healthcare if they had proper authorisations to market their products and whether the testimonials and photos included in the ad were genuine.

So, pretty serious charges. How did Life Healthcare respond? They didn't. They completely ignored requests by the ASA to explain themselves. The ASA upheld all complaints and said,

The ASA was concerned by Life Healthcare's lack of response and apparent disregard for the Code, which was a breach of CAP Code clause 2.6 (Non-response). We reminded them of their responsibility to respond promptly to our enquiries and told them to do so in future.

Their action was,

We told Life Healthcare not to repeat the claims in future advertising. We urged them to seek guidance from the CAP Copy Advice team before advertising again and asked CAP to inform its members of the problem with Life Healthcare.

I, for one, am not convinced that this direction will be adhered to.

Life Healthcare appears to make a business from evading legal restrictions on its practice. The from page of its website informs us,

With draconian EU legislation pending for the UK marketplace your right to buy optimum dose nutritional supplements may be limited, and some ingredients may no longer be available. Fortunately as we are based outside the EU (in the Channel Islands), Life Healthcare can continue to supply these high potency supplements that may have to be withdrawn from the UK and Europe in the coming months and years.

The current weakness of consumer protection laws in the UK will indeed be strengthened in the next few weeks as vastly improved consumer trading legislation comes into force. Whether this makes any difference to companies such as Life Healthcare remains to be seen.

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Postscript

It would appear that fleeing to the channel island might not be the get out of gaol free ticket Life Healthcare hope for. Yesterday in parliament, the Minister for Health Dawn Primarolo, responded to a question asking what the Government was doing about such loopholes. She replied,

The FSA continues to work with the Ministry of Justice, the Department responsible for the Crown Dependencies, and the administrations in the Crown Dependencies regarding implementation of the food supplements directive and Nutrition and Health Claims Regulation to prevent trade in food supplements that would be illegal in the United Kingdom.

Labels: ASA, regulation, vitamins

 

Today, the Advertising Standards Authority have upheld complaints against Equazen and their eye q™ products, finding them to have made untruthful and unsubstantiated advertising claims. This is about time. Their antics in promoting fish oil pills to school children have been well documented.

Equazen (now owned by Swiss pharmaceutical company Galenica) have been using local authorities to promote the idea that taking a daily fish oil supplement can boost children's' school performance. They call it the 'Clever Capsule' for your child. However, their evidence that could substantiate this has been hard to come by. Claims that the pills have been independently and scientifically tested in schools looked very weak with the only trials on record appearing to lack basic scientific controls, size or applicability. Nonetheless, the charge to sell loads of these pills to concerned parents has taken place in earnest.

Vitamin pill entrepreneur Patrick Holford has been pushing the pills on TV and through his Food for the Brain charity. Boots the Chemists have had displays extolling the virtues of the pills and their PR agencies have ensured that the credulous media, such as the Daily Mail, copy out the press releases as if it they were news.


All in all the message has been: you are an irresponsible parent if you are not shoving fish pills down your kids necks.


The ASA investigated whether the claim "A Hi-EPA fish oil formula that may help maintain concentration levels and healthy brain development" could be substantiated. Also they looked at the independence of the tests, the rigour of the test and whether the concentration and learning of all children would improve following supplementation. Equazen produced a huge amount of evidence to support their adverts but the ASA found that their claims could not be substantiated and they were misleading. The ASA instructed Equazen as follows:

We told Equazen to remove the claims "... may help maintain concentration levels and healthy brain development", "the Clever Capsule"Scientifically tested in schools", "proven in schools" and "proven by Science" from future advertising for eye q. We also told them to avoid implying in future that the advertised product could benefit the general population or that a trials results related to a product with exactly the same composition and dosage as the advertised product if that was not the case.

Now, I for one am mightily impressed by the ASA. This was quite a complex issue involving a lot of evidence and weighing of scientific viewpoints. This is something that many bodies wish to shy away from. We have seen the Guardian readers' editor this week talking about the difficulty of arbitrating readers disputes over scientific evidence. Some of the evidence was easy to dismiss, such as Equazen trying to pass off their adherence to the Food Labelling and Food Supplements Regulations as some sort of endorsement of the efficacy of their product. Other evidence required careful dissection of trial methodology to determine the applicability to their claims.


There is a problem in the UK of finding the right authorities to help in tackling the claims of quacks. If someone is making dangerous or misleading claims about a quack product then it is quite difficult to know who can help. Trading standards were set up to deal with dodgy plumbers and are run from local councils. The ASA is an industry run organisation with limited sanctions. The ASA deals with adverts only, but not web adverts. Trading standards are based in regional offices and may or may not have the experience to deal with more complex scientific issues. It is a bit of a mess.


The harm that the ASA ruling will have on Equazen is not a monetary one in the form of a fine. It is not the threat of legal action - it is rather a smack on the wrist from their peers. What they undoubtedly really fear is bad publicity and that is what an ASA ruling often leads to.


Far from perfect, and limited in scope and powers, the ASA appears to be remarkably willing to take on difficult issues and act on complex issues. I just wish that this approach could be applied more uniformly to challenge the problems society faces from quackery.

Labels: ASA, equazen, Patrick Holford

 

According to Allergy UK, they are "a national medical charity established to represent the views and needs of people with allergy, food intolerance and chemical sensitivity." Amongst their aims they say they are there to

Enabl[e] people with allergy, food intolerance and chemical sensitivity to receive appropriate diagnosis and treatment through education of healthcare professionals and the provision of dedicated services.

Allergy UK give awards to services they feel help promote their aims and "will generally benefit allergy sufferers and improve their state of health and wellbeing." They have given an award to YorkTest who are 'specialists in food intolerance testing'. They say,

The clinically validated York Test foodscan range represents a breakthrough in food intolerance testing. Using the Enzyme-Linked Immunosorbent Assay (elisa) method, the tests provide a rapid, accurate and reproducible way of determining food intolerance and identify which foods your body is and isn’t coping with properly from a pin-prick blood sample.

Patrick Holford gives similar endorsements to YorkTest,

My favourite laboratory is Yorktest Laboratories whose tests are clinically validated. Not only do they use this technology but they are the only lab to offer a home test kit for food and chemical allergies that requires a pinprick blood sample. This is sent back to YorkTest laboratories who then test you for sensitivity to all foods including gluten, gliadin, wheat and yeast. They send you a home test kit that enables you to take a pinprick of blood, so you don’t have to go to your doctor.

Yorktest have also carried out a number of ‘double-blind’ trials on their IgG test and have solid science to back up their claims of effectiveness.

His schools food charity "Food for the Brain" is supported by YorkTest.

Now what is funny is that the Advertising Standards Authority disagree with all this. Some mischievous member of the public complained about their adverts. The issues considered were:

The complainant challenged whether:

1. the claim "clinically validated" could be substantiated; and

2. the advertisers could substantiate the efficacy of the test

The ASA challenged whether:

3. the ads made claims that could lead to a mistaken diagnosis

All three complaints were upheld. YorkTest were found to be in breach for unsubstantiated claims, untruthfulness and for claims about Health and Beauty and Therapies.

This is about time. Misdiagnosis of allergies caused people to drastically and unnecessarily alter their diets in ways that may be harmful. It causes distress and may prevent them from seeking proper medical help. There is a huge industry out there preying on peoples concerns about allergies and food intolerances and it needs reigning in.

How long will it be do you think before Allergy-UK take away their award to YorkTest? And how long before Patrick Holford amends his web pages?

My personal guess is never. I may be wrong.

UPDATE:

A little dickie bird has just pointed out that a trustee of the charity Allergy-UK is a DR MICHAEL CHARLES MATTHEWS.

A Dr Michael C Matthews MB, BS, FHS was also a medical director of YorkTest.

Labels: Allergy UK, ASA, Patrick Holford, YorkTest

 

Paul McKenna, hypnotist, has fallen foul of the Advertising Standards Authority by claiming in print that his methods are " ... the most effective weight loss system available. Lose weight and keep it off ... ".

Today, the ASA upheld a complaint and told him not to repeat this claim as he had failed to produce satisfactory evidence to support his marketing. His claims were unsubstantiated.

All this is pretty standard stuff for the ASA. Today's rulings also slapped The Body Shop, for over the top health claims for various products, and an organisation called Ultimate Balance Ltd that offer hydrotherapy, a form of quackery that Charles Darwin was using 150 years a go.

Now, what struck me as interesting about this was that there is a school of thought that believes hypnotism depends totally on telling lies. Without the lies, hypnotism does not work. To understand this, we can look at the various opinions of what actually happens under hypnosis. In short, there are roughly two camps: the first contends that hypnosis induces some special state of mind in the subject that unleashes powers and capabilities that the normal mind state cannot tap into; the second camp contends that hypnosis is about inducing the belief that a special state of mind is being induced and that the subject acts out a role suggest by the hypnotist and the cultural expectations of hypnosis. With this second view, when therapeutic hypnosis is being employed, as with McKenna, hypnosis can be viewed as nothing other than a placebo, where the subjects' expectations of an effect are sufficient to create an effect. As such, and as with all placebos, a lie must be implicitly or explicitly told and believed, and the lie is that the hypnotists can unlock special mental powers within you.

It gets a little bit stranger than that, in that subjects may well be aware that they are acting out a role or, alternatively, may genuinely feel they have been in a different mental state. The comedy Little Britain lampoons this knowing complicity of subjects with the hypnotist with the sketch character Kenny Craig. Craig is an "obnoxious, charmless man, ...[who] has no worries about using his skills to get his own way". His victims act as if they are hypnotised so as to not offend Kenny, for their own ends, or out of sheer bemusement. Of course, in reality, it is very difficult to know what is really going on within the minds of individual hypnotised subjects. Can we trust anything subjects say about their beliefs under hypnosis as their whole experience is layered with play acting, expectations and suggestibility?

The hypnotist Derren Brown gives a very insightful view of what his experiences are with stage hypnotism and what we can reliable say about what is going on in peoples' minds. His scepticism makes refreshing and entertaining reading and is rare in this field. If this sort of thing interests you, I urge you to read his book Tricks of the Mind.

And so this ASA ruling presents a rather paradoxical and interesting view of how we should look at the claims of hypnotists. Maybe McKenna's courses do allow people to lose weight. But to do so, it is likely that this is because his clients believe hypnotism will really help, whether or not it actually does - if you see what I mean. Telling people that his course is "the most effective weight loss system available" can be viewed as part of the hypnotic act, as setting the required expectations and as the paradoxical lie that must be told in any placebo based therapy.

Now, I know that Paul McKenna is not afraid of using his legal routes if he feels that defamatory things are being said about him, so I would like to be quite clear that I have no idea if McKenna believes he is telling lies or not. He could really believe that hypnosis is inducing a special state of mind in people and that placebo-like effects have nothing to do with his results. McKenna was at fault, remember, for not being able to substantiate his claims, not for lying or being untruthful.

But, if there is no such thing as 'real' hypnosis, then 'sham' hypnotherapy can be viewed as just one more placebo based alternative therapy that is essentially based on a delusion. It works (to some degree) if you believe in it. And just as with pretty much all homeopaths, the best alternative therapists are those that have fooled themselves into thinking that they have special powers, potions and incantations. It is so much easier then to tell the required lies to your customers if you don't believe you are lying yourself.

Maybe many hypnotists really believe that what they are doing is nothing more than a placebo-based shamanistic ritual, and the required lies are justified to obtain a result. But within that stance is a whole other ethical minefield. Hypnotism presents the same dilemmas, as pointed out by David Colquhoun, regarding today's reporting of 'real' acupunture being no more effective than 'sham' acupuncture. The fact that 'sham' acupunture (or 'sham' hypnotherapy) has an effect does not mean that its use is justified as both requre a lie to be told.

Labels: ASA, celebrity quackery