Monday, February 2, 2009

SKEPTICAL SUNDAYS

Weasel Words and Red Flags,
Or how to save money by not spending it on crap.



In the world of logic and logical fallacies, weasel words are words peppered throughout a speaker’s or writer’s argument, usually adjectives, that can be used to deride their opponent, or an opponent’s argument. They have a negative connotation, but weasel words can also be used to affirm an argument, making it seem more appealing by whatever tactic the author chooses: more scientific, more humorous, more civilized, more well-thought out. The reason one should be on the lookout for weasel words in an argument is that they are irrelevant to the point under debate, and the one who uses them liberally is generally on the intellectually poorer side of the argument.

But weasel words aren’t limited to argument, and can be useful in spotting crap. In this instance, when they are used in advertising they are generally called red flags. While it is commonly understood that red means warning and/or stop, being that I live on the beach, it’s much more poignant. When the red flags go up here, no swimming is allowed in the ocean. No matter what the ocean looks like on the surface, the conditions are such, with currents and undertows, that you are likely to die. Just like in life, there’s no lifeguards, or law enforcement on the beaches to keep you from swimming. You are supposed to know what the red flags mean, then it’s up to you. Go jump in, it’s your choice.

In the realm of alternative medicine, red flags abound. Some general things to consider when looking over some pill, supplement, treatment, or dietary and lifestyle change that makes a claim, whether in the store isle, or on TV:

First, there is no such thing as “alternative medicine.” There is only medicine that works, and medicine that doesn’t. We have come a long way in the last 200 years, which has been, at the outside, about how long scientific medicine has been around. That is to say, treatments submitted to rigorous tests to establish if there is any effect, beneficial or otherwise. As well, this has gone hand in hand with an ever increasing knowledge of how the body actually works.
Second, there is no outside cure for a great many of the common ailments caused by disease organisms other than your immune system. There are things to ease the symptoms, but a great deal of your doctor’s work (or your alternative medicine scam artist’s) is actually done by you. This is in no way an endorsement for not seeing your highly educated, trained, and usually very dedicated doctor.

Third, I have some caveats regarding the generalizing I’m about to do, the current limits of human understanding about the body, and my attitude in general, which I will offer in closing to hopefully counter some judgment on the reader’s part. If you need them now, just scroll down.

ONE ( We Begin)

So on to our first red weasel. “NATURAL” an utterly meaningless, and unregulated term. Hmmm, perhaps not completely unregulated. The FDA requires on food that you ingest, that “natural flavors” must actually be derived from a real source, as opposed to laboratory derived. If it is natural bacon flavor, it must actually come from a pig (or at least a majority of it). I’m forever tickled that pills are labeled as “natural.”
“NATURAL”, “ALL NATURAL”, “MADE FROM ALL NATURAL INGREDIENTS. Don’t get me wrong, it may very well be that something is indeed made from non-laboratory/manufactured ingredients. If it is food, regulated by the FDA, it almost certainly is. If it’s alternative medicines, you roll the dice, with odds that always favor the crank.
Some of my contention with “natural” is this, pointed out more thoroughly by many others, including Brian Dunning of Skeptoid: Toadstools are natural, lead is natural, arsenic is natural, ultraviolet radiation is natural, so is the lethal radiation of nuclear decay, cowshit is natural. I think you get my point. Just because it says it’s “natural”, doesn’t mean it’s safe, or even that it actually is naturally derived, being that there’s no regulation for OTC supplements, so long as they don’t overtly claim to prevent, treat, or cure any disease.
What you read when you read “NATURAL” on something, is something like this: “This is from a natural plant, grown in untainted soil, with only natural fertilizers, no pesticides, far from urban air and pollutants. In fact, this was harvested in a rainforest 1000 miles from modern humanity, with absolutely no impact on the pristine environment. It was transported by electric car to a hippie commune, where deeply spiritual people used no modern technology to transform this all-natural substance into a pill (pr whatnot) inside a plastic bottle, arriving fresh, as nature intended, to my grocery or health food store.”
Sadly, there’s no regulation on the word natural in relationship to supplements. Natural has become a marketing tool, completely devoid of meaning, so I would counsel setting aside your expectations. Yes, aspirin is natural, of course. It can be derived by boiling the bark of a willow tree (though I’m not entirely sure if it’s species-specific) and that’s just what the Romans did. I challenge you to go do that next time you have a headache, bearing in mind that you have no control over the effective dosage, and have to consume everything else that leeches out from the willow bark, including the flavor, and I’ll be impressed at your commitment to “natural.”

TWO (The Long One)

Oh, and you expect it to work, too.
Also sadly, as long as the claims are kept vague, there’s really no regulation regarding what supplements imply they do, which is heal. Coupled with a mistrust in all things human made and science in general (don’t get me started), our current “green” movement has been hijacked by charlatans out to get your money. Here’s another choice red weasel: “BOOSTS/ENHANCES/SUPPORTS/INCREASES insert bodily function or the word “vitality” hereWhat’s so sad is how little education it really takes to get at least a generalized understanding of how the various systems in your body work. Even a cursory knowledge will plant suspicion in your mind when products make such vague claims. Let’s address “VITALITY” first. It doesn’t mean anything, even though it sounds like it does. There is some historical literature regarding “vitalism”, a long-discredited theory of life and medicine, wherein the body and life was dependant on “vital energy” for existence, and the flow, or balance of this (and in some cases various) energies affected your health, and imbalance was thought to cause disease. If you think this sounds valid, especially all you Chi and Chakra folk, I’ll address this a little later, hopefully letting you down gently. For the rest of you, just know this theory of disease was conceptualized BEFORE the germ theory of disease, and has yet to ever have any supporting evidence for any variation of it.
If the producer of the product you’re considering subscribes to this, you gather as you read the website or shiny product label, adorned with fairies, don’t waste your money. If they believe in “vital energy”, that’s their business, but they’re dong you a financial disservice by asking you to buy something that doesn’t do anything.
As for “vitality”, ask yourself this:
what does that mean?
Is that a valid term?
How would I measure it?
Does it mean I will have more energy?
Do they mean what I mean by energy?
A cup of coffee would "give me more energy."
Does it mean it will make me healthier?
If so, why aren’t they allowed to say in what way?
If it increases vitality, how will I know?
Will my heart rate increase, my feet sweat more (dear lord, no!), halos in my vision?
Does it do anything specific?
Why aren’t they allowed to say what it does specifically?
Ask yourself these, and any other troubling questions that pop into your mind while you look very carefully at the price tag.
As for the other terms, in regards to affecting the functioning of your immune system, digestive system (or health, they’re all big on saying it supports digestive/immune health. This appears to be just vague enough to slip under the FDA’s radar. Whether it’s the term support, or the vague use of health, I’m unsure), or any other system in your body, be very skeptical of these nebulous claims. All of these systems are very complicated, with various and sundry stages of function. If it supports digestive health, ask yourself, “How does it do that? Does it increase enzymatic action in my saliva? Does it regulate acid production in my stomach? Does it somehow increase the absorption of nutrition in my large intestine? My small intestine? Does it give a handshake to the symbiotic bacteria in my gut? Does it affect the muscles in all those various digestive components to work better, or more efficiently? Does it somehow affect the waste removal systems? What exactly do they mean?” When you or someone you know goes to the doctor for a digestion problem, you usually get a medicine that affects a specific problem, a particular aspect of digestion. The immune system, endocrine system, circulatory system, all of these are multi-layered, complicated, and interconnected. The ailments for these are pretty specific, and thusly so are the medications, so a panacea for overall system health starts to make no sense, and sound like either ignorance on their part, or supreme contempt for your part.
The only thing I know of that affects all aspects of any of these systems is diet! I won’t fail to mention exercise either, as it greatly affects the efficiency of these systems as well, mainly through efficient delivery of nutrition. Diet is important because you, theoretically, consume all sorts of vitamins and minerals, plus necessary carbohydrates, and roughage. Your systems need a diverse array of chemicals to keep each and every different stage of the systems running, and on a daily basis at that. Now, think on the Amazonian Teabag extract, and ask yourself (really asking the manufacturer), “Do you really expect me to believe that this one thing does the same thing as 2 dozen vitamins and minerals, especially when you don’t tell me exactly where, or what aspect of said system your product effects?” Use your perfectly healthy nervous system to walk yourself to the produce aisle.
A final note about the above red weasels. If they aren’t exactly implying that they cure something, or affect a disease process, or alleviate a vitamin deficiency, then they are doubtless implying that you should take their supporter, booster, enhancer propholactically. To avoid problems, take 2 pills twice a day, and buy monthly. Pretty insidious. I want you to picture this in your mind: the snake oil charmer talking to his ad executive, telling her to say this without actually saying this. Don’t forget, being that if you cross the line into specifics, the FDA WILL come down on you (never hard enough, sigh) both of them have lawyers present as well.
Why are all these nebulous wordings necessary? Because these people selling you their likely bogus health supplements have not proven their products do anything. They have not gone through the rigorous processes that drug companies must go through to:
1) Isolate the active ingredient.
2) Prove the efficacy of their product, and establish safe dosages.
3) Document the number of, and severity of side effects.
The overwhelming majority of health supplements (things like “herbal” supplements [yes, yes, yes, I know what your thinking. I will address that in the caveats upon closing]) have never gone through that process. Some have, and there’s negative evidence for effect, yet they are still sold as somehow having an effect on your health. Several new age therapies also have been tested, and still are being tested, showing negative effects, or indistinguishable from placebo. I’m staying close to the supplement, pill-form of alternative medicine. Getting into those other modalities also requires tackling the mindset associated with them, which can get complicated. Another time? Good.

THREE (Bear with the Tangents)

I want to make two things clear in this part.
1) Diseases have a natural progression, either simply due to a life-cycle, the time it takes your body to mount an effective response and win against the organism, but most likely a combination of the two. If something is meant to be taken propholactically (boosts, enhances, supports) then it is pointless to take it when the disease process has started. Bt my real point with this one is explaining “confirmation bias.” You get sick, and take a supplement. Even though it’s likely bogus, and it’s your own body’s immune system that kills the disease, your associate your feeling better with the pill you took, and will carry that belief with you even when someone points out to you that Australian Dingo Placenta was shown in a clinical trial not to do a damn thing. That’s confirmation bias, and we are all susceptible to it. Trust me, all sickness runs its course in due time. Now eat your chicken soup.
2) All real medicine has a real effect. It doesn’t matter to me if the active ingredient did come from a Dingo’s womb, but you do need to prove the extract actually does something, and I’d appreciate if you’d isolate which chemical(s) in the aforementioned placenta do what you’re claiming, establish how much of it I need to have an effect, but also how much is too much, and if you don’t mind, please replicate the chemicals in a laboratory so that my body can’t tell the difference, and we don’t have to kill any more pregnant Dingoes. Real medicine has real effects. We use them for the beneficial effects, and since there’s no free lunch, balance the good against the negative side effects. All those medicines that have those horrible side effects on TV, they actually do what they say they do, and it’s up to you and your doctor to decide if you want to risk the side effects. Medicines have side effects because, while they affect certain processes, or functions, they have no way of knowing you only want those processes to affect just the liver, so they affect everywhere that process happens, which may cause problems if they affect the same process in your pituitary gland. But who knows, you might luck out.
Supplements not only aren’t allowed to make specific claims, but they don’t list any side effects. Isn’t that strange? Makes me think it’s either a sugar pill, or whatever’s in it doesn’t do a damn thing at all. It’s cheaper, and healthier to go eat a apple, chock full of proven nutrition. If something’s had the money to go through the levels of testing our pharmaceuticals have gone through, it’s going to cost a lot of money. Even generic drugs are expensive, comparatively. I’m not saying price is always an indicator. There is plenty of bullshit out there that’s got a ridiculous asking price. I’m just here to save you money, whether it’s $5.99, or $59.99.
I haven’t even gotten into the weasels of red in this section yet! They are: RESEARCH SHOWS, and STUDIES SUGGEST, and sometimes, though more in verbal advertising, SCIENTISTS SAY/AGREE. Research means it’s in the process of experimentation. The results aren’t out yet. You don’t even know where they are in the research. It could be that research was just started because someone suspected an effect, but the lab isn’t even open yet. It might however, mean that legitimate research is being done by reputable organizations, and some preliminary paperwork is available, but regardless, don’t put the cart before the horse. You don’t get a prescription for anything manufactured under the auspices of research shows. RESEARCH SHOWS is empty techno babble, and means nothing: absolutely nothing.
Studies is such a vague term, you should ignore that one as well. While plenty of studies are legit, they aren’t clinical trials. Another example of dyslexic cart harnessing. Also, a study bandied about in the way alternative medicines use them could honestly mean anything, including that one person looked at a beaker, and pronounced he had studied it. Ignore this one unless you can track down literature, and it produced by reputable sources.
SCIENTISTS SAY/AGREE, and indeed they may, but they never tell you who, or what their specialty is. 20 veterinarians agreeing that the cosmos is collapsing doesn’t make me despair for creation.
All these are used to make the products sound authoritative, effective, safe, and to make you think somebody actually did the work. Well, to be fair, a chemist did make that $4.99 starch pill you're taking.

FOUR (Nice and Short)

“THEY DON’T WANT YOU TO KNOW.” Mmmm hmmm. It’s all a big conspiracy by government, Big Pharma, and no doubt the Illuminati. Right, why suppresses it, when they could make a mint selling these supplements, and home remedies legitimately? This one just drips of pure marketing. It’s an instant Do Not Buy.

FIVE (Sucker Punch)

ANCIENT WISDOM. I’ll be very brief. I will be the first to affirm that our ancestors were in no way stupid, but they were not technologically advanced, and had NO IDEA how the body really worked, beyond perhaps that the heart pumped blood, and a few other obvious things. And I will gladly proclaim their hits (remember aspirin?), but unlike some, I won’t ignore the monumental number of misses. Theirs was a world of trial and error (so is science, but very systematized, with ever increasing technology, and transmission of accurate information doesn’t depend on WORD of MOUTH) and riddled with ignorance. We have and are discovering that they got a few things right, but they got a spectacular amount wrong. A few hits in the Iron Age in no way means everything they did must be right. It’s like saying because you can balance your checkbook, your differential calculus must be right. And why do Orientals get special medical reverence? Ancient Oriental medicine is chock full of just as much “does not work, never did” as Europeans. Lastly, just because a culture has been doing something for 1000 years doesn’t make it work. Some traditions are stupid.

FINIS (Been waiting for this)

So there are some of the weasel words and red flags to be on the look out for when shopping in the world of alternative medicine. You’re looking for something that works, to relieve symptoms and pain, and make you feel better. I hope this essay gives you the skills to evaluate what’s likely to not really do anything but put your wallet on a diet. The best way to stay healthy is not in a pill. It’s diet, exercise, moderation of your vices, and a good attitude. When your sick, use the proven medications, all of which (well, perhaps not aspirin) were clinically trialed, and prescription once, so they have a long history of efficacy and safety, which you can look up anytime. If you’re really ill, consult your doctor, whose training, experience, and expertise you rely upon.
In closing, I just want you to know, I don’t have anything against the idea of supplements and alternative medicine in general, per se. I don’t think it’s unreasonable to ask that if you want me to buy something, I should know exactly what I’m buying. If your claiming it affects my health, all I ask is proof that it does that. The above weasels have been used in the promotion of snake oil after snake oil, so if I seem harsh, it’s just because I have standards: efficacy and safety. Why shell out money otherwise?
Nearly all of our pharmaceuticals come from plants, or other biological sources. I’d never deny that. That in no way means, however, that just because it comes from a biological source, it does anything at all, much less that it’s inherently good for you.
As for energy-based modalities, such as chi, charkas, or meridians in the body. Sorry folks, there’s no evidence for those energies. The body is an energy system, to be sure, and it’s that, ahem, vitality that no doubt was the genesis of the aforementioned belief systems. But 1) we’ve learned that the body is a chemical engine, using the heat generated from the transfer of electrical energy from chemical bonds (this is way simplified) being created and broken, and 2) we are very, very, very good at detecting and measuring invisible energies. For example, the Voyager 2 probe is over 9 billion miles away. It’s radio output is equivalent to a 20 watt light bulb. We can and do receive radio transmissions from that probe. We have instruments that can see a 20 watt light bulb 9 billion miles away. Sorry, but there’s no empirical evidence for chi, and all the rest.
Sure, there is plenty that we don’t know, in fact far more than we do. I’d advise against leaping on the gaps in our knowledge as a place to lay your favored belief, which inevitably turns out to be hope. Those gaps have a way of quickly closing within a human lifetime these days. Sure, evidence for other modalities may show up one day, and I even think it would be fun if they existed, but it would require altering our whole physics to incorporate them. Until that day, however, it makes no sense to give them any credence, as decades of study (tee hee) have shown nothing.
I'm not against every supplement, or alternative therapy. There are a few that actually do somewhat what they claim, and research is being done on them. This in no way makes the rest of them in any way correct.
Anyway, do good things for your body, real good things, and good things for your mind, and you'll find you inevitably do good things for your wallet.

Random Acts of Quotation!
On Evidence...

"Some circumstantial evidence is very strong, as when you find a trout in the milk."
Henry D. Thoreau

"The fact that an opinion is widely held is no evidence whatever that it is not utterly absurd." Bertrand Russel

"Don't accept your dog's admiration as conclusive evidence that you are wonderful"
Ann Landers

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