A sucker may be born every day, but you don’t need to be that sucker today or any day. In a capitalistic economy like ours, snake oil salesmen are everywhere looking to earn a fast dollar from gullible consumers. In such an economy, it is especially important for consumers to be able to clearly separate safe, effective products and services from ones that are harmful or do not produce the desired effect. This article will arm you with key principles that are necessary to separate science from pseudoscience so that you can more easily make purchases that help, not harm you and/or others.
PRINCIPLE ONE: Consider the Source
The first principle in distinguishing science from pseudoscience is to be skeptical of the source. I am amazed at how common it is for people to be gullibly trusting of certain writers, publications, or advertisers. For example, I have heard things like, “Did you know that eating bentonite clay is good for your gut health?” When you hear a claim like this it is important to be skeptical of the source, so let’s skeptically examine the typical sources of such a claim.
The “data” behind pseudoscientific claims often originate in one or more of five places:
- The label or exterior packaging of an ingredient or product
- A published or broadcasted ad for an ingredient or product
- A non-scholarly article in a non-scientific, non-peer-reviewed journal
- An interview of an “expert” (e.g., physician, NASA engineer, health guru) who uses scientific-sounding language and refers to research studies without providing the citations for the studies
- An article in a biased journal, especially one that is dedicated to proponents of a particular theory or ideology
All these sources lack scientific credibility to a greater or less degree. Typically, research results must be reported in a peer-reviewed, scholarly journal to be considered credible by the scientific community. The peer-review process makes it more likely that a claim made in an article will be supported by clinically substantiated evidence.
However, an article in a journal dedicated to a specific theory (see item 5 above) lacks some credibility because the “peer” group is too similar. Such homogenized groups are often biased in what they will publish. They do not always allow alternative viewpoints and may lack a proper sense of scientific skepticism when an article is submitted to them that supports their bias. For example, an article that claims that six weeks of treatment using Reality Therapy significantly relieved symptoms of insomnia in 99% of cases is more likely to be accepted “as is” by The International Journal of Choice Theory and Reality Therapy than it is by a journal with more diversity like The American Journal of Psychology.
If you come across a claim about a product made by any of the five sources in the above list, it is wise to either do your own research utilizing a comprehensive database of scholarly articles or to just set the product down and go on with your life.
PRINCIPLE TWO: Acknowledge Your Ideological Bias
It is obvious that most, if not all people have impenetrable ideological biases. Here are just a few examples of biases that you may have seen as pertains to diet:
- Someone who is closed to the possibility that a diet that includes some meat might generally be the healthiest diet because the person is opposed to killing animals
- Someone who is closed to the possibility that a strictly vegan diet might generally be the healthiest diet because they love the taste of meat and think that they “just can’t live without it”
- Someone who believes that strict adherence to one specific diet is best for all people, without allowing for even the slightest of variations from it, even for people with certain conditions such as being allergic to one of the diet’s essential food items
While we all have our own reasons for being closed to certain possibilities, to be truly scientific, we need to suspend our biases and open ourselves up to various possibilities. We need not fear the truth.
If you simply can’t suspend your bias, I recommend at least acknowledging that you have one. Arnold Beisser (1970) makes the case that before you can change for the better, you must first become aware of who you are and accept yourself as you are right now. He calls this notion, the paradoxical theory of change. If you are biased and apply Beisser’s theory of change to yourself by becoming aware of and acknowledging your biases, then I believe that this can eventually lead to you researching the evidence supporting claims that contradict your bias with scientific curiosity rather than rigid closed-mindedness.
PRINCIPLE THREE: Differentiate Between Theoretical Jargon and Evidence
Although it can sometimes be difficult to separate mere ideas or theory from evidence-based claims, doing so is necessary to distinguish pseudoscience from science. Some people tend to call scientific-sounding or reasonable-sounding ideas “scientific”. However, just because a theory sounds logical or scientific doesn’t mean that there is sufficient evidence supporting it. If an idea isn’t based on research, it is best not to refer to it as “scientific”, at least yet.
One example of an organization that is masterful at generating unfounded theories using scientific-sounding language is The Weston A. Price Foundation. An article on their website that is typical for them illustrates my point. It says:
…animal sources of protein including eggs are ‘better’ for you nutritionally since they contain all of the essential amino acids[….] Mother’s milk is nature’s most perfect food, and Figure 5 shows the egg to be in second place because its amino acid content mimics the levels in mother’s milk. (Kummerow, 2011, para. 2)
The article contains lots of scientific-“looking” charts and citations, but to substantiate the preceding claims, the author would have had to at minimum provide citations for well-designed outcome studies comparing the overall health status of the following groups of adult human subjects whose primary protein intake was from one of these sources, perhaps even to the exclusion of other protein sources:
- mother’s milk
- eggs
- various meats
- seafood
- dairy products
- plants (e.g., nuts, seeds, beans)
Without providing adequate citations to research, the above quote from the WAPF article merely conveys ideas, not established science. I could argue against the author’s claims by saying that there are lots of people on strict vegan diets who eat “complete” proteins as evidenced by the fact that they have healthy hair and teeth and that their fingernails grow just as fast as the nails of egg-eaters, but then I would just be making a potentially pseudoscientific claim, that is, unless I can substantiate it with citations to valid research articles. Regardless of how reasonable the claims of a theory might sound, before it can rightly be viewed as credible, the one making the claims must provide adequate citations to articles in peer-reviewed, scholarly scientific journals that report the results of well-designed studies.
PRINCIPLE FOUR: Be Initially Skeptical of a “Theory First, Research Second” Approach
The world’s most respected marital researcher, Dr. John Gottman (2011), maintains that a theory is more credible if it has been generated after research has been conducted rather than before designing an experiment. Similarly, even if they do not conduct their own research, the most credible theorists tend to examine the existing body of scientific evidence before creating and promoting a theory. Founders of theories who utilize such a “research first, theory second” approach are inherently more trustworthy than those who do the reverse, because they clearly have no agenda other than discovering the truth.
Even though those who employ a “research first, theory second” approach may make money by developing products and services based on the truths discovered from research after the research is complete, they have nothing to gain by falsifying research results. They have no predetermined interest in obtaining specific results while they are conducting or reviewing research because they can later develop and sell relevant products based on the results, whatever those results may be.
Conversely, a person has a lot to gain when he administers research to assess a product’s efficacy when that product has already made him millions of dollars. Such a person’s livelihood may depend on a positive result of the assessment of his product, and this may motivate him to falsify the data or misrepresent what the data suggests, should the data not support the sales of his product.
The skeptical consumer must develop an eye that can see which approach a particular person or organization tends to use. You may be surprised, but individuals and organizations often unabashedly report their preferred approach, even when it is a “theory first, research second” approach.
For example, WAPF from the example above, states clearly on their website’s home page for all to see that they put theory ahead of evidence:
The Weston A. Price Foundation (WAPF) is […] always aiming to provide the scientific validation of traditional foodways. (The Weston A. Price Foundation, n.d.)
This is a perfect example of a “theory first, research second” approach. WAPF starts with the idea that “traditional foods are the healthiest foods” and then seeks to find or create evidence to support that theory. If they were to approach theory creation in a more trustworthy fashion, they would have first done a comprehensive search of the existing body of scientific literature in the field of nutritional studies, and then created a theory or idea based on the evidence.
In contrast to WAPF, Joel Fuhrman, M.D., creator of the nutritarian diet, is an example of someone in the field of nutritional studies who employs such a “research first, theory second” approach, thus making him highly trustworthy. Before publishing his first book dedicated solely to offering nutritional guidance, he had taken “an exhaustive look at research data from around the world over the [previous] fifteen years” (2011, p. 80). When asked how many scholarly articles he reviewed before writing his first book offering nutritional advice, he said “more than 5,000” (J. Fuhrman, email, Sept 1, 2018).
When asked about his “scientific mindedness”, Dr. Fuhrman shared that he has stated in radio interviews and lectures that he lets the overwhelming evidence drive his recommendations and that he has “no predetermined agenda to promote or endorse” (J. Fuhrman, email, Aug 29, 2018). We can see this approach at play in the fact that, unlike with those who hold a pre-established vegan ideology, he allows for zero to five percent of one’s calories to come from animal products. Dr. Fuhrman’s unbiased scientific reasoning behind this allowance is that the evidence is unclear about whether that small of an amount of animal products is harmful. His use of a “research first, theory second” approach makes Dr. Fuhrman inherently more trustworthy than if he tended to do things the other way around, as is true for all theorists who employ this approach.
PRINCIPLE FIVE: Differentiate Between Casual References and Full Citations
Although I briefly alluded to the following point in Principle One above, I think it is worthy of revisiting here in greater depth. It is important to pay attention to the difference between a casual reference and a full citation when seeking to determine if a claim is truly backed by science. We must be skeptical of casual statements about the existence of this or that study that do not supply the reader, viewer, or listener with enough information to easily look up and read the research article himself.
“Experts” being interviewed on the news or talk shows will often say things like “research has shown” or “one study suggests” without providing citations for the research. Anyone can say that they have read a study that suggests that this or that is true, but saying so doesn’t mean that such an article is credible or even exists! It is wise to be skeptical of these “experts” unless you have read something of theirs that provides relevant and complete citations to peer-reviewed, scholarly articles in unbiased, credible journals.
PRINCIPLE SIX: Give More Credence to Well-Designed Studies
The best-designed studies are double-blind, randomized and placebo-controlled. Claims made by a study lose a degree of credibility if any one of these three elements is missing.
You can often tell which elements have been included in a study’s design because authors of studies will often showcase in an article’s title which elements they have used. For example, the title of one article reporting the findings of a study that was designed using all three elements is A Placebo-Controlled, Double-Blind, Randomized Trial of an Extract of Ginkgo Biloba for Dementia (Le Bars, et al., 1997).
However, some studies that contain all three elements don’t explicitly say so in their titles. When the title has no mention of these elements, you will need to read the abstract or perhaps the full article to determine how many of the elements were included in the study’s design.
When reading a research article to determine if the research utilized all three elements in its design, you would obviously need to first know what the terms “double-blind”, “randomized”, and “placebo-controlled” mean. I’ll briefly describe what they are and why they are important here.
Placebo-Controlled
Most people are familiar with the placebo effect. One could say that the placebo effect proves that the power of the mind can triumph over matter. If I have been given medicine that I believe will reduce my flu symptoms, then I am likely to report that the medicine did just that.
But what if the medicine had secretly been swapped with something that tastes the same but is known not to reduce symptoms? When my flu symptoms go away, I am likely to attribute it to what I ingested, even though it truly should have had no effect. This placebo effect is based on my belief that I took my medicine, not on the actual substance consumed. It is as if I willed myself into feeling better.
To account for the placebo effect, a well-designed study will contain a group of subjects called a placebo group, who will be given a substance or undergo a procedure that is known to have no therapeutic effect. A placebo-controlled study is one that has a placebo group.
Another group of subjects is normally given the substance, product, or treatment being studied and that group is called the experimental group. Ideally, only one variable will be different between the experimental group and the placebo group. It is by comparing the difference between the outcomes of these two groups that we can know whether it is likely that an outcome is due to the variable being tested or is best attributed to the placebo effect.
The group that the experimental group is being compared against is called a control group. While all placebo groups are control groups, not all control groups are placebo groups. This means that just because a study claims to be a controlled study, does not necessarily mean that it is a placebo-controlled study. It is important to pay attention to the distinction between a “generic” or non-placebo control group and a placebo control group because a placebo-controlled study is a better study-design than an otherwise comparable one that lacks a placebo group.
For example, if I was to design a study comparing an experimental group who underwent eight weeks of talk therapy treatment with me against a control group of clients who were on my waiting list for eight weeks, then my control group would not be a placebo group. Imagine that the anxiety symptoms of my clients receiving talk therapy treatment improved, but those on the waiting list didn’t. Why do you think the talk therapy group might have improved? Was it because my treatment method was effective, or was it merely because the talk therapy group believed that what I was doing would help reduce their anxiety? We can’t know if the positive change observed by such a poorly designed study was likely due to the variable being studied or due to placebo, that is, due to my treatment method or to the client’s faith in my treatment.
The only way that we can know that an experimental group improved for a reason other than the placebo effect is by making sure that our control group was a group that received a placebo “treatment”. Even if all that I asked of a placebo control group was to recite the Pledge of Allegiance every time that they felt nervous for eight weeks, it would be better than comparing the experimental group to a non-treatment or waiting list group. This is because a waiting list group would know that they are not being treated, whereas the anxiety of those in the Pledge of Allegiance-reciting group might reduce due to their belief in the efficacy of the “treatment” that they are receiving.
Double-Blind: Introduction
Another feature of the best-designed studies is that they have two levels of blindness: one blinding the subjects being studied and another blinding the experiment administrators. “Blind” here means that information that could affect the outcome of a study has been kept from a subject or administrator.
Double-Blind: Blind Subjects
When we say that the subjects in a study are blind, the most important piece of information that has been kept from them typically is whether they are in the experimental or control group.
It may be nearly impossible for a study on psychotherapy to be blind to the subjects because they will always be fully aware whether they have received a particular treatment or were placed on a waiting list, etc. It is also impossible for a study to be blind to the subject if the effects of eating a particular unprocessed, whole food (e.g., a stick of celery) are being studied, because subjects will always be aware of whether or not they have been assigned to eat that food.
However, if a food is processed, then there are ways to blind the subjects. For example, celery can be dried and ground up into a powder and then placed into a capsule. In this case, the control group can receive a capsule containing celery while the placebo group can receive a capsule with something in it that is known to have benign effects, like potato starch.
Double-Blind: Blind Administrators
While a single-blind study might only blind the subjects, a double-blind study blinds the administrators too. For example, in an outcome study for a particular type of psychotherapy, a therapist in the study might not be allowed to see participant self-reports during the experimental period, because otherwise the therapist might alter treatment mid-study based on the feedback. Doing so could skew the results of the study, possibly making the treatment being studied appear more effective than it is. Once the study period has ended, it is usually okay to reveal to all researchers which subjects were assigned to which groups so that they can help to summarize and analyze the data.
Double-Blind: Relative Difficulty and Ease of Blinding Subjects and/or Administrators
Even though it is possible to create a study design that ensures some degree of administrator blindness in an outcome study for a psychotherapy treatment, such a study will often not be double-blind because of the difficulty of preventing subjects from knowing what type of treatment that they are receiving and the impossibility of blinding therapists from knowing which therapy techniques they are using. In addition, even when a subject does not understand the differences between various psychotherapy methods, she usually cannot be fully blinded due to the ethical restrictions of doing studies on humans.
For example, a case can be made that it is unethical to hide the form of treatment from the subjects of a psychotherapy outcome study. Typically, clients are required to give informed consent before receiving psychotherapy treatment. When the type of therapy that subjects are to receive has been kept hidden from them, then they have not been fully informed, making it impossible for them to give informed consent. Hiding the form of psychotherapy treatment from subjects may be considered unethical by the internal review board governing over the study and, therefore, not allowed.
It is easier to design a double-blind study when studying the outcome of consuming certain pills or capsules than when studying the outcome of a type of psychotherapy treatment, because what is in a pill or capsule can easily be hidden from an administrator. With pills or capsules, it is possible to set things up so that there is only one researcher who knows what is in each capsule or pill. A coding system can be used by this researcher to keep the other research administrators from knowing to which group a particular subject has been assigned and even what is inside of a particular capsule or pill.
Randomized
It is understandable that those conducting a research study may have an agenda that their study will show a favorable outcome. They may wish to show that the product or service being tested does what they claim that it does. Perhaps future funding of their research depends on a successful outcome of their current study or maybe their egos have gotten involved, and they wish to avoid the humiliation of publishing that their hypothesis failed. Whatever the reason for their agenda, adding randomization to their study offers some protection against skewing the results in a particular way, thus making their study more credible to consumers and other scientists.
Randomization pertains to how subjects are assigned to groups. A study is randomized when the individual subjects in a sample are randomly assigned to either the experimental or control group.
In a psychotherapy outcome study, there can be an even further level of randomization when subjects are randomly assigned to this or that therapist within a group. Doing so avoids, for example, assigning clients with poor attention spans in an outcome study of a treatment for anxiety to the therapist with a side specialization of working with those having poor attention spans. If subjects with a poor attention span were systematically assigned to the only therapist on staff who specializes in working with these subjects, then those subjects’ anxiety symptoms might decrease, but we wouldn’t know if the treatment success was due to the anxiety treatment being studied or to the fact that those clients were paired with the attention span specialist.
However, if all subjects were assigned randomly, then it is statistically probable that some of the subjects with poor attention spans would end up with the attention span specialist and others would end up with each of the other therapists on staff who do not specialize in treating attention problems. This way, the subjects with poor attention spans would be evenly distributed, removing any excessive positive influence on the treatment of their anxiety by being assigned to this or that therapist.
Systematic randomization is important because it removes bias in how subjects are assigned. It helps us to know that the variable that we wish to study in the experimental group is being studied without influences due to how subjects are assigned.
The inclusion of each of the three design elements: double-blind, randomized and placebo-controlled —offer a greater degree of credibility to the conclusions made in reports of research studies over studies without these elements.
PRINCIPLE SEVEN: Prefer Citations of Head-to-Head Comparisons Over Ones on Theory
While Principle Three and Principle Seven share some similarities, they are not the same. Principle Three highlighted the importance of differentiating between theoretical jargon and evidence. The focus of Principle Seven is on distinguishing between citation types, that is, on distinguishing between citations referencing an article on theory and those referencing a highly credible report of research results.
When someone is selling a product and writes an article or book explaining why their product is superior to others, it is important to pay attention to the types of citations that predominate in their writing. If the citations within a writing are mainly referencing articles on theory, then the author may be using a marketing trick called “appealing to ‘reason’ alone.” While appealing to reason can be a good thing, to appeal to reason alone is not scientifically compelling because doing so means that one is making claims without providing adequate supporting evidence. Appealing to “reason” alone is a trick that pseudoscientific writers must employ because there are no credible scientific studies supporting their theories.
Much too often consumers will be convinced by a marketing claim about a good or service that appears reasonable and not require the marketer to cite supporting evidence before they purchase the product or service, but this way of going about things is not sound. The problem is that our “reason” sometimes lacks credibility. Why? Because we don’t know what we don’t know until we know it. Valid results of scientific studies can often surprise us and challenge our commonly held, preconceived notions. For example, everyone now knows that as methods for studying the movements of celestial bodies improved, what was once considered “reasonable”, that the sun moves around the earth, was reconsidered in support of a more credible theory, that the earth moves around the sun. Our “reason” must be backed up by the best evidence currently available if we are to be rightfully considered scientific thinkers.
Scientifically minded consumers shouldn’t care too much about whether any particular theory sounds convincing when credible evidence is lacking. What matters most is whether evidence exists showing that a particular product outperforms similar products in every relevant, meaningful measure while causing little to no harm to the consumer or the environment. Appropriately skeptical consumers require peer-reviewed reports of head-to-head comparisons between one product and a similar product before determining that a product is safe, beneficial, and effective.
In addition, when it is humans, not animals, who will be consuming a product, citations to reports on head-to-head comparison type experiments done on humans are preferable over citations to reports on experiments that are done on animals or in a petri dish. This is because the bodies of animals do not function exactly as the human body does, thus results of animal studies are not directly relevant or perfectly applicable to humans.
Example of Missing Citations of Head-to-Head Comparative Studies
The following example shows how to apply Principle Seven for a potentially pseudoscientific collection of products or services. William Walsh, Ph.D., and his associates have figured out a way to capitalize on the good desire of consumers who wish to wean themselves off of psychotropic medications like Zoloft, Prozac, and Wellbutrin. Such consumers can naturally become quite desperate to get off their medications due to the harmful effects that accompany ingesting such medications (Cf. Mayo Clinic, 2023: Zoloft harmful effects, Prozac harmful effects, Wellbutrin harmful effects).
These consumers are willing to try just about anything that might help them to get off of their medications, as long as they perceive that the product or service is relatively harmless and will help them to continue coping well with their mental and/or emotional problems. Such consumers may be willing to pay thousands of dollars and take out loans to pay for such an alternative treatment. This is where the research and services of Dr. Walsh and his associates enter the picture.
Dr. Walsh is a biochemist and author of the book Nutrient Power (2012). In the book, he outlines how physicians can treat psychiatric problems using specialized supplements purchased from compounding pharmacies after ordering bloodwork from special labs. This treatment sounds great… if it works.
A look at some of the articles cited in his book, shows that Dr. Walsh favors citations that point to articles on process and theory over ones that point to articles displaying the results of randomized, double-blind, placebo-controlled studies that pit one supplement against another and/or a placebo. So that you can more easily identify what types of citations aren’t very helpful in determining if a theory is valid, I’ve listed the titles of some of Walsh’s citations here:
- The Overthrow of Phlogiston Theory: The Chemical Revolution of 1775-1789
- Nobel Lectures, Physiology or Medicine 1901-1921
- Epigenetic inheritance of cell differentiation status
- Oxidative stress, undermethylation, and epigenetics—The Bermuda triangle of autism
- Elevated serum copper levels in women with a history of post-partum depression
While all the citations in this list point to papers that either report on tangential research results or merely describe theories, none of the citations point to studies that pit his treatment program against a placebo. If his treatment actually works, it might be because of the placebo effect, and you may be better off just buying placebo pills and taking those three times a day. That would be a lot cheaper!
Dr. Walsh’s book explains how methylation, oxidative stress, and metallothionein supposedly affect psychopathology. He uses big words and makes a good case for his ideas, but none of this means much if his treatment results for a particular problem have never been published in a peer-reviewed journal.
Nutrient Power has separate chapters on schizophrenia, depression, autism, behavioral disorders and ADHD, and Alzheimer’s disease. It gives the impression to the casual reader that the author must have had great success treating these conditions. However, a review of the literature at the time that I prepared to write this article only uncovered one outcome study by Walsh, et al., (2004) and that study was focused on the effect of biochemical therapy on prisoner violence, not the disorders named in the chapter titles.
Neither the title nor the abstract for the outcome study on prisoner violence mentions a placebo control group or control group of any kind. If there was no placebo group, then even if the outcome was spectacular, the good results may be accounted for by the placebo effect. To be fair, one would have to purchase the 2004 article to be certain that there was no placebo group, and I didn’t do that. Regardless, Walsh’s book has a poverty of citations to peer-reviewed articles reporting on head-to-head comparative studies.
In the absence of published outcome studies, snake oil salesman will often refer to non-published outcomes. If you watch Dr. Walsh speak in his videos online (Walsh Research Institute, n.d.), you’ll hear him mention the extensive database that he has and how this database informs him of how to treat various types of mental disorders. Naïve viewers may think that Walsh’s reference to a database makes up for his lack of published outcome studies, but his database means little unless he is able to use the data in it to publish the results of well-designed outcome studies in peer-reviewed journals.
Anyone can say that they have a database. Anyone can tell countless stories of success. Any so-called expert with the right initials after his or her name can make a lot of money from overly trusting patients who are desperate for a “natural” cure. Telling lies and making unsubstantiated claims obviously belong in the category of pseudoscience, not science. To be considered credible, Dr. Walsh will need to provide many more citations to relevant, meaningful articles reporting on the results of head-to-head comparisons instead of favoring citations to articles on mere theory.
Example of Including Citations of Head-to-Head Comparative Studies
The following example applies Principle Seven to a book that is scientific, not pseudoscientific, in its use of citations. The reference book, Nutritional Sciences (McGuire & Beerman, 2013), cites studies of head-to-head comparisons on humans to back up the nutritional claims made in the book. Unsurprisingly, the book is required reading for students seeking a certificate in nutritarian coaching, a program designed by Joel Fuhrman, M.D., who was acknowledged earlier in this article for being a scientifically minded promoter of a particular diet, a diet called the nutritarian diet.
Here are the article titles for a couple of the citations included in Chapter Three of the reference book (p. 111):
- Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial
- Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women
The first article listed above reports on the results of a head-to-head comparison between the daily ingestion of 300 ml of cranberry juice and the daily ingestion of a matching placebo beverage. The second article reports on results of a three-way comparison between 50 ml of cranberry-lingonberry juice concentrate daily for six months, 100 ml of lactobacillus drink five days a week for one year, or no intervention. While there are plenty of citations to articles on theory in the reference book, it is the citations of articles like the two just mentioned that give greater credence to the theories proposed in the book.
Consumers deserve to know which product, service, diet, etc. does what it is purported to do and if it does that better than alternative options. As can be seen by the previous two examples, marketers and “experts” who cite only articles on theory and tangential research do not give the scientifically minded consumer peace of mind that what they are promoting is the best compared to alternatives. In contrast, those who cite relevant, credible reports on head-to-head comparisons offer greater surety to the skeptical consumer that what is being marketed does what it is claimed to do and does it better than the alternatives.
PRINCIPLE EIGHT: Make Sure the Citation is to an Article That is Relevant to the Claim
It is naïve to trust a so-called expert because the “expert” merely has certain letters after his or her name and is a widely popular author. Popularity is certainly not equal to credibility.
One such example of a best-selling author whose claims cannot be trusted is Steven Gundry, M.D. A trustworthy scientist, T. Colin Campbell, noticed that one of Dr. Gundry’s books contains citations to studies that are irrelevant to his claims!
In one of their blog posts, Drs. T.C. Campbell, Ph.D., and Thomas Campbell, M.D., wrote about one of the irrelevant citations that they found in Dr. Gundry’s book, The Plant Paradox (2017, p. 43):
[Dr. Gundry] claims WGA “Contributes to the development of nephritis, or kidney inflammation.” There is a citation for a paper where researchers simply were documenting how some lectins stain kidney tissue. It has absolutely nothing to do with lectins causing nephritis or kidney inflammation. It’s as if the author did a search for the words “lectin” and “kidney” and just randomly picked a paper that popped up. (Campbell & Campbell, 2017)
Beware of unscrupulous authors who know that there is a lot of money to be made by selling pseudoscientific books and products to the scientifically naïve by providing irrelevant citations with the hope that most readers will not read or skim the actual articles cited by them. Even if we give Dr. Gundry the benefit of the doubt and consider that he may merely be incompetent at research rather than unscrupulous, the message is the same, check citations for relevancy no matter how believable of an argument the author makes.
PRINCIPLE NINE: Develop a Long-Term, Broad View
The scientifically minded have curiosity about what is being studied and look at it from many angles. If their curiosity is accompanied by a view that is truly broad, they will consider the truths that transcend science, such as that there is a God and that He endowed us with great dignity. It is because of our inherent dignity, doctors and sellers of goods should help, not harm us. Doctors and salespeople should care about our needless suffering and the overall quality of our lives. They should not enable us by giving us quick fixes that harm us in the long run instead of delivering the hard truth that if we change our lifestyles, we can often alleviate our ailments without drugs or surgeries. A “science” that disagrees with these truths is inadequate. In its shortsightedness it harms, not heals.
Most physicians in the U.S. have a myopic focus on treating symptoms, a focus that does not adequately consider the great lasting harm resulting from their prescriptions and procedures. They call it a success when they address the focus of treatment by relieving your pain or helping your current ailment to subside, even when in doing so they create numerous other present and future health problems for you in the process. A clarifying look into the term side-effects will make this more evident.
An honest description of over-the-counter and prescription-strength drugs is “harmful substances that also produce at least one desired effect.” Drug companies cleverly refer to the harmful consequences of taking a prescription drug as a “side effect”, but as one of my former mentors, William Glasser, M.D., author of Warning: Psychiatry Can Be Hazardous to Your Mental Health (2004), once told me, “There are no side-effects, only effects” (personal communication, circa 2008). This means that a drug that cures your insomnia, but gives you a headache the next day, is perfectly designed to help you to sleep and give you a headache!
Those in medicine who use the term side-effect implicitly minimize the gravity of the harmful effects of a treatment while amplifying the desirable effects. Sadly, nearly all medical doctors frequently and readily prescribe drugs and perform treatments that have harmful effects. Even more saddening is that in most cases these harmful effects will last long after the medication has been taken or the treatment course has been completed.
One example that supports this claim can be found in the abstract of a report on the safety of Accutane, which states, “Xeroderma, dry eye syndrome, arthralgia, and possible exacerbation of eczema, were considered to be infrequent but probable long-term side-effects” (Goulden, Layton, & Cunliffe, 1994). What this means in lay terms is that some people who take Accutane must face one or more of the following potentially lifelong consequences of taking it:
- extreme dry skin
- burning eyes, for example when driving with a window cracked open
- mild to disabling joint pain
- dermatitis that gets worse instead of better
After highlighting the possible long-term effects of Accutane, the abstract shows the myopic symptom-reducing focus that we are currently examining: “The findings of this study indicate that isotretinoin [generic term for Accutane] in the treatment of acne is a safe drug, with no serious long-term side-effects (bold added).” It makes no sense to list serious long-term harmful effects and then in the next line state that there are “no serious long-term side effects”… unless the authors have a myopic focus on reducing targeted symptoms regardless of the long-term harmful effects.
It is not just the article’s authors that have this view. This myopic view is shared by the doctors who rely on such articles to guide their treatment practices. This article with its irresponsible, harmful conclusion is published in a peer-reviewed, scholarly journal! It is an Official Journal of the British Association of Dermatologists (Oxford Academic, n.d.), which means that the peers who review the article submissions and the usual readers of the journal are medical doctors.
While the summary of the data in the article appears legitimate, we must be skeptical of the conclusions drawn from the data by the authors. The authors’ conclusion that there are “no serious long-term side-effects” is pseudo-scientific and wreaks of a greedy agenda to peddle drugs regardless of the harms caused by taking Accutane. A narrow view of science that leaves out God and how to treat consumers as persons created in God’s image, lends itself to collaboration with such greed and harms vulnerable consumers. Such a narrow view is not limited to dermatologists, but to most medical practitioners, as a discerning review of scholarly literature, like the review of Accutane here, will reveal. However, a thorough review of scholarly literature covering all areas of medicine is outside the scope of this article.
Alternative to a Symptom-Reducing Myopic Viewpoint
While it can be disheartening that most medical professionals and drug marketers hold a myopic view that is unacceptably harmful, we can perhaps find some relief in knowing that we can take responsibility for our own health and find trustworthy practitioners, salespeople, and leaders who hold an alternative, adequate view. Such a view must be informed, broad and loving, showing a deep concern for the total health of the consumer or client and the world in which we live. Drugs, while being powerful at producing effects, are toxic to our bodies (Paget & Barnes, 2013). Additionally, pharmaceutical pollution caused by improperly discarded drugs and by human excretion flushed down toilets affects our entire ecosystem (De Oliveira Souza, et al., 2021). Only a view that includes these realities has any hope of being both ethical and scientific.
Pope Francis, the highest-ranking Catholic authority on matters of faith and morals, is one example of a man who has a broad, ethical, and scientific view. The following excerpt from his encyclical Laudato Si’, an encyclical which addresses “every person living on this planet” (2015, para. 3), shows that he is in agreement with the notion that the myopia caused by business interests harms the world by polluting it:
Some forms of pollution are part of people’s daily experience. […] Technology, which, linked to business interests, is presented as the only way of solving these problems [concerning how our toxic environment produces health hazards], in fact proves incapable of seeing the mysterious network of relations between things and so sometimes solves one problem only to create others. (para. 20)
Applying Pope Francis’ words to our topic, drugs are a source of pollution that are part of people’s daily experience. Medical doctors make a lot of money by prescribing drugs instead of insisting on lifestyle changes, which are inherently toxin-free. Pharmaceutic salespeople have much to gain by convincing doctors to prescribe the drugs produced by their companies. Drugs linked to business interests are presented as the only way to heal this or that illness by highly-paid medical doctors and sales representatives who are incapable of seeing the long-term and widespread damage that their prescriptions or products cause. The reasons for their blindness? Ignorance and/or greed.
Even non-drug-prescribing doctors who at least at first glance seem to have their patients’ best interest in mind are often guilty of having a narrow, symptom-reducing focus compared to a view that is broad, scientific, and ethical view. They focus on treating your immediate presenting symptom without proper concern for, in the Pope’s words, “the mysterious network of relations between things”, that is, the long-term, broad-reaching consequences of following their treatment advice.
For example, the creator of the pseudoscientific Carnivore Diet, Shawn Baker, M.D., claims on his carnivore.diet website that his diet is “proven to be beneficial” in fifty-two different areas, including cancer and oxalate sensitivity (Carnivore.diet, n.d.). According to the Cleveland Clinic’s website, followers of the Carnivore Diet “…eat only meat, fish, eggs and some animal products; [they] exclude all other food groups — including vegetables, fruits, grains, legumes, nuts and seeds” (Patton, 2021, para. 3). This diet apparently “treats” oxalate-sensitivity by excluding food groups that may contain oxalates. This reflects a narrow symptom-reducing view on Dr. Baker’s part, given that certain low oxalate foods like kale (Khatri, 2022), are excluded from the diet, even though it can reduce one’s cancer risk (De Santis, 2021).
I cannot explain how Dr. Baker thinks that eating an all meat diet helps those with cancer when, for example, one study found that there is a correlation between a diet high in red meat and colorectal cancer (Reynolds, 2021) and another study found the same correlation and that there is a correlation between red meat intake and prostate cancer (Knuppel et al., 2020).
Data suggests that promoting a diet that is exclusively meat is environmentally irresponsible as well. Van der Weele, et al. (2019), report that the scientific literature reveals that the global trend towards greater meat production and consumption has raised concern about environmental problems such as land and water overuse, greenhouse gas emissions, pollution, and biodiversity loss. They also report that a “major reduction in meat consumption would lead to significant environmental and possibly also health benefits in Western countries” (p. 505) and that even though “consumers are often aware of these issues and feel ambivalent about meat consumption, the idea of eating less meat meets with resistance” (pp. 505-506), with consumers employing various coping techniques including “strategic ignorance”.
While ambivalence may be understandable, it is time for us to depart from our strategy of ignorance and look at the data with an openness to the truth. The evidence strongly suggests that the United States consumes an excessive amount of meat. One study comparing the land use required to produce the average US diet, which is high in meat consumption, to the average diet in India, which is low in meat consumption, discovered that the land use “associated with [US] food waste, including over-consumption […] was found to be twice that required for all food production given an average Indian per capita consumption” (Alexander, et al., 2016, p. 88). That the available land mass in the world is being grossly overused to support the excessive, wasteful, disease-promoting diet of Americans while those in certain other countries eat a more environmentally responsible diet is cause for serious self-reflection.
Pope Benedict XVI invited us to do exactly that in his message for the celebration of the 43rd World Day of Peace, when he asked:
Can we remain indifferent before the problems associated with such realities as climate change, desertification, the deterioration and loss of productivity in vast agricultural areas, the pollution of rivers and aquifers, the loss of biodiversity, the increase of natural catastrophes and the deforestation of equatorial and tropical regions? (Benedict XVI, 2010, para. 4)
Later in the address, he said that we “cannot remain indifferent to what is happening around us, for the deterioration of any one part of the planet affects us all” (para. 11) and then, drawing from St. Pope John Paul II’s encyclical, Centesimus Annus (CA), called for lifestyle change:
It is becoming more and more evident that the issue of environmental degradation challenges us to examine our life-style and the prevailing models of consumption and production, which are often unsustainable from a social, environmental and even economic point of view. We can no longer do without a real change of outlook which will result in new life-styles, “in which the quest for truth, beauty, goodness and communion with others for the sake of common growth are the factors which determine consumer choices, savings and investments” (CA, 1991, para. 37-39 [citation corrected]). (Benedict XVI, 2010, para. 11)
Scientifically minded practitioners who are open to being guided by moral authorities like Pope Benedict XVI will favor lifestyle recommendations that are most likely to foster growth in charity, improve the overall health of the individual, and cause the least harm to our common home. Doctors with an adequately scientific, ethical, and broad perspective would never liberally promote lifestyle changes that unnecessarily risk contributing to our global environmental problems such as promoting an exclusively meat or animal-product diet, especially when there are more health-promoting and effective alternatives.
Michael Greger, M.D. FACLM is one such doctor. Dr. Greger is a pioneer in public education on responsible, scientific lifestyle medicine options. The science-based non-profit organization called NutritionFacts.org which he founded has created a vast database of articles and videos in which he critically reviews the scientific literature regarding lifestyle change. Dr. Greger’s articles and videos offer evidence-based alternatives to many of the previously mentioned harmful recommendations, alternatives that do no harm, address problematic symptoms while providing a variety of other health benefits, and are better for the global community and environment as well. Some examples of videos that he has produced on treating acne through lifestyle change include:
- The Acne-Promoting Effects of Milk (Greger, 2012)
- Saving Lives by Treating Acne with Diet (Greger, 2014)
- Treating Acne with Barberries (Greger, 2016)
These three videos are representative of the other videos on the site in that they review and summarize scientific literature regarding evidence-based treatments. If you have a symptom that you want to treat with lifestyle modifications, NutritionFacts.org is a site that can be trusted to report on evidence-based options while providing critical commentary on pseudoscientific options.
Regarding treating symptoms of oxalate-sensitivity and cancer, a WebMD article states:
If you’re prone to kidney stones or have kidney disease, your doctor may recommend you follow a low-oxalate diet. But for most people, the benefits of nutrient-dense, high-oxalate foods can outweigh their risks [bold added]. (Khatri, 2022)
The bolded words above reveal the WebMD article authors’ broad perspective, a perspective that looks at total health instead of focusing on symptoms alone. It is worth noting that kale and bok choy, which top the list of low-oxalate foods highlighted in the article are both cruciferous vegetables, a type of vegetable that can reduce cancer risk (Higdon, et al., 2007). In addition, the other low-oxalate foods listed in the article are all plant-based whole foods, which means that the article’s recommendations are not only good for one’s overall health but are also environmentally responsible.
The evidence-based recommendations made by NutritionFacts.org and in articles like the WebMD article look at the total long-term health of individuals and are excellent options for creating and/or maintaining a healthy environment for all individuals living on our planet. They are trustworthy, credible, and broad-viewed rather than flawed, agenda-driven and/or short-sighted. The scientifically minded give much greater credence to sources like these which display a grasp of the big picture than to sources like the carnivore.diet site which myopically focus on symptom reduction to the degradation of the total and long-term health of the individual and the planet.
PRINCIPLE TEN: Pay Heed to Conflicts of Interest
Social media and traditional news sources promote pseudoscience by citing new scientific studies as they boldly proclaim a sensational and attention-grabbing claim. Following the guidance of Principle One, we scientific skeptics will look at the source to see what the report of the study actually says, but it still can be confusing when the media reports, for example, one day that consuming beef is unhealthy for one’s heart and on another day that eating beef is now deemed healthy. People understandably lose trust in science from such irresponsible reporting, even if they should really lose trust in social media and traditional news sources, not science.
What happens regularly and happened in the case of media reports on the health risks associated with eating beef is that the media reports on the stated findings of a new “discovery” as published in a scholarly article without first critically reviewing the article and comparing its findings to the existing body of evidence on the subject matter.
For example, the results of a study on beef consumption published in 2012 claimed that including lean beef in one’s otherwise healthy diet elicits “favorable effects on cardiovascular disease (CVD) lipid and lipoprotein risk factors” (Roussell, 2012, p. 9). This was shocking “news” given that the research in the preceding decades had provided a substantial and ever-growing body of evidence showing a strong correlation between beef consumption and cardiac disease. A press release by the beef industry was obviously distributed and the news was widely reported in the media at the time.
However, the study was poorly designed in that it took a low cholesterol diet, added lean beef to it, then compared it to a diet that was high in cholesterol. It is predictable that the low cholesterol diet with lean beef added to it produced “favorable” lipid and lipoprotein risk factors when compared to the high cholesterol diet. This is not news, nor shocking.
If the study had discovered that adding lean beef to your diet improves heart health, then that would be newsworthy given the existing body of scientific evidence contradicting such a finding. Instead, all we have is a study that compared two high cholesterol, disease-promoting diets and found that one is more harmful and deadly than the other. The importance of the finding is akin to the importance of finding an answer to the question, “Which is healthier, Twix or Butterfinger?” In the end, the study made a pseudoscientific claim when it concluded that eating a diet which includes a substantial amount of beef improves heart health.
Not only did the media fail to report on the contents of another 2012 article which scientifically critiqued the beef study (Bernstein & Willett, 2012) and was published in the same journal that published the beef study, they also failed to highlight the conflicts of interest between the primary author of the “lean beef is heart healthy” article and the beef industry. The primary author of the original article, Mike Roussell, Ph. D., is so tied in with the National Cattlemen’s Beef Association that he has a Q & A page dedicated to him on their agenda-driven BeefItsWhatsForDinner.com website (BeefItsWhatsForDinner.com, n.d.).
Furthermore, the media failed to report on other related conflicts of interest such as that the two agenda-driven organizations Cattlemen’s Beef Board and the USDA work together to promote beef regardless of the large body of credible evidence that beef production and consumption is harmful to humans and the planet (BeefItsWhatsForDinner.com, n.d.). The US public understandably trusts that the USDA does what they state that they do, that is, they “provide leadership on […] nutrition, and […] the best available science” (Usda.gov, n.d.). However, the USDA cannot be trusted to promote science over pseudoscience given another objective of theirs, that of having “a vision to provide economic opportunity through innovation” (Usda.gov, n.d.). The USDA’s task of financially supporting the cattle industry is in perpetual conflict with their duty to provide leadership on nutrition and the best available science. For those who naïvely trust the USDA to give adequate nutritional guidance, the USDA’s structural conflict of interest and inherent untrustworthiness is truly newsworthy!
It is important that we do not lose trust in science. We just need to avoid uncritically accepting new claims that are astoundingly contradictory to the existing body of literature. Over time, the peer review process is usually able to sort out what is credible from what is not. If peer review appears to be failing, then the scientifically minded know to look for conflicts of interest and to weed out the science from the pseudoscience.
While the principles detailed in this article are not comprehensive, they should give you a good foundation from which to begin distinguishing between products and services that are beneficial and do what they claim and products and services that are harmful and ineffective.
Why This Article on This Blog
Healing and Peace Catholic Therapy Services helps individuals, couples, and families in pain to experience deep personal and relational healing by using the top faith- and evidence-based treatments so that they can live out their unique vocations to love with ever greater peace, holiness, and joy. Likewise, this blog explains, among many other things, which therapy models are the top evidence-based ones and, when relevant and necessary, how we can know when one evidence-based model is better than the others.
I want to empower my readers to be informed on science and morals when reviewing their options for therapy and all other services or products that claim to offer healing and/or peace. My hope is that the reader will find this article foundational in the critical review that precedes their purchasing decisions and will ultimately guide them towards greater healing and peace.
Am I a Competent Guide on Scientific Thinking?
Naturally, you may be wondering if you can trust my writings on the topic of scientific thinking. Because I understand and respect your concern, I will briefly describe some relevant parts of my education on the scientific method.
My first introduction to the importance of scientific skepticism was a course that I took called Science and Pseudoscience during my undergraduate studies. Later, during my coursework enroute to my M.A. in Marriage and Family Therapy, I took a course called Quantitative Methods through which I learned not only how to create well-designed and valid research studies, but also how to intelligently critique poorly designed studies. Lastly, I have critically reviewed a large amount of the scientific evidence regarding lifestyle medicine since mid-2013, and the scientific sources often critique one another, thus they taught me how to better sort out science from pseudoscience.
Largely as a result of my studies on the scientific method, I strive to be simultaneously open-minded and skeptical regarding scientific claims and tend to do the necessary research to see if claims are valid before using or recommending a product or service. I also critically review products and services from a Catholic moral standpoint using what I learned in my graduate studies in moral theology at Holy Apostles College and Seminary as seen in my citing of relevant quotes from the writings and/or addresses of Popes Francis and Benedict XVI in this article.
Comments
As always, I invite you to tell me what your biggest problems are so that I can address them in future articles. Please let me know your thoughts about this article in the comments below. What is something new that you learned from the article? How will your purchasing habits change after reading this article, if at all? How about your medication use or trust of medical doctors?
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