The "Natural" Lie
How easily are you deceived?
"Our orange juice is superior to all others: it's 100% natural."
"The 100% natural ingredients used in our herbal remedy are much safer and just as effective as those used in prescription medicines."
"You can trust Natural Nut Corporation to use only 100% natural ingredients in each and every product. Remember, 'natural' means 'safe.'"
Each of the above statements contains at least one inaccurate or misleading statement. Were you deceived by any of them? Many people are, and similar claims appear every day on thousands of products that purport to be completely "natural."
The fact is that everything -- everything -- can be labeled "natural." All products, all materials, all medicines, and all "chemicals" begin in nature. However, this word is constantly misused to deceive consumers into believing modern medicines are evil and toxic, processed products are somehow unsafe or less nutritious, or modern products are less efficacious than those used by ancient cultures. The success of these deceptions relies on innuendo, poor logic, and an unreasonable appeal to emotion.
A dictionary definition of the word "natural" is present in or produced by nature. Since the base ingredients present in any product were created by nature itself, it is reasonable to assert that even the most highly refined medicine or product is of a "natural" origin. However, alternative definitions include not altered, treated, or disguised as well as in a state regarded as primitive, uncivilized, or unregenerate. It is in these latter definitions that marketing deceptions are practiced; since it is currently trendy and chic in some circles to deride and distrust anything produced by modern science, the association of "natural" with "primitive" is an attractive one. However it is not in the best interest of a marketer to describe a product as primitive or uncivilized; nor are the more accurate descriptions of most allegedly "natural" products (i.e. unrefined, unprocessed, and so forth) any more appealing from a marketing point of view since the prefix "un" provides a negative connotation. The word natural is ideal since it is appealing and nebulous, and from a legal standpoint it is accurate since all products eventually trace their components to unrefined ores, minerals, plant materials, or other "natural" sources.
As used in current marketing practice the word "natural" is meaningless--it is present solely to capitalize on the "back to nature" movement that presently enjoys wide support among many Americans and others. This desire in and of itself is not evil or misguided; indeed it may well represent a manifestation of Thoreau's desire to "simplify, simplify" and certainly there is nothing wrong with avoiding over-processed foods. However it is also obvious that marketers are well aware of this movement and are targeting the fears and desires of its proponents, just as is the case with any other specialty market. Indeed, the "back to nature" movement has even been co-opted by manufacturers of sport utility vehicles, who suggest ownership of their vehicles will allow one to have greater access to nature by being able to drive there.
Given the use of the word as outlined above, it would not be any more inaccurate or misleading if Ford Motor Company announced that all their automobiles were "100% natural."
The misuse of various phrases or concepts is not new in the world of product advertising, and often relies on the fact that many people will not examine product claims too closely. For instance, the statement the Chinese have used magnetic therapy for thousands of years makes use of a well known logical fallacy. It may be the case that the Chinese have used such techniques, but this statement tells us nothing about the actual effectiveness of so-called magnetic therapy. The logical fallacy in operation here is that of argument from antiquity, the basic premise of which is is that something must be effective or useful it it has been around for thousands of years, i.e. "it's been this way for a long time so it must be good." We can see by comparison that the antiquity of a method does not guarantee its effectiveness: bloodletting, leeching, and trephination were long used by many cultures but are now known to be counterproductive and dangerous except in certain very specific cases. The same goes for the similarly ancient use of animal products such as bear paws and livers, tiger hearts, and so forth in traditional Chinese or other primitive medicines; these treatments are now known to be useless or dangerous...especially to the animal whose organs are being sought!
By the same token, the commonly used marketing ploy "new and improved" relies on a related fallacy known as argument from novelty, i.e. the idea that new products must automatically be better than old ones. Likewise, an appeal from numbers leads us to the false conclusion that a product (or belief) is valid simply because so many people use or believe in it. In all these cases the marketer relies on manipulating the perception of the consumer rather than accurately describing the effectiveness of the product.
Consumers must be aware of all these ploys if they are to avoid being misled; each is commonly used by purveyors of various foods as well as alternative medicines and therapies. While "mainstream" medicine is subject to massive peer review and government regulation designed to manage claims of the effectiveness of a given treatment, most alternative therapies are not subject to any such regulations. Vitamin or "herbal therapy" producers can claim nearly anything without having to produce a single unbiased review, and frequently make use of anecdotal evidence or testimonials offered by physicians whose motives may be unclear.
Referring to the food industry, it should be remembered that only a few years ago in the United States it was legal for manufacturers to use the words "light" and "low fat" in any context as long as the product's fat content was measurably lower than the full-fat version. Only recently was legislation enacted to regulate the use of these terms, which had become meaningless marketing ploys designed to mislead consumers into thinking they were buying more healthful products when in many cases the nutritional changes were negligible. The same type of legislation is sorely needed to regulate claims made by hawkers of "natural" products and alternative therapies.
Does "natural" mean "safe?"
Many manufacturers of alternative medicines would have the public believe all "modern" medicines are composed of toxic chemicals that are the product of science gone mad. Their "natural" remedies, on the other hand, are "pure"--another meaningless word--and allegedly safe. This is hardly the case. One need only look at the histories of allegedly natural herbal remedies such as Ephedra and Kava, both of which have been removed from the market or placed under more controlled distribution methods after having been found to cause adverse reactions in a significant percentage of their users, to understand that the terms "natural" (or more accurately "unrefined") and "safe" are not necessarily synonymous.
Many people seem not to understand that "modern" medicines frequently begin life as a component in some traditional, folklore-based treatment. Willow bark was the basis for aspirin; Quinine is derived from Cinchona bark, and the same is true for any number of commonly used modern medicines. Modern pharmacological practice relies on extensive research and controlled testing to isolate and extract only the useful, active ingredients while eliminating those that are either useless or detrimental.
An additional advantage to the process of refining and isolating these active ingredients is that modern medicines deliver them in guaranteed, accurately measured doses, which is not the case for most herbal or traditional remedies. In fact, one of the reasons some herbal remedies may be "safer" lies in the distinct possibility that a given dose contains no active ingredient whatsoever. The fact that these products are currently unregulated means that, even at the same dosage level, different brands (or even different production runs by the same company) can contain widely varying amounts of the active ingredient. As Dr. Stephen Barrett of Quackwatch notes:
* A Good Housekeeping Institute analysis of six widely available St. John's wort supplement capsules and four liquid extracts revealed a lack of consistency of the suspected active ingredients, hypericin and pseudohypericin. The study found:
o A 17-fold difference between the capsules containing the smallest amount of hypericin and those containing the largest amount, based on manufacturer's maximum recommended dosage.
o A 13-fold difference in pseudohypericin in the capsules.
o A 7-to-8-fold differential from the highest to the lowest levels of liquid extracts .
* A similar investigation by the Los Angeles Times found that 7 of 10 Dr. John's wort products contained between 75% and 135% of the labeled hypericin level, and three contained no more than about half the labeled potency .
(The full article may be found at this URL)
Another method used by advocates of allegedly natural remedies is that "they contain no toxic chemicals," and often advertisements will say something like "I can't even pronounce the names of some of the chemicals in modern medications, it's obvious they're artificial and therefore dangerous." These statements are incorrect or at least misleading: toxic is another "wallpaper word" whose meaning can be manipulated in the same way that natural is misused. Consumption of a given substance at a certain level may be beneficial to ones' health, while higher amounts of that same substance may produce a toxic effect (even breathing air containing higher than normal levels of oxygen can produce oxygen toxicity). Likewise, mega-doses of vitamins are considered unwise by health professionals, since certain vitamins (A, D, E, K, etc.) can produce serious health problems if taken in excessively large doses. Quoting the article above, "Vitamin D is one of the most toxic supplements there is, and in extreme cases and in very large amounts can lead to liver and kidney failure."
Thus even supposedly "safe" herbal remedies can be toxic at certain levels, and the simultaneous use of multiple remedies, whether herbal or modern, can produce adverse reactions in the patient. "Natural" and "safe" are not necessarily synonymous: remember that substances such as lead, arsenic, blowfish toxin, snake venom, and hemlock are certainly "natural" according to every definition of the word. They are also most certainly toxic!
Update 6/10/2013: another excellent article has appeared in a UK newspaper, describing how the vitamin industry ignores and distorts evidence in order to maintain its sales figures. This article also describes how the antioxidant craze may be increasing, rather than diminishing, mortality rates by suppressing "free radicals" that are actually necessary in order to fight off disease and cancers. This article also lists a number of the dangers of allegedly safe "natural" herbs and supplements -- dangers that are never discussed or admitted to by proponents of "alternative" medicine.
The possibility of harm caused by natural products sold in health food stores isn't theoretical. Blue cohosh can cause heart failure; nutmeg can cause hallucinations; comfrey, kava, chaparral, crotalaria, senecio, jin bu huan, usnea lichen and valerian can cause hepatitis; monkshood and plantain can cause heart arrhythmias; wormwood can cause seizures; stevia leaves can decrease fertility; concentrated green tea extracts can damage the liver; milkweed seed oil and bitter orange (Citrus aurantium) can cause heart damage; thujone can cause neurological damage; and concentrated garlic can cause internal bleeding. [...]
The "unpronounceable chemical name" fallacy is even more amusing in its naive approach to science since it attempts to mislead consumers into believing that "natural" products contain no such chemicals. A quick review of the chemical names of various herbal remedies exposes this deception. Ephedra's active ingredient is Ephedrine, which acts in a manner similar to commercial amphetamines and has the chemical name alpha-[1-(Methylamino) ethyl] benzene-methanol. Kava-Kava's effects are created by kavalactones, which have chemical names such as Dihydromethysticin and Dihydrokawain. The active ingredient in Ginko Biloba is known chemically as ginkoheteroside. Hypericin, found in St. John's Wort, has the chemical name 1,3,4,6,8,13-Hexahydroxy-10,11-di-methylphenanthro (1,10,9,8,opqra) perylene-7,14-dione. None of these names are easily pronounced, showing that the irrational appeal against "unpronouncable chemicals" is yet another lie foisted on the consumer by deceitful marketers.
It is also certainly not the case that herbal or alternative therapies are somehow more "pure" or free of contaminants than modern medications. Recently a large manufacturer of herbal therapies in Australia was forced to recall hundreds of its products due to fears of widespread contamination and poor quality control practices. Quoting a press release from Australia's Therapeutic Goods Administration, "these included substitution of ingredients, manipulation of test results and substandard manufacturing processes." It should also be noted that a declaration statement issued by a Chinese importer of Ginkgo Biloba products included data on contaminant levels found in the product; this included lead at 66.7 ppb (parts per billion) and arsenic at <20 ppb. While these levels are certainly acceptable according to US FDA standards, it shows that even the most "natural" products are subject to contamination by pesticides, normal mineral levels found in growth media (e.g. soil), and other factors.
How Effective Are they?
We must now examine the methods used to evaluate the efficacy of herbal treatments. Modern medicines must be put through extensive double-blind studies before being released to the general public, and even then their release is not guaranteed if, for instance, questions about safety remain unanswered. Even with such strict controls it is still possible for harmful products (such as Thalidomide) to slip through the process, so we must be doubly skeptical of herbal remedies that in many cases have never been put through a rigorous testing regimen.
In far too many cases, claims of safety and efficacy of herbal or other alternative therapies are based on logical fallacies as discussed earlier in this article. The fact that "millions of people take St. John's Wort daily" is not a valid means of establishing either the safety or the usefulness of the product--it is a meaningless statistic amounting to nothing more than an appeal from numbers. In plague-ridden Europe it was common practice to carry a "posey" or bundle of flowers to ward off "bad air" and thus protect oneself from the plague. It didn't work, but hundreds of thousands of people used it and continued to die. Arguments based on this premise simply do not hold up under close scrutiny--they are simply attempts to mislead.
So few double-blind studies have yet been performed on herbal remedies that we are forced to rely heavily on anecdotal evidence, which is generally unreliable for a number of reasons. First, many common ailments (headache, sinus problems, stomach discomfort, the common cold, etc.) are self-limiting. Eventually, with or without treatment, they will simply resolve of their own accord. However if someone takes a pill and their headache disappears, the pill will be given credit. If they take a pill (say, aspirin) and nothing happens, but later they take a dose of Willow Bark and the headache resolves itself, the Willow Bark will be credited.
From a certain point of view this seems very logical: "the last thing I took cured me." But if the Willow Bark was taken an hour or so after the aspirin was ingested, then it is more reasonable to assert the aspirin was reaching its optimal level in the bloodstream when the Willow Bark was ingested, and therefore the aspirin was responsible for relieving the headache. This is also supported by the fact that one would need to drink roughly 30 cups of Willow Bark tea in order to receive the same amount of active ingredient as is found in a single aspirin tablet.
The above scenario is yet another instance of a logical fallacy at work. In this case, the fallacy is known by the name after this, therefore because of this. The false conclusion is that a given action produced a given result solely because the action occurred prior to the result. By the same logic, someone may arrive at the conclusion that rain is the result of washing a car or mowing a lawn.
Neither misleading claims of widespread use of a given therapy nor anecdotal evidence of its effectiveness provide a means of determining its true performance. The only valid measure involves rigorous testing under controlled conditions, where the effect of perception and expectation can be minimized if not eliminated altogether. Once herbal and other remedies have been subjected to these conditions on repeated occasions it may become evident that some or all are useless. However the same tests may suggest some of these substances actually provide measurable relief. In the latter case, the next step should involve isolation of the active ingredient responsible for this relief, and the packaging of that product in controlled, measurable amounts to ensure consumer safety.
The last topic for discussion involves the treatment accorded to various "natural" and other alternative therapies by various authors. Certain advocates of herbal/alternative therapies undoubtedly believe they have reasonable proof of effectiveness based on their own studies, but others are simply biased against science. Some of the more extreme are of the opinion that modern clinical medicine actually causes disease. Others rail against pharmaceutical companies' policies and accuse them of "suppressing" discoveries that would jeopardize their profits, while others accuse these same companies of financing the "drug culture" of modern medicine by subsidizing medical schools that train doctors to use drugs in excessive amounts.
While some concern regarding the motives of large multi-national corporations may be warranted, many of these views represent examples of the paranoid conspiracy theories that pervade the Internet. While it is certain that pharmaceutical companies will resort to strong measures in order to protect and expand their markets and profits, it is irrational and unproductive to find conspiracies and hidden agendas in every aspect of their activities.
In some respects, the tension between "modern" and "alternative" medical practictioners may be seen as a continuation of the ongoing feud that emerged between doctors and midwives in the early modern period. Midwives sought to protect their traditional positions as local healer and nurse while the emerging profession of medical doctor attempted to gain legitimacy and, for lack of a better phrase, "market share." Doctors may have been at least partly responsible for making accusations of witchcraft against women who acted as midwives; the women responded in kind by accusing physicians of incompetence. Then, as now, the consumer was caught in the middle.
Many consumers see herbal remedies as their last hope for a quick cure: after being told, for instance, that proper diet and exercise are their only option for losing weight, they find it far easier to pop a pill that promises immediate, effortless, safe weight loss. Others resort to herbal cures out of a desperate need for a foolproof means to stop smoking, regrow hair, or enhance their sexuality; their attitude might be summed up as "well, it can't hurt." Indeed this may be true, though the side effects of various herbal remedies may well outweigh any advantage they offer and the financial burden can be significant.
Still others, sometimes justifiably, seek to regain a measure of control over health decisions from managed care systems that are often seen as impersonal, bottom-line corporate entities. Herbal and other readily available alternative "cures" facilitate this control, and there would be no harm in this course of action if the effectiveness of said products were firmly established fact. It is not, and it is certain consumers are spending billions of dollars on unnecessary and frequently useless herbal remedies, having been misled into doing so by grandiose claims on the part of marketers and purveyors of these products.
This said, research into potential uses for these substances should continue since some may be proven to contain medically useful compounds. Just as Cinchona bark gave us quinine, various herbs and other substances may provide compounds of significant worth to the human race once their active ingredients are isolated and the mechanism by which they work is established. Some of this research is already in progress.
P.T. Barnum is said to have uttered the immortal words "there's a sucker born every minute." This is certainly true where medical care is concerned. In the case of herbal remedies and alternative therapies, fear of modern medicine coupled with a neurotic attitude about personal health and a desire for "easy, quick, painless" resolution to health issues will continue to drive consumers into the arms of marketers who feel no pang of guilt when they make use of manipulative language and advertisements to increase their profit margins. The products they sell may or may not be effective; many have never been tested in any proper sense to determine their safety or efficacy, but companies can claim they're "natural" with little fear of legal entanglement due to the nebulous nature of these words. Similar claims of herbal safety are simply false based on past incidents involving substances such as Kava and Ephedra.
Most people believe the claims of alternative medicine without examining the evidence for themselves. Given that consumers often turn to herbalism and "natural" cures due to a distaste for incomprehensible, impersonal, "corporate" modern medical practice, it must be asked why they implicitly trust the claims of similarly large and impersonal purveyors of herbal medicine. Herbal medicine is big business and, as such, is no different than an HMO or pharmeceutical company. Both are profit-driven enterprises seeking market share and name recognition; as such, those who believe in alternative medicine would do well to distrust their motives and practices, just as they distrust those of so-called "big medicine."
References and Further Reading
- "Herbal Remedies"
- "Herbal Supplements: Not Telling your Doctor Can Be Dangerous"
- "Little Known Risks from Popular Herbal Remedies"
- "Flaws of Argumentation"
- "Logic & Fallacies"
- "Pan Pharmaceutical Limited -- Regulatory Action and Product Recall Information"
- "Magnetic Therapy: Plausible Attraction?"
- "Ephedra, Ma Huang, safety and risks"
- "Medicinal or Toxic?"
- "Hoxsey's Herbal Tonic / Hoxsey Herbal Treatment: BC Cancer Agency"
- "Mega-dose of Vitamins can be toxic"
- Demos, John Putnam, Entertaining Satan
- Park, Robert, Voodoo Science
- "Seven Warning Signs of Bogus Science"
Note: All information contained in these pages is © 2003 Richard E. Joltes. Excerpts may be used where proper credit is given and permission is obtained in advance. All rights reserved.