Skeptoid @ Google

Google has a reputation for hiring really smart people. (I will burst your bubble on one small point: the urban legend that all prospective hires have to take a really hard test is untrue.) So I was pretty excited to give a talk there through their Authors@Google program. It’s always fun to have a really challenging audience. The San Francisco bay area is one of the world’s Woo Central headquarters too; it’s the home of alternative everything, and the all-natural fallacy is nowhere more deeply embedded. Combine that with a super-smart audience, and a skeptical speaker is sure to have a wild time.

As usually happens when I travel to give a talk, my core group of hosts are already on board with the whole skeptical thing, and so we had a good time before and after the talk snacking in one of Google’s many free cafes and having lunch. This provided a first-hand look at one of Google’s most visible bows to local custom: food woo. Everything is color coded. In the cafeterias, regular food is labeled in one color. Vegan is another. Organic is another. Gluten-free is another. They’re all given equal time, as if there is equal reason for a healthy person to seek out gluten-free food (there is no such reason) or organic food (ditto). The soda dispensers proudly state that all drinks contain only cane sugar (even the diet soft drinks, a humorous little accident), as if there is good reason to avoid high fructose corn syrup (there is not).

Drink refrigerators abound throughout the campus, and everything’s free. I’m less likely to look a gift horse in the mouth than I am to pour a gift drink into my mouth, but it was pointed out to me that the drinks are all color coded too: green, yellow, or red. It was explained that anything with “chemicals”, like a Diet Coke, would be labeled red, which the key explained should be avoided. Diet Coke has zero calories, and basically nothing that will hurt you if consumed in normal amounts. However, a fruit drink like a fruit smoothie, bursting at the seams with sugar and hundreds of calories, would be labeled green, due to its all-natural goodness. Hmm. I examined one of the refrigerators myself, and found the opposite; the labels were red for high calories and green for low calories, but it was not a good sample. This particular refrigerator contained only fruit drinks. From what I was told, different refrigerators around campus follow different rules. Milk might be labeled red because of its evil dairy nature.

During our Q&A, much of the talk centered on food woo. I did my best to lay out the basic case; that every compound on the planet is either harmless or poisonous depending only on the dose, that everything is made of chemicals, and that foods marketed as all-natural are no more likely to be any healthier than any other. The nice girl who organized the event, who had no prior exposure to Skeptoid, asked me a really good question. It’s such a great question because it’s honest, and reflects a wildly popular perspective. She asked “How do I find a happy medium; I don’t want to be taken advantage of by deceptive marketing, but I also don’t want to eat chemicals?”

My answer for this is in two parts. First, most obviously, is that everything is chemicals. If you looked at a chemical breakdown of an apple, it would read just as ugly as the ingredient list in a Diet Coke. Scary sounding chemical names. All molecules and chemical compounds generally have complicated names; it doesn’t mean there’s anything bad about them.

Second, it’s important to understand why you want or don’t want a particular food, and to make sure that your reasons are sound. There are many reasons why people make food choices. Some are ideological, and some are scientific. Some are based on wrong assumptions. If you choose to be vegan or vegetarian for ideological reasons, that’s wonderful, and perfectly valid. But if you choose organic food because you think it’s healthier, that’s based on faulty science. I drink diet soda instead of regular soda because I don’t want the calories, and that’s sound science. But if I eat gluten-free crackers because I think it will improve my general wellness, that’s false. If you don’t want to be taken advantage of by deceptive marketing, you will have to devote a little bit of elbow grease to research.

I had a wonderful time during my day at Google, and send my sincere thanks to my hosts. I would love to do it again.

Addedum: I really want to stress that last sentence. The day was an overwhelmingly positive experience, and the opinion I formed is that there is much more to praise about Google and its people than there is fault to be found. I mean, Toto toilets, come on…

Troupe of Proboscis monkeys

The purpose of the trip was to attend my high-school class of 1969 40th reunion. In addition to meeting up with classmates who stayed and made their lives in Malaysia, I met up with classmates from Canada, Australia, Singapore and the U.S.  A few of us made our way (45 min. flight, 5 hr. drive and 45 min. up river by boat) to the interior of Borneo and spend a few nights in the Kinabatangan valley to see for ourselves what was left of the virgin primary forest – and communed with orangutans, horn bills, proboscis monkeys and even a pygmy Borneo elephant.
This is the area where Alfred Russell Wallace spent two years (1854-56) collecting specimens, many of which were sent to Charles Darwin. His book “The Malay Archipelago” (dedicated to Charles Darwin) was prominently on display and for sale in many local craft shops and book stores. I had to get a copy and ended up reading it on the plane on the way home. (Ok, he was a collector of specimens not a conservationist so he shot 17 orangutans within a month of getting there and sent skin samples and skeletons to England! Yikes!)

The Malay Archipelago by Alfred Russel Wallace

One of our classmates Robert Chong owns and operates the Kinabatangan Jungle Camp which has been written up in many eco-travel guides as the place to go for a taste of the real jungle.  In addition to a generous classmate discount, he threw in all the beer and wine we can drink in the 3 days and 2 nights.  I hope we didn’t scare away too many orangutans with our giggling and howling all night!  Robert has served as the expert guide for many naturalists and birdwatchers who came from all over the world to this forest still teaming with wild life, so to be reintroduced to the wilds of our old Borneo by one of our own was an especially moving experience.

Kota Kinabalu (KK) has changed a lot since I left in 1970. Its claim to fame of course was from the TV Reality Show “Survivor.” The first season in 2000 was filmed on Pulau Tiga, just off the coast of KK. Except for Season 1, Survivor Borneo, the show has not been shown on local TV since then – but local tourism officials still recall fondly the time when the American TV crews bought up all the rooms in the only 5-star resorts in town! When I left KK (1970 pop. – 30,000), there was not even television broadcast yet! Today, this city of half a million is a striving modern metropolis with direct flight from Singapore, Kuala Lumpur, Hong Kong, Melbourne, Manila, and Taipei, four 5-star resorts, wall-to-wall malls and with Starbucks, KFC’s, Pizza Huts and McDonalds in every other block!

While all the malls are very modern and quite similar to any malls you will find in Anytown, U.S., there is one significant difference – the ubiquitous “health centres” on every level.  Woo is alive and well in KK shopping malls.  Every floor of every mall has their share of “health centres” which are actually facial and reflexology businesses.

“Facial” is not just for the face – it’s “skin care” woos of every description. Name any skin care and “youth restoration” product you ever saw on late night infomercial in the U.S. and they have it – and more. Other than the usual hype of different concoctions for different types of skin, they have specialties for different blood types, skin and facial treatments for different “time of the month” and time of the year (even though KK has no seasons and has average temp of 81 deg. and 90% humidity all year round.) For many of my female classmates, anecdotal evidence that their weekly visits to these parlors for their herbal/placenta wrap and botox/collagen cream treatment works was unfortunately reinforce by comparison with a few returnees’ foreign (read “white”) wives with their prematurely wrinkled and sun blotched skin (from over-enthusiastic sun tanning in their youth before SP30 sunscreen was deemed necessary!) True believers that they are, my suggestion that their good complexion may not be all due to their treatments at these facial salons devoid of any dermatological expertise was heresy. I suggested that they have such good complexion in their late 50′s should probably be credited to their Asiatic ancestor who endowed them with good genes and cultural taboo against being darken by the sun when they were young (every school girl walked under an umbrella when we were growing up.)

Reflexology centers are all adorned with anatomy posters on the wall with well-annotated “chi” lines and acupressure points.  But in reality, what is offered in these mall stores is nothing more than just hard pressure massage, and is offered for every combination and permutation of body parts. All my classmates, male and female, local to KK swear by them – a quick stop at one of these mall heath centers

Ear Candles - Made in Germany is the selling point!

on the way home after a hard days work is a must to be “rejuvenated” for the evening! Many of the health and facial centers like to attach the word “homeopathy” to their names. Upon questioning the “health professionals” in these centers, it became quite obvious that they have absolutely no idea what the term

What the heck is Homeopathy Reflexology?

“homeopath” really refers to. I think they confused “natural” or even “organic” with “homeopathy.” So, a “homeopathy reflexology centre” will use only organic oils and creams. Ear-Candling is big too – and European imported ear candles are all the rage.  Ear-Candling is included in most “package” deals you get from one of these health centers. My wife had to try the reflexology massage but definitely passed on the ear candling.

One of the Facial Rejuvenation centers advertise a “Breast Firming and Hot Mask” treatment which sounded very intriguing. In the interest of science and research, I tried to persuade my wife to find out what it was all about – I was going to pay for the RM$40 (about US$11.) But she was quite offended that the thought that her breasts needed firming would even crossed my mind. So, on that front, I have nothing to report!

Advise to husbands - do NOT suggest wife try last item!

The Centers for Disease Control has put out an alert: in Minnesota in 2008, there were five confirmed cases of Haemophilus influenzae type b (or Hib) among children younger than five years old. Of these five cases, three of the children were unvaccinated, one had started the series of vaccines but did not complete the series due to shortages, and the fifth — who had been fully vaccinated — had an immune deficiency.

Five cases may not sound like a lot… until you learn that one of the unvaccinated children died. This was a baby, just a seven-month-old infant.

I can barely type that sentence out; my heart is aching so. I can only imagine what the parents are feeling. I literally have nightmares about such things.

There are several things to note about this incidence of Hib:

1) It’s the largest number of cases in one year since 1992 in Minnesota, when 10 cases were reported. In the intervening years, between 0 and 4 cases were reported per year (1994 saw four cases, the average is about 2). These are small number statistics, so 5 cases may just be a normal statistical fluctuation. But the stakes are very, very high here.

2) We do not know why three of the five children were unvaccinated. It may be due to the antivax crowd, or it may be due to any number of other factors; the report doesn’t say (however, see (5) below).

3) Out of three unvaccinated children, one died. The historical rate of death from Hib, once infected, is about 1 in 20, so this is something of a fluke. But 1 in 20 is still way, way too high… and of the ones who do survive the infection, 1 in 5 will suffer deafness, blindness, or severe, permanent brain damage.

Russian roulette has better odds than 1 in 5; do you want to play that with your baby? If that sounds harsh, good. We’re dealing with babies’ lives here. The best thing you can do is make sure they don’t get the disease in the first place.

4) Getting a vaccine does not guarantee not getting the disease. We don’t know how many babies were vaccinated, and how many weren’t that didn’t get the disease. But with 1 in 20 odds, I know which way I fall.

5) There is a shortage of Hib vaccines right now, and it’s expected to last for a few more months. However, according to the CDC report, there are adequate supplies to have infants inoculated and complete the primary three-dose infant series.

Data were reviewed for 25,699 children born between November 1, 2007 and March 31, 2008… Among children aged 7 months, 3-dose primary Hib series coverage was 46.5%, which is lower than the age-appropriate coverage for children who had received pneumococcal conjugate or diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. In contrast, data from the 2007 National Immunization Survey, conducted prior to the shortage, showed that Hib vaccination coverage among children in Minnesota aged 19 months to 35 months was high and did not differ from the national average, suggesting that coverage has declined as a result of the shortage.

So there has been a decline in coverage due to the shortage, with roughly half the children in the survey being vaccinated.

Putting this all together is difficult, with so many unknowns. But to belabor the obvious, we do know one thing: of the three unvaccinated children who got Hib, one died. The doctors from the CDC add this editorial comment:

Before development of Hib conjugate vaccines, Hib was the most common cause of bacterial meningitis in children aged <5 years. Since implementation of the Hib conjugate vaccine immunization program in the United States in the early 1990s, the incidence of Hib disease has declined from a peak of 41 cases per 100,000 children aged <5 years in 1987 to approximately 0.11 cases per 100,000 in 2007.

In other words, the infection rate among infants dropped by a factor of nearly 400 after the Hib vaccination was developed. This recent increase may reflect a loss of herd immunity, meaning too many kids are not getting vaccinated.

Folks. Please. Vaccinate your children. The science is in, the tests have been done, the results are solid: vaccinations do not cause autism. What vaccines do is save the lives of thousands of children who would otherwise be suffering the effects of preventable diseases… and one of these effects can be death.

Save your kids’ lives. Take them to a doctor and get his or her advice on this. And if they recommend vaccinations, then do it.

My thanks to Dr. Joe Albietz for providing me with some of the numbers in this article.

MonaVie

If you follow my Skeptoid podcast at all, you probably know that my all-time leading episode, by number of comments posted to the web site, is the one about MonaVie. It was actually about “superfruit” juices in general, but MonaVie distributors are the ones who have been pounding the site like a horde of Mongols and posting their comments. I graciously call it “posting comments”, it’s really more like harling. Harling, for those perhaps unfamiliar with the term, is the process of refinishing the walls of a Scottish castle by harling, or throwing, a handful of plastery weatherproofing (called harl) at the wall. Manure was a prominent ingredient in some harl. So I like to describe what the MonaVie distributors do as “harling” their comments at my site.

And, for some reason, I’m still constantly amazed at how many people in my neighborhood buy into MonaVie, both literally and figuratively. Without exception they parrot what they’ve been told; that it gives them more energy, it prevents illness, and generally promotes better health. How does it do this? If pressed for an explanation, they best they can come up with is that the açai from which it’s made (in part) is high in antioxidants and/or vitamins. Thus MonaVie’s comically high price is justified (a variety of similar juices are available in supermarkets at about a tenth the price, just without the fancy wine bottle and high school dropout pyramid business model).

This health claim is, as the saying goes, “so wrong it’s not even wrong”. At every level, this logic fails. It is based on the following assumptions:

1. MonaVie is high in antioxidants.
2. Antioxidant supplementation has beneficial effects.
3. We are all suffering from some antioxidant and/or vitamin deficiency.

1. We know that açai juice is not especially high in antioxidants (see this study by Australia’s consumer publication Choice). Eating an apple gives you more antioxidants than drinking a serving of any popular açai juice. And açai is only one of MonaVie’s 19 fruit concentrates (the rest of its ingredients are sweeteners and preservatives, like most similar fruit juices).

2. We know that antioxidant supplementation has, so far, not been shown to have any health benefits (see this analysis of current research by Dr. Stephen Barrett of Quackwatch). The oxidation of molecules is an important metabolic process. It makes no sense to try to attack it with antioxidants, just because you heard “they prevent aging” or some such nonsense.

3. We know that vitamin supplementation has no plausible value for people not suffering from a deficiency. With few exceptions, almost nobody who eats most of their meals in an industrialized country is likely to have a vitamin deficiency. And if you did, you’d be symptomatic, you’d know it, and it would show up on a blood test. If that’s not the case (which it’s probably not for anyone wealthy enough to own a computer on which to read this), your body already has all the vitamins it requires, and your regular diet already delivers more than your body uses. It’s like a car with a full tank. Overfilling the gas tank, so that it spills on the ground, is not going to give your car superpowers or super speed or super endurance or “more energy”. More vitamins than your body needs constitute just one thing: Waste. Your car’s gas tank can’t be fuller than full, and your body can’t be healthier than healthy. You either have an illness, or you don’t: You can’t have a super duper lack of illness.

Sometimes when a friend boastfully tells me that he had his MonaVie shot this morning, I’ll react with mock horror and say “Oh my gosh!! How terrible; what did your blood test show?”

Nothing? What did he think he was treating? Health?

From the GTS Kombucha website:

“In 1995, founder GT Dave’s mom, Laraine Dave, had been diagnosed with a rare form of breast cancer with a trajectory of illness known to move quickly to the lymph and bones. When she was diagnosed, doctors held out little hope for her given the aggressive type of cancer and its advanced stage. But to the surprise of everyone, her cancerous cells were found to be dormant with no metastasis. Her physicians were baffled and asked what she was doing that others in her situation were perhaps not doing. The only thing she could think of was that she had been drinking homemade Kombucha every day for the last couple of years.”

Anecdotal evidence is never convincing to a skeptic, so I’ve remained skeptical about Kombucha’s health providing properties even though several of them profess its wonders.

First, what is Kombucha? It is a fermented, sweetened tea (either black or green is normally used) containing what’s technically known as a zoogleal mat of various symbiotic bacteria and yeast species. I prefer to call the mat “the octopus” in reference to the way it attacks your face when drinking straight from the bottle. Most people refer to it simply as a “mushroom”.

Research has identified the bacteria as belonging to the genus Acetobacter, which oxidize sugars or alcohols metabolizing acetic acid as a bi-product. These bacteria are used widely in the food industry, especially in the production of vinegars from wines and spirits, and have been ingested by humans for hundreds of years. So, if not healthful, they certainly aren’t known to be widely harmful to humans.

The yeast are from several different genera, including but not limited to Brettanomyces bruxellensis, Candida stellata, Schizosaccharomyces pombe, Torulaspora delbrueckii and Zygosaccharomyces bailii. Several of these species are used in either the brewing of beer or the fermentation of wine. All told, the combinations of bacterial and yeast species should have little negative effect on a healthy individual, and in fact more and more research suggests that ingestion of so-called pro-biotics might actually be beneficial.

Ok, so Kombucha has been around a while. Since 250 BC or so. It was first used by the Chinese, and made its way into Russia in the 1800’s. Since then it has grown in popularity, mostly as a home-brewed concoction. However, more recently it has become a commercially distributed product, which has allowed it to reach a wider segment of the population.

Most of the health benefits of Kombucha are not clinically supported in humans, but rather anecdotal. There has been limited conflicting research in mice and rats. While the fermented tea seems to have antioxidant and immunomodulatory activity in rats (likely due to the polyphenols present in the tea used to create the Kombucha), it has also been shown to increase the size of both the liver and spleen in mice. Significantly, the home-brewed variety has been linked with several health issues in people, ranging from bacterial infections to liver damage and to death. That said, Kombucha sold commercially is probably safer than homemade. However, due to processing differences, commercial Kombucha isn’t likely to have as wide a variety of bacterial and/or yeast species making up its zooglea.

In conclusion, the research and evidence that is available to date is not sufficient for the medical community to endorse the consumption of Kombucha for health related purposes. Until the proper studies are done, Kombucha will simply remain an interesting drink with a serious cult following.