IS IT POSSIBLE THAT “AMERICA’S DOCTOR” COULD BE A SCAM ARTIST?

                            

    Oprah Winfrey first referred to Mehmet Oz as “America’s doctor” in 2004, during one of his earliest appearances on her television show, and this label apparently stuck. Now he has his own show, and for several years, has regularly touted a series of questionable—often patently fake—remedies and concepts to an adoring, and uncritical, audience. Now, however, and probably long overdue, his hand has been caught in the proverbial cookie jar.

  Oz’s most recent transgression—but not the most outrageous—follows a charge brought by the U.S. Federal Trade Commission (FTC) that he is involved in a scam to deceive consumers through fake news sites and bogus weight loss claims: He now touts the use of the dietary supplement Pure Green Coffee as a potent weight loss treatment that supposedly burns fat. The FTC alleged that weeks after Oz’s promotion, several individuals, who control various companies—NPB Advertising, Inc and others—began marketing through sites that featured excerpts from Oz’s show and testimonials from “consumers” who were paid for their participation. They also set up sites that featured mastheads of fictitious news organizations such as Women’s Health Journal and Healthy Living Reviewed, as well as logos they appropriated from actual news organizations, like CNN and MSNBC. The FTC charged the defendants with falsely claiming that users of their product could lose 20 pounds in four weeks, 16% of body fat in 12 weeks, and 30 pounds and four-to-six inches of belly fat in 3 to 5 months. “Not only did these defendants trick consumers with their phony weight loss claims, they also compounded the deception by advertising on pretended news sites, making it impossible for people to know whether they were seeing news or an ad,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection.

     But how can Oz be connected to such shenanigans? This man has credible medical credentials, being licensed to practice cardiovascular surgery in a respected medical facility. To the vast majority of us “real” physicians, he has become a laughing stock. Although Oz supposedly never endorses specific brands, and it states on his Web site that invoking his name is not allowed. But when it comes to sales, the differences are blurred, for statements “as seen on ‘The Dr. Oz Show’ are often as valuable as the words “recommended by Dr. Oz.”

     For futher background reading, I would refer you to an article by Michael Specter (February 4, 2013) in the New Yorker Magazine, appropriately titled: “The Operator: Is the most trusted doctor in America doing more harm than good?”   Specter noted that in the past, Oz’s recommendations, even when unsupported by data, have usually done no harm. Lately, however, he seems to have moved more firmly into the realm of tenuous treatments for serious conditions. On one recent episode, “Dr. Oz’s 13 Miracles for 2013, he included “a revolutionary” new way to live years longer: “It’s red palm oil.” He went on, “Its red color is perfect, because I think of it as a stop sign for aging.” Specter asked Oz several times why he promotes that kind of product, and allows psychics, homeopaths, and purveyors of improbable diet plans and dietary supplements to appear on the show. He said that he takes his role as a medium between medicine and the people seriously, and he feels that such programs offer his audience a “broader perspective” on health.

    But such revelations are really nothing new: Oz was recognized the James Randi Educational Foundation (JREF) that promotes critical thinking through grants for outstanding educators, scholarships to inspire skeptical students, and annual conferences showcasing the best of skeptical thought. Every April Fools Day, this organization honors the five worst offenders who are intentionally or unintentionally pulling the wool over the public’s eyes, providing awards to the most deserving charlatans, swindlers, psychics, pseudo-scientists, and faith healers—and to their credulous enablers, too. The awards are named for both the mythical flying horse Pegasus of Greek mythology and the highly improbable flying pig (Pigasus) of popular cliche. In 2009 and 2011, the Pigasus Award went to Dr. Mehmet Oz, “who has done such a disservice to his TV viewers by promoting quack medical practices that he is now the first person to win a Pigasus award for two  years.” Dr. Oz, through his syndicated TV show, has promoted faith healing, ‘”energy medicine,” and other quack theories that have no scientific basis. Oz has appeared on ABC News to give legitimacy to the claims of Brazilian faith healer “John of God,” who uses old carnival tricks to take money from the seriously ill. He’s hosted Ayurvedic guru Yogi Cameron on his show to promote nonsense “tongue examination” as a way of diagnosing health problems. In March 2011, Dr. Oz endorsed “psychic” huckster and past Pigasus winner John Edward, who pretends to talk to dead people. Oz even suggested that bereaved families should visit psychic mediums to receive (faked) messages from their dead relatives as a form of grief counseling.   

      Finally we note that, in his article of May 26, 2014 entitled Diet Lures and Diet Lies, Frank Bruni, Op-Ed columnist for the N.Y. Times, has pointed out another bogus product, Garcinia Cambogia. “According to the label, the pills contain the powdered extract of an exotic fruit for which quasi-mystical claims are made. It blocks fat absorption, or at least it might. It suppresses appetite, or so a few people have reported. It regulates emotional eating, in unproven theory.”    Dr. Oz described Garcinia Cambogia as; “The Holy Grail of Weight Loss”.  Citing “clinical studies”, Oz emphasized that this “dual action fat burner” could be the magic ingredient that helps you lose weight, “even without diet or exercise!” But the facts state otherwise:  After scouring the scientific literature, I discovered that this product, containing the presumed active ingredient, hydroxycitric acid, has been, to some extent, studied scientifically. A pooled analysis of nine studies, published in 2011, showed that although the analysis revealed a small difference in weight loss favoring hydroxycitric acid over placebo, gastrointestinal adverse events were more common in the treated group compared with placebo, which, in itself, could have explained minor weight loss. On balance, however, the analysis showed no convincing effect on weight reduction.

     So with all this underwhelming information, your best bet is to avoid the Oz show entirely, but if you can’t, take it purely for its entertainment value and don’t be misled into spending any money on his recommendations!

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DIETARY SUPPLEMENTS: SOME GOOD, SOME USELESS, AND SOME DANGEROUS

During the past 25 years dietary supplements have rocketed in popularity in the U.S.A., reaching over $25 billion yearly in sales. Contributing to a misguided air of authenticity, they are offered in drugstores, supermarkets, and health-food stores. But what do we actually know about these products in terms of both safety and efficacy? In a  2013 Consumer Reports survey, 55% of respondents thought the government required supplement makers to include warnings about potential dangers and side effects on their products. They don’t, meaning that safety issues are often ignored!

   So let’s run down a list of highly popular supplements, and the pros and cons for each:

Multivitamins: Many people believe they can promote general health and ward off serious conditions such as cardiovascular diseases and cancer. But the facts don’t support these contentions. Clinical trials repeatedly fail to show benefit of multivitamin supplements to healthy people. But even worse, they can, under certain circumstances, be risky: Both vitamin A and calcium can be dangerous if taken in excess, especially when added to a normal diet. Adult males and females should not ingest a daily total of over 3,000 mg. of vitamin A. Total daily calcium intake should not exceed 2,500 mg. So check to see how much you are getting in your regular diet and avoid supplements that cause the totals to exceed these levels.

Vitamin E: Originally touted to prevent cardiovascular disease, later studies have totally debunked this premise. More recently, supplements of vitamin E were suggested in the hope of preventing prostate cancer, but actual study pointed in the opposite direction: This vitamin actually increased prostate-caner risk in men age 50 and older.

B vitamins: Often thought to promote healthy metabolism and energy, the evidence refutes this contention in most circumstances. A normal diet contains an excess of B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (Pyridoxine), B12 (cobalamin), and folic acid. Unless your diet is deficient (see below), then supplementation is a waste of money. Vegetarians, and people (especially the elderly) having difficultly with absorbing B12, may benefit from supplementation of this vitamin. Moreover, women who are or may become pregnant should consider supplementation with folic acid, 0.8 mg daily. The oral form of supplemental folic acid is usually absorbed better than that found naturally in food. One caveat, however, is that high doses of folic acid can mask B12 deficiency that can lead to serious physical problems.

Vitamin K:Believed to promote healthy blood clotting and protein synthesis and prevent cancer. The reality: Leafy greens and other vegetables provide more than enough to satisfy the body’s need for this vitamin. Moreover, the normal bacteria that inhabit the bowel synthesize vitamin K and can make up any possible shortfall. There is no evidence that supplemental doses can prevent cancer. But there is a downside risk: Too much vitamin K can make the anticoagulant (blood thinning) drug warfarin (CoumadinR) less effective, a serious potential danger.

Fish Oil:  This supplement is widely used with the intent to prevent and/or treat cardiovascular diseases. Although the evidence indicates that two or more servings of fish weekly is capable to reducing heart attacks and strokes, linking fish oil supplements to these diseases is less clear. Some evidence suggests that they may help, but the better choice is in the dietary consumption of the fish itself.

Calcium: An important mineral constituent of the body, calcium is often taken with the intent of building healthy bone, thus preventing osteoporosis and fractures. But the evidence does not support such claims. Even with supplemental consumption of over 1,000 milligrams daily, calcium has not been shown to prevent fractures in either premenopausal or postmenopausal women. Among the possible risks of high calcium intake, some studies suggest that it may increase the risk of heart disease.

Vitamin C: For many years high doses of this vitamin have been used for preventing and treating colds, heart disease, and cancer. Despite numerous studies, however, the actual evidence fails on all these counts.  Although generally safe, a possible risk of high doses of supplemental vitamin C can lead to unhealthy buildup of iron in body tissues and organs, posing a risk to the occasional individual suffering from iron storage disease (hemochromatosis).

Vitamin D: This vitamin is important in bone and muscle health, nervous and immune system function, cell growth and reproduction, and moderating inflammation. Although controversial, its administration is alleged to ameliorate certain types of heart disease, hypertension (high blood pressure), diabetes, and possibly multiple sclerosis. Some research suggests it may prevent colon cancer, and—although controversial—other cancers as well. It’s also associated with a reduced rate of depression in older people, and greater immunity against some infections. So far, however, few controlled prospective trials have investigated the potential benefits of vitamin D supplementation in preventing any of these problems.

      Normally we obtain vitamin D through sun exposure and dietary intake. It is manufactured by the body, but the process requires exposure to ultraviolet light. Given the widespread use of sunscreen, however, to prevent skin cancer, up to 36 % of Americans are low on this vitamin. Food sources for this vitamin are limited, although some products such as milk are fortified. Natural sources include fatty fish such as catfish, salmon, mackerel, sardines and tuna; eggs; beef liver; and cod liver oil. Your doctor can perform a blood test to determine whether you are deficient of this vitamin. If you are found to be deficient, instead of risking sun exposure, dietary modification and/or supplemental vitamin D should be considered.  

     The latest US recommendations for the minimum daily requirement of vitamin D, or cholecalciferol—vitamin D3, the preferred formare 600 IU (international units) for those under 70, and 800 IU for those older. These quantities appear to retard bone loss. Persons infrequently exposed to the sun, especially the elderly, and postmenopausal women may need 800–1000 IU daily. From a review of available information, I conclude that people who get at least 700 IU of vitamin D daily and take calcium supplements have denser bones, have better muscle strength, and are likely to suffer fewer falls and fractures than those who don’t. The only caution is to avoid exceeding the government’s safe daily upper limit of 2,000 IU.

Glucosamine/Chondroitin:  This supplement is widely used in the effort to help repair cartilage and relieve suffering from degenerative joint disease (osteoarthritis).  After many conflicting studies, however, a recent, more definite large study showed that glucosamine was unable to relieve knee pain or cartilage loss in people with osteoarthritis. Although generally safe, this product would pose some risk to some people with shellfish allergies.

                  SOME SUPPLEMENTS DEFINITELY TO AVOID

      Unless there is compelling evidence of efficacy—which is seldom the case—all supplements should be avoided. Three especially egregious products linked to serious dangers are the following: 1)  Kava, which is taken to relieve stress and anxiety, is capable of producing serious liver disease, 2) Yohimbe (yohimbine hydrochroride), used to treat erectile dysfunction, is risky because the impure ingredient present in over-the counter preparations, can cause unpredictable effects on blood pressure, rapid heart rate, and other problems,.and 3) Aconite, touted to relieve inflammation and joint pain, can cause nausea, vomiting, low blood pressure, respiratory system paralysis, heart-rhythm disorders, and even death.

                          IS ANYTHING WORTH TAKING?

    In general, normal diets contain more that enough to preclude the need for supplementation. If one has a demonstrated deficiency of any, then, upon the advice of a physician, supplementation may be justified. As noted above in the case of vitamin B12, folic acid, and Vitamin D, supplementation can be useful.