Naturopathy – nonsense on stilts cashing in on COVID-19

The exploitation of the COVID-19 pandemic by unscrupulous quacks is such a burgeoning problem that the excellent Advertising Standards Authority has set up a very convenient online form for making a quick complaint. I used it yesterday to report the College of Naturopathic Medicine for the three videos they have online. I ran these past my very good friend (and HealthWatch colleague) David Bender, who is Emeritus Professor of Nutritional Biochemistry at UCL. Here are his findings, with his comments in italics.

Part 1 – Coronavirus – What You Need to Know

This starts with standard information about coronavirus that seems sound, then descends into lists of things that will weaken your immune system – many of the usual suspects from this end of the scientific spectrum:

• Refined sugars “push vitamin C out of cells” – rubbish
• Vitamin C important for immune system – see my comments later
• Artificial sweeteners lumped together with refined sugars – why?
• Coffee
• Cigarettes and alcohol
• Dairy produce – “makes the body produce extra sticky mucus that viruses get caught in”. I don’t know of any evidence for this – perhaps a bit of confusion with the thick mucus of cystic fibrosis.
• Junk foods, convenience foods – no benefit to body
• Processed meats – bacon, etc – additives
• Microwaved meals that “deplete foods of their nutrients”. Nonsense. There is more retention of water-soluble vitamins and minerals in microwaved vegetables than in boiled, when nutrients leach out into the water that is usually discarded.
• Alcohol-based mouthwashes “destroy protective antibodies in saliva”. Possibly, for as long as you are swilling the mouthwash in your mouth.

There is then a discussion of the gut immune system and the importance of the intestinal microflora that is generally correct but irrelevant.

Then discussion of Antoin Béchamp (1816 – 1908) and his terrain theory that a diseased body, the “terrain”, will attract germs to come as scavengers of the weakened or poorly defended tissue. Béchamp believed that the pH of the body is important, and that an acidic pH will attract germs and an alkaline pH will repel them. (highlighted text from Wikipedia). Video goes on to say that poor nutrition and lack of oxygen will weaken the terrain, and infections caused by bacteria and viruses are after-effects rather than the cause of the disease. Béchamp was a contemporary of Pasteur, and we all know that Pasteur’s germ theory won out in the 19th century.

Part 2 – Preventative Measures

You can apparently boost your immune system by diet:

• Avoid drinking liquids with meals because “this dilutes the digestive juices and makes digestion more energy demanding”. Nonsense, and what does this have to do with the immune system anyway?

• “Opt for food that is light and easy to digest… for example warming soups”. I don’t really see how this fits with not drinking liquids with meals – by definition soups are liquid.

• Have a “fasting window” overnight – eat earlier in the evening and delay breakfast – ideally 12 hours between dinner and breakfast. This “ensures the body can repair itself overnight rather than digesting food”. I don’t think that makes much sense.

• Advocates fruit and vegetables as source of vitamins, minerals and phytonutrients. This is certainly sound advice, but then goes on to say choose organic “as this will best support immunity”. There is no evidence that organic produce is nutritionally any better than conventional, although there will indeed be fewer pesticide residues (not mentioned here) and possibly a better flavour because organic produce is sometimes from lower yielding heritage varieties with a better flavour.
  • Rather unexpectedly, they tell us that frozen is OK if fresh not available.

• Dietary fibre. Nonsense about toxins accumulating in the body if not enough fibre in the diet.
  • To enhance elimination of toxins through the bowels grind up flax seeds on porridge (and a note here, probably correct, that if you sprinkle whole flax seeds they will pass out unchanged at the other end).
  • For an adequate intake of fibre you should have 8 servings of vegetables and 2 of fruit per day. Problem – most people don’t meet the 5 servings fruit and vegetables per day. Correct that we should eat more vegetables than fruit (if you take the culinary definition) because of the relatively high sugar content of many fruits. In culinary definition, tomatoes and cucumbers are vegetables; botanically they are fruits. Similarly, to a cook rhubarb is a fruit; botanically it is a vegetable.

• Vitamin C “is an antiviral nutrient and helps to increase the number of the body’s immune cells”. I think not, but this is simply recalling Linus Pauling’s nonsense about vitamin C in the 1970s. I know of a very few trials that have shown a beneficial effect of vitamin C on common cold; one that was positive in Canada was repeated the next year with identical methodology and vitamin C was worse than placebo.
  • “Viral infection increases the need for vitamin C”. No. There is a fall in the vitamin C content per million white blood cells in infection, suggesting depletion of vitamin C. However, if you do a differential cell count you see a considerable increase in granulocytes in infection, and granulocytes are saturated with vitamin C at a lower intracellular concentration than other white cells. So, not vitamin C depletion, but a change in the proportion of cells normally containing less vitamin C.
  • Recommends 1000 mg vitamin C per day. This is nonsense. The video talks about expensive urine if you consume more than 1000 mg /day because excess vitamin C is excreted unchanged in the urine. This is correct, but excretion of excess unchanged starts at about 100 mg /day.

• Discussion of the importance of vitamin D for immune function. Correct.
  • Sources of vitamin D (apart from sunlight exposure, which is inadequate in winter on northern latitudes) lists shiitake mushrooms (many ordinary supermarket mushrooms now grown in light or irradiated with uv and are a source of vitamin D), chlorella (unicellular alga, dried pondweed, popular with health nuts) and wild oily fish such as salmon (why wild?). No mention of other foods that are sources of vitamin D, such as eggs, other oily fish, dairy produce (but we have been told to avoid dairy, see above).

• States that zinc contributes to normal functioning of the immune system and selenium supports the immune system. These are both claims permitted on food labelling, etc, by EFSA.

• Nonsense about selenium as an antioxidant (which it is), comparing inflammation with flames and fires in the body, and selenium like a fire extinguisher.

• Superfoods
  • Chlorella (dried pond weed) is “very good at helping the body to detox. Important to detox so that immune cells not dealing with toxins instead of virus”. But antibody producing cells and natural killer cells do not deal with these (mythical) toxins anyway.
  • Chlorophyll – get it from wheat and barley grass, no mention of other green vegetables that all contain chlorophyll. Then states that it is good for blood because chlorophyll is “almost identical to human blood (I presume they mean haemoglobin) but contains magnesium instead of iron”. This is obvious nonsense. I think it was in the 1950s that chlorophyll-containing toothpaste was marketed to freshen breath. Some-one coined the following ditty “the goat that reeks on yonder hill feeds all day on chlorophyll”.
  • Broccoli sprouts (sprouted seeds) are “good if the liver is congested. Rich in enzymes that will break down toxins in the liver”. Enzymes in foods are denatured in stomach and digested. If they entered the bloodstream intact there would be a massive immune response; possibly fatal anaphylactic shock. They certainly would not get into the liver.
  • Garlic – antimicrobial and antiviral. Possibly correct. “Chop it to release the enzymes”. Yes, chopping garlic releases the enzyme alliinase that converts alliin into allicin, which is responsible for the aroma of fresh garlic. However, these enzymes again will not survive the digestive tract.
    • Black garlic is apparently aged garlic that provides “all the good things of white (fresh) garlic, without the odour”.
  • Turmeric “helps with detoxication and … the liver to clear out waste” and has “a powerful effect on inflammation”. I am not sure how much of the information about turmeric is sound, and as with much of this video, I fail to see the relevance to avoiding or preventing coronavirus infection. Apparently the absorption of turmeric is improved by black pepper. I don’t know about this.
  • Mushrooms are good because the beta-glucans increase production of interferons. I don’t know if this is correct or not, but why is there no mention of the beta-glucans in oatmeal?

• There is discussion of the importance of water intake. We are told we should consume 1 – 1.5 L of clean filtered water per day; alternatively, “drink as much water as you can, then some more”. This is the usual mistake that although average urine output is 1 – 1.5 L per day, not all this water comes from liquid intake. There is the “hidden” water in foods, and metabolic water from the oxidation of fats, carbohydrates and proteins.
  • We are told that we should not drink coffee and tea (herbal teas are OK) because they are diuretics, and after drinking them we will need to drink more liquid to make up for the losses. Mainly nonsense.
  • We are told that drinking cold beverages “slows down the digestive system, which can impair the immune system”. Surely not. You don’t lower body temperature by drinking a cold beverage, and any temporary cooling of the stomach contents will soon be reversed because of blood flow around the organ.

Part 3 – Coronavirus – If You Become Infected

The first part is mainly about herbal medicine, and lacking in rigour. For most of these claims I don’t know of any evidence

• Echinacea increases white cell count. “Use it when you are exposed to infection.”
• Astralagus “specific for lungs and immunity, also anti-viral in its own right”. We are told to use it only as a preventative, not when you are infected (but this is the video about what to do if you become infected).
• Thyme “antimicrobial herb for coughs and sore throats” – claimed to act against bacteria, viruses and fungi. It is said to be an expectorant, and therefore good for a dry cough, which is typical of coronavirus.
• Elderberry and elderflower). “A pleasant immune-protective tea”, claimed to be antiviral. Liquid from boiled elder leaves claimed to be a strong anti-viral.
• Yarrow. Antiviral and immune-supportive, “makes you sweat”. This is apparently a good thing if you have a fever, as the sweat will cool you, but in my experience you sweat with a fever anyway.
• Ginger is spicy and warm, so helps to break up mucus.
• Antiviral herbal tea at onset of infection based on yarrow, elderflower, peppermint and ginger to make you sweat.
• There are more herbal remedies for later in infection, to “break up mucus”, make you sweat, etc.

Now for the weird stuff:

• Hydrotherapy applications – alternating hot and cold showers (or warm and cool), each for 20 – 30 seconds at a time for several minutes. This apparently moves blood back and forth between the surface and centre, so improving circulation. Really?
• Salt bath – ideally with Epsom salts, but could be sea salt. To relax (yes, very relaxing) and “promote excretion of waste”. I don’t think I have done that in the bath since I was a very small child. We are told that Epsom salts are magnesium sulphate (correct), and magnesium can apparently be absorbed through the skin (I doubt it) and will “pull toxins through the skin” (again I doubt it).
• Dry skin brushing with a stiff bristle brush to “improve circulation and stimulate the lymphatic system , where immune cells are located”. You should start at the hands and feet brushing towards the heart, then clockwise around the abdomen, parallel to peristalsis of the bowel. Really, why?
• Later in infection you should get active and exercise more (I presume by this stage you are really rather ill, and unlikely to want to exercise). You should do abdominal breathing exercises to massage the thoracic duct and improve lymph circulation. Again I question the anatomy and physiology of this.
• Sleep is important for “natural killer cells and to regenerate the body”. It is also about the only thing you are likely to want to do if you are seriously ill.
  • You should avoid stimulants like coffee, tea, alcohol, cola, etc
  • Drink herbal teas: passion flower, valerian, chamomile
  • Eat cherries as a source of melatonin. I am unsure whether or not cherries are a significant source of melatonin, and while it is released from the pineal in sleep, I don’t think the evidence for intake of melatonin for improving sleep or avoiding jetlag is very strong.
  • Avoid looking at mobile phones, tablets, etc before sleep because blue light lowers melatonin synthesis and secretion. There is some fairly good evidence here. This is followed about some nonsense about electromagnetic radiation from phones, tablets, etc disturbing sleep.

Thank you David. I can add that there are no approved EFSA claims for turmeric, so what is said here is unlawful.

Yes, the bit about chlorophyll is twaddle. For a start the plural of alga is algae not algae’s. They can’t even write good grammar. The only approved use of chlorophyll as a food supplement is as a colourant.

I did some work on an insomnia drug (ramelteon) some years ago, and learned a bit about oral melatonin. While several foods do contain melatonin, and they can increase blood levels of it, the main problem (as with ramelteon) is that it is highly and variably metabolised. But this video is about “boosting the immune system”, and there is no robust evidence from clinical studies that melatonin can do this.

I am particularly exercised by this outfit calling itself the College of Naturopathic Medicine. OK any group can call itself a college if it trains people, but believing a lot of nonsense does not make a person knowledgeable. Even worse, this is not medicine, it is a belief system based on fantasies, and extrapolations from minimal data. We should not be surprised, as this `college’ has strong links to Scientology.

If anyone tells you they are a naturopathic doctor, they are not. They are not any kind of doctor, and will do nothing for your health that you can’t do yourself. Anyone who relies on their advice regarding any medical condition is putting themselves at risk.

Tailpiece – The Regulatory Perspective

Naturopathy is listed as a profession by the Complementary and Natural Healthcare Council, and by the Federation of Holistic Therapists. Both are accredited by the Professional Standards Authority. The reason that naturopaths are accustomed to talking such nonsense is that their professional bodies are not required to back up any of their claims with evidence. The PSA accreditation is therefore of no value whatever. But we already knew that didn’t we?