Tuesday, November 29, 2011

Alberta Views: The Urge To Purge - A Health Centred Response

Alberta Views Magazine
Re: The Urge to Purge article - November 2011

When I opened Alberta Views and saw the article Urge to Purge. I was excited that I might learn something new.  I dived in at speed.  It was only a few seconds when I spotted the name Stephen Barrett.  I knew you’d been hoodwinked.  So, I read on, but got more and more depressed and dissatisfied as the article passed thru my ummmm….

Stephen Barrett reminds me of A.A. Milne’s poem Lines and Squares:

Whenever I walk in a London street,
I’m ever so careful to watch my feet;
And I keep in the squares,
And the masses of bears,
Who wait on the corners all ready to eat
The sillies who tread on the lines of the street
Go back to their lairs,
And I say to them, “Bears,
Just look how I’m walking in all the squares!”

I can see why Deepak Chopra describes Stephen Barrett as the “self appointed vigilante for the suppression of curiosity”.  I agree with Deepak Chopra.  Stephen Barrett never steps outside of the squares.  And he thinks that anyone who does is a bear (or worse, a quack).
Enough ranting about Barrett.  What about detox? 

The article subtitle 
Cleansing and detoxing isn’t scientific, so why do so many Albertans do it?

Let’s deal first with the technical error, the statement that “detoxing isn’t scientific”.  I suggest you look up scientific in a dictionary.  Trees are not scientific. Drugs and treatments are not scientific.  A healthy diet is not scientific. Scientific defines a process by which things are measured against a hypothesis. ‘Things’ are not scientific, with the exception of things like scientific procedures, scientific studies,scientific measurement and the like. Note, this phrase appears again in the conclusion – it’s just as silly there. And wrong too.

I think you meant to say 
there is no scientific evidence to support the statement that detoxing prevents illness”. 

And that is where we part company.  You are right.  And very wrong.

I run a blog called Personal Health Freedom. You can find me at www.personalhealthfreedom.com

My blog is about health – not about illness.  I write about the need to define and measure health. I define a hierarchy of health, so that we might learn how to study health - as opposed to studying illness.  I do take time out to define illness and the causes of illness, most of my energy is towards ‘health’. I take care to tell readers that I am not a doctor. Don't rely on my advice.  Check for yourself.

Health must be defined and measured separately from illness.  No-one bothers to measure health – our medical systems only measure illness.

Let me give a little example to clarify. Let’s talk about two hypothetical women, Alice and Zizi, both in their mid-forties.  You might know someone in each profile.

Alice gets, on average 5 to 7 colds a year, over the past 10 years. When she gets a cold, she is quite seriously affected, and the cold lasts, typically, between 8 and 10 days.

Zizi gets on average, a cold every 1 or 2 years.  Her colds typically last 3 to 5 days and she suffers only minor systems.

That’s what the medical system knows about Alice and Zizi.  About their illness.  But the medical system never looks at their health; in fact Alice and Zizi only contact the medical system when they are sick. And Zizi, because she is generally not seriously affected by her colds – has almost no contact with the medical system.  Alice is well known at the clinic, if not looking for medicine; she is at the very least, looking for a doctor’s note to stay home from work.

Now, the critical questions.  Who is healthier, Alice or Zizi?  I think we can agree that Zizi is the most healthy.  But we can also see that she is ignored by the (so called) ‘health system’, because the ‘health system’ is in fact a ‘medical system’, not a health system.

But if Alice and Zizi go to a doctor when they do not have a cold, they might both be told they are 'perfectly healthy'.  As if health was measure using yes or no answers.  "No illness" equals health. 

We don’t have a health system. There are no professionals, there is no scientific community that studies Zizi – and no-one that studies the differences between them.  Our medical system pays a lot of attention to Alice, and tries to cure or prevent her colds – but it ignores Zizi. Zizi is healthy, and there is no ‘health system’.

Now a more challenging question.   On November 12th, 2010 – Zizi got a cold.  It was minor on November 12th, full blown on November 13th – and she was recovering by November 14th. During that span of time, Alice did not have a cold.

So, on November 12th who was healthier?  Alice or Zizi?  On November 13th, who was healthier, Alice or Zizi?  On November 14th, who was healthier – Alice or Zizi.

It is clear that on November 11thAlice was healthier, and on November 15th, she was healthier again.    

A scientific answer should be independent of your opinion – and independent of my opinion.  

How would we obtain a scientific measurement of the health of Alice and Zizi?  Is it appropriate to measure healthiness – every day?  Or can we only measure sickness every day? Maybe, when we study healthiness – we will learn that the minimum resolution of a health measurement is 3 weeks.  Or longer. That a health measurement of one day, or even 3 days is irrelevant to health status, only relevant to ‘illness status’.

It seems clear that we need different ways to measure healthiness from illness.  Each illness is measured by a different set of symptoms, tests, and observations. But these symptoms, tests and observations do not measure healthiness.  

I believe an objective test for healthiness must ignore the cold, which is a temporary ‘illness’.  When we have a true test for healthiness - it will detect a significant difference between the healthiness levels of Alice and Zizi, without reference to the frequency or duration of colds. 

So what has this to do with detox?

Let’s go back to the scientific method question. Your quote: “why (do) detox diets never undergo scientific tests?”  You say “Then there’s the scientific method.  Detox proponents don’t seem to care for it.” 

But you, and the detox proponents and opponents, aren't understanding science. Detox proponents aren't necessarily the ones who don’t like the scientific method.  It might be the medical establishment that doesn’t like the scientific method (except when it is used for medical purposes). 

You asked Oregon naturopathic physician Dickson Thom why “detox diets never undergo scientific tests?”  he could only joke.  Why? Because he is so imbedded in the medical system he can’t see the forest (health) for the diseased trees (illnesses).  

If detox diets are about health, the scientific tests, to date, are measuring the wrong thing. 

If detox diets are about health, not about illness, then we need a scientific test to measure the health of people before, during and after the detox treatment.  We might search for a similar scientific test to use as a model.  Search away.  There are, at present, NO SCIENTIFIC STUDIES of the effect of any substance, treatment or action on HEALTH.  There are only scientific studies of the effects of substances, treatments and actions on illness.  Detox is about health, not about illness. Illness is not health.

So, let’s suppose that detox improves your health. I’m not saying it does – I’m interested in science.  But let’s suppose that a specific detox treatment improves your health, by x percent, on average. 

All tests by the ‘scientific medical system’ will not detect nor measure the improvement.  Our medical systems and our medical tests do not measure the difference between Alice and Zizi.  Because they don’t measure health.

We don’t have any independent, objective tests to measure health – so we cannot tell if health was improved or not. 

Let’s suppose the relationship is more complex.  If, as the medical scientists claim, detox kits might release toxins and thus actually harm your health status – then we need to take the measurement further.  It might be, for example that using a detox kit decreases your health for several days, or even a few weeks – but after that, your health is actually better.  Maybe this happened to you? Sort of like learning – first seem to go backwards and then rebound later.

But… Have there been any scientific tests to measure this possibility?  No.  There have been no tests of detox that measure effects on health, short term nor the long term.

So, is detox scientific?  Duh.  The people who, like Stephen Barrett, claim that ‘detoxing does not improve health’ are not scientific – because there has never been a test.  But Barrett claims that science proves detox is useless.  Where is the scientific evidence? There is some evidence that our ‘medical system’ and its ‘scientific tests’ cannot measure benefits from detox.  Is that because there are no benefits?  Or is it a deficiency in the scientific tests?  We don’t know.

What does each person who buys a detox kit decide?  I’m guessing they say something like this
   - I know it’s painful
   -  I believe my health is better after it is over
So they buy.  And use.  And if they feel healthier - that's the only measuring stick we have for health at present, they do it again, when they feel 'less healthy'. 

I make the same judgement when I go for my swim.  I know it’s painful.  Cold.  Wet. Messy.  But I believe my health is better if I do it regularly.  I know my health status does not change ‘because I went swimming once’.  I go and I swim. I suffer, and I feel better and I get healthier.

The scientific tests don’t measure this reasoning.  They measure ‘medical effects’, not health effects.

You are not the only person to make this mistake.  Many of the people you talked to in ‘health stores’ don’t understand the concept of health.  So you were told that ‘your thinking is too linear’ – when in fact Willard simply could not explain the situation in ‘medical terms’ – because it is not a medical question.  

He has not learned to think in terms of health. He may work in a 'health store', but he thinks in 'medical paradigms'. 

Arpana Taylor speaks of a necessary  ‘paradigm shift’, but cannot define the new paradigm.  Aparna might understand unconsciously that detox is about health, not about illness – but our ‘health systems’ only deal with medical issues  - and Aparna needs his own paradigm shift to understand, and then explain it to you.

Your conclusions, two:
  - detox may have its merits, but it is not scientific
  - detox diets don’t remove harmful substances from the body (Barrett is right)

Are false and misleading. 

As noted above, the statement that ‘detox is not scientific’ is not a scientific statement. If it is not false, it is nonsense.

If you meant to say “detox is not supported by scientific studies of illness”, you might be technically right. But if people take detox for their health - the statement is irrelevant. 

No-one has scientifically measured the health effects of detox.  Frankly, no one has scientifically measured the health effects of Vitamin C nor penicillin.  We have only measured their illness effects. 

The statement that “Detox diets don’t remove harmful substances from the body” is also unscientific, as is most of what Barrett says. 

There are no scientific studies concluding that detox does not remove toxic substances from the body. Proving that a detox diet does not remove a harmful substance from my body requires an exhaustive study of detox diets along with an exhaustive study of what is excreted from my body – through various orifaces, before I am on the detox diet and then again while on the detox diet and again after I complete the detox protocol. This study has not been started, and I suspect it will never be completed.

The statement that 'detox diets don't remove harmful substances from the body' is what I call a 'black swan statement'.  It is a wide generalization that can be proven wrong by a single exception. You can find a more detailed description and some examples of black swan statements in health here

A final comment...

You mention the possibility of a placebo effect.  But you missed a valuable alternative explanation.  The change effect.  The saying goes - a change is as good as a rest. Our diets sometimes tend to get 'stuck'.  If we do not exercise care, we might find ourselves eating the same thing, every week, every month, over and over and over again for years.  The detox diet changes this up - maybe only for a short period.  But this change might be enough to improve our health.  We don't know, because we cannot measure healthiness. 

To your health, tracy

Tracy is the author of two book about healthicine: