MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

bogus claims

A ‘pragmatic, superiority, open-label, randomised controlled trial’ of sleep restriction therapy versus sleep hygiene has just been published in THE LANCET. Adults with insomnia disorder were recruited from 35 general practices across England and randomly assigned (1:1) using a web-based randomisation programme to either four sessions of nurse-delivered sleep restriction therapy plus a sleep hygiene booklet or a sleep hygiene booklet only. There was no restriction on usual care for either group. Outcomes were assessed at 3 months, 6 months, and 12 months. The primary endpoint was self-reported insomnia severity at 6 months measured with the insomnia severity index (ISI). The primary analysis included participants according to their allocated group and who contributed at least one outcome measurement. Cost-effectiveness was evaluated from the UK National Health Service and personal social services perspective and expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. The trial was prospectively registered (ISRCTN42499563).

Between Aug 29, 2018, and March 23, 2020 the researchers randomly assigned 642 participants to sleep restriction therapy (n=321) or sleep hygiene (n=321). Mean age was 55·4 years (range 19–88), with 489 (76·2%) participants being female and 153 (23·8%) being male. 580 (90·3%) participants provided data for at least one outcome measurement. At 6 months, mean ISI score was 10·9 (SD 5·5) for sleep restriction therapy and 13·9 (5·2) for sleep hygiene (adjusted mean difference –3·05, 95% CI –3·83 to –2·28; p<0·0001; Cohen’s d –0·74), indicating that participants in the sleep restriction therapy group reported lower insomnia severity than the sleep hygiene group. The incremental cost per QALY gained was £2076, giving a 95·3% probability that treatment was cost-effective at a cost-effectiveness threshold of £20 000. Eight participants in each group had serious adverse events, none of which were judged to be related to intervention.

The authors concluded that brief nurse-delivered sleep restriction therapy in primary care reduces insomnia symptoms, is likely to be cost-effective, and has the potential to be widely implemented as a first-line treatment for insomnia disorder.

I am frankly amazed that this paper was published in a top journal, like THE LANCET. Let me explain why:

The verum treatment was delivered over four consecutive weeks, involving one brief session per week (two in-person sessions and two sessions over the phone). Session 1 introduced the rationale for sleep restriction therapy alongside a review of sleep diaries, helped participants to select bed and rise times, advised on management of daytime sleepiness (including implications for driving), and discussed barriers to and facilitators of implementation. Session 2, session 3, and session 4 involved reviewing progress, discussion of difficulties with implementation, and titration of the sleep schedule according to a sleep efficiency algorithm.

This means that the verum group received fairly extensive attention, while the control group did not. In other words, a host of non-specific effects are likely to have significantly influenced or even entirely determined the outcome. Despite this rather obvious limitation, the authors fail to discuss any of it. On the contrary, that claim that “we did a definitive test of whether brief sleep restriction therapy delivered in primary care is clinically effective and cost-effective.” This is, in my view, highly misleading and unworthy of THE LANCET. I suggest the conclusions of this trial should be re-formulated as follows:

The brief nurse-delivered sleep restriction, or the additional attention provided exclusively to the patients in the verum group, or a placebo-effect or some other non-specific effect reduced insomnia symptoms.

Alternatively, one could just conclude from this study that poor science can make it even into the best medical journals – a problem only too well known in the realm of so-called alternative medicine (SCAM).

I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:

The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.

The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.

For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.

In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.

The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.

cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.

In case you are interested, the programme can be seen here.

And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:

The WHO has a long history of uncritically promoting alternative therapies. The Indian government has recently advocated irresponsibly dangerous nonsense, such as the use of homeopathy for the prevention and treatment of covid infections. The two together make an ominous initiative when it comes to alternative medicine.
Of course, there is nothing wrong in hosting a constructive dialogue about this subject. What seem ill-conceived, however, is the fact that the conference exclusively includes speakers who are staunch proponents of alternative medicine, a subject that, after all, remains highly controversial. Progress is not created by voicing one-sided, biased opinions. I fear that this meeting will result in the often before voiced platitudes and wishful thinking which no true scientist is then able to take seriously.

The increasing demand for fertility treatments has led to the rise of private clinics offering so-called alternative medicine (SCAM) treatments. Even King Charles has recently joined in with this situalion. One of the most frequently offered SCAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility.

This study evaluated the scope of information provided by SCAM fertility clinics in the UK. A content analysis was conducted on 200 websites of SCAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on:Female infertility DIY acupuncture points【12MH】 - YouTube

  • the efficacy,
  • the risks,
  • the success rates

of acupuncture for infertility.

The authors concluded that this situation has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment.

The authors are keen to point out that their investigation has certain limitations. The study only analysed the information provided on the clinics’ websites and did not assess the quality of the treatment provided by the clinics.
Therefore, the study’s fndings cannot be generalized to the quality of the acupuncture treatment provided by the clinics.

Nonetheless the paper touches on very important issues: far too many health clinics that offer SCAM for this or that indication operate way outside the ethically (and legally) acceptable norm. They advertise their services without making it clear that they are neither effective nor safe. Desperate consumers thus fall for their promises. In the case of infertility, this might result merely in frustration and loss of (often substantial amounts of) money. In the case of serious disease, such as cancer, this often results in premature death.

It is time, I think, that this entire sector is regualted in a way that it does not endanger the well-being, health, or life of consumers.

This short news report appeared on X [formerly Twitter]:Short-haired blonde woman on a stage speaking into a headset microphone, wearing an animal stripe jacket with a bare lightbulb and draped cloth behind her

The Ohio State Medical Board just approved the indefinite suspension Dr. Sherri Tenpenny’s medical license, an osteopathic physician and longtime figure in the anti-vaccine movement. The board got around 350 complaints into her behavior, but that’s not why she’s being suspended.

As this could easily be unreliable, I looked for confirmations … and found several, for instance, this one:

An Ohio physician who sparked widespread ridicule in 2021 after spreading bizarre COVID-19 vaccine conspiracies to the House Health Committee by claiming the jabs magnetize their hosts and “interface” with cell towers had her medical license indefinitely suspended Wednesday. Anti-vaccine spreader Sherri Tenpenny sparked a firestorm in June, 2021 after making the comments, which saw 350 complaints sent to the State Medical Board. According to Cleveland.com, the board’s decision was not based on the comments, rather on procedural grounds, citing Tenpenny’s refusal to cooperate with investigators during the inquiry. “Dr. Tenpenny, neither you nor any doctor licensed by this board is above the law, and you must comply with the investigation,” said Dr. Jonathan Feibel, an orthopedic surgeon and medical board member, according to the outlet. “You have not done so, and therefore, until you do, your license will be suspended.” A lawyer for Tenpenny, Tom Renz, described the investigation as a form of “harassment” on her “free speech rights.” Tenpenny did not speak after the announcement, however Renz declared, “This appears very much like a lynch mob.”

Who is Sherry Tenpenny? Here is what Wiki tells us about her:

Sherri J. Tenpenny is an American anti-vaccination activist and conspiracy theorist who promulgates the disproven hypothesis that vaccines cause autism.[1] An osteopathic physician, she is the author of four books opposing vaccination. A 2015 lecture tour of Australia was canceled due to a public outcry over her views on vaccination, which oppose established scientific consensus. A 2021 Center for Countering Digital Hate analysis concluded that Tenpenny is among the top twelve people spreading COVID-19 misinformation and pseudoscientific anti-vaccine misinformation on social media platforms. She has falsely asserted that the vaccines magnetize people and connect them with cellphone towers…

The story is puzzling, in my view. The biggest question for me is this:

Why only now?

She should have been suspended years ago!

Online misinformation is disproportionality created and spread by people with extreme political attitudes, especially among the far-right. There is a debate in the literature about why people spread misinformation and what should be done about it. According to the purely cognitive account, people largely spread misinformation because they are lazy, not biased. According to a motivational account, people are also motivated to believe and spread misinformation for ideological and partisan reasons. To better understand the psychological and neurocognitive processes that underlie misinformation sharing among the far-right, an international team of researchers conducted a cross-cultural experiment with conservatives and far-right partisans in the Unites States and Spain (N = 1,609) and a neuroimaging study with far-right partisans in Spain (N = 36).

Far-right partisans in Spain and U.S. Republicans who highly identify with Trump were more likely to share misinformation than center-right voters and other Republicans, especially when the misinformation was related to sacred values (e.g., immigration). Sacred values predicted misinformation sharing above and beyond familiarity, attitude strength, and salience of the issue. Moreover, far-right partisans were unresponsive to fact-checking and accuracy nudges. At a neural level, this group showed increased activity in brain regions implicated in mentalizing and norm compliance in response to posts with sacred values.

The authors concluded that these results suggest that the two components of political devotion – identity fusion and sacred values – play a key role in misinformation sharing, highlighting the identity-affirming dimension of misinformation sharing. We discuss the need for motivational and identity-based interventions to help curb misinformation for high-risk partisan groups.

People who have followed the discussions on this blog closely could be forgiven in assuming that right-wing political devotion also plays an important role in spreading misinformation about healthcare (e.g. vaccination) and so-called alternative medicine (SCAM). It would be good, if someone could test this hypothesis more directly.

PS

Just as I had finished writing this post, I came across a quote given yesterday by Ben Habib on GBN:

“I’m very reluctant to put my destiny in the hands of scientists. You know, unbridled authority given to faux knowledge.”

QED

We have discussed the Miracle Mineral Solution (MMS) before. Now it has been making headlines again. It has been reported that a Miami federal jury convicted a father and his three sons of selling a toxic bleach solution as a “miracle” medical cure out of a fake Florida church’s website to thousands of consumers across the US. Mark Grenon, 65, and sons Jonathan, 37, Joseph, 35, and Jordan, 29, chose to represent themselves in their two-day trial in Miami federal court. But they said nothing during the trial as if they were silently protesting the proceeding. Only after the 12-person jury hit them with a quick verdict did one of the Grenons speak up. “We will be appealing,” Joseph Grenon said.

During the trial and closing arguments, prosecutors portrayed the four defendants as con men who used a phony religious front on a website, the Genesis II Church of Health and Healing, to sell $1 million worth of their “Miracle Mineral Solution” a cure for 95% of the world’s known diseases, from AIDS to the coronavirus. “This whole Miracle Mineral Solution scheme was built on deception and dishonesty,” the prosecutor said during his closing argument, telling jurors that the Grenons “created a fake church to make it harder for the Food and Drug Administration and government to stop them from selling snake oil.” But, “this was no church,” he argued. “This was a scam for money — an old-fashioned scam.” The jury found the four defendants — all wearing beige inmate uniforms, ponytails, and flowing beards — guilty of conspiring to defraud the U.S. government and FDA, which regulates the food and drug industry, by distributing an unapproved and misbranded drug, Miracle Mineral Solution (MMS). That conviction carries up to five years in prison.

During the trial, the prosecutor said the Grenons called themselves “bishops” and peddled MMS as “sacraments” to consumers in South Florida and other parts of the US in exchange for a “donation” to the Genesis church, before the FDA cracked down on the family in 2020.

The Grenons were charged that April with conspiring to defraud the U.S. government after the outbreak of the COVID-19 pandemic when they defied FDA and court orders to stop distributing the toxic MMS substance. Their criminal case was the first pandemic-related enforcement action in Florida. In public warnings, FDA said it received several reports of hospitalizations and life-threatening conditions as people drank the dangerous substance.

MMS is a chemical solution containing sodium chlorite that, when mixed with water and a citric acid “activator,” turns into chlorine dioxide, a powerful bleach typically used for industrial water treatment or bleaching textiles, pulp, and paper. During the trial, a FDA agent testified about three Grenon-produced videos that pitched the solution as a cure for cancer, lung cancer, and COVID-19, among other deadly diseases. “We are trying to create a world without disease,” Mark Grenon said in one video, pitching the MMS substance. “It’s been proven to be tremendously effective in curing cancer.” Another video, dated March 8, 2020, was titled: “The coronavirus is curable. Do you believe it? You better!”

Prosecutors said the Grenon family’s religious front, the Genesis II Church of Health and Healing, sold tens of thousands of MMS orders in violation of federal law since 2010. It was in that year that Mark Grenon claims to have founded the organization with a man named Jim Humble in a plan to avoid governmental regulation and arrest as they promoted MMS as a miracle cure. Humble, a man who has dabbled in Scientology and professed to be a billion-year-old god, began promoting the substance as early as 2006 in self-published works after he claimed to have discovered its medical properties while on a gold-mining expedition in South America. After Humble supposedly stepped away from the organization in 2017, Grenon continued to manufacture, promote and sell MMS with his three sons.

The Grenons’ open defiance of a court order ultimately led to criminal charges and a federal raid on the family’s Bradenton home, where federal investigators say they found loaded guns, nearly 10,000 pounds of sodium chlorite powder, and thousands of bottles of MMS.

The World Federation of Chiropractic (WFC) has recently launched a new Global Patient Safety (GPS) initiative:

Unanimously approved by the WFC Board at its May meeting, the project will be overseen by the Research Committee and involve the establishment of an expert task force. Planned projects will include a scoping review, identification of best practices in incident reporting and learning, risk management in chiropractic practice and knowledge translation activities.

In recent years, patient safety has increasingly been in the spotlight as health systems strive to reduce unnecessary incidents and iatrogenic injury.

“With adverse events having the potential to impact trust and confidence in the chiropractic profession, it is important that we do as much as possible to inform ourselves in relation to the risks and benefits of chiropractic treatments and related activities,” said Prof. Richard Brown DC, LL.M, WFC Secretary- General.

“While we know that serious adverse events are rare, patients with multiple co-morbidities and known risk factors require special attention. The WFC GPS Task Force will highlight key areas of patient safety to support chiropractors, build and strengthen the existing safety culture and help to meet the expectations of patients and the public.”

Chiropractors use a package of interventions in their treatment of patients, including hands-on care, adjunct therapies, health promotion, advice and exercise prescription. The process of shared decision-making involves consideration by the chiropractor of the suitability and safety of each intervention. In addition to direct patient care, chiropractors also have a duty to consider the safety of their offices and clinics.

A WHO resolution on patient safety, passed in 2019 at the World Health Assembly, made a commitment to take global action in tackling avoidable harm.

Its subsequent publication, Global Action on Patient Safety, set out goals and targets to reduce morbidity from healthcare related incidents.

Chair of the Task Force and Research Committee vice-chair, Dr Katie Pohlman DC, PhD, said: “With the current global focus on patient safety, I’m proud to be leading this WFC Task Force, which will support the chiropractic profession but, most importantly, work to minimize adverse events and protect patients.

“The creation of an open, transparent culture of patient safety is key to maintaining trust and credibility. The Task Force is looking forward to adding to the body of knowledge and advancing safe, evidence-based, people-centered practice.”

The WFC GPS Task Force will report to Research Committee Chair, Assoc. Prof Sidney Rubinstein. It will include members of the existing Research Committee as well as external experts.

____________________________

At first, most people will think: WHAT A GOOD IDEA!

After a bit of reflection, however, some might ponder: WHY ONLY NOW AND NOT DECADES AGO?

And after reading the above text carefully, skeptics might feel that the exercise can already be classified as a PR gimmick that will not generate the needed information:

  • The WFC has yet again failed to establish a monitoring system of adverse effects; without it ‘patient safety’ is not achievable.
  • They claim that “we know that serious adverse events are rare”. How do they know this? And if they already are convinced of this, the new task force is bound to be a pure ‘white wash’.
  • They think an “existing safety culture” exists in chiropractic. This is wishful thinking and far from reality.
  • They speak of the “expectations of patients and the public” but ignore the need for a monitoring system accessible to the public.

The Shakti Mat is all the rage! It is claimed to offer an “unforgettable experience that targets mind and body tension through acupressure. The nail bed is an ancient healing practice that has been used in India for over 3,000 years. 20 minutes is all it takes. Common uses are for pain and stress relief, muscle tension, soothing headaches and deeper sleep … Join a Shakti community of millions experiencing the benefits of relaxation and rest through this consciously crafted wellbeing tool. 20 minutes is all it takes to decompress and reset your body, unravel your mind and completely transform your sleep. Alleviate and unwind with powerful Eastern acupressure that will give you sanctuary within the demands of the modern lifestyle.”

Yes, that sounds like pure hype. A hopelessly uncritical article for physios is hardly any better; it concluded that “acupressure Mats are not something to be ignored if you have chronic pain, stress and anxiety, trouble sleeping or want to do everything you can to help recover faster. There is definitely some scientific reasoning and research backing up its use although not all research is conclusive or agrees.”

As it turns out, the Internet is full of such hype:

But is there any real evidence, at all?

Not a lot!

Here are two trials that I found:

This study investigated subjective and physiologic responses of lying on a bed of nails (BN) called the Shakti-mat and of listening to relaxing instructions and music. The BN has 6210 sharp-edge 5-mm plastic nails about 5 mm apart.

Design: Thirty-two (32) healthy participants went through four conditions in randomized orders combining BN and relaxing instructions.

Results: The subjective pain ratings on the BN increased immediately and reached a peak within 30 seconds. The pain then subsided gradually, indicating a habituation effect. Self-rated relaxation increased over time in all conditions. Systolic and diastolic blood pressures were higher, heart rate was slower, and there was more high-frequency power heart rate variability (HRV), and signs of increasing circulation in the back on the BN. The relaxation instruction especially affected breathing and the HRV-indices standard deviations of normal interbeat intervals and low-frequency power, both known to be responsive to slow breathing. There were no differences in saliva cortisol.

Conclusions: Healthy participants habituated to the induced pain on the BN and were able to subjectively relax. When on a BN, signs of both sympathetic and parasympathetic nervous system activity were observed. The pain may hypothetically have triggered a parasympathetic response.

________________________

Self-care treatments with bed of nails or spike mats have gained increased popularity world-wide; advertised as a method for pain reduction and wellbeing. Scientific studies regarding effects are still lacking. The aim of the present study was to investigate if daily relaxation on a spike mat for three weeks could induce beneficial effects. Participants were 36 individuals suffering from muscle ten-sion pains in their back or/and neck. They were randomly assigned to a control group or an experimental group, who were treated with 15 minutes daily rest during three weeks on the spike mat. Significant reduced experi-enced worst pain intensity was found. There were no effects on normal pain intensity, opti-mism, anxiety, depression, stress, energy, or sleep quality. The participants appreciated the treatment, but their enthusiastic verbal reports of experienced beneficial effects could not be verified in the statistical analyses. The reduction of worst pain may be explained by the gate-control theory, where competing stim-uli applied over the affected area produce a pain reduction. It can also be an effect of place-bo or the relaxation. More research on relax-ation on a spike mat is needed before its possi-ble effects can be confirmed. No negative effects were found in the present study, but it has to be remembered no studies investigating risks for treatment on spike mats exist.

_______________________

So, unless you have a masochistic streak, you might save the money and time the Shakti therapy would cost you for something more worthwhile and enjoyable.

Sobrenix (Kudzu, Milk Thistle, B Vitamins & More) is “designed to reduce alcohol cravings and help you detoxify your body so you can successfully manage alcohol consumption. Even better, taken before drinking, Sobrenix’s ingredients help you stop before you’ve had too much. DETOXIFY YOUR BODY with a powerful formula that combines herbs and nutrients that support liver health, curb cravings, and help you wake up without a nasty hangover. Sobrenix kick-starts the detoxification process with essential herbs like Milk Thistle and Chanca Piedra. Additionally, the formula contains the critical B-Vitamins that alcohol washes away so you can wake up happy and healthy again!”

Yes, you suspected correctly: this is pure BS!

Not only that but the Federal Trade Commission is taking action under the FTC Act and the Opioid Addiction Recovery Fraud Prevention Act of 2018 (OARFPA) against the makers of Sobrenix. According to the FTC’s complaint, the makers, a company, Rejuvica, and its owners, Kyle Armstrong and Kyle Dilger, made numerous unsubstantiated and false claims about Sobrenix and used paid endorsers in deceptively formatted advertising. The defendants also used bogus review sites to deceive consumers about their products.

As a result of the FTC’s suit, the defendants have agreed to a proposed court order that would permanently ban them from making any unsubstantiated claims about healthcare products or services, as well as require them to pay $650,000 to the FTC to be used for providing refunds to consumers.

“We will not tire in our pursuit of those who prey on individuals struggling with alcohol or other substance use disorders,” said Samuel Levine, Director of the Bureau of Consumer Protection. “This case evidences the breadth of the FTC’s authority to pursue such wrongdoing under both the FTC Act and OARFPA.”

The FTC charges that the defendants marketed Sobrenix with messages like:

  • “STRUGGLING TO CONTROL YOUR ALCOHOL CONSUMPTION? Sobrenix is designed to reduce alcohol cravings and help you detoxify your body so you can successfully manage alcohol consumption. Even better, taken before drinking, Sobrenix’s ingredients help you stop before you’ve had too much.”

The FTC charges that Rejuvica and its owners lacked adequate evidence to support these claims. The complaint charges that Rejuvica, Armstrong, and Dilger violated both the FTC Act and OARFPA. The proposed order contains a total monetary judgment of $3,247,737, which is partially suspended based on the defendants’ inability to pay the full amount. The defendants will be required to pay $650,000 to the FTC to be used to refund consumers. If the defendants are found to have lied to the FTC about their financial status, the full judgment will be immediately due.

______________________________

A few short comments might be in order:

  1. Regulators have the duty to protect consumers from false health claims.
  2. It is commendable that some authorities sometimes do their duty and go after some of the people responsible for making false claims related to dietary supplements.
  3. Such actions should, however, occur MUCH more often.
  4. They ought to happen also in countries other than the US.
  5. Similar actions should be initiated against ALL false claims made for healthcare products and services.
  6. This means that all practitioners of so-called alternative medicine (SCAM) would need to review their advertising, websites, etc., and erase therapeutic claims that are not supported by evidence.
  7. This would unquestionably amount to an enormously valuable service to public health.
  8. Most countries already have legislation that would make such steps possible; my question, therefore, is this:

WHY ARE CONSUMERS NOT ADEQUATELY PROTECTED BY THEIR NATIONAL REGULATORS FROM CHARLATANS WHO SELL INEFFECTIVE AND OFTEN DANGEROUS SCAMs AT HIGH COSTS?

 

 

 

 

The website of the World Federation of Chiropractic (WFC) points out that public health is defined by the WHO as follows:

“Activities to strengthen public health capacities and service aim to provide conditions under which people can maintain to be healthy, improve their health and wellbeing, or prevent the deterioration of their health. Public health focuses on the entire spectrum of health and wellbeing, not only the eradication of particular diseases.”

The WFC then continues stating this:

As primary contact health professionals, chiropractors can play an important role as public health advocates. This can range from providing support and advice on health matters such as physical activity, diet, and fitness as well as lifestyle choices such as injury prevention and avoiding tobacco use. Chiropractors can also play a role in counselling patients and communities on the benefits of public health measures, especially as this relates to immediate health needs of each region.

I think that this might merit a few comments.

  1. Physical activity is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  2. Diet is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  3. Fitness is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  4. Lifestyle choice is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  5. Injury prevention is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  6. Avoiding tobacco use is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.
  7. Counseling is undoubtedly an important issue for public health; however, there are clearly healthcare professionals who are in a better-informed position to advise on it than chiropractors.

So, what is the real contribution of chiropractors to public health?

I would therefore argue that, on balance, the contribution of chiropractors to public health might be considerable …

sadly, however, it goes in the wrong direction.

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