Although so-called alternative medicine (SCAM) is widely used across the US population, population-level associations with mortality remain understudied. Therefore, this investigation examined associations between SCAM use patterns and all-cause mortality among US adults.
Data from the National Health Interview Survey (2007/2012, N=55,023) were linked to mortality through 2019 (5,530 deaths; 472,636.5 person-years). This analysis examined 21 specific SCAM modalities, SCAM usage intensity, recency of use, and theoretically and empirically derived domains using Cox proportional hazards models with hierarchical covariate adjustment, Benjamini-Hochberg false discovery rate correction, and exploratory subgroup analyses.
The results show that 43.2% of adults engaged in 1+ SCAM practice. After full adjustment and FDR correction, yoga (HR=0.73, 95% CI: 0.62-0.87) and Pilates (HR=0.64, 95% CI: 0.49-0.85) were associated with lower mortality. Each additional SCAM practice was associated with 6% lower mortality (HR=0.94, 95% CI: 0.92-0.96). Recent users had lower mortality than past-only users (HR=0.79 vs. 0.90), and multiple practice users showed the strongest association (HR=0.76, 95% CI: 0.68-0.86). Exploratory subgroup analyses revealed suggestive but largely non-robust patterns.
The authors concluded that most individual SCAM modalities showed null associations with mortality, but yoga and Pilates demonstrated inverse associations that persisted after adjustment and FDR correction, and broader measures of SCAM engagement consistently indicated lower mortality risk. Whether these associations reflect SCAM-specific benefits or general physical activity and health-conscious selection warrants further investigation.
This study might be used as a textbook example for an elementary lesson on: ‘CORRELAATION IS NOT CAUSATION’. It seems highly unlikely that any SCAM has sepcific effects on longevity. Any type of regular physical excercise might have an effect, but this would not be specific to yoga and pilates.
A likely explanation for some of the observed reults is that SCAM users are nore health concious. The authors of the paper are well aware of this confounder when they state that SCAM users “were younger, more educated, higher income, less likely to smoke, more physically active, and reported better self-rated health than non-users.”
My message to consumers: if you want to live a long life, forget about SCAM and adopt a healthy life-style.
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