wellness
The BBC stands for reliable information, at least that’s what I used to believe. After reading a recent article published on the BBC website, I have my doubts, however. See for yourself; here are a few excerpts:
On a holiday to Kerala on India’s south-western Malabar Coast, Shilpa Iyer decided to visit Kotakkal, a town that became famous after the establishment of Arya Vaidya Sala, Kerala’s best-known centre for the practice of Ayurveda, in 1902. Seven days later, she left the historical treatment centre after completeing panchakarma, a cleansing and rejuvenating programme for the body, mind and consciousness.
“There was nothing really wrong, but I was always busy with the demands of modern life and plagued with continual aches and pains. So, I decided to focus on my own health,” Iyer says.
Panchakarma, a holistic Ayurvedic therapy, involves a series of detoxifying procedures. It integrates herbal medicines, cleansing therapies, personalised diet plans and wellness activities to eliminate the root cause of disease, revive and rejuvenate the body, and ensure health and longevity.
Iyer says she left “feeling lighter, healthier and better than ever before”. She isn’t the only one who signed up for an Ayurvedic treatment in Kerala; the holistic system of medicine is a way of life in this coastal paradise.
… Ayurveda translates to “knowledge of life” and originated in India more than 3,000 years ago. It is based on the ideology that health and wellness depend on a delicate balance between the mind, body, spirit and environment, and places great emphasis on preventive strategies rather than curative ones. The ancient system of medicine is centred on the idea of universal interconnectedness between prakriti (the body’s constitution) and doshas (life forces). Varied combinations of the five elements — aakash (sky), jal (water), prithvi (earth), agni (fire) and vayu (air) – create the three doshas.
Dr Gaurang Paneri, an Ayurveda practitioner, explains every person has the three doshas, vata, pitta and kapha, in varying strength and magnitude. “The predominant dosha determines their prakriti. Diseases arise when doshas are affected because of an external or internal stimulus (typically linked to eating habits, lifestyle or physical exercise). Ayurveda works to ensure harmony between the three,” he says…
The small state has more than 100 Ayurvedic government-run hospitals, 800 Ayurvedic pharmaceutical factories and 800 Ayurvedic medicine dispensaries. As many as 120 holiday resorts and private wellness centres offer specialised treatments such as kasti vvasti, an oil-based treatment for back pain and inflammation in the lumbosacral region; elakkizhi, a treatment with heated herbal poultices to tackles aches, pains and muskoskeletal trauma; njavara kizhi, a massage therapy for arthritis or chronic musculoskeletal discomfort; and shirodhara, a restorative therapy to ease stress and anxiety and that involves pouring warm, medicated oil over the forehead.
Most treatment centres offer therapies and treatments for a range of health issues, including immunity, mental health, anxiety, pain management, weight loss, skin and health care, sleep issues, psoriasis, eczema, eye care, arthritis, sciatica, gastric problems and paralysis. The treatments typically include dietary changes, herbal medicines, massage therapies, poultices, meditation and breath exercises…
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I find such advertisements disguised as journalism disturbing:
- No mention that the treatments in question lack conclusive evidence of effectiveness.
- Not a word about the fact that many can be outright dangerous.
- No mention of the often exorbitant fees visitors are asked to pay.
Please do better next time you report about health matters, BBC!
Few of us are aware of the fact that there are such things as alternative diagnoses, i.e. diagnoses used by practitioners of so-called alternative medicine (SCAM) that have no basis in science. They are nonetheless popular with some SCAM practitioners and usually cause a wide range of non-specific symptoms.
In part 1 of this series of posts, I dealt with:
- adrenal fatigue,
- candidiasis hypersensitivity,
- chronic intoxications.
Today I will briefly discuss three further alternative diagnoses.
Chronic Lyme Disease
Lyme disease exists, of course; it is a bacterial infection attained via the bite of a tick. By contrast chronic lyme disease is pure fantasy. It is often used to explain persistent pain, fatigue, and neurocognitive symptoms in patients without any evidence of previous acute lyme disease.
Once this diagnosis is given, prolonged treatment with multiple antimicrobial agents as well as a multitude of SCAMs are advocated. The range includes intravenous infusions of hydrogen peroxide, electromagnetic frequency treatments, garlic supplements, even stem cell transplants.
Unsurprisingly, none of them has been shown to work for chronic lyme disease.
Electromagnetic hypersensitivity
Electromagnetic hypersensitivity (EHS) is a condition where individuals report symptoms attributed to exposure to electromagnetic fields. It is not a recognized medical diagnosis.
Symptoms of EHS include headache, fatigue, stress, sleep disturbances, skin prickling, burning sensations and rashes, pain, psychological distress and many other health problems. The true case seems psychosomatic and unrelated to electromagnetic fields.
Practitioners nevertheless recommend all sorts of SCAMs including chelation, detox, diets, tocopherols , carotenoids, vitamin C, curcumin, resveratrol, flavonoids, sauna, blue light therapy none of which have been shown to be effective.
Homosexuality
Yes, it’s true: some SCAM practitioners offer treatments for homosexuality which must mean that they consider it to be a disease.
As reported in a previous blog post, the German ‘Association of Catholic Doctors’, Bund Katholischer Ärzte, claims that homeopathic remedies can cure homosexuality. On their website, they advise that ‘…the working group HOMEOPATHY of the Association notes homeopathic therapy options for homosexual tendencies…repertories contain special rubrics pointing to characteristic signs of homosexual behaviour, including sexual peculiarities such as anal intercourse.
Say no more!
We all have heard of so-called alternative therapies but few of us are aware of the fact that there are also alternative diagnoses. These are diagnoses used regularly by practitioners of so-called alternative medicine (SCAM) that have no basis on science, or – to put it simply – that do not exist. They are nonetheless popular with SCAM practitioners and allegedly cause a wide range of non-specific symptoms such as:
- anxiety,
- brain fog,
- constipation,
- depression,
- dizziness,
- fatigue,
- headaches,
- heart palpitations,
- insomnia,
- irritability,
- muscle and joint pain,
- loss of appetite,
- loss of libido,
- weight gain.
In this series of posts, I will briefly discuss some of these diagnoses and list the treatments that SCAM practitioners might recommend for them.
Adrenal Fatigue
Adrenal fatigue is not the same as adrenal insufficiency or Addison’s disease; it is a term coined by a chiropractor who claimed that the stresses of modern life tire out the adrenal glands. In turn, this phenomenon allegedly leads to generalised weariness.
There is not evidence that this is true, nor that adrenal fatigue even exists. A systematic review of the evidence concluded that “there is no substantiation that adrenal fatigue is an actual medical condition.”
Yet, SCAM practitioners advise to cure adrenal fatigue with a range of dietary supplements (e.g. fish oil, ashwagandha, rhodiola rosea, schisandra and holy basil, licorice, magnesium, various vitamins), special diets, lifestyle adjustments, stress management and many other SCAMs. They all have in common that their effectiveness is not supported by convincing evidence from rigorous clinical trials.
Candidiasis hypersensitivity
Most of us are infected by the fungus Candida albicans without being affected by it in any way. Yet, many SCAM practitioners claim that candidiasis hypersensitivity is a condition that causes symptoms like fatigue, premenstrual tension, gastrointestinal symptoms, and depression and therefore needs treating.
But, candidiasis hypersensitivity does not exist. An RCT concluded that, “in women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo.”
This, however, does not stop SCAM practitioners to recommend numerous forms of SCAM to treat the condition, e.g.: dietary supplements containing probiotics, milk thistle, red thyme, barberry, garlic, or external applications of coconut oil, essential oils of peppermint oil, lavender oil, oregano oil, and tea tree. No sound evidence exists to show that ant of these SCAMs can successfully treat the condition.
Chronic intoxications
Chronic intoxications do ecist, of course. But in the realm of SCAM, they are diagosed for the sole putpose of selling their various ‘detox’ treatments. The alleged rationale is that our bodies are overloaded with all sorts ot harmful substances, for instance, from the environment, from our food, from modern drugs, or from our own metabolism.
To eliminate them, we need to ‘detox’. For that purpose, SCAM practitioners recommend a very wide range of SCAMs; in fact, it is hardly possible to identify a single form of SCAM that is not said to detoxify our bodies. Yet, for none of them is there compelling evidence that it eliminates toxins from our body. Some of the most popular detox regimen include:
- acupuncture;
- CEASE therapy;
- chelation therapy;
- crystal healing;
- cupping;
- detox diets;
- detox supplements;
- gua sha;
- homeopathy;
- homotoxicology;
- Kombucha;
- oil pulling;
- vaginal steaming.
Interim conclusion: non-existing diagnoses are perfect opportunities for SCAM practitioners to rip off gullible patients.
I had never heard of him – but after getting insulted by ‘Dr. Nick Campos’ I became interested and looked him up. What I found was interesting. Here is how he describes himself.
Dr. Nick Campos is a teacher of universal principles and truths as they pertain to the health, wellness and evolution of body, mind and spirit, particularly as they relate to human growth and potential.
As a healer trained in the art of chiropractic, and as a prominent chiropractic sports physician, he has helped thousands of people overcome physical injury and trauma, allowing them to regain their functional lives.
Dr. Campos believes that wellness encompasses more than just the physical body, so a balanced mental and spiritual life is also necessary for full expression of being. Therefore, Dr. Campos assists people with mental and spiritual challenges and misperceptions, while teaching them tools to empower themselves in all areas of life.
Dr. Campos teaches universal principles of health, wellness, growth and evolution as they pertain to body, mind and spirit. His work is carried out through several media including books, articles and a widely-read, syndicated blog (Optimal Health). His book The Six Keys to Optimal Health is the quintessential guide to achieving and maintaining optimal wellness in the twenty-first century. Dr. Campos’ mission is to inspire people to adopt a new way of thinking and living.
In 2010 Dr. Campos launched his evolutionary personal growth and development consulting business dedicated to helping people tune-into and manifest their most inspired dreams. As the Dream Designer™, Dr. Campos shows people how to uncover their life’s purpose, and how to implement powerful strategies designed to create the life of their dreams.
Dr. Nick Campos has a planetary vision of impacting billions of people for years to come. His inspired mission is to help people tap into their incredible self-healing, self-regulating powers. With certainty and gratitude, he aims to teach the world the power inherent in the human mind, and prepare humankind for the next phase of planetary evolution. As the world changes rapidly, those that adapt steadily and most-balanced will have the greatest advantage to navigating new horizons.
Many people limp through their lives following other people’s standards, and striving for achievement in areas not really inspiring to them. As a result, they end up suffering from frustration, lack of fulfillment and potentially depression. Does this sound like you?
By not following your innermost drives, or by repressing your true heart’s desires, you run the greatest risk of succumbing to physical and mental pressures, strain and ultimately illness. Life can be stressful enough without the added anxiety of not knowing who you are or where you are going.
Chronic fatigue syndrome and fibromyalgia are modern manifestations of this lack of purpose, but that doesn’t have to be your destiny.
Dream Design consulting services starts by helping you tune-in to your most authentic self—who you are, what you value, and how your body and mind work to direct you down your most inspired path. You will uncover the fears, resentments and infatuations that have been acting as barriers to your personal growth, and learn effective ways to overcome them.
And Dr Campos gives courses. On his website, we currently find Upcoming dates:
January 14, 2023 Burbank, CA
January 26, 2023 Palm Desert, CA
February 11, 2023 Thousand Oaks, CA
February 23, 2023 Palm Desert, CA
March 11, 2023 Burbank, CA
March 25, 2023 Palm Desert, CA
______________________________
Either this line of his business is not doing all that well or he offers time travel as part of the package.
On X 9formally Twitter), ,Dr’ Campos called me a LOSER – perhaps I should return the compliment?
The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:
There are three types of health professionals who offer naturopathic treatment:
- Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
- Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
- Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.
At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.
Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.
… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…
ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”
… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.
…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.
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The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:
- How reliable are the claims made by naturopathic influencers?
- Naturopath jailed for selling fraudulent vaccination documents
- Naturopath fined for misdiagnosing and treating a rectal tumor for hemorrhoids
- Naturopaths are ‘not bound by science,’ lawyer argues
- Vaccination rates of Canadian healthcare professionals: those of chiropractors and naturopaths are at the lowest
- Is veterinary naturopathy animal abuse?
- Naturopathic ‘cancer specialist’ using coffee enemas found guilty
- Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab
- A naturopath responsible for the death of two cancer patients was sentenced to two years
- A naturopath in court after two of his cancer patients died
- Many naturopaths, homeopaths, and chiropractors are a risk to public health
- Naturopath treats autism with fecal transplants
- A naturopath promoting fake news about COVID vaccinations
- Naturopathy (according to the WNF) = quackery steeped in obsolete fantasies
- Canadian naturopaths may no longer call themselves ‘medically trained’
- Naturopaths’ counselling against vaccinations could be criminally negligent
- Naturopathy for cancer … claims that have the potential to be lethal
- Severe liver injury due to naturopaths’ prescription of Epsom salt
- Naturopaths should not treat children
- Some naturopaths are clearly a danger to public health
- Death of a child through naturopathy
Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.
I usually take ‘market reports’ with a pinch of salt. Having said that, this document makes some rather interesting predictions:
The size of the market for so-called alternative medicine (SCAM) is projected to expand from USD 147.7 billion in 2023 to approximately USD 1489.4 billion by the year 2033. This projection indicates a remarkable Compound Annual Growth Rate (CAGR) of 26% over the forecast period.
The market for SCAM is experiencing significant growth, fueled by increasing consumer interest in natural and holistic health solutions. This trend reflects a broader shift in societal attitudes towards health and wellness, emphasizing preventive care and natural health practices.
The market’s dynamics are influenced by various factors, including consumer preferences, regulatory standards, and evolving perceptions of health and wellness. As the popularity of these alternative therapies grows, it is crucial for individuals to consult with healthcare professionals to ensure that these non-conventional approaches are safely and effectively incorporated into their overall health regimen. The increasing acceptance of SCAM underscores a collective move towards more personalized and holistic healthcare solutions, resonating with today’s health-conscious consumers.
In 2023, Traditional Alternative Medicine/Botanicals led the market, capturing a 35.2% share, which reflects a strong consumer inclination towards these treatments. Dietary Supplements were prominent in the market, securing a 25.1% share in 2023, which underscores the high consumer demand for nutritional aids. Direct Sales were the most favored distribution channel, accounting for 43.2% of the market share in 2023, which indicates their significant impact on guiding consumer purchases. Pain Management was the predominant application area, holding a 24.9% market share in 2023, propelled by the growing acknowledgment of non-pharmacological treatment options. Adults represented a substantial portion of the market, making up 62.33% in 2023, signifying a marked preference for SCAM therapies within this age group. Europe stood out as the market leader, claiming a 42.6% share in 2023, a position supported by widespread acceptance, governmental backing, and an increasing elderly population. The regions of North America and Asia-Pacific are highlighted as areas with potential, signaling opportunities for market expansion beyond the European stronghold in the upcoming years.
Leading Market Players Are:
- Columbia Nutritional
- Nordic Nutraceuticals
- Ramamani Iyengar Memorial Yoga Institute
- The Healing Company Ltd.
- John Schumacher Unity Woods Yoga Centre
- Sheng Chang Pharmaceutical Company
- Pure encapsulations LLC.
- Herb Pharm
- AYUSH Ayurvedic Pte Ltd.
Recent developments:
- In December 2023, Adoratherapy launched the Alkemie Chakra Healing Line, an aromatherapy range aimed at harmonizing the seven chakras.
- Coworth Park introduced the Hebridean Sound Treatment in October 2023, merging traditional Hebridean sounds with guided meditation to offer a novel, restorative wellness experience.
- The World Health Organization released draft guidelines in September 2023 for the safe, effective application of traditional medicines.
- Telehealth services, expanding significantly in August 2023, have broadened the reach of SCAM, enhancing patient access to these treatments.
Of all the forms of so-called alternative medicine (SCAM), Reiki is amongst the least plausible. It is a form of paranormal or ‘energy healing’ popularised by Japanese Mikao Usui (1865–1926). Reiki is based on the assumptions of Traditional Chinese Medicine and the existence of ‘chi’, the life-force that is assumed to determine our health.
Reiki practitioners believe that, with their hands-on healing method, they can transfer ‘healing energy’ to a patient which, in turn, stimulates the self-healing properties of the body. They assume that the therapeutic effects of this technique are obtained from a ‘universal life energy’ that provides strength, harmony, and balance to the body and mind.
Despite its implausibility, Reiki is used for a very wide range of conditions. Some people are even convinced that it has positive effects on sexuality. But is that really so?
This randomised clinical trial was aimed at finding out. Specifically, its authors wanted to determine the effect of Reiki on sexual function and sexual self-confidence in women with sexual distress*. It was was conducted with women between the ages of 15–49 years who were registered at a family health center in the eastern region of Turkey and had sexual distress.
The sample of the study consisted of 106 women, 53 in the experimental group and 53 in the control group. Women in the experimental group received Reiki once a week for four weeks, while no intervention was applied to those in the control group. Data were collected using the Female Sexual Distress Scale-Revised (FSDS-R), the Arizona Sexual Experiences Scale (ASEX), and the Sexual Self-confidence Scale (SSS).
The levels of sexual distress, sexual function, and sexual self-confidence of women in both groups were similar before the intervention, and the difference between the groups was not statistically significant (p > 0.05). After the Reiki application, the FSDS-R and ASEX mean scores of women in the experimental group significantly decreased, while their SSS mean score significantly increased, and the difference between the groups was statistically significant (p < 0.05).
The authors concluded that Reiki was associated with reduced sexual distress, positive outcomes in sexual functions, and increase sexual self-confidence in women with sexual distress. Healthcare professionals may find Reiki to positively enhance women’s sexuality.
Convinced?
I hope not!
The study has the most obvious of all design flaws: it does not control for a placebo effect, nor the effect of empaty/sympathy received from the therapist, nor the negative impact of learning that you are in the control group and will thus not receive any treatment or attention.
To me, it is obvious that these three factors combined must be able to bring about the observed outcomes. Therefore, I suggest to re-write the conclusions as follows:
The intervention was associated with reduced sexual distress, positive outcomes in sexual functions, and increase sexual self-confidence in women with sexual distress. Considering the biological plausibility of a specific effect of Reiki, the most likely cause for the outcome are non-specific effects of the ritual.
*[Sexual distress refers to persistent, recurrent problems with sexual response, desire, orgasm or pain that distress you or strain your relationship with your partner. Yes, I had to look up the definition of that diagnosis.]
The aim of this systematic review and network meta-analysis was to identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.
The screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool. All randomised trials with exercise arms for participants meeting clinical cut-offs for major depression were included.
A total of 218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for
- walking or jogging,
- strength training,
- mixed aerobic exercises,
- and tai chi or qigong.
The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments.
The authors concluded that exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.
As far as I can see, there are two main problems with these findings:
- Because too many of the studies are less than rigorous, the results are not quite as certain as the conclusions would seem to imply.
- Patients suffering from a major depressive disorder are often unable (too fatigued, demotivated, etc.) to do and/or keep up vigorous excerise over any length of time.
What I find furthermore puzzling is that, on the one hand, the results show that – as one might expect – the effects are proportional to the intensity of the excercise but, on the other hand tai chi and qugong which are both distinctly low-intensity turn out to be effective.
Nonetheless, this excellent paper is undoubtedly good news and offers hope for patients who are in desperate need of effective, safe and economical treatments.
These days – 11 years after the closure of my department at Exeter – it is not often that I co-author a peer-reviewed paper. All the more reason, I think, to celebrate when it does happen:
Our review was aimed at determining the effectiveness of meditation, primarily mindfulness-based interventions (MBIs) and transcendental meditation (TM), for the primary and secondary prevention of CVD.
We searched CENTRAL, MEDLINE, Embase, three other databases, and two trials registers on 14 November 2021, together with reference checking, citation searching, and contact with study authors to identify additional studies. We included randomised controlled trials (RCTs) of 12 weeks or more in adults at high risk of CVD and those with established CVD. We explored four comparisons: MBIs versus active comparators (alternative interventions); MBIs versus non-active comparators (no intervention, wait list, usual care); TM versus active comparators; TM versus non-active comparators. We used standard Cochrane methods. Our primary outcomes were CVD clinical events (e.g. cardiovascular mortality), blood pressure, measures of psychological distress and well-being, and adverse events. Secondary outcomes included other CVD risk factors (e.g. blood lipid levels), quality of life, and coping abilities. We used GRADE to assess the certainty of evidence.
We included 81 RCTs (6971 participants), with most studies at unclear risk of bias. MBIs versus active comparators (29 RCTs, 2883 participants) Systolic (SBP) and diastolic (DBP) blood pressure were reported in six trials (388 participants) where heterogeneity was considerable (SBP: MD -6.08 mmHg, 95% CI -12.79 to 0.63, I2 = 88%; DBP: MD -5.18 mmHg, 95% CI -10.65 to 0.29, I2 = 91%; both outcomes based on low-certainty evidence). There was little or no effect of MBIs on anxiety (SMD -0.06 units, 95% CI -0.25 to 0.13; I2 = 0%; 9 trials, 438 participants; moderate-certainty evidence), or depression (SMD 0.08 units, 95% CI -0.08 to 0.24; I2 = 0%; 11 trials, 595 participants; moderate-certainty evidence). Perceived stress was reduced with MBIs (SMD -0.24 units, 95% CI -0.45 to -0.03; I2 = 0%; P = 0.03; 6 trials, 357 participants; moderate-certainty evidence). There was little to no effect on well-being (SMD -0.18 units, 95% CI -0.67 to 0.32; 1 trial, 63 participants; low-certainty evidence). There was little to no effect on smoking cessation (RR 1.45, 95% CI 0.78 to 2.68; I2 = 79%; 6 trials, 1087 participants; low-certainty evidence). None of the trials reported CVD clinical events or adverse events. MBIs versus non-active comparators (38 RCTs, 2905 participants) Clinical events were reported in one trial (110 participants), providing very low-certainty evidence (RR 0.94, 95% CI 0.37 to 2.42). SBP and DBP were reduced in nine trials (379 participants) but heterogeneity was substantial (SBP: MD -6.62 mmHg, 95% CI -13.15 to -0.1, I2 = 87%; DBP: MD -3.35 mmHg, 95% CI -5.86 to -0.85, I2 = 61%; both outcomes based on low-certainty evidence). There was low-certainty evidence of reductions in anxiety (SMD -0.78 units, 95% CI -1.09 to -0.41; I2 = 61%; 9 trials, 533 participants; low-certainty evidence), depression (SMD -0.66 units, 95% CI -0.91 to -0.41; I2 = 67%; 15 trials, 912 participants; low-certainty evidence) and perceived stress (SMD -0.59 units, 95% CI -0.89 to -0.29; I2 = 70%; 11 trials, 708 participants; low-certainty evidence) but heterogeneity was substantial. Well-being increased (SMD 0.5 units, 95% CI 0.09 to 0.91; I2 = 47%; 2 trials, 198 participants; moderate-certainty evidence). There was little to no effect on smoking cessation (RR 1.36, 95% CI 0.86 to 2.13; I2 = 0%; 2 trials, 453 participants; low-certainty evidence). One small study (18 participants) reported two adverse events in the MBI group, which were not regarded as serious by the study investigators (RR 5.0, 95% CI 0.27 to 91.52; low-certainty evidence). No subgroup effects were seen for SBP, DBP, anxiety, depression, or perceived stress by primary and secondary prevention. TM versus active comparators (8 RCTs, 830 participants) Clinical events were reported in one trial (201 participants) based on low-certainty evidence (RR 0.91, 95% CI 0.56 to 1.49). SBP was reduced (MD -2.33 mmHg, 95% CI -3.99 to -0.68; I2 = 2%; 8 trials, 774 participants; moderate-certainty evidence), with an uncertain effect on DBP (MD -1.15 mmHg, 95% CI -2.85 to 0.55; I2 = 53%; low-certainty evidence). There was little or no effect on anxiety (SMD 0.06 units, 95% CI -0.22 to 0.33; I2 = 0%; 3 trials, 200 participants; low-certainty evidence), depression (SMD -0.12 units, 95% CI -0.31 to 0.07; I2 = 0%; 5 trials, 421 participants; moderate-certainty evidence), or perceived stress (SMD 0.04 units, 95% CI -0.49 to 0.57; I2 = 70%; 3 trials, 194 participants; very low-certainty evidence). None of the trials reported adverse events or smoking rates. No subgroup effects were seen for SBP or DBP by primary and secondary prevention. TM versus non-active comparators (2 RCTs, 186 participants) Two trials (139 participants) reported blood pressure, where reductions were seen in SBP (MD -6.34 mmHg, 95% CI -9.86 to -2.81; I2 = 0%; low-certainty evidence) and DBP (MD -5.13 mmHg, 95% CI -9.07 to -1.19; I2 = 18%; very low-certainty evidence). One trial (112 participants) reported anxiety and depression and found reductions in both (anxiety SMD -0.71 units, 95% CI -1.09 to -0.32; depression SMD -0.48 units, 95% CI -0.86 to -0.11; low-certainty evidence). None of the trials reported CVD clinical events, adverse events, or smoking rates.
We concluded that despite the large number of studies included in the review, heterogeneity was substantial for many of the outcomes, which reduced the certainty of our findings. We attempted to address this by presenting four main comparisons of MBIs or TM versus active or inactive comparators, and by subgroup analyses according to primary or secondary prevention, where there were sufficient studies. The majority of studies were small and there was unclear risk of bias for most domains. Overall, we found very little information on the effects of meditation on CVD clinical endpoints, and limited information on blood pressure and psychological outcomes, for people at risk of or with established CVD. This is a very active area of research as shown by the large number of ongoing studies, with some having been completed at the time of writing this review. The status of all ongoing studies will be formally assessed and incorporated in further updates.
Some people will say that meditation is not a form of so-called alternative medicine (SCAM) but rather an aspect of lifestyle used for relaxation and well-being. As such, it should not be scrutinized like a therapy. This might be partly true, but as soon as proper health claims are made for meditation or similar modalities, they do need to be tested like any other therapy, in my view.
As our review demonstrates, meditation and similar treatments are not nearly as well supported by evidence as their proponents try to make us believe. In other words, the often-voiced claims that such therapies are effective for the primary and secondary prevention of cardiovascular disease are largely unfounded.
Yestderday, it was announced that King Charles has cancer. He had been in hospital for surgery for his enlarged prostate. Initially, the news was positive, as it was confirmed not to be prostate cancer. However, during the investigations, a cancer was discovered that apparently is unrelated to the prostate. Since the announcement, many journalists and other people have written to me asking what I think about it and what treatment Charles is likely to receive. I therefore decided to write a short post about the matter.
As a physician and human being I am very sorry whenever I hear that anyone has fallen ill, particularly if the condition is serious and potentially life-threatening. That this includes Charles goes without saying. Equally it is self-evident that I wish that all goes well for him, that the treatment he reportedly has already started is not too arduous, that he keeps in good spirit, that he has empathetic support from all his family and recovers quickly and fully.
Charles will, I am sure, have the best treatment anyone could wish for. Will he use so-called alternative medicine (SCAM), for example, the Gerson therapy, one of the SCAMs he once promoted as a cure of cancer? Of course not! He will receive the most effective, evidence-based care that is currently available. Will he thus not try any SCAM at all? I am confident that he will use SCAM wisely, namely not as a cure but as a supportive measure. In my book on this very subject, I go through all the relevant evidence and conclude that, while SCAM is most certainly not a cancer cure, it can have a place in supportive cancer care. Depending on the symptoms that develop during and after the conventional treatments, certain SCAMs can, according to fairly sound evidence, be helpful in improving wellness and quality of life.
Going through a battle against cancer is often a most humbling experience. Therefore, I am hopeful that, as he recovers from his ordeal, Charles will see that modern medicine – he once described it as being out of balance like the leaning tower of Pisa – is not just effective, empathetic and caring but also not nearly as unbalanced and unholistic as he often proclaimed it to be. In that sense, the experience might reform our king, and – who knows? – he might, after all, turn out to be not the self-proclaimed enemy but a true friend of the Enlightenment.
