It seems like every day I see another example of the dangers of scientific illiteracy. And I’m not talking about the big things like denying climate change or thinking the earth is 6,000 years old–I’m talking about the small, individual things that have become, in the grand neoliberal tradition, choices we make about our health. Now, I think there are many factors behind issues like juice cleanses and refusing to vaccinate, from impulses toward purity to distrusting the government (a not, I should note, altogether crazy stance to take). But at the core of these trends is a fundamental misunderstanding of some basic scientific truths, as well as a lack of knowledge of how to engage critically with the type of media that pushes these ideas. And this lack of knowledge is dangerous. It is dangerous in the direct effects it has (measles outbreaks! starving yourself!), as well as the indirect effects which include throwing good money at bad promises, and weakening the general public’s understanding and trust in the scientific process.
Toxins, Toxins, Everywhere
Let’s start with the idea of “toxins”. The funny thing about “toxins” is that no one who fears them can ever define them. They are a nebulous, abstract conception of something “bad” brought about by the food we eat or the pollution we live amid. Now, that initial concept–that there is something wrong with the food we eat and the pollution we breathe in every day is not a bad one. In fact, the World Health Organization recently released a report estimating that 7 million people died (that’s 1 out of every 8 deaths that year) due to pollution. That is really alarming. Especially since environmental crises disproportionately impact poor and marginalized people. And there has been oodles of literature looking at the ways that hyper-palatable, highly-processed foods use huge amounts of salt, sugar, and fat to make you want to eat more, more, more and to cover up the poor taste that can result from processing. But none of these issues relate to “toxins” which the Oxford English Dictionary defines as
A specific poison, usually of an albuminous nature, esp. one produced by a microbe, which causes a particular disease when present in the system of a human or animal body.
See, the thing about toxins is that they are bad, bad news. They are things like botulism which can cause death (or, you know, smooth your forehead wrinkles). They are dangerous and deadly substances that require medical care and often hospitalization. They are not free-floating, icky things that come from our frenetic pace and often-less-than-ideal diets. Now, there are things that aren’t good for us that do need to be dealt with. And the wonderful thing is that evolution, in its infinite
wisdom trial-and-error gave us four amazing tools for that. Our skin keeps a lot of the bad stuff out. Our skin is wonderful! Have you thanked your skin today? Our livers filter our blood to remove all sorts of harmful substances from ammonia from the breakdown of protein (which gets converted to urea which our kidneys help us get rid of) to byproducts of medications. And our immune system deals with bacteria, viruses and other foreign substances (that may or may not be harmful, e.g. cat dander). So if we’ve already got these brilliant, complex systems that fight against harmful substances, what do we need juice cleanses for? And how on earth have we survived as a species prior to the invention of cold-pressed juice?
The thing about juice cleanses is that they aren’t supported by science. Rather, they are a socially sanctioned form of ritual cleansing that can do real damage. Mostly to your wallet. But they can also support the emergence or re-emergence of unhealthy obesessive and/or restrictive habits around food. Body wraps are, similarly, bullshit.
But the thing is, on the surface, the idea of “cleansing” makes a sort of common-sense. After all, we clean our clothes weekly, we wash our lettuce before making a salad, we scrub our bathtub and toilet. Shouldn’t we clean our insides as well? The interesting thing about these fads is that they target both our need for ritual and our nagging fear of death and fragility, while relying on the fact that most of us have neither the time, the inclination, nor the training to critically engage with these ideas. They also rely on pseudo-scientific ideas and terms to quell the natural urge to investigate claims. We’ve all heard of “toxins” even if we’ve never had the term explicitly defined for us. And in our overworked, over-stimulated environments, doesn’t “rest” just sound right? I’d love some rest, but since the demands of everyday life aren’t conducive to it I might as well rest my digestive tract. And heck, I feel pretty good after not eating for two days, so maybe I’ll stretch that a little longer.
Starvation in a Pretty Bow
One of the problems with juice cleanses (as well as one of the few things working in its favour) is that it’s pretty hard to top 1000 calories in juice. Which means you are guaranteed to lose weight on a juice cleanse. Which is seen as proof that it’s working. Rather than as proof that if you under-nourish yourself your body will drop weight, whether you have weight to drop or not. And one of the things that happens when you drop weight quickly is that a lot of that weight is water weight. Which means that when you start eating normally again you instantly regain five pounds. Which feels like further proof that the juice cleanse worked. And is necessary. And maybe I should do it again this weekend?
Unfortunately, as a society, we are sorely miseducated on the role of calories and just how many we need. I bet you every woman you know has heard she should be eating 1200 calories. But, wait, is it that 1200 calories is what she should be eating to lose weight? Or that she shouldn’t go below 1200 calories? If myfitnesspal tells me to eat 1200 calories is that what I should do? Even though I’m active and weigh more than my friend who is also told to eat 1200 calories? Well, the UN Food and Agricultural Organization defines 1800 calories per day to be the average minimum requirement to avoid malnourishment. Not to fuel you properly through your work day followed by walking the dog and doing yoga. Not to let you bike to work and go out dancing afterwards. But just enough to avoid being malnourished. So that 1200 calories? It’s way too few. And the 1000 you might hit on your juice cleanse? That’s a recipe for disaster.
Related and even more worrying to my mind are things like the HCG diet. Here is a great article debunking the HCG diet but I’ll sum it up in a single sentence: starving yourself on 500 calories a day will make you lose weight; HCG has nothing to do with that but may have some nasty side effects like birth defects, ovarian overstimulation and fatigue. Now here’s where scientific illiteracy comes into the mix: HCG has been well-known to have no effect on weight-loss since the 1970s. It has been thoroughly debunked by scientists and decried by the FDA. But when medical experts and Kevin Trudeau are afforded equal merit, and you are dealing with desperate people, Kevin Trudeau is going to win. Think about it: you have spent years trying to lose weight, you face stigmatization and body shaming every day, you have internalized fat-shaming messages that you are lazy and worthless if your BMI is above some arbitrary number and your choices are to eat at a small caloric deficit while exercising and slowly lose weight or go balls-to-the-wall, eat 500 calories and shoot yourself up with placental hormone and shed pounds immediately? Just reading that sentence shows you how heartbreakingly desperate many people are. And the fact that we still think we can trick our bodies into running on far fewer calories than we need without long-term negative effects speaks to how little we know about our bodies and how little we respect them.
Finally, I want to look at adrenal fatigue and how it depends on the combination of desperation and scientific illiteracy. Here’s what adrenal fatigue isn’t: an accepted medical diagnosis. Here’s what it is: a hodge-podge, catch-all term used by alternative medical practitioners such as naturopaths. The problem with a diagnosis of adrenal fatigue is that it is broad enough to cover any number of symptoms which include fatigue, weight-loss or gain, irritability, trouble sleeping, etc., which can mean that you miss treatment for an actual devastating illness.
A year and a half ago I had to have my gallbladder removed after nearly a year of being horrifically ill. So ill that I could barely eat. During my recovery I gained a significant amount of weight, was chronically cold, was often light-headed and very foggy-brained, was chronically exhausted despite sleeping more than ever in my life, was emotionally fragile and, oh yeah, was working an incredibly emotionally demanding job in an incredibly dysfunctional work environment. So when test after test came up empty from my GP I went against my better instincts and tried a naturopath (I was desperate and the visit was covered by my insurance). Sure enough, I was diagnosed with adrenal fatigue. Now, getting a diagnosis is quite a relief. Even when that diagnosis doesn’t depend on any actual diagnostic tests. But despite following the naturopath’s directions (which included some VERY expensive supplements I could only get at her office–funny that) I wasn’t getting better.
Fast forward a few months and I have an answer why: I have polycystic ovarian syndrome. Due to a confluence of events around my surgery and recovery as well as the immense amount of stress hormones I undoubtedly had running through my body due to the realities of my old job, a genetic predisposition toward PCOS was triggered. Now, had I not kept up my dogged pursuit of a medically sound answer, I may have accepted the adrenal fatigue diagnosis and continued to suffer from untreated PCOS. That means insulin resistance that puts me at risk of developing diabetes in later life, that may mean infertility, that means an increased risk of cardiovascular disease and stroke.
It is only because I am a naturally skeptical person with a decent knowledge base of physiology and scientific literacy that I researched adrenal fatigue and realized it was a junk diagnosis. Thankfully my PCOS was caught early on and I am able to take lifestyle steps to deal with it. The possibility of what I would be dealing with if I had accepted the adrenal fatigue diagnosis, frankly, enrages me. The fact that there are countless people (mostly women from what I’ve seen and read) getting a diagnosis of adrenal fatigue from undoubtedly well-meaning alternative health practitioners (who are, nonetheless, doing harm) outrages me. And the fact that so many people do not have the tools to challenge a junk diagnosis and thus may be letting serious medical conditions like PCOS, depression, and others go untreated in favour of supplements and meal plans to treat their “adrenal fatigue” makes me want to cry.
A further note on adrenal fatigue, Amber over at GoKaleo has an excellent piece looking at whether adrenal fatigue is actually a response to severe and chronic underfeeding.
Finally, a note on scientific illiteracy. It is not your fault or my fault that we are scientifically illiterate. We have a culture that not only condones it but requires it for multiple billion-dollar industries to sustain themselves. It’s not a moral failing to not know how to read a scientific study or parse what conflicts of interest may occur. But it is something we can change.
Combating scientific illiteracy is a far bigger project than I know how to tackle but here are the steps I personally take when I’m unsure about an idea.
1) Look at who is presenting the idea and how. Is it a biologist writing a study? Is it a lifestyle blogger who just happens to have an affiliate link ready for you? Is it a journalist in a mainstream newspaper who may or may not have ever taken a biology class? If you can get your hands on an actual study, do it. It may not make a lot of sense at first but reading academic papers is a skill you can sharpen.
2) Ask yourself who makes money off this idea. Is there a lot of money to be made in eating mostly whole foods prepared at home and exercising most days of the week? No. Is there a lot of money to be made from selling weight-loss shakes tied to a hyper-intense workout video series? Heck yes.
3) Ask yourself what tactics are being used to promote this idea. Fear and shock tactics almost always hint that the idea is unable to stand on its own merit.
4) Use google scholar to check out what’s been written about the idea. For example, if you put “toxins” into google scholar you get page after page of studies dealing with bacteria, nothing about the scary nebulous things we must cleanse or wrap or detox out of us.
5) Build up a base of reputable sources you can use to fact check. Examine.com is a great source for evidence-based information on supplements written for a lay audience, while Science-Based Medicine is a great source for almost anything you could wonder about when it comes to bodies, health, and medicine.
If you want to learn more about how to parse pseudoscience from the real stuff (and why it’s important to do so) check out Ben Goldacre’s Bad Science. It’s approachable, funny, and very informative.