Categories
Complementary and alternative medicine Medicine Quackery

Consumer Reports and credulity towards alternative medicine

Et tu, Consumer Reports?

Since I was a teenager, I’ve intermittently read Consumer Reports, relying on it for guidance in all manner of purchase decisions. CR has been known for rigorous testing of all manner of consumer products and the rating of various services, arriving at its rankings through a systematic testing method that, while not necessarily bulletproof, has been far more organized and consistent than most other ranking systems. True, I haven’t always agreed with CR’s rankings of products and services about which I know a lot, but at the very least CR has often made me think about how much of my assessments are based on objective measures and how much on subjective measures.

Until now.

I just saw something yesterday on the CR website that has made me wonder just how scientific CR’s testing methods are, as CR has apparently decided to promote alternative medicine modalities by “assessing” them in an utterly scientifically ignorant manner. Maybe I just haven’t been following CR regularly for a while. Maybe it’s been doing this for a while, but seeing it shocked me nonetheless. The first red flag was the title, namely Hands-on, mind-body therapies beat supplements. The second red flag was the introduction to the article:

A new survey of subscribers to Consumer Reports found that prescription drugs generally performed better than alternative therapies for 12 common health problems. But hands-on treatments such as chiropractic care and deep-tissue massage, as well as mind-body therapies such as yoga and meditation, held their own, especially for certain conditions. Far fewer said that dietary supplements helped a lot.

Prescription drugs helped the most for nine of the conditions we asked about: allergies, anxiety, colds and flu, depression, digestive problems, headache and migraine, insomnia, irritable bowel syndrome, and osteoarthritis.

But chiropractic care performed better than drugs for back pain, and deep-tissue massage beat drugs for neck pain. Massage was as also as good as drugs for fibromyalgia. Those hands-on therapies also scored near the top for osteoarthritis as well as for headaches and migraines.

Oy, vey.

Clearly, whatever rigorous testing methodologies CR might bring to various products, its editors clearly have zero clue when it comes to science- and evidence-based medicine if they think that a survey is the appropriate way to determine which treatments work or how well treatments work relative to each other. There was a perfect example of what that is so just the other day with the study that appeared in New England Journal of Medicine that was touted as evidence that the placebo effect is powerful but in reality what the study showed is that, while placebos can make patients think they feel better, they don’t actually do anything to change the underlying pathology of the disease for the better. That’s why science and randomized clinical trials are necessary to determine what therapies work, which ones do not, and which ones work better than others. Surveys are a notoriously unreliable and deceptive (as in self-deceptive) way of trying to assess the relative merits of various therapies, representing as they do, mainly an aggregation of testimonials. Yet that’s what CR is using to try to rank alternative medicine therapies.

Worse, CR concludes its introduction:

For details, see our full report on alternative therapies, including advice on how to find a good chiropractor, massage therapist, yoga instructor, or other alternative-medicine practitioner.

I would submit to you that any reputable testing organization should not–I repeat, should not–be providing advice on how to find alternative medicine practitioners. On the other hand, note the bait and switch. Massage therapy is not necessarily “alternative.” At least it’s not alternative until it’s infused with woo like talk of “life energies” and such. Ditto yoga instructors, given that yoga, stripped of its woo, is basically stretching exercises. As for chiropractors, my standards for what would constitute a “good” chiropractor would be a bit different than most; I’d choose chiropractors who function primarily as physical therapists, eschewing any suggestion that they can cure any disease or treat anything other than musculoskeletal complaints. Any chiropractor who still believes in those mystical, magical “subluxations” that only chiropractors can find or who promote the idea of “innate intelligence” would not be a “good” chiropractor in my book; he’d be a quack.

My scientific orientation aside, it is nonetheless rather interesting to peruse CR’s report on “alternative” treatments entitled Alternative treatments More than 45,000 readers tell up what helped. The first thing I noticed was a rather obvious logical fallacy in the form of argumentum ad populum (i.e., appeal to popularity):

Done anything alternative lately? If so, you have a lot of company. When we surveyed 45,601 Consumer Reports subscribers online, we found that three out of four were using some form of alternative therapy for their general health. More than 38 million adults make in excess of 300 million visits to acupuncturists, chiropractors, massage therapists, and other complementary and alternative practitioners each year in the United States.

One wonders how long it will be before quacks start quoting the figure of three quarters of CR readers using alternative medicine or subtly misrepresenting the figure as three-quarters of Americans. After all, “complementary and alternative medicine” (CAM) and “integrative medicine” (IM) practitioners try very, very hard to paint those of us who are skeptical of their claims as hopeless Luddites trying to resist the inevitable CAM wave washing over medicine. Argumentum ad populum is one of the strongest logical fallacies that CAM proponents use. In fact, CR virtually admits that its survey is utterly useless for telling its readers what does and doesn’t work (although no doubt that’s not how the editors see it) when it states:

A total of 30,332 survey respondents gave us their perceptions of the helpfulness of treatments for their most bothersome conditions over the past two years. The respondents were Consumer Reports subscribers, and our findings might not be representative of the general population. Respondents based their opinions on personal experience, so the results can’t be compared with scientific clinical trials. And our results do not take into account the power of the placebo effect, the tendency of people to find even simulated or sham interventions helpful.

None of these caveats stops CR, though, which bravely dives right into the pool of pseudoscience promoted by appeals to popularity.

Even though this survey is pretty much useless (as CR admits while carrying it out anyway) for providing guidance about what therapies to use, I do have to admit–grudgingly–that this article does provide some rather interesting information, chief of which is that its results show that those nasty, evil, reductionistic prescription drugs in general outperformed any alternative therapy, even in a subjective, self-reported, Internet survey of CR’s subscribers like this. For instance, for allergy, prescription medications and over-the-counter medications were listed by CR readers by far as the top two therapies that “helped a lot.” It’s also interesting to note that only 2% of its readers used chiropractic to treat allergies, although 41% said that it “helped a lot.” Surprisingly, even for conditions for which “mind-body” therapies might be considered effective, prescription medications ruled the roost, including depression and anxiety. Other favorite conditions for which alt-med is used and for which alt-med claims success even though its success is virtually all placebo response yielded to the power of big pharma: Irritable bowel syndrome, insomnia, headache, and colds and flu.

In fact, for only two conditions did any “alternative” modality beat or even come close to conventional medicine even in this biased, self-reported survey: back pain/neck pain (which I lumped together because they’re both the spine), osteoarthritis, and fibromyalgia. And what was effective? For neck/back pain chiropractic for neck/back pain, chiropractic and massage were reported to be as effective as or more effective than prescription medication, which is not surprising because conventional medicine prescribes physical therapy for these conditions anyway and for spine problems chiropractic is generally physical therapy with woo liberally sprinkled on top. For fibromyalgia deep tissue massage was in a dead heat with prescription medication, which is probably more an indication of the lack of good therapies for fibromyalgia right now than it is an indication that alternative therapies work. Ditto osteoarthritis, where the effectiveness of massage probably indicates the same thing.

There are three other results of this survey that are worth mentioning, for instance this passage:

For most conditions we asked about, the No. 1 reason respondents gave for choosing an alternative treatment was simply that they were “a proponent” of it.

“Some people use these therapies because it’s just the way they were raised,” says Richard Nahin, Ph.D., M.P.H., senior adviser for scientific coordination and outreach at the National Institutes of Health’s National Center for Complementary and Alternative Medicine.

Some say they have gone through a transformational process, such as a major illness that has caused them to look at their life in a different way, Nahin says. Others believe dietary supplements are safer than prescription medication because they’re natural, even though that’s not necessarily the case, he says.

In other words, CAM is belief-based medicine, not science-based medicine, and here we have a senior advisor from NCCAM admitting just that.

The second thing is that this article once again tries to make the claim that conventional, scientific medicine is “embracing” CAM by including a section discussing doctors and CAM. Of course, the interesting thing about this section is that it actually portrays physicians who practice CAM as being relatively uncommon, while representing one as being a “brave maverick doctor” who practices acupuncture. Even though I’ve seen doctors who practice acupuncture before (I’m talking to you, Michael Berman), I still can’t figure out the mental contortions and cognitive dissonance that must be necessary to make that happen. Still, in this article, we have a family practitioner named Dr. Rick Hobbs sticking needles into people to realign their qi. He’s even a kindly-appearing, bespectacled old guy wearing a bow tie! Can it get any more Norman Rockwell than that?

Finally, CR’s Hands-on and mind-body therapies: A user’s guide is depressing to behold. First, one notes the classic bait and switch, where therapies that could be considered part of science-based medicine, such as massage, yoga (which is just gentle stretching exercise), and meditation (which is more or less relaxation) are represented as “alternative” and then lumped in with quackery (acupuncture) as though the quackery were equivalent. Chiropractic itself would be a form of physical therapy if it were stripped of its vitalistic woo. In other words, not only has CR apparently decided that pointless Internet surveys where the respondents are all self-selected are a valid way to assess the efficacy of therapies, even while in essence admitting that they are not, but it’s apparently bought into the pseudoscientific world view at the heart of CAM. Whether it did so through belief or cynically in order to pander to a large, woo-loving segment of its audience, I don’t know and don’t care. What I do know is that CR has in this article utterly failed its readers and betrayed its history of rigorous product testing.

I hope it was worth it for CR to shoot its own credibility in the foot with such abandon.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

306 replies on “Consumer Reports and credulity towards alternative medicine”

Okay, but it’s interesting that there does seem to be some wisdom in the crowd. Back pain and “fibromyalgia,” whatever it is exactly, are conditions for which medicine doesn’t have much to offer. As a matter of fact, in the case of back pain, we’re coming to learn that a lot of what has been done is counterproductive. So these don’t just happen to be the problems for which the people are choosing the alternatives. Furthermore, massage and chiropractic plausibly could actually help the symptoms in these cases. So stripped of any unwarranted extrapolation, you could see this as a useful exercise that does tell us something worth listening to, it seems to me.

Yes the debate as to what is “alternative” and what is actual science is always going to be going on. I mean for people in the East who have been practicing yoga and tai chi, this is a science to them even though it may not be in the West. Science puts most of its weight on results driven data and you cannot deny that millions of people have benefitted from yoga and other “healing” arts

Indeed, a woo-less massage therapist or chiropractor can do good things for back pain. It’s a shame the CAM crowd has pulled them into their list of “alternative” medicines, and also that there are massage therapists and chiropractors who practice woo.

Now if CR had pointed this out, that the physical therapy benefits of a woo-less massage or chiro is very much not the same as CAM, it would have been helpful. Their intro to the report didn’t appear to be too bad, to my eyes. I don’t know much about the claims of supplements so I’ll not comment on those. I’ve had some experience with woo-less massage and chiro, and CR do say that you should check with your doctor about expectations.

The full report says in the second paragraph that the alternatives were “far less helpful” than prescription medicine, and to their credit CR do point out that this report is based purely on anecdote, can’t be compared to a proper scientific study, and doesn’t take into account the placebo effect; also that just because supplements are natural they aren’t necessarily safer than prescription drugs.

If it weren’t for the last two paragraphs talking about acupuncture, and the lack of pointing out that (for example) massage therapy is physical therapy and an alternative or complement to painkiller or muscle relaxant drugs instead of being part of CAM and its woo, however much that group might like to claim that it is, this could have been a good report.

The “how to find” users guide, which is all about the woo, doesn’t seem to match the intro or the rest of the report at all. Even if they say “possibly effective” as a caveat, it still looks like promotion. A “how to find” users guide that had tips on how to separate physical therapy from woo, that would have been useful.

And, very interesting footnote at the bottom: “This report was made possible by a grant from the Airborne Cy Pres Fund, which was established through a legal settlement of a national class-action lawsuit (Wilson v. Airborne Health, Inc., et al.) regarding deceptive advertising practices”

Maybe since it was funded by a settlement on deceptive advertising, the report could use a tip on helping people spot deceptive advertising… now I want to look for CR’s contact info.

I’m not surprised.

A large portion of CR evaluations are based on surveys, whether it’s which car is most reliable or which point-and-shoot camera is the best.

Like you, I’ve found that when I happen to know something about a product (bicycles, camping gear) I strongly disagree with the CR story.

fusilier
James 2:24

@yoga cert:

yoga and tai chi are science everywhere… just like running, cycling, swimming, massage, and a mai tai by the pool are. Exercise and relaxation are science based ways to be more healthy. Increased flexibility, strength, cardiovascular condition, decreased body fat, and decreased cortisol (i.e. stress relief) are all accomplished through these scientifically understood modalities. It isn’t a “healing art” per se, but merely part of our understanding of what it means to be healthy. Nothing mystical about it. Until you add chakras and healing energies to it – then it is woo snuck in through science based clothing.

CR does have a history of publishing some consumer ratings (as noted, for car reliability/repair frequency, and also for restaurant chains), but for most products does its own in-house testing, whether it’s on new cars, cameras, vacuum cleaners or (more dubiously) food products like ice cream and peanut butter.

It strikes me that CR is irresponsible for delegating analysis of health care modalities to popular surveys, but in their eyes what to treat your pain and allergy symptoms with is no more important than considering the reliability of a Ford sedan.

Since CR has a policy of not permitting businesses to advertise their products’ CR ratings, it’ll be interesting to see what happens when “mind-body” therapists start promoting CR’s survey findings on their websites and in print media ads. If that’s allowed, it should do wonders for CR’s reputation.

Happy to be put to any test you choose.

It is no secret that Ashtanga Yoga is the best all round holistic and preventative health care system ever invented. It even has all of western medicine in it’s toolbox.

Many many thousands of years in the development, all tested on humans over many generations. Bad yoga caused reduced Himalayas biological fitness, good yoga increased it. Evolution itself was the father of our ‘medicine’.

Ashtanga [email protected]

Happy to be put to any test you choose.

It is no secret that Ashtanga Yoga is the best all round holistic and preventative health care system ever invented. It even has all of western medicine in it’s toolbox.

Many many thousands of years in the development, all tested on humans over many generations. Bad yoga caused reduced Himalayas biological fitness, good yoga increased it. Evolution itself was the father of our ‘medicine’.

OK, how does yoga deal with bacterial pericarditis?

30 years ago I was bicycle commuting 15-20 miles/per day, and averaging 50 miles on Saturday and Sunday group rides. My BP was around 100/60 and my resting heart rate was around 50 beats/min (AKA exercise bradycardia.)

I developed chest pain and severe difficulty breathing, but my EKG was normal.

Tell me how yoga would a) diagnose the actual problem and b) treat it.

fusilier
James 2:24

Generally,people go by experience and not by scientific proof and that is how it should be. This writer has been doing yoga for the last twelve years. I haven’t taken an allopathic medicine in the last 10 years,only Ayurvedic on a couple of occassions.So who cares a damn for scientific proof. Many know it works so they are not bothered about certificates from science.

Surendra – when I hear someone say “I haven’t taken western/allopathic medicine in X years” that doesn’t make me think “Wow, sCAM must really work!”. Instead, it simply tells me that you’ve ‘suffered’ with nothing more major than a cold or a tummyache during that time.

WRT – massage for fibro, of course physical attention is going to help make people with somatisation disorder feel better. That’s hardly rocket science.

@ 10
Lucky you! Personally my partners appendix burst last year and I have to say, we did not even consider yoga, perhaps you could enlighten me which positions and breathing exercises would be helpful under these conditions?

While there are obviously serious issues with “alternative medicines” due to all the quack that gets spread around and the damage that is done, I disagree with lumping it all in one big pot. Just because “modern medicine” has not found evidence that some of these things work, does not mean that there is none. It depends on the individual, on the condition, on the treatment style etc, etc. I think that methodologies used in science thus far were restricted to that medicine that is least subject to inter-individual variability and confounding variables.

As science moves into new methodological territories, both experimentally and statistically, I believe that more and more of these “alternatives” will prove to be just as useful as what we today see as the gold standard. But the truly major advances that this will allow, which I think is something that you need to be more open about, is the ability to finally weed out the quack from the useful. Just as some people today lump “alternatives” and give them all a good name, the same can be said about lumping all “alternatives” and giving them a bad name.

I believe there are biases towards and against both modern and alternative medicine, and good scientists should always be as skeptical of their own view as they are of those of others’.

Perfect example of the bias I am talking about: http://english.aljazeera.net/indepth/opinion/2011/07/20117313948379987.html

You know the other side of the bias 😉

Generally,people go by experience and not by scientific proof and that is how it should be.

That is exactly how it shouldn’t be lest we throw ourselves back into the dark ages of medicine and allow barbers to wantonly bleed people, basing treatments on the four humours and having some random person in the village assigning themselves the position of surgeon.

This writer has been doing yoga for the last twelve years. I haven’t taken an allopathic medicine in the last 10 years,only Ayurvedic on a couple of occassions.

So what? You are an anecdote and those don’t equal data. Your belief in woo doesn’t validate it.

So who cares a damn for scientific proof. Many know it works so they are not bothered about certificates from science.

Obviously you don’t and you missed the point of the post. Many of the modalities discussed are evidence-based, thus not alternative and don’t need the trappings of faerie-dust and unicorn farts. I use massage therapy for my muscle injuries because it is the recommended course of treatment by that pesky science of medicine. Pass on the acupuncture.

@Surendra Varma,
Without scientific proof you don’t know that what you’re doing works. All you have is an opinion – which you’re entitled to, naturally. But wouldn’t it be good to know if what you’re doing actually helps keep you healthy?

@Ashtanga London #7

“It is no secret that Ashtanga Yoga is the best all round holistic and preventative health care system ever invented.”

I do believe this is a secret as it’s probably news to a good many of us. So, please, feel free to share your evidence with us. “Argument from antiquity” and “argument from Orient/Occident” aren’t really valid, but I’m sure you have others.

To me, the disclaimer: “Respondents based their opinions on personal experience, so the results can’t be compared with scientific clinical trials”
has about the same meaning as “I’m not racist, I have lots of black friends but…” nothing good ever comes after the dots.

Yes you are correct it has been shown that where injury or illness occurrs, not only does yoga minimise the effects of injury and illness but also, people who do yoga seek medical treatment sooner. Not to mention better success and recovery rates after operations. Anyone who’s ever operated on an obese person will be slowly nodding at this point.

Yogis will get that lump checked tomorrow, we don’t crack open a bottle of wine and forget about it until it’s big enough to cause pins and needles!

Prehistorically, the only access you would have to wider medical knowledge was your fellow caveman family. Clearly if you had people still able to perform at age 80, their accumulated medical knowledge would be better than that of tribes people who never lived much past 70. Can’t write it down and pass it on, it’s 1000 BC. We know they were doing it at 1800BC, but no-one wrote it down until just before turn of the millennium. Vedic chanting was ‘good as’ writing for the time before it was written down.

If you want to know how healthy ashtanga yogis are, find some on facebook and stalk them until you know the score. If you can find a group that are healthier and happier, post it here and I will check it out personally.

If you can’t fix something with moving, breathing and diet, find the best medic you possibly can and use every knowledge-base at your disposal (ask your best doctor!). That is the rule that real yogis follow.

Ashtanga London @7

Bad yoga caused reduced Himalayas biological fitness, good yoga increased it.

Since the Karakorum range of the Himalayas are the highest mountains in the world, they must have practiced “good yoga”. I am convinced by your cogent argument. I am also impressed by the ability of mountains to hold a pose.

Sorry fusilier, I hope that answers your questions. Doing yoga means you either don’t develop the pain in the first place, or you notice it and treat it sooner and more successfully.

You don’t let me tell you what is the best treatment, I don’t tell you, Orac doesn’t tell us. One life is one shot so every medical question is a study in itself and if the patient has any sense he will try to OWN the process in it’s entirety. Trust no-one, full SWOT analysis at every move.

Of course you will find many fake yogis who don’t work it properly but we are not talking about fake yoga or ‘just stretching’ here.

@Ashtanga London: I also haven’t really needed “allopathic” medicine in the last decade either, though I have taken the odd Tylonol here and there for minor headaches. Guess what that means? I have the secret to everlasting health? no, I’m just lucky. My wife has the same lifestyle, but has had 3 children in that time, and she is alive today because of science.

Locklin what’s your point? are you suggesting we all just find a pocket of luck and sit in it to protect our health? That’s the fattest woo so far.

Yoga is great for fertility and pregnancy too!

@Ashtanga London: You tried to use your health for the last 10 years as evidence for your Yoga routine, I was simply pointing out the uselessness of that type of anecdote. Yes, physical exercise, stretching, and breathing exercises are excellent for a healthy pregnancy and birth. I know this because there is sufficiently good evidence to support it. It is, however, not sufficient (or rather not related to) the types of complications she had.

If yoga is great for fertility and pregnancy too, then you should have no trouble presenting the evidence demonstrating it to be so. Unsupported assertions don’t have any credibility.

PMIDs will suffice.

That’s it, yoga, like all exercise, is better than nothing, but which is best?

If you only do 30, 60, 90 or 120 mins of exercise each day, then what is the best set of exercises or the best system to use?

I’m sorry but I don’t see how a PMID can help you in this situation, can’t you think of a better way to check out ashtanga yoga?

Put it another way. Are you a virgin? No? Is sex good? Yeah? PMID Please? 😉

That’s it, yoga, like all exercise, is better than nothing, but which is best?

If you only do 30, 60, 90 or 120 mins of exercise each day, then what is the best set of exercises or the best system to use?

I’m sorry but I don’t see how a PMID can help you in this situation, can’t you think of a better way to check out ashtanga yoga?

You ask which exercise system is the best to use, with the clear implication that yoga is that system. Why do you believe that? What evidence do you have that 30 minutes of yoga is better than, say, 30 minutes of running or 30 minutes of calisthenics? Has someone done a study to show this? If not, how can we take the claim seriously?

Any activity that is based on a function other than strict function as a health system doesn’t count. Running, like sitting and eating too much fried chicken, is considered to be part of the every day wear and tear that yoga addresses.

You confuse the problem with the remedy. ‘Running’ is not a health system, it’s a survival strategy.

I will come back to Callisthenics, it deserves it’s own post (and a capital – C).

@Ashtinga, I believe you are outside of your element here. In science, you need to define your terms and provide evidence rather than assertions. First of all, what is the difference between a “function” and a “strict function”? and how does that matter medically?

As far as your assertions go, we are justified in asking for evidence. People make the same assertions you have about faith healers, magnetic bracelets, and WD40 for arthritis. I do not accept that I have to “try” these health panaceas in order to reject them. Unless you can provide reasonable evidence that Yoga is superior to similar forms of exercise, you have made no sale here.

@Licklan, We are way beyond establishing that science hasn’t got a seat on the panel, let alone fit to judge.

Go amongst those who do the thing and inspect them. Do it amongst ashtangis, then do it amongst any other class of person who does less than 2 hours exercise each day.

You will not find fitter.

The challenge is yours. The ashtanga yogi has nothing left to prove 🙂

So, wait – if someone begins a program of aerobic conditioning using running strictly for its health benefits and not to, say, avoid a hungry tiger or catch a departing bus, that’s not a set of exercises or a system?

I should add that running is a terrible comparison to yoga. If the assertion that yoga is better than similar forms of exercise, it should be compared to something that is low-impact, iso-static, low-aerobic and involving large range of motion at joints. Running is the opposite of all those things. The closest thing I can think of would be standard stretching routine combined with a variety of isostatic exercises (chair sits, etc). Perhaps Ashtanga could provide a better example that includes similar exercises, but lacks that special factor that makes yoga superior.

“Running, like sitting and eating too much fried chicken, is considered to be part of the every day wear and tear that yoga addresses.”

But if you only qualify running as daily wear and tear then you’re potentially missing out on the wider function of running as a medium through which one can affect ‘strict functions’, such as breathing functions (vital volume, tidal volume, rate and endurance), cardiac functions (stroke volume, stroke consistency, pressure and power) muscle function (strength, density, endurance, resistance, tone, defintion), as well as build volition, self-efficacy, perceptual and related cognitive skills, organisation and body image.

If you can’t even grasp what running (as a form of exercise) is and what it does – why should we believe you’re capable of any deeper analysis?

@Ashtanga, you have a poor understanding of science if you think science can’t evaluate the effectiveness of a fitness routine. What you are describing is called a group-control pseudo experiment. It’s not a true experiment because the groups are self-selected (i.e., you don’t randomly assign people to them, they just happen to already belong to one group or the other). The control group should be a group that is as similar as possible to the yoga group, not just regarding routine duration, but age, gender, affluence, prior medical history, etc. A selection of health criteria need to be selected ahead of time (without which it is tempting to choose criteria that happen to place the yoga group ahead, and ignore others). In science, this type of evidence would be considered poor, but acceptable (unlike anecdote, which has been shown useless time and again). The reason it’s considered poor is because it’s difficult to ensure that the control group is identical on everything other than the yoga teachings and practice. Such psueodo experiments are, however, routinely conducted in science because they are reasonably easy ways to identify effects that are worth funding true experiments.

“Go amongst those who do the thing and inspect them. Do it amongst rugby players/soccer-players, then do it amongst any other class of person who does less than 2 hours exercise each day.

You will not find fitter.”

I hope my edit illustrates the point.

You need to compare like for like in order to have a valid point. That you do not grasp the idea that people who work to improve thier fitness will generally be fitter than those who don’t is rather worrying, especially as you use it as the core of your structurally and logically false arguement.

Even more worrying is your rather arrogant assertion that you have nothing to prove, as if your mere say-so should be good enough for everyone else.

Well, it isn’t. Either put up or shut-up and stop wasting our time with your arrogance and ignorance.

Learn some humility and stop being so emotionally attached to an idea. You’re a really bad advert for Yoga at the minute buddy. You’re the Yoga equivilant of a sports-bore.

lol

Stop trying to split it up into individual measures. It’s too wide-reaching, you can ask 30,000 silly questions and you’ll still be none the wiser until you look at the bodies.

I’ll give you a clue, google ‘ashtanga pics’.

I believe that Tai chi is now so far removed from a fighting system that you could consider it to have no function other than health.

Licklan, We are way beyond establishing that science hasn’t got a seat on the panel, let alone fit to judge… Go amongst those who do the thing and inspect them.

Be very, very careful, though. If your inspection is too careful and you start getting objective, rigorous, and analytical, you might end up doing science which, as we know by some means not entirely clear, is not ‘fit to judge.’ Instead, the “challenge” is to do this inspection as a sort of personal vacation where you gather impressions in an easy, breezy, and good-natured way. Enjoy yourself, relax, stop being so critical and let go — jump in, the panel is fine.

Daniel Dennett sometimes talks about “deepities” — terms or concepts which trade on the ambiguity between two interpretations: one of them true but “trivial” (in the sense of being consistent with reason and science); the other one false but extraordinary. It would probably be useful to look at bit more carefully at what the yogi masters are actually claiming.

“Deepities” can also be known as the Trojan Horse, or Bait ‘n Switch.

@Ashtanga, again, you are demonstrating your ignorance of science. The subjective rating of physical fitness by visual inspection would be an excellent scientific measure of the effectiveness of yoga over a comparison group -provided A: it was done by raters who were not aware which bodies belonged two which group, and B: it was included in a group of many other measures (You cannot see cardiovascular disease for example, so you need a variety of measures). Google searching for soft-core does not, however, provide reasonable evidence Yoga is better than exercise in general.

I assert that if you look at people who swim an hour a day, you will find that they are healthier than those who practice yoga.

There, I’ve just proven you completely wrong, by the same standards you’re using. See why one has to provide actual EVIDENCE for such claims?

We are way beyond establishing that science hasn’t got a seat on the panel, let alone fit to judge.

That just states that you have no argument beyond continuous, blind assertion. After you make a statement like that, it becomes instantly clear that you have no idea what science is and can’t justify why you’re even arguing.

Good luck peddling that religion of yours.

OMG a poster!!1! Carefully-constructed trials can’t possibly stand up to the might of teh yoga posterz!

Google searching for soft-core does not, however, provide reasonable evidence Yoga is better than exercise in general.

I shouldn’t think Google searching for ‘soft-core’ should provide any evidence of Yoga at all… for a few pages of results, anyway. 🙂

I can pull up images for any number of fitness center posters, copies of fitness DVD covers, etc, etc, etc. that show incredibly fit people – to use that standard of evidence, I think porn actors & actresses must be the healthiest people on Earth, because Google has shown me how hot they are (and as such, sex workers must be the healthiest people on Earth).

Wow – who needs evidence when I can have porn?

@Beamup, That old chestnut, two problems:

Swimming is not available to all
Swimming is lethal.

Otherwise, looking at those that survive their risky swimming careers and swim 30, 60, 90 or 120 mins a day, yes they are healthier and fitter than ashtanga yogis who don’t also swim.

However, swimming is potentially lethal and excludes too many people who deserve good health.

Ever tried to swim for 30 mins in the Himalayas? That’s one experiment that needs no repetition.

The poster is so that you can see which ‘shapes’ are held/thrown/moved between when doing 90 mins of the basic therapeutic ashtanga yoga sequence.

Don’t judge the guy in the poster, I chose it because I’ve never heard of him before. Of course it would take the average person maybe 2 to 10 years to be doing the whole 90 mins as proficiently as the guy in that poster.

@Ashtanga said “yes they[swimmers] are healthier and fitter than ashtanga yogis who don’t also swim.”

Ok, so you concede that yoga is simply a good form of exercise, perhaps between running and swimming (with the added benefit of no drownings)? Boy you are a slippery devil. If we are just talking exercise here, mainstream medicine has an excellent handle on the health effects of physical activity. There is nothing “alternative” about it. Moderate exercise has a variety of positive health benefits -to a point.

@Ashtanga swimming is lethal? Talk about fear mongering. Yoga is potentially lethal. In fact, I am relatively certain that my iPad could, potentially, kill me. Do you tell people not to drive to yoga classes, and instead stay home, since driving is the leading cause of accidental death?

Swimming is not available to all

This is irrelevant to Beamup’s statement.

Swimming is lethal.

Patently false. I have been swimming any number of times and have not died. Yoga is equally lethal, as the building you are in can collapse during the session. Don’t get me started on the inherent risks of practicing yoga outdoors.

I wouldn’t say swimming was better actually, I wouldn’t be able to choose between the two and I’d love to see some real science comparing the two. I wouldn’t bother comparing anything else until you’ve compared ashtanga yoga and swimming.

If you think ashtanga is ‘moderate’ exercise then you haven’t seen what ‘ashtanga yoga’ actually is. Maybe you should try youtube unless you can explain to me how a PMID would deal with describing the intensity of a particular exercise regime?

I assert that if you look at people who eat precisely three potato chips a day, you will find that they are healthier than those who practice yoga.

I assert that if you look at people who power lift every day, you will find that they are healthier than those who practice yoga.

I assert that if you look at people who drink hard cider every day, you will find that they are healthier than those who practice yoga.

My asserting such things does not make them true or false, however.

Ok, forget yoga for a minute, I got a question?

If you had 30, 60, 90 or 120 mins every day, what is the best exercise and health system to practice?

You can say swimming if you like but I won’t be happy because I have nowhere where I can safely swim where I live. Anyway, is swimming the best? Is anything better?

@Nicole, yes I do suggest that students don’t drive to yoga class. I would rather they walk, cycle, swim, use public transport or to do their yoga at home.

I can afford to loose a student or two just to keep them off the roads for a couple of extra miles each day (though in all probability they will drive an extra 2 miles to go to a yoga class where the instructor isn’t so anti-cars!).

In the health fields, “Moderate exercise” is usually more about duration than intensity. The phrase is used to distinguish the kind of exercise recommended as part of a healthy lifestyle from high level athletics. This is because, while regular exercise provides plenty of health benefits, high level athletes often have unique medical issues due to the intense and repetitive strain they place on their bodies for competition. It is important to disambiguate the two for practical reasons, and was not intended as an insult to your activity.

@Ashtanga London – Perhaps you aren’t familiar with what “PMID” means. This stands for PubMed Identifier, a unique key to look up a study.

PubMed comprises more than 20 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

Essentially, you’re being asked to provide a published study, preferably peer reviewed, backing up your statements. Studies are done all the time to compare the effectiveness of various exercise regimes, in terms of measurable outcome (lung capacity, endurance, strength, and so on), opinion (how people feel after performing the exercise regimen), and lifestyle changes (how likely are people to continue performing the exercise regimen, how consistently do they perform it, and so on).
I really can’t understand why you’d think that science is incapable of measuring the effectiveness of exercise.

@mephisto, yes I believe that science is entirely capable of measuring ashtanga yoga.

The problem is, there are a hundred thousand small business which cannot seem to get together and pay for research to prove anything to anyone about their most excellent product. So we rely on word or mouth.

People do ashtanga, people see that they benefit, and so on. I can’t see how anyone is going to pay for the research, even though it is obviously the best system.

re: If you had 30, 60, 90 or 120 mins every day, what is the best exercise and health system to practice?

For people with health problems, that would be something which minimizes chance of exacerbating the problem. For everyone else, the best answer would probably be whatever that person feels most motivated to do. Compliance is key, and people will continue to do something they enjoy, and that may be yoga, or it may not.

For myself, I choose a routine that includes low-impact high aerobic exercise, and strength training. Those two goals are best accomplished with two different activities -I swim or cycle for the aerobic exercise, and progressive loading (weight training) for the strength training. Of course I include some stretching before, during and after. Yoga may be fun for some, but I find it boring and would not be motivated to stick with it.

See, that’s the thing. Without the research, you can’t know that it IS the best system. This isn’t some technicality. Humans are VERY bad at judging such things off the cuff – confusing correlation with causation, attributing significance to random variability, etc. Careful science is the only way to answer the question. In other words, your claim that “it is obviously the best system” is entirely unfounded. And almost certainly would be found factually false, given good evidence – simply based on the fact that there are so many possible systems, ANY of which might well be “the best” depending on how one chose to define that nebulous term.

And let’s please get off the details of swimming – it was just a semi-random form of exercise, not something to get caught up in!

While I might be the outsider in this particular forum, I find it frustrating when detractors choose to confuse the discussion by comparing apples and oranges.

I don’t understand the need to ask how Yoga will help bacterial endocarditis, or a burst appendix.

Discussing alternative medicines and yoga in regards to emergency medicine is absolute hogwash, and no person in those fields would argue a yoga move or a chiropractic adjustment would cure a broken bone, or save a person from a heart attack.

It would be the same as saying good nutrition is bogus because it wouldn’t help a person with gunshot wound.

To take it a step further, dermatology must be junk science since it they couldn’t help someone with bacterial endocarditis.

As a chiropractor, I do promote nutrition, exercise, and the ideal bio-mechanics of the spine, and the understanding of superior and ideal health. In the proper context this will make sense to anyone, and allow many sick people to get well.

If I break my arm I am going to an orthopedic surgeon for a consult, but it doesn’t discount the benefits that my profession provides.

It is too bad that someone like Locklin doesn’t set up the proper study that would measure the outcomes of said alternatives.

Swimming is lethal?

*life guard whistle* Everybody get out of the water! Get out of the water NOW!

Re: Ashtanga: “People do ashtanga, people see that they benefit, and so on. I can’t see how anyone is going to pay for the research, even though it is obviously the best system.”

Huh. I would say this is progress. You are still making an unfounded assertion, but it is a naturalistic one (as apposed to a supernatural one, so is testable by science) and it’s within the realm of exercise, rather than the new-age mess you started out with. You may have the opinion that yoga is the “best” exercise system, but their is nothing wrong with being a little biased about your favorite sport/activity, within reason.

good nutrition is essential sure. three things that happen when you do yoga:

Things like soda-pop, factory chicken, alcohol etc start to taste like the toxic muck that they are.
You fall over less, when you do fall, you hurt less, and then you see a doctor quicker and mend quicker.

As for bacterial endocarditis i’m guessing it’s a bug, do what we all do! if it’s not gone after 2 days or if blood is coming out, anything nasty, see a doctor or call an ambulance.

Burst appendix? I don’t know, are ashtanga yogis more or less likely to suffer this? I guess less but I don’t know. I bet when it happens we see a doctor quicker and recover quicker.

That doesn’t explain anything. Just the two most glaring flaws obvious from the abstract, either of which renders it incapable of supporting the conclusion:

– No control group. If you don’t compare ashtanga yoga to anything else, you can’t conclude that it is superior to anything else. There was apparently some attempt to compare to practices used previously, but this is fundamentally flawed. Naturally people currently practicing something think it’s superior to what they’ve done previously, or else they’d be doing the previous thing instead.
– Measures an outcome of unknown significance. Does a “flow state” actually improve real outcomes (e.g. risk of cardiovascular disease)?

Re: @Ashtanga: “This seems to explain it. Ashtanga yoga induces the ‘flow state’ which makes you better at managing everything in life and that includes your own health. ”

Awe crap. Scratch my last comment. I had hope.

I do commend you for making the attempt to produce real evidence, though.

Things like soda-pop, factory chicken, alcohol etc start to taste like the toxic muck that they are.

[Citation needed]

You fall over less,

[Citation needed]

when you do fall, you hurt less,

[Citation needed]

and then you see a doctor quicker

[Citation needed]

and mend quicker.

[Citation needed]

Dr. Graeme Gibson, D.C.
fusilier’s comment was in direct reaction to the statement “It is no secret that Ashtanga Yoga is the best all round holistic and preventative health care system ever invented.” I believe he was point out that the statement was unsubstantiated and overly broad, and he gave an example that would probe the claims about Ashtanga Yoga.
If you were to claim that “chiropractic is the best all round holistic and preventative health care system ever invented” (which I hasten to note you have not), you too might be asked to back that up.

let’s postulate an attempt at visualising a group.

This group do ashtanga yoga and they believe, rightly or not, that they have found the best health system.

Being the kind of people who like to be doing the best one, the very next thing any of us does is look for a better system.

We never find it.

Ashtanga yoga is like ‘anonymous’. An idea. You cannot measure the power of an idea. We will always have the best system because we are willing to use all systems including our core system.

If you are unwilling or unable to use a particular medical option then you are at a disadvantage of your own making.

You fall over less

How do you know how often I fall over?

@Graeme Gibson: If you followed this blog more I think you would be surprised at the things some Chiropractors and other “alternative” people claim. The recurring thing here, though, is the “bait and switch.” Sure it’s great that Chiropractors educate people about exercise and good nutrition -those are well established in science as effective. The problem arises when someone tries to co-opt these reasonable sounding ideas as “alternative,” and then start tacking on vitalistic nonsense and ineffective or dangerous treatments. If a yoga teacher claims yoga is amazing exercise, fine, ok, whatever. It’s when that teacher starts making claims that go beyond treating yoga as exercise and start treating it as some sort of health panacea that things start getting unethical and perhaps dangerous.

Alternative medicine does not exist. All medicine is complimentary to the core therapeutic activities of eating, moving and breathing.

Comments are closed.

%d bloggers like this: