It is a menace to the public when governments license nonsense. It is a betrayal of the public trust, it diminishes all professionalism, and it generally propagates confusion in an area where licensure is meant to provide clarity.
One egregious example is naturopathy, which is licensed in 15 states in the US. Naturopaths are health care pseudoscientists (here’s a good overview). Essentially, they are what happens when medicine is completely disconnected from science, evidence, and even common sense. They generally endorse any medical woo they come across, without any coherent philosophy – although they do weave together some recurrent themes.
As their name implies, naturopaths generally follow the naturalistic fallacy – if it’s “natural” it must be good, and anything that seems technological or artificial must be bad. I think somewhere along the line science and logic became lumped in with all things unnatural, because naturopaths seem to avoid both diligently.
Kimball Atwood has put together a nice collection of revealing quotes from prominent naturopaths. Here is just one sample:
“Some doctors recommend taking baths with a cup or so of 3% hydrogen peroxide in the water to bring extra oxygen to the entire surface of the skin, thus making the lungs somewhat less oxygen hungry. This method can be performed preventively. Another technique for an acute attack is to drink some hot water with the juice of one clove of garlic.”
“Often the upper thoracic vertebrae will be out of alignment after an asthma attack, which will ultimately put pressure on the lungs and possibly precipitate another attack.” [Kane, E. Asthma]
Pure pseudoscience – complete with superficial medical jargon but delightfully devoid of any evidence or scientific rationale.
One theme favored by naturopaths is a belief in the healing power of pure water. This is based entirely in their historical roots, rather than any body of scientific literature. Barry Beyerstein wrote:
American naturopathy also has native roots in the “hygienic movement” of health reformers such as Sylvester Graham in the 1830s. A Presbyterian minister, Graham preached the gospel of vegetarianism, sexual moderation, abstinence from alcohol, the virtues of fresh air and exercise, and, of course, the water cure . Graham, whose “Graham crackers” began life as the quintessential whole-grain health food, also influenced John Harvey Kellogg, another religiously inspired health reformer who was physician to the Battle Creek Sanitarium founded by the Seventh-day Adventist prophet, Ellen G. White. There, Kellogg concocted his original cornflakes recipe as a complete vegetarian source of nutrients. During its heyday from 1840 to 1870, hydropathy, as advocated by Kellogg, was practiced at over 200 spas in the U.S. and supported several publications such as the Water Cure Journal and the Hydropathic Review.
Today naturopaths still cling to quaint notions about water. CBC news recently ran a piece by naturopath Lorne Swetlikoff titled:Water: Still your best health bet. Swetlikoff promotes the health benefits of pure water – but not, apparently, the intellectual benefits of logic. He writes:
If water makes up such a vital component of our body, it follows that the volume of water consumed, the form in which it is consumed — pure versus some other beverage — and its quality can have a dramatic effect on one’s health.
Actually that doesn’t follow. Lorne mixes in some basic biology – yes, we are mostly water and yes water is certainly necessary for life and health – with some naturopathic logical leaps, like in the quote above. Terrestrial animals all evolved to get the water they need from their environment. It does not stand to reason that one form of water is better than another, or that pure water has health benefits over water from other sources. Koala bears evolved to get nearly all of their water from eucalyptus leaves. Does that mean they are all unhealthy?
Unless water is tainted with bacteria or toxic doses of chemicals or impurities, its quality does not have a “dramatic effect” on health. There is no evidence that it has any effect.
At my naturopathic clinic, I recommend to patients that they consume approximately two litres of pure water a day to meet their physiological water needs.
Two liters per day is a reasonable amount. If you do the math we lose about 3 liters per day, get about 1 liter from food, and so need about 2 liters from liquid. But this is a rough estimate of typical needs, which will vary greatly by individual and day-to-day with activity, environment, and other factors. In truth there is no simple answer or formula for how much water a person needs each day.
It is far better to gauge how much you need physiologically, rather than to force a specific amount. Evolution has largely taken care of this, of course – when you are thirsty you need more fluid. Unless you have a medical condition that requires specific attention to your fluids, thirst is a very reliable indicator of your water needs. Another excellent guide is your urine. The darker the urine the more dehydrated you are. So another guide is to drink enough to keep your urine pale.
There is also some common-sense advice worth giving. If you are going to be in a situation where your water needs are likely to be great, then it makes sense to pre-hydrate and stay ahead of your hydration, rather than waiting until you are already dehydrated. For example, if you are going to be in a very hot or dry environment, engage in physical activity, or be at a high altitude you may want to hydrate ahead of time (but not overdue it) and then keep up pro-actively with your hydration needs. This is because you can become dehydrated very quickly in these situations.
And, as I discussed before, there is no reason to drink “pure water.” You can get your water from other water-based liquids, like juices, tea, even soda will hydrate you. Drinks that have a lot of caffeine are not ideal because caffeine is a diuretic (it makes you pee) – but if you are dehydrated your need for fluid will trump this mild diuretic effect. So don’t avoid fluids if you are dehydrated just because they may contain some caffeine or sugar or something else.
In fact pure water is often not ideal for hydration. Your body fluids are not made of pure water (although they are mostly water) – they contain electrolytes and other substances. In fact you need electrolytes to hold onto your water. If you drink pure water while peeing and sweating salty water, for example, you will slowly waste salt and other electrolytes, and then your kidneys will try to get rid of some water to concentrate the electrolytes back to their normal range. Normally you can get the electrolytes (and other stuff) you need from food – so if you are eating normally then pure water is fine. But if you exercising and not eating, then pure water is not ideal. In fact many runners often do themselves harm by overhydrating with pure water. You are better off hydrating with something like a sports drink that has electrolytes in them.
Essentially you need to get enough water and electrolytes from various sources so that your body (through kidney function and other methods) can maintain your blood and “precious bodily fluids” within normal parameters. But it generally does not matter what form the water and other nutrients come in or how they are mixed together. They all end up in the same place eventually.
More dubious advice from Swetlikoff:
While identifying and removing impurities from water is essential for good health, several other parameters should be tested to establish whether or not you are drinking water that is giving you optimal health benefits. These include pH, redox potential and resistivity.
The optimal pH level of water is about 6.5-6.8, or slightly acidic (the pH range is 1-14, with 7 being neutral, that is, neither acidic nor alkaline). If the water is too acidic or too alkaline, this can upset the normal pH level of your body and create unhealthy stress.
If you consumed only soda pop or even fruit juice as a principle source of fluid, your pH level would likely be low or acidic and the rH2 levels too high. Such an acidic environment can set the stage for disease.
Oh, my – you have to measure the pH of your water to get optimal health benefits? Complete nonsense. Your body has elaborate mechanisms to maintain its own pH (do you think that Homo erectus was measuring the pH of their water on the plains of Africa?). You can overwhelm your body’s pH regulation by drinking a lot of really basic or acidic fluid. But you have to go out of your way to do this – you don’t have to measure the pH of your water to avoid it. You can also get all your water content from fruit juice without adversely affecting your pH. Essentially, if a food or liquid is safe for you to eat or drink, it is neither too basic nor acidic. So don’t worry about it.
I am having a hard time grasping this next one:
Resistivity (r) is a measure of the mineral content of water. Ideally, water will have a resistivity of at least 6,000 ohms, which indicates a fairly low mineral content. Minerals from water are poorly absorbed compared to those found in our foods, so water with a high mineral content can put undue stress on kidneys and other organs and tissues in the body.
So, minerals are poorly absorbed from water, then how would they get into the body to put undue stress on your kidneys or other organs? This would at least make sense (although would still be devoid of evidence) if he claimed that we absorbed minerals readily from water, so high mineral content water could give us too many minerals and our kidneys would have to work overtime to excrete them.
The primary minerals in water are calcium and magnesium – two minerals your body needs. And you get vastly more from your food than even from hard water. It simply is not an important factor. Here is what the World Health Organization has to say about water hardness and health:
There does not appear to be any convincing evidence that water hardness causes adverse health effects in humans. In contrast, the results of a number of epidemiological studies have suggested that water hardness may protect against disease. However, the available data are inadequate to prove any causal association.
This is the level of “science” typical of naturopaths. Lest you think I am picking on an unfair example, Lorne Swetlikoff is the current president of the College of Naturopathic Physicians of British Columbia. To a non-critical thinker the pseudoscience spewed by Swetlikoff and other naturopaths may sound compelling and “sciencey.” But on close examination it is pure pseudoscience. Generally they begin with some naturalistic philosophy and then back fill in some loose scientific justification. But their logic is flawed and their information incomplete or wrong, so their final recommendations make no sense.
They are also immune to criticism – and this is the key. If a scientist made such flawed arguments their own community would roast them. Eventually a consensus would settle on recommendations that were logical and compatible with existing evidence. This is the self-correcting mechanism that is essential to science. No such mechanism is evident within naturopathy.
As a side note I am always interested to read the comments with such online articles. The comments for this article are what I have come to find are typical. Half are nicely skeptical, even hitting upon specific criticisms of the nonsense presented. The other half rails against “western” science and being closed-minded. We are seeing a manifestation of distinct world views, and I both wonder and worry about how deep and wide the distinction runs.