Is alternative health a form of fundamentalism?

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average lifespan was … 35!

That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, American average lifespan was only 48. Today, advocates of alternative health bemoan the current state of American health, the increasing numbers of obese people, the lack of exercise, the use of medications, the medicalization of childbirth. Yet lifespan has never been longer, currently 77.7 in the US.

Advocates of alternative health have a romanticized and completely unrealistic notion of purported benefits of a “natural” lifestyle. Far from being a paradise, it was hell. The difference between an average lifespan of 48 and one of 77.7 can be accounted for by modern medicine and increased agricultural production brought about by industrial farming methods (including pesticides). Nothing fundamental has changed about human beings. They are still prey to the same illnesses and accidents, but now they can be effectively treated. Indeed, some diseases can be completely prevented by vaccination.

So why are advocates of alternative health complaining? They are complaining because they long for an imagined past that literally never existed. In that sense, alternative health represents a form of fundamentalism. Obviously, fundamentalism is about religion and the analogy can only go so far, but there are several important characteristics of religious fundamentalism that are shared by alternative health advocacy. These include:

The desire to return to a “better” lifestyle of the past.
The longing for a mythical past that never actual existed.
An opposition to modernism (in daily life and in medicine).
And the belief that anything produced by evolution (or God, if you prefer) is surely going to be good.

Advocates of alternative health bemoan the incidence of diseases like cancer and heart disease without considering that they are primarily diseases of old age. That both cancer and heart disease are among the primary causes of death today represents a victory, not a defeat. Diseases of old age can become primary causes of death only when diseases of infancy and childhood are vanquished, and that is precisely what has happened.

Alternative health as a form of fundamentalism also makes sense in that it has an almost religious fervor. It is not about scientific evidence. Indeed, it usually ignores scientific evidence entirely. All the existing scientific evidence shows that all of the myriad claims of alternative health are flat out false. None of it works, absolutely none of it. That’s not surprising when you consider that it never worked in times past; advocates of alternative health merely pretend that it did, without any regard for historical reality.

Alternative health is a belief system, a form of fundamentalism, and like most fundamentalisms, it longs for a past never existed. It is not science; it has nothing to do with science; and it merely reflects wishful thinking about the past while ignoring reality.

Amy Tuteur is an obstetrician-gynecologist who blogs at The Skeptical OB.

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  • Josh Briscoe

    What of “integrative medicine?”

    Many patients are going to experiment with alternative medicines anyway for a number of reasons (hopefully none of which is distrust of their physician, but that’s sometimes true). As long as it doesn’t interfere with more effective treatment, I don’t think it’s the physicians place to judge them, either.

  • Pingback: Wishing for a return to what never was « Whispers

  • Shan

    Can you give some statistics and actual factual data about your purported 33 year lifespans, specifically from the Eastern world where other forms of medicine were used (Ayurveda and Acupuncture)?

  • http://www.teslawav.com Michael Porter

    It is certainly true that there is a fundamantalistic approach to much of the claims of alternative medicine.To make the statement that none of it works shows an equally fundamentalistic faith in the scientific method and “conventional”, allopathic medicine.

    If you had said that much of it is unproven, that is a reasonable statement. To say that it is unscientific is absurd. There are many studies being done by conventional scientific organizations, through the NIH, for example, to determine the efficacy of so-called alternative medicine.

    Even the term alternative medicine is misleading. It all depends where one sits. From the perspective of ayurvedic medicine, or acupuncture, western medicine is alternative.
    They have been around for thousands of years.

    Taking a wholistic view toward health is certainly not a bad thing, and much of what you term alternative medicine is slowly creeping into conventional allopathic medicine.

    The medical profession evolves in fits and starts like any other. In 100 years, the practice of medicine will be much different than today. Belief systems change, attitudes change, and technology changes. If you were truly a healer you would at least show an open mind to “alternatives” and incorporate into your practice those things that work. Who cares what it is called.

    There are so many biases and inaccuracies in your few paragraphs that iI have only approached a few. The mysteries of life abound. I am sorry you have closed your mind to its wonder. Skepticism is good; closemindedness is just stupidity.

  • Andrew

    Should an “alternative treatment” go through a scientific, peer-reviewed analysis and shown to be effective, would it still, by definition, be “alternative”?

  • http://www.fitnessrocks.org drmonte

    Amy,

    I’m not sure what you include in your definition of “alternative medicine.” If it is limited to pills, potions, and treatments that come from a “provider” to a patient, then I would agree that much of what is promoted lacks rigorous scientific backing, and I don’t like it either.

    On the other hand, you seem to have a problem with organic food and I wonder if that reflects a lack of appreciation for the role of a healthy diet based mostly on plants?

    We live longer today for lots of reasons, beginning with learning how to wash our hands and dispose of sewage – sanitation advancements that curtailed the spread of infectious diseases. Antibiotics and vaccines helped us conquer even more of the infectious disease killers, so, yes, modern medicine has greatly improved our lives.

    But, you should rethink your position on the diseases of old age, especially since we now have children under 10 with type 2 diabetes, hypertension and metabolic syndrome. These kids may very well start having heart attacks as young adults. Autopsy studies in young people (teenagers) have shown the beginnings of atherosclerosis.

    The point about evolution and the importance of how our ancestors lived has nothing to do with the quality of their lives. I agree with you, sleeping in caves, getting eaten by tigers, or dying from plague would stink. The point about the environment of our ancestors is that it provided the stage upon which, and in which, we evolved. So, for example, we evolved in an environment that required lots of physical activity. We evolved in an environment in which food was scarce and there weren’t jelly donuts within arm’s reach around the clock. This evolutionary history has profound implications for our health today.

    The “diseases of old age” are becoming diseases of young people as we spend more time being sedentary and continue to consume calories well in excess of what we need.

    Speaking to your point about organic food. I don’t know what you meant by that remark, but another aspect of our evolution is that we need the thousands of nutrients with antioxidant and antiinflammatory properties to avoid the diseases of old age you describe. These nutrients aren’t found in twinkies.

    If you’re inclined to dismiss what I’m saying I would refer you to journals like the New England Journal of Medicine, JAMA, Archives of Internal Medicine, American Journal of Clinical Nutrition, etc. Research on the impact of lifestyle is abundant. Lifestyle is important. In fact, the diseases of old age are mostly diseases of lifestyle. Here are some fun facts: Research in the prestigious journals I just mentioned confirm that 90% of all cases of type 2 diabetes are preventable. 80% of all cases of coronary heart disease are preventable. About a third of all cancers are preventable. The means of prevention are simple healthy lifestyle habits.

    Here’s another fun fact: The strongest risk factor predicting whether a person will die prematurely from a “disease of old age” is measured aerobic fitness. I know, you thought it would be cholesterol, or diabetes, or smoking, or high blood pressure. But, it turns out to be how far and how fast you can go on a treadmill. Weird. This data does not diminish the importance of the other risk factors, but it does add some perspective doesn’t it?

    Yes, we grow old and die no matter how much broccoli we eat or how many miles we log on the treadmill. The issue is something called “Compression of Morbidity” and it has been described in articles in NEJM and other peer-reviewed journals by a group out of Stanford dating back to at least 1980. Basically, compression of morbidity is the idea that if you don’t smoke, if you eat a healthy diet, if you exercise regularly, and if you avoid being overweight not only do you live longer (on a population basis) but you live longer without disability from “diseases of old age.”

    Of course, it’s possible that you knew all this and were not including lifestyle in your definition of alternative medicine.

    One last note about pesticides. I won’t even talk about the potential human health consequences. The plethora of chemicals we have sprayed across the planet have had a devastating effect on the other creatures that live here – many of them now extinct. Perhaps there are reasons beyond our own self-interests to take better care of the planet?

    Monte Ladner, M.D.

  • http://www.skepticalob.com Amy Tuteur, MD

    “To make the statement that none of it works shows an equally fundamentalistic faith in the scientific method and “conventional”, allopathic medicine.”

    None of it works. There have been billions of dollars spent (wasted) testing it and none of it works. None of the myriad of claims put forth by practitioners of alternative health are true.

    “Alternative” health is no more real than “alternative” engineering or “alternative” chemistry. It is nothing more than wishful thinking on the part of its advocates, and charlatanism on on the part of its practitioners.

  • JoshMD

    That has to be the best piece I’ve ever read on alternative medicine. Thanks Dr. Tuteur.

  • http://www.fitnessrocks.org drmonte

    Amy,

    I am absolutely with you in demanding that medical treatments of all kinds stand the test of rigorous, objective scientific research. And I agree that much (perhaps all) of what is available in the alternative medicine world does not have this. Dietary supplements are my biggest pet peeve. The supplement industry has been given the freedom to market their products and make claims for their products with no requirement for clinical testing to prove either safety or efficacy. It is a disgrace that this is allowed to happen.

    On the other hand, we have a big problem with our own peer-reviewed research. Skip to the end of the next article you read about a new drug or device. Chances are very high that the research was funded and directed by the company that makes the drug. The influence of the pharmaceutical industry in the research we use to make clinical decisions is overbearing and is making our “evidenced-based” medicine somewhat of a joke as well.

    We need to insist that research on the drugs we prescribe and the devices we use are researched by public institutions that have no financial interest in the outcome of the research. In the absence of this sort of standard we aren’t being much more scientific than our alternative counterparts.

    Monte Ladner, M.D.

  • Jen

    While I don’t disagree with anything you said about alternative medicine, I do hope that you realize that the “35 year lifespan” was due to the extremely high infant mortality rate. If children could get past through the first five years or so, then they lived lifespans that were somewhat similar to ours (obviously not too many people lived to be 90, but certainly 60-70 wasn’t uncommon, at least in Western Europe and the Americas…I haven’t studied much about Asian history so I’m not sure about them).

    Just a pet peeve of mine, as so many people seem to think that it was pretty rare for people to live past 40 back then :-)

  • http://www.skepticalob.com Amy Tuteur, MD

    “In the absence of this sort of standard we aren’t being much more scientific than our alternative counterparts.”

    Those are two very different problems and they call for two very different responses. Manipulation of research by the pharmaceutical industry is unethical. Promotion of “alternative” health is unscientific.

    I agree that unethical research practices are a serious problem. However, they are, by definition, a violation of standards for scientific research. They should be identified, addressed, and, if necessary, punished accordingly. The truth exists. Some companies may try to obscure it, but ultimately we can learn what it is.

    “Alternative” health violates the basic principles of science. Not only do alternative health practitioners fail to prove their claims, they often dispute the need to prove them at all. “Alternative” health depends utterly on a lack of knowledge of basic science, medicine and elementary statistics. Alternative health is to medicine what alchemy is to chemistry, or astrology is to astrophysics. All three are pseudoscientific fantasies.

  • Shan

    You do understand that Alchemy lead to chemistry do you not? You also understand that Astrology and “Astrophysics” (which is a modern discipline, perhaps you meant Astronomy) too were and still are extremely intertwined, I hope anyway!

    There is plenty of proof for CAM, not to mention the fact that these systems have been being practiced for thousands of years before the arrival of allopathic medicine.

    I am still waiting for statistics however.

  • Greg

    Great piece. My own blood pressure goes up a few clicks whenever I hear another otherwise intelligent person spew vitriol towards scientific progress in the name of some nonexistent utopian past.

    It reminds me of the timeless quote from Thomas Hobbes’ Leviathan describing a state of humankind before the dawn of reason: “…the life of man, solitary, poore, nasty, brutish, and short.”

  • ninguem

    Jen – “35 year lifespan” was due to the extremely high infant mortality rate…….

    And obstetrical mortality from that “natural” childbirth, mentioned many a time by Dr. Tuteur. I’m sure she could give you a tour of a local colonial-era cemetery in Massachusetts. I know I could in my nearby area. The man who managed to live to older age. Multiple wives. We’re talking Massachusetts, not Utah. Sorry, no Mormon jokes. The multiple wives died in series. Check the dates on the gravestones. They died in childbirth. Then one wife lived to old age. A bunch of little gravestones, usually with lambs carved on them.

    Skulls with wings on the seventeenth and eighteenth-century stones, changing to weeping willows on the nineteenth century stones.

    The cemetery stood between my home and my elementary school. I got an education cutting through the graveyard. My teachers were glad to reinforce the lession.

    Actually, when you read of the nineteenth-century “Rural Cemetery” movement, the city fathers of a century ago would have been pleased to read this. They wanted the cemetery to be a pleasant place to stroll, and learn about the past.

    See the men, many of them lived to their 40′s and 50′s, dead of what we NOW call “early” coronary disease and uncontrolled hypertension.

    IF you survived all that, then the old man or old woman of the early-American town lived to be 70, 80, 90 years old. Now, we all want to live to be……..70, 80, 90 years old. Hopefully with our brains intact.

  • Anonymous

    Commenter Don Quixote wrote “There are many (alternative medicine) studies being done by conventional scientific organizations”

    Yes, this is always the case. And that was fine when the US was only spending 2% or 4% or 10% of our GNP on “health care. The problem today is limited resources.

    There are PROVEN MEDICAL TREATMENTS that are TODAY being displaced by the costs associated with the pursuit of alternative medicine…properly called quackery.

    Part of the reason the U.S. spends so much on health care with so little result is our quixotic pursuit “alternative medicine”

  • Brian Loveless, DO

    Bravo Dr. Amy. Nothing makes for a stronger argument than to frame the other side’s reasoning yourself.

    No one is doubting that medical science has improved lifespan, especially in the area of acute diseases and infections. However, a careful look at human history shows that the greatest improvement in life expectancy came during the late 19th and early 20th centuries and was due to a large extent to increased hygiene, especially by OBs who finally listened to Semmelweiss and washed their hands before moving on to the next delivery. Easy access to clean water and the introduction of penicillin in the 1930s-1940s led to the largest gain in life expectancy, almost 40 years.
    Later gains in the past 60 years have been more modest, almost 20 years. But the current approach to “preventative medicine” has only yielded small gains in life expectancy. This is because the public has bought into the miracle cures of modern medicine and therefore yielded all responsibility to us as physicians. I don’t have to worry about what I eat or whether I exercise, the doctor will have a pill to fix it. And when they don’t, I’ll just sue them for malpractice.
    Eating organic foods, getting exercise, not being obese, and avoiding use of medications when not necessary are simple, easy steps that people can use to extend their individual lifespan, while taking advantage of the enormous gains provided by modern hygiene and food safety. The role of the doctors should be as advisors, teachers, and as interventionists only last.
    l

  • http://www.skepticalob.com Amy Tuteur, MD

    “However, a careful look at human history shows that the greatest improvement in life expectancy came during the late 19th and early 20th centuries and was due to a large extent to increased hygiene, especially by OBs who finally listened to Semmelweiss and washed their hands before moving on to the next delivery.”

    I realize that alternative health practitioners tell each other that, but it is factually false.

    First, public health and hygiene ARE medical advances. They are the direct result of elucidating the causes of bacterial illnesses and taking the proper attempts to prevent them. Public health and hygiene measures were created by doctors and scientists, based on discoveries of doctors and scientists and implemented by efforts on the part of doctors and scientists.

    Second, Semmelweis’ story has been twisted by alternative health advocates for their own ends. The reality is quite different. According to medical historian Irvine Loudon, the notion that Semmelweis was a tragic hero whose great work was ignored is wrong:

    “…But most of the claims made about him in the twentieth century – that he was the first to discover that puerperal fever was contagious, that he abolished puerperal fever (or that if he did not, it was because of the stupidity of his contemporaries), and that his treatise is one of the greatest works in nineteenth-century medicine – are sheer nonsense…”

    Third, you say “the current approach to “preventative medicine” has only yielded small gains in life expectancy. This is because the public has bought into the miracle cures of modern medicine and therefore yielded all responsibility to us as physicians.”

    No, preventive health yields small gains because that is the nature of preventive health. Most diseases are not caused by lifestyle choices and therefore, they are not amenable to prevention by lifestyle choices. Preventive health doesn’t save money, either.

    The bottom line is that health and life expectancy have never been better than today and the reason is modern medicine.