Thursday, October 16, 2008

Rosehips for rosy hips? An adventure in PR and churnalism.

Avid readers of this humble blog should know by now the sort of fodder that boils up a Thinking Is Dangerous blogpost - dodgy quack medicines being touted as wonderdrugs, newspapers taking no notice of integrity and printing anything that pops into their inbox, the rubber-toothed fight by the Advertising Standards Authority to keep things in check, that sort of thing.

Once in a while, a story pops up which presses all the buttons, and with only a whisper of fat-fingered googling, I can sit in amazement watching the pieces of the story happily fall into place like a Christmas morning jigsaw.

Once again we'll turn the TID spotlight to arthritis, the Daily Mail, the ASA, and pretty pennies being made.

Modern medicine, although coming on leaps and bounds, is still a bit duff when it comes to diseases like arthritis. Outwith mechanical intervention, pain management is about all there is, and even then, the painkillers can have side effects and long term effects that aren't much fun.

Put yourself in that position - constant chronic pain, only slightly eased by medication - and suddenly old wives tales, exotic berries and other natural products seem to hold the answer. We can't hope for pill-pushers and nonsense therapy merchants to have much proof, because people buy the dream, not the evidence. We need medicine and knowledge that is evidence-based to be able to base our pain-management approach on treatments that have been shown to be effective. Otherwise, we're throwing our money at the moon.

We start the rosy story off with the Daily Mail, providing another excellent candidate for Dr* T's First Theory as it announces:

Are Rosehips a Remedy from the agony of arthritis? 18/06/2007

It's funny that the Daily Mail should put this in question form - it had already claimed they 'may reduce arthritis agony' in March 2006, 'tackle inflammatory diseases' in December 2006 and 'helps joint pain' in December 2007 - maybe they weren't sure, but just to drive the point home, they decided it was worth telling everyone again in September 2008 that they 'protect the joints from arthritis'.

Why so many touts for the humble hedgerow habitant, rosa canina? Well, it should take you less than 5 seconds to realise that the connection between all the touts is a product called LitoZin.

Here are a few quotes from the Daily Mail report:
A herbal medicine made from rosehips may regenerate joints in people crippled by arthritis, say scientists.
Studies show it can protect the cartilage cells which facilitate joint movement. Researchers claim the red hips - one of nature's richest sources of vitamin C - also improve activity levels by damping down an over-active immune system.

The Swiss studies looked at the action of the sugary fatty acid GOPO, the active ingredient in the rosehip supplement LitoZin. Researchers from the department of human nutrition and health in Basle, Switzerland, measured the effects of different doses on human cartilage cells.
The Department of Human Nutrition & Health in Basel, eh? Which university is that associated with, or indeed, why doesn't it say the name of the organisation? That's probably because the scientists are part of the Department of Human Nutrition & Health at DSM Nutritional Products, Basel, who manufacture i-Flex (nothing to do with Apple) which is marketed in Europe as .... LitoZin. (Press release here)

What a surprise. Now why was that bit left out of the Daily Mail report? The trademark is actually held by Dansk Droge, a Danish company, and perhaps why a lot of the Daily Mail articles refer to scientists in Copenhagen.

Now let me make two important points - firstly, the research may be of an astounding quality and impeccable beyond reproach. However, the fact that Daily Mail hides this information makes me think maybe it isn't. Also the fact that it is "announced at the Osteoarthritis Research Society's International World Congress in Rome" rather than in a peer-reviewed research journal means it's difficult to find out what went on. Secondly, there may well be some active ingredient in rosehips worth looking at, but, as I said above, with products like these, good research does little to enhance the sales, because people are buying a dream, regardless of the evidence. (I'll also remind you that we arthrites seem to be particularly susceptible to placebo). Why bother putting together a large well-run trial, when the same sales can be achieved by 2 or 3 small irrelevant ones?

So to recap, Daily Mail has published, on 5 separate occasions PR fluff from DSM (or their UK distributors - LanesHealth, or online from citing little/no firm evidence but being suspiciously cagey about where the evidence came from. Such is the state of churnalism in the UK press - the stories we read are there because they help line the pockets of the pill peddlers (and their PR agents) and nothing to do with public service, furtherance of scientific advances or importantly, helping people suffering from arthritis, except to empty their wallets.

One organisation who decided the evidence is absent, is the bastion of company's claims in print and other media, the Advertising Standards Authority. I've written about the ASA on a number of occasions, and praise them from the rooftops. My angst with them is that they have no power and no bite, save producing indirectly a few bits of negative PR.

Healthy Marketing Ltd (trading as Woods Supplements) came up against the ASA this week (15th Oct 2008). A direct mail catalogue had a claim, headlined "Rose-Hips may Ease Arthritic Pain ... ", appearing next to an image of the Daily Mail article headlined "Are rose-hips the answer to the agony of arthritis?", which stated rose hips had an unknown active ingredient that affected the blood cells involved in inflammatory and immune responses. The catalogue contained a myriad of en vogue health supplements which you can enjoy at your leisure.

According to the adjudication, Woods Supplements provided information, abstracts or the references of studies related to the properties of each supplement, including the Rosehip pills, to which the ASA summed up as follows:
We noted some references to clinical trials but that there was not enough information for us to assess whether the trial was valid or supported the claims. We therefore considered the information provided was insufficient to substantiate the claims made about the benefits of the supplements. We concluded the claims had not been substantiated and were therefore misleading.
So there you have it. Unsubstantiated and misleading. In the interests of disclosure, I should mention that I eat rosehip syrup quite often. Not for arthritis, but because rosehip syrup is easy to make, cheap and fantastically tasty with greek yoghurt. Maybe one day the pill peddlers will carry out a well-run clinical trial on rosehips which will warrant me to really indulge.



  1. Fine work Dr* T. Publishing the DSM PR fluff once would be bad enough, but on five separate occasions? The Wail are serial offenders.

    Interesting to see the Wail refer to the department the scientists work in, but not the name of the company they work for - shows how the media can feed you just the bits they want you to read. Using conference presentations is a classic woo / media tactic though. Krigsman's poster presentation at a conference and the Media's MMR hoax springs to mind.

  2. Excellent work. what's most amazing about this is that they republished the same stuff as if it were news - I don't know why but I thought even the Daily Mail wouldn't stoop that low.

    Then again as Ben Goldacre points out
    even academic journals are not entirely above this...

  3. Unfortunately it's not just the Daily Mail that republishes this drivel without questioning it.

    It's something that's happening across all sections of the media. The root cause of this downhill plunge in standards is profits - and big bonuses to executives.

    The problem is poor training of kids who think they know it all but don't, the slashing of budgets so that fewer journalists are having to fill ever more space and the diminishing role of sub-editors.

    You have every right to expect that someone with at least half a brain is going to filter out the rubbish and at least check some facts. But all too often it's not happening. Science is one subject area that has a particular problem in the media, as you're only too aware. Keep telling it as it is - and be sure to give us a shout of you spot any glaring examples. :)

  4. The typical quack doctor would arrive in a town or village, enthusiastically singing the praises of their elixir, often using a plant in the audience who would take the medicine and pronounce himself cured. They would sell their cure-all and then duck out of town, moving on to dupe the rubes elsewhere.
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