Healthiest JANUARY/FEBRUARY 2006 VOLUME 33 / NUMBER 1 The CENTER FOR SCIENCE IN THE PUBLIC INTEREST $2.50 Spreads — p a g e 1 3 —

BY DAVID SCHARDT Everybody loves Dr. Andrew Weil, “the guru of alternative medicine,” as the jacket of one of his 10 books describes him. Ditto for Dr. Phil McGraw, who catapulted from a 1998 guest appearance on “Oprah” to hosting a daily TV show seen by millions of Americans. And who doesn’t trust Larry King, who’s been interviewing kings and presidents and Hollywood stars since before many of his viewers were born? So when Weil tells us to take vitamin E every day, or McGraw says that his jazzed up multivitamin can help us lose weight, or King says that he uses a certain garlic supplement because it lowers cholesterol, we listen. And we buy. And, more likely than not, we overpay or waste our money entirely. C o n t i n u e d on page 3. Photos: Reuters. Photo illustration: Jorge Bach. COVER STORY

illionsillions ofof AAmericansmericans sswearwear bbyy tthehe aalternativelternative mmedicineedicine ooff DDr.r. AAndrewndrew WWeil,”eil,” ssaysays “ TIMETIME MMagazineagazine ooff tthehe ssoothing,oothing, ccherubicherubic mmedicineedicine mman.an. YYetet hhowow mmanyany aadmir-dmir- M ersers kknownow tthathat WWeil,eil, hhisis ccompany,ompany, aandnd hhisis ffoundationoundation aarere gguaranteeduaranteed $$1414 mmillionillion throughthrough mid-2008mid-2008 fromfrom thethe salesale ofof vitaminsvitamins andand otherother supplementssupplements hehe recommends?recommends?

Dr.Dr. PPhilhil MMcGrawcGraw sseemseems iinn ccommandommand wwhenhen ttalkingalking aaboutbout rrelationships.elationships. YYetet hhowow mmanyany ffansans knowknow thatthat hishis ShapeShape UpUp multivitaminsmultivitamins werewere pulledpulled fromfrom thethe market,market, reportedlyreportedly inin thethe faceface of a Federal Trade Commission investigation into complaints of false advertising?

NoNo ttalkalk sshowhow hhostost iiss mmoreore ttrustedrusted tthanhan LLarryarry KKing.ing. YYetet hhowow mmanyany vviewersiewers kknownow tthathat mmanyany of the supplements he has recommended are backed by questionable evidence?

There’s something wrong when the people we trust use their status to line their pockets.

(Repeated requests to interview Andrew Weil, Phil McGraw, and Larry King about their supplement endorsements went unanswered.)

Andrew Weil Doctor, Sell Thyself Weil offers himself to the public and the He’s been called “America’s doctor,” a media as an informed, sensible authority “pioneer in the medicine of the future.” on supplements. In September, he ap- Andrew Weil is the Philadelphia-born, peared on NBC’s “Today” show for three Harvard-trained physician who migrated consecutive days “to help us navigate to the Arizona desert 30 years ago to through the nutritional maze and the champion what he calls “integrative medi- role vitamins can play,” as host Katie cine,” which, he says, melds the best of Couric explained to the audience. modern science with alternative healing. In October, TIME Magazine put him Weil’s (mostly sensible) advice and on its cover and featured his advice for his focus on the body’s natural healing aging gracefully with healthy food, exer- powers is a one-two punch that’s hard to cise, and supplements. resist. And he has used his popularity to Millions of people go online to seek sell books (5 of his 10 titles were New York Weil’s advice about whether to take sup- Times best- sellers), CDs, and online advice plements. His “Vitamin Advisor,” a staple prominently on his Web site (but not (more than a million people a month visit on drweil.com for a decade, offers his mentioned in the TIME Magazine cover drweil.com and drweilselfhealing.com, “personalized” recommendations “based story or in the chapter on supplements in which is now owned by Martha Stewart on your specifi c health concerns.” his new book, Healthy Aging). Living Omnimedia). But Weil is hardly an objective expert. “I don’t get money from the vitamins He even sells cosmetics (Estée Lauder He markets his own brand of supple- that I make,” he told Couric. “My after-tax is producing his mushroom-based line of ments—18 products ranging from multi- profi ts go to a foundation that supports anti-aging face serum) and dog food (“Pet vitamins to B vitamins to high doses of integrative medicine.” Promise is the fi rst commercial pet food I vitamins C and E. Weil seems to be saying that people have found that truly supports my com- “How can we trust we’re getting the should trust his advice because he has mitment to their nutritional well-being”). straight skinny from you when you’re nothing to gain when they buy the vita- But it’s the vast sums of money Weil is obviously pushing your own vitamins?” mins he recommends. Not exactly. being paid to promote supplements that Couric asked him point blank during his In 2003, Weil signed a blockbuster fi ve- would raise consumers’ eyebrows—if appearance last September. year deal with the giant online pharmacy Photo: Reuters. they knew about it. Weil gave her his standard disclaimer, which is similar to the one displayed > > > > >

NUTRITION ACTION HEALTHLETTER ■ JANUARY/FEBRUARY 2006 3 COVER STORY drugstore.com. It seems to give him a lot (We could fi nd no mention of the some $2.5 million. to gain from recommending supplements. drugstore.com deal in Weil’s media inter- Maybe the money was swallowed up in According to their contract, which runs views, books, or Web sites. The details expenses before the after-tax profi ts were through the middle of 2008, drugstore.com came to light last summer when computed. Or maybe when Weil says “I has agreed to pay: drugstore.com sued Weil for breach of don’t get any money from the vitamins ■ To Weil directly: monthly honoraria that contract for “failing to use commercially I make,” he’s not including any salary will let him pocket a total of $1.6 million; reasonable efforts to promote” his prod- or consulting fees his company may pay ucts and his site on drugstore.com.1) him. Or perhaps Weil is saving it all up to ■ To Weil’s foundation: a “donation” of With those kind of sums passing hands, make a lump-sum donation later. 1 percent of all supplement sales from and with Weil saying “I get no money from We tried to fi nd out, but Weil didn’t re- Weil’s Web sites and his section of the vitamins I make” because his after-tax spond to repeated requests to his publicist, drugstore.com; profi ts go to a foundation, that foundation public relations fi rm, and foundation to ■ To Weil’s company (Weil Lifestyle): com- must be rolling in dough. talk about his marketing deals. missions of up to 30 percent on supple- Nope. In any case, Weil could have been ments Weil sells on his and drugstore more forthcoming about the foundation .com’s Web sites. Together with the Underfunded Foundation with the “Today” show audience. When “donation” to the foundation, that will he said that “my after-tax profi ts go to mean at least $12.4 million. The Weil Foundation received nothing a foundation that supports integrative Bottom line: the contract with drugstore from Weil or his company in 2003 and medicine,” he could have mentioned that .com guarantees Weil, his company, and 2004, according to the most recent tax the foundation’s “primary benefi ciary” is his foundation at least $14 million through returns the foundation fi led with the Weil’s own program at the University of June 2008, even if his commissions add up Internal Revenue Service. Yet during that Arizona. to less. If Weil sells more supplements, the period, drugstore.com was contractually Since it was launched in 2002, the total could be even higher. obligated to pay Weil and Weil’s company Weil Foundation (which was originally The Vitamin Trap

ho is your vitamin advisor? we’d need to take supplements total- WIf you want it to be AndrAndrewew ing $98.70 a month. Weil, click on the “Vitamin Advisor” Ordering the supplements that box at drweil.com to get a free “per- Weil recommended was as simple sonalized” vitamin recommenda- as checking the box next to each. tion “based on your specifi c health Every month a package would arrive, concerns.” the order form told us, with each The clicking may be free, but the day’s pills shrink-wrapped in their results aren’t. No matter how we own CustomPak. tried, we couldn’t get the Advisor Why was it so easy to spend so to stop recommending that we buy much money? A cynic might con- supplements galore. clude that it’s because drugstore The fi rst time we worked our way .com is paying Weil’s company a through the Vitamin Advisor’s 48 14 to 25 percent commission on questions, we were a non-smoking, non-drinking, 60-year-old every CustomPak or Weil-brand supplement he can persuade woman in tip-top health who eats a stellar diet—at least fi ve visitors to his or drugstore.com’s Web sites to buy. The online servings a day of fruits and vegetables and three servings of pharmacy handles the transactions, according to a contract dairy, plus fi sh at least four times a week. Weil’s recommenda- signed in 2003 that guarantees Weil, his company, and his tion: $48 a month worth of multivitamins, fi sh oil, and calcium foundation at least $14 million through the middle of 2008. pills. Weil also gets a cut from any supplement sales that come from A 30-year-old woman with the same profi le? $48 a month. subscribers to “My Optimum Health Plan,” his online customized A 25-year-old male? $45 a month. program intended to “help you address your health issues.” And if you’re not a paragon of good health? When we went My Optimum Revenue Plan sounds more like it. According to back as a 55-year-old man with an enlarged prostate, high the drugstore.com contract, “It is anticipated that vitamins, herbs, blood pressure, high total cholesterol, and low HDL (“good”) minerals and/or supplements, together with advice from Dr. Weil, cholesterol who doesn’t exercise and is under stress, who has will be sold in connection with the My Optimum Health Plan at least fi ve alcoholic drinks a day, and who eats little or no Assessment.” vegetables, fi sh, or dairy foods, the Vitamin Advisor told us

4 NNUTRITIONU T R I T I O N AACTIONC T I O N HHEALTHLETTERE A LT H L E T T E R ■ JANUARY/FEBRUARYJ A N U A R Y / F E B R U A R Y 20062 0 0 6 known as the Polaris Foundation) has Dr. announced four grants totaling just sychologist internalinternal e-mail $60,000. Half the money went to Weil’s PPhilPhil MMcGrawcGraw message discuss- Program in Integrative Medicine. waswas wworkingorking aass a Phil ing promotionalpromotional So despite Weil’s disclaimers, the more jury consultant in copy for his Shape supplements he can persuade people Texas in 1998 when Oprah Winfrey hired Up supplements, McGraw wrote: “...They to buy on his and drugstore.com’s Web his fi rm to help defend her against a “food need to redo the one that says I created sites, the more Weil, or his company, or defamation” lawsuit by the cattle industry. these products b/c I have no expertise.” his foundation, or his Integrative Medi- In April 1996, during a segment on how The e-mail is part of the court record cine program benefi ts. Ironically, Weil himself makes an mad cow disease could spread, Winfrey in a 2004 suit by three California consum- excellent case against listening to his told her TV audience that the way dead ers who charged McGraw with making advice on supplements. Here’s what he cows are rendered into feed for other false and misleading statements about writes in his book Healthy Aging about cows “has just stopped me cold from eat- his supplements, according to the New fi nding objective advice on human ing another burger.” After the broadcast, York Daily News, which made the e-mail growth hormone (HGH): beef prices plummeted. public in December.1 “It is hard to obtain unbiased infor- Oprah, impressed by McGraw’s In March 2004, facing a Federal Trade mation on the benefi ts, dangers, and appropriate uses of HGH, because most shrewdness and candor, invited him to Commission investigation into Shape Up’s of the doctors and other experts who appear on her show. That gig turned into claims, McGraw pulled his supplements talk and write about it are in one way or regular appearances, which “Dr. Phil” off the market and the FTC dropped its another involved with its distribution parlayed into a syndicated talk show that probe, according to the Los Angeles and marketing.” featured him as an expert on families, Times. To get “an objective view from an marriage, and relationships. (McGraw Soon after, McGraw showed up in unbiased expert” on HGH, Weil turned to has a Ph.D. in psychology from the Uni- the fi rst weight-loss milk moustache ad, an acquaintance who had “no fi nancial interest in promoting any anti-aging versity of North Texas.) telling magazine and newspaper read- product.” In 2003, McGraw branched out into the ers to “Get Real” about losing weight by In other words: beware of doctors who weight-loss business with a best-selling eating three servings of dairy foods every sell what they recommend. book plus a line of shakes, energy bars, day. and supplements. In 2004, the U.S. Dietary Guidelines Consider the Source But Dr. Phil’s Shape Up pills, which cost Committee said there was “insuffi cient Given his lucrative contract with $120 a month, couldn’t live up to their evidence” to link dairy to weight loss. drugstore.com, it must be tempting for labels’ claim: “These products contain sci- And several studies published since then Weil to downplay or ignore news that entifi cally researched levels of ingredients dispute the milk moustache ads’ claim. some of what he’s selling may not be that can help you change your behavior to That’s doing your homework before you worth buying. take control of your weight.” start talking? Take vitamin E. For years, Weil has In a 2003 interview with USA Today, recommended that people take 400 IU 1 a day—one of the dosages he happens McGraw boasted that “I do enjoy a level The consumers are seeking to turn their suit of trust with a lot of people who under- into a class action. A copy of their complaint to sell. (The Daily Value for vitamin E is has been posted at casewatch.org/civil/drphil/ 30 IU.) Yet recent studies have found no stand and appreciate that I do my home- classactioncomplaint.shtml. evidence that large doses prevent heart work before I start talking.” Yet in a 2003 disease, cancer, cataracts, or dementia. The subject came up during Weil’s ap- pearance on the “Today” show last year, when Katie Couric asked him about the ■ “They didn’t actually give vitamin E to diabetes, and gum disease, and think its two latest vitamin E trials, the Women’s people to see what happened.” (Wrong. benefi ts outweigh any risks.” Health Study and the HOPE-TOO trial. Both studies gave people vitamin E for up But in a 2003 review funded by the Neither found that vitamin E prevented to 10 years.) federal government, experts concluded 2,3 heart disease or cancer. “So both these “I took my vitamin E this morning,” that “the available scientifi c studies offer studies say, ‘why take it?’” said Couric. Weil told Couric. “I recommend that little evidence that supplementation with Weil dismissed the two trials: other people do.” vitamin C, vitamin E, or coenzyme Q10 ■ “These were populations of sick people Other instances where the research has any benefi t on cardiovascular disease on multiple medications,” he charged. doesn’t match Weil’s sales pitch: prevention or treatment.” What’s more, researchers in California, North Carolina, (Half wrong. While the HOPE-TOO trial ■ Coenzyme Q10. “It increases oxy- Ohio, Australia, and Finland have all looked at middle-aged men and women gen use at the cellular level, improving failed to fi nd that people who take CoQ10 with heart disease or diabetes, the Women’s the function of heart muscle cells and can exercise aerobically harder or longer Health Study looked at healthy women.) boosting capacity for aerobic exercise,” than people who take a placebo. ■ says Weil in his book Healthy Aging. “I “These were statistical analyses of previ- And the evidence that CoQ10 can help ous studies.” (Wrong. They were original take it myself, frequently recommend it

Photo: Reuters. studies.) to patients, including those with cancer, > > > > >

NUTRITION ACTION HEALTHLETTER ■ JANUARY/FEBRUARY 2006 5 COVER STORY

people with cancer, diabetes, or gum As for autoimmune conditions like What’s the research behind the three disease is “contradictory, insuffi cient, or rheumatoid arthritis, one study found herbs in the Energy Support Formula? preliminary.” That’s according to Health- that evening primrose oil helped reduce Ashwagandha: there’s not a single good notes—the pro-supplement encyclopedia tender and swollen joints, but at a dose study on energy levels. Cordyceps: in the that health food stores, vitamin shops, 28 times higher than Weil recommends. only three good studies, it was no better and Web sites use to help boost sales. In two other studies—using 10 to 12 times than a placebo at helping people exercise A 30-day supply of Weil’s Cardio Sup- what Weil suggests—EPO was no better harder or longer. Eleuthero (also known as port Formula, which contains CoQ10, than the placebo at relieving pain or eas- Siberian ginseng): it was no better than a costs $40. (Weil’s cut: $5.60 to $10.) ing movement in the joints. placebo at improving cardiorespiratory A two-month supply of Weil’s Evening fi tness or endurance, according to a recent ■ Evening Primrose Oil. EPO is a Primrose Oil capsules sells for $14. (Weil’s review of fi ve well-controlled studies.6 natural source of a fatty acid called GLA cut: $1.96 to $3.50.) If you want to take A 30-day supply of Weil’s Energy Support (gamma-linolenic acid), which “promotes the amount that seemed to help relieve Formula costs $30. (Weil’s cut: $4.20 to healthy growth of skin, hair, and nails,” swollen joints in one study, you’ll have to $7.50.) according to Weil. “I frequently suggest shell out $196 a month. “Current, valid studies (published in evening primrose oil for skin conditions peer-reviewed scientifi c journals) are the (including brittle nails and hair), arthritis, ■ Energy Supplement Formula. Feel- basis of our formulations,” says Weil. autoimmune disorders, and premenstrual ing tired? Run down? Need a boost? Try Do profi ts also qualify as a basis? syndrome,” he says on drweil.com. Weil’s “exclusive blend of tonifying herbs Yet according to a recent meta-analysis formulated to support healthy energy lev- 1 that pooled the results of 19 trials, GLA was els.” That’s the way drweil.com describes The text of drugstore.com’s complaint is at casewatch.org/civil/weil/complaint.shtml. A copy of no better than a placebo at treating derma- his Energy Support Formula—a mix of the 94-page contract is at casewatch.org/civil/weil/ titis or eczema caused by allergies.4 What’s eleuthero, cordyceps, and ashwagandha, contract.pdf. more, the two good studies that tested GLA “all traditional herbs which may give those 2 J. Amer. Med. Assoc. 294: 56, 2005. 3 on psoriasis came up empty, as did the energy levels the boost you need.” J. Amer. Med. Assoc. 293: 1338, 2005. 4 Brit. J. Dermatol. 150: 728, 2004. one good study on brittle nails. And EPO Weil says that all of his products “are 5 Control Clin. Trials 17: 60, 1996. was ineffective in the two best-controlled based on stringent scientifi c research.” 6 Int. J. Sport Nutr. Exer. Metab.15 : 75, 2005. studies on premenstrual symptoms.5

arryarry King has been a fi xturxturee on Larry and other degenerative diseases. L the airwaves for mormoree than 30 “Coral Advantage has changed my life years, the last 20 of them interviewing King and could change yours,” King said in his celebrities and newsmakers on CNN. radio ads for BarBarefoot’sefoot’s product.product. Since After suffering a near-fatal heart attack switching to Coral Advantage, “I sleep 19 years ago, he started a foundation to provide fi nancial help for more soundly, wake up with more energy than ever. Bottom line: heart patients who can’t afford adequate medical attention. Your body needs calcium for good health and good health means While King’s talk show appears only on TV now, he hasn’t given Coral Advantage. So look for my signature on the bottle.” up doing those supplement commercials that are familiar to his King probably didn’t sleep as well in 2004, when the Federal longtime radio listeners. Either he has a knack for picking weak Trade Commission halted Barefoot’s infomercial, charging that its products to pitch, or manufacturers seek him out to lend credibility claims about coral calcium were “false and unsubstantiated.” to supplements that could use some. Then there was Welch’s Grape Juice. “Studies have shown that In the 1990s, for example, King promoted the Ginsana brand because Welch’s 100% Grape Juice is made from antioxidant-rich of ginseng to boost energy levels, even though the best research Concord grapes with no added sugar, it’s actually good for your overwhelmingly shows that ginseng doesn’t help people feel more heart,” says King in one spot. energetic. (Ginseng-pill takers aren’t able to exercise longer or In fact, the research is still in its early stages and is far from harder than people who take a placebo.1) defi nitive. (Last summer, Welch’s replaced King as their spokes- In 1998, it was Garlique brand garlic pills. “Garlique’s a world person with Regis Philbin, another celebrity who has suffered a leader in product potency,” King said in one radio ad. “And since heart attack.) garlic has been clinically shown to maintain healthy cholesterol King’s latest gig? He’s the national spokesperson for Ester-C, levels, for me, that makes Garlique dietary supplement the one to an over-hyped brand of vitamin C that’s twice as expensive as trust.” regular vitamin C, even though there’s no good evidence in This time, the Better Business Bureau asked that the ads be people that it’s any better. changed or pulled because none of the research had been done Got an iffy supplement to sell? Have your people call Larry’s specifi cally on Garlique. (Garlic supplements lower cholesterol people. by around 5 percent in some short-term studies, but the impact seems to disappear after about six months.2) 1 Nutrition Reviews 59: 91, 2001. 2 Next came coral calcium, which self-labeled scientist Bob www.ahrq.gov/clinic/epcsums/garlicsum.htm. Barefoot claimed could prevent and cure cancer, heart disease, Photo: Reuters.

6 NUTRITION ACTION HEALTHLETTER ■ JANUARY/FEBRUARY 2006