Ben Goldacre - Bad Science

Some of them now deny that toxins come out in the footbath (which would stop me measuring them): your body is somehow informed that it is time to release toxins in the normal way – whatever that is, and whatever the toxins are – only more so. Some of them now admit that the water goes a bit brown without your feet in it, but ‘not as much’. Many of them tell lengthy stories about the ‘bioenergetic field’, which they say cannot be measured, except by how well you are feeling. All of them talk about how stressful modern life is.

That may well be true. But it has nothing to do with their foot bath, which is all about theatre: and theatre is the common theme for all detox products, as we will see. On with the brown goo.

Ear candles

You might think that Hopi Ear Candles are an easy target. But their efficacy has still been cheerfully promoted by the Independent , the Observer and the BBC, to name just a few respected news outlets. Since these people are the authoritative purveyors of scientific information, I’ll let the BBC explain how these hollow wax tubes will detox your body:

The candles work by vaporising their ingredients once lit, causing convectional air flow towards the first chamber of the ear. The candle creates a mild suction which lets the vapours gently massage the eardrum and auditory canal. Once the candle is placed in the ear it forms a seal which enables wax and other impurities to be drawn out of the ear.

The proof comes when you open a candle up, and discover that it is filled with a familiar waxy orange substance, which must surely be earwax. If you’d like to test this yourself, you will need: an ear, a clothes peg, some Blu Tack, a dusty floor, some scissors, and two ear candles. I recommend OTOSAN because of their strapline (‘The ear is the gateway to the soul’).

If you light one ear candle, and hold it over some dust, you will find little evidence of any suction. Before you rush to publish your finding in a peer-reviewed academic journal, someone has beaten you to it: a paper published in the medical journal Laryngoscope used expensive tympanometry equipment and found – as you have – that ear candles exert no suction. There is no truth to the claim that doctors dismiss alternative therapies out of hand.

But what if the wax and toxins are being drawn into the candle by some other, more esoteric route, as is often claimed? For this you will need to do something called a controlled experiment, comparing the results of two different situations, where one is the experimental condition, the other is the ‘control’ condition, and the only difference is the thing you’re interested in testing. This is why you have two candles.

Put one ear candle in someone’s ear, as per the manufacturer’s instructions, and leave it there until it burns down. Put the other candle in the clothes peg, and stand it upright using the Blu Tack: this is the ‘control arm’ in your experiment. The point of a control is simple: we need to minimise the differences between the two set-ups, so that the only real difference between them is the single factor you’re studying, which in this case must be: ‘Is it my ear that produces the orange goo?’

Take your two candles back inside and cut them open. In the ‘ear’ candle, you will find a waxy orange substance. In the ‘picnic table control’, you will find a waxy orange substance. There is only one internationally recognised method for identifying something as earwax: pick some up on the end of your finger, and touch it with your tongue. If your experiment had the same results as mine, both of them taste a lot like candle wax.

Does the ear candle remove earwax from your ears? You can’t tell, but a published study followed patients during a full programme of ear candling, and found no reduction. For all that you might have learnt something useful here about the experimental method, there is something more significant you should have picked up: it is expensive, tedious and time-consuming to test every whim concocted out of thin air by therapists selling unlikely miracle cures. But it can be done, and it is done.

Detox patches and the ‘hassle barrier’

Last in our brown-sludge detox triptych comes the detox foot patch. These are available in most high-street health-food stores, or from your local Avon lady (this is true). They look like teabags, with a foil backing which you stick onto your foot using an adhesive edging before you get into bed. When you wake up the next morning there is a strange-smelling, sticky brown sludge attached to the bottom of your foot, and inside the teabag. This sludge – you may spot a pattern here – is said to be ‘toxins’. Except it’s not. By now you can probably come up with a quick experiment to show that. I’ll give you one option in a footnote.

An experiment is one way of determining whether an observable effect – sludge – is related to a given process. But you can also pull things apart on a more theoretical level. If you examine the list of ingredients in these patches, you will see that they have been very carefully designed.

The first thing on the list is ‘pyroligneous acid’, or wood vinegar. This is a brown powder which is highly ‘hygroscopic’, a word which simply means that it attracts and absorbs water, like those little silicon bags that come in electronic equipment packaging. If there is any moisture around, wood vinegar will absorb it, and make a brown mush which feels warm against your skin.

What is the other major ingredient, impressively listed as ‘hydrolysed carbohydrate’? A carbohydrate is a long string of sugar molecules all stuck together. Starch is a carbohydrate, for example, and in your body this is broken down gradually into the individual sugar molecules by your digestive enzymes, so that you can absorb it. The process of breaking down a carbohydrate molecule into its individual sugars is called ‘hydrolysis’. So ‘hydrolysed carbohydrate’, as you might have worked out by now, for all that it sounds sciencey, basically means ‘sugar’. Obviously sugar goes sticky in sweat.

Is there anything more to these patches than that? Yes. There is a new device which we should call ‘the hassle barrier’, another recurring theme in the more advanced forms of foolishness which we shall be reviewing later. There are huge numbers of different brands, and many of them offer excellent and lengthy documents full of science to prove that they work: they have diagrams and graphs, and the appearance of scienciness; but the key elements are missing. There are experiments, they say, which prove that detox patches do something … but they don’t tell you what these experiments consisted of, or what their ‘methods’ were, they only offer decorous graphs of ‘results’.

To focus on the methods is to miss the point of these apparent ‘experiments’: they aren’t about the methods, they’re about the positive result, the graph, and the appearance of science. These are superficially plausible totems to frighten off a questioning journalist, a hassle barrier , and this is another recurring theme which we will see – in more complex forms – around many of the more advanced areas of bad science. You will come to love the details.

If it’s not science, what is it?

Find out if drinking urine, balancing on mountain ledges and genital weightlifting really did change their lives forever.

Channel 4’s Extreme Celebrity Detox

These are the absurd extremes of detox, but they speak of the larger market, the antioxidant pills, the potions, the books, the juices, the five-day ‘programmes’, the pipes up the bum and the dreary TV shows, all of which we will torpedo, mostly in a later chapter on nutritionism. But there is something important happening here, with detox, and I don’t think it’s enough just to say, ‘All this is nonsense.’