The TRUTH about all those dodgy health claims, by one of Britain's top researchers

By PROFESSOR LESLEY REGAN

From vitamin supplements to detox kits, alternative medicines to supermarket foods, we are bombarded every day with extravagant claims about the health benefits of the products we put into our shopping baskets. But can we trust those claims? That's what renowned scientist Professor Lesley Regan sets out to discover in a fascinating new television series.

She's the researcher whose investigation into anti-ageing products caused shockwaves in an industry built around impressive claims that are rarely properly researched - and sparked a stampede for Boots No 7 Protect and Perfect serum, which she identified as one of the few beauty creams that actually worked.

Now, Professor Regan is applying her trademark scientific training to examine the health credentials of an even wider range of products for her latest BBC2 series. And not only has she discovered some bestsellers have little evidence backing them up, she believes many companies are, in fact, touting spurious claims. Here, she shares a few of her intriguing findings...

WEIGHT LOSS AIDS

In Britain, we now spend £10 million a year on diet pills and patches. But while prescription weight loss tablets have real science behind them, do over-the-counter varieties too? When I set about trying to find out by asking the producers of popular diet products to send me details of their research, many companies flatly refused.

The Pink Patch said no evidence of its effectiveness actually exists, while Formoline L112 said they couldn't provide a copy as their research hasn't ever been published. Lipobind sent research results showing the tablets do bind with fat - but admitted they were yet to investigate whether the pills actually help people lose weight.

Only one company sent a paper showing a clear link between weight loss and their product - a herbal diet pill, called Zotrim, which makes you feel full. Their research had been published in a reputable journal and conducted with a control group to compare any placebo effect. Although statistics were not included, these are said to be significant. Yet I would still like to see more evidence as the study has never been repeated.

But even when diet pills are shown in studies to help weight loss, the results can still be meaningless. The secret is in the small print. For the instructions usually say that pills must be taken alongside a low-calorie diet and an exercise plan. They even say they should be taken before meals with a large glass of water - which will act as a bulking agent and stop you eating so much.

To prove this point, I developed my own diet pill and asked 17 overweight people to try it for a month, alongside a balanced diet and a sensible exercise plan. More than 70 per cent of the volunteers lost weight and believed the tablets had worked. Unbeknown to them, though, the tablets were simply sugar, a placebo - which shows the power of mind over matter. Yet I could easily use my results to launch an impressive marketing campaign, - as many companies do.

Diet and nutrition books are another minefield. There are 54,000 such books published worldwide, yet the authors need no qualifications and their diets are rarely scientifically proven. Anyone can call themselves a nutritionist. Readers must bear in mind that just because a diet book is published, doesn't mean the plan actually works.

DIET-FRIENDLY FOODS

Foods marketed at dieters are proliferating, with supermarket shelves stocked full of foods for different eating plans - low fat, low carb, low calorie, high protein. But consumers must make sure they carefully read the label as these claims can be very misleading. We assume products labelled 'reduced fat' and 'light' will be better for us - but they can still be relatively high in fat and calories.

The only regulation in place is that foods labelled 'low fat' must contain 3 per cent or less fat, and 'fat free' must not contain more than 0.5 per cent fat - so these are usually a good buy. It's worth comparing nutrition labels, though, as 'low fat' could still contain more calories than standard versions.

Food manufacturers are always trying clever ways to make their foods appear healthy. An advert for Jaffa Cakes claiming they only contain one gram of fat each was recently banned by the Advertising Standards Authority because a cake weighs only 10 grams - meaning they actually contain 10 per cent fat.

And processed foods marketed as healthy are often anything but. This is because they contain large amounts of sugar and salt, and, through processing, have lost many of their nutrients.

'Whole grain' is another marketing craze, and although whole grain foods are healthy, just because something contains fibre doesn't mean much. A product must be high or rich in fibre to have any real benefit.

But some prepared foods can actually be a healthier option than fresh. For example, frozen peas contain more nutrients than fresh peas. This is because fresh peas lose a lot of their goodness during the time it takes to transport them from field to shop to dinner plate.

VITAMIN SUPPLEMENTS

As a population, we also spend millions of pounds on vitamin supplements. But the simple truth is that people with a balanced diet don't need them, as even manufacturers admitted to me. Yet it is usually consumers who already have a balanced diet - the worried well - who take them, while those who have poor diets, and so could benefit from supplements, don't bother.

The result is that often people taking vitamin supplements end up getting far more of a vitamin than they actually need - which can do more harm than good. Evidence shows some nutrients have a range of adverse effects at high doses. A study of pregnant women taking 1,000mg of Vitamin C showed they gained no benefit but had an increased prevalence of premature delivery.

And the evidence which vitamin manufacturers cite as showing the benefits can be rather more complicated than it seems. For example, Immunace, which reportedly boosts the immune system, claims to have been proven in a 'ground breaking trial' - but when I asked for this research, I discovered it had actually been carried out on HIV positive people in Bangkok.

Another Vitabiotics product, Visionace, a supplement to maintain good eyesight, claims to have been independently verified, but again the research was not done on healthy recruits but on people with a specific eye condition called Marginal Dry Eye. Experts say you can't compare the benefits of someone with a damaged immune system or poor eyesight to healthy people.

The only vitamin worth taking is folic acid for pregnant women. That is scientifically proven to be beneficial: nothing else is.

Yet standing in a pharmacy, staring at the array of different varieties, even I sometimes start wondering about them myself. That is the result of the mass hysteria which clever marketing has created.

One supplement which has grown increasingly popular is fish oils, which people now generally believe can make you smarter. Yet the evidence is far from unanimous. EYEC market their fish oils as being beneficial for all children - yet their data comes from a study showing the supplement boosted the performance of a group of children with special needs.

Indeed, a new marketing trend which causes me some concern is the targeting of children. Or rather their parents, who are led to believe certain breakfast foods can improve their children's performance. In fact, the crucial thing is for kids to eat something in the morning, and it doesn't much matter what . .

PAINKILLERS

The power of perception means a lot of products succeed where, scientifically, they should fail. The marketing is so powerful that people actually believe the benefits are occurring when they are not. This is particularly obvious in painkillers. Aspirin, paracetamol and ibuprofen can be bought very cheaply, yet people choose expensive branded versions which cost ten times as much yet have the same basic ingredients.

Some luxury brands promise to perk people up but simply contain added caffeine. People would be just as well off buying the cheap paracetomal and drinking a cup of coffee.

Often, painkillers are said to target different issues such as migraine, period pain or back ache. Yet as far as I can see, there is actually nothing different about them.

Again, with pain relief, it is often perception that matters. I carried out a study on a rugby team which took two painkillers, believing one to be their usual favourite brand and one a cheaper version. They thought the former worked much better - but in fact they were both their favourite painkiller.

Research shows, too, that the larger a pill the better it is perceived to work, and the reason most painkillers are sold in packs to be taken two at a time - rather than simply double the dose in one tablet - is because people believe two pills work better than one. It is quite extraordinary the effect perception alone can have on pain - and manufacturers know that.

ALTERNATIVE MEDICINE

I believe that similar effects explain the burgeoning alternative medicine industry. A popular part of this is homeopathy, which nine million people trust to work for them. But, in fact, the solution sold is a highly diluted liquid, meaning only a very slim chance of the dose containing any active ingredients. And while practitioners wear white labcoats and surround themselves with an aura of science, there is in fact no real scientific backing for their remedies.

Again, I tested the placebo effect of homeopathy, giving insomniacs my own 'homeopathic sleep remedies' - in fact simply sugar balls. Yet the volunteers reported 'remarkable' effects and actually slept better, simply due to believing in the tablets and wanting them to work.

Herbal supplements, on the other hand, can be highly effective. Echinacea is proven to help fight infections and garlic can lower cholesterol - though the benefits of Evening Primrose Oil and Ginseng are rather less certain.

But because herbal remedies are so powerful, they can have sideeffects and need to be treated with respect. Consumers' belief that natural means safe is wrong. They can also interfere with normal medication. For example, St John's Wort can interfere with the body's ability to absorb the contraceptive pill, and so stop it from working.

DETOX PACKS

Detox products that claim to work through herbal ingredients should be treated with suspicion as most appear ineffective. When I spoke to people who design these products, nobody could even tell me what these packs are actually supposed to be detoxing. After all, our kidneys and liver are brilliantly effective at detoxing themselves already.

The packets tell people to stop drinking alcohol or caffeine and to eat healthily while taking them - which is likely to bring far more health benefits than the actual detox supplement. People would be better off simply following the advice and forgetting the product. Detox products are typical of the way many health and beauty companies are not interested in basing their developments on science - only their advertising campaigns. Yet customers assume the products they are buying are properly proven and researched. That is why we all need to be more enquiring about the products we buy. If the claims sounds too good to be true, it probably is.

Although I have investigated as a scientist, anyone can seek out information about what they are being told by companies about a product. When spending money we should ask ourselves: 'What is the science behind this? Where is the evidence?' If there is none, then step away. If consumers become savvier and more questioning, then manufacturers will soon realise they need to provide better science - and better products.

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THE GENETIC DIMENSION OF HEIGHT AND HEALTH

It may be no tall tale: A few inches taller or shorter could signal a risk for some diseases. It is discreetly not mentioned below but the overall balance is in favour of tall people

From Danny Devito to Yao Ming, the world is filled with short people and tall people and everyone in between. While factors such as nutrition influence height differences, much of that variation depends on genes. After all, both of Ming’s parents were basketball stars, and Devito’s were not.

But the genes that made Ming grow to 7 feet 6 inches and Devito stop growing several feet shorter could be important for more than sports. Changes in how height genes work could not only add or subtract a few centimeters from leg length, but could also affect underlying cell biology in ways that can lead to disease, recent research suggests.

Statistical studies find that shorter people are more likely to get heart disease, diabetes and osteoarthritis. Other studies show that the same genes that make healthy cells multiply to make a person grow taller can also make cancer cells proliferate in tumors. On the other hand, genes that make bones grow longer can form extra cartilage in joints, protecting them from the ravages of osteoarthritis.

The long and short of it is that height genes might affect health as well as height — although scientists don’t completely understand how.

Some genes that have been implicated in determining height have been well-studied for their connections to particular diseases, but not as well-studied for how they affect height. And while statistical links between height and disease are robustly documented, scientists don’t completely understand if or how the same genes could set the foundation for both height and disease.

Pinning down that connection could have payoffs for treating disease and ensuring health.

“When you take a kid to the pediatrician, the first thing they do is measure the child’s height,” says geneticist Guillaume Lettre of Children’s Hospital Boston and of the Broad Institute, in Cambridge, Mass. He is coauthor of a study that identified several genes associated with height.

Growing too fast or too slow could be a sign of health problems such as hormone imbalances. But if the genes controlling height were well known, pediatricians could easily determine whether a short-for-their-age child simply inherited the gene variants that denote a more diminutive stature, or actually has a more serious condition, Lettre says.

Linking height genes to health is difficult, though, because details of the genetic pathway to height are complex. Many genes work together to create normal variations in height. So far, the suspicion that height genes affect health is supported mostly by statistical studies.

In 2001, for instance, epidemiologist David Gunnell of the University of Bristol in England and colleagues found that taller people can face a 20 to 60 percent greater risk for various cancers, including of the breast, prostate and colon.

Last year, epidemiologist Luisa Zuccolo, also of Bristol, followed up on Gunnell’s work with a study focused on the link between height and prostate cancer. The risk of developing prostate cancer increased by 6 percent for every 10 centimeters over the median height of the 1,357 men in the study, Zuccolo and colleagues reported in Cancer Epidemiology, Biomarkers & Prevention. Despite the link, height was still less of a risk factor than age and family history, but “understanding why height is associated with prostate cancer could help us to understand its causes,” Zuccolo says.

One molecule that taller people have in abundance compared with shorter people is insulin-like growth factor 1, or IGF-1. The insulin-like molecule stimulates the growth of cells and tissues, and higher levels of the molecule have also been linked to the incidence and progression of several different types of cancer. IGF-1 can bind to the tumors of cancers of the breast, prostate and bladder, stimulating the growth of tumor cells. Zuccolo speculates that the IGF-1 gene could link height and prostate cancer.....

A height and cancer suspect

Genome-wide association studies offer one way to sift through the human genome by comparing genomes of thousands of people for variations associated with a specific trait. To hunt for height genes, researchers try to identify genetic variations that crop up more often in shorter people or taller people.

So far, several studies have related about 40 different genes to height. But more genes are likely to be found, says Gonçalo Abecasis, a statistical geneticist at the University of Michigan in Ann Arbor who collaborated on two of the studies. “There are lots of different genes that each only make a small contribution to height,” he says.

The researchers expect that the list of height genes will run into the hundreds. “We’re making progress, but there are many more height genes to find,” says geneticist Michael Weedon of the Peninsula Medical School in Exeter, England.

Weedon and his colleagues used genome-wide association studies to identify height gene candidates and found that the gene at the top of their list is also a well-known cancer gene. Variants of the high-mobility group A2 gene, called HMGA2, correlated with small variations in height within a population of just over 19,000 people, the researchers reported in Nature Genetics in 2007. That study was the first evidence that small variations in the gene could produce normal height differences among people.

“Sometimes it’s hard to link the gene you find to a height-related function — but this one was easy,” says Lettre, a coauthor on the study.

Scientists already knew that rare HMGA2 mutations could have severe effects on body size. Take 13-year-old Brenden Adams of Ellensburg, Wash., for example. An average-sized newborn, Adams began growing faster than anyone could explain and now stands 7 feet and 3 inches.

At first, doctors couldn’t figure out why. Then they took a look at his chromosomes. A portion of one copy of Adams’ chromosome 12 is inverted, as if a piece of the chromosome had broken off, flipped around and then reattached. The genes on this inverted section seemed to be undamaged — except for where the chromosome broke, which turned out to be at HMGA2.

Azra Ligon and Brad Quade of Brigham and Women’s Hospital and Harvard Medical School in Boston studied Adams’ case. They aren’t sure exactly how the change to HMGA2 is making Adams grow so much, but they speculate that the chromosome inversion disrupted the normal regulation of the gene.

The HMGA2 gene encodes a protein that activates other genes by rearranging how DNA is stored. To package huge amounts of DNA inside each cell, the DNA is twisted and coiled into the chromosomes, then compacted in an orderly fashion so that the correct section is easily available when needed. The HMGA2 protein recognizes and binds to specific twists in chromosomes in order to activate the genes needed for a wide array of biological processes, including the growth and proliferation of cells.

Weedon and colleagues speculate that mutations in the HMGA2 gene can affect how much of the protein is produced.

Previous work also showed that the HMGA2 gene is active only during embryo development in both mice and people. In mature tissues, gene
activity was almost undetectable, a sign that the gene may not have much effect on the later stages of growth and
development.

“It seems that the contribution of this gene is laid down early in life,” says geneticist Peter Visscher of the Queensland Institute of Medical Research in Brisbane, Australia.

But the gene does get turned on at later stages in cancerous cells. HMGA2 proteins are found in the tumors of several different types of cancer, including those of the breast, pancreas and lung, suggesting that the gene may help cancer cells grow and proliferate. But scientists don’t know whether the increased risk of cancer in taller people has anything to do with differences in the HMGA2 gene. While HMGA2 is implicated in both cancer and height, “the mechanistic dots have not yet been connected,” says Lettre.

“Right now, we fall short of explaining exactly how HMGA2 controls height,” he says. “We don’t know exactly how variations in HMGA2 that correlate with height could affect how the gene works.”

And while genes such as HMGA2 are already well-characterized because of their roles in disease or development, little is known about many of the height genes that the statistical studies turn up.

Figuring out what these genes do could explain the links between height and disease. “We’re not there yet,” says Abecasis. “But when you start looking at all these different genes, you find that they are linked to lots of different things.”

Adds Lettre: “We’re interested in learning more about how genes control height. But we’re hoping that some of the height genes will have other effects on health too.” That would help the scientists gain insights into the biological processes of growth. “Time will tell, but that is certainly a hope.”

The short path to osteoarthritis

Taller people may be at a higher statistical risk of cancer, but short people face height-related disease risks too.

A gene called growth differentiation factor 5, or GDF5, is related to height; it encodes a protein important for bone and cartilage growth and skeletal development. Geneticist Karen Mohlke of the University of North Carolina at Chapel Hill and her colleagues found that slight differences in the GDF5 gene caused differences of about 0.3 to 0.7 centimeters in height. The people on the shorter end of these differences were more likely to have the particular GDF5 variant associated with osteoarthritis, a type of arthritis caused by the breakdown of cartilage in joints.

People with lower levels of the GDF5 protein have shorter bones and less cartilage in their joints. Shorter people are more susceptible to osteoarthritis because they have less cartilage to wear down.

“It makes sense that a reduction in GDF5 would decrease bone growth and lead to reduced height,” says Gonçalo Abecasis, a statistical geneticist at the University of Michigan in Ann Arbor and a coauthor of the study, which was published in Nature Genetics in 2008. “And as well as this, there would be less cartilage in the joints, which could increase susceptibility to osteoarthritis,” he says.

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