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Salesmen of Supplements and Scams
Episode 4329th December 2023 • Fork U with Dr. Terry Simpson • Terry Simpson
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The Scams and Quacks of the Year

The New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit.  And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least.

 

TOP SCAMS OF THE YEAR

  1. Carnivore Diet
  2. Magnesium Supplementation
  3. Celtic Salt
  4. MTHFR Gene Mutation
  5. Cold Plunges

FORK U

Today, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them.

I'm Dr. Terry Simpson, and this is FORK U. Fork University.

Where we teach you a little bit about food as medicine

Busting myths and making sense of the madness.

The Liver King and Paul Saladino

Chief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know.

Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements.

Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet.  Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members.

The Shirtless Salesmen of Supplements and Scams

Being shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them.

I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients.

While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup.  Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles?

The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical School

Saladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time.  Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases.

In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school?

Do Doctors Learn Nutrition in Medical School?

As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in medical school, these are graduate-level courses.

The basic pathology of atherosclerosis, or how cholesterol is made, transported, and absorbed, is taught in medical school. The effect of dietary saturated fats causing an increase in low-density lipoprotein is taught in medical school. Moreover, the foods with high levels of saturated fats are taught in medical school.

Because of those basics, we surgeons can take the sickest patients and feed them with intravenous nutrition. Surgeons developed intravenous nutrition that has kept countless people alive. In addition, surgeons developed the ability to feed directly into the gut through a tube. But we may not learn that Popeye's chicken breast contains 1000 mg of sodium more than a regular chicken breast. We don't learn the practical side of food, but we learn a lot about the basic science, which is the foundation of nutrition. An analogy might be that an architect can design your home but may not know how to build it.

The Inflammatory Process in Medical School

The inflammatory process is one of the first series of lectures that medical students learn.  They learn that inflammation is an essential part of healing from injury and disease. That the inflammatory process is necessary to remove bacteria, viruses, parasites, and even cancer from the human body. Further, medical students learn that if the inflammatory process is overdone, destruction remains, such as in auto-immune diseases like rheumatoid arthritis, Sjogren's, or lupus.

Medical students are not taught to order C reactive protein or sed rates on everyone because that would be a waste of resources. Someone could have high inflammatory markers for various reasons, and blindly ordering tests is often a wasteful practice of doctors without a clue. Sometimes, we are clueless about a patient's condition, but oftentimes, medical students are taught that a history and physical exam will reveal more than a laboratory test.

Medical students are not taught that the inflammatory process is the basis of all diseases because this isn't true. Nor are they taught that atherosclerosis is all from inflammatory disease because that isn't true.

Vitamin Deficiencies and Surgeons

Vitamin deficiencies are taught in medical school. The first one noted, vitamin C and scurvy, was elucidated from the great work of the Scottish Surgeon Dr. James Lind. Scurvy is a disease with multiple parts - wounds reopen, teeth fall out, blood blisters form, and seemingly many symptoms, but is treated with a source of vitamin C. The root cause of disease, indeed.

The Root Cause of Disease

Or consider this mysterious constellation of symptoms: a person progressively develops difficulty walking, strange eye movements, muscle weakness, shortness of breath, swelling of the legs and feet, and ultimately death. The disease was called kakke. Eastern-trained physicians had worked on it for 300 years, and it affected the royal household and the elite in Japan. Did they have some ancient remedy? They did not.

A doctor, Kanehiro Takaki, dissatisfied with his Eastern medical education, decided to learn Western medicine. He apprenticed under a local doctor until the doctor said he couldn't teach him anymore, and the Imperial Navy sent him to St. Thomas in London to learn surgery.  There, he learned "Western" medicine and even epidemiology, as was taught there by John Snow, who elucidated the cause of the cholera outbreaks.

Using the tools of Western medicine, he showed that the cause of these symptoms was a dietary deficiency of what became known as vitamin B1, or thiamine. If you want to hear a podcast about it or read more, click here.

What We Don't Teach in Medical School

What we are not taught in medical school is that a low-carb diet, or keto diet, or paleo diet, or carnivore diet cure diseases. We don't teach that to medical students because it is not true.

We teach how the DASH diet with low sodium reduces blood pressure and how to encourage patients with hypertension to decrease their diet. Or how the Mediterranean diet decreases the risk of heart disease and cancer.

While diet is the most empowering thing people can do, often it will not be enough. While physicians can influence some of the health decisions of patients, often the patient will come to us beyond where diet and exercise can help.

The Carnivore Diet

The carnivore diet is the latest evolution of the low-carb fad. Saladino does a fruit modification of the diet, which will prevent scurvy. In fact, the musician James Blunt suffered from scurvy. as the carnivore diet is far from a complete diet.

Carnivore diet sounds great - just eat steak. Saladino will claim this is the most nutrient-dense food in the world. It isn't.

Others will claim you can get all your nutrients through this - you cannot.

The health problems of an all-meat diet are clear:

  • Keto vs Mediterranean diet - same weight loss, but Med diet had fiber and lower LDL (ref)
  • A good review of meat-based vs. plant-based show plant-based overall healthier (ref)
  • Another review shows that dietary fiber is associated with improved metabolic health (ref)
  • While Saladino refers to the Hadza, studies show their diet, like most hunter-gatherers, is rich in fiber (ref)
  • The Inuit in Alaska have high rates of heart disease, stomach cancer, and colon cancer - all diet-related (ref) (ref) (ref)

 

The carnivore diet increases the risk of diverticulitis, hemorrhoids, and stomach cancer (Sivasubramanian BP, Dave M, Panchal V, Saifa-Bonsu J, Konka S, Noei F, Nagaraj S, Terpari U, Savani P, Vekaria PH, Samala Venkata V, Manjani L. Comprehensive Review of Red Meat Consumption and the Risk of Cancer. Cureus. 2023 Sep 15;15(9):e45324. doi: 10.7759/cureus.45324. PMID: 37849565; PMCID: PMC10577092.) Although many chiropractors will dispute this. I wonder how chiropractors ever learned to do anything but cherry-pick studies?

Magnesium Supplementation

I recently covered this on a previous blog/podcast ( reference ). Suffice it to say that excess magnesium has become one of the more common problems seen in poison control centers. At best, excess magnesium can lead to loose bowels, but worse cases lead to depression of the carotid baroreceptor with POTS  symptoms, cardio-toxicity, and severe cardiac rhythm changes.

Legitimate reasons for magnesium deficiency include diarrhea, malnutrition, use of some diuretics, hyperaldosteronism, Crohn's disease, alcoholism, and advanced kidney disease. If you have any of these, you need to see a physician.

If you eat a lousy diet and don't get enough magnesium, it is time to grow up.

But this leads to the next scam of the year:

Celtic Salt

Celtic salt is simply sea salt harvested from the North Atlantic. It costs about $1.66 an ounce, compared to regular salt, which is $0.06 an ounce - six cents. Is there magic to justify this additional expense? To answer this, you can ask the naturopath, Barbara O'Neill.

For those who haven't seen her, she seems like a kindly lady, a pleasant voice and an easy smile. She is usually filmed while standing next to a whiteboard, explaining her version of reality to an audience who paid thousands of dollars to listen to her.

Her misinformation was considered so dangerous that she was barred from Australia's health care system.  She claimed cancer could be cured with sodium bicarbonate, that cayenne pepper could reverse atherosclerosis and stop a heart attack, and that infants with strep infections didn't need antibiotics.   If you didn't know, every one of those statements is dangerously incorrect.

She also states that she can treat high blood pressure with Celtic salt because Celtic salt has magnesium in it.  Celtic salt has 80 mg of magnesium for every 34,000 grams of salt (that is a toxic amount of salt). A serving of spinach will give you the 80 mg, as will almonds or half a serving of pumpkin seeds.

O'Neill goes on to say that magnesium is a water-hungry molecule and is good for hydration. Magnesium is not useful for rehydration. In severely dehydrated children, we use a combination of water with sugar and a bit of sodium chloride, and not magnesium.

Cold Plunges, MTHFR Mutations, and Gary Brecka

The last is a charismatic fellow named Gary Brecka, who is great at self-promotion. Selling people high-priced solutions to non-existent or rare problems. For legitimacy, Brecka calls himself a "human biologist." Brecka received a bachelor's degree from Frostburg State and another bachelor's degree from a chiropractic college.  In summary, Brecka has no formal medical training.

Often, Brecka starts his talks by making the claim he can tell a person when they will die to the month. Oddly, no one on planet Earth can tell when a person will die, let alone the month, year, day, or hour. Although there is an entire science, actuarial science, where they determine probabilities of surviving in any given year. However, Brecka claims he can tell based on labs or other issues. Yet this bold claim brought Brecka's most noted client, Dana White. Concluding that Dana White had ten years to live, White became an ardent disciple.

Today, Brecka advocates hydrogen water, cold plunges, and selling overpriced genetic tests for the MTHFR mutation.

 

Cold Plunges and The Polar Bear Club

I'm a member of the Polar Bear Club. I've swam from the waters coming from the Mendenhall glacier by Juneau, Alaska. When I did this, I had spent weeks preparing by swimming in other waters and acclimating my body to this. Growing up in Southeast Alaska, cold water swims were the only ones we had. In those days, I was young, athletic, and took many foolish chances. The last time I was in cold water was scuba diving in New Zealand at 60 degrees, and I had a 9 mm wetsuit on - even that was a bit cold for me.

Acclimation occurs with athletes who competitively swim in cold water.  First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

People who do cold water immersions claim this is good for their health and have a cult-like joy in this frigid experience. Such claims are as cold as the water they immerse themselves in.

Cold Water Immersion Immediate Effects

In all the advertisements I've seen on TikTok for cold water immersion tubs, I have never seen one of them warn people of the immediate consequences. Here is what we know based on laboratory studies:

  • Increase heart rate
  • Increased blood pressure
  • Increased respiratory rate
  • Increase in troponin levels - indicating heart damage
  • Increased shivering
  • Increased cardiac (heart) arrhythmias

Vasoconstriction of skin vessels begins at temperatures of 37.1 (98.78 F) when immersed in cold water or 37.5 (99.5 F) post-exercise (ref). The body attempts to maintain its core temperature by shivering. However, when immersed in cold water, the body loses its ability to protect its core temperature after 36.2 C or 36.5 post-exercise. This is where the danger begins, as heat is lost. exponentially by convection from water more than a cold shower or air ( ref ).

Because of the immediate effects

Cold Water Swimming

Acclimation occurs with athletes who swim in cold water.  First, these are athletes. Second, they have acclimated to it and often have a much higher level of body fat for insulation. The National Center for Water Safety has a good article regarding this.

Sudden Disappearance Syndrome

Perhaps you've heard about people who have jumped in the water and never returned? This was called "sudden disappearance syndrome." Jumping into cold water will cause some people to have an involuntary gasp. The shock will cause their body to take a sudden large breath underwater, which fills their lungs, and they sink. It is a miserable death.

Brown Fat and Fat Stripping Effect of the Plunge

Brecka says, "Nothing strips fat off the body faster than a cold plunge." He is incorrect, as physical exercise is faster, more efficient, and safer. Shivering is faster at producing heat, but once you get below 36.2 degrees, you lose that regulation and are prone to hypothermia.

What about brown fat, which generates heat from cold water exposure? This is true! But the average human adult male has about two to five ounces of brown fat in their entire body. When examined, brown fat oxidation in an adult is equivalent to two minutes of running (ref).

While Brecka would love to sell his $6000 cold plunge pool, he overstates the effects of what can be dangerous activity. This is, in my opinion, unethical.

Cold Water and Acute Injuries

What about the elite athletes who use cold for injuries? Certainly, they know more about this. To use this logic - let us look at the average career of an NFL player - 27 months; most careers end because of injury. Their lifespan is 56.9 years. Baseball players' lifespan is about ten years longer (ref)

The RICE protocol (Rest, Ice, Compression, Elevation) was originally coined by Dr. Mirkin in 1978 in "The Sports Medicine Book." While there was not good data to support this protocol, there were plenty of anecdotes. Who doesn't feel better with ice? But the effect of ice is to gate pain. It does not improve healing. Dr. Mirkin recanted his original position on the protocol in 2014.

More tests need to be done. But to assume the trainers in the NFL know more than the literature shows is dubious. Most NFL coaches consistently over-train their players and believe an injury will make them stronger. It doesn't - as should be seen by how quickly injury ends careers. One of the reasons Jim Harbaugh was more successful than others was his physical therapists, who limited practice injuries and used modern physical therapy to prevent major...

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