Cancer Decisions - Free Newsletter -December 7, 2003

A CLOSER LOOK AT CORAL CALCIUM, continued

Another claim that Mr.Robert Barefoot, enthusiastic champion of coral calcium, makes in his books and infomercials is that it is positively beneficial to consume huge amounts of calcium.

Take the following statement, for example, made by Mr. Barefoot in one of his infomercials: "[W]e went around the world and said, are there other places around the world where no one has cancer, no one has diabetes, and lo and behold, there are 19 different cultures spread all over the world, 10,000 miles apart, and we say what's the common denominator. And the common denominator is… the fact that they eat 100,000 milligrams of calcium a day."

Barefoot implies that 100,000 milligrams (about four ounces) of calcium per day is not only non-toxic but is actually extremely healthful. Many medical experts strongly disagree, stating that an overdose of calcium could lead to hypercalcemia, a dangerous excess of calcium in the blood. The Merck Manual clearly states that hypercalcemia can be caused by the ingestion of large amounts of calcium. Here is the Manual's description of hypercalcemia:

"The earliest symptoms are usually constipation, nausea, vomiting, abdominal pain, loss of appetite, and abnormally large amounts of urine. Very severe hypercalcemia often causes brain dysfunction with confusion, emotional disturbances, delirium, hallucinations, and coma. Muscle weakness may occur, and abnormal heart rhythms and death can follow. Kidney stones containing calcium may form in people with chronic hypercalcemia" (Merck 2003).

It is especially alarming that excessive amounts of calcium are being urged on cancer patients, many of whom already suffer from hypercalcemia since tumors themselves can disturb calcium metabolism (in what are called paraneoplastic syndromes).

The centerpiece of Mr. Barefoot's presentation, however, is his claim that there are 19 populations around the world that are virtually cancer-free. Members of these cultures supposedly have no chronic diseases and consistently live to ripe old ages. The reason for their spectacular good health? Coral calcium, of course! (To a hammer, everything looks like a nail.) He singles out the people who live on the southern Japanese island of Okinawa as a prime example.

The following dialogue comes from one of Barefoot's infomercials:

BAREFOOT: [About Okinawans]: Well, they do have cancer, but the rate is so phenomenally low.

KEVIN TRUDEAU: Okay.

ROBERT BAREFOOT: Virtually no cancer.

This is a half-truth, which contains a serious misrepresentation. It is true that the Okinawans on the whole enjoy greater longevity and generally better health than Americans. Researchers who conducted the celebrated Okinawan Centenarian Study have found that Okinawans statistically suffer lower mortality from heart disease, and breast and prostate cancers than Westerners, and more frequently reach the century mark per capita. It is a scientific investigation with fascinating implications.

However, Mr. Barefoot errs in stating that Okinawans' good health is due to the fact that they consume more than 100 times the US Recommended Daily Allowance (RDA) for calcium. They don't.

"The fact is that when it comes to calcium in the diet," wrote the scientists who conducted the Okinawan Centenarian Study, "research shows that the United States is actually near the top of the list at about 800 mg [milligrams] per day…with the Scandinavian countries, such as Finland (1,300+ mg day) being the world's leaders in calcium consumption. Okinawans actually consume less calcium than their Western counterparts. The average calcium intake in Okinawa is only about 500 mg a day (1998 Okinawa Prefecture Health and Nutrition Survey). This is a far cry from claims of '100,000 mg of calcium a day' for the average Okinawan as claimed in a recent TV infomercial."

Here are the reasons that these scientists give for the greater longevity on their island. Okinawans in general:

Eat a low-calorie, mostly plant-based diet with plenty of fish and soy foods and a great variety of vegetables as well as moderate amounts of the right kinds of fats;
Get regular, life-long physical activity;
Enjoy strong social and community support for the elderly; and
Realize the health benefits of a universal, affordable medical-welfare system that focuses on a preventive approach and integrates much of what is good about Eastern medicine with the best of the West (Okinawan 2003).

None of these factors is as easy to achieve as popping a supplement that one picks up at the checkout stand, but they are all very worthwhile goals for both individuals and societies.

The Okinawans also worry about the environmental impact of the coral calcium fad. "Okinawa's reefs are facing an unprecedented crisis due to sedimentation from large scale development, global warming and pollution," they write. "Over half have been lost in the last five years. We, at The Okinawa Centenarian Study, take the position that the reefs of Okinawa need to be protected rather than exploited." Amen.

Okinawans have reason to celebrate their generally good health and we have much to learn from them. Yet it is untrue that they are free from the scourge of cancer. For instance, the Department of Oral Surgery of Ryukyu University Hospital in Okinawa treated 188 cases of oral malignant tumors from 1996 to 2000 (Higa 2003). That's nearly 50 cases per year of just one kind of cancer treated at just one Okinawan hospital.

One reads in the medical literature that "in Okinawa…squamous cell carcinoma (SCC) is prevalent" (Nakazato 1997). There are also scientific reports on cancer of the thymus (Ogawa 2002), cervix (Maehama 2002), lymphoma (Miyagi 2002), etc. The idea that Okinawans do not suffer cancer is false. It is an evocation of mankind's ancient dream of Shangri-la, a mythic society in which no one gets sick or grows old. Unfortunately, in this case it is a myth in the service of commerce.

History of Charlatanism

The whole coral calcium phenomenon is amazing and worthy of a book-length expose. Medical charlatanism has a long history, particularly in the USA. The quacks and charlatans of old made their way up and down the East coast in the 19th century and then penetrated deep into the interior, hawking their wares. Generally, one miraculous panacea would be offered to cure all human ills. These bottles were filled with mysterious and secret ingredients, and often assumed the mantle of Native American medicine, but they shared a common denominator: such potions almost always included alcohol or narcotics.

There are many amusing or horrifying portraits of these charlatans in literature, such as Mark Twain's classic description of the encounter of two such fakers in his classic Huckleberry Finn:

Charlatan #1: "Jour printer by trade; do a little in patent medicines; theater-actor -- tragedy, you know; take a turn to mesmerism and phrenology when there's a chance…oh, I do lots of things -- most anything that comes handy, so it ain't work. What's your lay?"

Charlatan #2: "I've done considerable in the doctoring way in my time. Layin' on o' hands is my best holt -- for cancer and paralysis, and sich things…"

Typically, the quack arrived in an area populated by semi-literate folk afflicted by the "the thousand natural shocks that flesh is heir to." At that time there were few if any effective treatments or qualified doctors available and most people could not afford to spend a large amount of money on their health. The claims of a treatment's effectiveness came bolstered by testimonials from patients who had allegedly been cured, and from big city doctors who had been paid for their endorsements.

Today, we live in a more enlightened age. Most people in industrialized countries have completed high school and many have gone to college as well. We have instant access to medical information through the mass media and especially over the Internet. There are excellent Web sites that give accurate information on cancer and many other diseases. Yet despite the unprecedented availability of detailed information, we have not seen a proportionate decline in the promotion or popularity of nostrums and cure-alls.

There are many reasons for this disturbing phenomenon. Here are a few of them:

There are still many diseases for which there are no reliable cures, including many forms of advanced cancer.
The treatments that exist may come with very serious side effects, some of which have gained a reputation for being worse than the disease itself.
Medical care in rural areas of the USA is inadequate, with few hospitals and chronic shortages of primary doctors and appropriate specialists.
Forty-four million Americans have no health insurance at all and many others cannot afford the treatments that may be available.
There is widespread skepticism (sometimes verging on paranoia) about the statements coming from orthodox medical sources, based on the unhealthily close connection between Big Pharma and the medical profession.

All of which provides a fertile breeding ground for fraudulent treatments. As the coral calcium fad shows, it is still possible in this day and age to put across a colossal promotion of this sort if one can get the backing of a huge marketing organization. I am sure we have not seen the last of such phenomena.

On the other hand, while I think the FTC action was justified in this case, I am generally leery of solutions that rely on governmental prosecution. The government has blundered terribly in the past. In its worthy attempts to crush fraudulent treatments it has often ended up vigorously and indiscriminately attacking many promising new treatments that have emerged from alternative medicine. Once the repressive mechanisms of official oversight are geared up, they tend to see scams in every unconventional medical development, and have been known to generate prosecutions for no other reason than to further jobs and careers. As the ancient historian Tacitus said, "Who will guard the guardians?" (Quis custodiet ipsos custodes?)

I applaud the Council on Responsible Nutrition (as well as the Okinawa Centenarian Study and CAM leaders such as Andrew Weil, MD) for boldly speaking out on the coral calcium issue. Self-policing is a sign of maturity in any profession, and if the food supplement industry wants credibility it has to denounce the frauds in its own midst in a timely manner.

Above all, it is the responsibility of every consumer to find reliable sources of information on new treatments. There are abundant books, articles, newsletters and Web sites that can provide accurate information on alternative treatments. These can help to guard against exaggerated or fraudulent claims, such as those that have been made on behalf of coral calcium.

--Ralph W. Moss, Ph.D.

References:

Barefoot RR. Death By Calcium, 4th Edition. Southeastern, PA: Triad Marketing, 2002.

Barefoot RR. Barefoot on Coral Calcium: An Elixir of Life. Newark, NJ: Wellness Publishing, 2001.

Baron JA, Tosteson TD, Wargovich MJ, et al. Calcium supplementation and rectal mucosal proliferation: a randomized controlled trial. J Natl Cancer Inst. 1995 Sep 6;87(17):1303-7.

Chan JM, Stampfer MJ, Ma J, Gann PH, Gaziano JM, Giovannucci EL. Dairy products, calcium, and prostate cancer risk in the Physicians' Health Study. Am J Clin Nutr. 2001 Oct;74(4):549-54.

CNR Statement:
http://www.naturalproductsinsider.com/hotnews/35h16145457.html

Higa M, Kinjo T, Kamiyama K, et al. Epstein-Barr virus (EBV)-related oral squamous cell carcinoma in Okinawa, a subtropical island, in southern Japan--simultaneously infected with human papillomavirus (HPV). Oral Oncol. 2003 Jun;39(4):405-14.

Holt PR, Atillasoy EO, Gilman J, et al. Modulation of abnormal colonic epithelial cell proliferation and differentiation by low-fat dairy foods: a randomized controlled trial. JAMA. 1998 Sep 23-30;280(12):1074-9.

Maehama T, Asato T, Kanazawa K. Prevalence of human papillomavirus in cervical swabs in the Okinawa Islands, Japan. Arch Gynecol Obstet. 2002 Dec;267(2):64-6.

Merck Manual:
http://www.merck.com/pubs/mmanual_home2/sec12/ch155/ch155b.htm

Miyagi J, Toda T, Uezato H, Ohshima K, Miyakuni T, Takasu N, Masuda M. Detection of Epstein-Barr virus and human T-cell lymphotropic virus type 1 in malignant nodal lymphoma, studied in Okinawa, a subtropical area in Japan.Int J Hematol. 2002 Jan;75(1):78-84.

Nakazato I, Hirayasu T, Kamada Y, Tsuhako K, Iwamasa T. Carcinoma of the lung in Okinawa, Japan: with special reference to squamous cell carcinoma and squamous metaplasia. Pathol Int. 1997 Oct;47(10):659-72.

Ogawa K, Toita T, Uno T, et al. Treatment and prognosis of thymic carcinoma: a retrospective analysis of 40 cases. Cancer. 2002 Jun 15;94(12):3115-9.

Okinawan Centenarian Study 2003 position paper on coral calcium:
http://www.okinawaprogram.com/coral_calcium/coral-calcium.html

Van Gorkom BA, Karrenbeld A, van der Sluis T, et al. Calcium or resistant starch does not affect colonic epithelial cell proliferation throughout the colon in adenoma patients: a randomized controlled trial. Nutr Cancer. 2002;43(1):31-8.

Wang LD, Zhou Q, Feng CW, et al. Intervention and follow-up on human esophageal precancerous lesions in Henan, northern China, a high-incidence area for esophageal cancer. Gan To Kagaku Ryoho. 2002 Feb;29 Suppl 1:159-72.

Dr. Weil's statement:
http://www.drweil.com/app/cda/drw_cda.html-command=TodayQA-p t=Question-questionId=73935

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The news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.