On the Road with the Shambulance

Hello from the land of boxes!

I'm about to move across the country, so there will be a brief hiatus from new stories here. But in the meantime, please enjoy some travel-themed reruns.

The Shambulance is a vehicle with an identity crisis (it might travel by land, sea, or space, and is potentially horse-drawn). It's also a series on this blog examining dubious health fads. Below, you'll find its complete voyages.

It has been, I think you'll agree, a twisted journey.

* * * * * * * * * * * * * * *

Ionic Foot Detox Baths (June 2012)
Hint: Don't.

Ab Toning Belts (or, Muscle Tone Is All in Your Head) (July 2012)
This goofy infomercial product blew my mind. But not because it works.

Zero-Calorie Noodles? (August 2012)
The only Inkfish post ever to involve a taste test.

Infrared Body Wraps (September 2012)
Be glad this doesn't work.

5 Reasons Not to "Cleanse" Your Colon (October 2012)
#3: It's rude to firehose your friends.

Copying Roger Clemens Won't Help You Lose Holiday Pounds (November 2012)
The dirt on vitamin B12 shots.

Enough Already with the Juice Cleanses (January 2013)
In which a salesperson suggests I fast for five straight weeks.

Deer Antlers Are Not Unicorn Horns (February 2013)
Some professional athletes are confused about this.

Reflexology and Other Stories (April 2013)
Non-traditional non-Chinese medicine.

Laser Lipo Only Kind of Sucks (July 2013)
Surprisingly, the least sketchy place the Shambulance has traveled.

If you'd like to suggest a future destination for the Shambulance to drive, climb, dive, or teleport to, leave your suggestion in the comments!


Image: taken by me with my iPhone because we already packed the camera cord.

How to Convince People WiFi Is Making Them Sick

All it takes is an antenna on a headband. If you've got a breathless video report on the dangers of wireless internet connections, that will help your case. It doesn't take much, though, to turn an ominous hint into a real headache.

Some people consider themselves sensitive to electromagnetic fields. They report symptoms such as burning skin, tingling, nausea, dizziness, or chest pain, and they blame their malaise on nearby power lines, cell phones, or WiFi networks. A recent Slate article described such people moving to a remote West Virginia town where radio-frequency signals are banned. (The town is within the U.S. National Radio Quiet Zone, an area that's enforced to keep signals from interfering with radio telescopes there—telescopes that work because they receive the radio-frequency signals constantly hitting our planet from space.)

There's no known scientific reason why a wireless signal might cause physical harm. And studies have found that even people who claim to be sensitive to electromagnetic fields can't actually sense them. Their symptoms are more likely due to nocebo, the evil twin of the placebo effect. The power of our expectation can cause real physical illness. In clinical drug trials, for example, subjects who take sugar pills report side effects ranging from an upset stomach to sexual dysfunction.

Psychologists Michael Witthöft and G. James Rubin of King's College London explored whether frightening TV reports can encourage a nocebo effect. They recruited a group of subjects and showed half of them a clip from a BBC documentary about the potential dangers of wireless internet. (The BBC later acknowledged that the 2007 program was "misleading.") The remaining subjects watched a video about the security of data transmissions over mobile phones.

After watching the videos, subjects put on headband-mounted antennas. They were told that the researchers were testing a "new kind of WiFi," and that once the signal started they should carefully monitor any symptoms in their bodies. Then the researchers left the room. For 15 minutes, the subjects watched a WiFi symbol flash on a laptop screen.

In reality, there was no WiFi switched on during the experiment, and the headband antenna was a sham. Yet 82 of the 147 subjects—more than half—reported symptoms. Two even asked for the experiment to be stopped early because the effects were too severe to stand.

Witthöft says he expected to see a greater effect in people who had watched the frightening documentary. This wasn't the case overall. Instead, the movie mainly increased symptoms in subjects who described themselves beforehand as more anxious.

"It suggests that sensational media reports especially in combination with personality factors (in this case anxiety) increase the likelihood for symptom reports," Witthöft says.

Plenty of symptoms were reported without the sensationalist TV show, though. The antenna on the head, the researchers' allusion to a "new kind of WiFi," and the instructions to monitor their bodies closely were enough to trigger symptoms in many people who watched the other video.

Witthöft points out that his study would have been stronger if there were a third group of subjects who didn't wear the "WiFi" headband at all, but were simply told to pay attention to their bodies for 15 minutes. This kind of attentiveness might trigger symptoms on its own.

Still, Witthöft says, "I think the high percentage of symptom reports nicely shows how powerful nocebo effects are."

Though the researchers set out to show how irresponsible reports in the media can trigger a nocebo effect, they ended up showing how easy it is to make a person feel sick with just a a prop and a few choice words. Even a National Radio Quiet Zone can't protect against that.


Witthöft, M., & Rubin, G. (2013). Are media warnings about the adverse health effects of modern life self-fulfilling? An experimental study on idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) Journal of Psychosomatic Research, 74 (3), 206-212 DOI: 10.1016/j.jpsychores.2012.12.002

Image: Scott Beale/Laughing Squid (via Flickr)

The Shambulance: Reflexology and Other Stories

The Shambulance is an occasional series in which I try to find the truth about bogus or overhyped health products. Helping me keep the Shambulance on course are Steven Swoap and Daniel Lynch, both biology professors at Williams College.

Sticking a Q-tip up one’s nose is not the source of many great insights. Yet it’s how an American doctor in the early 20th century developed the theory that became modern reflexology. He would be proud—though maybe a little confused—to see people today flocking to reflexology spas, where practitioners treat all their problems via the soles of their feet.

The American doctor in question was William H. Fitzgerald, an ear, nose and throat specialist. In a 1917 book, he explained the genesis of his big idea:

Six years ago I accidentally discovered that pressure with a cotton tipped probe on the muco-cutinous margin (where the skin joins the mucous membrane) of the nose gave an anesthetic result as though a cocaine solution had been applied . . . Also, that pressure exerted over any bony eminence of the hands, feet or over the joints, produces the same characteristic results in pain relief . . . This led to my ‘mapping out’ these various areas and their associated connections and also to noting the conditions influenced through them. This science I have named "Zone Therapy."

Chapter titles from Zone Therapy include "Zone Therapy for Women" (tongue depressor into the back of the throat for menstrual cramps), "Painless Childbirth" (rubber bands around the toes, among other interventions) and "Curing Lumbago with a Comb."

A nurse and physical therapist named Eunice D. Ingham extended the idea of zone therapy in the 1930s and 1940s, eventually mapping the entire body onto the soles of the feet. She called each important point on the foot a “reflex” because it reflected back to a certain organ or body part. Ingham wrote two books on the subject, now called reflexology: Stories the Feet Can Tell and Stories the Feet Have Told.

Today, the International Institute of Reflexology describes its practice as as “a science which deals with the principle that there are reflex areas in the feet and hands which correspond to all of the glands, organs and parts of the body.” Stimulating these points “can help many health problems in a natural way.” The site insists, “Reflexology…should not be confused with massage.”

There has been some confusion and blending, though, between Western reflexology and traditional Chinese medicine. Ingham and Fitzgerald's idea of "zones" is similar to the Chinese principle of "meridians." In traditional Chinese medicine, meridians are paths that carry qi through the body and connect the acupuncture points. Reflexology groups like to say that Fitzgerald "rediscovered" the science from more ancient roots. They even claim that ancient Egyptians practiced it, based on tomb paintings showing people holding each other's feet.

Whoever thought it up first, the idea that the soles of your feet hold a miniature map of the entire rest of your body defies a scientific explanation.

“The problem is communication,” says physiologist Steven Swoap. “How does the foot talk to the pancreas?”

The foot is full of sensory nerves, Swoap explains. These can detect temperature, pain or position and send that information to the spinal cord. If the signal is something urgent—say, you stepped on a nail—the spinal cord will send a quick command back to the foot (“STOP!”). If the signal from the foot is a non-painful one (“Hey, I’m walking on grass”), it will travel all the way up the spinal cord to the brain.

“But in no instance do those sensory nerves bypass either the spinal cord or the brain and go directly to the liver, or the kidney, or the colon,” Swoap says. This means your foot can’t communicate directly with any other body part except your spinal cord or brain. Whatever stories the feet have told, they’ve had a limited audience.

Daniel Lynch, a biochemist, points out that sex organs are missing from some reflexology maps. “Why aren’t the gonads on there?” he asks. Other maps label a "testes and ovaries" region around the middle of the heel, but there's variation from one chart to the next.

Setting aside the map itself, Lynch says, “Where is the evidence that it actually works?”

The evidence is slimmer than a stiletto heel. In a 2011 review paper, complementary medicine researchers at the Universities of Exeter and Plymouth dug up every scientific study of reflexology they could find. Out of 23 randomized clinical trials, only 8 “suggested positive effects.”

The quality of the studies was “variable,” the authors write, “but, in most cases, it was poor.” Only four studies that found a positive effect used a placebo control—that is, did massaging the feet without regard to “zones” give patients the same symptom relief? In general, studies tended to use small groups of subjects and not to be replicated by other researchers.

Reflexology has been tested on conditions including asthma, premenstrual syndrome, irritable bowel syndrome, multiple sclerosis, and back pain. If reflexology does have a benefit, “The most promising evidence seems to be in the realm of cancer palliation,” or making patients more comfortable, the authors write. Overall, though, they found no convincing evidence that reflexology has power beyond the placebo.

Not that we should thumb our Q-tip-free noses at the placebo effect. The body has an impressive power to make itself feel better based on our expectations. A foot rub from a professional may very well ease a person’s pain. If that professional says anything about zones, though, it’s only a story.


Image: Foot reflexology chart by Stacy Simone (Wikipedia)

Ernst, E., Posadzki, P., & Lee, M. (2011). Reflexology: An update of a systematic review of randomised clinical trials Maturitas, 68 (2), 116-120 DOI: 10.1016/j.maturitas.2010.10.011

The Shambulance: Deer Antlers Are Not Unicorn Horns

The Shambulance is an occasional series in which I try to find the truth about bogus or overhyped health products. The chief navigational officer of the Shambulance today is Steven Swoap.

This Superbowl season saw a star linebacker forcefully denying that he'd ever sprayed juice made from ground-up deer antlers into his mouth. The player was Ray Lewis, and using deer antler spray would have seemingly violated the National Football League's ban on performance-enhancing drugs. Like the horn of a unicorn, this product is alleged to heal and strengthen its users. Also like the unicorn horn, it's probably not something the NFL needs to worry about.

Bottles of deer antler spray—also called deer antler velvet or IGF-1 spray—are legal and easy to purchase for $20 to $50. Though no one's checking what's actually inside the bottles, makers claim their products come from antlers that are harmlessly sawed off of male deer each spring, or from the soft skin covering these new antlers. A few times a day, you spritz the solution into your mouth and swallow it.

The suggestion is that deer antler spray will make your own muscles or bones regrow as rapidly as a deer's antlers. Some products make other claims that are variously expansive, including weight loss, better endurance, a boosted immune system, and higher sex drive. Fueling all these promises is a hormone called IGF-1 (short for insulin-like growth factor). Like medieval "unicorn horns" that were really the tusks of narwhals, IGF-1 is less glamorous in reality than in legend.

It's true that deer antlers "grow like crazy," says Steven Swoap, a physiologist at Williams College. "There are not many examples where a tissue grows faster than an antler. Except for maybe some pumpkins."

We humans are naturally curious about tapping into that growing power. And IGF-1 is certainly involved in growth. In humans as well as deer, it's mostly manufactured by the liver. We make more of it during growth spurts, Swoap says. Producing too much IGF-1 is linked to certain cancers—growth that can't be stopped.

"Does IGF-1 cause antler growth? It is possible," Swoap says. "A more likely candidate is testosterone." Female deer, which also make IGF-1, don't grow antlers; male deer have extra testosterone in their bodies during the antler-growing season. "There are likely many factors involved," Swoap says.

Whatever ingredient gives deer antlers their seemingly magical growing power, we aren't likely to capture much of it by grinding up the antlers themselves. "The antler is not a hormone producing factory," Swoap says. Antler growth is triggered by hormones sent from elsewhere in the body, such as the liver, thyroid, or testes. ("You would be much better off making a spray out of the testes of deer," Swoap suggests. "Or you could perhaps get the IGF-1 from the liver, where it is made, and have a liver milkshake with your deer nut spray.")

Even if a useful quantity of IGF-1 made it out of the antlers and into the spray, the molecule would have a hard time completing its journey into the hopeful athlete's body. Swoap says IGF-1 is a hefty protein that's unlikely to slip into your bloodstream through the soft tissues under your tongue. And once swallowed, it would break down in your digestive tract.

Swoap compares IGF-1 to another famous protein hormone: insulin. "For years, we had to inject it, and it is only recent technological advances that allowed us to deliver it subcutaneously," he says. "To say that the technology is replicated in a bottled spray is ridiculous."

Mitch Ross, the owner of the company that claimed Ray Lewis used its deer spray to recover from an injury, calls his products "technologies that are light years ahead of what people can understand." In other words, even if we can't explain the science, we should accept that deer antler extract helps people.

Except that it doesn't.

Researchers have given oral deer antler supplements to various groups of people, compared them with placebos, and looked for any effect. Men who took deer antler supplements during a strength training program showed no change in hormone levels (including IGF-1) and no difference in aerobic endurance. Rowers also showed no change in hormone levels and no difference in strength or endurance. (As for those other claims, a study in middle-aged men found no increase in sexual function.) A review paper last year concluded there is no convincing evidence that deer antler extract is useful to athletes.

It seems we haven't yet lopped anything special off the heads of those deer. Ray Lewis and (because even athletes who compete at a walk apparently want performance boosters) golfer Vijay Singh are busy defending their reputations against deer antler spray. Yet the product wouldn't have given them any extra powers except a placebo spritz of confidence. Professional sports organizations have plenty of real beasts to chase down in the world of banned substances, but this one is only a mythical creature.


Image: skipnclick (Flickr)

12 Days of Inkfish, Day 4: Help Desk

When you use website analytics, you quickly learn that there are a lot of people out there Googling things like "how do i make robot" and "which is best medicine for make baby." This year I've seen many visitors whose search queries were probably not answered here. To make things up to them, I'll try to address a few of those questions now.

orangutan stop following me

Unless you live in Borneo or Sumatra and spend a lot of time in rainforest trees, it's very unlikely that you're being followed by an orangutan. Are you sure it isn't a very hairy human or a large orange dog? If an orangutan is, in fact, following you, don't worry—they mostly eat plants.

can you use ab toning belt on butt for bigger muscles

Ab toning belts will not make your muscles stronger (they only stimulate the surface of the muscle) or more toned (because the contractions are involuntary). But if you're really attached to the idea, don't bother strapping the belt around your rear: they sell toning shorts too.

what pills can make a man's hair fall out in clumps

I don't know the answer to that but it sounds like you're working on a super hilarious prank.

toilet training pigeon
Here's a website with some advice on potty-training pet birds. Consistency is key! But if I had a pigeon I'd skip the toilet training and teach it to carry messages, or to find its home from hundreds of miles away. Or to take pictures, like those cool pigeons in World War I.

is science harmful or useful

Did you not just see that pigeon with a camera strapped its chest?

giant barbies on the loose
Please send a picture so I can better assess the problem. Maybe you and the person with the orangutan problem should coordinate.

that story about the monkeys in the room

Your faith in organic search is touching. I don't know what you're looking for, but here's a story about rhesus macaques raised by water bottles instead of mothers.

if you swap brains will you still have the knowledge inside?
Even if this question is only research for a science-fiction story, I really think you should reconsider.

unnecessary otter

No such thing. 

sex robot sperm go?

Since you clearly know search terms don't have to be in the form of a coherent sentence, I'm confused about why you think they still need a question mark at the end. On the off-chance you're wondering what the similarities are between a sperm cell and a Roomba, here are some.

why is sperm brown

Wow, please see a doctor. Why are all the sperm people coming here?

i have to pee

No one is stopping you. 

what company makes placebo

Okay, I quit.

Images: Help desk by Aryc Ogre; war pigeon via Wikimedia Commons 

The Shambulance: Copying Roger Clemens Won't Help You Lose Holiday Pounds

The Shambulance is an occasional series in which I try to find the truth about bogus or overhyped health products. With me at the wheel of the Shambulance are Steven Swoap and Daniel Lynch.

The injections he'd been receiving in the buttocks during his major-league baseball career, pitcher Roger Clemens explained to a jury this summer, were not steroids. They were perfectly legal and innocent shots of vitamin B12. The jury acquitted him, lifting the weight of a felony perjury charge from his shoulders. You, too, can use B12 to put some spring back into your step—at least, if you believe the companies that market the injections for weight loss, energy, and general well-being. In reality, this is not a performance enhancer.

B12 is a quirky vitamin that you can't get from plants. It's manufactured by bacteria that provide their services to some animals by living in their guts. Humans mainly get B12 from meat, eggs, and dairy. Of course, this means vegan humans have to find the vitamin elsewhere, such as in fortified breakfast cereals or Flintstones chewables. (They might also ingest B12 from soil bacteria on vegetables that haven't been washed well.)

"Healthy individuals have a six-year supply of B12 stored in their liver," says Daniel Lynch, a biochemist at Williams College. So even a temporary shortage in your diet shouldn't harm you. Long-term vegans, though, can become deficient in B12. Some older adults and gastric-bypass patients who can't absorb enough B12 from their food need to get it from an outside source. And patients who suffer from a disorder called (oddly) "pernicious anemia" need B12 supplements.

B12 deficiency causes weakness and fatigue, and an injection of the vitamin reverses those symptoms. This has apparently led some people to conclude that healthy, non-deficient folks will also get stronger and more energetic by taking B12. Why settle for normal functioning when you could be a vitamin-powered superhuman?

"[Weekly] vitamin B12 injections are intended to crank up the metabolism and boost energy levels to increase daily activity and help weight loss even when the body is at rest," says one Chicago weight-loss center.  An "anti-aging" clinic asserts that "B12 injections are...an effective means of boosting the body's metabolism for those looking to lose weight."

You'll start by shedding weight in the wallet region: a 3-month course of shots from that office will relieve you of nearly $500.

It's true that vitamin B12 is involved in metabolism. However, according to the National Institutes of Health, "Vitamin B12 supplementation appears to have no beneficial effect on performance in the absence of a nutritional deficit."

In other words? "Basically, for any healthy person this is a sham," Lynch says. "Any excess B12 is peed out anyway."

Non-human animals store B12 in the liver, just as humans do. "So you could get the same effect of the injection by munching on liver," says Steven Swoap, a physiologist who's also at Williams College. "This is how they 'cured' vitamin B12 deficiency a hundred years ago."

If you still feel a craving for B12 but don't care for liver sandwiches, you can buy bottles of B12 pills—and they'll run you about five cents a tablet. "It begs the question as to why anyone would stick a needle in themselves when you can buy this stuff as a pill at the local drugstore," Swoap says. Maybe we can find a Hall-of-Fame-nominated baseball player to explain it.

Image: Craig Strachan (Flickr)

The Shambulance: 5 Reasons Not to "Cleanse" Your Colon

The Shambulance is an occasional series in which I try to find the truth about bogus or overhyped health products. Physiologist Steven Swoap is with me at the helm.

If you've been tempted by promotions for "colon hydrotherapy"—that is, sessions in which you would pay someone to put a tube up your rectum and wash out your large intestine with water, like a dirty garage being hosed down in summer—then you've already overcome some impressive mental hurdles. Maybe you're almost ready to enjoy the relaxation, renewed energy, and improved health that the procedure promises. Before you take the plunge, as it were, here are a few points to consider.

It's not the 19th century.
People who offer colon hydrotherapy (also called a colonic) tell you the large intestine is full of "toxic waste and toxins." It does, of course, carry waste out of your body. But is it a two-way street?

"Intestinal autointoxication," the idea that poisons from your feces can move backward from your colon into the rest of your body, is an old one. Old as in ancient Egyptian. The Greeks were into it too, including Hippocrates and Galen.

In the 19th century, doctors prescribed laxative pills and enemas to cure all manner of illnesses. One man created and promoted a popular device called the Cascade. As alternative medicine researcher Edzard Ernst describes it, this was a rubber bottle with a nozzle for a person to insert into his or her rectum. When the person then sat on the bottle, it squirted 5 liters of fluid into up into the colon.

By the 1920s, though, some actual scientific study had been done on the subject. Unlike the Cascade, the theory of intestinal autointoxication did not hold water.

A toilet is not a gym.
"Having colonics is like taking your colon to the gym," declares the website for one colon hydrotherapy center. Filling the colon up with water and emptying it again, the theory goes, "exercises" the intestinal muscle so it can do its job better in the future.

"Injecting water into the colon will cause the colon to swell, and cause so-called 'stretch-activated' contractions of the smooth muscle surrounding the intestine," says Williams College physiologist Steven Swoap. These contractions are called peristalsis. "But the colon does this naturally as food stuffs pass through," he adds. "There is definitely no need to help this along for peristalsis to occur."

Colorectal surgeon Francis Seow-Choen points out in a review paper that since the colon is lined with smooth muscle (a type we can't voluntarily control), it cannot be toned like the muscles you work at the gym. Toned muscles are ones that we've consciously flexed so often, our brains learn to flex them automatically. Sit-ups work; water up the rectum doesn't.

It's rude to firehose your friends.
In addition to waste, your colon houses a large portion of your body's friendly bacteria. These gut microbes manufacture several vitamins we need, and seem to be involved in defending us from dangerous microorganisms and generally keeping us healthy.

One study found that cleaning the colon to prepare patients for a colonoscopy—in this case with a straightforward laxative, not with large volumes of pumped-in fluid as in a colonic—immediately altered the types of bacteria in patients' intestines. Another study found that cleaning out the colon both knocked down the bacterial population there and seemed to make it easier for new, potentially unfriendly bacterial strains to move in.

It might kill you.
"My biggest worry would be perforations caused by the water," Swoap says. "If abrasions or tears in the colon occur, you have the possibility of a dangerous bacterial infection." Ironically, one way to make the material in your colon as dangerous as colonic practitioners claim is to blast it with water. Breaking up the feces and creating tiny tears in the colon can turn a one-way street into a two-way hazard.

According to a paper in the Journal of Family Practice, reported complications from colon cleansing include cramping, abdominal pain, vomiting, rectal perforation, blood poisoning, kidney failure, fatal amoebic infection, and fatal accumulation of gas in the veins. Even if such a consequence is rare, Swoap points out, "it is sure not to happen if I don't let some technician put a hose in my rear."

Everybody poops.

Colons have been doing their job without outside intervention for hundreds of millions of years. "Your colon does not need help in a non-disease state," Swoap says. "Your colon is a pro!" If you want to thank it, step away from the hose and have some broccoli.

Image: Mykl Roventine

The Shambulance: Infrared Body Wraps

(The Shambulance is an occasional series in which I try to find out the truth about bogus or overhyped health products. Having recovered from my taste of no-calorie noodles, I'm back this week with Shambulance first officers Steven Swoap and Daniel Lynch.)

Sometimes it's for the best when product claims turn out to be blatant lies. If purveyors of infrared body wraps, for example, were telling the truth, clients would walk out of their spas dripping grease from their skin—and that wouldn't even be their biggest concern, next to the heart attacks.

All body wraps are not created equal. There are slimming volcanic ash wraps, herbal wraps, mud wraps, and even chocolate wraps. Some are only meant to be relaxing skin treatments. Others involve swaddling clients mummy-style in bandages and plastic wrap, then leaving them for an hour or so to stew in their own sweat.

These kinds of body wraps often promise weight loss or overall slimming. In reality, how much weight you lose will depend on how much water your body sweats out in a frantic effort to cool down. Additional svelte-ness might come from the squishing action of the tight bandages. Both effects will be temporary. 

As another benefit, spas that offer body wraps unfailingly promise "detox." This isn't the first time the d-word has come up here. Suffice it to say that unwanted molecules are filtered from our blood and sent out of our bodies by the liver and kidneys—not sucked from us forcefully by mud wraps, juice diets, or ionic foot baths.

But the most amazing promises of all come from the infrared body wrap. Unlike some of the body wrap's other incarnations, this treatment doesn't require you to strip down, be slathered in goo, and get bandaged head to toe. Instead, clients lie on a bed with their clothes on while several infrared-generating silicone pads are strapped around them. Then they're left under a heated blanket for a while.

So far, it sounds like nothing more than a toasty nap. But spas say that you'll leave an infrared wrap session skinnier and healthier, with better circulation, a faster metabolism, clearer skin, and less cellulite. How?

The pads give off long and short infrared waves that penetrate deep into your fat layers, websites claim, increasing your body temperature, metabolism, and blood circulation. The heat "break[s] down fats into a liquid form, allowing secretion of body water, toxins and fat as you perspire," according to one Chicago spa.

All that formerly stored fat, once liquefied by the infrared waves, is obviously eager to escape your body through the nearest exit. But don't worry if the fat gets stuck inside you—you'll burn it anyway. "You can burn 900 to 1,400 calories or more in just one 50 minute session," another Chicago site proclaims.

After studying this calorie chart, I'm thinking I've been wasting my time by walking to work. What I should really do is buy some of these silicone pads, strap them on, and see if I can get someone to roll me there.

This is "completely insane," says Williams College physiologist Steven Swoap. "How are they allowed to write this stuff?"

For one thing, "Fats simply don't come out of sweat glands," he says. Though if they did, you would definitely have to throw away your spa outfit after soaking it with grease from the inside.

Infrared radiation, Swoap explains, isn't a magical cellulite-blasting weapon. In fact, people naturally give off long infrared waves as body heat. "Instead of wrapping yourself with this stuff, maybe a good long hug with your significant other would work too," Swoap says. Or, if you're looking for shorter infrared waves, "You could take your TV zapper and shoot it at yourself all day long."

Daniel Lynch, a Williams College biochemist, says that heating parts of your body could certainly increase your water loss. But your fat isn't budging. "To get rid of the fat, it must be metabolized," he says, "and that is not going to be enhanced by lying on a bed with silicone wraps on your legs."

Furthermore, Lynch speculates, if your fat deposits really did get broken down and sent back into your blood—and you were, say, lying on a table instead of using those fat molecules for fuel—"You could actually have dangerous levels of fatty acids circulating in your blood. That's good for a heart attack!"

If you're looking for an exercise-free way to burn fat, Swoap suggests hanging out in a cold room rather than under a warm blanket. Being in the cold will raise your metabolism as your body tries to replace the heat you're losing. If you're still hankering after the spa experience, you could always wait until winter, wrap up in a scarf, and have someone log-roll you down the sidewalk.

Images: Top, Leah Chavie Skincare Boutique; middle, Formostar Infrared Body Wrap System; calorie chart, Formostar Infrared Body Wrap System.

Subliminal Placebo: You Didn't See It, but It's Working

The latest additions to the placebo effect family might be the rudest. First there was placebo, which uses your body's own tools to make you feel better after you try a treatment you imagine will help you. Then there was nocebo, placebo's evil twin: it makes you feel worse only because you think you will. Now researchers have discovered that placebo and nocebo effects can be triggered subliminally, which is like finding out that the good and evil twins have both been living in your basement without you knowing it.

Usually, placebo and nocebo look like cases of our own expectations manipulating us. Someone swallows his favorite headache remedy or visits a doctor, and his body, expecting to feel better, ramps up production of its own pain-relief molecules. Someone else steps onboard a plane and begins to feel nauseous, simply because her body has learned that airplanes mean queasiness. If we were more ignorant of our circumstances, the effects wouldn't be there.

But there seem to be some cues we can take in subliminally, without noticing them. So researchers led by Karin Jensen at Harvard Medical School wondered whether visual signals that are too brief to reach our consciousness—but perhaps not too brief for certain areas of our brains to snag as they pass—can trigger placebo and nocebo effects too.

For their visual signals, the team chose photos of male faces. "We know from previous studies that faces can be detected and processed very quickly in the brain," Jensen says. Their models came from a set of photos created for use in psychology experiments.

The researchers carried out two experiments, the first of which was a classic test of placebo and nocebo. Subjects were shown pictures of two expressionless male faces over and over. Each time they saw face A, they felt a painfully hot sensation on the forearm. Face B was paired with heat that was milder, but still uncomfortable. (The A and B models alternated between different subjects—just in case one man's face really was more painful to look at.) During the conditioning part of the experiment, subjects saw each face 25 times. This taught them to expect higher pain with face A and lower pain with face B.

Then came a second series where subjects saw the same two faces as before, with a few new ones mixed in as controls. With each face they saw, subjects rated the pain they felt from the heat instrument on a 100-point scale. The twist was that in this part of the experiment, the heat level was exactly the same every time. But subjects consistently reported high pain for face A and low pain for face B. When they saw a new face, subjects reported an intermediate level of pain (which corresponded to what they were actually feeling).

This first experiment showed the researchers that pairing faces with painful heat stimuli could create both a placebo effect (when subjects rated moderate heat as less painful because they saw face B) and a nocebo effect (when subjects found moderate heat more painful, thanks to face A). So they moved on to the second experiment. In this round, the visual signals would be "nonconscious,"or subliminal.

A new group of subjects went through the same conditioning sequence as before. Then they were given a testing sequence using face A, face B, and the new (control) faces, all paired with the same moderate heat on the arm. But the faces in this sequence flashed on the screen for just 12 milliseconds, compared to 100 milliseconds in the earlier experiment.

12 milliseconds is fast. Too fast, in fact, for subjects to consciously process the faces zipping by. They reported that they couldn't tell who was who (and a separate experiment confirmed that people can't recognize faces shown this quickly).

But, as the researchers report this week in PNAS, the pain scores still matched the faces subjects said they couldn't see. Face A got significantly higher pain scores than face B, with the control faces scoring in the middle—and don't forget that, once again, subjects were actually feeling the same degree of heat every time.

Even though the pictures flashed too briefly to enter conscious awareness, they seem to have snuck in through the brain's back door. These visual cues made subjects experience more or less pain than they should have, even though they had no idea what they'd seen.

There were only 20 subjects in each experiment; it would take further studies to show how consistent or how powerful the subliminal placebo and nocebo effects are. But the fact that they found an effect at all is exciting news to the researchers. "To the best of my knowledge, there has not been an experiment [previously] where placebo/nocebo effects have been activated by nonconscious cues," Jensen says.

The common assumption, Jensen says, is that placebo and nocebo rely on the signals we're paying attention to (pills, needles, drug commercials) and the results we expect (relief, discomfort, alarming side effects). But this study "proves that we don't need to be aware of the cue to elicit a conditioned response," Jensen says.

Don't expect to start seeing mysterious images flashing at you in the doctor's office. The subjects in Jensen's study had to be trained to associate photos of faces with high or low pain. And even if there were another kind of image that automatically produced a placebo effect in a wide audience (teddy bears? puppies?), our brains might not be able to recognize it as quickly as a human face.

But the idea that placebo and nocebo effects can be triggered by cues patients don't even notice could be important for healthcare, Jensen says. Certain conditions such as asthma, depression, and irritable bowel syndrome are known to respond well to placebos. Maybe doctors' offices and hospitals in the future will tailor everything patients see—from the posters on the wall to the instruments on the counter to the fish swimming in the lobby aquarium—to encourage placebo and avoid nocebo. Or maybe we'll be able to use the same tricks at home to keep ourselves feeling our best. Let's kick those weird placebo relatives out of the basement and put them to work.

Karin B. Jensen, Ted J. Kaptchuk, Irving Kirsch, Jacqueline Raicek, Kara M. Lindstrom, Chantal Berna, Randy L. Gollub, Martin Ingvar, & and Jian Kong (2012). Nonconscious activation of placebo and nocebo pain responses PNAS : 10.1073/pnas.1202056109

Image: freya.gefn/Flickr

How Placebo's Evil Twin Makes You Sicker

Whenever a pharmaceutical company tests a new migraine prevention drug, nearly 1 in 20 subjects will drop out because they can't stand the drug's side effects. They'd rather deal with the headaches than keep receiving treatment. But those suffering patients might be surprised to learn that the drug they've quit is only a sugar pill: the 5 percent dropout rate is from the placebo side.

Lurking in the shadows around any discussion of the placebo effect is its nefarious and lesser-known twin, the nocebo effect. Placebo is Latin for "I will please"; nocebo means "I will do harm." Just as the expectation of feeling better can make our symptoms ease, the expectation of feeling worse can make it a reality.

In a review paper published last week in the German journal Deutsches Ärzteblatt International, researchers say doctors and drug companies are unwittingly introducing patients to the demon of nocebo. Led by Winfried Häuser of the Technical University of Munich, the authors say that nocebo in the doctor's office can add unnecessary pain and distress to ordinary procedures. In clinical drug trials, it can create side effects that shouldn't be there—and perpetuate them in the patients who will take that drug in the future.

Chemically, nocebo seems to use the same toolkit that placebo does. Say you have a headache and treat it however you normally like to—maybe with an ibuprofen, or a few drops of homeopathic whatever under your tongue. If you expect to start feeling better soon, your body will use internal molecules such as dopamine and opioids to start creating its own pain relief. (Depending on what treatment you've used, you may or may not get some chemical backup once it kicks in.) It's good old-fashioned conditioning, just like Pavlov's hungry dogs salivating before food was anywhere in sight. But in nocebo, when you expect your headache to get worse, your body turns the pain-relief machinery down instead of up.

Nocebo doesn't need a doctor's help to find you. But a doctor can harness it too. The standard assumption in medicine, Häuser and his coauthors write, is that patients should be warned ahead of time about anything painful ("You're going to feel a little pinch!"). But telling a patient to expect discomfort might actually make it worse. In one study, patients getting an injection felt more anxiety and pain when their doctors used words such as "sting," "burn," or "bad," even if the doctor was only trying to express sympathy.

In another study, women receiving epidural injections felt more pain when they were warned that the "big bee sting" would be the worst part of the procedure. When women were instead reminded that the injection would numb them and make them more comfortable, they experienced less pain. The authors point out that patients in emergency situations or facing major surgery are often in a "trance state" that makes them even more suggestible than usual.

Nocebo can really throw a wrench into clinical drug trials. Placebo is well accounted for; these trials always include a large placebo group in which patients are given a sugar pill or other fake treatment. To minimize the effect of suggestion, neither doctors nor patients know which group they're in. After the trial, researchers can subtract the positive effect seen in the placebo group from that in the patients taking a real drug, and see how much good their treatment really did.

In both the real and placebo groups, subjects report any side effects they experienced. When drug companies report the results of their trials, the Food and Drug Administration asks that they only report side effects (or "adverse events") that they have some reason to believe were caused by the drug. But the FDA acknowledges that this is "a matter of judgment."

As we saw with the migraine patients, side effects can be common even with a sugar pill. In one study, 44 percent of lactose-intolerant people reported gastrointestinal problems after taking a fake lactose tablet. (Impressively, a quarter of people without lactose intolerance also reported digestive troubles after taking the tablet.) And in a somewhat cruel prostate drug study, one group of subjects was told that sexual dysfunction was a possible side effect, while the other group wasn't. The better-informed group reported sexual side effects at a rate of 44 percent, compared to only 15 percent in the blissfully ignorant group.

Whatever side effects are attributed to a new drug, doctors may increase patients' odds of feeling those effects just by mentioning them. In Germany, Häuser says, "most of the product inserts contain very many potential non-specific adverse events, raising the risks of nocebo effects." So how can doctors avoid making their patients sicker?

Häuser and his coauthors have a couple of suggestions. Patients could consent to not be informed about mild side effects, knowing that just hearing about these effects makes them more likely. And doctors can phrase their warnings more positively, emphasizing that most patients respond well to a treatment rather than focusing on potential negatives.

"Doctors can and should be trained to positively use the power of their words," Häuser says. If we know where nocebo is lurking, we may be able to keep it far away.


Winfried Häuser, Ernil Hansen, & Paul Enck (2012). Nocebo phenomena in medicine: Their relevance in everyday clinical practice. Deutsches Ärzteblatt International : 10.3238/arztebl.2012.0459

Image: takgoti/Flickr

The Plus Side of Eating Placenta

He's not suggesting new parents pause in the delivery room to whip up a placenta sandwich. But neuroscientist Mark Kristal says human mothers might be missing out on the benefits other mammals receive from gobbling up their afterbirth. With luck, there might be a way for us to take advantage of placenta power that's not totally disgusting.

Mark Kristal is a professor at the University of Buffalo who's been studying the practice of placenta eating--or placentophagia, if you want to bring it up in polite company--for more than 40 years. His interest in the subject sprang from his study of maternal behaviors in mammals giving birth. "I had the field to myself," he said in an email.

And he knows it's gross. "Unfortunately, people often ask me what my research is on during dinner," he says. "It always gets a laugh (and a gag)."

Humans, with the exception of some naturopaths and celebrities, don't eat placentas. But that makes us nearly alone among mammals. From rodents to cattle to apes, new moms turn to the business of eating or licking up the afterbirth, including the liver-like placenta, as soon as the baby is out.

In a new review paper (soon to be available here), Kristal and his coauthors discuss the potential benefits of placentophagia for mammals that practice it, as well as for mammals that don't (us). There are several practical reasons why animals might ingest their placentas. Maybe they want to hide the odor of blood from predators, for example, or to keep their nests clean. Maybe mothers are famished after the ordeal of giving birth, or perhaps the placenta replaces nutrients that were depleted during pregnancy.

Though some of these explanations fit subgroups of mammals, none of them works universally. So Kristal thinks there must be a more basic evolutionary explanation for placentophagia. If almost every mammal does it, the simplest explanation is that they do it for the same reasons.

One intriguing possibility, and the strongest lead researchers have so far, has to do with pain. In the 1980s, researchers discovered that female mammals' bodies produce pain-relieving endorphins during labor and delivery. Studying rats, Kristal found that eating the placenta increased the effect of these endorphins. The placenta didn't dampen pain on its own. But rats that ingested placentas felt less pain, because they responded more strongly to their bodies' own pain relievers.

The effect also works with morphine, a similar pain suppressant. Rats that ate placenta, or amniotic fluid, experienced greater pain relief from morphine. Kristal found that the pain-relief-enhancing effect of afterbirth works in male rats, too, and in animals of other species. It also worked when researchers fed rats with human placentas.

This suggests human placentas have the same health benefits as other mammals'. So why do humans, alone among land mammals, deny ourselves the pleasures of eating placenta? It's possible, Kristal says, that evolution destroyed our appetite for afterbirth for a good reason. Maybe it has to do with toxins caught in the placenta as the organ filters them out of the fetus's environment. Or maybe extra-painful childbirth was helpful in human evolution because it encouraged women to help each other through delivery.

Kristal thinks that with further research, scientists can identify the ingredient in placenta that enhances pain relief from morphine or endorphins. Then the compound can be made in the lab and used as a drug--for all kinds of pain in males and females, not just childbirth.

These days, a few women who have gotten wind of the potential advantages of placentophagia are experimenting with it themselves. But they're interested in more than just pain relief. There are claims that eating one's placenta cures conditions ranging from postpartum depression to nursing difficulties.

Though such claims aren't backed up by any research, Kristal is interested in these same postpartum problems--which, he says, are uniquely human. Sure, other mammals sometimes go so far as to kill and eat their newborns. Rodents, for example, are tempted to ingest everything that comes out of them during delivery, baby included. But a healthy newborn will get its mother's attention by moving around and making noise. Other mammals only eat their young after an extremely stressful pregnancy.

Kristal says none of these behaviors, though, are parallel to the human problems of postpartum depression or an inability to bond with one's baby. If scientists could pinpoint the mechanisms that cause these issues, they could then start asking whether any element in the placenta might help treat them.

While science lags behind, eager placenta-eaters are going ahead with their own methods. Actress January Jones recently outed herself as a fan of placenta pills. After delivering her son, she had her placenta dried and made into capsules. Pill poppers are also featured in this gruesomely detailed 2011 New York Magazine article about placentophagia. (Focused on trend-conscious Brooklynites, the story contains the horrifying sentence, "I threw a chunk of placenta in the Vitamix with coconut water and a banana.")

Mark Kristal gets emails "all the time" from women who have tried placentophagia, he says. Without exception, they all insist it helped them.

But the claims of placentophagia fans are the same regardless of how much placenta they ingested, when they took it, or how they prepared the organ (cooked? raw? encapsulated? smoothied?). And it's unlikely that any real medicinal effect of the placenta could be so universal. For example, experiments have shown that placenta loses its pain-suppressing power when it's heated.

It's more likely that the benefit human women report from eating their afterbirths is the benefit of placebo. The ability to make women feel that they're tapping into a primal force to keep themselves healthy may be the real power of placenta.


Mark B. Kristal, Jean M. DiPirro, & Alexis C. Thompson (2012). Placentophagia in Humans and Nonhuman Mammals: Causes and Consequences Ecology of Food and Nutrition

Image: avlxyz/Flickr (Note: This is a picture of someone's French toast remains. Not placenta.)