By Africa Check

The lifestyle sections and health pages of many major newspapers and magazines routinely tout questionable health claims that are unsupported by scientific research or evidence.

Some, like the popular claim that eating eggs and bananas at the same time may kill are really relatively harmless, with the main risk being passing indigestion.

Others can have severe repercussions. Take for instance the many treatments that have been falsely peddled as cures for HIV. If patients forsake their proven-to-work antiretroviral treatment in favor of these “cures”, the outcome will most certainly be devastating.

Or this “advice” by a doctor to consume a concoction of sweet pepper, raw eggs and sea salt as a miracle five-minute cure for diabetes. Getting off your treatment regimen in favor of this approach is unlikely to end well.Given that false health claims are often perpetuated by people who, at first glance, appear to be credible professionals, it is not always clear that the treatments they are touting are unproven.

False health-related claims also make up a significant part of fake news that is being spread via social media and other messenger channels like WhatsApp. In England, false claims regarding the link between the MMR vaccine and Autism continue to be fanned in this way, even though they have long been disproven. This particular myth has been perpetuated so effectively that MMR vaccine uptake in England is troublingly low and declining further, with 87.5% of children under five vaccinated, compared with the World Health Organization target of 95%. This has lead to calls for censorship by social media.

Even if the media were to clamp down on health hoaxes and quack products, it’s unlikely they are unlikely on channels through which are spread do clamp down on misinformation, they are unlikely to weed out all of the quackery. For the sake of our health and that of our communities, it is more crucial now than ever that we learn how to fact check information whether we’ve read it on a website, a newspaper, our newsfeed or on a group message.

We have put together this guide to assist journalists, editors and Joe Public in telling fib from fact.

Says who?

When testing the legitimacy of health claims it pays to embrace your inner sceptic. Do not take anything at face value. Instead, ask: “Who has made this claim, what are their credentials and can those credentials be independently verified?”

Be aware, for instance, that titles can be deceiving. “Doctor” can refer to any number of things: a medical doctor (MD), a doctor of philosophy (Ph.D.), a doctor of science (Sc.D.), an honorary doctorate or even a sham “doctorate” purchased online from one of the many websites that peddle bogus qualifications.

To get to the bottom of this, do a quick search for the credentials and associations of the person or organization making the claim. Are their qualifications relevant to their claims?

Check and check again

Be wary if you cannot independently verify someone’s academic qualifications. Similarly, be cautious of companies and organizations that claim to be legitimate but have a limited footprint on the web.

Usually companies and organizations have a clearly marked and detailed “about” section on their website and often also list their board of directors there. That is a good place to start. Who are the directors? Are they really on the board of the organization or company? What are their qualifications and backgrounds and can those qualifications be verified independently?

If you struggle to find this information, tread carefully. It stands to reason that anyone looking to market a proven treatment would be embracing publicity, not shying away from it.

Often just having a look to see who else is talking about a claim can help you discern between fact and fiction. Important breakthroughs in medicine will be covered by major news agencies, websites, radio stations and television channels and published on reputable medical websites. If the treatment has not received recognition in these channels, it is unlikely that there is sound evidence that it works.

The devil is in the detail

Sometimes it is the smaller stuff that gives away a false health claim. Inconsistencies, half-truths and disclaimers are all hints that the product or its promoter might not be sincere. Is it clear what the ingredients of the treatment are, what its mechanisms of action are and how effective it is? Why for example would a product that does not claim to be medicine be packaged to look like a pharmaceutical product?

If it looks too good to be true, it usually is. The FDA warns that products sold as a panacea, capable of treating a range of ailments, are usually hoaxes. So too are quick fixes and products that offer a satisfaction guarantee.

Also be weary of unnecessary medical jargon, confusing flourishes and name-dropping. Take for example this CBD oil, the manufacturers of which claim to have “normalized extensive testing to confidently assert the potential of [their] products”. They also want you to know that their oils are made in Swiss laboratories. These statements are designed to create the illusion of science in the absence of conclusive proof. In reality, the jury is still very much out on CBD, which has been called “the new snake oil” thanks to the frenzied enthusiasm with which hit has been embraced.

False claims are also often supported by anecdotal evidence and personal testimonies intended to make the ailment seem relatable and the treatment highly effective. But without scientific proof that a treatment works, these endorsements are about as reliable as office gossip.

To determine whether a treatment is safe and effective, it must undergo an extensive protocol of clinical testing where it is first deemed safe for human consumption and is then given to a large sample of people to determine whether it is effective. In order to obtain conclusive proof that the treatment works, it is compared to a placebo. This is known as a “controlled trial."

Clinical trials and patient safety

Not all of this research is published, although there is growing support for this information to be made universally accessible. The abstracts of most published studies are available online and they should give you a good overview of the findings. Google Scholar will bring up results from most reputable academic journals. The Medline database also features a comprehensive collection of published research.

Whilst there are arguments that the clinical trial process is prohibitively expensive for less profitable treatments, trials are considered integral to ensuring patient safety.

If you were unable to find any published research to support a claim, approach the person or organisation marketing the product or service and ask what evidence they can provide for the effectiveness of their product.

Remember: If a treatment has not been tested on humans, it cannot be considered safe or effective. If the study was not controlled and the sample was not large enough, the findings cannot be considered conclusive. (Later phases of clinical testing involve thousands of participants).

You might be told the product has been tested or is currently being tested, but without the results of these tests, the claim remains unproven. Wherever possible, also speak to a reputable expert in the relevant field to get their views on the issue and to help you make sense of complicated research.

Keep in mind that just because there is no conclusive proof that a treatment works, it does not necessarily mean it isn't effective. It simply means it has not (yet) been subjected to rigorous testing. In that case, saying with certainty that a treatment does not work would be incorrect.

However, selling or otherwise promoting a treatment or cure without proof that it does work is deeply unethical and should be called into question. It usually also means not enough is known about the safety of a particular treatment. It is important that these concerns are raised and readers are made aware of the lack of evidence and the repercussions this may have for them.

First, do no harm...

Sometimes patients will still choose to take a treatment even if they know there is not yet conclusive proof that it works. Their decision may be influenced by cultural norms or a need for spiritual engagement. Traditional herbal practitioners are often consulted as counsellors and spiritual healers, not just for the treatment of physical ailments.

Others may be inherently sceptical of modern, allopathic medicine and choose to look for what they consider more natural treatment options. Often this is spurred on by the common misconception that because something is labelled “herbal” it cannot be harmful. This belief is easily challenged by the fact that technically, nightshade, oleander and hemlock are all herbal, though definitely not safe for human consumption.

Interestingly, the placebo effect suggests that even if treatments are proven to have no effect at all, they may still have some positive impact on the people taking them simply because they believe it will make them feel better.

All these considerations make it extremely important that even if treatment is known to be ineffective, it is at least safe for human consumption. And if it is not, the public has a right to be told this in no uncertain terms.

In some cases those promoting a treatment will offer guidelines for safety. The Placenta Network, for instance, is clear about the precautions that need to be taken when new mothers decide to consume their placenta, a practice they say will assist in recovery after birth.

In other cases the safety of supposed treatment can be less clear and you may have to consult a medical doctor to get a better sense of the risks involved. Some herbal treatments can induce vomiting and thus interfere with the effectiveness of existing medication.

Follow the money

There is more scientific research to navigate now than ever. As a society, we have a growing faith in science and rising expectations that through it, we will lead long, pain-free, vital lives. Yet a large amount of scientific research is not undertaken in the pursuit if truth or even health, but rather in the hope for profit or success. Here it helps to follow the money. Most credible academic journals require the authors to submit a declaration of interest in which they are expected to disclose any competing interests.

But sometimes false claims can be the result of misinterpreted or insufficient research that has been exaggerated or sensationalised to inform or entertain. We see examples of this where a certain food is singled out for its beneficial properties without sound evidence to back up the claim.

When it comes to health advice, always turn to trusted sites. You can quickly get a sense of how seriously a publication takes the health content it creates by reading about their contributors and reviewers, sources of funding and partners. Take the extensive panel of medical professionals who contribute and check the content on Healthline, for example.

There is need for caution in such territory, particularly because claims like these come at the cost of more moderate and valid advice like paying attention to diet overall to stave off lifestyle disease. But other claims can be far more extortionate and are deserving of very serious scrutiny.

Herbal treatments can sell for large sums of money. Convincing the desperate and hopeful to part with their scant funds without actual proof that these treatments work constitutes fraud and should be exposed as such.

Do not assume regulators keep the sale of quack cures in check

As consumers, we easily fall into the trap of thinking all treatments being sold in reputable pharmacies or on legitimate-looking websites have been tested and proven effective. But it would be a mistake to assume that the government or any regulating body can weed out all false claims or that the public is protected from quack cures because their sales are not legal.

In South Africa, the newly-launched South African Health Products Regulatory Authority is expected to strengthen protections for users. Its predecessor, the Medicines Control Council, was not seen as always on the ball on this.

Whilst proven treatments are usually marketed directly to the medical community, quacks often go straight to the media or social media platforms and rely on the press and the public to advertise their products to the public. This makes it critically important that reporters take the time to interrogate health claims before publishing them.

But it cannot only be left up to the press to snuff out misinformation, especially those myths that are spread through personal messenger services. In an age where everyone participates in creating and spreading the news, we all have to learn to embrace our inner skeptic. Regularly reading myth busting content on websites like Africa Check, or this: “Behind the headlines” series by the UK’s National Health Service, or the FDA’s Health Fraud Scams content can help you hone your ability to sift through the fake and the fraudulent.

It is not always possible, practical or fair to label a treatment as ineffective or to make out a salesman as a fraud. But unless there is conclusive evidence that they are effective and safe, health claims should always be presented as what they are: merely claims.

Editor's note: This is an updated version of Africa Check's guide, which was first published in 2013. You can read that version here.