The word rhetoric, derived from the Greek noun “rhetor” meaning “speaker,” was once considered the art of verbal persuasion. Up to the late nineteenth century, rhetoric played a prominent role in the western education of orators, lawyers, counselors, historians, statesmen, and poets (Conley 1990). In fact, rhetoric originated in a school of pre-Socratic philosophers, thereby reflecting the intellectual assertions of enlightened minds. In modern society, where business and marketing often take precedence over intellectual integrity, rhetoric is thought of as the misleading ramblings of salesmen attempting to convert potential “leads” into paying customers. As a writer and speaker, it is sad to see rhetoric diminished from its noble roots to a pejorative term that implies style over substance (e.g., “marketing rhetoric”).

The average American is exposed to between 4,000 and 10,000 ads per day (Red Crow Marketing 2015). As such, there is greater competition than ever for the attention of potential customers, and marketing campaigns are employing increasingly aggressive rhetoric and so-called “direct response marketing” to exploit biases in human reasoning (Ković and Laissue 2016). Nowhere is this more apparent than in the health and wellness industry where regulations on advertising claims are virtually nonexistent. In this month’s column, I summarize ten of the most prominent health and wellness “buzzwords” that appear with such frequency in the sale of alternative therapies and other unproven (or disproven) products and that their use should immediately raise a skeptical eyebrow.

1. Superfood. This term was conjured by the advertising industry to describe products that supposedly conferred health benefits owing to their exceptional nutrient densities. There are hundreds of purported superfoods, with blueberries, cranberries, goji berries, chili peppers, garlic, ginger, chia seed, flaxseed, and quinoa most commonly studied in the scientific literature (Driessche, et al. 2018). These products are rarely described as “superfoods” by expert dietitians and nutrition scientists; however, labeling a product as such increases sales. In fact, the number of products labeled as “superfood,” “superfruit,” or “supergrain” increased by 202 percent from 2011 to 2015 (Mintel Press 2016). Yet, there is no merit to the term. In 2007, legislation by the European Union prohibited use of “superfood” in product advertising unless a “specific and authorized health claim” could elaborate on the product’s benefits (BBC News 2007). We are still waiting for the evidence, and the term is currently banned in European ads.
2. Immune (boosting). The immune system is a complex series of cells and proteins that become activated in response to bacteria and viruses. Fear about lackluster immunity has been exploited in marketing for decades, but COVID-19 exacerbated the problem. An online commentary by Dr. Mark Crislip stated that “The immune system, if you are otherwise healthy, cannot be boosted, and doing those things you learned in kindergarten health (reasonable diet, exercise and sleep), will provide the immune system all the boosting or support it needs.” Indeed, immunity can be chronically strengthened (not boosted) through good diet, good sleep, and physical activity (CDC 2022). Yet, in a study of the top 185 websites returned from a Google search on “boost immunity,” the most common approaches proposed were diet (77 percent of webpages), fruit (69 percent), vitamins (67 percent), antioxidants (52 percent), probiotics (51 percent), and vitamin C (49 percent): vaccination—the only evidence-based approach for boosting immunity—was ranked 27th in the list (12 percent of webpages) (Cassa Macedo, et al. 2019).
3. GMO (free). Bioengineered foods are defined as “Those that contain detectable genetic material that has been modified through certain lab techniques and cannot be created through conventional breeding or found in nature” (USDA 2018). However, before the invention of recombinant DNA (rDNA) techniques, our nomadic ancestors would inspect their crop yields and, based on the most desired traits, select superior individual plants for continued breeding. As such, “GMO-free” labeling is a misnomer, because there are scarcely any agricultural foods that have not been genetically modified, be it in nature or in a lab. Yet, the U.S. Department of Agriculture (USDA) has mandated that “bioengineered” food is labeled. Countless controlled studies, reviews, and meta-analyses, neatly summarized by the Credible Hulk, agree that GMOs are safe. Numerous concurrent policy statements from an overwhelming number of global science organizations concur (see image 1).
   
4. Natural. This is one of several words in modern marketing that exploits the “appeal to nature”informal logical fallacy. The appeal proposes that something that is natural is somehow healthier or better than something unnatural/artificial, but this is to insert meaning into the definition of “natural” that is not there. Many supplements are made with “all natural ingredients,” and some foods are portrayed as “natural alternatives.” The organic food industry, for example, claims efficacy (at least partially) on the basis that organic crops are naturally derived, while the anti-GMO movement is concerned that genetic engineering is unnatural (Marris 2001). Other products claim “no artificial ingredients.” According to the FDA, artificial ingredients are those that “are not found in nature and therefore must be synthetically produced as artificial ingredients” (FDA 2010). The human preference for natural produce is pervasive, but it is not based on logic or reason.
5. Chemical (free). Used frequently in ads for foods, cosmetics, and cleaning products, the claim “free from chemicals” is more rhetoric to exploit the “appeal to nature” because it is an attempt to capitalize on fear and stigma surrounding artificial ingredients. According to the U.S. Nuclear Regulatory Commission, chemicals are substances that “have a defined composition” (US NRC 2020). This means that all matter—from the food we eat to the clothes we wear, even the very stardust that constitutes our bodies—is made of chemicals.
   
6. Recovery. Supplements, recovery shakes, massage therapy, stretching, cryotherapy, ice bathing, among others, all claim to promote faster and more effective recovery. Invoking the term is another type of fallacy called “(definitional) ambiguity.” It is misleading or vague language used to deliberately deceive and/or make a claim easier to defend. For example, the words fast and faster, when applied in the context of human movement, have lucid definitions, such that if a trainer assured you that their exercise program could help you run a “faster marathon,” you could accept or reject their claim based on the common definition. However, “recovery” has no clear operational definition or even end point. For instance, does “recovery” include all facets of biological function, or is it specific to the musculoskeletal system? What about recovery of immune function, hydration, or psychological wellbeing? By itself, the term is ambiguous and can be interpreted to serve any number of functions from person to person. When ambiguous wording is used in a claim, the door is left wide open for a definitional retreat when the claim is challenged. By contrast, good science writing is precise and pointed, invoking terms that have common and agreed-upon meanings.
7. Energy. Certain complementary and alternative medicines (CAMs), such as homeopathy, acupuncture, and reiki, are subcategorized as energy medicines. They use words such as energy and energy flow to reference a supernatural force called qi (pronounced chi), which is a “vital energy” shared by ethnomedical healing and shamanic traditions (Mayor and Micozzi 2011). Proponents of traditional acupuncture, for example, claim that physical and emotional ailments derive from stifled flow in the body’s energetic systems. Of course, qi has never actually been measured or even properly defined, and the bulk of evidence does not support acupuncture (or any CAM) as an effective therapy (Tiller 2020). In real science, “energy” can be quantified and has a precise meaning: it is the capacity to perform work. In human biology, it is measured in Joules, and to “expend energy” requires burning Joules to accomplish work (e.g., muscle contraction). In other domains of health and wellness, energy is used as a synonym for vigor or vitality, which is still grossly nonspecific. Consider carefully how the term energy is employed in a claim because it frequently signals CAM or other alternative therapies.
8. Holistic. There are many words with benign dictionary definitions that take on more dubious connotations in health and wellness. The term holistic has been coopted by New Age medicine to denote approaches that consider the patient’s “psychological, familial, societal, ethical, spiritual, and biological dimensions in the search for optimal health and wellness” (Gordon 1982). Holistic practitioners believe that an imbalance in one area of the body can affect the whole. Alternative therapies and CAM are more often disguised as holistic medicine.
9. Integrative. Also used in the context of medicine (i.e., integrative medicine), this term is independent from holistic medicine in that it selectively incorporates elements of CAM into patient treatment plans alongside orthodox diagnoses and treatments (Rees and Weil 2001). Integrative medicine was established in response to the growing problem of skepticism surrounding CAM; i.e., that it was “complementary” to orthodox practices and thus, by definition, could not be considered real medicine: “Thus was born ‘integrative medicine’” wrote David Gorski at Science Based Medicine, “a term that eliminated all implication that quackery such as reiki, acupuncture, naturopathy, and the rest of the pseudoscience and antiscience … was somehow lesser medicine.” Nevertheless, the terms holistic and integrative and even functional medicine all contain elements of CAM: the widely discredited and dangerous pseudoscience(Ernst 2011).
10. Toxins/detox. Detoxes—usually offered in juice-fasts, herbal supplements, herbal teas, ear candles, homeopathy, and coffee enemas, among others—claim to purge the body of “toxins.” But we know that detoxes do nothing of the sort (Klein and Kiat 2015). The term detox, which we discussed in an earlier column, is characterized by ritualistic purification and draws inspiration from outdated notions of evil humors that were once blamed for medical ailments. Such tiny, unmeasurable demons in the body were conceived during a time of scientific naiveté, and their existence is not compatible with modern understanding. It is the liver and kidneys that are tasked with removing toxic compounds from the body, and there is nothing that an ear candle or coffee enema can contribute to the process. Toxins and detoxes have no meaning outside clinical treatments for drug addiction or poisoning; as such, it is a red flag whenever a product claims to deal in toxins.

Conclusions

The appearance of one (or more) of the above terms in a health claim does not mean you are necessarily dealing with a pseudoscience, but it should force deeper reflection on the claim because it may signal an emphasis on marketing rhetoric over science. Of course, the words themselves are not generally problematic because they have no agency. Rather, they have been coopted and their meanings corrupted by modern marketing and snake oil salesmen to sell product. Nor are the terms employed inadvertently, but instead pointedly, to imply meaning, reference a world view, or exploit an ingrained bias. As pseudoscience marketing becomes more prevalent, and more sophisticated, so too must the skeptical movement evolve to counter the growing threat of mis- and disinformation.

References

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