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The Trouble with Celebrity Science

Yes they're hot – but can their health advice burn you?

by Anne Underwood

When a famous person – a sexy, beautiful and powerful famous person – gives an endorsement, people tend to listen. That's why corporations hire tennis champ Maria Sharapova to endorse Canon or swimmer Michael Phelps to pitch for Kellogg's (at least until he took his famous bong hit). But what happens when stars weigh in on medical topics? Think of Tom Cruise and his sweeping condemnation of modern psychiatry. Celebrities may be perfectly qualified to evaluate sneakers, but that doesn't mean you want to learn biochemistry from them.

But stars are human too, and often cannot resist speaking out when a health crisis has touched their lives, even if there's little evidence for their solution. Here's a look at three celebs who have swayed public opinion on three health issues and where they went wrong – or got it right.

Oprah Winfrey on hormones after menopause

Her Take
Oprah says bio-identical hormones pulled her out of a major funk, restored her sense of vitality, and turned her life around. While she doesn't suggest they're right for all menopausal women, in January she devoted two shows to their advantages, giving a platform to the hormones' most enthusiastic proselytisers.

The Science
Taking hormones after menopause is serious business, whether or not you use trendy bio-identical hormones, which precisely mimic the ones your body produces. Studies on hormone therapy (HT) show that using it for more than a few years can increase the risk of developing breast cancer; it may also raise the risk of heart attack. That's not a blanket condemnation, however. Hormones are the most effective treatment for menopausal symptoms of the mind-bending, libido-sapping, shoot-me-now variety. If you have no personal history of breast, uterine, or ovarian cancer, the short-term relief may outweigh the risks. But don't assume you should take them indefinitely to restore youthful hormone levels, as actress Suzanne Somers suggested in her book Ageless and on the second of Oprah's shows.

''A 60-year-old should not have the same hormone levels as a 20-year-old,'' says Dr Wulf Utian, executive director of the North American Menopause Society. He calls Somers's ideas ''dangerous and irresponsible.''

If hormone therapy is right for you, then and only then does the issue of bio-identicals come into play. The problem is that the word bio-identical means different things to different people. Technically, it embraces any exact copy of a naturally occurring female hormone. That's in contrast to some traditional hormone products; for instance, Premarin, the leading oestrogen product, is made from the urine of pregnant mares. (''It's bio-identical if you're a horse,'' says Dr Christiane Northrup, author of The Wisdom of Menopause.)

Many other big-pharma products actually are bio-identical. FDA-approved drugs that precisely mimic women's hormones include Estrace, Evamist, Vagifem, Estraderm, and Climara for oestrogen and Prochieve, Prometrium, and Crinone for progesterone. Yet bio-identicals have become synonymous in many women's minds with a narrower set of products – those that are made to order in compounding pharmacies. These customised drugs have acquired a reputation as a ''natural'' alternative to hormone therapy. They are not: They're highly processed, potent medicines.

What really worries many doctors is the common perception that bio-identicals are safer. Some women do report that they're easier to tolerate, but in the absence of solid studies, Dr Utian says, doctors have to assume that any kind of supplementary oestrogen carries similar long-term risks – and others agree, including Dr Andrew Weil, a leading proponent of integrative medicine. The jury is still out on the safety of bio-identical progesterone as well.

Promoters of compounded bio-identicals often suggest that ''they have all the benefits but none of the risks of pharmaceutical brands,'' said Dr Utian on the first of Oprah's broadcasts. ''If you believe in that, you believe in the tooth fairy.''

Reader's Digest Version
If you need hormone therapy, take the lowest effective dose for the least amount of time possible (think one to three years). For bio-identicals, seek out FDA-approved brands.

Jenny McCarthy on childhood vaccines

Her Take
McCarthy's son, Evan, was diagnosed with autism at the age of two and a half. She blames vaccines.

The Science
Negative publicity about vaccines began to build in 1998, when British physician Andrew Wakefield and colleagues published a study in The Lancet suggesting a connection between autism and the combination shot for measles, mumps, and rubella (MMR). Dr Wakefield hypothesised that the MMR vaccine causes gut inflammation, allowing toxins to leak into the bloodstream and damage the brain.

But that research included only a dozen children; what's more, ten of his 12 coauthors later retracted their conclusion. And in 2008, a well-designed study provided powerful evidence against the theory, when biopsies showed that children with autism were no more likely than other kids to have the measles virus in their intestinal tissue. Other concerns have focused on thimerosal, a mercury-based preservative that was used in vaccines for years. ''Clearly, if you're talking about public health, defending mercury in vaccines is a tough row to hoe,'' says Dr Marie McCormick, chair of the Institute of Medicine's immunisation safety review committee. But the form of mercury in thimerosal is ethyl mercury, not methyl mercury, which is much more difficult for your body to clear and is notorious for causing neurological damage. More important, manufacturers removed thimerosal from most vaccines in 2001. If thimerosal had been to blame, the incidence of autism should have fallen since then. It hasn't.

In fact, the vast majority of studies – from the United States, Denmark, Great Britain, Japan, and Finland – that have looked for a possible vaccine-autism connection have failed to find one. Meanwhile, an emerging body of evidence is pointing toward genetic causes for the disorder. So why do vaccines still arouse suspicion? It's partly a question of timing. Autism symptoms tend to emerge around the age of 15 to 18 months – roughly the same time children receive the MMR vaccine. What can look like cause and effect is actually coincidence, says Dr McCormick.

Forgoing vaccines would not matter if the diseases in question weren't so serious. Before the measles vaccine was introduced, in 1963, there were up to four million measles cases a year in the United States and as many as 500 deaths. Now, with more parents declining the MMR vaccine for their children, the disease is making a comeback. Between January and July last year, 131 cases were reported in the US.

''Jenny McCarthy is very well-spoken, but the science is not on her side,'' says Dr Nancy L. Snyderman, chief medical editor for NBC News and a cancer surgeon affiliated with the University of Pennsylvania. ''I worry that children are going to pay for this with their lives.''

Reader's Digest Version
Childhood vaccines save lives by preventing killer diseases. They're not risk-free, but an immense amount of evidence says the risks do not include autism.

Elisabeth Hasselbeck on going gluten-free

Her Take
Hasselbeck, cohost of The View and author of the new book The G-Free Diet, says a gluten-free diet would benefit many people.

The Science
For five years, Hasselbeck tried to figure out what was causing her incapacitating stomach pain, indigestion, and diarrhoea. Doctors labelled it irritable bowel syndrome (IBS) but were unable to help her. Then, in 2000, she became a contestant on the TV show Survivor: The Australian Outback. Deprived of her favourite foods, Hasselbeck was astonished to find that her symptoms vanished. Further investigation showed that the culprit was gluten, a protein in wheat, rye, and barley.

Hasselbeck has an autoimmune condition called coeliac disease, which occurs in roughly one percent of the population. When a person with the disorder consumes gluten, the immune system responds by attacking that protein, in the process damaging the lining of the gut. The result: digestive woes and an astonishing range of possible complications, from osteoporosis and anaemia to infertility and lymphoma. The solution is a no-brainer – to remove gluten from the diet. (That's harder than it sounds. Besides lurking in obvious places like bread, it can be found in salad dressings, beer, condiments, sausages, lipsticks, pills, and envelope seals. Even trace amounts can trigger damaging reactions.)

For coeliac sufferers, a gluten-free diet is a lifesaver. But what about the rest of us?

''There's little evidence that most people need the diet,'' says Dr Peter Green, director of the Coeliac Disease Center at Columbia University and author of the foreword to Hasselbeck's book. He acknowledges one exception. Doctors are starting to realise that some people without coeliac have a milder gluten sensitivity that can lead to a variety of problems, including IBS. These people may be able to handle small amounts. But Dr Green advises anyone who suspects gluten sensitivity to be tested for coeliac disease, since it carries such serious risks.

These two groups of people are relatively narrow. Yet the increasing number of gluten-free products and menu offerings has convinced many people that ''G-free'' foods are somehow healthier for everyone. Don't buy it. For most people, these pricey versions of breads, cakes, crackers, and pasta are unnecessary.

However, there's a version of gluten-free (or at least reduced-gluten) dining we can all get behind. Hasselbeck advocates the healthiest of such regimens, consisting of fruits, vegetables, fish, meat, nuts, and grains like quinoa. Such a diet, she notes, is more nutrient-rich than the average American diet and is also conducive to weight loss. It's hard to argue with that.

Reader's Digest Version
People with coeliac disease need to follow a gluten-free diet to stay healthy. If you have a milder form of gluten sensitivity, you may find such a diet helpful too. Otherwise, there's no need to bother.

Adopted from Reader Digest