From the CBC’s Almanac Program, April 29, 2013
Heart disease is the second leading cause of death in Canada. (That’s according to Statistics Canada.) If you want to lower your risk, the usual advice is to see your physician. Well a study published today in the Canadian Medical Association Journal gives surprising evidence that maybe you should see a naturopath instead. House doctor Brian Goldman is here with the details:
Almanac: What’s the difference between the kind of medicine you practice and naturopathic medicine?
Goldman: As a physician, I practice some preventive medicine, but the main focus of my work is to use my understanding of the causes of disease to diagnose and to treat it with medication, surgery, radiation and other forms of Western therapies. Naturopathic medicine is a system of primary health care that promotes wellness and prevention of illness or disease. As distinct from primary medicine, naturopathic medicine tries to address the root causes of illness and supports the body’s own natural ability to heal itself. It uses a variety of techniques that include botanical medicine, physical medicine techniques like massage, acupuncture, clinical nutrition, lifestyle counselling, and sometimes a controversial method called homeopathic medicine. Doctors of naturopathic medicine are trained at their own professional college. In some provinces, they are regulated under provincial legislation (Alberta, BC, Ontario, Manitoba, Saskatchewan).
Almanac: How did naturopaths stack up against regular doctors in the study?
Goldman: Researchers enrolled nearly two hundred and fifty members of the Canadian Union of Postal Workers for a yearlong study to see how naturopathic lifestyle counselling would stack up against routine care from a doctor. The naturopathic doctors provided diet and lifestyle advice for patients to lose between two point three and four point six kilograms through a combination of calorie restriction and regular exercise. They also dispensed evidence based natural health products such as omega-3 fatty acids, soluble fibre, coenzyme Q10, and other therapies as recommended at the discretion of the naturopathic doctor. The results were impressive. Those that received routine medical care plus naturopathic medicine did better on their blood pressure and cholesterol testing; they reduced their risk of heart disease by seventeen per cent. Those who had routine doctor care alone increased their risk of heart disease. In absolute terms, for every one hundred people treated with naturopathic medicine, over a ten-year period, three heart attacks or strokes would have been prevented.
Almanac: Why was naturopathic medicine successful at reducing the risk of heart disease?
Goldman: It would be tempting to say that it was the omega-3 fatty acid or the coenzyme Q10 or something else. But the study wasn’t designed to prove that sort of thing in such fine detail. It was the entire basket of treatments that made up the naturopathic approach that made the difference. For all we know, it may have been the increased exercise and weight loss that played the biggest role in lowering the risk of heart disease. Family doctors are more than capable of dispensing that advice too. So maybe the patients did well because the naturopaths were practising medicine. But the bottom line is that approach taken by the naturopathic doctors worked.
Almanac: What are critics saying about the study?
Goldman: For one thing, since other therapies may have been provided by the naturopath but not included in the study, it’s possible one of these undocumented treatments reduced the heart disease risk. Another criticism is that the way the study was set up; naturopaths spent a total of four hours per patient counselling them on how to reduce their risk of heart disease over the course of the one-year study. For a family doctor, that’s a staggering amount of time to spend with one patient talking prevention. Critics have said that if family doctors had been given that amount of extra time to spend with each patient, their results might be just as good as naturopaths.
Almanac: How does this study change the debate over the value of naturopathic and other forms of complementary medicine?
Goldman: In an editorial, the CMAJ said complementary alternative therapies are frequently and legitimately criticized for failing to subject its methods to scientific scrutiny. And yet, when they publish studies (like this one), the journal gets criticized by mainstream doctors. The journal says physicians have a right to demand that complementary medicine be held to same standards of scientific proof as medicine itself – but no higher. After that, any objections to the right of naturopathic doctors to practice is just politics. The fact that Canadians are going to naturopaths in increasing numbers suggests they’re looking for something from them that don’t get from their regular doctors.