Saving the World From Pseudoscience, One Meme at a Time: Bromelain
Memes are fun. But they are also a wonderful way to spread Pseudoscience. So, as a professional scientist, I am going to take on my mission to save the world from pseudoscience, one meme at a time.
First, you may well ask: What is pseudoscience?
Pseudoscience is beliefs or practices that one keeps, and then believes is based in scientific fact, or explained with science-sounding words, but is actually not based in science at all.
Second, you may well ask: Why is pseudoscience bad?
Here's the thing. A lot of pseudoscience works sometimes. Why? Because of this fantastic thing called the placebo effect. Let me tell you something about the placebo effect. A little story, if you'll indulge me. I get frightfully motion sick. It's a huge problem. But there is one way to stop it on airplanes, and its name is ginger. I believe in ginger. I believe in it whole-heartedly. So, before I fly, I drink ginger ale. But did you know that ginger ale is not as easy to find in an airport as you would think? Did you furthermore know that a lot of ginger ale doesn't actually have any ginger in it? As far as I'm aware, the only one that actually does have real ginger in it is Canada Dry.
While in college, I would oftentimes fly home with my sister, Beth. To combat my motion sickness, she would go to a store in the airport, and buy me ginger ale, but rip off the label before she came back to me. If I didn't know that it wasn't Canada Dry, I would still not get motion sick. If I knew it was Schweppes or whatever, I would still get motion sick.
At the end of my last year of college, my brother, Caleb, and I were flying home for the summer. Beth wasn't with us, so I told Caleb to go and get me ginger ale, but to rip off its label before he got back to me. He asked why, and I explained to him the system that Beth and I had come up with. He said, "That's a total placebo effect." And it is. But we were in agreement: if it keeps me from using the dinky-adorable airsick bags in the seat-back pocket, all hail the placebo effect.
So, I have no problem with the placebo effect. What I have a problem with is the attitude that goes with the pseudoscience placebo effect: that this hokey-science whatever is a closely guarded secret that makes people ignore actual science, and oftentimes, actual medicine. And then, they go and buy over-priced extracts of the pseudoscience compound--which at that point, you are now taking a medicine, and usually a medicine that isn't safe. I'm for non-regulation as much as the next conservative, but the last time we didn't regulate medicine, we ended up with a lot of snake-oil salesmen, and a lot of opium addicted housewives. Just saying.
As such, I will now, periodically, take on a pseudoscience meme and save the world from its possible ill-effects. Today's case: bromelain.
I happened across this meme, and the overly-sciency-garbled language, plus the fact that it seems to not understand anti-inflammatory vs. antibacterial, made me pause. So, I looked into it. Read some peer-reviewed journals. Read up on its history. And here's the verdict: Hokey.
First thing's first. 98% of statistics are made up. Including that one. I looked high and low for a study that actually studied pineapples vs. cough syrup with no luck. So, unless you have actually measured the effectiveness, you can't claim its 500% more effective. Plus, if you're going to say 500% more effective, you probably need to have some quantifiable way to measure cough syrup effectiveness, which I don't know of a way to do that, personally. But, I suppose there could be a way. I just don't see one. Peak flow? That doesn't really measure a cough. O2 Sat? That's lung efficacy, not really measuring a cough. So, the first claim I'm going to call total garbage.
Next, let's get into this bromelain, shall we? It sounds very sciency that word: bromelain. And they even invoked the word enzyme! I'm convinced that many people who use the word enzyme don't know what the word enzyme means (see Three Amigos: "I would not like to think that a person would tell someone he has a plethora pinatas, and then find out that that person has no idea what a plethora is.") An enzyme is something that lowers the activation energy of a reaction that would have taken place theoretically on its own, if you could get it to the activation energy. They are wonderful little guys, and actually very abundant in nature, but I don't think it necessarily means what they think it means (see The Princess Bride: "You keep using that word. I do not think it means what you think it means.")
So, there is an enzyme (what?!) in pineapples called bromelain, I learned. I also learned that it is sold commercially (what?!). In the grocery store. It's a meat tenderizer. And then, pharmaceutically, under the trade-name, Nexbrid. It's used to debride wounds. Yes. This stuff is used to degrade dead flesh. It breaks proteins. That's what this enzyme does. Maybe that's why pineapples make your mouth tingle (note: papayas also have this effect, and their enzyme is called papain and is used in science labs a lot to destroy protein). Now, I'm being scientific about this, so I'm not saying don't eat pineapples. That would be just as pseudosciency as I'm combatting. I'm just saying, all chemicals in their proper context, right?
I also learned that to actually get a biologically active concentration of bromelain to do anything, you have to ferment the pineapple juice. FYI.
There has been some thought that bromelain might have some anti-inflammatory properties (which is different than antimicrobial, but we'll get to that). So, there were some studies who investigated its use in arthritis. I read five of these studies, and the findings suggest one thing: there was no statistical link between any arthritis improvement and bromelain. In fact, they found an increase in blood clots and tachycardia with the bromelain.
Bromelain is sold under the name Ananase as a folk medicine drug. But, not only is not approved by the FDA nor the European Food Safety Association, they refuse to do so. Some things aren't approved because they say that there hasn't sufficient evidence to back up the claims. In fact, these regulatory agencies have said that they refuse to do so, because there is sufficient evidence that they don't do what they claim.
I did find one study that suggested that maybe we should look into bromelain as a synergistic drug in treating neoplastic cancers. Interesting study, by the way, but the conclusion was, "Here's a promising area for research. Let's do more studies."
So recap: bromelain has been used to debride wounds (and is sold as such), but it has not, in studies, shown to be effective for any other pharmacological purpose--even in a study that quite extensively studied whether or not it could be useful for arthritis. They could not find a statistical link between any improvement at all. In fact, they found possible danger. It is sold in folk medicine, but neither the FDA nor the European Food Safety Association will approve it or back up its claims. One study, has possibly shown that it might have some use in cancer treatment, but that's one study with a minor statistical link.
Now onto the last claim that tipped me off that they didn't know what they were saying: "A specific type of enzyme that has anti-inflammatory characteristics which can combat infections and eradicate bacteria." There are so many things wrong with that sentence. Here's a glossary for all you:
Anti-inflammatory: decreases inflammation
Antibacterial: kills bacteria
Antiviral: kills viruses
Antifungal: kills fungi
Antiprotozoal: kills protozoa
Antimicrobial: kills all kinds of germs including bacteria, viruses, fungi and protozoa
Antiseptic: don't kill germs, but prevent their growth
Antibiotic: can kill living things (so no viruses, cause they ain't alive).
Anti-inflammatories do not kill bacteria or fight infections. In fact, they can hinder that. Why?
What is inflammation anyways, because everyone's always talking about these anti-inflammatories. Inflammation is your body's way of saying, "Hey! Hello! We need some help here!" It includes fever, swelling, and more. So, why do we want that to not happen? Because it's also painful, and sometimes your body just starts crying wolf (such as arthritis, psoriasis, etc). However, if you have a strong enough anti-inflammatory (not really talking about ibuprofen, we're talking like Cox-II inhibitors and stuff), you can actually impair your body's immune system. That's why all the arthritis and psoriasis drug commercials tell you to not use it if you've "been to an area where certain fungal infections are common," and to get tested for TB before you use it.
So, yes, they're awesome little buggers, but to even imply that they fight infections makes about as much sense as a screen door on a submarine.
So conclusion: pineapples are delicious and wonderful and have lots of vitamin C. But they aren't this wonder-drug that kills bacteria with its anti-inflammatory properties.
First, you may well ask: What is pseudoscience?
Pseudoscience is beliefs or practices that one keeps, and then believes is based in scientific fact, or explained with science-sounding words, but is actually not based in science at all.
Second, you may well ask: Why is pseudoscience bad?
Here's the thing. A lot of pseudoscience works sometimes. Why? Because of this fantastic thing called the placebo effect. Let me tell you something about the placebo effect. A little story, if you'll indulge me. I get frightfully motion sick. It's a huge problem. But there is one way to stop it on airplanes, and its name is ginger. I believe in ginger. I believe in it whole-heartedly. So, before I fly, I drink ginger ale. But did you know that ginger ale is not as easy to find in an airport as you would think? Did you furthermore know that a lot of ginger ale doesn't actually have any ginger in it? As far as I'm aware, the only one that actually does have real ginger in it is Canada Dry.
While in college, I would oftentimes fly home with my sister, Beth. To combat my motion sickness, she would go to a store in the airport, and buy me ginger ale, but rip off the label before she came back to me. If I didn't know that it wasn't Canada Dry, I would still not get motion sick. If I knew it was Schweppes or whatever, I would still get motion sick.
At the end of my last year of college, my brother, Caleb, and I were flying home for the summer. Beth wasn't with us, so I told Caleb to go and get me ginger ale, but to rip off its label before he got back to me. He asked why, and I explained to him the system that Beth and I had come up with. He said, "That's a total placebo effect." And it is. But we were in agreement: if it keeps me from using the dinky-adorable airsick bags in the seat-back pocket, all hail the placebo effect.
So, I have no problem with the placebo effect. What I have a problem with is the attitude that goes with the pseudoscience placebo effect: that this hokey-science whatever is a closely guarded secret that makes people ignore actual science, and oftentimes, actual medicine. And then, they go and buy over-priced extracts of the pseudoscience compound--which at that point, you are now taking a medicine, and usually a medicine that isn't safe. I'm for non-regulation as much as the next conservative, but the last time we didn't regulate medicine, we ended up with a lot of snake-oil salesmen, and a lot of opium addicted housewives. Just saying.
As such, I will now, periodically, take on a pseudoscience meme and save the world from its possible ill-effects. Today's case: bromelain.
I happened across this meme, and the overly-sciency-garbled language, plus the fact that it seems to not understand anti-inflammatory vs. antibacterial, made me pause. So, I looked into it. Read some peer-reviewed journals. Read up on its history. And here's the verdict: Hokey.
First thing's first. 98% of statistics are made up. Including that one. I looked high and low for a study that actually studied pineapples vs. cough syrup with no luck. So, unless you have actually measured the effectiveness, you can't claim its 500% more effective. Plus, if you're going to say 500% more effective, you probably need to have some quantifiable way to measure cough syrup effectiveness, which I don't know of a way to do that, personally. But, I suppose there could be a way. I just don't see one. Peak flow? That doesn't really measure a cough. O2 Sat? That's lung efficacy, not really measuring a cough. So, the first claim I'm going to call total garbage.
Next, let's get into this bromelain, shall we? It sounds very sciency that word: bromelain. And they even invoked the word enzyme! I'm convinced that many people who use the word enzyme don't know what the word enzyme means (see Three Amigos: "I would not like to think that a person would tell someone he has a plethora pinatas, and then find out that that person has no idea what a plethora is.") An enzyme is something that lowers the activation energy of a reaction that would have taken place theoretically on its own, if you could get it to the activation energy. They are wonderful little guys, and actually very abundant in nature, but I don't think it necessarily means what they think it means (see The Princess Bride: "You keep using that word. I do not think it means what you think it means.")
So, there is an enzyme (what?!) in pineapples called bromelain, I learned. I also learned that it is sold commercially (what?!). In the grocery store. It's a meat tenderizer. And then, pharmaceutically, under the trade-name, Nexbrid. It's used to debride wounds. Yes. This stuff is used to degrade dead flesh. It breaks proteins. That's what this enzyme does. Maybe that's why pineapples make your mouth tingle (note: papayas also have this effect, and their enzyme is called papain and is used in science labs a lot to destroy protein). Now, I'm being scientific about this, so I'm not saying don't eat pineapples. That would be just as pseudosciency as I'm combatting. I'm just saying, all chemicals in their proper context, right?
I also learned that to actually get a biologically active concentration of bromelain to do anything, you have to ferment the pineapple juice. FYI.
There has been some thought that bromelain might have some anti-inflammatory properties (which is different than antimicrobial, but we'll get to that). So, there were some studies who investigated its use in arthritis. I read five of these studies, and the findings suggest one thing: there was no statistical link between any arthritis improvement and bromelain. In fact, they found an increase in blood clots and tachycardia with the bromelain.
Bromelain is sold under the name Ananase as a folk medicine drug. But, not only is not approved by the FDA nor the European Food Safety Association, they refuse to do so. Some things aren't approved because they say that there hasn't sufficient evidence to back up the claims. In fact, these regulatory agencies have said that they refuse to do so, because there is sufficient evidence that they don't do what they claim.
I did find one study that suggested that maybe we should look into bromelain as a synergistic drug in treating neoplastic cancers. Interesting study, by the way, but the conclusion was, "Here's a promising area for research. Let's do more studies."
So recap: bromelain has been used to debride wounds (and is sold as such), but it has not, in studies, shown to be effective for any other pharmacological purpose--even in a study that quite extensively studied whether or not it could be useful for arthritis. They could not find a statistical link between any improvement at all. In fact, they found possible danger. It is sold in folk medicine, but neither the FDA nor the European Food Safety Association will approve it or back up its claims. One study, has possibly shown that it might have some use in cancer treatment, but that's one study with a minor statistical link.
Now onto the last claim that tipped me off that they didn't know what they were saying: "A specific type of enzyme that has anti-inflammatory characteristics which can combat infections and eradicate bacteria." There are so many things wrong with that sentence. Here's a glossary for all you:
Anti-inflammatory: decreases inflammation
Antibacterial: kills bacteria
Antiviral: kills viruses
Antifungal: kills fungi
Antiprotozoal: kills protozoa
Antimicrobial: kills all kinds of germs including bacteria, viruses, fungi and protozoa
Antiseptic: don't kill germs, but prevent their growth
Antibiotic: can kill living things (so no viruses, cause they ain't alive).
Anti-inflammatories do not kill bacteria or fight infections. In fact, they can hinder that. Why?
What is inflammation anyways, because everyone's always talking about these anti-inflammatories. Inflammation is your body's way of saying, "Hey! Hello! We need some help here!" It includes fever, swelling, and more. So, why do we want that to not happen? Because it's also painful, and sometimes your body just starts crying wolf (such as arthritis, psoriasis, etc). However, if you have a strong enough anti-inflammatory (not really talking about ibuprofen, we're talking like Cox-II inhibitors and stuff), you can actually impair your body's immune system. That's why all the arthritis and psoriasis drug commercials tell you to not use it if you've "been to an area where certain fungal infections are common," and to get tested for TB before you use it.
So, yes, they're awesome little buggers, but to even imply that they fight infections makes about as much sense as a screen door on a submarine.
So conclusion: pineapples are delicious and wonderful and have lots of vitamin C. But they aren't this wonder-drug that kills bacteria with its anti-inflammatory properties.
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