When Dr. Paul A. Offit published “Autism’s False Prophets” in 2008, he elected to skip the usual round of book signings. His defense of childhood vaccinations so enraged some people who consider them a cause of autism that he was getting credible death threats.
Others might have chosen to flee the public arena after that, but not Dr. Offit, the chief of infectious diseases at Children’s Hospital of Philadelphia, whose appetite for the good fight seems only to have grown. Over the last decade he has become a leading debunker of mass misconceptions surrounding infections and vaccines, and now he is taking on the entire field of alternative medicine, from acupuncture to vitamins.
This territory is not all that far from his usual stomping grounds; some of vaccination’s rabid opponents are enthusiastic supporters of unconventional medical interventions. Nor has Dr. Offit’s own stance changed: He speaks for rational, scientific medicine (and medicines) whose efficacy has been confirmed in impartial, reproducible clinical trials. Everything else, no matter how venerable, highly recommended or self-evidently 100 percent terrific, he places on the spectrum between unproved and dangerous.
His long “consume at your own risk” list contains most of the treatments and substances composing the nation’s multibillion-dollar alternative-medicine industry. The book’s subtitle may suggest that “sense” and “nonsense” will get equal play, but Dr. Offit spends most of his time discussing and dismissing nonsense. In fact, the sensible treatments he identifies can be summed up in one short paragraph.
And here it is: Dr. Offit gives a nod to 4 of the 51,000 supplements on the market: omega-3 fatty acids to prevent heart disease; calcium and vitamin D to prevent osteoporosis in postmenopausal women; and folic acid during pregnancy to prevent spinal-cord defects in newborns. As it happens, several months ago — presumably after the book went to press — an influential national task force found the evidence for calcium and vitamin D to be unconvincing. So that reduces the list of sensible supplements to two.
This doesn’t necessarily mean that the remaining 50,998 products are worthless, Dr. Offit points out, or that acupuncture, chiropractic, massage and other unproven procedures don’t bring …….