Author Archives: marcusblackmore

Supporting Research & Innovation

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“There is only one way to avoid criticism; do nothing, say nothing, and be nothing.” Aristotle

0095_DSC0626I’ve long taken to heart the negative sentiments of critics of complementary medicine – not understanding how anyone could be so narrow-minded as to exclude an entire approach to healthcare that has benefitted countless people for many generations.

 

But I stopped caring about them last week.

 

Last week the Blackmores Institute announced an unencumbered gift to establish the Maurice Blackmore Chair of Integrative Medicine at the Sydney Medical School, University of Sydney, in honour of my late father.​​

 

Both the University and Blackmores Institute professed the necessity for robust governance to ensure the independence of the research and education that would result from the financial contribution.

 

Both the University and Blackmores Institute knew that there were growing numbers of Australians embracing complementary medicines and that this was an area that was underrepresented in medical professional education.

 

According to the NHMRC Research Funding Datasets 2003- 2012, allocations for research funding into complementary medicine have been just 0.2% of total funding over the past ten years, despite use of complementary medicine by the Australian public remaining substantial.

 

Of that, the research funded has, at times, been questionable. Such as a recent NHMRC-funded study claiming the potential harm of vitamin D based on giving rats and mice a dose of vitamin D that would be equivalent to a 60kg human taking 360,000IU of the nutrient daily.

 

It was not unexpected that the critics professed their ‘concerns’ about the Integrative Medicine Chair, though it was certainly ironic. After years of demanding more research, they were unlikely to commend us for our actions.

 

They were misguided though in stating that Maurice Blackmore was not worthy of the honour of the name of the Chair claiming he was not an advocate of ‘evidence-based medicine’ (a concept coined in the 1990s – nearly 15 years after he passed away!).

 

Though the terms ‘evidence-based medicine’ and ‘integrative medicine’ were not used in his time, his life’s work is testament to these principles. His early observations of mineral therapy and his clinical applications of nutritional medicine were the foundation of an approach to health management that is still relevant today.

 

He dedicated his life to sharing his knowledge and published an extensive collection of observations and clinical notes. They are an interesting read given we now have the benefit of nearly 40 years of scientific exploration: sometimes he got it right…sometimes he didn’t. But he had an enquiring mind and a desire to help people, which is the same motivation that led to this Sydney University gift.

 

Somewhat prophetically, when I looked today at one of his journals, he notes his concerns that long-term aspirin use could cause serious gastric depletion (right!), he then states that polar bears are claimed to have the lowest mentality of animals which makes it unlikely that fish is a brain food (wrong!). But the most interesting of his reflections on that page was a quote from EH Chopin:

“Scepticism has never founded empires, established principles, or changed the world’s heart.  The great doers in history have always been men of faith.”

 

It was timely given the commentary of recent days. It’s time for the skeptics and the critics to step off the sideline and engage in furthering healthcare with a focus on prevention and wellbeing. I am proud of the legacy of my father as a pioneer of healthcare, that the Blackmores Group had the courage to contribute to independent research and education, and to play an active role in furthering the health capabilities of our healthcare professionals to the benefit of all Australians.

 

 

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The Brand Laureate

My sincere thanks to the Asia Pacific Brands Foundation for recognising Blackmores with the Brand Leadership Award 2014/2015, the Best Brand in Wellness – Natural Health Solutions, and for naming me Nutraceuticals Man of the Year.  I was humbled and so very proud of our wonderful team in Malaysia.

The Brand Laureate is given to brands that have demonstrated strong leadership and performance.

They graciously published a feature on Blackmores.  You can read it here:

http://thebrandlaureate.com/Public/Upload/pdf/Blackmores_article_spread_web.pdf

 

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Attack on homeopathy is not evidence-based

Eminent neurologist Dr Raymond Schwartz said it well over dinner one night, “Evidence of itself doesn’t always mean that a remedy works, and conversely, lack of evidence doesn’t necessarily mean that a remedy doesn’t work.”  He went on to explain that at present, the evidence behind the use of stem cells lacks evidence but that is likely to change over time.

The critics of homeopathy and complementary medicine have taken an interim report released by the National Health and Medical Research Council (NHMRC) today on the use of homeopathic remedies and raised questions about pharmacies stocking these products.

In my own experience as a Naturopath, I have mixed views on the use of homeopathic treatments.  I can say that on a recent trip to Italy I was presented with a homeopathic remedy from a homeopathic pharmacy with good results.

However, I have serious concerns that the NHMRC review has not considered the necessary body of evidence to classify this longstanding traditional modality as ineffective and their interim ‘findings’ may have provided a platform for criticism from the skeptics of natural medicine to express their narrow views.

Those questioning the place for traditional medicines in pharmacy should be aware of the limitations of the NHMRC complementary therapy review:

As a ‘review of reviews’ was employed to gather information, the evaluation fails to include any randomised trials or studies that have not been captured by a review.

  • Only papers published in the last five years were considered thereby excluding a lot of evidence.
  • The review only included databases published in English which, considering many traditional modalities have their origin in Europe, excludes some of the most compelling data.
  • The Homeopathy Working Committee has no homeopaths on its panel, though interestingly it did have a consumer advocate (would the NHMRC conduct an enquiry into psychology without having a psychologist on its panel?)
  • The totality of evidence was not also assessed, for example laboratory or animal (vet) studies were excluded.

So, is it fair to say the ‘review’ itself is ‘evidence-based’?

Dr Lesley Braun, Director of Blackmores Institute, reminded me of the words of Sackett, widely considered the chief founding father of modern day evidence based medicine, “evidence based medicine is not “cookbook” medicine. Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients’ choice, it cannot result in slavish, cookbook approaches to individual patient care. External evidence can inform, but never replace, individual clinical expertise…” (Sackett et al. 1996).

No profession, modality or therapy can claim to be the most effective or safe, however it is the right of the 70% of Australian pharmacy customers taking OTC herbal or natural supplements to access the therapies in which they find benefit particularly when they are well-tolerated and cost-effective.

Notwithstanding, there are currently severe limitations to building a more comprehensive evidence base including:

  • Lack of government funding into well-conducted research
  • Perceived bias against privately-funded research
  • Lack of private investment because of an inability to commercialise and IP-protect findings
  • Debate over methodology that acknowledges the nature of traditional treatments

Hopefully in time, we can overcome these limitations.  However in the meantime we must be cautious about making conclusions based on pseudoscience.

Dr Braun prudently observed that “making public health recommendations based on methodology shaped by inadequate resourcing rather than robust, good science isn’t very scientific at all.”

 
Read the NHMRC press release : http://www.nhmrc.gov.au/media/releases/2015/nhmrc-releases-statement-and-advice-homeopathy

Read Complementary Medicines Australia’s comments: http://www.cmaustralia.org.au/Resources/Documents/16%2012%2014_Fundamental_Flaws_of_the_NHMRC_Homeopathy_Review.pdf

 

Sackett, D.L., Rosenberg, W.M., Gray, J.A., Haynes, R.B., & Richardson, W.S. 1996. Evidence based medicine: what it is and what it isn’t. BMJ, 312, (7023) 71-72 available from: PM:8555924

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The Voice of Reason

This abc.net.au opinion piece titled  The War against Natural Medicine caught my attention  over the weekend.

 

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The Medal Maker

Copyright Victor Kovalenko 2014

Copyright Victor Kovalenko 2014

Someone who inspires me…

Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbour. Catch the trade winds in your sails.
Explore. Dream. Discover!”
– Mark Twain

Two of my greatest passions are Blackmores and competitive sailing, so it is little wonder that the numerous metaphors that align business performance to yachting resonate strongly with me.

Sailing and business are both impacted by who is ‘at the helm’, the tactics employed, adaptation to changing external conditions, the effectiveness of the team, the ability to read the conditions – the analogies are endless.

A couple of years ago, I invited Victor Kovalenko to speak to a team of business leaders within Blackmores and he did not disappoint with his wise words.

The Australian Sailing Team Head Coach, Victor is known as ‘The Medal Maker’, a title the humble Ukrainian-born coach is embarrassed by.

He has a unique gift for getting the best out of people. He brings high levels of discipline to the teams he coaches. He is never complacent about the success of his teams after a win and sets new challenges and reshapes his approach to achieve greatness.

He is currently working with Mat Belcher, Rolex World Sailor of the Year who won gold in the London Olympics, and Will Ryan, an up-and-coming talent. Mat and Will are the current world champions in the 470 yacht class.

I’m proud to be part of the supporting team and love seeing a wind-filled spinnaker sporting the Blackmores brand.

Victor has said, “I think of life and use it as a role model. Life is like a big race – sometimes you win by skill, sometimes you are lucky to meet interesting people and learn from them.”

As a sailor and as a great Australian, Victor Kovalenko is someone I’ve learned from. He places as much value on character and friendship as skill and discipline. He knows that in sailing, as in life (and business), there is skill and technique but it is feeling and passion that will take you over the line first.

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Vale Allen Oliver

I was getting mightily tired of the disruption to my working day with Daph Price regularly asking me to leave my office and put a replacement roll of shrink film on our one and only shrink wrapper. I guess it was my own fault as I had previously made a decision to shrink wrap our bottles, only the second company in the whole of the Pharma/health food industry to do so.

So I quickly decided Blackmores needed a ‘hands on’ Production Manager. One of our directors, Graeme Berman, arranged for me to meet Allen Oliver at North Sydney Leagues Club and the deal was done. Allen and Graeme had worked together at Scott and Bourne some years before. So began nearly 15 years of amazing commitment by Allen Oliver to Blackmores before his retirement in 1989. And what a contribution. I vividly remember meeting Lee McNichol in our foyer one day waiting to meet with Allen and lamenting how bad things were and how much wages had risen and that he had no alternative but to raise the prices on the products his company supplied us. I wished him luck! I met him again after his meeting with Allen only to be told that he had just reduced our prices by 2%. Allen’s catchword to suppliers is indelibly printed in my brain, “you will have to sharpen the pencil”.

In Blackmores early days, we couldn’t afford security services so the factory was well alarmed. Allen and I lived close to work so when the alarms went off at some ungodly hour of the morning it was a race to see who got to the factory first to catch any intruders. It was one of those races you never wanted to win for fear of getting a whack over the head when you arrived, I’m pleased that Allen won most of those races.

I was a member of Manly Rotary Club and asked Allen to join the club as my replacement. That cemented many years of outstanding community contribution by Allen and Betty Oliver. For some, charity means simply writing a cheque to a deserving cause but of even greater significance is giving one’s time and Allen did both of those in spades.  The 32 years of Rotary Christmas hampers would not have happened without Allen’s enthusiasm for that project.

Allen Oliver came up the tough way, he did the menial tasks, he swept the floors and his promotion in business life came as a result of nothing less than hard work. Australia would be a much better place if there were more Allen Oliver’s in life.

Allen Oliver was a man of substance, a man of generous spirit, he gave much to Blackmores in our fledgling years, I will never forget him.

May he rest in peace.

Marcus

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World Sight Day – some eye opening new research…

I am always excited about new research, especially in the field of nutrition and natural medicine. So it gives me great pleasure to announce our support of an Australian researcher, Dr Bamini Gopinath, who is exploring dietary and lifestyle interventions into Australia’s leading cause of blindness – Macular Degeneration.

Dr Bamini Gopinath is the recipient of the 2013-14 Blackmores Dr Paul Beaumont Research Fellowship. The fellowship is valued at $100,000 over two years and is largely funded by Blackmores Institute and the Blackmore Foundation with support from the Macular Degeneration Foundation’s research fund.

Dr Gopinath is a senior research fellow at the Centre for Vision Research, Westmead Millennium Institute and will be working under the supervision of Professor Paul Mitchell, one of the world’s leading experts in Macular Degeneration. Her proposed research involves a detailed analysis of the 15 year data from the landmark Blue Mountains Eye Study (BMES) to improve knowledge of the nutritional and lifestyle risk and protective factors (particularly dietary antioxidant and supplement intake, diet quality and food groups). This is expected to help explain the causes of disease, improve early detection of people at risk of progression, and facilitate new approaches to therapy.

Dr Gopinath has a remarkable track record with over 70 research publications in the last five years, more than half on which she was the lead author. I’m delighted to support her continued research and look forward to the results of her work.

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Seeing a vision become reality

80 years ago my father, Maurice Blackmore, saw the need the provision of high quality research and education in the area of natural health, and the acceptance of the usage of Nature and our own body as healing entities. He was a visionary in his field. Maurice developed some of the first naturopathic products in the country, opened one of Australia’s first health first stores and naturopathic clinics, published the first consumer and industry journals and established the nation’s first naturopathic education facility.

Today I feel proud to share the news that his vision is coming to fruition, with the launch of The Blackmores Institute. The Blackmores Institute will bring together the best minds, knowledge and evidence, and is dedicated to sharing this knowledge with the wider community of healthcare professionals, researchers, industry and consumers. Maurice would be overjoyed if he could see what The Blackmores Institute is aiming to achieve.

But this isn’t about my father. The Blackmores Institute will benefit each and every person who has an interest in maintaining their health, or helping others do the same. I look forward to sharing more updates about The Blackmores Institute as it evolves into a centre for excellence in the field of natural health.

Further details can be found at:

www.blackmoresinstitute.com

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The Forces Against Health in Australia

Ian Brighthope runs a fantastic company called Nutrition Care. He has been a personal friend for many years and he has written this outstanding article which I wanted to share with you.
Marcus

Nutritional medicine could save hundreds of millions of lives, but vested interests actively pursue the opposite.
Commentary by Ian Brighthope, M.D.
(OMNS June 25, 2012) Health practice in Australia is still focused on treatment of disease as opposed to its prevention and the optimization of health. Although the scientific literature has recently shown an increasing awareness of the importance of lifestyle factors in preventing disease, mainstream medical professionals continue to be trained to react to disease and pursue drug treatment. This “drug and disease” paradigm is costly, not only in monetary terms but also the human toll of pain and suffering and its impact on productivity and quality of life, and widespread illness and death caused by medical treatment.
Iain Chalmers, director of the UK Cochrane Centre, has said that “Critics of complementary medicine often seem to operate a double standard, being far more assiduous in their attempts to outlaw unevaluated complementary medical practices than unevaluated orthodox practices . . . These double standards might be acceptable if orthodox medicine was based solely on practices which had been shown to do more good than harm and if the mechanisms through which their beneficial elements acted were understood.” Unfortunately, neither of these conditions hold true.
The Australian government has made investment in the prevention of disease a priority in its $7.4 billion comprehensive reform package to the nation’s health system. Yet prevention has been a secondary consideration in most medical schools and practices. A huge amount of disease and death could be prevented by addressing the use of tobacco and alcohol. There remains an enormous void in the government’s health policy because it does not encourage and support the medical profession to practice nutritional medicine.
Changing Attitudes
“Individuals are ceasing to be mindless consumers of drugs and services, becoming more discriminating and aware in their choices. They are also bringing their new options back home to their family physicians, and contributing to an awareness among doctors of the existence and potential of natural therapies.”
Research in the field of nutritional medicine is growing at a phenomenal rate, and now that the human genome has been sequenced, the science supporting nutrition in preventing disease is more impressive than ever. Many general practitioners and academics are open to the use of diet and nutritional supplements as viable alternatives to drugs. However, there are still too few to make a significant impact on public health. There will always be resistance, even hostility from the nutritional “flat-Earthers” – those who believe that “if you eat a balanced diet then you cannot be deficient in essential nutrients” (despite overwhelming evidence to the contrary) – and the academic medical power brokers. But I believe the system will eventually change in line with the accumulating evidence.
Recently, leading economic forecasters Access Economics announced that expanding the use of complementary/nutritional medicines could maintain excellent patient outcomes while saving hundreds of millions of dollars a year in healthcare costs. They studied the cost-effectiveness of common nutritional treatments for common chronic and serious conditions. They evaluated acupuncture for chronic lower back pain, St John’s Wort for mild to moderate depression, fish oils in the prevention of heart disease and for the treatment of rheumatoid arthritis. The director of Access Economics, Lynne Pezzullo, said that analysing each treatment on a case-by-case basis showed patients could save a considerable amount of money by using nutritional medicines. In the case of St John’s Wort, for the 340,000 Australians who are being treated for mild to moderate depression with drugs that don’t work well, she estimated a saving of $50 million per annum. The potential savings from the use of vitamins C, D, and E and fish oils in heart disease is in excess of $2 billion.
The executive director of the National Institute of Complementary Medicine who initiated the study, Professor Alan Bensoussan, commented “I think governments should … look more closely at what implications this might have in the context of national health reform.” I agree wholeheartedly, and have been pushing for similar reforms for many years. I hope this will mark the beginning of a new endeavor to change our overburdened health care system. Politicians and regulators are very cautious about such change for fear of reactions from the medical and pharmaceutical establishment, who may perceive competition for the health dollar as a threat. But there is enough work to do in the goal of optimal health to keep every doctor, hospital, naturopath, and nutritionist busy for decades. That is, unless a miracle occurs and megadose vitamin C and a few vitamins and minerals become widely used. For these supplements can prevent widespread deficiencies that are responsible for many age-related diseases.
The “Wellness Model” of health attempts to prevent disease and optimise health by encouraging people with the proper nutrition and lifestyle tools. This can achieve the maximum level of health, physical and mental, for each individual. It creates an optimal environment for the expression of that individual’s genetic potential. The keys to achieving optimal health include the judicious use of nutrition and nutritional supplements, regular physical exercise, the avoidance of environmental pollutants, and the practice of positive outlook through simple techniques such as meditation. This concept of optimising health for everyone is foreign to most traditional doctors and is glaringly absent from medical school curricula and training.
Lobbying for Disease
In this debate there are insidious influences. A powerful lobby group called the Friends of Science in Medicine (FOSM) is actively discouraging the federal government from supporting universities with funding if they conduct courses in what they personally regard as unscientific. Shamefully, the FOSM don’t have members trained in NM and the nutritional sciences. FOSM is predictably against nutritional supplements, regarding them as expensive and wasteful. Could the money spent on nutritional supplements be better spent in more hospitals by treating the sick with drugs? In effect FOSM insists that universities should only teach what it defines as “correct” knowledge – emphasizing the treatment of disease, not the promotion of health. FOSM and the medical establishment would do well to become aware of the vast literature on nutritional medicine and the clinical experience of scientifically trained nutrition-aware doctors and nutritionists.
Nutritional Supplements in Medical and Pharmacy Practice
Most drug prescriptions are unnecessary, an estimated 80% in Australia. The list is long and includes antibiotics, statins, antidepressants, and many more. Yet through the best education, lifestyle, fitness, dietary change and the proper use of nutritional supplements and herbal medicines, patient health outcomes can be optimised and hospital admissions and adverse drug events significantly reduced. In 2009, government expenditure on the pharmaceutical benefits scheme (PBS) amounted to $6.9 billion and it is estimated that in 2009-10 it grew a further 9.3%. [8] I believe that at least $3 billion could be wiped off the total PBS expenditure and that these savings could be used to promote better nutrition, physical fitness and safe, effective natural therapies. For example, use of more cost-effective niacin or St. John’s Wort as antidepressants could free up more money to psychiatrists for proper counseling and to orthomolecular nutritionists for feeding the mind. Overall this would lead to greater knowledge, more support for the most appropriate research, and an economic benefit to the world’s population.
“There is an angry scornful tone used in leading textbooks of medicine regarding the discussion of micronutrient supplementation; an arrogance and ignorance concerning the evidence for the possible benefit of supplementation.”
Doctors and pharmacists play a major role in informing consumers about the safety, efficacy and correct use of nutritional supplements. A recent Australian study evaluated the use of both nutritional and prescription medicines by pharmacy customers. 72% had used nutritional supplements within the previous 12 months, 61% used prescription medicines daily, and 43% had used both. The most popular nutritional supplements were: multivitamins, fish oil supplements, vitamin C, glucosamine, vitamin B complex, probiotics, Echinacea, coenzyme Q10, Ginkgo biloba and St John’s Wort. The authors of the study explained that customers or patients want more information, ask more questions, and no longer blindly accept the authority of health care providers. This new class of customer differs drastically from the gullible consumer of nutrition supplements often characterized by the mainstream media. According to this study, nutritional supplements were selected by the majority of people themselves, although pharmacists and pharmacy assistants were helpful in this choice. From only a few bottles of vitamins in the 1980s to shelves of vitamins and essential nutrients lining the pharmacy walls, there has been a massive change in the retail pharmacy. The demands of an informed public plus the need for profits drove the pharmacy industry into selling nutritional supplements.
The study also highlighted that some customers currently feel pharmacists are ill-equipped to counsel them about nutritional supplements. Many don’t even refer to pharmacists as an information source. Pharmacists also felt ill-informed about supplements, and experienced frustration when dealing with inquiries about nutritional medicines and natural health products.
“We must act on the facts and the most accurate interpretation of them, using the best scientific information. That does not mean that we must sit back until we have 100% evidence about everything. When the state of the health of the people is at stake, we should be prepared to take action to diminish these risks even when the scientific knowledge is not conclusive.
Unfit to Practice
There is not a single medical school in Australia teaching adequate nutritional science to future doctors to ensure that they are fit to practice in proper health care. This applies equally to general practitioners and specialists. Most of any doctor’s patients are going to die from a nutritionally based disease, yet for years before they die they have formidably obvious nutritional deficiencies that go undiagnosed. Fortunately in Australia, we have highly qualified nutrition-aware health scientists in the profession of Natural Therapists who can help to correct these deficiencies.
Medicine stands on two feet – the science and the clinical art. Take away either one and it is going nowhere. Science on its own doesn’t work because people aren’t widgets; we all have different needs and different strengths, but medical research finds it easiest to treat us all the same. Got arthritis? Take this painkiller. But painkillers may destroy the joints, and in the case of the most common, paracetamol, cause damage to multiple internal organs – while simple things such as changing the diet, movement, vitamins, glucosamine and turmeric, among many others, have been shown to be very safe and effective.
Clinical skills also need to be advised by good science, the constant quest for understanding. In reality nutritional biochemistry holds the answers to most of our health problems, but movements such as FOSM actively seek to censor our knowledge of this.

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