Category Archives: Natural Healthcare Industry

More Than Lip Service … why industry has a responsibility to invest in research

The support that the recent Therapeutic Goods Amendment Bill received from both policy-makers and from industry is a timely reminder that natural medicine is firmly ingrained in the healthcare landscape.

It presents a significant opportunity for natural medicines that can only be realised by continuing to invest in research.

The body of clinical evidence has continued to grow, helping us understand everything from efficacy to interactions. This journey of discovery will continue – my father used to remind me that the quest for better health is never-ending.

One of the areas where we have a knowledge gap is to understand the reasons people use naturopathy and other complementary medicines, how they make decisions about the medicines and the therapies they use and how practitioners including naturopaths connect and communicate with mainstream hospital and primary care systems.

The Australian Research Centre in Complementary and Integrative Medicine at the University of Technology Sydney (UTS: ARCCIM), led by Distinguished Professor of Public Health and Australian Research Council Professorial Future Fellow Jon Adams, is seeking to progress this important work.

That’s why my wife, Caroline, and I are proud to partner with BioCeuticals to contribute $1.5 million to ARCCIM to support research into naturopathy and other complementary medicine. ARCCIM is a world-leading critical public health and health services research centre focusing on traditional, complementary and integrative health care that brings together experts in epidemiology and health economics. Its work has received substantial government research funding, including prestigious research fellowships from the National Health and Medical Research Council (NHMRC) and the Australian Research Council (ARC).

Our contribution does not reflect either generosity or goodwill. It is because we have an unswerving and ongoing responsibility to our consumers and to the practitioners who treat them. This research will be Australia-focused and national in scale and independent, since the donation is untied and the centre will design and apply it as it sees fit.

The momentum of evidence-based natural medicine must be more than marketing claims or lip service – it must be underpinned by a strong program of research.

Australian natural healthcare is vibrant and growing, enjoying strong public and practitioner support and I passionately encourage our friends and colleagues across this industry to seek to fulfil their social obligation by investing back into the community who support us.

UTS Vice-Chancellor and President Attila Brungs with BioCeuticals MD Eyal Wolstin, Marcus Blackmore, Caroline Blackmore and Terri Albert from The Jacka Foundation.

 

*This opinion piece was originally published in Nutraingredients

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In Legendary Company

My sincere gratitude to the New Hope Network for the honour of being inducted into the Hall of Legends at the natural health industry’s biggest convention, Natural Products Expo West.

The Hall of Legends is for those who have devoted a significant portion of their lives to making the natural products industry what it is today.

My friend Doug Greene recorded my acceptance speech on his phone:

 

 

 

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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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Forgive me, but I’m suspicious

I have never subscribed to the conspiracy theory when it comes to complementary and alternative medicine practice however the latest proposal from the TGA may yet be another nail in the coffin. The TGA has put forward a proposal to treat Naturopaths, Herbalists and Homeopaths as “general public” with the aim to regulate information produced for these healthcare professionals in order to “manage public health risks” (Remember Naturopathy and allied practices were once banned in the US and previous attempts to ban naturopaths in Australia was thwarted by my father Maurice Blackmore and his colleagues in Queensland in 1955).

Are we returning to the dim, dark ages of the past you may well ask?

Is there a link between the efforts of the so called ‘Friends of Science’ and the decision by Sydney’s Macquarie University to no longer teach Chiropractic, or for Southern Cross University to no longer teach a basic Naturopathic course, or the attempts by the Friends of Science to curtail NHMRC funding for complementary & alternative medicine? (or ‘pseudo-science’ as they call it!).

If you wanted to orchestrate a campaign to eliminate a profession, you would first eliminate their university education, you would make sure there was no research for the profession and then simply make it illegal for them to access their ‘tools of trade’… Too provocative, maybe not?

Maybe this is just a ‘proposal’ from the TGA but why contemplate such a draconian proposal for this profession when there is little or no data to show harm being done, quite the contrary.

The reality is that one in three of all medical consultations in Australia today is with an alternative health professional. I don’t wish to be alarmist but I dearly hope that common sense will prevail.

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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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