Consumer Health, Eighth Edition
Table of Contents

I. Dynamics of the Health Marketplace

1. Consumer Health Issues, 3
Misleading Information, 4
Quackery and Health Fraud, 7
Problems with Products, 8
Problems with Services, 9
Problems with Costs and Access, 10
The Need for Consumer Protection, 11
Intelligent Consumer Behavior, 13

2. Separating Fact from Fiction, 15
How Facts Are Determined, 16
Problems with Health Information, 20
Prudent Use of the Internet, 27
Further Suggestions for Consumers, 30

3. Frauds and Quackery, 35
Definitions, 36
Scope, 37
Vulnerability, 38
Hazards, 39
Common Misconceptions, 40
Recognizing Quackery, 43
Conspiracy Claims, 44
The Freedom-of-Choice Issue, 45

4. Advertising and Other Promotional Activities, 47
Psychologic Manipulation, 48
Puffery, Weasel Words,
and Half-Truths, 50
Advertising Outlets, 51
Professional Advertising, 51
Marketing by Hospitals, 53
Prescription Drug Marketing, 54
Nonprescription Drug Advertising, 55
Food Advertising, 56
Dietary Supplement Promotion, 56
Tobacco Promotion, 58
Mail-Order Quackery, 60
Weight-Control Promotions, 61
Youth and Beauty Aids, 63
Exercise and Fitness Products, 63
Program-Length Infomercials, 64
Multilevel Marketing (MLM), 64
Telemarketing Schemes, 66
Industry Self-Regulation, 66
Regulatory Agencies, 67

II. Health-Care Approaches

5. Science-Based Health Care, 71
Health-Care Personnel, 72
Choosing a Physician, 76
Basic Medical Care, 81
Surgical Care, 88
Quality of Medical Care, 90
Disciplining of Physicians, 92
The Intelligent Patient, 94

6. Mental and Behavioral Help, 99
Who Should Seek Help?, 100
Mental Health Practitioners, 100
Psychologic Methods, 102
Drug Therapy, 104
Electroconvulsive Therapy, 105
Psychosomatic Disorders, 105
Inpatient Care, 106
Help for Addictive Behavior, 106
Selecting a Therapist, 106
Questionable “Self-Help” Products, 108
Questionable Practices, 110
Mismanagement of Psychotherapy, 117

7. Dental Care, 121
Dentists, 122
Allied Dental Personnel, 122
Tooth Decay, 123
Fluoridation, 124
Periodontal Disease, 125
Self-Care, 126
Dental Products, 126
Dental Restorations, 129
Endodontics (Root Canal Therapy), 129
Orthodontics, 130
Dentures, 130
Dental Implants, 131
Dental X-Ray Procedures, 131
Questionable Procedures, 132
Dental Quackery, 133
Smokeless Products, 136
Choosing a Dentist, 136

8. The “CAM” Movement, 139
Definitions and Prevalence, 140
Acupuncture, Qigong,
and Chinese Medicine, 143
Reflexology, 147
Chiropractic, 147
Naturopathy, 154
Natural Hygiene, 155
Iridology, 156
Homeopathy, 157
Psychic Healing, 161
Occult Practices, 166
Astrology, 167
Biorhythms, 168
Transcendental Meditation, 168
Yoga Therapy, 170
Visual Training, 170
Other “Alternative” Practices, 171
Unscientific Medical Practices, 171
“Holistic Medicine,” 175
“Medical Freedom” Laws, 176
The NIH Center for Complementary and Alternative Medicine (NCCAM), 177

9. Self-Care, 183
Purposes of Self-Care, 184
Health-Promoting Behaviors, 185
Safety Measures, 187
Indoor Air Quality, 187
Rick Perception, 188
Self-Diagnosis, 189
Home Medical Tests, 190
Internet-Based Testing Services, 190
Self-Care for Chronic Problems, 190
Publications, 193
Self-Help Groups, 195
Internet Considerations, 195

10. Health-Care Facilities, 199
The Joint Commission, 200
Outpatient Medical Facilities, 200
Hospitals, 203
Home Care Services, 206
Nursing Homes, 207

III. Nutrition and Fitness

11. Basic Nutrition Concepts, 215
Major Food Components, 216
Human Nutrient Needs, 219
Food-Group Systems, 223
Evaluating Your Diet, 224
“Junk Food,” 225
Guidelines for Infants and Toddlers, 227
Vegetarianism, 228
Nutrients of Special Concern, 229
Nutrition Labeling, 230
Reliable Information Sources, 234

12. Nutrition Fads, Fallacies, and Scams, 237
Food Faddism and Quackery, 238
Dietary Supplements, 239
Megavitamin Claims vs Facts, 245
Appropriate Use of Supplements, 248
“Organic” Foods, 248
“Health Foods,” 250
“Natural” Foods, 250
“Medicinal” Use of Herbal Products, 255
Macrobiotic Diets, 258
Promotion of Questionable Nutrition, 261
Promoters of Questionable Nutrition, 267

13. Weight Control, 275
Basic Concepts, 276
Eating Disorders, 280
The Diet and Weight-Loss Marketplace, 282
Questionable Diets, 282
Prescription Drugs, 285
Nonprescription Products, 286
Low-Calorie Products, 289
Bariatric Surgery, 291
Dubious Products and Procedures, 291
Government Regulatory Actions, 293
Weight-Control Organizations, 294
Suggestions for Weight Control, 297

14. Fitness Concepts, Products, and Services, 303
Public Perceptions, 304
Benefits of Exercise, 305
Types of Exercise, 306
Components of Fitness, 306
Starting an Exercise Program, 308
Personal Trainers, 314
Sports Medicine Specialists, 314
Exercise Equipment and Supplies, 315
Exercise Facilities, 322
Children’s Exercise Centers, 324
Exercise While Traveling, 325
Corporate Fitness Programs, 325
Exercise and Weight Control, 325
Nutrition for Athletes, 325
Anabolic Steroids, 328
Other “Ergogenic Aids,” 328

IV. Major Health Problems

15. Cardiovascular Diseases, 337
Significance of Cardiovascular Disease, 338
Risk Factors for Coronary Heart Disease, 338
Blood Lipid and Homocysteine Levels, 339
Cholesterol Guidelines, 341
Dietary Modification, 343
Lipid-Lowering Drugs, 349
Preventive Use of Aspirin, 350
Questionable Preventive Measures, 350
High Blood Pressure, 353
Heart Attacks, 355
Diagnostic Tests, 355
Surgery to Restore Blood Flow, 357
Cardiac Rehabilitation Programs, 359

16. Cancer, 363
Avoidable Causes of Cancer, 364
Preventive Measures, 365
Diagnosis, 365
Prognosis, 365
Evidence-Based Treatment Methods, 366
Diet and Cancer, 367
Susceptibility to Cancer Quackery, 368
Questionable Methods, 369
Promotion of Questionable Methods, 379
Reliable Information Sources, 381
Treatment Guidelines, 382
Consumer Protection Laws, 382

17. HIV/AIDS, 385
Course of the Disease, 386
Testing for HIV Infection, 387
Prevention, 388
Treatment, 389
AIDS-Related Quackery and Fraud, 389

V. Other Products and Services

18. Drug Products, 395
Medication Types, 396
Pharmacists, 397
Prescription Drugs, 398
Generic vs Brand-Name Drugs, 399
Drug Interactions, 400
Drug Recalls, 401
Counterfeit Drugs, 401
Internet Pharmacy Sales, 401
Over-the-Counter Drugs, 404
Allergy Products, 405
External Analgesics, 408
Internal Analgesics, 408
Antacids and Other Heartburn Remedies, 410
Antibiotics, 412
OTC First-Aid Antimicrobials, 412
Remedies for Common Foot Problems, 413
Cough and Cold Remedies, 413
Sore-Throat Products, 414
Ophthalmic Products, 415
Diarrhea Remedies, 415
Anti-Hemorrhoidals, 415
Iron-Containing Products, 416
Laxatives, 416
Motion Sickness Remedies, 417
Smoking Deterrents, 418
Sleep Aids, 418
Stimulants for Fatigue, 419
Home Medicine Cabinet, 420
Prudent Use of Medication, 420

19. Skin Care and Image Enhancement, 425
Cosmetic Regulation, 426
Soaps, 427
Moisturizers, 427
Questionable Claims, 428
Wrinkles and Age Spots, 429
Fade Creams, 430
Antiperspirants and Deodorants, 430
Acne Care, 431
Head Hair and Scalp Care, 432
Hair Loss, 434
Tattoos and Permanent Makeup, 435
Body Piercing, 436
Sun Protection, 436
Camouflage Cosmetics, 438
Cosmetic Procedures, 438
Bogus Breast and Penis Enlargement Claims, 441

20. Sexual and Reproductive Health, 445
Menstrual Products, 446
Menstrual Problems, 447
Vaginal Hygiene, 448
Vaginitis, 449
“Jock Itch,” 449
Sexually Transmitted Diseases, 449
Contraception, 450
Voluntary Abortions, 454
Infertility, 455
Genetic Testing and Prenatal
Counseling, 456
Pregnancy and Delivery, 456
Infant Feeding, 460
Treatment of Menopausal Symptoms, 460
Help for Erectile Dysfunction, 461
Aphrodisiacs (Alleged Sex Enhancers), 461

21. Health Devices, 465
Medical Device Regulation, 466
Vision Products and Services, 468
Hearing Aids, 474
Humidifiers, 476
Personal Emergency Response Systems, 477
The Latex Allergy Epidemic, 477
Dubious Water Purifier Promotions, 477
Quack Devices, 478

22. Coping with Death, 483
Advance Directives, 484
Donations of Organs and Tissues, 488
Hospice Care, 489
Euthanasia and Assisted Suicide, 490
Reasons for an Autopsy, 491
Body Disposition, 491
Grief and Mourning, 494
Life-Extension/Anti-Aging Quackery, 495

VI. Protection of the Consumer

23. Health Insurance, 501
Background History, 502
Basic Health Insurance, 502
Major Medical Coverage, 504
Comprehensive Medical Insurance, 505
Contract Provisions, 505
Types of Plans, 506
Medicare, 508
Medicaid, 509
Other Government-Sponsored Programs, 509
Long-Term–Care Insurance, 509
Dental Insurance, 510
Loss Ratios, 511
Indemnity vs Managed Care, 511
Choosing a Policy, 512
Funding Out-of-Pocket Expenses, 512
Collection of Insurance Benefits, 514
Disability Insurance, 515

24. Health-Care Economics, 519
Health-Care Costs, 520
Cost-Control Methods, 523
Insurance Fraud and Abuse, 525
National Health Insurance (NHI), 528

25. Consumer Laws, Agencies, and Strategies, 533
U.S. Food and Drug Administration, 534
Federal Trade Commission, 545
U.S. Postal Service, 548
Other Federal Agencies, 549
State and Local Agencies, 550
Nongovernmental Organizations, 550
Consumer Action, 552

Appendix: Reliable Sources of Information, 555
Federal Government Agencies, 556
Nongovernmental Organizations, 556

Glossary, 559

Index, 571

This page was revised on July 20, 2006.