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Olympic Pseudoscience
Published by Steven Novella under Herbs & Supplements
Comments: 34
The Summer Olympics are coming up, which means that, in addition to world-class athletic performance, the public will be exposed to a variety of sports-related pseudoscience. This is not unique to the Olympics, of course. The world of sports competition is rife with pseudoscience, false claims, dubious products, superstitions, and magical charms. The most egregious example of this recently has been the energy bracelet scam – multiple companies have and are marketing little bits of rubber, plastic, or metal that you wear on your wrist and they claim (based on parlor tricks rather than evidence) will improve athletic performance. They give classically pseudoscientific explanations for the alleged effect, such as negative ions or energy frequencies. In fact the new icon of the entanglement of sports with pseudoscience is the Power Balance Stadium.

Occasionally the scientific community takes notice of such claims and bothers to review them. Also, in the internet age, the information is actually available to the public (rather than buried in an obscure journal). A recent joint investigation by BBC Panorama and the British Medical Journal (BMJ) recently found a shocking (to them) lack of evidence for many claims made to market performance-enhancing products. The BBC reports:

A team at Oxford University examined 431 claims in 104 sport product adverts and found a “worrying” lack of high-quality research, calling for better studies to help inform consumers.

High quality studies would be nice, but the article fails to ask the question – who is going to fund those studies? What incentive do manufacturers have in proving their products don’t work?

The researchers did learn a few things about how the game is played, how companies create the impression of scientific support for their claims without the substance of science. For example, regarding a popular sports drink:

Dr Heneghan and his team asked manufacturer GlaxoSmithKline (GSK) for details of the science behind their claims and were given what he said scientists call a “data dump” – 40 years’ worth of Lucozade sports research which included 176 studies.

GSK apparently pulled several classic pseudoscientific ploys. The first is to attempt to replace quality research with quantity. The assumption is, if you pile it high enough, you end up with compelling evidence (at least they hope the public will think so). A lot of low quality research does not add up to even a single rigorous study, however. Dr. Heneghan found that the studies were mostly of very poor quality, the kind of studies that are likely to generate some conveniently false positive results that are great for marketing (the goal is to slap the ubiquitous claim, “clinically proven,” onto the marketing).

Related to this is the problem of in house vs truly independent research. An in house study performed by researchers on the company payroll (not academics with reputations and careers to worry about) is less than worthless. You can produce any results you wish with even subtle tweaking of a study. Transparency, replication, and peer-review provide at least some check (although imperfect) on researcher bias. A variation of the in house study, which is more deceptive, are the “independent” companies that perform product testing for other companies. This is essentially outsourcing in house studies, with the added benefit that the company can say that their claims were “independently tested.”

The second ploy is to tout “minuscule effects” as if they were significant. All that is necessary is for the study group using the sports-enhancing product to perform slightly, barely, teensy tiny bit better than the other group, and the company can tout an effect (while not mentioning the effect size). Of course such tiny effect sizes are not even reliably real – they are within the noise of such studies, especially those that are small or not tightly controlled.

The third marketing tactic is to claim a real effect, but not one that is specific to the product, and which can be obtained much more cheaply from everyday items. With regard to nutritional supplements the BBC article reports:

Nutrition expert Professor Mike Lean of the University of Glasgow described what little evidence there is that certain amino acids, which form part of proteins, may improve muscle strength as “absolutely fringe evidence and I think that that is almost totally irrelevant, even at the top level of athletics”.

The marketing of such products typically will talk about basic science facts that make their claims seem plausible. Proteins are made of amino acids, so if you want to build muscle you have to have sufficient amino acids in your diet. This is true, and it is easy to conceptualize the food you eat fueling the building of muscle. The real question is, however, is this process limited by your nutrition, and is the nutrition you are getting from the sports product any bed than regular food you can buy from the supermarket. Dr. Lean concludes that the fancy supplements are, essentially, just really expensive milk.

Running shoes are another example. Fancy and expensive shoes designed to reduce injuries or enhance performance simply do not work any better than regular sneakers. Any effect is tiny and insignificant.

A fourth marketing ploy commonly used is to cite evidence for a small benefit at the extreme end of athletic performance (like marathon running) and then use that to support claims for the average user. This is an example of misapplying evidence or the unjustified extrapolation. Effects that are apparent for professional athletes may not be significant for the average user. Further, products that may help compensate for an injury do not necessarily enhance performance in healthy individuals.

The BMJ authors set out to review evidence – and they found that the evidence is low quality, with insignificant effect sizes and non-specific effects that do not justify high prices for specialty items. The marketing of sports products, however, has been very successful (as the Power Balance Stadium attests). The usual strategy is to get high profile sports stars to use the product. They will likely perceive a benefit, simply because of the inherent biases in making such assessments. Further, there is a huge financial incentive for them to feel that the product helps their performance. They then endorse the product, and the average sports fan likely believes that a professional athlete must know what they are talking about when it comes to performance. Sprinkle in some dubious in-house studies and you have a marketing campaign.

There are other countless products not discussed in the BBC/BMJ article. For example, breathe right strips – those little white strips that began appearing across the noses of many athletes. The claim is that they enhance performance by opening the nasal passages and making it easier to breathe. There is some evidence that the strips at least do open the nasal passages a bit, and this is often the kind of evidence that is used to support such products. It seems to support the claims made for the product, but is not a direct test of performance. Studies looking at endurance performance, recovery from exercise, and the work of breathing during exercise have all found no benefit from such strips, however.

Now a new product, kinesio tape, is looking to become the next breathe right strips. This tape is applied over muscles to, allegedly, enhance performance, reduce injury, and reduce soreness and stiffness. So far the evidence is mostly preliminary, but a recent review concluded:

In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries

There is some evidence that taping an injured muscle may help it perform better, just like a brace, but there is no convincing evidence that there is anything special about kinesio tape over regular tape. This is therefore an example of marketing a non-specific effect that can be gained from cheaper products as if they were a special feature of an expensive product. It’s not even clear from the existing evidence that kinesio taping has a net positive effect. The same article notes, for example:

KT had some substantial effects on muscle activity, but it was unclear whether these changes were beneficial or harmful.

There was also a study published since the review, looking at the effect of kinesio taping on the leg muscles of healthy women, which concluded:

Application of KT to RF, VL and VM muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or electromyographic activity of VL muscle in healthy women.

Conclusion

Consumers should be very skeptical of claims made for products marketed as athletic performance enhancing. Given that the BMJ article looked at 104 such products and found no convincing scientific evidence to support their claims, it seems reasonable to conclude that this is a general feature of the athletic performance marketplace. Some common sense rules of thumb seem reasonable - don’t believe the hype, don’t believe in magic, don’t be overly impressed by professional endorsements, be skeptical of claims for scientific support, and don’t waste money on expensive versions of products when cheaper versions are likely to be just as good.