Live Long and Well with Dr. Bobby
Let's explore how you can Live Long and Well with six evidence based pillars: exercise, good sleep, proper nutrition, mind-body activities, exposure to heat/cold, and social relationships. I am a physician scientist, Ironman Triathlete, and have a passion for helping others achieve their best self.
Live Long and Well with Dr. Bobby
#44: Why So Much Hype in Health?
Dr. Bobby unpacks the surge of health hype—from red light therapy to NAD⁺ boosters—and empowers listeners to stay curious yet skeptical using science-backed tools and critical thinking.
Are claims like “boost your mitochondria” or “natural detox” real breakthroughs—or today’s version of snake oil? Dr. Bobby explores why health hype is everywhere, why we’re vulnerable to it, and how to sift compelling theories from proven treatments. He outlines examples of widely accepted beliefs that ultimately didn’t hold up to rigorous scrutiny. Inserting stents to open clogged arteries seemed sensible, but studies like the COURAGE and ORBITA trials found no added benefit over medical management (NEJM).
Dr. Bobby then turns to newer fads. Claims around NAD⁺ boosters (like NMN or NR), red light therapy, PRP for knee pain, and hydrogen water often rely on plausible-sounding mechanisms or mouse studies—but currently lack human RCTs to back them up. While these ideas may sound promising, human trials are either missing or preliminary.
Why does this hype persist? Financial incentives are everywhere: the U.S. spends over $5 trillion annually on health, and the supplement market alone is worth $150 billion. Influencers, professionals, and even well-meaning providers may promote approaches they financially benefit from. As patients, we’re often eager for solutions to symptoms like fatigue or anxiety—especially when conventional medicine doesn’t have a satisfying answer. This opens the door for pseudoscience, placebo effects, and the viral spread of misinformation.
To navigate this environment, Dr. Bobby outlines seven action steps. First, demand human evidence: ask if a treatment has been tested in RCTs, replicated, and proven in diverse populations. He recommends Examine.com for non-biased supplement research and revisiting his episode on evaluating health headlines (#22). Second, follow the money—financial conflicts should raise your skepticism. Third, be alert to hypey language like “miracle cure” or “doctor secrets”—phrases designed to manipulate, not inform. Fourth, understand the placebo effect, especially with vague symptoms. Fifth, ask questions: “Compared to what?” “In whom?” “For how long?” “With what risks?” These shift the focus from excitement to real evaluation. Sixth, adopt what Dr. Bobby calls the mindset of a curious skeptic—open to ideas, but insistent on evidence. Finally, he urges listeners to consult evidence-literate doctors who will explore with you, both mainstream and emerging treatments with a critical eye—see episode #20 for more on choosing the right provider.
Takeaways: Ask, “Has this been tested in people?” before jumping on a health trend. Beware buzzwords and financial conflicts—science, not sales, should guide your decisions. Embrace curiosity, but anchor it in real-world evidence to truly live long and well.
everywhere you turn, someone is claiming a miracle cure for your health New supplements, special diets, curing your microbiome or repairing your mitochondria. The theories or mechanisms or stories seem compelling. Or stories seem compelling, but is this just today's snake oil salesman selling something without rigorous evidence to support it? Can we avoid getting drawn into these theory or expert-based approaches? Can we become curious but skeptical? Let's find out. Hi, I'm Dr Bobby Du Bois and welcome to Live Long and Well, a podcast where we will talk about what you can do to live as long as possible and with as much energy and vigor that you wish. Together, we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey and I hope that you feel empowered along the way. I'm a physician, ironman, triathlete and have published several hundred scientific studies. I'm honored to be your guide. Welcome, my dear listeners, to episode number 44.
Speaker 1:Why is there so much hype in health? Now you may have heard plant-based diets are the best or are wounded mitochondria are the problem, or is it food allergies is the problem, cancer patients shouldn't eat sugar or most chronic chronic diseases due to the microbiome? Have you heard of miracle cure secrets? Doctors won't tell you something that boosts immunity, or natural detox. Well, many of these health claims could sound plausible or even convincing, and they may excite us. However, I generally find there's no credible evidence to support claims like this. I also worry when chiropractors or naturopaths push nutritional supplements, or dieteticians promote things outside of their area of expertise and even functional medicine doctors that claim that inflammation or nutritional deficiencies or allergies are the cause for all of our symptoms. You know, as my grandmother said, if it sounds too good to be true, likely it isn't true or there's a newer version of this one. Just because something makes sense biochemically or is biologically plausible doesn't mean it works in real life. And we'll talk about things like well, mitochondria may be important, they may get damaged as we get older, but that doesn't mean treating them somehow will improve our fatigue. Or that magnesium is used in every cell of our body. Well, that doesn't mean your symptoms will improve if you take magnesium.
Speaker 1:This topic is not new. Think of the snake oil salesmen in the 19th century. They claimed. Of course they claimed it was actually snake oil, but it turned out most of the time it had nothing to do with the snake, but they claimed that their potions or their salves that you would put on your skin would cure arthritis pain, or they had powders that cured insomnia or sterility. Well, that was then. But how about now? So many of these exist Now.
Speaker 1:There is harm. Now you might say, well, this is just kind of fun or humorous, and certainly the snake oil salesmen were, you know, 100 or 200 years ago. But these claims are around us all the time today and there is harm. There's five different harms from this type of activity. The first there's the harm of wasting your money Green supplements or intravenous vitamin therapy shops or red light devices. They're expensive. There's the harm. Second, there's a harm of delay in getting the right diagnosis or treatment. So you may get sucked into doing supplements or trying these other types of things and you don't get to the doctor, you don't get a diagnosis right away and you avoid treatments that could really help you. Third, the harm of false hope, believing something that frankly has no support for. There's also the harm of being simplistic about our health. Yes, we'd all like to take a little pill and be done with it, and sometimes that means we avoid the hard work like losing weight or doing exercise or meditation or any of the number of the other things we talk about on this podcast. There's also a harm of bad science, which can lead to bad policy. So, not many years ago, young kids were told you shouldn't be and parents were told you should avoid peanuts when kids are young, and that's led to a lot of allergies peanut allergies in young people and this was all based on bad science and policies that came out of it.
Speaker 1:Well, this is the background, today's plan. I want to provide some examples so you can get motivated. This is a real issue that you probably run across quite a bit. Next, we're going to talk about why does this occur? Why is it that people promote these kinds of things? And, secondly, why is it we want to believe them? And, most importantly, part three, what are some action steps you can take to avoid this trap? Well, the first action step think about what you've heard from your friends, from your relatives, examples that are out there, that you read or you see on social media. Think about these. Bring these to mind as we go through this discussion.
Speaker 1:Well, I always like to begin with why. Now, as some of you may know, I spent my career asking questions from a health policy standpoint of what does the evidence tell us that works, and let's get more of that. And what does the evidence tell us of what doesn't work, and let's make sure that doesn't happen as much. Save money. Help patients. For example, you know what's the evidence about who would benefit from back surgery, because there's a whole lot of back surgery that doesn't help people, costs a lot of money. When is an MRI scan needed? Are expensive medications worth it? I published about 180 articles looking at the evidence, trying to figure out how best we should approach these aspects of healthcare. So I've always been interested in it and that's in great part, why I began the podcast.
Speaker 1:It also drives me crazy, and whatever hair I have left, most of it is gone because I pull out my hair when family or friends are so excited about the latest fad or trend and what they end up doing is avoiding facing what they really need to do. Oh, I can solve my blood pressure by taking this herb, or I can make sure my cholesterol gets better by this other approach. Well, frankly, it's putting off the inevitable. They're wasting money, they're wasting time because, in general, there's no evidence to support it. I want you to be curious or open-minded, but also to be cautious or skeptical. I like to call myself the open-minded skeptic. I tend to wonder about things and whether they actually work, but I'm open-minded to the evidence. I want you to be that as well. Well, before diving into the examples, I think I need to explain to you what do I mean. What does Dr Bobby mean by evidence? Because if you talk to other people they'll say oh yes, there's lots of evidence for red light therapy or why you need to take magnesium supplements.
Speaker 1:For me, evidence is scientific studies done in people, ideally randomized, controlled trials, where they compare one approach to another and it's blinded, so one person gets a placebo, one person gets the real thing. But there can also be good observational studies, but rigorous, peer-reviewed evidence. Well, what evidence is not a theory or mechanism, plus an anecdote, plus an expert pushing it? Well, what do I mean by that? So maybe there's a theory. Well, your knee pain is caused by loose bits of cartilage floating around in your knee and removing it will help you. So that's the theory, and theory sounds good to me. If you've got little things in your knee, that can't be good for you. Anecdote my cousin had that stuff removed and they got better. And then you have an expert who says oh, I do this in all my patients and they do great. Well, on this exact issue of removing debris from the knee, when randomized control trials were done, it didn't work. Well, other types of evidence, or what people might call evidence Well, I took red light therapy and I took cells and I put them in the lab and it repaired those cells, or it worked in mice. That's also not evidence. So you may have a great theory or a mechanism, there may be individuals that say it worked for me and you may have experts touting it. It doesn't make it for me as evidence. What is evidence are going to be those rigorous studies in people.
Speaker 1:Okay, now for part one. Let me walk through some examples of hype versus evidence. Well, as most of my listeners know, for decades eggs were maligned. They were assumed to be harmful because, in fact, eggs contain cholesterol. So here's the theory, and the theory obviously makes good sense. Your plaque in your arteries that can cause bad problems are full of cholesterol. Well, cholesterol can't be good for you. So eating cholesterol must be bad, and that makes perfect sense. But when they did large human trials and studies, what they found was that the cholesterol you eat in an egg or in shrimp or in lobster, didn't actually affect your blood cholesterol levels and it didn't affect your overall health outcomes. So here is an example we've all sort of lived through where the hype got everybody to change behaviors but in the end the evidence didn't support it.
Speaker 1:Well, how about the theory of clogged arteries cause heart attack and death and if you were to find a blockage you need to open that up with a stent? Well, when this was tested with randomized, controlled trials like the COURAGE trial, the ORBITA trial, it showed there was no benefit to doing the stents over good medical preventive treatment. Again, the theory makes perfect sense. Narrow blood vessels can't be good for you. Opening up the blood vessels must be good for you, but when they compared it in people with stable symptoms, there was no benefit. Okay, how about the theory that injecting cement a cement-like product, not actual cement into vertebral fractures, so fractures in your spine, will stabilize them and it will reduce pain? This was called vertebroblasty. Again, the theory makes sense. If we can stabilize the fracture by putting in this glue, the fracture by putting in this glue, that's going to reduce the pain and, as people know, when you get that broken vertebra it can be really, really uncomfortable for a long period of time. Well, when they did a sham-controlled trial meaning some people thought they got the procedure but didn't, and compared it to people who had the procedure again, no benefit. So these examples I've just talked about have been debunked and they're no longer being promoted.
Speaker 1:But there's a new set of these that are being promoted, so NAD, nicotinamide, adenosine, dinucleotide boosters like NMN and NR that you might take as a supplement or as an injection. It's touted that it slows aging. Well, what's the theory? Theory sounds good. Nad, this molecule helps your cells to create energy. Well, that's got to be good. And as we age, those levels fall. Okay. So now we have a problem. And they found that if you give these supplements to mice, it can boost those levels and the mice do better with exercise. It extends their lifespan. These are animal models, or what are called in vitro models when it's done in test tubes, human evidence. There isn't good rigorous, long-term studies showing that these supplements help us to slow aging or reduce diseases or whatever.
Speaker 1:Well, you've probably also other hyped claims. Well, you have knee pain. You need stem cell injections or PRP injections to heal the cartilage, or are you having muscle weakness or neurologic problems that may be due to injured mitochondria that need healing. Oh, do you have inflammation? You need hydrogen water? Or are you suffering from fatigue? Red light therapy can help you.
Speaker 1:Now, these are all lovely theories and they may sound compelling, but, just like the egg situation and the peanut allergy situation, without proper evidence they're not ready for prime time. They're not ready for prime time now, likely when the evidence becomes available. If it does, they'll never be ready for prime time. So, some examples they're all around you and, as I said in the earlier part about this action step, think about what you've heard from friends, from family, that you've read, seen on the internet. That sounds amazing. It sounds plausible. We wish it were to be true. Keep that in mind, all right.
Speaker 1:Now on to part two. Why all this health hype? Why is it abound everywhere we go and why are we likely to believe it? Well, there's a number of things I want to point out. First, and not a surprise to anyone, there are financial incentives. Health is a huge part of our economy. $5 trillion are spent on health. So everybody's focused on health and trying to improve it for themselves or for others. Supplements are a big business and that's often what you hear about, probably about $150 billion in the US. Sadly, most health podcasts advertise supplements or beds that you'll sleep better in, or wearables, and often the podcasters are owners of these companies or they get payments from the companies that make them. You'll also see that financial incentives are in your chiropractor's office or even your regular doctor's office, that they are expanding what they offer, what they sell, and that's also a financial incentive. There's a saying that if you walk around with a hammer, everything looks like a nail. So even people. Perhaps it's not a financial incentive, they just think that removing the bad debris from your knee will make you feel better. They truly believe it. Now they probably also do the procedure and they make money from that.
Speaker 1:I tend to call this self-serving sloppiness, meaning intellectually, we need to look at the evidence, and sometimes we don't look as carefully at the evidence as we'd like, because it serves us well to continue with a belief that is not supported by that evidence. All right, financial incentives, why else? Why would we as patients get excited about this? And that is that we want relief.
Speaker 1:There's a lot of folks out there who have unmet medical needs or chronic symptoms that traditional medicine doesn't seem to solve. You know how common do we hear? Or we feel oh, I got low energy, I'm not sleeping well, I have a lot more anxiety, I have aches and pains, and their regular doctor, the regular part of the healthcare system, may not have answers for them. So when we hear about a theory or a mechanism that makes sense, oh, you're fatigued, it's due to the mitochondria. The mitochondria create energy in your body and as you age or as you get illnesses, the mitochondria become impaired and we have a way to treat those mitochondria and you will feel better. Or similar theories that relate to the microbiome. Now, I'm not trying to say mitochondria are unimportant and I'm not trying to say the microbiome is never important, but the theories and how people promote it is way beyond what the evidence says. And we want this relief. And we hear somebody else who tried it and it worked.
Speaker 1:Look, as we've talked about, there is a placebo effect. So part of what you hear may not be that it actually works. Despite the wonder of theory, it is. But, frankly, the placebo effect. And then if it works for one person, they tell others. So the third part of this is an amplification process. You tell your friends, you tell your family. It goes out on social media. There may be catchy buzzwords that suck you in oh, it's a detox, or it's anti-aging, or it's the next breakthrough. Look on social media. You can say anything you want. There's no fact checking on Instagram or Facebook or Twitter and people may cherry pick little nuggets of data to support what they want to say. So beware. Okay, so I've given you some examples in part one.
Speaker 1:We've talked a little bit in part two about why is it that all of this hype is out there and why we might believe it. Now we're on to step three. What can we do about it? What are the action steps that you might take to help you and to protect you from some of this? Help you and to protect you from some of this. Okay, number one listen to the theory, be curious, but demand human evidence. So here's the action item for you.
Speaker 1:Ask the question has this been tested, this theory, in a randomized controlled trial in people, not just in mice or test tubes? Has it been replicated? Has somebody else shown the same thing? Very often, breakthrough findings are never shown to work. The next go-round Were the results seen in many different populations and looking at people over time, what's the evidence? Good science stands, the evidence of time, the test of time and scrutiny.
Speaker 1:If you're interested, you can listen to my episode on whether to believe health headlines. That's number 22. I also like the website examinecom. Also like the website examinecom. No, I'm not a financial part of it at all, but I use it. It's very helpful for summarizing evidence on nutritional supplements and things like that. All right. Next thing, to protect yourself. Follow the money.
Speaker 1:Action item number two ask who benefits. If I believe this is true, is the person who is promoting this theory also selling something that would be a red flag? Conflicts of interest are everywhere and there may be financial ties between the person who's pushing it, the product or treatment, and when that happens, their objectivity may be distorted. Now, this happens not just on hucksters on Instagram, but even our professionals that we go to see to care for us. So we have to be aware of that. Third, be wary of buzzwords on social media. So here's your action item number three Are there red flag phrases?
Speaker 1:Miracle cure secrets that doctors won't tell you? It boosts your immunity or it's a natural detox? Phrases may excite us, but that isn't science, all right. Number four understand the placebo effect can be very powerful. People may feel better. That doesn't always mean that the treatment actually was what caused it, especially when you have vague symptoms that tend to go up and down and you might attribute it to what treatment somebody said you should try. Action item number four listen to my episode 28 on placebo. It might help you, okay.
Speaker 1:Fifth ask good questions. So here's your action item. Number five Replace the question did it work with, compared to what? Did they have a comparison group? In whom, in what kinds of people, over what time period, and were there any risks associated with that? This shifts the conversation from just jumping in with excitement to really probing risk-benefit trade-offs and whether there is enough evidence to believe it and whether there is enough evidence to believe it.
Speaker 1:Number six be a curious or open-minded skeptic, as we've talked about Action item. Don't just say no and reject everything, but ask for rigorous evidence. Now, not all theories turn out to be wrong. So we talked about eggs. High cholesterol has been associated with heart disease, so lowering cholesterol might help us. Well, that gave rise to the development of statins, an incredibly important medicine in our toolbox, and it's been shown to reduce heart attack, extend years of life in numerous, numerous RCTs. So it was a theory and it was something people got excited about, but then we have the evidence to show that it works.
Speaker 1:Okay, last action area Talk to an evidence literate provider. So what's the action here? Number seven See if you can explore a topic like this with your doctor. Does your doctor take the time to do that? Does your doctor have an interest in that? So before jumping in and saying, oh, this supplement, I must take it, or this new thing, I must try it, talk to your doctor. See if your doctor will explore it in this kind of way. And, if you're interested, listen to my episode, number 20, on do you like your doctor?
Speaker 1:Okay, time to wrap up. Look around you. Do you find claims that seem to be too good to be true? I suspect the answer will be yes. Perhaps. Be that curious but open-minded skeptic. Try out the seven action steps that I just talked about and let me know about topics you'd like me to explore. Are there things that you think are hype, that you would like me to investigate and share with you what I learned? Well, I hope we all live long and well, not based on hype, but on what really works, based on evidence. Until next time, goodbye. Thanks so much for listening to Live Long and Well with Dr Bobby. If you liked this episode, please provide a review on Apple or Spotify or wherever you listen. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at drbobbylivelongandwellcom. That's Dr. As in D-R Bobby. Live long and wellcom.