Victor Herbert, Researcher and Antiquackery Activist, Dead at 75

Stephen Barrett, MD

Disclosures

Introduction

My good friend Victor Herbert, MD, JD, died quietly of a rare malignant tumor on November 19, 2002. He is survived by his wife Marilynne, sons Robert and Steven, and daughters Kathy Rose, Alissa, and Laura. At the time of his death, he was a professor of medicine and chaired the Committee to Strengthen Nutrition at the Mount Sinai-New York University Health System and was chief of the Mount Sinai Nutrition Center and Hematology and Nutrition Research Laboratory at the Veterans Affairs Medical Center in the Bronx.

A native of New York City, he was named for the famous composer who was his father's cousin. When Victor was 10, his father was killed while fighting in the Spanish Civil War. When he was 13, his mother died after a long battle with cancer. After living in foster homes for several years, he attended Columbia University where he earned a BS in chemistry in 1948 and his medical degree in 1952.

After specialty training, he began his long career of teaching, research, and patient care in hematology/oncology, nutrition, and internal medicine. At various times, he served full-time on the medical school faculty of Albert Einstein (New York), Mount Sinai, Harvard, Columbia, SUNY-Brooklyn (formerly SUNY-Downstate), and Hahnemann, before settling in 1985 at Mount Sinai.

He had a deep love of science and detested its detractors. His primary activity was scientific research, but fighting what he called quacks, scams, frauds, and medical con artists became his passion. He obtained a law degree in 1974 because he believed it would make his antiquackery work more effective.

His influence within the scientific community was enormous. He produced several books, many book chapters, and more than 850 papers, more than 300 of which were published in indexed journals. The Institute for Scientific Information lists him high among the scientists whose peer-reviewed publications are most cited worldwide by other scientists. Most of his research concerned the metabolism of folic acid, vitamin B12, and iron. Using himself as a guinea pig, he proved that dietary deficiency of folic acid can cause macrocytic anemia. He performed this experiment, which nearly killed him, by eating a folate-free diet for several months.

He served on the editorial boards of 6 scientific journals; sat on the WHO-FAO committees on nutritional anemias and on dietary requirements; and lectured at medical institutions and professional meetings throughout the world. From 1980 through 1985, he served on the Food and Nutrition Board of the National Academy of Sciences and its RDA Committee. He was president of the American Society for Clinical Nutrition; chairman of the Public Information Committee, Federation of the American Societies for Experimental Biology; chairman of the Committee on Life Sciences of the American Bar Association; and a longtime member of the federal Interagency Committee for Human Nutrition Research. He was a scientific advisor to the American Council on Science and Health and a board member of the National Council Against Health Fraud.

His research awards included the 1972 McCollum Award and the 1986 Robert H. Herman Award (both from the American Society for Clinical Nutrition); the 1978 Middleton Award (highest award for medical research given by the Veterans' Administration); and the 1993 American Institute of Nutrition's Lifetime Fellow Award (for "nutrition research, teaching and unique contribution to the fight against health fraud"). He also received the FDA Commissioner's Special Citation Award for Public Service in 1984 (for "outstanding and consistent contributions against the proliferation of nutrition quackery to the American consumer") and honorary lifetime membership in the American Dietetic Association (1988).

Victor was by far the most outspoken antiquackery activist in modern times. His expert guidance and testimony helped state and federal regulatory authorities stop scores of misleading promotions. His willingness to "tell it like it is" made him popular among television producers, print journalists, and health professionals who wanted to expose health frauds. In the early 1980s, he made headlines when 2 of his children's pets obtained "professional memberships" in fancy-sounding nutrition organizations whose only membership requirement was submission of a name, an address, and $50.

Victor was also concerned about world peace and social justice. He served voluntarily in the Army in World War II, Korea, Vietnam, and the Persian Gulf, eventually retiring as a Green Beret Lt. Colonel. Yet he was also active in the peace movement in the 1960s and in opposing Apartheid.

I met Victor in 1974 after he drafted a chapter on nutrition for a book I was editing on quackery. His chapter explained how easy it is to get one's nutrients through food, what vitamin overdosage can do, and 14 tips on how to spot a quack.[1] Our meeting began with a tour of a quack convention at which I saw example after example of the behavior his chapter described. We then went to a Middle Eastern sandwich shop where he ordered pita filled with chicken, lettuce, tomato, cucumber, sprouts, and yogurt -- which, he pointed out with delight, was nutritionally balanced as well as delicious.

Although Victor did not rail against supplementation with modest levels of essential nutrients as "nutrition insurance," he detested the tactics used to trick people into thinking this was necessary, and he warned that above-RDA amounts were more likely to cause harm than good. Over the years, our list of quack-spotting tips[2] has expanded and appeared in various forms in many articles, books, textbook chapters, and college course handouts. We also coauthored 2 books about the organization and dishonesty of the health-food industry.[2,3]

Quackery proponents tried to portray Victor as an extremist by saying that he was "against all vitamins." But that description was far from the truth. He was one of the first scientists to call attention to the importance of adequate folate during pregnancy. He believed that normalizing homocysteine with B-vitamins would eventually prove to be prudent. He recommended B12 supplementation for persons over the age of 50, based on the idea that many people lose their primary ability to absorb B12. Overall, however, he believed that dietary supplementation, if appropriate, should be based on individual dietary habits and genetic tendencies and that population-wide supplementation should not be done without proof that it will do much more good than harm.

He was particularly concerned about general recommendations to take antioxidants. Although epidemiologic and laboratory findings suggested, for example, that supplementary beta-carotene and vitamin E might reduce the incidence of cancer and heart disease, Victor predicted that clinical trials would demonstrate harm. He also warned that vitamin C supplementation would increase the incidence of hemochromatosis in susceptible individuals by increasing the amount of iron they absorb. So far, he appears to have been correct.

Victor did not mince words. He described the health-food industry as a form of organized crime and referred to certain of its leaders as "the quackery mafia." He was particularly concerned with the scientific community's unwillingness to label quack activities as such. He detested use of the words "alternative" and "complementary" to describe methods that are unsubstantiated and lack a scientifically plausible rationale. Nearly 15 years ago, he warned:

Irresponsible seekers of political advantage placate the masses by plumping for irresponsible alternative therapy, ignoring the fact that there is no such thing. "Alternative therapy" means an alternative to what works. . . . There is no such thing as orthodox versus unorthodox therapy, or establishment versus alternative therapy. These are euphemisms created by promoters of health fraud to legitimize what they do. There are only three kinds of therapy. One, there is therapy that works: it is more effective than doing nothing, and it is as safe as doing nothing, or, if there is any question of safety, whose potential for benefit clearly exceeds its potential for harm. There is therapy that doesn't work. . . . The third kind of therapy is experimental therapy. Experimental therapy by definition is therapy which has not yet been demonstrated to be more effective than doing nothing, or as safe as doing nothing, but which is being tested to determine its safety. The promoters of various quack (ie, fraudulent) remedies say the medical profession is just stodgy and behind the times, these are new therapies that they don't understand. Nonsense, new means experimental. Experimental means it has not yet been shown to be more effective than doing nothing, or as safe as doing nothing. Many of the quack remedies prove harmful.[4]

Donations in Dr. Herbert's memory can be made to the Dystonia Medical Research Foundation (http://www.dystonia-foundation.org), One East Wacker Drive, Chicago, IL 60601, or the National Council Against Health Fraud (http://www.ncahf.org), 119 Foster Street, Peabody, MA 01960.

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