Seely and colleagues’1 conclusion that “ ... the addition of naturopathic care to enhanced usual care may reduce the risk of cardiovascular disease among those at high risk” is, in our opinion, not supported by their study because nothing unique to naturopathic care was assessed. The authors have taken a science-based medical intervention and essentially reframed it as a naturopathic treatment.
The authors describe the use of well-established medical interventions (e.g., diet, weight loss and exercise) that have long been a part of standard medical treatment to reduce cardiovascular risk factors. An uncontrolled variety of “naturopathic” supplements were added, the effect of which, by the authors’ own admission, couldn’t be measured.
In a related CMAJ editorial, Stanbrook2 comments that “ ... some aspects of cardiovascular prevention could feasibly and effectively be delegated to naturopaths.” He rightly expresses concerns that for physicians to be willing to partner with naturopaths “... naturopathy will have to submit its practices to the same standard of scientific validation as other health disciplines.” To date this has not occurred, and most naturopathic recommendations fall far short of the quality of evidence expected to be considered science-based.
Although nonphysicians can counsel patients on health promotion measures, giving this job to groups that oppose basic health maintenance programs would not make sense. There are good reasons to be concerned about the quality of health information delivered by naturopaths. For example, the antipathy of some naturopaths toward routine childhood immunization is troubling.3
We expect CMAJ to be a major supporter of the principles of science-based medicine and find this article misleading. Nothing comprising “naturopathic care” has been assessed in this study, and its title would more appropriately have been “Standard science-based lifestyle advice can reduce cardiovascular risk factors.”
Dr. Stanbrook’s opinion that we should be open-minded and consider having naturopaths deliver this lifestyle advice is very concerning. We feel that it is critical that our patients get their health information from the most reliable sources. Giving credibility where it has not been earned falls short of what the public relies on our profession to do.