Another look at the science of wellness

Whether they call themselves health or lifestyle coaches or wellness practitioners, the person at the other end of the telephone of the wellness program offered by your employer or healthplan could be anyone. Wellness is not a recognized or licensed medical discipline.

This past week, the New York Business Strategies Examiner interviewed a wellness practitioner of therapeutic touch, reconnection healing and clinical aromatherapy. The story offered a helpful caution about wellness. This practitioner had recently moved from her corporate position to launch a company selling wearable aromatherapy that the inventor called “the first accessory-ceutical on the market.” Wicks are dipped in essential healing oils and worn as jewelry. For her, aromatherapy has been “the sweet smell of success.”

She offers seven blends of oils in her “life-enhancing jewelry” collection. One blend is said to provide emotional well-being and a deep sense of peace; another to think clearly, stay alert and energized; one is for joy, romance and inspiration; another to protect yourself from airborne micro-organism that cause disease; one for confidence, courage and self-esteem; Endoflex is said to balance your hormones from PMS to menopause and increase vitality; and the final blend promises to do “all that you desire with abundance.”

Her website, aromawear.com, says: “We have proof of the benefits of aromatherapy, the art and science of utilizing naturally extracted aromatic essences from plants to induce relaxation, increase energy, and restore lost balance to mind, body and soul.’” No proof was provided, however. Instead, visitors read that “since ancient time, special objects and plants were believed to possess magical powers and jewelry filled with herbs and their essences were worn for protection from disease and to promote mental and spiritual well-being.”

Aromatherapy — a homeopathic energy modality

Aromatherapy was first coined by the French chemist, Rene Maurice Gattefosse, in 1928. By the mid-1990s, aromatherapy had become a more than $100 million industry just in the United States. According to the National Association for Holistic Aromatherapy — a grassroots organization founded in Boulder, Colorado, with a nurse one of the co-founders — aromatherapy is a holistic energy medicine that acts as both a preventative and active treatment during acute and chronic stages of illness. The oils are said to “enhance the individual’s innate healing process [and] assist the body’s natural ability to balance, regulate, heal and maintain itself.”

All pleasing aromas — like any lovely fragrance worn as a perfume, bathed in or enjoyed with a massage; or even home-baked bread and cookies fresh from the oven — are enjoyable. The potential dangers with aromatherapy, like all alternative modalities, come when they are marketed as having medical and health benefits that exceed the science or biological plausibility. People can potentially be put at risk by turning away from proven, effective treatments or by being hurt financially, costing them when they’re most vulnerable.

Aromatherapy has been purported to be effective for everything from infections, asthma, depression, fibromyalgia to cancers. An illustration of the health claims being attributed to aromas is found in an article published in Aromatherapy Journal, the journal of the National Association for Holistic Aromatherapy. Author Linda Chudzik wrote of her personal path to enlightenment that began with nutritional and chiropractic healing after her own breast cancer and led her to energy healing and “balancing her electrical energy field …to obtain optimal balance of the body, mind and spirit.”

At the 4^th Wholistic Aromatherapy Conference, she wrote, naturopath and homeopathic practitioner, Bruce Berkowsky, taught that cancer is the result of “cancer miasm” and that aromatherapy’s essential oils can effectively “penetrate the layering of superficial symptoms in a case and gain access to the germinal, central disturbance of the dynamic plane from which those symptoms emanate.” Another aromatherapy concept developed by Rudolh Steiner, she said, “teaches that plants produce fragrance as a means of absorbing ‘the soul’ of the sun, which contains the essence of spirit.”

Cancer and other disease miasms, she explained, is a homeopathic concept from Samuel Hahnemann, its founder. It believes people are predisposed to disease passed down from generation to generation by bioenergy, not genetics and heredity. People with a cancer miasm are believed to have certain mental personality and emotional traits that predispose them to cancer — everything from fear of disease, love of animals and dancing, oversensitivity, sentimentality, to a desire for chocolate. [The “cancer personality myth” was covered here.]

Anyway, Chudzik continues through a convoluted string of energy beliefs, such as that malignancy is an expression of disorganized astral bodies and spiritual forces and abnormalities in our auric fields. She finally described the purported ability of essential oils to combine energetic modalities of natural healing and homeopathy to treat cancer miasm and a wide range of cancers. Aromatherapy, she says “may be the major breakthrough against cancer that mankind is so desperately searching for.”

Aromatherapy and other fragrance products are considered cosmetics by the FDA and cosmetic marketing claims “for cleansing, beautifying, promoting attractiveness or altering the appearance” don’t need FDA approval. But, according to the FDA, anyone who tries to market a scent by suggesting it is effective as an aid in quitting smoking, sleeping, or to treat or prevent any other condition or disease, or otherwise affect the body's structure or function, would be subject to regulatory action because such claims would come under FDA drug regulations.

Can odors really heal?

Dr. Edzard Ernst, M.D., Ph.D., chair of the Department of Complementary Medicine at the University of Exeter, has unwaveringly examined the clinical evidence for alternative modalities. Working with Brian Cooke, also at the Dept of Complementary Medicine., they did a systematic review of the published research on aromatherapy to learn if there were any clinical indications to recommend its use. Their findings were published in the British Journal of General Practice.

Their review found six studies — in none were the findings ever independently replicated — and all but one suggested benefits of aromatherapy merely for anxiety and general well-being. The effects, however, “were modest and could all have been attributed to flaws in the study design,” the authors said.

All of these studies were conducted by nurses, using aromatic oils with massage, and all suffered from methodological flaws, said Drs. Cooke and Ernst. Only one study was a randomized, double-blind study and it found no measurable benefit. “None of these studies offers a clearly stated hypothesis at the outset, and the general tone of the reports is one of documenting, assessing or evaluating (rather than testing) the ‘established’ effects of aromatherapy by using questionnaires administered before and after an intervention,” the authors concluded. As they described:

There was a prior assumption that the patients in these studies suffered from a degree of anxiety or distress that warranted intervention. Some of these patients were sedated, but there is no suggestion that they were candidates for conventional anxiolytic therapy. The patients were not seeking relief from a symptom and then being offered entry into a randomised controlled therapeutic trial of an established treatment for that symptom. They were not recruited into the studies because they were complaining of anxiety, but because the investigators believed that they were potential subjects with a level of anxiety or other symptoms that would respond satisfactorily to aromatherapy massage. This may of course be true, but the scientific rigour of this approach in effectiveness research is questionable.

There is no credible science to support the health claims surrounding aromatherapy. “Aromatherapy is pleasant and relatively safe compared with many other ways of spending an hour or so and £20 to £45,” said the authors. But the evidence is sufficiently flawed and has not shown aromatherapy to be cost-effective in health care settings and the overall evidence is insufficient to advocate its use, they concluded, adding:

There is no published literature that provides a sound rationale for the use of aromatherapy massage as a medical intervention. In the absence of hard efficacy data for lasting and relevant health effects, it is probably best considered as a pleasant diversion for those who can afford it and are prepared to pay for it.

There is no accreditation or licensure for wellness practitioners, meaning the person offering lifestyle coaching on the telephone or via the internet could be anyone. And their advice warrants the same caution as that from any unfamiliar person. Yet, even clinically-trained medical professionals and nurses are promoting aromatherapy at hospitals as part of wellness programs, and selling aromatherapy products on the side. With that, how can we trust that the life-and-death medical care we’re being given in the hospital is really grounded in good science and not based on how much money can be made on the side?