Tuesday, 29 May 2012



“The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.”
― Stephen Hawking

Probably the last thing a doctor would like to do, on completion of a hard day at work, is a visit to the local pharmacist. Yet that is precisely one ought to do, according to Dr. Ben Goldacre, one of the more impressive medical writers of our age, a brilliant debunker of present day myths in all sorts of disciplines, but especially the medical profession. It will only be a matter of time before he wields his axe against a discipline, which I am now told has been around for a number of years, although only recently has it had a boom – the area of nutritional cosmetics, defined as “the idea that beauty can be enhanced through the consumption of functional dietary products that may support healthier and thus more beautiful skin. The term nutricosmetics appears to borrow from the terms nutraceuticals and cosmeceuticals to reflect the goal of these products, that is, to provide health and beauty benefits to the skin via nutritional products consumed on a regular basis”, as defined by the editors of a book with that title, Dr Aaron Tabor and Robert Blair.

I was aware of Goldacre’s instruction, given on the 24th page, since I read his book a few years ago, but did not pay any attention to it until recently, when a dear person to me enquired about a recently released product of the ‘Minerva Research Laboratories’, a company founded by a businessman, Tony Sanguinetti, and based in Mayfair. A product called, ‘Pure Gold Collagen’, "the new anti-ageing liquid food supplement which perfects the skin's appearance from within, counteracting the ageing process where it begins, in the deep layers of the skin"[1] which claims to give the skin ingredients which, “reach the dermis, the deeper layer of the skin, from the inside where it re-activates the formation of collagen to give you younger looking skin”.

On hearing all this, my instinct was that it is utter nonsense. But – if one is after pursuit of truth – one should leave one’s instincts and feelings on the side and look at the matter objectively. Sadly, that is not what most of those research laboratories are after. As Ben Goldacre put it so well, “the cosmetics industry is playing on people’s dreams, and people are free to waste their money”. They would like to appeal to the subjective feelings of people (and furthermore, their pockets), as evidenced by their use of such emotive terms as‘pure’, 'perfect' and ‘gold’ – when there is nothing ‘pure’ or ‘gold’ about it. Even the claim that it is collagen is false – contradicted by the product’s own packaging itself, as we shall soon see.  And needless to say, there is no such thing as perfection in this world. 

And so off I went on an expedition to find out what this product was all about – and the best way was to indeed visit my local pharmacy (and there are three within 10 minutes of where I reside), and then to analyse the claims made on the manufacturer’s website, as well as customer reviews in various other websites.
So off I step outside all three of my local pharmacies. And what is the first thing that strikes me? On every single pharmacy’s shop window were posters about the product (see pictures). It was without a doubt the best advertised product. Even without deliberately looking for the product, it stared at to one straight in the face – and if that is not good advertising, I do not know what is. And as is usual with advertising campaigns, a young semi-clad (I hope) woman puts herself alongside the product. The reader may think of that what they may. But it left me confused: a product claimed to be anti-ageing, yet sponsored, in all its adverts by young women. 

The packaging is quite attractive and easy on the eye. The words ‘Pure’ and ‘Gold’ are especially highlighted, the former in a purple saw-tooth edged circle. I am unsure about the ‘O’ in ‘Gold’; whether it is a Japanese (where Mr Sanguinetti is said to have drawn his inspiration) symbol of sorts or an angulated depressed face. In any case, I think it adds nothing to the packaging. The other points highlighted other than the ingredients list, is that it is a ‘facial beauty drink’, that ‘skin care starts with sip’, that it follows the ‘original formula’, and that it is a product of, ‘Minerva Research Labs’. Let us take all these claims one by one.

Just like its sister word, ‘natural’, the word ‘pure’ conjures up images of unrivalled scenic beauty. American dermatologist Dr. Marsha Gordon put it thus:

“What does natural mean to you? It probably conveys images of Mother Nature, beautiful landscapes, clean air, and pure water. On a product label, the term carriers connotations of purity, gentleness, and radiant good health.

You may be surprised to hear there's no FDA definition for the term natural. It could mean that a product's ingredients come from nature (whether plant, animal, or mineral). It could also mean that the ingredients imitate natural substances or are chemical precursors of natural substances.

When you consider buying a natural product, remember the following: Even if only one substance in a product is natural, marketers can use this term. Natural ingredients could make up less than 1 percent of the total. Many items with natural ingredients also contain numerous chemicals, including preservatives, stabilizers, dyes, and fragrances and also very commonly, the word ‘natural’)”. 

Yet there is nothing ‘pure’ about this product, sold as it is on the very packaging, as being, “Based on a formula specifically developed to offer a unique blend of collagen and active ingredients for high absorption and bioavailability”. The full list of ingredients is as follows:

“Water, Hydrolysed collagen, Glucose-fructose syrup, Acidity regulator: citric acid, Soybean polysaccharide, Acidity regulator: malic acid, Antioxidant: ascorbic acid (vitamin C), Flavouring substances, Hyaluronic acid, Borage seed oil (borago officinalis) (solvent: glycerol, Emulsifier: soy lecithin), D-tocopherol (vitamin E),N-acetylglucosamine, Sweetener (sucralose), Pyridoxine hydrochloride (vitamin B6), Extract of black pepper(piper nigrum)”.

Following this we are told that the product “contains no preservatives and no artificial colours”. The more discerning will note the use of artificial sweeteners and flavourings. And of course, as we have already noted, no gold is to be found, before anyone start to claim that it will be a good idea to use it on those with psoriatic skin.

Next, we are told that it is a ‘facial beauty drink’. We shall not get into the age old debate about what is beautiful and what is not, whether there is any truth in aesthetic relativism or aesthetic absolutism. But let it be known that what the cosmetics industry experts believe is that facial beauty is not in the eye of the beholder, but what conforms to their standards. They have decided, and it is for the consumer to follow their decisions like a blind sheep.

The product is claimed to be ‘anti-ageing’; yet the claim is utter folly. There is no such thing as ‘anti-ageing’, for nothing can oppose the tide of time. We may fiddle around with appearances, but the core cannot be meddled with. Time is like Khayyam’s Moving Finger:

“The Moving Finger writes; and, having writ,
Moves on: nor all thy Piety nor Wit
Shall lure it back to cancel half a Line,
Nor all thy Tears wash out a Word of it.”

And who said that ‘ageing’ is wrong? Who decided that ageing ought to be, at least superficially, reversed? Once again, we are asked to conform to the ideals of the Western cosmetics industry here – an enslavement of thought that is much more malicious than any other form of enslavement.   
It is a drink, we are told, because:

“Aside from being much easier to swallow, liquid is more readily absorbed as soon as it enters the stomach. It is not uncommon to have pills that are poorly absorbed. Each daily dosage (50ml) of Pure GOLD COLLAGEN® contains 5,000 mg of hydrolysed collagen which is up to 100 times more powerful than a typical collagen pill. Pills and capsules may cost less, but in reality, liquid represents far better value due to more hydrolysed collagen being absorbed and distributed in the body”[2].

This somewhat comical writing is typical of the merchants of the cosmetics industry, and I sometimes wonder if the word ‘comical’ is a contraction of the word, ‘cosmetical’.

At a scientific level, there is confusion here – the end goal is the replenishment of collagen. Now to build up any protein-rich tissue takes weeks or months. It therefore does not matter if the delay in absorption, if it so occurs, is in minutes or hours. If the recommended course is “1 bottle per day for at least 4 weeks, preferably 8 weeks for best results in skin hydration and up to 12 weeks for best results in the reduction of deep wrinkles[3], does a few hours make any difference?

And we hasten to add, to one capable of swallowing, liquids are not “much easier to swallow”, and that pills are not commonly ‘poorly absorbed’. Those are the facts.   

So, why would they pack ‘pure gold collagen’ in a drink? I believe there are at least two reasons. Firstly, liquids have tastes while tablets do not, and we are told on the website that and it “has a lovely fruity taste of peaches and passion fruit”. Most reviewers (and we hasten to add, that customer reviews do not constitute truth, especially if they are endorsed by a manufacturer's website) agree with it and love the flavour[4]; one reviewer even went to go as far as say “the taste, I loved it! I could have drank a pint. I couldn't wait to take it first thing in the morning as soon as I got out of bed[5]. Now there is nothing wrong with making a ‘nutritional drink’ taste good. Heston Blumethall has been trying to do it with hospital meals for years now. What is wrong is abusing taste to offer something of no value, or worse still – harmful. The latter is done all the time by owners of doner kebab and fried chicken shops. I do not believe Minerva are quite in the same category, because as yet – there is no evidence of physical harm done by their product.

The second quality of liquids is that they have colour – no doubt looking at a glass of a ‘golden’ drink, as we have it above, is much more appealing than a plain pill[6].

The words, ‘original’ formula make no sense to me, except that they are emotive words that conjure up pictures of our wise elders and their original formulas of doing things. Except that there is no such history. There is no original formula or secret recipe to which the product has been prepared.

Now what of Minerva Research Laboratories? The company has been around for just under three years. 

They do not produce any other product. As a result of the sales of ‘Pure Gold Collagen’, it has become a wealthy company with a very high turnover[7]. It is not run by dermatologists or medical professionals of any sort, but by businessmen. True, the input of nutritionists (who get a particularly savage beating by Goldacre in his book) and I am told vets[8] is sometimes sought, but at the end of the day, this is a business plan. This is not about scientific truth or helping the distressed or reversing the trend of a major illness. It is about maximal profit for Mr Sanguinetti, who has embarked on a discipline that requires no specific medical regulation – since after all, it is a food product. He is using all his marketing expertise to this end, and he has thus far benefited immensely from it.  

And what a profit margin our Italian friend[9] must be making! The price for 10 bottles (each weighing 50 mls) is £36. And we are advised to use “1 bottle per day for at least 4 weeks, preferably 8 weeks for best results in skin hydration and up to 12 weeks for best results in the reduction of deep wrinkles” – thus costing between £100 and £300. Now what that translates into is 7.2 pence/ml, more than the cost of some vintage Champagne. And when one knows where the key ingredients of his ‘original formula’ come from – the profit margin will be only too apparent. At £4.59/kg for Pangasius fish, and £18/kg for Tilapia (and no doubt much less for wholesale purchasers like Minerva), the profit margins are absolutely incredible.  

But no; Mr Sanguinetti would like to fool us into believing that the story is one of inspiration, of passion for the wrinkled and the aged, a passion for Japanese culture, where the oral collagen industry is at its peak. While not advertising it as a medicinal product, and thus avoiding the extremely tight regulations of the pharmaceutical industry, he informs us it is “formulated for maximum absorption and bio availability”, terms only used in the disciplines of pharmaceuticals and pharmacology, and that ‘Pure Gold Collagen’ is “produced with advanced technology and the manufacturing quality of the pharmaceutical industry” (which in most readers’ minds, will subconsciously translate into ‘the standards of the pharmaceutical industry’), and somewhat desperately he requests us to “please watch the production video” – a request I have never seen any self respecting product manufacturer do before.  It is a sign of a desperate product, which fails to sell itself. For if it did, it does not need this ridiculous degree of attention. Has anyone ever seen a video of the manufacture of antibiotics? Or corticosteroids? Or anaesthetics?

His efforts do not stop at the use of emotive language and the language of the pharmaceutical industry. He also has a picture of a ‘white coat’ and stethoscope wearing[10] doctor as the background to his website[11]. He also uses two age old tricks of the industry which sadly many fall prey to.

Firstly, the cosmetic industry is not required to give the doses of its ingredients. If a certain chemical is shown to reduce the size of wrinkles by 50%, but at only very high, or even toxic concentrations, the cosmetic industry can still mention the product and give its end action, but they are by law only able to use it at low concentrations.

Thus, we see in our ‘Pure Gold Collagen’ the mention of vitamin E, which goes along the same lines as Goldacre is describing here in moisturising creams
“There are basically three groups of ingredients in moisturising cream. Firstly there are powerful chemicals, like alpha-hydroxy acids, high levels of vitamin C, or molecular variations on the theme of vitamin A. These have genuinely been shown to make your skin seem more youthful, but they are only effective at such high concentrations, or high acidity levels, that the creams cause irritation, stinging, burning and redness. They were the great white hope in the 1990s, but now they’ve all had to be massively watered down by law, unless on prescription. No free lunch, and no effects without side-effects, as usual.

Companies still name them on the label, wallowing in the glory of their efficacy at higher potencies, because you don’t have to give the doses of your ingredients, only their ranked order. But these chemicals are usually in your cream at talismanic concentrations, for show only”.

Second, their misinterpretation of research works. The claim that something is ‘clinically proven’ or ‘science has proven’ is an extraordinary one that is never made by the sane medical professional. Yet we see this statement repeated time and time again on that website. And on what basis? Two studies – made on a mere 80 women (33 in Japan[12] and 47 in France)[13]! To any proper reader of a medical paper, that is a statistically insignificant number to make any conclusions.

However, let us assume that the studies came to a statistically significant result. We still cannot utilise them to endorse the product. The reason is very obvious: both studies were done on 10 g/day doses of hydrolysed collagen, while a bottle of our Pure Gold Collagen contains just 5 g.[14] Thus – the evidence given by our research lab is flawed at every level.

Finally, we mention yet another strategy that is commonly employed by the cosmetics industry - the reliance on authority. We are told that, "MINERVA’s scientific knowledge and product research draws on the experience of the most advanced nutricosmetic market in the world, Japan. We weight European competence through reputable partners such as the University of Oxford, Lipoid in Germany, Polaris in France and a strategic alliance with Rousselot SAS (the largest producer of collagen in Europe)"

We are not told about the nature of the connection. It could be something as simple as a greeting card which was responded to - legally that would constitute correspondence. It has to be noted that those with arguments that are somewhat weak use such claims to bolster them with an air of authority. Reliance on authority is the weakest form of argument. 

Thus, to conclude, I have not used and will not use ‘Pure Gold Collagen’. And I do not know if it works. I am unsure whether Mr Sanguinetti has used his obvious creative genius to produce 'hydrolysed collagen' which specifically decides to ignore the rest of the tissues where collagen is required and opt to enter the dermis. I do not know. 

I am not against people purchasing it, or for that matter wasting their money on anything they will. It is a free world. What I am against is the misuse of science, and the pretence to knowledge, by men whose sole concern is their pockets. And it is the task of all servants of truth to expose their folly, their pseudoscience, and stop others from falling prey to their often very cunning ploys.

And ‘Pure Gold Collagen’? It is indeed something...very fishy.

[4] Some however dislike it, stating that it tasted and smelt like a mixture of fish and calpol! See http://muslimahbeauty.com/2012/01/24/would-you-drink-liquid-collagen/

[7]“Due to huge demand for Pure GOLD COLLAGEN the majority of Boots stores across the UK have sold out. Pure GOLD COLLAGEN has also been the no.1 seller on Boots.com which is also reporting stock issues.

We apologies for the lack of availability and the PGC team are working with Boots to increase supply and hope to have more in stores and online later this week. Thank you to all the PGC customers who are taking PGC and enjoying the benefits. We have had amazing feedback and are glad to hear that your are seeing such fantastic results” – reads their blog entry on the 12th of March 2012 - http://goldcollagen.wordpress.com/2012/03/12/its-a-sell-out-pure-gold-collagen-is-out-of-stock/.

[8] In response to an email I sent to the Minerva company about the sources of the collagen, the advisor responded as follows: “Our hydrolysed collagen Peptan™ produced by Rousselot SAS of France contains a blend of the best quality hydrolysed collagen extracted from farmed Tilapia and Pangasius fish. All fish used by Rousselot only come from establishments registered by the European Union for the import of edible fish, fit for human consumption and guaranteed by health certificates signed by official veterinarians”.

[9]Tony is of Italian origin and resides in London where he also lectures on Strategy and Business Management at the ESCP School of Management for Europe. He has an MBA from King’s College...He has over 15 years experience in senior management positions in sales and strategic marketing” - http://www.businesswireindia.com/PressRelease.asp?b2mid=28544
[10] I do not recall ever meeting a dermatologist who wore either.
[12] I could not locate either of the studies on Pubmed, further questioning their authority.