Natural - What does that word mean?

I often get questions from patients about natural foods and supplements. The marketplace and media are awash in the term “Natural”, but what does it mean? If you ask most people why they would choose to use something that is natural the most common answer you are most likely to get is that “its better for you”. To the average person natural means wholesome and safe. It seems only common sense that anything that is natural would be better for you than something that is manmade, but is it?
What does it really mean when we say something is natural? It seems like an easy question but the truth is that there is no agreed upon definition for this word. In fact the FDA does not even have an official definition of the word natural. When it comes to food, their policy has simply been not to object to the use of the word as long as “The food does not contain added color, artificial flavors, or synthetic substances.” The public assumes that natural means wholesome and unprocessed but that may not be true and in fact there are no guidelines restricting companies from extensively processing the products they label as natural. When the word natural is applied to remedies or supplements that supposedly have some health promoting quality the use of the word natural seems to have no real rules at all.

It's interesting to examine the assumptions we make about the word natural. Are natural products really safer or better for us and why? When you really look into it, the fact is that nature has no soft spot in it's heart for human beings or their health. Lots of so called natural substances are extremely harmful. One of the most potent cancer causing chemicals on the face of the earth is a naturally occurring substance called Aflatoxin that is produced by certain fungi. Poison Ivy is natural, and Arsenic is natural too but most people wouldn't consider ingesting either of them.
 
Where does the idea come from that natural products are safe? Most likely it derives from two sources. There is a trend in our crazy scary modern society to believe that things were simpler and safer when we all lived on a farm and our food came directly out of the ground on our own land. Its a rosy if not completely accurate view of the past that strikes a chord with many people. That's only part of the explanation though. The misperception that natural means safe also comes from the simple observation that most people who use natural remedies seem to have no ill side effects. The perception is also due in no small part to marketing agencies and manufacturers who have discovered the public is willing to pay more for products marketed as natural if the public believes these products are safer than the traditional alternatives.

Is there anything wrong with this thinking and why shouldn't we use natural products? The best answer to that question is that while there may be nothing wrong with foods that meet the vague definition of natural, there may also be nothing special about them either. To begin with, natural foods often cost a lot more than other foods and despite their wide and varied claims, there is little if any scientific evidence to show that natural or organic foods are any healthier than those grown with synthetic fertilizers and pesticides. In fact some of the worst food born e.coli outbreaks in the country have been caused by organically grown “natural” foods.
 
Although the worst thing about natural foods may be the added cost and wasted money, natural remedies are another story. The only reason most people seem to have no ill effects from these remedies is simply because most of these products have no effects at all.. good or bad. The word natural seems to carry an almost magical promise of a cure with no side effects. Unfortunately there is nothing magical about natural remedies. Remedies for any illness can only work if they have a biological effect inside the body, and any substance that has biological effects is by definition a drug whether they call it that or not. As such it is just as likely to have unforeseen side effects whether the product is natural or man made. Most natural products are completely harmless only because they are also completely useless. Its important to keep in mind that the reason we know about most drug side effects is because there is a system in place whereby side effects can be reported and tracked. No such system exists for natural remedies and supplements so similar side effects when they do exist generally go unreported. Even so a number of natural products have been removed from the market over the years because of harmful and even fatal side effects, but because these products are not monitored problems are not noticed unless they are extreme or effect a large number of people. It is also important to note that there is no requirement for natural remedies to prove that they are effective. The law does prohibit these remedies from claiming they cure or treat a disease or illness but skilful lawyers often craft the wording on these packages so it sounds like it can cure something even if a close reading of the claims technically abides by the law.  A company can not claim its supplement cures the enlargement of the prostate seen in older men known as BPH but it can list all of the symptoms of BPH and then claim the product promotes "prostate health" so the consumer comes away with the impression that it will treat BPH. They can do this despite a complete lack of evidence that the product does anything at all.

To answer the original question, what does natural mean? While the FDA and the manufacturers seem to be having a lot of difficulty defining the word, all you have to do is look at how they are using it and the definition becomes pretty clear. Natural means untested. It also means unproven, but the one thing it doesn't necessarily mean is safe. There are no magic words or shortcuts to good health. The best way to stay healthy is to eat more fruits and vegetables, cut down on red meat, sugars and starches, wash your food, cook it well, and use medicines and remedies that have been tested thoroughly instead of those which have little to offer except a meaningless word on the package.

Michael J. Melgar, MD