Mannatech is a scam - here is a summary of the "evidence" their science website provides

Mannatech is a pyramid scheme.  Ahem. Sorry - multi-level marketing scheme.

For more information and excellent research on Mannatech and their tactics - here you go:

http://mannatechscams.com/

A while back, an old friend from high school phoned me and asked whether I would like to make some money.

Tip: If any conversation starts like this, you are either going to end up broke and/or in jail.

He was selling Mannatech.  But I was not sure he knew what he was selling. So I offered to read up, in detail, about the product (which I knew to be a scam) - and get back to him.

We never did get to discuss the issue, but I did spend quite a few hours reading Mannatech's literature and writing a report on their "proof".

http://mannatechscience.org/home/publications

So now I have this piece, and no-one to share it with.  Except for the internet.

Maybe he reads my blog.

Maybe no-one in their right mind reads this.

So, well done for making it this far, you.

*playful shoulder punch*

Titled as "Love Punch 3". Wow. Such flirtation.

So here is a short (and perhaps not so sweet) shot at a company that can afford to pay 7 million dollars in fines and still be, well...fine.



First: Levels of evidence:

This diagram represents with how much confidence we can make claims about certain topics.  Not everything in medicine will ever be meta-analysis supported and this is partly due to ethics and practicality.  Anything that wants to make it into medicine has to, first of all, be based on a high level of evidence.

The evidence pyramid  is one of the great scientific wonders of the world.

The role of expert opinion, anecdotes and testimonials:

Firstly – when measured against the above – Mannatech's marketing, based on many testimonials is inappropriate, no matter how tempting it is.

Secondly, anecdotes are easily selected through cherry-picking and are subject to a confirmation bias.

Dr Darryl See, is/was Mannatech's science man.

He has had to surrender his medical license after a deluge of many, many accusations.

So...yeah.

Lastly, even if the internet is flooded with people making claims about Mannatech (or penis enlargement or weight-loss products) we must look beyond testimonials and look for evidence.

Sample sizes, p-values and confidence intervals

So say a study is a randomized controlled trial which has been double blinded.  Great.  But what is the P-value (measure of how likely this outcome was the result of chance), confidence interval (of the P-value), and overall quality of the research? 

Many studies, through their design, introduce biases which make positive results inevitable.  This is why it is very important that investigators share this information in great detail.

Large sample sizes which are representative of the population you want to apply the evidence to must be present in order to ensure that the findings are meaningful.

Patents are not evidence

A patent on any substance does not prove efficacy.  There are hundreds of thousands of patents on things which don’t work.

Trademarks and Registration are not evidence

The fact that Smarties™ is a trademarked, does not allow Nestle™ to make the claim that eating Smarties™ will make you smarter.

Citing inappropriate research

Research must directly support the claim that is being made, preferably in as similar a setting as possible.  If a claim is made about something for a certain condition – I must have the best available evidence at hand, done in as similar a population as possible for the same indication.

For example – if I want to prescribe a drug to reduce post-operative nausea and vomiting in children after anaesthesia for tonsillectomies, I need evidence gathered in as similar a setting as possible.

So if I want to claim that a drug works for people with MS, SLE, ischaemic heart disease, etc, I need to have evidence (high up on the diagram above), with a large sample size (determined statistically), and done in a population similar to the one I want to apply my results to.

With that in mind, let’s discuss the articles cited as proof for Mannatech.  The same articles were listed multiple times.  All of them were inappropriate.  

Virtually all of them are either completely unrelated for the claims being made, suffer from major methodological flaws, such as small sample sizes or lack of controls, or do not support the notion that supplementation offers a significant benefit:

BounceBack™ capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study

·    The fact that it is randomized, double-blind and placebo controlled sounds impressive, but it is unimportant.

·    Study only contained 10 participants.  The confidence intervals (which were not given) would most likely make the P-values meaningless

Brain-Specific Effects of Ambrotose® Products: A Preliminary Animal Study to Investigate Cognitive Benefits Found in Humans

·    Looks like a Meta-analysis, but is a collection of studies on healthy people, (each with its own major limitations (small sample sizes, lack of third-party involvement) and, most importantly, the use of healthy subjects precludes any possibility of generalizing to a diseased population.

·    The study itself is done on mice.  No health claims can be made from this.

Human Colonic Bacteria Can Utilize Stabilized Aloe Vera Gel Polysaccharides and a Mixed Saccharide-Based Glyconutritional Dietary Supplement, Advanced Ambrotose

·    This study doesn’t show anything.

·    It shows that a bacteria can metabolize a polysaccharide.  Anyone could show the same with a petri dish, their own stool, and some agar gel.

Effect of a combination dietary supplement product (BounceBack^TM) on the signs and symptoms of delayed onset

muscle soreness after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study

·    This study is the same one as the first one.

·    Only ten people participated.

·    The results (which would only be applicable to post exercise muscle soreness) are meaningless.

Effects of a Glyconutritional Supplement on Brain Potentials Associated with Language Processing

·    This study’s results are reported as “not statistically significant”. 

·    If you were to make generalizations from its findings, (which you shouldn’t), it would only be useful in refuting claims that Ambrotose works at all.

·    The most concerning is that this poster is happily cited as proof in the second article.

Immunomodulatory dietary polysaccharides: a systematic review of the literature

·     Nothing to do with Mannatech

·    Literally every English study ever  conducted on polysaccharides and the immune system.

·    Applicability:

o    “Taken as a whole, the oral polysaccharide literature is highly heterogenous and is not sufficient to support broad produce structure/function generalizations.”

Chemical characterization of polysaccharide-rich ingredients from Aloe vera, Larix laricina, Larix occidentalis, and Undaria pinnatifid

·    Nothing to do with Mannatech

·          Just a description of polysaccharides in terms of molecular weights and sugar contents.

Immunomodulatory activity of polysaccharides isolated from Clerodendrum splendens: Beneficial effects in experimental autoimmune encephalomyelitis

·    This study was conducted on a special type of mutant mice.

·     No generalizations can be made unless you are treating these mutant mice.

Intestinal microbiota’s naturally occurring enzymes and their  effects on plant polysaccharide digestion

·     This poster only showed that certain bacteria can digest polysaccharides.

A sensitive in vitro method for evaluation of immunostimulatory properties of natural products

·     This poster does not provide any proof for Mannatech at all and merely describes chemical analysis method and the effects of these chemicals when added to petri dishes of cells.

The Effect of Dietary Supplements on the Quality of Life of Retired Professional Football Players

·          Sample size was fifteen

·          Many, many different substances were used.

·          Self-reporting was the measurement.

·          No evidence for Mannatech’s efficacy.

An open-label dosing study to evaluate the safety and effects of a dietary plant-derived polysaccharide supplement on the N-glycosylation status of serum glycoproteins in healthy subjects

·          Sample size was 18

·          No confidence intervals given.

·          Limited information on samples.

·          Not clear how this relates to Mannatech products.

Effect of Ambrotose AO^® on resting and exercise-induced antioxidant capacity and oxidative stress in healthy adults

·     Sample size is 25.

·     “No statistically detected difference is observed in resting or exercise-induced oxidative stress biomarkers, in quality of life, or in GXT time to exhaustion.”

·     Study shows no statistically significant change.

Best, T. Bryan J, Burns N. An investigation of saccharide effects on memory performance. Abstracts of the 12th Annual Australian Psychiatry Conference, 2005.

·     “There were no statistically significant effects of the treatments on  the performance on any of the outcome measures”

The influence of a pre-exercise sports drink (PRX) on factors related to maximal aerobic performance

·     Sample size is 29

·     No confidence intervals given

·     Not generalizable

The Effectiveness of a Pre-Exercise Performance  Drink (PRX) on Indices of Maximal  Cardiorespiratory Fitness

·    Sample of 24

      Water might not be an appropriate placebo in this case.

·          The finding of increased cardiorespiratory fitness measurements after ingesting an energy drink is bizarre.

The effects of whey protein on cardiometabolic risk factors

·    This is an actual study on whey protein.  Which appears to be scientific.

·    It has nothing to do with Mannatech and was conducted by an independent research group.

Conclusion

Mannatech’s own website offers no evidence for their own products or any claims regarding their products’ efficacy.  

They just think that you are too stupid to read that which they have given you.