When a magazine ad or a disembodied voice on a TV commercial tells us that product X can eliminate wrinkles or help us to lose weight while we sleep, we tend to take these claims with a grain of salt. But if a friend or a neighbor talks enthusiastically about a product, recommends it to us and tells us personal stories of its effectiveness, we are much less inclined to be skeptical. Such is the principle behind network marketing, a highly effective sales technique that makes use of personal recommendation not only to sell products but also to recruit new sales associates.
This week I begin a two-part discussion in my occasional Friendly Skeptic series, looking at a group of products sold by Mannatech, Inc., a network marketing giant. My goal, as a Friendly Skeptic, is not to prejudge or to disparage unfairly, but simply to determine whether or not there is a solid scientific basis for the claims made on behalf of these products.
I take the same strictly objective, evidence-based approach in the 200 Moss Reports, each one of which is an in-depth study of the available conventional and alternative treatments for a particular type of cancer. My aim in writing these reports is to present an impartial and clear-eyed analysis of the most promising treatment options. People dealing with cancer need a reliable source of up-to-date information, a source they can count on to be honest and even-handed in assessing the many conflicting claims that assail them. The Moss Reports are designed to do just that.
If you would like to order a Moss Report for yourself or someone you love, you can do so from our website, www.cancerdecisions.com, or by calling Diane at 1-800-980-1234 (814-238-3367 from outside the US).
We look forward to helping you.
Recently a client asked my opinion of Ambrotose®. She had advanced cancer and her doctors held out little hope. Her medical history had been a succession of failures. After being told that her condition was essentially untreatable, she found details of a promising clinical trial on the Internet. She tried to enroll, but at the last minute was rejected because of the trial's rigid exclusion criteria. (It turned out that her 9-millimeter diameter tumor was one millimeter too small to permit her inclusion in the study.)
She became increasingly frustrated with the medical profession, perhaps understandably transferring onto her doctors some of the anger she felt at this cruel disease. She then turned towards alternative medicine. In particular, a neighbor sold her on a substance called Ambrotose.
What exactly is Ambrotose, and does it have any role in the treatment of cancer?
Ambrotose is the brand name for a mixture containing certain plant sugars called glyconutrients. It is widely promoted for its health-giving properties. Ambrotose is produced and marketed by Mannatech, Inc., a publicly traded company based in Coppell, Texas, which does about US $190 million per year in business (2003) and has grossed more than US $1.5 billion since its start in 1994. Its various nutritional products - there are now about thirty - are sold through what the company calls a global network-marketing program.
In this sort of multi-level sales structure, independent entrepreneurs become associated with the parent company as private contractors. They themselves receive a discount for shopping within the network, for selling products, and for expanding their network of people (the so-called "downline") who are doing the same thing. Those who sign up receive a percentage of the profits that are generated by the network of all other entrepreneurs who are introduced to the system by him or her, and also of the profits generated by the people introduced by those entrepreneurs, and so on.
In practice, this means that the sales pitch you hear tends to come from someone you know personally, who not only uses and sells the stuff, but has a strong incentive to recruit you to become a "downline" salesperson of the same products. I have had people in my own extended family try to convince me of the virtues of Mannatech's products. Only later did I realize this was not a disinterested excursion into medical science but part of a well rehearsed sales pitch. It is hard to resist this sort of pressure when it is a friend, neighbor or relative who comes a-calling. This helps account for the remarkable growth not just of Mannatech but of this network marketing phenomenon. The network marketing of health products (including other huge sellers such as noni and mangosteen juices) appeals to two of the most fundamental human desires, the simultaneous quest for health and wealth.
Mannatech began its meteoric rise in the world of network marketing with the development of a proprietary substance called Manapol®. The company offers a scientific rationale for the use of this product, claiming that various sugars - technically, monosaccharides and polysaccharides - provide specific sugars to the body that help support the immune system and facilitate cell-to-cell communication. In 1996, the company introduced its Ambrotose Complex®, a blend of Manapol and additional glyconutrients.
Describing Ambrotose, the company's website states the following:
"Ambrotose is a glyconutritional, a blend of specific plant saccharides that provides support for the immune system. These saccharides are necessary for the body's creation of glycoforms, the structures on cell surfaces used to 'talk' to other cells."
Ambrotose later evolved into Ambrotose Complex®, which, according to the company, is a mixture of Arabinogalactan (a gum from the Larix decidua tree), Manapol, which is a gel extracted from the inner leaf of aloe vera gel plant, gum ghatti, and gum tragacanth. Advanced Ambrotose in turn is said to contain gum acacia, aloe vera gel extract (inner leaf gel) or Manapol powder, oat fiber, brown macroalgae (Undaria pinnatifida) sporophyll, vegetarian glucosamine-HCl, ghatti gum, gum tragacanth and xylitol. The price of Advanced Ambrotose is between $69 and $76 for 75 grams in bulk, almost one dollar per gram or $28 per ounce.
In 2001, the company further broadened its line of proprietary ingredients by developing Ambroglycin®, which it describes as a balanced food-mineral matrix that helps deliver certain nutrients to the body. Additionally, in 2004 Mannatech developed a proprietary blend of antioxidant nutrients, called MTech AO Blend, which is used in its proprietary antioxidant product Ambrotose AO®. (AO stands for antioxidants.)
Don't be surprised if you have difficulty keeping all this new and registered or trademarked terminology in mind. It is dizzyingly complicated. As far as I can gather almost all of the company's products contain Ambrotose, which in turn contains Manapol. An earlier key ingredient was Acemanan. Then there's Ambroglycin.
I do not mean to disparage or diminish the totally respectable field of glycobiology or the potential use of polysaccharides in cancer. There is for instance the work of Prof. Hans-Joachim Gabius of the Ludwigs-Maximilians University of Munich and his coworkers. They have done pioneering research in glycobiology, investigating cell-agglutinating proteins known as lectins and the role they play in tumor formation.
Another very important area in glycobiology concerns the investigation of polysaccharides in mushrooms such as maitake, shiitake and reishi. This kind of research deserves the most serious consideration. So too do the lipopolysaccharides (LPS) that are associated with the cancer treatment known as Coley's toxins (mixed bacterial vaccine). But this is a very far cry from the claims sometimes made by proponents of Mannatech's products concerning the efficacy of orally administered sugars, such as are found in Ambrotose or related products.
Glycobiology is a promising avenue of research, to be sure. However, network marketing creates a rah-rah atmosphere, in which a chemical becomes a product and a product then becomes a profit center…and an ideological cause.
There have been reports in the media that glyconutrients have been sold with an implicit claim that they have benefit in the management of existing cancers. What is the scientific basis of such claims? I experienced a disconnect when I tried to track down the hard science behind such claims. Here for instance are the numbers of Google search engine 'hits' for various Mannatech products or their components compared to the number of citations in the standard 15-million entry US medical database, PubMed.
|Product||Google Hits||PubMed||PubMed + Cancer|
PubMed + Cancer refers to peer-reviewed article delimited by the further search term 'cancer'
For Ambrotose in particular, we see an enormous popularity in publications by and for lay people but nothing listed in the standard medical literature to substantiate claims of health benefits, at least not under this particular brand name. To put it mildly, this isn't very reassuring.
I also searched for arabinogalactan, a prime ingredient in Ambrotose. This is a sugar derived from the wood of the Larix, or larch, tree. Larch arabinogalactan is in fact approved by the Food and Drug Administration (FDA) as a source of dietary fiber. I had more success with this search. There were nearly 600 references to this topic in PubMed. But when I limited my search to articles investigating arabinogalactan in relation to cancer, there were only 17, mostly cell line studies.
According to PDRhealth.com, arabinogalactans mainly occur in the Western larch. It is not one substance but in fact a mixture of several different arabinogalactans with widely varying molecular weights. Arabinogalactans are water-soluble polysaccharides widely found in plants, fungi and bacteria. They may be involved in intercellular signal transduction pathways in plants.
Dietary sources of arabinogalactans are found in carrots, radishes, tomatoes, pears and wheat, among other plant foods. So whether we realized it or not, we all probably had some today. Gum arabic, a commonly used food additive, is also composed of highly branched arabinogalactans (from which the substance derives its name). Arabinogalactans are also found in herbs such as Echinacea and edible mushrooms such as Ganoderma lucidum (reishi) and may contribute to their possible immune-enhancing ability. But does this mean that Mannatech's products, taken orally, would be good for cancer patients?
I can find no hard evidence for this at all. While there is some indication that products derived from aloe, polysaccharides in particular, may possibly have a role in cancer treatment, the substantiation of such an effect is weak at best, and I can find no evidence whatever in standard sources that would point to the superiority of Mannatech's products. What's more, they seem quite expensive compared to other sources of monosaccharide sugars, such as generic aloe or plant gums.
According to a press release from a non-profit trade organization, the International Aloe Science Council, Inc.:
"To assert, as several writers have done - seemingly with information obtained from the developers of Manapol™ - that aloe-based products not containing Manapol cannot offer the benefits associated with aloe vera - seems little more than product ballyhoo..."
The main danger I believe is that patients will not only lose money but will also lose precious time. Cancer is a complex disease. It requires professional help. Regardless of the sometimes uncaring attitude of certain errant members of the medical profession, one should not reject everything that conventional medicine has to offer in favor of a regimen discovered on the Internet. The answer is not simply to construct a do-it-yourself program, but to find expert and sympathetic guidance in the rapidly expanding realm of complementary oncology.