Background
Two issues were investigated, both of which were Upheld.
Ad description
An ad in the magazine What Doctors Don't Tell You (WDDTY) for a natural health product was headed "Earthing Nature's Solution to Health". Text in a white box below stated "'Sleep better tonight - sleep Earthed' Earthing Institute Studies show: 100% of people woke feeling rested, 85% of people fell asleep faster, 93% experienced better sleep, 78% experienced better well being, 82% reported reduced muscle stiffness/pain. Sokal study reports benefits in blood sugar regulation, thyroid hormones, osteoporosis metabolics. Sinatra study shows blood thickness reductions and circulation benefits. 'Poor sleep can have a serious knock-on effect on your health'".
Text below, under the heading "How can Earthing help your health and wellbeing?" stated "You can connect to the earth with bare feet-or-with indoor Earthing sheets and mats. The Earth then shares it antioxidant [sic], anti-inflammatory anti aging electrons from its inexhaustible store. The Earth also stores natural rhythms - day/night, and reconnection supports sleep".
Text below, under the heading "Do clinical studies support the claims made for earthing?" stated "Robust studies show significant improvements in sleep, vitality, rebalancing of key hormones (cortisol - the stress hormone, influences thyroid hormone), improvements in circulation and reductions in blood pressure. Extensive case studies on reduction of inflammation (associated with -itis medical condition such as arthr-itis) were accompanied by reduced sensation of pain".
The ad featured pictures of people using the advertised products. Contact details were given at the bottom of the ad with the contact name given as "Dr John Kelsey PhD, ND".
Issue
The Nightingale Collaboration challenged whether:
1. the efficacy claims for the products were misleading and could be substantiated; and
2. the use of the title "Dr" in the name "Dr John Kelsey PhD, ND" was misleading, because they believed that he did not hold a general medical qualification.
Response
1. BEP Technology Ltd t/a Original Earthing (BEP) said their claims were concerned with promoting optimal health rather than treating disease and were therefore non-medical. They said conventional medicine was concerned with the latter and explained that natural resources and elements in the world were exempt from such considerations because they dealt only with optimising health. Notwithstanding that they recognised that statements that implied a benefit to health or wellness required validation and provided studies, articles and case studies in support of the claims.
BEP said the readership of WDDTY were a specific group with a demonstrated interest in health and who were naturally sceptical with a good, discriminatory awareness and who were therefore unlikely to be misled by any claims in the ad.
2. BEP said it was clear to anyone who wished to check on the GMC website that John Kelsey did not have a general medical qualification. They said his PhD was in Process Engineering from Birmingham University and that "ND" denoted that he held a Naturopathic Diploma.
They said the title of "Doctor" was used to refer to those who had a doctoral research qualification, e.g. a PhD. They said the use of "Doctor" to refer to those with medical qualifications was conferred by tradition rather than the law and that BEP were under no obligation to follow such traditions. They pointed out that the statement "Dr John Kelsey" was followed by the statements "PhD, ND" and argued this made clear the basis for the claim "Dr". They said there was no potential to mislead readers as they were not offering a medical service.
Assessment
1. Upheld
The ASA noted that an appendix to one of the studies provided explained that earthing (or sometimes "grounding") was the process of electrically grounding the human body to maintain the body at the natural electrical potential (voltage) of the earth. An example of this would be sleeping on a conductive mattress pad that was connected directly to the ground outside through a cable and a metal stake in the ground. We understood that proponents of earthing believed that it had numerous benefits to health and wellbeing. We considered that any claims for the efficacy of such a treatment would, by their nature, be ground-breaking claims and would require a high level of substantiation, such as a body of scientific research including clinical trials conducted on people, in order to substantiate them.
The ad made a number of claims for earthing and included references to osteoporosis, arthritis and blood pressure. We noted that it also referred to "blood sugar regulation" which we considered was an implied claim that earthing could be helpful in the treatment of diabetes. We also noted that it referred to blood thickness and circulation which we considered was an implied reference to cardio-vascular conditions. We considered those were all medical conditions for which medical supervision should be sought and that advice, diagnosis and treatment for them should only be conducted under the supervision of a suitably qualified health professional. Because we understood that was not the case in this instance, we concluded that those claims breached the Code as they could discourage consumers from seeking essential treatment for those conditions.
In relation to the remaining efficacy claims we assessed the evidence provided by BEP:
We noted the first study investigated whether earthing the human body during sleep would produce quantifiable changes in cortisol and result in changes in sleep, pain and stress. However, we did not consider that cortisol changes were directly relevant to the claims made in the ad and while the 12 subjects had reported improvements in the other factors, we did not consider that self-reporting was a sufficiently robust way in which to measure those factors. We further noted that subjects had acted as their own control and that the study had been conducted without any element of blinding.
We noted the second study supplied by BEP comprised five experiments of which one, which related to earthing and thyroid function, was relevant to the claims in the ad. That study however was only described in several short paragraphs with only minimal references to how the study had been conducted and the relevance of the results was not explained. Notwithstanding that it had been conducted on 12 healthy patients with no clinical symptoms of thyroid problems and we therefore did not consider that the study would be capable of showing that earthing was effective in the treatment of those with thyroid problems.
We noted that BEP had also provided a study in support of the claim that earthing had antioxidant properties. However, we noted that study was essentially an article comprising summary and discussion of research into earthing and did not itself robustly investigate its efficacy. We noted that BEP had also provided a number of individual case studies. However, we did not consider that individual case studies were capable of substantiating claims about a breakthrough therapy in the absence of any wider clinical data which supported its efficacy.
The ASA considers that it has yet to see any evidence for the efficacy of earthing products. These claims remain unproven and, in the absence of robust substantiation in this case we concluded that the claims that earthing products could aid sleep, affect the thyroid and metabolism, reduce muscle stiffness/pain and that it had antioxidant, anti-inflammatory and anti-aging properties, were misleading.
On this point the ad breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
(Misleading advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation),
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
and
12.2
12.2
Marketers must not discourage essential treatment for conditions for which medical supervision should be sought. For example, they must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment is conducted under the supervision of a suitably qualified health professional. Accurate and responsible general information about such conditions may, however, be offered (see rule
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
).
Health professionals will be deemed suitably qualified only if they can provide suitable credentials, for example, evidence of: relevant professional expertise or qualifications; systems for regular review of members' skills and competencies and suitable professional indemnity insurance covering all services provided; accreditation by a professional or regulatory body that has systems for dealing with complaints and taking disciplinary action and has registration based on minimum standards for training and qualifications.
(Medicines, medical devices, health-related products and beauty products).
2. Upheld
We noted BEP's response to the complaint, however, we considered that because the ad made claims about the treatment, its effect on the body and made reference to specific health conditions, consumers were likely to regard the claim "Dr" in a medical context. We understood however that the referenced PhD was in Process Engineering. Because we understood John Kelsey did not hold a general medical qualification we concluded that the use of the claim "Dr" was likely to mislead readers.
On this point the ad breached CAP Code (Edition 12) rules 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising).
Action
The ad must not appear again in its current form. We told BEP not to make efficacy claims for earthing products and to seek guidance from CAP's Copy Advice team before preparing marketing communications in future.
