The doctor and broadcaster Xand van Tulleken launched his latest book Make Me Well: A quest to Understand the Confusing World of Wellness this week with a blaze of media interviews.

The book is pitched as a personal investigation into the wellness industry from the perspective of someone who has taken – and recommended – a wide range of supplements and devices, and not, its author insists, “a grumpy doctor who thinks these things are all bad”.

But very quickly van Tulleken is on the offensive about an industry he accuses of “exploiting people’s vulnerabilities”, making “extravagant claims” about products – and of being inadequately regulated. The book is likely to be received by industry as a sustained attack on its integrity and values.

While Make Me Well investigates the wider wellness industry – including technologies such as wearables, trackers and the fast-growing health testing sector – most of the media headlines to date pick up on its author’s comprehensive repudiation of the case for preventative and protective supplementation.

While acknowledging the importance of vitamin and mineral supplements in addressing deficiencies, van Tulleken reiterated in interviews with Good Morning Britain, The One Show and The Times the book’s claim that “(the best) data say that vitamins and mineral supplements don’t help healthy people”.

‘Extravagant claims’
Van Tullken accuses the wellness industry of consistently being “ahead of the science” and of “extrapolating extravagant claims before proper trials can be done to establish whether there are any benefits”.

He also claims in his book that the supplements industry is under-regulated and that being regulated under Food Safety Law, as apposed Medicines Regulations, confers substantial benefits. While supplement firms are only able to make very limited health claims for their products, Van Tulleken suggests “this vagueness is as much as protection as a restriction”. He adds: “Supplement companies benefit from a strange but rather effective ambiguity that offers them a near-perfect market position.

“Consumers arrive already loaded with hopes and expectations, shaped by thousands of podcasts and influencers and newspaper articles willing to adopt the supplement industry’s talking points. The industry does not need to take legal responsibility for these claims because they have not technically made them.”

Call for further limits on claims
Van Tullken says he wants to see further restrictions made on the supplement industry’s ability to make health claims. “I don’t think health claims should be used to sell any product without it passing a very high standard of evidence. The current gap between what the rules forbid and what product branding communicates is what allows the industry to thrive. A product called ‘Immune Defence’ doesn’t make a health claim. It doesn’t actually say explicitly that it will improve your immune system’s ability to defend you against infection. But consumers pick up on it and think it’s going to do something. ‘Gut health’ printed on a yoghurt is not a claim in the regulatory sense, but the message is clear when you’re standing in the dairy aisle. The marketers are expert in using visual language – heart symbols, images of glowing skin, or pictures of people sprinting up mountains. None of these are health claims, but all of them are intended to make you believe their potential to improve your health that the evidence does not support”.

Van Tullken suggests the popularity of supplements may be because “we have a cultural, and perhaps an innate, predisposition towards adding things to our diet”. He posits that humans may have an “instinct to supplement” in the same way that other animals have been shown to display (for example, in the way that wild animals adjust their grazing an foraging according to their requirements for minerals and vitamins). This predisposition to supplementing, he says, may contribute to a susceptibility to supplement marketing. He says his ambition for Make Me Well is that it will “inoculate some people against supplementing marketing”.

Health versus wellness
In Make Me Well, van Tulleken says that a “shift in emphasis from health to wellness has profound implications for the way that health policy is made and how we understand our bodies”. He says that the wellness industry emphasises personal responsibility as key to maintaining good health and “the idea that ill health is our fault”. He claims this is misleading because “for almost all of us, the main risks to our health are caused by factors largely out of our control: income inequality, unhealthy food, the environment and air quality”.

Nonetheless, van Tulleken maintains that wellness is an “incredibly important” concept – and goal. He quotes the ideas of the “trustworthy new voices” in wellness. In particular, he highlights of the work of Daisy Fancour, the professor of psychobiology and epidemiology at University College London – and author of the acclaimed book Art Cure – whose research focuses on the powerful effects of social connections and behaviours on health. Van Tulleken says these findings are “optimistic and exciting”. But, he adds, “I would look outwards, not inwards, for your wellness.”

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