Another kind of coffee pyramid scheme. Largest pyramid of coffee cups from the India Book of Records.

Another kind of coffee pyramid scheme. Largest pyramid of coffee cups from the India Book of Records.

When my husband was helping a friend with a project at the house of someone he didn’t know, the lady of the house gave him an earful about the health benefits of the coffee sold by Healthy Habits Global (HHG), a multilevel marketing (MLM) enterprise for which she is a distributor. She sent him home with samples and a brochure with a long list of health claims. She told him she could provide lots of testimonials, and there was a wealth of evidence for her products on PubMed.

Before believing any health claims, especially from an unknown source, it is only prudent to examine the evidence. I consulted the company website, PubMed, and other sources; and I learned that the company’s advertising was full of false information and the whole rationale of the products was questionable. I am not persuaded that HHG coffee has any health benefits. It appears to be just another in a long line of gimmicks used by MLM businesses to sell untested, usually ineffective “health” products to gullible consumers who have little knowledge of science.

What is it?

It’s a whole line of beverages provided as single-serving packets of powder to be mixed with water: coffee, tea, hot chocolate, and energy drinks. The products contain TAGG, a combination of tongkat ali (Eurycoma longifolia, a flowering plant found in East Asia), Panax ginseng, and reishi mushroom (Ganoderma lucidum). How much of each? The amount is not disclosed on the website, and the distributor didn’t know, but she was able to get the information for me from her corporate office:

Energy drink

  • Ganoderma 30 mg

 
Coffee, tea, and cocoa

  • Ganoderma 24 mg
  • Tongkat ali 12 mg
  • Ginseng 12 mg

The rationale

The idea is to change everyday unhealthy habits such as drinking coffee, hot cocoa, tea, and energy drinks into healthy habits by enriching those beverages with beneficial nutrients. The underlying assumption is wrongheaded: drinking coffee in moderation is not an unhealthy habit. In fact, there are numerous documented health benefits of plain old coffee. Can those health benefits be augmented by the diet supplements added by HHG?

The claims

A video on the website starts by comparing HHG coffee to orange juice. They say HHG coffee contains 154 anti-oxidants and 200 phytonutrients vs. 8 and 4 in orange juice. (With 354 components, we can assume there must not be clinically effective amounts of all of them, perhaps not of any of them; and orange juice contains other important nutrients like vitamin C, so it’s not a fair comparison.)

Because the coffee is enriched with TAGG (tongkat ali, ginseng and ganoderma extracts), it “promotes the body’s ability to function in an optimal state in a single serving.” Here are the specific benefits they claim for the three components:

Ganoderma (reishi mushroom)

  • Used in China and Japan for 4,000 years
  • Provides more energy and vigor
  • Boosts immune system
  • Reduces cholesterol
  • Reduces blood pressure
  • Promotes sexual stamina
  • Helps regulate blood sugar
  • 5 amazing components:
  • Helps prevent degenerative diseases
  • Regulates digestive health
  • Helps prevent antigen-related allergies (aren’t all true allergies antigen-related?)
  • Helps regulate your whole body’s electrical system.
  • Contains 154 antioxidants, 200+ phytonutrients, is anti-bacterial, anti-viral, and anti-candida.

They say it is “The most studied herb on the face of the planet.” They invite you to see for yourself on PubMed, and they provide this handy link to a PubMed search that produced 634 hits, many of which are irrelevant, preclinical, uncontrolled, or poor-quality studies. Some of those hits are actually evidence for harm, not benefit, such as a recent case report of reishi ingestion being mistaken for a persistent parasitic infection. In fact, the very first study listed is a Cochrane systematic review that directly refutes some of the company’s claims. It found no evidence that ganoderma improves blood pressure, blood sugar, or cholesterol levels. And the typical doses used in the studies were between 1.4 and 3 grams daily. That’s 1,400 and 3,000 mg, compared to the 24-30 mg in HHG products.

Panax ginseng
They provide a long list of alleged effects including benefits for chronic fatigue syndrome and erectile [sic] dysfunction. Ginseng studies supporting those claims are largely in vitro or animal studies with only a few small, poor-quality studies in humans. For erectile dysfunction there have been a total of six randomized controlled studies (RCTs) in humans; four showed benefit and two didn’t. In the ones that showed benefit, the dosage ranged from 600 mg to 1,000 mg taken three times a day. Compare that to the 12 mg of ginseng in HHG products.

Tongkat ali
They say this triggers the body’s ability to produce testosterone, combating “the negative health risk revolved around Low Testosterone in both men and women.” The same webpage lists 10 benefits including “burns fat” and increases libido. They don’t provide any links to studies, and most of the claims seem to be for therapeutic doses of testosterone rather than for tongkat ali. They don’t say how much more testosterone is produced by the body with the amount of tongkat ali in their coffee, so any claims based on the benefits of testosterone are irrelevant. And the RCTs of tongkat ali that showed positive results in humans used doses on the order of 200-300 mg compared to the 12 mg in HHG products.

Arguments for the superiority of their products

They supply endorsements from the media and cite their high-quality production standards. (Neither of these can be taken as evidence that the products are effective).

They claim that regular coffee:

  • Is acidic. (Actually, coffee is relatively low in acid, lower than any fruit juice and no higher than carbonated water.)
  • Dehydrates you. (No it doesn’t; this is only a popular myth.)
  • Raises blood pressure. (Not in regular coffee drinkers).
  • Can give you caffeine jitters and coffee crash. (Only if you overdo it).
  • It takes 17 cups of water to neutralize the negative effects of one cup of coffee. (This is apparently taken from pseudoscientific websites that say coffee lowers body pH and it takes 17 cups of alkaline or ionized water to restore normal pH. This is completely false. Coffee doesn’t lower pH, and the body’s homeostatic mechanisms maintain the same narrow range of pH regardless of your intake of acidic or alkalinized liquids.)

In contrast, they claim that their coffee:

  • Hydrates. (Of course it does, because you prepare it with water!)
  • Balances your body’s pH levels. (Nonsense! See above.)
  • Naturally detoxifies. (Detoxification is a pseudoscientific alternative medicine buzzword).
  • Strengthens and boosts your immune system. (“boosting the immune system” is a common CAM claim that is meaningless, and anyway stimulating the immune system would be a big mistake for patients whose immune systems are already over-active enough to have caused immune-mediated diseases like arthritis and allergies.)
  • Improves energy and stamina with no jitters or caffeine crash. (Really? Where’s the evidence?)
  • Oxygenates the body. (Really? How? How do they know this?)
  • Improves blood circulation. (Really?)
  • Improves sleep quality. (Maybe if you have been drinking too much caffeine and switch to a product lower in caffeine, you will sleep better…)

They say their (unspecified) competitor’s coffee has mediocre taste and aroma (but how does the taste and aroma compare to brewed coffee?). And they say the competitor’s coffee is more expensive. HHG is as low as 80 cents per cup (cheap if it offers real health benefits, but expensive if all it offers is false hopes and the chance of a placebo response).

Aluminum?

Compared to the competitor’s coffee, HHG says its products contain four times the ganoderma, but they don’t tell you that still isn’t enough to produce any health effects. And they say there is no aluminum in the non-dairy creamer HHG puts in some of its products. They say, “Aluminum may cause Alzheimer’s or other diseases.” They cite a CDC website to support that claim, but that website actually says pretty much the exact opposite, even for large occupational exposures:

Three studies have examined the possible association between occupational exposure to aluminum and the risk of Alzheimer’s disease. Two case-control studies did not find a significant association between occupational exposure to aluminum dust or fumes and the risk of Alzheimer’s disease (Graves et al. 1998; Salib and Hillier 1996). Another study of former aluminum dust-exposed workers (retired for at least 10 years) found some impairment in some tests of cognitive function; the investigators raised the possibility that cognitive impairment may be a pre-clinical indicator of Alzheimer’s disease (Polizzi et al. 2002)…The possible association between aluminum and Alzheimer’s disease was proposed over 40 years ago; however, the evidence that aluminum may or may not be a risk factor is inconsistent and inconclusive…In conclusion, the available data suggest that aluminum is not likely the causative agent in the development of Alzheimer’s disease [emphasis added].

Incidentally, that same source says that aluminum levels in tea are 10-50 times higher than the typical levels found in drinking water, so if they are so concerned about aluminum, why are they selling tea?

Do you want antioxidants?

Coffee is the number one source of antioxidants in the American diet. Green coffee beans contain 1,000 antioxidants and brewing adds another 300. So the additional 154 antioxidants in ganoderma represent only a 12% increase over the number antioxidants already in coffee. Would you expect 1,454 antioxidants (in trace amounts) to be significantly better than 1,300 antioxidants?

Anyway, there is growing evidence that more antioxidants may not mean better health and in some cases may actually be harmful.

Beyond PubMed

I consider the Natural Medicines Comprehensive Database (NMCD) to be the most reliable source of information about natural medicines. It is compiled by an unbiased group of experts in various fields who have combed PubMed, herbal medicine texts, and other sources and have summarized all available evidence about the remedies. They rate natural remedies for safety and effectiveness. They rate all three of the TAGG ingredients as only “possibly” safe, below their ratings of “safe” and “likely safe.” Here’s what they have to say about their effectiveness, side effects, interactions, and precautions:

Tongkat ali

  • Possibly effective for male infertility. Insufficient evidence to rate it for other uses.
  • Avoid in pregnancy and lactation.
  • Drug interaction with propranolol (a prescription drug that is widely used for heart disease, blood pressure, migraine prevention, and other indications): reduces propranolol levels by 29%.
  • There are concerns about contamination with heavy metals.
  • The plant is a protected species

Ganoderma

  • Insufficient evidence to rate effectiveness for any use.
  • Adverse reactions have included stomach upset, nosebleeds, and bloody stools.
  • Numerous interactions with herbs, supplements, and drugs.
  • May increase risk of bleeding in some patients, should be discontinued two weeks before surgery.

Panax ginseng

  • Possibly safe when used for up to 6 months, possibly unsafe with longer use. Likely unsafe in infants, possibly unsafe in pregnancy: has teratogenic effects in animal models.
  • “Possibly effective” (less than their rating of “probably effective”) in Alzheimer’s disease, COPD, cognitive function, erectile dysfunction, HBP, premature ejaculation, sexual arousal.
  • Most common side effect is insomnia; many other reported side effects including vaginal bleeding, HBP, diarrhea, fever, vertigo, euphoria, and mania.
  • Multiple interactions with herbs, supplements, alcohol, and a long list of drugs including caffeine, insulin, anticoagulants, immune suppressants, estrogens, antidepressants, heart drugs, and many others.
  • Might exacerbate autoimmune diseases.
  • Decreases blood coagulation.
  • Contraindicated for women with hormone sensitive conditions including uterine fibroids, endometriosis, and breast cancer.
  • Might increase the risk of hypoglycemia in diabetics.
  • Should be used with caution in patients with cardiovascular disease.
  • Typical dosage for erectile dysfunction: 900mg taken 3 times daily.

Conclusion

The rationale for adding these supplements to coffee is far from clear. This specific combination and dosage of ingredients has not been shown clinically effective; in fact, it has never been tested. If you are convinced by some of the favorable studies in PubMed and decide to take ginseng, ganoderma, or tongkat ali to get a possible health benefit, it would make a lot more sense to take the amount that had been shown in those studies to provide that benefit, not a minuscule amount that is entire orders of magnitude smaller. These substances have potential harms, and it is doubtful whether distributors know about them. Do they warn their customers to stop using HHG beverages if they might be pregnant or if they have uterine fibroids? Do they warn customers to stop using the products two weeks before surgery? I doubt it.

There is no good evidence that adding TAGG to coffee will make it any healthier. You could arguably make coffee healthier by adding red rice yeast containing therapeutic amounts of natural statin drugs known to be effective, but I can’t imagine anyone would want to do that. Admittedly, the TAGG additives have fewer adverse effects than statins, but they are not entirely innocuous. Although in this case they are present in such small amounts that we needn’t worry.

The claims for HHG products range from the unsubstantiated through the misleading to the demonstrably false. Both the customers and the lower-level distributors are being duped by those at the top of the MLM pyramid who are the only ones likely to make money. They hype the income opportunities and even offer a luxury car club bonus, but the sad fact is that 99% of MLM distributors end up not only not making a profit but losing money. The mission statement of the company is all about creating income opportunities, not about improving the health of their customers. Caveat emptor.

 

 

Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.