calcium" is a dietary supplement said to be derived from
"remnants of living coral that have fallen from coral reefs, as
a result of wave action or other natural processes." It is also
said to be mined from the old ocean beds at the base of the
coral reefs in Okinawa, Japan [1:120]. Simply put, "coral
remnants" are limestone, which coral organisms originally
manufacture as a protective shell. Since coral reefs are
protected by law, "coral calcium" is made by grinding up
limestone that no longer contains live organisms.
Limestone has no unique health properties. It is merely calcium
carbonate, with some magnesium and trace amounts of many other
minerals. Limestone fertilizer, available at garden centers,
costs as little as a dollar for an 80-pound bag. For people who
need to consume extra calcium, purified calcium carbonate pills
are safer and far less expensive than "coral calcium." But
Robert R. Barefoot, of Wickenberg, Arizona, would like you to
believe that limestone obtained from Okinawa provides "the
scientific secret of health and youth" and can cure cancer. His
ideas are promoted through books, lectures, his Web site, an
audiotape, a 30-minute infomercial , interviews, and
thousands of Web sites that sell "coral calcium" products.
Although his sales pitch is preposterous, he has gained a wide
audience. During the past two years, all nutritional suppliers
have been flooded with inquiries stimulated by his infomercial.
His book, The Calcium Factor , first published in 1992, has
undergone five editions and on January 31, 2003 enjoyed an
Amazon Books sales rank of #412, which is extremely high. On the
same day, his Death By Diet , originally published in 1996
and now in its fourth edition, was ranked #1790; and his other
book, Barefoot on Coral Calcium , was ranked #8114. Searching
Google for "Robert Barefoot" yielded more than 31,000 hits, and
searching for "coral calcium found more than 80,000! In January
and February, Barefoot's infomercial was among the most
frequently shown infomercials and was the most frequent one
connected with a dietary supplement. Barefoot's Cure America Web
site lists his email address as email@example.com,
which, considering his probable sales volume, is probably an apt
Here is a
sampling of Barefoot's claims followed by critical comments.
Except as noted, all are from his infomercial.
degenerative diseases caused by calcium deficiency. That
includes cancer, heart disease, diabetes, Alzheimer's, you name
it. These diseases are caused by acidosis -- acidification of
the body -- lack of minerals, especially calcium. When you start
taking coral calcium, your body alkalizes and drives out the
of these statements are incorrect. Calcium deficiency can weaken
bones (osteoporosis), but it does not make the body more acidic
or cause a wide range of diseases. The idea that calcium
supplements (or dietary strategies) can change the acidity of
the body is nonsense. The only acid level that diet or
supplements can modify is the degree of acidity (pH) of the
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seven major cultures in the world that never, ever, ever get
sick. They never get cancer, they never get heart disease, they
never get diabetes. They have no doctors. These people live 30,
40 years longer, and they don't grow old. What's the common
denominator? One hundred times the RDA of everything. So they're
taking 100 times the RDA. They take so much, they get all they
need and the body passes what it doesn't need."
This statement is preposterous. There is no culture in which
nobody gets sick. And nobody ingests 100 times the Recommended
Dietary Allowances of everything. That amount of iron, for
example, would probably be fatal within a few days.
"The body can
cure itself of all disease if given the nutrients it needs."
[1:142]. Ninety percent of the disease in America can be wiped
out if people get on appropriate nutrients."
Not true. Although nutritional strategies can help prevent and
manage many diseases (most notably cardiovascular diseases),
there exist many diseases never shown to be related to nutrient
percent of people over age 60 are "totally calcium-deficient."
That's why we have all this trouble with heart disease, lupus,
and Parkinson's disease.
Barefoot doesn't say what "totally deficient" means or where he
gets this figure. However, U.S. government surveys indicate that
at least half the people in this age group are getting at least
900 mg per day, which would hardly make them "totally
On the other
hand, 97% of the population is known to be magnesium deficient,
and excess calcium consumption is sure to make this deficiency
even worse! Magneisum deficinecy leads to constipation, heart
irregularities, msucle cramps and at least 40 other serious
relevance to high blood pressure may play a small role in the
incidence of heart disease, but lupus and Parkinson's disease
are not caused by calcium deficiency. Keep in mind that low
calcium intake has very little impact on calcium blood levels.
Most of the body's calcium is stored in the bones, which can
release whatever amounts are needed to maintain adequate blood
levels. Over a period of many years, this can produce
osteoporosis, but it has little or no effect on other disease
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pH level of the saliva is the most reliable test of calcium
deficiency and can also tell the state of a person's health."
Testing saliva has no practical value in evaluating general
health. The level is usually similar to blood pH, which the body
keeps within a narrow range. When the saliva flow is high, the
pH is usually about 7.4 (7 is neutral, low numbers are acid, and
higher numbers are alkaline). Calcium intake does not affect the
pH of saliva. The most common cause of low (acid) salivary pH is
the presence in the mouth of bacteria that cause cavities. In
diseases (such as diabetic acidosis) in which blood pH is
dangerously low, the level is determined by blood pH testing and
calcium pills have no relevance to treatment.
should not be concerned about their cholesterol levels because
abnormal levels are not the cause of heart disease. The real
problem is calcium deficiency. Cholesterol problems will correct
themselves if your minerals are balanced. (In another TV
interview, Barefoot even states "Everyone blames cholesterol,
but it absolutely has nothing to do with heart disease."
true. While there are no scientific studies that establish a
relationship between abnormal cholesterol levels and calcium
deficiency and Barefoot cites no evidence that supports what he
says, there is ample research data (Harvard's prestigious
Framingham Heart Study) to show elevated homocysteine levels,
reversible by adequate B Vitamin intake, is the most critical
predictor of cardiovascular disease and Alzheimer's as well..
important things people can do to be healthier, live longer, and
disease-free are to take coral calcium and get a minimum of two
hours of sunlight on their face every day-- without sunscreen."
Barefoot presents no data to back either of these claims. Even
worse, two hours a day of unprotected sun exposure --
particularly in warm climates -- could place the person at high
risk of getting skin cancer.
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quoted in the Journal of the American Medical Association say
that calcium can prevent and reverse colon cancer."
Barefoot doesn't cite the article, but a search of the journal
site for "calcium" and "colon cancer" found that in 1998,
researchers at the Strang Cancer Prevention Center and another
prominent medical institution reported that increasing the daily
intake of calcium by up to 1,200 mg via low-fat dairy food in
subjects at risk for colonic cancer reduced growth
characteristics thought to be associated with the development of
cancer . The study indicates that increased attention to
calcium may find a role in cancer prevention, but the study had
nothing to do with either calcium supplements or the "reversal"
of an established cancer.
claims to have seen "millions of testimonials, had a thousand
people tell him how they cured their cancer, and witnessed
people with multiple sclerosis "get out of wheelchairs just by
getting on the coral."
doesn't say how he could possibly have received and read
millions of testimonials, investigated a thousand cases of
alleged cancer cures, or determined that patients with multiple
sclerosis were actually helped by coral calcium. Proper
evaluation of claimed cancer cures would require (a) checking
whether the patient had a biopsy, (b) checking whether or not
the patient had standard treatment, (c) checking whether the
patient was actually cancer-free, (d) following the patient's
course for several years, (e) and compiling detailed statistics.
Do you think that Barefoot has done any of these things? The
Calcium Factor contains seven brief testimonials from cancer
patients, but none contains enough detail either to identify any
of the people or to evaluate what they report. Multiple
sclerosis testimonials are even more difficult to verify because
the disease normally has ups and downs. Controlled studies are
needed to determine whether a method is effective.
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in which people live very long, all the people consume 100,000
milligrams of calcium."
would be enough to cause kidney stones, calcium deposits
throughout the body, and death within a short period of time
. The Institute of Medicine recommends taking no more than
2,500 milligrams a day . Taking twice that amount would be
risky . Taking 40 times that amount would be insane. And
unless the calcium intake is balanced 2to1 by magnesium in a
bioavailable form, you are heading for heart stoppage.
Factor contains hundreds of scientific references that back up
what it says. "
Comment: If it does, they are well hidden. There are fewer than
100 citations to be found, many of which were to magazine
articles and quacky books. The normal way to report journal
references is to list the author, journal, volume, page numbers,
and year of publication. Despite looking carefully, only a few
are to be found that were specified in this way, and some were
written by authors known to be untrustworthy. A few passages
gave enough information to locate the article to which they
referred, and some passages cited standard medical textbooks.
However, many of these were outdated, some were quoted out of
context, and none appears to be support any of the claims
challenged in this article.
years ago, people in Okinawa began putting coral calcium in
their food and discovered that they gradually got healthier.
About 100 years later, Spanish explorers came and found
virtually no disease. So they filled up their shipholds and
brought it to Spain, where they analyzed it and found not only
calcium but a perfect balance of magnesium and 70 other trace
metals and other minerals."
Comment: That's an amazing story, (as hard to swallow as the
product it promotes) considering the fact that 500 years ago the
nature and existence of trace minerals was unknown.
not get cancer."
claim is easy to explode by doing a Medline search for articles
about cancer that mention Okinawa in their title. You will find
at least ten that describe the incidence of various cancers.
Barefoot's ideas and various coral calcium products have also
been promoted by several multilevel companies, one of which, in
1999, was ordered by the FDA to stop making health claims that
related its products to blood pressure, arthritic conditions,
heart disease, or digestive reflux. 
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Web sites refer to Barefoot as "Dr. Robert Barefoot" or Robert
Barefoot, Ph.D. However, he is not a medical doctor and does not
have a Ph.D. degree. In 1999, Barefoot was not permitted to
testify as an expert in a case in which the Maryland Attorney
General stopped the marketing of T-Up (an aloe vera concentrate)
and cesium chloride for the treatment of cancer and AIDS. The
case was extremely serious because the regimen had killed
several of its users. During hearings in the case, the
defendants sought to have Barefoot testify that cesium was
effective. The curriculum vitae that Barefoot submitted
described his formal education after high school as "1964
Northern Alberta Institute of Technology, Chemistry" and "1967
Graduated with Honors, Chemical Research Technology."  This
means that his highest educational credential is a diploma (not
a university degree) that reflects only three years of
coursework. The presiding Administrative Law Judge noted that
Barefoot had formal training and experience in inorganic
chemistry but had not had any professionally supported or
supervised training or done any professionally recognized
research in organic chemistry and biochemistry in the human
body. Although Barefoot described having many discussions with
doctors and patients about using cesium for in treating cancer,
the judge concluded that "this experience and study was not
scientific." In 2000, a civil court judge ordered the defendants
to pay millions of dollars in restitution and $3.7 million in
civil penalties [12,13]. In 2001, the Maryland Court of Special
Appeals upheld this decision in a ruling that explained why
Barefoot's exclusion had been justified . One of the
defendants received a 46-month prison sentence in a parallel
criminal case .
Web sites also describe Barefoot as a "world-renowned chemist"
His curriculum vitae states that between 1968 and 1972 he
published six scientific research papers on analytical chemistry
and diagenesis. Diagenesis refers to the changes that occur in
sediments as they are buried under other sediments. This appears
to have some relevance to the formation of limestone, but it
certainly has nothing to do with human biology or human health.
Searching Medline, which is the most comprehensive database of
medically-related journals, there are no articles with Barefoot
listed as author. His curriculum vitae states that he has
patented an ore-extraction process and headed two companies that
serviced the petroleum industry. His marketing activities have
attracted considerable attention, but I doubt that he deserves
to be called a "renowned chemist."
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Reich, M.D., who co-authored The Calcium Factor, is a Canadian
physician whose license was canceled in 1983. According to
Barefoot, Reich had a thriving practice in Calgary, Canada, but
the Alberta College of Physicians and Surgeons considered his
practices "potentially dangerous." [2:92]. The College's public
report states: "A hearing was held before a panel of three peers
on March 4, 1986. The allegations were:
3rd day of June, A.D., 1982 and the 3rd day of December, A.D.,
1982 provide treatment to patients contrary to the Order of The
Council of the College of Physicians and Surgeons of the
Province of Alberta dated the 3rd day of June, A.D. 1982.
lack of skill and judgment in the practice of medicine in
accordance with an assessment of his medical practice as
conducted on December 13, 1983 by an Assessment Committee
appointed by the College of Physicians and Surgeons of the
Province of Alberta.
On March 20, 1986 the Council of the College of Physicians and
Surgeons of the Province of Alberta advised Dr. C.J. Reich that
his name was to be struck from the Register of the College of
Physicians and Surgeons of the Province of Alberta.
Trudeau, who hosts Barefoot's current infomercial, has been the
object FTC regulatory action for false advertising. In 1998, in
connection with six infomercials that he developed, Trudeau
signed a consent agreement to (a) pay $500,000 in consumer
redress, (b) be barred from making false claims for products in
the future, and (c) establish a $500,000 escrow account or
performance bond to assure compliance . In the current
infomercial, Trudeau acts skeptical by questioning why listeners
should believe various claims that the overwhelming majority of
medical doctors would dispute. Barefoot's answer is simple (and
incorrect). Doctors, he says, are too busy to read journals and
get their information from drug companies; and drug companies
don't want them to know that coral calcium is more effective
than their drugs. (Doctors actually get most of their
information from journals, continuing education courses, and
conversations with colleagues, not from drug companies.)
During the early 1990s, according to a report in the Wall Street
Journal, Trudeau served nearly two years in prison. In 1990, he
pled guilty to larceny in a Cambridge, Massachusetts, state
court in connection with $80,000 in worthless checks he had
deposited at a bank. The sentencing memorandum said that he had
posed as a doctor to increase his credibility with bank
officials. In 1991, he pled guilty to credit-card fraud in
Boston federal district court. Among his misdeeds in the federal
case, he misappropriated for his own use the credit-card numbers
of customers of the memory-improvement courses that he offered
at the time .
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ostensible purpose of the infomercial is to sell The Calcium
Factor and Death By Diet. The infomercial states that listeners
can get a special price by calling a toll-free number. One can
assume that the product is not mentioned on the program because
the cancer claim would make Barefoot and Trudeau sitting ducks
for FDA prosecution. But by selling the book, they may be
protected by freedom of the press as long as the contents of the
book are accurately described. When one calls the number to get
the price of the books, it is quoted as $37.97 plus $7.99 for
shipping, a total of $45.96. The list prices on Amazon Books
total $35.90, but buyers of both pay no shipping charge, and
used and nearly new copies are available for less. One can also
find a coral calcium suppler who sells both books for $27.40
cost of coral calcium varies with the brand, price charged by
the retailer, and the number of capsules taken per day. Barefoot
recommends determining the daily dosage by testing the pH of
your saliva (a test that is not valid for determining calcium
needs).The Calcium Factor states that only 3 are needed for
people in the "healthy range" but 6 or 9 are needed for people
who are ill or are developing an illness [2:119]. Since most
people will test alkaline (7.2 to 7.4), the most likely dosage
would be 3 per day.
During the infomercial, Trudeau states that callers to a
toll-free number who mention the program's name ("A Closer
Look") can take advantage of "special arrangements" he makes
with all of his program's guests. When one calls the toll-free
number, the operator answers "The Calcium Factor." When asked
whether this is a regular business, the operator says it is just
an order center. When asked who owns it, he first said he didn't
know and then said their names were "Tom" and "Steve." When
asked about the "special arrangements, the caller is told that
the books, three videotapes, and three audiotapes are available
free as part of a package that includes ten 90-capsule bottles
of "Coral Calcium Daily" for $299.99 plus $19.98 shipping ($32
per bottle), and that buyers of the package can get additional
bottles for life for half that much. The product contains
calcium carbonate, 3 other minerals, and vitamins A, C, D, and
the operator says the recommended dosage is 3 capsules per day,
which would make the monthly cost about $32 for the first ten
months and about half that much thereafter. There seems not to
be anything "special" about the arrangement, since the same deal
is on a Web site for $50 less.
The "Barefoot Calcium Plus" formula, which appears to be a major
competitor, contains the same ingredients plus seven more
minerals. The Coral Calcium Supplement Center sells twelve
90-capsule bottles for $263.40 plus $17.70 for shipping, which
would total about $23 per month. Neither product is rationally
formulated. Purified calcium carbonate tablets, which should be
chewed to enhance absorption, can be obtained in drugstores and
other retail outlets for about $2 per month. Vitamin D can be
important, especially for people who have minimal exposure to
sunlight. However, people who need supplementary vitamin D can
get it combined with calcium carbonate at no additional cost.
The other nutrients in these products are readily available in
more complete multivitamin/multimineral products that need not
cost more than $2 per month .
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inexpensive calcium supplement may also be safer. Laboratory
analyses have shown that some calcium supplements contain
significant amounts of lead and other heavy metals . The UC
Berkeley Wellness Letter has warned:
"There has been little or no good research on coral as a source
of calcium or as a treatment for disease. But that doesn't stop
the marketers from making their claims, since dietary
supplements are virtually unregulated. You have no idea what's
really in the bottle or if the stuff is safe. Historically,
calcium supplements haven't always been safe: years ago calcium
carbonate from bone meal or oyster shells, for instance, was
used in some supplements -- but was later found to contain high
levels of lead. Since then the government and manufacturers took
action to reduce lead levels in existing calcium supplements.
But new supplements can go untested ."
intake is an important factor in bone health and may play some
role in the prevention of colon cancer. Barefoot has embellished
these simple facts to create an elaborate scheme to promote his
publications and coral calcium products. Your best bet is to
completely ignore what he says and follow a medically approved
program that includes adequate calcium and other measures for
preventing osteoporosis. The National Academy of Sciences
advises Americans and Canadians at risk for osteoporosis to
consume between 1,000 and 1,300 milligrams of calcium per day
. This can be done with dairy products, supplements, or both.
Readily absorbable supplements need not cost more than a few
cents a day.
Coral calcium products are a waste of money, and some are
irrationally formulated. For professional advice on calcium
intake, ask a registered dietitian (R.D.) or physician to help
you. Meanwhile, if you have purchased a coral calcium product
and would like to share your feelings about it with us, please
send me an e-mail message.
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a. Acid/Alkaline Theory of Disease is Nonsense
b. Robert Barefoot's Curriculum Vitae
1. A Closer Look. Infomercial hosted by Kevin Trudeau, broadcast
in January 2003.
2. Barefoot RR, Reich CJ. The Calcium Factor: The Scientific
Secret of Health and Youth 5th edition. Southeastern, PA: Triad
3. Barefoot RR. Death By Calcium, 4th Edition. Southeastern, PA:
Triad Marketing, 2002.
4. Barefoot RR. Barefoot on Coral Calcium: An Elixir of Life.
Newark, NJ: Wellness Publishing, 2001.
5. Robert R. Barefoot Coral Calcium Interview. Audiotape
transcript. Coral Calcium Supplement Center Web site, accessed
Feb 1, 2003.
6. Mirkin G. Acid/alkaline theory of disease is nonsense.
Quackwatch, Feb 6, 2003.
7. Standing Committee on the Scientific Evaluation of Dietary
Reference Intakes, Food and Nutrition Board. Dietary Reference
Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and
Fluoride. Washington, D.C., 1997, National Academy Press.
8. Holt PR and others. Modulation of abnormal colonic epithelial
cell proliferation and differentiation by low-fat dairy foods: a
randomized controlled trial. JAMA 280:1074-1079, 1998.
9. Scofield HR. Milk-alkali syndrome. eMedicine Web site,
revised Feb 28, 2002.
10. Setterberg SM. Warning letter to Gregg Barna, CEO of Health
Thru Nutrition (d.b.a. Health Technologies Network (HTN), Aug
11. Barefoot, RR. Curriculum vitae. Undated, circa 1999.
12. Curran orders aloe company to stop "miracle cure" claims and
to pay restitution and $3.7 million in civil penalties. Maryland
Atorney General news release, May 10, 2000.
13. Court affirms order requiring aloe company to cease miracle
cure claims, pay restitution & $3.7 million penalty. Maryland
Attorney General news release, April 11, 2002
14. Rodowsky J. Opinion in T-Up, Inc, et al. v. Consumer
Protection Division, Office of the Attorney General. In the
Court of Special Appeals of Maryland, No. 0064, September Term,
15. Willis L. Man gets term of 46 months in aloe vera case:
Concoction distributed as a treatment for cancer. Baltimore Sun,
Dec 1, 2001.
16. Infomercial marketers settle various charges: Ad claims for
"Hair Farming," "Mega Memory System," "Addiction Breaking
System," "Action Reading," "Eden's Secret," and "Mega Reading"
were deceptive. FTC news release, Jan 13, 1998.
17. Barrett S. Dietary Supplements: Appropriate Use. Quackwatch,
revised May 20, 2002.
18. Emshwiller JR. Nutrition for Life's top recruiter has a
criminal past despite convictions, Trudeau gets new distributors
to fork out the cash. The Wall Street Journal, Jan 19, 1996.
19. Ross EA and others. Lead content of calcium supplements.
JAMA 284:1425-1429, 2000.
20. How to sell a 5¢ supplement for $1. UC Berkeley Wellness
Letter, Feb 2003.
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