A Critical Look at Robert Barefoot
and Coral Calcium

Stephen Barrett, M.D.

"Coral calcium" is the name of a dietary supplement derived from either coral remnants that have falled to the ocean floor ("marine coral") or coral harvested from land quarries as found in islands. It is mostly calcium carbonate but contains magnesium and trace amounts of other minerals. Although coral minerals have been mined for centuries, the term "coral calcium" was brought to public attention about ten years ago through a massive advertising campaign by Robert R. Barefoot, of of Wickenberg, Arizona, who claimed that coral minerals obtained from Okinawa provided "the scientific secret of health and youth" and would cure cancer. His ideas were promoted through books, lectures, his Web site, an audiotape, two 30-minute infomercials [2], interviews, and thousands of Web sites that sold products. Although his sales pitch was preposterous, he gained a wide audience. His book, The Calcium Factor [1], first published in 1992, was revised several times and on January 31, 2003 enjoyed an Amazon Books sales rank of #412, which was quite high. On the same day, his Death By Diet [3], originally published in 1996 and then in its fourth edition, was ranked #1790; and his other book, Barefoot on Coral Calcium [4], was ranked #8,114. In January and February 2003, Barefoot's "A Closer Look" infomercial was among the most frequently shown and was the most frequent one connected with a dietary supplement. In March 2003, a newer infomercial version hit #1 on the frequency list and a Google Search for "coral calcium" topped 120,000. Barefoot's Cure America Web site listed his email address as kingofcalcium@hotmail.com, which, considering his probable sales volume, was probably an apt description. Barefoot's infomercials were among the most outrageous I have ever seen. In 2003, the U.S. Federal Trade Commission stopped their broadcasting, but coral calcium products are still widely marketed with lesser claims.

Dubious Claims

Here is a sampling of Barefoot's claims followed by my comments in red type. Except as noted, all were from his infomercial "A Closer Look."

In 2003, a newer Barefoot/Trudeau infomercial ("The Debbie & Kevin Show") highlighted and misrepresented the JAMA calcium study and claimed that coral calcium had cured many cases of terminal cancer.

Barefoot's ideas and various coral calcium products were also 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 [11]. Other regulatory actions are listed below.

Questionable Credentials

Thousands of 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." [12] This means that his highest educational credential was a diploma (not a university degree) that reflected only three years of coursework. The presiding Administrative Law Judge noted that Barefoot had formal training and experience in inorganic chemistry but had no professionally supported or supervised training and had not 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 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 [13,14]. In 2001, the Maryland Court of Special Appeals upheld this decision in a ruling that explained why Barefoot's exclusion had been justified [15]. One of the defendants received a 46-month prison sentence in a parallel criminal case [16].

Web sites also described Barefoot as a "world-renowned chemist." His curriculum vitae stated 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 has 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, I located no articles with Barefoot listed as author. His curriculum vitae stated that he had patented an ore-extraction process and headed two companies that serviced the petroleum industry. His marketing activities attracted considerable attention, but I doubt that he deserves to be called a "renowned chemist."

Carl J. Reich, M.D., who co-authored The Calcium Factor, was a Canadian physician whose license was canceled in 1983. Barefoot claimed that Reich had a thriving practice in Calgary, Canada, but the Alberta College of Physicians and Surgeons considered his practices "potentially dangerous." [2:92] However, the College's public report stated:

A hearing was held before a panel of three peers on March 4, 1986. The allegations were:

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.

Kevin Trudeau, who hosted Barefoot's infomercials, has been the object of many FTC regulatory actions 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 [17]. In the infomercials, Trudeau acted 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 said, were too busy to read journals and get their information from drug companies; and drug companies didn't want them to know that coral calcium was 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 [18].

The ostensible purpose of the infomercial was to sell The Calcium Factor and Death By Diet. The infomercial stated that listeners could get a special price by calling a toll-free number. I assume that the product was 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 would be protected by freedom of the press as long as the contents of the book are accurately described. When I called the number to get the price of the books, I learned that the price was $37.97 plus $7.99 for shipping, a total of $45.96. The list prices on Amazon Books totaled $35.90, but buyers of both would pay no shipping charge, and used and nearly new copies were available for less. I also found a coral calcium supplier who sold both books for $27.40 postpaid.

Cost Considerations

The monthly cost of coral calcium varies with the brand, price charged by the retailer, and the number of capsules taken per day. Barefoot recommended determining the daily dosage by testing the pH of your saliva (a test that is not valid for determining calcium needs). The Calcium Factor stated 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 "A Closer Look," Trudeau stated that callers to a toll-free number who mention the program's name can take advantage of "special arrangements" he made with all of his program's guests. When I called the toll-free number, the operator answered "The Calcium Factor." When I asked whether this was a regular business, he said that it was just an order center. When I asked who owned it, he first said he didn't know and then said their names were "Tom" and "Steve." When I asked about the "special arrangements, I was told that the books, three videotapes, and three audiotapes were 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 contained calcium carbonate, 3 other minerals, and vitamins A, C, D, and E. The operator told me that the recommended dosage was 3 capsules per day, which would make the monthly cost about $32 for the first ten months and about half that much thereafter. I couldn't find anything "special" about the arrangements, and I found what looked like the same deal on a Web site for $50 less. Bob Barefoot's Coral Calcium Supreme, the product promoted by the Debbie & Kevin infomercial, had a similar range of prices.

The "Barefoot Calcium Plus" formula, which appeared to be a major competitor, contained the same ingredients plus seven more minerals. The Coral Calcium Supplement Center sold twelve 90-capsule bottles for $263.40 plus $17.70 for shipping, which would total about $23 per month. Neither product was 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 [19].

Safety Considerations

Using an inexpensive calcium supplement may also be safer. Laboratory analyses have shown that some calcium supplements contain significant amounts of lead and other heavy metals [20]. 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 [21].

The Wellness Letter statement turned out to be prophetic. In June 2003, ConsumerLab reported that Bob Barefoot's Coral Calcium Supreme contains 2.5 micrograms of lead per gram of calcium [22]. This might not pose a physical threat (except, perhaps, to a developing child when taken by a woman who is pregnant or breastfeeding). However, there is no logical reason to take such aproduct when many other calcium supplements have a lower lead level. California requires that products exceeding the "no significant risk level" of 1.5 micrograms of lead provide a warning label—which Barefoot's product did not.

Government Actions

The outrageous nature of Barefoot's claims triggered regulatory action here and abroad. In June 2003, the United Kingdom's Independent Television Commission (ITC) announced that it had levied a £60,000 fine on the television shopping channel, Shop America (a subsidiary of Trustar Global Media) for several breaches of the ITC's Advertising Code. The main offense was an ad which claimed that Bob Barefoot's Coral Calcium Supreme could help reverse cancer and other serious diseases and could benefit everyone, including babies. The penalty also covered misleading ads for the Fresh Start diet plan and a golfing product [23]. One week later, the U.S. Federal Trade Commission charged Barefoot, Trudeau, Shop America (USA), and Deonna Enterprises with making unsubstantiated claims that "go far beyond existing scientific evidence regarding the recognized health benefits of coral calcium." The FTC filed suit in Chicago federal court abd quickly obtiained a temporary restraining order and an asset freeze. In addition, the FTC and FDA sent warnings to many Web site operators who are making similar claims [24] and U.S. Marshals seized $2.6 million worth of Coral Calcium Supreme [25].

In a separate action, the FTC alleged that Trudeau violated the 1998 FTC order prohibiting him from making unsubstantiated claims about the benefits, performance, or efficacy of any product. The FTC alleges that Trudeau violated the order by making false and unsubstantiated claims about Coral Calcium Supreme and Biotape (a purported pain-relief product which Trudeau promotes through a separate infomercial). In this action, the FTC is seeking a finding of contempt, monetary relief, and other injunctive relief, as well as a temporary restraining order that would prohibit Trudeau from making the challenged claims, and would freeze his assets [26]. Biotape's developer, Darrell Stoddard, claims that pain is caused by blockage of "life force" ("chi") and that the tape is conductive mylar that "connects the broken circuits." [26] Users are instructed place a strip of Biotape directly on the parts of their body where they feel pain.

In January 2004, shortly before a trial would otherwise taken place, the FTC announced that Barefoot had agreed to a permanent injunction under which he, Deonna Enterprises, Inc., and Karbo Enterprises, Inc., are:

The court order also permitted the FTC to recover all royalties owed to Barefoot in connection with the Coral Calcium Supreme infomercial marketing [27,28].

The Bottom Line

Calcium intake is an important factor in bone health and may play some role in the prevention of colon cancer. Your best bet for osteoporosis prevention is to follow a medically approved program that includes adequate calcium, exercise, and other measures. The National Academy of Sciences advises Americans and Canadians at risk for osteoporosis to consume between 700 and 1,300 milligrams of calcium per day, depending on age [7]. This can be done with dairy products, supplements, or both. Readily absorbable supplements need not cost more than a few cents a day, which means that taking coral calcium products for their calcium conent is a waste of money.

Government regulatory actions have caused marketers of coral calcium claims to be much more cautious in their claims. Most current promotions suggest that trace mineral deficiencies are common and coral calcium products are ideal for preventing them. Some also claim that coral minerals also improve health by correcting pH imbalances. Such statements are misleading because (a) people who eat sensibly do not need supplements of trace minerals, and (b) unless someone is severely ill, the body pH will remain within its proper range.

For professional advice on calcium intake, ask a registered dietitian (R.D.) or physician to help you.

For Additional Information

References

  1. "A Closer Look" and "The Debbie & Kevin Show," both televised in 2002 and 2003.
  2. Barefoot RR, Reich CS. The Calcium Factor: The Scientific Secret of Health and Youthm 5th Edition. Southeastern, PA: Triad Marketing, 2002.
  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 Fed 1, 2003.
  6. Mirkin G. Acid/alkaline theory of disease is nonsense. Quackwatch, Fed 6, 2003.
  7. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, D.C., 2010, 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 Fed 28, 2002.
  10. Packer-Tursman J. From the depths: Many experts don't swallow extraordinary claims for calcium supplements derived from sea coral. Washington Post May 20, 2003.
  11. Setterberg SM. Warning letter to Gregg Barna, CEO of Health Thru Nutrition (d.b.a. Health Technologies Network (HTN), Aug 20, 1999.
  12. Barefoot, RR. Curriculum vitae. Undated, circa 1999.
  13. Curran orders aloe company to stop "miracle cure" claims and to pay restitution and $3.7 million in civil penalties. Maryland Attorney General news release, May 10, 2000.
  14. 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
  15. 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, 2001.
  16. Willis L. Man gets term of 46 months in aloe vera case: Concoction distributed as a treatment for cancer. Baltimore Sun, Dec 1, 2001.
  17. 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.
  18. Barrett S. Dietary supplements: Appropriate Use. Quackwatch, revised May 20, 2002.
  19. 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.
  20. Ross EA and others. Lead content of calcium supplements. JAMA 284:1425-1429, 2000.
  21. How to sell a 5¢ supplement for $1. UC Berkeley Wellness Letter, Fed 2003.
  22. Product review: Calcium. ConsumerLab, accessed June 10, 2003.
  23. ITC imposes £60,000 financial penalty on Shop America. ITC news release June 2, 2003.
  24. FTC charges marketers of Coral Calcium Supreme dietary supplement and a pain-relief product with making false and unsubstantiated claims. FTC news release, June 10, 2003.
  25. FDA Dietary Supplement Enforcement Report, July 2003.
  26. Stoddard DJ. Pain healed "immediately" (Severe, chronic, intractable pain, not masked or managed, but healed) by applying a highly conductive, patented, polymer membrane. Pain Research Institute Web site, accessed June 13, 2003.
  27. Marketers of coral calcium product are prohibited from making disease treatment and cure claims in advertising. FTC news release, Jan 22, 2004.
  28. Gettleman G. Stipulated final order for permanent injunction and settlement of claims for monetary relief as to defendants Robert Barefoot, Deonna Enterprises, Inc. and Karbo Enterprises, Inc., U.S. District Court, Northern District of Illinois, Eastern Division, Civ. No. 03-C-3904.

This article was revised on September 13, 2012.