Lendon H. Smith, MD [1921-2001] was a pediatrician who contended for decades that nutrition plays a major role in behavior and that nutritional strategies are helpful against a wide range of diseases and conditions. He claimed, for example, that allergies, alcoholism, insomnia, hyperactivity in children, and a variety of other ailments are the result of enzyme disturbances which can be helped by dietary changes. During the 1970s, his ideas were promoted widely on his own syndicated TV program and through hundreds of guest appearances on Johnny Carson, Phil Donahue, and other shows. After that, he had little media exposure, mainly because of regulatory actions by his state medical board. Smith's curriculum vitae stated that after graduating from medical school, he took a one-year internship and served for two years as a psychiatrist in the Army. His CV listed no specialized training in psychiatry [1]. Despite this apparent lack, he apparently felt qualified to advise the world on how to manage mental, emotional, and behavioral problems in both adults and children.
Smith's books recommended using various food supplements and avoidance of white sugar, white flour, pasteurized milk, and other foods that are not "natural." The books include The Children's Doctor, Feed Your Kids Right, Improving Your Child's Behavior Chemistry, Encyclopedia of Baby and Child Care, Feed Yourself Right, Foods for Healthy Kids, Dr. Smith's Low Stress Diet, Dr. Smith's Diet Plan for Teenagers, and Feed Your Body Right. In Improving Your Child's Behavior Chemistry, Smith wrote, "It is amazing how children's behavior can be turned around 180 degrees by a vitamin C and B injection. Overnight, they sleep better, begin to eat, and are cheerful, calm and cooperative the next day." (I suspect that the reason for any such behavior change is not nutritional but fear of having more shots.) In Feed Your Kids Right, Smith suggested that a daily dose of 15,000 to 30,000 units of vitamin A is "about right for most of us." He also recommended a stress "formula" with up to 10,000 mg of vitamin C and 50,000 units of vitamin A each day for a month.
These dosages, of course, are dangerous-particularly to children. For pregnant women, he recommended daily supplements of 20,000 to 30,000 units of vitamin A, a dosage high enough to cause birth defects. Feed Your Body Right described the Life Balance International's program of dietary supplementation based on computer analysis of a blood test (see below). In 1973, the Oregon State Board of Medical Examiners placed Smith on probation for prescribing medication that was "not necessary or medically indicated" for six adult patients, one diagnosed as hyperactive and the other five as heroin addicts [2]. He was also ordered to confine his practice to pediatrics. According to a report in The Washington Post, Smith, like many pediatricians, had prescribed Ritalin to calm hyperactive children. While working in a free clinic for drug addicts, he theorized that many heroin addicts had been hyperactive children and prescribed Ritalin for them also. However, trouble arose when some of the addicts sold his prescriptions to buy heroin [3].
Ritalin is a controlled substance, and Smith did not have federal approval to run a program for addicts. In 1974, the Oregon Board agreed to allow Smith to write prescriptions for narcotic drugs under certain conditions [4], but in 1975 he was again restricted because the Board felt he was prescribing Ritalin for too many children [5,6]. His probation lasted until 1981. Shortly after the Board's action in 1973, Smith turned to "nutritional therapy" and allied himself with naturopaths, homeopaths, and chiropractors. Later he became the first physician named to the board of the Portland-based National College of Naturopathic Medicine. He was a frequent speaker at health-food-industry seminars. He also lectured at many dental meetings until program planners became aware of his regulatory trouble. In 1987, Smith permanently surrendered his medical license rather than face Board action on charges of insurance fraud [7]. According to press reports, the trouble arose because he had signed documents authorizing insurance payments for patients he had not seen.
The patients had actually been seen by chiropractors, homeopaths, and others whose treatment was not covered at "nutrition-oriented" clinics in which Smith had worked. In June 1977, Oregon Times magazine published a lengthy interview with Smith that included the following remarks: Q. How does the rest of the medical community react to your diet theories? A. I get flack from my medical peer group who think I'm completely nuts. Q. At least they are reluctant to buy your ideas on hyperactivity. A. Most doctors are people that are academically oriented. They did well in high school and college. And in medical school, in order to get through they had to be still. They are not restless and hyperactive in general. Q. Were you restless and hyperactive? Q. How did you get through medical school, then? A. I was just bright enough that I could do it. I would sit in the back of the class in medical school and write letters to girl friends and do crossword puzzles.
And if it really got bad I would pick my nose [8]. In 1988, after I mentioned Smith in Nutrition Forum newsletter, he sent me a cordial letter, which ended: "I would like to keep in touch with you because you are right, we must get rid of the quacks and charlatans, but I find it very difficult to tell where to draw the line. I replied: "I prefer to think of quackery rather than quacks; most people who promote it are not charlatans but sincere individuals who reply on personal experience and not enough on testing their theories. I'm not sure I can help you sort things out." After "retiring" from medical practice, Smith became less visible in both the general and "alternative" media. He wrote columns for health-food and chiropractic publications, and in 1987 began publishing a newsletter called The Facts. In Total Health magazine, he advised parents that if a child who has a good self-image shows symptoms of depression, they should consider inappropriate diet as an explanation: "My rule is, if a person likes something and they must have it every day, it is probably causing the symptoms.
If depression comes and goes, then diet is surely the inciting agent." In 1993, Video Remedies Inc. of Davie, Florida, began marketing "Homeopathic Care of Infants and Children," a videotape that portrayed Smith as a practicing physician. The videotape showed Smith in what appeared to be a medical office, with four framed certificates behind him. During the tape he advised a mother whose toddler sat on her lap with a stethoscope draped around her neck. He explained what homeopathy was about and suggested that vaccinations did more harm than good. The tape was intended to guide the use of a homeopathic remedy kit that had Smith's picture on its case. One piece of advice that was particularly horrendous was that if an acute earache does not respond within 24 hours to a homeopathic remedy, another should be selected from the brochure accompanying the tape. (Proper advice, of course, should be to have the child examined by a physician.) At the end of the "appointment," Smith quipped, "Now go pay your bill."
Smith also promoted the Life Balances International Program, which he described as "a monitoring method that clearly shows if one is nutrient deficient, or alkaline, or skewed in some metabolic, chemical, or enzyme department." Purchasers completed a questionnaire and underwent standard blood tests that include a chemistry profile and complete blood count. The tests results were then fed into IHF's computer, which issued a report stating which supplements were needed. The products, which were marketed by the International Health Foundation (IHF), of Portland, Oregon, included 20 bottles of vitamins and minerals, 6 dropper bottles of minerals, and an electrolyte solution. Smith claimed that sniffing the bottled nutrients enabled users to determine current body needs [10]. He stated: "The sweeter or more delightful the smell, the more it is needed. If the contents smell repugnant, it is not to be taken at that particular time." The initial cost of the "complete program" was $688 plus shipping.