We Americans are pretty particular about our pooping habits. Camping trips aside, there’s generally only one acceptable way to go: sitting down. U.S. tourists returning from international trips share horror stories of bathroom conditions in other parts of the world. “It was a hole in the ground!” Sitting to poop is just more civilized than squatting, we tell ourselves. It can’t be sanitary to hover over a hole.

But we are mistaken. Billions of people around the world squat at bathroom time. Squat toilets are the norm in Asia, the Middle East, and parts of Europe. And for a while now, the pro-squat squad has been trying to get America on board. Proponents of squatting say seated pooping is not only harder—it’s hazardous to your health.

Our bodies certainly aren’t designed for the toilets we use. The alimentary canal ends with the rectum, where waste is stored, and the anus, where it leaves the body. The tube between them is slightly kinked, which is what allows you to hold it. Standing up pinches off the passageway. To a lesser extent, sitting does the same. This is great when there’s no rest stop in sight, but when it’s time to go, you want the channels clear. The squatting position straightens out the tube, allowing your poop to show itself out. There’s less straining, which we can all agree is a good thing.

Hemorrhoids are a pretty big problem in this country. By age 50, approximately half of Americans have had them. And the number one cause (no pun intended)? Straining during bowel movements. 

But we don’t have to live this way. A niche industry of squat enablers has sprung up in the U.S. It’s dangerous to sit on your toilet, say the manufacturers, who offer footstools, and adapters to squat-ify Western toilets. Their websites blame our seated poopstyle for colon cancer, heart attacks, sexual dysfunction, heartburn, and appendicitis. You can prevent all these problems, they say, if you just buy what they’re selling.

David Ling, inventor of the Sandun-Evaco toilet converter, promises users “a lifetime of health benefits (better skin, flatter abdomen, reduced toxicity, better mental clarity and reduced risk of disease as a result of a cleaner and healthier colon).” The makers of the Squatty Potty—a footstool with a toilet-shaped cutout—claim their product can ease constipation, prevent colon disease, and improve pelvic floor issues. The $25 to $80 Squatty Potty has been endorsed by Howard Stern, and has inspired the most glittery train wreck of a commercial we’ve ever seen.

Is there any truth to these claims? Maybe. Some of them. There’s definitely no evidence that you can get clearer skin or better abs from a toilet converter, and nobody’s testing the effects of squatting on vague concepts like “mental clarity” and “toxicity.” A few studies have shown that squatting does make pooping easier and faster and may reduce the risk of hemorrhoids. The rest of it remains to be seen.