For Ada Lovelace Day: Lucy Wills
Lucy Wills was the haematologist who discovered folate, publishing reports of her studies into ‘anaemia of pregnancy’ in the Indian Journal of Medical Research.
Principle Healthcare and the ASA
Principle Healthcare, who removed claims from their website shortly after I contacted the MHRA in 2009, also made some claims on their website for products that did not come under the jurisdiction of the MHRA. So, with their remit extended to cover marketer’s own websites, I thought I’d try the ASA… Read the rest of this entry »
Excess Woo – Reduce, Reuse and Recycle?
Far too much energy is being expended on producing and consuming the bullshit of the counterknowledge industry: nutritionism, homeopathy, and the various forms of energy medicine that rely on vitalism being prime examples of this industry. Worthless remedies are produced, and worthless books and pamphlets are published. Read the rest of this entry »
Briffa on Statins and CoenzymeQ10
Old news, I know – but it is one of Briffa’s hobby horses (not to mention Cybertiger, for those JABS aficionados reading this) and I happened upon an internet forum discussion that was linking to Briffa’s blog. His blog post contained this gem: Read the rest of this entry »
Holford and Histadelia
[BPSDB] Patrick Holford’s book Optimum Nutrition for the Mind (ONM) includes information on a condition known as histadelia. Read the rest of this entry »
Brain Pills in Schools
Just a very brief post today on ‘brain pills’. I found this in my daily email from the BBC today. The report states that:
Schools and universities may soon need to test students sitting exams for brain improving drugs, experts say.
So, in the near future society will be policing children’s use of substances that are thought to improve brain function. We will administer urine drug tests for cognitive enhancers and regulation may have to be introduced to stop these treatments and future ones from giving people an unfair advantage in examinations and tests. What a contrast with the Durham fish oil ‘trial’. I’m not trying to make the argument that cognitive enhancers should be allowed. Rather, I am trying to comprehend the distinction between (1) schools and their county council actively pushing fish oil pills on kids and (2) the ‘need’ for regulation due to a possibility that children may use a brain-enhancement drug for exam success. Is there some kind of moral difference between fish oil pills and ritalin or aricept – or is it a matter of health and safety? Is it cheating to take ritalin… but not cheating to take fish oil pills? Are fish oil pills assumed to be completely safe and pharmaceutical drugs assumed to be inherently unsafe? Was there even a risk assessment made by Durham County Council before they pushed these pills?
Superfoods
The nutritionistas and health food stores (not to mention the press) would have you believe that there is such a thing as a ‘superfood’. There isn’t. Not pomegranate, not walnut, not even any kind of special berry harvested by Tibetan monks and recommended by Patrick Holford or Gillian McKeith. The Birmingham News ran a piece on Wednesday this week that included the claim that Read the rest of this entry »
IANT write terrible response to Cochrane – and block comments
The Irish Association of Nutritional Therapy have written a response to the Cochrane review of antioxidant pills. It’s not very impressive. Holford Watch have posted on it here: IANT and have also attempted to leave a comment (or comments) on the IANT piece. Unfortunately, the IANT appears to be blocking these comments and I haven’t been able to comment either. The following comment was stuck in moderation:
I’m afraid that not everything you have written in this response is true. For example, this: “The final exclusion involves the trials with selenium with no reason as to why. Selenium trials generally show a positive result on the disease in question when supplemented.” is simply untrue – as can be seen if you follow this link: http://holfordwatch.info/2008/04/26/irish-association-of-nutritional-therapy-giving-the-facts-about-the-cochrane-review-of-antioxidant-supplements/
When this comment failed to appear, I fired off a very brief email pointing out just one or two of the mistakes in the IANT piece:
Unfortunately, this piece: http://www.iant.ie/2008/04/18/response-to-the-recent-media-coverage-regarding-antioxidants/ contains several errors. I know that, as nutritional therapists, you will feel compelled to give the public the facts of this case and I am sure that you will amend any errors in your response to Cochrane. I look forward to reading the revised article.
Regards,
jdc.
“Many of the studies are with dosages that far exceed what is in most vitamin products.” – this has been covered by Dr Ben Goldacre in his Bad Science column in the Guardian. (1)
“The authors have excluded over 400 trials many of which have a positive outcome and have no deaths so if these were included the findings would be different.” – the study was on mortality. How exactly would those studies that do not report mortality be useful in studying mortality?
“There are no adverse risks with taking vitamin and mineral supplements that are available at the current levels.” – the levels of vitamins and minerals available at many ‘health food’ stores do have associated risks. (See again Ben Goldacre’s comments on available supplements)“Research in the UK shows that many people are deficient in various nutrients. (4) It also shows that large parts of the population come nowhere near consuming 5 portions of fruit and vegetables especially in the younger populations. There is ample research to show that at least a third of all cancer is linked to diet.” Yes, cancer is linked to diet (i.e., the food we eat – not the vitamin pills we take). However – the evidence in respect of diet and health is for fruit and vegetables, not isolated nutrients sold in pill form.
See Holford Watch [sorry for the previously broken link] and Bad Science for more on the responses to Cochrane.
Here’s a picture of a Nutritional Therapist engaging with the evidence: 
Another Holford Response
Yesterday I covered Patrick’s response to criticism of his comments on the Gladys Block paper. Now, I’ll take a brief look at the reasons for Mr Holford’s continued support for York Test and York Test’s IgG blood testing kits.
Two types of antibodies, called IgE and IgG, are thought to be the main contenders for most allergic reactions. Both can be reliably tested using a technique known as ELISA.
Here’s my first problem with this response: IgE and IgG are said to be the ‘main contenders’ for allergic reactions. The expert view seems to be that the “significance of IgG anti-food antibodies is particularly uncertain since the sera of many children with such antibodies in their serum tolerate the foods in question perfectly well.” (The American Academy of Allergy, Asthma and Immunology, via breathspakids). The breathspakids blog is also the source for this quote from The Australasian Society of Clinical Immunology and Allergy:
IgG antibodies to food are commonly detectable in healthy adult patients and children, independent of the presence of absence of food-related symptoms. There is no credible evidence that measuring IgG antibodies is useful for diagnosing food allergy or intolerance, nor that IgG antibodies cause symptoms. The exception is that gliadin IgG antibodies are sometimes useful in monitoring adherence to a gluten-free diet patients with histologically confirmed coeliac disease. Otherwise, inappropriate use of food allergy testing (or misinterpretation of results) in patients with inhalant allergy, for example, may lead to inappropriate and unnecessary dietary restrictions, with particular nutritional implications in children.
Given that there is no credible evidence that measuring IgG antibodies is useful for diagnosing food allergy or intolerance, I can’t see how it can possibly be relevant that IgG “can be reliably tested using a technique known as ELISA.”
Patrick also provides a reference to back up his claims for effectiveness. This reference is to a survey on whether people felt better after following a diet which eliminated the foods that had been identified as allergens by Yorktest. I had a look on Pubmed to see whether I could find G Hardman, Journal of Nutrition and Food Science (2007), vol 37, pp 16-23. Nothing. Which is a shame really – I had quite fancied reading that. Apparently, the study found consistent evidence that noticeable benefit was gained from removing offending foods from the diet. We just don’t know what kind of evidence – were the respondents simply reporting on how they felt or were there objective measures of benefit? Holford then points out that: the more strictly they followed their allergy-free diet, the better their results. That’s an interesting point. Until recently, I had never heard of the confounding effect of compliance. There is a fascinating piece in the New York Times that deals with the Bias of Compliance.
If you want to learn more about expert opinion on IgG, or the House of Lords or Advertising Standards Authority views on this kind of testing, Holford Watch have a piece here that includes direct quotations from a House of Lords committee and from an ASA adjudication. The breathspakids blog has an entire category on IgG. The Bad Science post about the show is here and you can listen again here. I love Radio 4.
Holford’s Full Responses
Having listened to part two of the Radio 4 show The Rise of the Lifestyle Nutritionists, I followed some links that had been posted on Ben Goldacre’s blog by Patrick Holford’s PR at 100% health and reached a page titled “Patrick’s full responses to Radio Four’s questions”.
The first clarification/response is on the Gladys Block paper. I seem to recall someone on the Radio 4 programme making the point that the people who were taking supplements may well have been taking other positive steps to improve health/maintain good health. I’d imagine it might be tricky to work out if there really were beneficial health effects from supplements if, say, the people who tended to take supplements also tended to: be in a different social class; and/or take more exercise; and/or eat a better diet. Rather than clarifying or defending his position, however, Mr Holford has simply linked to his original comments on the Block paper. No mention of the confounding factors that were referred to during the broadcast. How is that a ‘full response’ to Radio 4’s questions? Never mind ‘full’ – it’s not even a response.
Incidentally, the authors of that study made clear in their conclusion that their “study findings should also be weighed in the context of recent randomized controlled trials and related meta-analyses [39,40] which have raised concern about potential detrimental effects of select dietary supplements, particularly beta carotene and alpha tocopherol.” Ref 39 is to the Bjelakovic study. You know, the one that was a systematic review and meta-analysis of Randomised Controlled Trials. That’s right – it’s the one that Patrick Holford criticised for not using two observational studies.
*Check out Holford Watch on Patrick and The Rise of the Lifestyle Nutritionists here and here. EDIT: Holford Watch have previously covered the Block paper here.
**Patrick’s pages can be seen here and here.
***PDF of study: here.
****EDIT: Nearly forgot – there’s also a site called Holford Myths.
Stuff And Nonsense 