Introducing the Dip IONs – Patrick Holford’s Shock Troops of Optimum Nutrition

(1) Ex-professor Patrick Holford of Teeside Univesity and Head of Science and Education at Biocare is not alone. (And we are not talking about his collection of free range rabbits here.) As you know the learned scholar set up the Institute for Optimum Nutrition back in 1984. It is registered as a charity whose object is

the preservation and protection of health of the general public.

Unfortunately, none of Patrick’s pills can help him to be in more than one place at the same time so the ION was given the task of training the next generation of shock troops in Optimum Nutrition. One might describe it as a kind of franchise operation. Many of them, possibly a majority, are available to the general public for consultations. The ION website provides a handy directory to enable us to find out who these pioneers of new thinking are. Could we possibly be wrong? Should we be recommending to you all that you consult an ION trained nutritional therapist? Well we thought we would do a meta-analysis using information from the websites of all the Dip IONs we could find. After all it is easy to laugh at the lunatic fringe, but to find out how good they are you have to consider them as a group. (We MUST make it clear before you read any further that all the following information was found on publicly available websites. We are unable to comment on those without websites.)

(2) Now at Through a Glass Darkly we are sometimes accused of claiming that nutritional therapists are stupid. We are pleased to report to the world at large that this is not the case. Nearly all are relatively well-qualified. Indeed, around thirty appear to come from a science or health related background including three with PhDs. Some worked in the food industry so obviously know a lot about food. Others have come from fields such as nursing. It is great that Patrick has such discerning people promoting his work. Presumably they will know to treat his wilder ideas with, if you’ll pardon the expression, a pinch of sodium. We do not have any quarrel with these people and hope they can bring a bit of scientific rigour to the world of optimum nutrition.

(3) Unfortunately, more than half of Dip IONs with websites do not appear to have a background in science or if they do they are not telling us about it. Nothing wrong with that. Many seem to be undertaking a career change. It takes a great deal of courage to train for a new career, but what kind of training are these folks given? Well for a start you do not need A-levels in chemistry and biology. You merely need to take a few science access courses which

concentrate on aspects of these subjects that are particularly relevant to nutrition

It would be interesting to know how they decide what to leave out but there you go. The course itself is three years part-time and is summed up in a nice little booklet. This contrasts with the training that dieticians undergo. They do a full-time three year honours degree in nutrition followed by a year’s postgraduate clinical experience. In contrast the ION diploma course is equivalent to a two year foundation degree. Of course, the ION has recently launched a BSc honours degree in co-operation with the University of Bedfordshire. Although, it is a full-time degree only one day a week is required at the university. How much time for clinical practice does this leave …? Incidentally, in his recent book Ben Goldacre points out (Bad Science p178, Harper Collins 2008) that the university of Bedfordshire has been subject to criticism with regard to its accreditation of foundation degrees. Read paragraphs 45 to 52 of this report if you are interested in finding out more about the establishment with which the the ION decided to link itself.

(4) It does not look like any of these Dip IONs are planning to convert their qualification into an honours degree. Though let’s be fair possibly, again, they just don’t want to tell us about it. It could be they are too busy studying for their next diploma in complementary medicine. Many seem to be experts in metabolic typing, phytobiophysics, iridology, colour analysis, bowen therapy, emotion freedom techniques, applied metabolic ecology, bio-energetics (SCENAR) and blood microscopy. If you understand what half of these things are please enlighten us. Most of us struggle to be competent in one discipline so you have to marvel at these polymaths. Strangely enough there seems to be a correlation between those without scientific or healthcare qualifications and those who practice alternative therapies.

(5) One of the more controversial aspects of nutritional therapy has been the tests its practitioners offer. There are a wide variety available. For example, click here if you want to find out what one Northern Ireland therapist offers. Now I have neither the time, expertise or inclination to analyse all the tests nutritional therapists use to find out about our supposed problems. However, one is particularly controversial namely hair mineral analysis. The American Medical Association has gone so far as banning its practitioners from using the technique. To find out why you might like to read this article by the Little Black Duck last year. However, as you are probably aware the AMA and the Quackometer blog are not sources likely to be trusted by supporters of the ION and Patrick Holford. Consequently, we were very surprised to read an article on the subject of hair mineral analysis in Optimum Nutrition Magazine’s October 2007 edition. (Optimum Magazine magazine if you have never heard of it is the in-house journal of the ION.) The author science writer Alex Gazzola states:

“HMA is perhaps best viewed as an evolving area in need of open-minded scientific review. It has a limited present value because of the lack of evidence behind it – but it MIGHT [my emphasis] have untapped potential of enormous value. (Optimum Nutrition Magazine, p.30 Winter 2007.)

(We have a scanned copy of the article that can be sent to you if you want to read it.) Shockingly, many Dip IONs still declare they offer Hair Mineral Analysis. We have to wonder whether they are aware of the lack of evidence as to its usefulness for detecting mineral deficiencies.

(6) We are a bit concerned that nutritional therapists can be let loose on vulnerable people with so little training. How do they decide when they are out of their depth? Are they possibly assigned a mentor? Many of them speak of how they are bound by the BANT code of ethics, but BANT describes itself as the professional regulator working towards The Nutrition Therapy Council’s code of practice. However, the NTC refers those wanting to complain back to BANT as part of what they call

transitional arrangements

If you are confused by the above don’t worry so are we. May we suggest that, for the time being, all complaints are directed to HRH Prince Charles as he seems to be the driving force behind the regulatory plans for the nutritionista industry. Statutory regulation of doctors began with the Medical Act 1858 and if you have a complaint you can, ultimately, take it to the GMC. A similar arrangement exists with dietitians and despite what Holford Myths says they are regulated by the Health Professions Council and NOT the British Dietetic Association.

(7) It seems strange that many Dip IONs put the letters MBANT after their name on their websites. This might lead to the impression they have studied for another qualification when actually all they have done is pay their membership dues to the recently renamed British Association for Applied Nutrition and Nutritional Therapy. After all, members of the Chartered Institute of Management Accountants and the Chartered Institute of Marketing and the Chartered Institute of Purchasing & Supply only get one set of letters. We have to point out dietitians don’t put MBDA after their names! Several give the impression – we are sure it is unintentional – that their Dip ION and Foundation Science Degree (FdSc) from the University of Bedfordshire are two separate qualifications, for example see here and here. They are, of course, actually one and the same. Presumably, the proper way to display the letters on the door at your “clinic” is Dip ION or Dip ION/FdSc. Some appear to misunderstand the nature of their qualification. One describes herself as having

a Post Graduate Diploma from Patrick Holford’s world renowned Institute for Optimum Nutrition.

A few years after leaving university I did an afternoon first aid training course. I wonder if that counts as postgraduate medical training in the eyes of the ION? Three describe themselves as Clinical Nutritionists even though BANT advises its members to describe themselves as nutritional therapists. (See “Understanding The Differences Between Nutrition Health Professionals” The Nutrition Society, Sep 2004, p34)

(8) Consequently, we regret at this stage we do not feel we can recommend a visit to a nutrition therapist. If you want to learn more about nutrition why not buy a copy of Nutrition for Dummies written by Sue Baic and Nigel Denby, two state registered dietitians. It may be that you feel that you are a bit overweight in which case you might want to book an appointment with the practice nurse at your local health centre. He will be able to give you plenty of advice about routes to a healthier lifestyle. If you feel you have a serious problem go and see your GP who, if necessary, can refer you to a dietitian. A nutritional therapist practising in the south of England put it rather well: ***Always consult your GP if you have a health problem.*** [See small print at the very bottom of your screen]

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11 Responses to “Introducing the Dip IONs – Patrick Holford’s Shock Troops of Optimum Nutrition”

  1. LeeT Says:

    According to my stats this is a very popular post. However, no one has left any comments.

    This my first piece of research in a very long time so I would very grateful to know your thoughts on the following questions … Please subject me to merciless criticism.

    (1) HaveI been too hard on Dip IONs or too soft on them?
    (2) What information has been left out?
    (3) What do you think of the methodology? We are looking at those Dip IONs with websites (100 or so). What about those without websites or who possibly choose not be listed in the ION directory? What conclusions can we draw from them?
    (4) What possible future can there be for Dip IONs with integrity?

  2. You & Yours on Barbara Nash and the risks of nutritional therapy Updated (again) « Holford Watch: Patrick Holford, nutritionism and bad science Says:

    […] 21: Through A Glass Darkly has now posted about the qualifications and career backgrounds of DipION […]

  3. Mark Walterfang Says:

    I think it’s a very entertaining post, but what might really enliven it – given your survey of websites – is some basic numbers. For example, out of the 100 or so websites, how many put both DipION and FdSC? It’s not impossible to turn something with a bit of statistical analysis like this into an article for a standard scientific journal – I’ve read a number of papers that essentially “reviewed” the information on web sites and classified them according to similar variables. I’d certainly be interested in looking at it as a reviewer – it would make a nice change from the methods-dense neuroimaging papers that are flooding through my door at the moment!

  4. LeeT Says:

    Mark

    I hesitated to put numbers in the post because I was conscious of the limitations of what I was doing. Not all nutritional therapists have websites and possibly not all nutritional therapists have chosen to be listed in the Institute for Optimum Nutrition’s online directory. I did not want to say, for example, 50 therapists did not have a science background and then be told later it was a 58 or whatever.

    However, I think the 88 people I looked at are fairly represenative of nutritional therapists. Possibly those without websites or not listed in the directory are not available for private consultations.

    I’ll come back with some figures at the week end.

    If any nutritional therapists have read this I would be very interested to know how they see the future of their profession. Are you proud of Patrick Holford?

  5. LeeT Says:

    In response to Mark’s questions I thought I had better provide some more information about my methodology.

    Patrick Holford claims the Institute for Optimum Nutrition’s diploma in nutrition therapy provides better training to “advise an individual about their nutritional needs” than a degree in a nutrition. My aim was to find out whether that was true in. I am not a dietitian or a registered nutritionist nor do I have any direct experience of such individuals. My research was carried out mostly with the aid of publicly available websites.

    The Institute for Optimum provides a directory of nutritional therapists available for consultations. 83 of them have websites and these are the ones I have looked out. It would be a valid criticism of my analysis to ask if it is significant omission that those without websites have not been investigated. They could have been telephoned, but that would have involved making lots of long distance telephone calls and I think it most likely that they would have agreed to co-operate.

    Also of interest is how few people are listed in the directory, less than 200 in total. The Winter 2007 edition of “Optimum Nutrition” magazine shows us a photograph of 70 individuals receiving their diplomas. Consequently, a conservative estimate of the number of Dip Ions in circulation – given the ION started in 1984 – would be 500. Where are they all hiding and what they are doing?

    35 out of 83 nutritional therapists have a science related background. Four have PhDs. Only two appear to have a record of carrying out peer-reviewed research. 19 therapists declare themselves to be qualified in various alternative therapies. Interestingly, only four of these individuals have a science background. One person is a registered member of the Nutrition Society, hardly surprising as the Nutrition Society is on record as saying the ION diploma does not cover enough biochemistry.

    The most astonishing observation is that none of the 83 therapists I looked at seemed to be working towards converting their diploma in to a BSc honours degree. I can’t believe that is true – some one must have signed up for the course! Possibly they don’t want to members of the public that they don’t yet have a full honours degree in nutrition.

    Just about all therapists seem to offer a wide variety of tests and treatments.

  6. Charlotte Says:

    Commenting as requested, sorry it’s a little late.

    Thanks for the numbers, it makes your article seem more solid – less like mockery and more like serious commentary. Not that there’s anything wrong with mockery.

    To be utterly cynical about the whole thing, might I suggest that people who don’t know what it means are more impressed by an FdSc than they would be by a bog-standard BSc? After all, it almost looks like FRCS and the like. I’m not feeling inclined to be charitable to them after following your link to that NI site. £60 for a thrush test! It must be massively superior to the test the NHS do for free. And that’s one of their cheapest. Still, I suppose it’s good for the economy.

  7. LeeT Says:

    Well, it is not nice to mock people and I hope I was not doing that. Nonetheless, the more I found out about them the more ridiculous it all seemed.

    I was inspired to do this “study” when a nutritional therapists posted on Holford Watch and was indignant that people were implying they were all thick. I wanted to take a serious look at who becomes a nutritional therapist and how they get there. They are certainly not stupid. It is a very slick and well-organised operation.

    What truly surprised me was how many Dip IONs practised alternative therapies. As Ben Goldacre points in his recent book “Bad Science” the House of Lords did not list orthomolecular medicine or whatever you want to call it as an alternative therapy. Nonetheless, many of Patrick’s frontline troops have no problem with publicly aligning themselves with scientifically dubious treatments.

    There is more to say about these people and I am sure we’ll come back to them.

  8. dvnutrix Says:

    One of the interesting aspects of the ION is how the diploma has progressed from being dependent on a course, taught by (mostly) one man who set up the ION as a business, taught on a weekend or so a month for less than 2 years, to a course in something converted to an educational charity, taught on the odd weekend, by more lecturers over 3 years, and with a board of trustees to guarantee the ‘respectability’ of the course.

    Of course, these days, the ION stipulates that people must have science A-levels or their own ‘science foundation course’ before commencing the DipION. However, still no indication that ION has lab facilities for measuring food values; bod pods or similar for establishing body composition or assessing metabolic activity etc. etc.

  9. draust Says:

    “Many seem to be experts in metabolic typing, phytobiophysics, iridology, colour analysis, bowen therapy, emotion freedom techniques, applied metabolic ecology, bio-energetics (SCENAR) and blood microscopy. If you understand what half of these things are please enlighten us.”

    As I am sure you know, Lee, the common feature of all of the above is that they are all utterly bogus hocus-pocus with zero basis (even of the most tenuous kind) in science or physical reality.

    Anyone who practises one of these is either a fool, or a con-artist. In neither case should anyone with any sense take “nutritional advice” from them.

  10. pv Says:

    I am quite taken with this ION quote:

    “HMA is perhaps best viewed as an evolving area in need of open-minded scientific review. It has a limited present value because of the lack of evidence behind it – but it MIGHT [my emphasis] have untapped potential of enormous value. (Optimum Nutrition Magazine, p.30 Winter 2007.)

    Unless I am particularly slow, which quite likely, isn’t the “enormous value” measured in £ sterling? Surely, rather than advice to treat it with caution it’s a clear incitement to offer the service.

  11. globalee Says:

    Hair mineral testing gives a good indication of mineral imbalances and toxic heavy metals in your body.
    Hair mineral analysis tests seems to be a reliable way to get an indication of nutritional imbalances and mineral deficiencies.

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