Get a life, get a wife and some manuka honey

December 28, 2008

It is surprising how many attacks you receive when you set up a little old blog. I thought everyone who knew me would be enthused and very interested in the public service I was performing. Unfortunately, some one declared:

Ohhhh …. Puhhhlease … You need a life … Go and get yourself a wife …

Some else commented

Why don’t you look in to the medicinal benefits of manuka honey rather than slag off Gillian McKeith and Professor Patrick Holford?

So this post is dedicated to my critics to prove I’ll investigate and research anything including things as exotic as honey. After all I am a fan of Winnie the Pooh which makes me well-qualified for this research.

According to one article I read

Manuka honey is a natural remedy that actually has some proper research behind it

It is great to know that the “natural” industry – whatever that is! – has actually gone to the trouble of doing some research. However, if the reader scrolls to the bottom of the page, there is a link to buy mauka honey products. Errr … wait a minute before I go to the New Zealand Honey Shop let’s take a little look at the evidence. According to its Wikipedia article

Manuka honey is from bees who feed on the flowers of the Manuka bush , also known as the “Tea Tree” to produce honey that has anti-bacterial properties

So where is this research coming from? Well, there is actually a honey research unit at the University of Waikato in New Zealand. Their mission is to

study the composition of honey and its antimicrobial properties

According to their website they were set up in 1995 with “support from the New Zealand Honey Industry Trust”. Anyway, it would appear from their table of contents that they have a wide range of interests. Currently some of the things they are looking at include: wound dressings for leg ulcers; ezema; gastroenteritis in cattle and pigs; acne; flavonoids in New Zealand honey; and, predictably, finding honey with obligosaccharide constituents that could be growth factors for probiotic bifodoacteria – after all everyone else has entered the probiotic market so why not bee keepers? How long will it be before Patrick Holford writes a book about the benefits of manuka honey? Perhaps The University of Waikato will make him a visiting professor in …. ummm … manuka honey ….

Unfortunately, the attempt of manukaists to take over the world has not all been plain sailing. Apparently, one of their research project actually attracted some criticism and they had to issue a statement

Statements that have been made about the results of the HALT trial on honey dressing on venous leg ulcers (…) give the impression that the results were negative . The reality is that the results were inconclusive, not negative. Honey gave better results than the standard treatment.

Unfortunately, they have to conclude that

statistical analysis showed that these differences could have been due to chance so it cannot be concluded with certainty that honey gave better results

Apparently, more participants were needed which would have the trial more expensive. Possibly the New Zealand Honey Industry Trust could have been asked for a bit more cash? Oh well, just a suggestion.

So what is the evidence for honey? I looked on the food facts section of the British Dietetic Association, the place I usually go for nutritional advice with a good evidence base. Unfortunately, there was nothing there. However, they did a factsheet on wholegrains suggesting that we ate a wholegrain with every meal. Possibly we should have a table spoon a of manuka honey with our wholegrains? Just remember you read it here first. Luckily for us readers The Cochrane Collaboration has done a systematic review on using honey to treat wounds which you can read here. They conclude:

Although honey may improve healing times in mild to moderate superficial and partial thickness burns compared with some conventional dressings, it was found that honey dressings used alongside compression therapy do not significantly increase leg ulcer healing at 12 weeks. There is insufficient evidence to guide clinical practice for other wound types

Due to coverage in the press by The Daily Mail the NHS Knowledge Service felt compelled to cover the issue. They explain the findings of the systematic review in every day language. Apparently, it would appear that at the present time the hype is ahead of the evidence. Still, there do seem to be promising avenues for future research. Possibly one day we won’t need to buy first aid kits we’ll just smear honey over ourselves to treat minor ailments.

Now what about finding that wife …..?

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One coincidence after another …

December 21, 2008

Do you remember dear readers how I told you about my seminar with Patrick Holford? Well he was very pleased that Health Products for Life were able to attend. What a coincidence that they were free that evening! They were selling plastic containers with Patrick’s face on them. They were filled with pills coincidentally recommended by Patrick. Mrs Holford was running a book store at the back of the hall. It just so happened all the books were written by her husband.

I have experienced a number of coincidences recently as well. Recently I learnt that David Colquhoun will be in Oxford on the afternoon of Saturday 07 February 2009. Rather coincidentally it appears Andy Lewis of the Quackometer blog will be in town at the same time. Even more bizarrely Oxford Town Hall has a room available for hire on the very same afternoon. By a strange twist of fate I am free that afternoon as well and could bring some coffee and biscuits along if I can find any shops selling such items.

Possibly some of you will be in Oxford as well that day or would that be a coincidence too far ???

A man who really knew about coincidences was the late and much-lamented Professor Richard Feynman:

You know, the most amazing thing happened to me tonight. I was coming here, on the way to the lecture, and I came in through the parking lot. And you won’t believe what happened. I saw a car with the license plate ARW 357. Can you imagine? Of all the millions of license plates in the state, what was the chance that I would see that particular one tonight? Amazing…

Enjoying your food

December 7, 2008

Were you aware that it was recently British Food Fortnight a celebration of British food producers? In this country we are often guilty of selling ourselves short when it comes to food in favour of supposedly superior products from other countries. According to the British Food Fortnight website Britain now produces more cheese than France! Yesterday, I purchased a very nice looking chilli and lime condiment from my local farm shop. I am very looking forward to trying it out on my next Chinese stir fry. I also got myself a bottle of Satan’s Sister – that’s a bottle of beer in case any of you are wondering! There seem to an awful lot of small independent breweries round here producing high quality real ales. I’ll report back to you when I have got through them ..

If you are a supporter of ex-professor Patrick Holford and the Food for the Brain Foundation you may have missed British Food Fortnight. You would have thought they would have been keen on promoting healthy, wholesome and nutritious British food. Apparently not as they have certainly not sent out any emails promoting it recently. Perhaps the commission being offered was not high enough? I found a very interesting article on The Guardian website which made me wonder if celebrity nutritionists actually like food very much. Journalist Rachel Cooke went to interview Gillian McKeith. (Her full correct academic title as Ben Goldacre pointed out is actually Gillian McKeith.) She gained the impression that, dare we say it, Dr [sic] McKeith was not very healthy:

She is famously tiny woman, but even so, there is something papery about her skin; when she shakes my hands, I feel bones wrapped in parchment. She would no doubt laugh out loud at the suggestion that she is absolutely famished but, beyond all the wild enthusiasm and the preaching and the ‘positive energy’, this is precisely what she radiates. She looks hungry.

After listening to Dr [sic] McKeith Ms Cooke concludes that:

the real problem with her is that she is so anti-life. Food is about history, and culture, and ritual (…) there is so little that is celebratory ..

I very much enjoy visiting Basingstoke Farmers’ Market. It would be great to take ex-professor Holford there with me. How about a bottle of English apple juice? No too much sugar! Or some freshly made doughnuts? Also too much sugar. For some reason he seems to have a grudge against sugar. How about some minced beef or pork sausages. No, meat is unhealthy for reasons not too clear. How about some Cotswold cheese? No, apparently you will develop a dairy allergy if you eat too much. Ahhh yes, he does like his berries doesn’t he? Raspberry Mr Holford?

Michael Pollan in his recent book In Defence of Food suggests there is a real problem with he calls nutritionalism:

In the case of nutritionism, the widely shared but unexamined assumption is that the key to understanding food is indeed the nutrient. Put another way: Foods are essentially the sum of their nutrient parts.” (In Defence of Food, p.28)

He goes on to declare:

[P]eople don’t eat nutrients; they eat foods, and foods can behave very differently from the nutrients they contain.

He then goes on talk about how certain supplements may actually increase mortality. Do you remember the Cochrane Collaboration’s report earlier this year?

The quest of our celebrity nutritionist friends, people like Patrick Holford and Gillian McKeith is to find the ideal combination of nutrients to create the ideal diet. If that were genuinely possible you would possibly expect to find that different kind of diets would produce different health outcomes. Unfortunately, this does not appear to be the case. Human beings appear to be able to survive on a wide variety of diets. Think of the Greeks and the so-called Mediterranean diet, Scottish crofters and their oats or the Inuit who eat a diet rich in fish. Pollan coins an interesting term when discussing the current nutritional related health problems in the western world: the Western Diet. The Western Diet is high in processed food. Are celebrity nutritionists part of the solution to this problem? Down at my local supermarket you can find a Gillian McKeith Vitamin C bar. Can you think of better sources of vitamin C? Possibly you might like to buy an orange? However, according to Ben Goldacre our friend ex-professor Holford believes some supermarket oranges do not contain any vitamin C. (It is there in black and white in the latest edition of The Optimum Nutrition Bible.) Rather coincidentally, you can get some vitamin C pills from Health Products for Life the company he recently sold to Biocare for £464,000 Goldacre invites Holford to send a vitamin C-free orange to him care of his publishers. (Note – send the orange to Ben NOT me.) Truly I hope things have not quite got that bad! Pollan points out:

Most consumers automatically assume that the word “organic” is synonamous with health, but it makes no difference to your insulin metabolism if the high-fructose corn syrup in your soda is organic. (In Defence of Food, p.178)

Nearly a year ago The World Cancer Research published a report Food, Nutrition, Physical Acitivity, and the Prevention of Cancer: A Global Perspective on lifestyle and cancer. The idea was to do a systematic review and look at all the available data on lifestyle and cancer, though readers of The Daily Mail could be forgiven for thinking the report was simply about demonizing bacon! Their conclusions tie in very well with what Pollan recommend in “In Defence of Food”, for example,

limit consumption of processed food with added salt (p. xx).

The report informs us

Rates of overweight and obesity doubled in many high-income countries between 1990 and 2005” (p. xvii)

It is very depressing that having conquered malnutrition in the Western world many of us are eating ourselves to death. The sad thing is that celebrity nutritionists and their army of admirers are playing on our fears. For example, Dr [sic] Gillian McKeith offers us a detox potion available for more than £15 from our local supermarket. So what can we do?

Be subversive. Don’t pill buy the pills and potions offered by the lifestyle gurus. Eat lots of fresh fruit, vegetables and wholegrains. Check out local suppliers who you might miss if you rely on supermarket advertising. Get a bit of exercise. (In a few weeks I’ll tell you how to get 40% off the retail value of a bicycle.) Above all cook your own meals from scratch then you’ll be the one doing all the processing! Possibly you could even grow your own vegetables or better still get them from a member of your family who does. Enjoy your meal !!

A Letter to Oxfordshire County Council Education Services

November 22, 2008

Ms X
Head of Adult Education Services
Oxfordshire County Council

22 November 2008

Dear Ms X

I was interested to read the section on complementary therapies in the latest brochure of Oxfordshire County Council adult education services. I hope you are willing to answer a few questions.

A frequent criticism of practitioners of complementary therapies is that they often claim to be able to cure particular medical conditions even when there is no evidence to support what they are saying. For example, on page 42 you are offering a course in kinesiology a belief system which has no basis in science. What steps does Oxfordshire County Council take to ensure tutors on complementary medicine courses are not making false or fraudulent claims about the treatments they offer? Indeed, how do you recruit tutors?

You are doubtless aware of the case of Dawn Page who suffered brain damage after visiting the Oxfordshire nutritional therapist, Barbara Nash. (See http://www.oxfordmail.co.uk/news/2380792.detox_diet_led_to_brain_damage/ to read the full story.) I note that you are offering courses led by a local nutritional therapist. If any harm were to befall a student following advice given by one of your tutors the council might possibly be held liable. At the very least I think you should consider adding a disclaimer to the courses, something along the lines of: “Our complementary medicine courses are for information and entertainment only. If you have a medical problem please see a GP or nurse at your local health centre.”

Finally, I should very much like to know how much public subsidy is being used to support these courses. Presumably the true cost per person of, for example, “Crystals & Herbs for Health” on page 41 is not £33.

I very much look forward to hearing from you soon.

Yours sincerely

Lee Thacker

An Offer to Serve Up Some Food to you on Sunday 16 November ….

November 8, 2008

What celebrity nutritionists often seem to forget is the social justice aspect of food. For example, ex-professor Holford made no mention of Fairtrade Fortnight 2008 in messages he sent to his supporters at the start of this year. It is almost as if they are unaware of the toil that goes in to producing food. Possibly they do not care.

In Britain less than 5% of the population works on the land. Despite the best lobbying efforts of the farming community food production is probably not something most of us consider very often. However, in some parts of the world livelihoods depend on agriculture. One example of this is Palestine. The olive tree dominates the landscape of the West Bank. Agriculture, particularly olives, supports half the population. Olive oil has become very popular in northern Europe. The British celebrity chef Jamie Oliver is very fond of it. In one our major supermarkets you can see his smiling face on bottles of olive oil in the same way that you can see Patrick Holford’s face on plastic bottles containing vitamin pills. The ex-professor also endorses Nairns oat cakes. (Despite that I am still buying them!) Clearly Mr Oliver and Mr Holford have no problem reaching consumers.

Olive farmers in the West Bank struggle to reach international markets. See this article for more information about their problems. Five years ago some young British volunteers went to help and observe the olive harvest. They were asked whether there might be a market for Palestinian olive oil in the United Kingdom. Initially, 200 bottles were brought back. The oil called Zaytoun – from the Arabic for olive – proved to be very popular and in 2007 more than £1million worth of produce was sold up and down Britain. You may be asking how you have missed the bottles in your local Sainsbury’s or Tesco. The simple answer is that most of it has been distributed by either volunteers or Fairtrade organisations such as Traidcraft and Equal Exchange. I bought a few cases for Basingstoke Summer Fete. It proved to be very popular and before long we were having a pallet delivered every two or three months and buying more than £4000 worth of stock a year. Click here to find your nearest stockist. Hopefully, the oil will be appearing in the Co-op in time for Fairtrade Fortnight 2009.

Next week I shall be leaving Basingstoke behind for the bright lights of London. Cultural organisation Hafla is putting on a bit of a party in Kent House, the home of Westminster Synagogue. According to their website:

Hafla is a London-based organisation creating cultural events, celebrating a vision of peace and prosperity in the Middle East. We bring together Israelis and Palestinians, Muslims, Arabs and Jews and all people who are committed to creating peace in this part of the world.

The event takes place on Sunday 16 November 2008 and is called Cooking from the Heart and is

A celebration of food and culture from across the Middle East.

I’ll be there promoting Sindyanna of Galilee an organisation of Jewish and Palestinian women from northern Israel that markets the agricultural produce of the local Palestinian community. At the same time I’ll be preparing an optimally nutritious dish. Hope to see you there. If not next time you pick up some food think about how it was produced ….

How to Quit with Feeling S**t with Patrick Holford at Baden Powell House

October 12, 2008

What were you doing on the evening of Thursday 09 October 2008? Watching Eastenders perhaps? Well, I travelled up to London to listen to and speak with Patrick Holford, founder of the Institute for Optimum Nutrition and former visiting professor at the University of Teeside. Mr Holford was talking about his latest book – How to Quit Without Feeling S**t along with his co-author Dr David Miller.

The venue for the academic seminar was Baden Powell House. When I saw that in the email containing my ticket I imagined that I would be visiting the headquarters of the Scout Association. Not exactly as Baden Powell House is a youth hostel owned by the Scouts close to Gloucester Road underground station. The entrance foyer was crowded with German backpackers, but I was able to make my way around them to the large conference room at the side of the building. I would say more than 200 people were seated in the room each paying £15. Mr Holford had just started was doing a bit of name dropping in regard to Abram Hoffer. Apparently, at the age of 96 he was semi-retired and now only works four days a week. As Patrick Holford often points out he spends his time reading all the latest up-to-date research on nutrition and in the course of this research he discovered Dr David Miller.

Dr Miller is a recovered or recovering alcoholic. (I am not sure what the correct term is. It seems to change.) More than thirty years ago he was addicted to alcohol. He spoke rather movingly of his struggle to break free from the grip of alcohol. People think rather simplistically that once you stop taking a drug your problems are over. Nonetheless, addicts complain of symptoms such as mood swings and feelings of irritability. Dr Miller described these feelings as “chronic abstinence symptoms.” This does appear to a recognised medical condition. For example, see the following published research in respect of marijuana users.

A cartoon was shown of two doctors, one of whom was shaking whilst talking to his colleague. The caption read: “Doctor I seem to be addicted to prescribing drugs.” I remember that from Mr Holford’s Optimum for the Mind. Ho, ho, ho. Dr Miller then took us on a very short tour through the history of what the addiction treatment: (1) we had the moral model where the addiction arose from defects of character (2) there was the disease model where the problem was seen to be medical (3) the psychological model where the addict was perceived as having a mental disorder and finally (4) you have guessed it we have the integrative or holistic model. Addiction he declared is a “Bio psycho social spiritual disorder.” We were all given a hand out with the grand title “Scale of Abstinence Sympton Severity” and 26 possible symptoms. We were invited to rate ourselves on the scale of one to ten

There is a vicious cycle of stress and fatigue. In fact, there is a paradox in recovery in that in order to recover we need abstinence yet abstinence-based symptoms interfere with our ability to stay sober. Some of these symptoms last months or even years. “1 in 4 Britons are addicted” “13 million Britons have taken illegal drugs” According to The Observer newspaper “Many of us believe alcohol and tobacco pose greater health risks than ecstasy and cocaine.” Be scared. BE VERY SCARED. Before I go any further I would like to ask a few questions. It is a shame there was no opportunity to ask them at the time: (1) What are ¼ Britons addicted to and what is the nature of their addictions? From where does this statistic originate? (2) In what respect do ecstasy and cocaine pose a greater health risk than tobacco and alcohol? Presumably more people are taking the latter, though I would not imagine many muggings and burglaries are committed by people wanting to buy low cost Tesco lager. (3) How often do Britons take illegal drugs? I would imagine many simply take them when young or on just a few occasions.

In our seminar we then went to look at how our brains become addicted. Apparently, once again it is all to do with the neurons and neurotransmitters in our brains. If I had my way I would get rid of them all. Neurotransmitters in our brain are built from amino acids which our body of course obtains from proteins. Neurotransmitters will calm or excite us. Dopamine was given as an example. We were told that addictive substances mess with your brain. Here is a study I found on PubMed

Alcoholism is associated with shrinkage of brain tissue and reduction in the number of neurons

Addictive substances either mimic feel good chemicals or shut them down. The neurotransmitters in the brain that help motivate us become insensitive and dopamine is given as an example. Indeed on the Wikipedia, we read:

Dopamine has many functions in the brain, including important roles in behaviour and cognition. (…) A common hypothesis, though not uncontroversial is that dopamine has a function of transmitting reward prediction error.

For more information have a read of this fascinating article. Did you know that:

Although DA neurons account for less than 1% of the total neuronal population of the brain, they have a profound effect on brain function

So basically what Dr Miller and Mr Holford are telling us is that addictions mess up the biochemistry of our brain. I am sure most mainstream neuro-scientists would not disagree. So with all 200 members of the audience suitably scared what solution could be offered?

Well, we had another hand out listing six neurotransmitters. We were informed: (i) which amino acid it was made from (ii) what it does (iii) the symptoms of deficiency and (iv) the substances addicts use to compensate for deficiency. For example, Dopamine is made from L-tyrosine and gives rise to good feelings comfort and alertness. If you are deficient in it you feel empty, depressed and lack motivation which leads you to seeking alcohol, marijuana, cocaine, caffeine, sugar and tobacco. It all sounds a bit simplistic, but fortunately on the other side of the page is a solution to all your problems. There you will find a ready-made presciption for recovering alcoholics. Apparently, they need to take: (i) combination chill/sleep formula 4 pills a day (ii) Methyl-nutrient formula 2 pills a day (iii) Omega-3 EPA-rich capsule 2 pills a days and (iv) Vitamin C, 1000mg 2 pills. BUT DON’T FORGET ALWAYS TAKE THE BASIC SUPPLEMENTS which means that in addition you need: (i) an optimum multivitamin & mineral (ii) Additional Vitamin C: ideally with berry extracts (iii) Essential omega-3 and 6 fats (iv) Phospholipid complex. Fortunately, when Patrick took over he explained to us that we only have to take the amino acid supplements for a month or so. When the total abstinence symptoms were down you could just rely on the basics. Patrick was very pleased to note that Health Products for Life were able to make it that evening. Indeed, how fortunate they were not doing anything else. I wonder who asked them to come along? They were at the back of the hall selling lots of pills some of which, coincidentally, were recommended by Mr Holford himself.

By the time the break arrived I was extremely hungry. I reasoned that seeing as the place was a hostel for young people there should be a snack machine somewhere. I was correct and found one close to the reception. Unfortunately, Optimum Nutrition has not yet reached The Scout Association so the machines were full of chocolate, crisps and fizzy drinks. I bought a packet of Walkers Ready Salted crisps – low in sugar, only 0.5g of salt and a moderate amount of non-essential fatty acids. However, I dared not go back in the main hall with such a substance. Possibly I could have been lynched by a group of nutritional therapists. At that point I noticed an exhibition in the corner of the room. Unsurprisingly it was about Baden Powell and the foundation of the Scout movement. The text on the first panel explained that back in 1907 Britain was a very different place. There was much poverty and many young people experienced malnutrition. Rickets was not unknown. Baden-Powell’s solution was not a supplement programme, it was teaching self-reliance. Members of the Scout movement experienced life out-doors, got plenty of exercise and learnt how to cook over camp fires. Unfortunately, I seemed to be alone whilst reading the exhibition.

The second part of the evening was taken up with Patrick telling us various things about allergies, testing for allergies, the pressure group Sense About Science, how to detox, why you should not eat dairy products and antioxidants. What this had to with addiction I was not sure, but it was his seminar after all. If I have time I’ll write that up another time. I was a bit disappointed that there was no opportunity to ask questions so afterwards I went up to the front to speak with Patrick. Again another post for another time. I also spoke with David Miller. Meanwhile next to us Mrs Holford was tidying away the audio equipment. She asked if I wanted privacy to speak with Dr Miller. Well no, I did not. Quite the opposite as what I wanted to know was whether there had been any studies done comparing what he was doing with more conventional treatments. We would not want to be shy and private about our successes would we? He told me that studies were shortly to short. That was a pleasant surprise. He handed me two leaflets about two centres offering the treatment. Click here and here for their websites. Both seem to specialise in intravenous therapy which according to one of the leaflets I was given

Delivers nutrients to the brain while by-passing the gut

Bridging the Gaps is based in the Shenandoah Valley of West Virginia. Placebo therapies such as acu-detox are available as is Yoga and gym membership. Possibly that has as much to do with their success rates as the nutrition therapy offered? If Patrick Holford were to open a similar facility in Britain where would it be located – Dartmoor, the Brecon Beacons, the Lake District or the Wye Valley? As soon as we find out we’ll let you know so you can vary your holiday plans accordingly.

As I left I overheard Mrs Holford talking to Dr Miller

David you must be so hungry

I wondered whether I should point him in the direction of the chocolate machine in the foyer. No. Perhaps not.

An Evening with ex-professor Holford

September 30, 2008

Well I said I would do it and now I have done it.

Yes, that’s right I have paid £15 to attend a book promotion umm … I mean an academic seminar with ex-professor Patrick Holford. It had better be good that’s all I am saying.  If anyone is free next Thursday evening and is in London perhaps they would like to join me.  I am quite excited about it all!!

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

September 18, 2008

(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]

The Food for the Brain Foundation Needs YOU

September 6, 2008

Readers I have just been sent an email (see below) from The Food for the Brian Foundation (CEO: ex-professor Patrick Holford offering me the chance of a job. Lucky old me ehhhh? Unfortunately, it is not one for which I am remotely qualified so I don’t think I’ll be applying. They are looking for “a BANT registered nutritional therapist with clinical experience.” Now I don’t wish to boast here, but I think I must be one of the country’s leading experts on Dip ION qualified BANT nutritional therapists. Yes, yes I know the research has not yet been published but do give me time my dear readers. Some of them I have read their websites so many times they seem almost like family. Obviously, I need to organise a safe house to go to before I upset the alties. Is there anyone on a Pacific island reading this who might be interested in helping me out? Ummm, sorry now where was I?

The trouble is that very few of them are actually qualified to do an MSc project in nutrition and mental health. A Dip ION is actually a foundation degree in science from the University of Bedfordshire. Quite sneaky that ehhh – two qualifications for the price of one? Of course, no one would be dishonest enough to put the letters Dip ION/FdSc on their website to imply they had two separate qualifications would they? Umm … we shall return to that matter on another occasion. A foundation degree is actually equivalent to two years full-time study. So “Food for the Brain” is actually specifically targeting people for an MSc – nutritional therapists – who have skipped the final year of their degree. However, we must be fair here. It is possible to convert the Dip ION/FdSc in to a University of Bedfordshire honours degree. However, on looking at Dip ION websites it would not appear that not very many have done so. Also it has be said that many Dip IONs have first degrees in relevant things like nutrition, biological sciences or nursing. These qualifications were obtained before they went down the Dip ION route.

However, I would estimate that there are probably less than a few hundred people in the whole country who are both BANT registered nutritional therapists AND holders of a relevant first degree in nutrition/biologicial sciences or health care. Presumably there are thousands of bright young things out there with good degrees in psychology, medicine, life sciences or nutrition who might be qualified to do an MSc about nutrition and mental health, but Food for the Brain want a nutritional therapist and THAT is THAT. Possibly, if we were being a bit cynical we might think they already have some one in mind.

What of the research itself? It is all jolly vague. They are looking for some one to evaluate the clinical efficiency of ADHD (does that stand for Always Dependent on Holford’s Direction?), schizophrenia or depression. It is as if they are saying “come on now we don’t care what research you do as long as it is something that proves there is a reason for our existence.” Usually, you would expect a prospective employer to provide a job specification. In this case “Food for the Brain” are inviting research applicants to set the agenda. One would have expected their scientific advisory board to have a few meetings and make a decision: “Okay, the scientific world is skeptical that nutritional approaches can help schizophrenia. Let’s do some research to prove them wrong and win ourselves a Nobel prize in the process. We can then come back and cure depression and ADHD in 2010 and 2012.” The way they have behaved is not very well-organised or proactive is it? Perhaps I’ll send in application to research the training and continuing professional development of nutritional therapists. What they are trying to do is find some one to prove the concept of optimum nutrition more technically known as orthomolecular medicine. If you remember the religion of orthomolecular medicine was founded more than thirty years ago by Abram Hoffer,“the pioneer and perfector of the faith.” They want some one to review both mainstream and anecdotal evidence. Fortunately, Ernst and Singh have recently reviewed the mainstream scientific evidence in their book “Trick or Treatment?”. Here is what they had to say:

“Proponents of this approach believe that low levels of these substances cause chronic problems which go beyond straightforward mineral or vitamin deficiency. These problems include a tendency to suffer from infections such as the common cold, lack of energy or even cancer. [Readers of Optimum Nutrition for the Mind will know that ex-professor Holford believes other conditions such as autism, schizophrenia, ADHD and bipolar disorder can similarly be cured.] (…) The hallmarks of orthomolecular medicine are the extremely high doses that are usually suggested and the individualization of the prescription.”

He goes on to conclude:

“The concepts of orthomolecular medicine are not biologically plausible and supported by the results of rigorous clinical trials. These problems are compounded by the fact that orthomolecular medicine can cause harm and is often expensive.” (Trick or Treatment? Alternative Medicine on Trial, Ernst and Singh, p.320, Bantom Press 2008)

So there we have it conventional science is not yet very impressed by the claims of ex-professor Holford and his friends. However, the researcher is also going to be expected to investigate “anecdotal evidence of nutritional interventions”. I bet there are going to be one or two of those ehhh readers?!! Heyyy, let me tell you a joke: “What did the alternative therapist think was the plural of anecdote?” “Data!” Oh no, don’t tell me you have already heard that one before. I’ll get back to being serious then.

Earlier this year I read a little book in Oxford University Press’ Very Short Introduction series. Have you read any of them? Most of them are quite excellent and enable you to become an expert on a subject in a very short space of time. The one I was reading was by two people – Professor Chris Frith and Professor Eve Johnstone – who are very respected in the field of schizophrenia. Do you think they spent much time discussing nutritional interventions in schizophrenia? Unfortunately, for Food for the Brain in more than 150 pages there was not one mention of nutrition even to demolish the idea that it could help those with schizophrenia. You would think that if there was any merit in the idea Professor Johnstone would have come across it at some point in the last forty years. Oh dear.

Research Opportunity Researcher for a MSc project on nutrition and mental health We are seeking a BANT registered nutritional therapist with clinical experience, to undertake a MSc research project evaluating the clinical efficacy of a nutrition-based approach in the treatment of depression, ADHD or schizophrenia. The research will involve both a comprehensive literature review and analysis of client data treated at the Brain Bio Centre. The objective of this research is to review both mainstream and anecdotal evidence of nutritional interventions in depression, ADHD or schizophrenia, and to determine whether individualised nutritional interventions, as an add-on to existing treatment, improve psychometric scores in specific patients using an open label study design. Applicants need to have previous research experience. Please send your CV plus an example of any research, indicating which mental health condition you are interested in to info@foodforthebrain.org entitled ‘MSc Research. Please submit your details by October 1st 2008.

What is septoplasty and what is the evidence for its effectiveness?

September 5, 2008

Readers I have been “on the sick” this week. Quite shocking really usually I am like Patrick Holford and never have the need to see a doctor. However, for the first time in my life I have been confronted with a document known as the GP note.

The reason I have been taking some time off is that last week I had a bit of minor surgery known as septoplasty. Before I went to see the ENT consultant on 25 June I had never heard of the condition. This week, with a bit of time on my hands, I thought I would do a bit of research. According to Wikipedia, “Septoplastry is a corrective surgical procedure done to straighten to the nasal septum, the partition between the two nasal cavities. (…) When it deviates into one of the cavities, it narrows that cavity and impedes air flow.”

The nasal septum impeding air flow can have a number of consequences. Most importantly off all your breathing is rather irregular and you may have difficulties with exercise. This may mean that you conclude you are not a sporty person and that you give up on exercise which itself may have consequences for your health. A few months ago some one asked me if I smoked, presumably because I get out of breath rather easily. Other problems could include bad snoring and a poor sense of smell both of which I have suffered from. It can also have an effect on the sinuses.

Now for many years I have had problems with concentration and often felt tired even when I had managed to obtain a good night’s sleep. Sometimes the lack of sleep was so bad that I was left with a headache. In short, I was one of those vaguely unwell people looking for something or some one to put him on the path to health and happiness. I spent about £700 on counselling to try to turn myself in to a normal person, but that did not seem to work. Back in January 2004 I had an appointment with the local Patrick Holford representative. He prescribed me with lots of pills and a new diet, both of which were soon discarded.

I then began wonder whether it my destiny to be permanently miserable, apathetic and unsuccessful. After all it would not be possible for Mr Holford and his friends to be successful if there were not lots of people like me around? However, feeling sorry for yourself is never a good idea in the long term especially if it involves comparing yourself negatively to some one like Mr Holford.

You may be asking yourself if there are any alternatives to septoplasty. It appears not: “Nasal drops, sprays or tablets will not relieve an obstruction caused by a bent nasal septum. They may improve nasal breathing a little, but problems return when the treatment stops. Using nasal drops for a long time may actually damage the lining of the nose (muscosa) and make the blockage worse.” http://www.privatehealth.co.uk/private-operations/ear-nose-and-throat/septoplasty/ So that little potion you get from a Chinese herbalist is not actually herbalist is not actually going to help you and make the problem worse. If you remember, going back to my first post, the only bit of original advice the nutritional therapist I saw in 2004 could offer me was to give up citrus fruits! Rather bizarrely, the author of this alternative medicine site: http://www.health-diseases-tips.com/does-septoplasty-work-44699.html says a doctor told him “that septoplasty rarely works”. This contradicts what my ENT consultant and all the anecdotal evidence I found on the internet. (Nonetheless, the site does advise those with sinus problems to let chiropractors put some micro balloons up their noses. I suppose some people like furry handcuffs and plastic whips whilst others go in for chiropractors and mini-balloons: whatever turns you on.)

The anecdotal evidence looks good, but that’s never enough really for those who believe in evidence-based medicine rather than quackery is it? What about the evidence gained from clinical practice, preferably clinical trials. See http://www.emedicine.com/ent/topic128.htm “which states Literature documenting the outcomes of septal surgery is not abundant. Siegal et al and Samad et al have reported patient satisfaction and clinical improvement rates after septoplasty, and both agree that success rates for septoplasty are approximately 70%.” When it comes to obstructive sleep apnea hypopnea syndrome septoplastry can be performed “to straighten a deviated nasal septum (cause of substantial nasal obstruction). This procedure has a very high rate of success in improving the nasal airway if the nasal septal deviation is the major etiology of the nasal obstruction. There are, however, no controlled studies that evaluate the long-term effect of septoplasty on OSAHS.” (See http://www.guideline.gov/summary/summary.aspx?doc_id=10809&nbr=5634&ss=6&xl=999) Also it would appear “nasal septoplasty results in significant improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use.” (See Journal of Otalyngology: Head + Neck Surgery http://linkinghub.elsevier.com/retrieve/pii/S0194599803021673 ) I could go on, but I hope the above goes some way to proving the clinical effectiveness of septoplasty.

I was trying to think about how you could provide a placebo with this type of procedure. The only way I could think of would be to give 50% of patients in a given hospital the anaesthetic, tell them they had had the surgery and then ask them how their breathing was two months later. Presumably you would think it would be worse than those who had actually had the surgery! Still behaving like that would be a bit mean wouldn’t it?

Apparently, about 20% of randomly surveyed adults have problems that could be resolved or relieved by septoplasty. Possibly you are one of them. Many of those individuals will be wasting money consulting various quacks and therapists not realizing that the solution to their problems is very simple. The first thing to do is consult your GP. If necessary she will refer to an ENT consultant who will examine your ears, nose and throat to check what he thinks is causing the problems with your breathing. The waiting list on the NHS is four to five months, though could be a bit longer depending on where you live in the country. The only harmful side effects you may experience are nosebleeds. For the first few days after surgery you will find it difficult to eat and your nose will be blocked up. However, as time goes on your breathing should improve and hopefully will be better than when you went in. I’ll certainly report back. Who knows, as Patrick Holford, puts it the procedure may, “add life to your years.”