November 21, 2009
When discussing “why you crave sugar the way you do” with East Coast Radio in South Africa, Patrick Holford blames “ignorance” as the main cause of ill health. There are a number of issues here:
- I remain unconvinced that Holford’s work on topics such as nutrition or HIV has helped to improve the knowledge of the general public.
- In his discussion with East Coast Radio, Holford draws extensive conclusions (on issues including causal relationships) from a survey of 60,000 people; I would also have concerns re the design of the survey. This suggests a problematic understanding of research design and interpretation.
- I am unconvinced that ignorance is the main cause of ill health. Issues around poverty, inequality, addiction, disease and access to appropriate treatments all play significant roles. Even if people know for example that smoking is bad for them, this will – sadly – not be sufficient to enable them to stop.
There are currently serious health problems in South Africa. Rolling out Holford’s ‘100% health’ ideas – as a supposed solution to the dangers of ignorance – would not be an appropriate solution.
Evidence-based social policies to target inequality, poverty and access to healthcare all have important roles to play in South Africa. ‘Alternative’ nutritionism marketed by British media nutritionists would not be a helpful import.
November 17, 2009
The BBC have now responded to a complaint I submitted about how Scott Quinnell was allowed to plug Dore for dyslexia on Radio 5. The substantive parts of the BBC’s response are below:
It’s not always possible or practical to reflect all the different opinions on a subject within individual programmes. In dealing with any controversial matter the BBC is required to give a fair and balanced report. However, balance can’t simply be judged on the basis of the time allocated to the representatives of either side of an argument. Account also needs to be taken of the way a subject is covered over a period of time, across our output as a whole. Perfect balance is difficult to achieve on every single occasion but overall we believe it is a more achievable goal.
It’s part of our role as an impartial observer is to report a wide range of views on a particular topic but the BBC makes no editorial comment or judgement on the views expressed by contributors to our programmes. Although some people believe that a programme should not allow certain groups or individuals to air their views, we feel that it’s better to include many viewpoints wherever possible. This may include hearing opinions which some people may personally disagree with but which individuals may be fully entitled to hold in the context of legitimate debate.
We hope such an approach is more likely to provide the public with access to differing perspectives on a subject and to help explain context. Programmes do aim to ensure guests are challenged about their views or provide opportunity for contrasting views from other contributors and the audience. I’m sorry if you felt this wasn’t the case on this occasion but as mentioned this isn’t always possible within individual programmes.
However, a key part of ‘5 Live Breakfast’ is listener contribution and they do have different ways for listeners to get in touch and add to discussions and debates. The following website provides details on how you can do this:
http://www.bbc.co.uk/5live/shows/5live-breakfast/get-in-touch/
In this context, the reference to balance is completely unhelpful. There is not good evidence that Dore is effective. If ‘balance’ means giving non-evidence-based interventions as much or more coverage as evidence-based ones – and attributing as much credibility to interventions without a good evidence-base as to evidence-based ones – this does not serve the BBC’s listeners well. Keep reading →
November 16, 2009
Long-term readers may member that we blogged extensively about the charity Life’s 4 Living back in 2008 – see here and here. We were critical of a number of aspects of their work and their uses of alternative medicine.
I was therefore interested to see that Life’s 4 Living’s accounts for the year ending Dec 2008 [PDF, p.5] state that:
In a meeting held on 15 June 2009 the trustees came to a decision to cease all fund-raising activities and close the charity. There were two main reasons for this. The current financial situation has made it very difficult to find another major sponsor [and] although there was an increase of more than £90,000 in street fundraising this year the costs of fundraising and office support were too high for the amount raised
The charity’s website is still active and it’s not entirely clear what the current situation is. However – while it is always unfortunate if the recession is putting people out of work – I would not be disappointed if certain of Life’s 4 Living’s practices are now coming to an end.
November 8, 2009
BBC Radio 5 Live had Scott Quinnell on the 6/11/09 breakfast show*, for Dyslexia Awareness Week. Unfortunately, his conversation on the breakfast show gave him an opportunity to plug Dore unchallenged. We have a number of concerns about this radio segment:
- Quinnell is allowed to state that by “stimulating…three senses” Dore “allows the neural pathways to be automatic between the cerebellum and…your thinking brain”. There is not good evidence for this claim, but Quinnell is allowed to assert it unchallenged.
- The BBC presenter talking with Quinnell comes across as supporting such claims, stating that it is “extraordinary…to think that [Dore exercises] can translate into being able to look at a page and to read”.
- There is no mention of the lack of good evidence that the Dore treatment is effective.
- There is no mention that Dore UK went into administration last year.
- There is no mention of the fact that Dore is a commercial (and rather expensive) programme, nor that Dynevor, which now owns Dore, was established by Quinnell
- The presenter has to check pronunciation of ‘Dore’ while discussing it with Quinnell on air. I am not sure if this speaks to the quality of the pre-broadcast research into Dore and dyslexia.
In response to a previous complaint, I was told that the BBC
never intended to give Quinnell a platform in any way to promote Dore
I wonder what the intention was with this national radio slot?
It is a shame that Dyslexia Awareness Week could not have been used as a reason for discussion of evidence-based approaches to dyslexia. It is not appropriate for the BBC to allow an expensive and highly time-consuming commercial dyslexia treatment – without good evidence of efficacy – to be promoted in this way. I will be complaining to the BBC about this. I would encourage readers to do the same.
* on iplayer now, about 2:56 in.
PS: apologies if there is some repetition of this post: some of the mistakes made were similar enough that I found this hard to avoid.
October 24, 2009
Patrick Holford has made clear his opinions on vitamin C and swine flu (we have already discussed an earlier version of his post, and I don’t know that there is much else to add). However, I was interested to not some of the user comments now on this post, and Holford’s responses. Giving health advice online is always problematic, and Holford does a good job of demonstrating some of the pitfalls.
It is always problematic to give advice without a full – and competently taken – patient history, not something which can be done in blog comments. This issue comes to light when one woman asks in the comments:
I think I have swine flu with a terrible cough and phlegm. What do you recommend I eat and drink?
In such circumstances, one would have hoped that the commenter would have been advised to phone her GP’s surgery or another competent medical professional: a lot of things cause coughs; many (thankfully) heal fine without any intervention, but some will require medical treatment.
Perhaps most worrying, though, is advice relating to current product use. ‘Vix’ states that
I am trying to ensure that both of my sons (aged 2 and 9) are well prepared to battle the impending flu season. I currently give my eldest son 500mg of Vitamin C per day – along with Echinacea, 2 teaspoons of Sambucol and a teaspoon of Colloidal Silver. My youngest gets about the same. Is this enough? And is there a childrens Vitamin C powder that you can specifically recommend? I can’t seem to find one on the Totally Nourish website – only capsules.
Colloidal silver carries risks, but does not bring any benefits. Dosing varies between products, so it is quite possible that a 2 year old and 9 year old child could be getting significant doses of the stuff. I would have hoped that Vix would have been warned of the risks of the product and referred to a competent professional; at a minimum, one would have hoped that enquiries could have been made as to the doses used. However, Holford responds by stating that:
I am not sure that Echinacea is the right thing for swine flu during infection. RE vit C BioCare do a good value vit C powder. I don’t see it on the Totally Nourish website though. I’m sure they can get it for you if you ask. That, in some diluted juice, works best for children.
I do not think that Holford’s blog post is an appropriate setting to offer this type of advice. I also have concerns about some of the advice offered. I will therefore be sending a complaint off to BANT (Holford is a Fellow) this weekend; I hope that they take prompt, effective and transparent action on this issue.
October 20, 2009
Here at Holford Watch, we would like to congratulate Patrick Holford in being selected as one of only two Health experts in the prestigious Guest Getters directory. We were interested to note that Guest Getters have a standard charge of £79.99 for ‘experts’ to register*. We are sure, nonetheless, that Guest Getters impose strict checks on the ‘experts’ they register. We therefore feel that it is important to recognise this significant addition to Holford’s qualifications. Keep reading →
October 12, 2009
I was concerned to see that Food for the Brain are say they are close to beginning their “MSc Research Project into a Nutritional Approach for the Treatment of Schizophrenia”. While I would welcome good quality research into nutrition and mental illness, the approach suggested by Food for the Brain is problematic. They argue that:
Since the core assumption is that there is no single biochemical imbalance that causes schizophrenia, the usual study design of testing a single intervention (double blind controlled clinical trial), is not applicable when it comes to complex nutrient interventions. Instead, the aim is to measure the effectiveness of the approach used at the Brain Bio Centre, both in correcting biochemical imbalances, and in restoring mental health. We hope to involve both recently diagnosed and long-term sufferers.
However, there are ways in which (aspects of) such research can still be blinded. Keep reading →
September 28, 2009
ITV Yorkshire chose to dedicate over two minutes of their 6pm news bulletin today to an uncritical plug for the Dore treatment for learning difficulties.* The lack of good evidence that the Dore programme works – and the fact that Dore UK went into administration last year – were not enough to prevent them from doing so.
Joanna – a dyslexic Dore client – is introduced as someone whose life was “transformed” by “a special programme designed to help stimulate the part of the brain that stimulates learning”. This type of position is maintained throughout the segment, but there are a number of problems with it:
- Whatever Dore is designed to do, there is no good evidence that it works.
- Dore aims to stimulate the cerebellum. This region of the brain appears to play a role in learning, but so do others. There is no one ‘part of the brain that stimulates learning’.
Joanna was on the Dore programme for two years, and has clearly made good progress over those two years. However, people with learning difficulties do develop and progress, even without treatment: there is no way of knowing whether or not Dore was responsible for her progress.
These are all pretty obvious points, but the news segment did not have anyone presenting this point of view or explaining about evidence-based treatments for learning difficulties. Indeed – rather than referring interested viewers to reliable charities such as the British Dyslexia Association – the segment ends with a link to Dore UK’s website displayed on the screen (and read out by the presenter).
A final concern is the negative approach to learning difficulties outlined in the ITV segment. Joanna’s dyslexia is said to have affected her chances of “leading a normal, independent life”. Dyslexic people – even quite severely dyslexic – can and do live independent lives.** Especially as there is not good evidence that Dore cures dyslexia, it is highly irresponsible to present such a negative view of the life chances of dyslexics. Keep reading →
September 26, 2009
We were fascinated to come across a Madeleine Portwood presentation on the Food for the Brain site [PDF]: discussing “Essential Fats, School Performance and Behaviour”. One quote stands out, repeated on two slides alongside pictures of very sweet-looking children:
this is not about chemistry. This is about children.
At a first glance, this sounds very compelling: after all, who could argue with the fact that educational psychology in our schools needs to be about children? However, the dichotomy invoked by Portwood here is extremely problematic. A brief discussion of the Cochrane Collaboration will help to make clear why.
The Cochrane logo features a prominent diagram. The diagram
shows the results of a systematic review of RCTs of a short, inexpensive course of a corticosteroid given to women about to give birth too early. The first of these RCTs was reported in 1972. The diagram summarises the evidence that would have been revealed had the available RCTs been reviewed systematically a decade later it indicates strongly that corticosteroids reduce the risk of babies dying from the complications of immaturity. By 1991, seven more trials had been reported, and the picture had become still stronger. This treatment reduces the odds of the babies of these women dying from the complications of immaturity by 30 to 50 per cent.
Because no systematic review of these trials had been published until 1989, most obstetricians had not realised that the treatment was so effective. As a result, tens of thousands of premature babies have probably suffered and died unnecessarily (and needed more expensive treatment than was necessary). This is just one of many examples of the human costs resulting from failure to perform systematic, up-to-date reviews of RCTs of health care.
Research is about both chemistry and children. Because of suboptimal evaluation of the research into how particular chemicals worked in particular situations, a number of babies will have died who might otherwise have been saved.
It is because we care about children – and because children are important – that we need to insist that research conducted in children and on childhood conditions meets the highest possible standards. Keep reading →
Filed under dyspraxia, fish, omega 3
Tags: durham, Durham Fish Oil Initiative, durham trial, Equazen, fish oil, Food for the brain, Food for the brain foundation, Madeleine Portwood, omega 3, omega 6, Portwood
September 23, 2009
Holford has had varied engagements with Cochrane Reviews, so we were interested to see the Holford Diet site – which promotes a low glycaemic load (LGL) diet plus supplements – celebrating one Review’s alleged finding that
a low GL diet is more effective than any other diet for weight loss and improving overall health…’Overweight or obese people lost more weight on a low Glycemic Load diet and had more improvements in lipid profiles than those receiving conventional diets.’
However, on looking at the Review itself we noted that it did not distinguish between LGL and low glycaemic index (LGI) diets. This was a review of
Randomised controlled trials comparing a low glycaemic index or load diet (LGI) with a higher glycaemic index or load diet or other diet (Cdiet) in overweight or obese people.
The review found some evidence that LGI and LGL diets can be especially beneficial, but did not aim to find whether an LGI or LGL diet was best. Given that this was a review of only six trials involving only 202 participants, this seems a sensible decision.
While it is nice to see a Holford site referring to such good quality sources, it is a shame that the Review could not have been reported more accurately.
