Holford Watch: Patrick Holford, nutritionism and bad science

17 responses so far ↓

• 

  UKdietitian // May 23, 2007 at 9:00 pm

  It’s kind of you to allow Holford to quote his defensive statement on your website in an attempt to undermine your meticulous analysis of his musings.
  I hope he reciprocates the gesture if you request he posts one of your comments on his site.

  And Holfords statement -
  “as you continue to attack my apparent lack of qualification to call myself a nutritionist despite 30 years in this field, perhaps you would care to explain what your qualifications are”
  is an interesting one. Whatever your ‘qualifications’, the quality of nutritional comment far exceeds that achieved by Holford in his worry-fest of websites.

  And despite ‘30 years in the nutritional field’, it’s a pity Mr Holford still finds it difficult to translate nutritional research in an accurate and meaningful manner - and needs to descend to the ad hominem insult in an attempt to undermine your approach.

  For what its worth, a prolonged period of pseudo-nutrition doesn’t make you a bona fide nutritionist -whatever the duration. Mr Holfords own qualification from his own Institute does not confer eligibility to join either the UK Nutrition Society, nor the British Dietetic Association - no matter what his opinion of his own qualification and practice implies.

  I’ve 35 years of gardening under my belt. Doesn’t make me a gardener. Still manage to kill green things outdoors at an alarming rate - and not just the aphids……

• 

  Claire and Jeff // May 23, 2007 at 11:20 pm

  I’m not a nutritionist - I’m a very naughty girl. (Apologies to Python fans)

  However…

  Holford writes: “high serum folate levels, but are B12 deficient - estimated to be 4% of the elderly population - are already showing increased incidence of cognitive decline. This is a direct consequence of folate fortification”

  It is not yet clear that 4% is an accurate estimate for “the elderly population”, although it was accurate for this study.

  In Jon’s 2nd piece, he mentions the Mulligan paper. Similarly, 3 other recent studies that observed an adverse effect of high folate status reported that 33–67% of participants acknowledged that they take folate-containing supplements. Morris et al. (2005) - 33%. Morris et al. (2007) - 67%. Troen et al. (2006) - 54%.

  Radimer et al (2004) surveyed US adults to estimate dietary supplement use and report that around 35% use a multivitamin/multimineral that contains folate.

  It seems plausible that “high serum folate levels” in some populations may well be partially attributable to the use of folate-containing popular supplements such as multivitamins/multiminerals.

  Regards - Shinga

  PS Ignore the log-in. I have a cookie problem.

• 

  Claire and Jeff // May 23, 2007 at 11:23 pm

  The missing Radimer reference on dietary supplement use.

  Regards - Shinga

  I also shouldn’t get so frustrated with log-in problems that I neglect to preview.

• 

  Anonymous // May 24, 2007 at 6:24 am

  “…you continue to attack my apparent lack of qualification to call myself a nutritionist…”

  This is a non-issue. Anyone can call themselves a nutritionist.

  Holford complains about this, but I don’t see any mention of it in either the Grauniad letter or the blog article. have you ever questioned his right to call himself a “nutritionist”?

  When Holford claims to be qualified to call himself a nutritionist, it’s almost as if he’s trying to give the impression that some sort of qulifications are necessary to use the title.

  Now, if he were to call himself a dietitian, it might be different…

  Regards, Mojo.

• 

  pv // May 24, 2007 at 11:22 am

  “…you continue to attack my apparent lack of qualification to call myself a nutritionist…”

  A non issue indeed Mojo, except that since no such real qualifications actually exist, Holford’s lack of qualification is real rather than apparent. And it’s quite right to point it out, even if it doesn’t quite fit with the man’s commercial aspirations.
  The delusions of celebrity, eh!

• 

  Jon // May 24, 2007 at 12:08 pm

  thanks for the comments.

  Shinga- as I argue, one easy way to achieve high serum folate levels is through supplementation (one study found that 94% of the elderly people included who has a high folate consumption took supplements).

  In terms of a right to call himself a nutritionist - absolutely Holford has that right (I’ve got every right to call the duck in my local park a nutritionist, if I so desire). There’s no obligation for media outlets like the Guardian to play along, though - and in the context of the Blythman article, I think Holford’s commercial interests were relevent and should have been mentioned (i.e. he should not just have been called a ‘nutritionist’). The Guardian would quite rightly be slated if they described a drug company rep’s statement as just coming from a ‘biologist’ (even though many are qualified in biology at a postgrad level). I would argue that it is also important to acknowledge competing interests in ‘alternative’ medicine.

• 

  Shinga // May 24, 2007 at 2:00 pm

  I was agreeing with you, Jon. There are now several studies that report high folate status with adverse effects but observe that supplement use is common in those with high folate status.

  Regards - Shinga

• 

  Jon // May 24, 2007 at 3:02 pm

  thanks Shinga. And yeah, there definitely does seem (as you’d expect) to be a link between folate supplementation and high folate status - which, of course, is also why folate supplementation can be a very good idea in some cases…

• 

  Anonymous // May 26, 2007 at 11:51 pm

  So who are YOU (blogger.com) working for and what are YOUR qualifications?

  Admittedly, Holford risks his credibility if he steps outside his area of expertise. But I can hardly wait for the day when his glib detractors find themselves boxed-into a situation where conventional medicine has nothing to offer them. I.e., toxic drugs, surgery, radiation and psychotherapy (witch-doctors) either don’t work (and they admit it), or quit working (and they have nothing left to offer).

  This web-site is a titter. Someone (singular or plural) dislikes what Holford has to say, badly enough to devote time and energy, and enlist that of others, to attacking his efforts? It smells a lot like “Big Pharma” and the medical establishment.

  Let’s see the color of your money. ;)

• 

  Jon // May 27, 2007 at 11:25 am

  Anonymous - glad that you enjoy the website. I’m not up-to-date on blogger.com corporate structure, so can’t comment on “who are YOU (blogger.com) working for” - can only speak for myself, which I presume is what you’re asking about. As I’ve said, I’ve made no money from this website (I’m not paid to do this, and I’m not selling anything). Costs for this site are currently running at under £10; funding therefore hasn’t been an issue. Also, I’m flattered at the suggestion that I’ve “enlisted” others, but you’re much too kind. People have been looking critically at Holford’s work for a good while now - and I’m delighted to be able to play a part in this.

  Although evidence-based medicine cannot offer a cure for some conditions, I’d follow the late John Diamond in arguing that this is no reason to subject yourself to a whole range of ineffective treatments that could even make things worse. Certainly, nutritional interventions can be effective and valuable - e.g. there’s good evidence that women who are pregnant/trying to become pregnant can reduce the risk of birth defects by supplementing with folic acid - but that’s all the more reason why information on nutrition needs to be as accurate as possible, and why inaccurate information should be criticised.

• 

  Shinga // May 28, 2007 at 12:23 pm

  “I can hardly wait for the day when his glib detractors find themselves boxed-into a situation where conventional medicine has nothing to offer them. I.e., toxic drugs, surgery, radiation and psychotherapy (witch-doctors) either don’t work (and they admit it), or quit working (and they have nothing left to offer).”

  Is this the same Anon who was upbraiding us for lacking compassion and an open mind in a different comment? Or, are we not the recipients of these ill-wishes because we are discussing the lacunae in the scientific evidence rather than detracting glibly?

  I’m failing to understand the “color of your money” comment. This is typically used in a “put up or shut up” context which doesn’t make sense here. Or, are we being called pharma shills?

• 

  Anonymous // May 29, 2007 at 5:17 pm

  I saw Patrick Holford on tv the other day and was quite impressed. I have also been thinking about studying nutrition and looking at his institute as a place to study.

  I certainly don’t agree with everything alternative medicine has to offer, but some of it does work, so please don’t criticise too much!

  Nutritionists (as opposed to dieticians)want to help people towards optimum health - who doesn’t want to feel good? Some of us can’t seem to get the balance right ourselves and, since doctors and buying heavily marketed products often doesn’t help (docs, like dietitians, tend to want to cure rather than prevent), we want to ask someone who knows more than us.

  Why do you not think that people who have studied the subject for a few years and gained a qualification, are qualified to help people in this way?

  Who else would you suggest consulting?

  I ask this as someone who both wants nutrition / health advice, and who is considering re-training under the nutrition umbrella.

  Thanks,
  Clare

• 

  Shinga // May 29, 2007 at 7:15 pm

  Clare - if you want nutrition/health advice, you might be well advised to consult a registered dietitian.

  You will be aware that ‘nutritionist’ is not a protected title and it is possible that somebody you might consult would not be more knowledgable than you are.

  I would imagine that registered dietitians would challenge your view of their calling and practice.

  Why is it not appropriate to criticise someone when they are wrong? Or do you think that confusing mortality figures of 250,000 for CHD when the actual figure should have been 60,000 is neither here nor there? What did you think of the Wifi avoidance advice that would turn your domestic wiring into an aerial? Is it acceptable to extol the virtues of a prophylactic pendant that works by faith and magic rather than science? What about Holford’s fauxrious claim that Watchdog had misrepresented the strength of the research literature for food intolerance tests?

  As for the studying for years issue - your mileage may vary on this.

  Good luck with your studies.

  Regards - Shinga

• 

  Catherine Collins RD, London // May 29, 2007 at 10:01 pm

  Clare
  As a practicing Registered Dietitian (RD), I’m concerned about the biased and inaccurate views that you have of my profession.

  I guess you’ve been reading prospectuses from ’self-styled nutritionist’ organisations such as ION or CNELM - or perhaps the pseudo-regulatory organisation BANT, which typically make these inaccurate claims. I guess this is their way of trying to justify their ‘nutrition-lite’ practices to people like yourselves who are thinking of training in this field.

  RD’s are basically BSc graduate nutritionists with an extra year of study tagged on to the original 3 years to learn and practice the interface of nutrition with clinical disease. As such it gives us a very broad and deep spectrum of expertise which we can use to work in any arena we like.

  In the community we work in private practice, health promotion attached to local education and health authorities, self-help groups and organisations, and increasingly sports nutrition (2012 beckons!). Our skills are valued by the food industry, food retailers, and other businesses related to healthcare - or not.

  Alternatively - and as in my case - we have the skills to work with the clinically unwell in a hospital setting. Yes, some aspects of our work are dealing with those who abrogate health and nutrition issues until seriously unwell. But my field of intensive care also deals with those unfortunate individuals in the wrong place/ wrong time, and for whom nutrition treads a fine line of providing fluid, electrolytes,and macronutrients in the presence of multi-organ failure.

  I take your point regarding the occasional benefits of non-conventional approaches to illness. Yet in the field of nutrition, you will find that the ‘alternative’ do not use a parallel evidence base (such as TCM does when compared to western medicine)- they just misintepret the SAME clinical evidence to promote their practices and wares - as this excellent site demonstrates.

  It’s rather ironic of you to agree that “buying heavily marketed products” is not the key to good nutritional health, yet you feel an affinity towards an organisation and an individual which - from this site alone- can be seen to promote products which existing research indicates are futile, or even harmful.

  Why should self-styled nutritionists take this approach? I guess it comes down to two reasons -
  EITHER
  they are unconciously incompetent (so they THINK they know the subject, but they don’t have the ability to translate it accurately or in context for the individual or group)
  OR
  they are deliberately misleading those who seek their advice…..

  But where does that lead dietitians? well, you won’t find us promoting detox or superfoods or megadose vitamins - because ’sexing up’ key nutrition research distorts the context for the public, and we don’t expect our patient to become guinea pigs for future interest - as all the work on high dose vitamins is increasingly demonstrating.

  Equally, you won’t find dietitians pestering for column inches and broadcast time. We are well respected in the media because of our sound background, ethical approach and our conduct - incidentally, being the only nutritional professionals regulated by law (HPC Act 2002, formerly the CPSM Act 1980). Just google the term ‘dietitian’/ ‘dietician’ and you can see how we feature ‘out there’.

  Finally, I wish you well on whatever nutrition path you take. Check out the dietitians website at ww.bda.uk.com, or the bona fide Nutritionists at http://www.nutritionsociety.org.

  You can’t shortcut a route to nutrition, just as you can’t shortcut knowledge of atomic physics - despite what the nutrition-lite lobby will have you believe. If you choose the latter I guess you have to reset your moral compass or ignore the shortfalls in your training when it comes to dealing with the public who trust you……

• 

  Shinga // May 30, 2007 at 10:51 am

  Clare, there’s little to add to Catherine’s comment.

  You might be interested to read through an article on the phenomenon of Holfordism and the likely rigour of the associated training.

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