Holford Watch: Patrick Holford, nutritionism and bad science

Entries from June 2007

Patrick Holford gives the British Dietetic Association the benefit of his high quality research on autism

June 30, 2007 · 6 Comments

As Dr Crippen notes, Patrick Holford has taken it upon himself to educate the British Dietetic Association (BDA) on the benefits of dietary interventions for autism. On this blog, Shinga has also analysed Holford’s wisdom on this issue. I’m also going to look over some of Holford’s ‘evidence’ base on this.

If you’re going to take it on yourself to lecture a learned body like the BDA, you had better make sure your research stands up to scrutiny. Sadly, the ‘evidence’ that Holford provides for a gluten free casein free (GFCF) diet to treat autism doesn’t stand up to even cursory scrutiny.

Holford’s first piece of autism-specific evidence is a link to Robert Cade’s work. Unlike in other Holford work, the link works this time - I suppose one should give Holford some credit for this. However, he doesn’t get any credit for the quality of this ‘evidence’. Read remainder of entry

Categories: BDA · Food Is Better Medicine Than Drugs · Jerome Burne · catherine collins · patrick holford

Patrick Holford Believes That He Is More Knowledgeable Than the BDA?

June 29, 2007 · 4 Comments

Patrick Holford and his Magic Answers have come to Dr Crippen’s attention recently: mostly because of Holford’s:

claims to enable people to say “no” to cancer, arthritis and heart disease.

And diabetes. It seems that Patrick Holford and other nutritional therapists who claim that doctors have no interest in nutritional or lifestyle approaches to health problems are wrong. Read on for more

Categories: Andrew Wakefield · BDA · British Dietetic Association · Dunning · Holford · Kruger · Wakefield · catherine collins · patrick holford
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Patrick Holford alias Doctor Knock aka Holt Senior?

June 28, 2007 · 2 Comments

Patrick Holford brings out the lyrical in people. In an overview of his work, Mike Stanton discusses Patrick Holford and his striking similarity to the father of Felix Holt.

Patrick Holford would be proud. He is a great believer in bran. Unfortunately, like Holt’s father, he is also a great believer in pills and elixirs and cures for cancer. In fact Holford thinks he can cure most things including cancer, diabetes, heart disease, alzheimers, arthritis and, of course, autism - hence my interest. And once you are cured he promises to give you beautiful skin and improve your sex life as well!

Patrick Holford raises many intriguing possibilities. Maybe he is a candidate for a contemporary Doctor Knock. Read on for more

Categories: Doctor Knock · Holford · knockisme · patrick holford

Patrick Holford Encourages You to "Say No" to Cancer

June 28, 2007 · No Comments

Patrick Holford makes more remarkable claims than Holford Watch can keep up with so we are grateful to Dr. Crippen for tackling the issue of Holford’s claims for cancer. Pay £6.99 to say “no” to cancer also expresses Dr. Crippen’s disappointment at learning of Patrick Holford and his support for the discredited findings of Dr. Andrew Wakefield.

Several people have expressed their disappointment about Patrick Holford and his support for unusual or discredited theories. There has even been literary speculation as to whether Patrick Holford is akin to a contemporary Doctor Knock.

Kevin Leitch on Andrew Wakefield and the death of the MMR debacle and
Justice for Katie
Mike Stanton on Patrick Holford and his unusual views on vaccination, MMR and autism
Patrick Holford and Dr Andrew Wakefield’s Discredited Findings: Part 1
Patrick Holford and Dr Andrew Wakefield’s Discredited Findings: Part 2
Patrick Holford Claims Remarkable Benefits for Homeopathic Vaccinations

Holford Watch has a number of posts about Patrick Holford and his support for Dr. Andrew Wakefield.

Categories: Andrew Wakefield · Holford · MMR · Wakefield · autism · measles · patrick holford · vaccination

Patrick Holford and Some Fishy Numbers

June 27, 2007 · 3 Comments

Patrick Holford had a problem with numbers. Sometimes, he cannot reproduce numbers accurately when they are laid out plainly, nor can he interpret them. However, there are times when his presentation of numbers is fishier than ever and this is causing some confusion. Some young readers have written to us.

Dear Holford Watch,

It was bad enough when we were being force-fed healthy-eating dogma during PSHE but now it is infesting our after-school clubs where we have to learn about nutrition with only brownie points on offer rather than the real thing.

We are tired of older people looking at us with crocodile tears in their eyes as they gloat that we will be the first generation to die before our parents. Then teachers set up projects where we have to review the research and data that assure us of our untimely deaths through toxic overload, pollution, Wi-Fi, too much food, too few nutrients etc. but certainly not a deficit of Prozac or Ritalin.

Last night we were advised to eat fish but to be careful because it contains toxins. We were told to look at a table of Omega-3 and mercury levels in different fish and to write a poem about how it made us feel. The table was quoted from a book by Patrick Holford so we were already a little suspicious. After all, Patrick Holford is the bowel-whisperer and doom-monger in residence for GMTV.

Chart of Omega-3 and mercury levels in fish: taken from pg. 101, New Optimum Nutrition for the Mind
Omega-3 g/100g Mercury mg/kg Omega-3/mercury
Fresh wild salmon 2.7 0.05 54.0
Canned sardines 1.57 0.04 39.3
Canned and smoked salmon 1.54 0.04 38.5
Fresh mackerel 1.93 0.54 35.7
Herring (kipper) 1.31 0.04 32.8
Trout 1.15 0.06 19.2
Fresh tuna 1.5 0.4 3.8
Cod 0.25 0.11 2.3
Fresh sole 0.1 0.05 2.0
Canned tuna 0.37 0.19 1.9
Marlin 1.1 1.1 1.0
Swordfish 1.1 1.4 0.8


We couldn’t work out what the last column was supposed to tell us. The supervisor looked in the book but it didn’t say anything helpful. Then there was a fight because some people said that the numbers were wrong but when we asked the adults they did a nervous count on their fingers, giggled and changed the subject. Then they said that it is in a book that has been released in this new edition so it must be right.

Please help us.

Class 9, Erewhon School for the Jaded

Holford Watch is sympathetic to the plight of the young who are subjected to jeremiads about their health and bamboozled by adults who fail to understand the flaws in the basic science or maths of the ‘research’ that they thrust at them.

Dear Class 9,

We can understand why you are puzzled by the chart and we, too, find it annoying when we see a table without a legend to explain it. Before we address the errors in basic arithmetic, we recommend that you read Sandy at Junkfood Science who reassures us about the safety of fish despite the flip-flopping news headlines that are enough to frighten anyone into math hysteria.

There is no source given for the values that Holford quotes and some of his advice for fish consumption differs from that of the Food Standards Agency. Reading the text that precedes the chart, we learn that it:

lists fish in order of best to worst, in terms of the greatest amount of omega-3 with the lowest amount of mercury.

You were right to have misgivings about the numbers; what we have here is a failure to understand and convert units of measurement. The detail follows but we can only speculate that there are typos in the chart and errors in basic arithmetic.

The fresh wild salmon has 2.7 g/100g Omega-3, 0.05 mercury mg/kg but the 3rd column estimates that the ratio (or whatever that is supposed to be) is 54.0. Holford Watch reasons that the salmon has 27 g/kg of Omega-3 (or 27,000mg) which makes it a little easier to compare to the mercury. We estimate that Holford’s calculation is out by a factor of 10,000 but what’s a few orders of magnitude between guru and follower. We think that the number in the final column should be an unwieldy 540,000 rather than 54.

Ever ready to give Holford the benefit of the doubt, we ran some of the other calculations to determine whether there was (say) a consistent error in the units which would make some sort of sense. Sadly, there isn’t. E.g., Holford reports that marin has Omega-3 of 1.1 g/100g and mercury of 1.1 mg/kg and calculates the ratio as 1. We think that this should read 11g/kg (11,000mg) and 1.1 mg/kg with a ratio of 10,000 rather than 1. This is the same error of order of magnitude as for the fresh wild salmon. However, at a glance, it was obvious that there was a different order of magnitude error for the fresh mackerel: Holford reports around 10x more mercury, and a similar amount of Omega-3, yet the ratio is approximately the same, rather than differing by an order of magnitude (as it should). Fresh mackerel is reported to have 19.3 g/kg (19300mg) Omega-3 and 0.54 mg/kg of mercury: Holford calculates this as a ratio of 35.7. Holford Watch estimates that this should read 35,741: so, this is a lower order of magnitude than the other calculations.

Holford Watch is delighted that you spotted something fishy with the numbers as soon as you saw the table but we are a little dispirited that the adults who gave this to you didn’t spot the errors. It is irritating that these mistakes have obviously persisted despite the new edition of the book.

Did you write a poem about how you felt?

Pisces vobiscum - Holford Watch

Dear Holford Watch,

Our mothers always taught us that we should never be unkind
But they’ve never read New Optimum Nutrition for the Mind.
If Class 9 could have one retrospective, fervent, longed-for wish
It would be we’d never looked at Patrick Holford’s chart of fish.

Yours - Class 9

Categories: Holford · New Optimum Nutrition for the Mind · fish · mercury · omega 3 · patrick holford

Holford is sceptical about off-label prescribing, but thinks that secretin for autism is "Worth considering"

June 25, 2007 · 2 Comments

A correspondent has been nice enough to send me a copy of Holford’s latest 100% Health newsletter. There are some moving words about off-label prescribing: Holford writes that “In the US, one in every five prescriptions is ‘off label’, meaning a drug is given to treat a condition other than the one it was originally licensed for. Of these, 75% lack any scientific basis for their prescription.”

Clearly, this is a concern: medicine is not evidence-based enough. While some off-label prescribing may be necessary (for example, because drugs are very rarely tested on children and therefore are generally not licensed for use on children, this practice would be hard to avoid in paediatrics), I would absolutely agree that doctors should draw on the best available evidence when determining how to treat their patients.

What’s odd, though, is that Holford himself argues that off-label use of secretin as an autism treatment is “Worth considering”. It is almost certain that secretin will never be licensed for this use. This is for a very good reason: as I’ve shown, the evidence shows that secretin is either useless for treating autism, or even performs worse than placebo. It may also be associated with adverse effects. Drugs should not be licensed for purposes for which they are either useless or worse than useless; generally, aside from the occasional disaster, they aren’t.

In the same newsletter, Holford argues that “true medicine must be people-centred not drug-centred”. I’d be quite happy to agree with that (as would, I imagine, my GP). With this in mind, though, it’s worth looking at Holford’s ‘reference’ for the efficacy of selenium: the controversial Autism Research Institute, which has also been a key force behind Defeat Autism Now! When trying to defend the safety of secretin, an article on the Institute’s website argues that “It is possible that the problems described above [when secretin was administered] may not be caused by secretin but instead by the panic and stress experienced by a child who is held down by adults while an IV needle is inserted.” So, the off-label use of secretin for autism which Holford thinks is ‘worth considering’ can cause real distress to autistic children, while being - at best - a placebo.

Adults holding down a panicking child, while forcibly inserting an IV needle - and all so that they can administer a drug that is useless or harmful. That doesn’t sound very person-centred to me.

Categories: autism · newsletter · patrick holford · secretin

Patrick Holford and His Insights on the Scourge of Depression

June 25, 2007 · 2 Comments

Patrick Holford provides remarkable insights that are worth every penny of the subscription that we purchased for our own enlightenment and that of others. In the May 2007 newsletter, we learn this nugget of wisdom that will stand you in great stead, the next time that you are dithering in the supermarket.

There’s poor logic in treating diet and lifestyle-related diseases, like breast cancer and heart disease, primarily with drugs that block some enzyme in the body, thus usually creating side-effects. It makes much more sense to correct the factors that led to your body or mind going out of balance in the first place. For example, omega 3 deficiency can cause depression. Prozac deficiency does not. [My emphasis.]

So, if you were wondering how best to spend the household budget, sardines rather than Prozac: or sardines and Prozac if your GP prescribed it and economise elsewhere. The gnomic poignancy of Holford’s insights is hard to beat. There are no prizes, but I would welcome suggestions that encapsulate more of these profound observations:

X deficiency can cause something nasty. Y deficiency does not.

Categories: Holford · Prozac · depression · newsletter · omega 3 · patrick holford

Holford believes Secretin is "Worth considering" as an autism treatment; however, there is no evidence that this treatment is effective

June 24, 2007 · 3 Comments

Holford is, generally, pretty anti-drug: for example, he has co-authored a book on how ‘food is better medicine than drugs’, and gives an overly negative summary of the potential usefulness of Alzheimer’s drugs and statins. I was therefore very surprised to see Holford arguing that secretin is “Worth considering” as a treatment for autism (Holford New Optimum Nutrition for the Mind, p.336).

You might expect that - as Holford thinks secretin is ‘worth considering’ as an autism treatment - the evidence as to its benefits would be remarkably strong. However, you would be disappointed. As far as drugs go, the evidence on secretin for autism is pretty clear - and it’s negative. A 2005 Cochrane review found that there is “no evidence that single or multiple dose intravenous secretin is effective across a range of outcomes, and [secretin] should not currently be recommended or administered as a treatment for autism”. Quackwatch notes some potential adverse effects of this drug.

As Dr Edwin Cook describes in his recent Autism Omnibus testimony, when he tested secretin as an autism treatment against a placebo, “saltwater was slightly better than secretin.” This is, as Cook rather charmingly understates the point, “not what one looks for.” Because of this lack of evidence, secretin is not licensed as a treatment for autism and therefore - when used in this way - has to be prescribed ‘off-label’ (a practice that Holford’s co-author Jerome Burne has been very critical off).

Secretin is thus an autism treatment which does not have reliable evidence of efficacy, which does have the potential to cause adverse effects (before one even takes into account the damage done by subjecting people on the autistic spectrum to additional, and pointless, medical interventions in order to inject the secretin), and which is - with good reason - not licensed as a treatment for autism. So, why on earth does Holford think that secretin is ‘worth considering’ as an autism treatment? Surely this is an excellent example of a case where a drug doesn’t work, and may worsen one’s situation - but here, unlike with many drugs, Holford thinks that treatment with this secretin is ‘worth considering’.

See also a follow-up post, on Secretin and off-label drug use

Categories: Jerome Burne · New Optimum Nutrition for the Mind · autism · patrick holford · secretin

Patrick Holford and Supplements for Weight Loss: A Reader Asks

June 22, 2007 · 2 Comments

Patrick Holford has sent his latest email on weight-loss to our faithful reader, Precious Ramotswe. Mma Ramotswe has written to Holford Watch to ask for our advice.

Dear Holford Watch,

I am a traditionally-built lady, as you know. Most of the time, this is of great advantage to me (e.g., snakes know where I am and I can cast shade for small children), but I am subject to much advice on the topic of weight-loss. Patrick Holford has sent me an email about his eating programme. I have looked through it but there is no mention of cake which makes me a little sad. However, it may be possible to put something together from oats and fruit, although that may make me sadder as it does not resemble cake. (more…)

Categories: 5-HTP · GL diet · HCA · Holford · chromium · chromium polynicotinate · garcinia cambogia · patrick holford · weight loss

Holford, gluten, casein and autism: yet more shoddy referencing

June 22, 2007 · 4 Comments

I’ve been looking over Holford’s recent e-mail on GETTING TO THE GUTS OF TRUTH ABOUT AUTISM, ALLERGY AND MMR. I’ve been trying to analyse Holford’s evidence base - but, given the shoddy references provided as ‘evidence’, this has been a rather frustrating experience.

Holford seems pretty keen on a gluten- and casein-free diet for people on the autistic spectrum: he approvingly quotes Robert Cade arguing that, when they strictly follow such a diet in order to reduce the levels of peptides in their blood, “most patients either improve dramatically or become completely normal”. I’ll put aside, for a moment, the assumption that ‘normal’ is either an unproblematic concept or something to aspire to: there is, at any rate, not convincing evidence that dietary changes can make people on the autistic spectrum ‘normal’.

Holford’s reference for this statement is http://www.panix.com/paleodiet/autism/cadelet.txt. Sadly, however, this link doesn’t work. The closest thing I could find was a link from paleodiet.com to an archived version of Cade’s site (I’m not sure why Cade appears to have taken the site itself offline). There is a tantalisingly named ‘research’ section on this archived site; however, this is disappointing.

The site argues that “for an autistic individual, it has been found that a defect in the intestinal wall permits incompletely digested components of the original proteins to pass from the intestine into the bloodstream”. This could be very interesting - except this is simply asserted, without any evidence being provided.

The site also asserts that “[b]y removing sources of gluten and casein from the diet of autistic children, we have had immense success in at least alleviating and at times eliminating the symptoms of autism.” On seeing this exciting information, I looked over the site for details of research methodology used, control group, randomisation, verification of the elimination of autism, etc - but, oddly, these details seem to have been omitted.

The only other ‘research’ that the site provides us with is a cursory description of a “blood test called a gluten/casein screen”. While the site asserts that “we feel that it provides valuable information on the potential benefits of the diet as well as an opportunity to monitor changes”, it does not provide any convincing evidence that this test does anything useful (or even much detail on how the test might work).

The really odd thing here is that there is some evidence that gluten- and casein-free diets may benefit some people on the autistic spectrum (although not provide any kind of miracle cure, if one wants to view autism as something to cure). I’ve spent way too long chasing up Holford’s shoddy referencing of Cade’s work - but a couple of minutes of searching pubmed led me to the excellent 2004 Cochrane review of the data. When analysing the research on such diets, the review found that only “one trial met the criteria for inclusion” (none of Holford’s ‘evidence’ for the benefits of this diet met the criteria for inclusion in the Cochrane review). The review concludes that there should be more research in this area but there is some - small scale, limited - evidence that such diets may bring some benefits:

Extensive literature searches identified only one randomised control trial of gluten and/or casein free diet as an intervention to improve behaviour, cognitive and social functioning in individuals with autism. The trial was small scale, with only 10 participants in the treatment group and 10 participants in the control group. Results indicate that a combined gluten and casein free diet may reduce some autistic traits. This is an important area of investigation and large scale, good quality randomised control trials are needed.

Even where there is some evidence that dietary changes may bring benefits for people on the autistic spectrum - and where there is the need for more good quality research in this area - Holford instead prefers to reference older papers and broken links. I’m not at all sure why. At any rate, if this is Holford’s ‘normal’ standard of evidence and referencing, I really don’t think that ‘normality’ is something to aim for.

Categories: autism · gluten- and casein-free diet · patrick holford