Holford Watch: Patrick Holford, nutritionism and bad science

Professor Patrick Holford of Teesside University and Head of Science and Education at Biocare has an interesting take on what level of “scientific proof is deeply impressive”. For example, see Holford’s endorsement of the QLink:

There are many gadgets out there promising to protect you from electromagnetic radiation and give your energy a boost. I’ve investigated many and didn’t find any stacked up. The one exception is QLink. The scientific proof is deeply impressive…

After researching all the products available that claim to combat EMR, I’ve finally found one where the science stacks up: QLink. This revolutionary pendant provides continuous support against EMR via a microchip which resonates at the same frequencies as the body’s own energetic field. This so-called Sympathetic Resonance Technology works along the same principles as acupuncture – but without the needles! [Emphasis added.]

So, the magical coil may not be connected to anything and Holford appears to have an imperfect understanding of EMR, but he is impressed by the quality of the research. Further, he has been fortunate enough to find a product that he feels confident enough to recommend to the general public who may have been made apprehensive by poor reporting about EMR and are repeatedly told that Holford is:.

regarded as Britain’s best-selling author and leading spokesman on nutrition, food, environmental and health issues.

However, with outstanding examples like the QLink and the poor understanding of the general literature that Holford exposed in his breathless reporting on statins, one might have some misgivings about the claims of scientific research and rigour behind some of the Holford recommendations.

Holford provides a glowing testimonial for the YorkTest IgG food intolerance tests:

The vast majority of food allergies happen because individuals produce IgG antibodies to specific foods. If symptoms, pain or energy levels come and go for no obvious reason, then you may have a hidden food allergy or intolerance. A simple YORKTEST Laboratories IgG food allergy home test provides clear, laboratory analysed, scientific results.

On his own site, Patrick Holford ascribes a far greater diagnostic role for YorkTest products and praises their “solid science”:

The best tests for food and chemical allergies and intolerances measure the presence of antibodies in the blood called immunoglobulins…
My favourite laboratory is Yorktest Laboratories whose tests are clinically validated…
Yorktest have also carried out a number of ‘double-blind’ trials on their IgG test and have solid science to back up their claims of effectiveness.

Holford Watch has explored IgG food intolerance tests and why, despite the claims put forward by Holford and other YorkTest-designated experts, there is a dearth of scientific or clinical support for the role of such testing in the diagnosis of food intolerance. Indeed, Dr Glenis Scadding , Consultant Allergist at the Royal Nose, Ear and Throat Hospital characterised IgG tests for food intolerance as a waste of money”:

What I do dispute is that it is worth making any attempt to identify IgG antibodies. We all make IgG antibodies to food….I see no way in which this can be used to guide diet.

I don’t think there’s any point in spending money on IgG antibody tests. You’re better off going to see a dietitian and using an exclusion diet followed by reintroduction. The IgG antibody tests are liable to leave patients on diets that are inadequate and patients often like to think they’re improving. They carry on in the teeth of very little improvement and may end up malnourished.

I think [self-testing kits] should be banned.

Holford was extensively quoted in support of IgG food intolerance testing as part of YorkTest’s publicity for a recent survey. Ironically, the YorkTest survey revealed that many people are sceptical of claims of food allergy and intolerance because so many people self-diagnose them. Many people like Holford complain that GPs are unsympathetic or unaware:

most doctors aren’t aware of the symptoms than can be caused, and cured, by avoiding unidentified food intolerances.

The news coverage was uncritical and nobody challenged the implicit assumption that YorkTest products are scientifically or clinically validated for the diagnosis of food intolerance although there is no strong scientific support for the role of measuring IgG levels as an indicator of food intolerance or the role of IgG-guided food elimination practices. Appropriately qualifed and experienced clinical allergists and immunologists make this point regularly and yet Holford, amongst others, continues to present a contrary opinion although it is groundless: sadly, it is this viewpoint that is more widely publicised, ironically, with an emphasis on the scientific support for this test. The mainstream media reporting appears to favour truthiness, a thing that Holford feels to be true, rather than the evidence-based approach.

The House of Lords has appointed a committee to investigate allergy and intolerance in the UK. The Committee has investigated some important issues with implications for public health and public policy. They heard extensive evidence on the role of appropriate allergy testing and the lack of scientific support for currently available direct to consumer food intolerance or allergy tests. The committee is releasing its report tomorrow: it will be interesting to read what they say about the tests that Holford supports so strongly.

Is it just me, or is there a parallel between Holford’s understanding of EMR and endorsement of QLink and his endorsement of YorkTest IgG testing in the diagnosis of food intolerance?

Update 13:45: Claire has rightly commented on something that I seem to have lost. The shorthand version would be that inappropriate diagnosis of a medical condition using unfounded testing techniques has eroded the public understanding of allergy and intolerance and tainted the area. It is possible that this has even adversely influenced some people into disregarding the importance of obtaining an appropriate clinical history and diagnosis and paying allergies the full respect that they deserve for their potential impact on people’s lives.

Update 2 16:15: Holford Watch is indebted to a correspondent who has alerted us to a fine piece of Holfordism on IgG testing and food intolerance in The Independent:

The IgG antibody is the new kid on the block,” says Holford. “It is often regarded as suspect; there is a lot of debate as to whether it is or isn’t important.

That is remarkably open-minded for him and seems to represent a shift from his usual stance but he is soon back to his usual form:

Holford believes that “leaky gut syndrome” is often to blame. “The best way to develop a food allergy or intolerance is to drink lots of alcohol, which irritates the gut, take some paracetamol, get a gut infection, take some antibiotics and then eat cheese on toast. Do that often enough and I guarantee you’ll develop a wheat or lactose intolerance.”

Guarantee? Wow.
The BDA is given a modest amount of space for its temperate comment:

The British Dietetic Association’s problem with York Test Laboratories is twofold,” says Towell. “The first is that we don’t agree that the presence of IgG antibodies in the blood is always a sign that there is an intolerance to a food. The second is the lack of support for patients.

But Holford is back with a snappy riposte which seems reminiscent of something we have heard before when Holford affects to believe that he is more authoritative and knowledgeable than members of the BDA:

“I think the BDA are possibly a bit behind on the importance of the IgG antibody,” adds Holford. “I agree that it is not the only way to diagnose a food intolerance, but some people simply take the test, avoid the identified foods and move on.”

So, people who are actually interested in whether there is any authentic science to support this test are “a bit behind”. It would be fascinating to read Holford’s fully-reasoned explanation as to why the BDA, Scadding and a variety of well-credentialled and respected clinical allergists and immunologists are wrong about this.

The timing of all this is very interesting. I shall be very interested in the House of Lords report and any further informed comment on IgG testing for food intolerance that may come into the public domain within the next few weeks.

Update 3 16:45: A valued correspondent has drawn my attention to a pertinent comment by Dr Lourdes de Asis, a US board-certified clinical allergist which may provide an accurate context for Holford’s “new kid on the block” assertion:

Cell mediated or delayed reaction hypersensitivity reactions are usually related to GI symptoms as in eosinophilic esophagitis/ gastroenteritis or in contact dermatitis rashes. IgG levels have not been found to be related to any kind of hypersensitivity,this is an old concept. I would consult with a fellowship trained, board certified allergist before subjecting a child to severe food restrictions and labeling him or her as having multiple allergies.

For purposes of completeness, I searched Entrez PubMed with the terms IgG food intolerance; I found a citation from 1972: Circulating antibodies to cow’s milk proteins in ulcerative colitis. 35 years ago; new kid on the block indeed. As ever, Holford is speaking as if he is leading a field to which he has made no original contribution and owns a body of knowledge. Patrick Holford puts me in mind of the cat from Red Dwarf. He reads about something, and suddenly, he owns it:

Hey, this is mine. That’s mine. All of this is mine. Except that bit. I don’t want that bit. But all the rest of this is mine. Hey, this has been a really good day. I’ve eaten five times, I’ve slept six times, and I’ve made a lot of things mine.

Update 26 Sept: It rather seems as if the House of Lords and the experts that they consulted do not agree with Holford as to the value of YorkTest or IgG testing for food intolerance.