Holford Watch: Patrick Holford, nutritionism and bad science

In the first part of this two-parter, Ben Goldacre does an excellent job of reminding us that of how “food has become a modern obsession”. We’re taken through the colourful history of nutritionism in the US - and, in a sense, this is a rather sad story. If you missed it the first time round, you can listen again here.

In the early days of nutritionism, medicine wasn’t able to do that much - so there was a certain rationale for focusing on lifestyle change or, even, using a relatively harmless snake oil (although not all nostrums were harmless, it had not been that long since many prescription medications contained remarkably toxic or addictive substances). If the choice appeared to be palliation or heroic surgery, it is understandable that people were interested in the promise of elixirs and potions from alternative health practitioners. While early nutritionists (Kellogg, McFadden etc.) may have had an unhealthy obsession with pumping various fluids into the behinds of their patients - in Kellogg’s case, an eye-watering 15 gallons in a matter of seconds - and spouted nonsense about the insanity-inducing properties of mustard and so forth, a lot of the advice was basically sensible. In particular, McFadden’s emphasis on good diet and exercise as part of a ‘physical culture’ has something to be said for it. There are even some interesting attempts to emphasise ‘physical culture’ today as an alternative to the more image-focused approach seen in many gyms.

Unfortunately, though, lifestyle nutritionism failed to keep pace with developments in modern medicine: while medicine has developed greater and greater capacity to help patients (with the development of antibiotics and vaccines for example) lifestyle nutritionists have continued to sell the same snake oil. With the marketing of ‘cures’ like Hadacol - a heavily-advertised mix of vitamins and alcohol, which supposedly cured most things - there was a shift towards using a belief in wonder-potions to camouflage other activities. Hadacol was promoted as a health tonic but in the abstemious South USA, it was sold in shot-glasses as a respectable form of alcohol consumption; it could put the pep in grandma by allowing tee-totallers to consume alcohol in the home. Although this wasn’t covered in the programme, Hadacol is an interesting early example of lifestyle camouflage; some current commentators on diet remark that many young people claim to be following a vegetarian diet as a way of refusing food and covertly following a weight-reduction programme.

The progamme then looks at how bona fide nutritional science has developed, and how it’s distorted by lifestyle nutritionists today. In particular, Tom Sanders buries the myth that food today is less nutritious than it used to be - and that we therefore need to supplement our diet with vitamin pills. As Sanders points out, the increased availability of fresh and lightly-processed foods means that our diet is actually more nutritious than used to be the case. We have easier access to fresh food and a diverse range of foodstuffs. In past years, vegetables were limited in their availability and prone to crop failures. Fridges were not common in UK homes until comparatively recently and few homes had cold rooms or basements to store perishable foods. Even with the advent of canning, vegetables tended to be overcooked and over-salted according to modern practices. Food is so much tastier than pills, too…

Tantalisingly, Part 2 is going to look at nutritionism today. Goldacre argues that there are strong and surprising parallels with health gurus of the past and lifestyle nutritionists today: while nutritionists often represent themselves as “men of science”, Goldacre will ask whether or not this is correct. I wonder if anyone we know will feature in Part 2.