Catherine Collins: “Patrick has [given] an absolutely perfect example of why one should be wary of nutritional therapists.”

A new Cochrane review of the evidence on antioxidant supplements and mortality [PDF] has found that taking anti-oxidant supplements caused

significantly increased mortality by vitamin A…beta-carotene…and vitamin E…but no significant detrimental effect of vitamin C…Low-bias risk trials on selenium found no significant effect on mortality…The current evidence does not support the use of antioxidant supplements in the general population or in patients with certain diseases.

Holford was speaking about the review on Radio 4 and 5 Live this morning – the Head of Science and Education and the supplement company Biocare was defending the role of antioxidant supplements. Did we mention that Biocare sells a range of supplement pills with a charming picture of Holford’s face on them.

We have already looked in more detail at Holford’s specific claims, and you’ll also find a nice discussion of this review and some responses to it on the Quackometer. We’ll post more on this at a later date. First, though, there was a lot of good discussion on these radio shows that it’s worth looking at here.

On Radio 4′s Today programme (listen again here – about 2hr35min in) the dietitian Catherine Collins makes clear that – regarding these antioxidant supplements – the evidence that they are ineffective and/or harmful as been “added to over the years”. The Cochrane review is definitive: “at best they do you no good, at worst they may actually increase your risk of death”.

On the programme alongside Collins, Holford is left to scrabble around complaining about the studies which have been excluded (more on that later in this post, and in our previous post) and complain about “political bias”. Collins provides a neat summary of Holford’s quibbling, though:

I think Patrick has [given] an absolutely perfect example of why one should be wary of nutritional therapists. He’s playing about with numbers, dropping in names…

Even better was the discussion on Victoria Derbyshire’s Radio 5 show (download the podcast here). Firstly, Professor Holford of Teesside University discussed the Cochrane review with Prof Gluud (one of the paper’s authors). Holford complained bitterly that the review excluded poor quality trials with a high risk of bias; Gluud quickly and concisely explained that – in good quality research – it is important to focus on trials with “proper methodology”.

When Holford complained – again – about “political bias”, the issue of who pays him came up. Holford claims that his wages are mainly paid by publishers, although he’s “a consultant for a supplement company [and Biocare] pay me a small amount”. Holford characterised this payment from Biocare in the accepted SI unit for industry interests: “less than about a fifth of a drug rep’s salary”.

Holford acknowledges that he’s not as independent as the Prof Gluud, but we do feel that he has rather underplayed the amount he gets from the supplement industry. Somehow, Holford neglected to mention that he has been paid over £200,000 by Biocare (for his supplement selling Health Products for Life company) and has another £200,00 coming in July. Drug reps may be relatively well paid, but 6 figure plus salaries are – I would imagine – really rather rare.

Holford then got the opportunity to discuss nutrition with Catherine Collins again. Collins argued that consumers should avoid high dose supplements – and view them as something to avoid taking to excess, instead of like “nutritional smarties”.

Most worryingly, Collins discusses a case with a patient at the Brain Bio Centre (which was founded by Holford, and had him as director until 2007). This patient was prescribed a toxic level of vitamins and herbs for her condition. As Collins highlighted, although the Brain Bio Centre quickly retracted that advice once this was highlighted by medical professionals, there was no effective regulator with which she could raise her concerns.

It seems, then, that Teesside have conferred a visiting professorship onto a consultant for the supplement industry – who is, by his own admission, less independent than Professors such as Gluud. Despite his own research being exceptionally flawed, Prof Holford also feels able to complain about political bias and flawed methodology in research done by qualified, skilled and experienced scientists such as Gluud. Unfortunately, Prof Holford lacks the ability to do so particularly well – betraying, for example, difficulties in understanding what constitutes proper methodology in his criticisms of Gluud et al.

This does make one wonder – yet again – whether Teesside believes that Holford’s work has achieved a professorial standard. And, if they do hold this belief – why?