Professor Patrick Holford of Teesside University and Head of Science and Education at Biocare has been out and about in the mainstream media, providing the industry response to the Cochrane Review of Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases (pdf). In this, he was joined by assorted other representatives of the supplement industry in an interesting example of manufactroversy or an artificially contrived controversy. Bertrand Russell wrote:
A stupid man’s report of what a clever man says can never be accurate, because he unconsciously translates what he hears into something he can understand.
A disappointing amount of the criticism reflected Russell.[1] Various critics implied that the Cochrane reviewers had been wrong to exclude various studies although the reviewers had followed a transparent, well-specified process and explained their reasoning within the review. They seem to have been criticised for only selecting trials that contained mortality data although mortality was the topic of the review.
Oddly, the reviewers were also responsible for all of the calculations and findings that industry critics accused them of distorting or overlooking. When discussing these findings, the industry spokespeople were careful to ignore the findings that even when you gather together all of the trials, and include those with poor methodology, the results indicate that the vitamins do not show any positive benefit for reducing mortality; the best that can be said is that there is no evidence of harm (the status of selenium is equivocal as the studies that reported reduced mortality were at high risk of bias influencing the outcome).
However, not withstanding the Russell-like misinterpretations, there seemed to be some concerted and purposeful strategy of confusion. Using tactics that are reminiscient of those used by Big Tobacco,[2] the critics were uncritically allowed to muddy the waters as to the quality of the review and were rarely challenged to specify a worked-out and substantiated specific criticism. Amidst the disinformation about the number of participants and the trials included or excluded in various analyses, the critics seemed to have overlooked the reviewers’ helpful elaborations.
More than two thirds of the included trials with more than 180,000 participants fall in the group of low bias risk trials. This highlights the validity of our results…Our estimates of increased mortality in low-bias risk trials increased significantly when we excluded factorial trials as well as other trials with collateral interventions. These trials may all suffer from potential confounding from the collateral interventions. This highlights the potential dramatic public health consequences of our results.
A large number of unpublished trials on supplements may exist. Their results are more likely to have been either neutral or negative than to have shown beneficial effects…Accordingly, our estimates of increased mortality are likely to be conservative. [pg. 10 document; pg. 13 pdf. Emphasis added]
It is all the more remarkable when one considers that one of the most ubiquitous industry spokespeople was Patrick Holford. During the extended coverage on Radio 5, it seems as if Holford criticised the Cochrane Review while solemnly, and with no apparent sense of irony, offering his own anecdote of the benefits of supplements; a short-term ’study’ with two participants that relied upon self-report. You can not parody this because it defies exaggeration.
Kruger and Dunning explain why it might be too much to expect Holford to form an appropriate assessment of his own level of comparative competence.[3]
Sarah Bosely has put together an overview of the vitamin pill industry faux outrage over the Cochrane Review. She acknowledges the expertise of the Cochrane reviewers and drily observes:
[their] findings have been met with howls of protest from the vitamin and health-food lobby who make a living by promoting supplements. Their denials are likely to give comfort to the large numbers of people who want to think vitamins make them healthier.
Her concluding paragraph is rather miserable but probably more accurate than I care to admit.
And so the debate goes on, with large numbers of people convinced a bit more of what is good for you can’t do you any harm and scientists using methodological techniques that only scientists understand to prove them wrong - only to be disbelieved. In the end, maybe the safest thing is just to eat a better diet.
My outstanding and unanswered question is whether it is possible to have a debate if one side refuses to try and understand why the stats of the other side make sense and constitute a fair test? Along with other industry spokespeople, Holford might have embraced an opportunity to educate the public on the merits of this form of systematic review and the importance of its findings for public health. They might have discussed their plans to upgrade their own education for clients and practitioners. However, none of this happened. Instead, the industry commenters seemed to refuse to accept the demonstrable merits of a systematic review in favour of their own interpretation of it. Beyond this, some of the commenters appeared to question the competence and independence of the Cochrane reviewers although the grounds for this were never made clear.
Yet again, is this an example of what Professor Holford will be teaching to the impressionable minds of students at the University of Teesside? Contriving a controversy and passing it off as informed criticism? Proferring an anecdote in preference to a systematic review that follows careful, agreed, and well-specified procedures?
Update: Added reference to Big Tobacco’s strategy of Doubt is their product and manufactured uncertainty.
Update 2: Effectively, the systematic review process is geared towards evaluating whether or not a particular study was a ‘fair test’. One of the best explanations of ‘fair tests’ is Evans, Thornton and Chalmers’ Testing Treatments (available for free download). We strongly recommend this generalist and entertaining book to interested parties as it explains all the ins-and-outs of what makes a fair test and the fair way in which to interpret the results.
Update 3 (18 April): We should hush our mouths because the celebrities have spoken.
Sir Cliff Richard, Gloria Hunniford, Jenny Seagrove and Carole Caplin have joined health industry experts in rejecting the widely publicised antioxidant review and reassuring consumers that concerns over these supplements are unfounded.
So, that should be that then. What do you mean they’re speaking a load of nonsense about the number of trials and that they are obviously reading someone else’s crib notes rather than read the paper for themselves?
Update 27 April: A Holford canard about the excluded studies is gaining surprising popularity: Are supplements harmful?
In this review, which is a rehash of their paper published last year in the Journal of American Medical Association (JAMA), they first excluded over 400 trials, many of which had positive outcomes, but had no deaths. They then decided which trials they liked (low risk bias) and did not like (high risk bias), a factor that has received criticism in mainstream medical journals
We responded earlier and a very patient Professor Gluud corrected Holford in the course of a Radio 5 item.
Essentially, Bjelakovic et al discuss their exclusion of 405 trials. These trials involved 40,000 participants: they were mostly small Phase I or II trials and short-term with little or no follow-up and no clinical outcome measures (pg. 8 (pdf), pg. 5 document). Bjelakovic et al contacted all of the authors to enquire whether there were any deaths. Around 20% of the authors replied and reported that there were no deaths in either arm of their studies. The authors did not exclude studies that were positive for the supplement arm but negative for the placebo or control arm.
Several people have expressed concern that eliminating the 405 studies “create[s] a bias in which the therapy on trial appears to be associated with deaths?”. However, these trials were, as the authors described above and only involved 40,000 rather than the 232,550 participants in the 67 trials that were assessed: 164,439 of these participants were healthy. You can read about the characteristics of the excluded studies in the review (pp. 118-42 (pdf), pg. 115-39 document).
The authors did take account of the 405 trials by performing a sensitivity analysis.
Therefore we performed exploratory analyses adding an imagined trial with 1 death and 20000 participants in each intervention group. The influence of zero events trials on our final result was not noticeable.
Their findings didn’t change.
Notes
[1] Some of the criticism might be more thoughtful but not as reported to date. Both selective7 and Woobegone direct our attention to Bernadine Healy’s remarks about the 2007 JAMA review. She mischaracterises the reviewers’ careful work as “blenderizing” and this has been adopted by others who have use it as a glib dismissal without explaining it further. And without explaining why such a criticism is sufficient grounds to dismiss the findings of this review.
Oddly enough, one of the recurrent criticisms of this review is that it concentrated on randomised controlled trials and did not include observational studies. There are some commenters such as Truswell who question whether the Cochrane Review process is appropriate for assessing what are essentially observational and cohort studies. These are legitimate issues that are soberly and thoughtfully discussed. On the other hand, we have Holford and other industry spokespeople, criticising the authors on the basis of their understanding or interpretation of this review.
[2] The Paranoid Style in American Science: Doubt is their product. Daniel Engber discusses Big Tobacco’s skilful use of the corporate strategy of “manufactured uncertainty” to deny that “scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer”.
[3] You may be interested to read an overview of the Justin Kruger and David Dunning paper that discusses how difficulties in understanding one’s own incompetence can lead to inflated self-assessments.
What’s even more amazing is that when they then shared the performance of other participants with the people who performed poorly (hoping that they would then adjust their self-perception downward) people who scored poorly failed to adjust their self-perception of their performance. In other words, they are completely unaware of their own [in]competence, and can’t detect competence in others.
It really it a very helpful paper that explains many otherwise inexplicable actions.
A Photon in the Darkness likewise offers a helpful discussion of this paper: The Arrogance of Ignorance
82 responses so far ↓
gaius // April 17, 2008 at 7:26 pm
You may describe the reviewers’ work as “careful” rather than “blenderizing”, but it is hard to argue with Dr Healy’s actual point, which is that:
“…this study violates a cardinal rule of meta-analysis. Pooled studies must be compatible. That means combining apples and apples—or at the least, similar patients and comparable doses and duration of treatments.”
To offset any accusation that I am misunderstanding my own incompetence, I freely admit to being statistically-challenged. I am so incompetent that I can’t even see that this matters in this case. Why? Because the reviewers “carefully” chose as an outcome for selection of the trials death — from any cause.
Does this not have ANY bearing on their conclusion?
gaius // April 17, 2008 at 7:29 pm
“There’s this vague idea - which has been going around for the past few centuries - that statistics is quite difficult. But in reality the maths is often the least of your problems: the tricky bit comes way before the number crunching, when you are deciding what to measure, how to measure it, and what those measurements mean.”
– Dr Ben Goldacre
http://www.badscience.net/?p=653#more-653
Woobegone // April 17, 2008 at 8:06 pm
gaius : You seem to be jumping from one criticism to another. I think there is a sensible case to be made that combining data on the different antioxidants cannot be justified a priori, although in this case all of the results (except selenium) were very consistent so it probably worked out all right in the end. See my remarks linked to above…
But then you attack the reviewers for using as their outcome all-cause mortality. They wanted to know whether antioxidants would increase or reduce your chance of dying, so they looked at all the studies pertinent to this question. Yes, it’s another question entirely whether vitamin C reduces your chances of getting a cold or whatever, this review wasn’t aiming to measure that, that wasn’t the purpose. I think most people would agree that an increased risk of death is a reason to avoid something, no matter how many colds you avoid before you prematurely die.
gaius // April 17, 2008 at 10:11 pm
Thanks Woobegone,
Not “jumping”, more like staggering non-sequiturally (?) from one to another; sorry about that.
Dr Healy doesn’t say anything about combining different antioxidants in the sense of it not being valid to compare, say, vitamin C and vitamin E. What she does query is the validity of including trials that… tested a single vitamin as well as others that used multiple nutrients; used doses ranging from below the recommended daily intake to way beyond the tolerable upper limit; reported on people using the antioxidants for time scales ranging from days to years; and included people whose ages ranged all the way up to 103!
On my second point, as I said, I am a statistical infant, but your comment has nothing to do with my question. To stumble towards an even simpler way of putting it… if I take 20 trials on antioxidants and from those pick the 10 trials in which there was at least one death (from ANY cause, even old age), then meta-analyse only them…isn’t it inevitable that one of my conclusions will be, hey, when people take antioxidants they die?
I’m not grinding any axes here, just trying to increase my understanding.
UK dietitian // April 17, 2008 at 11:49 pm
Ah, Holfordwatch
You have managed to out-quote Holford, too
well done
Dr Aust // April 18, 2008 at 1:49 am
Gaius
There are several relevant points:
1. Most of the trials they authors left out for not reporting mortality data were relatively small trials. They actually tell us approx total no. of subjects in all these 400 odd trials put together: about 40,000 people. And these trials didn’t REPORT mortality data; that doesn’t necessarily mean no-one in them died.
The trials the authors analysed (mostly big ones) included many more people than that, close to 240,000.
The bigger the trial, the more reliable the results.
The authors actually also did the extra calculation “What if there had been a measurable low death rate in the populations in the trials we left out? How would it change the analysis and conclusions?”. The answer is - hardly at all.
Anyway, the claims that the analysis “ignored 90% of the available evidence” is thus factually wrong. It would be more accurate to say:
“The analysis included data from around 85% of all the test subjects who had participated in trials of antioxidants. ”
2. The trials left out were also usually short-term. Some of the supplement lobby gang were complaining that this analysis only included trials that had 3 -year follow up, saying loudly “that’s obviously not long enough”. Well, the studies that they are complaining were “unfairly excluded” were largely much shorter-duration than 3 yrs. Err… shurely shome mistake?
3. ALL the trials included in the analysis were randomized controlled trials; so each trial had a group of people taking antioxidants AND a group not. Thus the trials were ALWAYS comparing death rates between the two groups. There were deaths in both groups in the vast majority of the trials analysed. The overall death rates were about 13% of enrolled subjects in the taking-antioxidants gp and about 10% of enrolled subjects in the control group. Given the numbers of subjects in the big trials (see above) this means most studies will have been counting enough deaths to quantify population death rates with good accuracy.
A word about small trials. They are useful for initial safety studies, and for experimental scientists and theory-builders. But to answer, with a reasonable degree of certainty, the overall question “Are supplements at the kind of doses people commonly take them good for you - yes or no?” small trials are utterly useless. Sometimes smaller trials can be combined, which is what meta-analysis does. But - if the small trials were not done carefully and in such a way as to exclude bias (double blinding, proper randomization) then the data are so shaky that including then in a bigger analysis just makes the results of the bigger analysis so “all over the place” that you can’t work out anything. It is an example of “garbage in, garbage out”.
The not-so-hidden truth here is that lots of sloppily done small trials help the supplement people, as this allows them to claim positive effects of supplements (”Look at all these 100s of trials which report positive effects!”). But most of these apparent positive results are illusory, and disappear in bigger trials which rigorously exclude bias.
gaius // April 18, 2008 at 4:11 am
Dr Aust: thank you. You totally cleared up one of my major not-understandings with this:
“ALL the trials included in the analysis were randomized controlled trials; so each trial had a group of people taking antioxidants AND a group not. Thus the trials were ALWAYS comparing death rates between the two groups. There were deaths in both groups in the vast majority of the trials analysed. The overall death rates were about 13% of enrolled subjects in the taking-antioxidants gp and about 10% of enrolled subjects in the control group.”
dvnutrix // April 18, 2008 at 10:46 am
Gaius - you might be interested in reading the Testing Times book we mention in update 2; it is well-written and available as a free download.
I’m interested in general impressions of the media coverage of the Cochrane Review and the influence of the industry spokespeople and the truncated reports in the media. As a matter of interest, was it the commentary that you heard that led to the impression that the authors had, for no good reason, decided to cut out some trials without discussing their reasoning?
dvnutrix // April 18, 2008 at 11:06 am
Thank you, Dr Aust. Just to add to your point 1. The review authors wrote to the authors of all the studies that didn’t mention mortality data and they heard back from around 20%. They take account of these data.
And, as you say in your discussion of the small trials, most of the trials in those small studies were either Phase 1 or Phase 2, both with negligible or short follow-up and without assessment of clinical outcome measures (pg 5 doc; pg 8 pdf).
As for your point about the impression of 100s of positive trials, I found this observation to be particularly interesting:
dvnutrix // April 18, 2008 at 11:08 am
Professor UK dietitian - always an honour to have you stop by our small corner of the blogosphere.
tifosi246 // April 18, 2008 at 11:20 am
From the substantial quotes and references I certainly get the strong impression that HolfordWatch and folk like Dr. Aust have actually read the Cochrane Review, or at least substantial chunks of it. No mean feat given its considerable length.
On the other ear, having listened to Holford on Radio 5 and others railling against it, they don’t actually seem to have bothered to read it first before complaining; just snipped a few comparative figures, like the number of trials excluded, to support their a priori view and strapped on their megaphones.
This systematic review was a serious, well considered and diligently executed piece of research and Dr. Gluud et al deserve more than just a perfunctory rejection that it is a cynical “stitch-up”.
Wulfstan // April 18, 2008 at 12:09 pm
Not gaius - but I do wonder if some people have been unduly influenced by the canards put about by WDDTY and the like? ‘Antony’ cuts and pastes them over at LCN. This is a snippet.
As far as I can tell, you and Dr Aust have dealt with most of that except for the same old nonsense about synthetic v. nature identical products.
Dr Aust // April 18, 2008 at 1:26 pm
On the other ear, having listened to Holford on Radio 5 and others railling against it, they don’t actually seem to have bothered to read it first before complaining; just snipped a few comparative figures, like the number of trials excluded, to support their a priori view and strapped on their megaphones.
I think that gets to the heart of how this has reported; it is just like a political story.
The front-men, like PH, do not have the know-how to even read the study intelligently. They rely on a critique from someone more knowledgable. The originator for a lot of the criticism being bandied about by the pro-antioxidant folk is Prof Balz Frei of the Linus Pauling Institute at Oregon Health Sciences U. Prof Frei is a scientist of note, but it is fair to say he is also thoroughly pro-antioxidant - that is why he works for the Pauling Institute, which is “ab initio pro- supplement” . Anyway, his and one or two other folks’ (like Bernadine Healy’s) comments have been recycled ad nauseam by people like Patrick H who are, in effect, spokespersons - hired mouthpieces. Or, in my view, acting exactly like politicians, who do not understand the detail but are good with soundbites, and are “briefed” on what soundbites to use by the civil servants and media advisors at their elbow.
A classic example of this is that some of the “criticisms” they use work directly against one another - e.g. the “they left loads of studies out” and “the analysis wasn’t long term enough”, as detailed above. The rationality of the critique is not the point - it is PR soundbites all the way.
dvnutrix // April 18, 2008 at 3:00 pm
Wulfstan - we may have something to say on the topic of synthetic v. nature identical vitamins. But yes - a positive flock or gaggle of canards there. One wonders if they:
understand randomised controlled trials and why they are A Good Thing;
actually read the report where they would have learned that 21 of the trials included 164,439 healthy participants;
read the reviewers’ transparent explanation for how they handled the 405 trials with zero mortality in both the experimental and control groups and for which the total number of participants in those 405 trials was about 40000.
Finally, the reviewers wrote (with supporting references): “We confirmed that trials with inadequate bias control significantly overestimate intervention effects”. It doesn’t seem that the critics (should that be doubt-mongers?) want to engage with this fundamental argument that there is a general impression of a vast literature of studies with positive results (actually, a comparatively small number, but referenced over and over again and salami’d into different papers) and that many of the positive findings are grounded in a methodology that inflates the intervention effects.
dvnutrix // April 18, 2008 at 3:09 pm
tifosi246 and Dr Aust - you are both right. There are striking correspondences between this and the Big Tobacco fomenting of scientific controversy that spawned the infamous ‘Doubt is our product’.
The idea that Holford was spearheading this offensive was offensive. His own work is riddled with errors and he frequently displays an inability to handle even basic numbers yet he was casting aspersions on the value of this systematic review. Again, this stuff is beyond parody.
As per Update 3 - now the celebrities are dispensing words of wisdom, we should all hush our mouths and cleanse our ears.
Dr Aust // April 18, 2008 at 5:15 pm
Talking of Bernardine Healy, she has just recently used her column to stick her boots into the MMR / mercury / autism nightmare.
*sigh*
It is a shame since in other circumstances she is a good writer and has been known to talk significant sense, e.g. here.
I think Healy’s brand of libertarian Republican “individualism” probably underlies her position on EBM and some other contemporary medical issues. I suspect she has an instinctive distrust of aspects of EBM because she sees bits of it as “creeping neo-statist authoritarianism from averages” and “dictating to individual patients and doctors”. But her critique of EBM, as others have pointed out, is full of flaws, and she seems to be losing the plot a bit - read her comments here about the infamously ludicrous Dave Holmes et al. “microfascism” argument.
[NB - a reasoned riposte to Healy's shots at EBM can be found here].
The danger is that as an ex-Johns Hopkins Professor of Medicine, ex Dean of a medical school, and ex-Head of the NIH (although the latter is a primarily political appointment), Healy makes an attractive authority figure for the supplement crowd, as in:
“The lid comes off! Mainstream authority figure speaks out to tell us anti-vaxers / antixoxidant freaks we were RIGHT ALL ALONG!!”.
- read the comments after her column on mercury and vaccines and you will see what I mean.
dvnutrix // April 18, 2008 at 5:44 pm
I’ve just read through the comments to the mercury-autism article and have been overcome by sadness.
Next stop, Aids-HIV+ debunking plus 9/11 troofism?
Irish Association of Nutritional Therapy on the Cochrane Review of Antioxidant Supplements « Holford Watch: Patrick Holford, nutritionism and bad science // April 23, 2008 at 6:11 pm
[...] We have dealt with some of the content of the more common puzzling ‘criticisms’ in these posts: Patrick Holford and His Own Reality: Part 2, estimating risk bias in Cochrane reviews Catherine Collins: “Patrick has [given] an absolutely perfect example of why one should be wary of nutritional therapists.” Patrick Holford and Contriving a Controversy: the Cochrane review of antioxidant supplements [...]
Mike Maybury // April 23, 2008 at 6:30 pm
I am neither a highly qualified scientist nor expert statistician, so all you qualified people can stop reading now, if you wish.
I have a simple point to make, not as complicated as a study or group of studies.
****************************************
If a similar study was undertaken to see what link existed between mortality and high intake of medical drugs from doctors and hospitals, I guess that the conclusion might well be, in simple terms:
The higher the quantity and variety of drugs and interventions used ,per day,the higher the death rate.
******************************************
Some time limits would have to be applied, as some survivors might continue to take cocktails of drugs and treatments ( to the glee of the pharmaceutical industry!) for ages and ages.
These patients might survive with some sort of existence, which could hardly be called living.
As some people say, you can provide proof of almost anything with statistics.
Wulfstan // April 23, 2008 at 7:18 pm
Mike - you probably know that your example isn’t a good analogy or related to this post.
Nicking from another post about this:
I read it and it explains fair tests really well and still managed to make it a very enjoyable read.
LeeT // April 23, 2008 at 8:49 pm
People taking a cocktail of drugs are, presumably, extremely ill so it is hardly surprising many of them die.
Perhaps we could do an experiment to see whether - as Patrick Holford - puts it “food is better medicine than drugs.” We take several thousand people taking drugs for managing chronic conditions. Half of them stop taking their medication for eighteen months and start eating copious amounts of Holford endorsed super foods and supplements. The other half continue following the advice of their doctor.
Any volunteers?
Teel // April 24, 2008 at 8:42 am
The only reason these people are ill in the first place is because the are in a state of imbalance. Doctors drugs never have and never will correct any of these imbalances. What do you think a chronic condition is Lee. Have they reached that stage of health because they are defeicient in some sort of drug. I dont think so
dvnutrix // April 24, 2008 at 10:51 am
*cough* - Type 1 diabetes is chronic; while it can not be cured at present (albeit some interesting therapies are under investigation), it can be managed.
What do you mean that people become ill through “a state of imbalance”?
Teel // April 24, 2008 at 12:52 pm
What is this cough thing you arrogant [edited for obscenity]?
By chronic i am refering to long term health conditions which the majority are not gentic and cannot be sorted out by drugs.
Is type 1 diabetes not an imbalance? There was me thinking that insulin is not produced, thus there is an imbalance of insulin production, blood sugar, glucose in cells etc etc.Note this is a hormone not a drug
You will not find holford reccomending anyone coming of insulin for type 1 D.
The majority of chronic complaints that drugs are prescribed for are also just imbalances that do not need drugs
throw up some complaints and i will explain
Wulfstan // April 24, 2008 at 1:25 pm
You have amply demonstrated your ability to sustain a decent argument, Teel. I would imagine that you explanations would be on a similar level. I, for one, shall resist your invitation to “throw up”.
As someone pithily expressed the matter,
“I have an inherent dislike of the sewer and the language it produces, I can only doff my cap in admiration at your existence in such a place, which you obviously feel so at home in”.
Prof Patrick Holford makes a basic error about antioxidant side effects « Holford Watch: Patrick Holford, nutritionism and bad science // April 24, 2008 at 1:49 pm
[...] and mortality, Holford characteristically manages to stand out from the crowd. Aside from errors already discussed on this site, Professor Patrick Holford of Teesside University makes a very [...]
superburger // April 24, 2008 at 2:16 pm
“Note this is a hormone not a drug”
insulin, is ineed, a hormone (and knowing this is part of the GCSE science syllabus).
Teel, would you consider insulin, as prepared and sold for injection by, say Novo Nordisk (a big farmer supplier of insulin listed in the BNF) a drug?
“You will not find holford reccomending anyone coming of insulin for type 1 D.”
No, but you will find him flogging cinnamon and chromium for type ii diabetes. Perhaps HW can provide a link to the predicatable consequences of Professor Holford going toe-to-toe on GMTV with someone with a meaningful science qualification.
Wulfstan // April 24, 2008 at 4:14 pm
Would that be the entertaining Dr Sarah Jarvis?
LeeT // April 24, 2008 at 8:07 pm
I suppose one might describe illness as an unbalanced state. Death, for me at least, would be totally unbalanced. No one of sound mind is ever forced to take prescription drugs. If you don’t want to that is up to you and, ultimately, no one is going to force you to.
Have to confess to never having read Mr Holford’s “Food is Better Medicine” than drugs. Is there anyone out there who could explain it to me to save me the trouble of having to read it?
Teel // April 25, 2008 at 6:43 am
You lot seem to be obsessed with a short clip of a doctor who is denying that holford has completely reversed her type 2 d.
Although holford looks like a smug [edited] he has got the result.
This is an example of where drugs are not needed yet prescribed. Again just a breakdown in homeostasis like every other illness symptom disease due to environment.
Hence change the cellular environment which you cannot do with drugs.
LeeT // April 25, 2008 at 8:45 pm
Isn’t it the case that if diabetes is diagnosed early enough blood sugar levels can often be managed without the need for drugs? Could this possibly be the case with the woman Mr Holford paraded on GMTV making it a bit dishonest for his supporters to claim he has reversed her diabetes?
The major problem, as I understand it, is that many people go for years without having their diabetes diagnosed. Can Mr Holford cure them as well?
koo // April 26, 2008 at 1:39 am
Fear not the path of truth
for the lack of people walking on it.
Yes Diabetes can be prevented and treated without the need for drugs (except for once you are on insulin there is no turning back unfortunately). Have you looked into the potentials of grapefruit for one example? I doubt it…
They have been using it in India for the last thousand years, now theres a trial for you.
Oh and LeeT the thing that jumped out at me most from the article that you posted about Holford and his funding is that the lawyers of the parents of the afflicted children are so convinced about Holfords argument they are prepared to put their money where their mouth is………
and what is this massive misconception that supplements, herbs etc have not been ‘clinically tried’
They have been on trial ever since they were first began to be discovered in 1905, check out the American Journal of Medical science if you want some clinical trials on supplements (I know you like that sort of publication)
And herbs, herbs………
Now they have been tested and tried for thousands of years just try and say that they haven’t and you will just unveil your purposeful ignorance.
Together, Hopkins and Funk formulated the vitamin hypothesis of deficiency disease - that a lack of vitamins could make you sick.
The food the majority of people eat in the Western world is deficient in vitamins and minerals due to modern farming methods, junk foods etc. This is the argument for supplements and people like Holford.
Modern medicine wants to put a plaster on the problem in the form of inadequate drugs that cause damage to other areas of the body. Nutritionalists such as Holford look for the cause….
Nice work Teel, except no need to operate on their level (swearing etc) although tempting I know
Diabetes can’t be cured nutritionally you people are so myopic.
Sorry been busy hope you didn’t miss me too much
koo // April 26, 2008 at 1:43 am
Dominutrix
Do you really have no idea about how a state of imbalance can make you ill really?
I do hope you are not a practicing doctor because you clearly do not have a clue
koo // April 26, 2008 at 2:09 am
Teel
sorry just read your book recommendation sounds really interesting thanks for the tip :0)
and to the group of people who think nature is bad for your health…
Would anyone be up for a discussion about the bad science behind coke putting vitamins and antioxidants in their caffeinated drink.
I’ll kick it off
It is a fact that caffeine interfears with the bodies absorption of vitamins:
‘Caffeine has a diuretic action and causes nutrient depletion of several important nutrients vital for optimum psychological health, like vitamin B6. The tannin interferes with nutrient absorption of essential minerals including calcium, iron and magnesium and B group vitamins’
1. Bruce M.S. et al (1989) Caffeine Abstension in the Management of Anxiety Disorders, Psychol. Med. 19 pp 211 - 214, mentioned in Snaith P. (1991) Clinical Neurosis, 2nd edition, Oxford Medical Publications.
Now this is terrible misconduct and misinformation on a grand scale, it is making a sadly unaware public believe they are getting their vitally needed vitamins where in fact they are depleteing their nutrients.
and you want to attack Holford ever even considered that you were barking up the wrong tree here…………………………………………..
koo // April 26, 2008 at 2:37 am
Oh and vampires of the chemical abyss have you ever tried to think independently instead of being fed all this nonsense?
It might be a bit painful at first but you do get used to it and it really is quite liberating.
Don’t turn your backs on what has sustained the human race for thousands of years thinking pharms with their short and troubled history of trials and misadventure is the solution.
Its you that has got it wrong and back to fount.
Noticed none of you picked me up on the aspartame I wonder why……
Teel // April 26, 2008 at 7:32 am
Isnt it obvious that the bodies job (or the cells that makes us) is to keep every thing in balance. Thats all it does.
It does this by our cells communicating with each other via binding of membrane receptors, changing of gene expression and working of the cell according to need.
The working of the cell (and the whole organism) is then reliant on the environement outside the cell. If the environemt is disrupted and the wrong receptors are being frequently engaged, then gene expression and the working of the cell will be disrupted. There is then an imbalance of secretions of proteins that inturn will engage other protein receptors.
An inflammatory mediator viscous cycle is agreat example of this. Cytokine sickness syndrome or the NO/ONOO cycle.
Anyway the point to this is that illness comes from imbalance of engagement of protein rececptors and gene expression. Drugs that you seem to think are so important will only add to the wrong cellular environment. Lets try and put our cells (That are more intelligent than the organism it creates) back in the environment it recognises.
draust // April 26, 2008 at 10:00 am
koo, you really are remarkably deluded.
Type 1 (classic “insulin dependent” diabetics) have to take insulin. Otherwise they die. Full stop.
In Type 1 the insulin-producing cells (pancreatic Beta cells) have been destroyed. Type 1 is typically not detected until more than 90% of these cells are gone, because that is the point where blood glucose starts to rise (hyperglycaemia). Therapy for type 1 almost always means replacing insulin by injections.
Before injectable insulin was developed (in the 1920s and 1930s) type 1 diabetes - which mostly happens young - was universally FATAL before people reached their late teens. They had to starve themselves to anorexic proportions even to make it that far. You can look it up.
Type 2 diabetes is different, as it is not caused by insulin lack per se (like type 1) - it is caused by the body’s systems being or becoming “insensitive” to what insulin is there. This causes the body to “push” insulin release (increase it). Eventually this usually means insulin production cannot cope with demand, at which point the people need treatment because otherwise they get dangerously hyperglycaemic.
Mild and/or early stage type 2 diabetes can sometimes be treated by dietary control, and especially by losing weight (the majority of type 2 patients are overweight). People are typically told to exercise more and watch their food to try and drop some weight, as even 7-10 pounds can make a big difference. However, sadly many people find it difficult or impossible to lose the weight. If they can’t achieve decent blood glucose control this way then they need drugs. The drugs may include insulin if the body is not managing to produce enough to meet the increased demand.
There are, it goes without saying, NO “magic foodstuffs” which will fix type 2 diabetes. Another Alt Health urban legend. It is largely a matter of a “sensible balanced diet” (again) - all that stuff like “Eat regular meals, reduce high sugar foods and eat less fat, five portions of fruit and veg a day, less salt, moderate drinking”. All, it goes without saying, mainstream dietary advice you get from nurses, doctors, dietitians etc etc.
Anyway, if you think eating grapefruit is going to make a difference to diabetes, you are a nutjob (but we knew that anyway). Eating grapefruit can, however, interact with various prescription drugs in ways that can be quite dangerous. These drugs include statins (for treating high cholesterol) and some anti-high blood pressure drugs. Anyone taking these medications should avoid grapefruit like the plague.
Wulfstan // April 26, 2008 at 11:11 am
Because, as ever, every sensible person is aware that the aspartame scare has been exploded long ago except for conspiracy theorists with a diploma from Google U.
Are either of you ever going to come up with references for the majority of your assertions?
And, a paper from 1989, you really need to update your ‘knowledge’. Even newspapers know that caffeine really isn’t a powerful diuretic for most people as it was thought to be. Doesn’t mean that this negates the pharmacalogical effect of caffeine on someone with a nervous disorder or anxiety but, really, not that powerful a diuretic.
Wulfstan // April 26, 2008 at 11:16 am
Teel, I think some of the issue is, normally, when commenters like you start talking about ‘imbalance’, you normally turn into ‘germ-theory deniers’. tbh - that’s the way that I thought you were going. I was waiting for the whole Beauchamp-Pasteur schtick.
However, looking at your other stuff, such as, “change the cellular environment which you cannot do with drugs”, it looks like new schtick is similar to other schtick.
Wulfstan // April 26, 2008 at 11:34 am
“Cytokine sickness syndrome” - almost, but not quite, had a Googlewhack, but Teel’s comment was one of only 2 internet uses. It doesn’t appear in the whole of PubMed, and there was only 1, unhelpful, reference in Google Scholar which was concerned with IL-6 - however, it points to a couple of other references.
Having broadened the search, doesn’t really seem germane to a discussion of manufacturing controversy about the Cochrane review of antioxidant supplements.
dvnutrix // April 26, 2008 at 11:42 am
It’s extraordinary how often this nonsense about our so-called depleted food comes up. LCN wrote a good item about The Mineral-Depleted Food Scandal which is worth a look.
When you are making assertions about statements you think we have made - back them up with an example.
Teel // April 26, 2008 at 12:45 pm
when i talk about the cellular environment i am concerning the interstitial fluid. This dictates which receptors are engaged and hence which genes are being expressed, hence which proteins are being manufactured. C S S was just an example!
Receptors are can also be engaged by non physical molecules. Not a subject you lot would want to endulge in as you do not except things that you cannot see.
A great example of what i am talking about would conditions such as ME chronic fatigue, multiple sensitivity syndrome. (you know, the conditions doctors dont seem to know where to start!) Just imbalances which doctors cant grasp.
In my clinic i have some fantastic results with so called ME with people who have been crippled with the condition for years. Most of the time they are told by there doctors that it is all in the head .
Anyway i need lunch
koo // April 26, 2008 at 1:53 pm
I have first hand experience of thyroid related chronic fatigue. All the doctors and endocrinologists I saw for a period of 7 years did not have a clue what to do with me, not a clue. I have never felt to let down and alone with this condition until coming across Holford who started me off on the whole balance thing.
Though supplements, herbs I have a much improved quality of life, I am a different person, if I had continued to put my faith in medical mainstream I would certainly be in a wheelchair.
Now I do not even bother to see my consultants. One endocrinologist achally said to me that thyroid function had nothing to do with calcium levels oh my god!!!!!! what is going on here, another said in no uncertain terms that there is no such thing as vitamin deficiency in the UK, rather broad and sweeping me thinks, alcoholics for a start are usually deficient in vitamin B, Post natal women are usually deficient, and hyperthyroid sufferers are definitely deficient as the disease takes a major toll on the body.
When I was very ill with this condition I started to develop diabetes symptoms which I was able to reverses after beginning to correct the chemical imbalance in my body.
In a nut shell mainstream medicine let me down so badly the alternative practices enabled me to gain my health back.
Yes grapefruit does interact badly with some of your dodgy drugs.
Statins they are lovely aren’t they cause memory loss and all the rest of it, You can find an equivalent in the herbal world that do not have these dreadful side effects.
So you are saying aspartame is harmless, you really are irresponsible
Wulfstan // April 26, 2008 at 2:28 pm
I’d imagine that your anecdotes of what you think that your consultant said to you are as reliable as your written work.
Oh, I think the relative merits of sense and responsibility are apparent to most people. Novel concept for you, the relative judgment of harm depends on the dose (as in “the dose makes the poison”: too much oxygen or water over too short a time can make you ill or even kill you, but ordinarily…) and may also depend upon other issues such as susceptibility (e.g., why some people develop anaphylaxis in response to prawns but others don’t).
As for ‘herbal statins’ - they contain the same substance, yes, which is why they can have the same side-effects as statins. Beyond that, the reason people go for one rather than the other is the standardisation issue, amongst others. Red yeast rice contains lovastatin, so if someone wishes to take that, fine, but they are still taking a statin with no control over quality and dose. It is a statin, like other statins, and will therefore have some of the side-effects associated with prescription statins. Interestingly, of course, there is no way of registering those side-effects, you can’t notify the MHRA. If you were to tell your GP, as you didn’t have it prescribed for you, my understanding is that there won’t be a yellow card scheme.
koo // April 26, 2008 at 3:00 pm
Yes I remember my GP not even bothering to fill in a yellow card over my allergic reaction to certain drugs, when I asked him about it he merely shrugged his sholders
Teel // April 26, 2008 at 4:30 pm
From observation from clinic chronic fatigue appears to have a number of contributing factors, with a particular intitial trigger.
The trigger could be infection, over exercise, emotional stress etc. These triggers increase the inflammatory response and oxidant damage.
The trigger then appears to act as the ’straw that broke the camels back’ so to speak.
Exacibating factors then keep this inflammatory/oxdative cycle going, with increased levels of inflammatory compounds such as cytokine and nf kappa B, leading to an increased inflammatory response
These exacibating factors include;
Adrenal fatigue (which has also likely to have led to hypothyroidism)
increased gut permeability
Gut flora imbalance.
Therapy concentrates on;
Lowering inflammatory mediators
Healing the gut wall
rebalancing gut flora (candida/parasite etc)
Supporting adrenal glands
Teel // April 26, 2008 at 4:34 pm
Have you noticed how this all relates to cellular balance.
Balancing hormones
balancing gut flora
Balancing inflam mediators
Balancing oxidant/antioxidant equlibrium
Acheiving gut membrane homeostasis.
draust // April 26, 2008 at 5:18 pm
Koo
It is the parathyroid gland that regulates, and is regulated by, body calcium levels. Not the thyroid, which play a major role in regulating overall body metabolic rate.
The parathyroid and the thyroid are different glands that do different things.
Any chance you could spare us the endless stream-of-unconsciousness about things you do not understand?
Irish Association of Nutritional Therapy: Giving the Facts About the Cochrane Review of Antioxidant Supplements « Holford Watch: Patrick Holford, nutritionism and bad science // April 26, 2008 at 7:54 pm
[...] has [given] an absolutely perfect example of why one should be wary of nutritional therapists.” Patrick Holford and Contriving a Controversy: the Cochrane review of antioxidant supplements Possibly related posts:Irish Association of Nutritional Therapy on the Cochrane Review of [...]
LeeT // April 26, 2008 at 8:51 pm
“Oh and LeeT the thing that jumped out at me most from the article that you posted about Holford and his funding”
Sorry, what article was that?
“Oh and vampires of the chemical abyss”
No just some one who likes food. I have just had a steamed smoke haddock fillet with sweet corn, broccoli and wholegrain rice. Would you not at least consider the fact that it might be possible to oppose Mr Holford and at the same time also eat healthily?
draust // April 26, 2008 at 10:25 pm
Sounds deeply healthy, Lee.
Mine was rice (the evil white version, sorry) with a sauce of mushrooms, onions, cream and fresh parsley, topped with grated fresh parmesan. Yummy. Let’s hope Patrick will allow me the cream and evil cheese since I had it with nice veggies.
LeeT // April 26, 2008 at 10:42 pm
The BDA recommends two to three servings of wholegrains a day: http://www.bda.uk.com/Downloads/July05factsheet.pdf
I am sure your white rice is okay if you are picking up the wholegrains elsewhere.
Regarding the dairy products there is no BDA fact sheet on them which would indicate people who know about nutrition don’t see them as a great problem. I eat a little slab of cheese and drink soya/dairy milk to get my daily calcium. I have never come across any evidence that dairy products cause any harm.
dvnutrix // April 26, 2008 at 11:07 pm
LeeT, you’ve reminded me that we meant to cover the BDA involvement in a yeast-free, sugar-free diet for people with ME (pdf). Participants were randomly assigned to this special diet or a well-balanced one:
The Hobday et al paper is an interesting read: Dietary intervention in chronic fatigue syndrome. One implication from the high drop-out rate is that people with ME find it difficult to follow any eating regime.
LeeT // April 26, 2008 at 11:28 pm
Oh dear DVN, you are sooooo behind. If you and the BDA had gone to the following website you would have realised there IS a cure out there for ME:
http://www.theoptimumhealthclinic.com/clinic/practitioners.html
One of the practitioners at the clinic talks to so-called experts and valiantly defends the cure here:
http://www.bbc.co.uk/radio4/youandyours/transcripts_2007_45_thu_04.shtml
draust // April 27, 2008 at 2:25 am
..and how gratifying to see that all four of the Optimum Health Clinic’s Nutritionistas, sorry, nutritionists, are graduates of “Professor” Holford’s Institute of Optimum Nutrition. High standards, of credulity are thus presumably guaranteed.
I note from the clinic’s website that they sell a water filter system. Of course it is well known that ME comes from toxins in the water….
…in a parallel universe where you have to wear a tinfoil hat to keep out the thought-control rays.
Teel // April 27, 2008 at 8:25 am
you seem to have a really poor understanding of ME/chronic fatigue.
Teel // April 27, 2008 at 8:27 am
I love the way you dont respond to a subject that you dont understand.
Wulfstan // April 27, 2008 at 9:14 am
Most people are too sporting to engage the unarmed in intellectual combat. You can read that either way; I’m sure that you and Koo will read it one way and others another.
I place as much value on your ‘clinical’ observations as I accord to your writings. And, in the latter, you mix together phrases you don’t appear to understand fully, alongside some unbelievably dubious stuff that most people find it hard to believe that anyone still espouses.
Teel // April 27, 2008 at 11:09 am
can you explain in greater detail please wulfy.
Try telling that to over fifty pateints i have freed of this condition. Ask them about the help they recieved from ther GPs. (Im not criticising GPs particularly, but when it comes to conditions such as ME/chronic fatigue/multiple sensitivity syndrome/fibromyalgia they do seem rather lost).
What do you know about these conditions? It is something i have been interested in for over fifteen years. The likes of yourself should be interested in my therapy/results and observations instead of being so closed off. Its is always possible to learn you know.
Teel // April 27, 2008 at 11:26 am
your evidence against the anti candida diet is a little silly.
This would only be implicated if a yeast over growth was present. People need to be looked at individually. As i have mentioned before, candida is only one of the possible exacibating factors that keep the inflam/oxidative cycle going. It is not always a factor in chronic fatigue.
Studies like these are also going to be poor because sugar and processed carbs are very hard to stop eating if you suffer from candida (were these people keeping to the rules)
Plus they were aloud to eat fruit, which isnt really conforming to the anticandida diet.
Supplentation is so important to the candida program. This really wasnt a very good study (although you will disagree)
A condition like chronic fatigue needs to be looked at from many angles per individual.
it interesting to note that the inflammatory mediators that are possibly responible are very short lived, thus causing different symptoms in different tissue depending on the individual.
So my conclusion is that all the conditions i have mentioned are actually the same condition but affecting individuals in different ways.
LeeT // April 27, 2008 at 11:30 am
Dr Aust
Did wonder whether providing the relevant links would be a breach of The Optimum Nutritionists (Protection from Criticism) Act 2010, but we haven’t quite reached that point yet.
I often get accused of being disrespectful or flippant about alternative medicine, but most of the time one only needs to report what’s out there.
Teel
I, and I am sure most other people, are interested in new and alternative approaches to the management of chronic illnesses. Personally I am constantly learning more about nutrition, diet and mental health.
I’ll tell you what I would do if I discovered a new treatment that seemed to be curing my patients symptons. I would not rest until I had persuaded the scientific and medical establishment to take my claims seriously. I would try - fund permitting - to conduct some small scale trials. Why don’t you ask Professor Ernst at the University of Exeter for some advice?
What is strange is that practitioners of so-called alternative medicine are unconcerned as to whether what they are doing actually works.
Wulfstan // April 27, 2008 at 12:12 pm
And yet, you continue to learn nothing while pumping out a high nonsense to fact ratio.
Breathless with anticipation - do write up your results and get them printed in a peer-review journal. In fact, write to the journal with your observations about the Hobday paper, after all, you’re criticising it, you must have read the full thing. Right?
In anticipation of that, name the standardised, universally accepted lab test that you use as part of your diagnostic protocol for candida.
As for your ‘15 years interest’ - oh dear. Like Holford, you obviously believe that reading work by others and a little facility with Google is the equivalent of formal study or supervised clinical practice. How very sad. It’s even sadder that you are practising such faux expertise on others. It’s not even coming across that you would be a particularly pleasant person with whom to have a therapeutic encounter.
LeeT // April 27, 2008 at 12:21 pm
“Try telling that to over fifty pateints [sic] i have freed of this condition” I love the language of therapists - a lot of it seems to be about freedom and deliverance.
Here is a little song I composed in honour of alternative therapists everywhere ….
Long my imprisoned spirit lay,
Fast bound in sub-optimum nutrition and Big Pharma night
Thine eye diffused a quickening supplement array,
I woke, the consultation room flamed with light,
My lethargy disappeared, my mind was free,
Patrick Holford he’s the man for me
No condemnation now I dread;
Patrick and all in his book is mine!
Alive in Him, my living Head,
And clothed in righteousness sublime,
Bold I approach the ion diploma without a moan or groan,
And claim the nutritional crown, through Patrick my own,
PS Advance apologies to anyone who loves the hymns of Charles Wesley as much as I do
Dr Aust // April 27, 2008 at 12:40 pm
Contrary to what you imply, Teel, the mainstream has thought long and hard about ME/CFS, and there is a recognised treatment which helps a lot of sufferers get better. It is graded exercise therapy, delivered by a properly-trained specialist therapist or doctor… plus addressing any diagnosable and treatable psychiatric problem present, sometimes use of CBT if deemed appropriate, and sensible dietary advice if needed - which means, in my book, from a dietitian and NOT from someone with Holford Diploma in Snake Oil.
The problem most GPs have with the kind of “syndromes” you list is twofold. One is that they know these conditions have, as one medical blog puts it, “”no physiological and anatomical pathology for which there is [an] …evidence base”. Conversely, these Conditions DO have a large psychological element, an idea which the available evidence strongly supports but which patients routinely refuse to countenance. A further problem is that the patients sometimes arrive “fore-armed” by supporter groups, the Internet and Alternative Reality practitioners with an evangelical belief that, by suggesting the above treatment options, the doctor is “trying to tell me that I am mad… I have a real illness which you are refusing to investigate properly” etc etc. This does not make for easy doctor-patient collaboration on a path forward.
Alternative Reality Practitioners are not constrained by either evidence or a requirement not to lie to their patients. Thus they can say “Oh yes, you have a real physical disease which conventional medicine can’t cure because it refuses to take it seriously… but I can help you with my special diet” …whatever particular daft diet that happens to be. This statement by the “practitioner” contains multiple untruths, but in Alt Theray it is caveat emptor.
My wife, who is a doctor, has had a far bit of success referring people with CFS type problems to the graded exercise programme specialists. This kind of treatment option makes no assumption about underlying causation, by the way. But it does require the patient be ready to explore the therapeutic options without getting mired in “CFS Evangelism”.
Teel // April 27, 2008 at 5:10 pm
Lee T - Results are showing me what i am doing works
Wulf - how did you get to become so arrogant, im not pleasent because im telling you about a particular therapy that has some very good results, how strange! With phrases like ‘breathless with anticipation’ you come across as someone most people would call a [edited for obscenity]. its sad that you would rather see someone suffer than speak to someone who has a huge interest in the subject and in helping people. your one of these people who thinks dysbiosis doent exist.
Dr aust - graded exercise, this is another way of saying, we have no idea of the physioligical mechanisms behind your symptoms. Yours wifes a doctor! That explains a lot then. Here i am telling you about what im up to and i am being attacked. charming!
Its almost as if you feel threatened.
LeeT // April 27, 2008 at 6:38 pm
“It’s not even coming across that you would be a particularly pleasant person with whom to have a therapeutic encounter.”
We hear a lot about the placebo effect as being the reason for the apparently postitive results of some therapies. Just wonder if a negative placebo effect exists? Say you tentatively ask your therapist for the rationale behind the treatment and they call you “an ignorant ****.”
Teel - I would certainly never call anyone a ****, can’t even bring myself to type the word. If you think most people behave like that one can only speculate as to the type of company you keep.
Whilst it is nice to know what you are up to I am still puzzled as to why so-called alternative therapists prefer anecdotes to clinical trials. Nothing wrong with anecdote and specuation, just that has to be the beginning not the end. Possibly deep down you feel threatened and are afraid your therapies don’t actually work …?
Still, despite all this we must remember folks everyone involved in alternative health is extremely “nice” and has “a finely tuned moral compass.”
dvnutrix // April 27, 2008 at 7:08 pm
Apologies, LeeT. We have no idea how that made it through the filters.
Teel - this is your final warning. Any more of your obscenities and you will be barred.
draust // April 27, 2008 at 7:39 pm
Teel - you really don’t get it. The graded exercise approach is shown by proper trials to be the best approach to get the CFS patients better. That is why it is used.
As to the “physiological mechanisms”, the research reveals none for which there is any convincing evidence, as I said in the last post. None. The research does, however, reveal a high level of coexisting psychiatric problems in ME/CFS patients. These obviously can be part of the cause or part of the consequences of the condition, but they are certainly often part of the “negative cycle of exacerbation” that the patients find themselves in. Again, the psychiatric approach is often taken in helping these patients because it can help them get better, which is the point.
I find it hilarious that AltMed clowns like you huff and puff about “but … but… that’s like saying you don’t know the mechanism!” while simultaneously selling people pure Snake Oil in the form of quack diets for imaginary “yeast sensitivity” or “multiple chemical sensitivity”.
What is better - encouraging people to try the therapies that serious properly-conducted clinical trials show helps them get better? Or encouraging them to reject proven interventions and pin their hopes on believing their symptoms are caused by something that, according to the best scientific and medical evidence we have, does not really exist?
Your answer to this and mine are obviously different. But then you are making a living out of these peoples’ misfortune. You should be ashamed, but from reading what you have written I don’t think you have the necessary self-insight.
PS As to calling Wulfstan “arrogant” and “a prat”… well, pots and kettles come to mind. I think Wulfstan has been amazingly restrained about politely pointing out the mistakes and total lack of logic in the things you have posted on here. If he has finally resorted to sarcasm, it is because you have shown that you are impervious to reason, a characteristic (along with self-righteous arrogance) that you appear to share with many Alternative Practitioners.
LeeT // April 27, 2008 at 7:45 pm
Thanks dvn, though rather than you apologising to me it should be Teel apologising to Wulfstan as the abuse was directed at him.
dvnutrix // April 27, 2008 at 8:33 pm
You’re right, LeeT - I was apologising because you saw it before I could moderate it.
Teel, we expect you to apologise to Wulfstan in particular and the other readers.
dvnutrix // April 27, 2008 at 8:55 pm
And, belatedly, LeeT - the Wesley was very enjoyable :-) Good attention to scansion and very appropriate.
jdc325 // April 28, 2008 at 11:43 am
Teel wrote: “Receptors are can also be engaged by non physical molecules. Not a subject you lot would want to endulge in as you do not except things that you cannot see.”
I’m rather interested in these non-physical molecules. Where can I get some?
dvnutrix // April 28, 2008 at 12:15 pm
Teel has chosen to respond with another flurry of obscenities, abuse and off-topic meanderings. So, sadly, jdc325, you may have to wait some time longer to find out more about these “non-physical molecules”.
koo // April 28, 2008 at 12:52 pm
faust
The thyroid regulates calcitonin, calcitonin is a hormone known to participate in calcium and phosphorus metabolism.
I know the parathyroids role in calcium but clearly you don’t know the thyroids role in calcium…………dear oh dear
koo // April 28, 2008 at 12:53 pm
Teel
Are you up on codex alimentarious
If you are a nutritionalist you need to know whats coming in 2009.
dvnutrix // April 28, 2008 at 2:10 pm
People who are interested in the enthralling intricacies of our metabolic pathways may recall the diagram posted by Gimpy in January.
Anyone with a particular interest in the hormonal control of calcium in and out of the blood or extracellular fluid knows that it is a fascinating set of interactions.
Those with a passing familiarity with calcitonin will be aware that it is the counter to parathyroid hormone and hypercalcemia. In addition:
Crudely, if you are a healthy adult, high calcitonin activity might be suggestive of medullary thyroid cancer among other derangements. However:
The fact that something might participate in a form of metabolism does not mean that it is always clinically significant.
The Endocrine Web has some good overviews of thyroid, parathyroid and other endocrine disorders.
draust // April 28, 2008 at 2:57 pm
Dvnutrix, I am amazed you manage to deadpan these responses…
Koo, your last post gave me a good laugh. Funnily enough I actually worked, for a decent part of the last decade, on the mechanisms by which calcium acts on the parathyroid gland, including publishing several papers on it. …oh dear, appeal to authority, sorry. Anyway, I am glad I can have my unfortunate scientific misapprehensions corrected by someone who has read the real truth in an IoN brochure.
In endocrinology, as Dvn as indicated, there are usually multiple homeostatic mechanisms for most things, some dominant and some minor and / or modulatory.
One of the crucial things we teach scientists and doctors is which of these categories are which. The University of Google sometimes does not provide this useful information, especially if your Googling is to Alt Health sites.
Furthermore, if you automatically assume that people who do know about these things (I don’t mean me, but I might be thinking of, say, consultant endocrinologists) are ignorant or liars - and therefore conclude that what they say is a priori untrue - it will be no surprise if what you end up believing is the opposite of reality.
On the positive side, I would suspect your consultant is feeling as positive (or at least relieved) about not seeing you as you are about not seeing him/her. And doubtless you will have been able to find a sympathetic Nutritionist who is happy to agree with your Google-based self-diagnosis provided you keep paying for the consultations. So a result all round.
Claire // April 28, 2008 at 8:11 pm
“Yes Diabetes can be prevented and treated without the need for drugs (except for once you are on insulin there is no turning back unfortunately). Have you looked into the potentials of grapefruit for one example? I doubt it…
They have been using it in India for the last thousand years, now theres a trial for you…”
India: the diabetes capital of the world’ -
http://news.monstersandcritics.com/health/news/article_1221737.php/India_-_the_diabetes_capital_of_world
They don’t appear to be having a lot of success with the prevention-by-grapefruit.
Dear Terence Kealey, About Natural v. Synthetic Vitamins « Holford Watch: Patrick Holford, nutritionism and bad science // April 29, 2008 at 1:00 am
[...] has [given] an absolutely perfect example of why one should be wary of nutritional therapists.” Patrick Holford and Contriving a Controversy: the Cochrane review of antioxidant supplements Irish Association of Nutritional Therapy: Giving the Facts About the Cochrane Review of [...]
My (Paid) Friend Says This Product Is Really Good: FFTB and Cherry-Picking « Holford Watch: Patrick Holford, nutritionism and bad science // May 2, 2008 at 8:07 pm
[...] Registered Dietitian will be familiar with such tests although it is Registered Dietitians such as Rhona Hobday who have recently assessed anti-Candida diets and found them to be [...]
Patrick Holford and the Bikini Diet « Holford Watch: Patrick Holford, nutritionism and bad science // June 8, 2008 at 11:56 am
[...] Review of diets.[1] I am confused. It seemed to me that very recently he was saying that these Cochrane people produce stitch-ups and I wasn’t to trust [...]
Anti-oxidants and Supplementation: Not As Straightforward As It Is Made Out To Be « Holford Watch: Patrick Holford, nutritionism and bad science // June 12, 2008 at 1:53 pm
[...] Well, the coup against anti-oxidant supplements hasn’t happened but there is a definite groundswell of grumblings and scientific evidence that indicates that anti-oxidant supplementation is not delivering the promised benefits. Lisa Melton gave a good overview of the gulf between the hype and reality of anti-oxidants: The antioxidant myth: a medical fairy tale. More recently, Professor Tom Sanders gave the Burke Lecture (pdf) in which he briefly summarised the state of play for the outcomes of trials that tested the antioxidant hypothesis.[1] The Cochrane Review of anti-oxidant supplements (pdf) reported that there was no reduction in mortality associated with them (there was some manufactured controversy around these findings). [...]
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