Can you get 23 portions of fruit and veg in a single glass of juice: Patrick Holford Ponders, Briefly, Before Suggesting a Product

Former Visiting Professor Patrick Holford and Head of Science and Education at Biocare has many enthusiasms to which he continues to express slavish devotion, justifying his partiality by claiming that there is scientific evidence to support his stance. Uncannily, and in a way that has fortuitously contributed to his financial wellbeing, it is not unusual for Holford to be able to recommend a niche product to meet the supplementation levels that he recommends or the tests that he declares to be essential. So, it is perhaps understandable that Holford cleaves to some enthusiasms irrespective of research that shows there is no basis for his claims or that his hyperbole is far in advance of the actual evidence.

One of Holford’s recent enthusiasms is for advising his audience about how to increase their consumption of ORAC units (pdf). Apparently, lavish supplementation of vitamin and mineral pills and ORAC units will help you to live long and healthy lives, more Ryder Haggard’s She than Swift’s Struldbruggs. This is, of course, despite the official stance of 50 longevity experts who issued a position statement, deploring the hyperbole around longevity. Buettner summarised the quest for longevity well:

The idea of discovering a magic source of long life still has so much appeal…that charlatans and fools perpetuate the same boneheaded quest, whether it comes disguised as a pill, diet, or medical procedure. In an all-out effort to squash the charlatans forever, demographer S. Jay Olshansky of the University of Illinois at Chicago and more than 50 of the world’s top longevity experts issued a position statement in 2002 that was as blunt as they could fashion it.

“Our language on this matter must be unambiguous,” they wrote. “There are no lifestyle changes, surgical procedures, vitamins, antioxidants, hormones, or techniques of genetic engineering available today that have been demonstrated to influence the processes of aging.”

Back in June, Holford and his team were advising a consumption of 6,000 ORAC units a day by means such as a 1/3 teaspoon of cinnamon, or similar amounts of oregano, chili or turmeric. At the time, we wondered when we might see a product recommendation rather than the implied suggestion that one might obtain 6,000 ORAC units by eating comparatively large quantitities of spices and herbs, as well as more sensible quanitities of unsweetened chocolate and fresh fruit.

Somewhat fortunately for his finances, Holford has now identified that it is possible to meet these levels by consuming a product that he endorses: remarkably, Holford not only endorses Cherry Active as an individual celebrity nutritionist, but, in a stroke of good fortune, Cherry Active is endorsed by Food for the Brain, the charity for which Holford is currently the CEO.

Just recently, Holford has emailed round, with the rhetorical question, “Can you get 23 portions of fruit and veg in a single glass of juice?”. Now, this should elicit the answer, “No” because it really isn’t possible unless you adopt some very odd and selective criteria but, dictu mirabile, that is what happens. Holford chooses to concentrate on only the ORAC units rather than fibre, vitamins, minerals, or the many other micronutrients present in fruit and vegetables. Holford selectively quotes some ORAC values from fruit and vegetables to make achieving his recommended level seem like an insurmountable task and then rescues his anxious readers with the assurance that they will obtain his recommended number of these units per day if they will just consume a serving of Cherry Active concentrate, at a mere 65-85p per person, per day (depending on whether you buy the product in bulk).

At no point, does Holford lay out any scientific support for his assertions about the health benefits of consuming high levels of ORAC units.

The anti-ageing hit of 23 portions of fruit and veg in a single glass of juice?

Sounds amazing, but a delicious cherry concentrate delivers just that!

As winter approaches, it’s tempting to opt for more carbohydrate-rich comfort foods at the expense of fresh fruit and vegetables. Even in the summer, many people still don’t achieve the minimum recommended intake of ‘five a day’. That’s why I’ve been interested to discover that just one serving of a delicious juice concentrate called CherryActive contains the equivalent antioxidant capacity of more than 20 portions of fruit and veg.

CherryActive is made from Montmorency tart cherries and each 30ml serving has an impressive ORAC (or antioxidant) score of 8,260. To put this in perspective, five servings of fruit and vegetables have an ORAC score of around 1,750 units…

ORAC stands for Oxygen Radical Absorbance Capacity – it’s a measure of the antioxidant levels in foods. Foods with a high ORAC score protect cells from oxidative damage by eliminating compounds called oxygen radicals (also known as free radicals). These are chemicals that form naturally inside the body through the process of oxidation. Everyday functions such as breathing, digestion and physical activity produce these free radicals, as does exposure to polluted air, fried or over-cooked food and oxidizing radiation from the sun.

Oxidation causes disease and ageing
A common example of oxidation is when rust attacks metal. As the rust eats away at the metal, the metal starts to weaken and decay until it can no longer work. This is what happens to your body when free radicals attack it. Organs, cells and body tissues can be weakened by oxidation. This process is what can lead to diseases such as cancer, heart disease, senile dementia and osteoarthritis.

Eating foods rich in antioxidants, with a high ORAC score, neutralises free radicals and therefore not only helps protect you from life-threatening disease, but is also thought to slow down the ageing process itself.

The recent Horizon documentary How to Live to 101 showed that the longest living people in the world all achieve a very high intake of antioxidants, measured as over 6000 ORACs a day. As CherryActive contains 8,260 ORACs per serving, I’m including it every day as part of my anti-ageing strategy.

CherryActive is sold in a highly concentrated juice format. Mix a 30ml serving with 250ml water to make a deliciously healthy, low GL cherry juice. Each 946ml bottle contains the juice from over 3,000 cherries – that’s half a tree’s worth – and contains a month’s supply. Prices start at £13.95 for a 473ml bottle.

We’ve helpfully reproduced Holford’s table of ORAC values for some foodstuffs and for Cherry Active concentrate.

Now, there are so many canards here that it would be unwieldy to address all of them. We will comment on some of the more egregious but actively solicit other people to chip in with those that particularly annoy them.

Discussing unfamiliar ORACs rather than the vitamins, anti-oxidants and minerals with which people are familiar, makes them sound as if they are an additional extra to the diet that has to be consciously incorporated, rather than something that is already present in substantial quantities. Holford chose to make his comparisons by selecting some foodstuffs (e.g., tomato, watermelon) that are very high in water weight. It is not difficult to work out that the ORAC value per gramme for a raisin is much higher than that for the grape from which it is derived because it has none of the waterweight.

Oddly enough, it looks like it is not at all difficult to consume 8,000 ORAC units or so – the following list doesn’t even include the ORACs that are available from green tea, coffee, or red wine.

Does it look even remotely difficult to perm some foodstuffs from the above to obtain 6-8 thousand or more ORAC units per day?

23 portions of a variety of fruit and vegetables would probably deliver a rich, healthy complex of fibre, some fats, vitamins, minerals, polyphenols and other micronutrients. It is implausible that the cherry concentrate would deliver anything like as rich and varied a selection.

The ORAC analysis of a foodstuff does not reveal anything about the impact of the associated antioxidant activity on the body. It is far from clear that high ORAC values in foodstuffs translate to higher plasma (blood) antioxidant capacity (AOC), far less any anti-ageing or chronic disease countering effects. E.g., although plums yield a high antioxidant content upon analysis, plums did not raise plasma AOC levels in volunteers who participated in an experiment where they ate them and then had their blood analysed after consumption. It seems as if “one of the major phytochemicals in plums is chlorogenic acid, a compound not readily absorbed by humans”.

As Professor UK Dietitian has pointed out on a previous occasion, it is desirable to have a mix of food sources for desirable micronutrients:

anti-oxidant capacity of a whole apple is higher than that of an orange and is attributed to its polyphenol content. However, after eating an apple the rise in blood polyphenols is negligible, yet the additional anti-oxidant benefit is now attributed to the uric acid formed from its fruit sugar (fructose). Some polyphenols in fruits are poorly absorbed – and so may have a benefit in protecting the bowel as they pass along. Other phenolic compounds -such in tea and coffee – are absorbed to some degree, confering some advantage (perhaps) to the circulation and the organs it supplies.

Lastly, because the mistakes are more than we can bear, although we have written to Cherry Active on several occasions to point out their mistake, they are still claiming that there are only 10 calories in a serving of Cherry Active concentrate, when there are clearly more than 100. It is more than a little disingenuous to claim, “There are no added sugars in any of our products – only 100% natural sugars” when 21/40g in the serving are sugar and much of the remaining weight must be water. Anyone who is familiar with cooking terms will recognise a simple syrup when they see it (1:1 of sugar and water).

So, Patrick Holford, famously styled as the “academic lynchpin at the centre of the British nutritionism movement” by Ben Goldacre in Bad Science, and indefatigable critic of sugary drinks that he does not endorse, recommends that you should consume a calorie-dense, high sugar syrup everyday. There is no clinical evidence to support Holford’s hyperbolic claims for the value of ORAC units in staving off the ravages of ageing or promoting health, and you are probably better off spending that money on a varied mix of fruit and vegetable to eat every day that would provide a more useful selection of micronutrients.

So, expect to see more of this guff in the newspapers, and don’t be surprised to see it receive a rapturous reception on some TV programmes that really should be better at serving the needs of their viewers. Tessimond’s The Ad Man seems particularly germane:

He hunts for ever-newer, smarter ways
To make the gilt seem gold; the shoddy, silk;
To cheat us legally; to bluff and bilk
By methods which no jury can prevent
Because the law’s not broken, only bent.

BPSDB