Holford Watch: Patrick Holford, nutritionism and bad science

HolfordWatch has just learned that Patrick Holford has resigned his post of Visiting Professor at Teesside; a call to Teesside confirms that the reception don’t have a record of any Professor Holford at the University. We don’t have any more details at the moment: we will post information as it arrives.

Clearly, this is good news: Holford does not produce professorial-standard work. We trust that Holford will update his CV ASAP, and that Teesside will soon put out a press release to clarify the situation. (more…)

Just a quick post - to note that Prof Patrick Holford of Teesside University has a pretty terrible article on hayfever on the Natural Products website. (more…)

BANT has a sufficiently flexible code of ethics that nutritional therapists are allowed to earn commission from selling tests and pills. That in itself is not particularly striking. What is unusual is that the therapist is under no obligation to declare this commission to the client (pdf):

In addition to supplying supplements as an integral part of a consultation, the Member may also act as a supplier of laboratory tests, or any other products related to Nutritional Therapy. The member may choose to benefit from trade discounts and commission payments when offered by the supplier on products purchased by him for such use. The member decides whether such payments, in whole or in part, are retained in his Nutritional Therapy business, or passed onto the client. [pg. 9; S 7.3 a); emphasis added.]

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Professor Patrick Holford of Teesside University and Head of Science and Education at Biocare and Drew Fobbester are joint researchers and authors of the Food for the Brain Child Survey, September 2007 (pdf). The report lists a distinguished Board of Scientific Advisors for Food for the Brain (FFTB) and thanks them for their overview of the data and analyses. (more…)

Professor Patrick Holford of Teesside University and Head of Science and Education at Biocare frequently upbraids professionals and researchers for what he perceives as their lack of up-to-date research.

Holford’s 100%health newsletter for November 2007 is full of the usual inexactitudes and creative interpretations of quite straightforward research. He once again conflates allergies and intolerance and discusses IgG as if it is relevant to any such discussion. (more…)

I thought that - when the Scotsman published Blissett’s dire article on Holford a while after the Standard - it was just letting its standards slip, and running a poor-quality cast-off from the London media. However, having taken a closer look, the Scotsman have form on this type of ’science’ journalism. Last year, they gave Holford the chance to share his insight into how “autistic children are almost all allergic either to wheat, milk or both”. This is an interesting claim - and very likely inaccurate.

IgE-mediated allergies are pretty rare, symptoms generally come on pretty quickly, and we do have reliable tests for such allergies. If ‘almost all’ autistic children were allergic to such staple foods as wheat and milk, one would expect that evidence-based medicine would have noticed by now. Oddly, they haven’t. The available evidence just does not support this claim.

It may be that Holford is talking about something else (e.g. he might believe that almost all autistic children are gluten and casein intolerant). However, this isn’t clear from the Scotsman piece (and even this weaker claim is not supported by reliable evidence). The article also does not make clear that - if cutting milk and wheat out of their child’s diet - parents should do this under the supervision of a suitably qualified medical professional such as a dietitian.

The Scotsman therefore allowed Holford to - incorrectly - give the impression that “autistic children are almost all allergic either to wheat, milk or both”. They also failed to warn parents of the need to see a qualified medical professional if removing staple foods from their child’s diet. This is horribly bad science, and horribly bad journalism. Surely the Scotsman’s readers deserve better.

Holford’s Whole Health Manual is a real joy to read: flicking through it in the library, it provided excellent light relief from the more serious texts I was reading. As well as writing positively about health dowsing, Professor Holford of Teesside University also seems to have had a soft spot for Applied Kinesiology (AK):

While the concepts behind this technique are often hard to grasp there is little doubt that it works and is a useful test in improving the overall function of our bodies. (Holford 1983, 130).

Unfortunately - while Holford has also written in the Whole Health Manual about the utility of intuition - whatever intuition, evidence or knowledge Holford was drawing on appears to have let him down here. As John Garrow has shown, Applied Kinesiology produces results similar to chance when subjected to blind testing. (more…)

I’m starting to get a bit annoyed here. In April, Food for the Brain agreed to modify their advice on autism: they had previously suggested eliminating several types of food, without mentioning the need to seek professional advice; they modified this advice to emphasise the need to find replacement foods under the supervision of a professional.

However, I looked at the Brain Bio Centre site today (where readers are greeted by a very fetching favicon picture of Patrick Holford). Guess what their advice for autism is? Among other things, one is advised to:

Remove Allergens - In addition to nutrient deficiencies, the most significant contributing factor in autism appears to be undesirable foods and chemicals that often reach the brain via the bloodstream because of faulty digestion and absorption. The foods which seem to adversely influence a large number of children include wheat and other gluten containing grains, milk and other dairy products including casein, citrus fruits, chocolate, artificial food colourings, paracetamol, salicylates (prunes, raisins, raspberries, almonds, apricots, canned cherries, blackcurrants, oranges, strawberries, grapes, tomato sauce, plums, cucumbers and granny smith apples), nightshade family foods (potatoes, tomatoes, aubergines). The strongest direct evidence of foods linked to autism involves wheat and dairy and the specific proteins they contain - namely gluten and casein. These are difficult to digest and can result in allergy especially if introduced too early in life.

Many people would struggle to eat a balanced diet after removing all these foods, and people on the autistic spectrum may find this harder than usual. Depressingly, though, the Brain Bio Centre site does not make clear the need to find suitable replacement foods, or to carry out such radical dietary changes under medical supervision.

I could go through the ’science’ behind some of these claims in more detail, but it’s late and my brain cells are starting to revolt at all this Holfordesque ’science’. What I’d emphasise for now is that the Brain Bio Centre page on autism is lacking in some very basic, and important, cautions. And that these are points I’ve previously made, and which have lead to modifications to Food for the Brain advice - but not, apparently, to the more radical advice on the Brain Bio Centre’s site.

Patrick Holford’s Institute for Optimum Nutrition (ION) has a remarkable offer-for only £235 and through the marvels of:

Home Study…you will learn more than you ever thought possible and by the time you have completed the course, will know enough to keep you your family and friends in the best possible health.

The course is not modest in scope or ambition. ION’s Home Study Course promises:

You will discover a lot about ‘what makes you tick’, including how food is turned into energy, how to slow down the ageing process, strengthen your immune system, discover and deal with food allergies and addictions, improve your energy and concentration, prepare for a healthy pregnancy, safeguard your baby’s health, be well in old age - and a lot more besides!…

The course is ideal for the layperson who wishes to acquire sufficient knowledge to plan a personal nutrition program for over all [sic] health or for the Complementary Therapist wanting to enhance their practice with sound nutritional advice. [Emphasis added.]

I’m not sure how to reconcile that last part with the disclaimer:

The Home Study Certificate of Completion is recognition that you have understood and successfully completed the course to ION’s standards. It is not a recognised qualification and will not count as points towards a degree. The certificate will not be regarded by ION or any other body as a means to set up in practice as a nutritional therapist. The Home Study is a self-learning program and does not enter into nutritional therapy.

The course has modules about foods that harm or heal; it also offers information about the digestive, cardiovascular, immune and respiratory systems and their diseases. I would be interested to learn more about some of this content.

E.g., an entire module is dedicated to “foods that harm” and those listed include:

coffee; sugar; refined and convenience foods; fats - trans and hydrogenated; salt; red meat; wheat; dairy products; alcohol; chemicals and pollutants in food; GMO - genetically modified food.

It would be fascinating to learn if there is a consensus of the literature on whether or not these foods are intrinsically harmful, as for some of them, their perceived harm may be related to several factors such as the quantity that is consumed as part of the normal diet (e.g., there is plenty of support for the benefits of moderate alcohol consumption for some groups and similarly for the dangers of excess consumption). It may be entertaining to unequivocally demonise foods, but it would be good to know if there is a sound basis for it. E.g., is the claim that GM foods are harmful based on well-received research or discredited studies of scary potatoes?

I assume that somewhere in those modules, there is a guide to how many calories people need throughout the lifecycle. This might be particularly relevant if the modules that cover topics such as hyperactivity and ADD, sugar-free toddlers or discovering/preventing allergies and intolerance recommend the exclusion of particular foodstuffs or food groups. I would also hope that there is some guidance as to knowing the limits of your knowledge and competence and when it is essential that you should consult an appropriately qualified professional, such as a paediatric dietitian. I am a little apprehensive about the inclusion of some of these topics because they are potentially quite serious and may have a significant impact on somebody’s health and quality of life; it seems to me that this may be straying from the remit of keeping “you your family and friends in the best possible health”. In a basic course like this which is concerned with “sound nutritional advice” it may be rather too advanced to cover these topics in the sort of detail that they would demand.

It would be good to know if anyone has pursued this home study course and ‘learned more than they ever thought possible’. I would be particularly interested in learning more about the course materials and the practical tests. Has the course influenced anyone to change their way of eating in a significant manner?

On May 1 I wrote up my attempt to discover Food for the Brain’s evidence for allergy and intolerance testing in children. Today, May 10, I noticed that Food for the Brain (FFTB) has removed the evidence and search facility that I criticised and withdrawn access to the summaries of the papers that they cited in support of some of their claims and recommendations (as addressed in my original piece).

My original search for FFTB’s evidence behind their recommendations for allergy and intolerance testing was an unsatisfactory experience and I expressed myself at some length on the matter.

I have no idea what the search engine algorithm on that site was doing but I doubt that I could have had less relevant or helpful ‘answers’ if I had been sticking my hand in some truthiness and referenciness tombola and pulling out solutions.

I have several concerns about the quality of FFTB’s evidence for some of their recommendations.

Following FFTB’s recommendations for allergies and intolerances may have substantial financial and social implications for a family and the way in which they accommodate the needs of family members. It would probably be very helpful for parents who are interested in exploring some of FFTB’s recommendations for their children if FFTB explained some of their recommendations more fully and provided references to the scientific literature that directly support those recommendations.

Today, May 10, I learned that FFTB has withdrawn the evidence and search facility. The page now carries the forlorn notice:

Please accept our apologies but this part of the site is under re-construction at present. We hope to have the research and search database facility back on-line in July this year.

Thank you for your patience and your continued support.

Further than that, FFTB has also withdrawn the summaries of the papers that they provided to support their claims and recommendations.

FFTB offers a range of special reports (authors not identified):

From in-depth articles on autism to the latest clinical approach to schizophrenia, here you will find detailed information on the link between nutrition and mental health.

Unfortunately, you can’t see the reports unless you pay to subscribe to FFTB. Based on what I’ve seen of the relevance, research and writing quality of the FFTB site, I’m reluctant to part with the money to see the reports although I would gladly accept some review copies on relevant topics. E.g., I would very much like to see: Autism and a gluten-free, casein free diet - is this an appropriate dietary intervention and what is the rationale behind this approach; Oxidative Stress in Autism; Final Report on Food for the Brain’s School Project at Cricket Green.

Although I do not know why FFTB has chosen to reconstruct the evidence and search section, nor why they have withdrawn access to their summaries of the research papers, I am pleased that they are revising these sections. I hope that their future evidence will be fully referenced and more relevant to the parents who are consulting it.