Category Archives: 08 Nov 2013

How homeopathy might work

How might homeopathy workThe article has referenciness. Several of these references are familiar. As usual TatMaggot doesn’t give the full reference (wouldn’t want to follow journal practice, after all, or make it too easy to debunk her credulous nonsense)`, and references include that peerless source of cutting edge medical discovery, the Daily Mail.

TL;DR summary

In the end, I’m disappointed. After the debunking of the previous WDDTY advertorial on homeopathy and the Banerjis, this amounts to little more than repeating precisely the same refuted claims because TatMaggot believes she’s right so refutation of Benveniste etc. can be ignored. I was hoping for something new to get my skeptical teeth into, this provides nothing new. Not even a new spin on the tired old conspiracy theories. Medicine sometimes fails, therefore unicorns.

The only genuinely new study since the last go-round is ” The potentized homeopathic drug, Lycopodium clavatum (5C and 15C) has anti-cancer effect on hela cells in vitro” (J Acupunct Meridian Stud. 2013 Aug;6(4):180-7).

 

Bang!

 

This has yet to be replicated (as is the case for most homeopathy basic research) and contains, as usual, no evidence of generalisability, no evidence of potential therapeutic effect, no credible rationale for selection of the “remedy” and no evidence that this will be linked to the “similimum” or any other symptomatic presentation.

It’s all the same old long-debunked rubbish. It’s almost as if there is no credible evidence for homeopathy, just a lot of wishful thinking by believers.

Oh, wait…

Seriously? It is just possible that a homeopath might stumble upon a substance that at clinical doses produces a useful effect. Given the sheer number of substances they use, anything else would be statistically improbable. But there’s no compelling evidence of any persistent effect at homeopathic dilutions, no credible evidence that the diluted and potentised “remedies” have any specific clinical effect, and ridiculous quote mining expeditions like this do nothing other than perpetuate the smokescreen of confabulation used by homeopaths to hide the fact that everything about their beliefs is simply wrong.

The first batch of references seem to be drawn from those cited in the Homeopathy journal’s special issue on the memory of water. We can assume that these are the best of the bunch from that issue.

  • Complement Ther Med. 2007 Jun;15(2):128-38 is “The in vitro evidence for an effect of high homeopathic potencies–a systematic review of the literature” by Witt et. al. Witt is paid by a homeopathy promotion body, the Carstens Foundation. This paper reviews primary research into mechanisms for homeopathy, finding 67 experiments of which 1/3 were replicated (i.e. 2/3 were not replicated, in line with the norm for homeopathy). It notes that the designs were inhomogeneous. Witt claims that “[e]ven experiments with a high methodological standard could demonstrate an effect of high potencies” but notes that “[n]o positive result was stable enough to be reproduced by all investigators. So the take-home from this is that believers can produce a positive result, but can’t replicate it.
  • J Therm Anal Calorim, 2004; 75: 815-36 is “New Physico-Chemical Properties of Extremely Diluted Aqueous Solutions” by V. Elia and M. Nicoli. This was discussed in a Bad Science Journal Club. The significance of this is that Elia claims, according to another paper in homeopathy, to have documented an effect which increases over time – i.e. which apparently violates the second law of thermodynamics. In the nine years since, this has not become anything like mainstream.
  • Homeopathy, 2007; 96: 175–182 is “The defining role of structure (including epitaxy) in the plausibility of homeopathy” by ML Rao, Rustum RoyW, Iris Bell and Claudia Witt (again). BadSciencers fisked this one too, noting that “different” spectra turned out to be the same graph and so on. A letter to the journal, reproduced in a JREF discussion, notes fatal flaws with the data as presented.
  • Physica A, 2003; 323: 67-64 is “Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride” by Louise Rey. The Bad Sciencers didn’t have a lot to say about this other than that it’s speculative: it seeks to project condensed matter effects onto liquids. Definitive or conclusive it ain’t.
  • Biochim Biophys Acta, 2003, 1621: 253-60 is “Effects of ultrahigh dilutions of 3,5-dichlorophenol on the luminescence of the bacterium Vibrio fischeri“, by Brack et. al. I can’t find any significant discussion of this other than drive-by citations in laundry lists of references on homeopathy apologist websites.

So TatMaggot sets out her stall with a series of papers that include weak, irreproducible or uninterpretable results, and which advance in some cases contradictory hypothetical explanations for how homeopathy might work in some classes of substance.

None of these shows any link between “remedy” and symptom or disease, none of them shows any evidence of a clinically useful effect, none of them shows any evidence of a general or universal effect that is unambiguous and specific. This is, in other words, a re-warming of the Homeopathy “memory of water” issue.

Molehill Montagnieering

No paean to the refuted “memory of water” thesis would be complete without reference to Jacques Benveniste and Luc Montagnier.

TatMaggot of course believes Benveniste, it goes without saying, all avid homeopathy believers do. The special pleading is all reproduced: the pejorative characterisation of Randi, the claims that they “changed” the protocol and so on. It really doesn’t mater how sincerely you want to believe in it, the Benveniste experiment is a busted flush. Attempted replications have failed.

Montagnier has a self-published series of experiments that purport to back Benveniste, but these have not been independently validated either and when interviewed by CBC’s Marketplace he acknowledged that his work “cannot be extrapolated to the products used in homeopathy” – and indeed the same is true of Benveniste’s work, had it not been refuted.

Lastly, there is the knotty problem of shelf life. The effects Montagnier claims to have observed, last a few tens of femtoseconds – a fraction of a picosecond. This is entirely incompatible with the claims of an effect that increases over time, or is stable.

Jumping on the Banerji wagon

As with the previous issue of WDDTY claiming homeopathy is “much more than placebo”, the intellectual heart of this thread lies in the Banerji foundation and their extraordinary claim to reverse cancer using homeopathy alone.

Papers cited include the uninterpretable rubbish that is “Cytotoxic effects of ultra-diluted remedies on breast cancer cells” (Int J Oncol. 2010 Feb;36(2):395-403) and the followup “Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer” (Int J Oncol. 2003 Oct;23(4):975-82). The balance of the sources are: a WashPo editorial, the Banerjis’ publication in the best cases series (which explicitly does not establish the validity of the treatment), a Yahoo group, the Banerji website, the “journal of acupuncture and meridian studies“, the only genuinely new source since the last go-round as far as I can tell, (spoiler alert: meridians don’t exist and acupuncture is an elaborate placebo), and the BBC News website. Oh, and the Daily Mail, often cited in the top-tier medical journals for its groundbreaking basic research on the influence of immigration on the British pint or some such.

Doctors misdiagnose depression 86 per cent of the time

Doctors misdiagnose depression 86 per cent of the time
An accurate title for this story would have been: “86% of over-65s in the U.S. who say they recall a doctor or other medical professional saying they had “depression” in the past year don’t remember enough symptoms in the past year to meet the DSM criteria for MDE“.

Instead, WDDTY magazine went with the scaremongering headline: Doctors misdiagnose depression 86 per cent of the time

That’s a wildly inaccurate account of the research. But the magazine went a step further, and converted that claim into direct advice for its readers. Here’s the first paragraph of the WDDTY piece:

Has your doctor diagnosed you as clinically depressed and prescribed an antidepressant? If you’re a senior citizen, you should get a second opinion — because there’s a very good chance you’re not depressed at all.

That’s both an irresponsible, and an inaccurate, piece of journalism. The research is silent on the rates of 12-month, or current, antidepressant usage for this (or indeed any) sub-group of study participants, so WDDTY has absolutely no basis for its claim that if you are over 65 and have been prescribed antidepressants “there’s a very good chance you’re not depressed at all”. WDDTY gives direct advice to an already vulnerable population, on the basis of misreporting somewhat nebulous research.

Continue reading Doctors misdiagnose depression 86 per cent of the time

Polio in WDDTY

WDDTY on polio and polio vaccination
According to WDDTY, polio isn’t that dangerous, it’s mainly caused by the oral polio vaccine, the vaccine doesn’t work and it causes other things besides just polio including AIDS, M.E. and autism. Doctors have a safe vaccine but don’t want you to have it because of lobbying from Big Pharma, the prevalence is much lower than governments would have you believe, a baby that’s just been vaccinated should be treated like a biohazard, and polio was dying out anyway before the vaccine was invented.

As an encapsulation of all the things that are wrong with WDDTY, its relentless barrage of polio and polio vaccine disinformation spanning over two decades is a superb study in how to be wrong, and remain wrong in the face of new data.

Cranks and charlatans are accorded equal time with “experts” who aren’t, but whose past employment allows them to be presented as brave whistleblowers. The authority of an anti-vaxer is never questioned. The authority of a scientist defending vaccines is never admitted. Studies showing that vaccination works are presented as evidence that it doesn’t, and that it causes damage. Honesty about the risks of vaccines, openly published, is presented as if it has had to be wrung from the hands of a reluctant establishment.

WDDTY are “viciously, viciously anti-vaccine”. And here we see that this agenda takes precedence over concern for one of the most dreaded of all vaccine-preventable diseases.

Continue reading Polio in WDDTY

WDDTY invents advice from researchers on antidepressant use in pregnancy and Autism

Two major drug groups could cause autism
Autism is a fertile hunting ground for quacks and cranks. Pseudoscience is rampant. It’s hugely draining for parents, there is precious little anyone can do about it, and the causes are unknown. It’s notorious as the foundation of Andrew Wakefield’s fraudulent MMR studies, and quack treatments such as chelation therapy and bleach drinking cross the line into child abuse. Parents are driven to horrific and desperate lengths, often by the very cranks who claim to support them.

The SCAM community (naturally) tries to pin the blame on the bogeyman du jour: vaccines, of course, antibiotics, mercury, fluoride in the water, electrosensitivity – and here, antidepressants.

There are three truly evil aspects of this story. First, it screams about a threefold increase in risk, when actually it goes from 0.6% to 1.3% . Second, it screams cause when the study referenced explicitly repudiates this, as well it should – a case control study has no way of telling if, for example, there is a genetic cause which is a cofactor in both maternal depression and autism. Third, and worst by far, it lays a burden of guilt at the feet of the mothers, without any good evidence to back this.

There’s no doubt that the less medication a pregnant mother uses, the better. On the other hand the dramatic effects of depression are well documented. There is always  a balance of risk and benefit in any effective treatment (whatever the peddlers of natural woo tell you to the contrary).  WDDTY cynically exploit and exaggerate the risks, and ignore the benefits, in order to serve their own agenda – a case this eloquent blog post makes very clearly.

 

Reblogged from NurtureMyBaby with permission

“What Doctors Don’t Tell You” is a magazine that apparently, for the princely sum of £3.95 “aims to meet the demand of those seeking information about alternatives to conventional medicine.”

In my opinion this should actually read misinformation. And as GP, Margaret McCartney, put it “The only ethical way I can see of selling it is if it is kept behind the counter in a plastic bag, with a label saying the contents are dangerous.”

Yet supermarkets continue to stock it (apart from Waitrose), despite many people making them aware of issues with its content.

If you’ve not heard of this magazine before there are many, many blog posts about the misinformation presented in this magazine. On cancer and chemotherapy. HIV/AIDSHomeopathyThe HPV vaccineMMR.

There’s a master list of posts over on Josephine Jones’s blog too, as well as a whole blog dedicated solely to highlighting the issues with this magazine.

autism-antidepressantsIn this post I want to talk specifically about the article titled “Two major drug groups could cause autism” found on page 17 of the November edition that states:

“Women who take certain prescription drugs while pregnant are increasing the chances of Autism in their child”

The drugs that the magazine “reports” on are antidepressants and Epilim. I wanted to take a closer look at the claims made about antidepressants. I tend to get my knickers in a twist about flippant pill shaming so any hint of that and my interest is piqued.

I checked the reference that the magazine points you to and I don’t think it backs up what is written.

The magazine tells you:

“All antidepressants, including the newer generation of SSRIs, triple the chances of the unborn child developing autism”

There’s a few issues with this statement in my eyes.

Absolute risk versus relative risk

“Triples the chances” Crikey. Sounds dramatic doesn’t it. Well first off the “triples” figure is not backed up by the results in the paper. We can look at that in a bit more detail later.

But a big issue I have with this is that WDDTY have done that thing, where, in order to make a story sound a bit more exciting, a bit more headline grabbing, they have reported solely on the relative risk.

This seems to happen quite a lot in the media in general, it’s certainly not unique to WDDTY. It’s frequent enough that Cancer Research UK have gone to the trouble of writing a pretty good explanation of the meanings of relative and absolute risks here.

The relative risk tells us:

“how much more, or less, likely the disease is in one group, compared to another.”

When it is reported that the risk is tripled, this could mean that the risk is 20% in one group and 60% in another. Or it could mean the risk is 0.1% in one group and 0.3% in another. The figures I’ve given in these examples are known as “absolute risks”

As there is a big difference between a 60% risk and a 0.3% risk, you can see that to solely report on the relative risk with no mention of the actual figures involved ie. the underlying absolute risks does not give the full picture. From looking at the WDDTY article we have no idea what the absolute risks are, nor is the writer clear about the two groups being compared.

I’m no expert, but looking at the actual paper, I tried to work out where this “triple the chances” came from. I’m not entirely sure.

In very (and probably, over-) simple terms, the research took a load of people with autism (cases) and then took a load of people who matched the autism group in terms of sex and age, but did not suffer from autism. This second group is known as the control group. Then they looked at information on the parents of the people in both groups and looked at how many suffered from depression and how many mothers took antidepressants during the pregnancy, including the type of antidepressant.

Then they did lots of clever number crunching. It’s impossible within the scope of this blog post to go into the details of the statistical analysis that was performed. But a key conclusion that they reached is that:

“Any antidepressant use during pregnancy in mothers of cases was 1.3% compared with 0.6% of controls equating to an almost twofold increase in risk of autism spectrum disorder”

So it seems that the figures for the absolute risks in these two groups are rather low and ultimately, when they did all their odds ratio calculations, it showed almost double the risk, not triple. I think reporting on the figures shown above, alongside the relative risk, would have given WDDTY’s article a bit of a different feel.

(It is all a bit tricky, and my understanding of the numbers and the way the study was done means that the above percentages do not relate directly to risks in women that do take antidepressants versus those that don’t – so it is a bit unfair to simply say that they should have quoted these numbers as absolute risks – but I think some context is needed other than just saying “triples” – this all goes to show the really big problems with just taking numbers out of context in the manner that WDDTY have done. I’m sorry if my attempt to clarify the numbers has made matters worse. Perhaps I should delete all of this section and just say – “I think you’ll find it’s a bit more complicated than that”)

That’s not to say that relative risks are unimportant, indeed they are of great importance in decision-making – comparing risk/benefit of one exposure/treatment vs another, but the absolute risks do put them in context, and I feel that context is important.

Sadly, context is frequently missing in WDDTY. (Another example of missing context can be seen in an article on UTIs and antibiotics, where in failing to tell us the actual purpose of the research they cite, WDDTY try and take a figure from the paper and extrapolate it to the general population, thus having us believe that 70% of women can get better from uncomplicated UTIs without antibiotics, when the figure is actually estimated to be 25 – 50%)

To be fair to WDDTY, (I don’t know why I keep bothering to do that) I think I can see where they got the “triples” figure from. I think (from looking at table 4 in the paper) it is from looking at a link between depressed women taking antidepressants and autism in offspring, rather than a link between taking antidepressants and autism in offspring. (Antidepressants can be prescribed for things other than depression, such as neuropathic pain.)

I think this serves to highlight the importance of my earlier question of what two groups are we comparing when we talk about a tripled risk, and it also highlights the general importance of context.

Causality

The paper this article is based on is very cautious about saying that antidepressant use directly causes autism. It says:

“it is not possible to conclude whether the association between antidepressant use and autism spectrum disorder reflects severe depression during pregnancy or is a direct effect of the drug.”

And

“Caution is required before making causal assumptions or clinical decisions based on observational studies”

I don’t think this is reflected in what we see in WDDTY. I think the two statements I’ve already quoted from the magazine infer that autism is caused by the drugs. Here they are again:

“Women who take certain prescription drugs while pregnant are increasing the chances of Autism in their child”

“All antidepressants, including the newer generation of SSRIs, triple the chances of the unborn child developing autism”

Notice that in that first sentence, it’s not even the drugs that WDDTY wants to blame, it’s the women themselves that are increasing the chances by taking the drugs.

No consideration at all that it might be the severity of the depression that could result in an increased risk of Autism and that perhaps treatment might reduce the risk (the researchers even explicitly say this later, as we’ll see, so I’m not sure what WDDTY’s excuse is for failing to mention this.)

Certainly no consideration for the fact that it is not the individual fault of any women that she might end up in a position where taking antidepressants is necessary. Just a straight up blame game, yep, take these drugs and YOU, pregnant lady, are increasing the risk of damaging your unborn child. I can’t put into words how much I’m annoyed by the way WDDTY frames this sentence.

I’m not the only one who sees a problem with how happy WDDTY seem to be to blame pregnant women.SouthwarkBelle has also written about the way WDDTY misrepresent this research.

Perspective

Further reading of the paper offers further perspective on the figures:

“From a public health perspective, if antidepressant use had a causal relation with autism spectrum disorders, it would explain less than 1% of cases”

The actual figure, given elsewhere in the paper is 0.6%. So looking at it this way, not only is “triples” inaccurate, it also appears to be a little alarmist. What would you do if you were a responsible health journalist, would you report on an invented tripled risk or would you report on the 0.6% of cases that would result if antidepressant use did cause autism?

(I think ideally, you might write more than 3 paragraphs, so that you can go into a little more depth and provide context)

Also of relevance is this:

“All associations were higher in cases of autism without intellectual disability, there being no evidence of an increased risk of autism with intellectual disability.”

Once again if WDDTY looked closely at the study and were careful to point out this detail….well it paints the research in a different light doesn’t it? An association between anti-depressants and autism was found but only with autism without an intellectual disability. Less alarmist, for sure, not really WDDTY’s style.

“Seek out non-drug therapies, say researchers”

Now we move onto what I find to be the worst part of the article. Here is the full sentence I’m talking about:

“So women who suffer from depression during pregnancy should seek out non-drug therapies, say researchers from the University of Bristol”

Gosh. If I was pregnant and had decided to take or stay on antidepressants, I think I’d already be quite concerned by the article so far. But that is quite a recommendation from the researchers isn’t it? Quite firm advice. The researchers must be certain about the clinical implications of their research.

Apart from of course, they are not, as we’ve already seen from the quote about clinical decisions requiring caution.

Here’s what else they say:

“….the results of the present study as well as the US study present a major dilemma in relation to clinical advice to pregnant women with depression. If antidepressants increase the risk of autism spectrum disorder, it would be reasonable to warn women about this possibility. However, if the association actually reflects the risk of autism spectrum disorder related to the non-genetic effects of severe depression during pregnancy, treatment may reduce the risk. Informed decisions would also need to consider weighing the wider risks of untreated depression with the other adverse outcomes related to antidepressant use. With the current evidence, if the potential risk of autism were a consideration in the decision-making process, it may be reasonable to think about, wherever appropriate, non-drug approaches such as psychological treatments. However, their timely availability to pregnant women will need to be enhanced.”

It’s just not the same as what was written in this magazine is it? I have to wonder how the folk at WDDTY translate “a major dilemma in relation to clinical advice to pregnant women” into what I read as a quite firm statement telling pregnant women suffering from depression to “seek out non drug therapies” I recognise that there is mention of non-drug approaches by the research, but saying “it may be reasonable to think about, wherever appropriate” is very different from saying “should” I really think that once again WDDTY has taken a study and misrepresented it. Either that or the researchers spoke to WDDTY and made additional comments on the research aside from what is published.

Only that is not the case either.

I had email correspondence with Dr Dheeraj Rai, the lead author of the BMJ paper who said,

“It would be unwise to suggest that clinical decisions be based solely on our one study. As we mention in our paper, it is not yet clear whether the associations that were observed between antidepressant use during pregnancy and offspring autism were causal, or related to the risk associated with the underlying depression. Although future research will help answer this question, it is understandable that the possibility of potential harm creates concern. However, decisions regarding treatment require a large number of considerations including type and severity of symptoms, risks to mother and baby, and potential benefits. Doctors or other relevant healthcare practitioners can discuss these with concerned women in relation to their personal circumstances and help them to make informed decisions.”

I know it can’t be easy to simplify such a study into a small accessible, informative snippet, (and I wonder how wise it is to attempt it at all) but I’m just not impressed with the job done here. I hate to think that a pregnant woman struggling to make decisions around antidepressants in pregnancy might read this at take it at face value. And I also hate to think of the Mum who has a child with Autism and took antidepressants during pregnancy, who reads this and ends up feeling to blame.

I also think, that in ignoring the complexities surrounding making decisions around antidepressant use in pregnancy, WDDTY trivialise depression. Their flippant suggestion of seeking out non drug therapies shows no understanding of the condition and the effect it can have on a person. By making such a suggestion, I would argue that WDDTY contribute to the stigma surrounding mental health and potentially their writing could affect more than just the person that chooses to read it. Elsewhere they have done a similar thing with TB patients, ie contribute to stigma, by promoting fear of and discrimination towards people that they would have you believe are suffering from a disease that is incurable (Note: TB is curable).

For responsible advice on anti – depressants and pregnancy read here.

What can be done?

This magazine is damaging. If people trust this magazine with its impressive sounding references without realising the extent to which it misleads, then they will make decisions about health based on wrong information and possibly form attitudes towards patient groups that result in discrimination.

The way they write about cancer and quack cures does nothing but sell false hope. (Read that blog post if you get a chance – it sums up my views on this magazine very well)

Having it available in Smiths and supermarkets with its glossy cover gives it a certain air of respectability it does not deserve. The thought of anyone I care about being seriously ill and picking up this magazine for advice scares me. I wouldn’t want them to use it to educate themselves about depression either, being that it’s something that I personally suffer from.

Myself and many others, would love to raise awareness of the bad reporting in this magazine and get this magazine out of high street stores, and have been making their views known to the relevant companies.

Waitrose have already listened to peoples’ views and have decided to stop stocking it. But the likes of WH Smiths, Tesco, Asda and Sainsbury’s are less responsive. (Sainsbury’s did say they were going to stop selling it, however they appear to have backtracked)

Putting more pressure on these big chains could make a huge difference.

If Tesco and Asda can withdraw their mental health patient costumes because they recognise that selling them reinforces stigma and causes damage to those living with mental illness, then when the damage that this magazine could cause is brought to their attention they ought to act accordingly. If you agree, and fancy letting your views known then here are some email addresses:

[email protected]

[email protected]

Sainsbury’s can be emailed here

[email protected]

The more people who are aware of the misleading information in this magazine the better. So if you agree that this magazine is problematic please spread the word in whatever ways you can. Twitter it(#wddty), Facebook it, blog it, tell your neighbour, if you find a copy speak to the manager of the store or have a word with the pharmacist. Whatever small things you can do. Whatever you think is appropriate.

As always, please let me know if anything is unclear or you feel I have made any mistakes.

See also

Use of Selective Serotonin Reuptake Inhibitors during Pregnancy and Risk of Autism, Anders Hviid, Dr.Med.Sci., Mads Melbye, M.D., Dr.Med.Sci., and Björn Pasternak, M.D., Ph.D. N Engl J Med 2013; 369:2406-2415:

CONCLUSIONS: We did not detect a significant association between maternal use of SSRIs during pregnancy and autism spectrum disorder in the offspring. On the basis of the upper boundary of the confidence interval, our study could not rule out a relative risk up to 1.61, and therefore the association warrants further study. (Funded by the Danish Health and Medicines Authority.)

Too much copper?

Too much copper?
One of the repeated criticisms of WDDTY has been its tendency to be alarmist, to publish fringe information without context, and to give the impression of a logically developed argument but without the essential step: logic. A  good example is the call-out “Too much copper?” within the article on “6 ways to keep Alzheimer’s at bay”

WDDTY presents entirely mainstream findings, then tacks on a fringe opinion published in a magazine devoted to the highly problematic chelation therapy subculture within alternative medicine. The result is an alarmist piece which raises fears while omitting very simple factual information that would reassure readers and help them reduce exposure at minimal cost.

Continue reading Too much copper?

In the O-Zone

In the O-Zone
In the o-zone is an article from the November 2013 edition of WDDTY.

It conflates legitimate science, exaggeration of early findings, fringe claims and unproven claims to present a novel synthesis that is significantly different from the consensus view. The stated authorities for the more extravagant claims have evident conflicts of interest and red flags for fringe practitioners such as claiming unrecognised certification. Outright quacks are quoted alongside qualified doctors, albeit with practices that push the boundaries of what is ethically and evidentially supportable.

Ozone therapy occupies an interesting niche at the fringes, and WDDTY’s coverage of it is usefully indicative of its approach to fringe subjects generally. While it is not a quack therapy as such, fringe claims made by true believers go well beyond the current state of evidence. The most dangerous words in medicine are said to be: “in my experience”. The cited authorities are trusting their instinct and not listening to the cautious voice of scientific inquiry; as a result they are promoting a “miracle cure” which may well be legitimate in some cancers and from which useful therapeutic results may come, but without going through the process of checks and balances that is being applied by their more cautious colleagues. 

These sciencey-looking pods are used by quacks to perform "ozone therapy" on the credulous and/or desperate. They have pretty much nothing to do with the contents of the article.
These sciencey-looking pods are used by quacks to perform “ozone therapy” on the credulous and/or desperate.  They have pretty much nothing to do with the contents of the article.

In the o-zone

Ozone therapy is being used to treat a wide spectrum of diseases

It makes the sky blue, provides our planet with a protective layer from the sun’s UV rays and, for almost a hundred years, has been used medicinally to treat a wide variety of diseases. The German army used ozone extensively during World War I to treat battle wounds and anaerobic infections. Prior to that, ozone gas was used to disinfect operating rooms in Switzerland.7

Reference 7: Altman N. The Oxygen Prescription: The Miracle of Oxidative Therapies. Rochester, VT: Healing Arts Press, 2007

Interesting fact: a substantial proportion of the miracle cures promoted in WDDTY are formed around inflated claims for anti-oxidants; vitamin C megadoses are founded on the idea that antioxidants cure cancer, ozone therapy on the idea that massive oxidisation cures cancer. One of the cited sources uses both at once.

“Why, sometimes I’ve believed as many as six impossible things before breakfast” – The White Queen

You have to be kidding. Using a “miracle cure” book as a source? A “miracle cure” book by a palmistry believer?

And no, ozone does not make the sky blue. Rayleigh scattering occurs throughout the atmosphere. The benefit of the ozone layer is primarily in reducing ultraviolet radiation.

Not a good start: a schoolboy error and a citation to a worthless source.

Today, physicians around the world are using ozone to treat a wide spectrum of diseases, including AIDS, asthma, cystitis, herpes, rheumatoid arthritis and cancer, and it was part of my mum Gemma’s treatment.

That’s one view. Another is:

Ozone
Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals. – FDA

On the face of it, “physicians all around the world” appears to be code for quacks.

“Oxidative therapies induce your white blood cells to make tumourkilling properties,” explains California-based physician Dr Robert Jay Rowen. “When introduced into the bloodstream, ozone triggers an avalanche of beneficial changes: it boosts circulation, activates the immune system and improves the exchange of oxygen in the blood.”

What actually happens when ozone hits the blood is that (unsurprisingly) it generates free radicals which cause significant tissue damage. Inhaled, it is even worse: projectionists exposed to ozone as a result of the burning arc lamps suffered damage to the lungs, and this is also seen when ozone is inhaled “therapeutically”.

Dr. Robert Rowen is undoubtedly popular with the likes of Mercola, having “[pioneered] the nation’s first statutory protection for alternative medicine in 1990” (source: Robert Rowen). He is a real doctor. He is also an ozone quack and a peddler of supplements. He also claims to be “board certified in clinical metal toxicology” – this is a fake certification awarded by unrecognised “boards” set up by chelation quacks.

For over 80 years, it’s been known that low oxygen levels are associated with cancer. Dr Otto Warburg, a Nobel Prize-winning physician working in Germany, made this discovery in the 1930s and presented his findings at a Nobel Laureates’ meeting at Lake Constance, Germany, in 1966. “Cancer cells meet their energy needs by fermentation, not oxidation. Thus, they are dependent on glucose, and a high
oxygen environment is toxic to them,” he said.

Warburg’s research was confirmed in 1980, when scientists reported laboratory evidence showing that ozone selectively inhibits the growth of cancer cells.8

Reference 8: Science, 1980; 209: 931–2 Ozone selectively inhibits growth of human cancer cells. Sweet F, Kao MS, Lee SC, Hagar WL, Sweet WE.

An in-vitro study. Given the toxicity of ozone, this is hardly surprising, the problem is clinical applicability. As it says, “evidently, the mechanisms for defense against ozone damage are impaired in human cancer cells.” Ozone damage.

Meanwhile, back on planet Earth:

Available scientific evidence does not support claims that increasing oxygen levels in the body will harm or kill cancer cells. It is difficult to raise the oxygen level around the cancer cells in the middle of a tumor because the blood supply tends to be poor. But there are differences in the way cancer cells use oxygen that may allow new treatments to better target cancer cells. (American Cancer Society)

This suggests the standard SCAM trope of taking an early result, inventing a treatment from it, and then castigating medicine for failing to accept this naive treatment as the One True Cure for Cancer. Medicine, meanwhile, has to deal with tiresome details like the well documented toxicity of ozone, the difficulty of delivering it to the actual tumour and so on.

Dr Joachim Varro offered one of the first reports of successful treatment of cancer with ozone at the Sixth World Ozone Conference in 1983,9 reporting that his patients were free of metastases and tumour relapses for remarkably long periods of time, with improved quality of life. Italian researchers at the University of Siena theorized the supposed anticancer effects of ozone may due in part to its ability to induce the release of tumour necrosis factor (TNF), after measuring ozonated blood and discovering that most of the TNF was released immediately after ozonation took place.10

Reference 9: Medical Applications of Ozone, LaRaus J, ed, International Ozone Association, 1983: 94–5, not PubMed indexed

Evidence of the medical or any other credentials of Julius LaRaus is lacking. This might be a good time for a word from Dr. Kimball Atwood:

Practitioners of pseudomedicine band together to create pseudomedical pseudoprofessional organizations, complete with pseudo-legitimate names, pseudo-legitimate conferences, pseudo-legitimate appearing websites, pseudo-“board certifications,” protocols for pseudo-therapies, patient brochures hyping pseudo-therapies, pseudo-consent forms for pseudo-therapies, pseudo-Institutional Review Boards to approve pseudo-research, pseudo-journals to publish reports of pseudo-research, very real contributions from pseudoscientific corporations to help pay for very real advertising, very real lobbying, very real legal representation, and more – The Pseudomedical Professional Organisation, Kimball Atwood, Science Based Medicine

Reference 10: Lymphokine Cytokine Res, 1991; 10: 409–12. Studies on the biological effects of ozone: 2. Induction of tumor necrosis factor (TNF-alpha) on human leucocytes. Paulesu L, Luzzi E, Bocci V.

Another in-vitro study.

In the medical literature, the few scientific trials conducted on ozone to date to assess whether it helps overall survival have had problems with study design, but numerous studies on patients with cancer show a variety of benefits, such has treating osteonecrosis of the jaw in patients with bone metastases or ulcers in those with colon cancer.11

Reference 11: Haematologica. 2007 Sep;92(9):1289-90. Role of ozone therapy in the treatment of osteonecrosis of the jaws in multiple myeloma patients. Petrucci MT, Gallucci C, Agrillo A, Mustazza MC, Foà R.

Reference 11: Oral Oncol. 2011 Mar;47(3):185-90. Efficacy and safety of medical ozone (O(3)) delivered in oil suspension applications for the treatment of osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates: Preliminary results of a phase I-II study. Ripamonti CI, Cislaghi E, Mariani L, Maniezzo M.

The jaw is one area where ozone would plausibly be useful: the problems of delivering ozone to the cancer without collateral damage are probably reasonably good. However, there is substantial risk from inhalation, and these are preliminary studies.

Animal studies also show promise; in one, 86 per cent survived lethal squamous cell cancer, with complete tumour regression.12

Reference 12: Int J Cancer. 2008 May 15;122(10):2360-7. Treatment with ozone/oxygen-pneumoperitoneum results in complete remission of rabbit squamous cell carcinomas. Schulz S, Häussler U, Mandic R, Heverhagen JT, Neubauer A, Dünne AA, Werner JA, Weihe E, Bette M.

Promising animal study, but still does not properly address the issue of toxicity (therapeutic side effects may be missed in animal models).

Furthermore, the clinical evidence from the many doctors using ozone worldwide is compelling. Dr Rowen, who has educated hundreds of doctors worldwide about the use of ozone for many illnesses, says he witnesses his most profound effects with cancer. One patient, a 76- year-old-man with endstage colon cancer and two metastatic tumours in his liver (11 cm and 9 cm) was diagnosed as having at most a few weeks to live. Within four months of starting Rowen’s treatment with ozone and ultraviolet blood irradiation, another treatment often used with ozone, the patient’s liver tumours had shrunk by 85 per cent. After 16 months, his liver tumours disappeared, and he had his colon tumour removed surgically. Today he has no trace of cancer.

Bait and switch alert: we have moved from the scientific definition of evidence to the SCAM definition, where the best outlier is presented as the representative example.

Also note blood UV irradiation, another treatment at the fringes:

Ultraviolet blood irradiation treatment is approved by the U.S. Food and Drug Administration (FDA) for treating T-cell lymphoma involving the skin. Photopheresis is sometimes used conventionally when organ transplant rejection or graft-versus-host disease (a complication related to bone marrow or stem cell transplants) does not respond to usual conventional treatments. Some clinical trial results look promising for the treatment of immune system diseases such as multiple sclerosis, systemic sclerosis, rheumatoid arthritis, lupus, and type 1 diabetes. Available scientific evidence does not support claims for alternative uses of UV blood irradiation.

Medicine is not “suppressing” this “miracle cure”, but the conclusions of medicine are neither bold enough nor fast enough for those who have Belief.

So what does ozone therapy involve?

“The patient sits in a chair and has from six to 12 ounces of blood removed into a sterilized bottle,” says Dr Dan Cullum, a holistic practitioner based in Oklahoma. “Then ozone is injected into the bottle and the bottle is gently shaken, allowing the red and white blood cells to take up the ozone. The ozonated blood is then returned to the body. The entire procedure takes about 30 to 40 minutes.”

“Dr” Dan Cullum is a chiropractor, homeopath and practitioner of multiple forms of mutually contradictory quackery.

Other versions of the treatment exist, as is normal for treatments that have not been developed through clinical trial and peer review.  The effects of blood ozonation are not quantified, the evidence for delivery of ozone to the tumour site is scant other than in very specific regimens (as noted above).

Most centres, like Oasis of Hope in Mexico, offer ozone therapy as just one part of a holistic program. Vitamin C infusions, potent supplements and conventional treatments including chemotherapy may also form part of the patient’s package. Breast cancer survival rates at Oasis are two to three times higher than the US national average, and in the case of stage IV lung cancer, the survival rate at Oasis is five times the national average. Doctors claim ozone limits the damaging effect of chemotherapy to healthy tissues; a 2004 animal study from Cuba found that ozone reversed the toxicity caused by chemotherapy (cisplatin) and reduced kidney damage.13

The problem is that there is little or no evidence to support the claims of these treatments and some of them are potentially harmful, the Tijuana clinics are essentially set up to deceive and it’s a disgrace. – Richard Sullivan, head of clinical programmes, Cancer Research UK.

Reference 13: Mediators Inflamm, 2004; 13: 307–12 Protection by ozone preconditioning is mediated by the antioxidant system in cisplatin-induced nephrotoxicity in rats. Aluet Borrego, Zullyt B Zamora, Ricardo González, Cheyla Romay, Silvia Menéndez, Frank Hernández, Teresita Montero, and Enys Rojas

There is probably no bigger red flag for quackery than being offered by the Oasis of Hype, a marble and mirror glass edifice located in Tijuana, just beyond the reach of the FDA but convenient for a lucrative trade treating desperate American cancer victims. Quack therapies on offer include amygdalin (laetrile), detox, megavitamin therapy, shark cartilage, the Issels treatment and others.

The source describes an experiment in a rat model which is interesting but its clinical relevance is unclear in the context of the toxicity of ozone; it would be interesting to see subsequent work on this line of inquiry, but a nine-year-old study is cited as the last word. There are two citations of this work from 2010, one is not directly relevant and the other discusses renal lipid peroxidation, which is linked but not really a development of the idea.

Interestingly, Cuba is the only country in the world that offers ozone therapy on national insurance and is leading the research.

If Cuba is leading the research, then why is only one published peer-reviewed Cuban source cited?

Other resources:

What Doctors Don't Tell You
Why don’t doctors tell you that ozone therapy reverses cancer?

Because at this stage the evidence does not support it.

 

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WDDTY – The evidence for homeopathy (WARNING: Accurate statement detected)

It seems the WDDTY team do sometimes read what sceptics write. I’m not quite sure how this happens, since McTaggart is prone to blocking and deleting the least criticism, but apparently it does. Witness this little exercise in misinformation, which turned up in a slightly reworded and longer form in the Nov 2013 issue.

The evidence for homeopathy

Homeopathy is a nonsense, at least according to scientists and sceptics. Yet Indian doctors are using it every day to treat cancer—and now the US government is interested

Doctors call it “nonsense on stilts”, and professors of medicine have been bullying government and health authorities to stop offering it on the UK’s National Health Service (NHS), while scientists say it is implausible, if not impossible, as it breaks every law of science they know.

Homeopathy is everyone’s favourite whipping boy, and if it does clear up a snuffly cold or minor headache, it’s all due to the placebo effect: it’s just mind over matter, and people merely think it’s making them better. Any active ingredient in a homeopathic remedy is diluted sometimes thousands of times, so any effect must be entirely in someone’s imagination.

That makes perfect sense,…

Let’s take that apart, shall we?

The evidence for homeopathy

Homeopathy is a nonsense, at least according to scientists and sceptics.

I hear echoes of that reality-denialist cry “You and your science!” that galvanised me into actively seeking out and debunking anti-science fuckwittery wherever it may lurk and fester. Funny how pro-SCAM whackjobs are quick to laud science when they think they can use it to support their favourite money-making placebo though. Here’s a classic example: five occurrences of the word “science” on a page selling a form of Thinking Happy Thoughts Really Hard, touted by one… Lynne McTaggart. Funny, that.

Yet Indian doctors are using it every day to treat cancer—and now the US government is interested

Yeeees. Indian homeopaths (they are not doctors) may be using homeopathy to treat cancer, but that doesn’t mean it actually does any good. The USA is not exactly renowned for always letting reality prevail over fuckwitted dogma, either, so even if the two claims were more than fallacious arguments from popularity and authority, they still wouldn’t mean dick.

Doctors call it “nonsense on stilts”, and professors of medicine have been bullying government and health authorities to stop offering it on the UK’s National Health Service (NHS), while scientists say it is implausible, if not impossible, as it breaks every law of science they know.

The doctors are correct, the scientists are correct and the professor in question (it’s an obvious attack on Edzard Ernst, who has studied homeopathy and other fringe therapies for years) hasn’t been bullying anybody, merely stating the truth. In fact, he has rather been the victim of bullying, notably from homeopaths trying to smear and discredit him.

Homeopathy is everyone’s favourite whipping boy, and if it does clear up a snuffly cold or minor headache,

… which it doesn’t …

it’s all due to the placebo effect: it’s just mind over matter, and people merely think it’s making them better. Any active ingredient in a homeopathic remedy is diluted sometimes thousands of times, so any effect must be entirely in someone’s imagination.

Bloody hell, I think I’ve just found an accurate statement about homeopathy in WDDTY. I claim my prize.

That makes perfect sense,…

Yes, Lynne, it does. And funnily enough, it’s the power of the imagination you claim to harness in your Intention dingbattery. Is it just me, or are you trying to have your cake and eat it, while selling it a slice at a time?

Is dairy ‘cancer food’?

Is dairy ‘cancer food’?
Is dairy ‘cancer food’? asks WDDTY rhetorically in its “special report” by an unnamed writer.

Based on the opinions of a “cancer expert” who is not an oncologist, is no longer GMC registered and sells supplements, a notorious crank with a history of misleading claims, and arm-waving appeals to “every expert” which are not backed up by evidence of consensus of expert opinion, a favourite bogeyman of “nutritionists” is asserted to be a cause of cancer.

Where sources are cited, they fail to back the text supposedly based on them. For example, a source that states a risk from high but not low-fat dairy intake is stated as evidence that dairy per se increases risk.

2013-11_15Is dairy ‘cancer food’?

Author not identified

“In my view, anyone with cancer should give up dairy completely,” says Dr Patrick Kingsley, British cancer expert and author of The New Medicine. From Tokyo to Arizona, every expert who focused on cancer and nutrition repeated the same mantra: Give up dairy.

Patrick Kingsley is not an oncologist. he is not GMC registered. He is a proponent of his self-originated “new medicine” and a vendor of alternative treatments. Support for his claims to expertise and the validity of his treatments comes primarily in the form of books authored by himself. He appears to have no peer-reviewed publications indexed by PubMed.

Searches of common databases and information resources reveals no consensus n favour of dairy exclusion among dieticians or oncologists. The primary search term linking cancer and dairy is a study finding slightly elevated risk of prostate cancer associated with dairy consumption, which acknowledges that it cannot unpick the effects of dairy from the role of calcium in vitamin D metabolism (see below).

British scientist Jane Plant was 42 years old when she first noticed a lump in her breast; six years later, the disease had spread to her lymph system and she was left with a lump “the size of half a boiled egg” protruding from her neck. Plant’s situation, deemed terminal, rapidly turned around when she decided to cut out dairy.

Within days the malignant lump on her neck began to shrink and, within six weeks, it had vanished completely. That was 25 years ago—it hasn’t returned since.

The idea of a metastatic malignancy that was cured in weeks by simply excluding dairy from the diet, is implausible. No sources are provided for the claim.

Jane Plant is a geologist and geochemist, not a medical scientist.

New evidence From Kaiser Permanente research division, which tracked nearly two thousand breast cancer survivors for up to 12 years, shows that women who continue eating dairy after their  breast cancer has
been diagnosed are 49 per cent more likely to die from their cancer (and significantly more likely to die from any cause) than women who cut such foods from their diet.1

Reference 1: J Natl Cancer Inst. 2013 May 1;105(9):616-23. High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. Kroenke CH, Kwan ML, Sweeney C, Castillo A, Caan BJ.

BACKGROUND: Dietary fat in dairy is a source of estrogenic hormones and may be related to worse breast cancer survival. We evaluated associations between high- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis.

RESULTS: In multivariable-adjusted analyses, overall dairy intake was unrelated to breast cancer-specific outcomes, although it was positively related to overall mortality. Low-fat dairy intake was unrelated to recurrence or survival. However, high-fat dairy intake was positively associated with outcomes. 

CONCLUSIONS: Intake of high-fat dairy, but not low-fat dairy, was related to a higher risk of mortality after breast cancer diagnosis (emphasis added)

The claim that cancer outcomes are significantly worse in women who consume dairy products is specifically refuted by this study. It finds, however, an association between high fat dairy (i.e. more of the oestrogenic hormones in dairy fat) and mortality.

This would be a good reason to switch to lower fat dairy products and a terrible reason to exclude dairy, especially for post-menopausal women at risk of osteoporosis.

“There is now consistent and substantial evidence that the higher the milk consumption of a country, the greater their breast and prostate cancer risk,” says British nutritionist and author Patrick Holford.

Patrick Holford qualified as a psychologist, has no legitimate qualifications in diet, is a vendor of supplements, an HIV-AIDS denialist and promotes quack ideas such as hair analysis.

According to 2008 figures, the incidence of breast cancer for women in China was 21.6 for every 100,000 people, while in America the rate is 76, in the UK it’s 89.1 and in France—a country famous for its love affair
with butter and cream—it’s 99.7.2 These differences cannot be reduced to genetics, as migrational studies reveal that when Chinese and Japanese people move to the West, their rates of breast (and prostate) cancer go up.

This is an example of the post hoc fallacy. There is no proven causal relationship.

Reference 2: http://globocan.iarc.fr/factsheets/cancers/breast.asp#INCIDENCE

Compare this with a list of countries by milk consumption. Fourth highest milk consumption per capita is India. India has well below average breast cancer incidence. While a link is possible, it is not supported by these figures.

Adulterated milk

But the problem may have more to do with the state of today’s store-bought milk, and our obsession with ‘low-fat’ rather than with dairy per se. For instance, when scientists look for the link between dairy and prostate cancer, they find that the risk is higher only with low-fat milk, which delivers too high levels of calcium and strips out the protective anticancer effects of conjugated linoleic acid (CLA),a powerful anticarcinogen.3

Reference 3: Am J Clin Nutr. 2005 May;81(5):1147-54. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Tseng M, Breslow RA, Graubard BI, Ziegler RG.

CONCLUSIONS: Dairy consumption may increase prostate cancer risk through a calcium-related pathway. Calcium and low-fat milk have been promoted to reduce risk of osteoporosis and colon cancer. Therefore, the mechanisms by which dairy and calcium might increase prostate cancer risk should be clarified and confirmed. (emphasis added)

This finding is inconsistent with the breast cancer finding, and is stated by the authors to be a weak finding (“may increase risk”) which requires further analysis to unpick the different factors involved, including the roles of calcium and vitamin D.

Why milk might feed cancer

CLA also protects against the most cancer accelerator: insulin-like growth factor 1, or IGF-1. The hormone naturally circulates in our blood and, like cortisol, progesterone and oestrogen, it’s necessary—it’s in mother’s milk to ensure the baby grows, and levels of IGF-1 rise in puberty to stimulate the growth of breasts. As we grow older, levels naturally drop off. That is, unless you’re a dairy lover.

This appears to be addressed by reference 1: it is related to fat content not dairy per se.

“We certainly know that people who consume a lot of dairy products will have higher levels of IGF-1,” says Patrick Holford.

“It simply does what it’s meant to do—stimulate growth. It also stops overgrowing cells from committing suicide, a process called ‘apoptosis’.”

Besides breast cancer, elevated IGF-1 levels have been linked to increased risks of colorectal, breast, pancreatic, lung, prostate, renal, ovarian and endometrial cancer.4 In fact, men with the highest IGF-1 levels quadruple their risk of prostate cancer 5

Reference 4: Recent Pat Anticancer Drug Discov. 2012;7:14–30. Insulin-like Growth Factor: Current Concepts and New Developments in Cancer Therapy Erin R. King, MD, MPH and Kwong-Kwok Wong, PhD

A somewhat puzzling source as it is reviewing patent reports related to IGF-1.

Reference 5: Science. 1998 Jan 23;279(5350):563-6. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P, Hennekens CH, Pollak M.

“Identification of plasma IGF-I as a predictor of prostate cancer risk may have implications for risk reduction and treatment” – the source mentions dairy only once, as a citation to Am. J. Epidemiol. (2007) 166 (11): 1270-1279. Calcium, Dairy Foods, and Risk of Incident and Fatal Prostate Cancer The NIH-AARP Diet and Health Study, Park et. al. which states: “Although the authors cannot definitively rule out a weak association for aggressive prostate cancer, their findings do not provide strong support for the hypothesis that calcium and dairy foods increase prostate cancer risk.”

A search for each of the cancer types listed plus dairy, taking the first obvious peer-reviewed study for each:

  • Colorectal cancer: “Milk intake was related to a reduced risk of colorectal cancer” – J Natl Cancer Inst. 2004 Jul 7;96(13):1015-22. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies.
  • Breast cancer : As above, a risk associated with high but not low-fat dairy produce
  • Pancreatic cancer: “Total meat, red meat, and dairy products were not related to risk” – Am. J. Epidemiol. (2003) 157 (12): 1115-1125. Dietary Meat, Dairy Products, Fat, and Cholesterol and Pancreatic Cancer Risk in a Prospective Study Michaud et. al.
  • Lung cancer: No obvious significant studies, but dairy farmers have lower lung cancer incidence.
  • Prostate cancer: As above, weak evidence of increased risk, uncertain at this stage whether it is dairy specific or related to calcium / vitamin D link
  • Ovarian cancer: “Overall, no associations were observed for intakes of specific dairy foods or calcium and ovarian cancer risk” – Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):364-72. – Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies. Genkinger et. al.
  • Endometrial cancer: “Total dairy intake was not significantly associated with risk of preinvasive endometrial cancer. [W]e observed a marginally significant overall association between dairy intake and endometrial cancer” – Int J Cancer. 2012 Jun 1;130(11):2664-71. Milk, dairy intake and risk of endometrial cancer: a 26-year follow-up. Ganmaa et. al.

So the boldly asserted claim of a strong link with numerous specific cancers, not backed by references to sources, is contradicted where sources address the question directly.

However, the claim that dairy increases risks of these cancers is stated as fact (again without sources) by  Vegan International Voice for Animals, and contradicted with allusions to sources but no specific references by The Dairy Council, whose summaries are in line with the studies listed above.

In general, claims that milk is a significant and substantial risk factor for cancers are linked primarily to sites with an ideological commitment to reduced dairy consumption or other alternative diet and health claims.

But what about bones? 

We’ve been repeatedly told that drinking milk builds strong bones, yet clinical research tells a different story. One study, which followed more than 72,000 women for 18 years, showed no protective effect of increased pasteurized milk consumption on fracture risk.

The source of this figure is Am J Clin Nutr. 2003;77:504–511. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women Diane Feskanich, Walter C Willett, and Graham A Colditz. This refers to post-menopausal women; as it notes: “A review of the literature concluded that there is no clear benefit of higher milk or dairy food intake on bone mass or fracture risk in women > 50 y of age but that a benefit is seen in women < 30 (37)”

The WDDTY article appears to be using the bait-and-switch tactic of conflating two cohorts (pre- and post-menopausal women)with different risk and benefit profiles.

Could eating your greens provide better protection?

A report from the US Nurses’ Health Study found that those eating a serving of lettuce or other green leafy vegetables every day cut the risk of hip fracture in half compared with eating only one serving a week.6

Reference 6: Am J Clin Nutr, 1999; 69: 74–9 Vitamin K intake and hip fractures in women: a prospective study. Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA.

CONCLUSIONS: Low intakes of vitamin K may increase the risk of hip fracture in women. The data support the suggestion for a reassessment of the vitamin K requirements that are based on bone health and blood coagulation.

This applies to post-menopausal women, for whom dairy is not found to be protective.

A much later and wider-ranging study is Health Technol Assess. 2009 Sep;13(45):iii-xi, 1-134. Vitamin K to prevent fractures in older women: systematic review and economic evaluation. Stevenson M, Lloyd-Jones M, Papaioannou D.:

CONCLUSIONS: There is currently large uncertainty over whether vitamin K1 is more cost-effective than alendronate; further research is required. It is unlikely that the present prescribing policy (i.e. alendronate as first-line treatment) would be altered.

This suggests that sources may have been selected to serve an agenda rather than on the basis of the best and most current research.

Dark leafy greens not only provide calcium, but are also a potent source of vitamin K, which helps in calcium regulation and bone formation. There’s another benefit to choosing non-dairy foods. “Eating nuts, seeds and greens gives you the right balance of calcium and magnesium, but you don’t get that balance in dairy products,” says Holford. For those considering switching to soy milk, you might be interested to hear how it is made. According to Dr Al Sears, a physician with extensive experience in natural healthcare, it involves “washing the beans in alkaline or boiling them in a petroleum-based solvent; bleaching, deodorizing and pumping them full of additives; heat-blasting and crushing them into flakes; and then mixing them with water to make ‘milk’.”

This rather transparent dig at soya milk is no doubt entirely unrelated to the fact that in the US soya is routinely sourced from GM crops. Surely it would be entirely out of character to attack an entire food source on the basis of an instinctive dislike for genetically modified crops.

Thankfully there is a plethora of options available for the non-dairy consumer today, ranging almond milk to raw truffle chocolate.

Thankfully there is no credible evidence that any such thing is required, as fake milk products tend to be an acquired taste.

What Doctors Don't Tell You
Why don’t doctors tell you that cutting out dairy will prevent or cure cancer?

Because there’s no good evidence it will.

Trust in the treatment

Trust in the treatment
Trust in the treatment is a segment in the November 2013 issue of WDDTY, part of an article on “the survivors’ six steps to surviving cancer”. It’s the opinion of Lynne McTaggart.

McTaggart makes assertions without any evidence to support them – several are contradicted by published research -offers an anecdote as “proof” without any of the necessary supporting data, and cites in support a doctor who has been sanctioned for ethical violations and whose treatment has been shown to deliver quicker death and lower quality of life.

Trust in the treatment

Is WDDTY’s advice to “trust in the treatment” evidentially sound?

A cancer diagnosis can leave you paralyzed with fear and unable to access your rational brain. Many experts therefore recommend giving yourself a week to process the news and look into all your options. But once you’ve done your research and decided on a direction that’s right for you, it’s important to put your faith in the treatment plan. “Belief is the first, most important factor,” says Lynne McTaggart, author of The Bond: The Power of Connection and co-editor of this magazine.

And if you are unable to use your rational brain, you become prey for those promoting irrational ideas. Lynne McTaggart, author of “The Bond: The Power Of Connection”, promotes many irrational ideas, both in her books and in much of the content of WDDTY.

There is no credible reason to stick with the plan you make in your first terrified week; it is very likely that as you work with your medical team and they more accurately assess the stage and type of disease, you might be in a very good position to make informed choices that are distinctly different.

What you definitely should not do is go home, read WDDTY, decide to follow some quack regimen and then stick with it when your doctor points out that, well, it’s a quack regimen.

“What do you think will work for you? If you have a strong belief about something, that’s been shown to help boost the success of the treatment.”

No source is cited for this.

In the current climate, following gut feelings about health might seem radical, even reckless. But time and time again, the word ‘intuition’ came up in my survivor interviews.

This is due to confirmation bias. Cancer survivors who use evidence-based treatments are unlikely to be talking to WDDTY; people who have died after taking quack nostrums are not there to tell the tale.

A 1994 study shows that users of alternatives to medicine believe that their health could be improved and they are loyal to their alternative practitioners and skeptical of evidence-based treatments (source); a 2004 study showed that these beliefs are worryingly incorrect. Alternative users present later when they get cancer, particularly since they often delay evidence-based diagnosis and treatment in favour of unproven or invalid alternatives, and even after controlling for this, they still die sooner (source).

After being diagnosed with aggressive breast cancer at the age of 31, Rachel Kierath came under a huge amount of pressure to undergo conventional treatment. “Finally, the day before I was due to start [chemo], I just thought ‘You know what? I’ve got to listen to what’s true for me.’

The idea that there are different forms of truth, is seductive but wrong. You don’t get to opt out of cancer being horrible, you don’t get to opt out of alternative treatments being useless. you don’t get to choose whether your body follows normal human physiology.

You do get to choose whether to believe the testimonial a huckster holds up, or engage your critical faculties and ask whether this person is representative. For example, Stanislaw Burzynski claims significant success in treating cancer, holding up a few prominent survivors (at least some of whom also had evidence-based treatment). He is less forthcoming about the large number of cases where his treatment caused massive expense, serious side effects, and did not save the patient. It turns out that he routinely misclassifies responses.

When I thought about chemo, I felt utterly defeated, my energies zapped . . . I couldn’t think of anything worse than being sick all day and then trying to find the energy to fight it. So as soon as I made the decision to go with my gut instinct—which was to reject that and do things my way—it was just this huge weight off my shoulders, and I knew that I had just released myself from all that stress and that I would be all right.”

The fact that the alternative medicine press has very effectively poisoned the minds of its readers about chemo is well-known. This is not a good thing. The misery lasts a few months. In the case of liquid tumours, chemo is the primary therapy and often extremely effective. In the case of solid tumours it may reduce the chances of recurrence or metastasis following surgery. The choice to forego chemo should be made on logical and evidential grounds, not “gut instinct” and the bogeyman mythos of alternative practitioners. Read Kate Granger’s books. Follow @GrangerKate, @Xeni and @SusanGerbic on Twitter. These are real women who have undergone real chemo and can tell you what it’s really like from the other side.

This is probably a better idea than listening to someone with a strong anti-medicine agenda whose claims about chemo are “quite misleading to patients“.

Kierath received the ‘all-clear’ a year after her diagnosis.

Without further information (surgery? radiotherapy? stage of cancer?) this is meaningless.

Dr Nicholas Gonzalez, a leading cancer specialist based in New York, sheds some light on the power of belief. “When people believe in something, it creates a sense of relaxation, which is when healing occurs,” he says. “Nutrition is wonderful, but there is no vitamin, mineral or trace element that can override someone’s psychology.”

WDDTY tells us that “big pharma” cannot be believed because it profits from the ill.

Gonzalez is anything but a “leading cancer specialist”. While he has a large and lucrative practice treating desperate people, his medical licence has already been placed on probation once for ethical violations, his claimed cures turn out to be down to selection bias and confounders, and a controlled trial of his modestly-titled “Gonzalez protocol” found that his patients died faster than those treated with conventional chemotherapy, and had significantly worse quality of life.

This advocacy of a person who profits directly from unproven claims, or claims that are soundly contradicted by diligent scientific investigation, is characteristic of the alternative medicine subculture, a subculture within which it appears that scientific evidence contradicting a claim is taken as validation rather than a red flag, even when the person making the claims is clearly profiting substantially from selling the product or treatment.

What Doctors Don't Tell You
Why don’t doctors tell you that belief in your gut instinct is more important than following the evidence?

Because it would be stupid and wrong.

Older but not healthier

Older but not healthier
Older but not healthier: Ignore the government’s advice about to what eat if you want live to a ripe old age is an article in the November 2013 issue of WDDTY.

It is written by Robert Verkerk, founder of the Alliance for Natural health, a supplement industry pressure group based in the UK.

It advises readers to ignore government advice on nutrition and take instead the advice of a pressure group. Is this a sound approach?

Older but not healthier: 

Ignore the government’s advice about to what eat if you want live to a ripe old age

Robert Verkerk, founder, ANH Europe

National statistics give us a clue of our predicted lifespan on this planet. Most men and women in the UK are expected to live more than 80 years, but relatively few make it beyond 90. That may be better than we were doing 50 years ago, but recent statistics suggest lifespans might be shortening again.

This is true, and is indeed thought to be mainly due to the effects of diet and an increasingly sedentary lifestyle. Some contend that those who grew up during and shortly after the war, with rationing, have better health as a result.

But mortality statistics show us just one side of the coin. Possibly the more relevant issue is how long we remain healthy and disease-free. As a society more of us are living longer, but with chronic illness.

This is true up to a point: chronic illnesses such as arthritis are age-related and not really preventable at present, whereas type II diabetes is largely caused by lifestyle. The best advice is to eat healthily and exercise moderately. Give or take the occasional fancy bit of dressing-up, this has been the advice for a long time.

Heart disease and diabetes, two of the big killers, are now developing among children, and few of us make it to 70 without cancer, heart disease, diabetes or dementia. This raises the question: How much control do we have over our destiny?

These are two disjoint statements. Childhood obesity is a significant problem, but is separate from the question of, say, cancer, where it’s widely recognised that improved early diagnosis is a significant driver for increased diagnosis. This is not universally thought to be a good thing: Margaret McCartney’s The Patient Paradox details some of the issues with screening for cancer.

The evidence suggests that while it may be more difficult to dramatically alter our lifespan, we can easily reduce our risk of disease and improve our quality of life. Although Big Pharma and modern medicine have yet to come up with a silver bullet that helps us prevent disease to any significant degree, the science is clear on one factor: our choice of diet and lifestyle is the single strongest determinant—genetics apart—of the health quality we experience during our lives.

Let’s unpack that.

  • The evidence suggests that while it may be more difficult to dramatically alter our lifespan, we can easily reduce our risk of disease and improve our quality of life

Yes, we can reduce risks of some diseases and improve quality of life, mainly by eating less and exercising more. But “easily” is a questionable claim, and still the greatest determinant is income. So you could just as well say that we can “easily” reduce our risk of disease and improve our quality of life by becoming richer.

  • Although Big Pharma and modern medicine have yet to come up with a silver bullet that helps us prevent disease to any significant degree

This is rubbish. Leaving aside the subtext of demonising “Big Pharma”, the elimination and prevention of infectious disease, the ability to treat bacterial and other acquired infections, and improved survival from trauma, have all had a major impact on life expectancy. Nobody has died of smallpox, or even contracted it, since the 1970s. The last large poliomyelitis outbreaks in the West were half a century ago. Vaccines have done vastly more to prevent disease than diet ever has or can.

  •  the science is clear on one factor: our choice of diet and lifestyle is the single strongest determinant—genetics apart—of the health quality we experience during our lives

Debatable. The WHO lists three main determinants of health:

  • the social and economic environment,
  • the physical environment, and
  • the person’s individual characteristics and behaviours

The order in which these are placed is a judgement call, but health outcomes are very strongly correlated with income both within and across populations. Put simply, the rich can afford better choices more easily than the poor, and that is directly relevant to this article.

Given the wealth of evidence on this point, you’d think that governments would be bending over backwards to ensure we make the best possible choices to help reduce the future burden on our already overtaxed healthcare system, but they simply pay lip service to the notion. And sometimes their advice is in conflict with the latest scientific views.

They do. And if the advice sometimes lags the latest scientific views, that is because the latest scientific views are not necessarily the consensus scientific views. Most early findings are wrong, constantly following the early findings is a recipe for constantly see-sawing between potentially contradictory poles.

So government advice tends to be small-c conservative. Following the consensus, not the bleeding edge, is prudent.

Guidance on nutrition, for example, can be found in the form of the ‘eatwell plate’ on the NHS Choices website. But nearly 60 per cent of the food recommended—from starchy carbs, milk and dairy to “foods and drinks high in fat and/or sugar”—is unnecessary to health and largely responsible for the current type 2 diabetes and obesity epidemics.

The eatwell plate is designed by dieticians (the trained and regulated health professionals) not nutritionists (who are unregulated and often untrained, and may believe in copromancy). It’s not intended to be the minimum or optimum for health, it’s designed to be an achievable goal that improves on the unhealthy choices that might otherwise be the default.

It is not the be-all and end-all of advice on diet, it is a reasonable, pragmatic guide. And it’s not presented as anything else. There is no real evidence that the composition of the eatwell plate is responsible for the prevalence of diabetes; the small segment for sugary junk is there because people actually like it and want to eat it, so it proposes a maximum that such foods should form as part of a healthy diet and lifestyle.

In other words, you are letting the best (specifically, your narrow vision of “best”) be the enemy of the good.

Yet the industries that make these foods are by far the dominant ones in the food industry, with the ‘Big 10’— Nestlé, PepsiCo, Unilever, Coca-Cola, Danone, Kellogg, Mars, Mondelez International (formerly Kraft Foods), General Mills and Associated British Foods, amidst a sea of 1.5 billion food producers worldwide—controlling around 70 per cent of our food choices.

This packs two fallacies into one: appeal to motives and poisoning the well.  These companies are indeed large and influential, something of which ANH are plainly jealous (see below) but there’s no evidence that their influence guides the health advice produced by the NHS.

It is true that in the matter of promoting abject nonsense in sciencey-sounding language, the likes of Danone acknowledge no master. But since precisely the same rhetoric is used by the supplement industry, as represented by ANH, this is a bit of a pot and kettle situation.

These companies exert their influence in many ways, but lobbying and advertising are two of the most important. They also function under several guises: as themselves through their trade associations; or sometimes via third parties, ranging from celebrities to ‘patient groups’ that supposedly represent the interests of those suffering from a wide range of diseases or conditions like diabetes, Alzheimer’s and cancer.

Bait and switch. They do indeed exert influence, and this is felt in policies. Try to introduce a rule limiting portion sizes of fizzy drinks, and you’ll get an astroturf campaign by return.

But there’s no credible evidence that they use pernicious influence to skew advice given by Alzheimer’s’ patient groups and the like.

The use of celebrity endorsements is of course a staple of the promotion of quackery, too, as we saw with the recent “homeopathy works for me” campaign which aims to use pictures of flowers and butterflies painted onto the bodies of female celebrities, as an alternative to all that tiresome evidence that homeopaths can’t provide.

Most scientists and skeptics would be more than happy to see celebrity endorsement removed from the field of health advice.

There are undoubtedly many behind-closed-doors meetings that few of us ever get to hear about, while the more public interactions are between the large trade associations and both unelected and elected representatives of government—officials and MPs and MEPs, respectively.

Yes, for example the meetings that Prince Charles has had, where he lobbied for alternatives to medicine. And we know that his meetings affected the material published by the NHS, because someone inside the NHS blew the whistle. There’s no evidence that the bogeymen listed above have been doing the same in respect of dietary advice.

One simple rule applies in lobbying: the influence exerted is directly proportional to the size of the company represented. That’s why in the food and natural-health areas, Europe-wide associations like the Association of the European Self-Medication Industry (AESGP), FoodDrinkEurope, the International Life Sciences Institute and Food Supplement Europe, which represent both Big Pharma and Big Food, wield the lion’s share of influence. Smaller associations and groups such as the European Association of Craft, Small and Medium-Sized Businesses (UEAPME), ourselves (Alliance for Natural Health Europe) and the European Benefyt Foundation need to work very hard to even be heard.

So ANH are jealous of the influence of larger lobbies and want the same ability to push their agenda. The alternative – reducing lobbying activity – does not seem to be suggested. Why would it be bad for all special interest groups to be excluded, rather than for the special interest groups you like to get a larger slice of the action? This is not explained.

Many who become aware of this reality feel disempowered. But there are two simple things we can do.

First, we can reduce our dependence on products made by these companies. Put simply, that means avoiding processed foods whenever you can. The size and might of these corporations is maintained only if we support them via our wallets.

Fine if you have adequate disposable income. But WDDTY’s core demographic will already be avoiding “processed foods”. Note, though, that “processed food” is a bit like “toxin”, a word that sounds bad and is easy to pin on the things you don’t like, but meaningless in practice. Bread is a “processed food”. Flour is a “processed food”. It’s hard to see how anything other than uncured meat, raw milk and eggs, and fruit, would qualify as being anything other than “processed foods”.

There’s good evidence that processing can be entirely desirable. Pasteurisation of milk is controversial only with extremists. Preservatives mean that meat is much less likely to contain bacteria such as e.coli or salmonella. Obviously these are entirely natural but most people regard them as undesirable nonetheless.

So without needing to write letters to your MP or bearing a placard in an anti-globalization rally, you can make different choices over the way you feed yourself and your loved ones. One of the easiest ways of doing this is to ‘go local’, or choose wisely when you are doing your weekly shop. Try to buy organic fruit and vegetables as much as you can.

Sorry to rain on your parade, but for urban dwellers there is not much in the way of local produce to be had, and evidence of the superiority of organic produce is sadly lacking.

You can subscribe to an organic-box scheme and have your weekly supply of organic fruit, veg and other produce delivered to your door. And for those of a non-vegetarian persuasion, you can buy locally sourced meats at your local butcher.

Or, you know, don’t. If you’re on a limited income you are almost certainly better off buying fresh fruit and vegetables from your local supermarket, than spending the equivalent sum on a reduced quantity of the more expensive organic produce you recommend.

While you may pay a premium for such foods, many find the net cost is no higher mainly because wastage is reduced and the many temptations in supermarket aisles are avoided.

This is simply wishful thinking. Organic produce is more expensive, and organic produce from farmers’ markets is generally more expensive than the equivalent organic produce from supermarkets.

For those yet to experience the pleasure of becoming independent of the Big Ten, you have almost nothing to lose and so much to gain—not least of all, a healthy long life.

Translation: buy produce from our members not their members, it will make you live longer (terms and conditions apply, value of investments may go down as well as up, objects in the mirror may be closer than they appear, we reserve the right to substitute opinion for evidence as we see fit).

What Doctors Don't Tell You
Why don’t doctors tell you that eating organic food will make you live longer?

Because there’s no real evidence it does.

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