Category Archives: Leaky gut syndrome

Autism: it’s all in the gut

WDDTY is consistently wrong about autism. From promoting chelation quackery to pretending that recent academic work vindicates Andrew Wakefield’s fraudulent attempts to pin autism on MMR, they are reliably incorrect.

This “special report”  is no exception: it appears designed to further the commercial interests of WDDTY’s contributors and advertisers.

The Autism Research Unit (ARU), University of Sunderland, has concluded that autism is not a mental illness, but a metabolic one.

Who said autism was a mental illness? An immense body of recent work points to a genetic causation and objective differences in brain development. The idea that it is metabolic is seductive (that might allow a simple cure, and quacks have been all over that for years with the “autism biomed” nonsense) but there’s no proof that the link between autism and intestinal disorders is as they present it: it is every bit as likely that the stress exhibited by the autistic patient is the cause of the intestinal problem.

And the ARU has not been part of the University of Sunderland since 2009.

ESPA is not, as WDDTY present it, an academic research entity within the university, it is a separate group dedicated to promoting research into metabolic treatment of autism. This may or may not be valid, but in any group that exists to research a single hypothesis, there is an inherent danger of confirmation biasW and even pathological scienceW.

One red flag is the involvement of Malcolm Hooper, who has been involved in attacks on Professor Sir Simon WesselyW by a subset of the ME/CFS community (see here for a discussion of some of this group).

So, this may well be legitimate research and could even lead to some palliative treatments, but it has to be viewed in the wider context of research finding evidence of autism from birth (see for example reports at BBC, LA Times). You certainly can’t say that the researchers have ”concluded” this, since they seem to have started off from the premise that it was the case and looked for evidence to support it.

In their research of more than 1200 children with autism over 11 years, they have evidence that autism is caused by the action of peptides outside the brain and central nervous system. These peptides result in effects which either cause opioid activity or help to break down the opioid peptides that occur naturally within the CNS. Natural opioid peptides, which include the enkephalins and endorphins, play a central role in regulating the CNS, affecting all high cognitive functions, like perception and emotion. Through the action of these peptides, the neuroregulatory role may be altered or intensified to such an extent that most higher processes within the CNS are completely disrupted.This interference would affect perception, cognition, emotions, mood and behaviour, leading to all the diverse symptoms we characterise as autism.

That’s one view. Here’s another:

We have presented abnormal neural connectivity as an explanatory framework within which genetic and neuropathological findings on autism may be unified with neuroanatomy, neurophysiology, and behavior. Communication between these levels of analysis promises a greater understanding of mechanisms underlying both normal and pathological development of neural and cognitive systems and has the potential to render a multiplicity of experimental and theoretical approaches more coherent.

And another:

Normal brains, they found, are alike in that for about 500 genes, gene expression in the temporal lobes — which regulate hearing, language, and the processing and interpreting of sounds — is very different from gene expression in the frontal lobe, which plays a role in judgment, creativity, emotions, and speech.

But in as many as 75% of the autistic brains there was very little difference in gene expression between the temporal and frontal lobes.

In the autistic brains, genes related to synaptic function — information sharing between neuronal brain cells — were turned down to low levels of expression.

“This points to a developmental patterning defect,” Geschwind says. “That means the usual patterning of the brain — the way different parts of the brain hook up — might be altered in autism.”

So it looks as if, as usual, WDDTY are cherry-picking their results and representing single striking findings as if they are generally accepted and proven.

Once again we come back to the fact that increasingly autism is seen as likely to be a genetic disorder, with evidence found from birth (before gluten or casein are introduced to the diet) or even in utero.

But where do these extra peptides come from? The ARU believes the culprit is certain foods and the inability of the body to process these foods due to an inadequacy of the enzymes ordinarily responsible for breaking them down. The most frequent causes are gluten from wheat and other gluten containing cereals, like rye, barley and oats, and also milk and dairy products.

Nutribollocks motherlode! Gluten and dairy, two of the things the paleo fools finger for all that ails mankind. In practice, while there may be effects here, the primary difference is unlikely to be related to well-established disorders such as coeliac disease and much more likely to be a co-morbidity of some genetic malfunction.

Genetic factors or nutritional vitamin or mineral deficiencies may be behind the inadequate function of the enzymes involved.

Genetic factors might be, nutritional deficiencies not so much. The autism biomed community has conducted a lengthy albeit uncontrolled and unstructured experiment on this, supplementation does not cure autism.

These rogue peptides make it to the CNS largely due to a damaged gut. Normally, the proteins lining the gut wall are sulphated, forming a protective layer over the gut wall surface. But when the gut doesn’t produce enough sulphation, proteins in the gut wall tend to clump together, causing an uneven gut wall surface and increasing gut permeability. This, in turn, allows foods into the bloodstream (and eventually the CNS).

This sounds suspiciously like that other crank favourite, “leaky gut syndromeW”. Yet another condition that only cranks appear able to identify.

Most of the children examined by the ARU have this abnormality in the gut. These gross gut wall abnormalities appear to be the result of an insult to the body or a toxicity. The ARU has evidence that one of the most common insults is the MMR vaccine (see box, p 3). Gut abnormalities and the onset of autism have also followed a bout of encephalitis or meningitis. Other environmental toxicities, such as pesticides, also appear to be implicated in damaging the gut.

It has been noted elsewhere that one of the symptoms of autism is high levels of stress and nervous energy. This is known to prompt changes in intestinal behaviour. And look, they finger the MMR vaccine. You know, the one that has been extensively examined and found to have no association whatsoever with autism. For example, when Japan went to single vaccines, the autism diagnosis rate did not change at all. And signs of autism begin at birth, not with MMR vaccinations.

Why don’t doctors tell you that autism is caused by the “insult” to the immune system posed by the MMR vaccine?

Because it’s a long-disproven, vicious anti-vaccine lie.

What Doctors Don’t Tell You is wrong about autism

A splendid fisking by Mike Stanton (@Convivir) of WDDTY’s latest nonsensical piece on autism, the quack target du jour for pretty much every jour since Andy Wakefield’s fraudfest. Numerous other hot buttons of the SCAM community are also present.

Reblogged with permission from penumbrage.com

What Doctors Don’t Tell You (WDDTY) is a magazine that claims it is “helping you make better health choices.” But it has drawn criticism from those like Andy Lewis who wrote on the Quackometer blog,

this magazine is the latest offering from Lynne McTaggart who produces the What Doctors Don’t Tell You website. It is one of the most consistently misleading health sites in the UK, reveling in misinformation that routinely undermine readers’ confidence in their doctor and to scare them into accepting questionable alternatives, such as vitamin pills. The website and magazine advertise many problematic health products that could harm people if used in place of real medicine.

I have just bought a copy from my local supermarket. It is a glossy magazine with lots of adverts and articles promoting diets, vitamins, supplements, creams and  lotions, super foods, exercise regimes and holistic therapies. There are even alternative remedies for pets. It is not always clear where editorial content ends and advertising begins. The pet therapies are a case in point. Paul Boland contributes a two page spread on veterinary acupuncture. Turn over and there is a full-page advert for Natural Health Vet, a company selling products “developed, used and recommended by …” Yes, you guessed it, Paul Boland. Advertorial, anybody?

The headline story is called, “Reversing osteoporosis. You can rebuild your bones.” It tells us that osteoporosis is “a lifestyle disorder” that is reversible by following a diet, supplement and exercise plan. We are told that Linus Pauling was right. Cancer is curable with high dose Vitamin C. But you have to inject it, not ingest it. An osteopath writes an article claiming you can cure whiplash with osteopathy. Lifestyle changes can reduce your risk of dementia by 60%.

Like most people who pick up magazines in supermarkets I am not a doctor and have no way of evaluating these claims. I have no argument with healthy eating and regular exercise. But I am suspicious of claims that doctors and drug companies are in it together to spread misleading information and promote the use of profitable but unnecessary medications. However this issue does contain an article on autism, which is why I bought it.  And I do know enough about autism to critically read that article. And if WDDTY is wrong about my area of expertise why should I believe them about anything else?

The Autism Explosion

This month (April 2014) the print edition of WDDTY features an article entitled “Autism: it’s all in the gut,” which begins with a familiar claim.

There’s one startling fact about autism that marks it out from all the other chronic diseases of modern times – the explosion of cases over the past 30 years.  Back in 1985, just six children out of every  10,000 were diagnosed with autism; today one in every 88 children has the condition, and some reckon it affects one in 50 children.

I have four problems with this statement, apart from the fact that it is wrong.

  1. If you are going to compare statistics do not make your readers do the math. Make the comparison obvious. 1 in 88 equates to 112 in 10000 which makes for easier comparison with 6 in 10000.
  2. Source your statistics. There are a number of references at the end of this article. But none are given for the epidemiological data. Hence the reader cannot check its accuracy.
  3. Use real statistics. WDDTY is a UK publication and the key data points for autism epidemiology in the UK are 4.5 in 10000 (Lotter 1966); 21.2 in 10000 (Wing and Gould 1979); 116 in 10000 (Baird et al 2006). All these studies are referenced on the National Autistic Society website. None of them are mentioned by WDDTY.
  4. Make sure you are comparing like with like. Wing and Gould found similar results to Lotter when they used his criteria. But a broader definition of autism produced their higher figure. Baird used different criteria again (ICD-10) and found 38.9 in 10,000 for childhood autism, and 77.2 in 10,000 for other autism spectrum disorders. WDDTY use headline figures for all autistic spectrum disorders and pretend they are referring to the narrow definition of childhood autism used by most researchers for 40 years after Kanner’s original description of autism in 1943.

There may or may not have been an actual increase in autism over the last 30 years. But there are alternative explanations for the increase in numbers.

  1. If you go out and look for autism in the general population you will find more cases than if you sit in your office waiting for patients to arrive. Studies that screen whole populations and directly assess individuals identified in that screening process produce higher figures than studies that interrogate patient databases.
  2. If you change the criteria for autism you can engineer dramatic increases as demonstrated by Wing and Gould in their Camberwell study. Using Lotter’s strict criteria they found 4.9 in 10000 which compares well to Lotter’s finding of 4.5 in 10000. But  by including all children identified with the now familiar triad of impairments, regardless of whether or not they met Lotter’s criteria, they found a four-fold increase. This is easy to understand if you compare the criteria. Lotter required “a profound lack of affective contact.”  The triad refers instead to impairments in ability.
  3. The success of  advocacy groups in raising awareness has led to better estimates of the numbers. Autism statistics were just not collected thirty years ago and are still not in many countries. Without numbers there is no impetus to create services. But once services exist they drive the numbers up. California’s autism statistics were used to fuel claims for an autism epidemic until it was pointed out that the massive unevenness in rates within California coincided with the availability of services in affluent areas (high rates) and the lack of services in poorer areas (low rates). Those states in the USA with a reputation for providing good autism services have higher rates than the national average. In the UK 40 years ago autistic children were denied access to education. Now a diagnosis is a passport to special educational provision, albeit of variable quality,

All of which gives me cause to question that sentence at the beginning of the WDDTY article.

There’s one startling fact about autism that marks it out from all the other chronic diseases of modern times – the explosion of cases over the past 30 years.

It’s All In The Gut

WDDTY argues that

New research is narrowing the focus to the gut. Many autistic children have a host of gastrointestinal (GI) problems that carry on into adulthood, and some of the worst symptoms seem to improve if the diet is changed, often to exclude gluten.

The GI narrative has a long history and very little definitive evidence to support it. In 2010 a Consensus Report by 28 doctors and researchers published in Pediatrics, the Official Journal of the American Association of Pediatrics, concluded that most studies suffered methodological limitations. Small sample sizes, lack of a control group, failure to apply standardized definitions of GI disorders and of severity of autistic symptoms were commonly cited. The consensus was that GI symptoms were probably more prevalent in people with ASD but we did not know for certain and could not say why. Among the 23 consensus statements the following are most pertinent to our present discussion.

Statement 1 (Key Statement)

Individuals with ASDs who present with gastrointestinal symptoms warrant a thorough evaluation, as would be undertaken for individuals without ASDs who have the same symptoms or signs. Evidence-based algorithms for the assessment of abdominal pain, constipation, chronic diarrhea, and gastroesophageal reflux disease (GERD) should be developed.

This is the key statement. Too often GI symptoms in autistic patients are misinterpreted as behavioural manifestations of autism and treated accordingly. This is most likely to happen in young children and others who are unable to verbally describe their symptoms. The symptoms continue unabated and may worsen. Caregivers then turn to practitioners of alt-med, like the purveyors of WDDTY, who persuade them that these GI symptoms are not the result of autism but its cause. And of course they have the explanation and the cure. But other consensus statements from the AAP undermine this simplistic perspective.

Statement 4

The existence of a gastrointestinal disturbance specific to persons with ASDs (eg, “autistic enterocolitis”) has not been established.

Statement 5

The evidence for abnormal gastrointestinal permeability in individuals with ASDs is limited. Prospective studies should be performed to determine the role of abnormal permeability in neuropsychiatric manifestations of ASDs.

Statement 11

Anecdotal reports have suggested that there may be a subgroup of individuals with ASDs who respond to dietary intervention. Additional data are needed before pediatricians and other professionals can recommend specific dietary modifications.

Statement 12

Available research data do not support the use of a casein-free diet, a gluten-free diet, or combined gluten-free, casein-free (GFCF) diet as a primary treatment for individuals with ASDs.

Statement 18

The role of immune responses in the pathogenesis of gastrointestinal disorders in individuals with ASDs warrants additional investigation.

Statement 19

The role of gut microflora in the pathogenesis of gastrointestinal disorders in individuals with ASDs is not well understood.

This is serious work. There were seven working parties reviewing the expert literature in their fields: child psychiatry, developmental paediatrics, epidemiology, medical genetics, immunology, nursing, paediatric allergy, paediatric gastroenterology, paediatric pain, paediatric neurology, paediatric nutrition, and psychology.

Antibiotics and Processed Food

Yet WDDTY chose to ignore them completely. Instead they make this claim for a study of 20 autistic children entitled “Reduced Incidence of Prevotella and Other Fermenters in Intestinal Microflora of Autistic Children.”

The findings suggest that an overuse of antibiotics and  the typical Western diet of processed foods could be significant factors in autism.

But the study specifically excluded children who had received antibiotics in the previous month on the grounds that antibiotic usage would have confounded their results. Moreover the study is clear that its autistic subjects do not follow a typical western diet. Five of the twenty were on a gluten-free, casein-free diet at the time of the study compared to one in the neurotypical control group (n=20). 13 were taking additional supplements compared to 5 in the control group. Taken overall the autistic group consumed more probiotics and more sea food than the control group. Nearly all the parents of the autistic reported problems with the amount their child ate and their child’s restricted diet. This data was not available for the control group. From this it is reasonable to assume that their atypical diet was more likely to contribute to their atypical microflora than the “typical western diet of processed foods” consumed by the typically western control group.

While the autistic group did have significantly higher GI symptoms than the control group there was no relation between the severity of GI symptoms and the severity of their autism. All of which gives me cause to question the statement that

The findings suggest that an overuse of antibiotics and  the typical Western diet of processed foods could be significant factors in autism.

Gluten and Casein

WDDTY believes another study supports their suggestion that antibiotics and processed food are significant factors in autism. In fact it does nothing of the kind. It does not mention antibiotics and did not collect data on or control for variation in diet. It included four children on a gluten-free diet “Because the effect of gluten-free diet on antibody levels in autism is not known.”

It tested autistic children for antibodies in their blood associated with celiac disease and compared them with normal controls. Despite higher levels of antibodies to gluten in the autistic group none of them had celiac disease. There are problems with this study. All 37 autistic subjects were recruited in the USA. But 62 out of 74 members of the control group were recruited in Sweden. Why? And there was no data on the GI disorders in the controls despite extensive but incomplete data on the autistic group. I agree with Laurent Mottron who commented on the study.

These data are uninterpretable in their relation to autism without a non-autistic comparison group matched in gastro-intestinal problems, (using the same instrument of course).

But WDDTY did not cite these studies to prove a point. They are included because they bear some relation to the subject and seem to show that WDDTY have done their research. WDDTY rely on their readers not following up on references and reading the actual studies. I very much doubt whether the author read them either.

Meanwhile back in the UK

WDDTY turns to:

researchers at the Autism Research Unit at the University of Sunderland, now working as ESPA Research.

This was an offshoot of the university that now operates under the auspices of ESPA since its driving force, Paul Shattock, has retired from his position in the Pharmacy department at the university. I know Paul Shattock. He has an autistic son and set up ESPA to provide educational services for autistic people in the Sunderland area. For this and other services to autism he received a well-merited OBE. For a while I was sympathetic to his opioid excess theory of autism causation, often referred to as the Leaky Gut Theory of Autism. But other researchers have tried and failed to replicate his findings.

The theory has been around for a lot longer than the fifteen years cited by WDDTY. I bought a copy of the pamphlet, “Autism as a Metabolic Disorder” from Paul Shattock in 2002 when I was in Sunderland to see if ESPA could provide a suitable placement for my son. Mine is the second edition (May 2001) and even then it stated that the Autism Research Unit had been testing samples for fifteen years. But the theory is older than that. According to the pamphlet

This model is based upon acceptance of the opioid excess theory of autism as initially expounded by Panksepp (1979) and extended by Reichelt (1981)  and ourselves (Shattock 1991).

When I first entered the online autism world of newsgroups and email listservs back in 1997 the leaky gut theory was very popular with parents. It went like this.

  1. Some children have difficulty digesting the proteins gluten (found in grains like wheat and barley) and casein (found in dairy products).
  2. This leads to an excess of peptides in the gut.
  3. If the gut wall is damaged these peptides will leak into the bloodstream and cross the blood brain barrier.
  4. Once inside the brain they either imitate the activity of opioid peptides occurring naturally in the brain or bind to the enzymes that normally break down these naturally occurring opioid peptides.
  5. The result is the same: excess opioid activity in the brain.
  6. This explains the “autistic” behaviour of sufferers. They are like drug addicts who swing between being “high” on the peptides or doing “cold turkey” when they need more peptides. This may also explain some of the cravings for dairy and grain based products in autistic children.
  7. Remove gluten and casein from the diet and the symptoms will diminish.
  8. But they may get worse initially when the “cold turkey” phase kicks in.

This hypothesis was attractive to parents because it seemed to fit their experience; children with food fads or a history of being picky eaters, who appeared to suffer from disruptions to normal perceptual, cognitive, emotional and social development with resultant mood swings and behavioural difficulties. But the hypothesis proved rather too flexible.

The initial theory suggested that children who were prone to infections would have their gut damaged by antibiotics which destroyed the good bacteria in the gut and let the bad bacteria take over.  Yeast and other fungal agents were also suggested as potential villains. So you had to repair and restore the gut to good health while removing the gluten and casein from the diet. Vaccines, particularly MMR, were also implicated based on parental reports. The measles virus from the vaccine was supposed to invade the gut and damage it. So was the damage bacterial, fungal or viral? The picture was further confused by arguments that it was the measles virus that invaded the central nervous system and led to  the autistic symptoms by causing encephalitis. Then came attempts to synthesize all this with a hypothesis from the USA that the mercury content in some vaccines was to blame. Either it induced mercury poisoning in vulnerable children which was mistakenly diagnosed as autism or it acted to make the gut more susceptible to damage from the MMR vaccine.

Pick a card, any card …

Real science, when faced with conflicting and sometimes contradictory theories, tries to control for all the variables and test each one in turn. What is the evidence for leaky gut in autistic subjects? Is leaky gut caused by bacterial, fungal or viral factors? Can we detect excess opioid activity in the brains of autistic people? Given that autistic people are supposed to suffer the double whammy of leaky gut and gluten/casein intolerance what is the evidence for a “single whammy” (either leaky gut or gluten/casein intolerance) in the non-autistic population?

WDDTY does not ask these questions. It does not ask any questions. Instead we are asked to accept that all the theories of causation promoted by the alt-med community are equally valid. There is no conflict between them. Choose a theory, any theory. You pays your money (in most cases a lot of money) and you takes your choice. Any number of therapies may help: vitamin D therapy; gluten and casein free diet; supplements; sensory enrichment (which just snuck in with no mention in the main article of the genuine sensory difficulties in autism); chelation therapy – the  removal of toxic heavy metals like mercury that are alleged to be there in excessive quantities in autistic children.

The Bits on the Side

The article includes two sidebars. One is a puff piece for a book in defence of Andrew Wakefield and the role of vaccines in autism by a quacktitioner called Graham Ewing of Montague Healthcare, a one man operation that he runs from his family home in a village near Nottingham, who promotes his own “virtual scanning” technology as a cure-all for most things. If your credulity is already stretched prepare for it to be snapped by Dr Weinberg and his NeuroModulation Technique™ which has reversed autism, cured arthritis, Crohn’s disease, IBS and other inflammatory disorders. Moreover the person being treated does not have to present for the treatment. The therapist can test functioning by muscle-testing their own arm and transmit their therapy by the power of thought. As WDDTY states in its intro to this sidebar

People of a logical, dogmatic or sceptical disposition, please look away now.

Yes. please do. And on this evidence I suggest that we continue to look away and dogmatically insist on evidence based science to guide our health choices rather than the “good old-fashioned medicated goo” on offer from WDDTY.

100 ways to live to 100: Your healthy digestion

Part of a series on WDDTY’s “free” advertorial report “100 ways to live to 100

Your healthy digestion

11 Cut down or avoid eating wheat

Lots of people can’t tolerate this relatively new food in the human diet, particularly as it’s been so genetically tampered with. Each grain contains wheat-germ agglutinin (WGA); in small quantities it can inhibit nerve growth factor, which is vital for healthy neurons.8 WGA can disrupt endocrine function,

causing rheumatoid arthritis, ulcers, insulin resistance, and kidney and digestive problems;9 it can also bring about cell death10 and chronic inflammatory conditions. Switch to carbs like millet, buckwheat, quinoa, rice and corn.

Reference 8: Scand J Gastroenterol, 2010; 45: 1197–202; Positive serum antigliadin antibodies without celiac disease in the elderly population: does it matter? Ruuskanen A, Kaukinen K, Collin P, Huhtala H, Valve R, Mäki M, Luostarinen L.

Reference 9: BMJ, 1999; 318: 1023–4 Do dietary lectins cause disease? David L J Freed

Reference 10: Toxicol In Vitro, 2004; 18: 821–7 Studies on the joint cytotoxicity of Wheat Germ Agglutinin and monensin. Dalla Pellegrina C, et. al.

Those references don’t support the overall claims, of course. The first finds that “Although AGA positivity is of clinical relevance only in a subset of elderly people, it seems to be related to rheumatoid arthritis and depression, both conditions linked to celiac disease”. This is testable using tTG antibody testing. Valid, worth pursuing, narrowly applicable as the summary suggests. The second says “The evidence is suggestive—and raises interesting possibilities for treatment”, again valid but speculative, and if we don’t have something firmer than speculative nearly 15 years later, perhaps it’s not that significant.

The third reference is a corker. It suggests that eating wheat could treat cancer – the self-same apoptosis that is promoted by some of their quack advertisers. But of course that would never do, wheat is a baddie not a goodie, so it’s spun as “causing cell death”.

There are at least a couple of other problems with the section itself, in addition to the sources not saying what WDDTY claims for them.

First, wheat is an excellent source of essential dietary fibre, while quinoa is ethically and environmentally dubious. Second, wheat intolerance is massively less common than rancid quack tomes such as Wheat Belly would have you believe. Coeliac is the best known and is relatively common – up to 1% of the UK population – but that can be objectively tested, and those with genuine wheat intolerance do not have coeliac.

It’s unlikely that as many as 5% of people have wheat intolerance.

Wheat is the bête noire of many a quack nutritionist, but solid evidence to support this status is lacking. Intolerance and allergy is more common in children than in adults (children often outgrow it), and it introduces non-trivial restrictions on diet.

Bottom line: do not self-diagnose as allergic or sensitive to anything, and don’t allow anyone else to diagnose you either unless they are a fully trained and qualified dietician or doctor. Remember, even prominent TV “nutritionists” can turn out to have bought their worthless degrees off the internet.

12 Dump homogenized or pasteurized lowfat dairy

People who consume large quantities of dairy products have higher levels of circulating insulin-like growth factor 1 (IGF-1), linked to an increased risk of numerous cancers.11 Men with the highest IGF-1 levels quadruple their chances of getting prostate cancer with low-fat milk, which strips away the anticancer protective effects of conjugated linoleic acid (CLA).12

Reference 11: Recent Pat Anticancer Drug Discov, 2012; 7: 14–30 Insulin-like growth factor: current concepts and new developments in cancer therapy. King ER, Wong KK.

Reference 12a: Science, 1998; 279: 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.

Reference 12b: Am J Clin Nutr, 2005; 81: 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.

This is a rehash of WDDTY’s “is dairy cancer food”. We checked that question and found that the answer is probably “no”, and the sources WDDTY use to support it, generally don’t support it and occasionally say pretty much the opposite.

13 Root out any allergies or food intolerances

Besides wheat, suspect the other big seven: corn, soya, sugar, nightshades (potatoes, tomatoes, aubergines, sweet and chilli peppers), yeast, egg and dairy. Find out if you’re intolerant by following an elimination diet (see WDDTY November 2012).

This is also a rehash of old material including the silly article on arthritis. WDDTY seem to have a particularly schizophrenic view of tomatoes. They contain lycopene (which apparently makes you immortal), are part of the immortality-conferring mediterranean diet, but it turns out they also cause all manner of illnesses.

According to the Mayo Clinic the eight most common food allergies are:

  • Milk
  • Eggs
  • Peanuts
  • Tree nuts (such as almonds, cashews, walnuts)
  • Fish (such as bass, cod, flounder)
  • Shellfish (such as crab, lobster, shrimp)
  • Soy
  • Wheat

Corn, Solanaceae, yeast and sugar do not figure at all. The FDA has the same list, the NHS has a longer and more specific list split into allergies common in children versus adults, again:  corn, Solanaceae, yeast and sugar do not figure at all.

It’s so confusing! Unless you look at the actual evidence rather than a filtered, cherry-picked version in an anti-medicine rag promoting the quackery of so-called nutritionists, of course.

14 Eat your greens for calcium

Dairy products actually accelerate the rate at which calcium is lost from the body, and calcium supplements as a rule are not properly absorbed; in one large study, an increased consumption of pasteurized milk did not protect against bone fractures. Just one serving of green, leafy vegetables a day, rather than once a week, can cut the risk of hip fracture in half.13

Reference 13: 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.

Another rehash of the arthritis article’s claims, and continuing the WDDTY agenda against dairy. Needless to say the source does not support the claim: it finds that “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.”

15 Check out your stomach acid

If you suffer from acid reflux or poor elimination, get your stomach acid levels tested by Biolab Medical Unit (9 Weymouth Street, London W1W 6DB; www.biolab.co.uk; tel: 0207 636 5959) or Genova Diagnostics (63 Zillicoa St, Asheville, North Carolina 28801, USA; tel: (828) 253 0621).

This message was brought to you by our sponsors. Biolab is a respectable lab but it also runs some distinctly dubious tests. It refers patients to a number of the WDDTY editorial panel (can you say “undeclared conflict of interest”? I thought you could) for treatment of medically unrecognised conditions based on questionable tests.

16 Find out if your gut is ‘leaky’

If the walls of the large intestine are excessively permeable, allowing larger food molecules through, this will reduce food absorption and lead to allergic symptoms. Confirm the diagnosis through Biolab or Genova (see the infobox) and repair the gut wall with probiotics, plus the amino acid glutamine and glutathione, an important antioxidant. If you have digestive difficulties, get checked for Candida overgrowth and parasites by doing a stool test (Contact Genova Diagnostics Europe, Parkgate House, 356 West Barnes Lane, New Malden, Surrey KT3 6NB; tel: 0208 336 7750; www.gdx.net/uk).

This message was brought to you by our sponsors.

Leaky gut syndrome is a quack diagnosis.Candida overgrowth is a quack diagnosis. If WDDTY were a responsible publication they would tell you this, rather than feeding you to labs which will diagnose non-existent or unrecognised conditions and refer you to quacks who will “treat” them.

17 Give up the white stuff

Besides causing tooth decay and diabetes, just 10g of any simple sugars, brown white, will temporarily suppress immune system white cells by a whopping 40 per cent.14 Consuming sugar is linked to inflammatory bowel disease, gallstones and kidney stones, high blood pressure, stomach and endometrial cancer, and even shortsightedness. It’s just plain bad for you, full stop.

Reference 14: Dent Surv, 1976; 52: 46–8, Sucrose, neutrophilic phagocytosis and resistance to disease. Ringsdorf WM Jr, Cheraskin E, Ramsay RR Jr.

This study is rapidly approaching its 40th birthday. NHS Choices offers much more moderate advice, that is also (obviously) more practical.

18 Periodically detox

Virtually all of us are walking around with a cocktail of some 100,000 ubiquitous environmental chemicals in our blood, some of which are now known to be ‘bioaccumulating’ in human fat and causing a variety of health problems.15 Take regular saunas, exercise and extra fibre plus Chlorella, Spirulina and coriander (cilantro), as they all show evidence of clearing heavy metals from the body (see pages 80–81 for more detox tips).

Reference 15a:  Altern Med Rev, 2000; 5: 52–63;

Reference 15b: Environ Health, 2011; 10: 9 Knowns and unknowns on burden of disease due to chemicals: a systematic review Annette Prüss-Ustün1, Carolyn Vickers, Pascal Haefliger and Roberto Bertollini

If there’s one thing that marks out a quack, it’s “detox”. Hysterical references to unidentified “toxins” building up in our bodies, are used to sell expensive treatments that vary between worthless and downright dangerous. Exactly what you’d expect, in fact, given that the first reference is to Alternative Medicine Review, a junk journal devoted to promoting quackery.

The second source is reputable, but does not support detox. It is instead discussing the human effects of dioxins and other known toxins (real ones, identified by name) and recommending means to reduce exposures to these. It does not mention detox even once.

And the reason the reputable source doesn’t mention detox? Detox is what your liver does.

The only known value of detox is as a red flag to avoid a quack.

19 Steer clear of high-fructose corn syrup (HFCS)

Found in virtually every processed food and soft drink (a standard cola has about 17 teaspoons’ worth), HFCS picks up deadly mercury during processing. Also avoid chemical sweeteners like aspartame, now characterized by many as an excitotoxin, shown to cause seizures and brain neuronal damage in animals.16 Aspartame also been linked to cancer in animal studies.17

Reference 16a: J Neuropathol Exp Neurol, 1972; 31: 464–88 Glutamate-induced brain damage in infant primates. Olney JW, Sharpe LG, Feigin RD.

Reference 16b: Eur J Clin Nutr, 2008; 62: 451–62 Direct and indirect cellular effects of aspartame on the brain P Humphries, E Pretorius and H Naudé

Reference 17: Am J Ind Med, 2010; 53: 1197–206 Aspartame administered in feed, beginning prenatally through life span, induces cancers of the liver and lung in male Swiss mice. Soffritti M, Belpoggi F, Manservigi M, Tibaldi E, Lauriola M, Falcioni L, Bua L.

Aspartame is another of WDDTY’s bogeymen. It’s also, according to the best available evidence, safe (and the unreliable evidence is equally unreliable, with mercola.com describing it as “by far the most dangerous substance on the market that is added to foods”. 1972 is the oldest source used anywhere in the entire article. Wikipedia has a nice discussion of aspartame controversyW. It’s one of the most heavily studied additives in use, and there is a vast amount of evidence indicating its safety.

20 Drink a bit of alcohol

Drinking lightly (a glass every few days) rather than heavily or abstaining seems to be the safest and healthiest overall drinking for preventing heart disease.18But make it red wine, which contains health-giving resveratrol, and also helps prevent inflammation.19

Reference 18:  Eur J Clin Nutr, 2010; 64: 561–8 Relationship between alcohol intake, health and social status and cardiovascular risk factors in the Urban Paris-Ile-de-France Cohort: is the cardioprotective action of alcohol a myth? Hansel B, Thomas F, Pannier B, Bean K, Kontush A, Chapman MJ, Guize L, Bruckert E.

Reference 19: FASEB J, 2009; 23: 2412–24 Resveratrol attenuates C5a-induced inflammatory responses in vitro and in vivo by inhibiting phospholipase D and sphingosine kinase activities. Issuree PD, Pushparaj PN, Pervaiz S, Melendez AJ.

Red wine may indeed be good for you in moderation, but these sources don’t prove it. The first is vulnerable to multiple confounders, the second does not discuss red wine, because the amount of bioavailable resveratrol in wine is unpredictable. It is possible that resveratrol is clinically useful, but the studies don’t compare it with other substances and don’t support its use along with the well-known and potent toxin: ethanol.

Leaky gut syndrome

Leaky gut syndrome
Leaky gut syndrome is a condition invented by nutritionists and sold by sciencey-sounding nonsense.

As we shall see, the diagnosis of “leaky gut syndrome” is a convenient catch-all to offer an illusion of knowledge to patients suffering from medically obscure symptoms. This is particularly pernicious, since in many cases such conditions have a psychosomatic component: the illusion of diagnosis is almost its own cure.

A competent and ethical health publication would urge caution around unproven diagnoses that make claims which should be verifiable from pathology, but aren’t.

WDDTY of course supports the nutritionist industry agenda.

Leaky gut syndrome

Leaky Gut Syndrome
‘Leaky gut syndrome’ is a proposed condition some health practitioners claim is the cause of a wide range of long-term conditions, including chronic fatigue syndrome and multiple sclerosis.

Proponents of ‘leaky gut syndrome’ claim that many symptoms and diseases are caused by the immune system reacting to germs, toxins or other large molecules that have been absorbed into the bloodstream via a porous (‘leaky’) bowel.

There is little evidence to support this theory, and no evidence that so-called ‘treatments’ for ‘leaky gut syndrome’, such as nutritional supplements and a gluten-free diet, have any beneficial effect for most of the conditions they are claimed to help.

While it is true that certain factors can make the bowel more permeable, this probably does not lead to anything more than temporary mild inflammation of an area of the bowel.

NHS Choices

The world of alternative medicine has a certain fondness for inventing conditions in order to be able to sell a “cure” that medicine cannot offer. morgellonsW and chronic Lyme diseaseW are two of the better known. Another, particularly beloved of nutritionists, is leaky gut syndromeW.

Often there is an overlap with reality: in morgellons the condition is delusional parasitosisW, patients preferring the alternative because they repudiate the psychological cause; in chronic Lyme there is a genuine condition (post-Lyme syndrome) though many self-diagnosed sufferers show no evidence of borrelia burgdorferi, the cause of Lyme disease.

Other genuine disorders such as infectious mononucleosisW (also known as glandular fever) have lasting effects similar to chronic fatigue syndromeW (CFS).

In the case of “leaky gut syndrome” there is some substance to the idea that the gut wall can become more permeable in those suffering from inflammatory bowel diseaseW but the crossover between this and the alternative diagnosis of “leaky gut” happens early. However, the idea of a leaky gut syndrome, particularly as the cause of autism, CFS and even multiple sclerosisW, is entirely speculative and not supported by credible evidence.

Nutritionists typically pin the blame for “leaky gut” on whichever idée fixe they happen to hold: gluten is a frequent target, milk and candida overgrowth are also fingered.

leaky gut As an example, the website leakygutcure.com uses the illustration at right. This shows: top left, a normal gut wall; top right, villous atrophy, a diagnostic sign of coeliac diseaseW, and bottom, vague references to food and unspecified “toxins”.

I am not aware of any credible pathological findings of undigested food in the blood, as this suggests, nor is any such objective test proposed for “leaky gut”. Instead the diagnosis is one of – well, guesswork: usually exclusion diets, but with the nutritionist’s favourite bête noire always in the mix, and (it seems) always found to be the One True Cause.

Comparison with coeliac is illustrative. Coeliac is an autoimmune disorder where the immune system attacks the gut wall where the proteins in gluten are absorbed. Diagnosis is by blood tests for tissue transglutaminase (tTG) antibodies, possibly confirmed by duodenal biopsy, which typically shows exactly the features seen at top right in the picture: blunting of the villi, enlargement of the crypts and invasion of the crypts by lymphocytes (white blood cells).

Arthritis: it’s not old age, it’s inflammation

Arthritis patients: Fertile prey for quacks.
Like any sufferer from a painful chronic condition, arthritis patients are fertile prey for quacks. Here WDDTY engages in its signature combination of legitimate new research, prehistoric papers beloved of cranks, and uncritical acceptance of practitioners with an agenda and a business to promote, to synthesise a claim that is not actually supported by the sources they cite.

“Doctors have long assumed that osteoarthritis is largely caused by traumatic injury or ‘wear and tear’, but new research suggests that the disease may actually be driven by low-grade inflammation”

Except that doctors are quite clear on the plausibility of autoimmune disorders as a contributor to osteoarthritis, the contribution of one factor does not contradict the contribution of other factors, and the cited studies acknowledge limitations that WDDTY airily waves aside.

The pièce de résistance is representing mainstream research on the side-effects of non-steroidal anti-inflammatory drugs as “proof” of the quack diagnosis of “leaky gut syndrome“.

Continue reading Arthritis: it’s not old age, it’s inflammation