Tag Archives: Diet

Evil ASA 5: Dr Vernon Coleman

This is the fifth of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

Dr Vernon Coleman.

Advertisements for Dr Coleman’s book, Food for Thought, mentioned a link between certain foods and cancer.

Although countless studies-and government reports-have supported the claim, the ASA found against him. As Dr  Coleman said: “I hate to think how many people might have died unnecessarily if the world had taken notice of the ASA and had decided that there was no link between food and cancer.”

Did you spot the bait-and-switch there? Is there a link between food and cancer? Plausibly. Is there a provable causal link between specific foods and cancer? That would require specific evidence. Evidence of the type that tends to become very elusive, slippery even, when cranks start talking about it. An innuendo here, a tangential finding there, and voila! A case built on smoke and mirrors.

The hubris of claiming that lives have been saved by ignoring the CAP is quite remarkable. The vast majority of information about cancer is not provided by Coleman, or indeed by the alternative community in general.

But hubris is what Coleman does.

His claim was not the measured statement that there may be a link between food and cancer. Nope. He says things like:

As your knife cuts into the meat you could well be cutting into a lump of cancer. The piece of meat you raise to your mouth, on the end of your fork, could well contain a tumour.

This adjudication was harder to track down than the others because it is old, but you can still read it via the wayback machine.

The ad is splendidly deranged (and trust me, it is not an outlier):

A national press ad, for a book by Dr Vernon Coleman, was headlined “How Many Times A Week Do You Eat Cancer? Dr Vernon Coleman”. Text continued “Cows, sheep, pigs and other animals all get cancer. So, how do you know, when you cut into a steak, a lamb chop or a piece of ham, that there isn’t a lump of cancer inside your steak, chop or ham? How do you know that your burger or sausage doesn’t contain ground up bits of cancer? You don’t. As your knife cuts into the meat you could well by [sic] cutting into a lump of cancer. The piece of meat you raise to your mouth, on the end of your fork, could well contain a tumour. Now that animals are increasingly likely to have been ‘fed’ or ‘treated’ with carcinogenic chemicals, this risk gets greater every year. Farmers and butchers claim that animals are checked before they’re slaughtered. But they can’t possibly see what is happening inside an animal’s tissues. You won’t be able to see the lump of cancer. But you’ll be eating it. So will everyone else who eats meat. And I thought you’d like to know. You will never forget this warning. Every time you eat a piece of meat (or see someone else cut into a piece of meat) you will wonder … how much cancer am I eating today? For more information about food, cancer and health read Food for Thought and Coleman’s Laws by Vernon Coleman. Available from all good bookshops and libraries

This is Linda McCartney on crack.

The complainants, long before Nightingale started, complained as follows:

The complainants challenged whether:

1.  the ad misleadingly exaggerated the likelihood of cancerous tissue being present in meat products and

2.  Vernon Coleman could substantiate the implication that eating cancerous tissue was damaging to human health.

3.  Two of the complainants challenged whether the ad used an undue appeal to fear to promote the views of Vernon Coleman.

One of the complainants questioned:

4.  whether the claim “Now that animals are increasingly likely to have been ‘fed’ or ‘treated’ with carcinogenic chemicals, this risk gets greater every year” could be substantiated and

5.  whether the ad unfairly denigrated farmers and butchers by suggesting that they allowed sick or diseased animals to enter the food chain.

Coleman did not respond. Guess what? the adjudication went against him.

So, was the ASA suppressing the vital fact that there is a link between food and cancer, or were they responding to frankly bonkers claims that every sausage is a skin full of cancer just waiting to get you, and unable to view it other than on its face because the crackpot author refused to even respond? You decide.

Evil ASA 4: Zoë Harcombe

This is the fourth of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

You can see why this is more appealing than the NHS version eat well plate
Harcombe version. Mmmmm, steak. NHS version. WHERE’S MY STEAK?

Zoë Harcombe

This is a best-selling author

Really? According to whom? The Obesity Epidemic is currently ranked 1,231,560 in Books by amazon. That’s not really Dan Brown territory. Speaking of which: Dan Brown is  a best-selling author. He still writes unmitigated tripe. And so, it seems, does Zoe Harcombe…

who holds ‘alternative’ views about weight gain and diets.

You can say that again. Or you can say this:

Looking at her overall message, Zoe basically disagrees with the advice you would get from mainstream health organisations. The result of this is that people are likely to become confused. […]

And the fact is that Zoe’s conclusions that relate to cancer, at least as presented in the Mail, just aren’t supported by the overall body of scientific evidence.

This is why it is best to ignore the advice and stick to credible sources of health information from charities like World Cancer Research Fund (WCRF), or from NHS Choices.

She believes, for example, that the calorie theory and conventional weight-loss advice are wrong-and she said so in a recent video that’s on her website. However, as she
had recently published a new book, The Obesity Epidemic: What Caused It? How Can We Stop It?, the ASA considered
the video an advertisement for the book and so subject to its rulings.

This is similar to the issue Fran Sheffield had in ACCC v. Homeopathy Plus: a claim made “in trade or commerce” is taken to be any claim generally supporting the sale of a product, or from which the person making the statement might expect to profit.

There’s little doubt that the promotional video was selling the whole concept of her miracle diet plan: it’s “Zoe Harcombe: The Brand”.

The term “calorie theory” is used almost exclusively by quacks trying to sell miracle diets where you can eat as much as you like and still lose weight. The easiest way to spot if a miracle diet is fraudulent is this: it’s a miracle diet.

Another litmus test is when it’s credulously promoted by the Daily Mail.

WDDTY’s view that Harcombe’s claims are valid appears to rest on her status as a “bestselling author”. The ASA takes a different view:

Not surprisingly, it found against the video,

Please read the adjudication for yourself.

1. the claims in ads (a), (b) and (c) relating to Candida, hypoglycaemia and food intolerance misleadingly implied that they caused food cravings and could be treated by the Harcombe diet;

2. the claim “In no way is the body as simplistic as energy in = energy out – and, therefore, we do not need to put less energy in and/or try to get more energy out. We need to eat better, not to eat less” in ad (e) and comparison in ad (g) misleadingly implied that conventional weight loss advice was wrong;

3. the implication in the testimonials in ad (d) that the Harcombe diet led to weight loss could be substantiated;

4. the claim “it is recommended to stay on Phase 1 for longer if you have more than 20lb to lose” in ad (b) marketed treatment for obesity which would not take place under suitably qualified supervision;

5. the claim “Imagine yourself in just 30 days time feeling healthier than you can ever remember being. Imagine that you’ve successfully and easily lost up to 20 pounds in weight” and testimonials in ad (f) made reference to a rate of weight loss that was not compatible with good medical and nutritional practice; and

6. the testimonials in ad (f) implied the diet could treat medical conditions, including conditions that required medical supervision.

Harcombe’s response was another of the standard SCAM responses: a list of peer-reviewed studies which appeared to cast doubt on some elements of the current consensus understanding of the role of calorie intake on obesity.

The problem with this is that the scientific consensus, by definition, already incorporates all valid views according to their validity and the quality of evidence. That is the definition of a scientific consensus. And when you blow away the smoke:

We had not been provided with any evidence that Candida, hypoglycaemia or food intolerance were associated with being overweight or food cravings, nor that the conditions could be treated by the Harcombe diet. We therefore concluded that the claims breached the Code.

And:

The claim “In no way is the body as simplistic as energy in = energy out – and, therefore, we do not need to put less energy in and/or try to get more energy out. We need to eat better, not to eat less” appeared in ad (e) on the home page for the Harcombe Diet Club website. We considered that the claim was presented as factual and that it implied it was not necessary to consume fewer calories to lose weight by dietary change and that conventional weight loss advice was therefore wrong. Ad (g), a page on a website which promoted a book by Zoë Harcombe, included a comparison between a “Mother Nature” diet and the NHS recommended “‘Eatwell’ Plate”, which included the description “Fat & Sick”. We considered that, because the claim appeared in the context of a website focused on promoting a book and was connected with the content of that book, that it fell within the ASA’s remit. We considered that although it was clear that it related to the content of a book the comparison was presented as factual, and that it implied that conventional weight loss advice was wrong and contributed to obesity.

The thing is, if you are going to stand up and say that essentially the entire medical community is wrong about diet, you need to have solid credentials and robust research.

Harcombe claimed in 2011 to be “studying for a PhD in nutrition”, but told Ben Goldacre that she was not actually enrolled anywhere. She claims to have graduated from Cambridge in Mathematics, and actually her entire research base looks like an n=1 study.

Se claims to be “a qualified nutritionist with a Diploma in Diet & Nutrition and a Diploma in Clinical Weight Management”. The title nutritionist is not protected, qualifications such as these are often worth nothing. She says she is “first and foremost an obesity researcher”. A PubMed search turns up exactly one paper, a somewhat underwhelming piece in the Mayo Clinic’s house journal, with a respectable impact factor of roughly 6. The finding covers a small part of Harcombe’s claims, and definitely not the part about the “calorie theory” being wrong.

So, the ASA ruling is founded on the fact that (a) Zoe Harcombe provided no credible evidence to back her own claim, (b) the views she asserts to be wrong are backed by a mass of evidence, and have the weight of endorsement by governments, obesity specialists and diet researchers, and (c) Harcombe’s own authority falls well short of the level necessary to establish her dissenting opinion as being valid.

Not, as WDDTY imply:

as the CAP code holds to the calorie theory

No the CAP does not “hold to the calorie theory”. The CAP merely says that diet claims have to be well founded. The guidance is quite straightforward and entirely in line with sane guidelines for weight loss. Because, you know, people do stupid things. Fortunately Zoe Harcombe would never stoop to exploiting such a tragedy. Oh. She did.

In response, Zoe said: “CAP admit they have no evidence [to support their views].

No, they do not. They state, rather, that you provided no evidence to support yours. If you rely on reversing the burden of proof – “go on, prove me wrong” – then you have already lost.

The ASA admit they have no choice but to administer the opinions of CAP. If someone complains to the Alternative-view Silencing Agency about you, don’t waste a second of your time
submitting evidence.”

Gosh, the ASA can’t ignore the code by which it is committed to regulating advertisements, just because you demand special treatment and your own special code. How evil is that?

In reality, of course, people who have genuinely defensible claims can and do submit evidence. 14% of health-related claims that went to adjudication last year, were Not Upheld.

So, were the ASA unjustly suppressing alternatives to the “calorie theory” dogma, or were they just upholding their own published standards against special pleading by somebody whose credentials and evidence fall well short of where her ego believes them to be? You decide.

The Vitamin Wars

Few columns in WDDTY reveal the hypocrisy of the SCAM industry quite so consistently as Rob Verkerk’s. Rob runs the Alliance for Natural Health Europe (ANH-Europe), a SCAM industry lobby group indistinguishable in function and purpose from the lobbying companies used by “big pharma”, but far less scrupulous when it comes to accuracy, because Rob (like many of his contemporaries) not only lobbies for SCAM, he also makes money from SCAM, and makes more money promoting in print the SCAM from which he makes money.

His February 2014 is perfect of its type:

Few Natural-health aficionados would have been unable to miss the media reports about vitamins being a waste of money. They hit every major newspaper, radio and TV station last December.

Yes, it’s a welcome change from the usual credulous nonsense planted by people like Rob Verkerk.

The Times’ science correspondent, Tom Whipple, the journalist that has had his crosshairs focused on this very magazine in separate articles appearing on the 1st October and 2nd November, was the most condemning.

No evidence that Tom Whipple was the most condemning, but to say he has his crosshairs focused on WDDTY is a classic appeal to motives: according to Verkerk, Whipple cannot be trusted because he has an agenda against WDDTY. In fact, the opposite is true: Whipple can be trusted precisely because he has spoken out against the misleading information in WDDTY, rather than either parroting it or ignoring it as most journalists do.

Rob Verkerk, like Lynne McTaggart and all the other contributors to WDDTY, is unable to separate objective scrutiny of false information from suppression of free speech. That’s because they sincerely believe things which are unsupported by scientific evidence, and that’s precisely why any trustworthy health journalist will give overwhelmingly negative coverage to WDDTY.

His piece, in the 17th December edition of the newspaper, declared, “Vitamin pills are a waste of money, experts warn.” The Daily Mail said multivitamins “do nothing to protect us from illness”.

And this is true: for most people eating a healthy balanced diet, supplements are unnecessary. And for those who are not eating a healthy balanced diet, a change of diet is vastly preferable to supplementation.

So who are those experts, and what did they actually reveal or say? The first thing to recognize is that the most damning headlines about vitamin and mineral supplements weren’t generated from any new clinical trials or even analyses of previous trials. They actually came from an opinion piece written as an editorial by a number of scientists and appearing in the same issue of the medical journal Annals of Internal Medicine (AIM) that also included three reviews of past studies. Some of the authors had been engaged in previous studies of high-dose synthetic vitamin supplements.

Apparently Rob Verkerk doesn’t understand the process of scientific consensus building. This article summarised several reviews and other evidence, and drew a conclusion. That’s what science does. It’s interesting, though, that a columnist in WDDTY would try to play the “appeal to authority fallacy” card to undermine a published paper – great swathes of WDDTY would be blank if the editors adopted the view that appeals to authority are not reliable.

But this was a serious, highly credible, well-researched article in a major  peer-reviewed journal. That’s why it is so important, and why Verkerk has to spin like crazy to downplay it.

One review, the biggest by far, evaluated 26 studies to see if there was a link between taking typical dosages and forms of multivitamin/ mineral supplements and death from any cause, as well as death from either cancer or heart disease.

Another looked at two studies that evaluated the effects of a multivitamin on reducing cognitive decline in the elderly, and the third investigated whether a multivitamin could reduce cardiovascular events among those who’d already had a heart attack.

Indeed. And the results were underwhelming to say the least.

Any clinicians worth their salt and practising in the field of nutritional medicine, if asked to propose the likely outcomes of the multivitamin interventions evaluated by the three AIM articles, would have said “no chance”. And guess what? That’s just what was found. But this then gave the editorial authors a chance to blast their anti-supplement sentiments through an opinion piece that generated international news headlines.

A physician worth their salt and practising in the field of nutritional medicine, is called a dietician. It’s a protected title, and practitioners are subject to training requirements and statutory regulation. And yes, they would say that the chances of a positive result from precisely the kinds of routine supplementation that makes millions for the SCAM industry in product sales is slim. Multivitamins are, as the article says, probably a complete waste of money. How many shelves in your local pharmacy would that empty?

It’s big business. And the business needs its spin machine – including mouthpieces like Verkerk – to undermine a finding that is in the end neither surprising nor controversial.

The anti-supplement machine is rather well oiled and appears to be wheeled out every couple of years or so, presumably to try to dissuade people from doing too much to manage their own health. Short of banning supplements—something already happening especially within the EU and causing us to lose some of the most efficacious products, which threaten drug sales—this appears to be the favoured strategy among those with this particular agenda.

The pharma shill gambit rides again. What “anti-supplement machine”? When was the last time you saw an advertisement telling you not to buy supplements? When did you last see a campaign to stop shops selling supplements? Who is behind this “anti-supplement machine”? Certainly not “big pharma”, as they own many supplement brands. Whoever it is, they are doing a startlingly inept job: supplements are everywhere, touted by all kinds of credible-looking people using sciencey-sounding words, and they are getting away with it. Nearly a third of the UK population are popping supplements, and according to the evidence they are mainly worthless. That’s not evidence of a well-oiled anti-supplement machine is it?

The statement that this is “presumably to try to dissuade people from doing too much to manage their own health” is an appeal to motives; what Verkerk really means is that promotion of good science (i.e. science talking down the benefit of supplementation) is designed to dissuade people from giving unnecessary money to him, and others like him. The whole point of recent activity around regulatory changes is precisely that people are not managing their own health by taking supplements, they are mainly handing money to charlatans. Hence controls on maximum doses, to provide some control over vitamin megadoseW quacks.

What you don’t read in the papers is what was actually found in the studies. Did you read that a simple multivitamin can lower cancer risk in men by 8 per cent? You probably didn’t read that there were many studies that found positive effects. It’s just when you pool studies that have conflicting results, the very nature of a systematic review of this type, that you run the risk of cancelling out the variable results, even when they may have been due to other factors.

The whole point of a systematic review is that it balances the chance positive findings inevitable in clinical studies, and finds the overall effect to a much greater degree of certainty. As with homeopathy, the number of positive studies is completely irrelevant to the consensus of review studies that there is no credible evidence of effect. The positive studies are not ignored by systematic reviews, they are assessed, weighted according to methodological quality, and factored into the mix.

When the summary finding is no benefit, there’s no point howling about the positive results. The systematic review has already taken account of them. That is, after all, the point.

Also conspicuously absent from the news reports was any discussion of the reasons why most people take a daily multivitamin. They do so because of perceived benefits regarding things like energy levels, athletic performance, mental alertness and immune support.

Really? Where do they get this perception of benefit, given that the reviews find no actual benefit? Ah, wait: it’s a placebo effect caused by people like Verkerk talking up the clinically indefensible products from which he makes such a nice living.

In fact, many of these kinds of relationships have actually been proven scientifically, and have been officially authorized as health claims for use on commercial products EU-wide by the European Food Safety Authority (EFSA), the EU’s highest authority on food safety.And the EFSA is notoriously tough on accepting health claims. They’ve only approved about 250 in total, and most of these are for vitamins and minerals.

Not strictly true, since these approvals often rely on subjective assessments of benefit, but why would this be a problem? If the evidence is there, then the product is licensed and can be sold. If it’s not, then the evidence isn’t there. Verkerk appears to be arguing that because EFSA approves other products of this class, albeit not many, then all products of the class should be sold as if they were covered. Why would that be a good idea?

Another point made in the AIM editorial is that people can get everything they need from their diet.

Well, I agree. But only in theory, or in relation to a tiny section of society who are able to put in huge amounts of effort to source and prepare the best highest-quality foods and eat them consistently, day in, day out.

That is a fantastically implausible claim, and actually it’s the Nirvana fallacy. It is not hard to eat a balanced diet, and if it were then we’d scarcely have survived the harsh evolutionary realities of life. It doesn’t have to be the absolute best (either as defined by dieticians or quack nutritionists), it only has to be good enough.

The idea that a normal diet is substantially deficient in nutrients, is self-evidently bizarre. Vitamins were essentially unknown prior tot he late 18th Century and there is little doubt that the nutritional quality of our diet has improved vastly since then due to refrigeration and other techniques to prevent spoilage.

In practice, many of us fall dismally below optimal levels in one or more nutrients, and population-wide surveys show us that deficiencies in vitamin A (for immunity), vitamin K (for bone health), magnesium (for muscles and energy) and zinc (for immunity) are rampant. Worse than this, many of us carry genetic defects, referred to as ‘single nucleotide polymorphisms’ (SNPs), which mean we benefit from taking above average levels of particular nutrients to compensate. None of this gets a mention of course, despite the fact that this area of nutritional science— nutrigenomics—is one of the most rapidly expanding areas today.

This is a great argument for eating better and a truly terrible argument for buying a product which, according to the evidence, is routinely mis-sold by its proponents.

It seems that newspapers like The Times can only get away with creating headlines out of these issues if they are highly selective about the ‘facts’ and omit doing justice to the commonly accepted principles of standards of journalism and critical, unbiased reporting. I’m confident that most insightful readers will have been able to read past the agenda of the scientists and journalists involved.

You “forgot” to show that they were in the least bit selective. They didn’t toe the vitamin peddlers’ line, but that is a point in their favour rather than against them

What Doctors Don't Tell You
Why don’t doctors tell you to take supplements instead of eating a reasonable balanced diet?

Because doctors, unlike vitamin peddlers, care about your health, not their profits.

Mediterranean diet

One of the more consistent pieces of advice in WDDTY is to follow a “mediterranean dietW”; it’s recommended over 30 times. Wikipedia describes this as “a modern nutritional recommendation inspired by the traditional dietary patterns of Greece, Spain and Southern Italy” – in other words an idealised caricature of the actual Mediterranean diet, which varies around the region.

Mediterranean Diet
While there were similarities between the countries, there are also important differences in the food habits of the Mediterranean countries. Neighbouring countries’ food habits are closer than those on opposite sides of the Mediterranean Sea…. There is no single ideal Mediterranean diet.

Noah A. and Truswell A. S. (2001), Asia Pacific Journal of Clinical Nutrition, 10:2-9.

There is no single diet that could be called Mediterranean, and there are more similarities between the diets of non-Mediterranean countries bordering Mediterranean countries than between the diets of countries on opposite sides of the Mediterranean, and at least one author concludes that:

[I]t appears that currently there is insufficient material to give a proper definition of what the Mediterranean diet is or was in terms of well-defined chemical compounds or even in terms of foods…. The all-embracing term ‘Mediterranean diet’ should not be used in scientific literature….”

A. Ferro-Luzzi, “The Mediterranean Diet: an attempt to define its present and past composition”, European Journal of Clinical Nutrition 43:13-29 (1989)

Needless to say, WDDTY is not scientific literature, and neither are the books, websites and journals beloved of “nutritionists”. These seem to broadly agree that a Mediterranean diet consists of:

  • Fruit, especially tomatoes
  • Vegetables
  • Bread
  • Olive oil as the principal source of fat
  • Dairy products
  • Fish and poultry
  • Eggs
  • Some red meat
  • Some wine

Fat forms 25%-35% of the calorific value, with saturated fats below 8%.

A jaunty nautical type demonstrates the Mediterranean diet WDDTY style, with all toxic elements removed, but falls at the last hurdle because it's canned.
A jaunty nautical type demonstrates the Mediterranean diet WDDTY style, with all toxic elements removed, but falls at the last hurdle because it’s canned.

However, WDDTY has a problem with some of these.

  • It recommends against tomatoes (they are “nightshades”, or solanacaeW), a dozen or so separate mentions of this stricture going right back to the early days and continuing in recent issues.
  • It recommends against wheat, and columnists routinely finger wheat as the first thing to cut out of your diet, well over a hundred times; WDDTY goes way beyond the real incidence of wheat intolerance.
  • It identifies dairy as “cancer food”.
  • It recommends saturated fats, even going so far as to advise “don’t limit saturated fats”.
  • It recommends caution when eating fish, because mercury.
  • Eggs are correctly identified as a common source of food intolerance (one of the three of WDDTY’s “big 7” food allergens that actually appears in the top 8 as defined by the reality-based medical community).
  • It recommends against red meat.

So if you try to follow all of WDDTY’s advice simultaneously, you’ll be left eating mainly spinach.

 

WDDTY on the HCG diet

Even WDDTY is not always wrong. But its coverage of human chorionic gonadotropinW as a “miracle” diet has a minor issue: doctors don’t tell you that HCG is a miracle diet aid. Well, most doctors don’t – a few quacks do and only doctors can legally prescribe this off-label use of HCG. However, the mainstream view is, and has been for half a century, that the HCG diet is a scam, to the point that the FDA warns against it, the entirely mainstream Mayo Clinic debunks it, even the evil big pharma shills at Science Based Medicine have debunked it. A 1995 meta-analysis noted:

Pharmacists and physicians should be alert on the use of HCG for Simeons therapy. The results of this meta-analysis support a firm standpoint against this improper indication. Restraints on physicians practicing this therapy can be based on our findings.

So, what do WDDTY say doctors don’t tell us about the HCG diet?

A controversial diet that was first popularized in the 1950s has seen a surge in public interest in recent years. The HCG diet, which combines hormone injections with a low-calorie diet, has made a huge comeback in the US, and there are now hundreds of websites dedicated to promoting its effectiveness.

However, despite all of its spectacular claims, there’s little proof that the diet actually works. Worse, it may even be seriously bad for your health.

The HCG diet: Don’t fall for the hype

The full story is pretty much exactly how a story on a quack treatment should be. It misses only one thing that I would have included: detail about the homeopathic HCG diet which, while it is discussed, fails to mention that (a) it is illegal to sell homeopathic HCG in the UK or the USA and (b) according to the (admittedly bogus) principles of homeopathy: if HCG promoted weight loss, then homeopathic HCG could be expected to promote weight gain (as part of a calorie-controlled diet, presumably, to use the old-fashioned diet product weasel words).

But this misses the point:

Why don’t doctors tell you that human chorionic gonadotropin is not effective in promoting weight loss and the Simeons protocol is dangerous?

They do.