Tag Archives: Nutritionists

July 2015 in review: Part 4

So far we’ve reviewed the cover stories, pages 1-10, pages 11-21 and pages 22-39.  We’re nearly at the staple, without a hint of any remotely credible advice that doctors don’t give you. Lots of adverts, though.

Page 40  is the start of an article titled “sweet not-so-nothings”. (it runs on pp. 41, 43, 44, 47, and a listicle on page 49 (the intervening pages being advertisements), and  which advances this idea:

Artificial sweeteners may have zero calories, but they cause weight gain by boosting blood sugar and crippling the system that regulates it.

Aside from the missing word “may” (as in they may cause weight gain and it may be by this mechanism), this is all consistent with current science.

The inherent problem with artificial sweeteners is that they are promoted as a magic bullet to achieve weight loss without changing your behaviour. Any long-term reader of these pages will know that miracle cures, never are.

And the essential problem with the WDDTY article is that it uses studies such as Fueling the Obesity Epidemic? Artificially Sweetened Beverage Use and Long-term Weight Gain to assert a proven causal link. Continue reading July 2015 in review: Part 4

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.

Kefir

The February 2014 issue is really one long advertorial for kefir. It’s dairy, Jim, bit not as we know it: while dairy is denounced as “cancer food“, this is, apparently, completely different. Because probiotic.

This is how to make kefir:

Basic kefir
You can use the method below to make any amount of kefir you desire; just keep in mind that a good rule of thumb is to use 1 Tbsp of kefir grains per cup of milk. So if you want to make 1 cup of kefir, use 1 Tbsp of kefir grains and 1 cup of milk. For 2 cups of kefir, use 2 Tbsp of kefir grains and 2 cups of milk, and so on.
Step 1: Place the kefir grains in a glass jar that can be securely sealed. I like canning jars with plastic lids, but you can use any jar that closes securely.
Step 2: Using the 1 Tbsp to 1 cup ratio of kefir grains to milk, add the appropriate amount of milk to the jar.
Step 3: Securely seal the jar, and leave it on your kitchen counter away from direct sunlight or in a cabinet at room temperature for 24 hours.
Step 4: After 24 hours, remove the kefir grains using a slotted spoon or mesh strainer. (The strainer can be stainless steel or plastic.) Add the kefir grains to fresh milk to begin another fermentation or for storage.
Step 5: Transfer the strained kefir to your refrigerator. At this point, it is ready to use. You can keep kefir in your fridge in a sealed container for up to one year. But remember, the longer it’s in the fridge, the more sour it will become because the bacteria eat the lactose in milk.

Eurgh. On to the claims.

Let’s look at one small section:

1 Stimulates the immune system. Peptides formed during fermentation or digestion appear to do the job, at least in animal studies.

Reference 1: J Dairy Sci, 2002; 85: 2733–42; Matar C et al. ‘Biologically active peptides released in fermented milk: role and functions’, in Farnworth ER, ed. Handbook of Fermented Functional Foods. Boca Raton, FL: CRC Press, 2003: 177–201

Interestingly, WDDTY appear to be starting to give some full citations, making it much easier to verify whether they have correctly represented the sources. In this case we have a legitimate source, an early study (therefore likely false), but fact-washed via a book by a nutritionist. The claims of nutritionists are, of course, always questionable, and the original source is available; it’s not clear why this indirect sourcing has been done, unless Lynne McTaggart has been reading a book proselytising kefir and is simply regurgitating the nonsense in WDDTY (which on the evidence does seem very likely).

In the last dozen years, why has this finding not been confirmed?

2 Stops tumour growth. Although most dairy products have been implicated in the promotion of prostate and other cancers, a polysaccharide isolated from kefir grains, whether in cow or soy milk, appears to inhibit a variety of tumours, including lung cancer cells and melanoma—again in animal studies.

Reference 2a: Jpn J Med Sci Biol, 1983; 36: 49–53; 

The original paper is hard to trace, no doubt because it is not in translation. It is a 30-year-old animal study. Your starter for ten and no conferring: what is the term for thirty-year-old findings of anti-cancer activity not confirmed in later work in mainstream journals specialising in cancer research? Yes: Likely false.

Reference 2b: Immunopharmacology, 1986; 12: 29–35; Immunopotentiative effect of polysaccharide from Kefir grain, KGF-C, administered orally in mice Mitsugu Murofushi, Junichiro Mizuguchi, Kageaki Aibara, Tyoku Matuhasi.

Reference 2c: J Agric Sci Tokyo Nogyo Daigaku, 2000; 45: 62–70

This source is not PubMed indexed, nor would I expect it to be – medical articles are not commonly published in journals of agricultural science.

All three of these seem to be drawn second hand from Farnworth, as with the first reference. There is a dearth of confirming evidence.

3 Allows better digestion and tolerance of lactose in the lactose-intolerant. Gassiness and digestion has been improved in both animals and humans given kefir.

Reference 3: J Am Diet Assoc, 2003; 103: 582–7  Kefir improves lactose digestion and tolerance in adults with lactose maldigestion. Hertzler SR, Clancy SM.

Why would this matter? According to WDDTY, dairy (other than kefir) is “cancer food”.

4 Improves digestion generally. Studies in animals show that regularly consuming kefir helps bacteria in the bowel grow significantly.

Reference 4: Lett Appl Microbiol, 2002; 35: 136–40 Dietary influence of kefir on microbial activities in the mouse bowel. Marquina D, Santos A, Corpas I, Muñoz J, Zazo J, Peinado JM

This would not be a surprise (it applies to all probiotics, after all), but why another ancient animal study from a dozen years back?

5 Provides a natural antibiotic. Kefir has been shown to inhibit E. coli and Streptoccocus bacteria.

Reference 5a: J Food Prot, 2000; 63: 364–9; Inhibitory power of kefir: the role of organic acids. Garrote GL, Abraham AG, De Antoni GL.

Reference 5b: Lebensm Wiss Technol, 2004; 37: 663–7; Determination of some characteristics coccoid forms of lactic acid bacteria isolated from Turkish kefirs with natural probiotic. Yüksekdag Z.N., Beyatli Y., Aslim B.

Reference 5c: Indian Vet J, 01/2004; 81: 687–90; 

Again we have studies in vitro and in animals – and from some time back. Why? There is credible evidence that kefir grown on milk infected with e.coli may induce resistance to e.coli, and there are credible reasons why this might be, but there’s no indication that this is inherent to all kefir, only to that grown in an infected medium.

6 May help reduce cholesterol. Small studies show that blood triglycerides are lower and good high-density lipoprotein (HDL) cholesterol slightly increased in those consuming kefir compared with milk
for four weeks.

Reference 6: BMC Complement Altern Med, 2002; 2: 1 Kefir consumption does not alter plasma lipid levels or cholesterol fractional synthesis rates relative to milk in hyperlipidemic men: a randomized controlled trial [ISRCTN10820810]. St-Onge MP, Farnworth ER, Savard T, Chabot D, Mafu A, Jones PJ.

This has Farnworth as co-author, and it’s in a quackademic journal, so might be expected, from context, to be positive.

Nope.

RESULTS:

Kefir had no effect on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol or triglyceride concentrations nor on cholesterol fractional synthesis rates after 4 wk of supplementation. No significant change on plasma fatty acid levels was observed with diet. However, both kefir and milk increased (p < 0.05) fecal isobutyric, isovaleric and propionic acids as well as the total amount of fecal short chain fatty acids. Kefir supplementation resulted in increased fecal bacterial content in the majority of the subjects.

CONCLUSIONS:

Since kefir consumption did not result in lowered plasma lipid concentrations, the results of this study do not support consumption of kefir as a cholesterol-lowering agent. [emphasis added]

Cherry picking secondary outcome measures and ignoring the disconfirmation of primary measures is scientific misconduct. Just as well McTaggart is not a scientist and WDDTY is not a science journal. You have to hand it to WDDTY, though – to cite a source in order to support a statement that is flatly contradicted by the results and conclusions of that source, takes balls.

But then, WDDTY is nothing if not a load of balls.

 

100 ways to live to 100: Your best supplements

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

Your best supplements

Supplements are the “gateway drug” of the SCAM industry. They skirt the boundaries of legitimacy, alluding to incredible claims that are never explicitly made in the adverts – relying instead on extraordinary testimonials and sciencey-sounding bullshit in alternative magazines like WDDTY. Most of the WDDTY editorial panel appear to profit from selling supplements, and this is also a profitable sideline for homeopaths, chiropractors and other quacks.

Unless you live on a farm, grow all your own organic vegetables and have access to free-range meat, it’s almost certain you have vitamin deficiencies even on the best of diets. Ideally, get yourself tested by a knowledgeable nutritionist to determine which nutrients you need or aren’t getting from your food, and customize your supplement programme accordingly.

This is a blatant sales pitch. There is no good evidence that organic produce is significantly more nutritious than equivalent intensively farmed produce, there is a robust consensus that most people with a healthy balanced diet do not need supplements, and SCAM propagandists are in total denial regarding the rather obvious fact that routine supplementation is medication by any definition, and many of the largest supplement manufacturers are also pharmaceutical companies.

Whatever your political slant, you’ll find an ideologically consonant source telling you that supplements are a waste of money. Daily Mirror, Guardian, Telegraph,  Huffington Post, even the Daily Mail. The claim that the human body has evolved such that even the highly nutritious and enriched modern diet is routinely deficient in large numbers of essential nutrients is implausible, and the promotion of this idea is evidence of the propaganda machine that underpins the immensely profitable supplement industry.

And if your diet is deficient in essential nutrients, wouldn’t the prudent thing be to fix your diet?

The very last person you should consult is a “nutritionist”. Has the public learned nothing from Gillian McKeithW, the noted celebrity copromnancer and holder, like Ben GoldacreW’s cat, of a worthless fake “doctorate” form a worthless fake “health college”? Nutritionists are unregulated, may be untrained or (worse) trained in batshit crazy doctrines with no basis in reality, and their main source of income may well be selling the very supplements they recommend.

21 Choose a good quality multivitamin/mineral supplement

Choose a supplement from a reputable brand. If you can’t find one to your liking, take the nutrients individually.

What constitutes a reputable brand? NBTY, formerly Nature’s Bounty, is a $3bn corporate conglomerate; it owns Holland & Barrett and is owned in turn by the Carlyle GroupW. Centrum is owned by Pfizer. Seven Seas is owned by Merck.

22 Make sure you’re getting enough vitamin D

About a third of the general population is vitamin D-deficient. The vitamin offers natural protection against most cancers and heart disease, and can also boost immunity and vascular function. People who regularly supplement with vitamin D increase their longevity by 7 per cent. The body naturally produces it when exposed to sunlight—just 5 to 15 minutes of sunshine a day between 10am and 3pm, without sunscreen, is about enough to do the job.20 Otherwise, supplement with 600–1,000 IU vitamin D/day (400–1,000 IU/ day for those aged 18 and under).

Reference 20: Am J Clin Nutr, 2004; 80: 1678S–88S  Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Holick MF.

Vitamin D is the new vitamin C. The same inflated claims, the same mega dosage recommendations from the same industry lobby groups (e.g. the “Vitamin D council”).

The evidence that adequate vitamin D is important, is pretty solid. The evidence that most people are deficient, not so much. For example, it has been found that the apparent deficiency of vitamin D in African-Americans is an artifact of an evolutionary adaptation; the amount of bioavailable vitamin D is much higher than blood tests suggested.

It is likely that modest supplementation would benefit older people, especially postmenopausal women, though there are potential disbenefits and  some of the claims are shown to be false.

More research is needed. The supplement industry instead spends more money on marketing.

23 Make antioxidants the mainstay of your supplement programme

To minimize damage from free radicals, the toxic byproducts of your body’s metabolism, take adequate daily levels of vitamin A (up to 25,000 IU as beta-carotene or 10,000 IU as retinol), 1–3 g of vitamin E (tocotrienols, up to 600 IU), zinc (10–50 mg), selenium (200 mcg) and vitamin C (1–3 g). And take a good B-complex supplement containing at least 50 mg of thiamine and riboflavin, and 50 mcg of B12.

It’s astonishing that the human race has evolved a metabolism that s incapable of surviving without industrially refined supplements, especially since the availability of these supplements only goes back two or three generations.

Before necking bottles of beta-CaroteneW, it’s as well to be aware that it may increase the risk of prostate cancer, intracerebral hemorrhage, and cardiovascular and total mortality in people who smoke cigarettes or have a history of high-level exposure to asbestos (source).

Once again, a normal healthy balanced diet should contain all the nutrients you need unless you are assessed as deficient by a competent medical professional (i.e. not a nutritionist).

24 Don’t forget magnesium (200–400 g/day) and chromium (100 mcg/day)

According to a large-scale study by the renowned British lab testing service Biolab (see #15), people become deficient in both minerals as they age, and both are necessary for heart health. Magnesium is also essential for bone health and more absorbable than calcium supplements.

Biolab is mainly “renowned” as a lab which offers dodgy diagnostics alongside proper ones and refers people to half the editorial board of WDDTY for treatment of the non-existent conditions they thus diagnose.

NHS Choices seems to think that magnesium and chromium are both widely present in the diet, with no supplementation necessary. The difference may be explained by the fact that NHS Choices is not selling diagnostic tests to allow its referred physicians to profit by selling you the supplement. But that would be conspiracist thinking, and we should probably leave that to WDDTY.

25 Take good-guy bacteria

Invest in a quality probiotic, which includes lactobacilli, bifidobacteria, Saccharomyces boulardii and non-disease causing strains of Escherichia coli and streptococci.

I think you’ll find it’s a bit more complicated than that.

Probiotics have been tested on a long list of diseases and conditions, and it appears that a scientific consensus is approaching for the use of certain probiotics for lactose intolerance and rotavirus diarrhea. Claims related to these benefits may be the first to be accepted in many jurisdictions. Before other claims are approved, manufacturers will have to invest considerable time and money to obtain data to show the efficacy and safety of their probiotic product. The data and documentation required to obtain a label health claim will be different in different jurisdictions because of differences in legislation. These discrepancies will add to the challenges faced by probiotics producers and consumers. – J. Nutr. June 2008 vol. 138 no. 6 1250S-1254S The Evidence to Support Health Claims for Probiotics

That’s probably why the Mayo Clinic says that “You don’t necessarily need probiotics — a type of “good” bacteria — to be healthy”.

The probiotic industry is also huge. Major manufacturers are Danone (a multi-billion-Euro French multinational) and the Japanese Yakult corporation. Yakult submitted a request for marketing authorisation, the result of which was:

The Panel concludes that a cause and effect relationship has not been established between the consumption of Lactobacillus casei strain Shirota and maintenance of the upper respiratory tract defence against pathogens by maintaining immune defences.

Still, at least Yakult is actually paying for some research, albeit that it has precisely the same sources of bias as any other industry funded research, and still doesn’t support the claims they want to make.

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).

When science is a dirty word

An anti-science commentary by Lynne McTaggart makes some bold and controversial claims about science. Do they stand up to scrutiny?

One of the most misused terms being hurled at us as a rebuttal to What Doctors Don’t Tell You is the term ‘science’.

One of the terms most misused by WDDTY is science.

The main contribution of science to medicine has been objectivity: the ability to minimise the well-known cognitive biases that affect all human observations, to turn the practice of medicine from an essentially religious field to an essentially scientific one.

WDDTY prefer to view mainstream science as a sinister activity pursued by a technocrat minority, an elite that is simultaneously brilliantly manipulative and ideologically hide-bound, lacking in vision, intelligence and the ability to grasp the unfamiliar.

Like proponents of every religion whose precepts are at odds with objective science, they seek ways to portray science as lacking objectivity.

In reality most people now have at least the rudiments of a scientific education and scientific methods of inquiry are a part of everyday life. The room is dark: how do you work out if it is the fuse, the switch or the lamp? The tests are essentially scientific. You do not use intuition, you isolate the components one by one, look for common points of failure (one lamp on,another not, probably the lamp) and thus arrive at the correct answer.

WDDTY’s approach to the darkened room is to basically to advocate a return to candles. And oil lamps. And remote viewingW. Anything other than electricity, because what do scientists know about visual perception?

We have been accused of being unscientific, of pedaling (sic) unproven and harmful alternatives, as opposed to the real thing, true ‘scientific’ medicine.

The evidence supports the accusation that you peddle unproven and harmful alternatives, also that you distort and misrepresent the science you do quote.

That is not to say that evidence-based medicine is perfect, only that the solution to its imperfection is not to jettison all attempts at objectivity in favour of a credulous acceptance of any claim based primarily on its ideological appeal.

Science is pursued by humans, humans are fallible. The scientific method is, fallible humans or not, the most reliable means ever devised to tell truth from fiction. Without it, you would be printing WDDTY with wooden blocks on coarse paper and distributing it at street corners. The process that delivered the knowledge that makes computers and the internet work is fundamentally indistinguishable from the process of medical science delivering knowledge to be used (or abused) by medicine.

There are three points to be made here, adding up to one indisputable truth: there is nothing remotely scientific about conventional medicine.

That statement is neither true nor indisputable.

1.Most of the science behind standard treatments is fiction. As leading members of the medical establishment have made clear in recent books, the so-called ‘proof’ of most so-called ‘proven remedies’ is data that has been invented or manipulated by drug company marketing teams.

Some of it is, some of it isn’t. Cochrane reviews are usually pretty objective, and they are the highest tier of evidence. There’s good reason to suspect systematic manipulation of scientific results by any party with a vested interest in the outcome of the trial – this is a big problem for medicine and a huge problem for alternative medicine, where virtually nobody other than True Believers does any research at all.

But the issue of manipulation of studies is not the us-and-them situation that Lynne presents here. In the case of homeopathy, for example, proponents routinely bring up known issues with individual treatments but miss the point that the entire field of homeopathy is based on refuted doctrines, lacks a coherent framework, is inconsistent with robustly established scientific principles and so on. All clinical trials are prone to bias, therefore they are necessarily less compelling when the treatment is completely implausible.

There is no informed dissent from the view that measurable quantities of pharmacologically active compounds can have an objective effect on the body; there is no credible evidence that giving unmeasurable amounts of substances whose connection to disease is arbitrary and based on a refuted doctrine, can cause any effect other than placebo.

The therapeutic systems of Hoxsey, Gerson and their ilk are not “whole medical systems” existing in a parallel bubble universe apart from science, like homeopathy, acupuncture, chiropractic and the like, but they are still entire classes of unproven therapy, rather than unproven members of a proven class.

This is an important distinction, because the issues with individual medicines are often exposed by diligent scientific comparison of effect between treatments.

2.Most treatments haven’t been proven to work. The British Medical Journal has concluded that only about 12 per cent of all medical treatments have adequate evidence demonstrating that they work.

This is a zombie statistic. The BMJ article did not say that at all, and indeed specifically counsels against interpreting the figures as Lynne interprets them.

What the source says is that of the treatments currently on the books, 11% are well established to be beneficial, 24% are likely to be beneficial, 7% have a trade-off between benefit and harm, 5% are unlikely to be beneficial, 3% are likely to be ineffective or harmful, and 50% have unknown effectiveness, established from RCTs. These will include older treatments, those for which an RCT would be unethical.

This is not a reflection of the evidence base for individual prescribing decisions. Further:

‘Unknown effectiveness’ is perhaps a hard categorisation to explain. Included within it are many treatments that come under the description of complementary medicine (e.g., acupuncture for low back pain and echinacea for the common cold), but also many psychological, surgical, and medical interventions, such as CBT for depression in children, thermal balloon ablation for fibroids, and corticosteroids for wheezing in infants.

‘Unknown effectiveness’ may also simply reflect difficulties in conducting RCTs of an intervention, or be applied to treatments for which the evidence base is still evolving. As such, these data reflect how treatments stand up in the light of evidence-based medicine, and are not an audit of the extent to which treatments are used in practice.

We make use of what is ‘unknown’ in Clinical Evidence by feeding back to the UK NHS Health Technology Assessment Programme (HTA) with a view to helping inform the commissioning of primary research. Every 6 months we assess CE interventions categorised as Unknown effectiveness and submit those fitting the appropriate criteria to the HTA via their website: http://www.nets.nihr.ac.uk/programmes/hta.

So it turns out that the large number of “unproven” interventions include most SCAM interventions (the balance are unlikely to be beneficial or are known to be harmful; this is Minchin’s Law in action).

How would you conduct an RCT for emergency surgery for ruptured aortic aneurysm?

3.Most treatments cause harm. Modern medicine is the third leading cause of death in the western world. Fact. Prescribed drugs and medical error kills 204,000 people every year in America alone, with only cancer and heart disease claiming more

This claim has already been debunked. It is based on taking an invented figure, taking a second invented figure which would be part of the same figure, adding the two together and arising at a figure that is wronger than wrongW.

In fact, medical misadventure does not figure anywhere close to the top ten causes of death in the USA, and the real figure is nearly two orders of magnitude smaller according tot he very source McTaggart claims to have used for this figure.

Your greatest risks

According to data assembled by the Alliance for Natural Health, which examined the statistics of all the most and least likely things that could kill you, the greatest risk of death any of us face is going to the hospital. If you add the risk of reactions to correctly prescribed drugs, any interaction with modern medicine has to be the greatest risk to your life and limb.

Amazing. A SCAM trade body comes up with a figure that shows you should use SCAM instead of going to the hospital. Who predicted that? Presumably they remembered to exclude people rushed to hospital with acute surgical emergencies, as Gary Null… didn’t?

Feel free to come back with a reliable source.

Let’s look at so-called ‘unscientific’ natural health care, which supposedly causes so much harm. The risk of dying from taking any herbal remedy or food supplement is around 0.01 per one million people. In other words, 100 million people would have to take a supplement or herb before there is a risk of one person dying because of it.

Presumably according to the same source? Not that they have a dog in the fight or anything?

A repeatable feature of WDDTY is accepting the most optimistic claims of the SCAM industry and the SCAM industries worst (and often entirely false) claims about medicine, entirely uncritically.

Why would a manufacturer of supplements be any less likely to misrepresent the science than a manufacturer of a drug?

Why would a university biochemist working on disease biochemistry be any more likely to misrepresent a claim than a SCAM believer looking for proof of his pet theory?

This is never explained.

Compare that to the risk of pharmaceutical drugs, which kill 1000 people for every million people taking them.

According to?….

Leaving aside the tautology, yes, drugs can have adverse effects. So can supplements. There’s a list of recalls. Ayurvedic herbs with heavy metal contaminants, aristolchic acid, OxyElite Pro. And what about the harms due to untreated or incorrectly diagnosed disease?

The biggest difference between medicine and SCAM in this regard is that medicine acknowledges the potential for harm and has proactive and reactive monitoring in place. The reaction of SCAM to problems is best characterised as denial.

So that risk is: 0.01/1 million for natural substances vs 1000/1 million for drugs. In other words, the risk of lethal harm from modern medicine is 100,000 higher than that of herbal or nutritional medicine.

Source? Risk v benefit figures? The risk in a homeopathic remedy is close to zero (it will almost certainly be inert). The benefit is also zero. There is an attendant risk due to failure to treat disease. A homeopath weighs this equation, adds belief in the unverifiable on the positive side of the scale, and asserts that homeopathy is superior to medicine. That is not a rational, consistent or appropriate view.

This beggars the basic question: which form of medicine is the least scientific?

Lynne appears not to understand the language of formal logic, understandable since the entirety of SCAM is founded on logical fallacies. It does not even beg the question. It invites it, but the answer will not be found by listening to a biased argument based on several provably incorrect numbers.

Biochemical individuals

There’s a good reason why medicine is not a science. Drugs constitute a one-size-fits-all model, whereas every human being is unique. Drugs that work on me may not work on you and vice versa; most drugs can’t be made smart enough to, say, slot only tab A into slot B without affecting slot C, D and E, because humans are holistic.

This is complete nonsense. Most diseases have more than one treatment, different treatments are used depending on patient history and other factors. Some drugs are incredibly individual: they are based on genetic profiling.

The idea that SCAM is “holistic” because the practitioner listens to you for an hour before giving you the ideologically driven “prescription” for magic sugar pills, acupuncture, alkaline diet, dairy and wheat exclusion or whatever, is simply fatuous.

Medicine is holistic. It embraces everything from physiotherapy and diet to the latest cutting edge microsurgery or genetic therapies. You don’t become more holistic by abandoning the majority of medicine and substituting evidentially questionable practices.

Biochemical individuality creates mayhem with drug trials, which are designed to look for common results in everyone—one reason their results are so often manipulated, massaged or even made up. As the new medical explorers are discovering, the systems of the body interact as a complex, dynamic and highly individualistic whole.

The decline effect is well-known, it is an inevitable result of moving from idealised trial populations to non-idealised real populations. However, the differences between individuals are as nothing compared with the similarities.

Any two randomly selected humans will share between 99.6% and 99.9% of their genome. We share the majority of biochemical pathways (absent genetic defects), a doctor trained in surgery on Africans will have no difficulty with Europeans and vice versa.

There are differences, but not in the way that “holistic” practitioners pretend when listening to the worried well for an extended period before selling them the same witches’ brew of supplements or herbs that they sold the last person.

No humans are known to have yin and yang. The flow of qi is not evidentially established as different between individuals.. Tests for these things give the same result for everyone – namely that they don’t exist.

Basing your diagnosis and prescribing practice on provably false premises such as homeopathic similimum, subluxation complex, damp kidney or whatever, merely makes it unlikely that you will be right, other than by accident.

It’s important here to make a distinction between science—the open-minded pursuit of truth without fear or favour—and scientism, a solidified set of beliefs around which academics, industries and professions are framed.

It is indeed. Science is the process that has skepticism at its heart, scientism is a term primarily used by believers in creationism and other empirically unverifiable ideas, to attack those who accept the scientific consensus, and try to pretend that ideology is equivalent to following the evidence wherever it leads.

Science is the process that found helicobacter pylori to be the cause of ulcers, rather than stress as had been previously supposed.

Scientism would be the insistence that only the empirically proven causes of disease should be accepted, and that no credence should be given to the possibility that they are caused by miasms, qi, subluxations or whatever. This is perfectly reasonable in the absence of credible evidence that these concepts exist.

Pseudoscience, pathological science and cargo cult science are various flavours of activities giving the outward appearance of science but pursued in a way that excludes any conclusion that conflicts with the ideology of the inquirer. Homeopathic experiments are a perfect example. This is in contrast with the open-minded testing of alternative ideas by medical science, even though those tests rarely produce anything other than an equivocal or negative result. The US National Center for Complementary and Alternative Medicine (NCCAM) and its predecessor have spent well over a billion dollars testing alternative therapies. They have yet to validate a single one, but it’s not for want of trying.

The resistance we’ve experienced has more to do with the latter. This seems clear from the way the scientism of medicine greets any discovery, breakthrough or possibility that questions or threatens the current medical paradigm—by dismissing such ideas out of hand as ‘quackery’, even when they are the work of eminent scientists at prestigious institutions such as Oxford, Harvard and Cambridge.

It is certainly more appealing to believe that opposition is due to an ideological bias against you, rather than the fact that you are wrong, but the facts are against you.

The advice WDDTY gives is either wrong, misleading or (conversely) perfectly normal advice that your doctor would give you. The problem is that you seem unable to distinguish the three.

True science is heresy

We tend to regard science as presenting some sort of static truth, but science is an ever evolving story, told in instalments. New chapters refine—and usually supplant—chapters that have come before.

Someone has been reading Kuhn, the crank’s favourite author.

This view is superficially true but actually wrong. For example, relativity technically supersedes Newtonian mechanics, but Newtonian mechanics is till used for the vast majority of calculations because it the results of the two systems approximate extremely closely other than under extreme conditions.

Schroedinger wave equations technically supplant the classical Bohr electron model, but the Bohr model is still close enough for many calculations and the difference only becomes significant at extremely small scales.

Every last advancement in science and healthcare begins as heresy, each important new discovery negating the prevailing views of the day.

This is simplistic to the point of being wrong. Improvements in medical treatments may be incremental or revolutionary.

What s being asserted is essentially the Galileo gambit. In truth, Galileo was following the scientific method and his opponents were the dogmatists, and the thing that SCAM proponents always forget about Galileo is that he was also right. Now, SCAM proponents always think that they are right, but there are so many “lone geniuses”, “brave maverick doctors” and so on, with so many often mutually exclusive ideas, that it is inconceivable that more than a tiny handful are right – whereas SCAM proponents tend to believe most of them, the process known as”crank magnetism”.

This idea that SCAM has the best, the brightest, the visionaries, and medical science the ideologically blinded plodders, requires that not only the process of medical science, but also the entire system of education is wrong, since the process that supposedly delivers those with the highest academic achievement is, according to this view, instead delivering venal dullards.

A Sagan quote reveals the more likely explanation:

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

The most telling thing is that science is full of examples of self-correction, wrong ideas being discarded. We have yet tot race a single example of a SCAM treatment that has been discarded after being found to be false by scientific inquiry.

What if stones fall from the sky? What if there is no end of the earth to sail off? True science always begins by asking outrageous questions or pursuing unpopular notions, even if the answer threatens to overturn every last one of our cherished beliefs.

The idea that stones fall has never been controversial. Empirical scientist Robert Hooke suggested that it worked by an inverse square law. Newton quantified it. This may appear revolutionary, but it was evolutionary, with moments of very rapid progress.

The idea that earth is flat was based on the existence of the horizon. It doesn’t take much sailing before you work out it’s wrong.

I struggle to think of any scientific discovery in the last couple of centuries that renders the entirety of the previous theory and practice redundant. As soon as people started measuring and recording, results converged on what was true and theories had to fit observed facts (the Baconian school). The Cartesian school allowed for theory to run ahead of evidence, but the theory had to be discarded if the predictions it made did not hold up.

Even geocentric cosmology, which persisted for longer than it should, did so primarily due to religious belief.

True science seeks to drive a stake into science, particularly scientism.

No it doesn’t. True science seeks to explain the observed facts as accurately and completely as possible, The best example is probably evolutionary theory, a complex set of interlocking ideas founded on the fossil record, observations, DNA analysis and even planetary geology.

Consilience is the term used for multiple lines of inquiry leading to the same conclusions. Most medical science is consilient. Physiology, biochemistry, anatomy, chemistry – all offer different views of the same facts.

And then the Brave Maverick Doctor asserts some other set of facts that is inconsistent, and lacks a complete or consistent framework. Occasionally the brave maverick is right: Marshall and Warren took several attempts to persuade, but they admit this was because they had left important questions unanswered (notably: how bacteria could live in the acid environment of the stomach).

SCAM proponents brush these inconvenient details under the carpet and accuse those who ask about them of “scientism”.

Nevertheless, mainstream science, particularly mainstream medicine, has grown ever more fundamentalist, dominated by a few highly vocal people who believe that our scientific story has largely been written and that the job of science is simply to confirm it.

That is one opinion, just not supported by facts. Feel free to cite prominent authorities in medical science who think our understanding is anywhere near complete.

Thankfully, an enormous body of resistance carries on in defiance of this restricted—highly unscientific—view. May they and all the true scientists like them continue to light our way.

Whatever helps you manage the cognitive dissonanceW, I suppose. Doesn’t make it any more correct, though. I close with three quotes that illustrate how real science actually works:

The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That’s funny…” – Isaac Asimov

In science it often happens that scientists say, ‘You know that’s a really good argument; my position is mistaken,’ and then they would actually change their minds and you never hear that old view from them again. They really do it. It doesn’t happen as often as it should, because scientists are human and change is sometimes painful. But it happens every day. I cannot recall the last time something like that happened in politics or religion. – Carl Sagan

The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts – Bertrand Russell

As to which party in this dispute shows the attributes of religion, of fools and charlatans, of the “Eureka!” moment versus the patient inquiry of “that’s funny….”, we leave that  as an exercise for the reader.

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.

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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Treating ear infections naturally

Treating ear infections naturally
Treating ear infections naturally is an article from the November 2013 issue of WDDTY.

It offers a number of folk remedies for ear infections of varying advisability, misrepresents the only source cited, sows fear, uncertainty and doubt against antibiotics and includes nonsensical concepts drawn from pre-scientific superstitious medical systems. The author recommends allowing the eardrum to rupture rather than taking antibiotics.

Otitis mediaW is a very common childhood ailment. 80% of cases resolve spontaneously. Complications can include perforated eardrum, acute pain and occasionally permanent hearing loss. The advice in this article is a little worse than useless.

Continue reading Treating ear infections naturally