Tag Archives: Skin cancer

July 2015: the firehose of stupid at full blast

Your challenge: guess how much of this is valid information that doctors don't tell you.
Your challenge: guess how much of this is valid information that doctors don’t tell you.

The July 2015 issue of WDDTY is out.  You can tell from the cover that it’s going to be a cracker. HPV vaccine: new dangers revealed! Why low-cal sweeteners make you fat! Recipe for better breast health! How I beat Lyme disease! Staying sun-safe naturally! And the headline: 10 minutes to stronger bones.

Based on these I predict: an anti-vax diatribe based on misleading presentation of data with no balancing reference to the benefits of preventing cervical cancer; anti-aspartame conspiracist whacknuttery; pimping some refuted nonsense about breast cancer; favourite quack fake disease “chronic Lyme” cured by some quack nostrum; anti sunscreen bollocks; and something doctors already told you.

Let’s see how I do. Continue reading July 2015: the firehose of stupid at full blast

100 ways to live to 100: Your healthy lifestyle

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

Your healthy lifestyle

Oh good, lifestyle advice. We all love to be told what to do, if only so that we can feel appropriately virtuous when it’s what we would do anyway.

91 Don’t shield yourself from the sun’s rays

The sun is our best source of vital vitamin D, which to protect against numerous diseases and conditions. Most of us in the northern climes are vitamin D-deficient. Opt instead for sensible sun exposure by supplementing with antioxidants like selenium, lycopene, beta-carotene, and vitamins C and E, which offer natural sun protection without the need for potentially harmful chemical sunscreens.

One of the most baffling things about WDDTY is that they tell you things like WiFi cause cancer (which they don’t) then promote not only exposure to the sun (which irrefutably does cause cancer), but unprotected exposure, asserting (falsely) that sunscreens cause cancer.

In fact, that the Skin Cancer Foundation’s Francisca Fusco MD tells you exactly why doctors don’t tell you that sun exposure is the best way to get vitamin D or that sunscreen causes cancer: it’s utter bollocks. Dangerous bollocks at that.

92 Get at least seven hours of sleep

This amount of sleep may “significantly” reduce your risk of cancer, says recent research.60 Lack of sleep alters insulin levels, contributing to overweight and even diabetes. Seven hours seems about right while nine is too much; women sleeping more than this have the highest risk of stroke.

Reference 60: Cancer. 2011 Feb 15;117(4):841-7. Short duration of sleep increases risk of colorectal adenoma. Thompson CL, Larkin EK, Patel S, Berger NA, Redline S, Li L.

All together now: Correlation is not causation. How do you know that those who sleep less are not rampant caffeine addicts? How do you know they’re not heavy drinkers? Alcohol intoxication seriously impacts quality of sleep, after all.

The answer is, you don’t, and you certainly don’t from a study whose 95% CI is 1.05-2.06, meaning that either it makes no difference or it doubles your risk. The study is underpowered to draw any firm conclusion about a causal link.

WDDTY did suggest that a lie in could cure diabetes. If that’s the level of rigour at play here, then perhaps it explains the sloppiness of the argument.

93 Ensure you are breathing through your nose

Breathing incorrectly can contribute to asthma,61 and even attention-deficit/hyperactivity (ADHD)-spectrum problems. If you aren’t breathing correctly, try the Buteyko Breathing Technique or the breathing exercises (pranayama) practised in yoga.62

Reference 61: BMJ, 2001; 322: 1098–100 Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey Mike Thomas, general practitioner, R K McKinley, senior lecturer, Elaine Freeman, primary care research coordinator, and Chris Foy, medical statistician.

Reference 62a:  J Asthma, 2000; 37: 557–64; A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video. Opat AJ, Cohen MM, Bailey MJ, Abramson MJ.

Reference 62b:  J Asthma, 1991; 28: 437–42 Effect of yoga training on exercise tolerance in adolescents with childhood asthma. Jain SC, Rai L, Valecha A, Jha UK, Bhatnagar SO, Ram K.

The first reference concludes:

About a third of women and a fifth of men had scores suggestive of dysfunctional breathing. Although further studies are needed to confirm the validity of this screening tool and these findings, these prevalences suggest scope for therapeutic intervention and may explain the anecdotal success of the Buteyko method of treating asthma.

This qualifies as blindingly obvious, as does the second paper, because bronchospasm is self-reinforcing: teaching breathing techniques that help recover normal breathing rhythm, will minimise the symptoms of bronchospasm. But Buteyko does not claim to be merely palliative, it claims to cure asthma. The second reference shows this not to be the case – there are improvements in quality of life and reduced bronchodilator use, but no evidence of cure.

Wait, isn’t it medicine that’s only supposed to treat the symptoms?

Here’s what Asthma UK say:

Buteyko

  • There has been little research published in medical journals about the Buteyko technique. This makes detailed comment difficult.
  • A Cochrane Review of breathing exercises found no improvement in lung function. However, four clincial trials have suggested that breathing exercises can lead to a reduction in asthma symptoms and reduced use of a reliever inhaler.
  • In 2003 (Cooper et al) Asthma UK funded research into the clinical effectiveness of the BBT as a complementary addition to conventional asthma treatment. This study showed that for some people with asthma, the use of the BBT helped to reduce their asthma symptoms and to reduce their use of reliever inhaler; although no effect on the underlying condition itself was found.
  • The BBT may help people with asthma to feel more in control of their breathing and may be worth trying for those who are willing to give it a try and commit the time required to learn the technique.
  • More research is needed to identify if certain people with asthma benefit more than others.
  • BBT can be expensive and this should be taken into account when considering it as an option.

Yoga

  • Yoga is an ancient Hindu discipline that uses a variety of postures and breathing techniques to help to increase fitness and aid relaxation.
  • One aspect of yoga, Pranayama uses breathing exercises, and has been studied with regard to asthma. These breathing exercises were found to be beneficial, with participants showing fewer asthma attacks and a higher tolerance to certain triggers.
  • Simple relaxation techniques, which do not incorporate the philosophical aspects of yoga, have also been shown to have some benefit.
  • It’s uncertain whether yoga and breathing exercises help asthma by reducing stress (which can be a trigger) or by other physical effects. More research is needed to establish this.

So, breathing techniques help the symptoms of bronchospasm, it probably doesn’t matter much which one you use, in both cases you’re dealing with “brands” that have a side-order of claptrap so go in with your eyes open and don’t succumb to the usual woo.

Remember that the appeal to tradition is fallacious, that starting with a treatment and then generating evidence to support your business is always a red flag, and never give your money to anyone unless they can prove they are fully qualified with proper degrees from accredited colleges.

94 Walk

Especially if you’re a woman, walking at even a moderate pace (3 miles per hour) provides every benefit that running does for staving off degenerative diseases and cardiovascular events. Power walking will even burn more calories than running at a similar speed with no harmful effects on your joint cartilage. Use a Swiss ball to work your ‘core’—the muscles of the trunk, front and back—as this will strengthen the abdominal muscles that support the spine, hip and buttocks. Opt for free weights over machines, which are less effective for strengthening the body holistically.

Free weights also carry a higher probability of injury, because they are less controlled in the axis of movement and have no mechanism to control release on muscle failure.

Here’s a simple and easy fact about exercise: the type you enjoy most is the type you will keep up. Running, walking, rowing, cycling, on crosstrainer, climber, stationary bike or treadmill, on the road or on singletrack. Whatever you enjoy, you will be motivated to do.

The single best piece of advice is probably to exercise as part of a group who have healthy attitudes to their bodies and what they want to achieve. A cycling club, or a group of ladies who meet for half an hour on the treadmill followed by a skinny latte. Whatever gives you pleasure. 

Regardless, this advice is precisely what your doctor will tell you.

95 Sleep in the very dark dark

Too much light at night interrupts our body’s production of melatonin, the hormone that regulates our internal sleep–wake cycle; working at night and sleeping in a too-bright bedroom have also been linked to an increased risk of cancer.63 Get yourself a sleep mask or blackout curtains, particularly for the bright summer months.

Reference 63: J Natl Cancer Inst, 2001; 93: 1557–62 Night shift work, light at night, and risk of breast cancer. Davis S, Mirick DK, Stevens RG.

Yes, night shift work adversely affects your health. Remember to thank the nurses and juniors and buy them biscuits and chocolate next time you’re in a hospital, they do it for you. Now what does the study actually say?

RESULTS: Breast cancer risk was increased among subjects who frequently did not sleep during the period of the night when melatonin levels are typically at their highest (OR = 1.14 for each night per week; 95% CI = 1.01 to 1.28). Risk did not increase with interrupted sleep accompanied by turning on a light. There was an indication of increased risk among subjects with the brightest bedrooms. Graveyard shiftwork was associated with increased breast cancer risk (OR = 1.6; 95% CI = 1.0 to 2.5), with a trend of increased risk with increasing years and with more hours per week of graveyard shiftwork (P =.02, Wald chi-squared test).

CONCLUSION: The results of this study provide evidence that indicators of exposure to light at night may be associated with the risk of developing breast cancer.

That was in 2001, over time the evidence that prolonged night shift work is associated with higher cancer risk has firmed up. Sleep masks and blackout curtains? Not so much. These studies refer to long-term shift workers (nurses, in fact) and don’t establish any causal link between levels of darkness in normal sleep and cancer.

96 Seek out the new

Keep your brain active, stay curious and maintain goals—even physical ones. Routine is not only deadening to the senses, but can actually make us ill. According to Bowling Green State University psychologist Jaak Panksepp, one of the most important basic human instincts is the ‘seeking’ mode, a nature that remains intensely engaged in the search or the puzzle, or is simply curious about what’s new. Every study of longevity shows that those who live to a ripe old age set themselves goals and stay curious. An interest in new things and change and, most of all, a “pioneering spirit” seemed to be the longevity elixir of a group of long-lived Civil War nurses.64 Vary your activities and ensure that you engage in ones that involve problem-solving.

Reference 64: Nurs Forum, 1991; 26: 9–16 New Surprises in Very Old Places: Civil War Nurse Leaders and Longevity, Wendy Woodward

Just when you think the Weird has peaked…

While the average woman in the U.S. Civil War times lived to the age of about 40, a group of 17 extraordinary nurses–including Louisa Mae Alcott, Dorothea Dix, and Clara Barton–survived to much older ages. A variety of possible reasons, from social and marital status to altruism and religion, is explored. More than any tangible factor, however, the presence of a “pioneering spirit” seems to be at the root of their longevity.

 Is this genuinely the best source supporting this claim?

97 Love your work; work to serve

Don’t settle for anything less than work that makes your heart sing, and do it with gusto. People at peace with their lives and life’s work live longer than those at war with the world. One of the most fulfilling types of work is living a life of service to others.

Doctors, for instance? Oh, wait…

We hope our public service in debunking WDDTY’s egregious nonsense will indeed confer long life, but we don’t put money on it because the actual evidence for positive attitude making the blindest bit of difference is pretty thin.

If you live to be 100, you’re likely to be pretty chipper about it, but you can be the Duracell Bunny and still die aged 30 from a heart attack.

98 Find your tribe

Various studies have revealed that the root emotions of stress are a sense of helplessness and loneliness, and anything that can help re-establish connections—with family, with the community, with God—is a potent healer. Joining just one group this year will halve your chances of dying; connecting also protects against heart disease and stroke. If you don’t have a close community, then assemble one either through your church, or through work or leisure organizations. Meet and share regularly.

A classic confusion of correlation with causation. Does going to church make you live longer? It would be nice to think so, but nobody has successfully unpicked this from a general attitude of acceptance of the world, rather than perpetual angst. 

Oh, we believe chocolate works as well. Also probably gardening, certainly cycling, and who knows what else. It’s likely that anything that gets you out of the house and makes you happy, works. Which doesn’t explain the longevity of Victor MeldrewW, and although it’s definitely true that Tom Good has outlived Jerry Leadbetter, we reckon Margot Leadbetter is wearing the years more gracefully than Barbara Good.

99 Erase your old inner emotional tapes

Try one of the new energy psychology methods like  Thought Field Therapy (TFT) or the Emotional Freedom Technique (EFT), both of which are ‘needlefree’ forms of acupuncture in which the therapist or patient ‘taps’ on various meridians of the body while making a series of statements. In one study of patients suffering from post-traumatic stress—considered extremely difficult to treat—TFT reduced such stress by more than half.65

This message was brought to you by our sponsors.

Reference 65: Traumatology, 1999; 5: 1, article 4 – reference unclear (see contents)

This kind of bullshit makes professionals who deal with PTSD very angry. There is an immense body of research into PTSD, much of it centred on combat veterans. CBT and other techniques have an effect, as does EMDR, but it is a complex and long-lived disorder that is likely to require a lot of intensive effort from well-trained professionals.

Thought Field TherapyW is ideologically acceptable to Lynne McTaggart, author of many pseudoscientific discussions of similar concepts, but there’s no credible evidence it works.

Emotional Freedom TechniqueW is also purest hogwash.

Both are practised mainly by hippy-dippy New-Age quacks who believe that the body is regulated by the flow of an empirically unverifiable life force whose balance is vitally affected by meridians and acupoints that have no known associated biological structures.

The evidence that these points exist is, to put it mildly, not compelling. Nobody has yet succeeded in proving that tapping them (or sticking needles in them or anything else) has any differential effect over doing the same thing in the “wrong” place. Oh, and Chinese and Japanese versions are different, so if you’re a Chinese and get sick in Japan, be sure to let them know.

100 Cultivate a readiness to empathize and forgive

One of the greatest antidotes to stress is heartfelt forgiveness and empathy. Learning to forgive can help overcome depression and stress.66 Gratitude and generosity are powerful, health-promoting game changers.

Reference 66: Explore [NY], 2006; 2: 498–508 Positive emotional change: mediating effects of forgiveness and spirituality. Levenson MR, Aldwin CM, Yancura L.

Opinion masquerading as fact, basically pure new-age hogwash. But what the hell, to err is human, to forgive divine. However, it does require that the sinner first repents. When WDDTY apologises for some of its egregious errors, we’ll start to forgive them for their decades long anti-health crusade.

100 ways to live to 100: 10 bits of medical advice you should question

 

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

10 bits of medical advice you should question

In general, it’s always fair to ask for the evidence supporting any proposed medical intervention.

In general, WDDTY does this for you by quote-mining and cherry-picking to suit its anti-medicine agenda.

What WDDTY does not do is to provide any actual evidence that this information is anything other than a routine part of the normal process of informed consent, especially in the UK. For example, discussion of radical prostatectomy is dominated by a test that has been deprecated in the UK for over twenty years and an operation that never reached a quarter of its peak level in the USA.

81 Lower your blood cholesterol levels

The theory that high-fat foods—like meat and dairy—build up fat in our arteries has never actually been proven. After people eating high-fat diets were followed for 10 years and not one suffered a heart attack, researchers concluded that “the evidence is not there” to support a high fats–heart disease connection.48 In fact, high levels of the ‘bad’ LDL cholesterol may actually be good for us, especially as we get older.49

Reference 48: Nutr Metab Cardiovasc Dis, 2012; 22: 1039–45 Biomarkers of dairy intake and the risk of heart disease. Aslibekyan S, Campos H, Baylin A.

Reference 49: J Gerontol A Biol Sci Med Sci; 2007; 62: 1164–71 Statins and dietary and serum cholesterol are associated with increased lean mass following resistance training. Riechman SE, Andrews RD, Maclean DA, Sheather S.

The first reference is specific to dairy, noting:

Dairy product intake as assessed by adipose tissue 15:0, 17:0, and by FFQ is not associated with a linear increase in the risk of MI in the study population. It is possible that the adverse effect of saturated fat in dairy products on cardiovascular health is offset by presence of beneficial nutrients.

This is a great point against WDDTY’s anti-dairy agenda, but not really a point for the argument that cholesterolW is good for you. The second source finds:

These data suggest that dietary and serum cholesterol contribute to the skeletal muscles’ response to RET in this generally healthy older population and that some statins may improve this response.

A great point against WDDTY’s anti-statin agenda, but not much of a hit for the promotion of cholesterol either since this applies to people undergoing “12 weeks of high intensity resistance exercise training (RET) with post-exercise protein supplementation”. Few 60-69-year-olds do this, and the overall evidence is taken from the largely sedentary general population not from atypical sub-populations like this.

WDDTY seems to be disputing the lipid hypothesisW but without actually tackling it head on, still less addressing the evidence base behind it. In fact both the lipid and the chronic endothelial injury hypothesisW are converging over time to a single hypothesis which puts LDL front and centre in the mechanism of hypertension.

The Centers for Disease ControlW are blunt: “Having high cholesterol puts you at risk of developing heart disease, the leading cause of death in the United States”.

82 The mercury in your fillings is permanently locked in and harmless

Dentists have been saying this for years, but the European Commission’s BIO Intelligence Service (BIS) begs to disagree. The group recommends that a total ban on amalgam fillings be fully implemented in five years’ time, and the use of mercury fillings virtually eliminated throughout the EU.

No, the EU does not say that your fillings are a problem. It has a rather technical document detailing measures to reduce usage and pollution from mercury in the environment. It puts the report by Bio Intelligence Service S.A. (which is,a s the name suggests, a commercial entity and not an EU body) into context. Its principal argument is that dental use of mercury represents an environmental, not a toxicological, problem.

The report does not say that amalgam fillings in-place are a significant source of concern, instead it discusses the pollution caused by the mixing and installation of amalgam, and the disposal of amalgam after teeth are extracted or the patient dies.

Overall, you’re probably fine as long as you don’t heavily chew nicotine chewing gum. A controversy that has raged for a century without any consensus forming or any concrete and damning evidence of significant biological effect – a “smoking gun” – is evidence of philosophical differences, not provable harm.

83 Go for angioplasty

Balloon angioplasty and stents were to be medicine’s ‘miracle’ treatments for blocked arteries, but around one in 10 heart patients returns to hospital for emergency treatment following the procedures, and nearly a third of non-emergency ‘drug-eluting’ stents are also likely to cause potentially fatal harm.50 Patients given a cocktail of generic heart drugs instead do just as well .51

Reference 50: Arch Intern Med, 2012; 172: 112–7 Factors associated with 30-day readmission rates after percutaneous coronary intervention. Khawaja FJ et. al.

Reference 50b: N Engl J Med, 2007; 356: 1009–19 Long-Term Outcomes with Drug-Eluting Stents versus Bare-Metal Stents in Sweden Bo Lagerqvist et. al.

Reference 51:  N Engl J Med, 2007; 356: 1503–16 Optimal Medical Therapy with or without PCI for Stable Coronary Disease William E. Boden et. al.

This is a particularly pernicious piece of misinformation. It is very easy to find cases where people are readmitted not long after surgery for coronary heart disease: the reason they have had the surgery is often because they are very sick. Unsurprisingly, they are a poor surgical risk and a high risk for post-surgical complications. In other words, even with surgery, doctors may not be able to save them. That’s a great reason for keeping your heart in good shape and a truly terrible reason for refusing heart surgery if it’s indicated.

WDDTY say that nearly a third of drug eluting stents are likely to cause potentially fatal harm. The source absolutely does not support this.

Drug-eluting stents were associated with an increased rate of death, as compared with bare-metal stents. This trend appeared after 6 months, when the risk of death was 0.5 percentage point higher and a composite of death or myocardial infarction was 0.5 to 1.0 percentage point higher per year. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials. (emphasis added)

 WDDTY have been caught before confusing relative and absolute risks, but rarely this blatantly.

The final study also doesn’t support WDDTY’s statement:

As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.

WDDTY recommending intensive pharmacologic therapy. That’s a turn-up for the books.

84 You don’t need your womb anymore

A University of California committee of gynaecologists once concluded that three-quarters of all hysterectomies done are not necessary.52 Except for genuine indications like uterine cancer and life-threatening bleeding during childbirth, some 90 per cent of referrals for hysterectomies can be treated with conservative surgery, medication, alternative medicine, nutritional supplementation or just waiting until menopause.

Reference 52: Obstet Gynecol, 2000; 95: 199–205 The Appropriateness of Recommendations for Hysterectomy, Michael S Broder et. al.

This is an US study. One in three US women will undergo hysterectomy, compared with one in five in the UK. The US removes ovaries in 73% of cases, the UK in 20%.

WDDTY editor Lynne McTaggart is American. Sometimes she forgets which side of the pond she’s living.

Sometimes she also forgets that the anecdotal claims of quacks to “cure” endometriosis, fibroids and the like are a long way short of being evidence that they actually can do this.

85 Have ‘catch it early’ surgery for prostate cancer

Men in the early stages of the disease are often offered radical prostatectomy, where the entire gland is removed. At best, it’s a trade-off, mostly because of the high risk of permanent impotence and incontinence. Unless you’re under 55, you’re more likely to die with the disease than from it.

That’s why the standard of care for indolent prostate cancer is “watchful waiting”. Who are these doctors who supposedly “don’t tell you” this? I suspect they may be American again, though even there it’s been in decline since the early 1990s. The UK has deprecated screening since the 1990s and the UK’s rate of radical prostatectomy never reached 10 per 100,000, a quarter of the peak rate in the US.

Bottom line: if your doctor recommends radical prostatectomy, it’s probably the conservative option.

86 Have a radical mastectomy to ‘catch it all’

This mutilating operation involves removing the breast, the chest wall, the lymph nodes and much of the skin, but it confers no advantage over other, less aggressive forms of mastectomy, including the simple removal of the lump with radiotherapy.53 Also, some 70 per cent of double mastectomies—where both breasts are removed following a diagnosis of breast cancer—are unnecessary as the cancer was never likely to have spread, say researchers.54

Reference 53: Ann Surg, 1986; 204: 136–47 Treatment of primary breast cancer without mastectomy. The Los Angeles community experience and review of the literature.

Reference 54: J Clin Oncol 30, 2012; suppl 34: abstr 26 [Medline does not find this reference]

This advice is literally decades out of date. Radical mastectomy no longer involves routine axillary clearance, instead the lymph nodes are staged, often in real time. Prophylactic mastectomies will only be advised for women who already have cancer, or who, like Angelina Jolie, have both genetic and family history indications.

WDDTY were among the strident chorus of natural-woo promoters who denounced Jolie for her decision. Jolie showed grace and fortitude in the face of this torrent of bullshit, pointing out that the risk for her was in excess of 80% given family history and evidence of specific expressed genetic mutations.

Lumpectomy is the standard of care for small, well-defined tumours; radical mastectomy is not recommended lightly.

The moral of this story is, listen to oncologists, not cranks who hate the entire world of medicine on reflex.

87 Let’s fix your inguinal hernia

The wise doctor will delay surgery until the patient is in pain or discomfort—partly because he knows that surgical repair carries a long-term risk of recurrence and can itself cause more groin pain than the hernia, as it does in a quarter of patients.55 When more than 700 men with hernias underwent watchful waiting instead, the vast majority carried on with their everyday lives without a moment of pain and without the need for surgery.56

Reference 55: Ann Surg, 2001; 233: 8 Groin Pain After Hernia Repair, Robert E. Condon.

Reference 56: JAMA, 2006; 295: 285–92 Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. Fitzgibbons RJ Jr, et. al. 

Once again, WDDTY recommends the standard of care. Well done for telling your readers what doctors already do tell them.

The only problem with WDDTY’s commentary is that it seems designed to deter anyone from undergoing repair, based on a speculative finding from 2001 (“Could it be that the major change in the technique of hernia repair that has evolved over the most recent two decades—the widespread use of implanted prosthetic mesh, whether needed or not—is a cause?”) and a report based on minimally symptomatic patients.

The 2001 paper refers to what is now termed post herniorraphy pain syndromeW, a recognised complication that leads to – guess what? – the standard of care being “watchful waiting” for minimally symptomatic patients. The problem does not seem to be caused by mesh itself, but by damage to the nerves, which may be consequent from the original injury

So as usual it’s safe to follow WDDTY’s advice as long as you’re not actually ill…

88 Let’s cut out your gall bladder

This procedure (cholecystectomy) may increase the risk of colon cancer, according to a review of 33 studies.57 Surgery can often make matters worse by injuring the bile duct, releasing gallstones and causing more digestive issues. Stones can usually be sorted out by avoiding processed food and sugar, eating less red meat and eschewing HRT, which doubles the risk.

Reference 57: Gastroenterology, 1993; 105: 130–41 A meta-analysis of cholecystectomy and risk of colorectal cancer. Giovannucci E, Colditz GA, Stampfer MJ.

CONCLUSIONS: Because the risks varied substantially by study design and because time since cholecystectomy or potentially confounding factors were often not considered, we could not firmly quantitate this risk. However, the findings are consistent with other evidence that suggests some characteristic of bile acid metabolism increases the risk of cancer of the proximal colon.

CholecystectomyW became much more common in the 1990s after laparoscopic techniques were devised which made the surgery effectively a day-case. Yes, like any surgical procedure, it has potential complications, and those should be (and are) taken into account when considering surgery.

The accuracy of WDDTY’s commentary can be demonstrated pretty simply:

WDDTY: Surgery can often make matters worse by injuring the bile duct, releasing gallstones and causing more digestive issues

Goldman’s Cecil Medicine (24th ed.): The most serious complication of cholecystectomy is damage to the common bile duct. This occurs in about 0.25% of cases.

Often… 0.25%. I think this might be a problem of perspective.

WDDTY: “Stones can usually be sorted out by avoiding processed food and sugar, eating less red meat and eschewing HRT, which doubles the risk”

NHS: “There are several non-surgical ways to break down gallstones, but they are only effective in around less than 1 in 10 cases and are rarely a viable option.”

Perhaps WDDTY has been mistaking the claims of its advertisers for fact.

89 Sort your overactive thyroid with surgery

Nearly a third of all cases will resolve on their own. Even when just part of the thyroid is removed, only 30 per cent will have normal thyroid levels after eight years, a whopping 41 per cent will have a permanently underactive thyroid and 12 per cent will still be hyperthyroid.58

Reference 58:  J Endocrinol Invest, 1993; 16: 195–9 Follow-up evaluation of patients with Graves’ disease treated by subtotal thyroidectomy and risk factor analysis for post-operative thyroid dysfunction. Sugino K, Mimura T, Toshima K, Iwabuchi H, Kitamura Y, Kawano M, Ozaki O, Ito K.

Grave’s diseaseW is the commonest but not the sole cause of hyperthyroidismW, and it’s not the sole indication for thyroidectomy. In fact, it’s been considered debatable for some time:

Operation is indicated mainly when the disease is severe with a larger goitre or in younger age groups (below 40 years) where radioiodine may not be advisable. For preoperative treatment the use of antithyroid drugs in preferred, although iodine perhaps in combination with beta blockers may be used safely as well at least for moderate cases. In the presence of alternative means of treatment surgery should not exceed an operative risk of 0.5-1.5% with virtually no mortality

It’s unlikely that any patient will be offered surgery for management of hyperthyroidism without first excluding non-surgical approaches. WDDTY seems to think partial thyroidectomy is common, in the UK at least this is not the case. As the NHS says:

Surgery to remove all or part of the thyroid gland is known as a total or partial thyroidectomy. It is a permanent cure for recurrent overactive thyroid.

Your specialist may recommend surgery if your thyroid gland is severely swollen (a large goitre) and is causing problems in your neck.

Other reasons for surgery include:

  • a person is unable to be treated with radioiodine treatment as they are pregnant and they are unable or unwilling to take thionamides
  • a person has a severe form of Graves’ ophthalmopathy
  • the symptoms return (relapse) after a previous successful course of treatment with thionamides

It is normally recommended that the entire thyroid gland is removed as this means there will be no chance of a relapse.

See that word “specialist”? In the UK you will not get anywhere near thyroidectomy for Grave’s disease without seeing a specialist endocrinologist and exhausting the alternatives.

It’s almost as if doctors know what they are talking about and WDDTY don’t.

90 You need a blood transfusion

This routine medical practice suppresses the immune system, increasing the chances of infection, pneumonia—and cancer. Patients who received a transfusion during cancer surgery are 42 per cent more likely to develop cancer again, say Johns Hopkins University researchers.Transfusions should be reserved for emergencies like trauma or haemorrhage, when they can be a lifesaver.59

Reference 59: Anesthesiology, 2012; 117: 99–106 Variability in blood and blood component utilization as assessed by an anesthesia information management system. Frank SM, Savage WJ, Rothschild JA, Rivers RJ, Ness PM, Paul SL, Ulatowski JA.

CONCLUSIONS: The use of data acquired from an anesthesia information management system allowed a detailed analysis of blood component utilization, which revealed significant variation among surgical services and surgical procedures, and among individual anesthesiologists and surgeons compared with their peers. Incorporating these methods of data acquisition and analysis into a blood management program could reduce unnecessary transfusions, an outcome that may increase patient safety and reduce costs.

Needless to say, this does not support WDDTY’s statement. The article proposes spreading of best practice in the context of the US health system (where interventions may risk being profit-driven).

Yes, transfusions might indeed have negative effects, especially in the US where payment for blood donors has led in the past to contaminated supplies. However, cancer surgery tends to be at the upper end of things that are not considered “emergencies” even by WDDTY’s rather arbitrary standards, and some people might consider that the chances of being offered a transfusion just on the off chance when you’re not in mortal danger is probably pretty low. Especially in the NHS.

100 ways to live to 100: 10 situations that don’t usually require a doctor

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

10 situations that don’t usually require a doctor

If there’s one thing you can rely on doctors telling you, it’s when you don’t need a doctor. They are about as keen to see people with the common cold as WDDTY is to see evidence that vaccines are safe and effective. And in both cases, that doesn’t stop it happening, all the time.

61 Backache

Some 80 per cent of us suffer from back pain, but medicine doesn’t offer much besides potentially dangerous surgery (which leaves only a quarter of patients free of pain) and drugs. In most cases, an osteopath, chiropractor or Alexander Technique practitioner can sort you, as can exercise.

Let’s unpick that. If medicine cures back pain by surgery, that’s evil. If medicine gives drugs to manage the pain, that’s evil. If medicine recommends exercise and physiotherapy, that’s ignored because it would undermine WDDTY’s pretence that these are “alternative” and thus the sole preserve of quacks like their advertisers.

Why don’t doctors tell you that Alexander Technique works for low back pain? They do. They also recommend osteopathy and chiropractic, but there are severe problems with both these fields, due to the prevalence of crank ideas. Osteopaths need to discipline and exclude charlatans who practice “cranial osteopathy”, and chiropractors need to recognise that there is no evidence that chiropractic works better than evidence-based manipulation therapy, and substantial evidence of actively dangerous practices such as cervical spinal manipulation, potentially leading to stroke, bullshit claims to treat ear infections, asthma and other things unrelated to the musculoskeletal system, anti-vaccination propaganda, and of course the big scam: never discharging a cured patient, but instead trying to sell them an indefinite course of worthless “maintenance”.

If you have back pain, see your doctor, they will recommend the most appropriate treatment. Which might be surgery, drugs, exercise or some form of physiotherapy. Unlike WDDTY’s advice, this won’t be based on dogma or pleasing the advertisers, it’ll be based on the best currently available evidence.

62 Earache

Shout it loud: antibiotics just don’t work for earache. Nor does removing adenoids fix glue ear.39 Instead, try time, mullein oil, a woolly hat, a hot-water bottle, homeopathic Pulsatilla,40 osteopathy or auricular therapy (acupuncture of the ear). Before having grommets inserted in your child’s ear, cut down his fat and sugar, and investigate food or airborne allergies as the potential cause.

Reference 39a: JAMA, 2006; 296: 1235–41 Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED.

Reference 39b: BMJ, 2004; 328: 487 Adenoidectomy versus chemoprophylaxis and placebo for recurrent acute otitis media in children aged under 2 years: randomised controlled trial. Koivunen P, Uhari M, Luotonen J, Kristo A, Raski R, Pokka T, Alho OP.

Reference 40: Ullman D. Discovering Homeopathy: Medicine for the 21st Century. Berkeley, CA: North Atlantic Books, 1991; AHZ, 1985; 230: 89–94

If you follow this advice, a repeat of a recent and particularly dreadful article,  you’ll have to “shout it loud” because your child may be deaf.

The standard of care is watchful waiting, but adenoidectomy may be indicated in the presence of both glue ear and persistent nasal symptoms. Antibiotics work as a primary treatment for bacterial ear infections. Most children will grow out of them in time, but leaving the infection untreated when treatment is indicated, on ideological grounds as WDDTY propose, is perverse.

HomeopathyW has three problems: first, there’s no reason to think it should work; second, there’s no way it can work; and third, there’s no proof it does work. Of all alternatives to medicine, it is the most thoroughly debunked. Its doctrines were refuted over a century ago and its only real value now is as a litmus test for lack of critical thinking. A test WDDTY fails on a truly epic scale.

Dana Ullman, the cited source, is a high priest of the cult of homeopathy, he is a proven liar who claims Darwin and Nightingale for homeopathy despite their well documented contempt for it, and is responsible for propagating the lies that Montagnier’s work proves homeopathy and that the Swiss Government found it safe and effective. His propagandising for homeopathy knows no bounds. Each new publication by a True Believer is presented as the final clinching proof of homeopathy, and when it’s shown to be flawed or fraudulent he merely moves on to the next, occasionally repeating the old ones if he thinks nobody will notice. His self-promotion and steadfast denial of reality got him banned from Wikipedia.  There’s even an eponymous law: the Dull-Man Law. In any discussion of homoeopathy, being Dana Ullman loses you the argument – and gets you laughed out of the room.

AcupunctureW is also nonsense, though it is only recently proven to be completely useless. Auricular acupuncture has absolutely no basis in fact and lacks even the marginal credibility of acupuncture. The ear looks a bit like a baby, therefore the bits of the ear correspond to the organs that would be there if it was a baby. No, not even vaguely sensible.

63 Infection

For common and non-serious infections, try Echinacea, essential oils like clove, lavender, lemon, marjoram, mint, niaouli (Melaleuca), pine, rosemary and thyme oils, and goldenseal, manuka honey, tea tree oil, good old garlic and cranberry, all of which are powerful alternatives to antibiotics.

Alternatives they may be. Effective? Not so much. There’s some evidence of manuka honey as a topical antibiotic but why on earth would you not use antibiotics? They work very well, are generally well tolerated, and they have saved countless millions of lives.

This references a May 2013 article, we’ve added it to the work list.

64 Just-in-case checkups, particularly if you’re aged over 50

If you have nothing particularly wrong with you, going to the doctor won’t necessarily protect but is likely to unleash the entire arsenal testing apparatus have you leaving prescription (or three) in your hands.

So let’s get this straight: it’s wrong to see your doctor in case he finds something wrong with you.

Er, right.

65 Menopause In most cases, holistic measures

In most cases holistic measures (diet, homeopathy, herbs) will help you through the change in a safer way than using hormone replacement therapy (HRT), which continues to be discredited, despite protestations by doctors, because of a link with breast cancer.41 Our medical detective Dr Harald Gaier has had greater success with Phytoestrol N (which contains rhubarb root) than most of the popular herbals for menopause.

Reference 41:  Am J Public Health, 2010; 100 [Suppl 1]: S132–9 Decline in US Breast Cancer Rates After the Women’s Health Initiative: Socioeconomic and Racial/Ethnic Differentials Nancy Krieger, PhD,corresponding author Jarvis T. Chen, ScD, and Pamela D. Waterman, MPH.

HRT was discredited years ago, when it was shown not to protect against coronary heart disease but instead to promote it. Well-informed doctors don’t push it unless the symptoms of menopause are extremely bad, or for very early menopause or occasionally hysterectomy.

Homeopathy doesn’t work. Herbs may or may not (remember that a herbal remedy is basically an unknown dose of a potentially pharmacologically active compound with unknown impurities). The source for Harald Gaier’s success stories is Harald Gaier – WDDTY seem to think that blatant conflict of interest is fine as long as the message is ideologically acceptable.

66 Chronic but non-life-threatening conditions

Eczema, psoriasis, non-life-threatening asthma, arthritis and the like generally respond better to alternative measures than drugs, which only suppress symptoms. Check out the alternatives before resorting to lifelong drug use.

Few things are more infuriating than the claim that medicine “only suppresses symptoms” so alternatives are better.

Alternatives do one of two things: suppress the symptoms less effectively and less predictably, or nothing.

There are no alternatives which cure chronic conditions. If there were, they would no longer be alternative (Minchin’s Law).

The easiest way to demonstrate how wrong this advice is, is with a simple case study of one of the “non-life-threatening conditions” listed: eczema.

A couple whose baby daughter died after they treated her with homeopathic remedies instead of conventional medicine have been found guilty of manslaughter.

Gloria Thomas died aged nine months after spending more than half her life with eczema.

The skin condition wore down her natural defences and left her completely vulnerable when she developed an eye infection that killed her within days of developing.

And it’s not the only case. It’s extremely clear that the very last thing you should do when faced with a chronic condition is to consult an “alternative” practitioner, who will follow an ideologically-determined path with no provable value to you, for profit.

67 Slimming

All doctors usually have to offer are drugs and calorie counting, which aren’t long term solutions, and numerous slimming drugs have potentially fatal side-effects. Look first for potential food intolerances, get your thyroid checked out, clean up your diet, and opt for low-GI foods and lots of fruit and veg.

The GI diet was developed by doctors. It’s recommended by doctors, who also recommend exercise and weight management clinics. Oh, and they can also refer you for lap band or other surgical interventions which have a reasonable success rate in the chronically obese who are not compliant with diet regimes. Doctors are also pretty good at spotting thyroid problems.

In the end, though, there is only one diet that is proven to work 100% of the time: the ELEM diet. Eat less, exercise more. Every reputable doctor in the UK, and probably the world, will tell you the same. WDDTY seem to prefer nutritionists who generally have no recognised qualifications whatsoever but nevertheless often sell miracle or fad diets.

68 Colds and flu

Unless you’re elderly and your immune system is compromised in some way, there’s nothing your doctor can give you (or your children) to end a cold or flu, which is usually caused by a viral infection (against which antibiotics mostly don’t work). Bed rest and plenty of fluids, plus zinc, Echinacea, Pelargonium sidoides, Andrographis paniculata, vitamin C and probiotics can all shorten the life of a cold (see WDDTY December 2013).

We’ve critiqued these claims recently. No reputable doctor prescribes antibiotics for uncomplicated viral illness. WDDTY’s view of current medical advice seems to be 20 years out of date and from another continent.

69 Fever

Heat is the body’s extremely clever method of killing foreign invaders of all varieties, and taking anti-inflammatories and other drugs to lower your temperature just hampers that process. Allow your body to self-help by not interfering with a fever unless it’s so high that it may cause permanent damage. Fevers for ordinary viral and bacterial infections won’t exceed 105 degrees F (40.5 degrees C), which generally isn’t dangerous. But see a doctor immediately if you suspect a serious problem like meningitis.

WDDTY don’t seem to know the difference between anti-inflammatories and antipyretic|antipyreticsW. As it happens, Clay Jones at Science Based Medicine recently wrote a much more nuanced piece on fever, in the context of acute cases in hospital, which seems to be the situation WDDTY are considering.

As it happens, Clare Gerada, chair of the Royal College of General Practitioners, recently tweeted a much more pragmatic piece by an actual doctor. Why would you allow your child to suffer the symptoms of fever, if a cheap and safe drug can bring them relief and let them at least get to sleep?

70 Acne

All your doctor can offer are drugs with horrendous side-effects; isotretinoin, marketed as Accutane and Roaccutane, can cause permanent damage to the cornea, impaired hearing, fatal pancreatitis, depression and even suicide.42 Try changing your diet, balancing your blood sugar and identifying any food intolerances first, then look to acupuncture, shown to help in 80 per cent of cases, or herbs like the Ayurvedic herb guggul (Commiphora wightii).43

Reference 42a: Arch Dermatol, 2012; 148: 803–8 Ocular Adverse Effects of Systemic Treatment With Isotretinoin Meira Neudorfer, MD; Inbal Goldshtein, MSc; Orna Shamai-Lubovitz, MD; Gabriel Chodick, PhD; Yuval Dadon; Varda Shalev, MD

Reference 42b: Am J Ther, 2004; 11: 507–16 Polar hysteria: an expression of hypervitaminosis A. O’Donnell J.

Reference 43a: J Tradit Chin Med, 1993; 13: 187–8 Treatment of 86 cases of local neurodermatitis by electro-acupuncture (with needles inserted around diseased areas). Liu JX.

Reference 43b: J Dermatol, 1994; 21: 729–31 Nodulocystic acne: oral gugulipid versus tetracycline. Thappa DM, Dogra J.

The first source says that “Isotretinoin use may be associated with short-term ocular events, especially conjunctivitis, underscoring the importance of educating patients and caregivers about these potentially important AEs of the therapy.” In other words: always read the label and be mindful of the balance of risks and benefits. To spin “may be associated with short-term ocular events” as “can cause permanent damage to the cornea” is typical of WDDTY.

The second source discusses accutane’s similarity to vitamin A, and thus the possibility that it may lead to hypervitaminosis A (but of course no actual vitamin is bad, as because natural). It’s an interesting paper that specifically note that accutane is indicated only for severe recalcitrant nodular acne but is being prescribed for less serious cases. However, this applies almost exclusively in the US, where drug manufacturers can advertise direct to consumers. In the UK, doctors are much closer to following the actual indications, because parents and patients are much less likely to pester the doctor for the drug they just saw advertised on TV. The increase in suicide with accutane should also be weighed against the fact that acne itself may induce suicidal thoughts. Bottom line: ask your doctor. This is the kind of thing GPs are trained for.

The third source is in a journal dedicated to promoting “traditional” Chinese medicine – in fact largely an invention of Mao. Such journals have serious issues with publication bias. The combined weight of evidence is pretty clear: needling results in only placebo effects. Electroacupuncture may have similar effects to TENS, but traditional it is not. Chinese acupuncture uses bamboo needles – bamboo is a notoriously poor conductor of electricity,

The fourth source, from 1994, promotes gugulipid (guggul). There’s decent evidence this works, but (as with every effective treatment) it has side-effects, which WDDTY either haven’t seen or don’t care about because natural.

It can cause side effects such as stomach upset, headaches, nausea, vomiting, loose stools, diarrhea, belching, and hiccups. Guggul can also cause allergic reactions such as rash and itching. Guggul can also cause skin rash and itching that is not related to allergy […].

Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Guggul might act like estrogen in the body. If you have any condition that might be made worse by exposure to estrogen, don’t use guggul.

Underactive or overactive thyroid (hypothyroidism or hyperthyroidism): Guggul might interfere with treatment for these conditions. If you have a thyroid condition, don’t use guggul without your healthcare provider’s supervision.

So, quite a lot of problems there. And guess what? Thanks to assiduous lobbying by the supplement industry, you might well never find out about these.

Acne is a bugger. See your doctor for good evidence-based advice, and see a counsellor if you find the bullying of your peers to be distressing.

100 ways to live to 100: Your healthy children

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

Your healthy children

It’s not clear how your children’s health could help you live to 100, though if you follow WDDTY’s anti-vaccine advice you certainly need them to be as healthy as possible to minimise the chance of death or permanent harm from vaccine preventable disease.

41 Get fit before you conceive

Work with a doctor experienced in preconception nutrition who will check your nutritional status and help you correct any deficiencies, hidden infections, heavy-metal toxic overload and the like, all of which can contribute to infertility and pregnancy loss. Contact Foresight for their complete programme of preconceptual care (www.foresight-preconception.org.uk). The organization reports a 90 per cent success rate of healthy babies born to the nearly 1,600 couples who completed the full Foresight programme, many with a previous history of lost pregnancy or infertility.

This is  a blatant sales pitch. Foresight’s website scores easily 8 ducks on the Quackometer – anything inspired by a “psychiatrist-with-vision” can’t score less!

The chances of anyone living a normal middle-class British lifestyle having “heavy metal toxic overload” are vanishingly small. Unless you ask a chelation quack like Dr. John Mansfield, a member of the WDDTY editorial panel. And most British women conceive without any special measures, so don’t throw your money down the drain until you’ve at least satisfied yourself you have a problem – and if that is the case, be sure to consult only a doctor who is registered and licensed to practice in the UK. The GMC has an online register which is a tad cumbersome but allows you to check for a name and verify that if, say, they qualified before 1976 at Guy’s, they are not licensed to practice in the UK.

In short: the heading is misleading. WDDTY are promoting quackery before conception. Avoid like the plague.

42 If you are pregnant, minimize your exposure to prenatal tests like ultrasound scans

Scans have been linked to low birth weights, delayed speech and dyslexia. Unless a problem is suspected, wait till after your baby is born to take its picture

“Scans have been linked” is classic WDDTY weasel words. Of course women with red flags for suspected problems will be referred for scans to see if the baby is developing normally. That doesn’t mean the scan has any effect on development.

Ultrasound is safe, cheap, and reassuring especially to the anxious primagravida. It can also pick up serious defects such as cleft lip and palate and prepare parents for informed choices at an early stage.

Some forms of diagnostics lead to many false positives and undesirable outcomes. Antenatal ultrasound is not one of these. It is an entirely reasonable check for developmental abnormalities, which is why virtually every doctor and midwife recommends it.

43 Breastfeed

Give your child this lifelong gift and breastfeed for as long as possible—at least one year, according to the WHO. In addition to providing the perfect food and the full complement of essential fatty acids, for your child, it also protects against allergies and helps improve vision and IQ. Resist the suggestions of experts to add supplemental feeds unless something is clearly wrong. The baby is usually getting enough if allowed to feed on demand.

Can anybody name the doctors who “don’t tell you” this? It’s entirely mainstream. Unfortunately, it is also so deeply embedded in the middle-class psyche that women who find they can’t breastfeed, for whatever reason, may feel bullied and inadequate (warning: Daily Mail). This is not just tabloid hysteria.

44 Get informed about vaccination

There’s no such thing as a totally safe vaccine; official organizations like the US National Academy of Sciences and the Centers for Disease Control and Prevention (CDC) tacitly acknowledge that all vaccines have the potential to kill or cause serious harm. Assess every last jab with the following questions: How necessary is this vaccine? How effective? How safe? Especially question vaccinations against illnesses that are rare or generally not life-threatening in healthy, well-nourished children. This includes the MMR (measles–mumps–rubella), cervical cancer, Hib (Haemophilus influenzae type b) and meningitis C vaccines.

Informed consent is good, as long as the information is reliable. WDDTY’s information on vaccines is grossly unreliable. Its claims for harm are massively inflated, its anti-vaccination agenda was established from the very outset and no story about vaccines has ever been published in any edition of WDDTY, as far as we can tell, which is accurate, positive, or correctly reflects the balance of risk and harm. A recent story claimed that “Andrew Wakefield was right”. He wasn’t. A story in this very issue repeated the vicious anti-vaccine lie that HPV vaccine has seriously harmed 1,700 girls. It hasn’t.

The best source for accurate information about vaccines is, and always has been, your family doctor. The implication that doctors claim vaccines are 100% safe or 100% effective is false, official documents have never supported this. they are, however, extremely safe and at least very effective.

Measles, pertussis (whooping-cough), Hib and other vaccine-preventable disease are killers. The anti-vaccine agenda is denialism at its most selfish, relying on others taking the tiny risk to provide the herd immunity that allows anti-vaccinationists to claim that vaccine preventable diseases are rare anyway.

45 Suspect allergies first

If your child has any chronic problems like earache, eczema, bowel problems or hyperactivity, suspect food/chemical allergies, and get them identified and treated.

Allergies are more common and more diverse than many parents think, and less common and less diverse than WDDTY would have you believe. If your child has a chronic health problem there are three very important things to remember:

  1. Intolerance is not allergy.
  2. Many children grow out of both intolerance and allergy.
  3. Avoid any allergy diagnostic services that claim to find yeast overgrowth, leaky gut and the like, and instead ask your GP for a referral to the local NHS allergy clinic.

Allergies, and chronic disease generally, are fertile hunting ground for quacks. Just look at the back pages of WDDTY.

46 Avoid plastic toys containing phthalates

These chemicals have clear evidence of causing ‘feminization’ and abnormal gonadal development in boys.

So all the boys who have ever played with Action Man are eunuchs? Get real. But don’t worry, the problematic pthalates have been banned from toys since the end of last century.

47 Be wary of giving your child unnecessary chemicals and drugs like antibiotics for benign conditions

Antibiotics have been linked to childhood diabetes; cold and flu medications can be deadly in small children; and steroids are responsible for many paediatric deaths. Avoid medications like salbuterol for asthma—it doesn’t work and can make the condition worse.

Dangerous nonsense. The basis on which WDDTY claims that cold medications are deadly is primarily evidence that you should only use the dose and type of medicine indicated for a child of the correct age; the adverse effects tend to be overdoses from giving infants doses designed for older children or even adults. Accidental and deliberate overdoses are both included.

WDDTY’s long-standing agenda against antibiotics is more puzzling: as a class of drugs, antibiotics have saved more lives than any other except perhaps vaccines. Oh, wait…

Past stories indicate that WDDTY believe you should allow your children to suffer ruptured eardrums rather than give them antibiotics for ear infections. Because natural. This may qualify as child abuse.

48 Avoid Ritalin and other drugs for hyperactivity

They can increase cardiovascular risk and trigger new psychiatric symptoms plus sudden death. If your kids are hyperactive, suspect sugar or processed foods. Artificial colours like tartrazine used in juice drinks or ‘squashes’ and salicylate foods can all cause hyperactivity and attention deficit.

Ritalin was never as widely used in the UK as in the US (where drugs are marketed direct to patients). NICE maintains a useful database of evidence. And this is what an evidence-based discussion might look like. Do you see how it includes both risks and benefits, unlike WDDTY?

In the UK, Ritalin is used only for serious cases, not for self-diagnosed or questionable diagnoses. As usual, it’s safe to say that your doctor is probably better informed on the risk / benefit balance for your child than some shrill anti-medicine harridan.

49 Avoid toothpastes with fluoride, and filter your water if it’s fluoridated

High levels of fluoride in drinking water can dramatically lower IQ in children, say Harvard scientists—enough to cause learning difficulties in children who already have lowish IQ.26

Reference 26: Environ Health Perspect, 2012; 120: 1362–8  Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Choi AL, Sun G, Zhang Y, Grandjean P.

And by high levels, they mean levels dramatically above the safe limits in drinking water. No water company adds these levels of fluoride.

It’s astonishing that as we approach the half-centenary of Dr. Strangelove, cranks are still repeating Major T. J. “King” Kong’s fulmination against fluoridation of water. The provable effect is a reduction in dental caries. And that’s it.

As always in medicine, anything given to healthy patients is subject to much more scrutiny than a drug given to the sick. Vaccines are another example. The evidence of safety has to be much more robust than for , say, a new antibiotic, because the risks of side-effects are offset only by potential benefits. Fluoridation of water (and toothpaste) has been studied intensely for a long time. There is no credible evidence of harm. Fluoridation is safe.

There is no credible reason at all to avoid fluoridated toothpaste. It might be wise not to snack on it, though.

50 Throw kids outdoors

Most infants and toddlers have low levels of vitamin D, some with levels below those needed to maintain and grow healthy bones.27 One school of thought maintains that by ‘protecting’ children against exposure to dirt and germs, we are inadvertently destroying their immune system’s ability to respond appropriately to infection and other stimuli. Diseases like eczema are far less prevalent in children who live in less sanitized conditions like farms and rural communities.28

Reference 27: Pediatrics, 2010; 125: 627–32 Adherence to vitamin D recommendations among US infants. Perrine CG, Sharma AJ, Jefferds ME, Serdula MK, Scanlon KS.

Reference 28: Clin Exp Allergy, 1999; 29: 28–34 Prevalence of hay fever and allergic sensitization in farmer’s children and their peers living in the same rural community. SCARPOL team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution. Braun-Fahrländer C, Gassner M, Grize L, Neu U, Sennhauser FH, Varonier HS, Vuille JC, Wüthrich B.

The idea that being in the outdoors is good for you is plausible and uncontroversial. WDDTY’s obsession with vitamin D, the idea that sunlight is “natural” and so “safe”, and their bizarre agenda against sunscreen, combine to make nonsense out of sense.

Australia has one of the best developed networks for surveillance of skin cancer. Guess what? Rural Victorians (those who get “thrown outdoors”) are 24% more likely to be diagnosed with melanoma.

So even when WDDTY advice has “truthinessW”, it turns out to be questionable and potentially dangerous, because WDDTY cares only about what WDDTY cares about, whereas medical advice usually cares about everything.

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100 ways to live to 100: Your healthy digestion

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

Your healthy digestion

11 Cut down or avoid eating wheat

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

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

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

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

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

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

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

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

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

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

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

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

12 Dump homogenized or pasteurized lowfat dairy

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

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

Reference 12a: Science, 1998; 279: 563–6 Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P, Hennekens CH, Pollak M.

Reference 12b: Am J Clin Nutr, 2005; 81: 1147–54 Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Tseng M, Breslow RA, Graubard BI, Ziegler RG.

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

13 Root out any allergies or food intolerances

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

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

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

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

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

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

14 Eat your greens for calcium

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

Reference 13: Am J Clin Nutr, 1999; 69: 74–9 Vitamin K intake and hip fractures in women: a prospective study. Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA.

Another rehash of the arthritis article’s claims, and continuing the WDDTY agenda against dairy. Needless to say the source does not support the claim: it finds that “Low intakes of vitamin K may increase the risk of hip fracture in women. The data support the suggestion for a reassessment of the vitamin K requirements that are based on bone health and blood coagulation.”

15 Check out your stomach acid

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

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

16 Find out if your gut is ‘leaky’

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

This message was brought to you by our sponsors.

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

17 Give up the white stuff

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

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

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

18 Periodically detox

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

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

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

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

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

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

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

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

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

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

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

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

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

20 Drink a bit of alcohol

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

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

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

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

100 ways to live to 100: Your healthy diet

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

Your healthy diet

1 Customize your diet to match your biochemistry

William Wolcott, the world’s leading authority on metabolic typing and author of The Metabolic Typing Diet (New York, NY: Doubleday, 2000), followed in the footsteps of his mentor, cancer pioneer Dr William Kelley, by exploring how the sympathetic and parasympathetic branches of the nervous system each regulate a different set of metabolic activities and so different organs and glands.

Most of us are influenced more strongly by one or the other neurological system, according to Kelley’s theory, depending on whether we are ‘sympathetic-dominant’ or ‘parasympathetic-dominant’—so one man’s meat may literally be another man’s poison. A high-protein diet has one effect on a ‘protein’ type, but a totally different effect on a ‘carb’ type. Wolcott discovered that by customizing a person’s diet according to metabolic type, many people with serious illnesses—including cancer—regained their health.

For a detailed test to determine your metabolic type, go to www.healthexcel.com.

William Wolcott is claimed to be the world authority on Metabolic Type® and The Metabolic Typing® Diet. Genuine physiological concepts do not have registered trademarks. Nobody is the world authority on Digestion®.

One of the more baffling things about WDDTY is its failure to appreciate that the same issues of commercial conflicts apply to the world of SCAM, as apply to “big pharma”. Merely liking the sound of what someone says does not change whether they have a vested financial interest in it.

The Kelley cranks are a weird lot. Bill Wolcott is an acolyte of Kelley, a former real estate salesman who married Kelley’s ex-wife Suzi and took up Kelley’s mantle; Kelley himself was an orthodontist who developed a version of cancer quackery that forms the basis of the Metabolic Type®  nonsense. He also used prayer and osteopathic manipulation.

Kelley’s most famous patient was Steve McQueenW. As usual in the world of quackery, McQueen’s rapid decline and death was no barrier to continued commercial success. Kelley became paranoid and depressive as a result of his failure to convince the medical community, was divorced by Suzi, lost his dental license, and his health deteriorated. He finally died of a heart attack in 2005.

Nicholas GonzalezW developed his quack cancer diet from Kelley’s. MSKCC describes both as lacking any credible evidence of efficacy: a clinical trial in 2009 found that patients on the regime died faster and experienced worse quality of life. Like McQueen’s death, this has done nothing to lessen the commercial success of the regime.

It is theoretically possible to accumulate more red flags for quackery, but it is quite challenging.

And this is no. 1, so presumably top of the list in terms of purported value.

2 Check your acid/alkaline balance—but in relation to your metabolic type

A food’s effect on the body depends upon the body’s many homeostatic controls, including the autonomic nervous system, the master controller of metabolism. According to Wolcott, vegetables alkalinize an autonomic-dominant person, but acidify an oxidative dominant type, those whose oxidative or aerobic system (responsible for the ‘long slow burn’ that keeps running in the background) is the controlling force. To maintain a slightly alkaline status, determine and eat for your metabolic type.

The human body has intricate homeostatic mechanisms that maintain bodily pH in the range 7.35-7.45. A blood pH below 7.35 is called acidosisW, and a blood pH over 7.45 is called alkalosisW.

Virtually everything said by nutritionists about pH is nonsense. This is no exception.

As noted above, Wolcott has absolutely no medical qualifications whatsoever. If you fancy trusting your health to a former estate agent who ran off with the wife of the many who taught him the quackery from which he now makes an evidence-free living, you are probably beyond help.

3 Eat organic whole foods and opt for locally grown, seasonal organic produce

Pesticides have been implicated in many illnesses, including infertility, cancer, birth defects, skin irritations and impotence. Organically reared stock fed on grass (what they’re meant to eat), not grains, and organic produce not only contains substantially more of the basic nutrients than intensively farmed varieties, but also up to 10,000 secondary nutrients essential for human health. As organic bacon and sausages may still include nitrates (carcinogens), purchase them from sources that guarantee nitrate-free products.

Over 50 years of nutritional assays have failed to establish that organic produce is nutritionally superior to non-organic. The evidence of pesticide effects is based on much higher exposures than the safe levels in produce, and as a recent WDDTY piece pointed out, these pesticides are much more serious in unregulated sources such as Chinese herbs.

Is whole food better for you? Maybe not.Whole grain products may be short of fibre.

If you are environmentally conscious it may make sense to buy from a local farmer’s market, but even that is open to question.

4 Cook from scratch

Avoid anything processed, canned, fried, preserved or laden with chemicals, processed, refined or in any way interfered with. Vary your diet as much as possible; most allergy specialists claim that allergies are more likely from tins and plastic bottles, which can leach bisphenol A, and avoid water in plastic bottles, which may contain oestrogen mimicking phthalates.

Terms like “laden with chemicals” are emotive but lack any substance. Everything is made of chemicalsW. That is rather the definition of chemicals. Canned and preserved food can be an important source of vitamins during the off-season (which is why canning was invented in the first place). Processed food is a pejorative without a formal definition. It covers everything from KFC to craft-produced ragout in jars at Waitrose.

The correct mix of foods and how they are prepared is strongly dependent on your household budget, not that WDDTY seem to understand or care about anything outside its core demographic of ABC1 women.

5 Eat a ‘power breakfast’

Those who consume a large proportion of their total calorie intake in the morning eat significantly less over the course of the day, which helps to treat or prevent obesity.2 Plus skipping breakfast increases your chances of a heart attack, high blood pressure and diabetes.

Reference 2: J Nutr. 2004 Jan;134(1):104-11. The time of day of food intake influences overall intake in humans. de Castro JM.

The results suggest that low energy density intake during any portion of the day can reduce overall intake, that intake in the morning is particularly satiating and can reduce the total amount ingested for the day, and that intake in the late night lacks satiating value and can result in greater overall daily intake.

Or to put it another way, people who snack in front of the TV at night, eat more.

This one study definitely does not prove a causal link, it is associative only – and as we know, most observational studies are wrong, though there is evidence that skipping meals causes people to overeat at the next meal. Skipping breakfast is probably a bad idea, but stuffing yourself full of carbs at breakfast time may well not make any difference over and above a normal healthy breakfast.

6 Don’t limit saturated fats and don’t ever opt for ‘low-fat’ or hydrogenated foods

The supposedly ‘good fats’—polyunsaturated fats from vegetable oils (corn, soy, safflower and the like)—appear to predispose people to cancer, whereas animal fats may be protective, preventing heart disease, osteoporosis and even cancer. Two large studies show that regularly consuming more saturated fats leads to less disease progression than following a diet higher in polyunsaturated fats and carbs.3

But avoid trans fats—produced by hydrogenation, when hydrogen added to liquid vegetable oil to make it solid at room temperature—as they’re linked to greater risks of heart disease and stroke.4

Reference 3a: Am J Clin Nutr. 2004 Nov;80(5):1175-84. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. Mozaffarian D, Rimm EB, Herrington DM.

Reference 3b: J Intern Med. 2005 Aug;258(2):153-65. Dietary fat intake and early mortality patterns–data from The Malmö Diet and Cancer Study. Leosdottir M, Nilsson PM, Nilsson JA, Månsson H, Berglund G.

Reference 4: J Am Coll Nutr. 1996 Aug;15(4):325-39. Dietary trans-monounsaturated fatty acids negatively impact plasma lipids in humans: critical review of the evidence. Khosla P, Hayes KC.

A rather more sensible approach is to eat less fat. The three studies’ findings:

  1. In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression.

  2. With the exception of cancer mortality for women, individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality.

  3. Preliminary evidence suggests that at least part of [trans fats’] impact on lipoproteins reflects increased serum cholesteryl ester transfer protein activity, i.e., increased transfer of cholesteryl esters from HDL to LDL. Since the adverse effects of t-FA on human plasma lipids may be confined to specific isomers, future studies delineating their effects are warranted.

So a source which applies only to post-menopausal women is asserted to be general, a source that finds no increase in cancer except for women is portrayed as saying that saturated fats prevent cancer (pretty much the opposite of the actual finding, which finds an increase in women but not much of one), and a technical preliminary finding that is spun because WDDTY love the idea of the “good cholesterol vs. bad cholesterol” debate that they use as a stick with which to beat statins.

In other words, this is agenda-driven and often counterfactual spin. You should not eat unlimited saturated fat as they claim.

7 Don’t count calories

Keep your weight steady with index diet (or When compared diets, the GI diet was the best of all for losing weight.5 The diet ranks carbs according to their effect on blood glucose levels. Carbs with a low GI score produce only small fluctuations in blood sugar and insulin levels, whereas high-GI foods cause a sudden sugar rush. Avoid processed foods and ‘white stuff’—white bread, white sugar and white rice—as well as fried foods and potatoes in favour of low-GI meats, fish, pulses (beans) and most vegetables.

Reference 5: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005105. Low glycaemic index or low glycaemic load diets for overweight and obesity. Thomas DE, Elliott EJ, Baur L.

This study does not claim that GI is the best diet, only that it was more effective than the other diets tested. It refers primarily to obese people undergoing treatment for obesity. It acknowledges that further work is required to establish whether there is a long term benefit.

However, the low-GI diet is rational and not in the least bit alternative. It was first proposed over 30 years ago in the American Journal of Clinical Nutrition, and is a mainstay of the advice offered by dieticians. There is no doubt that nutritionists like those who write and advertise in WDDTY follow a range of fad diets of variable implausibility so if this represents the first steps in a move away from advertising fad diets and towards evidence-based advice, it’s good. Admittedly the blanket prohibition on “white stuff” is not a good start; dieticians tend to look at the overall diet not just howl “teh processed!” at things they find ideologically unacceptable.

8 Don’t drink the water

Our entire water supply contains some 350 toxic chemicals plus industrial waste, disease-carrying microorganisms, chlorine and fluoride, some 100 pharmaceutical Pregnant women usual heavily chlorinated water double their risk of giving birth to a child with serious defects.6 Consider installing a reverse osmosis water filter with an added carbon filter, which will remove everything. But as this includes minerals too, be sure to supplement.

This message was brought to you by our sponsors…

There is no credible evidence of a general requirement to filter domestic mains water in this way, and WDDTY’s advice to use bottled water is diametrically opposite to their advice re buying local produce – transporting bottled water is an incredibly wasteful business because whatever WDDTY claim, the water delivered to your tap by your water company is clean, safe and environmentally sustainable. It almost certainly contains no significant levels of the “toxic chemicals” WDDTY assert, though this is hard to verify because as always the appeal to “toxins” lacks any actual definition of what toxins and at what level.

Water itself is toxic, in excess. It’s also a chemical. So arguably, yes, your tap water contains dangerous levels of deadly dihydrogen monoxide.

9 Get your omega-3 to omega-6 ratio right

Avoid an imbalance between the ratio of omega-3 to omega-6 essential fatty acids (EFAs), as these fats regulate the major bodily functions, and deficiencies are behind many degenerative diseases. The optimal ratio is 1 to 1,7 but the modern Western diet’s usual ratio is around 1 to 20 in favour of omega-6 EFAs from vegetable oils (like safflower, sunflower and corn oils). As a general rule, increase your intake of omega-3s (like eicosapentaenoic acid, or EPA) and reduce your omega-6s (like gamma-linolenic acid). Opt for fish oils and foodgrade flaxseed (or linseed) oil, which is 60 per cent omega-3.

This claim was covered in our discussion of the December 2013 issue’s nonsensical article on arthritis. It’s not well supported.

10 Eat fish with caution

Most are now tainted by industrial waste and high levels of mercury, including ‘farmed’ fish, which have been fed inappropriately with grains. Avoid swordfish, tuna and other deep-water fish, as these are likely to have more mercury than smaller varieties of fish from shallower waters. Rotating your protein sources will help to minimize your exposure to specific chemicals.

WDDTY is turning into an Eddie Izzard skit on the Daily Mail. Fish is good, but it gives you cancer. The reference to “specific chemicals” is amusingly ironic, since it’s unspecific and everything we eat is made of chemicals by definition.

How about: eat a balanced diet? Would that cover it? I’m sure doctors don’t tell you that, at least not unless you actually ask them.

Polio in WDDTY

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

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

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

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

Continue reading Polio in WDDTY

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).

Natural pain relief

From WDDTY e-news 3 April 2007 No.347

Natural pain relief

A reader is eager for advice on how he can replace prescription pain medication with a natural alternative.  He suffers from multiple herniated discs and degenerative disc disease and without medication the pain is unbearable.  He has chronic pain in his lower back, buttocks and sciatic nerve.  He currently takes oxycodone, fetanyl (skin patch) and methadone in high doses, but doctors say his medication can be reduced if he opts for surgery.  He has had surgery for his condition in the past and is not keen to have any more operations.  Is there a natural remedy out there that may be able to help?

If you seriously believe that a magnetic bracelet can replace high dose methadone, then you have absolutely no business offering health advice.

Let’s be really clear here: as @LennyLaw pointed out on Twitter, this man is in agony due to serious structural problems. He is unlikely to get relief without some form of surgical intervention. The pain killers he is using are among the strongest available, and go way beyond the “ooh my dodgy knee felt a bit better” kinds of effects that the quack treatments proposed could provide, even if they worked as advertised.

But what counts as “natural”? What “works”? Let’s review the responses one by one:

Bioflow wristbands

According to Nick, you should try a Bioflow wristband, which uses a patented magnetic module to treat the blood and assist the body to heal itself, providing natural pain relief.  “My arthritic thumbs and knees no longer give me any pain and I am sleeping better and have more energy,” he reports.  Another reader points out that the wristbands have been proven to reduce pain in a clinical trial of nearly 200 men and women with osteoarthritis of the hip or knee (BMJ, 2004; 329: 1450-4).

Apparently, Bioflow comes with a 90-day money back guarantee, so there is nothing to lose – but the pain!  See www.usefulmagnets.co.uk for more information.

Does it work?

Bioflow have a sciencey-looking study and are apparently classified as a class 1 medical device. So how do they work?

ernst-bioflowEr, apparently they don’t. The website makes no claims for therapeutic effect other than to cite the study. To see the problem with this approach, check this crank website making all kinds of inflated claims for the product – note the weasel words. Intriguingly the study is from Peninsula, and was overseen by Edzard ErnstW. I asked @EdzardErnst whether the result was reliable. His reply was unequivocal (right).

The consensus of systematic reviews is that magnets do not objectively improve symptoms of arthritis or any other condition (Complement Ther Med. 2009 Oct-Dec;17(5-6):249-56, FACT Volume 13, Issue 1, pages 5–6, March 2008).

Is it plausible?

No. There is no reason to suppose that these permanent magnets should have any effect whatsoever. They are, after all, quite small magnets, much stronger fields are used in medical imaging with no evidence of clinical effect (CSI, BBC). Some of the authors of the study Bioflow cite, have since published a rather different view.

 

Is it natural?

No. There is nothing remotely natural about wearing chunks of rare-earth magnets. These are an industrially manufactured product. And a profitable one: the magnet therapy industry was estimated at $1bn by CSI five years ago.

Should WDDTY have known this?

Probably. They promoted Bioflow in vol 16 no. 9 (Dec 2005), vol 17 no. 4 (Jul 2006) and vol 18 no. 3 (Jun 2007), as well as in this article from their e-news. Claims for magnets date back a long way, with sciencey-looking studies in the late 90s being prominently promoted (CSI). They have been busted for at least as long (e.g. Ann Intern Med. 1993;118(5):376-383).

Icewave

Another recommended product for natural pain relief is IceWave.  According to the manufacturer’s website, IceWave is “a non-invasive nanotechnology product that works within minutes to provide a cooling effect and soothing relief to inflamed and injured areas.”  See www.lifewave.com for more information.

Does it work?

You have to be kidding. LifeWave is a vendor of devices to “protect” you from non-ionising (i.e. essentially harmless) radiation, it is a predator on the vulnerable (people with chronic pain).

Our exclusive non-transdermal patch system utilizes new technology to gently stimulate acupuncture points – literally improving the flow of energy in the body for improvement of pain and discomfort – within minutes of use!

Needless to say, there is no good evidence that acupuncture points are of any physiological significance (J Intern Med. 2006 Feb;259(2):125-37). There’s no uniform definition of where they are or what they do; the apparent uniformity within parts of TCM is largely an artifact of the Maoist refactoring f TCM in the 1950s – Japanese analogues exist but are different, and needling does not seem to have any different effect whether the “correct” points are used or not.

The sales pitch relies on the usual anecdotes. Oh, and the packaging says they are homeopathic, hence the nanobollocks, presumably. And note the quack Miranda warningW.

Is it plausible?

Not remotely. And to be fair they don’t even try to make it look plausible, other than using sciencey-sounding language.

Is it natural?

No. It’s an entirely synthetic product with completely made up claims.

Should WDDTY have known this?

Almost certainly. The community that promotes LifeWave’s numerous bogus products is well aware of the fact that skeptics know it to be bogus. Oh, and it seems to be sold via multi-level marketingW, which is another red flag.

Homeopathy

If these suggestions don’t appeal to you, why not try readers’ favourite, homeopathy. According to Sue, the homeopathic remedy Mag Phos in a 200C potency (available from homepathic pharmacies such as Helios and Ainsworth’s) is known to be very effective for pain relief, especially if dissolved in a little warm water and sipped at regular intervals.  Norene also swears by homeopathy for the treatment of pain – although she uses arnica:  “Start with a very high dose of arnica (for myself I used 10M).  After a couple of days, reduce the dose and continue taking the remedy for a while, according to personal needs.  To maximise effectiveness, take homeopathic Symphytum (comfrey) in addition to arnica.”

Does it work?

No. There is not one case where homeopathy has been unambiguously and objectively proven to have cured anything, ever. All observations are consistent with the null hypothesis (see homeopathyW at Wikipedia, which goes into great detail).

Is it plausible?

No remotely plausible mechanism has ever been advanced, and the doctrines of homeopathy conflict at a fundamental level with basic principles of physics such as the Heisenberg uncertainty principle and the laws of thermodynamics and conservation of energy. Unless you believe in “future-information medicine“, in which case you may be interested in buying this rather fine bridge I have for sale.

Is it natural?

No. Not only is the entire system of preparation by dilution and twerking entirely man-made, most over the counter remedies are manufactured by industrial scale pharmaceutical companies.

Should WDDTY have known this?

Yes. Homeopathy has been known to be wrong since at least 1840, and the doctrines were refuted by the early years of the 20th Century.

Bowen therapy

Other suggestions for this problem are Bowen therapy and osteopathy.  Says Lorraine of osteopathy, “I cannot sing its praises enough…I suffered terrible back problems but have not felt a twinge in the past six years since my treatment.”  As for Bowen, Angela reckons it can bring amazing relief to many pain sufferers.

Does it work?

It depends who you believe. SCAM believers claim it is “useful” (source),  but when challenged, practitioners were unable to provide any credible evidence.

So that’s a no.

Is it plausible?

Bowen was an unregistered osteopath. There’s no reason to suppose that Bowen technique  has any effect beyond that of massage, which is basically what it is, when the bullshit is stripped away. Claims to allow the body to “reset” itself are fanciful. You’re probably better off with a warm bath.

Is it natural?

Massage is sort of natural, Bowen technique is completely made up.

Should WDDTY have known this?

If you look for any credible evidence, you find none. If on the other hand you routinely believe the claims of commercial providers of services at face value without looking for evidence or applying any critical judgment then you’ll probably not spot that it’s quackery.

So, if WDDTY pretends to be in any way scientific or evidence based, it absolutely should have spotted this.

Osteopathy 

Finally, we have an encouraging story from Diane:

“I have suffered from bulging discs, sciatica, oedema and a host of related problems for the past three years.  But recently I have started several therapies which have helped me immensely.  First of all I started going to acupuncture once a week, then I began drinking Green’s Plus – adding powdered calcium, magnesium, and powdered MSM (Methyl-sulfonyl-methane) to the drink – everyday for nutrition.  MSM is a great natural pain reliever, along with magnesium.  I also use magnesium oil – either in the bath or applied directly to the site of pain.  It works wonders!

Does it work?

Osteopathy is a grey area. There is evidence of effects for musculoskeletal pain, as for any manipulative therapy, but the claims of the fringes of osteopathy (and especially cranial osteopathy aka cranio-sacral therapy) are unambiguously bogus. The writer also adds acupuncture (bogus), magnesium (plausible to a degree) and MSM (bogus) to the mix.

Is it plausible?

As invented by Andrew Taylor Still the practice is completely speculative – he surmised that the bone (osteon) was the root of all disease, and this is unambiguously nonsense, but subsequent changes have resulted in a variety of manipulative therapy which is plausible for some conditions, but wildly implausible for others. Note that this varies around the world, the Wikipedia article on osteopathyW is essential reading.

Is it natural?

The practice was invented from whole cloth in 1874. It’s a manual therapy so you could defend it as natural, but the practice is largely a set of man-made rituals.

Should WDDTY have known this?

Yes. The consensus around osteopathy has been settled for a long time.

Chiropractic

In addition to this, last year I started seeing a chiropractor, who uses a ‘Pro Adjuster’ on me.  I have now been free of pain for the last month.  I was told that I was going to have to have back surgery, but now I am feeling so wonderful that I am considering not having the surgery at all.  I can go all day without my pain medication and can sit and stand longer than I ever thought I would again!”

Does it work?

No. OK, technically, it is as effective as other forms of manipulation therapy for musculo-skeletal pain, but so many chiropractors exceed the bounds of evidential supportability that it is safer t avoid them altogether, especially given their history of antivaccinationism and the fact that one of their signature moves is potentially deadly.

The chiropractic profession includes some of the most cynical charlatans on the planet. Their training is big on “practice building” (i.e. maximising revenue) and chiropractors’ aim is to get you in, and keep you coming back, not to discharge a healthy patient. They use all manner of superstitious nonsense about “maintenance adjustments” and maintaining optimum wellness, but basically they are the canonical manipulative quacks.

Is it plausible?

As Wikipedia says:

A critical evaluation found that collectively, spinal manipulation failed to show it is effective for any condition. The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation. The ideas of innate intelligence and the chiropractic subluxation are regarded as pseudoscience.

So as with osteopathy, it’s plausible up to a point, but the profession as a whole is deeply untrustworthy due to widespread belief in completely bogus ideas, and a tendency to duplicate the action of hanging.

Is it natural?

No. It was invented from whole cloth by D. D. Palmer in 1895

Should WDDTY have known this?

The facts about chiropractic have been known for a long time. Yes, WDDTY should know that this is a dangerous woo-riddled field that no responsible person could possibly recommend without serious caveats around the likely harms and the costs of endless unnecessary treatments.

Summary

WDDTY’s ideas of what constitutes a “natural” remedy are absurd and seem to be founded more on the absence of credible evidence (i.e. being “alternative”) than on any actual natural origin. They try to have their cake and eat it, simultaneously claiming that something is “natural” and that it’s “nanotechnology”.

Their approach to the therapies is entirely credulous. Homeopathy was refuted over a century ago, they still promote it. There is no evidence that their enthusiasm for a product or treatment is conditional on plausibility or evidence of effect.

The article acts primarily as a propaganda piece for disproven or unproven therapies, often at significant potential cost.