Archive for June, 2008

From Cochrane reviews to celeb bowels: Holford bestrides the arena

June 8, 2008

Star UK Nutri-Guru Patrick Holford may not be an Honorary Professor any more, but he still likes to quote (or perhaps “cherry-pick”) science to help pitch his advice, books and supplements.

An example is on the extensive website dealing with the modestly-entitled “Holford Low-GL diet”, where he has a bit talking about a recent Cochrane review of Low Glycaemic Index (GI) / Low Glycaemic Load (GL) diets for weight loss. Somewhat oddly, since the review is about both, Holford’s site only talks about the study saying that low GL diets might help with weight loss (in fact, he manages to mention this a stunning seven times in under 200 words). I hope this omission of any mention of low GI diets is not coloured by the fact that Patrick promotes “low GL” schemes heavily as being far superior to “low GI” ones. Perhaps I will come back to this another time.

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Science (ish) AND celebrity testimonial! How splendid.

Directly under the link to the Cochrane review on Holford’s website is a link to the inevitable celebrity testimonial anecdote, where we are treated to the story of Z-list celeb and serial footballer-dater Danielle Lloyd’s dramatic loss of 10 lbs on the Holford diet.

Patrick tells us that poor Danielle was in a bad way when she consulted him:

“A diet of crisps, sweets, McDonalds and beer as well as lack of exercise had led to Danielle becoming her heaviest ever, and suffering from health problems such as poor digestion, lack of energy and severe premenstrual syndrome.”

Ah… so that was what all the Celebrity Big Brother 5 fuss was about…

Anyway, the food Patrick’s diet includes, if the daily menu listed for Ms Lloyd is representative, is perfectly sensible. Of course, this is not altogether surprising since there is rather less difference than you might think between a “detailed Low-GL weight loss diet plan” and the famously concise dietary advice from New York Times writer Michael Pollan that Holfordwatch like to quote:

“Eat food. Not too much. Mostly plants”

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But – Food is never enough for Nutritionistas

If sensible dietary advice was all that was on the table (lame pun), Patrick and the rest of the Nutri-gurus would not annoy me so much. As ever, though, the Nutritionistas cannot just leave it at that. You invariably need a whole load of add-on nonsense too, preferably at considerable expense (to you).

This pattern is followed for Danielle Lloyd. As Patrick goes on to tell us, after the inevitable York Laboratories “Food Intolerance” test

*sigh*

- and the equally inevitable resulting diagnosis of “dairy intolerance”

(PS – does anyone who has Patrick’s tests ever NOT get diagnosed with dairy intolerance?)

- Ms Lloyd is now much restored, thanks to, inter alia:

“[ supplemental] digestive enzymes, probiotics and a teaspoon of glutamine powder- which is like an MOT for your insides.”

Luckily, Danielle will not have to maintain this punishing regime because now that she has had her Holford Full Service Bowel MOT she can be kept roadworthy with some minimal (though not exactly cheap) routine nutritional maintenance:

“She will… not need these but will continue to take my Optimum Nutrition Pack”.

Which is one of Patrick’s cheaper supplements at a mere £ 1.25 a day. The advertisting tells us that this supplement is Taken on a daily basis by Patrick Holford himself”.

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A (proper) doctor writes

Dr Crippen over at NHS Blog Doctor has been blogging about nutritionists this weekend, and summarizes the mainstream medical and scientific view – and cynicism about the supplement peddlers – thus:

“There is nothing wrong with dietary advice and anyone out there wanting sound dietary advice need look no further than the British Dietetic Association which I frequently recommend to patients. There is nothing wrong with good nutrition either. Where most doctors part company with “nutritionists” is when they start to make extravagant and scientifically unfounded claims about the healing powers of particular nutritional regimens. Eat more “insert your favourite food” and you will have less chance of getting “insert your favourite cancer”. Odd diets are often supplemented by recommendations to take huge quantities of additional minerals and vitamins, and the really astute “nutritionists” will have internet web sites from where they sell plausible combinations of said vitamins and minerals.”

Of course, this doesn’t sounds like a description that could fit Patrick Holford…

…er…

No, surely not. Patrick truly bestrides the world of nutrition like a colossus. From Cochrane reviews to Micro-celeb tummy in one click of a mouse. Truly, mere words cannot do the man justice.

Who needs facts? These vaccine conspiracy pieces write themselves…

June 4, 2008

As I write this, Chief PR Man and Publicist of the “New Wave” Vaccines-Cause-Autism-No-They-Really-Do movement, David Kirby, should have done his turn in the House of Lords and be winding up his “free public lecture”. I won’t wish him the stocks and some rotten fruit – that would be churlish – though I might hope his audience includes some of the London-based Badscience fraternity, and/or a few sceptical scientists and doctors.

(Sadly, an audience of rabid mercury obsessives, anti-vaccine nuts, ambulance-chasing lawyers, credulous journalists, nutritionistas, Patrick Holford and Dr John Briffa seems more likely. But let’s hope I’m wrong).

What I am really, really hoping is that Kirby’s turns at the HoP and later do not produce more dismal newspaper articles tomorrow like the one the Daily Telegraph ran last week.

Ah, the Telegraph.

Those snippy satirists over at Private Eye have been running stories for some weeks suggesting that all is not well at the Telegraph, that once esteemed bastion of the more pepper-ish end of the British Establishment.

(For any non-UK based readers, I should explain when I was growing up in the 60s and 70s it was understood that all retired British colonels read The Times. Retired colonels who felt we could have kept the Empire by shooting more indigenous people, and who mourned the abolition of hanging and flogging, also read the Telegraph, as did all Conservative Party voters aged over 60).

Several of the Private Eye stories involve the abolition of posts at the Telegraph for specialist correspondents, all while the number of people there tasked with reporting the minor doings of “Celebs” increases. In the latest piece on this, Private Eye comment on the departure of one of the Torygraphs’s science reporters.

When I read this it reminded me I had meant to do a post about the Telegraph’s deeply lame more MMR “controversy” article, before I got buried under a pile of students’ exam essays.

So now that I have some time, what is the connection between the Telegraph’s latest here-we-go-again chunk of MMR idiocy, and the apparent disappearance of their specialist correspondents?

Wanted: MMR journalists – relevant background strictly optional.

Well, Cassandra Jardine, the journalist credited with the Telegraph story, is not a science or medical correspondent. She is a writer who mainly deals with parenting and parent issues.

If the reporting of the MMR saga taught us one thing, it is that media coverage of medical and scientific topics by non-science-literate journalists is a recipe for slavishly credulous bollocks.

A lot of serious analyses of the media coverage of the original Andrew Wakefield-triggered MMR furore have been written. One scholarly one, written by academics at the Cardiff University School of Journalism , can be found here.

One of the points highlighted is how vast quantities of the coverage was written by news or “feature” writers, and not by specialist medical or science correspondents – who might have had a chance of understanding the issues, or at least of thinking it was important to report that all the science, scientists and doctors were lined up solidly against Wakefield.

Instead, the coverage keyed on parental fears, on the feeling that public health officials and the Government were being evasive – vastly exacerbated by the Blairs’ refusal to reveal what jabs they had given baby Leo – and on the narrative device of the ”Brave Maverick Doctor” (Andrew Wakefield).

A number of the feature journalists writing about MMR seemed to find Wakefield’s undoubted charm and charisma, plus the triple narratives of “tragic parents”, “brave maverick doctor” and “Government conceals the truth” utterly irrestible. Quite a number of them seem to have made virtually entire careers out of it.

Michael Fitzpatrick, GP, author, parent of an autistic child and vaccine scare debunker, wrote an angry piece some time back in which he produced a list – though as he says, a non-exhaustive one – of:

Gullible hacks: journalists duped by the anti-MMR campaign

One of the names that appears on his list is that of Beezy Marsh of the Daily Mail. Many of Marsh’s articles on MMR for the Mail were coauthored with Sally Beck.

…who is credited at the end of the Cassandra Jardine piece for “additional reporting”. A quick Google of:

“Sally Beck” autism MMR

- reveals many previous MMR / autism stories, including the ones co-authored with Beezy Marsh.

So Cassandra Jardine’s “researcher” on the Telegraph story is a journalist with a long history of writing credulous MMR stories. What a surprise.

Who needs balance when you’ve got controversy?

A hallmark of many stories written by the journalists on Mike Fitzpatrick’s list is that they purport to cover the MMR saga in a balanced way, but have been castigated by the Bad Science blog-o-verse for factual errors, for quoting multiple anti-vaccination campaigners without making their allegiances clear, and for presenting the story as if the evidence and informed opinion over MMR and autism was evenly balanced. To give an example, you can find Sally Beck’s and Beezy Marsh’s articles being flayed online by one blogger from the genetic and “neurodiversity” autistic causation / treatment camp (e.g. here).

Jardine’s Telegraph article, with Beck’s “additional reporting”, quotes David Kirby extensively. It also quotes ex-NIH Head Bernardine Healy. It quotes actress and “model” turned autism and anti-vaccination activist Jenny McCarthy It quotes a lawyer for UK parents who want to sue the MMR vaccine manufacturers. It quotes Laura Hewitson of the University of Pittsburgh, whose (very) preliminary study on giving monkeys vaccines is being touted as the new “smoking gun” by anti-vaccination activists.

The only voice on the other side is Sir David King, the former Government Chief Scientist, quoted early on (in one line of an article that runs to nearly 1700 words) as saying that epidemiological studies have found no link between the MMR vaccine and autism.

Everyone else quoted in the article, with the possible exception of Bernardine Healy, is an out-front anti-vaccination voice. There is the parent and campaigner (Jenny McCarthy). There is the spokesperson (David Kirby). There is the lawyer for the parents who are convinced that vaccines damaged their children. Remember that the abandoned UK anti-MMR vaccine litigation depended heavily on lawyers acting for the parents, who secured the legal aid that eventually paid out over £ 15 million pounds to fund the lawsuit. Much of this £ 15 million of taxpayers’ cash went to a motley collection of often ill-qualified or discredited “experts”, most of them connected to Wakefield, almost all of them unashamedly anti-vaccine, and some of them quite clearly bonkers.

Laura Hewitson is described in the Telegraph article as a scientific specialist in obstetrics, gynaecology and reproductive sciences at the University of Pittsburgh. All of that is accurate. However, she is also, as revealed on the autism blogs, a litigant in a vaccine-injury suit. Her partner is the IT man for Andrew Wakefield’s Thoughtful House autism clinic. And Andrew Wakefield is a co-author on her work, which is yet to appear in a peer-reviewed publication and has been scientifically dismantled on the blogs.

[2010 update - as those who follow the MMR story will know, Wakefield is now gone from Thoughtful House, his departure closely following the damning GMC judgement. However, the TH website now tells us that Laura Hewitson "joined Thoughtful House in 2008 as a staff scientist". Hewitson also appears no longer to be employed by the University of Pittsburgh. So Hewitson seems to have replaced Wakefield as TH's senior researcher.]

Of all those quoted, only Bernadine Healy has the slightest claim to be taken in any way seriously. And even she is hardly reliable when the consensus of expert opinion is completely opposite to what she is saying. Healy has recently used her newspaper columns to make rather odd statements lashing out at the “Evidence Based Medicine” movement. It is also a long time since Healy was involved with the NIH – she was director from 1991-3, appointed by George Bush Senior, and in recent years she has been mostly a high-powered administrator. It has brought a wry grimace to the face to see how her remarks about MMR have been hailed by the anti-vaccine lobby, who are usually vociferous in their loathing of any “medical establishment authority figure”, and complain loudly about “argument from authority”. Personally I do not think Healy is terribly credible on the MMR-autism issue. She is, or was, a cardiologist, not an immunologist, paediatrician, epidemiologist or vaccine specialist.

So – was this a balanced article? Hardly.

So what was it?

It’s The Men in Black (Vaccine Branch)

An interesting comment by Sally Beck appeared last summer on the noted Autism blog Left Brain Right Brain (comments thread here), and seems to me to give an insight into the kind of journalistic thinking so much in evidence over MMR:

Sally Beck on July 18th, 2007 23:03:03

Just to throw this into the mix. As a journalist checking this shambles since 1998. It’s interesting that the first two facts thrown at me by government didn’t stand up. The first was that MMR has eradicated measles. Check the ONS figures back to 1890 and you’ll see that the measles problem was solving itself nicely without intervention. The graph had virtually flatlined before any medical intervention, meaning that the single measles jab and the MMR had very little to do with the reduction in deaths. Plot a graph logarithmically and you’ll see that deaths from measles would have ceased quite naturally this year. To put deaths from measles into perspective, the year the MMR was introduced there were 16 deaths. Deaths from asthma currently stand at around 1500 annually…

When the medical profession disected Wakefield’s peer reviewed 1998 study, in a newsletter titled ‘problems in pharmacology’ (monthly newsletter to GPs, interestingly titled) they concluded that they could neither prove nor refute the findings. They felt this was enough to recommend continued use of the MMR. I wonder why they didn’t recommend further research so that they could conclusively prove or refute?

In the chronology of the affair I’ve been noticing that newspapers have continually forgotten to list that the MMR jab was withdrawn here – as it was in Canada and Japan – because the cheap version they introduced was causing encephalitis and meningitis. All the children in Wakefield’s study had received this jab with the Urabe strain of mumps.

The children who’ve allegedly died from measles: So far we have no names, only newspaper reports. What do we really know about these kids? Do we know whether they actually existed – if so, someone put me in touch with a parent so I can interview them. Do we know whether their immune systems were compromised in some way? Do we know whether they were taking immunosuppresant drugs? We know very little about them. What we know after centuries of catching measles is that healthy children do not die of measles. I suspect most of the authors here over 40 have all had measles. I know I certainly have and I don’t seem to be impaired in any way – even at this late hour.

What we can conclude is that we are not being given the full picture. Nothing here is transparent and until the facts from both sides are laid out on the table, we really won’t know. I’m looking forward to following the GMC hearing.

(italics mine)

So basically, it seems Sally Beck is from the “there must be a conspiracy here somewhere” school of journalism that has done so much over the last decade to sustain the MMR-autism link mass delusion.

For a recent example of what can happen to healthy children who catch measles, even if there are no lasting consequences, this is worth a read.

A re-write of some of Sally Beck’s comment above, to re-adjust it closer to reality, might run as follows:

“What we know after centuries of catching measles is that most healthy children do not die of measles, provided we have sophisticated hospital care available for the ones that get really ill. And even then about 1 in every 2000 kids who get measles will be permanently brain damaged, or will die. I suspect most of the authors here over 40 have all had measles. I know I certainly have and I don’t seem to be impaired in any way – even at this late hour. Of course, because the numbers that suffer permanent damage are small with modern advanced care, we are likely not to have personally known anyone who was seriously ill with measles. This tends to make us believe – erroneously – that measles is just uncomfortable, and no more.”

Well, I have some news for Sally Beck:

The doctors who have treated kids with life-threatening acute viral illnesses on the medical wards and ICUs, including Mrs Dr Aust, would disagree.

And I also have a suggested alternative title for the Telegraph article:

“MMR – the “debate” that won’t go away – because journalists don’t understand science, but instinctively see column-inch generating Govt cover-ups everywhere”

PS - one of Andrew Wakefield’s greatest fans among UK columnists has always been that scourge of centre-left orthodoxy Melanie Phillips, who also weighed in again on MMR last week. A special Talking Science “above and beyond” award ought to go to Black Triangle.blog proprietor Anthony (Cox), who can be found on the comments thread below the article trying to explain science and evidence to the anti-vaccine believers. His restraint and calm in the face of flaming, taunting and name-calling, not to mention blinding stupidity and frank obsessional psychoses, is positively superhuman.


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