Archive for the ‘Patrick Holford’ Category

The Tragic Human Cost of Political Idiocy and AIDS Pseudoscience

December 13, 2008

In which Dr Aust ruminates somewhat unoriginally on the desperate consequences of delusional thinking about medicine… when the deluded are the people running the country.

Somewhat submerged under the media storm over the Bombay terrorist attacks, last month saw the publication of a sobering estimate of the true human cost of the Mbeki government’s decade of incomprehensible HIV denialism in South Africa. The Guardian covered the story here.

The basic history is no doubt well known to most readers in the Badscience blogosphere; as the millenium dawned, South Africa faced an unprecendented AIDS crisis, with 10% of the population infected with HIV. However, seemingly enchanted by the claims of maverick scientists like Peter Duesberg, President Thabo Mbeki and his government decided to pursue a policy based on the view that HIV was not the cause of AIDS. They therefore failed to implement programmes of treatment with antiretroviral drugs – the drugs that had transformed the prognosis of HIV-positive patients in other parts of the world in the late 90s.

They continued with this policy as yet more scientific evidence accumulated that HIV was the cause of AIDS.

They continued as HIV-positive people in many other countries had their death sentences stayed by antiretroviral therapy.

They continued even when the cost of the antiretroviral drugs tumbled, and when global schemes were set up to fund the treatment programmes.

They continued even though studies showed antiretroviral treatment was cost effective in South Africa.

And they continued even when South Africa’s poorer regional neighbours, like Botswana and Namibia, managed to implement treatment programmes.

The authors of the recent estimate summarise some of the timeline in a handy diagram:


To see the original,  go to the paper, click the “Full text” link, then “Fig. 1”, and finally click the figure itself to get an enlarged version – or, when you reach the full version of the paper, click “View full-size inline images”.

Among the things the Mbeki government failed to do was implement programmes to treat HIV-positive pregnant women. An untreated HIV-positive woman has around a 25% chance of passing HIV on to her child during childbirth. With antiretroviral therapy, that transmission risk can be reduced to around 10% in developing world settings with vaginal delivery, or even to only a few per cent in some recent studies (for a medical review of some recent trials see here, or the Cochrane summary here). This is not enough on its own, sadly, as breast feeding can also pass on the virus – but it is a start. Around half to two-thirds of children who acquire HIV from their mothers in the developing world do so during delivery.

Estimating the true cost in lives

The stories that appeared last month centred round a new analysis, by a group of workers from the Harvard School of Public Health, that estimated how many lives the Mbeki regime’s failure had cost. They did this by assuming that South Africa could have achieved something approaching the kind of treatment coverage and results that proved possible in neighbouring Botswana and Namibia, countries with similar social and infrastructure “contexts”.

The authors estimate – and they make clear that their estimates are “conservative”, so likely to be on the low side – that each year from 2000 to 2005, about 7000 HIV-positive babies were born in South Africa who could have been born virus-free had their mothers been treated.

They also estimate that around a third of a million people in all died unnecessarily over these five years. People who might have lived had they got timely treatment with antiretroviral medication.

The terrible effects of this death toll, of course, go beyond the lives of those lost. In the Introduction of their paper, the authors note that:

Approximately 1.2 million children [in South Africa] younger than 17 years have lost one or both parents due to the [HIV/AIDS] epidemic”.

So what caused the Mbeki Government’s disastrousfailure? The authors of the study discuss one salient issue, that of the cost of the antiretroviral drugs, and conclude that this cannot account for the South African government’s actions. They could have afforded the programme, as their poorer neighbours ultimately did. The cost of the drugs has dropped dramatically over the last decade, largely due to pressure on the pharmaceutical companies from activists and campaigners – the real heroes of the hour – as well as from governments, NGOs and charities. So cost alone was unlikely to have been the decisive issue.

The South African government also chose to convince itself that the scientific consensus that HIV caused AIDS was uncertain.

One vehicle for this was Mbeki’s notorious Presidential Advisory Panel on AIDS in 2000. The Panel included Peter Duesberg and a bunch of other “HIV sceptics”, like Harvey Bialy and David Rasnick (the latter now seems to have fetched up working for the Dr Rath Health Foundation in South Africa).

As the British Medical Journal noted at the time:

“At least half of the Presidential Advisory Panel on AIDS, as the group is now known, are scientists and doctors who have disputed the orthodox views on AIDS. Many of these do not believe HIV causes AIDS.”

Unsurprisingly, the Panel rapidly split into two distinct groups; those who believed HIV was the cause of AIDS, and recommended rapid institution of retroviral treatment programmes along with public health measures; and those, like Duesberg, who denounced the HIV hypothesis and recommended (largely) public health measures alone. The Panel’s report, which can still be found online in full here (warning! – 1 MB PDF), makes bizarre reading; it is really two reports in one.

What appears nowhere in the report is any hint that the HIV sceptics, who were well represented and even in a majority on the Panel, were representative of a tiny – if vocal – minority of the scientists and doctors studying AIDS worldwide.

In a recent editorial, entitled “The Cost of Silence?” Nature suggests that the mainstream scientists and doctors might have done better to have refused to serve on the Mbeki Advisory Panel at all. Their participation, Nature says, led to the appearance in the Panel’s deliberations that there was a real scientific issue to be argued. The Panel’s report, in turn, presented this “dichotomy of views” – when really there was a massive preponderance of evidence, and expert views, on one side, and a lot of evidence-free fringe theorizing on the other. This appearance of an undecided issue gave the Mbeki government the fig-leaf it needed to state that the issue was still contested, and to stall on antiretroviral therapy programmes. While Nature does not state outright that it thinks the South African government had already made up its mind when it set up the Panel, the implication is clear.

Reading the Advisory Panel report, one can perhaps catch glimpses of why the “HIV is not the cause” case might chime with the thinking of some populist politicians. Since they had decided HIV was not the agent causing the AIDS epidemic, the “HIV sceptics” could instead call for progress on a long list of the kinds of things dear to politicians’ hearts:


The recommendations listed below were proposed as necessary and sufficient to combat all the risk factors that are the real cause of AIDS:

1. Improving sanitation and public health measures to decrease water-borne diseases.

2. Strengthening health infrastructure.

3. Reduction of poverty and improving general nutrition and implementing nutritional education and supplements for the general population.

4. Improving screening for and treatment of sexually transmitted diseases.

5. Promoting sex education based on the premise that many sexually transmitted diseases and pregnancies could be avoided.

6. Implementing public education campaigns to destigmatise AIDS and reduce public hysteria surrounding the disease.

9. Treating infections vigorously and timeously (sic – possibly meaning “in a timely fashion”).

10. Increased support for and promotion of research into the development of drugs against AIDS, its cofactors and risk factors.

12. Implementing aggressive programmes to empower women and change the power relations between men and women.

13. Reducing the vulnerability of communities by improving access to health care.

14. Improving literacy.

[Presidential AIDS Advisory Panel Report: March 2001: pp 86-87].


Now, none of these is a bad thing – far from it. Who could argue with any of it? All good stuff, and the “HIV causes AIDS” group on the panel said many of the same things in their recommendations.

But – and it is a very, VERY big “But”- these laudable measure were, sadly, just not what was needed as a first priority in the face of an unprecedented epidemic of a deadly but slow-acting viral disease. Or, at least, they were not enough, and never would be. They would do some good – but not nearly as much good as if they had been combined with an immediate and vigorous campaign of treatment with antiretroviral drugs.

There is also another side to the catastrophe, as noted by many commentators, including Bad Science’s own Ben Goldacre, and also the Harvard authors:

The South African government, through the Health Minister Manto Tshabalala-Msimang, …continued… to divert attention from ARV drugs to non-tested alternative remedies, such as lemon juice, beetroot, and garlic, sometimes even promoted as better alternatives and not supplements for AIDS treatment

Tshabalala-Msimang scores high on the infamy scales for me because she is, almost unbelievably, a medical doctor who trained in obstetrics and gynecology and later in public health. I am truly dumbstruck that a person with her professional background could have participated in such an orgy of delusion. Though if some of the stuff that newspapers in South Africa have printed about her is true (see e.g. here and here) it is pretty scary that she was a Minister in the first place.

Anyway, the quackery was doubtless not just Tshablala-Msimang’s idea; the promotion of alternative therapies was prominent in the recommendations of the HIV denier half of the Advisory Panel. The keen-eyed reader will have noted the omission of several numbered points from the list above. The missing ones are as follows:


7. Investigating the use of immune-boosting medications, such as interferons, growth factors, B-complex vitamins and herbs (such as ginseng, Chinese cucumber, curcumin, aloe vera, garlic and echinacea).

8. Encouraging the detoxification of the body through several inexpensive interventions, such as massage therapy, music therapy, yoga, spiritual care, homeopathy, Indian ayurvedic medicine, light therapy and many other methods.

11. Encouraging the involvement of complementary medical and health practitioners, including indigenous healers, in research and clinical fields.

(Italics mine)


Following the embracing of this menu of delusion by the Mbeki government, Tshablala-Msmang enthusiastically promoted it – no doubt applauded by plausible nitwits, sorry, “Nutritionists”,  like Patrick Holford, and by the “Pope of Vitamins”, Dr med Matthias Rath. Both Holford and Rath have spent a lot of time in, and promotional effort on, South Africa these last eight years or so.

It does not take a genius to surmise that they would have seen a large market, full of often poorly-educated people, where their seductive nutritional remedies (“no nasty toxic drug side effects!”) would appear almost officially sanctioned.

Admittedly, the role of AIDS deniers, of alternative medicine idiots, and of vitamin pushers like Rath and Holford, are minor compared to the overwhelming responsibility of Mbeki, his Health Minister, and the rest of the President’s deluded inner cabal. But there is an obvious element of “toxic enabling” at work.Which suggests:


A BadScience Formula:

Self-deluding scientifically illiterate politicians

+ vocal “skeptics of the scientific orthodoxy”

+ “traditional healing practices” enthusiasts

+ vitamin salesmen and Nutritionistas

+ endless ill-informed media reportage, especially of the previous three groups

= possibly catastrophic consequences


Anyway, I would like to think that the next time dear old Patrick Holford says something mind-bogglingly dim like:

“[The retroviral drug] AZT is… proving less effective than vitamin C” [ in treating HIV]

– or the next time that Matthias Rath claims that modern medicine is a Pharma conspiracy to keep people sick – that someone will be there to remind them of just where their preferred nostrums and delusions can lead.

You might, for instance, like to ask Patrick:

“So can Vitamin C prevent mother-to-child transmission of HIV, the way that anti-retrovirals do?”

I would love to know what his answer would be.

Getting back to the paper, the authors’ conclusion is chilling:

“Access to appropriate public health practice is often determined by a small number of political leaders. In the case of South Africa, many lives were lost because of a failure to accept the use of available [antiretrovirals] to prevent and treat HIV/Aids in a timely manner.”

One can only hope that political leaders elsewhere have proper scientific and medical advisers. And that they can keep their minds free of the soothing claptrap peddled by the fans of Alternative Reality.

Although looking at the way that politicians in the UK these days persist in regarding CAM as purely an issue of consumer choice, with no health implications… sometimes I am not so confident



This post is not very original, and obviously owes a lot to Ben Goldacre’s coverage of the issue. Talking of which, word in the bookosphere has it that the revised edition of Ben’s Bad Science book, due out next Spring, will have an extra chapter devoted to Herr Dr Med Matthias Rath, in which the learned Herr Doktor’s South African activities can presumably be expected to feature prominently.

Another good guide to the history of the South African HIV denialism catastrophe is the Skeptical Inquirer article by South African economics Professor Nicoli Natrass.

Finally, a longer and more scholarly article written earlier this year by Prof Nattrass for the journal African Affairs, can be found here. It includes an earlier estimate of the human cost of Mbeki’s policies, broadly similar to the Harvard study’s conclusions. This article also has a section (pp 169-171) dealing with Rath and other peddlers of “nutritional solutions”, and their relationships with Tshabalala-Msimang.



The First Nutritionista’s Song

November 19, 2008

In which Dr Aust gets all Gilbert and Sullivan on celebrity Nutritionistas and their airs

Dr Aust is into rhyming at the moment.

This is in part because the Aust-mobile (a twelve-year old tin box on wheels with the absolute minimum of features) finally gave up the ghost a few weeks back. The clutch started making strange groaning noises, and was diagnosed as terminal, and the gearbox is apparently also on its last legs. As result I have been travelling to work and back each day on our wonderful (note: irony) local public transport system, after a gap of nearly a decade. I now get 40 minutes* each way, daily, to read a book (too much paper-folding to read a broadsheet, the Metro is too brain-numbing to count as a newspaper, can’t face working), or to do some thinking.

(*median value: the range so far is 30-55)

Anyway, one of the more relaxing ways I have found to pass these journeys is to try and think up lyrics to comic (more specifically, parody) songs.

But who to write them about?

Well, recently I was thinking it had been a while since I wrote anything about our friends the Nutritionistas. And then I saw this amusing – if rather depressing – piece about an Old Friend of the BadScience Blogosphere who is something of a National Nutritionista celeb.

The final piece of the jigsaw fell into place when my father, while visiting last weekend, told me that he was once in the chorus for a student production of Gilbert and Sullivan’s H.M.S. Pinafore.

For those not familiar with HMS Pinafore, Wikipedia notes that one of its underlying themes is

“pok[ing]…fun at… the rise of unqualified people to positions of authority”

G and S were rather good at puncturing pomposity and sending up those with inflated ideas of their eminence and importance. The particular scene that swam into my mind’s eye on this occasion was this one from Act One of H.M.S. Pinafore.

I have attempted a Nutritionist re-write.

Scene: A conference held in the Institute of Optimistic Nutrition.

An audience of worried looking people sit in anticipation. Many are clutching books with a picture of a bronzed and healthy-looking smiling man with short greying hair on the cover.

Enter THE CHORUS stage right. They are dressed as journalists, and carry notebooks, laptops and Blackberrys. Some are Lifestyle journalists, recognisable by their GoreTex bicycle clothing (men) or unfeasibly large handbags (women)

A second chorus of younger people (THE GRADUATES) files on stage left. They are wearing white coats and smart trousers and carrying clipboards and glossy brochures. Their leader is a glamorous blonde (the NUTRITIONAL THERAPIST).

Finally, THE NUTRITIONIST enters, smiling and waving, to applause from the CHORUS OF GRADUATES. He is clad in jeans and a collar-less denim shirt, and looks about 35.

[Note: If the production budget stretches to this, he may be accompanied by a MINOR CELEBRITY, for instance an actress, model, has-been singer or serial footballer dater, The MINOR CELEBRITY does not speak or sing, but should look at THE NUTRITIONIST adoringly].

Music: “Now give three cheers” (sometimes known as “I am the monarch of the sea”)

NUTRIONIST (N): I am the Great Nutritionist

On that my revenues quite insist

To whom packed lecture halls pay tribute

NUTRITIONAL THERAPIST (NT): And so do the graduates of his Institute!

ALL: And so do the graduates of his Institute!

The Graduates of his Institute!

N: I know what’s best for you and me

Vitamins A, B, C, D and E

My supplements are just as good as eating fruit

NT: And so say the graduates of his Institute!

ALL: And so say the graduates of his Institute!

The Graduates of his Institute!

N: When sceptics try to catch me out

To claim the rules of evidence I flout

I’ll just deny I made the statement in dispute

NT: Supported by the graduates of his Institute!

ALL: Supported by the graduates of his Institute!

And also by his clients who think it must be a science Institute!

(music changes to tune of Gilbert and Sullivan’s “First Lord’s Song”, sometimes known as “When I was a lad”)

The Nutritionist’s Song

N: When I was a lad I took a degree

In experimental psychology

In a library book I found the odd conceit

That schizophrenia is caused by what we eat

ALL: That schizophrenia is caused by what we eat!

N: I seized on this idea so avidly

That I now am a Nutritional Authority

ALL: He seized on this idea so avidly

That he now is a Nutritional Authority!


(NB Repeats similarly for each following verse)


Finding that my skill was at the writing game

I churned out books and got a shot at fame

I found that people crave Eternal Youth

And pseudoscience makes my Snake Oil sound like truth

I flannelled away so semi-plausibly

That I now am a Nutritional Authority


My Richard Gere looks and healthy glow

Won me a slot on a breakfast TV show

I plugged antioxidants and vitamin pills

Whilst denouncing the Poisons of the Pharma Shills

I smiled so winningly handsomely

That I now am a Nutritional Authority


To improve education I took a new route

By setting up my very own Institute

And no-one could have been more surprised than me

When it then awarded me a very special degree!

I burnished my CV so meticulously

That I now am a Nutritional Authority


Now I lecture round the country giving more hard sell

To my target audience of the worried well

I listen to their piteous laments

And then I plug my own-brand range of supplements

I’ve played this game so successfully

That I now am a Nutritional Authority


So nutritionists all whoever you may be

If you wish to rise to the top of the tree

The Golden rule is to smile – insist it’s “common sense”

And at all costs have no truck with evidence

Stick to this rule – and charge eye-watering fees

And you too may be Nutritional Authorities


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.


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”


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


– 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”.


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…


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.

Patrick Holford’s mentors and inspirations – but who are they exactly?

September 23, 2007

One of the lessons of reading material – especially on the internet – that deals with Alternative Therapy is that when people cite scientific-sounding “authority figures”, these luminaries aren’t always quite what they are being presented to you as.

Digging online will often reveal all, or at least a fair bit. But how many people bother?

Let’s take the example of media nutritionist Patrick Holford, and the mentors and teachers he mentions on his CV.

Diversion – skip the next bit if you are already familiar with the ongoing “Patrick Holford vs. the Bad Science Blogosphere” saga

The backstory – on the blogs I read that deal with pseudoscience, like Ben Goldacre’s Badscience, David Colquhoun’s Improbable Science, and the Quackometer, Patrick Holford has been getting a bit of a trashing. The Bad Science blogosphere has been examining his work, including his claims, in print and on TV, about such things as Vitamin C and HIV

Several of the bloggers have pointed out that Patrick’s CV, as printed on his website, contains a number of inaccuracies. They suggest that the net effect of these inaccuracies has been to tend to make Patrick seem more expert and scientifically-based than he actually is. For anyone wishing to catch up with all this, apart from the three blogs already mentioned, there is one devoted (if that’s the word) almost entirely to Patrick called Holfordwatch

Anyway, back to Patrick Holford’s mentors. I love a bit of Internet digging – especially when I’m dodging writing a turgid lecture – so thought I would investigate.

Let’s look at a key section of Holford’s CV, the bit detailing how he got started in looking into “nutrition and mental health”, which appears on his website here

“[Patrick] started his academic career in the field of psychology. While completing his bachelor degree in Experimental Psychology at the University of York he researched the role of nutrition in mental health and illness. He became a student of the late Dr Carl Pfeiffer, director of Princeton’s Brain Bio Center, and later a student of Dr Abram Hoffer, Director of the International Schizophrenia Foundation in Canada, who were leading the field in mental health and nutrition. In 1980 he started treating mental health patients with nutritional medicine.”

As has been observed by Patrick’s critics in the Blogosphere, the last sentence is interesting in itself since we don’t know where this happened. We also don’t know in what capacity Holford treated them, since he has no recognized postgraduate training or qualification in clinical psychology (either or sometimes both is necessary to become a psychologist treating patients in the NHS, for instance).

However, I want to focus on the two people Holford’s CV says he studied with after his degree – Drs Pfeiffer and Hoffer, described as “leading the field in mental health and nutrition”.

These two gentlemen are not quite what you might think. A different bio might read like this.

“Carl Pfeiffer and Abram Hoffer are controversial figures, known for their belief in treating psychiatric disorders with vitamin “therapies”. These practices were, and continue to be, regarded as having no real basis by mainstream medicine and psychiatry. By the 1970s Pfeiffer and Hoffer had largely ceased to publish in the mainstream scientific and medical journals, which they claimed were biased against their vitamin work. Hoffer quit academia for good in 1967 (many years before Patrick Holford came in contact with him) to go into private psychiatric practice (he later seems to have also used vitamin therapies to treat cancer sufferers). The “Princeton Brain Bio Center” which Pfeiffer directed was not affiliated in any way with Princeton University (as the name might suggest) but was a private clinic set up by Pfeiffer and his associates in the early 70s to offer nutritional therapies.

Pfeiffer and Hoffer’s work from the late 60s on appeared mainly (or pretty much wholly in Hoffer’s case) in the alternative literature, mostly in Hoffer’s own journal, founded in 1967 as the Journal of Schizophrenia. After several name changes the journal is now called The Journal of Orthomolecular Medicine (JOM) .The JOM is where Patrick Holford has published several of the recent research papers listed on his CV.

The JOM is not listed on Medline (generally a prerequisite for a “serious” academic journal in the sciences), and espouses or has espoused many viewpoints regarded by mainstream medicine as dangerous and unfounded nonsense, e.g. the idea that mercury amalgam fillings cause mercury toxicity, the use of “chelation therapy” to address such mysterious supposed heavy metal toxicities and for other conditions, and dietary therapies for cancer. A brief list of areas of interest for the journal can be found on their front page

Apart from Pfeiffer and Hoffer (who between them authored over a hundred papers in the journal), other names familiar to those who follow the “Alternative Health” field appear as authors in the JOM, including Matthias Rath and the late Bernard Rimland. Rimland was the founder of the Autism Research Institute, which now promotes chelation and unproven nutritional therapies for autism, and supports Dr Andrew Wakefield. Rimland was a high-profile supporter of the discredited idea that the mercury preservative thimerosal in vaccines caused autism.”

To hear Dr Hoffer in his own voice, you can read a self-penned account of his life and work here, or his history of the JOM here

Given all the above, you may feel that an alternative to Pfeiffer and Hoffer “leading the field in mental health and nutrition” would be that Pfeiffer and Hoffer were “convinced that much mental illness was caused by nutritional imbalances and deficiencies, and were consequently regarded by mainstream psychiatrists as cranks”

As a final note, an extensive bibliography of Hoffer’s published work here reveals no articles co-authored with Patrick Holford, around 1979-1980 or since.

So when you see claims that Patrick Holford is “one of the world’s leading authorities on nutrition and mental health”:

…caveat emptor, as they say. All is not what it seems.