The Quackometer

Hair analysis is worthless for assessing the body's nutritional status or serving as a basis for dietary or supplement recommendations. Should you encounter a practitioner who claims otherwise, run for the nearest exit!

• Your body's level of nutrient minerals and toxic metals Mineral ratios
• A list of recommended foods - and those to avoid
• Food allergy indicators
• Body chemistry balance analysis Suplement [sic] recommendations

Email the company and they tell you the following...

The cost of the test is £49 and the laboratory will test for 29 nutritional minerals including calcium, copper, zinc, sodium, potassium, magnesium etc) and 8 toxic minerals (including lead, aluminium, mercury and cadmium). The results are presented as a graph with a report attached explaining them and making diet and where appropriate supplement recommendations. Your sample can be sent by post and the report is returned by post.

1. How does the mineral concentration in hair relate to whole body concentration?
   We are not actually interested in hair concentrations as such, but the levels in tissues that need the minerals, such as the blood and other organs. Does hair take up minerals in direct relation to body concentration? It need not. We need to know the answer to this question for each element being analysed.
2. What individual variation is there in hair growth and mineral levels?
   How does age, ethnicity, sex, activity levels and health affect the result? Again, we need to understand this for each element being tested.
3. What levels in hair are normal and what ranges are acceptable?
   And how does this vary across different geographies with different diets and lifestyles?
4. How can we relate these levels to health issues?
   Even if a mineral level is outside the normal range, this does not mean that there is a problem. Mineral levels may be biologically unimportant within a wide range.
5. How best should we collect samples?
   Does using steel scissors introduce contaminants? What about any sample packaging used? Is 'home' sampling OK, or do you need controlled lab conditions?
6. How much hair do we need to get a reliable, repeatable result?
   One strand, a bunch, how long should the hair be?
7. Do we need to prepare the sample to remove environmental contaminants?
   Shampoos, car fumes, cigarette smoke and general dirt will be on the hair. Can this be easily removed? Is it absorbed into the body of the hair? Do hair treatments, such as bleaching and colouring, affect the result and how?
8. What analytical technique is best?
   Most techniques are poor at measuring wide ranges of elements, but are good at targeted elements. Do we need several techniques or the same technique optimised in many ways?
9. How do we ensure the right levels of accuracy and precision at an affordable level to the testing laboratory and their customers?
   It is no good having a whizzy technique if it costs millions.
10. How do we get good calibration samples?
    In order to get good results, you need good standard samples to compare against. How can a laboratory obtain known and certified reference materials for each mineral being tested at concentrations similar to that being tested? What analytical technique should be used to certify the references?
11. How should Hair Mineral Analysis laboratories undertake external quality assurance?
    Good laboratories validate themselves against other independent laboratories to make sure they are not systematically getting this wrong. Who will do this?
12. What do bald people do?

Now, the problem is that there are few answers to these questions and much work to be done. It could be one day that we answer these question in sufficient detail to have hair analysis as a useful diagnostic tool. But we are not there yet, and one of the reasons is that other more direct techniques, such as blood or urine analysis, are better tools to put our research energy into.

Given the poor state of the science of hair mineral analysis, one might expect that laboratories offering this service might lead to shabby, inconsistent and meaningless results. And that is what is found. Several studies have looked into the quality of results obtained from commercial laboratories. One 1985 study entitled, "Commercial hair analysis. Science or scam?" concluded,

The reported levels of most minerals varied considerably between identical samples sent to the same laboratory and from laboratory to laboratory. The laboratories also disagreed about what was "normal" or "usual" for many of the minerals. Most reports contained computerized interpretations that were voluminous, bizarre, and potentially frightening to patients.

Six laboratories recommended food supplements, but the types and amounts varied widely from report to report and from laboratory to laboratory. Literature from most of the laboratories suggested that their reports were useful in managing a wide variety of diseases and supposed nutrient imbalances. However, commercial use of hair analysis in this manner is unscientific, economically wasteful, and probably illegal.

As this was 20 years ago, we ought to be cautious, but luckily a similar study has been done more recently to see if things have improved. It concluded,

...Variations also were found in laboratory sample preparation methods and calibration standards. Laboratory designations of normal reference ranges varied greatly, resulting in conflicting classifications (high, normal, or low) of nearly all analyzed minerals. Laboratories also provided conflicting dietary and nutritional supplement recommendations based on their results.

CONCLUSIONS: Hair mineral analysis from these laboratories was unreliable, and we recommend that health care practitioners refrain from using such analyses to assess individual nutritional status or suspected environmental exposures. Problems with the regulation and certification of these laboratories also should be addressed.

It is no surprise then that QuackWatch calls this technique a 'Cardinal Sign of Quackery'. Even worse, the American Medical Association issues a policy on the technique which states,

The AMA opposes chemical analysis of the hair as a determinant of the need for medical therapy and supports informing the American public and appropriate governmental agencies of this unproven practice and its potential for health care fraud.

So, why do people including MineralCheck continue to carry out such analyses? It is difficult to conclude anything other than it is very lucrative and a good way of pursuading people to buy supplements. Whilst blood analysis needs qualified practitioners to take and analyse the sample under medical conditions within a strict legal, ethical, and scientific framework, hair analysis requires none of this. Its much easier, and importantly, much cheaper; posting off a hair sample and getting a computer read-out back. Follow that up with recommendations to buy £50 worth of supplements per month, an order form, and a recommendation to repeat the test in a few months time and you are quids in.

Worryingly, there is a danger that, as the technique looks near useless as a diagnostic tool and the recommendations that come from it arbitrary, there is not only the risk that customers will waste their money, but that harm may come too from needless and drastic changes in diet and excessive supplements.

And, as promised, what do we know about the background of the web site MineralCheck? They don't say much on their pages - no names, no company information, an anonymous email address, but they do give a telephone number. A quick Google reveals that this telephone number is also used by a Mrs Karen Watkins BA(Hons), Dip.I.O.N, MTTS. It turns out that as well as doing Hair Mineral Analysis, Karen is also Principle of Education at Patrick Holford's Institute of Optimum Nutrition.

My advice for any school or parent involved with programmes to improve kids nutrition, and is using Food For the Brain for help, should be to question Patrick, the Charity Trustees and the Scientific Advisers to the Charity very hard about the value that Hair Mineral Analysis is bringing to the children. If you get evasive answers, particularly questioning the qualifications of those who doubt the advice from Food for the Brain, I suggest you follow Stephen Barret's advice and 'run for the nearest exit!'

Labels: minerals, Patrick Holford

Labels: awards, daily mail, homeopathy, journalists, mckeith, minerals, newspapers, pseudoscience, quackometer, quacks, vitamins

A nutritionist is a person who advises people on dietary matters relating to health, well-being and optimal nutrition. Nutritionists should not be confused with dietitians. Dietitians are health care professionals who have received specialised formal accredited tertiary education and training, and undertake internship in hospitals, and who are required to adhere to their regulatory body's code of conduct. They are also the only non-medically-trained health-care professionals permitted to practise clinically in hospitals or health-care facilities. Many "nutritionists" appear on television, in newspapers and magazines, and write bestselling nutritional books.

Self-identified nutritionists have varying levels of education, and can be someone with little education up to someone who may have the equivalent of a master's degree in Physiology or Biology.

• It's not just about eating healthily. Bad diet is promoted as being the root cause of almost all diseases and conditions. Eating in a certain way can restore the 'balance'.


• It is not possible to get all your vitamins and minerals from food today because of modern farming methods. The nutriquack can sell you the right supplements.


• Organic is healthier.


• Claiming that a simple change of diet or popping a vitamin cure complex social issues, like omega-3 fish oil pills helping poorly performing kids in schools,


• Promoting radical diets which usually involve cutting out entire food groups.


• Promoting the health benefits of consuming huge volumes of vitamins.


• Advocating 'superfoods' that allegedly have remarkable health benefits.


• Obsessions with discredited and weird diagnostic techniques, such as examining stools.


• They use pseudoscience to sound knowledgeable. Talk of 'detoxification' is common.


• Selling weird made up foods with remarkable properties such as this nonsense salt seller and shrouding it in ridiculous claims.
  

All these things have in common is their overstatements and lack of evidence. Making health claims in this way is quackery. From now on, I will call such people the nutriquacks.

I think the problem of the nutriquack arises from the simple fact that good nutritional advice (for most people) is quite simple - eat a balanced, varied diet with a low amount of fat and lots of green stuff. You are not going to make a fortune with that mantra - even though getting people to follow it is quite hard sometimes. By making the whole thing appear more complicated though, the nutriquack is creating a market for their services. You cannot get enough antioxidants - my superfood berries (available on my website) will do it for you though! Register with my site, complete my questionnaire and I will personally compose your optimum nutrition plan and supplement mix. And so on.

What is happening is that nutriquacks are fetishising food and bamboozling people. Rather than enjoying food for its own sake, many people are led down the path of analysing everything they put in their mouth, jumping to conclusions about why they might be overweight or unwell and fruitlessly giving money away to people who do not deserve it. The real heroes of healthy eating for me are those people who try to instill a love of good food into people. Chefs and writers who try to excite about the benefits of buying good ingredients, how to source fresh ingredients inexpensively, how to be creative in the kitchen without needing top-chef skills and basically try to impart a joy about food. That is surely the route to people having a good, healthy relationship with their food and so end up getting a more rounded, varied and balanced diet. People like Jamie Oliver, Nigel Slater and Nigella Lawson spring to mind, but there are many more. These people do not resort to pseudoscience in order to justify what they do.

When science does make some well researched discoveries about the food we eat, this is often drowned out in the swamp of nutriquack baloney. It is often impossible to tell good science from nonsense in the popular press and TV. All this does is make people despair of the 'scientists' with their constantly contradictory advice and silly discoveries. It undermines a reliable source of knowledge for society that genuinely could help improve peoples' lives.

Nutriquacks operate in a legal void. Selling food is not illegal after all and vitamins and minerals are just food. However, make medical claims and use ingredients that might be medicinal in nature and you might end up in hot water. At least this is a curb on the excesses of nutriquacks, although it is seldom invoked.

However, such is the fate of arch-nutriquack 'Dr' Gillian McKeith. Today, the MHRA (the British organisation that is supposed to control the use of medicines) has ordered that McKeith stop selling illegal products. McKeith has been capitalising on her TV fame by selling all sorts of expensive and silly 'superfoods' to her fans. At last, the law has caught up with her, at least in a little way and she will have to re-think how she goes about her business now.

Labels: Ben Goldacre, detox, diets, Gillian McKeith, minerals, nutritionist, Quack Words, vitamins

• If this is indeed true, there is nothing in this report to suggest that the levels have fallen to dangerous levels. Is it still likely that a varied and balanced diet will supply most peoples' needs? The report declines to comment.
• There have been several criticisms of the methodology of this research (comparing government tables, the best part of a century apart). Analytical methods have changes enormously over this time and there is no correction for biases that will have been introduced as a result. (Remember the famous iron-in-spinach myth?)
• The report goes on to show that 8% of women might be mineral deficient but (this is the important bit) the report does not say that this is a result of the (alleged) lower mineral levels in food. This could be down to these women just having very poor diets. This is to be expected, as we know some people do not eat well and there is no attempt to correct for this. This is either a little disingenuous or just plain not rigorous enough. The report allows the connection to be made in the readers mind - but does not state the connection itself.

Labels: diets, minerals, nutritionist, vitamins