The Quackometer » Ben Goldacre

Curing Homeopathy

Le Canard Noir — Sat, 05 Jan 2008 11:00:00 +0000

How should homeopaths be regulated? I am not sure I have made up my mind yet about what I would like to see and I am not convinced there is a perfect solution. However, I hope some debate has been kicked off by all the goings on last year, here and on various other blogs and forums. One thing I am pretty sure of is that homeopaths have pretty much ruled themselves out of the discussion. Adults only from now on.

And the reason for this is that they have had their chance – and a good shot at trying to regulate themselves. Indeed, this was the stated aim of the Society of Homeopaths last year. Two of their annual goals were:

To facilitate the smooth handover of Society regulatory processes to a new regulatory and registration body

and,

To uphold and review The Society’s professional standards especially in relation to the development of a new regulatory and registration body (NRRB)

They failed miserably at both.

The farce of creating a single homeopaths’ single register is being documented at gimpy’s blog. Squabbling about money made sure the register did not get off the ground. I believe this reflected deeper rivalry between the various homeopaths’ groups based on philosophical differences and also just plain old human power struggles.

The Society also demonstrated that their code of ethics could not protect the public from the worst delusional beliefs of their members. Their utter two-faced failure to tackle the problems posed by members offering anti-malaria advice led to the Society being prepared to directly misrepresent their own actions to the papers. They were also last year promoting homeopathic intervention in HIV people in Africa. It is difficult to think of more exploitative, deluded and dangerous actions.

So, to start off – what are we trying to protect against? Ben Goldacre has been quite clear about the dangers of alternative medicine – bullshit. And that bullshit manifests itself in a couple of dangerous ways with homeopaths. Firstly, they may delay a customers access to effective treatment – in the case of serious illness this can be fatal. Secondly, they may present themselves as serious alternatives to real medicine. We have found this most shocking when homeopathic missionaries tell vulnerable African people with HIV that they can treat them. Homeopaths use the denigration of medicine as a standard marketing tool. Homeopaths stand out in the alternative medicine crowd in their anger and hostility towards real doctors and medical practices. It is how they define themselves and what makes them most dangerous to the public. They most definitely are not a ‘complementary medicine’.

It is not that I want people to stop visiting homeopaths and other therapists. People often do get benefit from the self-indulgent friendly chat that a GP is just not in a position to offer. Homeopaths ought to be in a prime position to offer this as I have said before. However, in visiting a practitioner, we need to consider how the public may be protected against two main problems we find in quackery: being exploited financially, and being given inappropriate and dangerous medical advice.

One potential solution is coming from Prince Charles and his Foundation for Integrated Health. FIH is looking into setting up a Natural Healthcare Council that will offer regulatory functions to the broad church of complementary and alternative therapies. The Times reports that this new voluntary register should be established this year and,

will be able to strike off errant or incompetent practitioners. It will also set minimum standards for practitioners to ensure that therapists are properly qualified.

Their hope is that,

all practitioners will be forced to join or lose business as the public will use the register as a guarantee of quality. The council will register only practitioners who are safe, have completed a recognised course, are insured and have signed up to codes of conduct.

Funnily enough, the homeopaths appear to be deeply hostile to this move. “The homeopathy profession has been unanimous in rejecting federalisation as an option for regulation” reports the Alliance of Registered Homeopaths. But, as I have said, I am not really interested in what they think – their only motives in discussing regulation appear to be self-interest and survival.

So, will the chief tree-talker’s ideas be a good move? Should Prince Charles’ organisation be allowed to succeed?

I have some serious reservations.

Firstly, by what standards will the Natural Healthcare Council set for competence and training? Professor David Colquhoun has documented the training dilemma of alternative medicine by noting that most alternative therapies are based on nonsense ideas that have no scientific and objective merit. “It cannot be expected that a universities will provide a course that preaches the mumbo jumbo of meridians, energy lines and so on… Can any serious university be expected to teach such nonsense as though the words [of alternative medicine] meant something? “. Since, homeopaths cannot even agree amongst themselves what homeopathy is and what are its essential elements (not surprising, as it is not based on reality) then the Council risks either alienating large swathes of practitioners or being completely arbitrary in its criteria. Either will not protect the public. Setting education standards for homeopaths is like trying to accommodate Hogwarts into the National Curriculum.

Secondly, by what standards will practitioners be judged in handling complaints and when upholding professional standards? Should we uphold a homeopath to standards of homeopathy, aromatherapy, reiki or – heaven forbid – evidence and science? This is important. In deciding whether a homeopath has crossed a line of ethics in offering malaria prophylactics, who will judge them? If homeopaths are involved, the the public will not be protected as they have dangerous and delusional ideas about their magic sugar pills. However, if they are to be judged by the standards of best evidence, then no homeopath will join the organisation as they know that they cannot practice within their strongly held beliefs. In either case, the Council will fail to protect the public. You might think that homeopaths would be willing to disengage from their wilder healing fantasies in order to gain the credibility of the name of Prince Charles, but all my experience says that homeopaths are fiercely proud, angry and determined not to be constrained by any external forces (probably orchestrated by ‘allopaths’).

And if the Council do uphold the strongest standards and do this in a transparent and accountable way, will the UK suddenly be free from rogue practitioners? Well, no. My recent example of the the ASA upholding a complaint against Osteomylogist, Robert Delgado, showed that even statutorily registering complementary therapists has big loopholes. This non-statutory and voluntary registered body, the Natural Healthcare Council, will have even less power over practitioners.

But what it will achieve is that Prince Charles’ name will give credibility to all sorts of unproven therapies and wacky non-medically qualified people to go out there and pretend to be healers. And at the same time, offer no guarantee of protection to the public.

I don’t think this is the answer and I think it will even lead to a greater threat to the public.

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The $100 Homeopathy Challenge: Update

Le Canard Noir — Thu, 13 Dec 2007 08:08:00 +0000

Well, I have had two conversations with homeopaths now about taking the challenge. Recap: its a simple challenge to see if a homeopath can determine which remedy is which out of a sample of six when they do not already know which remedy is which. If the claims of homeopaths are correct, it ought to be easy.

First up: Sarah K, who left comments on my blog to say she was up the challenge. Fantastic news. Unfortunately, quite quickly she appeared to get rather defensive and say she would not be rushed into things. And ultimately decided that she did not want to do it. A huge shame.

Some of her excuses were that remedies could take a long time to take effect and might interfere with each other. Fine. But she has the choice to decide which remedies to use. For example, I suggested Nelsons Insomnia remedy. Customers of Nelsons might expect their insomnia to be reduced in a few hours, not over several weeks, and they would expect no lingering side-effects too, which homeopaths claim do not happen. Oh well. So close.

Another homeopath appeared to contradict Sarah K in the most striking terms. Soroush Ebrahimi was up for the challenge, but unfortunately not mine – he had his own ideas. He wanted to give me a remedy and be able to seal an envelope with a prediction of what the remedy would do to me – a ‘reproving’. I think it best to allow the IM chat to speak for itself…

(for explanation, Soroush has already challenged Ben Goldacre to a similar test. This is IM, so spelling and sentence order may be erratic)

SE: Hi – did you want me for something? Welcome to my group of friends

LCN: Just wanted to know if you were prepared to take the quackometer $100 challenge. If you claim you could guess ben g’s symptoms from taking a single remedy, then this test ought to be a walk in the park and great public proof of homeopathic claims.

SE: Hi – I did explain that the quackmaster test involves to elements:

SE: 1- Is the homoeopath any good?

SE: 2- Does a potentised substance work?

LCN: yes i am happy with that – do you think you are good homeopath?

SE: So if the result is a fail you do not know whetehr the homoeopath was poor in his selection or whether potentised substance have no effect

LCN: sure. but if you succeed then you win!

SE: So my ‘reproving’ exercise is better, because it elliminates the uncertainty about the ability of the homoeopath

LCN: no it does not. it relies on both the homeopath to interpret the symptoms correctly and the subject to report them correctly – both subjective and so unlikely to yield a good result for anyone. Eitgher side could cry foul. With my test, no one can cry foul.

SE: Neither with my test – when they are in agony and asking for help, then we will know for sure!

LCN: well frankly – if you are prepared to inflict agony on someone then you are not fit to conduct such tests. and ben was quite right to refuse.

SE: Oh – so dilute potentised substance do have an effect?? Make up your mind

LCN: so, you want to induce agony in someone and then claim that homeopathy is right? I think you do not understand anything about obtaining objective evidence

LCN: you are telling me they do. i think ben was quite right to worry tha tyou might poison him. i would be. my test involves no such risks.

SE: Ben was QUITE wrong – because if you read my post, you would have realised that he would have had the substance tested for himself and my half of the remedy would have been in a safe-box only to be opened with both of us present

SE: You guys have to put your body where your mouth is

SE: Either a potentised highly dilute material has powers or it does not

LCN: i am happy to take homeopathic remedes – but not from someone who promises to have me in agony! it shows a lack of ethics in the trial that you would be prepared to do so.

LCN: i have no doubt that the homeopathy would do nothing. I just would not be prepared to take a pill forom you.

SE: So tell me do potentised highly dilute substance have any power?

SE: if not – you are just taking a sugar pill as you lot claim

LCN: i believe they do not. but can i trust you to give me a potentised highly dilute substance ?

I hope you understand my reluctance to take part. The conversation went on for a while more. Mostly, me repeating a question to ask Soroush to take my test or work out a better protocol for his own.

For the record, I would take such a test, but Soroush needs to think up a protocol to take into account the following:

S should not be allowed near any pill I would take.
We need end measures that are not subjective – if the test fails I do not want homeopaths accusing me I was misreporting symptoms.
We need a quantifiable result. At present, a success for S would not give us any idea of the significance of the result. Could it have been chance? We have no way of quantifying that.
If it is going to cost more than my proposed test, I want to know why it is a better test and worth the money.

Without these things, Soroush’s test is just a circus stunt. And, if I may say so, a very disconcerting circus stunts. Like a scary clown juggling sheep’s hearts.

It is remarkable than no one else has come forward. This is a basic test of homeopathy. Something that ought to be easy and yet nothing quite like it appears never to have been done. It would show basic evidence that homeopathy is not a delusion. And yet, homeopaths feel no shame in taking on the responsibility for sick people. A responsibility that cannot be grounded in reason or evidence and instead relies on fragile anecdotes. Homeopaths’ preference to counter criticism is to sue people rather than provide argument and evidence.

I am offering the chance for some homeopath to give me a metaphorical bloody nose, humiliate me, and prove me wrong – all for the cost of some postage and and few remedies.

So far, none of them have the courage of their convictions.

Extending the ‘Simple Challenge’ Homeopaths claim that their pills can induce predictable and distinct sets of symptoms in healthy people. That is how they prove their powerful medicine. This is basic stuff for homeopaths...
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On the Muppet Show Tonight… In his Guardian article, Ben Goldacre wrote about how homeopaths respond to criticism: With alternative therapists, when you point out a problem with the evidence, people don’t engage with you...

On the Muppet Show Tonight…

Le Canard Noir — Mon, 10 Dec 2007 18:39:00 +0000

In his Guardian article, Ben Goldacre wrote about how homeopaths respond to criticism:

With alternative therapists, when you point out a problem with the evidence, people don’t engage with you about it, or read and reference your work. They get into a huff. They refuse to answer calls or email queries. They wave their hands and mutter sciencey words such as “quantum” and “nano”. They accuse you of being a paid plant from some big pharma conspiracy. They threaten to sue you. They shout, “What about thalidomide, science boy?”, they cry, they call you names, they hold lectures at their trade fairs about how you are a dangerous doctor, they contact and harass your employer, they try to dig up dirt from your personal life, or they actually threaten you with violence (this has all happened to me, and I’m compiling a great collection of stories for a nice documentary, so do keep it coming).

The homeopaths have responded to this article in a number of ways. But today we learned that Ben can add another tantrum type to his list: complaining to the Press Complaints Commission. When I read this, I spat out my cornflakes with laughter. Apparently, two homeopaths have complained to to the PCC. Muppets. Or as Ben put it at the end of his article,

But when they’re suing people instead of arguing with them, telling people not to take their medical treatments, killing patients, running conferences on HIV fantasies, undermining the public’s understanding of evidence and, crucially, showing absolutely no sign of ever being able to engage in a sensible conversation about the perfectly simple ethical and cultural problems that their practice faces, I think: these people are just morons.

The irony is suffocating.

But what is even more moronic, is the grounds for their complaint. Apparently,

“Goldacre seems to think that homeopathic remedies are prepared by diluting substances. He omits the critical component of shaking (’succussion’) between serial dilutions without which they would, indeed, be merely water rather than potentised substances.”

Of course Goldacre thinks this. There is not a shred of evidence, that can withstand more than a second’s scrutiny, that would suggest that so-called succussed water is any different from ‘mere’ water. The person who can show there is a difference will be the next Nobel Prize winner.

This is at the heart of my $100 Homeopathic Challenge. If a homeopath can tell what a succussed homeopathic remedy is when the label is removed, then they win. Full Stop. The test can be done cheaply and in a few weeks. Does any homeopath want to put down their pen, stop writing to the Press Complaints Commission, and demonstrate the difference?

These homeopaths are not the only ones making fools of themselves. We also hear from, Jayne Thomas, Vice-chair of the Society of Homeopaths (pictured), complaining about Chief Scientific Adviser, David King and his criticism of the health service and the Medicines and Healthcare Products Regulatory Agency supporting homeopathy. Jayne trots out the same old nonsense about patient choice, no side-effects, the failure of doctors, high training for homeopaths and a strict code of ethics. But what is really moronic is how the Bristol Homeopathic Hospital Customer Satisfaction Survey is trotted out as evidence of efficacy. This must have been explained to SoH a hundred times: it was uncontrolled and had poor methodology – no conclusions on efficacy can be drawn. And yet, Jayne Thomas keeps on repeating the tired old story.

And finally, and rather innexplicably, Jeanette Winterson forces the Guardian to issue a correction. But what the correction is, I cannot see. They write,

A comment piece critical of homeopathy, A kind of magic? (page 4, G2, November 16), responded in part to an earlier article by Jeanette Winterson with the headline In defence of homeopathy (page 15, G2, November 13) and referred to her view that there is a role for homeopathy in the treatment of HIV in Africa. Jeanette Winterson has asked us to make clear, in case there is any doubt, that she does not believe that homeopathy can replace anti-retroviral drugs (ARVs) and she does not support homeopaths who make claims that may deter those with HIV from taking ARVs.

Now, I never got the impression from her artcile that she thought anything else. However, I did think she was being naive to assume that homeopaths could be trusted to behave in complementary ways. Homeopaths define themselves against real medicine – they call doctors ‘allopaths’ and use this term in derogatory ways. A few minutes perusing homeopathy web forums will convince you of this. As the Society of Homeopaths say on their home page – “Homeopathy is a complete system of medicine, suitable for everyone.”. No need for a real doctor then. You will find no discussion of how homeopathy should be used in a complementary manner on their “What is Homeopathy?” page.

It does look like Winterson has been putting some pressure on the Guardian to print this ‘clarrification’ as she does not want to be associated with AIDS-denialists or other murderous notions. But for me, what is not on, is that the Guardian has not published a letter from Edwin Cameron, Supreme Court of Appeal of South Africa, after he felt Jeannette Winterson had misrepresented him in her article.

Winterson/Goldacre Head-to-Head in the Daily Mail The Daily Mail have re-printed the Guardian’s homeopathic spat between Jeanette Winterson and Ben Goldacre. Both articles (trimmed down) are now head-to-head. But not all is at it seams. I...
Jeanette Winterson in Blistering Attack on Homeopathy Yesterday, prize winning author, Jeanette Winterson, delivered a devastating blow to supporters of homeopathy by calling for ‘better regulation’ of the profession and for the Society of Homeopaths to...
Homeopaths Changing Stories This, morning David Colquhoun was on the Radio 4 Today programme (listen again, 20 minutes in) making the charge that today’s Society of Homeopaths Symposium on AIDS was deeply irresponsible....

Winterson/Goldacre Head-to-Head in the Daily Mail

Le Canard Noir — Wed, 28 Nov 2007 18:08:00 +0000

The Daily Mail have re-printed the Guardian’s homeopathic spat between Jeanette Winterson and Ben Goldacre. Both articles (trimmed down) are now head-to-head.

But not all is at it seams. I have done some photo analysis on the pictures on that page and uncovered a disturbing truth. Look at the picture below. After some photo manipulation I have been able to reveal this…

Look at the picture close up. Who do you see? Now get out of your chair and look again from ten feet away.

Proof that this is a Big Pharma stitch up by getting novelist to defend homeopathy and make it look silly. Or was Goldacre behind the whole thing? Is Jeanette Winterson for real? Who can we trust? Is Jeanette Ben’s nom-de-Friday-night after a hectic week at the hospital and delivery of his Bad Science copy?

Jeanette Winterson in Blistering Attack on Homeopathy Yesterday, prize winning author, Jeanette Winterson, delivered a devastating blow to supporters of homeopathy by calling for ‘better regulation’ of the profession and for the Society of Homeopaths to...
Jeanette Winterson: Art and ‘Misrepresentations’ Healing fools. The seemingly miraculous ability of our bodies to naturally fight and recover from illness, and our inquisitive brains that are eager to seek out causative patterns in all...
On the Muppet Show Tonight… In his Guardian article, Ben Goldacre wrote about how homeopaths respond to criticism: With alternative therapists, when you point out a problem with the evidence, people don’t engage with you...

The Society of Homeopaths: Truth Matters

Le Canard Noir — Sat, 27 Oct 2007 18:32:00 +0000

I doubt we will ever see an X-Factor moment where a homeopath is forced to brutally confront the totality of their own delusions as they are exposed to a direct and uncompromising truth assault by a quackbusting Simon Cowell. Their emotional commitment to their healing fantasies is far stronger than their intellectual commitment to reason, truth and evidence. But I would have hoped that a homeopath’s disregard for truth was limited to the truths of science, however, events in the last week or two have made me wonder.

Last week, Ben Goldacre wrote an article in the Guardian newspaper (Threats – the homeopathic panacea) about how the Society of Homeopaths had attempted to silence this site over its criticism of the Society’s ability to protect the public from harmful advice from its members. This was highlighted by the BBC Newsnight/Sense about Science investigations into homeopaths giving advice about malaria prevention. As you might recall, at no point did the society try to contact me to explain their grievances – they used legal chill on my website hosts to silence me. The Society saw fit to respond the Guardian article and sent the editor a letter. To the best of my knowledge it has not been published. However, it is published on the Society web site and is the first insight into their thinking.

However, before exploring that, a number of things jumped out. In their letter of 22nd October 2007, they said (with my emphasis),

We contacted the programme makers directly to ask for their evidence that any Society members had given dangerous or misleading advice to members of the public. They were unable to provide a single example. The Society’s professional conduct procedures cannot be invoked without a specific complaint, an alleged offender or any evidence. In these circumstances, The Society was unable to investigate a specific case.

Elsewhere on their web site, they state that,

The Society of Homeopaths takes any alleged breach of its Code of Ethics & Practice very seriously and we must follow a due process when dealing with any allegation.

And,

The research conducted by Sense About Science failed to identify the homeopaths interviewed. Not all homeopaths are registered members of The Society. Nevertheless, any alleged breach by a registered member, of The Society’s Code of Ethics & Practice, will be investigated by our Professional Conduct Department.

Now, what I do not understand is how these statements can be made in light of the fact that I have an email from Paula Ross, Chief Executive of the Society of Homeopaths, addressed to the programme investigators (dated 22 August 2006), that starts,

“I am in receipt of your summary transcripts.”

The transcripts contain two conversations between an undercover investigator and a named homeopath who just so happens to be a Fellow of the Society of Homeopaths. I will not name him, but I am happy to do so if the Society dispute this.

In the transcripts, the investigator asks if the named homeopath is able to offer a homeopathic alternative to her doctor-prescribed anti-malarials. The homeopath confirms that he is able to, and offers a consultation on that basis. In a subsequent transcripted conversation, when asked by the investigator why the Health Protection Agency web site says that you should not take homeopathy for malaria, the named homeopath laughs and replies “Of course they did. Right, if you are influenced by that go with whatever will make you comfortable.”

The investigator, still acting as a client, asks why the Faculty of Homeopaths says pretty much the same thing. The homeopath replies, “the faculty are all medics so they must more or less toe the medical line.” The homeopath constantly portrays this as an either/or choice for the client: either they stick with their side-effect inducing ‘orthodox’ treatments or go with homeopathy. The homeopath tells the investigator to do some research on the Society of Homeopath’s web site and on the What Doctors Don’t Tell You web site. When asked to confirm again that there is a homeopathic alternative, he replies, “The answer to that is yes, but not approved by orthodoxy. Plain and simply.”

(You can see a summary of all the transcripts here.)

So, what the hell is going on here? It is possible that the Chair of the Society of Homeopaths, Andy Kirk, who wrote letter to the Guardian, may not have been aware that the Chief Executive, Paula Ross, was in possession of the transcript evidence and had been given the name of the Fellow of the Society who gave the advice. Presumably, their complaints officer, Patricia Moroney, was also not in possession of the evidence. This would be fairly shambolic – a word I used in the first sentence of my ‘banned’ article.

It may also be possible that Paula Ross came to the conclusion on her own that the transcripts did not contain sufficient evidence of wrongdoing. However, the Society is quite clear that “we must follow a due process when dealing with any allegation”. Was due process not undertaken? Again, they are quite clear: “the Society was unable to investigate a specific case.” It is worth pointing out that Paula Ross is not a trained homeopath, nor is she trained scientifically. She is an English graduate who has a Post-Graduate Diploma in Management.

There are, of course, far worse interpretations of this situation. Unfortunately, it looks like we may never know why these contradictory statements have been made by the Society. Did an investigation take place? If not, why not? If it did, why no apparent action? And why make statements that suggest that it was the failure of the BBC/SaS team to hand over evidence and names that prevented the Society from taking action? They quite clearly did hand over the evidence required. I have written to the Society and Ms Ross twice now over the past week to help me clarify the issues and they have seen fit not to reply.

One reason they might not have replied is contained in their letter to the Guardian. Rather than highlight what they thought was defamatory in my blog post, they say,

Dr Lewis, in his article, stated as fact highly offensive comments about The Society and it is for that reason that The Society decided it had no option but to take action.

Due to the unpleasantness and surprisingly vitriolic nature of the postings on the Quackometer website and others, The Society has taken a conscious decision not to respond to these bloggers.

So first, offensive is not the same as defamatory. And, as Richard Dawkins put it so well, “offense is what people take when they can’t take argument”. Offense is so often the refuge of the unquestionably right. What I find offensive is the fact that a Fellow of the Society of Homeopaths is quite prepared to let a gap year student or young tourist travel deep into Africa with nothing but a magic fairy pill to protect themselves against a common and often fatal disease. And more deeply offensive is that his so-called regulatory body sees no reason to take any action at all and is even prepared to state untruths about the matter in a national newspaper and on their website. And unpleasant? I hear dying of cerebral malaria is unpleasant.

Vitriolic? Vitriol suggests I was abusive. That I was not. What I was, was shocked and angry at what I was discovering and I was forthright in my opinions. I was not the only angry person. It is always worth re-quoting Dr Peter Fisher – the Queen’s Homeopath – on the affair, “I’m very angry about it because people are going to get malaria – there is absolutely no reason to think that homeopathy works to prevent malaria and you won’t find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.”

The vitriol undoubtedly came from a stream of emails from around the world to the Society following their attempt to silence me. I do not condone this abuse – reasoned argument is much stronger and it has given the Society a fig-leaf to hide behind. But their quoting of this vitriol is typical of homeopathic thinking – it has confused the nature of cause and effect. The vitriol was the result of their actions, not the prompt for them to take action.

And so, as Nick Cohen discussed in yesterday’s Observer, we live in a society that sees organisations like the Society of Homeopaths as “a funny little alternative institute we too casually dismiss as quaint”. But homeopathy is founded on a cavalier attitude to reason and truth and that makes the practice dangerous. Their propaganda tells us that homeopathy is safe, natural and effective. This is not true – and truth matters most when dealing with life and death issues. I do not favour heavy handed legislation to stamp out these practices – I still believe homeopathy could just about evolve into something genuinely useful. But maybe the zeitgeist is changing. Holding dangerous beliefs, that show such a lack of care for consequences, should be as seen as socially unacceptable and as selfish and as irrational as running a gas guzzling 4×4 for city school runs, or as dangerous and irresponsible as drink driving.

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Follow Up

The Society of Homeopaths: The Failure of Self Regulation The Adverting Standards Authority has today found that a homeopath advertised their asthma clinic for kids by making untruthful, unsubstantiated and irresponsible claims. Archway House Natural Health Centre holds...
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Unanswered Questions Just in case you were wondering, here is the letter I wrote to the Society of Homeopaths, asking them just why they were so upset about me. This letter was...

Absence of Evidence

Le Canard Noir — Sun, 15 Jul 2007 11:06:00 +0000

The absence of the Bad Science column in yesterday’s Guardian has all the makings of a bigger story than had there actually been a column. Ben Goldacre, writer of the column, has been one of the few voices in the British press that has reliably and careful pointed out the evidence against the assertion that the MMR vaccine causes autism in children. Last Sunday’s appalling story in the Guardian’s sister paper, the Observer, and the non-appearance of Ben yesterday, cannot be a coincidence.

Last week saw two pretty awful bad science stories: the first was this unnecessary muck-raking around MMR on the eve of Andrew Wakefield’s competence to practice hearing; the second, was Patrick Holford’s parading of his non-science nonsense on the gullible Trevor McDonald programme. The latter was broadcast too late for inclusion in Saturday’s paper. No, Ben just had to write about the MMR story that spread across the British Media like wildfire last week. I am sure it was tearing at the very heart of Ben’s Bad Science existence. I can feel his pain.

So, has the Guardian gagged him? Told him not to write about it? Today’s Observer offers a piss poor explanation for their story. Maybe, the Guardian wanted to let the Observer offer its own explanation for why it made the story front-page? Well, if their readers’ editor comments is justification then it falls a long way short. The non-apology offers in response to the charge that it was conflating the issues of MMR safety and an autism increase that,

We didn’t conflate the two issues; the issues are already conflated.

Fantastic. And I thought the more progressive papers were all about trying to disentangle the lies, half-truths, confusions and propaganda so readily dished out by most of the press. It is a great shame that the two newspapers that stand the best chance of offering rational reporting based on good science find it so hard to do so.

The Observer tries to justify its story in that it managed to get hold of leaked previews of the Cambridge results that deserved reporting. In this respect it is behaving as if it has got hold of leaked cabinet papers. It forgets that science is a process that has many checks and balances. Break that process and what you end up with is inherently unreliable – it is no longer science. Leaked results, before they have been peer-reviewed and amended are deeply provisional and may well be worthless.

What I find galling is that the original article is essentially repeating the same mistakes that led to the MMR debacle in the first place, namely:

reporting unpublished research that has not gone through a proper peer-review and scientific analysis and promoting such reports as if it was reliable and important.

feeling the need to report ‘balance’ by giving undue prominence to fringe views and small numbers of dissenting voices

failing to properly report careful and sound science that could settle the issues and instead continue to look for a sensationalist angle.

Newspapers appears to misunderstand that good science reporting is intrinsically different from reporting financial issues, politics, fashion and sport. Science is not democratic. It is not about the fair counterpointing of opinions. It is not ‘pluralistic’. It cannot be selective. Science reporting should not focus on the motives of researchers as its primary analysis. It should not be about conspiracies and shenanigan’s as a matter of course.

And the reason is that science is the the best way, indeed the only way, that we know of finding out the truth about the world. And it is a truth that is deeper than the ‘truths’ of politics and the love lives of celebrities. Our wishes, aspirations, prejudices and world views make no impact on scientific reality, no matter what the post-modern educations of our media masters may have told them. Does MMR cause autism? This is a question that cannot be answered by readers’ polls, a show of hands and an editorial in a paper. It is a question about the nature of reality; a scientific question that can be, and has been, answered by the meticulous collection of relevant evidence.

Understanding science is about understanding the evidence: about how that evidence has been collected, analysed and criticised. It is about the best conclusions we can draw from that evidence and how we might improve on that evidence to gain deeper insights. Reporting that concentrates on fringe views, that are in contradiction to reliably established facts, might do when we discuss base-rate changes, Spice Girl reunions or the size of Tony Blair’s manhood, but cannot make the mainstay of scientific reporting. The end result is just a total distortion of what science knows and just adds to public mistrust of the reliability of science.

Now, of course there are very important human interest stories in the MMR controversy. Science is a human process too. But the process of science is different from the established conclusions of science. In science there are deceptions, intrigue, anguish and politics. These issues too need reporting. The charges that Andrew Wakefield will face need covering to counter the arguments in the mad press that this is just the ‘establishment’ hitting back. There are thousands of confused parents and many who are convince that MMR caused their children’s problems, despite their beliefs being due simplistic and faulty reasoning. There are the quacks that seek to exploit the fear of MMR and offer their own self-serving money making schemes. But the science is different from the human ping-pong. The non-MMR/Autism link is as settled as any scientific question can be now. This ought to be the starting point of the stories, not something that can be played with like antics of Paris Hilton.

So, will the Guardian let Ben write what needs to be written? What is more important, can the Guardian and the Observer cover the GMC disciplinary hearings for Andrew Wakefield in a way that can start putting the whole sorry mess to bed? We desperately need newspapers that can do this. We do not need more sensationalist rags. I shall not be buying a paper this week. A small step, I know.

These things are important. As a society, we have forgotten how bad childhood illnesses can be. We have forgotten how they were feared by our grandparents. Instead we just just get idiots in the Daily Mail saying how we should not be too worried about immunising our children, because there are no cases of measles about.

postscript:

Response now posted…

http://www.guardian.co.uk/commentisfree/story/0,,2128834,00.html

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Lethal Trust

Le Canard Noir — Sun, 01 Jul 2007 22:28:00 +0000

If you were to believe the Society of Homeopaths, the quacks that were handing out lethal advice to Newsnight investigators about malaria prevention, were just a few rogue and unregistered practitioners and unrepresentative of the profession.

Peter Fisher , the Director of the Royal London Homeopathic Hospital (currently funded by the NHS) told the programme that,

I’m very angry about it because people are going to get malaria – there is absolutely no reason to think that homeopathy works to prevent malaria and you won’t find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.

It is worth reading that quote again as it is going to be important.

As we saw in my previous post, homeopaths are not very good at defining the boundaries of their profession and their so-called professional bodies turn a blind eye to outrageous and dangerous claims. The question of whether homeopaths can be trusted to self-regulate hinges on how they police the boundaries of their own profession. Is Dr Fisher right in his belief that you cannot find real homeopaths that think you can cure or prevent dangerous diseases with sugar pills? Unsurprisingly, his claim looks very weak.

The Alliance of Registered Homeopaths (ARH) is a

UK professional organisation that supports and promotes a high standard of safe, effective homeopathic practice.

This would be a good organisation to look at if we wanted “high standards and safe practice” inside a regulated profession and definitely we would hope to find an organisation that condemned dangerous practices. It publishes a quarterly magazine called Homeopathy in Practice and is full of articles from homeopaths and their musings, philosophies and experiences. We saw the quality of the sort of pseudoscience is offers recently, in an article pleading that homeopathy was science by changing the definition of science to one that would include astrology, scientology and Greek myth.

Fortunately for us, we do not have to subscribe to get an idea of what the ARH promotes through this journal. We have access to a list of contents and even some sample articles. A quick scan through shows one article entitled, Silent and deadly: Prophylaxis and treatment of malaria by Theresa Partington. Luckily, the full text is available for us to view. The article views the recommended homeopathic prophylaxis and treatment options as given by ‘experts’. On prophylaxis it says,

All recommended [homepathic] prophylaxis for visitors. The ‘African’ homeopaths recommended Malaria Co Nosode 30 on a weekly basis for visitors, starting a week before arrival and continuing for a month afterwards, Jennie also recommends the concurrent use of China 30, following recommendations of Susan Curtis in ‘Alternatives to Immunisation’; Liz Hennel, who works in Nicaragua, uses Plasmodium falciparum nosode (available as a single nosode from Ainsworths) and China sulphuricum in areas where this type of malaria is prevalent, but otherwise Malaria officinalis and China.

The same type of advice is given for treatment. Shockingly, the article proudly reports how a homeopath is teaching people in high risk areas of Africa about the ‘benefits’ of homeopathy,

[Assie Pittendrigh] is working in the Great Lakes region of Africa, teaching homeopathy to local nurses and doctors who run charity clinics in the region. The project began at the end of January 2006 and has two purposes:

1) To introduce homeopathy for First Aid and Acute Diseases (her quick reference guide is being translated into the required language).

2) To run a professional clinical trial to test the effectiveness of malarial prophylaxis using homeopathy. The exact format of the trial will be agreed with the medical staff and this information will be made available as soon as is feasible.

In other words, according to Peter Fisher’s above criteria, Assie (Alison) Pittendrigh is killing people. The title of this article is ‘Silent and Deadly’. The denial of Peter Fisher, and the silence the Society of Homeopaths, and the ARH is indeed deadly.

Again, this failure to set boundaries for the profession is not limited to its views on malaria. Grace DaSilva-Hill MSc LCPH MARH MAAMET RGN has written, in the Winter 2006 edition, a two part essay on ‘Treating acutes with homeopathy’. Fortunately again, the first part is available to us to read. DaSilva-Hill discusses the use of homeopathy in serious acute conditions, when the ‘most common reaction amongst people is to take the patient to the hospital’.

She says after discussing a case of bacterial meningitis,

It requires a great deal of trust between patient and homeopath, for a serious acute to be treated solely with homeopathy.

Amazing. I would also add a great deal of stupidity, negligence and arrogance too. The only reason we do not see too many deaths from thinking like this is that the vast majority of parents would be at their GPs and casualty in a flash if a serious illness threatened their children. The danger is that a few hours delay while a homeopath picked their ‘ultra-potentized’ sweetie pills, could make all the difference between a favourable and tragic outcome. A parent taught by their homeopath that this is the safer and gentler route to health might be misplacing a lethal trust.

DaSilva-Hill pulls back from saying that she does treat without recourse to real medicine by saying,

I guess it’s the voice of my nursing background still lurking somewhere reminding me of professional accountability to a statutory body.

Her inference is thought, that others may not feel such a compunction. Homeopaths have no statutory body to make practitioners accountable.

The journal gives us another freebie article worth checking out: Vaccinations: what cost? By Christina Head. It is as if being in one area of alternative medicine, you are required to adopt a full credo of beliefs about the evils of real medicine and science. We find in this article the usual discredited MMR-autism story and a general distrust of all vaccinations. Head gives us sentence after sentence of the usual anti-vaccination canards, including,

I have in my practice about 500 unvaccinated children of all ages. They are much more straightforward to treat because they don’t have a ‘kinked up’ immune system. But they still have their inherited or acquired susceptibilities.

and

Treating unvaccinated children is truly creative medicine and provides a real base for good health in the future life.

Now, as you know, vaccinations have saved countless lives. But on their own do not guarantee immunity from childhood killers. A particular vaccination may only be 80% effective, say. Real protection comes when the vast majority of the infectable community are vaccinated. The infection can then not get a foothold in the population and spread. If the level of vaccination drops below a threshold, then the disease can spread, even to vaccinated children. Thus, Christina Head’s advice not only endangers the children of parents who believe this rubbish, but all children too. Peter Fisher also supposedly believes that the homeopathic community supports vaccination. Is he in touch with his community?

It is easy to be lured into believing the homeopaths’ platitudes that their practice is without side-effects and is harmless. What does not appear to be recognized, as Ben Goldacre pointed out in the Guardian last weekend, is that the effluent and discarded waste of alternative medicine is bullshit. And bullshit can be very dangerous, especially medical bullshit. Complementary medicine undoubtedly has beneficial roles in health care, but not if it is in the business of dishing out pseudoscientific nonsense, lies about real medicine and doctors, and over inflated claims about its own efficacy. Quackery kills.

Wisdom is often described as a second-order type of knowledge. Wisdom is not what you know, but what you know about what you know. How do I know what I know? Can my knowledge be trusted? How could I be wrong? What do I know that is sound and what do I know that is speculative? Competence at a skill is not just about performance, but about having a self-critical awareness of your own performance. Where are my failings? How can I improve? Am I deluding myself about my performance?

The homeopathic community shows itself to be devoid of any sort of critical appraisal of its limits, responsibilities and capabilities. It lacks group wisdom and acts incompetently. Its beliefs endanger its clients. It exports its delusions with a missionary zeal to countries in desperate need of real health care and in doing so, places them in even greater danger. Its embracing of the usual alternative medicine canards, such as the unnecessary antagonism towards vaccination, puts its clients and all of society at risk.

Peter Fisher, of the the Royal London Homeopathic Hospital, is currently lobbying hard to keep public funding for homeopathy and specialised homeopathic hospitals. Fewer referrals are being made to these hospitals as it becomes more apparent how little value they add in a world of evidence-based medicine and strict cash limits. Let’s hope this lack of trust in homeopathy as a good use of NHS resources turns out to be lethal. The need for good complementary care within the NHS is not well served by homeopaths.

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The Depths of Ms McKeith’s Anti-Science

Le Canard Noir — Wed, 14 Feb 2007 12:52:00 +0000

It’s been a bad week for Gillian. The anti-quackery blogging brigade have been partaking in bouts of the great British pastime of uncontrolled Schadenfreude (why did we leave it to the Germans to coin that term?) after the Advertising Standards Authority stopped Gillian McKeith as advertising herself as ‘Dr Gillian’. The Guardian printed a huge article by Ben Goldacre about how she is a ‘Menace to Science’ and how her particular brand of nutrionism is deeply anti-science and harmful.

Is there anything else left to say on the subject? One thing that Ben and Gillian’s defenders have in common is their belief that, in many ways, it is immaterial by what title she calls herself. Obviously, her use of the title offends the many hardworking PhDs who have sweated and slaved to use their title in order to try to secure upgrades at airport check-ins. But if her advice leads to people eating more sensible diets then surely ‘all’s well that end’s well’? That would be fine. But Gillian just speaks nonsense at people. Her thoughts on chlorophyll and food colour have been well addressed as non-scientific silliness. If people take her seriously, then how do they know what is good advice and what is rubbish? Therein lies the problem.

My contribution to the debate is going to be to show just how deep her embrace of anti-science is. I don’t think even Ben has described just how far she is prepared to go. She does not just embrace the language of science in a pseudoscientific way, but is also quite prepared to get into bed with a deep anti-science agri-woo in order to sell her products. Let’s just look at one of her products for sale on her web site: Veggie Vitality, available in 200ml quantities for £1.79. Her description reads…

My Veggie Vitality is produced to BioDynamic and Organic principles. BioDynamic is the highest standard for food excellence in the World today. These dedicated farmers grow their vegetables holistically according to the rhythms of the earth, sun, moon and stars. Using mineral-rich composted soil, natural homeopathics, soft music, happy conversation and meditation for the enjoyment of the crops, BioDynamicfarmers garner the perfect vibrational energy to help me create the most delicious vegetable juice ever made.

In itself, this description is pretty scary – holistic, organic, homeopathic, happy conversations – but the really kooky stuff is a little under the covers. Apparently, this drink is made to BioDynamic standards, which is supposed to be some sort of pinnacle of food excellence. Let’s look at what this actually means.

Biodynamics is a farming method that was the precursor of the now popular organic food movement. Supporters of Biodynamics still stick to the founding fathers’ original ideals of how farming should be done. If you are easily frightened, do not read on. This stuff is off with the fairies.

First the easy bit. Biodymanics believes that you should re-use stuff from the farm as fertilizer and not import chemicals and so on. Treating pests should also be done with readily available and local materials. There ends the fairly sane stuff.

Using any old horse shit as fertilizer is not good enough though. You have to ‘activate’ it using a number of formulated preparations. Let me describe a few to you…

Filling a cow horn with crushed quartz and burying it in the field you wish to help.
Yarrow flowers are stuffed into the bladder of a Red Deer and then buried over-winter before digging up in Spring
Oak bark is stuffed into the skull of a dead cat, or other domestic animal, and then also buried in peat
Chamomile flowers are stuffed into cattle intestines and buried in Autumn.

Once retrieved, the resultant gunge is used in teaspoon sized quantities on the whole dung heap to add special ‘life-forces’. Other flower preparations, similar to Dame Mossop’s Phytobiophysics, in near homeopathic concentrations, can also be used for the same effect.

It gets better. If you have an infestation of field mice, then catch a few, ceremoniously burn the little buggers, and then sprinkle the ashes around, but do this only when Venus is in Scorpio. (I am serious.)

What is quite clear is that Gillian’s ‘highest standard for food excellence’ is little more than a mystical collection of nostalgic wishful thinking, voodoo, astrology and quackery. Her carrot and cucumber juice has to be that expensive as the farm workers are spending significant amounts of their time killing cats, stuffing stinging nettles into cow’s squelchy bits, digging holes in peat bogs to bury this stuff, consulting astrological charts, succussing homeopathic preparations, and not forgetting to run around catching mice and the burning them at the stake. And she wants to be called Doctor.

Unless you wear purple a lot, I doubt I have to convince you that Biodynamics is at the nuttier end of the organic food movement (but not that far off in my opinion). Nonetheless, the issues that the organic farmers are trying to address, such as land use and animal care, are serious and need good answers. However, they do not get these answers by clinging to magical thinking. How do we make best use of our land, without cutting down more forest, and still produce the yields to feed everyone? How do we ensure our crops reliably grow every year so that disease, climate change and flooding do not produce regular shortages? How do we ensure that our soils can grow the yield of crops we need, year on year? How do we make sure that crop growing is energy effiecient and that the food on our table is not producing ridiculous amounts of greenhouse gasses in the field-to-table process?

Whilst mincing around with astrological charts, skulls and quartz crystals is going to be fun at Glastonbury Festival this year (my prediction – the Police will headline), it is not going to produce a reliable and sufficient amount of food, year on year, in the challenging times ahead. Only science can tell us the right and wrong paths to take. Superstition, nonsense and wishful thinking will only cloud our judgements and add to the confusion. Only serious enquiry and hard choices will steer us around the problems. Does GM have a role? How do we protect seed stocks? What energy sources should we use? These are serious questions that will affect the health of millions, if not billions, of people over the coming decades. This is for real and is a long way removed from the middle-class shit-poking, superfood obsessing, bullying and nonsense-promotion of the TV and Sunday Supplement nutriquacks.

Ms McKeith’s anti-science is not helping us on this most critical journey.

Quack Word #12: ‘Organic’ I believe that organic food is a con, is not necessarily more healthy for you, tastes no different, and is damaging to the environment. There, I have got that off...
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Quack Word #39: ‘Superfood’ Regular listeners to BBC Radio 4’s Womans‘ Hour will have recently heard nutritionist Suzi Grant extolling the virtues of so-called superfoods. Quackery, I say. But what on earth can be...

Quack Word #39: ‘Superfood’

Le Canard Noir — Fri, 02 Feb 2007 16:30:00 +0000

Regular listeners to BBC Radio 4’s Womans‘ Hour will have recently heard nutritionist Suzi Grant extolling the virtues of so-called superfoods. Quackery, I say.

But what on earth can be wrong with a superfood? Surely eating foods rich in nutrients has nothing to do with quackery, but is just common sense? I don’t think it is quite that simple, and I would contend that anyone using the word ‘superfood‘ is a quack and deserves to score Canards on the Quackometer. Using the term ‘superfood‘ is at best meaningless and at worst harmful. Let me explain.

Suzi has been appearing on the show regulalry talking about her ideas on superfoods. This Friday’s edition of Womans‘ Hour (listen here) was not such a clear run for her though. This time, Suzi was joined by a dietitian by the name of Catherine Collins. Now, as you know, dietitians are for real. They train for years, have to be registered in order to call themselves a dietitian. They are accountable for what they say and can be struck off if they behave in inappropriate ways. They work in hospitals. Nutritionists tend to be or do none of these things. Anyone can call themselves a nutritionist or nutritional therapist. You are a nutritionist. Tell your Mum – she will be proud. They are accountable to no-one but their own conscience and need no training. What training they do have may be severely lacking in credibility. If you are ill with a condition that needs sounds eating advice, like cystic fibrosis, you would best talk to a dietitian. Taking advice from a nutritionist could well seriously damage your health.

So, Catherine (dietitian) vs. Suzi (nutritional therapist). The show was all very Radio 4, cosy and good natured and rather lacked the impact that it ought to have had. After all, Catherine was there to debunk the superfood nonsense, but the interviewer, Carolyn, rather engineered the conversation to an apparent consensus – which there most definitely was not. So, let us here have a look at the issues.

Let’s start with a definition of superfood… and at the first hurdle we get stuck. There is no accepted definition, and definitely no scientific way of classifying foods into superfoods. Suzi contended that, when faced with the choice of blueberries and lasagne, she ‘knows’ which is a superfood and which is not. (The berries, obviously!) Catherine thought this rather ironic as dietitians do not look at individual foods particularly, but instead try to get people to eat ’super diets’. And a Southern Mediterranean diet, with its balance of food groups, including lasagne, is very close to what might be considered a ’super diet’. Of course, Suzi contended that eating loads of lasagne will make you feel woozy and so on. If you stuff yourself silly, answered Catherine. But of course, Italians do not do that. They eat small portions, of many courses, in a varied meal. Moderation, variation and balance. Simple stuff for a super diet. So, the difference so far can be summed up as the dietitian concentrating on the whole diet (holistic, dare I say) and the nutritional therapist fetishising particular trendy foods.

So, is the thing about superfoods just misdirected good intentions? I think it is worse than that, as nutritionists tend to surround their superfood advocacy with wrappings of pseudoscience, mumbo-jumbo and misinformation. This is not good as it confuses people, misinforms then and gets in the way of understanding what makes a good diet. This side of the superfood phenomenon was also on display in the BBC interview.

The first idea that is just plain wrong is that just because certain foods are bursting with a particular vitamin or nutrient then they will be especially healthy for you. The idea is that because Vitamin C stops you getting nasty illnesses, then lots of Vit C must be very, very healthy. The truth is that your body has a requirement for sufficient nutrients in order to work. Sufficient is the key word here. If it has an excess amount of these nutrients, and cannot store them, then they will essentially go to waste. So much food quackery is based around the canard that ‘more good stuff is better’.

Next, there are certain woo-like beliefs that seeds and sprouts are ‘bursting’ with all the ‘energy’ that a plant will need for its life. Utter rot. Plants obtain their energy from photosynthesis and nutrients and water from soil. A seed’s job is to produce a leaf or two and a small root so that it can start extracting the stuff from the environment that it will need to grow. In that sense, a seed is no more special than any other plant matter. Lucky seeds do not contain all that energy the nutriquacks talk about. Imagine the energy in an acorn required to make an oak tree. One wrong tap and it would go off like a nuclear bomb. Dangerous walking in Autumn.

One last canard on display was that the colour of foods is very important. Superfoods are often brightly coloured. Somehow a food’s nutritional value can be judged by its colour. Now, to be fair, getting people to eat a variety of different coloured foods may help in promoting variety and the use of fresh products – but that is it. Colour is not a flag for nutritional value, but might just liven up a damp salad.

I can almost hear Suzi typing an angry email to me saying that all her pronouncements are backed up by scientific studies. To that, I would say that Ben Goldacre has done a fantastic demolition job on the quality of superfood research. In this Saturday’s Guardian he wrote about finally getting hold of ‘Dr’ Gillian McKeith’s PhD ‘thesis’, probably better described as a PhD pamphlet and recipe book. It has long been expected that its academic quality may be questionable as her PhD was awarded by a non-accredited US correspondence college cum vitamin supplement shop. Best read Ben’s analysis of the thesis for all the gory details.

I said earlier that concentrating on superfoods could well have the capability to actually harm people. I think this comes about as heeding advice about taking superfoods misses the big picture. And the big picture is to simply eat a balanced, varied and modest diet. Superfoods give the impression that ordinary, affordable and everyday foods are somehow deficient. Rather than spend five pounds on wooberries and mumbo-jumbo bean sprouts in Waitrose, a family would be better off buying regular and larger quantities of fresh fruit and veg from their local market. On a restricted budget, it is even more important to ignore dubious, expensive products in the belief you can take shortcuts to a good diet. Rather than buying imported African blue-green energy-algae, with all the CO2 emissions associated with travel, eating a cheap British apple would be better for the environment too.

So what’s left for superfoods? Little really. Like most alternative medicine quackometer words, it is a word without substance and is just a marketing word, like ‘holisitic‘, ‘organic’, or Gillian McKeith’s use of the term, ‘Doctor’. The word sells expensive berries in Waitrose, bottles of weird algae extract on nutriquacks‘ web sites, and unimaginative and lazy recipe books. Oh, and it fills slots on the radio with nonsense.

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Quack Word #16: ‘Nutritionist’

Le Canard Noir — Tue, 21 Nov 2006 14:32:00 +0000

A regular comment to me is to ask “why have I got it in for Nutritionists?” Surely, these are dedicated health professionals who do wonders for peoples’ health by improving their diets and making sure people take the right supplements, if required. Well maybe. The problem is that so many nutritionists are not doing this and often resort to pseudoscience and quackery. This week’s Quack Word blog entry will argue that the Quackometer is quite right (most of the time) in scoring highly a web page with the word ‘nutritionist’ in it.

So, a quick definition of ‘nutritionist’. Whilst one should always take wikipedea articles with a sceptical eye, their definition of nutritionist is a good starting point:

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.

So, there is our first major cause for concern, anyone can call themselves a nutritionist. Call your self a dietitian without a formally recognised qualification and you would be breaking the law. But, if you just want to write in a Sunday supplement or set up a health food web site selling vitamins, by all means, call yourself a nutritionist.

The wikipedia goes on:

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.

I have discussed before how some high profile UK nutritionists have little formal education, like to flaunt their unconventionally acquired titles and awards, and glow under self-styled accolades, such as ‘world’s foremost nutritionist’.

Now, there are varying trade associations that do seek to represent nutritionists in the UK. Membership is not compulsory and of course, they cannot stop someone calling themselves a nutritionist if they act in a way thought to be harmful or dishonest. Some appear to have little interest either in monitoring the behaviour of their membership as was well documented by Ben Goldacre of the Guardian when investigating The Nutrition Society.

But, surely this is all a side issue – getting people to eat healthily is what counts? Well yes, but I will argue that the advice of so many of the Sunday supplement writers can actually be counterproductive. Let me list some ways in which nutritionists go astray…

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.

Quack Word #39: ‘Superfood’ Regular listeners to BBC Radio 4’s Womans‘ Hour will have recently heard nutritionist Suzi Grant extolling the virtues of so-called superfoods. Quackery, I say. But what on earth can be...
Alleged Victim of Oxford Nutritionist ‘Detox Diet’ wins £810,000 Barbara Nash is a nutritionist based near Oxford. Dawn Page was overweight and sought the advice of Nash. It is alleged she was put on a ‘detox diet’ which included...
Quack Word #3: ‘Doctor’ UPDATE 12/2/07 Congratulations to Ben Goldacre and the crew at Bad Science for getting Dr Gillian McKeith banned from using the title ‘Dr’. In today’s Guardian she is fully exposed...