Quack Word #16: 'Nutritionist'

Tuesday, November 21, 2006

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.


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PHYTOBIOPHYSICS® - Flower Power or Duck Weed?

Tuesday, November 14, 2006

A big thanks to quackometer correspondent, a broadcaster, journalist and nutritional therapist, Suzi Grant for bringing me to the attention of the wonderful sounding healing technique of Phytobiophysics®. (please don't sue me...) This is a technique that is being promoted by the Institute of Phytobiophysics which follows the Mossop Philosophy through its products and courses. The Mossop philosophy is supposed to:

harnesses the vibration energy of plants to release energy blocks in the human body so that balance is re-established for all levels of consciousness; spiritual, emotional, mental and physical.

So far, just the usual pseudoscience, sounding a bit like a Bach Remedy. However, the Mossop Philosophy is based on the 'discoveries' of Professor Dame Diana Mossop. Wow. Regular quackometer followers will now just how much flaunted titles excite the little black duck. A Professor and a Dame! That has to be worth a little dig.

So before we inquire a little deeper, just what are the claims of Prof. Dame Mossop and the science of Phytobiophysics?

The Professor apparently suffered from malaria and did not respond well to real medicine as it was at the time. During some convalescence in the Far East and some 'organic nutrition', the Dame became convinced that illness was caused by 'unhappiness' and that plants provided the 'vibrations' to cure us. Much 'research' followed before Diana was able to bring forth her extensive range of healing flower products to the world.

The Dame now runs a web site selling flower essences, a bit like Bach Remedies, but somewhere (its a bit confusing) vodka is used rather than brandy and the flower vibrations are 'amplified' and not 'diluted, as in homeopathy'. One has to wonder just how much vodka is not reaching the manufacturing stage.

Now, flowers are nice, and I might not mind too much, but PDDM (I can't be bothered to type her full name all the time), claims that her pills (manufactured by a homeopathy factory, apparently) are much stronger than homeopathic pills (not hard) and bach remedies (for brandy lovers only) and can cure viral diseases. Oooh. Scary. Viral infections can be lethal and need proper medical care. We are are now getting into danger territory - the sort of territory that gives rise to HIV deniers and the bonkers thinking of some unfortunately misguided African politicians that will undoubtedly end in the deaths of millions of people unless some very clear thought is applied. Whilst I see nowhere on PDDM's web site to suggest that she is in this genocidal thought camp, claims for viral cures really do need to be backed up with sound evidence. The stakes are high. Who knows who will misuse this technique.

Anyway, the web site and her biography leave many questions unanswered. But for my correspondent, Suzi Grant, Prof Dame Mossop is someone I "might like to talk to ... before deciding it is also 'quackery'". Suzi is a journalist and so I would like to apply some journalistic techniques here. Basically, checking my facts, not taking anyone's word for it, and asking the obvious questions.

So, here are the questions I would like to ask the Professor Dame...
  1. You claim to have been made a Dame in 1993 after being "honoured with a Knighthood by the International Order Knights of Malta of St John of Jerusalem for her contribution to medical research".

    - So, you were not made a Dame by the Queen - the usual route? I can find no mention on the web of the International Knights' Order you talk of (is this organisation the same as the Knights Hospitaller?) and no mention of anyone else similarly honoured. Does this organisation exist? If they do, why their secrecy? Why are you allowed to talk about them and no-one else? Puzzling.

  2. You claim to be a Professor, but I see in your biography no mention of any academic degrees.

    - What subjects have you studied at postgraduate level? Who awarded your Professorship? To me it looks like the only organisation that could have done this is the 'Institution' you set up yourself to sell your products. Did you award the title to yourself? Most web retailers do not call their founder a Professor. Puzzling.

  3. You claim that your 'Institution' is "affiliated to the Open International University for Complementary medicine". Looking at the Open International University web site, it would appear that the sole function of this organisation is to organise a shin dig for various complementary therapists once a year. This university would appear to have no students, no lecturers, no premises and no courses. Puzzling.

  4. You claim your bizarrely unique Dameship is for your 'contribution to medical research' and yet nothing appears to be published on this. You claim to be "the author of seven unpublished books". Why are they unpublished? Why hold back your knowledge from the world if it really is so important? How did the da Vinci Code people who gave you your Dameship know you had made a contribution to medical research?
  5. On that note, how do you yourself know what you claim to be true? What experiments have you done? Where have you published your papers, Professor? I can find no mention of Phytobiophysics® on pubmed. Surely, you are not telling me that Phytobiophysics® has no independently peer-reviewed and published work in respected medical journals? Puzzling.

  6. You claim that "unlike bacteria, viruses are electrical in nature – they interfere with the electrical field forces of the body". Those are all words in a gramatically correct sentence, but they appear to make no sense. Are you aware of viral theory? In what possible sense are viruses 'electrical in nature'? This looks like classical pseudo-scientific gibberish and as the black duck would say, you don't appear to know the meaning of the words. Is the consensus and well established view of viruses being either fragments of DNA or RNA wrapped in a protein caspid wrong? A nobel prize becons if you are in any sense right. Puzzling.

  7. Why do the flowers have to be picked at the full moon? So you can see? Why not take a torch? Or even do it during daylight? What if it is cloudy? Deeply puzzled.

I could go on. But the depth of ridiculousness is far too much for one blog. Next time perhaps...

I will end on an odd observation. Diana Mossop (I shall drop the titles for now until I get my answers) claims to have helped supermodel Jodie Kidd through a bit of a crisis. Great. Good Stuff. But didn't my last suspect Professor, the Distinguished Provost of the Royal College of Alternative Medicine, Professor Joseph Chikelue Obi also have thing about supermodels, only this time Kate Moss?

What is it with supermodels? I must investigate...

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    Kryotherapy - Freezing the Balls off a Brazen Quack

    The Quackometer is far from perfect. Sometimes quackery slips though its little webbed feet and I need to update it. Often a story in the paper requires a little more dissection to reveal its inner quackery.

    So, today we hear that standing in a freezer can improve your health. Daily Mail reporter, Barney Calman, freezes his bits off as a piece of investigative journalism into whole-body cryotherapy. This is a technique that claims to cure a whole host of problems by allowing yourself to stand in a freezer at -120C for a few minutes. Funny, the chickens I put in the freezer never appear to get any better.

    As is often the case in the Daily Lunacy, the article is a thinly veiled piece of advertorial for a new business in Battersea, the London Kriotherapy Centre, which charges £300 pounds for the benefit of sticking you in its deep freeze.

    The newspaper article looses all credibility when it describes how the technique works.

    Cryotherapy apparently shrinks the molecules in the body and then, when you emerge from the cold, the molecules then expand, increasing the blood flow which then helps ease pain and swelling, as well as fighting inflammation.
    Obviously, the science editor was having a day off. For that matter, anyone with a science GCSE was probably down the pub or at the dentists too, as this is just plain bollocks. Its possible to see where the confusion has slipped in here, confusing the thermoregulatory response to cold of vasoconstriction with some imagined molecular physics.

    Anyway, poor reporting does not mean that there is no merit in the claims that getting your extremities cold very quickly can help with:

    rheumatism and osteoporosis to multiple sclerosis, chronic fatigue syndrome and depression, and even ... as an anti-cellulite and skin-firming treatment.
    The Kriotherapy Centre even suggests that low libido can be helped by a short, sharp cold shock!
    However, the cryotherapy bandwagon is fully rolling with sports injuries. The Guardian can be just as quacky as the Mail at times. They have already reported on crytherapy treatments as part of a healthy holiday in Poland. The Poles treat injured athletes in this way and, aparently, it has nothing do with former Soviet times when failed athletes were sent to Siberia.

    So, what evidence is there that this is an effective treatment for illness and injury? Well, pubmed is the place to look. A search for crotherapy and sports injury reveals a study entitled "Does Cryotherapy Hasten Return to Participation? A Systematic Review." This concludes, that whilst the technique may work, the studies that show an effect are of "low methodological quality" and,
    Despite the general acceptance of cryotherapy as an effective intervention, evidence on which to base these conclusions is limited. Only with strong randomized, controlled clinical trials will we know the true efficacy of cryotherapy.
    So, those that do promote such techniques right now, may well be guilty of quackery. Without evidence, you stand the risk of severely overstating your case. However, we should be careful here. Cryotherapy is a broad term that implies the use of cold temperatures for many therapeutic ends. Warts have been frozen off with extreme cold for long time. Some cancers use similar techniques to kill the cancerous cells. But standing in your grundies in a very cold room? Can this really be a miracle cure for multiple sclerosis and osteoporosis?

    People report pain relief for this sort of activity. Studies show that this may indeed be true, but that there is no evidence that this has any long term benefit. It is easy to see how endorphins released during the process of freezing your skin off may temporarily take your mind of your back pain or arthritis. People report similar effects from saunas or even having needles sticking in them. This does not mean that the technique is cost effective (would a locally applied ice pack do just as well?) or have any lasting effect beyond the immediate relief. People who report long term effects may just be confusing a general remission with treatment effectiveness or be suffering from plain old wishful thinking. That is why controlled and blinded trials are so important.

    Of course, the Daily Wail backs up its claims with anecdotes (why trust any authorities?) and so acts as a good free advertisement for the Kriothrapy clinic. (Why am I thinking of Krusty the Klown?) I bet they were popping the ice-cold bubbly there today.

    Depressingly, and despite showing a few signs of critical thinking, Barney ends his article on a completely credulous note:

    I have suffered from eczema around my eyes for four years; I use a medicated cream daily to stop flare ups, but remarkably, since having cryotherapy it’s been itch and pain free. I’ve not needed to use my medication for the first time in a year and a half.

    As bizarre as whole body cryotherapy sounds it’s worth remembering that commonplace alternative treatments such as reflexology, acupuncture, massage and osteopathy, now available on the NHS, were once considered ‘loony’ and ineffectual.

    A future blog entry will be on the NHS and their State Sponsored Quackery. Just because they have a web site about so-called alternative medicine (SCAM) does not mean that these techniques are not loony and ineffectual.

    In the meantime, I fully recommend a Finnish sauna and ice plunge pool if you want to see various external bits of you shrink back into the body cavity. Cheaper, communal and the vodka is good.

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    An Holistic View of the Quackoblogosphere

    Friday, November 03, 2006

    For a while now, the quackometer has been regularly and automatically scanning various blogs for good writing about quackery. The end result is a twice-daily distillation of what's hot in the blogosphere about quackery -or as the little black duck calls it, the quackoblogosphere.

    Now, this digest is available as an RSS feed so that you can see who is writing the best stuff in one easy to find location.

    Please let me know if there is a blog out there that is not being scanned. You can see the full list of scanned blogs from the quackoblogosphere's home page.

    PS Apologies for using the word 'Holistic' in the title. I felt rather dirty when typing it.

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