So what has ozone ever done for us?

June 26th, 2003 by Ben Goldacre in alternative medicine, bad science, celebs, oxygen, scare stories | 3 Comments »

Ben Goldacre
Thursday June 26, 2003
The Guardian

· What is it with alternative therapists and oxygen? Last week’s Time Out offered a glowing report on ozone therapy, and the fact that they called it O3 (with a superscript) should be enough to tell you that whoever wrote it wasn’t necessarily paying attention during basic chemistry. God only knows what its sub-editors think they’re playing at. They go on to tell us that “O3 is a clear blue gas (hence the colour of the sky)”. I hate to use the same gag twice in a month, but if you really want to know why the sky is blue, and I know this is getting boring now, you only have to type “why is the sky blue?” into any search engine on the internet, and you will be instantly directed to, where your question will be answered. And it has nothing to do with ozone.

· Now it occurs to me that since the World Health Organisation is worried about monitoring levels of ozone that exceed guidelines by a few micrograms per cubic metre – since it has been implicated in all kinds of conditions, including exacerbation of asthma and bronchitis, headaches, fatigue, nausea and respiratory problems – we might all be a little concerned about Enrida Kelly, a “naturopath” in west London, flogging ozone therapy “mixed in a ratio of 99 parts oxygen to one part ozone”. But not our experts at Time Out. In fact, they reserved special praise for its deployment in colonic irrigation, “bringing the benefits of oxygenation, and cleaning the parts of the body that can benefit most”. Check out Kelly’s website at Lots of wonderful promises: “Many people have had their limbs saved by such therapy.” And a lovely disclaimer: “Though we will be glad to assess and supervise sessions aimed at improving your well being, we do not ‘treat’ or aim to ‘cure’ disease.” But not a randomised control trial in sight.

· Speaking of experts, WebFusion was lucky enough to get Philippa Forrester, “Tomorrow’s World presenter and technology expert”, to endorse its products in its latest round of advertising. “WebFusion has always represented innovative thinking, the best technology, and great value,” she says. Forrester, you may remember, is so technically adept that she was last seen in the paedophilia edition of Brass Eye, holding her (big) head behind a T-shirt printed with a tiny body, saying: “Wearing a T-shirt like this, the paedophile can disguise himself as a child.”

The last prescription

June 20th, 2003 by Ben Goldacre in bad science, nutritionists | 6 Comments »

Ben Goldacre responds to nutritionist Paul Clayton further down below…

The last prescription

The future of healthcare lies not at your local chemist, argues Paul Clayton, but at the supermarket checkout.

Tuesday June 10, 2003
The Guardian

We are spending more money on healthcare than ever before. We are living longer, yet never have we been less healthy. Our medicines have reached the highest level of sophistication, yet the incidence of degenerative diseases continues to increase, with many, such as diabetes, appearing in progressively younger people.

Five out of six people in their 60s have symptoms of one or more of the chronic degenerative diseases, such as coronary artery disease, osteoporosis and Alzheimer’s. Drugs alleviate their symptoms, but do little to alter the underlying illness, which generally continues to deteriorate. Drugs are designed to block a single step in the process leading to the symptoms of illness: a strategy unlikely to cure, and with a high risk of side effects. Iatrogenic illnesses – ill health caused by side effects of drugs – are listed as the fourth most common cause of death.

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Modern medicine is practised as crisis management: wait until diagnosis, then start treatment. But by the time the symptoms of disease appear, damage has been done that drugs cannot address. Most apparently healthy people are “pre-ill”; arteries are furring, bone is thinning, leading eventually to a heart attack or fracture. Drugs can do little to prevent this.

But are these conditions inevitably degenerative? A new science, known as pharmaco-nutrition, is emerging which focuses on the pre-ill, and analyses the metabolic errors that lead to clinical illness, in order to correct them before the first twinge of angina or fracture. Forget drugs: the next wave of healthcare will be food and diet supplements. The old adage that we are what we eat is being re-examined – and it promises longer, healthier lives.

There is a commonly held belief that adequate nutrition is obtained from a well-balanced diet. However, studies such as the US department of agriculture survey of micro-nutrient intake have revealed that malnutrition is common in the west. This is not the calorie and micronutrient deficiency associated with developing nations (type A malnutrition), but multiple micronutrient depletion, usually combined with calorific balance or excess (type B). According to the 1997 survey, 68% of Americans are not getting adequate levels of vitamin E, 55% are deficient in vitamin A, 54% in B6, and 37% in vitamin C. There is also evidence that the American diet is dangerously lacking the newer micronutrient groups such as essential fatty acids, xanthophylls, various fibre types and flavonoids. This is due to a combination of factors:

1. We were designed to live active lives, and to consume 3,000-4,000 calories per day. No longer hunter-gatherers, we live sedentary lives, and typically burn fewer than 2,000 calories daily. When we eat less, we’re consuming fewer micronutrients.

2. Many (not all) processed foods are depleted in micronutrients, and more processed foods are being consumed than ever before. British consumption of fresh green vegetables declined by 7% in 2001-2.

3. Many soils are low in key minerals, and crops or animals raised in these areas are depleted in these minerals also.

4. Smoking, pollution and excessive alcohol all deplete the body of micronutrients.

5. Type B malnutrition worsens with age. Activity levels fall, and reduced finances may mean a restricted diet.

The progressive worsening of our health in most cases has less to do with ageing than with worsening type B malnutrition. Lacking the micronutrients needed for repair and those that normally keep the process of decay in check, we slide prematurely into degenerative disease. If this is the case, then it is logical to treat such diseases not with drugs, but with multiple micronutrient repletion, or “pharmaco-nutrition”.

This approach has largely been neglected hitherto because it is relatively unprofitable for drug companies – the products are hard to patent – and is a strategy that does not sit easily with modern medical interventionism. The pharmaceutical industry has invested heavily in developing drugs to treat the diseases we are subject to.

However, although we have drugs that suppress the symptoms of degenerative disease, we have hardly any cures – suggesting that when the pharmaceutical industry was founded on the “magic bullets” of Robert Koch and Paul Ehrlich, it started at the wrong place. We should have followed Pasteur, who realised that “le terrain” (our internal physiology) was all important. And “le terrain” is in bad shape because of the increasing prevalence and severity of type B malnutrition.

One problem for supporters of this approach is lack of the right evidence. We have data linking dietary factors to disease risks, and plenty of information on mechanism, ie how food factors interact with our biochemistry. However, most intervention studies with micronutrients have produced negative results. Our “science” appears to have no predictive value. Does this invalidate the science? Or were we asking the wrong questions?

Most studies have attempted to measure the impact of a single micronutrient on disease. But in the field of nutrition, this is nonsense. It is like the mechanic who, confronted with a chronically undermaintained car, insists on a test drive after changing the oil filter, another after replacing one of the spark plugs, and so on. Each intervention on its own will hardly make enough difference to be measured. To make the car run noticeably better and last longer requires a comprehensive service. Similarly, to enable humans to live healthier and longer lives, comprehensive nutritional support is needed.

For example, the etiology of coronary artery disease reveals that there is no single weak link. The logical response is to combine micronutrients which, working together, normalise the “terrain”, leaving its owner effectively immune to the disease which currently kills one in two UK citizens. The prospective changes in mortality, which may represent as many as 25 additional years of healthy middle and old age, are staggering.

In Finland, one simple dietary change – the reduction of salt in manufactured foods and the introduction of a substitute called pansuola – halved heart attacks and strokes during the 80s and 90s, significantly reducing drug sales. British GPs who attended a pioneering course in nutritional therapy at the University of Surrey have reported up to 30% savings in prescription costs. Such trends, if duplicated in larger markets, would be disastrous for drug companies.

Recent media scare stories about certain vitamins and herbs have helped to push consumer groups into the anti-supplement camp. There are certainly problems with the existing supplements business, which is worth almost £400m a year. Most over-the-counter supplements are not well designed and most consumers do not take them regularly enough or for long enough to see any effect. None of this, however, justifies the attack on the supplements and vitamins industry by the government’s food standards agency last month.

None the less, there are forces on the side of pharmaco-nutrition. These include the manufacturers of so-called functional foods, which are already making major contri- butions to Japanese and Finnish public health. Functional foods contain supplements specifically designed to improve health or reduce the risk of disease. In this country, we’ve seen the introduction of pro- biotic yoghurts, which improve gastro-intestinal conditions, and chewing gums that contain xylitol and prevent decay.

But what pharmaco-nutrition needs is the support of a few far-sighted politicians who grasp that the next wave of healthcare will be food, not more drugs, and that the point of delivery will shift from the pharmacy to the supermarket, providing a kinder and more cost-effective way of preserving the nation’s health.

· Paul Clayton is a fellow of the Royal Society of Medicine and author of Health Defence, published by Accelerated Learning Systems. This is an edited version of an article that appears in the June issue of Prospect magazine.

I beg to differ: A doctor replies
Ben Goldacre

It’s all about laziness: intellectual and physical. People have bad diets because they can’t be bothered to eat properly. Then along comes someone to tell us that we needn’t worry, because we can cure all ills by taking a few pills with our chips. Unfortunately, diet fads have all the hallmarks of classic pseudoscience. Firstly, there is always a sinister conspiracy to suppress their truth. Well, I’m a doctor who tells his patients about eating properly, and I read a lot more about funny diets, pills and fads than I do about eating a proper, sensible, balanced diet, which is after all the only thing that has been proven – convincingly – to make us healthier.

Perhaps I could wake you up by pointing out a few of the more worrying suggestions of the diet-fad movement. “We have never been less healthy”? Lowest ever infant and perinatal mortality, longest ever life expectancy, shortest hospital admissions. Of course people are getting more diseases in old age, if they are living to be older.

And are we really getting fewer calories since we stopped hunter-gathering? That seems unlikely, with the figures taken here from the US, the most overfed nation on earth.

In the real world, poverty is the main determinant of ill-health. People with no car who live in “food deserts”, created by supermarkets closing down local shops, who are literally unable to get regular fresh produce, who eat processed long-life rubbish: are they going to be buying micro-nutrients? I don’t think so.

What I find most worrying is the way these theories are always coupled with an attack on conventional medicine. That old chestnut about medicine addressing “symptoms not cures” is so poorly evidenced, prevalent and long-winded that I am writing a long, boring book on the subject. Medicine isn’t all about painkillers. What about surgery? What about replacing genetically absent clotting factors, or insulin in type I diabetes?

And lastly, doctors deal only with crises because you all decided to elect governments that systematically underfunded the health service. Your bad luck, I’m afraid.

· Ben Goldacre is a doctor who writes Bad Science for the Guardian’s Life section.

Is there a link between breast cancer and antiperspirant?

June 19th, 2003 by Ben Goldacre in bad science, scare stories | 3 Comments »

Is there a link between breast cancer and antiperspirant?

Ben Goldacre
Thursday June 19, 2003
The Guardian

This scare started in 1999 with a circular email claiming that toxins were “purged” through perspiration, and that when the armpit sweat glands were blocked, toxins built up in the lymph nodes behind them, causing cancer in the upper outer quadrant of the breast.

While it’s true to say that an excess of cancers occur in this quadrant of breast tissue – the one closest to the lymph nodes – it is also by far the largest area of breast tissue.

Furthermore, sweating is certainly not the primary means by which the body rids itself of toxins. But the email caused so much concern at the time that the American Cancer Society and the National Cancer Institute issued statements to reassure people, and scientists began to study the issue.

If you really want to get to the bottom of whether an environmental factor is causing an illness, it’s good to be able to compare one group who were exposed to your toxin, antiperspirant for example, with a group who weren’t. In 2002 a large study was published looking at 1,600 women and found no link between antiperspirant use and breast cancer. It was testament to the influence of the original “hoax” email (as Harvard medics called it) that they also went out of their way to study its specific claim that shaving before using antiperspirant increased the chances of it causing cancer, because toxic chemicals could get in more easily, and again found no link.

This week the story rose again when Dr Philippa Darbre, a molecular biologist from Reading University, published a speculative hypothesis paper, in a small but respected academic journal, describing the effects of some of the ingredients of antiperspirants on non-living tissue in the laboratory, in other peoples’ experiments. Specifically, that aluminium has been reported to at least bind to DNA, and also to alter gene expression in some situations, and that parabens (preservatives used in some cosmetic creams) have been reported to work similarly to oestrogen in some experiments.

This has certainly generated more media interest than any of her other more eminent papers on, for example, IGF-II receptors and breast cancer, although she tells me that she never sent out a press release, but happened to mention it to a friend who worked for the Sunday Times.

Science is all about testing interesting hypotheses. In this case we have an interesting but half-finished laboratory-based story against a convincingly large study of real people that showed antiperspirants to be safe.

Unfortunately, it looks like the largest risk factors for breast cancer at the moment are the ones we can’t control such as age, sex, and family history; or the ones we might not want to such as smoking and age at childbirth.

Cures for quacks

June 19th, 2003 by Ben Goldacre in alternative medicine, bad science, dangers, herbal remedies, water | 8 Comments »

Ben Goldacre
Thursday June 19, 2003
The Guardian

· The plural of anecdote is not data. Although it’s always very tempting. So although I’ll contain my evil desires to titillate you with tales of patients who’ve needed liver transplants after taking Chinese herbal remedies, I’m very amused by an article in the Lancet about a Chinese remedy company who seem to be putting artificial drugs in their potions. Spes capsules were examined by physicians treating a patient who developed Cushing’s Syndrome and were found to contain betamethasone, a potent synthetic glucocorticoid you wouldn’t expect to find in any magic herb. They also found alprazolam, a synthetic benzodiazepine much like the addictive “mother’s little helpers” of the 60s, which might go some way to explain the improvement in “quality of life” claimed for Spes. Neither was mentioned on the label. Alternative therapy fans might bear in mind that, if a herbal remedy works it’s probably got something potent in it.

· A BMJ paper recently found that children being treated with Chinese herbal skin creams for eczema were on average receiving five times the recommended adult dose of dexamethasone, a potent steroid. Which makes it very amusing that the alternative medicine lobby has ganged up against an EU directive to use proper ingredients labels and submit to regulation, like anyone else peddling a medicine. They say it’s part of a campaign by the medical establishment to discredit their products, and 5,000 people marched against the regulations in London last Sunday. They had Tory MP John Redwood lambasting the EU for over-regulating us. But even the Daily Mail, champion of anecdotal evidence, favourably reported a study of 200,000 people that showed a 0.4% increase in deaths from all causes in people taking beta-carotene supplements, and no benefit at all from vitamin E.

· 200,000 people seems to be enough for a study disproving alternative therapies to be taken seriously. If you’re in the business of promoting pseudoscience, standards seem to be less stringent. Last weekend’s Sunday Telegraph devoted the whole of page 3 to alternative therapy porn, with a story on how drinking the Queen’s Royal Deeside spring water improved arthritis symptoms in two-thirds of patients. It was a study of 34 patients over three months and there was no control group. It’s hard to imagine an experiment where it would have been easier to come up with a convincing placebo. Water.

Work out your mind

June 12th, 2003 by Ben Goldacre in alternative medicine, bad science, brain gym, religion, water | 15 Comments »

Work out your mind

Ben Goldacre
Thursday June 12, 2003
The Guardian

Talk about bad science

· Children are so sweet, so trusting – those pseudoscientists just can’t help but prey on them. A reader writes about his experience at a primary school in northern England. He found they were employing a technique called Brain Gym. It’s from California. “Brain Gym appears to comprise a series of simple hand-eye coordination tasks which allegedly improve learning. Before doing these tasks, children are required to take a swig of water and hold it in their mouths for a few seconds until the teacher tells them they can swallow. When I asked why, the teacher, who had been sent on a Brain Gym course by the school, informed me that the water was partially absorbed through the roof of the children’s mouths and was absorbed by the brain, improving learning.”

In an ideal world, we would be teaching children enough science in school that they were able to stand up to a teacher who was spouting this kind of rubbish. Or perhaps I’m wrong: perhaps the teacher had misunderstood the course. Being a trusting soul I went to their website and had a peek: after all, if education authorities are going to spend my taxes on this stuff, there must be something in it. Here I learned that Brain Gym was a form of “educational kinesiology,” which “focuses on the performance of specific physical activities that activate the brain for optimal storage and retrieval of information”. “Focus is the ability to coordinate the back and front areas of the brain…Centering is the ability to coordinate the top and bottom areas of the brain… Brain Gym movements interconnect the brain in these dimensions.” On the off chance that it might not be rubbish I looked it up on the main public research databases. Nothing supported their assertions. Brain Gym do, however, run their own journal, although I’ve got a very strong feeling that it’s probably not peer-reviewed. Hungry for more? “A research report including over 10 years of information collected from field studies and experimental research is available for $25 (plus shipping) through the Foundation office.”

· Fans of Brain Gym aren’t the only ones targeting children: Noah’s Ark Zoo Farm has the distinction of being the only pseudoscience zoo in the UK. If you were hoping for New Agers in cages, you’ll be let down, but if the idea of Christian creationists making their last stand against evolutionary theory – quite literally amongst the horse shit – amuses you, I suggest you start with their website. “To a rational mind there are at least three proofs that a creator exists.”

The Sokal affair

June 5th, 2003 by Ben Goldacre in bad science, postmodernist bollocks, quantum physics, very basic science | 6 Comments »

Ben Goldacre
Thursday June 5, 2003
The Guardian

Talk about bad science

We’ve been focusing on the negative for too long: it’s time I introduced you to my hero. Alan Sokal is an icon for bad science hunters the world over, the man who pulled off the greatest academic scam of our times, and gave post-modernist commentators on science the public slapping they’ve always deserved.

A physics professor in New York, in the 1980s Sokal went to teach in Nicaragua because he approved of the Sandinista government. When he returned to America, the liberal left agenda seemed to have been hijacked by hip intellectuals and postmodernist literary theorists teaching that reality is a socially constructed text, about which you can say anything, as long as you say it murkily.

A political pragmatist, Sokal doubted they had much to offer. More than that, he was horrified that they were rubbishing science. Suspecting they didn’t know their scientific arse from their elbow, he decided to attack. He wrote and submitted a spoof article, Transgressing the Boundaries: Towards a Transformative Hermeneutics of Quantum Gravity to Social Text, a trendy academic journal. By flattering the editors’ ideological preconceptions, he hoped his meaningless waffle might just get published.

The article is a masterpiece of foggy prose. In it, Sokal claimed Jacques Lacan’s psychoanalytic speculations had been confirmed by recent work in quantum field theory. He suggested that the axiom of equality in mathematical set theory was analogous to the homonymous concept in feminist politics. He employed scientific and mathematical concepts in ways that even an A-level student should have spotted as rubbish, but crammed the article with nonsensical – but authentic – quotes about physics and mathematics, by prominent French and American postmodern intellectuals.

Of course the article was published: they couldn’t resist a physicist switching sides. But did the journal subject the article to peer review by a scientist before publishing? No. Did the article say anything meaningful at all? The author certainly didn’t think so.

The day that Social Text came out, Sokal began deriding the editors in the media. They attacked him for dishonesty and some post-modernist commentators suggested he needed psychiatric treatment. Sokal emerged a hero. He wrote a book, attacking them, in French. Go Sokal! So visit the website ( ), read the article (, tell your friends and buy his book, out now in English (ISBN: 1861976313). And one day, these intellectual fraudsters could be out of a job.