Dr Gillian McKeith (PhD) continued

September 30th, 2004 by Ben Goldacre in bad science, channel 4, gillian mckeith, nutritionists, PhDs, doctors, and qualifications | 12 Comments »

Ben Goldacre
Thursday September 30, 2004
The Guardian

· I once saw a bloke at the opening of a Jackson Pollock exhibition in the Tate, wearing a T-shirt that said: “my cat could do better”. What, you may be wondering, has that got to do with Dr Gillian McKeith (PhD)? Well now. Besides her PhD, which we have already discussed, there were a few other interesting entries on her CV. For example, she is proud to announce under “Professional Associations” that she is a certified member of the American Association of Nutritional Consultants (AANC), which certainly sounds impressive. I bet you get a little certificate and everything.

· In fact, I know you get a certificate, because I’m holding it in my hand right now. It’s in the name of my cat, Henrietta. I got it in return for $60, and it’s a particular honour since dear, sweet, little Hettie died about a year ago. So, coming in a bit cheaper than Gillian’s non-accredited correspondence course PhD and Masters degrees (although she will have got a discount from “Clayton College of Natural Health” if she ordered them both at once), it looks as if all you need to be a certified member of the AANC is a name, an address, and a spare $60. You don’t need to be human. You don’t even need to be alive. No exam. No check-up on your qualifications. And no assessment of your practice. I guess that could be embarrassing for some of their certified professional members. Presumably, the diploma is there to certify that you have $60.

· If you know anyone else who is showing off about being a Professional Certified Member of the AANC, I’d like to hear about it. The only one I can find so far is a man called Dr Bannock who presented Why Weight on Channel 4 and Fat Academy on Discovery. No, I’d never heard of him either. He says he is a “Member of the American Association of Nutrition Consultants (Board Certified Nutrition Consultant)”. Glad you added that bit at the end, Dr Bannock. His website mentions his PhD in Nutritional Physiology, but he doesn’t say where it’s from; his website also features the odd photograph of a stethoscope, although to my disappointment, unlike Hettie, he’s not gone as far as dressing up in it endearingly.

· But back to the money: if anybody wants nutritional advice from the decomposing corpse of my ex-cat, I shall be setting up a small shrine at the bottom of the garden, where you can leave chewed mice, ready cash, and offers of a primetime TV series on Channel 4.

Cranial osteopathy

September 23rd, 2004 by Ben Goldacre in bad science, gillian mckeith, nutritionists, PhDs, doctors, and qualifications, times | 49 Comments »

Ben Goldacre
Thursday September 23, 2004
The Guardian

· “Cranial osteopathy – aligning the plates of the skull.” Sounds great. Maybe I can use it to treat my hangovers. The Times certainly likes it, and it even got Dr Toby Murcott to tell us how it works in a box, alongside a case study, called “What’s the evidence?” Toby says: “Can cranial osteopathy treat the brain? Cranial osteopathy is a gentle technique – practitioners claim to feel a subtle pulse in the fluid surrounding the brain. There is some research to suggest that these pulses are related to slow, regular changes in blood pressure in the brain. This has yet to gain wide acceptance and it’s not clear how working with these might lead to health improvements.” Here’s what you need to know.

· First, cranial osteopaths don’t even think the pulses are blood pressure; their theories revolve around the “inherent rhythmic motility” of the brain and spinal cord, mixed with breath and cardiac cycles, causing rhythmic fluctuation of the brain and surrounding fluid, which they think they can feel through the bones of your skull, and fix up with a bit of wiggling. They write long articles about actin and myosin (the things in muscle cells that make them move) being present in brain cells; unfortunately, they always forget to mention that brain cells lack the dense arrays of those filaments which are necessary to generate any significant movement.

· But are there real “cranial pulses” to be felt, however they may be generated? It’s easy to find out: ask a couple of cranial osteopaths to write down the frequency of the pulses on the same person’s skull, and then see if they give the same answer. There have been five papers published doing just this, and in none of them did the osteopaths give similar answers. Which suggests to me that (a) this is not a reliable biological phenomenon, and (b) perhaps these cranial osteopaths are, er, imagining it. So: the discipline is based on a misunderstanding, they can’t measure what they claim to measure and work with, and there’s no evidence to say it works.

· When I see a box labelled “What’s the evidence?” next to a health article by a Dr Toby Murcott, call me naive, but I assume he’s a medical doctor, rather than a science journalist with a PhD. And by now, regular readers must be wondering how I’m going to crowbar Gillian McKeith into this column. Well, what do you know, Dr Toby Murcott was the “science adviser” on You Are What You Eat, the TV show that told us we should eat more dark leaves, because the chlorophyll would oxygenate our blood. Bravo.

The following appeared two weeks later:

Don’t knock it

Thursday October 7, 2004
The Guardian

I don’t care what Ben Goldacre says (Bad science, September 23), after having severe sleeping problems for almost two years due to stress I was referred to an osteopath by my GP. I haven’t needed sleeping pills since (three months now). Bad science? Perhaps, but it worked for me.
E McDonald
Antwerp, Belgium

It’s all in the title

September 16th, 2004 by Ben Goldacre in bad science, dangers, herbal remedies, nutritionists, PhDs, doctors, and qualifications, times | 2 Comments »

Ben Goldacre
Thursday September 16, 2004
The Guardian

· It’s hard to know who to trust these days, what with pseudoscientists pretending to have all kinds of qualifications and quoting authorities all over the shop. Susan Clark’s consistently entertaining “What’s The Alternative?” column in the Sunday Times recommends artemisinin this week, as an alternative herbal malaria prophylaxis for someone travelling to Asia. “The Global Fund to Fight Aids, Tuberculosis and Malaria is funding the shift to artemisinin-based combination therapies in 26 countries,” she says. Sounds good. I’ll do you a favour, and spare you the rant about how chloroquine costs 20 cents per treatment while fashionable ideas like artemisinin cost $2.40, and stick to more important facts. Like: artemisinin is a treatment for malaria, not a preventive measure, because its half-life is too short, and the excellent and sensible Global Fund does not recommend it as a prophylaxis, nor does it endorse anything, as it is just a funding body. Perhaps Susan Clark can’t tell the difference. Here’s hoping her readers are a bit more cautious.

· So who do you trust? What about a “consultant podiatric surgeon”? Sounds a bit like “consultant orthopaedic surgeon”, doesn’t it? Or “consultant vascular surgeon”? Except a consultant podiatric surgeon is just a chiropodist who has decided to charge a bit more. Nice move, but it’s hard to prove that the public have been misled here. Sorry, I mean to say they have “misunderstood” the innocent phonetic coincidence between “consultant orthopaedic surgeon” and “consultant podiatric surgeon”. So the British Orthopaedic Trainees Association has surveyed 262 members of the public, and what do you know: 95% thought that consultant podiatric surgeons had qualified as doctors, while only 9.5% thought chiropodists were doctors. Ker-ching. Mind you, 97.3% thought consultant orthopaedic surgeons had been to medical school, and even a few junior doctors got the answers wrong. In a world full of “Dr Gillian McKeith PhDs”, until the government starts protecting professional titles, and regulating all the people who have popped up to make money out of our obsession with health, I can’t start to think about the financial gain for these wily characters because (holds head sanctimoniously aloft), there are actually rather serious issues about what goes through the heads of people who think they’re giving informed consent to treatment by self-appointed professionals.

Sitting pretty

September 9th, 2004 by Ben Goldacre in adverts, bad science, cosmetics | 3 Comments »

Ben Goldacre
Thursday September 9, 2004
The Guardian

· I prostrate myself before you and admit defeat. I’ve been writing this column for nearly two years, and I still haven’t managed to stiff a single multinational cosmetics firm: they’re just too good at constructing legally defensible pseudoscience. I’m picturing huge laboratories and rows of scientists writing incomprehensible but legally sound babble onto their clipboards.

· Cosmetics companies take laboratory data – stuff at a molecular level, the behaviour of cells in a glass dish – and then pretend it’s the same as the ultimate issue of whether something makes you look nice. This amino acid, they say, is crucial for collagen formation. Perfectly true, along with 19 others. No evidence to say that anyone is deficient in it, and, crucially, no explicit claim from the company that rubbing that actual amino acid on your face is what is going to make you look better. That link is made only in the customer’s mind: because the claim that the cream makes you look good is an entirely separate one, made for the cream as a whole, and it’s true, because all creams will hydrate your skin and make you look good. Vaseline, as it happens, also does it rather well, but leaves a greasy sheen. And most cosmetics research, since you ask, comes down to conserving the moisturising properties of Vaseline, but avoiding the greasiness. Diprobase, at less than £10 for a half-litre tub, represents a pretty good stab at solving this problem.

· What about the other magic ingredients? One thing kind of works: cooked and broken-up protein (hydrolysed X-microprotein nutricomplexes, or whatever they’re calling them this month). These are long soggy chains of amino acids, which contract when they dry, and so temporarily contract your wrinkles. That’s temporarily. And all the expensive creams have got that in them anyway. A couple of other things kind of work. Vitamin C, and alpha-hydroxy acids affect skin significantly, although only at such high concentrations that they also cause irritation, stinging, burning and redness: so now they have to be watered down, to pretty useless dilutions. But companies can still name them on the label, and wallow in the glory of their efficacy at higher potencies, because by law you don’t have to give the doses of your ingredients, only their ranked order.

· Now, I’m begging you, find me one that makes a properly fraudulent pseudoscientific claim I can write about without getting sued, and I’ll give you a free tub of Diprobase.

Rusty results

September 2nd, 2004 by Ben Goldacre in adverts, alternative medicine, bad science, detox, very basic science, water | 14 Comments »

Ben Goldacre
Thursday September 2, 2004
The Guardian

· Time for a Johnny Ball kitchen science experiment, I think. I could have told you from the start that “Aqua Detox” was a scam, and a popular one at that. Why? Because it is claimed to extract “toxins” from your body through the “2,000 pores in your feet” discovered by those ancient Chinese scientists. And because it’s so charmingly theatrical: you put your feet in a water bath, containing “natural organic salts”, with an electrical current that “resonates” with your “bio-energetic field” passing across it, and the water goes first tea-coloured, and then properly brown, with a sludge on top. You think I’m making this up, but it’s been in the Daily Telegraph, and innumerable other places. So it must be true. And this brown, the Aqua Detox people proudly tell you, is from the toxins coming out of your body.

· Thinking back to GCSE chemistry, it seemed likely to me that it was rust rather than toxins, since they have, after all, got a pair of metal electrodes in a salt water bath with a current passing across them. And so we set up, on a kitchen table, a bowl containing salt and water, with two metal nails attached to a car battery. And what do you know: our water goes brown too, with a nice sludge on top. Could this be the same brown as the Aqua Detox water?

· Bravely I sent along my friend Dr Mark Atkins to have himself Aqua Detoxed. He took water samples from the bowl, which we sent off to the Medical Toxicology Unit at New Cross, south-east London. You can only imagine our excitement, especially as they charged us £200 for the analysis. And so – triumphant music – the water taken out before they switched their Aqua Detox machine on contained only 0.54mg per litre of iron (probably from the metal spoon); but afterwards it contained … 23.6mg/l. Our water, from our kitchen table setup, contained 97mg/l (and it was a bit browner).

· But did it extract toxins? “Toxin” is classic pseudoscience terminology. Essentially, the Aqua Detox people are offering dialysis, through your feet. Urea and creatinine are probably the smallest molecules – call them “toxins” if you like – that your body gets rid of, in places like urine and sweat: if “toxins” were going to come out, anywhere, you’d expect those to come out, too. There was no urea or creatinine in the water before the Aqua Detox, and there was none in the water afterwards. Which means, I believe, that we win.