Okay, you lot are seriously on a roll. Following a complaint from a badscience reader, the ASA have found that Patrick Holford made untruthful, unsubstantiated claims in a leaflet he was sending out. Pasted below is the full adjudication and also the original advert in question, so that you can decide for yourself about the content, and I’ve also pasted my brief guide to making ASA complaints about dodgy adverts for a rainy afternoon.
I’m in a bit of a rush, but there are a few things in this ruling which I find extremely interesting.
Most important is this: the ASA seem to be vaguely under the impression that Patrick Holford does not sell pills. This is incomprehensible to me. In the Holford books I have read he recommends pills, in fact his own, from the companies he works with, and indeed from his very own pill vending company. His face appears on pill bottles. His latest pill vending operation “Health Products for Life” has just sold for £464,000. He has recently signed up with yet another pill company, Biocare, to sell even more pills with them.
To me, these are just some of the classic tell-tale traits to look out for if you think you may be dealing with a man who sells pills.
Now I speak as a man who is highly critical of the whole phenomenon of pill dependence, whether it’s the multi-billion pound supplements industry who have unbridled access to a gushing media, or big pharma peddling new diseases like “female sexual dysfunction” (I’ll post a lecture in which I discuss medicalisation in the podcast over the next few days).
I happen to think that while commercial interests are trying to persuade us that there is a biomedical, rather reductionist and mechanical reason why we are suffering from tiredness, headaches, shaglessness or heart disease, the real answers often lie in social and lifestyle issues which are intellectually simple, but motivationally and politically complex. I’m talking about things like diet, exercise, and social inequality: good luck cracking them.
Anyway, the whole pill-selling thing is, of course, all the more amusing given Holford’s frequent and rather surreal claims to have no competing interests, and his even more unpleasant and unsubstantiated suggestions that other people do have competing interests. For students of irony I very strongly recommend that you read this all-time comedy classic from the BMJ rabid responses here. It is pwnership, but on an unprecedented scale.
I could write about Holford from now until the day I die, much as these gloriously overinclusive people seem to plan to do. The only question is whether I’m bored of him: there are things which could easily awaken my interest, and there is more, but I’ve got work to crack on with. Enjoy, and don’t miss the instructions below for making your own ASA fun at home.
100%health Ltd Carters Yard London SW18 4JR Number of complaints: 1
Date: 19 September 2007 Media: Direct mail Sector: Health and beauty
A direct mailing for books by Patrick Holford, a nutritionist, contained a booklet entitled “100%health”. Headline text stated “You don’t swallow junk food. Why swallow junk health advice?” Text in a letter from the “Editor of 100%health”, Patrick Holford, on an inner page of the booklet stated “I would like you and your family to stay healthy, free of pain and the need for drugs. But if I told you the truth in this letter, I would break the law … I’d love to tell you how powerful nutrition is, both for your mind and body. But I can’t. Why? Because advertising law prohibits me saying anything that claims to ‘treat, prevent or cure’ any condition! Even if there’s undisputed proof that nutrient ‘x’ cures condition ‘y’ I’m not allowed to tell you here. By law, I can tell you in my newsletters, but I can’t in this publication … So, excuse me if you have to read between the lines …”. Text on a separate page stated “Don’t waste your money on vitamins Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!”.
The complainant challenged the claims:
1. “… I’d love to tell you how powerful nutrition is, both for your mind and body. But I can’t. Why? Because advertising law prohibits me saying anything that claims to ‘treat, prevent or cure’ any condition! Even if there’s undisputed proof that nutrient ‘x’ cures condition ‘y’ I’m not allowed to tell you here. By law, I can tell you in my newsletters, but I can’t in this publication … ” ; and
2. “Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!” could be substantiated.
The CAP Code: 3.1;7.1;50.1;50.21;50.20
100%health said the mailing was sent to subscribers to their own mailing list and also to subscribers to four other health newsletters. They explained that the booklet was an educational publication by Patrick Holford, the founder of the Institute for Optimum Nutrition, which was a degree-accredited educational charity formed to undertake research and educate the public about individuals’ optimum levels of nutrients depending on genetics, needs and life circumstances.
1. 100%health explained that the booklet provided general nutrient information only. They pointed out that they did not sell nutritional supplements, but books and other publications, which referred, generically, to the scientifically supported health benefits of nutrients. They said they understood that they were not able to state or imply in their mailing that specific nutrients could be used to prevent or cure certain conditions, even if they believed that to be the case. They asserted that the ad’s wording reinforced both ASA and legal guidelines and was not misleading; it merely pointed out to readers that they were unable to share information in their mailing about the therapeutic effects of nutrients, however well proven, although they could do so in their associated newsletters or books, because those referred to generic nutrients only. They said that position was supported by the Medicines and Healthcare products Regulatory Agency (MHRA).
They reiterated that the leaflet promoted Patrick Holford’s 100%health newsletter only and pointed out that neither the leaflet nor the newsletter promoted named supplements. They believed the European Union (EU) directive on food supplements referred to health products, but not to publications.
2. 100%health said the statement “… Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!”, when read in context, informed readers that any 100%health newsletter to which they chose to subscribe would give substantiated information about diet, including information on sub-groups of people who might not receive all the nutrients they needed from what was generally regarded as a ‘well-balanced’ diet; they understood that the definition of ‘need’ was subjective.
They explained that the European Commission’s Scientific Committee on Food, which was responsible for setting recommended daily amounts (RDA) of nutrients, stated that the consumption of nutrients above the Population Reference Intake (PRI) was not uncommon and was a result of the well-publicised claims that some nutrients had extra health benefits at intakes much higher than those needed to prevent recognised deficiency signs. They argued that their mailing was a vehicle for sharing the results of a growing body of evidence.
100%health also pointed to a publication from the Department of Health (DH), entitled “Dietary Reference Values”, which discussed whether the optimum level of nutrient consumption was above that which merely prevented deficiency. They said DH did not define what an optimum level might be and explained that their publications explored such questions.
They said vitamin RDA levels, which, they pointed out, were designed as population averages rather than individual recommendations, were sometimes inadequate for those wishing to maintain good health and reduce disease risk; they gave vitamins B, C and D as examples. They also said some essential vitamins and minerals, such as chromium and selenium, had no RDA. They submitted details of clinical studies and other academic articles that examined the effects of supplementation.
One study submitted, entitled “Clinical Studies on chromium Picolinate Supplementation in Diabetes Mellitus – A Review”, showed that, when Chromium was supplemented at a level much higher than that achievable through diet alone, it had had a positive effect on the normalisation of insulin function in study subjects with type two diabetes. The study was a meta-analysis of 15 clinical studies, 11 of which were randomised and controlled; 13 of the studies, which involved 1,690 subjects, reported significant improvement in at least one outcome of glycemic control and all 15 studies showed salutary effects in at least one parameter of diabetes management.
100%health also submitted an article, taken from the journal Lancet , which looked at the supplementation of the antioxidant selenium and its effect on gastrointestinal, lung and prostate cancers in cases where selenium intake through diet was found to be inadequate, especially in men; a dissertation paper, entitled “Vitamin C: What is the Optimum Daily Intake?”, which showed that smokers’ optimum daily intake of vitamin C to minimise the severity and duration of colds exceeded the normal RDA by up to four times; and a pooled analysis, which showed how the supplementation of vitamin D in the elderly was seen to have a positive effect on protection against breast cancer. They also pointed out that studies had shown that athletes and other active individuals could benefit from the supplementation of B vitamins.
100%health argued that those examples showed that the needs of some individuals were not necessarily met by a well-balanced diet alone. They suggested, however, that they would amend the ad with the help of the CAP Copy Advice team to clarify that, in Patrick Holford’s opinion, not everyone could achieve all of the nutrients they needed from a well-balanced diet.
The ASA understood that the Editor’s letter, which referred to legislation preventing him from revealing his views on the health benefits of optimum nutrition in the booklet, encouraged readers to subscribe to a 100%health newsletter in which, he suggested, his views would be legally disclosed. We recognised that the mailing acted only as an introduction to 100%health’s paid subscription newsletter and also that the booklet did not identify specific nutrients or medical conditions.
We noted the complainant was concerned that text in the booklet implied it was possible to reveal that certain nutrients were able to “treat, prevent or cure” specific conditions because he understood that, if that was the case, those nutrients would be classed as medicines and, as such, must comply with the regulatory requirements of the MHRA (i.e. Directive 2001/83/EC on the Community code relating to medicinal products for human use). We contacted the MHRA who confirmed that, because Patrick Holford did not sell any specific products or brands but was instead marketing his publications (which contained articles on generic nutrients only), claims made for those nutrients (whether in the booklet or the newsletter) were not caught by the Directive.
However, we were concerned that the booklet implied the newsletter included information, that could not be disclosed in the booklet for legal reasons, on the ability of specific nutrients to cure specific medical conditions. Because we had not seen evidence to show that specific nutrients cured specific medical conditions and because there was no legal restriction, we considered that the claim “… I’d love to tell you how powerful nutrition is, both for your mind and body. But I can’t. Why? Because advertising law prohibits me saying anything that claims to ‘treat, prevent or cure’ any condition! Even if there’s undisputed proof that nutrient ‘x’ cures condition ‘y’ I’m not allowed to tell you here. By law, I can tell you in my newsletters, but I can’t in this publication … ” was likely to mislead.
On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), 50.1 (Health & beauty products and therapies – General) and 50.20 (Health & beauty products and therapies – Vitamins, minerals and other food supplements).
We noted the complainant believed the claim “… Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!” was misleading, because it suggested that adequate levels of nutrition were possible only through supplementation, which he understood was at odds with generally accepted scientific opinion.
We also understood that 100%health had intended to point out that, in Patrick Holford’s opinion, scientific evidence showed that, for some individuals, a well-balanced diet that used RDAs as guidelines was inadequate.
While we noted that was 100%health’s intention, we considered that the claim implied a balanced diet was insufficient to support well-being amongst the population
in general, which we had not seen evidence to support. The CAP Code stated that “A well-balanced diet should provide the vitamins and minerals needed each day
by a normal, healthy individual …”.
While we understood that 100%health believed vitamin and mineral supplementation was essential for some people to achieve optimum nutritional benefits, we considered that the claim did not make clear that it was representative only of the author’s views. While we recognised the promising indications realised by the evidence submitted in support of vitamin supplementation for some groups, we considered that 100% health had not substantiated the implication that a balanced diet was inadequate in providing all the vitamins and minerals needed by a normal, healthy individual and the claim was, therefore, likely to mislead. We welcomed their willingness to amend the claim with the help of the CAP Copy Advice team.
On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.21 (Health & beauty products and therapies – Vitamins, minerals and other food supplements).
We told 100% health to remove the claims “… I’d love to tell you how powerful nutrition is, both for your mind and body. But I can’t. Why? Because advertising law prohibits me saying anything that claims to ‘treat, prevent or cure’ any condition! Even if there’s undisputed proof that nutrient ‘x’ cures condition ‘y’ I’m not allowed to tell you here. By law, I can tell you in my newsletters, but I can’t in this publication …” and “Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!” from future marketing and advised them to seek guidance from the CAP Copy Advice team before issuing further similar material.
Adjudication of the ASA Council (Non-broadcast)
Meanwhile here is the advert in question:
Lastly, here is my brief guide to complaining to the ASA from the badscience activism forum:
Complaining to the ASA is very straight forward and often bears fruit. They investigate claims thoroughly and publish their adjudications and voluntary agreements:
Complaints can be made online:
They deal with adverts only, for in-store posters and packaging complain to trading standards (www.tradingstandards.gov.uk/ see here). The ASA do, however, also cover leaflets which you can take away from shops. Websites you will probably have to discuss with Trading Standards, contact the office covering the area where the business is based, but the text of paid web adverts is covered by the ASA. They list on their site what they deal with:
* Magazine and newspaper advertisements
* Radio and TV commercials (not programmes or programme sponsorship)
* Television Shopping Channels
* Posters on legitimate poster sites (not flyposters)
* Leaflets and brochures
* Cinema commercials
* Direct mail (advertising sent through the post and addressed to you personally)
* Door drops and circulars (advertising posted through the letter box without your name on)
* Advertisements on the Internet, include banner ads and pop-up ads (not claims on companiesâ€™ own websites)
* Commercial e-mail and SMS text message ads
* Ads on CD ROMs, DVD and video, and faxes
I happen to know that further complaints are in line with the ASA on Holford. It will be very interesting to see what the outcome is.
And seriously. Check out the value you’ve got here. I have pointed you to a comedy classic and one of the greatest BMJ special issues of all time. Life is too rich. Hurrah for ideas, hurrah for the ASA, and hurrah for Holford!