Now with audio – The Rise of the Lifestyle Nutritionists Part II – BBC Radio 4

March 31st, 2008 by Ben Goldacre in bad science, fish oil, gillian mckeith, nutritionists, onanism, patrick holford | 39 Comments »

grundig_satellit_2000.jpgBusy bee today, sorry for the late link, the second part of the BBC Radio 4 two-part series “The Rise of the Lifestyle Nutritionists” is going out at 8pm this evening, presented by yours truly (part one here) and produced by the excellently sharp Rami Tzabar from the BBC Radio Science Unit. I think it’s rather good, and makes a single clear point: lifestyle is important, and we all want to improve our health, but the evidence on diet and health is not sufficient to justify the very specific and confident advice which we crave, and which some will sell to us.

You can listen to the whole show here:

www.bbc.co.uk/radio/aod/radio4_aod.shtml?radio4/lifestylenutritionists

And I think it makes quite a good partner with its first half which you can find here:

www.badscience.net/?p=648

(If you don’t want to install evil Realplayer software on your computer for the BBC’s Listen Again iplayer then you can download Real Alternative here and just install that, I use it and it’s much better than Real’s proprietary resource-hogging kludgeware).

I should say that radio is the best place in the world to do popular science. They actually let you examine some quite complicated ideas in detail, it’s bizarre. I think I’m presenting another two-parter on placebo over the summer, and we’ve got a pitch in for a series on the evils of big pharma later this year, which I think could be barnstorming. Fingers crossed, and of course, clickety click on the listen again links above to make sure it gets commissioned…

Oooh:

It got pick of the day in the Torygraph too (I archive these here for my mum).

www.telegraph.co.uk/arts/main.jhtml?xml=/arts/2008/03/31/nosplit/bvtv31.xml

The Rise of the Lifestyle Nutritionists
Radio 4, 8.00pm
Last week, setting up this series, Dr Ben Goldacre painstakingly took us through the early leaders, all Americans, in the “what you eat will make you better” stakes. There was Graham (of the wholemeal crackers), Kellogg (of the cornflakes and colonic shampoos) and the chap who invented a panacea called Hadocol (whose magic ingredient was alcohol). This week he’s going for the people who rule the lucrative roost today, usually without benefit of serious medical credentials. And he promises to name names.


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If you like what I do, and you want me to do more, you can: buy my books Bad Science and Bad Pharma, give them to your friends, put them on your reading list, employ me to do a talk, or tweet this article to your friends. Thanks! ++++++++++++++++++++++++++++++++++++++++++

39 Responses



  1. Jamie Horder said,

    March 31, 2008 at 7:15 pm

    On a related note, the latest Viz has an excellent strip featuring “doctor-in-a-very-broad-sense-of-the-word” McKeith and her quest to carry a huge pile of bollocks across America. It’s eerily realistic.

  2. Despard said,

    March 31, 2008 at 7:33 pm

    Very nice! I laughed out loud at how flustered the nutritionist lady got when you asked her if her tests had been validated… beautifully done.

    Also nice to hear from John Stein, my boss’s former boss. :-)

  3. jimcarmichael26 said,

    March 31, 2008 at 7:56 pm

    Truly amazing – anyone got a transcript of the nutritionalist spokeswoman defining phenotype? I hurt myself laughing…

  4. Ben Goldacre said,

    March 31, 2008 at 8:00 pm

    i actually thought sue mcginty from BANT was very nice, and although our discussion was very revealing about the culture within the profession, i wouldn’t want anyone to be mean about her as an individual. don’t mean to be sanctimonious, but i guess it’s just rare to find anyone from this kind of world who is at least willing to engage in a sensible discussion. and she was actually nice, and we did have a really interesting longer chat about all kinds of stuff in the field of nutritionism.

  5. Despard said,

    March 31, 2008 at 8:03 pm

    I’m sure she is a very nice person, and huge props to her for having a go, absolutely. But as you say, the way she answered your questions was extremely revealing, and hilarious.

  6. Ben Goldacre said,

    March 31, 2008 at 8:15 pm

    oh yeah, i didn’t have much to do with organising the holford section, it was all done by wunderchild science producer Rami Tzabar and the BBC (academics were queueing up to talk about holford, especially since the Teeside thing, it was quite heartwarming, they were literally fought off with a stick).

    holford’s conditions were basically that the BBC should broadcast, unedited, an enormous essay that would have taken about ten minutes of airtime. despite repeated clarification he just couldn’t understand that the programme was about a wider set of interesting ideas than just him.

    he has, interestingly and rather bizarrely, posted some things which he claims are the answers the BBC refused to broadcast, and Holfordwatch.info are starting to analyse these (some are quite funny).

    holfordwatch.info/2008/03/31/holford-tries-to-respond-to-questions-raised-by-bbc-documentary-he-fails/

    I can tell you absolutely for definite that those are NOT the questions which the BBC sent to Patrick Holford asking for a response.

    And furthermore, those are NOT the answers which Patrick Holford sent back to the BBC.

    This would seem to be further clear evidence of the spectacular unreliability of Patrick Holford’s claims, which more than anything just become a bit tedious, after a while.

  7. jimcarmichael26 said,

    March 31, 2008 at 9:05 pm

    …now feel bad for laughing at the BANT lady, but really – those people really must take responsibility for what they say and do, being nice just doesn’t cut it.

    True, full marks to her for actually stepping up and debating. Would be interested in hearing what else she had to say, I’m sure there’s some sensible stuff in amongst all the nonsense…

  8. LeeT said,

    March 31, 2008 at 9:10 pm

    “And furthermore, those are NOT the answers which Patrick Holford sent back to the BBC.”

    Goodness me Ben, are you saying he is lying on his website then? To be fair, perhaps he has not been taking his fish oil pills lately and has just become a bit forgetful.

  9. Dr* T said,

    March 31, 2008 at 10:01 pm

    “I should say that radio is the best place in the world to do popular science.”

    Would you say that should that be “BBC Radio 4″ rather than “radio”?

    I do find it incredible the amount of in-depth ‘stuff’ you hear on an average day of hardcore Radio 4-ing.

    Excellent program – I couldn’t understand how Sue McGinty seemed to think that her argument was justified. She had (however politely) admitted that she (and BANT) are unregulated, unscientific and unvalidated, yet claimed quite the opposite.

  10. Dudley said,

    April 1, 2008 at 7:30 am

    www.bbc.co.uk/radio/aod/radio4_aod.shtml?radio4/lifestylenutritionists

  11. used to be jdc said,

    April 1, 2008 at 8:56 am

    Really enjoyed it – interesting interview with Sue Mcginty. Top quality guest appearances as well: David Colquhoun on Holford’s Vitamin C claims, Tom Sanders on the RCT meta-analysis and David Carter from the MHRA on policing supplements. It was pretty funny listening to you trying not to giggle about Gillian McKeith’s Horny Goat Weed.

  12. Steph said,

    April 1, 2008 at 11:00 am

    Dear Ben – I dealt with the questions sent by Rami for Patrick Holford to answer. Your statement that the questions Patrick has responded to on www.pa trickh olford.co m are categorically NOT the questions that were sent to us and the answers provided are NOT the ones sent back is completely untrue. Here is the link to the questions and answers sent to Patrick by Rami and responded to – www.pa trickhol ford.co m/conte nt.asp?id_Con tent=2275. As you can see these are not an enormous essay and any one of these questions could have been used alone as long as they were used verbatim. If you personally want to see the emails sent by Rami with these questions in and the document sent to Rami with Patrick’s comments I can easily do that to clarify this. You may have confused the fuller responses Patrick has provided on the website as the questions and answers provided for comment – these are in fact the responses to the topics Rami initially sent us for discussion and which we therefore assumed may be covered in your programme – again I have an email from Rami with these topics. I appreciate you may not have seen the questions sent by Rami as you say you did not have much to do with organising the Patrick Holford part of the programme, but if this is the case I’m not sure how you can say “absolutely for definite that those are NOT the questions which the BBC sent to Patrick Holford asking for a response. And furthermore, those are NOT the answers which Patrick Holford sent back to the BBC.”

  13. Ben Goldacre said,

    April 1, 2008 at 12:09 pm

    Hi Stephanie Fox (Patrick Holford’s PR at 100% health),

    Sure… but…

    You have changed your website since I wrote those comments yesterday!

    I believe the original is archived by Holfordwatch

    holfordwatch.info/2008/03/31/holford-tries-to-respond-to-questions-raised-by-bbc-documentary-he-fails/

    This to me typifies the tediousness of dealing with Patrick Holford’s empire, and demonstrates how different it is to questioning the ideas and scientific claims of an academic.

    I am pleased to see you have nowposted Professor Holford’s responses to the questions which were actually posed, so people can see for themselves whether and how he responded (there’s some very good fun to be had there).

    As I believe the BBC explained repeatedly we were making a general programme about the misuse of science by nutritionists and the $56 billion food supplement industry in the Radio Science Unit, not a consumer programme about the various problems with Patrick Holford, and I personally am not very interested in a programme simply examining Patrick Holford’s CV, history, pill claims, and business practises. However I understand there may be a separate larger project underway, and I’m sure they will find this episode instructive.

  14. Ben Goldacre said,

    April 1, 2008 at 1:37 pm

    hi stephanie fox,

    the link you post above was not to be found on your site when i was alerted to it yesterday, only the preceeding two, and one of those has completely changed. if you say that page was there, and you are absolutely clear that the other pages have not changed, then all well and good, i am not interested in quibbling over this, and am much more interested in the science, and professor holford’s claims on HIV, cancer, 50% of the population having an “allergy” requiring his treatment, mass medication of children with supplements, etc.

    i’m also not sure it’s very realistic of you to repeatedly suggest on your website that the bbc behaved unreasonably. as you especially will know there are extensive protocols and guidelines on an issue like this which i understand were all followed meticulously.

    as i am more than happy to link to patrick holford’s pages, and also to post your comments on my website, perhaps you would like to place a link on your webpages to this website, or a response from me to patrick’s increasingly bizarre comments about my work? then people can hear the show for themselves, read the concerns that others have about the scholarship of patrick holford, and make their own mind up?

  15. gimpyblog said,

    April 1, 2008 at 5:18 pm

    Steph, I followed your link and would like to quote this section which I believe emphasises some of the concerns about Mr Holford’s understanding and use of science.

    Q.That in the same book, Chapter 24, still on the subject of vitamin C, Mr Holford cherry picks studies in order to back up his claims about the role of vitamin C in the treatment or prevention of colds. What is Mr Holford’s reasoning for using a retrospective analysis of data from studies carried out before 1974 only and ignoring the many studies that have taken place since?

    A. “The referenced study used in the Optimum Nutrition Bible in relation to colds and vitamin C, was the most up-to-date systematic review of studies on vitamin C, published in 2000. The most recent systematic review of studies on vitamin C, published last year reaches more or less the same conclusions that Vitamin C supplementation reduces the duration of symptoms, reduces the severity of symptoms, but there is no convincing evidence on reducing incidence ie the number of colds. It reports that the strongest effect is for immediate high doses on the onset of a cold, for example if 8 grams is taken 46% of subjects have a cold for no more than a day. That is the equivalent of 176 oranges, hence the recommendation in the Optimum Nutrition Bible to supplement vitamin C in high doses when you have a cold. When the book is next updated I will cite this more recent review.

    The most recent review of vitamin C and the common cold is this one from the Cochrane Library. The plain language summary is below:

    Plain language summary
    Vitamin C for preventing and treating the common cold

    The term ‘the common cold’ does not denote a precisely defined disease, yet the characteristics of this illness are familiar to most people. It is a major cause of visits to a doctor in Western countries and of absenteeism from work and school. It is usually caused by respiratory viruses for which antibiotics are useless. Other potential treatment options are of substantial public health interest.

    Since vitamin C was isolated in the 1930s it has been proposed for respiratory infections, and became particularly popular in the 1970s for the common cold when (Nobel Prize winner) Linus Pauling drew conclusions from earlier placebo-controlled trials of large dose vitamin C on the incidence of colds. New trials were undertaken.

    This review is restricted to placebo-controlled trials testing at least 0.2 g per day of vitamin C. Thirty trials involving 11,350 participants suggest that regular ingestion of vitamin C has no effect on common cold incidence in the ordinary population. It reduced the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small its clinical usefulness is doubtful. Nevertheless, in six trials with participants exposed to short periods of extreme physical or cold stress or both (including marathon runners and skiers) vitamin C reduced the common cold risk by half.

    Trials of high doses of vitamin C administered therapeutically (starting after the onset of symptoms), showed no consistent effect on either duration or severity of symptoms. However, there were only a few therapeutic trials and their quality was variable. One large trial reported equivocal benefit from an 8 g therapeutic dose at the onset of symptoms, and two trials using five-day supplementation reported benefit. More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials.

    With specific regard to Patrick Holford’s claim that the review states that 8 g of vitamin C causes 46% of recipients to have a cold for no more than a day the review actually states:

    The statistically significant Anderson 1974e entry combined two different dosage arms. Anderson 1974e administered 4 g/day, and Anderson 1974f administered 8 g/day on the first day of illness only. The mean duration of illness episodes for those in the 4 g/day arm was 3.17 days, while that for 8 g/day arm was 2.86 days compared with the duration in the placebo group #4 of 3.52 days. This 1974 trial was bedeviled, however, by the fact that the investigators originally intended to compare results with two separate placebo groups. One of the placebo groups (#6) had substantial baseline differences when compared with the six vitamin C groups. The comparisons presented here are with the placebo group #4 that was much closer to the vitamin C groups with respect to baseline data (seeHemilä 2006a). If comparisons had been made with the placebo group #6 or a combination of the two placebo groups as the investigators had originally intended, the benefits would have been minimised as the mean episode duration for the placebo group #4 was 3.52, and for placebo group #6 was 2.83. Nevertheless, notwithstanding the placebo group problem, the proportion of ‘short colds’, that lasted for only one day was larger in the 8 g/day group (46%; 222 out of 483) compared with the 4 g/day group (39%; 164 out of 417) (P = 0.046), consistent with the possibility of therapeutic benefit at the higher dosage (see p. 42 in Hemilä 2006a).

    This is rather at odds with Mr Holford’s analysis of the 8 g claims and his claim that the review endorses therapeutic dosage with vitamin C. Frankly I do not have the time nor the inclination to investigate Mr Holford’s responses in more detail but hope Holfordwatch will.

    PS apologies for loser length but you know how it is sometimes..

    PPS balls, typo messed up html.

  16. Ben Goldacre said,

    April 1, 2008 at 5:43 pm

    It’s quite possible that in his “responses” professor holford of teeside university makes more errors or misrepresentations than in his original claims.

    eg

    we demonstrated in the programme that patrick holford had cherry picked the evidence on vitamin C preventing colds. remember, there are two separate issues, prevention and treatment: there is some evidence for efficacy of vitamin C being weakly beneficial in <i>treating</i> cold symptoms (nothing much treats cold symptoms), at v high doses. however, the evidence from the definitive systematic review by cochrane shows it does not prevent colds: it does not reduce the “incidence” of colds.

    professor holford’s response confuses these two entirely unconfusing issues. to be honest, reading his response – where he responds on the issue of treatment not reducing the incidence – makes me wonder if he understands what “reducing the incidence” actually means, which is worrying since he writes about it in his books.

    here is what professor holford says in his updated response to the programme:

    “My suspicions proved correct. Having been accused of systematically misrepresenting scientific evidence, Goldacre and Professor of Pharmacology David Colquhoun, then referred to a Cochrane Systematic Review (the kind that they say is the best) on Vitamin C in colds saying that there was no evidence of a lesser incidence of colds . . . but failed to mention that the review concludes that Vitamin C reduces the severity and duration of symptoms. It also reports that the strongest effect is for immediate high doses on the onset of a cold, for example if 8 grams is taken 46% of subjects have a cold for no more than a day.”

    etc.

    and so it goes on. what we see is incremental mistatement, responses to questions that were not posed, responses which are as flawed as the original claims, etc. if you don’t pay attention then his responses have the superficial appearance of academic scholarship, and yet a medical undergraduate could pull it apart.

    it’s a very, very peculiar and absolutely fascinating phenomenon, and made all the more amusing by the authority with which he is introduced in the mainstream media.

  17. Sili said,

    April 1, 2008 at 6:59 pm

    Someone should send this to Mark Liebermann of LanguageLog

    itre.cis.upenn.edu/~myl/languagelog/archives/005516.html

    Who knows – he might end up being swayed to join the BBC knowing that there is indeed some solid science reporting lurking under the surface.

  18. Dr Aust said,

    April 1, 2008 at 9:15 pm

    It is an interesting three-way question, really: liar, bullshitter or fool?

    Liars know what the truth is but deliberately proffer untruth.

    Bullshitters (in the sense that philosopher Prof Harry Frankfurt uses the word) don’t really think it matters what is true.

    And fools simply can’t tell what is true, even though many loudly insist they can.

    A philosophical conundrum, eh?

  19. WoollyMindedLiberal said,

    April 1, 2008 at 11:13 pm

    As a skier I’d be interested in knowing how good the claims are of a possible 50% reduction in the chance of catching a cold.

  20. evidencebasedeating said,

    April 2, 2008 at 12:35 am

    Hi Stephanie

    I thought your comments were merely topical of the moment when I saw them posted at 11am on the 1st April- especially as Professor Patricks exceedingly long and sulky ramblings about the BBC were posted and promo’d ad nauseum via his own electronically signed email, and website rants, well in advance of part 2 of Ben’s programme.

    But then I realised you WERE seriously attempting to suggest, Al-Fayed style, that there was some conspiracy going on between Patricks Truth and Media Truth

    Your link represents an exceedingly pruned version of the original as it existed up until last night on Professor Patricks website.

    Perhaps Patrick would benefit from the ‘less is more’ approach? – in supplement promotions, nutritional musings and media self-aggrandisement. I know we would feel better for it

    In fact, it seems you are suggesting the only modest thing about Patrick is his ‘Empire’. Turnover (ker-ching!!) is of more interest to Holfordwatchers than number of acolytes at head office….sorry!

    And WELL DONE Ben. He can write. He can niftily present. What’s left?

    Strictly Come Dancing?

  21. Steph said,

    April 2, 2008 at 1:31 pm

    Hi ? I’ve sent an email to Ben letting him know how I think holfordwatch linked to the pages BEFORE they were up as a link on our home page as I assumed you’re all more interested in discussing science than the logistics of a web page being created. Clearly I was wrong. So let me explain. BOTH pages – the one linking to Patrick’s full responses and the comments provided to Radio 4 always had the same questions posted up on them as these were quite simply the questions that Rami emailed to me. The pages were not made live as a link through from our home page until AFTER the programme as even the powers of nutrition don’t allow us to listen to a programme that hasn’t been broadcast yet. Obviously they are a response to the programme and we therefore removed a couple of the topics, from the FULLER response, that Rami had originally posed to us, as they were not featured in the programme and therefore not relevant to anyone clicking on the page as a result of listening to the programme. They however have not been ‘exceedingly pruned’ and have existed on the website unchanged since we made them live from our home page on Monday 31st April after the programme aired. The comments Patrick provided to Radio 4 DID NOT CHANGE AT ALL as these comments are simply a copy and paste of the email I sent to the producer which if you want to give me your email (and you can find mine on our website) I can email you if you really don’t believe me. Also we did not send out an e-letter to our subscribers until AFTER the programme. Holfordwatch, I assume, managed to access the pages before they were made live on our home page, by searching for a page number – they were made live off the home page so we could see the pages but were not clickable through the site at the point I assume Holfordwatch accessed them. You will see if you pass your curser over Patrick’s Short and Concise Response link on the holfordwatch page you will just about be able to see that this is filed under miscellaneous – this is an area on our site where pages we are working on can be placed so that no-one else can see them unless they are making a note of the page number on the site we are on – they are not clickable from the site. If you pass your curser over his fuller response you’ll see that this is filed under Press – I briefly made this page live under here on Friday to check it would appear there and then took it back off – I assume Holfordwatch accessed that page at that moment. So there you have it – not a conspiracy but a pretty simple if long, laborious and boring response for which I apologise.

  22. Ben Goldacre said,

    April 2, 2008 at 1:40 pm

    thanks steph.

    i think it would be useful if you could expend the same amount of energy explaining why professor patrick holford of teeside university responds to a question on prevention of colds with vitamin c by referring to studies about treatment of colds with vitamin c? it seems from reading his response that he doesn’t understand what “incidence” means, and assumes this is about treatment?

    we can then move on to the other issues that patrick holford has not addressed. i think it is important that this stays on the science, and i am sure professor holford feels this way too.

  23. Steph said,

    April 2, 2008 at 2:14 pm

    It didn’t use much energy or time – probably a couple of nuts worth and a minute as like you I’m a speedy typer. . . though I admit I nearly fell asleep typing it. Regarding specific issues you have with Patrick’s work I’d suggest if you want to make any progress with correcting anything you understand to be wrong in Patrick’s books or on the website then you write to his book publisher (Piatkus) or 100%health documenting this. Patrick and his publishers can then assess any evidence you send them.

  24. LaughingStatistician said,

    April 2, 2008 at 2:31 pm

    W00t!

    Engaging with Professor Patrick Holford on his Scientific Errors:

    Point out errors to Professor Holford – > get ignored.

    Point out errors to Professor Holford – > get response to completely different question.

    Point out errors to Professor Holford – > get bizarre ad hominem attacks.

    Point out errors to Professor Holford – > get more errors in response.

    Point out errors to Professor Holford – > get told to point out errors to someone else who will pass on concerns to Patrick Holford.

  25. j said,

    April 2, 2008 at 3:19 pm

    Steph- perhaps Prof Holford of Teesside University might start by correcting/clarifying some of his ‘responses’ to the Radio 4 programme: for example, he could look to correct his continued misinterpretation of the evidence re. Vitamin C and colds and the apparent confusion between cold prevention and treatment.

    HolfordWatch e-mailed Prof Holford with a number of questions about the Food for the Brain child survey back in January 2008. Our questions have not been answered satisfactorily. Some of our questions have not been answered at all, and we did not get a reply to our e-mail.

    Should HolfordWatch – and other people who note the numerous mistakes in Holford’s work – now send details of these errors to his publishers and the 100% Health company, then? I must say, though, that I find it rather surprising if a self-styled researcher chooses to leave the important business of correcting errors in his work to 3rd parties…

  26. ACH said,

    April 2, 2008 at 3:36 pm

    Ben, Sue from BANT may have been a very nice lady, but she really should look up what words like “phenotype” actually mean before pontificating in a magnificently clueless way about her (mis)understanding of the term.

    As for all this obfuscation from Holfords PR, Steph, it’s the funniest thing I’ve read today – second only to LaughingStatistician’s brilliant summary.

    What is it with nutritionists that they pick up on scientific terms with a specific meaning (like phenotype and incidence) and they just scatter them into conversation/text using them completely incorrectly?

  27. used to be jdc said,

    April 2, 2008 at 4:53 pm

    The good people at Holford Watch must type quickly – I see there’s been two new posts since your previous comment j.
    I see Gimpy has a post up as well.

  28. hickory said,

    April 2, 2008 at 5:06 pm

    Ben – I am admirer of many of your investigations but I think you are making a mountain out of a molehill about vitamin C and HIV. You’ve had a stab at Holford many times viz his statement, written in 1998, regarding a study by Dr Raxit Jariwalla in 94/95. I looked into this in the interest of my patients and these are impeccable in vitro trials with unequivocal benefit of vitamin C, which is non-toxic to cells, over AZT. The author stated some years back, following one of your earlier articles, in his letter to the Guardian “Patrick Holford’s conclusion that ‘AZT, the first prescribable anti-HIV drug is proving less effective than vitamin C’, as interpreted from the results of our experiments, is correct. In two published studies ( S Harakeh and R Jariwalla ‘ Comparative analysis of ascorbate and AZT effects on HIV production in persisitently infected cell lines’ Journal of Nutritional & Environmental Medicine, 4:393-401 (1994); and S Harakeh and R Jariwalla ‘Ascorbate effect on cytokine stimulation of HIV production’ Supplement to Nutrition: Vol 11: pp 684-87 (1995)) in which we compared vitamin C to AZT in chronically and latently infected cells, our experiments consistently showed that AZT was less effective than vitamin C. I made this clear in my letter to the Guardian and am surprised that the Guardian journalist continues to wrongly accuse Mr Holford.’ If you have an issue with these studies why don’t you take it up with the author, not with the messenger?

    After your first snipe, Holford admitted that he had referenced the wrong Jariwalla study, and corrected it. I have his 2007 edition of the New Optimum Nutrition Bible in front of me and it does clearly state that these ‘in vitro’ studies on human T-cells show that vitamin C suppresses the HIV virus in both chronically and latently infected cells, while AZT has no significant effect. It is a tragedy that this simple, non-toxic treatment hasn’t been further tested.” There has been, as he points out on his website, one human trial of high dose vitamin C and N-Acetyl Cysteine, the results of which are extremely encouraging and show the kind of reduction in reduced HIV viral load, improved immune cell (CD4) count that the in vitro studies would predict. ((Eur J Clin Invest 30: 905-14, 2000). I have given my patients high dose vitamin C and seen this for myself on several occasions. I also think it is a tragedy that no-one has been willing to fund a large-scale trial, but I guess there’s no money in this potentially important and inexpensive approach. Why can’t you just admit that you were wrong on this one and move on to something more interesting? It’s certainly not a case of bad science.

  29. gimpyblog said,

    April 2, 2008 at 5:12 pm

    hickory, did you give your patients vit C at the expense of AZT? I’m pretty sure that would constitute a massive breach of the code of ethics of your profession, if indeed you are a healthcare professional with statutory regulation. Or are you a sockpuppet making things up?

  30. Dr Aust said,

    April 2, 2008 at 6:16 pm

    Priceless. Can one of our resident IT-geeks track down the sourceperson?

    Gimpy – I guess our mysterious “hickory” didn’t say flat out either “I am a doctor” or “..instead of retrovirals”… so hickory (if s/he actually exists) could be a “nutritional therapist” who is recommending Vitamin C to HIV-positive people. Under such circumstances – as we have discussed before – there would be no regulatory system of any kind to prevent him/her doling out the antioxidants.

    An interesting issue is whether it would be ethical for an actual doctor treating HIV positive people with standard ARV therapies to encourage the patients to also take megadose vitamin C, N-acetyl-cysteine or similar. I am pretty sure there is not actually a rule that says they can’t, apart from the general understanding that giving things for which there is no evidence-base, and which might have biological actions which haven’t been well-studied, is not really a great idea.

    Any infectious disease specialists, or indeed any other sorts of MDs, out there care to enlighten us?

    [It is also, of course, clearly possible that people taking ARV therapy take it upon themselves to "add" antioxidants without telling their doctors.]

  31. evidencebasedeating said,

    April 2, 2008 at 9:01 pm

    Hickory says:

    ” have given my patients high dose vitamin C and seen this for myself on several occasions”

    Hickory – there is a difference between dose administered and amount of Vitamin C that can absorbed. The bioavailability of Vitamin C diminishes as oral dose increases, and plateau’s at oral intake around 200mg. The Vitamin C guru is NOT Professor Patrick, but the ninja researcher Mark Levine. His detailed work on bioavailability of Vitamin C and excretion kinetics is seminal work in this area.
    In fact, a recent AJCN summary of nutrients v foods summarises the issues nicely:

    www.ajcn.org/cgi/content/full/87/1/5

    Unless Vitamin C is given iv (and yes, Levines group have been awarded grants to investigate Vit C as adjunctive chemo with iv administration) large oral doses of Vitamin C have absolutely no effect on blood levels.

    Placebo effect only.

    But generates dosh from the vulnerable

    Ker-ching!!!

  32. JQH said,

    April 2, 2008 at 9:18 pm

    I see “hickory” is trotting out the tired old canard about nobody doing the vitaminC to treat AIDS trials because there’s no money in it.

    Surely the NHS would save a bomb if they could dole out VitC instead of ARVs? They have a financial incentive to do the trials so there must be some other reason.

    Such as it being unethical to deprive patients of a treatment regime that works.

  33. LaughingStatistician said,

    April 2, 2008 at 11:34 pm

    DrAust “Priceless. Can one of our resident IT-geeks track down the sourceperson?”

    “Hickory” certainly reads as if he is Patrick Holford.

    1. Extrapolates from an in vitro finding to clinical claim

    2. Deliberately reframes a criticism of the Holford interpretation as a criticism of the study. Goldacre has not criticised the Jariwalla study, he criticised the Holford interpretation, and has been clear on this eg in this Radio 4 programme and in 2005. Classic Holford.

    3. “vitamin C, which is non-toxic to cells” direct Holford quote

    4. Knows Holford wrote the ONB first in 1998

    5. And has the most recent 2007 edition

    6. Refers to Jariwalla letter – who would bother?

    7. Says it’s a tragedy that nobody will fund trials (Holford works for a pill company, maybe they should?)

    Everything about this approach screams Patrick Holford.

    Was it from him? Have you checked the IP addresses?

  34. gimpyblog said,

    April 3, 2008 at 8:19 am

    hickory, here are some studies looking at the role of vitamin c in AIDS treatment, I mentioned this on my blog, there may be a role for vitamin C in reducing some of the side effects of AZT – not a role in replacing it. Perhaps you should make this clear to your ‘patients’, or are they your customers?

  35. evidencebasedeating said,

    April 8, 2008 at 10:49 pm

    LaughingStatistician says:

    ““Hickory” certainly reads as if he is Patrick Holford”

    Well, I wouldn’t be surprised. Hickory makes statements like:

    “I have given my patients high dose vitamin C and seen this for myself on several occasions. I also think it is a tragedy that no-one has been willing to fund a large-scale trial, but I guess there’s no money in this potentially important and inexpensive approach”

    1. The power of the anecdote. A Patrick Special

    2. Oblivious to medical research out there over the last year:
    www.jaoa.org/cgi/content/full/107/6/212
    and
    www.cmaj.ca/cgi/reprint/174/7/956
    and
    www.emaxhealth.com/83/19681.html

    anecdote +
    big pharma attack +
    oblivious to ‘conventional’ nutrition/medical research in progress
    = Hickory Holford

  36. mrjohnc said,

    August 2, 2009 at 11:44 am

    Oh that’s not fair, get me hooked with part 1 on your website then part 2 is not on here and the BBC have stopped it too.

    Please post part 2 on here

    Pretty please?

  37. mrjohnc said,

    August 2, 2009 at 12:06 pm

    I found some links to the .mp3s for parts 1 and 2 here

    holfordwatch.info/2008/11/29/ben-goldacres-rise-of-the-lifestyle-nutritionists-on-radio-4-won-a-norwich-union-medical-journalism-award/

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  39. mark kislich said,

    December 27, 2011 at 3:07 pm

    Nice.

    Too much bogus out there, you have to be very careful about the advice you choose to take.

    Thanks,

    Mark