Vitamins advertised

November 25th, 2004 by Ben Goldacre in adverts, bad science, nutritionists, weight loss | 3 Comments »

Ben Goldacre
Thursday November 25, 2004
The Guardian

· Come with me as we pull back the veils, and examine the bizarre world of the nutrient marketing industry: I give you Nutraingredients, one of the many trade publications that feed the vitamin headlines. They enthuse about the developing trend among confectionery manufacturers to fortify their products with vitamins and minerals: nice. They eagerly explain how Unilever-owned Solero leapt on the noble campaign to get us to eat five pieces of fruit and veg a day, by advertising itself as the “ice cream to help you reach five a day”. Decadent westerners, open your ears and not your mouths: ice cream is not good for you in the same way that fruit and vegetables are.

· They also suggest that a rather small (albeit satisfactory) trial of vitamin E supplements in diabetics can be deployed in campaigns to negate the impact of that very large well-publicised meta-analysis of 14 separate placebo trials which damaged their industry by finding that vitamin E supplements can actually increase your risk of death: which is a problem notably not associated with a proper balanced diet. Reader Roger Daniels certainly knows his onions. “Most of us get our fat-soluble vitamin E through a balanced diet containing such things as nuts, vegetable oils or oily fish,” he explains, before revealing, with a flourish: Andrex with Aloe Vera and Vitamin E.

· It’s not clear to me exactly what proportion, if any, of the recommended daily allowance of vitamin E I’m expected to absorb from my anal verge: certainly the French are in favour of the rectal administration of drugs, partly on grounds of taste – feel the irony – and partly because the veins that take blood away from the rectum can go straight into the bloodstream without passing through the liver, and so an entire phase of first-pass metabolism may be avoided. Look, there’s no reason why this shouldn’t be educational, just because we’re talking about my sphincter; we’re all grownups, and we’re perfectly capable of talking openly about our bottoms without deploying puppies. I’m equally willing to entertain the hypothesis that the vitamin E is there for cosmetic reasons, intended perhaps to reduce sphincteric wrinkling. After all, you can also find vitamin E in Body Shop Tinted Moisturiser, and just like their blurb says, “as an antioxidant, it can help protect the skin from the harmful effects of pollution and extreme weather”. Which could be very useful in the adverse meteorological conditions of my cleft.

Health food shopped

November 18th, 2004 by Ben Goldacre in bad science, nutritionists, weight loss | 7 Comments »

Ben Goldacre
Thursday November 18, 2004
The Guardian

· Imagine what would happen if I just went crazy one day and started making stuff up. I mean, we’ve built up such a relationship of trust over the years. But I’ve found my evil twin (thanks to reader Deirdre Janson-Smith), and he’s working for the Bucks Free Press. Peter Marcasiano claims “some health foods are just as bad as junk snacks,” and the joy is he’s got buckets of science to back it up. Debunk away, Peter.

· First he rails against fruit juice: “What it actually does when you drink it is go straight to the liver – fructose does not enter the blood stream like other sugars – and the liver readily turns it into fat.” Now, I’d be really interested to know how this boy thinks absorbed nutrients are getting out of the 30 feet of well-vascularised gut that’s jumbled up in his tummy, and then across to his liver, if it’s not in his blood. Some might naively read medical textbooks and suggest that the answer lies in the hepatic portal vein. Perhaps in his world it gets absorbed into some amorphous mush behind his belly button, and then diffuses over to the liver under its own steam. I’m also enjoying the idea that every last fructose molecule gets picked up the moment it passes through the liver, without any getting into the systemic circulation. If anything, of course, the liver has to play around with what fructose it picks up to turn it into the glucose that your body can use, so the blood glucose levels from fruit don’t peak so high, and it doesn’t mess with your insulin so much. Which is one of many reasons why fruit is better than a Mars bar.

· He goes on. Commercially-treated vegetable oil is bad because it’s had sodium hydroxide bubbled through it, and “just in case you didn’t know what that is, it’s the substance you put down blocked drains to unplug them”. It is therefore a “poison”. Although to be fair, Peter, it’s not like you’re eating highly concentrated alkali, any more than the hydrochloric acid in your gut is going to melt your toes. But no, I was wrong, it’s been proven with science: “The trans-fats that are produced during the pre-frying have been isolated by researchers and injected into animals.” Gosh, what happened next, Peter? Er, that’s the end of the story. I guess that someone scientifically injecting it into animals is scary enough. Margarine “will damage your heart like no other spread,” pasteurising dairy “denatures the beneficial fats and proteins” and … Sigh. Just eat your greens. You’ll be fine.

Mixing medicines

November 11th, 2004 by Ben Goldacre in bad science, dangers, death, herbal remedies, times | 3 Comments »

Ben Goldacre
Thursday November 11, 2004
The Guardian

· Ah, Susan Clark of the Sunday Times (What’s the Alternative?), how I love her. This time she’s giving advice about which natural substances are safe to take with warfarin. First, she bemoans the dearth of research on the subject. Then she ignores the useful stuff in what we do know. “As a simple guideline, patients who are taking warfarin should avoid any natural remedies that have an action on the cardiovascular system.” I have no idea where that idea came from: but warfarin is famous for being interfered with by other drugs. St John’s Wort, for example, is a very popular drug – herb, collection of drugs in a plant, whatever – that reduces the plasma concentration of warfarin, along with phenytoin and rifampicin: that’s not because they’re active on the cardiovascular system, that’s probably because they interfere with liver enzymes, which means it makes them work harder. Those enzymes also break down warfarin, so if they’re working harder, they break down the warfarin more too, so there’s less of it around in your blood, and you’re more likely to have another nasty clot and die. Likewise, ginseng reduces the plasma levels of warfarin, so they shouldn’t be mixed either. And lots of others.

· So: stand by for the kind of nerdy, and usefully boring science story you’ll see in a paper when I am prime minister of the world government. In a recent study, 2,600 patients on warfarin were sent a questionnaire on what alternative therapies they took: 1,360 responded (believe me, that’s a high response rate) and a whole 19.2% of those responders were, it turned out, taking one or more complementary therapies. Ninety-two per cent of them hadn’t thought to mention this to their doctor. Only 28.3% of all respondents had even thought that herbal medicines could interfere with prescription drugs. Because hardly anybody’s telling them. And, the patients who were taking the complementary therapies – the ones you’d hope would be aware of the risks – were even less likely to think they might interfere with prescription drugs (at a statistical significance of P<0.001, which means there’s a one in 1,000 possibility of that finding occurring by chance).

· Now, doctors have a responsibility to ask about alternative therapies. Patients have a responsibility to themselves to volunteer the information. And the PR arm of the alternative therapy industry, the ones who write articles in national newspapers, have a responsibility to know their onions, and share their knowledge.

Monkey business

November 4th, 2004 by Ben Goldacre in bad science, gillian mckeith, nutritionists, religion | 5 Comments »

Ben Goldacre
Thursday November 4, 2004
The Guardian

· For a bloke who looks a lot like a monkey, George W Bush has a strange disdain for evolution. Now, this might all seem very trivial to you, but the Bush administration has decided, just before this week’s vote, to stand by its approval for a book that’s being sold in National Park museums and bookshops. This book explains to young minds that the Grand Canyon is only a couple of thousand years old, and was created by Noah’s flood, rather than by geological forces.

· Lo! Grand Canyon National Park superintendent Joe Alston heroically intervened and referred the sale of the book to his superiors but they sinisterly kept it on the shelves. They also appear to have ignored a letter from the presidents of the Palaeological Society, the American Geophysical Union, the National Association of Geoscience Teachers, the American Geological Institute, the Geological Society of America, and more, all pointing out that the book was nonsense. And they told Congress that they’d have a review of whether they were going to sell the book, and then calmly didn’t bother.

· Verily you may now laugh at the Americans in a smug European way, for truly they are in the grip of religious freaks: or, alternatively, you can go to the City of Bristol’s Festival of Nature, which includes an extensive exhibition from Bad Science repeat-offenders The Noah’s Ark Zoo Farm, Britain’s own creationist outfit, which specialises in targeting children, and advertises in its festival blurb that “huge educational mazes are part of these displays”. I think that might be a reference to the Intelligent Design argument.

· But if it’s back doors to enlightenment you’re after, you need look no further than Bach Flower Remedies’ new Yoga in a Bottle, which has several marketing advantages over real yoga: mainly, it requires the deployment of absolutely no exercise. Its only side effect is to eradicate the opportunity for meeting nice women at yoga class, but if you’re so physically non-viable that you’ve decided to buy yoga in a bottle, then you probably gave up any hope of action between the sheets several years ago, you decadent, obese, lazy, pathetic, unfit, feckless, unmotivated moron. Sorry, I think I’ve got low blood sugar this afternoon. And I always get bad-tempered if I haven’t mentioned Dr Gillian McKeith PhD for a while. “To avoided bloated tummy,” she writes, in this month’s Heat, “try not to eat when you’re tired, hungry, or upset.”

This letter followed a week later:

Monkey puzzle

I’m not convinced that Darwinian evolution comes across as that flattering for monkeys (Bad Science, November 4). They are often portrayed as a “rung down the evolutionary ladder”, which could be taken as an insult – especially now Bush (to mix metaphors) is “top dog” again.
Ella Smith