Testing the water

January 27th, 2005 by Ben Goldacre in adverts, bad science, references, water | 3 Comments »

Ben Goldacre
Thursday January 27, 2005
The Guardian

Promoting the public misunderstanding of science this week we have Waitrose Food Illustrated, talking about Penta bottled water: “It’s ‘ultra-purified, restructured micro-water’ that offers ‘optimal cellular hydration’.” Sounds expensive. I wonder how it works. “By disrupting the naturally occurring molecule clusters in water with high-energy sound waves, they are able to pass more easily through the body’s cell membranes, quenching the thirst better.” Apparently it offers significant health benefits.

So I try to find out how and whether it works. Just watch as I waste a whole morning. First I go to Penta’s website. It’s dripping with scientific terminology and links to research, which end at best with a couple of very tenuous papers published in obscure Russian journals. Here’s a sample. “There are many types of bioactive molecular structures, including clustered water that scientists are continually researching, for instance at Cambridge.” Follow the link and you find a serious page about physics from a scientist and the disclaimer: “LINKS FROM ANY COMMERCIAL ORGANISATIONS TO THIS SITE ARE ENTIRELY UNAUTHORISED AND UNWELCOME. THE MAINTAINERS OF THIS SITE HAVE NO CONNECTIONS WITH ANY SUCH COMPANIES OR THEIR PRODUCTS.” I phone him. He roars with laughter, but isn’t in the mood to be quoted on something that has nothing to do with him. And rightly so. I get on to Penta. Got any peer-reviewed data, I ask? Apparently not yet. All the stuff on performance isn’t out yet, they’re keeping their heads down while they do the research. While they’ve been keeping their heads down, the Penta website quotes Metro as saying “hydrates at the intercellular level and has many recorded health benefits”, Men’s Health said it is “proven to hydrate more quickly” and the Daily Mirror said it will “increase the body’s cell survival by over 200%,” meaning I will die sometime after the year 2200. “The claims aren’t as far-fetched as they sound,” says the Evening Standard. I can’t wait to see the coverage they get when they go public with this.

But they do have a published paper, I’m told, on liposomes in vitro with aquaporins in an artificial membrane, “or something”, that shows the water is absorbed faster. They’ll email me the reference. Instead I get a call from the MD, who gets very upset that I am trying to catch her out on the science and asks that I don’t quote her. So I didn’t even get a confirmation that the paper exists. The morning is over, and confusion reigns supreme.

Letters ” Vitamin C research is not bad science”

January 20th, 2005 by Ben Goldacre in bad science | 3 Comments »

Vitamin C research is not bad science

Ben Goldacre describes one of my papers of a research study evaluating the anti-HIV action of vitamin C, and labels it as “bad science” as it was a laboratory study and it had nothing to do with AZT (Bad science, January 6). That is an unfortunate categorisation.

Laboratory studies are necessary prior to treating HIV in humans as they provide a rationale for clinical evaluation. It seems that the author was looking for a study comparing vitamin C with AZT and found an incorrect reference that evaluated only vitamin C. I should like to point out that subsequent to that first report, we published two successive papers that compared the anti-HIV effects of vitamin C to AZT. Both studies showed that whereas vitamin C suppressed HIV activation in latently or chronically-infected cells, AZT had no significant anti-HIV effect.

Our results on AZT were consistent with an independent report from another laboratory that also showed AZT to be ineffective in suppressing HIV expression in chronically-infected cells.

Simply because vitamin C has not been tested in humans, does not make vitamin C research a bad science. In fact, the reasons one would perform a clinical study are apparent in the above laboratory studies which have provided a compelling rationale for such testing. However, since vitamin C is a simple, inexpensive nutrient and not a drug with profit-generating potential, there has been little interest in testing it clinically. This is unfortunate as it keeps a potential non-toxic treatment from being further evaluated against a deadly life-threatening disease.
Raxit Jariwalla
California Institute for Medical Research, San Jose

[ Ben Goldacre responds here. ] or here

Working papers – Patrick Holford

January 20th, 2005 by Ben Goldacre in bad science, nutritionists, patrick holford, references | 4 Comments »

Ben Goldacre
Thursday January 20, 2005
The Guardian

Here’s an interesting question, and I’d be interested to hear your thoughts. Can a published research paper ever be Bad Science? I think not. This week, we publish a letter from Raxit Jariwalla, the author of a study on vitamin C and HIV, who feels done down for being mentioned here two weeks ago. He wasn’t singled out, but Patrick Holford, of the branded vitamins, misrepresented the paper in his Optimum Nutrition Bible. Holford said: “AZT, the first prescribable anti-HIV drug, is potentially harmful, and proving less effective than vitamin C,” and referred to the paper as proof. In fact, the paper was a lab study on what happens if you tip lots of vitamin C onto HIV-infected cells and measure a few things related to HIV replication. It did not compare vitamin C with AZT and was not a clinical trial where tablets were given to people to see how well they did. Read it here: tinyurl.com/4l7vz.

Patrick Holford was guilty of at least incompetence in claiming that this study demonstrated vitamin C to be a better treatment than AZT. But is the Jariwalla paper Bad Science? No. I don’t think a paper ever can be. The meat of a paper is the methods and results section. In the discussion at the end, granted, things sometimes go a bit weird. But the meat of a paper honestly and accurately describes an experiment and its results. We all know that all experiments could have been done better or worse, to a greater or lesser extent. That’s the point of critical appraisal, of learning to pick papers apart. Maybe the sample size could have been bigger; maybe what you measured, the surrogate marker, turns out not to be as valid as you thought. Scientists know this. And by scientists, I mean people who know a bit about science and are capable of thinking it through, no white coats required.

A paper, an experiment, is merely one bit of evidence, and how you choose to interpret it, how you fit it into your understanding of whether a theory holds, with lots of other evidence, is a thing that a person does, with varying degrees of fallibility: you weigh it up, come to a verdict, personally, on the evidence, accounting in your own imperfect way for the flaws in all the bits of evidence you happen to know.

Jariwalla’s paper is useless as supporting evidence to Holford’s statement. It is excellent evidence for lots of other statements. So Jariwalla I have no opinion on, his paper is just a paper, and Holford is a fool or worse. Or am I wrong?

Follow up to this.

Vitamin deficiency – Patrick Holford

Straight jabs

January 13th, 2005 by Ben Goldacre in bad science, independent, magnets, mail, MMR | 2 Comments »

Ben Goldacre
Thursday January 13, 2005
The Guardian

People sometimes say to me, “I enjoy Bad Science, but often the jokes go right over my head, which makes me worry that I must be ignorant.” To which I always reply: “Good.” Over to reader Anne Pickard: “Unable to get a copy of our Saturday Guardian, my husband bought the Independent, which included a feature on ‘The 50 best spa treatments’. You may be interested to learn that in seventh place comes “Magnetic Massage”, where your torso “is shrouded in an infrared-heated blanket that warms up your kidneys to help speed up the detoxification process in your internal organs”. Brilliant. Is there anything else I can do to warm my kidneys up? “Do something unexpectedly kind for one person every day,” says the careers development section of www.telecomsjobsource.co.uk, “this tends to warm your kidneys.”

Meanwhile, it’s good to see some of you have been keeping an eye on the Daily Mail, particularly the story of a new “triple jab” as the paper called it. The vaccination they are talking about is the conjugate pneumococcal vaccine that the Joint Committee on Immunisation and Vaccination recommended at its last meeting. Most people had expected the Mail to get its knickers in a twist, but where did it pull the idea of a triple vaccine from? The pneumococcal vaccine currently licensed in the UK (given to children at high risk of complications from pneumococcal infection) is a 7-valent conjugate vaccine which protects against seven of the most common serotypes of pneumococcus. Shut up. Nobody complains about the Books section being too “Booky”. So anyway, it’s not a “triple” vaccine, that great Daily Mail bogeyman, because it only confers protection against one organism (Streptococcus pneumoniae), just like the Hib vaccine confers immunity to Haemophilius influenzae type B, and the conjugate Men C vaccine protects against Neisseria meningitidis.

Presumably, and this is the best explanation I can offer, the Mail journalist took the Department of Health’s suggestion that the vaccine would protect children against bacterial meningitis, pneumonia and septicaemia, and assumed this meant three separate diseases, like MMR protects against measles, mumps and rubella. But bacterial meningitis, pneumonia, and septicaemia are three – potentially fatal – outcomes of a pneumococcal infection. As our spotter says: “It’s a good job they hadn’t picked up on the 7-valent bit. They would have got even more excited about a septuple vaccine.”

Vitamin deficiency – Patrick Holford

January 6th, 2005 by Ben Goldacre in bad science, nutritionists, patrick holford, references | 7 Comments »

Ben Goldacre
Thursday January 6, 2005
The Guardian

You’ll be pleased to hear that my new year’s resolution is to stop going on about nutritionists and find some new targets to bait. However, due to the curved nature of spacetime in newspapers I’m writing this in 2004, so by my reckoning I get one more pop, not at dear Gillian McKeith, but at Patrick Holford. Lots of people seem to like him. He’s a clever guy. I thought I’d grab his book, The New Optimum Nutrition Bible, because it would be handy to have a desk reference, instead of always going to Medline to check wacky claims.

Now, I absolutely swear blind, the first thing I did was open it at a random page: HIV Infection and Aids. “Leading researcher Dr Raxit Jariwalla … found that with continuous exposure to ascorbic acid (Vitamin C) … the growth of HIV in immune cells could be reduced by 99.5%.” That’s 99.5%. Wow. But there’s no reference. You’d have thought, in a book with no less than 241 academic references, that this astonishing fact would be something worth referencing, but hey, it’s Christmas.

So I hunt through the references section at the back, and finally find one paper by Jariwalla. Then, like a young Sherlock Holmes, I find the place in the book, sorry, the “Bible”, where this mysterious paper is referred to. Holford’s sentence, on page 208 reads like this: “AZT, the first prescribable anti-HIV drug, is potentially harmful, and proving less effective than Vitamin C.” Then there’s a little superscript 23, referring you to this Jariwalla paper. Just like in a proper academic article! So, vitamin C is better than AZT. Obviously I had to read that paper. The abstract is at tinyurl.com/4l7vz. The paper is free online. It doesn’t compare vitamin C to AZT for efficacy. It’s a laboratory study. It doesn’t look at whether Vitamin C treats HIV in humans. It measures a few jolly complicated things like extracellular reverse transciptase activity, p24 antigen, giant cell syncytia formation. It has nothing to do with AZT. If anyone can read that paper and tell me how it backs up Holford’s sentence about AZT, then I would like to know how. The paper doesn’t even contain the word AZT. Not once.

Everything Holford writes is plastered with references. He’s almost impossible to argue against, because he’s constantly pulling these references out of the bag. Each one takes about an hour to check – so if you’d like to join the struggle, his book is only £12.99. I hope some of them are better than this one.

Followed up here.