The second part of the BBC Radio 4 show The Rise of the Lifestyle Nutritionists (listen again here, later tonight) starts by noting that “Everybody wants to be healthy, but how do you know who to trust?” Ben Goldacre then spends a considerable amount of time speaking to a number of eminent professors, in order to demonstrate that one cannot trust Holford’s science: Holford’s science fails in numerous ways.
The interviewees are extremely critical about the quality of Holford’s work, and Holford has predictably claimed that the programme was unfair. However, this programme is actually an accurate and balanced assessment of Holford’s work. If Holford finds such assessments harsh, we would argue that he should look to improve the quality of his own work and offer a meaningful response to some of the criticisms raised, along with correcting his numerous errors. His current (non)responses to the serious questions raised are woefully inadequate.
Holford is arguably the most influential nutritional therapist in the UK:Goldacre analyses Holford’s New Optimum Nutrition Bible (NONB) as an example of influential writing in the field of nutritional therapy. Initially, Prof David Colquhoun discusses Holford’s claims about vitamin C – both as an AIDS treatment and as a prophylactic against colds. In both cases, he concludes that Holford misrepresents the evidence. Colquhoun is shocked that Holford refers to an in vitro test to justify his claims about vitamin C and AIDS: as Colquhoun argues, such studies are of little value to clinicians making treatment decisions. Colquhoun also finds that cherry-picking of studies is a frequent problem in Holford’s work. For example, Colquhoun finds that Holford’s focus on a study offering the ‘right’ results on vitamin C and the common cold is an astonishing example of cherry-picking data (the first Cochrane Review of the topic was available in 1998 and updated ones were also available by the time of Holford’s revision to NONB). Did we mention that Holford is Visiting Professor at Teesside University, and there are plans for him to head the University’s CACTUS clinic – I’m sure that Teesside will be pleased to know that their new professor is leading the field in something. And I do like cherries…
Prof Tom Sanders then discusses Holford’s response to a meta-analysis of Randomised Controlled Trials (RCTs) of antioxidant pills which showed that these pills don’t improve survival, and that some may even increase mortality. As reported on this blog, Holford complained that two association studies – not RCTs – had not been included in the meta-analysis of RCTs: this strikes Sanders as a misrepresentation of the scientific literature, and gives him the impression that Holford does not understand the difference between association studies and RCTs. But, then again, Holford’s only being lined up to lead some of the research at Teesside from his new professorial position – one mustn’t be too harsh on him. And – while Holford is Head of Science and Education at Biocare – a little confusion between associations studies and RCTs isn’t much of a problem. Right?
As Goldacre summarises matters, the BBC’s investigation found a fairly enduring pattern of poor scholarship in Holford’s work. When appointing Holford as a Visiting Professor at Teesside, or as Head of Science and Education at Biocare, one does wonder whether those appointing him also took the opportunity to review his work – and whether they picked up on the very basic errors therein.
A number of people have chosen to associate themselves with Holford’s work, and to act as if it is scientifically credible. This is not a trivial matter: Holford offers (often erroneous) advice on treatments for a number of serious conditions, and is seeking to influence public policy and academic research agenda. We would therefore suggest that Biocare and Teesside University might like to reconsider their positions. We would also suggest that the academics on the Food for the Brain Scientific Advisory board reconsider whether they want their names associated with such poor quality work, and also look to produce a full list of errata to supplement the error-ridden Food for the Brain child survey report. Finally, we would ask that Holford’s publishers work with Holford – or independently – to produce suitable lists of errata to accompany his work, and that those mainstream media outlets that promoted his work look to correct their previous errors and run a compensatory more accurate assessment.