Tara Parker-Pope and Jonny Bowden

Expert PR people will tell you that the best form of advertising is that which looks like editorial rather than advertising. It is comparatively cheap and in ‘advertising value equivalents’, it is invaluable to the pundit whose work is thereby promoted because it enhances not only their pundit brand equity (‘Pundit Z – as featured in The New York Times‘ etc.) but can lead to increased book sales and sales of related products. It seems that people trust editorial more than advertising because the perception is that the material overcame close scrutiny to make it into the main part of the paper/broadcast, rather than purchasing advertising space.[1]

Tara Parker-Pope recently posted one of those ever popular lists: The 11 Best Foods You Aren’t Eating. As soon as HolfordWatch saw the title, we suspected that we were about to read a list from a nutritionist rather than a Registered Dietitian, and this was confirmed by:

  • the poor quality evidence given in support of list items
  • the inclusion of cinnamon for ‘blood sugar and cholesterol control’, and turmeric for its “anti-cancer properties”.

We don’t like to appear curmudgeonly and the list was mostly fruit and vegetables so perhaps this was only worth a “Tsk” before passing on to better-researched items.

But, the list was given the imprimatur of authority because it had been drawn from an article by Dr Jonny Bowden and itself drawn from one of his books. In a very short article, Parker-Pope gave Dr Jonny Bowden this form of address 3 times. However, it is unlikely that this would happen in the UK because Bowden has a PhD in Nutrition (pdf) from Clayton College of Natural Health[2] – the self-same place that awarded a PhD to Gillian McKeith, the one that the ASA was going to recommend that she should not use in some contexts because it is misleading. McKeith pre-empted the ASA ruling by voluntarily agreeing not to use it to promote her products.

Dr Bowden has the same alma mater for his PhD as Gillian McKeith, and, eerily, he is a CNS Diplomate of the American College of Nutrition (searchable database is down at present) – the institution from which Gillian McKeith mistakenly claimed accreditation. Gillian McKeith actually has an accreditation from the same institute as that which lent its lustre to Hettie (formerly, the feline companion of Dr Ben Goldacre). Bowden’s CV also lists a qualification that we hadn’t heard of previously: National Institute of Nutrition Education at American Health Sciences University: Degree: Certified Nutritionist (C.N.) We tried to look up more information but the American Health Sciences University seems to be in abeyance – even on the Wayback archive.[3] [See footnote for an update which reveals that this is not currently a degree but certification so it looks as if Bowden made an error when he listed it as such.]

15 times in the comments, Parker-Pope or Jonny Bowden respond to comments and refer to him as Dr Bowden. Comment 376, somebody asks if Bowden is a Registered Dietitian and Parker-Pope responds by quoting parts of his CV:

Dr. Bowden has a Master’s Degree in psychology and counseling and a PhD in nutrition, and has earned six national certifications in personal training and exercise. He is board certified by the American College of Nutrition. He is adjunct faculty at Clayton College for Natural Health.

One of those “six national certifications” is in metabolic typing and it has some unusual certification outcomes from an academic viewpoint..[4] In comments 405 and 443, commenters raised the issue of Clayton College of Natural Health (both link to Quackwatch on the CCNH) but Parker-Pope still hasn’t addressed the issue although she has responded to other commenters. (Interestingly, in comment 501, she drops the Dr when she advises someone on where she might purchase Bowden’s books.)

As far as HolfordWatch is concerned, people can promote lists of foods that they consider to be A Good Thing, Unduly Neglected, Ripe for Revival etc. to their heart’s content. We only demur if said list is presented with the imprimatur and respectability of someone with the title of Dr, when, in the UK, that title is awarded on the basis of a qualification that does not cut the mustard with our own Advertising Standards Authority and has been deprecated by several sources.

HolfordWatch also has a difference of opinion concerning the implicit clinical claims made for the state of the evidence about turmeric and cinnamon.

This is all very disappointing. HolfordWatch expected better from a paper of record like the New York Times. To add insult to injury, Parker-Pope has not clarified Bowden’s status for her readers despite commenters bringing it to her attention. Furthermore, she has gone on to post an item about a study that is so unexciting and lacking in novelty while also failing to make a substantial contribution to the scientific literature that it is difficult to understand why she is highlighting it: Lying About Your Vegetables. Regular readers might not be surprised to learn that this paper was published by Nutrition Journal: Effects of social approval bias on self-reported fruit and vegetable consumption: A randomized controlled trial.

This randomised control trial attempts to be both an observation study and an RCT: it is a very odd design. One would normally wonder what the reviewers were doing in letting this through but Nutrition is a pay-to-publish journal and although it styles itself as peer-review, it isn’t in the usual meaning of that phrase.[5] We find ourselves in some agreement with the criticisms of Nutrition and its peer-review policy in comment 78:

Some pay to publish journals are excellent but this is not one of them. [Nutrition] is also fast becoming the preferred publication venue for supplement companies…
This is an a faint echo of what is typically understood to be peer-review. Posting an online response to a paper means that it is not listed in PubMed – publishing a response that would be listed probably involves paying to publish your response (US$1900).

Readers expect better from a US paper of record. Not only that, but, as Goldacre highlighted recently, the NYT was the subject of the fascinating Phillips et al study: Importance of the lay press in the transmission of medical knowledge to the scientific community. Goldacre wrote:

Phillips et al showed, in a seminal paper from the New England Journal of Medicine in 1991, that if a study was covered by The New York Times, it was significantly more likely to be cited by other academic papers. Was coverage in the NYT just a surrogate marker for the importance of the research? History provided the researchers with a control: for 3 months, large parts of the NYT went on strike, and while the journalists did produce an “edition of record”, this was never published. They wrote stories about academic research, using the same criteria of importance as ever: the research they wrote about, in articles which never saw the light of day, saw no increase in citations.

People read newspapers. Despite everything we think we know, their contents seep in, we believe them to be true, and we act upon them.

So, whether somebody is seeking to increase their pundit brand equity or to raise the profile of an academic paper, it is significant if something is cited in the NYT.[6] One thing is clear, with all due respect to the well-credentialled shade of the long-dead Hettie, the NYT needs to pay more care and attention to selecting its sources for nutrition information if it is going to claim more authority for them than “X thinks eating this list of fruit and vegetables is A Good Thing“.

Update: In comment 636 RD Catherine Collins has commented on the value of a Mediterranean Diet and admonished the NYT.

It is rather sad the prestigious NYTimes should have to descend to the musings of self-styled nutritionists to support this weak article. I’m sure my American Registered Dietitian colleagues would concur with my opinions. Lets have more Michael Pollan, and less pseudoscientific nutrition. Your readers deserve better.

Although Parker-Pope has not yet put an addendum on her post that acknowledges the comments about Bowden’s PhD and other qualifications, she has stopped referring to him as Dr Bowden in the comments. However, this is not good enough and it would be better if she were to update her post.
Update 2: TPP continue to disappoint. She refers to him as Dr Bowden when discussing his qualifications in comment 672 and doesn’t elaborate on the PhD.
I would hope that the US Registered Dietitians and their associations will contact the NYT to express their displeasure about this item.
Update 3 July 3: Well, the embarrassment continues. We have added further information about the AHSU in footnote [3]. TPP continues to fail to answer reasonable questions about Bowden’s PhD and is now affecting not to understand english in spots. TPP apparently doesn’t understand the use of the word ‘topic’ and she is now concentrating on a defence of Bowden’s certification by the American College of Nutrition. TPP is ignoring a perfectly clear set of questions in comment 700; and some pertinent observations in #733.
In perhaps one of the oddest comments that I’ve seen, TPP writes:

It doesn’t matter to me if somebody’s degree is from Harvard or a local community college. What I’m interested in is the science and evidence that backs their claims.

Which would be commendable if the evidence that she provided for cinnamon and turmeric were not so poor and unrepresentative of the state of the scientific literature on this point.

Notes

[1] Advertising equivalents are a frequent topic for discussion. Proving the value of public relations gives a good overview of the current state of this discussion: Advertising Value Equivalents Revisited.
[2] The PhD must be quite a recent acquisition because as recently as 2005, Jonny Bowden was listing MA CNS as his qualifications: see the cover of Living the Low Carb Life. HolfordWatch’s first sighting is the cover of a CD in 2006. As for the PhD itself, the Clayton College of Natural Health states its accreditation as follows:

Clayton College is accredited by the American Association of Drugless Practitioners and the American Naturopathic Medical Accreditation Board . The International Iridology Practitioners Association accredits CCNH’s Iridology Certificate program. These private associations offer professional accreditation in the field of naturopathy and other areas of natural health. As such, they are designed to meet the needs of non-traditional education and are not recognized by the United States Department of Education…Clayton College is licensed by the Alabama Department of Postsecondary Education. [Emphasis added.]

There is some cause for concern here. Some people are attempting to use the visibility and media status of people like Jonny Bowden to amend the Wiki entry about CCNH which currently quotes the QuackWatch view. It would be ironic if somebody were to gain pundit brand equity through non-standard qualifications and that pundit equity was then used to validate the ‘respectability’ of the course and give it standing in the mainstream.
The CCNH was formerly known as the American Holistic College of Nutrition: it was known by this name when Gillian McKeith acquired her PhD from this institution.
[3] This degree from National Institute of Nutrition Education at American Health Sciences University is also mentioned at Quackwatch. AHSU is discussed at Quackwatch.

American Health Science University offers a Certified Nutritionist (CN) credential to students who complete its six-course “distance learning program” and take an examination. Although accredited, it is closely aligned with the health-food industry and should not be regarded as trustworthy. Its president, James R. Johnston, does not appear to have a accredited doctoral degree.

The CNS from the American College of Nutrition requires “requires an advanced degree, professional experience, and a passing score on the CBNS certifying examination”. The exam is described thus:

Examinees for certification as Certified Nutrition Specialists will be allowed four hours to complete the examination. The examination questions will be drawn from a bank of questions submitted by examination committee. The examination will consist of 200 questions, all in single-answer, multiple choice format, and will cover the broad spectrum of basic and applied nutritional science. Themes such as nutritional science, nutrition assessment, treatment outcomes, epidemiology, and integration of these areas are threaded throughout examination. An adjusted score of 65% is required to pass the examination.

However, it is remarkably unfortunate to have ‘qualifications’ from CCNH and ASHU on the same C.V. as it detracts from a more bona fide qualification such as the ACN board certification.
Update July 3: We managed to contact the AHSU. AHSU state that they offer a certification,
and not a degree so we have to assume that Bowden made a mistake when he listed it as a degree on his CV (pdf). ASHU states that this qualification is suitable for candidates with no science background, and can be completed in 2-3hrs/week over 15-20 months. They report that they’ve had candidates complete the course in eight months. The certifications costs about $3100 in course fees.
[4] You can read all about Bowden’s Certificate in Advanced Metabolic Typing and Analysis. Successful certification allows:

access to the online questionnaire. This questionnaire is a thorough and accurate computerized test, based on over 25 years of clinical experience analyzed at Healthexcel, Inc. The Advanced Program identifies Metabolic Types (autonomic, oxidative, endocrine), proper diet plans, Candida Albicans Overgrowth propensity, and life-style considerations.

One of the outcomes from certification is “40% commission for supplement orders from your clients through Ultra Life”. Oddly enough, the outcome of going through this online questionnaire is a programme of recommended supplements – ones that you can purchase from your nutritionist who is entitled to a 40% commission for any client orders placed through them. Depending on how many clients you persuade to purchase the designated supplements, the course price of $445 for the online version or $795 for the workshop version may represent good value and open up a good ROI.
[5] From Nutrition Journal‘s Peer Review Policies:

Each manuscript submitted to Nutrition Journal will be assigned to one or two external reviewers for peer-review, which is normally completed in 2 to 8 weeks. In deciding whether to accept or reject a manuscript, a reviewer asks him/herself whether the scientific community is better served by publishing or not publishing the manuscript. In the absence of compelling reasons to reject, Nutrition Journal advises that reviewers recommend acceptance, as ultimately the quality of an article will be judged by the scientific community after its publication. [Emphasis added.]

[6] It would be invaluable if somebody were able to design a study that assessed the impact of (say) the NYT’s blogs. Would the impact be diminished because it is a blog rather than the paper? Do more people find the papers because they are actively linked from blogs (although, the NYT is notable for its policy of linking to papers that it discusses in health and science articles)?

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27 Comments

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27 responses to “Tara Parker-Pope and Jonny Bowden

  1. This is rather like nutritionist bingo – Clayton College…and, of course, delicacies like beet juice and blueberries in chocolate soya milk.

  2. It is, isn’t it? It’s a shame that Ben Goldacre was never able to gather together the readies to purchase a Clayton MSc and PhD for Hettie. However, he does make this generous offer:

    if anybody wants nutritional advice from the decomposing corpse of my ex-cat, I shall be setting up a small shrine at the bottom of the garden, where you can leave chewed mice, ready cash, and offers of a primetime TV series on Channel 4.

  3. Wulfstan

    I know that this is light-hearted but what is the NYT coming to – promoting this stuff and nonsense? If they are unaware of the value of allocating ‘editorial’ space to this sort of nutritionist or poor excuse for scientific paper then it is time that their editors reminded them.

    otoh, I would like to see a Venn diagram of Hettie, Jonny Bowden and Gillian McKeith – obviously, Gillian would be the overlap between the others.

  4. I agree, sometimes I read TPP and it makes me cringe. She’s not a horrible health writer, but she’s also not a person that people should be looking up to as a source of all things health and nutrition. Unfortunately, because she writes for something as august as the NY Times, people are going to think that she hung the moon.

    That said, she (and her ‘experts’) are not saying anything different from the nutritional advice I see in my ‘Runner’s World’ or ‘Shape’ every month.

  5. I can’t disagree, Scicurious. As you say, the difference is the NYT’s reputation and influence. I’m not that familiar with Runner’s World or Shape but I doubt that either of them shift the citation patterns of academic papers in the way that Goldacre describes. And I doubt that “As featured in…” has the same cachet as it does for the NYT or similar papers of record.

    This was such an easy article for her to write as it was basically a re-hash of an article by Bowden. It behoved her to spend more time checking Bowden’s credentials and status rather than thinking it was enough to cut and paste them without investigating them further.

    Similarly, apart from introducing Pollan angle, the post on the Nutrition journal paper was an easy one – again, she should have checked the source.

    Plus, the links she gave for the turmeric and cinnamon claims were poor, lamentable, and she neglected to mention that the cinnamon review was supported by a grant from a manufacturer of a cinnamon and cassia product. I just feel that she would fail the Schwitzer and Health News Review test for this item.

  6. Claire

    I noticed somewhere in the (huge) tail of comments Mr Bowden promoting raw milk, now becoming fashionable and promoted for all kinds of chronic disorders. IIRC ‘I’m big on raw milk’ was his comment – don’t have time to go back and find it. Did anybody pick him up on this? –
    the FDA begs to differ, e.g.

    http://www2.guardian.co.uk/worldlatest/story/0,,-7578800,00.html

  7. Tony Wellcome

    If you don’t want to have your comments lost in that really long thread, is it OK if I post some of your material on cinnamon and turmeric – with attribution?

  8. Yes, go ahead, however, I would caution that from the look of that thread, I doubt that many people are interested in the state of the scientific evidence rather than the claims. On her recent form, I would be surprised if TPP addresses any counter-arguments.

    No idea about the raw milk (comment 63). It is odd as the NYT ran some good articles not that long ago on the hazards of raw milk.

    Edit: less about the hazards then I seemed to recall. Making Their Case for Raw Milk.
    Despite Strides, Listeria Needs Vigilance.

  9. Pingback: Tara Parker-Pope suggests that consulting a nutritionist if “on a renal diet in advanced stages of CKD” « Holford Watch: Patrick Holford, nutritionism and bad science

  10. Pingback: Cialdini and Consistency: Why This Might Influence Trust in CAM « Holford Watch: Patrick Holford, nutritionism and bad science

  11. You are certainly welcome to attack my credentials and to dismiss my recommendations about healthy food. But allow me to correct a few factual errors.

    In no particular order of importance:

    The “certification in metabolic typing” that you spend so much time attacking is not one of the certifications I refer to in my bio. I did indeed take this course, but I did not find it particularly helpful. I do not use it, do not sell any of their supplements, and have nothing to do with it. Nice people, good idea, but not something I practice or advertise. My national certifications that i refer to in my CV are in exercise from such organizations as American College of Exercise, American College of Sports Medicine and National Academy of Sports Medicine. I do not keep these certifications current since I no longer practice personal training and am more likely to be lecturing at their conferences these days than to be attending them as a student.

    I do not know this Gillian person and no nothing about her travails.

    My Masters degree comes from a very highly respected bricks and mortar school in New York City, the Graduate Faculty for the New School For Social research. My MA is in psychology and is a rigorous science program for which i took years of statistics and research design.

    I chose Clayton because it has a very excellent albeit non traditional curriculum in areas I wished to learn more about, like Ayruvedic, Traditional Chinese Medicine, and the like. Clayton is an “alternative” school, yes, but one which won an award for excellence from the US Distance Learning Association.

    A more general correction: You should understand that being a Registered Dietitian simply means someone has gone through a very very conservative, traditional program of two years of study and joined the ADA “union” which fights tirelessly to keep anyone but its members from speaking in the public square about nutrition. There are many- many- superb nutritionists (MDs, PhDs, MS’s, CNN’s, CNS’s) who are not RDs and whose knowledge dwarfs that of the average RD. I am not asking you to consider me one of these brilliant ones- I’m simply saying that they’re all over the place and they tend to scoff at the RD designation. The typical exam question for the CNS exam (which is given by the American College of Nutrition) asks something like “the product of enterokinase reactions is….”. (taken from sample questions, Exam Study Guide 2nd edition). The typical RD exam question is “what are the ingredients in a lemon meringue pie?” Whatever you think of me personally, please don’t perpetuate that RDs are the only people who know about nutrition. That is like saying that only right wing politicians in the US know about the Iraq war.

    Finally a word about magazine writing in general. Articles like this are for the general public, and are meant to be fun and light. “11 foods you might not be eating”, “five great exercises you might not be doing”. This was not meant to be an exhaustive list of every food you must eat and why. It was a distillation of my reading of the literature and some healthy suggestions that some people would like. I’m actually kind of flabbergasted at the viciousness of the response, as if questioning where I got my education is really relevant to the question of whether or not you should eat high omega-3 foods. Would you feel better about my recommendations if Ms. Parker Pope had simply referred to me as “Jonny”? That’s fine with me. I’d just like you to be healthy.

    Finally, a word about “evidence”. Most evidence on food is suggestive not definitive. It comes from lab studies of individual nutrients (which don’t really reflect how nutrients work synergystically), it comes from epidemiological studies linking eating patterns with certain outcomes, and it comes from an awful lot of “connecting the dots”. Recently the NY Times did a cover story on a cancer drug that costs 100,000 a year (Avastin) which is being used widely and promoted by cancer docs and which has woefully less “evidence” of helping people than any of the foods on my list.

    I’m sorry you were so offended by my suggestions. I wasn’t trying to cure cancer. I was trying to suggest some healthy foods to eat.

    Sincerely,
    Jonny Bowden

  12. We were taking our information from the links on your own site. E.g., the CV on your site lists the certification in Metabolic Typing which seems to make up one of the 6 certifications to which TPP referred.

    Similarly, had you clicked on the link and read the text we supplied, you would have learned that you and Gillian McKeith share an Alma Mater in CCNH and that it is a qualification that has been deemed misleading in some contexts by our Advertising Standards Authority. It seems that it mislead people into thinking that she had medical qualifications or that she had actually researched a topic in nutrition for her PhD.

    RDs have 4 years training in the UK. However, having obtained a course catalog from CCNH, it is both gratifying and amusing to read that you appear to disdain the content of formal academic courses. Although it is good to learn that you have at least an exam familiarity and facility with enteropeptidases.

    We are somewhat taken aback by your reference to viciousness. It’s hard to believe that you are the same writer who referred to Jane Brody as the Nutritional Antichrist and adopted cliches that implied physical violence.

    As you have now pointed out, some of the evidence concerning food and nutrients is equivocal – that is certainly a nuance that is missing from some of your writing and some of your interviews.

  13. Tony Wellcome

    It’s worth quoting more of that deplorable piece about Jane Brody in case it disappears.

    I frequently find myself stifling some of my more pugilistic tendencies when it comes to speaking out against public idiocy, largely out of an ill-advised desire to remain objective, impartial, above-the-fray, and ‘respectable’. ..

    When it comes to nutrition, Jane Brody is an idiot. She is a know-nothing who repeats any crap the American Dietetic Association tells her, she’s incapable of reading or understanding complexity of thought, and she’s not much better than a paid shill for the worst elements of the dietary establishment and the American Medical Association. She’s basically the Nutritional Antichrist. …Thanks for being brave enough to point out that the emperor not only doesn’t have any clothes, she also doesn’t look particularly good naked.

    It is surprising that Bowden regards the comments he has read as vicious give his own style. Rather like Holford in that regard, it seems.

    Plus, is it just me, or is there a nasty smell of misogyny in that attack on Brody?

    You can get your nutrition and medical news by reading the journal articles directly, combing through PubMed, going to conferences- or by reading people like Tara and me in our respective media, who collect and filter that information and then report on it. [Bowden response to 700.]

    Given the self-lauding comments about his own writing and interpretative skill and those of Tara Parker-Pope, are we to infer that some health writers are less equal than others and if so, does it not follow that some writers might over-value their own abilities in that field?

    It certainly wasn’t my impression that either Bowden or TPP had given a reasonable overview of the state of the literature for some of those recommendations such as cinnamon and turmeric.

  14. clare

    Yes it is interesting that you lot believe that the only poeple who know about nutrition are RDs, how so narrow minded

  15. Wulfstan

    Clare, your lack of reading comprehension never fails to disappoint but is strangely comforting in its predictability. However, let’s celebrate that you are not shilling for supplements for once.

    Did you listen to the Radio 4 programmes on This Rise of the Lifestyle Nutritionists? If so, you would have heard from some excellent Professors of Nutrition such as Tom Sanders who had some stinging opinions of the knowledge of Patrick Holford and other nutritionists like him.

  16. Mary Parsons

    Have to say that I don’t see any attack on credentials – it’s more fair comment. Particularly when compared and contrasted to Jonny Bowden’s attack on Jane Brody (now, that was an attack and I think there is a stench rather than whiff of unpleasantness.)

    Jonny Bowden doth protest too much methinks. I feel sorry for any recognisably and appropriately credentialled nutritionists like Profs Summerbell, Sanders and Stein that have to put up with being lumped together with CCNH pseudo-qualified graduates and people who have attended a few lectures or taken a home correspondence course. However, they should be more aggressive in making sure that the wider public understands the difference.

  17. Rise of the Lifestyle Nutris? Spooky. I was listening again to part one earlier. Listen Again Here
    Part two featured everybody’s fave media nutritionist.

  18. Thanks for the link, jdc. I wasn’t sure how long those programmes stayed up; it’s good to know that they are still available for people who may have missed them.

  19. @Mary Parsons, I don’t know if you have seen the discussion about the BDA’s responsibility for allowing confusion about nutritionists and dietitians to stand unopposed.

    @Wulfstan as well. Too many professional bodies have stood aside and allowed this to happen.

    Credulous coverage in MSM and lack of willingness to defend their status has led to the wretched state of affairs that we now have in the UK.

    @Tony Wellcome and others – yes, that post about Jane Brody and similar ones are particularly unpleasant. And, yes, the parallels with Holford are striking.

  20. Pingback: When did Jonny Board become a Certified Nutritional Specialist « Holford Watch: Patrick Holford, nutritionism and bad science

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