Patrick Holford Loathes Reductionists, So What About His Advert for His Pills?

Patrick Holford and Bioharmony advert

Patrick Holford and Bioharmony advert

Former Visiting Professor Patrick Holford is still Head of Science and Education at Biocare. This senior appointment might give the wary some food for thought if they should decide that they need an evidence-based supplement or lifestyle advice and are wondering whether Biocare is an adequate source for either/both. Biocare claims have a team of qualified nutritionists and scientists” (my emphasis) working for them yet they don’t seem to have noticed Holford’s lack of relevant credentials. This rather makes a nonsense of their undertaking to provide science-based information:

We recognize the importance of education in order for the customer, whether a healthcare professional or a member of the public, to make informed choices about what natural substances may be of benefit to them or their patients as part of a healthy lifestyle. BioCare will be launching http://www.biocarescience.co.uk to provide in-depth scientific information on the natural ingredients that make up our unique formulations.

You may recall that Holford recently compared himself to ‘de Vinci’ in his dislike of reductionists. We mention this because we have recently received a copy of one of Holford’s adverts and we have reproduced part of it (click on it to read it in its enlarged horror or content yourself with extracts below). Amid the usual unsubstantiated claims about extensive research is a paragraph that would look awfully like reductionism if someone other than Holford were responsible for it.

At the ION, Holford and his associates asked: “What intake of vitamin X equates to the maximum possible wellbeing and the greatest possible reduction in risk of disease?”

Eatwell has some useful information about vitamins and minerals for different ages and stages of life and definitions of Recommended Daily Allowances and Dietary Reference Values.

DRV is a general term used to cover:

  • Estimated average requirement (EAR): This is the average amount of energy or a nutrient needed by a group of people.
  • Reference nutrient intake (RNI): The amount of a nutrient that is enough to meet the dietary needs of about 97% of a group of people.
  • Lower reference nutrient intake (LRNI): The amount of a nutrient that is enough for a small number of people in a group with the smallest needs. Most people will need more than this.
  • Safe intake: This is used when there isn’t enough evidence to set an EAR, RNI or LRNI. The safe intake is the amount judged to be enough for almost everyone, but below a level that could have undesirable effects.

A full list of DRVs can be found in the ‘Dietary Reference Values for Food Energy and Nutrients for the UK’, Department of Health, 1991: Report of the Panel on DRVs of the Committee on the Medical Aspects of Food Policy (COMA).

You may have noticed that, contrary to the text in Holford’s advertisment, there is no indication that RDA’s (now DRVs) were ever set just about the level to avoid the diseases associated with vitamin deficiency, such as “scurvy, beri-beri and pellagra”.

Holford has steered away from using Recommended Daily Allowance (RDA) levels of nutrients as these are the very basic levels prescribed by governments to avoid obvious vitamin diseases such as scurvy, beri-beri and pellagra.

Not that he is entirely consistent even about this:

Holford says RDAs are average measures aimed at average health.

Average health strikes me as a good deal better and a long way away from scarcely avoiding diseases such as “scurvy, beri-beri and pellagra” and even Orthomolecular.org doesn’t offer such a biased interpretation. Orthomolecular.org says:

The Recommended Daily Allowance (RDA) of the United States Food and Nutrition Board are intended for normal, healthy people. By definition, sick patients are not normal or healthy and not likely to be adequately served by the RDA. [Point 5]

But anyway, Holford wants to perusade the consumer that he or she is sick and in need of supplementation in the form of his Optimum Nutrition Formula that delivers Optimum Daily Allowances for which there is no peer-reviewed, published justification from Holford and for which there are there are no prospective trials to demonstrate their value.

Beyond that, it is interesting that the Bioharmony Optimum Nutrition Formula contains vanadium which is not permitted as part of supplements in the EU unless a particular country has a derogation (the UK no longer has a derogation and “any food supplements already in existence containing them can no longer remain on the market or be placed on the market”). Holford does not give any reason as to why he includes vanadium (neither there, nor in his New Optimum Nutrition Bible) when there is no indication of a need for supplementation as it is:

  • readily available from the diet
  • there is no accepted function for it.

It is also slightly odd that vanadium is listed in the ingredients list when it really should be one of its 6 forms (it doesn’t occur independently) such as vanadyl sulphate (vanadium forms are typically used as a colour fixer and binder in a supplement pill).

But, there you have it. Vanadium can not be sold as a food supplement in the UK but Holford includes it in his Bioharmony Optimum Nutrition Formula for South Africa without stating any reason why or hinting at the dreadful disease relating to vanadium deficiency that consumers will now be spared. Holford accuses others of reductionism but poses questions such as “What intake of vitamin X equates to the maximum possible wellbeing and the greatest possible reduction in risk of disease?”

And, if anybody’s interested, Patrick Holford’s Biocare range, the one carefully formulated and endorsed by Biocare’s Head of Science and Education also lists vanadium as part of the Optimum Nutrition Formula that is sold in the UK.

On the UK, but not the SA website, you will read this warning about vitamin B6:

Long term intake of amounts greater than 10mg of Vitamin B6 may lead to mild tingling and numbness.

Note that the consumer is advised to take 2 tablets daily and that if you do so, you will be supplementing a total of “20mg Vitamin B6 (as Pyridoxine Hydrochloride and Pyridoxyl-5-Phosphate)” per day. But somehow, that is probably in the spirit of an article about vitamin myths in the Orthomolecular Medicine newsletter:

Since vitamin myths persist, the facts of orthomolecular medicine must be presented in straightforward, memorable terms, such as:
“The number one side effect of vitamins is failure to take enough of them.”
“Negative vitamin studies use low doses. Positive vitamin studies use high doses.”
[Emphasis added.]

As we mentioned above, “BioCare will be launching http://www.biocarescience.co.uk to provide in-depth scientific information on the natural ingredients that make up [their] unique formulations”: it will be interesting to see if one of these explanations is a defence of vanadium. If not, it’s unfortunate that Holford was unable to anticipate the european directive concerning vanadium. We trust that the current Biocare formulation will be removed from the market very soon and replaced with a formulation that does meet european standards. It might also be helpful if the Bioharmony.co.za site were updated to reflect some of the additional information that is available on the UK site.

We would hope that the claim that people meeting the RDA/DRV for various nutrients will not read Holford’s advertisements and be alarmed that they are teetering on the brink of “scurvy, beri-beri and pellagra” or such. As for the “What intake of vitamin X” conundrum, if Holford were to consult a dictionary, he might find his own photograph with the caption, “Reductionist: a notable figure” and that phrase used as an example to us all.

BPSDB

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8 Comments

Filed under patrick holford

8 responses to “Patrick Holford Loathes Reductionists, So What About His Advert for His Pills?

  1. superburger

    Here is a SA TV advert for BioHarmony featuring Holford

  2. I just noticed that Holford seems to be recommending 10mcg per day for Manganese. Most supplements containing Manganese have it in milligram rather than microgram amounts. I’ve seen anything from 0.5mg to 5mg, but nothing as low as 10mcg. Maybe he means 10mg? Although…
    Eatwell says of this mineral with regards older supplement users: “Using the NOAEL from the Kondakis study, it can be assumed that up to 0.5 mg/day manganese (equivalent to 0.008 mg/kg bw for a 60 kg adult) in addition to the diet would not result in adverse effects in older people” and the FSA met with supplement companies selling products containing greater than 0.5mg Mn and asked them to include a warning on the pack. No agreement between industry and the FSA was reached on this warning, but I think that, speaking personally, I would be rather wary of advising the general public to consume 10mg Mn per day without warning the elderly. I’ve read that there did used to be an RDA for Manganese in the region of 2.5-5mg, but I think that because manganese deficiency has only been observed under experimental conditions, the RDA was removed. [Can’t find confirmation of this on any reliable sites at the mo, so am a bit unsure if this is actually true]

    And 100mcg for Chromium? COMA reckons “an adequate level of intake for trivalent chromium lies above 0.025 mg/day for adults and between 0.0001 and 0.001 mg/kg/day for children and adolescents”
    0.1 to 1 mcg is adequate for children and adolescents, but PH thinks 100 times the upper amount I quote is “optimum”? And he’s basing this on… peer-reviewed, published justification? Oh. He isn’t. Oh dear. Happily, the EVM state that “ingested trivalent chromium has a low level of toxicity, due partly to its poor absorption”, but they also point out that “the data on oral chromium toxicity are limited” so I think I’d be rather reticent to recommend levels much higher than those cited by COMA (about four times the recommended level for adults and one hundred to one thousand times the level for children and adolescents.

    [Sorry for the horrendously long comment. I’ll probably be back in a bit once I’ve read the Orthomolecular site, so you should probably brace yourselves for more verbiage]

  3. I’m back. Orthomolecular.org has a ‘myths’ page.
    “Myth: Vitamins are dangerous.
    Truth: In over the past 10 years, no one has died from taking vitamin supplements.”
    In their minds danger = death. Even if that were a fair point, Bjelakovic tells us that certain antioxidant vitamins may increase mortality [treatment with beta carotene, vitamin A, and vitamin E may increase mortality and the potential roles of vitamin C and selenium on mortality need further study] – I think the people behind the Orthomolecular may be referring solely to a lack of acute toxicity cases causing death, which is a bit different to a blanket statement that vitamins are not dangerous.

    “Myth: No one is deficient of essential nutrients” is followed by the stated fact that 50-60 per cent of Americans (up to 75 or 80% for some nutrients) are failing to achieve the RDA for certain vits and mins. That they are not achieving the RDA (I note that just how far short of the RDAs these Americans were falling is not specified by Orthomolecular) does not mean that they are deficient in vitamins. If I may quote Derek Shrimpton –
    “The term [RDA] recognises that particular groups of individuals (E.g. infants and those over 60) have different needs and for each group, the intention was to be sufficiently generous to encompass the presumed (but unmeasured) variability in requirement among people. This meant that the value was usually set deliberately high”, so… we are all different, we all require different amounts of vitamins and minerals [as any nutritionist will tell you], but this doesn’t mean that RDA amounts are likely to be insufficient for some of us – given that RDAs are usually set deliberately high it’s actually more likely that they are over and above our needs rather than being ‘sub-optimum’. I wonder how many people who have seen Holford’s ODAs in the Optimum Nutrition Bible are aware of that?

  4. UK dietitian

    well done Holfordwatchers in explaining nutrient requirements – and demonstrating again how Holford fails to understand the basic science out there.

    Wonder how Biocare reconcile this oversight?

  5. The nonsense about RDAs in the advert is par for the course for the patrickholford.com website and the books.

    If there is one predominant message that should be clear, there is no multivitamin formulation/panacea that suits all ages and stages of life and for many reasons (including some of the fine points that jdc adds above) I’m not sure that promoting the idea that there is a good foundational multivitamin that suits all adults is an exercise that has any merit.

    I have no idea why Biocare believes this to be a formulation that is grounded in solid research from an appropriately qualified person. It is lamentable that people rely on them for appropriately-researched and justified products yet they are happy to include a product and range like this.

  6. Mojo

    “Biocare claims have a team of “qualified nutritionists and scientists” (my emphasis) working for them yet they don’t seem to have noticed Holford’s lack of relevant credentials.”

    What qualifications or credentials does he need to call himself a “nutritionist”?

  7. Strictly speaking, none. However, there seems to be a recent move towards distinguishing nutritionists (with degrees in nutrition, food science and similar) from ‘nutritional therapists’ who have studied with the ION or similar.

    It is all very odd.

  8. Pingback: Vitamins and Minerals: The Truth About Deficiency and RDAs « jdc325's Weblog

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