What do they teach people at the Institute for Optimum Nutrition? When the founder of one’s alma mater is Former Visiting Professor Patrick Holford this might, occasionally, give one pause as to exactly what is taught to the aspiring cohorts of students of nutritionism. Patrick Holford set up the Institute of Optimum Nutrition as a limited company, back when he was in such a state of despair as to the disparity between his own auto-didact expertise and that of people who had actually studied the topic for several decades and researched it in rigorous detail, that he felt that he had no option but to set up his own institute of learning to spread his own special take on nutritionism throughout the tranche of gullible like-minded, well-heeled seekers after knowledge.
Given that Patrick Holford was still entranced by the promise of kinesiology and dowsing in the diagnosis of food allergies and the need for supplements at that time, it would be fascinating to know more of the early curriculum. One would hope that the current curriculum is free of such nonsense (albeit, the heavy reliance on YorkTest’s IgG blood tests for food intolerance would suggest not). Sadly, recent nonsense from IONistas poses the question as to whether the standard and content of the teaching has really changed that much.
We’ve highlighted IONista Fiona McDonald Joyce’s somewhat unusual (and erroneous) claim that chicken drumsticks and thighs are leaner than breast meat and that breast meat has a higher glycaemic load (it doesn’t have any carbs and so, can not have a meaningful glycaemic load). Now, after Dr Ben Goldacre’s classic pwnage of detox on the Today programme, we learn that the hapless Detox in a Box entrepreneur is being advised by Diana Green, an IONista who brings her own special typos to the party.
I am Diana Green, a qualified, associate member of the Institute for Optimum Nutrition, one of the leading Nutritional Institutes in the country providing a high standard of education based on up to date scientific research. See my Notes from our Nutritioinst page.
I am also a member of the British Association for Nutritional Therapy (check out BANT at http://www.bant.org.uk)
Diana Green lists her qualification as Dip. in Nutritional Therapy rather than Dip.ION so there is a reasonable chance that she qualified quite some time ago and may have received most of her training from Patrick Holford.Patrick Holford is, inevitably, a fan of detoxing and uses it to make some of his more elaborate and disturbing analogies.
We are threatened by internal toxins as well as external ones. For example oxygen, the basis of all plant and animal life, is our most important nutrient, needed by every cell every second of every day. It is also chemically reactive and highly dangerous. In normal biochemical reactions oxygen can become unstable and capable of ‘oxidising’ neighbouring molecules. This can lead to cellular damage that triggers cancer, inflammation, arterial damage and ageing. Known as ‘oxidants’, this equivalent of ‘nuclear waste’ must be disarmed to remove the danger. Oxidants are made in all combustion processes including smoking, exhaust fumes, radiation, fried or barbecued food and normal body processes. Antioxidants disarm these harmful oxidants.
Yes, absolutely the equivalent of “nuclear waste”. And it’s not as if the antioxidant hypothesis and the virtues of supplementation hasn’t taken a pounding this year. Is it any wonder that Dr John Crippen styles such wibble as the “eclectic concatenation of cod science”?
Anyhow, one must assume that this sort of nutritional and lifestyle wisdom is common to IONistas. This may explain why Diana Green may be responsible for the misguided comments on the sample menu or has not seen fit to advise Detox in a Box that they should not promote nutritionism and nonsense. For reasons of fashion rather than nutritional evidence, the menus offered by Detox in a Box contain neither of those scapegoats, dairy or wheat (apparently, dairy products “can slow down digestion and detoxification” – who knew? Certainly no one who is indexed in PubMed).
We do always take account of your allergies and food preferences. We do not use wheat, red meat or any diary products. [sic]
We direct your attention to the interesting claims on the sample menu of Day 1 that “1/2 tsp of cinnamon per day helps lower cholesterol!” (we have covered the issue of cinnamon at some length as Holford regularly promotes the health-giving benefits of cinnamon supplements although there really is little clinical support for such a claim in the non-diabetic population); “Tuna helps lower blood pressure and is a rich source of nutrients!” (Pubmed doesn’t have much on the topic of tuna rather than other fish for this astonishing benefit); and “Garlic a great antioxidant, helps protect against damaging free radicals!”.
Day 1 Menu from Detox in a Box
Your mileage may vary, but given the usual nutritionista snootiness about jam, we can only assume that the company has managed to source an extraordinarily high-quality, no added sugar conserve for Day 2 menu’s breakfast that consists of melba toast with “Fig and Apricot jam”: “Figs are a great source of fibre and have a positive effect on weight management”. Just how much fig jam are people expected to eat for this to be true? According to USDA, a medium-sized fig (50g) has around 1.4g of fibre: we don’t know how much is in this jam but we doubt it is enough to justify painting our delight on banners. Mung beans (as served with lunch) may well have “a low glycemic index and are rich in antioxidants!” but the glycaemic load of that meal will owe more to the fat and protein content of the egg mayonnaise that accompanies it and the quantity of the red rice salad.
Day 3’s menu reaches a new low spot with the hyperbole for the squash and aduki bean casserole:
Aduki beans are said to be “The Slimming Bean”, they promote regular bowel movements & strengthens the kidneys!”.
We couldn’t begin to comment on where these people picked up this information about aduki being known as “the slimming bean”, far less ‘strengthening the kidneys’. We refuse to comment on the bowel movements.
Day 5’s menu frisks about like a wet puppy shaking off woo-ster claims rather than water: “Pumpkin seeds are a natural depression cure!…Lemon helps maintain healthy teeth and bones!…Olives help delay the effects of ageing”. Anyone know of a seed or fruit that confers emotional fortitude to bear up under such nonsense?
Day 6’s menu is a humdinger: “Oats Reduce hardening of the arteries!…Aubergines help reduce high blood pressure & protect the heart!”.
Day 7’s menu is a little short of content but that possibly says something about the amount of food that I eat in a day but it does tantalise us with this comment on the Persian herb and pearl barley soup: “Since the dawn of time herbs have promoted health & well being!”. That’s obviously why life-expectancy in Europe has doubled in the last century, then.
For these astonishingly evidence-free and optimistic claims, the company charges an individual more than £100 per week to feed you every day (£16.50 per person, per day). Presumably, the liberal sprinkling of exclamation marks and inappropriate capitalisation is there to distract the reader from the extraordinary cost of these meals and any gnawing reflection that if you wanted to eat like that, then it would be possible to eat like that for substantially less financial outlay. And, maybe, just maybe, some of those nutritional claims would not stand up to much scrutiny. However, you would be cleansed of these doubts the moment that you read this comforting statement:
Detox-in a box is proven to work with men & women
Marvellous. It would be good to see the evidence but one can only assume that the company wouldn’t make such a strong claim without appropriate support.
Detox in a Box has now removed the more egregious claims that their detox system removes heavy metals from the body and other such nonsense but the remainder stands. Yet again, one wonders what is taught to these nutritionistas at the ION. One worries that practitioners with such qualifications have been given a new respectability by the HPC (pdf). People are free to spend their money as they wish but it should be possible for companies to market such services without abusing science and distorting it to pretend that it supports their nonsensical claims for their products.
The Advertising Standards Authority currently has no jurisdiction over the accuracy of text that is on a commercial website and Trading Standards is so overwhelmed that they seem to have few resources and little inclination to investigate such matters.
Ultimately, of course, the pwnage of detox and Detox in a Box is irrelevant: the same person so comprehensively trounced by Ben Goldacre was back on a different BBC programme, selling her wares, with no reference to the former debacle, just a matter of hours later. As Goldacre says in Bad Science
As ever, Tessimond’s The Ad Man seems an appropriate conclusion:
He hunts for ever-newer, smarter ways
To make the gilt seem gold; the shoddy, silk;
To cheat us legally; to bluff and bilk
By methods which no jury can prevent
Because the law’s not broken, only bent.
Update: Dr*T offers us Doc mocks detox in a fine attempt to forge a new career as a tabloid headline writer. Professor David Colquhoun offers an excellent overview of the brouhaha and the media outlets that have covered the detox story. Dr John Crippen of NHS BlogDoc has also shared his own delight at the BBC Today item: The Detoxification Fraud and offers his own variation on “I would invite you to notice that they win”.
Detox in a Box is an easy target for anyone with a modicum of common sense. But there some serious points. In the first place, why do the BBC give people like Nas any exposure at all? There is no such thing as bad publicity for these people. “Dr” Gillian McKeith is still trading, and I have no doubt that Nas Amir Ahmadi MD will continue in business as well. Nas is not a doctor, by the way. MD stands for Managing Director, not Doctor of Medicine. Nice try, Nas.
In the second place, family doctors are inundated with New Year’s resolutioners all looking for a quick fix for months or years of excess. There isn’t a quick fix. Much can be done, but it takes time and patience and it involves following a lot of advice that is deemed to be boring. More exercise, less alcohol, a balanced diet, and don’t eat in between meals. You know it makes sense really but your heart starts to sink, allowing Nas or one of her cronies to pounce with promises of easy solutions.
Holford Watch: Patrick Holford, nutritionism and bad science 
While the claims made for the menus aren’t exactly evidence-based, there is evidence that a familiar approach to describing one’s own qualifications may have reached detoxinabox.
Exaggeration and distortion at every term, whether it’s their education or their pretensions to their work being supported by “up to date scientific research” – perhaps there’s a pill for it.
That and chutzpah – for I gather that there was absolutely no break in Nas’ demeanour following the pwnage when she appeared in another BBC programme. One has to admire the resilience if nothing else but you sometimes wonder if some of these people actually understand that their entire intellectual foundation has disappeared beneath them.
Mind – it’s never stopped actual IONistas, why should it be different for an HND (?) graduate of the Dorset Institute.
Like you say, this is obviously a rich source of nutritionista nonsense but it is unnerving to think that this run of woo is par for the course for people who study at the Institute of Optimum Nutrition.
It makes it almost beyond belief that these people will be recognised by the HPC and that the ION is spoken of as an academic institution.
Wulfstan: Maybe we need a word for this kind of institution. Pseudo-academic is a bit wordy. Crackademic? Woo-niversity?
Actually, all they have removed (as far as I can see) is the names of specific metals; the claim that “One of the most complex detoxification functions is against heavy metals” is still there.
Neuroskeptic, do you have Dr R W’s fine quackademic in mind? I like woo-niversity, though – it sounds like one of the characters from a Dickens’ novel trying to promote something – maybe a little something that produces prodigies such as The Infant Phenomenon.
Mojo – true. Always trying to give people the benefit of the doubt and where does it get us, eh?
Well, they don’t actually know which metals chemists / biologists call “heavy metals”, see their inclusion of aluminium. I would imagine they would call Lithium and Beryllium “heavy metals” too.
The point is that the Nutritionista definition of a “heavy metal” is
Incidentally, I wonder how Zinc got excluded from the list of horrid heavy metals? For some reason Nutritionistas all seem to regard Zinc as cuddly and Woo-friendly. I suspect the answer is “because Zinc often turns up in multivitamin concoctions”.
The typically circular logic should hopefully be obvious to anyone with half a brain.
Dr Aust, all too often we have crossed swords with people who dispute bad outcomes from chelation for metals that have severely disrupted someone’s calcium, “Calcium isn’t a metal”, they cry, “It’s a mineral”.
In alt.reality, neither calcium nor zinc can possibly be included in a list of metals.
What Brainduck said.
Thing is, although the evening meal plan works out about £9 for one course, I can imagine that for some people, that is worth it to avoid shopping, cooking as opposed to just heating, washing-up etc. But…if I were that bothered about what I was eating, I’d be more likely to buy a bunch of Healthy Living, Special Steamers, or particular lines of gourmet frozen stuff from supermarkets because:
1 they would give me the nutritional breakdown of the food on a label that I could see before buying
2 I could just purchase food that I know I like (seems if you don’t like celery or peppers, you’re out of luck with Detox in a Box)
3 it’s cheaper from a supermarket, even if you were buying a Novelli, Ramsay or other celeb-endorsed dish
4 supermarket could deliver it to me
If you don’t care about seeing the label, you’d be as well off seeing if the WI in your local area runs a freezer service. You tell them what you want, they cook it and they have a very sensible pricing structure. This would also allow people to order in family meals.
If you know you hate cooking or you can’t plan and stick to a menu then the WI (God Bless Them) are a boon.
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From the looks of this there is something to be concerned about. If this is a private college is there no official oversight as to the standards of the course content?
Admin edit: no, in a way, the oversight as to minimum standards for the course is provided by the accreditation for the Diploma as a Foundation Degree by the Uni of Beds. It depends how much confidence one has in that.
That was a good piece by Alexandra Frean about the re-examination of CAM degree courses with some trenchant commentary from David Colquhoun and others. Despite the renewed spirit of interest in whether or not these courses have a substantial scientific core to their curriculum, should I assume that ION is outside such considerations?
Maybe they teach them ways to influence people to buy supplements and follow absurd dietary advice that ensures that they need supplements.
I can’t get over the fact that this is an accredited school – even if the accreditation is by ‘one of the worst universities in Britain’.
And all set up by someone who deluded himself that he had greater insights that people who had actually been studying the topic in which he professes expertise.
Is there anything in the field of health in which Patrick Holford doesn’t claim to be an expert?
Admin edit: hmm, very little. He has opinions on dentistry, Wi-Fi, kinesiology (the food diagnosing kind, not the posture kind), diabetes, obesity, homocysteine, cholesterol, mental health, addiction etc. etc. Other people spend decades to master one speciality, Patrick de Vinci Holford vaunts his own knowledge as a master of many.
Just been convinced to buy a supllement called Synaptol to help my ADHD teenage girl.
Some folks swear by it, some revile it. I was persuaded by the association with a British University (Teeside). I have e-mailed them to ask their view of Holford and his claims.
Hello Alan G, as far as we can tell, Synaptol is not the subject of any papers or reports that are listed in PubMed or Google Scholar. Looking through the official website, the distributors don’t mention any studies or evaluations of the safety, efficacy etc. so it looks as if there are none. I’ve seen reference to a ‘study’ but couldn’t see it on the site – I notice that they seem to have modified their claims to: “Ingredients in glyco-8 products have been suggested in studies to support healthy attitude, concentration, and attention span”.
I have to admit that I’m struggling to understand why most people would need additional amounts of the sugars that make up the first part of the list of ingredients or why it is thought to be useful to include ingredients such as mannose that are not well metabolised or xylose that is more frequently used to test for intestinal malabsorption.
Glucose
Mannose
Fucose
Galactose
Xylose
N-Acetylgalactosamine
N-Acetylglucosamine
N-Acetylneuraminic acid
As for the ingredients – to single out glucosamine, the amount of glucosamine in the typical supplement dose is on the order of 1/1000th or 1/10,000th of the available glucosamine in the body, most of which is produced by the body itself.
This Synaptol discussion doesn’t sound too promising.
Depending on the outcome for you, might you be able to claim a refund from the company? It would be interesting to learn Teesside’s response to learning that you had trusted something that seemed to have the aegis of its respectability.
Just been sent a link to a glyconutrients and ADHD paper. I’m restricted to looking at the preview but even for a pilot this is not a helpful study in terms of it being i) open-label ii) uncontrolled (as far as I can tell) iii) non-randomised iv) the behavioural assessments were made by parents and teachers with no independent assessments from (say) clinicians or psychologists. I’m also wary of researchers who don’t state their significance values in the abstract.
As per Big Pharma so with supplement studies, it is not unusual for there to be a positive result in a study that they have sponsored/conducted.
Although the Dykmans report (unquantified that I can find from what’s online) positive results Arnold describes this as no more than “promising prospective pilot data”.
Arnold, L.E. (2002). Treatment Alternatives for Attention-Deficit/Hyperactivity Disorder. In P.J. Jensen, & J. Cooper (Eds.), Attention-Deficit/Hyperactivity Disorder: State of the Science and Best Practices. Kingston, NJ: Civic Research Institute.
There is no obvious reason as to why there hasn’t been a subsequent, better-quality study given the remarkable sales of glyconutrients. In default of some decent evidence, I’m inclined for now to side with those who express concern that it is possible that “legitimate discoveries in glycobiology have been used as marketing tools to help sell plant extracts termed “glyconutrients”” and that the hype is running ahead of the evidence to the point where the Texas Attorney General refers to the “glyconutrient scam” (full version here).
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