Homocysteine, B Vitamins, Brain Atrophy and Mild Cognitive Impairment

A new PLoS article has been published, arguing that

The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins

I don’t have time to deal with this in as much detail as I would like (lots of things getting in the way of blogging, which is why it has been quiet here lately) but I think this is worth some quick notes. This post is short and a bit messy: for a summary of what the article does and doesn’t know, see Behind the Headlines; for a summary of some concerns with it, see Evidence Matters. Keep reading if you’re interested in the Holford angle.

The Independent confuses algal DHA with fish oil

In an Indepedendent article arguing that science journalism “standards are pretty high”, Jeremy Laurance discusses Goldacre’s critique of Denis Campbell’s recent Observer piece on DHA and children’s concentration. Laurance describes a trial which

showed that the fish oil “enhanced the function of those brain regions that are involved in paying attention”, as revealed by a brain scanner.

However, as Goldacre noted

It wasn’t a study of fish oil…but of omega-3 fatty acids derived from algae

Nom, algae.

UPDATED: Observer plugs fish oil for concentration, ADHD and depression

I was surprised to see the usually excellent Guardian Science tweeting that “Fish oil helps schoolchildren to concentrate”. This linked to Denis Campbell’s Observer article, reporting that

Fish oil helps schoolchildren to concentrate
US academics discover high doses of omega-3 fish oil combat hyperactivity and attention deficit disorder
Children can learn better at school by taking omega-3 fish oil supplements which boost their concentration, scientists say.

Boys aged eight to 11 who were given doses once or twice a day of docosahexaenoic acid, an essential fatty acid known as DHA, showed big improvements in their performance during tasks involving attention.

Dr Robert McNamara, of the University of Cincinnati, who led the team of American researchers, said their findings could help pupils to study more effectively and potentially help to tackle both attention deficit hyperactivity disorder (ADHD) and depression.

Unfortunately, the Observer’s claims about fish oil are not evidence-based.

Nature Publishing promote bad autism science

UPDATE: Nature Publishing Group now appear to have removed the links criticised in this post and the page looks to be much improved (although see the additional criticism at LBRB)

Nature Publishing’s Publishing Group’s (NPG) Scitable has previously been a fairly good example of accessible online science information. However, as Kev has noted, Nature’s NPG’s autism Scitable is well below their usual standard:

who thought it necessary to link to no less than three anti-vaccine links on the home page of this….blog? Wiki? Two links to Autism Speaks whose controllers recently attended a DAN! conference and one link to ARI itself.

Nature also links to Thoughtful House (the US autism clinic where Wakefield was based) when “Explaining the rise of reported cases”. Classy.

Particularly interesting – ‘interesting’ in the banging-head-on-desk-sense of the world – is the Autism Research Institute document they link re the Nutritional Treatment of autism

BBC Grow Your Own Drugs: implausible and risky advice

I have been disappointed with some of the content of the BBC’s Grow Your Own Drugs: in particular, its discussion of the use of turmeric and willow bark. I have therefore submitted two complaints to the BBC, and will explain my concerns in this post.

The programme suggests a daily dose of turmeric tea for arthritis treatment: arguing the curcumin in this may be beneficial. Sadly, though, this treatment is simply implausible: curcumin’s bioavailability is poor and (even if black pepper can improve bioavailability) it seems impossible that a daily cuppa would give enough of a dose to do anything particularly useful. I pointed this out to the BBC, and they responded to me:

While we appreciate your concerns, it’s always been the case that James Wong doesn’t believe that natural remedies are a replacement for conventional medicine, and he reminds viewers of this during the series. The programme’s website also explains this

While I am delighted that the BBC make clear that implausible treatments shouldn’t be used to replace actual medicine, it is nonetheless unhelpful for them to suggest implausible treatments in the first place. I have therefore asked them to consider my complaint again.

British Chiropractic Association: poor quality research on posture

The British Chiropractic Association (BCA) claims to represent a certain expertise regarding backs and bodies. BCA states that:

Chiropractic is a primary health-care profession that specialises in the diagnosis, treatment and overall management of conditions that are due to problems with the joints, ligaments, tendons and nerves of the body, particularly those of the spine.

I was therefore interested to see that they had released some research on posture in 2009, for the Straighten Up campaign which is linked to Chiropractic Awareness Week*. The BCA carried out some research into posture in the UK. Given the expertise claim for Chiropractic, I was expecting a detailed assessment of people’s posture in different circumstances (sitting, standing, walking etc.) However, the BCA’s website reports that:

New consumer research by the British Chiropractic Association shows that, in just two years, the incidence of poor posture appears to have risen at an alarming rate. Over half (56%) of the UK population currently believe they have a bad posture, compared to 38% in 2007, an increase of 16%.

There are big problems with self-assessment of posture: it can be hard to know whether you are holding yourself ‘right’. This type of self-reporting is therefore very problematic.

To make matters worse, I can’t seem to find basic details about this research on the BCA’s site : what questions were asked, the sampling of research subjects, the size of the sample, etc. This research – and the BCA’s publication of it – is therefore very weak. It is hard to see how one can draw meaningful conclusions from what is described on the BCA website. For an organisation which works to come across as a credible representative of healthcare professionals, publicising ‘consumer research’ in this way is really rather unfortunate.

* Which, pleasingly, this year coincided with the end of the BCA’s ill-fated libel case against science writer Simon Singh.

Holford claims a study shows his recommendations reduce Alzheimer’s risk

We were interested to see Holford’s blog trumpeting a new study by Yian Bu et al, on Alzheimer Disease and dietary patterns: claiming that the study shows that “Holford diet reduces Alzheimer’s risk”. Holford’s blog argues that the
study

findings are completely consistent with out recent 100% Health Survey and the diet I recommend in the Alzheimers Prevention Plan book.

These principles are also incorporated into the Holford Diet which also factors in eating a low GL diet. In our 100% Health survey we found that the consumption of sugar-based snacks and sugar were strongly associated with worsening memory and concentration. All the other findings in this recent study, soon to be published in the Archives of Neurology (Arch Neurol. 2010;67[6]), are completely consistent with our survey results.

However, the study states that

We identified a DP [dietary pattern] strongly associated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.

This seems rather close to the advice of mainstream organisations such as the BDA (or to my Gran’s advice to ‘eat your greens’). As far as I can tell, the study doesn’t consider the benefits (or disbenefits) of a low glycaemic load diet. It certainly doesn’t show that Holford’s supplement recommendations are effective: instead, “nutrient intakes from foods and from supplements were separately estimated, and only the nutrient intake from foods was used in the RRR analysis.”

Certainly, we have no objection to some of Holford’s recommendations: for example, eating lots of green veg seems perfectly sensible. However, these good recommendations are not at all original and we have not seen any convincing evidence that his more novel recommendations are any good.

Science: So What? Bad nutrition on garlic and cancer

We blogged last week about bad nutrition from Science: So What? So Everything – a science communication initiative ran by the Department for Business, Innovation and Skills. I was disappointed to find more on their website: this time, a poor discussion of the evidence re garlic and cancer. Science: So What state that

recent studies have shown that our love of garlic may also be good for our health.

A study published in the medical journal Carcinogenesis in 2008 showed that garlic-derived substances had an effect on colon cancer cells.

Bad nutrition from Science: So What?

I was disappointed to some new, rather bad nutrition content on the UK Government’s Science: So What? So Everything website: there is some unfortunate discussion of turmeric, ginger and cancer.

Food for the Brain still describing Holford as a Teesside Visiting Professor

Teesside University previously gave Patrick Holford a Visiting Professor post – which, we believe, has now ended. However, the charity Food for the Brain (CEO: P. Holford) are currently referring to Holford as

Visiting Professor at the University of `Teesside, School of Social Sciences and Law

It does appear that these endorsements tend to linger.