Category Archives: yorktest

Patrick Holford, YorkTest and a Migraine Study

Former Visiting Professor Patrick Holford but still Head of Science and Education at Biocare has an enthusiasm for interventions that we wish we might share but, too frequently, when we examine the studies on which he relies, the results do not support his claims or the scope of his optimism.

In a recent newsletter, Patrick Holford was rather excited about a recent study: Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. For reasons that may become clear, he neglected to mention the full title of the paper.

Last month a study published in the Nutrition Journal showed that 85% of people affected by debilitating migraines had their symptoms reduced, and quality of life improved, when their food triggers were discovered and avoided. Having a hidden food allergy is one of five common causes of migraines.

This recent study tested migraine sufferers for food allergy using YorkTest’s FoodScan test. Eighty four of the volunteers were put on their food allergy free diet, while 83 were given a sham ‘allergy’ diet based on fake test results. At the end of four weeks those on the real allergy free diets had had 23% less migraines than those on the sham diet.

You might be a little surprised that Holford was quite so excited by this result after 4 weeks of assessment that the newsletter was subject-lined, “Relieve your migraine without painkillers” and headlined, “What’s causing migraines?”. Holfordwatch consulted the original study and can not agree that Holford provides a useful interpretation of its outcome.[1] According to the reported results, it seems as if even the study’s authors might quibble with Holford’s optimism:

The results indicated a small decrease in the number of migraine like headaches over 12 weeks, although this difference was not statistically significant (IRR 1.15 95% CI 0.94 to 1.41, p = 0.18). At the 4 week assessment, use of the ELISA test with subsequent diet elimination advice significantly reduced the number of migraine like headaches (IRR 1.23 95%CI 1.01 to 1.50, p = 0.04). The disability and impact on daily life of migraines were not significantly different between the true and sham diet groups. [Emphasis added.]

There are many other problems with this paper (eg, the participants are effectively self-selected from a group that is pre-disposed to believe that food intolerance influences migraine; there is no clinical verification of the migraine-like headaches description; respected experts in allergy and immunology caution against the notion that Yorktest’s IgG Food Intolerance test is diagnostic of food intolerance or clinically relevant; the number of study drop-outs compromises the power of the study effect). The study lacks scientific rigour to the extent that the only surprise is that a journal reviewer changed his opinion between 1st and 2nd review:

This paper has strong deficiencies in respect to the study design, recruitment, compliance, and no medical control and assessment of the subjects, not meeting the criteria for a scientific paper. Due to the huge amount of uncertainties, also acknowledged by the authors, this paper has no new information to offer and is of limited interest.
Level of interest: Reject as not of sufficient priority to merit publishing in this journal. [1st review]

Such flaws in the design and other areas can not be corrected merely by re-writing yet the reviewer accepts the revisions (eg, the revised title now refers to “migraine-like headaches” rather than “migraine”) and changes the review comment to:

Level of interest: An article whose findings are important to those with closely related research interests. [2nd review]

Recall that the research finding is not, as Holford leads, “[You can relieve] your migraine without painkillers” but that the study revealed that at 12 weeks (the study’s stated primary outcome): “this difference was not statistically significant“. Holford’s account is partial and inaccurate. This is lamentable when one considers that he claims to be a valuable intermediary between the public and the practical reporting of health research. It is unsettling when one considers that there is considerable apprehension that some patients and healthcare providers might be persuaded by such claims to lobby for such ineffective tests and diets to be funded by the NHS despite their lack of clinical relevance or efficacy.

Notes

[1] Holfordwatch notes that Yorktest provided a similarly partial account of the study findings in their September 2011 news items and that the media that ran the Yorktest release on this study did not investigate the findings but reproduced this and other unduly favourable interpretations (the rollcall of shame includes: Metro, Red Online, Top Sante, Women’s Fitness, Women’s Weekly, OK Magazine, Woman’s Weekly, Female First.

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Filed under food intolerance, IgG tests, intolerance, patrick holford, yorktest

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. Continue reading

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Patrick Holford: Why Did BBC Oxford Radio Give Him Free Advertising?

Patrick Holford on ITV Lunchtime 16 April 2008
BBC Radio Oxford broadcast an infomercial for Patrick Holford’s books and his commercial diet programme (transcript below). BBC i) did not invite any experts to discuss Holford’s diet or claims, ii) question whether the ‘free diet trial’ involved purchasing supplements or blood tests iii) ask for details of the ‘science’ that he claims supports his advice. Continue reading

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Filed under GL diet, glycaemic load, glycemic load, Low GL Diet, patrick holford, supplements, yorktest

Patrick Holford and the Vitamins for Asthma That Become All About Food Intolerance and YorkTest

I have explained this many times
Patrick Holford is Head of Science and Education at Biocare and a busy man. However, he has a little time on his hands since becoming a former Visiting Professor at the University of Teesside so he started a blog on which only paying-subscribers were allowed to comment. Sadly, despite the additional writing practice, Holford’s ability to provide accurate references or even link to the correct paper has not improved. We also have a splendid example of flip-flopping on the value of meta-analyses that is nicely captured in a recent Will Wilkinson summary of David Brooks:

Scientists have discovered X. Mostly X vanquishes my intellectual bugbears and confirms me in my prejudices. To the extent it doesn’t, science isn’t really an authoritative source of wisdom, now is it?

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Anton Emmanuel on why IgG testing for intolerances is not a useful diagnostic tool

Dr Anton Emmanuel is a Senior Lecturer in Gastroenterology at UCL. He has also studied the use of IgG testing kits – specifically, Yorktest testing kits. His research has been referred to (very likely inappropriately) by Yorktest in defence of their products. He is also one of the experts listed as backing Food Intolerance Awareness – which refers people to Yorktest for IgG tests.

When Radio 4’s Case Notes investigated food intolerance, Emmanuel was interviewed re IgG testing. We were surprised to hear him offering a rather (in our opinion, appropriately) negative assessment of the diagnostic value of such tests for identifying food intolerances.

Emmanuel is introduced by the presenter as not being very impressed with testing kits, and describes this process of testing as “not nearly as specific as one would like it to be”. For Emmanuel, the fact that wheat, yeast etc. come up often on these tests probably reflects “as much as anything else, our exposure to these things in our diet” rather than a specific intolerance/allergy.

Emmanuel is not impressed with these tests due to, among other issues:

  • No external standard as to levels which show intolerance: the tests rely on internal standards which aren’t as robust as one might like.
  • The effects in the patients Emmanuel has seen using these tests have largely been unimpressive, period. Even where patients did appear to benefit, results have not been great in the longer term.
  • A slightly leaky gut may lead to an IgG response to various proteins. It is erroneous to tie this response to specific proteins.

Continue reading

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Allergy UK Wants YorkTest IgG Food Intolerance Tests Available on NHS

I am constantly in awe of the resilience of people and companies: their nonsense can be exposed in the most public of fora and yet they bounce right back with their marketing message unchanged or tactfully edited but still ignoring the point that it is underpinned by nonsense. Former Visiting Professor Patrick Holford comes to mind as does Nas Amir Ahmadi of Detox in a Box. YorkTest (so beloved of Patrick Holford, Allergy UK, and a slew of self-declared experts as well as TV doctors) is another such company. YorkTest offers a food intolerance product that has been declared irrelevant by clinical allergists and immunologists and publicly deprecated but manages to garner pages of laudatory press coverage through its attractive press releases and to win customers because it ‘sounds science-y’. Recently, YorkTest piggybacks onto Allergy UK‘s Blossom Awareness Week to highlight the issue of allergies in children. Continue reading

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Filed under food intolerance, home test, IgG tests, patrick holford, yorktest

Patrick Holford, Still Claiming IgG Levels Are Relevant to Food Intolerance and Weight Loss

Patrick Holford on ITV Lunchtime 16 April 2008
Former Visiting Professor Patrick Holford Head of Science and Education at Biocare so, presumably, they believe that he has scientific credibility and they persist in this belief despite the stack of evidence that might prompt them to revise their estimation of his scholarship, his level of discourse or hyperbolic styling as a in the field of health and nutrition. Holford is particularly obdurate on the topic of IgG tests for the diagnosis of food intolerance. Dr Robert Burton would probably find Holford’s continuing enthusiasm an interesting case-study for the next edition of Believing You Are Right Even When You’re Not. However, it may be understandable that Holford cleaves to this despite the explicit advice from actual immunologists and allergy researchers and clinicians because it makes up part of the platform that allows him to sell tests, pills and special diets that are guided by his books. Continue reading

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Filed under food intolerance, IgG tests, patrick holford, weight loss, yorktest

Patrick Holford: “conventional medicine, doesn’t have a very good track record”

Patrick Holford on ITV Lunchtime 16 April 2008
Former Visiting Professor Patrick Holford is Head of Science and Education at Biocare so, presumably, they believe that he enhances their reputation and scientific credibility. Holford regularly presents himself as a fearless advocate for scientific accuracy and rigour and the bringer of unpleasant truths. Despite an abundance of evidence to the contrary, he is so convinced of his own competence that Holford regularly accuses others of inaccuracy and questions the integrity of leading researchers such as Professor Carolyn Summerbell (we should point out that Holford was in error, not Summerbell). Holford usually does all this under the guise of a plucky underdog and gadfly to medicine so it’s not surpising that he has recently claimed that “conventional medicine, doesn’t have a very good track record”. Continue reading

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Filed under Ben Goldacre, blood sugar, patrick holford, yorktest

Holford on alcohol, home liver testing kits, and evidence

I had thought that the stream of Holford’s comedy health/marketing e-mails had dried up, so I was surprised to see him tell his mailing list yesterday that “One in two daily drinkers have liver dysfunction”. Not, in itself, an implausible claim. However, the evidence Holford bases it on is, not surprisingly, completely inadequate – this is not encouraging, given that Holford is trying to promote himself as an expert in addiction. Continue reading

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You and Yours on Which? Investigation into Food Intolerance Tests

Listen again while you can: BBC Radio 4’s You and Yours on Which?‘s Investigation into Food Intolerance Testing with participation from Dr Mike Walker of Cambridge Nutritional Sciences Ltd.

One note that should be of particular interest to Patrick Holford, given his claims for IgG testing in the diagnosis of food intolerance, is a significant change in stance by the companies who promote, distribute and carry out such tests. We shall write more about this at a later date but Walker was at pains to stress that the Cambridge Nutritional Sciences’ IgG test is indicative of food intolerance but not diagnostic of food intolerance. The tap-dancing on this point was painful and brought a similar episode to mind involving Patrick Holford and his qualifications. Continue reading

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Filed under allergies, food intolerance, patrick holford, yorktest