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. Continue reading
We were fascinated to come across a Madeleine Portwood presentation on the Food for the Brain site [PDF]: discussing “Essential Fats, School Performance and Behaviour”. One quote stands out, repeated on two slides alongside pictures of very sweet-looking children:
this is not about chemistry. This is about children.
At a first glance, this sounds very compelling: after all, who could argue with the fact that educational psychology in our schools needs to be about children? However, the dichotomy invoked by Portwood here is extremely problematic. A brief discussion of the Cochrane Collaboration will help to make clear why.
The Cochrane logo features a prominent diagram. The diagram
shows the results of a systematic review of RCTs of a short, inexpensive course of a corticosteroid given to women about to give birth too early. The first of these RCTs was reported in 1972. The diagram summarises the evidence that would have been revealed had the available RCTs been reviewed systematically a decade later it indicates strongly that corticosteroids reduce the risk of babies dying from the complications of immaturity. By 1991, seven more trials had been reported, and the picture had become still stronger. This treatment reduces the odds of the babies of these women dying from the complications of immaturity by 30 to 50 per cent.
Because no systematic review of these trials had been published until 1989, most obstetricians had not realised that the treatment was so effective. As a result, tens of thousands of premature babies have probably suffered and died unnecessarily (and needed more expensive treatment than was necessary). This is just one of many examples of the human costs resulting from failure to perform systematic, up-to-date reviews of RCTs of health care.
Research is about both chemistry and children. Because of suboptimal evaluation of the research into how particular chemicals worked in particular situations, a number of babies will have died who might otherwise have been saved.
It is because we care about children – and because children are important – that we need to insist that research conducted in children and on childhood conditions meets the highest possible standards. Continue reading
In response to a FOIA request, Durham has told us about another significant flaw in their fish oil (non)trial: the ‘treatment’ arm was students with more than 80% reported compliance with supplementation with Equazen fish oil pills; the ‘control groups was selected from any students with less than 80% reported compliance. This means that – while a student with 80% reported compliance could have counted as an example of the success of this ‘treatment’ – a student with 79% reported compliance could have been compared to them as part of the ‘control group’.
I am really not sure what to say Continue reading
Filed under Equazen, fish
The Daily Mail is affectionately known as the People’s Medical Journal. Whether we like it or not, now that the Telegraph has effectively withdrawn from any attempt to provide decent medical journalism, the Independent is episodically odd, the Guardian is distressingly full of woo in its lifestyle section, the Times does what it can but is hampered in its editorial tone by the occasional flakiness of Dr Stuttaford and his fondness for supplements and PSA levels, so the Daily Mail is, by default, a high-volume source of medical news for a goodly proportion of the UK public. If anyone had the money to identify the source of newspaper clippings brought into GPs’ surgeries, I would bet good money that a disproportionate number would be from the Daily Mail. Which makes it all the more distressing that the Daily Mail is not only bewildering the nation with the flip-flop of its reporting but possibly trying to gaslight us into believing that we have difficulties with reading comprehension from which only fish oil supplements can save us: Is your Omega-3 fish oil supplement any good – or a load of old codswallop? Continue reading
Food for the Brain seem very pleased about an embarrassingly poor quality interview with Holford in National Health Executive (PDF): a journal targeted at senior health managers. Food for the Brain have sent out an e-mail to their mailing list to proudly plug this piece. However, the questions are frankly rather odd, and Holford is allowed:
- to bask in the glory of a Associate Parliamentary Forum report on diet, mental health and behaviour (despite the fact that the report failed to mention his work or that of Food for the Brain)
- to cast aspersions on the nutritional knowledge of qualified health professionals
- to accuse healthcare professionals of being biased against nutrition due to the role of pharmaceutical industry funding although Holford himself works for a company part-owned by Elder Pharmaceuticals, and accepted £464,000 from Neutrahealth.
It also looks like the NHE takes pay-to-print articles which might or might not explain the appearance of an article that reads like an extended advertorial for Food for the Brain and Holford. Continue reading
When I was 12-years old I had a run of history and science projects that absorbed all my interest and exhausted the resources of my local library. Inexplicably, I was granted in-library reading privileges at the University Library. I was free to consult not only books but academic journals and popular reviews. For the first time, I saw publications that I had only read about: London Review of Books, Time Magazine, Paris Match, The Economist, New Yorker. I was overwhelmed by the glamour and gravitas of these periodicals: the smell and weight of the paper stock, the photo-journalism and, above all, the quality of the writing and editing. Continue reading
Yesterday, a draft of Durham’s report on their fish oil (non)trial flopped into my inbox like a fortnight old fish – courtesy of a Freedom of Information Act request, and Durham’s helpful FOI coordinator. Sadly, the report stinks to high heaven, but there are a number of things to note.
Firstly, the report is quite clear (page 2) that the trial has failed to demonstrate any benefit from the supplement pills. Given the lack of a placebo control group, the benefits that attach to more compliant children and families, the raised expectations due to media coverage and so forth, concerns about what they chose to judge ‘success’ by, other factors like improving school food, etc., the performance ‘benefit’ of those on the supplement group is actually rather disappointing. It’s a shame that Durham’s recent press release on the (non)trial did not make this clear. When Durham does publish this report (in the prestigious journal of the Durham Council website – clearly, they had good reason to withhold the non/trial data in order to avoid prejudicing publication) can I suggest something along the lines of ‘Durham trial fails to demonstrate any benefit from EyeQ fish oil pills’ as the headline of the press release announcing publication?
Anyway, having noted that headline point, I will now go through this awful report in more detail. Continue reading
In the course of a truly dire article on Patrick Holford – ‘Eat Your Medicine’ – the Irish Times states that “Holford has been a vegetarian for 30 years”. This seems a peculiar claim: the Independent has previously referred to Holford eating fish, and the Health Products for Life web shop states that Holford takes fish oil pills.
Honestly, I wouldn’t generally care what Holford ate or what pills he takes: if he wants to eat fish, he has every right to do so; he is also quite entitled to take fish oil pills, although I would imagine that the fish is tastier. But Holford makes a big play of his own lifestyle when selling his ideas and his products:
people are motivated to follow my advice because I explain the logic of it and I embody it
Which makes it peculiar for Holford to be described as a vegetarian – and a vegetarian for 30 years, no less – at the same time as discussing eating fish and taking fish oil pills. If fans of ‘alternative’ nutrition are going to base their lifestyle on one other person who happens to be healthy (a pretty daft move in itself – I’m sure we all have anecdotes of people who lived long, healthy lives while smoking and drinking heavily, avoiding exercise, etc.) surely Holford could at least publicise a consistent account of his lifestyle? Continue reading
In their continued efforts to provide a textbook example of why science by press release is a very bad thing, Durham Council’s press releases about their fish oil (non)trial even manage to muddy the water as to which Essential Fatty Acids (EFAs) were in the capsules that Durham gave to their schoolchildren. Their latest press release on the issue refers to the “Omega-3 tablets” the children were taking. However, back in 2006 Durham’s press release implied that Equazen’s Eye Q capsules (not tablets) were being used: it quoted Equazen’s Managing Director saying that
the eye q formula can really help enhance achievement in the classroom
Eye Q does not just contain omega 3 fats: it also contains “Omega-6 Gamma Linolenic Acid (GLA) from evening primrose oil and its metabolite Arachidonic Acid (AA)”. However, as well as Durham’s latest press release, recent coverage by the BBC referred to “fish oil” and Omega-3 supplements. The Northern Chronicle also referred to “fish oil capsules”. Ironically, it took an otherwise pretty poor article in the Daily Mail to point out that evening primrose oil was also given to the children.
It might seem like I’m being pedantic, but Equazen clearly view Evening Primrose Oil as significant, claiming that this “also plays a structural role, assisting in normal nerve function, especially learning and memory.” If we’re going to have ‘pill solves complex social problem‘ stories, people could at least be clear as to what is in the pills. Continue reading