Had dodgy advice from a nutritional therapist? We have!

by , Senior Food Researcher Consumer Rights 16 January 2012
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Have you ever visited a nutritional therapist? In this month’s Which? magazine we investigated the profession and found some worrying practices, such as therapists advising against going to your GP.

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One therapist advised our researcher, who was posing as a cancer sufferer, against having conventional treatment (a lumpectomy and radiotherapy), saying that she should try for three to six months to rid herself of the cancer through diet (by cutting out sugar).

Nutritional therapy can be big business; therapists charge up to £80 for a consultation and often prescribe expensive supplements on top. So we wanted to investigate whether it was worth the money.

How our investigation worked

We asked five undercover researchers to each visit three therapists. Each researcher was provided with a scenario.

One researcher (in her early 30s) had been trying to conceive unsuccessfully for over a year. Two (in their 50s) had been suffering from severe tiredness for the past three months. And two women (in their 40s) had recently been diagnosed with DCIS (Ductal Carcinoma in Situ), the most common type of non-invasive breast cancer.

A panel of experts (a dietitian, a GP and a Professor of Pharmacology) then assessed recordings of the visits and any other information the therapists provided to the researchers, including prescriptions for supplements.

Are nutritional therapists worth the money?

Our expert panel concluded that visiting a nutritional therapist wasn’t worth the money – and in some cases could have actually endangered the health of the researcher. Six of the fifteen consultations were rated as ‘dangerous fails’.

This could have been down to a number of reasons:

  • The advice given by the therapist could have potentially harmed the researcher.
  • Therapists were diagnosing conditions without relevant testing (even though their Code of Practice says they shouldn’t diagnose).
  • Researchers were advised not to visit their GPs about the problem, recommending unproven testing such as hair mineral analysis, and the case above, advising against cancer treatment.

Of the remaining visits, eight were rated as ‘fails’ and only one was graded as a ‘borderline pass’. Our experts were disappointed by the advice given by therapists and concerned at their poor knowledge of the body and how it works.

The experts were also worried by some therapists using non-evidence-based testing to diagnose symptoms. These tests included iridology (studying the patterns, colour and other characteristics of the iris), hair mineral analysis and a researcher being given several liquids to hold in his mouth before being told he had a chromium deficiency.

Are the recommendations right?

Twelve of the therapists prescribed supplements to the researchers, costing up to £70 a month. Researchers were told not to buy them from Boots or other high street chemists as they weren’t ‘pure enough’ and you were effectively ‘flushing your money down the loo’. Instead, they were asked to buy them from the retailers recommended by the therapist.

Of course, there is benefit in following healthy dietary advice, but most of what was provided by the nutritional therapists is freely available on websites such as the NHS site.

Plus, most of the therapists in our investigation recommended quite restrictive diets that excluded several foods (predominantly dairy and wheat) and taking expensive supplements.

If you do have a medical condition that you are concerned about, your first port of call should be your GP. If necessary they can then refer you to a dietitian. We have contacted the British Association of Applied Nutrition and Nutritional Therapy (BANT) with our findings and concerns.

People who have visited nutritional therapists emailed us to say that they found the diets recommended to them difficult to maintain over a long time and eventually gave up.

Have you visited a nutritional therapist? What was your experience like – do any of these findings ring true or did you have a more positive experience?

1951 comments

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Ellie

I think I have changed my stance a bit since participating in this blog. It has made me feel that Statutary regulation of Nutritional Therapists may well be a good thing, and probably sooner, rather than later in order to protect the well qualified NT’s who are practising responsibly.

 
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wavechange

Just called back to say that CNHC now has a descriptor for nutritional therapy:

http://www.cnhc.org.uk/assets/Nutritional-Therapy-4-009.pdf

 
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Liz

Ellie, I think you are absolutely right, the whole alternative field seems fair game for accusations of all sorts and to be able to feel confident in the qualifications and professionalism of a Therapist is vital. Both the Therapist and the Patient would benefit especially if the Regulating Body could also monitor and gather evidence of good practice and benefits to patients.
I believe the lack of credible/indisputable evidence of efficacy is the main reason why detractors can do so much damage to the reputation of soundly based Therapies delivered by dedicated and well trained Practitioners. Sadly jumping through some ‘orthodox hoops’ might make the work of delivering these valuable Therapies more successful and effective. The biggest question is who will foot the bill?

 
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Alan Henness

Liz said:

“the whole alternative field seems fair game for accusations of all sorts and to be able to feel confident in the qualifications and professionalism of a Therapist is vital. Both the Therapist and the Patient would benefit especially if the Regulating Body could also monitor and gather evidence of good practice and benefits to patients.”

Cart and horse here. First show that a therapy has a worthwhile, repeatable, beneficial effect; find out the parameters relating to conditions, use, dosage, training of practitioners, etc, etc, etc then you can start thinking about what regulation might be appropriate to protect the public. You can’t regulate nonsense – you have to first show that it’s non nonsense.

“I believe the lack of credible/indisputable evidence of efficacy is the main reason why detractors can do so much damage to the reputation of soundly based Therapies”

I can’t disagree with the first bit – it’s just how you can come to the conclusion that they are soundly based that I have problems with.

“delivered by dedicated and well trained Practitioners.”

I have little doubt that most providers of alternative therapies are dedicated and well trained (in whatever they are trained to do), but being dedicated and well-trained in nonsense still leaves them practising nonsense.

“Sadly jumping through some ‘orthodox hoops’ might make the work of delivering these valuable Therapies more successful and effective.”

Providing robust evidence isn’t jumping through ‘orthodox hoops’: it’s about providing a good level of assurance that the public are not going to be harmed and that there is a good chance they will be helped.

“The biggest question is who will foot the bill?”

Not me! Do you agree the onus is firmly on those who want their treatment to become accepted to come up with the money?

 
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Maria

Liz said,

“I believe the lack of credible/indisputable evidence of efficacy is the main reason why detractors can do so much damage to the reputation of soundly based Therapies delivered by dedicated and well trained Practitioners.”

The lack of credible evidence is one of the mains reasons, the fact that they are not “soundly based” is the other. The lack of scientific plausibility coupled with the lack of evidence for efficacy is the reason why any further research into a “therapy” like homeopathy is a waste of time.

 
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Maria

Sorry, I cross-posted with Alan. Didn’t mean to pile on.

 
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chrisb

Barney, your reply to Alan………………..

“Alan, it would indeed be wonderful to compare just how many people have been helped by non-orthodox medicine with those helped by conventional methods, just as it would be marvelous to know for sure just how many people are injured and killed by both approaches”.

Now let’s see, Modern Medicine has been around for about 150 years or so, give or take a decade, whereas Alternative Therapies have been around for thousands of years, such as TCM about 2500 years; Ayurvedic Medicine about 5000 years and so on.

Now if we use a bit of logic/reasoning (popular here BTW) and some here say that I am devoid of, then these Alternatives would have vanished into the night as being ineffective hocus-pocus, but here they are today being used by thousands if not millions.
This of course presupposes that all these millions of people are mindless gullible morons, who have been duped, and had their money extracted from their wallets under false pretences.
Does anyone seriously believe that these therapies, which have stood the test of time, are worthless and ineffective, and kill on a scale akin to the holocaust?
Logic dear friends. Logic.

 
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Stuart

“whereas Alternative Therapies have been around for thousands of years, such as TCM about 2500 years; Ayurvedic Medicine about 5000 years and so on.”

An thinly veiled appeal to tradition.

“then these Alternatives would have vanished into the night as being ineffective hocus-pocus, but here they are today being used by thousands if not millions.”

An appeal to popularity which says nothing about how effective something is. Smoking has been around since 5000BC, and we only discovered relatively recently that its harmful. Smoking is still very popular today.

“This of course presupposes that all these millions of people are mindless gullible morons, who have been duped, and had their money extracted from their wallets under false pretences”

Strawman. No it doesn’t. It supposes that human beings are capable of wrongly attributing cause and effect, and are succeptible to conformation bias, placebo effect etc. No-one has accused anyone of fraud, although its telling you feel the need to defend it against this accusation.

“Does anyone seriously believe that these therapies, which have stood the test of time, are worthless and ineffective, and kill on a scale akin to the holocaust?”

Are you close minded to that possibility? How can you regulate alt med if you cannot at least consider its potential for harm. No-one mentioned the holocaust, or any scale.

 
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Stuart

You haven’t answered alans question.

How many people have been helped by drugs and conventional medicine, lets include any intervention which saved a life, improved quality of life, relieved pain etc.

How many? Simple question. Then we can discuss those harmed by it and look at risk/benefit.

 
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Barney

Come on Stuart, you cannot simply dismiss with an airy wave thousands of years of human experience and learning, to which chrisb was referring, as “a thinly veiled appeal to tradition”. This experience is a form of scientific evidence: observational, experiential, a process of development over long periods of time. It may not be randomised, controlled, clinical trials, but it’s still a genuine form of scientific evidence. If you’re going to base your position on what you term ‘science’ and ‘critical reasoning’, jettisoning huge portions of the data simply won’t do. And if you’re going to wait for the clinical trials evidence of every aspect of traditions like TCM and Ayurveda, you’ll be here until Doomsday.

As I mentioned in my previous post, it’s difficult if not impossible to obtain figures for morbidity and mortality caused by non-orthodox methods, purely since they are overwhelmingly practised outside the big institutions that collect those data. On the other hand, providing figures for how many people have been helped by orthodox medicine – or non-orthodox, for that matter – is far from a “simple question”! If it was such an easy matter, don’t you think someone would have done it by now? You’re asking for the numbers of people who visit their GPs, receive medicine and get better as a result of the medicine and not regression to the mean; for the numbers of people who go to hospital, receive treatment and get better as a result; for the numbers of people who take an aspirin for a headache, who take an antacid after a big meal, who take Alka-Seltzer after a night out, etc. etc. etc. I’m pretty sure those data aren’t available, anywhere, but I’m open to being proven wrong. Ditto for the numbers of people helped by non-orthodox approaches.

All we can do at this stage is get an idea of the relative harm caused by orthodox and non-orthodox medicine. Yesterday, I provided robust data, taken from government institutions, meta-analyses and major peer-reviewed scientific papers, that orthodox medicine is likely the third-leading cause of death in the USA – a country using pretty much the same medical orthodoxy as the UK. As a comparison, data from the American Association of Poison Control Centers revealed 6 deaths from vitamins/minerals, herbs and homeopathy combined in 2010. I fully admit that these data are incomplete, and I fully admit that many alternative therapies are not included in the dataset. But I think it gives us a fair idea of the comparative safety of the two approaches. Do you have any data that indicates any different, please?

 
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Stuart

“Come on Stuart, you cannot simply dismiss with an airy wave thousands of years of human experience and learning, to which chrisb was referring, as “a thinly veiled appeal to tradition”.”

It an appeal to traditon which has no bearing on whether it works or not. Plenty have things have a long history and tradition. That doesnt validate them. People have been wrongt many many times.

“This experience is a form of scientific evidence: observational, experiential, a process of development over long periods of time. It may not be randomised, controlled, clinical trials, but it’s still a genuine form of scientific evidence.”

Agree. Would you also agree that its a form of evidence which we know can be subject to bias? Would you also agree that anecdotes are not a rational way of making decisions, since there is anecdotal evidence that everything works at some time? How do you propose dealing with that?

“If you’re going to base your position on what you term ‘science’ and ‘critical reasoning’, jettisoning huge portions of the data simply won’t do. And if you’re going to wait for the clinical trials evidence of every aspect of traditions like TCM and Ayurveda, you’ll be here until Doomsday”

Science is about using the best quality data we have, not all of it. High quality evidence is more rational and less subject to bias, and so its logical to give that greater weighting in decision making.
We know blood letting was anecdotally a good idea. When good quality evidence emerged it was harmful, did we simply ignore that? Of course not. We went with the stronger less biased evidence. The only reason for using less rigourous evidence is special pleading because it shows that your modality works . Luckily we don’t need to wait until doomsday. many of the alt med practices have been subject to controlled clinical studies which have either shown no effect or inconclusive results.

 
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Prime Minister

What do you mean by ‘Logic’.

 
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Maria

“What do you mean by ‘Logic’.”

Prime Minister raises a good question. chrisb, You are misusing the term ‘logic’ What you are offering here is not ‘logic’ (which is a system for determining the validity of arguments) but circular reasoning, which is a formal logical fallacy. Your argument boils down to this:

If it didn’t work, people wouldn’t use it, therefore it must work.

You supplement this with a number of other fallacious arguments. Stuart has pointed these out and offered rational counter arguments that counter the fallacy and which, unfortunatley, have been ignored by Barney who simply repeats the same fallacy, to which Stuart has had to respond again.

To stop going round in circles, let’s take a more critical look at your Appeal to Tradition (i.e. argument that a practice or a belief is justifiable simply because it has a long and established history).

You said, “these Alternatives would have vanished into the night as being ineffective hocus-pocus,”

I note you specify Modern Medicine as starting in the 19th century, which is fair enough but it’s actually irrelevant. Historical records indicate that people have always practised some kind of ‘medicine’ in the hope that it will have specific beneficial effects.

Historical records also tell us that much of what was used as medicine was, at best, useless superstition which had no beneficial effect and, at worst, was actively harmful. We now know that people didn’t necessarily abandon useless or harmful practices quickly. Some continued for thousands of years.

Why do you think people continued to use leeches and bleeding over centuries? Do you think it is because they worked, that they saved lives? Do you think the Big Pharma was forcing them on people?

No. People used harmful practices for the same reason they used harmless practises: because (a) they didn’t know what else to do and (b) they believed they could be effective. This raises the question of how people could possibly believe that practices like leeching and bleeding ever worked?

The answer is that some people recovered in spite of these practices, not because of them, and human beings erroneously (as we now know) saw a causal connection between the administered practice and the recovery. Exactly as they do today. This has nothing to do with what kind of treatment is being offered and whether it is ‘orthodox’ or ‘alternative’. It is to do with the flawed way human beings think: Sore throat better? Must have been the antibiotics/homeopathic remedy.

(Of course, when people died after whatever useless or barbaric practice was inflicted on them this was explained by the illness being too serious or advanced for treatment, coupled with speculation about God’s purpose.)

These are the same reasons why people use treatments of any sort today. The thalidomide tragedy is, in this way, no different from the tragedies of children like Cameron Ayres and Gloria Thomas. Notably, the first tragedy was caused by faith in modern medicine and the others were caused rejection of modern medicine.There is a point here being about proportioning one’s belief to the evidence.

Your ‘evidence’ that some therapies have lasted for thousand years and so people must have benefitted from them is undermined by the fact that some therapies, also lasted for thousands of years, even though they were worse than useless. People who are sick and who die whether in spite of or because of the treatment they were given, don’t leave testimonies.

I hope you can see the problem with your appeal to tradition now.

(If we were on another forum, I would also challenge your premise that TCM is 5,000 years old but here is not the place.)

 
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Barney

People might have been wrong “many, many times”, but we’re talking systems of healthcare that have survived for, literally, thousands of years. We’re not talking the odd, isolated anecdote, but the combined wisdom of civilisations! The traditions have grown, diversified and developed in that time – and continue to do so. As I pointed out earlier in this thread, the danger of an over-reliance on RCTs is that we end up in a “tyranny” where all human experience is dismissed as an anecdote – which you sail perilously close to doing here.

I also find it remarkable that anyone can consider that Western, orthodox, pharmaceutical-led medicine is the only way forward for healthcare, and that the rest of the world has nothing to offer at all. Especially when this supposedly most evidence-led of disciplines is killing and maiming people every day.

Since bloodletting has reared its ugly head once again, it’s worth noting a) that it was only practised by orthodox physicians, like other quackery such as mercury (=quicksilver or ‘quackselber’ in German – ironic that a term originally used to describe orthodox physicians has been highjacked by them and their followers to denigrate the competition), and b) its use wasn’t discontinued because of evidence from clinical trials. Good old observation and clinical experience were enough for doctors to finally give it the heave-ho. Funnily enough, the age of EBM is seeing something of a resurgence in bloodletting, AKA therapeutic phlebotomy (tongue slightly in cheek): http://www.ncbi.nlm.nih.gov/pubmed/8261683, http://www.ncbi.nlm.nih.gov/pubmed/1642354. Anyway, comparing a subtle, complex, interlocking system of medicine like Ayurveda or TCM to a single intervention like bloodletting – as I note Maria has just done – is like comparing apples and oranges. Or rather, a single mouldy apple with an entire orange grove.

There is no ‘special pleading’ in asking for all forms of scientific evidence to be considered. I think someone posted this before, but it contains some interesting arguments: http://www.orthomolecular.org/resources/omns/v07n15.shtml. As I’ve said before, I agree with Dr Sackett when he says that clinical and RCT evidence must be considered. There are flaws with the EBM model as a whole and with RCTs in particular, not least that they are incredibly difficult to organise and expensive to perform – so most forms of non-orthodox medicine don’t have the resources to fund them. Hence lots of poor-quality trials and inconclusive results. Plus a small army of people dedicated to picking holes in even the decent ones. It is an easy matter to rig RCTs anyway, as a critical look at most of the large negative studies into vitamins shows: for example, some have studied a high daily dose of a synthetic vitamin form that isn’t found in nature, and lo and behold, negative results ensue [http://www.bmj.com/content/341/bmj.c5702.long]. Such poor science then gets plastered all over the media and yet more people think that all vitamins are bad for you.

What we need is to look again at how we assess treatments, so that important, non-RCT evidence isn’t excluded. I don’t know how we do that, before you ask. I am not proposing that we ditch the RCT entirely, only that we don’t assume it’s the one and only way to truth. At present, even the best, most instinctively brilliant practitioners of whatever stripe are in danger of being prevented from exercising any kind of art or discernment in their clinical decision-making: if it ain’t in an RCT, it doesn’t work, you can’t do it. It’s a short step from that to robotic, mindless, tick-box medicine. Is that what you want?

Incidentally, you’ve completely avoided addressing the main issue of my post, which was about the relative safety of orthodox versus non-orthodox methods.

 
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Stuart

“People might have been wrong “many, many times”, but we’re talking systems of healthcare that have survived for, literally, thousands of years. We’re not talking the odd, isolated anecdote, but the combined wisdom of civilisations!”

Repeating the same fallacy over and over again does not make it true. Maris’ examplanation above is far more elequant than I could manage ^

“The traditions have grown, diversified and developed in that time – and continue to do so.”

I disagree, many are belief based systems based on concepts long since shown to be wrong. Many haven’t evolved or diversified especially in the light of new evidence that they were wrong (meridans, Chi energy, law of simliars, succussion).

“As I pointed out earlier in this thread, the danger of an over-reliance on RCTs is that we end up in a “tyranny” where all human experience is dismissed as an anecdote – which you sail perilously close to doing here.”

I acknowledged that human experience is one form of evidence, and that RCT are not the only form of testing that can help to eliminate bias. All I am asking is that bias is removed as far as is practicable, and decision making uses the best evidence of benefit and harm available. Do you disagree with that aim? If so, you sail dangerously close to having virtually no standard of rigour.
I’ll ask again – bearing in mind there are anecdotes which tell us everything is effective, how should we make decisions with such conflicting evidence? How do we ensure that we hear all anecdotes/observations (not just the positive ones which reinforce the belief) and reach a balanced conclusion? Do you believe that these are better evidence when we have controlled trials clinical trials which show us no such effects when bias is controlled?

“I also find it remarkable that anyone can consider that Western, orthodox, pharmaceutical-led medicine is the only way forward for healthcare, and that the rest of the world has nothing to offer at all.”

Strawman. No-one said that, I don’t care where healthcare comes from if it is effective and we have a reasonable understanding of the risks involved.

“Especially when this supposedly most evidence-led of disciplines is killing and maiming people every day.”

The failings of conventional medicine has no bearing on whether alt med works as you are well aware. You havent yet defined the benefits.

“Since bloodletting has reared its ugly head once again, it’s worth noting a) that it was only practised by orthodox physicians,”

……..who changed their approach when their ‘beliefs’ in that intervention were shown to be wrong.

“…….. and b) its use wasn’t discontinued because of evidence from clinical trials.”

Nobody said it was. However, once robust irrefutable evidence was provided that blood circulated within the body, the concept that new blood was made and old blood destroyed was found to be wrong. The concepts on which blood letting were based were shown to be without basis. Had someone suggested this without strong evidence do you think they would have abandoned their traditional and long believed system of medicine, or continued?

“Anyway, comparing a subtle, complex, interlocking system of medicine like Ayurveda or TCM to a single intervention like bloodletting – as I note Maria has just done – is like comparing apples and oranges.”

Why?

“There is no ‘special pleading’ in asking for all forms of scientific evidence to be considered.”

You suggested that we should consider less rigourous forms of evidence, but didn’t first address why this would be beneficial. Special pleading.

“There are flaws with the EBM model as a whole and with RCTs in particular, not least that they are incredibly difficult to organise and expensive to perform – so most forms of non-orthodox medicine don’t have the resources to fund them. Hence lots of poor-quality trials and inconclusive results.”

Yes things could be improved.

The poor quality of studies I have seen have been nothing to do with lack of funding, but through poor experimental design to eliminate bias and a lack of critical review.

“What we need is to look again at how we assess treatments, so that important, non-RCT evidence isn’t excluded.”

But we should be cautious about using poor quality information or that susceptible to bias, and use high quality information where available.

“It’s a short step from that to robotic, mindless, tick-box medicine. Is that what you want?”

No, never said I did.

“Incidentally, you’ve completely avoided addressing the main issue of my post, which was about the relative safety of orthodox versus non-orthodox methods.”

Sorry, Chrisb derailed it! The numbers of people killed by orthodox and alternative medicine can only be considered in the context of the benefits. You cannot simply look at the figures you have given and conclude that one is ‘safer’ and therefore better. There is no point in a safe ineffective treatment is there? Also as I have pointed out all interventions carry some degree of risk, there is no such thing as 100% safe treatment.

 
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Maria

Barney

As Stuart has noted, you persist in your fallacious argument and “simply dismiss with an airy wave” the flaw that has been pointed out without actually responding to it.

You said:

“Since bloodletting has reared its ugly head once again, it’s worth noting a) that it was only practised by orthodox physicians,”

This is a red herring. A thousand years ago, there was no ‘mainstream’ versus ‘alternative’ medicine. There was just medicine and most of it was useless and a lot of it was harmful. And yet it continued to be used.

“its use wasn’t discontinued because of evidence from clinical trials. Good old observation and clinical experience were enough for doctors to finally give it the heave-ho.”

Straw man. I asked “Why do you think people continued to use leeches and bleeding over centuries?” To put it another way, why did it take a thousand years of “good old observation and clinical experience” before it was finally given the heave-ho.

That is the key to understanding why your fallacious argument is fallacious.

“I also find it remarkable that anyone can consider that Western, orthodox, pharmaceutical-led medicine is the only way forward for healthcare, and that the rest of the world has nothing to offer at all.”

Straw man. Nobody has argued this. The arguments have been entirely about what constitutes good evidence. I think the non-quacks contributing here would agree that evidence-based medicine is the only way forward for healthcare and this is not to say that “the rest of the world has nothing to offer at all” – another straw man. I’m sure nobody would deny that there are complementary therapies that have a place as, well, complementary therapies.

“As I’ve said before, I agree with Dr Sackett when he says that clinical and RCT evidence must be considered. There are flaws with the EBM model as a whole and with RCTs in particular, not least that they are incredibly difficult to organise and expensive to perform – so most forms of non-orthodox medicine don’t have the resources to fund them.”

That is a misrepresentation of what Sackett says. You imply Sackett gives RCT and clinical evidence equal status. In fact, he says,

“Because the randomised trial, and especially the systematic review of several randomised trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm.”

Nor does he say there are flaws in the RCT and, anyway, what you are describing is not a flaw in the methodology but a practical problem that limits their use. Sackett acknowledges there are limitations. He goes on to say,

“However, some questions about therapy do not require randomised trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomised trial has been carried out for our patient’s predicament, we must follow the trail to the NEXT BEST external evidence and work from there.” (My emphasis)

In a nutshell,

“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”

Please note this is not an argument to treat thousands of years of anecdotes as if they were scientific evidence because they aren’t.

 
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Barney

And with respect to both Maria and yourself, repeatedly calling my point of view a fallacy doesn’t make it so, either :-)

For me, the main benefits of raising the importance of clinical and observational experience are to maintain medicine as an art rather than an algorithm, and so that the experiences of the healer (of whatever stripe) can be taken into account. The failings of modern, orthodox healthcare – or rather, sickness management – are absolutely relevant to this argument. If modern medicine is so evidence-based, and if EBM is the be-all and end-all of unbiased analysis, how come so many people are killed and injured by it? That doesn’t sound like “The best evidence of benefit and harm available” to me! The EBM model is clearly missing something if only a fraction of its vaunted treatments are of known effectiveness [http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html].

Something is also going wrong if systems of medicine that have served people well, and which continue to serve people well today, have no place in the EBM system. Non-orthodox medicine has far more to offer people suffering with the chronic conditions of the modern age than modern, orthodox medicine.

The comparison of bloodletting with Ayurveda is specious, because one is a single treatment and the other goes beyond a system of medicine and encompasses an entire way of living! You can’t do an RCT on a philosophy, and the scientific evidence that exists doesn’t refute the effectiveness of Ayurveda. Same with Chinese medicine. Every day, thousands of people gain clinical benefit from these techniques, with measurable, repeatable results. Both of them may be based on concepts you don’t care to understand, but they consist of many different techniques – including herbs, breathing techniques, acupuncture, massage, oils, scents, dietary advice and more – that can be adapted to the needs of each individual patient. This is why those systems have survived for so long: because they work and because they are almost infinitely adaptable. Bloodletting is bloodletting is bloodletting, and survived so long because physicians probably felt better doing something than nothing.

I have never said that Sackett put RCTs and other evidence on the same level. What I did say was that he warned that, “Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient.” He was worried that clinical evidence was being ignored as EBM developed – which has happened a lot more since he wrote those words in 1996, and which you seem perfectly happy with.

Speaking of which, going back to bloodletting for a second, aren’t red blood cells are made in the bone marrow and broken down in the spleen?

 
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Maria

Barney said,

“And with respect to both Maria and yourself, repeatedly calling my point of view a fallacy doesn’t make it so, either”

Indeed it doesn’t. But I have just “called” your point of view a fallacy, I have demonstrated why it is so but as you have refused to engage with that argument and have ducked the very simple and straightforward question I have asked, I’m afraid I can’t be bothered to read the rest of your comment.

 
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Barney

If you had actually read my comment, you’d see that I addressed the question you asked quite clearly. It says a lot about the standard of this debate that a refusal even to engage with an argument is given 7 thumbs up.

 
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Stuart

I share Maria frustration that despite pointing out the difficulties and assumptions made when relying on anecdotal evidence and tradition you still fail to address the major logical flaw at the very heart of your argument.

There seems little point engaging with you in rational debate on that basis.

 
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Stuart

“Speaking of which, going back to bloodletting for a second, aren’t red blood cells are made in the bone marrow and broken down in the spleen”

I have no idea, I was talking about blood, not cells. The assumption around the time of blood letting was that blood was created at one point in the body and then flowed to another point where it was destroyed and new blood was continuously ‘made’ to replace it. The idea of letting was to purgue out the bad blood in the system to enable new blood to be generated to take its place.

Of course, once it was shown that blood flowed continuously pumped around by the heart the traditional wisdoms of the time seemed a very very bad idea.

 

As interesting as this debate is (it’s almost a debate about debating!) it’s veering slightly off the main topic at hand. Your comments are also getting a bit heated – so I just want to remind you of my final warning below.

Can we draw a line under this thread? Thanks.

 
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chrisb

Maria said,
“The lack of credible evidence is one of the mains reasons, the fact that they are not “soundly based” is the other. The lack of scientific plausibility coupled with the lack of evidence for efficacy is the reason why any further research into a “therapy” like homeopathy is a waste of time”.

Let’s try and look at this in a rational manner: the only plausible evidence that a therapy works, and works effectively, is the test of time and the testimony of patients who have used those therapies. Thousands upon thousands of them.
Like me, and others like me.

The question for science should be: WHY do they work, and the mechanisms for their efficacy.

This reminds me of the quote from a surgeon after an operation which states: the operation was a complete success……………………but the patient died.

 
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Alan Henness

Ditto.

 
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Stuart

“Let’s try and look at this in a rational manner: the only plausible evidence that a therapy works, and works effectively, is the test of time and the testimony of patients who have used those therapies. Thousands upon thousands of them. Like me, and others like me.”

We’ve had this discussion before. If you believe that anecdotes/experience are the only suitable evidence are you happy for these to be used for assessing the effectiveness of drugs and alt med?

“The question for science should be: WHY do they work, and the mechanisms for their efficacy.”

Another discussion we had previously. Lets assume you are right and these things work. Why is the mechanism important at all?

 
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Liz

What a hornet’s nest I have stirred!
Thank you ‘chrisb’ for your voice of reason!
I am retiring from the fray, will spend my time more effectively elsewhere.
Maybe reason will prevail one day, in the mean time I shall continue to benefit from the Therapies I trust. I hope that eventually they will win the respect they deserve so they can help more people thrive.

 
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Ellie

I think we are in danger of taking the ‘science of logic’ too far. I doubt that we would have survived as a human race long enough to be contributing to this forum – if all we relied on was logic.

We have survived because our ancesters were intelligent, creative, inventive and adaptable and shared their knowledge and expertise with their fellow human beings.

 
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chrisb

Wavechange, you said………………………
“Those who sell expensive supplements would have us believe that they are better but a lot of it is advertising. Advertising is not always as honest as it should be and there are plenty of people ready to swallow both the hype and the expensive pills”.

Now we’ve had this out before, but you are still repeating the same old mantra.
Supplements are not expensive, in fact they are quite inexpensive in comparison to pharmaceutical drugs, which can compete for the same market. I can get a high quality supply of Magnesium Ascorbate (Vitamin C) that lasts me for 3 months at just over £21.50, and a high quality supply of Vitamin D3 for £12.50 which lasts for about the same time period.
To compare: I spend in excess of £80.00 per week on fuel for my car, £200.00 per week on my household shopping and so on and so on and so on.

This is not rocket science, as supplement manufacturers are forced to advertise (as with any other product for sale) to enable people to ascertain their efficacy and usefulness, unlike prescription drugs, which require little to no advertising (except in the USA) because they are already have a very substantial market (the entire population of the free World and beyond) via Medical Doctors who prescribe and approve them.
I suggest you read this thoroughly about supp-le-menting your diet.
http://www.chlorellafactor.com/
Touche.

 
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Stuart

“Now we’ve had this out before, but you are still repeating the same old mantra.
Supplements are not expensive, in fact they are quite inexpensive in comparison to pharmaceutical drugs, which can compete for the same market.”

They are also cheap compared to buying say, a Ferrari. But we are not comparing supplements to drugs or sports cars. We are comparing them to not taking anything which is the alternative.

“To compare: I spend in excess of £80.00 per week on fuel for my car, £200.00 per week on my household shopping and so on and so on and so on”

…..likewise fuel and shopping. Rather a pointless comparision.

“This is not rocket science, as supplement manufacturers are forced to advertise (as with any other product for sale) to enable people to ascertain their efficacy and usefulness”

You might want to think whether the supplement manufacturers are therefore in the right position to give an impartial view on how effective and useful they are, bearing in mind they sell them?

 
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wavechange

Thanks for the link to the book about Chlorella and Spirulina. The claims are impressive, especially the one about killing tumours. From what is stated, this seems to offer the answer to so many medical problems.

For goodness sake. I know that there are some gullible people in this world, but I think they would be more likely to trust a snake oil salesman. :-)

Actually, Chlorella and Spirulina may become extremely important if conventional agriculture cannot produce sufficient food to sustain the rising population. I first read about Chlorella in the 1960s, in a book that I was given as a school prize.

 
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wavechange

As Stuart points out, price is relative. Anyone surviving on a state pension could not afford these prices. I could afford them, but taking chemicals I am unlikely to benefit from is as pointless as buying dishwasher tablets when I don’t have a dishwasher.

Oh, and it is magnesium ascorbate, not Magnesium Ascorbate.

 
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ExR&D

Wavechange said:

“The Eatwell plate is simply an acknowledgement that most of us will eat some junk food and not a recommendation that we do.”

Beneath the eatwell plate on the NHS Choices website it says:

“The eatwell plate shows the different types of food we need to eat – and in what proportions – to have a well balanced and healthy diet.”

One segment of the plate is devoted to foods and drinks high in fat and/or sugar. It clearly shows foods and drinks that are not needed in a healthy balanced diet: sweets, cakes, biscuits, chocolate, crisps and cola.

This information on the NHS Choices website comes from the Department of Health (DH) advised by one of their committees: the Scientific Advisory Committee on Nutrition.

On the DH website it says:

“The eatwell plate is a policy tool that defines the Government’s recommendations on healthy diets. It makes healthy eating easier to understand by giving a visual representation of the types and proportions of foods needed for a healthy and well balanced diet.”

DH goes on to say:

“The eatwell plate is based on the five food groups:

• Bread, rice, potatoes, pasta and other starchy foods
• Fruit and vegetables
• Milk and dairy foods
• Meat, fish, eggs, beans and other non-dairy sources of protein
• Foods and drinks high in fat and/or sugar

The eatwell plate encourages the choice of different foods from the first four groups every day, to help ensure the population obtains a wide range of nutrients needed to remain healthy. Choosing a variety of foods from within each group will add to the range of nutrients consumed.”

And then DH says:

“Foods in the fifth group – foods and drinks high in fat and/or sugar are not essential to a healthy diet.”

So on the NHS choices website via the eatwell plate DH are saying foods and drinks high in fat and/or sugar are an essential part of a healthy balanced diet. They also say this on their own website. But further down on their own website they then say foods and drinks high in fat and/or sugar are not essential!

Don’t worry, I shall be writing to DH to bring these discrepancies to their attention, as well as introducing them to the Harvard healthy eating plate.

 
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wavechange

Sorry for giving my interpretation rather than checking the information.

I believe that my suggestion is practical. There can be few who manage to completely avoid foods that are high in sugar and/or salt, and for most people a bit of unhealthy food will do no harm. We need everyone to eat a good diet but not cranks who are obsessed with what every mouthful contains. You can try and deprive children of sweets, etc. but that is a recipe for encouraging them to eat junk whenever their parents are not looking.

Hopefully the NHS will reprimand their graphic designer and introduce consistency.

 
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Maria

wavechange said,

“There can be few who manage to completely avoid foods that are high in sugar and/or salt, and for most people a bit of unhealthy food will do no harm.”

Ian Marber Dip ION aka the ‘Food Doctor’ incorporates this reality into his healthy eating guidelines with his “80:20″ principle, which is that if you follow his healthy eating principles sound, I am not qualified to say but they seem pretty close to mainstream nutritional advice.

 
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Maria

OK, that ended up as gibberish, I’ll try again.

wavechange said,

“There can be few who manage to completely avoid foods that are high in sugar and/or salt, and for most people a bit of unhealthy food will do no harm.”

Ian Marber Dip ION aka the ‘Food Doctor’ incorporates this reality into his healthy eating guidelines with his “80:20″ principle, which is that if you follow his healthy eating principles 80% of the time, you can break them the rest of the time. Whether the rest of his principles are sound, I am not qualified to say but they seem pretty close to mainstream nutritional advice.

 
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Stuart

Yes, because as we discussed previously its highly unlikely that people would eradicate these thing entirely from their diet. People like sweet high fat things, that isnt harmful in a balanced diet.

Simply question then ExR&D whats for health:-

Everyone adopts eatwell (including a proportion of high fat/sweet things)
People ignore eatwell entirely because they are being denied food types they enjoy.

Its about gradual change. This assumption that any amount of fat/sugar is wrong and I think by doing this you actually give an unacheivable target for someones diet.

This only serves to reinforce the Which? findings that people were recommended restrictive diets by NTs lacking in some food groups.

Food can be enjoyable. Its not a punishment.

 
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chrisb

Stuart said………………….
“Another discussion we had previously. Lets assume you are right and these things work. Why is the mechanism important at all”?

Well for one thing, it would get you and others like you “off our backs” as the science in proving those mechanisms would silence the critique of those therapies.
It seems that you are unable to fathom what is really quite obvious.

 
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Stuart

It isn’t obvious, thats why I am asking you to explain.

If something has a scientific validated mechanism for action, then shouldn’t that by definition also lend itself to providing strong evidence of its efficacy Without relying on anecdotal evidence?

 
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Emma

Stuart,
Strong evidence of its efficacy is sometimes not enough:-Drug trial victim’s ‘hell’ months

(http://news.bbc.co.uk/1/hi/health/5121824.stm

 
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Stuart

“Strong evidence of its efficacy is sometimes not enough:-Drug trial victim’s ‘hell’ months”

Thats why they test the safety of drugs and have procedures for reporting adverse effects.

Safety and efficacy are both key components of an effective treatment. Its pointless to have a safe but ineffective treatment isnt it?

All medical interventions carry some degree of risk. Its whether the benefits outweight the costs.

By safety, I of course mean that the side effects are reasonable in relation to the benefits they offer, not that it is 100% safe. Thats a bar so high nothing would ever pass.

 

Hello everyone, particularly Alan, Chrisb, Selina and Stuart, we have once again had to delete a number of comments as they were what can only be described as personal attacks on other commenters.

This is completely against our commenting guidelines as we’ve said many times before. Comments should about the topic at hand, in this case nutritional therapists, and not other commenters. Tackle a commenter’s arguments not the commenter themselves.

This thread has so often stepped away from our commenting guidelines that we may have no other choice than to close this Conversation for good. I’m sure that’s not what you would like to see happen.

So, we will treat this as your final warning, otherwise that will be the action we will be forced to take. We are planning a new nutritional therapists Conversation and we hope that you will treat each other with respect there. Thanks, Patrick.

 
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Stuart

Patrick, sorry if some of the comments have stepped over the mark. I think some of us feel very passionate about this subject, especially when we feel that people may read comments and see them as an endorsement of dangerous, or unproven treatments. The intention is only to provide information in response to mis-information and sometimes that means asking people to support whath they say.

Bearing in mind the subject of many of the comments on here, particularly those endorsing cancer treatment with diet and Vit C, I am amazed Which? has allowed this thread to continue as long as it has.

Perhaps its time to leave this thread and participate on the new one on the basis you describe above.

 
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wavechange

Mis-information is one thing that has compelled me to participate in many discussions and this topic in particular. But the T&Cs state “Any content you add to the website will:
-be factually accurate and/or be your genuinely held belief or opinion that is based on facts;

What annoys you, Stuart, (and me) are legitimate comments. It would be difficult to run this site on any other basis.

It might help if the moderators or users could flag comments as off-topic, to keep us on track. Of course, I would have more flagged comments than most, and this is a good example. :-)

 
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Maria

As the only reason anyone is posting here is because it is still open and, as I said a couple of pages back, it has become cyclical and repetitive, I don’t see any reason not to close it.

It’s obviously outlived its purpose and isn’t going anywhere except round in circles (or down the pan).

 
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Selina Import

Patrick, I am sorry. You are quite right. It is easy to get drawn in.

 
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wavechange

Just called in to read the recent messages. I do like Stuart’s comment that “Food can be enjoyable. Its not a punishment.”

 
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Ellie

My view is that you cannot use the same kind of evidence for Nutritional therapy as for orthodox medicine. That does not mean that is should not be evidence informed, using as wide a base as research as possible.

At the end of the day it is still a complementary therapy and as such doesn’t advocate the replacement of modern orthodox medicine, however, if it helps to the extent that it reduces the need for medical interventions and pharmaceuticals, – then thats a positive result for all concerned!

As an example – the aim of the Human Genome Project was to chart all the genes in the human body in order to discover their relation to health. Hundeds of scientists from all over the world worked on this amazing project. Many scientists believed that gene therapy would be the health breakthrough of the future, and that in the long term faulty genes might simply be replaced by healthy ones (and thIs may still be achievable – to a degree)

You could say that this was an extremely logical approach using convergent thinking i.e. one problem, one solution.

Has it proved to be the case? No……………..what has been discovered is that a cascade of molecular interactions are involved in the transcription of many genes and that genes interact uniquely with the envornment.

What are the main environmental factors? Well surely the food we eat and nutrition has to be near the top of the list? Manipulated in the right way and it can potentially have a huge impact on our genetic make-up and especially on chronic ill health.

Other detrimental environmental factors include toxins in the environment and chronic stress – (which is rife in our society, as we live life at such a fast pace). All kinds of complimentary therapies have a positive effect on reducing stress, meditation, reflexology, massage etc. We do not need to produce robust evidence (as in double-blind controlled trials which are used for pharmaceuticals, – which would be impossible to do anyway).

If someone feels less stressed, then they are less stressed, and surely thats all the evidence that is required if the therapy is non-interventional?

 
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Ellie

Just as an add on….

Dr Andrew McCulloch (Chief executive for the Mental Health Foundation) has stated that:

“the economic costs of unmanaged stress are huge (and increasing) – 11 million lost working days per year, – at the last count”

 
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Selina Import

Yes Barney. We did evolve and learn to survive through communicating with each other long before science and any organised kind of medicine turned up. To deny anecdotes seems to me to deny the very essence of what it is to be human.

 
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chrisb

Stuart commented………………
“You might want to think whether the supplement manufacturers are therefore in the right position to give an impartial view on how effective and useful they are, bearing in mind they sell them”?

First of all many, though not all Nutraceuticals, ARE in direct competition to Pharmaceuticals, and why current proposals within the EU are trying to restrict their usage to RDI’s or less, rather than allow them to be available at a therapeutic dosage. Big Pharma anticipated this well in advance, and have effectively lobbied to that effect, ensuring a monopoly for them in the future. (source MEP).
The comparison I made between both Nutraceuticals and Pharmaceuticals as to cost, is therefore entirely relevant to their usage and sale. Not forgetting that the latter are far far more expensive than the former.

In addition, supplement manufacturers usually cite references of many scientific nutritional studies which support the information about their products, and which forms the basis on why they can be purchased and targeted at specific disease-states; but even health-claims re’ Nutraceuticals are now under threat, even though there is a wealth of Scientific information that provides factual scientific health benefits from the same.

This is especially so in the United States where the FDA and FTC state that it is LEGAL for DRUG Companies to advertise known harmful DRUGS, drugs that have been documented to kill and maim patients, as “SAFE and EFFECTIVE” for the prevention and treatment of disease.
The FDA’s legal definition of a drug, is anything that “diagnoses, cures, mitigates, treats, or prevents a disease”. So next time you eat an orange, you are actually eating a drug, as it contains Vitamin C which prevents and cures scurvy.

 
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wavechange

Please let greegrocers know that they are drug dealers.

Food for thought?

 
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Stuart

Chrisb, ignoring all the wild conspiracy theory you’ve dodged the central question:

Do you think that a commerial company which exists to make a profit can be trusted as a wholy impartial source of information on the efficacy of their product?

 
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Ellie

Out of interest here are some facts and figures taken from the Mental Health Foundation website and the Government white paper ‘Healthy Lives, Healthy People’:

‘Depression is linked with a 67% increased mortality form cardiovascular disease and a 50% increase in cancer, and a 2-fold increase in respiratory disease’

‘Individuals diagnosed with Bi-polar and Schizophrenia have a 4-fold higher risk of contracting an infectious disease’

‘Depression is linked to a higher incidence of back pain and IBS in later life’

’11% of adult health care costs in the UK are attributable to physical symptoms caused or exacerbated by mental health problems’

and this is an interesting one:

‘Between 20% – 30% of consultations in primary care are with people who are experiencing medically unexplained symptoms and have no clear diagnosis’

 
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Ellie

Sorry I ran out of time to sum up – but the last statistic in particular indicates that almost a third of patients have unexplained symptoms that never recieve a diagnosis.

If nutritional therapy can help some of these clients and thus reduce their stress, anxiety and possible depression then it has to be worthwhile.

 
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Chloe

18 Feb 2012:The Guardian

for Wavechange

Scientist claim that giving up almost all food for one or two days a week can counteract impact of Alzheimer’s and Parkinson’s – interesting to investigate and keep an open mind!!??

 
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wavechange

The way to take this forward is to do some carefully designed studies, publish them and critically review the findings. As with nutritional therapists there are some scientists who are not very good and it is becoming common to make speculative statements long before they have been substantiated.

 
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LiveandLetLive

Is, or is not, a member of the public entitled, or able, to find information (in this case, from NTs, but indeed from any practitioner) about approaches to health which differ from the current ‘medical’ or ‘scientific’ viewpoint?

Or are all responses from all alternative (and you may call them complementary if you wish, I do not) therapists to be dictated by the current ‘establishment’?

(Please don’t bother to repeat the tedious ‘we’re right, you’re wrong’, ‘we’re proven, you’re dangerous’ replies which have taken up so many pages of this conversation so far as they do not address this issue. It is already assumed that you think you are right.)

If all alternative responses are to be censored, then from where are enquiring members of the public to get information, other than from ‘establishment’ opinions?

 
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wavechange

As far as I know you can choose any therapist you want and they don’t have to be a member of BANT or registered with CNHC. They might get into trouble with Trading Standards but that’s their problem.

 
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LiveandLetLive

That wasn’t the question.

 
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LiveandLetLive

There’s no choice in ‘choosing’ a therapist, if all they have to parrot is the establishment viewpoint.

 
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Selina Import

LiveansLetLive, It is a very serious qustion that you ask. I sat for about ten minutes thinking to see if my mind could come up with a meaningful answer which everyone could accept. So far I cannot.

 
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Selina Import

LiveandLetLive. I did just catch a quote at the end of a conversation on the radio as I switched on recently. It was a conversation I think with a voluntary organisation and maybe educating young offenders. I had to guess the queation. The interviewee said “If we had to bent our thinking to meet someone else’s expectations then we wouldn’t be us.” Sorry this doesn’t answer your question either.

 
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Maria

“Is, or is not, a member of the public entitled, or able, to find information (in this case, from NTs, but indeed from any practitioner) about approaches to health which differ from the current ‘medical’ or ‘scientific’ viewpoint?

Yes. Such misinformation is all over the web.

 
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LiveandLetLive

Again, Maria, please read the question before posting an irrelevant comment.
…to find information (in this case, from NTs, but indeed from any practitioner) …
If I had wanted to request misinformation, I would have said so.
If I had wanted to say ‘all over the web’, I would have done so.

 
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Maria

OK, let’s start again. You said:

“Is, or is not, a member of the public entitled, or able, to find information (in this case, from NTs, but indeed from any practitioner) about approaches to health which differ from the current ‘medical’ or ‘scientific’ viewpoint?”

Yes – try google.

 
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ExR&D

Yes, Stuart, of course it’s about gradual change. I’ve never consulted an NT but I would expect the competent ones to start where a patient is at with their diet, not immediately instruct the patient to cut out foods and drinks high in fat and/or sugar.

However, the fact remains that foods and drinks such as sweets, cakes, biscuits, chocolate, crisps and cola are not essential to the diet. Not only are they not nutrient dense but we have not evolved to take these things into our bodies. Therefore, nutrients have to be drawn from elsewhere in the body to process them through the system.

Eating and drinking these things doesn’t even equal zero nutrition: it equals negative nutrition. So how does one address negative nutrition, i.e. nutrient robbery for an unevolved purpose?

 
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Stuart

“However, the fact remains that foods and drinks such as sweets, cakes, biscuits, chocolate, crisps and cola are not essential to the diet. ”

Agree they are certainly not essential. But as part of properly balanced diet they are also probably not harmful.

“Not only are they not nutrient dense but we have not evolved to take these things into our bodies.”

Specifically what ‘things’ have we not evolved to take into our bodies?

“Therefore, nutrients have to be drawn from elsewhere in the body to process them through the system.”

Can you provide anything specific that supports that assertion?

“Eating and drinking these things doesn’t even equal zero nutrition: it equals negative nutrition. So how does one address negative nutrition, i.e. nutrient robbery for an unevolved purpose?”

That conclusion would infer that these things are harmful to us. What evidence is there that this is the case?

 
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wavechange

Fair questions, Stuart. I would like to ask whether we have evolved to take the sort of supplements recommended by some NTs into our bodies. Either we decide the argument is not valid or we should be avoiding the supplements too.

It is perfectly true that we have not evolved to cope with some things, such as trans-fats and D-amino acids, for reasons such as the substrate specificity of enzymes. I will be interested to read the responses to Stuart’s questions.

 
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Stuart

I think wavechange, there is a naturalistic fallacy which underpins a lot of the thinking behind nutritional therapy

ie. the assumption that anything ‘natural’ is inherently ‘good’ and anything processed or ‘unnatural’ is somehow ‘bad’ or dealt with differently by the body.

 
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wavechange

This Conversation has done a lot to make me feel lucky that, at the age of 12, I decided that I wanted to go into the science form at my secondary school.

The lack of public knowledge is such that many don’t distinguish between the roles of colours and preservatives when looking at a list of food additives.

I keep hoping that enlightened NTs will come forward in these discussions to push for better standards and to promote ideas that people like you and I would support.

Orthodox medicine and NTs should work together to try to identify the cause of disease. It is often pointed out that we use drugs to treat symptoms rather than establish the cause. NTs certainly have a role in investigating food intolerances and other problems.

As an easier challenge, perhaps we can all work together to encourage everyone to cut down on processed foods, without getting obsessed about eliminating all junk food from the diet.

 
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Selina Import

ExR&D, Excellent point “to start where a patient is”. I always thought of people who consulted me as Client c** students (not “patients”). I always hoped that they would aspire to a greater knowledge about themselves than I could ever have as what was best to enable them to be well..

Another good pont you made about the junk type foods you mentioned is that “nutrients have to be drawn from elsewhere in the body to process them” Some nutrients which enable metabolism and utilisation may have been depleted altogether.

 
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wavechange

You mention that ‘some nutrients which enable metabolism and utilisation may have been depleted altogether.’

I cannot find any information about this, but maybe it would be easier with some examples of relevant nutrients. Is it covered in an NT’s training and is there any scientific evidence to support this?

 
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Selina Import

Chrisb, I hope you will be able to rephrase and submit the comment that you made that had to be removed.

 
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chrisb

Maria,
“What do you mean by ‘Logic’.”

I was referring to deduced reasoning or deductive logic.

“I am using circular reasoning, which is a formal logical fallacy. Your argument boils down to this:
If it didn’t work, people wouldn’t use it, therefore it must work”.

In other words you think that I am attempting to support a statement by simply repeating that statement in different or stronger terms, or using as a true premise a proposition that is yet to be proved.
I suppose I am repeating a viewpoint, because other than using a hammer with some nails to knock that message home, you are adamant in your denial of it. What you are essentially saying is experience counts for nothing, and is meaningless, when in every other walk of life experience counts for a great great deal.
I assume you mean that the only real evidence is via RCT’s exclusively? correct me if I’m wrong, and the experience of millions upon of people, who have received much benefit from, for example, Ayurvedic Medicine counts for nothing.

BTW I didn’t say that TCM is 5000 years old, as I actually stated that TCM dates back to about 2500 years ago; you are confusing that with Ayurvedic Medicine where I stated it dates back to about 5000 years ago. The timelines are debatable of course.

You said……………….
“You supplement this with a number of other fallacious arguments. Stuart has pointed these out and offered rational counter arguments that counter the fallacy and which, unfortunately, have been ignored by Barney who simply repeats the same fallacy, to which Stuart has had to respond again”.

I think that Barney would agree with me in saying that you are clearly using circular reasoning and logical fallacies.

I did not say however that because a practice has a long and established history, it MUST be beneficial, but what I did say (and there does seem to be some comprehension issues here) is that for a therapy to have survived for thousands of years, it must have at least some benefit, otherwise it would have been discarded. The evidence of successful experience passed on from one generation to another.
This isn’t difficult to understand, and to use a simple analogy: if I visit a garage to have my car fixed or serviced, and it was found not to be so, and this occurred to many many people over a long period of time, the business would in all likelihood go out of business, and cease to exist for providing shoddy workmanship. Crude analogy I know, but you get my drift.

And again………..
“I note you specify Modern Medicine as starting in the 19th century, which is fair enough but it’s actually irrelevant”.

Irrelevant to what? I was using that time scale in comparison to TCM and Ayurvedic Medicine. Modern Medicine is still in its infancy.

“Historical records also tell us that much of what was used as medicine was, at best, useless superstition which had no beneficial effect and, at worst, was actively harmful”.

Absolutely. I agree with you.

“Why do you think people continued to use leeches and bleeding over centuries? Do you think it is because they worked”?

Perhaps you would like to read this concerning Leeches………………….
http://news.bbc.co.uk/1/hi/health/3858087.stm

And bleeding or blood-letting……………….
http://articles.latimes.com/2001/aug/06/health/he-31093

“There is a point here being about proportioning one’s belief to the evidence”.

Absolutely Maria. Absolutely.

“I hope you can see the problem with your appeal to tradition now”.

Problem? What problem?

 
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Stuart

http://en.wikipedia.org/wiki/Appeal_to_tradition

 
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Stuart

“In other words you think that I am attempting to support a statement by simply repeating that statement in different or stronger terms”

Not exactly

“or using as a true premise a proposition that is yet to be proved.”

Yes. There an appeal to tradition included two assumption which are not neccessarily true read the link above.

“but what I did say (and there does seem to be some comprehension issues here) is that for a therapy to have survived for thousands of years, it must have at least some benefit, otherwise it would have been discarded. The evidence of successful experience passed on from one generation to another.”

Thats an entirely different question and has already been answered. Your assertion that humans are good at judging what practices are beneficial is demonstrably wrong. Blood letting was harmful and based on a wrong traditional assumption, and human experience failed to stop that. HUmans are very succeptible to bias and wrongly attributing cause and effect.

“Irrelevant to what? I was using that time scale in comparison to TCM and Ayurvedic Medicine. Modern Medicine is still in its infancy.”

A differently worded appeal to tradition.

 
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wavechange

Earlier we had claims that supplements are not chemicals, which is clearly nonsense. Now we have reference to ‘negative nutrition’, which seems to hijack the well established meaning of nutrition? It is perfectly possible to condemn a poor diet without the need to use this term.

I hope that better NTs don’t mention negative nutrition.

 
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chrisb

Wavechange,
I don’t think that anyone claimed that supplements are not chemicals, as of course they are, but you have distorted the meaning of what has been said. Nutraceuticals are bioavailable nourishing chemicals, as opposed to the chemicals that my body does not need on a physiological/biological level.

The lower case m I used for Magnesium that was highly significant to my message. Not forgetting that the purpose of language is to to convey meaning in communication and the reason I am not chatting with you in Spanish.
Correcting grammar mistakes is hardly relevant and of little significance.

 
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Stuart

Magnesium is ‘Mg’ Chris

 
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wavechange

chrisb

If you had not tried to teach me chemistry after I had declared an understanding of the subject, I might have been a little more tolerant.

I wonder how your body is able to distinguish between nutraceuticals and those that it does not need. Mine is not that clever, but works really well without any supplements.

 
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Penelope

Genuine qualified and professional Nutritional Therapists use the functional medicine model for assessing patients. A good quick explanation of the differences of conventional medicine and functional medicine is given here
http://www.youtube.com/watch?feature=player_embedded&v=p7Dzz1ewyO8

 
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chrisb

Penelope,
I just wanted to congratulate you in providing such an excellent post/link, on the differences between conventional medicine and functional medicine.
http://www.youtube.com/watch?feature=player_embedded&v=p7Dzz1ewyO8

Many thanks.

 
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Alan Henness

wavechange & Stuart

I don’t know if you’ve come across http://www.skepticalhealth.com before (its tag line is “Combating Quackery With Science”), but they have just published an article looking at various studies of vitamins in adults with a regular food intake: Vitamins: The Big Picture.

The whole article is worth reading (and easy to understand), but I’ve copied the summary below (I don’t know why the summary for Vit D is missing).

Please note what this is investigating:

“We are well aware that certain vitamins are absolutely essential to normal human function and that legitimate deficiencies result in disease, such as vitamin C deficiency causing scurvy, or vitamin B(3) and pellagra. We are investigating the use of vitamins in persons with regular food intake who are not suffering from legitimate dietary deficiencies.” (My emphasis)

“Summary of Vitamin Findings:

Vitamin A: Increases overall mortality in all adults.

Beta-carotene: Increases incidence of lung cancers and overall mortality in smokers. Increases overall mortality in all adults.

Vitamin B(1): Does not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. Nonsignificantly increases risk of both cardiovascular events and cancer.

Vitamin B(6): Does not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. Nonsignificantly increases risk of both cardiovascular events and cancer. Increases overall mortality in older women. No decrease or increase risk of total invasive cancer or breast cancer among women.

Vitamin B(12): Does not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. Nonsignificantly increases risk of both cardiovascular events and cancer. No decrease or increase risk of total invasive cancer or breast cancer among women.

Vitamin C: Does not reduce risk of cardiovascular events in middle-aged and older men. Detreimentally affects therapeutic response to cancer treatment.

Vitamin D:

Vitamin E: Significantly increases risk of prostate cancer in men. Increased risk of death from hemorrhagic stroke. Does not reduce risk of cardiovascular events in middle-aged and older men. Increases overall mortality in all adults.

Multivitamins: Increases overall mortality in older women. Does not decrease risk of cardiovascular disease or cancer.

Selenium: Nonsignificantly increases risk of type 2 diabetes mellitus.

Folate: Increases overall mortality in older women. Increases frequency of overall cancer. Significantly increases risk of prostate cancer. No decrease or increase risk of total invasive cancer or breast cancer among women.

Iron, Magnesium, Zinc, Copper: Increases overall mortality in older women.

Calcium: Decreases risk of total mortality in adults.”

 
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wavechange

It is important that those taking supplements are aware that they may not be necessary and there could be dangers that we know little or nothing about. Some are swallowing the things as if they are sweeties.

In the same way that I do not trust information on websites promoting supplements, I doubt that a website intended to combat quackery with science might not be giving an impartial balanced view.

I would be happy if recommendations on vitamin intake were reviewed, making use of the best studies available and disregarding inadequate studies, whatever their conclusions. Vitamin D might be a good start because dietary need will vary greatly with exposure to sun and the message about limiting exposure to sun is getting through to many people. There is, of course, the current warning that it is harmful if taken in excess.

I guess you have not had your multi-vitamin pill today, Alan. Neither have I. :-)

 
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chrisb

Alan the……………
“Summary of Vitamin Findings which are not factual or based on the real evidence………………..

For example, the Iowa Women’s Health Study initially showed that women who supplemented with vitamins C, D, E and calcium had significantly lower risks of mortality………………..
Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr. Dietary Supplements and Mortality Rate in Older Women: The Iowa Women’s Health Study. Arch Intern Med. 2011 Oct 10;171(18):1625-33.
http://www.lef.org/featured-articles/1014_Flawed-Study-Used-To-Discredit-Multivitamin-Mineral-Supplements.htm

Vitamin A: Increases overall mortality in all adults.

You………………
“Beta-carotene: Increases incidence of lung cancers and overall mortality in smokers. Increases overall mortality in all adults”.

Actual results…………………….
Beta Carotene lung cancer study flawed: Experts………………………..
http://www.nutraingredients.com/Research/Beta-carotene-lung-cancer-study-flawed-Experts

You said……………
“Vitamin B(1): Does not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. Nonsignificantly increases risk of both cardiovascular events and cancer”.

But why wait till you have Cardiovascular Disease…………
http://www.massagemag.com/News/print-this.php?id=3389

Vitamin B(6): Does not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. Nonsignificantly increases risk of both cardiovascular events and cancer. Increases overall mortality in older women. No decrease or increase risk of total invasive cancer or breast cancer among women.

Actual Vitamin B6 Studies………………..
http://www.iahf.com/b6-res.html

The B Vitamins best work as a team rather than in isolation and as a prophylactic

You said………………
“Vitamin C: Does not reduce risk of cardiovascular events in middle-aged and older men”.

In animals Vitamin C deficiency has been confirmed as an important role in the development of hypercholesterolemia and atherosclerosis, but due to ethical reasons placebo-controlled human studies are impossible to do………………………..
Ginter E (2007). “Chronic vitamin C deficiency increases the risk of cardiovascular diseases”. Bratisl Lek Listy 108 (9): 417–21. PMID 18225482

You said………………..
“Vitamin C detrimentally affects therapeutic response to cancer treatment”.

National Institute of Health / National Cancer Institute – “Early clinical [Cameron/Pauling] studies showed that high-dose – oral OR intravenous vitamin c iv, may improve symptoms and prolong life in patients with terminal cancer. At concentrations above 1000 µmol/L, vitamin C is toxic to some cancer cells but not to normal cells in vitro.
We found 3 well-documented cases of advanced cancers, confirmed by histopathologic review, where patients had unexpectedly long survival times after receiving high-dose intravenous vitamin c iv therapy. We examined clinical details of each case in accordance with National Cancer Institute (NCI) Best Case Series guidelines. Tumor pathology was verified by pathologists at the NCI who were unaware of diagnosis or treatment. In light of recent clinical pharmacokinetic findings and in vitro evidence of anti-tumor mechanisms, these case reports indicate that the role of high-dose intravenous vitamin c iv therapy in cancer treatment should be reassessed.”
Also………………..
http://www.naturalnews.com/034663_IV_vitamin_c_cancer_treatment.html
http://www.whale.to/cancer/intravenous_vitamin_c_and_cancer.html

You said………………
“Vitamin E: Significantly increases risk of prostate cancer in men. Increased risk of death from hemorrhagic stroke. Does not reduce risk of cardiovascular events in middle-aged and older men. Increases overall mortality in all adults”.

Yet another flawed study on Vitamin E and which I have posted on previously within this thread.
They used the wrong form of Vitamin E and at too low a dose………………….
http://www.oneradionetwork.com/newsflash/nci%E2%80%99s-flawed-select-study-attacks-vitamin-e-articl/
http://www.lef.org/featured-articles/INFEML_Rebuttal_E_1018.htm

You said………………
“Multivitamins: Increases overall mortality in older women. Does not decrease risk of cardiovascular disease or cancer”.

I answered that nonsense above.

You said……………….
Selenium: Nonsignificantly increases risk of type 2 diabetes mellitus.

Maybe, but the benefits outweigh the “risks”.
Where have I heard that before?

You said………………
Folate: Increases overall mortality in older women. Increases frequency of overall cancer. Significantly increases risk of prostate cancer. No decrease or increase risk of total invasive cancer or breast cancer among women.

Folate, or its synthetic counterpart Folic acid, is extremely beneficial in much higher supplementary doses than can be obtained from the diet, in the prevention of Neural tube defects and anencephaly, so again the benefits outweigh the risks for everyone.
Findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention……………………….
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0025340/

You said………….
Iron, Magnesium, Zinc, Copper: Increases overall mortality in older women.
Probably the shock to the body cells after being deficient for so long.
Also no indication as to the type of supplements and only provided an “association” and not whether the supplements caused these particular effects……………………………..
http://www.nutraingredients.com/Research/ANH-Multivitamin-study-is-classic-example-of-scientific-reductionism

You said…………….
“Calcium: Decreases risk of total mortality in adults.”

Good.

“Progress is impossible without change, and those who cannot change their minds cannot change anything.”——— George Bernard Shaw.

 
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Alan Henness

chrisb said:

“You said…………….”

I said no such thing.

However, I note that the author of that article I quoted invites comments.

 
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chrisb

I assume that if RCT’s are the only EBM, then perhaps to survive, or maintain good health, we should have an RCT of whether we need water/fluids.
Place 50% of trial subjects on freely available water or fluids, and the other 50% with no water or fluids. If the latter group die, we can safely conclude that water is essential for life.
Better still, we can recommend that the current “5 a day” are also required for health, but we’d better have an RCT to establish this because it is not “evidence-based”.

The comment…………………
“foods and drinks such as sweets, cakes, biscuits, chocolate, crisps and cola are not essential to the diet. ”

You replied…………………….
“But as part of a properly balanced diet they are also probably not harmful”.

Cakes and biscuits are made with white flour. When companies ship refined white flour in large 50 lb. bags, they don’t have to use any insecticide whatsoever. That’s because if an insect gets into the bag of white flour and starts eating it, that insect will die from consuming it. White flour is a natural insecticide because it kills any insect that attempts to live off of it.
Try this experiment yourself, (EBM) by buying some white flour, putting it in a bowl and throwing some ants in with it. Give them a little bit of water, just so they don’t die from dehydration, and then find out how long they live. You’ll find they won’t live very long at all.
An experiment conducted recently involved leaving a newly bought cheeseburger from a well-known burger-chain, which was placed on a kitchen shelf; one year later it had not decomposed or changed form whatsoever; even the insects stayed clear. No flies would go anywhere near it.
But this is apparently fit human consumption?
Your consumption maybe, but not mine.

Many refined-carb foods — particularly sweetened beverages like sodas — provide little nutritional value other than calories………………….
http://www.webmd.com/diet/features/truth-about-white-foods
http://www.healthy-eating-politics.com/white-flour.html
And then you say that biscuits etc will not probably not do any harm

Crisps…………
http://news.bbc.co.uk/1/hi/health/5367822.stm
http://www.ehow.com/list_6114268_health-risks-potato-chips.html

Cola……………….
http://www.clinicalcorrelations.org/?p=4273

and so on and so on and so on..

You said……………..
“Specifically what ‘things’ have we not evolved to take into our bodies”?

Any processed foods/drinks unless God made a mistake.

In reply to…………………
“Therefore, nutrients have to be drawn from elsewhere in the body to process them through the system.”

You said……………….
“Can you provide anything specific that supports that assertion”?

Yes…………
Diuretics, stress, Antibiotics…………….
http://www.doctorshealthpress.com/food-and-nutrition-articles/the-nine-thieves-that-are-stealing-nutrients-from-your-body

Prescription drugs that deplete nutrients……………………
http://www.lef.org/magazine/mag2010/aug2010_Drug-induced-Nutrient-Depletion_01.htm
References……………….
1.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 121.

2.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 286-8.

3.al-Ghamdi SM, Cameron EC, Sutton RA. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis. 1994 Nov;24(5):737-52.

4.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 219.

5.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 259.

6.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 40.

7.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 23.

8.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 262.

9.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 77.

10.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 135.

11.Quamme GA . Renal magnesium handling: new insights in understanding old problems. Kidney Int. 1997 Nov;52(5):1180-95.

12.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd Ed. Lexi-Comp Inc; 2001: 147.

13.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 223.

14.Pelton R, LaValle JB, Hawkins EB. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Lexi-Comp Inc; 2001: 166.

You said…………….
“What evidence is there that this is the case”?

Please read the above thoroughly.
Thank you.

 
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chrisb

Stuart,
you commented……………………
“Do you think that a commercial company which exists to make a profit can be trusted as a wholly impartial source of information on the efficacy of their product”?

Probably not, but that equally applies to Pharmaceutical Companies as well, who are not as impartial as we are led to believe………………….
http://www.sciencedaily.com/releases/2010/05/100507092335.htm
http://www.livescience.com/8365-dark-side-medical-research-widespread-bias-omissions.html
http://healthandpharma.awardspace.com/Week%205%20Readings/Angell-Industry%20Sponsored%20Clinical%20Research.pdf

But commercial supplement companies do not sponsor much research into their own products due to cost, but merely report independent findings of studies that would support their products.

 
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Alan Henness

chrisb said:

“But commercial supplement companies do not sponsor much research into their own products due to cost”

Why is cost a barrier to a multi-billion dollar industry?

 
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chrisb

Wavechange,
“I wonder how your body is able to distinguish between nutraceuticals and those that it does not need. Mine is not that clever, but works really well without any supplements………………

Much in the same way that if you ingest a chemical that is poisonous and harmful to the body, instead of a Nutritional chemical element which is nutritious and beneficial to the body…………..
http://en.wikipedia.org/wiki/Nutraceutical

I think the assumption here is that all nutraceuticals are of a synthetic origin, and where I will freely admit that some of these are next to useless, but if we use food-derived nutraceuticals in higher amounts than be obtained from the diet (Folate being one example) then the health-benefits can be enormous.
I also refer to extremely nutritious foods such as Chlorella and Spirulina, which can be used to supplement the diet and which have an extreme therapeutic value. BTW both of these “Superfoods” were instrumental in my health recovery along with supplemental Vitamin D3 at 20,000 ius per day.
http://www.chlorellafactor.com/
http://www.medicalnewstoday.com/releases/112633.php

I am sure that your body does indeed work very well without supplements, but this does not mean that you have the “optimum amounts” of nutrients from your diet, bearing in mind that current RDI’s of nutrients are set at a minimum level in the prevention of disease.

I have far more energy now, and sleep much much better than I did when I was 25 and over 30 years ago.

 
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wavechange

Many (I did not say all) synthetic chemicals are identical to naturally occurring chemicals. You will remember that I said that the fructose in HFCS is the same as that in fruit when we were discussing sugars. Like some synthetic chemicals, naturally occurring chemicals can be poisonous. Think about the toxic substances in mushrooms and botulinum toxin, from Clostridium botulinum. I don’t believe that anyone has synthesised anything as toxic as that toxin. It certainly is possible to make many synthetic chemicals that the body cannot cope with, but I am not aware that this is much of a problem in products sold for human consumption.

I will take the risk that I am not consuming the optimum amount of nutrients. Though I don’t subscribe to the idea that we should be eating a Stone-Age diet, we cannot have evolved to consume more vitamins etc. than can be possibly be provided by food.

I am glad that you are in good health but I would be very worried if anyone recommended that I consumed the amount of vitamin D3 you take. As I have said elsewhere, I am happy that intake of vitamin D should be reviewed – on the basis of what good scientific studies are available.

I have no idea why some can’t sleep. On the rare occasions this happens I get up an have a cup of coffee and sometimes a piece of cheese (one of the few things you can eat without the need to brush your teeth). Neither is recommended for insomnia, but it works for me.

 
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chrisb

Hello Alan,
you said………………
“Why is cost a barrier to a multi-billion dollar industry”?

Not sure, I suppose the owners are too busy having a permanent holiday in the Bahamas.
But in all seriousness, I have never said that the supplement industry does not have skeletons in the cupboard, and are probably just as Human as the rest of us: you know greed/corruption and so on.
No system is perfect and that includes the supplement industry.
The Federal Institutions of the NIH and USDA in America do most of their nutrition studies, so we just use theirs for the most part as this is where most of it comes from.
Why finance research yourself when someone does it for you?

 
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chrisb

Wavechange,
further information on the health-benefits of chlorella (science).
Research is still in its infancy so time will tell.
http://www.yaeyama-chlorella.com/36/chlorella-research/
http://www.canceractive.com/cancer-active-page-link.aspx?n=533

Try not to be too quick off the mark concerning its dubious efficacy in health-maintenance and disease-prevention/treatment.
Thanks.

 
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chrisb

Selina, Barney, Liz, EX, and others I may have omitted to mention, I think it is time to call it a day.
It is obvious now, or should have been some time ago, that we are preaching to those who are in denial about Alternative Therapies, and which we know have a proven track record in their efficacy.

Doubtless there are a number of these which could be defined as quackery, but then that accusation can be justifiably leveled against some of Mainstreams treatments as well.

I for one know only too well my own personal experience with Nutritional Medicine, and how this restored my health to levels I never dreamed to be possible, when the best private care that I had with Allopathy, had failed me for over a year, and desperation had set in.
Nutrition I believe, along with diet, will be the prophylactic of disease in the future, and will take on a much more prominent role, saving the NHS here billions of pounds in costs to the taxpayer. Nutritional Medicine then could be described as “an ounce of prevention is worth……………

 
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LiveandLetLive

Ditto …thanks to all those (Chrisb, ExR&D, Selina, Elle, Barney, and their ilk) who kept the conversation above dreg level :) and put forward intelligent and thought provoking debate to counteract all the negative pettiness which appeared when the ‘we’re right’ lobby ran out of anything bright to say!

I’ve enjoyed the positive and interesting contributions, and hope to read more from those authors in the future. Thanks and bye!

 
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chrisb

Stuart,
re’ my appeal to tradition………………..
http://en.wikipedia.org/wiki/Appeal_to_tradition

Well no, not really. I am not appealing to tradition per-se, and to tradition only, but more in the way of “experienced and efficacious tradition” or “know-how” or “procedural knowledge”, rather than propositional knowledge: “on-the-job training” rather than “book-learning”.
Philosophers dub knowledge based on experience “empirical knowledge” or “a posteriori knowledge” which has stood the test of time.

 
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Stuart

Yep, I undertstood that and I addressed that issue seperately in the post below it.

 
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Maria

“It is obvious now, or should have been some time ago, that we are preaching to those who are in denial about Alternative Therapies”

At least you acknowledge that you were preaching.

All the best.

 
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chrisb

Maria,
I probably should have substituted the word “preaching” with “defending Alternatives”, and that would have been a more accurate description, or what the French describe as the mot-juste.
So thank you for highlighting that.

All the best to you too.

 
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chrisb

Alan,
in response to my comment……………..
“I said no such thing”.

You commented……..
“However, I note that the author of that article I quoted invites comments”.

The website entitled…………………..
Skeptical Health.
Combating quackery with science.

Yes, but this would be akin to flaming the fires……………but I did it anyway.
My post is not being shown as yet, so perhaps being moderated or even censored?

 
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Ellie

For me too its time to call it a day: Practically everything has been said to cover this topic.

I don’t think its necessary for those who wish to make their own health choices to have to defend that right quite so vigourously.

I wish you all well and hope you have a good weekend.

 
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Selina Import

Yes Chris I agree it is time to call it a day. There are great doctors and others in the NHS. There are great people in complementary medicine and therapy too. Great people have the ability to recognise and appreciate each others value.

Ellie, Just to say I very much appreciated what you said in your last few posts.

All the best to all of you who are involved in enabling others to find their best way to be and stay well

 
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chrisb

I find it quite amazing that I get so many thumbs down on my posts.

Is this because it is clicked on just because of my username, with a predetermined viewpoint? or after weighing/evaluating the contents of my post?

Most likely the former reason me thinks.!!

 
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wavechange

I can’t see your username being a factor, chrisb.

– You have done little to acknowledge that there may be anything wrong with nutritional therapy as currently available. I and others acknowledge that Which? has alerted us to a possible problem that deserves investigation. Getting rid of quack techniques could really help NTs gain more respectability.

– You and others have focused on criticising the NHS and orthodox medicine, which is not the topic we should be discussing. If we were discussing the inadequacies of GPs, I could make many criticisms, though I would also make some very positive points.

– You have misused science, in my opinion, and have provided links and citations to articles that do the same. I recall Appleton’s list of reasons for treating sugar as poison, followed by a long list of references. Most of us know that we should avoid sugar if possible, but to treat it as a poison is absurd and your support for this and other misuse of science damages your credibility in my eyes.

– You have provided links to some very dubious information. For example, the information about Chlorella and Spirulina refers to very bold claims such as killing cancers and other statements that have not, as far as I know, been substantiated. Whatever the merits of eating the stuff, the claims make it look like the modern equivalent of snake oil.

– You have promoted taking supplements without testing and in amounts that exceed official recommendations, without any acknowledgement of the possible dangers.

– Only recently have you acknowledged that supplement industry may deserve some of the criticism that you and others have made about the pharmaceutical industry.

– To the best of my knowledge you have offered no criticism of the marketing of supplements. Indeed, you have introduced me to Mercola, who could probably sell snow to the Eskimos, but it would have to be his special snow.

This is not intended to be a tirade of personal abuse but a personal appraisal of why I have not been very happy with some of the comments you have posted. I’m sure that you could provide feedback on all of my points, but it might be better if avoid further discussion or at least stick to the subject of nutritional therapists.

Best wishes
wavechange

 
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wavechange

Thanks Maria for all your input to these discussions.

It is disappointing that there has not been much common ground in the discussions, apart from the importance of a good diet.

I agree with the ‘opposition’ that prevention of disease should be more of a priority than treatment, but so do many of those in orthodox medicine. However, the best way to take this forward is a scientific approach, making use of well designed studies that are published in respectable journals for everyone to make use of. Well not everyone, because much of the scientific literature is currently available only to those with access privileges.

 
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Maria

wavechange, your posts here have been fantastic and I very much agree with your last one.

 
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david colquhoun

I have the feeling that these prolonged arguments might be coming to an end.

The remarkable outcome, for me, has been the inability of the NTs and their defenders to admit that anything is wrong with the advice given by NTs, despite the evidence that Which? has produced.

I see very few condemnations of the lunatic fringe methods like iridilogy. I even see defence of homeopathy.

The NTs who have commented here (perhaps not representative of all NTs) have shown by their own words that they are very firmly in the world of alternative medicine. They are quite free to be part of the alternative world view (as long as they don’t harm people) but that has nothing to do with science. The transcripts were judged according to the standards of current scientific knowledge. If you don’t believe in science, you are unlikely to agree with the conclusions.

My reason for believing in science is, in part, because it has delivered results. One of those things is the internet, which, ironically, is used so widely to disseminate anti-scientific views.

I think that there has been a tendency, throughout the long discussion, to underestimate the great difficulty of finding out whether a treatment works. It is largely because of this difficulty that people are easily deceived by alternative views. In contrast, it is quite easy to tell whether a mobile phone works, or whether an aircraft works. This, I suppose, is why there is no flourishing industry in “alternative telecommunications” and no “alternative aeronautical engineering industry”.

 
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Jane Reed

The only information we have about what ‘they said’ is what ‘you said’. I refer to the recordings made by Which? clients. It is all hearsay as far as I am concerned. This is like being in a kindergarten.

I think all the regulatory bodies should stand back and let the courts prevail. Health practitioners (I include those involved in drug trials) whose procedures kill or maim members of the public should be subject to the full force of the law and that means they never practise again. The victims and their families should receive full compensation. I include in the group of practioners also pharmacists who should be discouraged as a group from relying on theory in ‘signing off’ a long list of drugs, particularly in the case of the elderly. How many old people do we know on a cocktail of ‘beta-blockers, stomach acid inhibitors, statins, blood thinners, thyroid hormone, ACE inhibitors, with a few dementia drugs added in etc, etc. ? Show me the long list of RCTs in a LARGE population of over 80s with conclusive evidence that this long list is safe.

David, you have an axe to grind so your opinions are not balanced.

Jane

 
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wavechange

Thanks David. For years I have warned students about using websites intended for the public, and that much of the information about health and disease has been written by those with little knowledge and understanding. I had not any appreciation of the number of people and organisations that use scientific papers to support questionable or fallacious claims.

With more open source publication it could get worse, though I am not sure how many articles are read, never mind understood.

 
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Stuart

The misuse of scientific papers is absolutely rife. Its quite shocking. People will often quote a paper which says the opposite of what they are arguing!

They crave the status of scientific evidence, but are unwilling to have the discipline to follow is it defining principles.

 
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Jane Reed

Stuart,

“The misuse of scientific papers is absolutely rife.”

Quite right you are.

Basing clinical decisions on studies carried out in other countries such as America or Timbuctou or Japan is not good and is very rife.

Or applying studies carried out in health young populations and applying the results to old people on a long list of drugs. This is not satisfactory.

 
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wavechange

Jane

I agree about the potential hazard of the drug cocktails taken by many people, particularly the elderly. It is difficult to ensure that a single drug is safe to use and that taking it offers a worthwhile benefit and that the dosage is right, taking into account such factors as impaired renal function. Throw in other drugs and their side effects and trying to manage risk/benefit becomes a lot harder. I do not believe that adequate tests have been carried out or are likely to be in the near future. It is difficult enough to diagnose problems in the elderly without having to cope without having to deal with problems created by drugs.

There is plenty of examples of drug/food interactions. For example, those taking statins are recommended to avoid grapefruit. Those taking proton pump inhibitors may need extra vitamin C in their diet.

Orthodox medicine is certainly aware of the problem and I have seen more than one article in the BMJ when staying with friends in the medical profession.

As I have said many times in these discussions I am opposed to people swallowing supplements unless there is a good reason for doing so, but I am much more concerned about the situation with prescription drugs. Perhaps we should be grateful for limited NHS budgets, or more pills might be handed out.

Obviously this is not relevant to the subject of the discussion, but there could be a lot of anecdotes if we have a Conversation on NHS medical treatment.

 
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Stuart

Final thought from me.

(Ellie wrote..)
“I don’t think its necessary for those who wish to make their own health choices to have to defend that right quite so vigourously.”

I agree we should all have the right to ‘health choices’. We are all free to read the internet if we choose and buy supplements if that is our belief, or to follow conventional medicine.

But this discussion is about the provision of advice given to paying customers by NTs who wish to be seen as valuable mainstream health professionals. In my opinion holding that position of means that they have a moral (and legal in the case of cancer) obligation and responsibliity to provide recommendations which are backed by robust evidence, otherwise they risk doing harm.

Health choices are only true choices if they are well informed. Its simply not good enough to assume that anyone visiting an NT by definition believes in unproven diagnostic techniques, or unproven methods. Many people lack the critical thinking and training to properly test claims. This leave vulnerable people very succeptible to harm.

A choice to consult with a NT shouldn’t be a choice to abandon science, evidence and reason.

Good health to you all :)

 
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Jane Reed

I may have the right to health choices in the U.K. but the choices are limited. Can anyone tell me where I can get IV Vitamin C in England before I make an appointment with my French GP. It would save me a lot of money on travel costs.

 
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Maria

Jane

Before you spend all that money, are you sure you need it?

 
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chrisb

Wavechange, Stuart and David.
Comment/conclusion regarding the observational study/comments by the panel of experts.

The reports findings are perceived by many, including myself, as questionable because of a lack of objectivity and impartiality by its “expert panel”, where only one out of the three could be judged to have any in-depth knowledge of the subject. I have done little to acknowledge that there is anything wrong with Nutritional Therapy for that reason. If the expert panel had been chosen more carefully, and because of a greater expertise of the subject, then the report would have been more believable. BANT have also questioned this lack of impartiality/objectivity from the chosen panel, and commented to this effect on their most recent update, stating that the study was most likely designed to fail before it even took place.
It is because of this, that the WHICH discussion and debate has been prolonged.

But this has not just been about the report made by WHICH, as the dialogues that have taken place throughout, are evidence enough of a general prejudice and bias against that form of therapy, or ANY Nutritional intervention in the treatment of disease, in the recovery of health and/or health maintenance, and despite the wealth of scientific evidence in support of it, and that you are all in denial of. This is not “misused science” as some of you believe, but information gleaned from your own Journals and mainstream websites such as PubMed; the Archives of Internal Medicine; JAMA, The Journal of the American Medical Association, and many many others of equal standing.

It must also be gratifying for you all to know, that your end-conclusions/opinions were correct from the beginning, and even before any discussion had taken place, and which have largely been self-congratulatory.

But I do understand your viewpoints and opinions, as these are a product of your upbringing and educational background, which are “set in stone”, and seemingly impervious to any deviancy from the dogma you have been conditioned to believe in.

I however, although educated to degree level, I have been fortunate enough to see “out of the box” of my training and educational dogma, and which many scientists seem unable to do as they just tow the party line. Anything that challenges this status quo of opinion and dogma, is roundly criticized and brought to bear, and yet another reason why Medical Doctors, within the framework of Orthodox Medicine, rarely if ever question what they have been taught, and just accept their health-paradigm of the teachings of their mentors as being gospel.

This is not helpful to science and restricts its boundaries into a form of narrow-mindedness that allows them to attack and critique anything that challenges their own perceptions and belief systems.

The comparisons I have made personally of Orthodox Medicine with Nutritional Medicine, were to enable you all to see that their is another successful perspective on healthcare and health-recovery, and to highlight that Orthodoxy have their own serious failings which are largely ignored by the Media.
An observational study made of Nutritional Therapy, should therefore be counterbalanced with one of some of Mainstream therapeutics, which currently stand as the 3rd leading cause of death in the United States, both by correctly prescribed pharmaceuticals, and Iatrogenic deaths combined.
All of this of course is conveniently ignored by the media generally, because they hold the power of the status quo and the political/financial influence to maintain the same.

In evaluating the competency of a handful of NT’s, and probably successfully whitewashing the entire nutritional therapeutic base because of this, we should try and achieve a more realistic perspective as to WHO, WHY and WHERE the responsibility for by far the most danger lies.

Wavechange,
” I have promoted taking supplements without testing and in amounts that exceed official recommendations, without any acknowledgement of the possible dangers”.

Incorrect. You have yet again misconstrued my position in that I have not promoted taking supplements that exceed RDI’s, but if one requires to supplement a good diet then they are free to do so. Notice I actually said supplements can be used for the health-conscious as a supp-le-ment. Even Harvard Public School of Health has endorsed this recommendation. Supplements do not and should not replace a healthy diet. Please try and adhere to what I actually have stated, rather than your own interpretation of this.
However, I have said that anyone who wishes to treat a disease with Nutrition, then they should see an Orthomolecular (Nutritional) Doctor for qualified and specialized medical advice.

Just one of your most recent comments Wavechange……………….
“Thanks David. For years I have warned students about using websites intended for the public, and that much of the information about health and disease has been written by those with little knowledge and understanding. I had not any appreciation of the number of people and organisations that use scientific papers to support questionable or fallacious claims”.

Only serves to illustrate what I have mentioned above.

 
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wavechange

Here we go again. I’m wrong, as usual. I see that scientists and doctors are also coming in for some criticism this time.

Even if though you disregard with the Which? report, there is evidence of NTs engaging in dubious practices such as iridology and homeopathy on various websites and some are are profiting on the sale of supplements, which could conceivably result in people being encouraged to take pills they do not need.

To avoid the risk of making further errors I won’t bother to say anything else. I’m clearly a hopeless case and there is no point in spending time trying to change my mind.

 
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Maria

chrisb said,

” I think it is time to call it a day.”

That was 24 hours ago. Now you’re back flogging the dead horse of an ‘argument’ that came up at the beginning of this conversation and has been addressed over and over again. As I said myself several days ago, why don’t we just agree to differ?

There are other internet forums where you can go and preach.

 

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