/ Health

Had dodgy advice from a nutritional therapist? We have!

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.

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?

Comments

Hi all, just wanted to come back and explain why we’re editing some of your comments. We appreciate that it may look like we’re picking on certain posters and editing their comments, and I’m very sorry if it seems that way. As I’ve explained already a few times during this discussion, we do try our hardest to moderate as little as possible and allow people as much freedom of speech as possible.

However, it is becoming a bit tiresome to read so many personal attacks on one another – many of which are childish and unnecessary. We have never had to close a Conversation to comments before, but are coming quite close to doing just that now, which would be a shame, given that in-between all the arguing some interesting points are still being made.

Can I just remind everyone of a few points from our commenting guidelines:

“Avoid purposely provoking members of the community into a desired emotional response”

“We may remove posts that others may find offensive, harassing, threatening or abusive or we consider to be defamatory.”

Selina Import says:
26 January 2012

Yes Which, it is so important to avoid personal and professional attack. It is difficult to be free of bias towards one’s own speciality. In learning we need to be able to develop our capacity to look at and challenge our own beliefs, knowledge and experience. We need to let go of established patterns of thought so that we are able to make open and unbiased comparisons with all points of view. Belief is always open to question. We need to remind ourselves constantly that we are ordinary people. Trained as professionals, it is often the hardest thing to do to be an ordinary person. After searching I am lucky to have a great NHS doctorand in the past have found an excellent complementary doctor. If we look for fault we will find it. If we look for excellence we will find it too.”Where there is discord, may we bring harmony. Where there is error, may we bring truth” Where there is misconception, may we bring understanding. Where there is blame, may we bring compassion.

Penelope says:
27 January 2012

I would just like to direct people to an article published by the Alliance for Natural Health which outlines the distinct differences between the approach of dieticians and nutritional therapists. In my opinion this clearly demonstrates why the approach taken in this investigations was fundamentally flawed.

http://anh-europe.org/news/anh-feature-dieticians-and-nutritional-therapists-never-the-twain-shall-meet

Asking a dietician or a professor of pharmacology to assess the advice given by an NT is as valid as asking a dentist to judge a GP.

Maggie says:
25 January 2012

Finally Hannah thank you…

Can I just mention that I am low in vitamin D and calcium … NHS blood test… But did have to pay for a prescription my GP prescibed…So all consumers please note this..

Ellie says:
25 January 2012

Frozenwarnings

Thankyou for the above response and I take on board the comment that in this scenario the doctor should ask “why do you think you need a test for Vitamin D and what are your symptoms?” but the point I am making is about choice and not just about advertising.

When you take away choice you force the consumer to accept what is on offer or nothing. and this is hardly fair. In the article we have one sector of NHS professionals asking their collegues to listen to the evidence about Vitamin D because they are trying to highlight the issue.

My point is that if there is no consensus about this within the NHS then where does the consumer stand on this issue? It should not be a matter of luck whether your GP is on one camp about Vit D or the other. What is important here is that your GP has an open mind and is willing to admit that they don’t have all the answers but that they are willing to look at the evidence and discuss it with you.

Life is not black and white with one group being ‘all wrong’ and one group being ‘all right’ as this situation has shown.

frozenwarnings says:
25 January 2012

Ellie,

Choice is fine, but when that choice is between a health professional and people who would simply like to be health professionals, it is advisable to go with the professionals.

There is consensus on vitamin D, it is in the NICE Guidelines. Some GPs are apparently unaware of this and are now being encouraged to make themselves aware of those Guidelines. If you need more information on diet and nutrition see a registered dietician. There is no need for another profession to be invented.

The British Society of Dieticians has very sound advice on supplements here, by the excellent Catherine Collins. http://www.bda.uk.com/foodfacts/supplements.pdf

If nutritionists/nutritional therapists are telling people something that goes above and beyond BDA advice then they are doing something wrong and possibly potentially dangerous.

If you are someone who is interested in advising people about diet and nutrition, then become a dietician. Ditto if you are interested in physical therapy, become a physiotherapist, not a chiropractor.

Jamesy says:
25 January 2012

It is just not accurate to say that NTs do not test vitamin D properly – they do not use iridology!!!!!!!!!!!! but most use the best biochemical testing approved by the Vitamin D External Quality Assurance Scheme (DEQAS). It is not expensive.
One is not likely to be aware they are deficient. – one wouldnt take oneself to the doctor and say i think i have vitamin D deficiency but now hopefully all health professionals are aware of symptoms that might indicate its presence. This is a fairly new development Hopefully doctors are becoming equipped to deal with the widespread deficiency. It seems so with the coverage for example on the news this week.
THe point that I made in a previous correspondence, I repeat is that NTs have known about vitamin D deficiency and the lack of recognition of it for a long time as it is in the field of nutrition and there are some clever scientists in this field who support nutritional therapists and their work!!!

David
In response to your points. You are correct that hip replacements are expensive but in many cases they are due to obesity (which the NHS is failing to solve). A friend of mine who is an orthopaedic surgeon operated on 1 tonne of patients in one week recently. He said that he often sees the same patients a years later after they have failed to loose weight and need the second hip done as well. Your use of the phrase ‘real medicine’ is subjective and unscientific. In regard to the value for money of GPs, I must clarify that my comments (as with previous comments) are limited to how GPs treat chronic conditions not other areas (where they do a much better job). I do not blame GPs for this but the department or health who define chronic conditions as those which can only be managed not cured (I can find the reference if you want). In response to your last point, I am sure that many NTs would use the NHS to help with infectious diseases but would then take measures to achieve an improved level of immunity through diet and lifestyle. It is also of interest to note that a recent survey of senior NHS staff showed that 60% had private health insurance ( i.e. do not believe in the effectiveness of the company that they work for). I could not imagine a private company surviving with this level of staff loyalty.

Andrea says:
25 January 2012

To Alan Henness.
There is nothing here to hide about my origins, mon amie. I would rather happy if your comment has been left as it was, so everyone could see it and make their justice about your other comments. It makes me feel as you are defendig your personal interests here. Also, please remember, that this is a consumer’s magazine and anyone with irrelevant to the discussion qualifications (and without them) are welcomed.
I steped into conversation because I have noticed that many of you trying to discredit a whole profession, while giving credits to your own.
Also, I felt sorry for fantastic Nutritional therapists, who work with fabulous nutritionist PhD in the fields of women health and fertility. Thankfully to them I gave birth to my precious son, while conventional medicine has failed to help.
So, would you exume me please and give me a right to say what I wanted to say!

Alan Henness says:
25 January 2012

Andrea

Unfortunately, I did not keep the text of what I actually said. Suffice to say, I discussed science degrees at universities and that having one was no guarantee that science was studied and linked to a website that gave more information about the nonsense that is being studied at some of our seats of higher learning.

Rest assured, I made no ad hominem attacks on you or anyone else and I’m at a loss to understand why it has not been published. I hope that you will look back through my comments and realise that I have been asking questions, questioning some commenters’ reasoning, pointing out comments that had nothing to do with the topic at hand and supplying them with information as part of a genuine attempt at engagement. I have asked many questions (that were rarely properly answered), but I have not made any ad hominem attacks. Unfortunately, I’ve been on the receiving end of one or two.

I entirely agree with you that your origins are irrelevant.

However, I think you’re trying to build a straw man: I have certainly never said (and I’m not sure anyone else has either) that all nutritionists are tarred with the same brush of appalling behaviour that Which? uncovered. Indeed, I’ve been at pains to point out several times that I have no doubt there are nutritionists who do a good and worthwhile job of giving sound, evidence and science-based advice.

“So, would you exume me please and give me a right to say what I wanted to say!”

I wasn’t stopping you: I have no such power to do so.

Jamesy says:
25 January 2012

My final word for now is

There have been some nutriitonal therapists who have pushed unecessarily supplements
There have been some dieticians who have been too heavily influenced by the food industry and pushed processed foods
There have been doctors only interesting in quickly prescribing a possibly unnecessary medication and not considered nutritional matters
Isnt it time now to recognise that all professions have important but different roles as far as i’m concerned based on scientific evaluation using the broader definition of the word mmore suited to addressing the topic of nutrition.

Andrea says:
25 January 2012

To Alan Henness.
Please read the title of the review one more time and you understand what many of as mean.

To the unfortunate nutritionist, who “gave dangerous advice for the cancer patient”. If you are sure you you haven’t done anything unlawful, consider legal advice.
Your professional body has stated that they could not find direct suggestions on avoiding treatment. Nobody, apart from the court have a right to announce you guity. Good luck.

Alan Hennsss says:
25 January 2012

Andrea said:

“Please read the title of the review one more time and you understand what many of as mean.”

The title of this page asks a question: “Had dodgy advice from a nutritional therapist? We have!”

The title of the main webpage about what they found also asks a question: “Nutritional therapists: gambling with your health?”

The sub-heading is: “Which? rates six consultations as ‘dangerous fails'” and the standfirst is: “A Which? investigation has found that some advice given by high street nutritional therapists could seriously harm patients’ health.”

The title in the printed magazine is yet another question: “Are nutritional therapists gambling with your health?” and the subheading: “Our undercover investigation finds evidence of nutritional therapists giving out advice that could seriously damage patients’ health”

If these are what you are referring to, please point out where is says that all nutritionists give misleading or dangerous advice.

It may not say all nutritionists give misleading advice or dangerous advice but it most definitely tells us above that visiting a nutritional therapist is not worth the money and could be dangerous to your health in some cases.
Imagine if three panelists had said this statement about conventional medicine on the basis of 15 consultations across the UK and left it at that.

If the panel are shocked by their findings why not an article on iatragenic deaths in this country.

Maria says:
25 January 2012

HST wrote:

“Imagine if three panelists had said this statement about conventional medicine on the basis of 15 consultations across the UK and left it at that.”

Interesting question. If Which? investigated, say, 14 private cosmetic surgeons in the same way that investigated NTs and researchers found a majority of them were, say, telling customers that for best results they needed to take unnecessary supplements that they could purchase from the clinic, I’m sure anyone considering cosmetic surgery would be pleased to know about it. Wouldn’t you be?

Alan Henness says:
25 January 2012

HST said:

“it most definitely tells us above that visiting a nutritional therapist is not worth the money and could be dangerous to your health in some cases.”

No, it tells us that they got misleading and dangerous advice for the nutritionists they visited and that they want to hear from others who have also had dodgy advice.

Do you agree that what needs to happen now is that the organisations responsible for representing and regulating nutritionists need to conduct independent research to find out how widespread the problem is and take steps to protect the public?

“If the panel are shocked by their findings why not an article on iatragenic deaths in this country”

Perhaps you could suggest to Which? that they investigate?

WHich? wrote.
“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.

So the panelists are telling us not to visit one as its not worth the money and in some cases dangerous.

Elizabeth says:
25 January 2012

To all, specially including professor Colquhoun:
After the discussion about vitamin D and how necessary or not it may be, I thought some people should listen on their computer to BBC Radio 4 broadcast this after noon (Wednesday) in the series “inside health”. It occurs 20 minutes in to a half-hour programme.
A professor of paediatrics from Sheffield recounts how he was visiting Canada with his wife who was breastfeeding her young child, They visited a doctor because his wife was having problems.
The doctor gave them a test for vitamin D and found them deficient, and solved their problem by dosing suitably. The paediatrician was duly impressed, especially when it was pointed out to him that his young child was showing signs of vitamin D deficiency to the point of early rickets. They make sure now that this is part of his work at Sheffield,
. About time that England caught up with Canada, I think.

Elizabeth
I have already pointed out, with links, that the BMJ. the British National Formulary and NICE have all given extensive coverage to the potential problem of Vitamin D deficiency in pregnancy. Both diagnosis and treatment are available free on the NHS.

Maggie
I was interested by your comment

“Can I just mention that I am low in vitamin D and calcium … NHS blood test… But did have to pay for a prescription my GP prescibed”

I’m really surprised you had to pay, If you’d like to email me details I’d be happy to investigate why you were made to pay, and what you were charged.

Guy
You say
“You are correct that hip replacements are expensive but in many cases they are due to obesity”

Have you got information on how many cases of osteoarthritis are caused by obesity? There is certainly a correlation between body mass index and knee osteoarthritis and to a lesser extent, hip osteoarthritis, but I haven’t been able to find the distribution of BMI among people getting hip replacement, Have you?

I have some personal interest in this question, because on Friday 27th, I have to get a revision of a total hip replacement (which has lasted 15 years) and I’m not overweight. At least that may prevent me from commenting for a few days.

It’s true that the NHS has not been very successful in reducing obesity. But I wonder whether there are any good data on the success rate of nutritional therapists in reducing obesity? Do you know of any good numbers? We are drowning in sensible advice about eating, but sadly that doesn’t seem to have the desired result, As so often, it seems to be more complicated than that.

nobbyuk says:
25 January 2012

its seems that another conversion has begun surrounding the:

“To the unfortunate nutritionist, who “gave dangerous advice for the cancer patient”. what advice was it?
from the Which press release:
“One therapist advised against surgery and radiotherapy to treat cancer, telling the researcher she could rid her body of cancer through diet.

The nutritional therapist said: ‘Cancer lives off sugar; if you feed it sugar it’s going to thrive. If we starve the cancer of sugar then you have a better opportunity of the cancer going away’.

dont foget the BANT response which i have mentioned earlier but just to add it: BANT appear to accept what that “unfortunate nutritionist” said just not in the way they presented it as they clearly state in their response:

“Whilst the information could have been better presented”

so in what way could this information have been presented in a way that would still result in the notion of getting rid of cancer through diet and advising against cancer treatment? any takers?

Ellie says:
26 January 2012

nobbyuk
I would like the opportunity to reply to this from a patient/consumer perspective and through some of the very valid contributions that different individuals have made to this debate.

Simon Rogers raised a question that I don’t think has yet been answered:
‘BANT say the NT who made cancer recommendations suggested the researcher did this with the Oncologists permission. Only WHICH can answer this question. Did the NT in question and the pseudo-patient make reference to the Oncologist or not?’

It seems to me that a whole profession is being ‘shot down in flames’ because of assumptions that may or may not be true. HST gave links to medical articles which suggest that Ductal Carcinoma in Situ is regarded by some experts as a pre-cancerous condition which can sometimes regress with the help of diet, lifestyle changes, and hormonal rebalancing. If this is true then the final decision should surely lie with the patient, – who might , understandably wish to avoid unecessary surgical and medical intervention? However………..this should be done with the sanction and knowledge of her Oncologist, who would then be able to discuss the pro’s and con’s of taking this approach and monitor it closely. If this were a real patient the Oncologist might also suggest she take Tamoxifen (or similar) during the ‘trial’ period.

If there was a good rapport with the NT then diet and lifestyle issues could be discussed in an integrated way, or if the Oncologist was not happy with the qualifications of the Nutrtional therapist he/she might suggest the patient sees a Dietician at the hospital.However, a Dietician, although expert in his/her field is still a clinician and the ‘patient’ may not wish to be regarded as ‘a patient’ and thrown headlong into a clinical setting at this stage.

We must remember that the NT in question was, in a way, the victim of a ‘honey trap’. Real patients are very unlikely to behave in the same way:

I had breast cancer many years ago and when you have a genuine life-threatening condition you do not generally put up barriers to getting the best care for yourself. So NT’s beware of anyone who comes to your practise rejecting conventional healthcare for cancer!

Thankfully things have changed now, but as a matter of interest, when I found a breast lump I was told I would have to wait 3 months before my lump could even be investigated. Fortunately my husband had private healthcare insurance through his workplace and as a consequence I was seen and treated within 3 weeks at a BUPA hospital (ironically by the same consultant surgeon as I would have seen at the NHS hospital, and was excellent).

I, and others in our local community campaigned for a fast-track service on the NHS, and I am happy to say that locally, – we now have one of the best cancer facilities in the country. To WHICH magazine and all the consumers who are confused I’d like to say that at the end of the day it is always the quality and integrity of the individual professional you see that is important.

Don’t make judgements wihout knowing all the relevent facts and if you are still confused and don’t know who to believe in, look in the mirror – and believe in yourself. In your own judgement, your own instincts, and listen to those who you sense genuinly care and are not trying to score political points.

Its your life, your health. Make an informed choice!

nobbyuk says:
26 January 2012

“HST gave links to medical articles which suggest that Ductal Carcinoma in Situ is regarded by some experts as a pre-cancerous condition which can sometimes regress with the help of diet, lifestyle changes, and hormonal rebalancing. ”

one of the links which was a piece of research that was looking at the screening of breast cancer that does not even mention diet or lifestyle changes. The article that did mention these were comments on the original piece of research that went well beyond anything contained within it. what the reasearch paper recommended was:

“We propose that after needle biopsy of a small (<10 mm) oestrogen-receptor-positive cancer detected in screening, .If tumour progression occurs, a patient should undergo immediate surgery. If no growth or tumour regression occurs surgery could be postponed."

but the practioner was quoted as saying: "Cancer lives off sugar; if you feed it sugar it’s going to thrive. If we starve the cancer of sugar then you have a better opportunity of the cancer going away’.

maybe you can highlight where that appears in the research or the other commentary article, none of them mention sugar like the practioner did in that or any context?

if you do not believe me here is the main research paper in full pdf: http://www.iumsp.ch/Enseignement/postgradue/medecine/doc/JC17012012.pdf

also it would be interesting to find out if Which's investigation was carried out before or after nov 20th when the commentary article was wriiten. that way you could argue if it was an attempt to try to tie something in after the investigation had already took place. but seeing how the commentary is useless to defend the statement made by the practitioner it would not really matter would it.

you could have answered simons question yourself by looking at the response by BANT
"The practitioner made it quite clear that the client’s oncologist must be involved and that the client should refer the suggestions to them to seek their opinion and agreement."

but you did not answer my question and that was:
"so in what way could this information have been presented in a way that would still result in the notion of getting rid of cancer through diet and advising against cancer treatment? any takers?"

but by quoting a commentary piece which contained research that states:"a patient should be invited to be treated with tamoxifen or aromatase inhibitors during continuous MRI or ultrasound monitoring of the size of the lesion" i guess you cannot as that is a recommendation for cancer treatment which the practioner was advising against them having.

ExR&D says:
25 January 2012

Contributors have referred to “normal UK diet”, “healthy balanced diet”, “good eating” but no one apart from me (in a previous post) has attempted to define what they mean. As I said in an earlier post, it seems to me that the diet for optimum health is one close to what Stone Age people ate. That means a much higher proportion of fruit and vegetables than is generally advocated (70%) with meat and fish, nuts, seeds, eggs, milk products and cereal products (30%).

Persistent stress is a problem these days. Stress is an acidifying process because of cortisol, a hormone produced by the adrenal glands. The secretion of cortisol has the effect on the alkaline/acid balance as when you eat highly acid-forming foods, e.g.chocolate. Therefore there is a case for increasing the 70/30 ratio to 80/20.

There is a link in the introduction to this Conversation which takes you to the NHS Choices website. The information thereon is provided by the Department of Health who are advised by the Scientific Advisory Committee on Nutrition. How they can say we need foods and drinks that are high in fat and/or sugar, as well as 33% cereal products? Such a statement is indefensible.

GPs and dieticians no doubt follow Government advice which is not good news for the Health of the Nation. The Government needs to invest far more money in research into preventive health measures, including non-mainstream hypotheses, take a much tougher line with the food manufacturing and processing companies, e.g. impose a complete ban on trans fats, and focus on changing the public’s behaviour which, I realise, is difficult.

While I strive toward eating according to Stone Age principles it is impossible to get all the nutrients I need for optimum health from food.

Fresh, locally sourced sun-ripened food is not available. I eat organic food but much of this comes from abroad. Even if it is organic it is unlikely to have been grown in an unpolluted atmosphere. Meat is not available from animals in the wild that have been running around vigorously, only domesticated ones. Nuts and seeds are not as fresh as they might be.

Water is another problem. Even if I filter tap water it doesn’t get rid of, for example, other people’s HRT. I have read that distilled water and water filtered using the reverse-osmosis system has its drawbacks.

Parabens (suspected carcinogens) are present in numerous cosmetic and pharmaceutical products, such as shampoo, conditioner, bodywash and make-up. Clothes are impregnated with chemicals (dye) and to make them non-iron. Towels are hazardous too: I learnt recently why I should “wash before first use” – to get rid of residual chemicals that might enter the bloodstream though the skin.

Formaldehyde (another suspected carcinogen) is present in furniture and cleaning materials, including washing up liquid.

Plastic made from chemicals is everywhere these days, notably in the kitchen, e.g. containers, cling film, freezer bags.

The list of hazards goes on: microwaves (kill enzymes in food), mobile phones, cordless phones (just as bad as mobile phones), wi-fi, satellite dishes. Then there is radiation from flying. Last but not least is Geopathic Stress.

All these things have an impact on nutrient status of the body. And what research has been done that shows without a shadow of doubt that all these modern-day things are safe anyway?

Stone Age people had none of the above unnatural hazards in their lives so of course they could get all the nutrients they needed from food. However, that is not the case for us in 2012.

I have no intention of succumbing to cancer, arthritis, heart problems or any other nasty disease. I take supplements to PREVENT myself getting ill which means RDAs are set too low. I am not going to wait until symptoms appear before thinking about taking any supplements.

If anyone wants to know what works and what doesn’t, I commend to you the book “The supplements you need every day – and the ones you can ignore” produced by What Doctors Don’t Tell You (independent information on medicine’s dangers and alternatives that work). They also produce “Proof!”

Stuart says:
26 January 2012

This post nicely sums up what is wrong with people attitude to health – pop a few supplements and all is well.

What about lifestyle which is actually quite important too?

Watch your weight, don’t smoke, don’t drink alcohol too much, exercise regularly and eat a balanced diet with plenty of fresh fruit and vegetables daily.

Unfortunately that’s hard to market and to make a profit on. Supplement pills, on the other hand….

Alan Henness says:
25 January 2012

ExR&D

What do satellite dishes do to you?

frozenwarnings says:
25 January 2012

Of course Stone Age Man could expect to live to the grand old age of 20 so that worked out well.

Precisely!
I expect, though, that most NTs would not agree with the extreme views of ExR&D.s The comments here show a huge range of views, At the sensible end, demonstrable nonsense like iridology is rejected, The problem is that many NTs do not seem to reject that sort of thing, and neither does BANT,

frozenwarnings,
Stone age man probably lived to the grand old age of 20 because they lived in the wild and were subject to all the harsh realities of life without the comfort of domesticated armchair critics.
If their lifespan were to be assessed on diet alone, then I suspect their longevity would have been much greater.
I thought ExR&D’s post was extremely relevant in illustrating how diet is indeed related to health and longevity, and where the stone age diet, or the Paleolithic diet lifespan, was considerably higher than what you have stated…………………….
http://paleodiet.com/life-expectancy.htm

I enjoyed ExR&D’s input as he/she is on the right track in highlighting the importance of diet in health, and how it acts as a prophylactic against most all disease, and provides the health and energy to live life to its fullest. Take the case for example of Luigi Cornaro who lived an active and healthy life up to the age of 102 because of diet and other healthy lifestyle choices…………………….
http://raoulpop.com/2009/07/14/luigi-cornaro-and-the-simple-life/

Contrary to what some have said that ExR&D’s views are extreme, this is just not the case. There are numerous exogenous toxins that are now a part of everyday life, and where these can have a deleterious effect on our health, with the use of mobile phones being particularly hazardous or injurious………………………
http://www.psrast.org/mobileng/mobilstarteng.htm

Microwave cooking is also seen as extremely hazardous to health and where there are some Scientific studies about this listed here………………………
http://www.health-science.com/microwave_hazards.html

As far as what satellite dishes may do to you? well I suppose they could possibly fall from a building and kill you. ! (Humor) .

The above examples serve to illustrate what ExR&D highlighted in their post, so we shouldn’t be too quick off the mark in criticizing those items that he has highlighted, because it challenges the status-quo and conservative thinking and health-opinion.

frozenwarnings says:
26 January 2012

Chrisb

If you want to refute something please use reliable scientific sources.

Working in allergy I see lots of examples of people using crazy diets and espousing pseudoscientific theories/scare stories. I also see those people are often severely malnourished .
I do hope you and ExR&D are not charging people for nutritional advice because that would pretty much confirm the Which report that people are being given dangerous advice.

“One therapist advised our researcher, who was posing as a cancer sufferer, against having conventional treatment (a lumpectomy and radiotherapy)”

Are the panelists saying this is bad advice or good advice or dangerous advice or just some advice from the Nutrtionist Therapist

Here is very good evidence that not treating DCIS as mentioned is good advice.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2811%2970250-9/abstract

http://www.virginiahopkinshealthwatch.com/2011/11/do-some-breast-cancers-go-away-on-their-own/

Stuart says:
26 January 2012

Rather than whether the advice was correct, or incorrect you might want to consider the ethics and appropriateness of someone without proper recognised medical training, who isnt properly regulated advising someone on the treatment of cancer.

Its this fundamental ‘therapy x’ vs ‘evidence based medicine’ conflict which is part of the current problem. Many alternative therapies promote themselves as ‘complementary’ but are far from it.

Stuart says:
26 January 2012

Some of the comments from the NTs are truly staggering. If I was a member of a professional body and some members were providing dangerous advice which risks peoples health and devalues my training and membership of that professional body I would be incandescent with rage.

But I wouldn’t direct that anger at the messenger. I would direct it at those giving out the advice and at the professional body for allowing members to work in such a manner.I would direct it at the Universites who approve and run degrees full of dubious pseudo science, that leave graduates struggling to occupy a niche which is overflowing with other perhaps better recognised/qualified advisors.

There are clearly different factions with NTs, some of which stick closely to the guidelines and some who desire to use NT to treat illness and have delusional views of its usefulness. I can understand that those more moderate NTs are angry to be lumped in with the cranks.

However, rather than shooting the messenger I would urge those reasonable NTs to engage BANT en mass, and ask for a full investigation into the therapists caught up in the Which? report, including if neccessary legal action under the Cancer Act 1939, and removal from BANT membership. If you dont do this, you are very much part of the problem and deserve to be bunded in with the ‘quacks’.

While I dont want to get into the specifics (as it seems the transcripts arent available) can engaging a cancer patient in the manner discussed ever be acceptable? If BANT is so clear there is no wrong doing why dont they publish the transcripts in a redacted form so people can see the context and form their own view?

The parallels with homeopathy, which I think Prof. Colquhoun mentioned are obvious. This is similar to the newsnight: homeopathy and malaria scandal – I would urge NTs to look at this. The outcome of that was shambolic from their professional body and IMO shattered any credibility that it was a regulated industry. Instead of action we got denial, legal threats, sham profesional conduct reviews and then a weasel worded statement which tacitly encouraged practitioners to go back to business as usual.

Don’t fall into the same trap, its very much in your hands.

Jamesy says:
26 January 2012

One more final contribution

Actually properly trained NTs are perfectly able to interpret vitamin D tests and other associated biochemical markers

So after all the hew-hah, discussion and debate on alleged bad/dangerous advice given by some NT’s, perhaps Which will now conduct a clandestine survey on the merits or otherwise of for example, well-meaning Oncologists and other Medical Doctors, to ascertain whether their advice is accurate, safe and reliable.

However, not a word is mentioned anywhere about Iatrogenic causes of Death. In the USA – and reported on by Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health, Baltimore – in the Journal of American Medical Association Vol. 284 July 26, 2000, gives in her article “Death from Iatrogenic Causes” the following information ….. That in regard to deaths each year in the U.S – 12,000 are attributed to unnecessary surgery 7,000 to medication errors in hospitals 20,000 from other errors in hospitals 80,000 from infections in hospitals 106,000 from negative effects of seemingly appropriately administered drugs………………….
http://www.freelancecommentaries.com/iatrogenic-deaths-due-to-medical-mistakes
http://www.yourmedicaldetective.com/public/335.cfm

So in comparison to the advice given by a select few NT’s, doesn’t anyone think that the above cause of death and medical malpractice be highlighted and generally publicized for patient and consumer protection?

The reality is we never hear anything from anyone about this because of the status quo, and it’s powerful status within society as a whole.

Stuart says:
26 January 2012

Which? are a consumed magazine and they look at things purchased by consumers. In this case, a number of randomly selected NTs provided expensive, unneccessary and potentially dangerous advise to researchers.

Your argument is an off topic strawman and seems to be “drugs and doctors kill people, so what if you’ve identified a number of NTs who offer expensive potentially dangerous advice?”.

You might want to consider if this logical fallacy really is a particularly strong argument.

Simon Rogers says:
26 January 2012

Let’s get back to the research. Which?’s article and BANT’s response are not compatible. Without sections of transcripts, we have to decide who to trust. Now, “deciding who to trust” is not a reasonable basis for a decision in this context. So, I have some questions for Which? and BANT?

1. Which? say that some nutritionists did not suggest that researchers should see their GPs. BANT say they did, but the researchers either denied they wanted to see their GPs or were otherwise evasive. So, which is it?

2. BANT say the NT who made cancer recommendations suggested that the researcher do this with the oncologist’s permission. Which? don’t. These two positions can’t simultaneously be true. Which is it?

My problem is with this shoddy journalism, not necessarily the conclusions. I’d like an answer.

Stuart,
Indeed Which are a consumer magazine, where its existence is to advise and protect consumers, whether that be in electrical goods or whatever; in this case it was to highlight and protect consumers from ill-advised health advice. As you say, the NT’s were a randomly selected and offered arguably expensive and possibly unnecessary,potentially dangerous advice.

My point/argument is most definitely on topic, and relevant to the subject, in that this group of randomly selected and qualified individuals, were targeted by a panel of Mainstream health professionals, whose impartiality is questionable given that most all Alternatives are regularly attacked by the Mainstream fraternity.

By highlighting Iatrogenic deaths and malpractice within Mainstream, as I have, this was designed to serve as a counterbalance to that targeting, and where I offered that evidence as grounds for a possible further undertaking by Which to investigate Mainstream professionals, whose record in patient safety is far far worse than this observational report.

I have reconsidered what you refer to as my “logical fallacy” and have come to the conclusion that this is indeed a logical progression from the report made Which.
Thank you for your input.

Stuart says:
26 January 2012

Chrisb – you are still making the mistake of playing the man not the ball (appeal to motive + ad hominem = logical fallacy). The motives of the individuals on the panel and who they are does not change what Which? found: dangerous, expensive and unneccessary/pseudoscientific treatment.

Do you have evidence that the panel was involved in targetting indiviudal practitioners? Please show this evidence…..Which? have suggested they chose the sample.

We dont yet know the detail (without the transcripts), but on the face of it the advice and techniques are difficult to defend.

Do you accept that the treatment provided was unacceptable?

The question NTs now need to ask BANT are how widespread this problem is, what actions are being taken against those bringing NT into disrepute and what the causes were. This thread is surely to discuss this, and how NTs can recover public confidence. I have made a few suggestions on what not to do, but the responses from NTs would seem to suggest that they are happy to point a shotgun squarely at their own feet.

Obviously this exercise by Which? has limitations and it won’t get to the bottom of these issues, thats now for NTs and BANT to sort out. The spotlight is very much on NT to clean this mess up.

Chris James says:
26 January 2012

The elephant in the room?

• David Colquhoun supplied calculated beyesian confidence limits for the Which? study on 17th, This calculation assumes and requires the sample to be random.

• Expert reviewer and dietitian Catherine Collins confirmed the sampling was random on 18th January.

• Shefalee Loth (Which? staffer) confirmed the sampling was random, also on the 18th.

BUT:
• 19th January Colquhoun states that the ‘the sample was not a random sample of all nutritional therapists.’

As a stats ‘enthusiast’ (but definitely no expert) this has to be a key issue, which is not really being discussed at all. If sampling is not random, you may have a valid investigation, but you dont have a scientific study. And you can’t draw any conclusions at all about the general population of nutritional therapists.

Martina Watts describes the study as one “whose sole basis for legitimacy is the stridency of its own conclusions”. Right now, I can’t disagree. No matter how barmy some the consultations may (or may not) have been, carelessness in sampling methodology is enough to make generalised conclusions baseless.

Maria says:
26 January 2012

On page 7 of this discussion, Shefalee responded to my own query with this:
“I can confirm the nutritional therapists were chosen as David says. We tried to replicate how a member of the public would find a nutritional therapist. We used online search engines and directories of nutritional therapists and chose those that appeared at the top of the search results.”

In other words, they found the NTs in exactly the same way that I or any other potential consumer might do.

Chris James says:
26 January 2012

Absolutely fine, but that’s not a random sample.

Stuart says:
26 January 2012

Which? doesn’t state this is a scientific study with statistically signficant outcome, although it does generalise on some issues which is, with hindsight a mistake IMO.

However, this is the nature of, and whole point of ‘mystery shopper’ exercises isn’t it? NTs will be judged by the worst of their kind if they are unlucky enough to be selected.

In this case they were pretty worryingly bad.

Chris James says:
26 January 2012

So that’s that then. Nothing more to say. Exactly my point.

No-one wants to really examine the sampling methodology, which could undermine the entire report. Its much more interesting (and safer ground too!) to just talk about the conclusions, because they are all that matters.

Never mind the quality, feel the width?

Chris James says:
26 January 2012

David Colquhoun calculated confidence limits, presumably on behalf of Which? which showed the results were significant.

Chris James says:
26 January 2012

…and David Colquhoun got pretty robust with anyone (examples on request!) who challenged the scientific basis for the Which? conclusions.

Stuart says:
26 January 2012

I think you are putting words into my mouth.

While the sampling may not have been random the standard of advice received from virtually all of these NTs was very poor and in some cases appallingly dangerous. Just because the selection of the sample wasnt random, it doesnt excuse the need for strong action in these cases, and further investigation to see what is going on.

If the poor advices is a result of training and lack of regulation, then this probably extends much further than 15 out of 2000 practitioners. This is a challenge for BANT and the NT to clean up the bad practitioners.

Statistic’s and sample size don’t excuse OR invalidate the poor quality of advice.

And if (as many are insinuating without evidence) these were poor practitioners which were easy to ‘target’ doing this by Which? – this just leads to the conclusion that BANT is asleep at the wheel and isnt being proactive enough in protecting their reputable members.

Chris James says:
26 January 2012

No intention of misrepresenting you. And I’m not excusing appalling advice either.

I’m criticising the report on the basis that, without random sampling, you simply cant scientifically or statistically extend the results beyond those people actually sampled. It would have been so simple, so easy, to get it right I’m just totally bemused that Which? scored this own-goal.

We have no idea how good or bad the sample selection process was, but for example the fact that the same therapist was selected twice, from such a small sample out of a population of about 2,000 could easily imply that the sampling was heavily biased to “that type of practitioner”. (whatever that may mean! but it could mean biased towards incompetency, who knows?).

Why on earth Which? didn’t randomly select from some kind of list, I’ll never know. But they didn’t, and we are where we are.

It’s correct to say that the sample was not a random sample of all NTs. But it is a sample of those most likely to be chosen by anyone who uses the web to find a practitioner, and that’s probably more relevant these days.

I suspect that the origins of the problem lie in training rather than in lack of regulation. See my comments above about the failure of the CNHC (as well as BANT) to provide effective regulation.

In real life the effect of statutory regulation appears not to be to stop exaggerated claims, but rather to lend an air of verisimilitude to any otherwise bald an unconvincing narrative,

Stuart says:
26 January 2012

Yes, agree with your points.

Maria says:
26 January 2012

“Why on earth Which? didn’t randomly select from some kind of list, I’ll never know.”

I’ll hazard a guess it’s because it’s a consumer magazine that represents the interests of consumers and – has been repeatedly pointed out – the investigation was not intended to be a scientific study. Which? could possibly have got a list of all NTs represented by BANT or represented by the CNHC or whatever and taken a random sample. Out of that list they would presumably have to exclude any that didn’t advertise themselves on a website or were located too far for the Which? researchers to visit. But for the purposes of this article, they didn’t actually need to do any of that.

It seems to be that the report was written by a journalist reporting on a mystery shopper experiment and she used the word “random” in the vernacular way. Thus Which? didn’t take a random sample from all NTs but simply chose some “at random” using the internet. This may “undermine the entire story” to NTs and their sympathisers but it doesn’t make any difference to most of the rest of us.

14 NTs chosen from top hits returned by an internet search and not a single one of them worth a penny. That’s a pretty powerful message.

Chris James says:
26 January 2012

Thanks David for responding.
There are clearly causes for concern revealed by the report which I’m not disputing.

What ‘got to me’ about the report was the willingness to generalise its findings in a way that was not supported by its own methodology, whilst (for several days) insisting that the sampling was random when it pretty clearly wasn’t. Its as short and sweet as that.

My own conclusion is that Which? staffers should attend some of your own lectures on statistics. And we’ll have to differ on your view about taking lists from google … I can see a few flaws in your analysis.

Chris James says:
26 January 2012

The only problem here Maria is that the reports has been repeatedly defended as being scientific. (examples on request)

Maria says:
26 January 2012

Chris wrote: “(examples on request)”

Yes please.

Chris James says:
26 January 2012

Try David Colquhoun’s one here:
http://thehealthbank.co.uk/whichs-brew/#comments
(Although I suspect this was coined before the true meaning of vernacular random had quite sunk in).

Maria says:
26 January 2012

Chris, I sense a sleight of hand going on here. Our point of contention was over the method of selecting the sample investigated. You argued that it isn’t scientific and I argued that it doesn’t have to be for a consumer magazine. You responded with the claim that the article has been “repeatedly defended as being scientific. (examples on request)”.

The one example you provide, however, does not show anyone defending the report as being scientific and it certainly doesn’t show anyone claiming the sampling methodology was scientific. You link to a comment where David is simply responding to a point made about the confidence limits of the sample. David wasn’t responsible for the design of the survey.

Any other examples of the article being “repeatedly defended as being scientific”? Preferably from Which? itself seeing as its their report?

Nah, don’t bother. It’s a moot point anyway.

Chris James says:
26 January 2012

Maria – Lets call this one an honourable draw.