/ 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
Guest
RICHARD says:
21 January 2012

Hello Maria: I’m not qualified myself to answer that, though there should be well qualified experts who have studied and practiced in this field. I’m sure the the Council for Nutritional Therapy would be a good place to start.

Guest
Maria says:
21 January 2012

@Richard

Thank you for your response. I’m surprised you feel your own lack of qualification should preclude you from saying what you consider to be appropriate qualifications for the task of assessing advice given by NTs, especially when this hasn’t stopped you saying what qualifications you think are not appropriate.

I hadn’t heard of the Nutritional Therapy Council before so thanks for the heads up. Having perused their website, I respectfully suggest that, if an objective assessment is what’s required, the Nutritional Therapy Council would be a very bad place to start.

In Which? magazine I expect to see topics approached from the perspective of the potential consumer, not from the perspective of the industry being investigated. It’s a consumers’ magazine and any panel selected to assess the results of such investigations must have the confidence of the potential consumer. I think a panel that includes people who have a vested interest in the public image and the reputation of the industry being investigated, is unlikely to have the confidence of the potential consumer.

The Which? article reports that some therapists are giving potentially dangerous medical advice and recommending unnecessary supplements. As a potential consumer – rather than a promoter – I have to say that I have more confidence in the judgement of a physician, a dietician and a pharmacologist than in people who have completed the courses accredited by the NTC and worked as NTs. How could we know they’re not giving equally bad advice themselves?

Guest
jamesy says:
21 January 2012

To Wavelength

With respect I picked vitamin D to make a point as it actually has low toxicity in relation to normal recommended dose – it is necessary to multiply dose many times before it becomes toxic. It is harmful to generalise and throw together all supplements vitamins and drugs (you give aspirin as an example). Vitamin D is a classic example of how new research is demonstrating the positive benefit/risk ratio even at higher doses. People need to know this. If you or anyone is in doubt please look at the work of Dr Veith at University of Toronto

Guest

Vitamin D is more difficult than others because exposure to sunlight can produce more than what we consume in our diet, though obviously this will depend on the individual. You are absolutely right that vitamins, drugs and other supplements differ. With drugs the difference between an effective dose and a harmful one is expressed in terms of the therapeutic range (or ratio, or index).

If we take prescribed drugs, the GP, consultant or hospital doctor will prescribe a safe dose, and sometimes (e.g. warfarin) it is necessary to take samples and adjust the dose for a patient. Many non-prescription supplements are unlikely to cause problems but it is well known that St John’s Wort deserves to be used with great care.

It worries me that so many people use supplements without any evidence that they need them. They may be harmless but on the other hand they may not. When I studied chemistry at university, benzene was widely used in teaching labs and I can still remember the smell after nearly 40 years. At the time, no-one knew that it was a rather dangerous chemical. What might we learn about supplements in the next decade?

Guest
George Barker says:
21 January 2012

I had indigestion and a feeling of general weakness. I went to Sarah Burt, who said I belonged to a group for whom certain foods caused stomach acidity and this acid found its way all over the body and caused weakness in the muscles. Sarah gave me some horrible potion to start putting thngs right and gave me this guide:

ACID FORMING FOOD

Alcohol, chickpeas, eggs, lentils, noodles, pepper, shellfish ,
asparagus, cocoa, fish, meat, oatmeal, plums, soft drinks,
beans, coffee, flour, milk, olives, poultry sugar, brussels sprouts,
cranberries, legumes, mustard, pasta ,
prunes, tea .

LOW LEVEL ACID-FORMING FOODS

Butter, grains, canned fruit, cheeses ,
ice cream, nuts (most), sulphured fruit

ALKALINE FORMING FOODS

Avocados, corn, dates, fresh fruit (most), fresh vegetables (most), honey, maple syrup, molasses, raisins, soy products, almonds, brazil nuts, buckwheat, chestnuts, Lima beans, millet, soured dairy products potatoes

*ESPECIALLY ALKALINE

apples* garlic *strawberries * spinach *cucumbers *watercress *parsley *
*figs *carrots *celery
,

ADVICE

Try to eat a good percentage of fresh raw foods daily, such as apples, avocados, bananas, grapefruit, grapes, lemons, pears, all fruit and veg reduce acid. Start with small amounts of citrus and add them in slowly. A freshly juiced combination of celery, apple, carrot and parsley would be beneficial.

One has to eat some protein food which is acid forming but this is balanced by following the general recommendations I have been fit ever since. So don’t condemn all complementary nutritionists.

My NHS nurse granddaughter, of course told me it was a load of nonsense – the NHS has a one-size-fits-all nutrition system.

See http://www.sarahburtnd.co.uk/

Guest

Are you aware that your stomach is intended to contain acid, George?

Some people have problems with acid reflux into the oesophagus (and that can be exacerbated by certain foods and other factors) but I don’t think acid will find its way all round the body as you claim to have been told. The acidity (pH) of the blood is closely controlled.

Your granddaughter may have a point.

Guest
jamesy says:
21 January 2012

I do apologise for getting your name wrong – though its true we are not all on the same wavelength!!!

Guest

No problem. I nearly chose wavelength as my user name, but had already used wavechange on a vintage radio forum.

Guest
George Barker says:
21 January 2012

Iridology is geting a ot of stick! I don’t think it is supposed to be more than an additional diagnostic technique with limitations and there is a regulatory international guild. I saw a clear change in the colour of my iris after being cured of acidity problems.

I think that a good practitioner at iridology, herbalism and nutrition can use iridology to help to diagnose and cure diseases that have slipped through the cracks of the NHS at the moment.

Guest

George Barker
No, it is not true that “an additional diagnostic technique with limitations”. It has been shown clearly that it has no diagnostic ability whatsoever. The result are random and the method is simply fraudulent.

Guest
George Barker says:
22 January 2012

To David Colquhoun,

I am just an ignorant mechanical engineer airing my theories. The origin of the technique by a vet (some say) and then the Austrian doctor who thought he found correlations in humans as well and now there being an international guild http://www.gni-international.org/ makes it look romantic and attractive! But it doesn’t make it true.

I wonder whether it is the practitioners who claim too much for it who are being shown as deluded. A more believable description ot its limitations is:
“Iridology does not reveal specific diseases because many diseases create similar changes in body tissues.
The iris reflects the condition of the tissues (eg. inflammation, acidity, toxicity, congested lymph, hardened arteries, etc.) Iridology is therefore not concerned with named diseases but with restoration and maintenance of health through building up the patient’s immunity and life force”. A. Jackson Read his book “Eye Signs”

The nutritionist who gave me a successful regime claimed what we saw in my eyes was a condition of acidity in my tissues, not a specific disease. As far as I can remember the blue of the iris was very pale on the inside and coloured up again when the acidity went down.

Quite often people put up an effigy they have created themselves to rubbish.

However you are probably right and what I saw was by coincidence.

all the best,

George Barker 93 and still going strong

Guest
RICHARD says:
21 January 2012

Hi Maria
I quote from Wikipedia: “In academia peer review is often used to determine an academic paper’s suitability for publication.” “Professional peer review activity is widespread in the field of health care” and “Peer review requires a community of experts in a given (and often narrowly defined) field, who are qualified and able to perform impartial review.” If it is widespread and considered essential in the medical profession, why would one not include at least one Nutritional Therapist in a panel of experts – especially when clearly the other 3 are NOT experts in the field being reviewed?
If Which? chose to do a survey of patients’ thoughts on the care received and level of accurate diagnosis given by their GP and other medics, would it be unreasonable to include a qualified GP in such a panel?

Guest

The reason for not including a nutritional therapist on the panel has been explained several times already. They are the group under investigation. It would make as much sense as having a washing machine manufacturer on the panel judging washing machines.

In fact it’s much worse than that because so many nutritional therapists use methods (like iridilogy) that are well known to be nonsense. Such people disqualify themselves from assessing evidence.

In any case, the panel included one of the country’s foremost experts in nutrition, Catherine Collins.

And, on top of that, you don’t need a great deal of expertise to know that it’s very foolish to suggest to a patient with breast cancer that they should postpone treatment for 3 to 6 months. Any sensible member of the public can see that, and it’s a tragedy the BANT can not.

Guest
Maria says:
21 January 2012

Richard

It is indeed the case that peer review is employed in academia to determine the validity, originality and importance of a paper before deciding whether to publish it. It is also the case that peer review – with a somewhat different meaning – is widespread in many occupations that provide a service to the public, as a means of staff development and maintaining standards.

However, as I said before, Which? is a consumer magazine whose purpose above all else is to protect the consumer. It doesn’t publish academic studies or peer reviews. It publishes articles that alert consumers to pitfalls when choosing products and services and, if it is to be taken seriously by its target market, it needs to be sure that the information it provides has been evaluated by experts who have no competing interests. In this case, NTs do have competing interests.

I am happy to agree to differ on the matter of whether a dietician is enough of an expert in nutrition, whether a GP is enough of an expert in how the body works and disease processes and whether David Colquhoun is enough of an expert in the statistical assessment of evidence. I am satisfied by my own investigations that they are and, as a result of what I have read over the past few days, I’m sorry I can’t say the same of NTs as a group.

I’m happy for all those who feel they’ve benefitted from seeing an NT and I’m sure some of them are very good. But as a profession, they have a long way to go before they can hope to achieve the status they seem to think they are entitled to.

Guest
Monika says:
21 January 2012

I’m going to have to sign off this forum now but would like to say thank you to all who posted it has been a really interesting discussion.
Cheers.

Guest
jamesy says:
22 January 2012

Please can we now have an article by the press about several nutritional therapists describing how they work in an evidence based fashion. I know that the practice of some NTs is highly professional and the results that they have are noticeable. This deserves to be highlighted.

What happens about therapists (and other professionals eg GPs) who do not meet minimum standards is a separate issue