/ 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
Ellie says:
2 March 2012

Selina – yes we do want you to live to a ripe old age. I do anyway. For a start you are more sweet-natured than I am – so deserve to!

Guest
Selina Import says:
2 March 2012

Thank you Ellie. You make sure you keep your good work.

Guest
Selina Import says:
2 March 2012

“The medical pendulum seems to have swung radically from a focus on the clinical aspects of practice to scientific investigation. An extreme position of hyperanalysis has been adopted. We need now to return to synthesizing ALL of what we know in order to apply it in clinical terms rather than continuing on our march in the direction of analytical methods alone. Certainly medicine has contributed some significant answers in the past half centuary, particularly in areas of infectious diseases and infant mortality, but the price paid has been forgetfulness of the patient as a whole person.” Abram Hoffer “Orthomolecular Nutrition” 1978.

Let us always put first enabling people to find the best ways for them to be well and stay well.

Guest
Selina Import says:
2 March 2012

Sorry Ellie “Make sure you keep up your good work”

Thank you Chris. You have done well, I wish you all the very best

Guest

Stuart said…………….
An article on teeth which is only relevant if you are Vit D DEFICIENT in the first place. Laughable.

You are missing the point here Stuart by a long chalk.
The whole point is about what is meant by deficiency, and where the RDI for Vitamin D has been set too low for too long; so what has been recommended as an RDI, or the normal requirements for health for Vitamin D has been woefully inadequate.
RDI’s for Vitamin D have been set by many experts on the Vitamin as being at least 4000 to 6000 ius per day and to enable body markers to be above 30 to 50 ng/l. This is not achievable on a paltry 600ius per day when for example 20,000 ius are obtained from all-over body exposure within 30 minutes of sunlight exposure.
It is the absence of sunlight exposure for many of us, and for various reasons (climate, occupation, sedentary indoor lifestyle and so on) that supplementation is seen as necessary for health, and the avoidance of disease.
Recent studies have found that that their is a strong correlation between real Vitamin D deficiency and diseases such as MS and some cancers, and the recommendation of Vitamin D supplementation as as prophylaxis for the general populous.

Guest
PollyB says:
3 March 2012

Chris – you are advocating supplementation at very high levels here. There haven’t been enough long-term studies to determine if this level is safe and furthermore there is some evidence (epidemiological) that those people with high serum levels of vitamin D (> 50 ng/l) have higher mortality than people with more moderate levels. One study did show a link between pancreatic cancer and vitamin D levels (but a later study did not prove this link). Most intervention studies have been in groups with underlying medical conditions so it is not possible to use the data to recommend general supplementation for the general public. I am aware of studies that recommend up to 4,000 IU (100 mcg) per day but these studies were not long-term enough to find potential risks. For example, if a study is carried out for 6 months, it does not predict anything about risks to health several years down the line (think asbestos – it takes time for an exposure to lead to a disease). It used to be thought that antioxidant supplementation was desirable but it is now thought that antioxidant supplementation can lead to higher mortality levels.
For sensible advice on vitamin D supplementation – try the consensus statement from several leading UK groups (including Cancer Research UK and the National Osteoporosis Society). http://www.sunsmart.org.uk/prod_consump/groups/cr_common/@nre/@sun/documents/generalcontent/cr_052628.pdf
I don’t think this will change your mind! but I hope that others reading this will realise that high levels of supplementation are not risk-free.

Guest
Chloe says:
3 March 2012

Polly Bs blog should have said ‘
for sensible but soon to be out of date advice with regards to vitamin D’
.
UK consensus statements on nutrition are often behind those of US or Canada. Anyone who is interested should attend the vitamin D convention at Stanmore orthapedic hospital.

I wish everyone on the conventional side would come off their high horses and stop protecting their territory. Equally some of the arguments put forward by others have been far too eager and unsubstantiated

I think it is time to accept that things change and that there is room (I didnt say at the detriment of other professionals) for a middle ground in terms of nutrition professionals, NTs who practice evidence based nutrition and who use the functional medicine model.

Guest
PollyB says:
3 March 2012

The guest speaker at this event is Professor Susan Whiting (Canadian professor with special interest in nutritional supplementation and bone health). The last paper I have read from her was the Canadian consensus on osteoporosis and vitamin D supplementation in which the recommended supplement was the same as the that in the consensus statement I posted (i.e. 10 mcg per day but 25 mcg is probably safe for adults with no risk factors). People with risk factors for osteoporosis will (even in the UK) be taking higher doses than this but will also require monitoring of their serum status.
The main difference in the Canadian consensus compared to the UK is the assertation that for adults over 50, it may be advisable to supplement with 20 – 50 mcg (800 – 2000 IU still far lower than the dose Chris recommended). The UK would still recommend 10-25 mcg (400 – 1000 IU) for this group unless recommended otherwise by a health professional.
I personally would love to attend this event – are you going Chloe? Perhaps you could feedback some of the research presented.

Guest

Chloe
I am very happy for recommendations for vitamins to be reviewed, making use of all the better quality studies and rejecting any that are questionable or flawed. In some cases this should have been done some time ago.

When I am reminded that the Chair of BANT practises iridology I am rather more comfortable with orthodox medicine and I feel genuinely sorry for NTs who are trying to do a good job.

Guest

Thank you for your input PollyB.

It depends on what you really mean by “supplementation at very high levels”, when I am only advocating this at between 4000 ius and 6000 ius per day, and then only in the absence of adequate sunlight exposure, and the preferred method of receiving cholecalciferol via the conversion of cholesterol.
However, the further you live from the equator, the longer exposure you need to the sun in order to generate vitamin D. Canada, the UK and most U.S. states are far from the equator.
People with dark skin pigmentation may need 20 – 30 times as much exposure to sunlight as fair-skinned people to generate the same amount of vitamin D. That’s why prostate cancer is epidemic among black men — it’s a simple, but widespread, sunlight deficiency.

A single exposure to summer sun in a bathing suit for 20 minutes produces the equivalent of 15,000 to 20,000 IU of vitamin D3″ in Hawaiian surfers and in response to physiological needs, and thereafter production will shut down before any excess is produced………………
Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol.
Heaney RP, Davies KM, Chen TC,…
Am J Clin Nutr. 2003 Jan;77(1):204-10. Erratum in: Am J Clin Nutr. 2003 Nov;78(5):1047.
PMID: 12499343

……………………but in the absence of sunlight, most Vitamin D experts will recommend at least 4000 ius per day or more depending on a Vitamin D test: a 25-hydroxyvitamin D, or 25(OH)D, test.
Studies indicate that for proper health, serum vitamin D levels should be a minimum of 50 ng/mL (125 nmol/L), with optimal levels falling between 50-80 ng/mL (125-200 nmol/L).

Regarding the risk of higher mortality rates amongst those with high serum levels of Vitamin D, I think you will find the bulk of the evidence is to the contrary, in that it is low levels of Vitamin D that are responsible, with this being just one example……………..

You commented PollyB that……………….

“Most intervention studies have been in groups with underlying medical conditions so it is not possible to use the data to recommend general supplementation for the general public. I am aware of studies that recommend up to 4,000 IU (100 mcg) per day but these studies were not long-term enough to find potential risks. For example, if a study is carried out for 6 months, it does not predict anything about risks to health several years down the line (think asbestos – it takes time for an exposure to lead to a disease)”.

In what is considered the first scientific trial that meets the most stringent criteria for “evidence-based inquiry,” US researchers Drs. Hollis and Wagner divulged their findings at a recent international vitamin D research conference in Bruge, Belgium.
Their findings included………………………..
Mothers who took 4,000 IU’s (ten times the RDA of 400 IU) of vitamin D during pregnancy had their risk of premature birth reduced by half.
Premature babies born to women taking high doses of vitamin D were reduced by half at both 32 and 37 weeks, and there were also fewer babies who were born “small for dates”
Women taking high doses of vitamin D had a 25 per cent reduction in infections, particularly respiratory infections such as colds and flu as well as fewer infections of the v****a and the gums.
The “core morbidities of pregnancy” were reduced by 30 per cent in the women who took the high-dose vitamin D. (Including diabetes, high blood pressure, and pre-eclampsia – a potentially deadly increase in blood pressure and fluid)
Babies getting the highest amounts of vitamin D after birth had fewer colds and less eczema.

Another 2009 study on vitamin D deficiency in newborns with acute lower respiratory infection confirmed a strong, positive correlation between newborns’ and mothers’ vitamin D levels.
This study found that over 87 percent of all newborns and over 67 percent of all mothers had vitamin D levels lower than 20 ng/ml, which is a severe deficiency state. As a result, the researchers recommended that all mothers optimize their vitamin D levels during pregnancy, especially in the winter months, to safeguard their babies’ health.
In addition, numerous other studies have found that vitamin D may protect against a number of birth defects.
Researcher Dr. Bruce Hollis of the Medical University of South Carolina also said:
“I’m telling every pregnant mother I see to take 4,000 IUs and every nursing mother to take 6,400 IUs of vitamin D a day and I think it is medical malpractice for obstetricians not to know what the vitamin D level of their patients is. This study will put them on notice.”

Not too sure as to your reasoning in comparing Asbestos with Vitamin D supplementation, as any exposure to the former is extremely hazardous to health, and where the latter is a nutrient actually required for health. Please bear in mind, that the RDI’s for Vitamin D have been set at much too low a dose for far too long, and unless you live near the Equator and receive all the sunlight exposure you need, then the rest of us at placed at a severe disadvantage in terms of adverse health consequences.

You also commented……………….

“I don’t think this will change your mind! but I hope that others reading this will realize that high levels of supplementation are not risk-free”………….

Dr MICHAEL F. HOLICK, MD, PhD and arguably the Worlds leading authority on Vitamin D in an interview with DY News……………….
HOLICK: One man took 1,000,000 IU of vitamin D per day, orally, for six months. Of course, he had the symptoms of severe vitamin D intoxication.
DY NEWS: But he lived to tell the tale?
HOLICK: Yes. His treatment was hydration (lots of water), and no more vitamin D or sunshine for a while. He’s perfectly happy and healthy. This was published in the New England Journal of Medicine. (Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med. 2001 Jul 5;345(1):66-7.)
DY NEWS: How many people have died from vitamin D or other vitamins?
HOLICK: I have no experience of anyone dying from vitamin exposure. In thirty years, I’ve never seen it.

So the dangers of Vitamin D supplementation are negligible, but no one is advocating Vitamin D at such high doses as those described above.

I don’t have the time to argue the case for antioxidant supplementation.
I would argue the last place to take advice on Vitamin D supplementation is Cancer Research UK and the National Osteoporosis for sure.

Guest

For proper functioning, a healthy human body utilizes around 3,000-5,000 IU of vitamin D per day – indicating the current recommended intakes are not high enough to raise and/or maintain the vitamin D levels necessary for proper health…………………..
Heaney R.P., Davies K.M., Chen T.C., Holick M.F., Barger-Lux M.J. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003 Jan; 77 (1): 204-10.

Now as dietary sources of Vitamin D are minimal, how do we obtain these recommended requirements of Vitamin D in the absence of sunlight exposure?
Supplements of course.
Is there any other way?

Guest
Selina Import says:
3 March 2012

It is refreshing to note discussion rather than confrontation. Well done Chloe, PolyB and Chrisb

Guest

Selina

I recall that (many pages ago!) you said that you would not automatically recommend that a client should take supplements, and I respected you for this. I hope this is still the case because we are fast becoming a nation whose answer to treating illness and avoiding poor health is to take pills, whether these are drugs or supplements.

Guest

PollyB you said…………
“But Chris – this article doesn’t say that you CAN’T get your nutrients from a healthy diet. What it says is that most Americans DON’T get their recommended amounts from their diet – mainly because they are not eating a healthy diet (or they have a health problem, or they are taking medication or they are restricting their diet to lose weight)”.

Which is my point exactly. So it appears we need to re-educate people on how to eat healthily, while at the same time prevent the Corporate food industry in playing such a major role in decision making, and influencing the way we live, plus how they are allowed to advertise foods that promote instead of avoiding disease. I think you will find that money is the name of the game here.
Also bear in mind that soils generally have been depleted of much of their nutrition, and for one reason or another, therefore the crops that grow within them are also deficient. I provided some scientific links/studies to this in an earlier post; so if crops are deficient, then it should come as no real surprise that we are also nutrient-deficient in eating them and regardless of how “balanced” it may be.
I have also highlighted in a previous post, that many nutrients (either singly or in combination) can be used very successfully against disease, and where the RCT on Infant Heart Failure, using Vitamin D at higher than RDI’s, have illustrated this quite emphatically.

Guest
Selina Import says:
3 March 2012

Yes, Wavechange, it is a essential to make sure that a person knows how to get themselves is on the best possible diet first.