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Patrick Holford is a controversial British nutritionist, author, and the founder and director of the Institute of Optimum Nutrition in London. Holford is also the director of the Food for the Brain Foundation, a registered charity that claims to help children with special needs through improved nutrition, and the Brain Bio Centre, an outpatient clinical treatment clinic for those with mental health issues wishing to pursue a nutrition-based approach. He appears regularly on television and radio in the UK.

His nutrition advice and his lack of formal qualifications have been criticised by professional dieticians.

Career

Holford obtained a BSc in experimental psychology from the University of York in 1976. As a psychology student, he became interested in the biochemistry of mental health problems. His research brought him in contact with Dr Carl Pfeiffer and Dr Abram Hoffer, both of whom claimed success in treating mental illness with nutritional therapy.

In 1984, Holford founded the Institute of Optimum Nutrition (ION). At that institute, he has worked on nutritional approaches to depression, schizophrenia, and eating disorders. His research into the role that nutrition plays in children's IQ levels was the subject of a Horizon documentary in 1987. In 1995, the ION, of which he was a director, awarded him an honorary Diploma in Nutritional Therapy.

Holford has written more than twenty books, the first of which was The Optimum Nutrition Bible, which has sold over a million copies worldwide. His books have been translated into seventeen languages.

Criticism

Holford's qualifications and expertise have been questioned. His only formal qualification in Nutrition is an honorary Diploma from the Institute for Optimum Nutrition (which he founded, and of which he was Director at the time of this award). Holford is a Fellow of the British Association of Nutrition Therapy (BANT), which claims to regulate nutritional therapists; however, this is not a statutory body since the field is not regulated, and there are a number of bodies which claim to regulate such therapists.

His claims about nutrition have also been questioned. For example, Dr Ben Goldacre has criticised Holford's claim, in The New Optimum Nutrition Bible, that "AZT, the first prescribable anti-HIV drug, is potentially harmful, and proving less effective than vitamin C". Goldacre points out that Holford based this conclusion on a non-clinical study where "you tip lots of vitamin C onto HIV-infected cells and measure a few things related to HIV replication". Goldacre notes that the paper does not compare vitamin C to AZT for efficacy: in fact, it "doesn't even contain the word AZT". He argues that "Holford was guilty of at least incompetence in claiming that this study demonstrated vitamin C to be a better treatment than AZT."

Catherine Collins, chief dietician at St George's Hospital, London, has called on BANT to investigate Holford over advice he gave to a young autistic girl. Collins alleges that the girl suffered sleep problems and lost weight as a result of Holford's advice. Holford has dismissed the allegations as the product of “professional jealousy”. He claims that "his girl hasn't suffered. She's got better and is behaving better. Her parents are delighted with the results. It's only Catherine Collins who is not.". Unlike Holford, who courts media publicity to ensure fuel for his current campaigns, Catherine Collins is bound by professional and legal responsibilities to maintain the patients confidence, thus undermining her ability to justify her comments to the broader audience.

In January 2007, a Guardian article written by Goldacre detailed how Fuel PR, a public relations firm working for Holford, had anonymously removed all criticism from his Misplaced Pages article. Holford says this was not his intention: he had intended for the PR firm to add a defence to the criticisms. The user account was banned indefinitely from Misplaced Pages.

Response from Patrick Holford

ANSWERING THE NUTRITION CRITICS

When you tread a path that's not yet mainstream, people will often criticise you for it. This year has kicked off with a flurry of attacks on 'media nutritionists', vitamin C and HIV, food intolerance testing, supplements for children, and also the Food for the Brain schools campaign. We must be ruffling some conservative feathers to attract so much attention! For those of us who are committed to pursuing better health naturally and harmlessly, sometimes it's necessary to answer our critics and correct the misinformation they quote.

As a result, I'd like to share my responses to several recent assaults in the press. I appreciate there's a lot of information to wade through here, but as these different cases have a similar theme, I thought I'd deal with them all together. So let's start with my response to material written by a journalist called Dr Ben Goldacre.

Today, the Guardian published my reply to Goldacre's claims:

"In Goldacre's column on 6 January 2007, he once again accuses me of 'bad science' in reference to a statement in one of my books that 'AZT is potentially harmful and proving less effective than vitamin C'. As he well knows, the author of the research - Dr Raxit Jariwalla - wrote to the Guardian (20/1/05) the last time Goldacre made this claim to confirm that my statement is correct on the basis of two studies on HIV infected cells. The real crime here is that no full scale human trials have been funded on vitamin C to follow up Jariwalla's important finding because it is non-patentable and hence not profitable. Goldacre seems unconcerned about the way commercial interests distort scientific research."

To read my full reply - and to find out what Dr Raxit Jariwalla, the leading immunologist on vitamin C and HIV, has to say - click here

Tirade against 'media nutritionists'

Last week, Goldacre continued his tirade against 'media nutritionists' in the British Medical Journal (BMJ), scoffing at the all these makeover programmes, claiming false information is being dispensed.

Here are some extracts from my reply in the BMJ:

"The estimated cost of diet-related diseases to the NHS is in excess of £15 billion, according to the Royal Society. Obesity has become the second most common cause of premature death, with smoking being the first. Type 2 diabetes, a preventable and largely reversible diet-related disease, is predicted to affect approximately one in twenty , and possibly one in six people over age 40 by 2010. Prostate cancer, according to the East Anglia Cancer Surveillance Unit at Cambridge University , is predicted to effect 23% of men by 2015 - representing an 83% increase in thirty years - strongly linked in epidemiological studies to high dairy consumption . Clearly, many people in Britain continue to dig their own graves with a knife and fork. The fundamental political issue is how to radically and swiftly change the diet culture in Britain.

There is reason to believe that the media will play a major role in encouraging such a culture shift, and that health messages need to be entertaining to achieve impact. Media nutritionists who demonstrate that transformation, weight loss and disease reversal is possible by diet and lifestyle modification should be actively encouraged, not attacked, as Ben Goldacre, a doctor with no apparent speciality in nutrition or research expertise, has done in his article 'Tell us the truth about nutritionists'.

In his article, which contains not one single reference to substantiate his claims, he attacks advice to eat turmeric for cancer protection, including that of the prostate. Some 1834 studies are cited in PubMed on turmeric or curcumin, thought to be the active ingredient in this spice, many of which demonstrate clear anti-inflammatory and immune enhancing properties, 648 of which relate specifically, and consistently, to it's anti-cancer properties."

"Goldacre's plea to know the truth about nutritionists pales into insignificance in relation for our need to know the truth about nutrition and, most imperatively, to channel more public money into researching foods such as turmeric which, unlike patentable drugs, have no significant commercial return, and hence cannot attract commercial private sector funding. In researching nutritional approaches to common diseases in my book 'Food is better Medicines Than Drugs' (www.foodismedicine.co.uk) I cite several hundred studies, many of which are randomised control trials. Many doctors, such as Goldacre, are simply unaware how much good quality evidence does exist for nutrition approaches and consequently underestimate the power of optimum nutrition in disease prevention and reversal. As George Bernard Shaw aptly said 'Those of you who say it can't be done should not interrupt those of us who are doing it'."

Patrick Holford - media nutritionist and founder of the Institute for Optimum Nutrition

Medical journalist Jerome Burne's letter in the BMJ also made the following points:

"It's striking that in damning the 'media nutritionists' actions, he fails to ask the two most basic questions about any form of treatment - does it work and is it safe? There are certainly hundreds of thousands of people who would tell him that following dietary changes recommended in books or TV programmes has benefited them enormously. Not a randomised trial, of course, but surely worth considering. Furthermore, even their sternest critics have failed to make a serious case that 'media nutritionists' kill or maim people. Unlike prescription drugs which, puzzlingly, are never the target of Goldacres's tirades.

This is especially puzzling because the essence of his assault on all non-drug medicine is that it is unscientific. Look at the charges he levels at media nutritionists - they: 'wear a cloak of scientific authority', 'make up evidence when it is missing', 'cherry pick the literature', 'only quote favourable studies'.

Is he really unable to see that every one of these is regularly done on a far larger scale and with far more damaging effects by the pharmaceutical companies? The concealing of evidence of problems with SSRIs, the marketing and distorting of evidence over Vioxx, the failure to issue warnings over anti-psychotic drugs - to mention just three - not only did harm to innumerable patients but also seriously and deeply tarnished and undermined the meaningful research work of genuine academics."

You can read these letters in full by clicking here

Children's health in question

Meanwhile, the Food for the Brain schools project has been coming in for some flak too. An article in the Independent on Sunday on 7 January quotes Catherine Collins, chief dietician at St George's Hospital in London, expressing concerns about the health of a particular child involved in the project.

What's strange about this is the child's mother is absolutely delighted with her daughter's transformation and believes she's made considerable progress. However, as Ms Collins is not the girl's dietician and, as far as we know, has never met her, it's no wonder she's not aware of the full story. Click here to read my reply, submitted to the Independent. And click here to hear me answer Ms Collins's objections to IgG food allergy testing. Readers are also directed towards Badscience.net, where the polarisd approach of Mr Holford is discussed, and the counter-arguments available.

The results of this first Food for the Brain school project are impressive with many children with autism, ADHD and even genetic conditions and cerebral palsy showing major improvement. If you'd like to see these results for yourself, go to www.foodforthebrain.org and look under 'reports'.

Of course, you'd think that everyone would be delighted to hear that children with special educational needs have improved dramatically, but some critics seem more concerned to point out that it wasn't a double-blind placebo controlled trial so you don't know what did what. Was it the diet, the supplements or the exercise?

When science isn't science

The general thrust of these kind of medical and dietetic critics is that there isn't scientific evidence for, for example, giving vitamins to children. They often imply that the only real science is 'randomised placebo-controlled trials' often called RCTs.

Yet, in the case of multivitamins and children's IQ, there have been 13, of which ten have shown significant improvement. The rebuttal is 'children don't need supplements, they just need better diet'. Unfortunately, there just isn't any RCT evidence that dietary changes alone produce these kind of results. So, if you really wanted to be a stickler for the science, you wouldn't change the diet!

The same point is illustrated by Goldacre's concerns about vitamin C and HIV, or turmeric and cancer. There aren't any RCTs proving their effect. And it's true, there aren't. But all the available evidence (epidemiological - meaning studies of associations; animal studies; cell or 'in vitro' studies) all show good evidence of benefit.

The reason that some spokespeople ignore and want suppression of anything other than RCTs (at least on nutritional issues) may be simply because RCTs cost so much money, and favour pill trials (very hard to do placebo trials on diet or exercise), that almost all are funded by the drug industry, thus perpetuating the unhealthy monopoly within medicine today.

But, of course, even when the RCTs do exist - as for multivitamins and children - somehow the evidence is ignored. The real hypocrisy is that newspapers are full of stories about drugs that can cure diseases 'coming next year', not based on RCTs.

In summary.

Somebody once told me that 'expecting people to treat you well just because you are a good person is like expecting the bull not to charge just because you are a vegetarian'. I guess Jerome Burne's and my book Food is Better Medicine Than Drugs - not one single fact in which has yet been disputed - is a red rag to the pro-drug bull. Ridicule and attack are to be expected in the dying throes of the old pharmaceutical model of treating disease, as it inevitably makes way for a more holistic approach with optimum nutrition at its core.

Books

• The Family Nutrition Workbook (1988)
• The Whole Health Manual: Comprehensive Guide to Nutrition and Better Health (1988)
• The Better Pregnancy Diet: The Definitive Guide to Having a Healthy Baby (1993)
• The Optimum Nutrition Bible (1998)
• Say No to Heart Disease (1998)
• 30-Day Fatburner Diet (1999)
• 100% Health (1999)
• Beat Stress and Fatigue (1999)
• Say No to Cancer (1999)
• Improve Your Digestion (2000)
• Say No to Arthritis (2000)
• Supplements for Superhealth (2000)
• Solve Your Skin Problems (2001)
• Six Weeks to Superhealth (2002)
• Optimum Nutrition for the Mind (2002)
• Natural Highs: Chill - 25 Ways to Stay Relaxed and Beat Stress (2003)
• Natural Highs: Energy - 25 Ways to Increase Your Energy (2003)
• 500 Health and Nutrition Questions Answered (2004)
• The Alzheimer's Prevention Plan (2005)
• The Holford Low-GL Diet (2005)
• The Holford Diet GL Counter (forthcoming)
• Food is Better Medicine Than Drugs (2006)

References

1. ^ Patrick Holford, Patrick Holford: Profile. patrickholford.com. Accessed 6 January 2007.
2. Rachel Shabi, “Food fighters”. The Guardian, 8 January 2005. Accessed 6 January 2007.
3. The British Association of Nutrition Therapy, “About BANT”. Accessed 7 January 2007
4. ^ Ben Goldacre, “Vitamin deficiency”. The Guardian, 6 January 2005. Accessed 6 January 2007.
5. ^ Ben Goldacre, “Working papers”. The Guardian, 20 January 2005. Accessed 6 January 2007.
6. Sophie Goodchild and Jonathan Owen, “Doctors warn against food fad dangers”. The Independent on Sunday, 7 January 2007. Accessed 18 January 2007.
7. ^ Ben Goldacre, "Doctored information on celebrity nutritionist". The Guardian, 6 January 2007. Accessed 6 January 2007.
8. Ben Goldacre, "Doctoring the records - updated thrice". badscience.net, 7 January 2007. Accessed 7 January 2007.
9. S. Fairweather-Tate, 'Human nutrition and food research: opportunities and challenges in the post-genomic era', Royal Society, 9 September 2003, published on-line.
10. YHPHO, 'PBS Diabetes Population Prevalence Model - Phase 2 June 2005, available on line at www.yhpho.org.uk.
11. East Anglia Cancer Surveillance Unit, Cambridge University.
12. D Ganmaa et al, 'Incidence and mortality of testicular and prostatic cancers in relation to world dietary practices', International Journal of Cancer, 2002, 98 (2): pp 262-267.

See also

• Patrick Holford's Website
• Institute of Optimum Nutrition
• Food for the Brain
• The Brain Bio Centre
• Doctoring the records - Criticism of Patrick Holford at http://badscience.net

• Living people
• Nutritionists
• Alumni of the University of York