Wednesday, January 21, 2009

ASA tightens restrictions on nutritional & health claims made on foods

The Advertising Standards Authority is bringing its Committee of Advertising Practice code up to date in line with new European legislation on nutritional and health claims made on food, with immediate effect.

This should prove interesting, as it may have quite an effect on the types of claims made in broadcast and print advertising.

The .pdf document of the changes can be found here, although I've reproduced it here for ease of reading:

51.10 Claims for food products that refer to a rate or amount of weight loss are not permitted. Claims made for other products that individuals have lost exact amounts of weight should be compatible with good medical and nutritional practice, should state the period involved and should not be based on unrepresentative experiences. For those who are normally overweight, a rate of weight loss greater than 2 lbs (just under 1 kg) per week is unlikely to be compatible with good medical and nutritional practice. For those who are obese, a rate of weight loss greater than 2 lbs per week in the early stages of dieting may be compatible with good medical and nutritional practice.

47.10 Marketing communications should not give a misleading impression of the nutritional or health benefits of the product as a whole.

50.21 A well-balanced diet should provide the vitamins and minerals needed each day by a normal, healthy individual. Marketers must not state or imply that a balanced or varied diet cannot provide enough nutrients in general and should not encourage anyone to swap a healthy diet for supplementation. Marketing communications must not imply vitamin or mineral supplements can be used to prevent or treat illness. Marketers may offer vitamin and mineral supplements to certain groups as a safeguard to help maintain good health but they must not, unless the claims are authorised by the European Commission, imply that they can be used to elevate mood or enhance normal performance. Claims about higher vitamin or mineral intake for a specific function are permitted if authorised by the European Commission. Without well-established proof, no marketing communication should suggest that there is a widespread vitamin or mineral deficiency.

50.22 People who are potentially at risk of deficiency may be safeguarded by vitamin and mineral supplementation. If the claim made for a vitamin or mineral supplement is relevant only to a group that is at risk of inadequate intake, marketing communications must state clearly the group likely to benefit from the supplement. Indicative groups include:
a) people who eat nutritionally inadequate meals
b) the elderly
c) children and adolescents
d) convalescents
e) athletes in training or others who are physically very active
f) women of child-bearing age
g) lactating and pregnant women
h) people on restricted food or energy diets
i) people with Asian ancestry from the Indian sub-continent
j) people who smoke.

50.17 Marketers should not use health professionals or celebrities to endorse medicines. Health claims in marketing communications for food products must not refer to the recommendation of an individual health professional.

56.10 Marketing communications may give factual information about:
a) product contents, including comparisons, but must not make any health claims
, which include fitness or weight control claims. The only permitted nutrition claims are “low alcohol”, “reduced alcohol” and “reduced energy”.

I've emphasised a few of the key phrases above in bold.

I'm sure there are plenty of products being advertised that now flout these rules. It'll be interesting to see how the regulations are interpreted, whether there is much fallout or whether the use of weaselly words will be ascended to an art form.

Let me reclassify that....

Please allow me to get all political on your ass.

In the UK, the Chief Scientific Adviser is responsible to the Prime Minister and Cabinet for the quality of scientific advice to them on scientific and science policy issues. The Government Office for Science is located within the Department for Innovation, Universities and Skills.

The current Chief Scientific Adviser is Professor John Beddington FRS, who has a pretty impressive CV, by all accounts.

So how come cannabis is being reclassified to a Class B drug next week (Mon 26th Jan 2009), when the evidence from Advisory Council on the Misuse of Drugs (ACMD) said it should remain a class C? (The AMCD is an external, independent panel of experts that advises the Government on drug-related issues).

It's generally considered not very clever to ask your expert advisers for their advice and then reject the evidence because it doesn't suit your agenda - I believe it's called Policy-based Evidence, and was enjoyably discussed on BBC Radio 4's More or Less program this week with Tim Harford - still available as a podcast.

The Guardian reported yesterday that the Commons Innovation, Universities, Science and Skills Committee berated Prof Beddington for not doing his job as Chief Scientific Adviser, by not holding the Government to account in terms of the reclassification of cannabis and for defending the Government's position on alternative medicines, despite there being no evidence for either. [A cynic would say the Daily Mail reader's vote is being bought with the first one, and Prince of Quackness Charles Windsor is ensuring no change on the second, and that Prof Beddington has no choice].

So how accurate is the charge "The government is ignoring its own Scientific Advisers" and how is the Government currently relaying this rebuff?
In July 2007 the Home Secretary requested, in the light of “real public concern about the potential mental health effects of cannabis use, in particular the use of stronger forms of the drug, commonly known as skunk”, that the Council re-assess the classification of cannabis.
This is from the ACMD: Cannabis Re-classification website. The full report is also on this site.

The ACMD came back with 21 recommendations of which the Government promised to implement 20 - guess which one they decided not to implement? Correct - the one they originally asked the ACMD to report back on:

Recommendation 3: Cannabis should remain a Class C drug

A similar-minded cynic to that above might suggest that the Home Secretary had already decided to reclassify cannabis to a B and was hoping for some support from the ACMD - a textbook case of "Policy-based evidence".

Needless to say, the Government is making a big deal of saying that it is implementing 20 of the 21 recommendations, and not a whole lot about the one they actually wanted information on:
The decision follows a review of cannabis classification which was carried out by the Advisory Council for the Misuse of Drugs, at the request of the Prime Minister [...]
The government accepted 20 of the 21 recommendations from the ACMD report. The government’s response to the ACMD report explains its decision in detail.

Very disingenuous towards the ACMD, to suggest the decision 'follows' the review - 'follows' chronologically, but not by content.

But what of Prof John Beddington FRS, chief Scientific adviser to the Government, the voice of evidence-based policy in the scientific arena - surely, he had something to say? Indeed he did (via a spokesman):
There will of course be times when contradictions exist between scientific advice and other policy imperatives [...]

Or to translate:
The government will use evidence-based policy when it happens to coincide with their plans or if there is a block-vote at stake.

How very.....democratic.


Tuesday, January 20, 2009

A tidying-up result - Science Museum remove JABS from their MMR pages.

In December, I blogged about the Science Museum's very out-of-date guide to the MMR hoax.

The website previously directed people inquiring about single vaccines and further information to the JABS, a anti-vaccine, anti-science, anti-sense site pressure group - see here for regular updates on the lunacy of the inhabitants of JABSworld.

After a complaint to Science Museum in Dec, I received today a cordial email from Holly Cave at the Science Museum letting me know that the site was historic - suggesting (I think probably correctly) that JABS hadn't necessarily shown their true colours at that time and has since morphed into this bizarre world of conspiracy and unreason. She agrees that it is 'no longer appropriate' to link to JABS and will remove the link. The pages will all be clearly datestamped to show it is really archived material rather than a current position.

So that's all good news - another little positive change made; the BBC stopped linking to JABS some time ago, which is how it should be.

RIP MMR hoax.


Thursday, January 15, 2009

The Beginning of the End for Quackademics at Salford Uni - but only the beginning for AIDS patients in Tanzania

According to their website, University of Salford (the Greater Manchester University) is the top university in the UK for winning funding from the EPSRC to promote public interest in science, maths and engineering - beating off competition from universities like Cambridge and Oxford.

This accolade is heavily diluted by the fact that you can also graduate with a Bachelor of Science (sic) in Homeopathy in Practice. I know, I know - the 'science' bit threw me as well. Prof David Colquhoun has been leading the charge in blogging about quackery in colleges and Unis for some time.

EDIT 22/01/09 - DC has now blogged this story fully here.

But things are to change, according to today's Times Higher Education Supplement article, "Salford to Shut Complementary Medicine BSc". The University seems to be coming to its senses by announcing that the courses are no longer considered "a sound academic fit". That's a euphemism for "the courses are a load of codswallop wrapped in bullshit". Chinese Medicine is one of the courses as part of this degree and according to the University;
The university plans to run out the undergraduate programme in traditional Chinese medicine for financial and strategic reasons.

However the University and College Union had the following quote, which aptly displayed their attitude towards any University course:
It's tragic that they are closing down a profitable course for spurious reasons related to it not having a social-science methodology.

Or roughly translated;
It doesn't matter if we're teaching bullshit that breaks every law of physics, chemistry and biology ever observed and pretending it's true, it MAKES MONEY!

To quote Adrian Gaylard from the comments section:
Good that its to be stopped; almost beyond belief that it was ever run in the first place

This is a quote I hope to be able to apply to the incredibly disturbing case of Jeremy Sherr, the evangelistic homeopath, who is trying to use his sugar pills to cure AIDS and thereby convince people that nasty lifesaving drugs like AZTs are unnecessary.

I know, difficult to believe.

This isn't just the organic yummy mummies giving Jocasta sugar pills because she didn't sing happily while pouring her exotic five-fruit muesli, this results (if they stop taking the AZT) in people dying. This is one of those occasions where the "What's the harm" argument is demonstrated by a body count.

The story is pretty big, but it is being covered expertly elsewhere, but please read the whole sorry tale - the trial involving AIDS patients on homeopathy or placebo (spot the difference?) followed by Mr Sherr's retraction, website changing, and all the dirty tricks involved with someone who is a homeopathy True Believer™. As is shown time and time again, True Believers™ cannot be wrong, the cognitive dissonance will not allow them to be unblinkered, even when there are people who will die as a result.

Gimpy first blogged about Jeremy Sherr in 2007.
The incredibly unethical 'trial' is blogged by Gimpy here,The Lay Scientist here, JDC325 here and JQH here.
Following some criticism, Jeremy Sherr responded with a typical CAM response - something akin to sticking his fingers in his ears yelling BLEAH BLEAH. The Lay Scientist responded here.
Gimpy's most recent post demonstrates that Jeremy Sherr is not just one whacko crazy mango on the fringes of the homeopathic tree, but in fact acts with the support of the whole homeopathic establishent.

So there you go - in effect, 2 blogs posts for the price of one. What the hell, it's a January sale.

Monday, January 12, 2009

Recommended Arthritis Cure #3,275 - Montmorency Cherries

Another day, another natural arthritis cure recommendation.

Another extremely helpful and well-meaning person offering me a haven from my gammy hips (which are pretty good at the moment, thanks for asking). The conversations follow a similar pattern - a recommendation from them, a cursory googling by me, a you-should-really-take-it follow up from them, a there's-no-evidence reply from me, and the obligatory blog post.

In the past, I've dealt with silicon gels, glucosamine, condroitin, rosehips and cod liver oil, and blogged them for posterity. When real medicine can't deliver, there are plenty of 'natural medicine' and quackery companies ready to pounce in with stories of cure and relief from these stubborn diseases.

So, how do you go about finding out if cherries are the wonderfruit we are being lead to believe it is? It's actually quite tough - googling "cherries, arthritis" brings up reams and reams of companies either promoting cherries as an arthritis cure, or publishing press releases on behalf of these companies - no balance, no evidence, no proof, no journalism, just unequivocal breathless fawning.

So I made a few assumptions - the most well-promoted cherry seller will probably have somewhere on their website the strongest possible claims backed up by the strongest possible evidence that cherries can cure arthritis. (Actually, thanks to the work of the MHRA, no self-respecting company would claim a cure, the strongest they can get away with is "alleviation of the pain of arthritis" or similar - this turns the potion from a cure into a painkiller at best). Given that they want to sell me their cherry produce, no doubt they will have done the hard work for me and compiled all the different studies from all over the world to convince me of it's efficacy and encourage me to buy.

Let me introduce to you CherryActive. I should say, that CherryActive aren't touting an arthritis pill per se, their magical cherries will help a whole range of ailments and in various situations, such as:

Healthy Joints
Healthy Muscles
Regular Sleep
Healthy Heart
Lower Cholesterol
Improved Recovery from sport
Frequent Flying
Healthy Children
Brain Health

What a panacea. However, I'll stick to the arthritis section. My cherry advocate kindly sent me "The Montmorency Cherry Nutrition Report", commissioned by the Cherry Marketing Institute (CMI), an organization funded by North American tart cherry growers and processors. A cynic might question the independence of such a brochure, but at least we can be sure it will be thorough, if perhaps over-egged.

(There is good reason to believe it may be over-egged, as the FDA last year announced a permanent injunction against some cherry-sellers for putting medicinal claims on their packaging that were not based in fact. In 2005, the FDA sent a warning letter to a list of cherry manufacturers warning them that their dubious claims could land them with a hefty fine. These are the same cherry growers and processors who fund the CMI).

Straight to page 5, for the heading "Arthritis & Gout".

[First of all, it's important to distinguish between arthritis and gout. Gout is the deposition of uric acid crystals on the cartilage of joints and tendons, which causes inflammation and pain. These crystals can continue to form Tophi, which can go on to cause "gouty arthritis". Arthritis is one of those catch-all words, which means 'joint inflammation' and covers a multitude of different conditions. Gout, however, although an inflammatory disease, is very different from rheumatoid or osteoarthritis.]

Gout seems to have some research in its favour - a paper in the Journal of American Nutrition (Jacob, 2003) indicates that a good dose of cherries of a day can lower the plasma urate level and may give credence to its anti-gout legend. The 10 candidates had to eat 45 cherries in 10 minutes after a overnight fast. The significant (p<0.05) decrease in plasma urate (╬╝mol/l) went from 214±13 to 183±15 - this was compared with other fruit, however strawberries gave a reduction, and given the wonder-components associated with cherries are supposed to be the anthrocyanidins which give them their red colour, it's surprising they didn't compare more red fruit. In any case, they used sweet Bing cherries, not tart Montmorency cherries, and a study with 10 people and huge error bars doesn't carry much weight, but nonetheless, it's a maybe, for mild gout.

So what about arthritis, either osteo or rheumatoid? The brochure gives two papers that "suggest that consumption of cherries may be beneficial for the management and prevention of inflammatory diseases". (We all enjoy woolly modifying words like 'suggest' and 'may'). The first, van Acker (1995) is a research communication connecting flavenoids (such as anthrocyanidins) as scavengers of Nitric Oxide radical, however this molecule is ubiquitous in the body and very beneficial - it helps gentleman stand to attention when required. It has nothing to do with cherries and nothing directly to do with arthritis - to put this research in the category of "Cherries help with Arthritis" is really cloud cuckooland and another example of the nonsense surrounding 'antioxidants'.

The second is by Kelley et al, published in 2006 in Journal of Nutrition. It was a follow on from the Jacobs study above involving more people (18) and again involved the consumption of a daily amount of 45 sweet Bing cherries (not a pill nor a syrup but the cherries themselves). This study was longer term, looking at some inflammation markers after 0, 7, 14 and 28 days and 28 days after the discontinuation of the study. There was also a reading taken 8 days before the study began. The study found that C-Reactive protein, a protein found in the blood as a response to inflammation, decreased during the intervention period with the cherries. The researchers admit that it was a small study, with no placebo and that the difference seen could have been something other than the cherries, but it still warrants more research:
These should be confirmed in studies with larger number of subjects and also in subjects with preexisting inflammatory conditions such as CVD, arthritis, smokers, and older subjects.

There is a third paper (Tall 2004), but it involves heating rat's paws and measuring the inflammation - to be honest I want to know if a human with arthritis will benefit from eating cherries; this paper talks about anthrocyanins (present in many different fruit) in treating inflammatory pain in rats. Those two statements are very, very far apart.

And there you have it. That is the weighty mass of evidence that the Cherry Marketing Institute has helped fund, and my goodness it is unimpressive - to the point where I'm annoyed I won't get the three hours back again it has taken me to research it all.

To recap, a company called CherryActive, which sells Montmorency cherry cordial & pills has presented as the strongest evidence it has on arthritis the following:

1. A paper on a surrogate endpoint for gout using sweet Bing Cherries based on 10 people.
2. A paper based on 18 people eating sweet Bing cherries looking at general inflammation markers
3. A paper on rats with no cherries but anthrocyanins, present in loads of fruit.

You can see for yourself that the evidence is weak to non-existent. Of course, that doesn't mean the evidence won't be there in the future, the point is they don't need it. They have people willing to be duped in to believing it works (placebo-effect alone), with the press as their willing conduits - it seems churlish not to put yet another fawning, uncritical Daily Mail link in time-honoured fashion, so here it is, from Sept 2008. Cut&paste-tastic.

You may be amazed, given my incredible tabloid headline writing skill that I didn't stoop to use a gag on 'cherry-picking the evidence'. That's because CherryActive have caught the eye of other dietary-minded bloggers such as HolfordWatch, who used it with conviction. An nutri-nonsense product that has Patrick Holford and Food for the Brain endorsing it, is almost guaranteed to be pimping pills to a gullible public in Holford's happy evidence-bending way.

It turns out they can't do maths either - have a look at the nutritional information on CherryActive's website. Show me someone who can put 21g of natural sugars (81 kCal) into 10kCal, and I'll show you someone who has done their sums wrong. Let's hope not too many dieters or diabetics rely on those numbers.

EDIT: May09: CherryActive, having been made aware of their mistake, have amended it to read 110 kcal, not 10.

Perhaps I should tell the CMI to go back and try again, give them another bite of the cherry, if you will.


Thanks to Chris Preston & Gadgeezer from Bad Science for their help.

Monday, January 5, 2009

Doc Mocks Detox

Who says I couldn't be a tabloid headline writer?

Anyway, the airwaves and dead-tree media have been choc-a-bloc-a-detox (see? ok, fair point) with Sense About Science once again announcing to the world the ridiculousness of 'detox' diets and products.

In his post "Detox: Nonsense for the Gullible", David Colquhoun has nicely laid out the bones of the story, as well as the list of media outlets that ran the story.

One such place that picked it up was BBC Radio 4's flagship news program, Today. The interview was with science-behemoth Dr Ben Goldacre of Bad Science and Nas Amir Ahmadi, managing director of Detox-in-a box, now named Bollox-in-a-box, or indeed, Quack-in-a-box.

The interview can be found here, or even better, at Ben's own site, which has a marvellous discussion attached. During the interview, Dr Goldacre questions the validity of saying that detox can remove heavy metals from the body, claiming it is scaremongering and overcomplicates dieting and thereby disempowering. He questioned Amir directly as to what proof there was of detox removing cadmium from the body, to which the reponse was:
Well, we haven't actually made any claims on our website regarding cadmium or mercury, so I don't actually know what claims you are referring to.
The relevant quote from the Detox-is-for-cocks' website:

Detox is a bodily process that transforms health threatening toxic substances from our environment, diets, as well as our own bodies into something harmless or excreted.
Orange Couscous Detox Food - One of the most complex detoxification functions is against heavy metals such as lead, mercury, cadminum [sic], nickel, arsenic, and aluminum.
... a quote that was removed at 10.02am this morning, about 100 minutes after the interview.

They have now updated their website to include an apology to Dr Ben:
We acknowledge that Dr Ben Goldacre was correct at the time of interview that the Detox in a Box website did contain the words '"One of the most complex detoxification functions is against heavy metals such as lead, mercury, cadminium, nickel, arsenic, and aluminum" and apologise for not confirming this at the time. The website has now been amended to avoid any further confusion.”
I hope BBC Radio 4 will mention it in tomorrow's program.

What's immensely silly, is that the website still contains the claim about heavy metals, just without the list of them.
One of the most complex detoxification functions is against heavy metals.
An apology, but no understanding of the nonsense they are spouting.
Anyone who buys Detox-in-the-docks products or any detox product is a simple misguided fool and as always, there will be quacks ready to detox them of their money.