Holford Myths: what is the problem with Nutritionist Patrick Holford?

Summary: Professor Patrick Holford is a popular media pundit who is celebrated for his scientific approach to nutrition. Pundit brand equity may partially explain why the mainstream media do not seem to care that Holford’s work is riddled with errors that substantially undercut some of the scientific claims that he makes: that is irritating but understandable, given the economics of advertising. Mainstream media may also find it difficult to admit that they were duped or indifferent to the accuracy of what they were offering.

However, it does not explain why the University of Teesside persists in lending him academic credibility or why reputable scientists continue to be associated with him. Ironically, perhaps these people who should know better would only be prompted into appropriate action if the mainstream media were to cover his errors and to appraise the quality of his scholarship. Maybe Ben Goldacre will mention something in the next instalment of The Rise of the Lifestyle Nutritionists.

Professor Patrick Holford of Teesside University is also Head of Science and Education at Biocare as well as one of the mainstream media’s preferred sources of nutritionism. His CV is packed out with references to his appearances on TV and radio and in newspaper snippets. One consistent message is that in amongst the anecdotal advice of healthy eating books from lifestyle journalists, graduates of celebrity fit farms, TV critics and presenters, Holford is the voice of science. He is the visionary who reads the scientific literature and turns it into principles to live and supplement by for the masses.

Right.

Holford appears on TV, waving printouts of “the latest research” (which seldom is) and uses it in an attempt to upstage or quell the commonsense and scientific knowhow of his fellow pundit. Who can forget his desperate scrabble for the meta-analysis on the virtues of chromium with which he hoped to quash Dr Sarah Jarvis into submitting to his superior scholarship? He brandished it like a crucifix before a particularly peckish vampire.

Holford sprinkles references to scientific papers through his speech and writing with the same heaviness of hand as an out-of-control sugar powderer in a doughnut factory. And, many of those references are similarly decorative and nutritionally irrelevant. Holfordwatch has minutely detailed and drawn attention to this decorative abuse of references and to the Holford way with numbers that might make you reluctant to put him in a customer-facing role, vis-a-vis, the correct totting up of a bill or the return of change.

We mean no disrepect to Holfordwatch which acknowledges that it is a niche blog but the mainstream media must be aware that Dr Ben Goldacre has published some thoughtful and spirited commentaries about the level of Holford’s scholarship that cast doubt on his ability to understand the research that he reads and cites with such abandon. Holford has written odd items about My Right to Be Called a Nutritionist (a right he shares with everyone else in the UK as it is not a restricted title). He has (wisely, perhaps) refrained from asserting, My Right to Be Called a Competent Researcher or My Right to Describe Myself as a Cutting-Edge Scientist. (I feel that many of us would relish a rematch of Holford and the redoubtable Emer Keeling if she were ever to learn the true state of Holford’s training in nutrition. We have excerpted part of the video for your entertainment.) Another notable exception to the mainstream media’s acceptance of Holford is Damian Thompson who describes him as a propagator of “potentially dangerous counterknowledge”.

So, what is happening? Why do the mainstream media turn to Holford with such monotonous regularity to allow him to disseminate his nutritionism and repurposing of scientific research? Activities that are sometimes akin to watching the leader and acolytes of a particular flavour and fervour of cargo cult science?

A partial answer may lie in the conservation of pundit brand equity. A pundit’s power and influence reflect their brand building by the PR company and the willingness of media to accept comparatively cheap copy. Copy that may, nevertheless, generate some exciting ad sales for particular products or supplements. It takes a lot of long-term schmoozing to attain the status of a “trusted pundit”, someone that a deadline-oppressed journalist can turn to for just the right quote. Which may explain why, even when there are egregious signs of obvious and repeated error, notional reverence for the brand is maintained.

In the same way that we are frequently told that we have been trained to respond to brands in consumer goods, it seems that we are increasingly conditioned to expect our health news from brands (C5’s Diet Doctors, C4’s McKeith and ITV’s Holford come to mind). Conditioning associated with celebrity status is a formidable force in consumer culture, too frequently they overpower critical thinking and education.

So, according to mainstream media, Holford is a scientist and reputable researcher, no matter how much verifiable evidence there is to the contrary. And despite his association with nonsense such as the Q-Link and food intolerance tests that remain unvalidated no matter what his claims to the contrary. And despite the biographical errors that marr his CV and raise questions about just how long he spent studying mental health and nutrition before he started to treat patients.

Bless them, Holfordwatch has been through several of Holford’s works and probably haven’t even begun to tap this rich source of error. In many ways, it’s like following a guide to how not to fall into the many traps that science and research have for the unwary.

Holford repeatedly asserts that nobody has ever criticised his science or search. Holfordwatch has examined some of his work in remarkable detail and the errors that they report are not matters of opinion but matters of fact. Anybody can check their references or workings and verify that Holford made an error. Yet, with only a couple of exceptions, Holford shows no sign of correcting most of the errors. Why?

Scientists don’t expect to be right all the time; they generate hypotheses, design ways to test them and collect their data. Sometimes, the hypothesis was wrong – and maybe in an interesting way. This is why researchers tend to write with careful attention to accuracy and nuance. When, like Holford, you mostly stitch together other researchers’ work to form a patchwork for your own beliefs, there may be times when you make a mistake in your interpretation. It may be annoying or even a little embarrassing, but ultimately, scientists know that accepting correction is essential.

So, why hasn’t Holford corrected his many errors? Is it because when you use the media as a conduit for asserting your expertise and impeccable scientific credentials, there is no entertaining or valuable copy to be had from admitting that you over-interpreted or mis-cited scientific evidence for your assertions? The mistakes are not sexy enough to justify the sort of mea culpa interview in which Oprah calls James Frey to account. Oprah acknowledged that she was duped and told Frey that he had betrayed millions of readers.

Admitting that you made an error of judgment or made a spectacular mistake is fine for celebrities but a fatal crack in celebrity pundit status. It is implausible that there would be lucrative book deals for Patrick Holford Mis-Reports Papers, Can’t Do Sums, and 101 other gaffes of varying significance. There wouldn’t be any prime-time slots on GMTV or Tonight with Trevor Macdonald for a penitent pundit who has to admit that the evidence for what he has been selling you is not quite as strong as he made it out to be. We’d like to see it, but we don’t expect to see Lorraine Kelly telling Dr Hilary Jones that she feels duped by his assertion that he had read the Food for the Brain Child Survey 2007 from cover to cover and it was reliable. Nor do we expect to see a penitent Holford on a couch with Sir Trevor.

Yes, some of Holford’s errors are substantial enough that Holford should issue errata slips with his books and it is arguable that Food for the Brain should withdraw their fatally flawed survey report. But, as an interim measure, it should be possible for Holford to dedicate parts of his website to listing the errors in each book and correcting them. He would then have a list of essential corrections for the next revised issue of his books. Why isn’t this happening?

Pragmatically, maybe it is appropriate for his continued media career to refuse to acknowledge his errors because doing so would devalue his punditry brand. His academic career is a separate issue. Why is the University of Teesside willing to appoint a professor whose behaviour in this respect is antithetical to the training in rigour and accuracy that they must give their young scientists?

Ordinarily, this is where one has recourse to an invaluable overview of the Justin Kruger and David Dunning paper that discusses how difficulties in understanding one’s own incompetence can lead to inflated self-assessments.

What’s even more amazing is that when they then shared the performance of other participants with the people who performed poorly (hoping that they would then adjust their self-perception downward) people who scored poorly failed to adjust their self-perception of their performance. In other words, they are completely unaware of their own [in]competence, and can’t detect competence in others.

It really it a very helpful paper that explains many otherwise inexplicable actions and A Photon in the Darkness offers his helpful discussion of this paper: The Arrogance of Ignorance.

But, although Kruger and Dunning may offer an explanation for Holford, the paper can not explain away Teesside’s actions or those of respected academics such as Professors Cowen and Smith who continue to endorse him. (We should recognise, of course, that some academics have struggled to have their endorsements removed; notably Prof Tylee and Dr Marks.)

This is not a trivial matter – Holford is attempting to obtain funding to carry out research. He wants to have a say in the spending of taxpayers’ money despite his less than encouraging track record for appropriate rigour. Ironically, perhaps the only thing that would persuade the likes of Teesside and others to address this matter properly is coverage of his errors in the mainstream media. Like Holfordwatch, we wonder if Professor Holford will come in for any scrutiny in the 2nd part of Goldacre’s exploration of The Rise of the Lifestyle Nutritionists.