MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

diet

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It has been reported that King Charles’ charity, formerly the Prince’s Foundation, is compelled to return £110,000 to the Indian government. The funds were earmarked for an NHS alternative medicine clinic championed by Charles, which never materialised. The proposed clinic was aimed at integrating Indian traditional medicine into the UK’s healthcare system.

But why did the plan fail?

The answer is simple: the National Health Service (NHS) did not approve it.

The history of the UK ‘Ayurvedic Centre of Excellence’ goes back several years. Here is an excerpt of my book ‘CHARLES, THE ALTERNATIVE KING‘ where I discuss it as one of Charles’ many pipe dreams in the realm of so-called alternative medicine (SCAM):

In 2018, India’s prime minister Narendra Modi paid a visit to the Science Museum in London where he inspected the ‘5000 Years of Science and Innovation’ exhibition. The event was hosted by Charles and included the announcement of new ‘Ayurvedic Centres of Excellence’, allegedly a ‘first-of-its-kind’ global network for evidence-based research on yoga and Ayurveda. The first centre was said to open in 2018 in London. Funding was to come partly from the Indian government and partly from private donors. The central remit of the new initiative was reported to be researching the effects of Ayurvedic medicine.

Dr Michael Dixon (yes, you may have met him several times before, e.g. here, here, or here) commented: “This is going to be the first Ayurvedic centre of excellence in the UK. We will be providing, on the NHS, patients with yoga, with demonstrations and education on healthy eating, Ayurvedic diets, and massage including reflexology and Indian head massage. And all this will be subject to a research project led by Westminster University, to find out whether the English population will take to yoga and these sorts of treatments. Whether they will be helped by it and finally whether it will reduce the call on NHS resources leading to less GP consultations, hospital admissions and operations.”

 On its website, the College of Medicine and Integrated Health announced that a memorandum of understanding with India’s Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) had been signed “to create centres of excellence in the UK … Dr Michael Dixon agreed the joint venture to provide the UK centres, which will offer and research traditional Indian medicine… The Indian government will match private UK donations to fund the AYUSH centres in the UK”. In November 2019, the following press release by the president of India offered more details:

The Prince of Wales called on the President of India, Shri Ram Nath Kovind, at Rashtrapati Bhavan today (November 13, 2019).

Welcoming the Prince to India, the President congratulated him on his election as the head of the Commonwealth. He said that India considers the Commonwealth as an important grouping that voices the concerns of a large number of countries, including the Small Island Developing States.

The President said that India and the United Kingdom are natural partners bound by historical ties and shared values of democracy, rule of law and respect for multi-cultural society. As the world’s pre-eminent democracies, our two countries have much to contribute together to effectively address the many challenges faced by the world today.

The Prince planted a Champa sapling – plant native to the subcontinent which has several uses in Ayurveda – in the Herbal Garden of Rashtrapati Bhavan. He was taken around the garden and shown different plants that have medicinal properties. The Prince showed a keen interest in India’s alternative model of healthcare.

The President thanked the Prince of Wales for his support for Ayurveda research. The Prince of Wales Charitable Foundation and the All India Institute of Ayurveda signed an MOU during the visit of Prime Minister Narendra Modi to the UK in April 2018. Under the MOU, the All India Institute of Ayurveda and the College of Medicine, UK will be conducting clinical research on Depression, Anxiety and Fibromyalgia. They will also be undertaking training programme for the development of Standard Operating Protocol on “AYURYOGA” for UK Health professionals.

_________________________

END OF EXCERPT

Charles’ initiative, encompassing Ayurveda, yoga, naturopathy, and homeopathy, was intended to be a landmark project, with the Indian government contributing £110,000 to the King’s Foundation for its implementation. However, the NHS, responsible for St Charles Hospital, never endorsed the project. Despite initial talks, the proposed collaboration did not progress, and the clinic failed to materialise. According to the west London clinical commissioning group (CCG), which oversaw the hospital at the time, there was no official involvement, and discussions ceased in 2020.

Under charity law, funds designated for a specific project cannot be diverted without donor permission and regulatory approval. The King’s Foundation has acknowledged the need to return the remaining budget to the Indian government but has not disclosed when this decision was made or why the funds were not promptly returned.

The initiative faced opposition from the NHS, as a year before the clinic’s launch, NHS England’s CEO Simon Stevens had issued guidance discouraging the prescription of homeopathy and herbal remedies, citing their limited efficacy and misuse of NHS funds.

Despite the failed project, connections between key figures persist. Dr Michael Dixon played a significant role in finalising agreements with the Indian government. The King’s Foundation defended its actions, stating that due to the Covid-19 pandemic, the project shifted online, resulting in reduced costs. They claim to have contacted the Indian government for the return of unused funds, emphasising that the money remains in a restricted account.

As the controversy unfolds, questions arise about the intersections between alternative medicine advocacy, royal endorsements, and international collaborations within the context of public healthcare.

An article in the Daily Mail reported that the original plan proposed that Ayush treatments would be provided to patients, who would be referred by local GPs, at St Charles Hospital in Kensington. Isaac Mathai, who runs Soukya, a homeopathic yoga retreat in Bangalore which Charles and Camilla have visited, was an adviser to the project at St Charles Hospital.

The Indian government made a payment from the budget of the Ayush Ministry, which Mr Modi has used as a tool of diplomacy to promote Indian medicine and culture worldwide, to the King’s Foundation. It was proposed the charity would use its expertise to help set up the clinic. But the NHS at no point agreed to the plans.

A spokesman of the west London clinical commissioning group (CCG), which administered St Charles Hospital at the time, said: ‘Provision of homeopathy and herbal treatments were not considered as part of the project by the CCG. The aim of the project was to test the use of yoga and massage to support the overall health and wellbeing of patients with long-term conditions.’ A King’s Foundation spokesman added that the initial intention had been to deliver Indian traditional medicine at St Charles Hospital.

TOXIN BUILDUP CAN CAUSE:

  • Brain Fog
  • Irritability
  • Exhaustion
  • Stress Induced Muscle Aches
  • Inability to Concentrate
  • Tiredness
  • Restlessness
  • And Many More Problems

At least this is what we are being told on the Nuunu website which appeared in my emails recently (how did they know that I am full of toxins?). Here is some more of the infinite wisdom promoted by Nuubu:

Improve your body and mind with a natural Asian solution!

  • Traditional Wisdom: Nuubu was inspired by Centuries-old traditional Asian knowledge, passed on by generations. True trust is earned by passing a test of time. Nuubu is made of natural herbs and herbal extracts. Forget about harmful, toxic chemicals and embrace the soothing power of nature!
  • Detox Through Sweat: Nuubu is a revolutionary detox foot patch that can greatly increase your sense of wellbeing. Nuubu supports the body’s natural way of removing toxins through activated sweat glands.
  • Holistic Approach: Tackle the cause, not the symptoms – your body is riddled by toxic elements, which may harm your wellbeing and increase stress. Using sweat detox and vitamin infusion Nuubu helps you to strengthen your mind, body and soul!

Natural Body Toxin Removal:
Amazing
New Way to Improve Your Life

  • A Secret to a Stress-Free Living

    Tired? Stressed? Fatigued? You are not alone – our lifestyles are extremely taxing on our bodies and minds alike. Headaches, bad sleep and stress are the unfortunate hallmarks of fast-moving modern life. Active ingredients that are found in the Nuubu foot patch are known for their ability to remove accumulating harmful elements from your body, which can greatly improve your sense of wellbeing!*

  • Traditional Medicine gets Modern Upgrade

    According to Japanese traditional knowledge, the human body has over 360 acupuncture points, with more than 60 points found on the soles of the foot. Nuubu combines tried-and-true Asian techniques with a sleek and modern approach – attach the herbal-remedy based patches to your feet and wait a few hours for the toxin removal through your sweat glands. It has never been that easy!

  • Natural Approach

    Are you tired of hazardous man-made chemicals being used in every aspect of your life? There is a better way to harmonize your lifestyle! Nuubu foot patches are made using natural herbs similar to ones found in the remote East-Asian mountainsides. Forget the harmful toxicity and side effects!

Traditional Wisdom

Traditional Asian wisdom that has been passed down through the ages is what inspired the Nuubu Patches. The test of time is what allows us to provide you with a product that you can trust. Forget about hazardous, dangerous drugs and enjoy nature’s calming influence instead.

Only the most natural herbs and herbal extracts are used to make the Nuubu Patches. We have blended together ancient herbal therapies to create the ultimate in cleansing wellness.

The soothing herbal aroma of Mother Nature’s finest plants and botanicals allow you to know that the Nuubu Patches are doing their job and providing you with optimal wellness.

______________________

I hope you are as impressed as I am!

So, I searched for the evidence?

Does detox work? Specifically, does the Nuubu reduce my:

  • Brain Fog
  • Irritability
  • Exhaustion
  • Stress Induced Muscle Aches
  • Inability to Concentrate
  • Tiredness
  • Restlessness
  • And Many More Problems

No matter how hard I searched, I did not find any evidence. Eventually, I had to conclude that the patch does not work.

Hold on!

The website might be correct with one claim: it helps you to strengthen your mind

… to such an extend that you will

never fall for the lies of detox entrepreneurs!

The NZZ recently published a long and horrific report about a natural health clinic and its doctors. Here is a  version translated and shortened by me; perhaps it makes a few people think twice before they waste their money and risk their health:

It is a narrow mountain road that they are racing down on this spring evening. Over the green Appenzell hills, towards Herisau hospital. Kathrin Pfister* is fighting for her life in the car. At the wheel is Thomas Rau, internationally renowned practitioner of so-called alternative medicine (SCAM) and director of his own luxury clinic, the Biomed Centre Sonnenberg. Three days later, Kathrin Pfister is dead. The most likely finding according to the experts: Pfister was injected with a drug that was not authorised in Switzerland at the time, the side effects of which killed her.

Pfister is not the only woman to have lost her life following treatment at the Sonnenberg. Other experts accuse Rau of serious breaches of duty that led to the death of a patient. Rau and another doctor are thus being investigated for involuntary manslaughter.

The events remained hidden from the public for over two years. It’s not just about one doctor, not just about one clinic. The events are politically explosive for Appenzell Ausserrhoden. The canton is the centre of alternative medicine in Switzerland. SCAM doctors are an important economic factor in Ausserrhoden. Wealthy people from all over the world fly here for therapies that most conventional doctors just shake their heads at. Treatments lasting several weeks with a hotel stay cost five-figure sums.

The 73-year-old Dr Rau is the star among Swiss alternative medicine practitioners.He describes himself as the “Mozart of medicine”. The Biomed Centre Sonnenberg is “Mozart’s” last big project. The clinic has a hotel and gluten-free vegan restaurant from the Tibits chain. Even the feather pillows are replaced with bamboo ones. All for the “detox” that Rau praises.

Kathrin Pfister’s case began in mid-April 2021, just four months after the Sonnenberg centre opened. She is actually healthy and comes to the clinic anyway; because of some digestive problems and headaches. The hospital records show that Pfister received infusions. Initially only those containing vitamin C and homeopathic remedies. Then one with artesunate, a preparation against malaria. And finally, on a Friday, Pfister was injected with a solution of alpha-lipoic acid into his bloodstream. The infusion is used in Germany for long-term diabetics with nerve damage. It was not authorised as a medicinal product in Switzerland at the time. According to the forensic experts, it was this substance that was “ultimately causally linked to the death”.

A few hours later, Pfister had severe abdominal cramps. Then pain throughout the body. The number of platelets in her blood drops dramatically. Anxiety sets in at the clinic. The intensive care doctors in Herisau and later at the cantonal hospital in St. Gallen can do nothing more. Pfister had a massive blood clotting disorder. Her liver and kidneys were no longer functioning.

Mary Anne Hawrylak meets Thomas Rau by chance at the clinic that weekend. She too is a patient, recently flown in from the USA. Hawrylak had massive side effects after infusions that Friday. “When I told him about it, he turned white as a sheet, like a ghost,” says Hawrylak. “Doctor Rau told me in horror that I had received the same infusions as ‘Kathrin’ and that he had to test my blood.” The tests showed that her blood platelet count had also dropped, says Hawrylak.

The forensic experts point to a central fact: Alpha lipoic acid can cause blood clotting disorders.  They come to the conclusion that this is “most likely a lethal side effect of a drug”. The use of drugs that are not authorised in Switzerland is legal if they are authorised in a country with a comparable procedure. However, there is no real reason to inject this medication into the bloodstream of healthy people. It was authorised in Germany for diabetes patients with nerve damage. So, Pfister did not have this authorisation.

Experts refer to such applications as “off-label use”.  Off-label treatments should only be carried out “on the basis of valid guidelines, generally recognised recommendations or scientific literature”. The guidelines also require that patients are given comprehensive information about off-label use. This counselling session should be documented in writing. None of this can be found in the clinic’s files. No written consent, no documented risk-benefit assessment, no reference to the risk of blood clotting disorders. The forensic experts state: “The scant documentation from the Sonnenberg Biomed Centre does not contain any corresponding information document.” The question arises as to “whether the medical treatment at the Sonnenberg Biomed Centre was carried out with the necessary medical care”.

Patient Hawrylak also says: “I was not told exactly what was in the infusions. I was never told that the medication was not authorised in Switzerland or that its use was off-label. I spoke to Dr Rau about what had happened to ‘Kathrin’ because I was worried about myself,” says Hawrylak. “He said to me: ‘I don’t think it was the infusions. I think it was the Covid vaccinations.” He only justified this with his “intuition”.

The Pfister case triggered an investigation by the public prosecutor’s office. But what hardly anyone knew at the time was that it was not the first questionable death at the clinic – not even the first in a month. Ruth Schmid*, a 77-year-old Swiss woman, had died just three weeks earlier. In this case, the forensic pathologists accused Rau: He had made mistakes that not even a medical student should have made, thus causing Schmid’s death.

Schmid was also in the clinic for a kind of cure. When she was about to leave, she began to tremble violently and had extreme stomach pains. She screamed “like an animal”, her partner said during the interrogation. Ultrasound examinations were carried out at the clinic and Rau gave Schmid painkillers, including morphine. According to the partner’s statement to the public prosecutor’s office, he asked Rau whether Schmid needed to be taken to hospital. Rau said no. Schmid stayed in the hotel room overnight. The next day – according to Rau, she had been feeling better since the previous evening – she travelled home. According to Rau’s confiscated notes, “she was to report closely” and return in four days. At home, Ruth Schmid fell into a coma-like state overnight. Admitted to Zurich University Hospital in an emergency, Schmid died there of cardiovascular failure due to septic shock.

The Zurich forensic pathologists performed an autopsy on Schmid’s body. Their findings: Schmid had suffered from intestinal paralysis. As a result, bacteria entered her body and poisoned her blood, leading to a heart attack. “From a forensic medical point of view, it is incomprehensible why the attending physician, Dr Thomas Rau, did not carry out appropriate diagnostics.” The irritation of the forensic experts is evident in almost every line. There had been several warning signs of intestinal paralysis. The forensic experts wrote: “This knowledge is taught in medical school and is considered basic knowledge in human medicine.” Rau’s behaviour was “a breach of the doctor’s duty of care”. With timely treatment, the prognosis for intestinal paralysis is excellent. The sad conclusion: Ruth Schmid did not have to die.

During questioning by the public prosecutor’s office, Rau denied any guilt. Schmid had left in “good condition”. There was no causality between what happened in the clinic and the death. The findings and conclusions of the Zurich forensic pathologists were wrong. Schmid did not have intestinal paralysis or septicaemia. He had been able to rule out intestinal paralysis because intestinal noises had been audible in the morning. The dose of morphine had been very small, so that it had had no effect. There were no indications of a serious condition. Rau testified that he had acted professionally, as would be expected of an internal medicine doctor.

In the Kathrin Pfister case, the doctors treating her also deny any culpability and question the forensic medical report. The doctor’s lawyer writes that the criminal investigation will show that there was no breach of the doctor’s duty to provide information. Alpha-lipoic acid was not responsible for the death. The expert opinion is not convincing in terms of method or content: “When analysed in depth, it contains no justification that the use of alpha-lipoic acid was in any way causal for the patient’s death.”

During the hearing on the Pfister case, Rau said that restricting the use of alpha-lipoic acid to diabetics was “a joke” and far too narrowly defined. He claimed that Pfister had polyneuropathy, a complex nerve disease. However, there is no mention of this in the files of Rau’s clinic.

The criminal investigation is ongoing in both cases. But did more happen on the Sonnenberg? A former hospital employee, who independently reported to the police, told the public prosecutor about other hair-raising incidents. During the interrogation, she testified that she had seen a young woman being carried out of the clinic extremely weak after an infusion. Days later, she had overheard parts of a telephone conversation between Rau and the patient’s angry husband which made it clear that the woman had died. The former employee also recounted a conversation with Rau’s wife, who is a trained nurse. She said that she had driven a patient to a hospital in Zurich in a private car with Rau because Rau was determined to take her to a particular specialist. The patient was so unwell that she was afraid the woman would die on the way. If this is true, Rau would have travelled past several hospitals with a seriously ill patient.

Hawrylak has one last memory of Appenzell etched in his memory. The departure. She was just leaving the clinic when Rau wished her good luck: “I could only say to him: I wish you good luck too, Doctor Rau. I think you’re really going to need it.”

*Names were altered.

Mushrooms are somewhat neglected in medical research, I often feel. This systematic review focused on clinical studies testing the effectiveness of mushrooms in cancer care. A total of 39 met the authors’ inclusion criteria. The studies included 12 different mushroom preparations. Some of the findings were encouraging:

  • A survival benefit was reported using Huaier granules (Trametes robiniophila Murr) in 2 hepatocellular carcinoma studies and 1 breast cancer study.
  • A survival benefit was also found in 4 gastric cancer studies using polysaccharide-K (polysaccharide-Kureha; PSK) as an adjuvant therapy.
  • Eleven studies reported a positive immunological response.
  • Quality-of-life (QoL) improvement and/or reduced symptom burden was reported in 14 studies using various mushroom supplements.
  • Most studies reported adverse effects of grade 2 or lower, mainly nausea, vomiting, diarrhea, and muscle pain.

The authors caution that limitations included small sample size and not using randomized controlled trial design. Many of the reviewed studies were observational. Most showed favorable effects of mushroom supplements in reducing the toxicity of chemotherapy, improving QoL, favorable cytokine response, and possibly better clinical outcomes.

The authors concluded that the evidence is inconclusive to recommend the routine use of mushrooms for cancer patients. More trials are needed to explore mushroom use during and after cancer treatment.

The use of mushrooms for medicinal purposes has a long history in many cultures. Some mushrooms are known to be highly poisonous, some have hallucinogenic effects, and some are assumed to have pharmacological effects that have therapeutic potential. Some mushrooms possess pharmacologic properties such as anti-tumour, immunomodulating, antioxidant, cardiovascular, anti-hypercholesterolemic, anti-viral, anti-bacterial, anti-parasitic, anti-fungal, detoxification, hepatoprotective, and anti-diabetic effects.

Many modern medicines were derived from fungi. The best-known example is penicillin; others include several cancer drugs, statins and immunosuppressants. In Traditional Chinese Medicine, numerous herbal mixtures contain mushrooms; examples are reishi, maitake and shiitake which are all assumed to have anti-cancer properties.

As the review authors point out, there is a paucity of clinical trials testing the effectiveness of mushrooms, and the existing studies tend to be of poor quality. At present, most of our knowledge comes from traditional use or test-tube studies. The adverse effects depend on the specific mushroom in question and, can in some instances, be serious.

Considering the potential and the complexity of mycomedicine, I find it surprising to not see much more research into this subject.

There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. The aim of this review was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis.

The researchers systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. They calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach.

In total, 37 publications based on 24 cohorts were included. The results are impressive:

  • There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3].
  • There was moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2].
  • Replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality.

The authors concluded that their findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality.

I am not a vegetarian or vegan but have been interested in vegetarian diets for some time.

The mechanisms by which a vegetarian diet bring about the health benefits are still not entirely clear and require more research. Likewise, we need more evidence on the question wether it is necessary to avoid all animal-based foods to generate the benefits. My reading of the evidence is that a reduction of such foods might suffice. Yet, the optimal balance is unclear as yet.

Guest post by Ken McLeod

Readers will recall that Barbara O’Neill is an Australian health crank, completely unqualified in anything, who is subject of a Permanent Prohibition Order issued by the New South Wales Health Care Complaints Commission, (HCCC),[1] preventing her from engaging in any health-related activity, including ‘health education,’ in Australia. The NSW Public Health Act 2010 provides that it is an offence for a person to provide ‘health education’ in contravention of a prohibition order, with a fine of $60,500 AUD ($38,151 USD, 36251 Euros) for an individual or imprisonment for 3 years, or both, or $121,000 AUD for a corporation.

For jurisdictional reasons that Order does not apply outside Australia and for several years she been touring the world giving health education lectures. The latest was a lecture tour of Ireland.[2] Despite the thorough debunking of her fruitloop beliefs by the HCCC,[3] she has maintained them and continues to give the ‘health education’ that was so dangerous that it led to the Prohibition Order in Australia.

Her Irish ‘health education’ lectures were live-streamed to people in Australia who paid the 20 Euro fee, and one was recorded by us.[4]

A transcript was made and is available online.[5] Her statements were analysed and some comments are made as follows. Alas, we didn’t have time to take a deep dive of her lecture to find the best references, but the following shows that an amateur with limited time and resources can prove that she does not know what she is talking about and that her advice is dangerous, even life-threatening.

It is up to the health regulators and immigration authorities in each country to act on her activities there, but so far none outside Australia have done so.

So a quick analysis of her ‘lecture’ in Dublin on 27 September 2023 shows that O’Neill has learned nothing from her experience with the HCCC. Some comments:

1. O’Neill and her husband, after the Prohibition Order was issued, changed the name of their facility from ‘Misty Mountain Health Retreat’ to ‘Misty Mountain Lifestyle Retreat’ to avoid the jurisdiction of the HCCC. However on four occasions in her lecture O’Neill referred to it as a ‘health retreat.’ 00:07:23 , 00:15:48, 01:30:04, 01:40:16.

2. At 00:12:53 O’Neill claims that the Amish don’t get autism. That is false, as explained by AP Factcheck. [6]

3. At 00:12:54 O’Neill claims that the Amish, ‘They don’t vaccinate their Children. Did you know that they don’t vaccinate their Children and yet they don’t get autism Very rare. Maybe 1%. And often that’s because of chemical exposure. There is always a reason. So why are vaccinations causing autism? Well, it’s neurotoxins, the neurotoxins. ‘

False; Amish do vaccinate their children. [7] However, studies have documented cases of autism, diabetes and cancer among the Amish, albeit at lower rates in some cases than the broader population and for reasons that are unrelated to their vaccination status. These reasons include the cultural norms and customs that may be playing a role in the reporting style of caregivers. [8] O’Neill is engaging in cherry-picking on a grand scale here.

4. At 00:13:37 O’Neill claims that ‘there are still two more neurotoxins’ (In vaccines.) Because children are still autistic. There’s formaldehyde, and there is aluminium, both neurotoxins.’

This is scaremongering disinformation. The CDC says ‘Formaldehyde is diluted during the vaccine manufacturing process, but residual quantities of formaldehyde may be found in some current vaccines. The amount of formaldehyde present in some vaccines is so small compared to the concentration that occurs naturally in the body that it does not pose a safety concern.’ As for aluminium, the CDC says ‘Ingredients like aluminum salt help boost the body’s response to the vaccine.’ The CDC says that both are safe. [9]

5. At 00:15:01 O’Neill claims ‘did you know that the milk in the supermarket if you give that to a newborn baby cow, that cow will die?’

I can find no reference supporting that and I suggest that it is pure fantasy.

6. At 00:18:29 O’Neill claims that ‘parents discover that they put their trust in the princes and vaccinated their child. Now their child has epilepsy. Now their child has autism.’

This is misleading panic-mongering that is a misrepresentation of the science. The Royal Australian College of General Practitioners says ‘Seizures and status epilepticus can occur within 14 days following administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. Vaccine-proximate status epilepticus (VP-SE) is uncommon but may be the first manifestation of genetic developmental epileptic encephalopathies, including Dravet syndrome.’ So ‘epilepsy’ may be first encountered [10] following vaccination but the root cause is genetic.

7. At 00:20:27 O’Neill says that she would like to suggest that no child would be vaccinated, because the fact is, our body was designed to heal itself.

This is pure crazy antivax propaganda, unsupported by the facts.

8. At 00:22:01 O’Neill claims ‘skin cancer has only been around in about the last 80 years, and you know what they’re finding today? That vitamin D deficiency is a big contributing back factor to skin cancer’.

The first claim is false; the science shows that skin cancers have been around ‘since the beginning of time.’ [11]

As for the second claim, the research published at the US National Library of Medicine shows that O’Neill’s advice is dangerous. ‘It is, therefore, preferable and safer to obtain adequate levels of vitamin D through diet than through sun exposure. In fact, it is currently accepted that dietary and supplemental vitamin D is functionally identical to that produced after UV exposure, being more reliable and quantifiable (the risks of keeping high levels of vitamin D have not been extensively studied) source of this vitamin.’ And ‘Neither natural nor artificial sun exposure should be encouraged as the main source of vitamin D.’ [12]

9. At 00:23:18 O’Neill disputes claims that ‘cholesterol causes heart disease. Well, it’s been going for 40 years now, and it still hasn’t proven that. But you know what? It has proven that people with high cholesterol levels don’t get Alzheimer’s.’

O’Neill’s first claim points to the conflicting research as revealed by the Cochrane Collaboration. [13] As for her second claim, the research does not justify her claim that it is ’proven.’ The evidence is conflicting and as the Alzheimer’s Society of the UK say, ‘More research is needed to better understand this relationship and what it can tell us.’ [14] O’Neill’s conviction is not based on evidence.

10. At 00:34:41 O’Neill said that at Dublin airport ‘about 10 days ago,’ she was approached by a man who asked ‘Are you the Australian doctor? And I smiled.’

O’Neill did not correct him and allowed him to be duped into believing she is a real doctor. Despite having no qualifications in anything O’Neill has used the honorific title ‘Dr’ many times in social media,[15] so it is no surprise that he assumed she was a doctor. I can’t help but be confused by her use of the ‘Dr.’ Throughout her lectures she denigrates real doctors, and then tries to boost her credibility by adopting the title.

11. At 00:35:21 she claimed that with ‘epigenetics, you can actually turn your genes on or off.’…. ‘So Michael effectively turned those genes off with castor oil. Castor is very effective for for cataracts. Put it in your eye, one lady said. Is it safe? Does anyone ever ask that of the doctor? Is that drug safe? Then the people have been putting cholesterol in their eyes for centuries. It’s safe.’

Bollocks! As Consumer Lab says ‘Although eye drops containing castor oil may help improve symptoms of dry eye and blepharitis, there is currently no compelling evidence that applying castor oil to the eye can diminish cataracts.’ [16] And there is no evidence that Michael turned the genes off.

12. At 00:40:08 she refers to a woman who recently had a stroke. She says

‘… because she had a stroke, she was put on the protocol she was on put on statins. Cholesterol lowering medication with clear arteries. How much sense does that make? You don’t have. You don’t have to be a rocket scientist to work this out. Trust in your gut feeling trust in this incredible body that God has given you. Her blood was no longer thick. Her arteries are open now. And so she came to our retreat and I said, Well, I can’t tell you what to do. And I have no authority over your medication. Only you, and go. You and your doctor do. But this is what I would do. I would stop the blood thinning medication immediately because that aspirin causes brain bleeds, eye bleeds and stomach bleeds. Got that? And I would stop the statin drugs because that the side effect of statin drugs is Alzheimer’s dementia, uh, memory loss, muscle wasting. And they’ve just added another one, which is breast cancer, because all our sex hormones are made from cholesterols.’

O’Neill told a woman who had suffered a stroke to stop taking her life-saving medication! These medications are prescribed by highly qualified medical specialists based on the research. As the UK Stroke Association says, ‘Blood-thinning medications reduce your risk of stroke by helping to prevent blood clots from forming. You might be prescribed them after a transient ischaemic attack (TIA) or a stroke caused by a blockage (an ischaemic stroke, or clot).’[17] It is clear that O’Neill, who has no qualifications in anything, does not know what she is talking about.

As for her claim that the side effects of statins is breast cancer, the research shows the opposite. ‘While statins do not affect the incidence of most cancers, they do exert significant benefits on recurrence and survival in many cancer types, including breast cancer.’ [18]

13. At 42:48 O’Neill claims ‘If you are on cholesterol lowering medication and many have been deceived….’ As above, it is O’Neill who is doing the deceiving.

14. At 45:09 O’Neill claims that ‘If you stop your cholesterol lowering medication, there will be a side effect. Your memory will return. Your muscles will get stronger. Any little appearances of Alzheimer’s will start to ease.’

As above, the available research does not show that.

15. At 48:57 O’Neill claims ‘Why did they put fluoride in water? The claim was to harden the teeth. Has it hardened the teeth? Not at all. Has it reduced tooth decay? Not at all.’ And ‘But that fluoride is very hard on the kidneys, very hard on the liver.’

The research here is overwhelming; as the CDC says: ‘The CDC named community water fluoridation one of 10 great public health achievements of the 20th century.

‘Many research studies have proven the safety and benefits of fluoridated water. For  75 years people in the United States have been drinking water with added fluoride and enjoying the benefits of better dental health.

‘Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults.’

As for O’Neill’s claim that fluoride is very hard on the kidneys, very hard on the liver,’ the research is inconclusive, and in fact the reverse may be true. Research shows ‘Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.’ So the science does not support O’Neill’s certainty.

16. At 48:57 O’Neill claims that ‘all body symptoms and body diseases and shows how dehydrating has a huge factor.’ O’Neill gives no evidence to support that huge claim.

17. At 01:00:20 O’Neill claims that a woman told her ‘I had the vaccine. Now I’ve got clots. Barbara, I had the vaccine. I can’t. I cannot even remember all the diseases that are arising. Have you noticed? And so many people were blackmailed into that vaccine.’ And ‘Is that (COVID19) a crisis? it’s not a crisis at all. And yet we’re seeing so many problems arising.’

O’Neill is dreadfully wrong here. COVID 19 was a crisis. How else would we describe a pandemic that is known to have killed at least 6,961,014 deaths, as reported to the WHO? [19] And what are the problems that we are seeing arising? Outside her imagination, that is.

18. At 01:00:20 O’Neill claims that ‘one man said, Show me the safety studies. They gave him three pages of blank paper. No safety studies, no safety studies at all.’ (On vaccines). And ‘drugs never cure disease.’ And a few lines later, again, ‘Drugs never cure disease.’

The allegation that ‘They (doctors) gave him three pages of blank paper’, is just so deranged. No doctor would do that because there are thousands of studies of vaccine safety.

O’Neill’s claim that there are no safety studies on vaccines is hopelessly wrong and dishonest. It’s one of the many anti-vax lies circulating on the internet, so beloved by the gullible. As the Australian Dept of Health and Aged Care say, ‘Research and testing is an essential part of developing safe and effective vaccines. In Australia, every vaccine must pass strict safety testing before the Therapeutic Goods Administration (TGA) will register it for use. Before vaccines become available to the public, they are tested on thousands of people who take part in large clinical trials.’ [20] It took me a few seconds on the internet to find an interesting research paper on HPV vaccines, including a section on safety. [21] O’Neill could do that so the inevitable conclusion is that she set out to deceive. As for ‘drugs never cure disease,’ that is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.

19. At 01:10:49 O’Neill claims ‘some (medications) can be stopped immediately, like your statin drugs and your blood thinners. Yeah, what do you take instead of statin drugs? Well, there’s no need, because cholesterol is not a problem.’

O’Neill’s advice here is life-threatening rubbish. As the Mayo Clinic says ‘Abruptly stopping an anticoagulant can increase your risk of a stroke.’ [22] As for her advice on cholesterol, see above.

20. At 01:15:39 O’Neill claims that there was ‘No diabetes on the planet til sugar was well established.’ And lack of nose-breathing causes ‘Chronic fatigue syndrome. There’s one cause; it’s lack of oxygen at the cellular level.’

Humans have gathered sugar since we first became homo sapiens and diabetes has always been a problem for us and other animals.

As for her claim that lack of nose-breathing causes ‘Chronic fatigue syndrome;’ the Mayo Clinic says ‘The cause of ME/CFS is unknown, although there are many theories. Experts believe it might be triggered by a combination of factors.’ They go on to list many possible causes but lack of nose-breathing is not one of them.[23]

21. At 01:26:08 O’Neill claims that a researcher ‘…. could turn cancer cells on and off by the amount of animal, pro and animal protein that he was giving’ and liver cancer could be prevented by ‘a simple diet and cancer weights were very low low compared to the city again, with that high meat diet….’ There is some truth in this, but it does not justify O’Neill’s other advice to avoid prescribed medications.

22. At 01:49:26 O’Neill claims ‘if someone has a rash and they put cortisone on it, what happens to the rash? It’s gone, but But it comes back in about another week. Is that right? Twice as bad.’ And ‘No drug can heal cancer. The body and the body alone when it’s given the right conditions can cause cancer to be conquered in the body.’ And ‘A fever is nothing to fear.’

O’Neill’s claim that ‘No drug can heal cancer’ is demonstrably wrong. Life expectancy following cancer treatment has improved vastly over the decades, largely due to better detection and prescribed medications. As the US National Cancer Institute (NCI) estimates, ‘due to improved detection and treatment, deaths have dropped 41 percent from 1989 to 2018, according to the ACS.’ [24]

As for O’Neill’s claim that ‘a fever is nothing to fear,’ the Victorian Dept of Health says ‘High fever (about 41.5°C or more) is extremely dangerous and could trigger convulsions.’ [25]

23. At 01:53:47 O’Neill claims that drug therapy is not working.

What does O’Neill mean by that? Does she mean that prescribed medication does not work? If she is repeating her earlier claim that ‘drugs never cure disease?’ I repeat my earlier rebuttal. That is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.

I’ll finish the analysis here because you have suffered enough.

Readers everywhere now have rock-solid evidence that should be presented to their national health regulators, showing that O’Neill, as the HCCC put it, ‘poses a risk to the health and safety of members of the public’ and therefore ‘should be permanently prohibited from providing any health services, whether in a paid or voluntary capacity.’ And you have rock-solid evidence that should be presented to venue managers who have allowed O’Neill to present life-threatening ‘education’ to the public on their premises, asking them to cancel the booking. It’s not hard; it was done in Ireland by members of the public. That led to cancellation of the booking, and a rush by O’Neill’s supporters to find a new venue.

References

1 https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-statement-and-statement-of-decision-in-relation-to-in-relation-to-mrs-barbara-o-neill

2 https://www.independent.ie/irish-news/controversial-wellness-coach-barbara-oneill-set-to-host-talk-in-ireland-this-month/a1781099169.html

3 https://www.hccc.nsw.gov.au/ArticleDocuments/216/Statement%20of%20Decision%20-%20Mrs%20Barbara%20ONeill.pdf.aspx

4 The video is available at https://rumble.com/v3lt611-barbara-oneill-positive-life-event-27th-september.html and a backup is available at https://www.dropbox.com/scl/fi/vqe9plhgjijunvl22kvb6/Barbara-ONeill-Positive-Life-Event-27th-September.mp4?rlkey=1kjyi9jdl8kfdp8kcdf1p4xba&dl=0

5 https://www.dropbox.com/scl/fi/csl95hg7gomr318nygotx/TRANSCRIPT-BARBARA-O-NEILL-POSITIVE-LIFE-EVENT-DUBLIN-27-SEPT-2023.pdf?rlkey=z2d5uh59fwagzdfdk30hvpauy&dl=0

6 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165

7 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165

8https://www.researchgate.net/publication/268144514_Prevalence_Rates_of_Autism_Spectrum_Disorders_Among_the_Old_Order_Amish

9 https://www.cdc.gov/vaccines/vac-gen/additives.htm

10 https://www1.racgp.org.au/ajgp/2020/october/seizures-following-vaccination-in-children

11 https://www.usatoday.com/story/news/factcheck/2023/08/03/false-claim-skin-cancer-has-only-been-around-for-60-years-fact-check/70515019007/

12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709188/

13 https://s4be.cochrane.org/blog/2018/07/02/cholesterol-and-heart-disease-whats-the-evidence/

14 https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/cholesterol-and-dementia

15 https://www.facebook.com/people/Dr-Barbara-ONeill/100093111507726/

16 https://www.consumerlab.com/answers/castor-oil-eye-drops-for-cataracts/castor-oil-cataracts/

17 https://www.stroke.org.uk/resources/blood-thinning-medication-and-stroke

18 https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-018-1066-z#author-information

19 https://covid19.who.int/

20 https://www.health.gov.au/are-vaccines-safe

21 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565290/

22 https://connect.mayoclinic.org/blog/take-charge-healthy-aging/newsfeed-post/know-the-warning-signs-of-blood-thinner-complications/

23 https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490

24 https://www.healthline.com/health/breast-cancer/survival-facts-statistics#breast-cancer-stages

25 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever#bhc-content

Yes, that would be nice!

You want to lose weight?

Just take a few pills an Bob’s your uncle!

There is, of course no shortage of such pills – but do they work?

This study aimed at quantifying and ranking the effects of different nutraceuticals on weight loss. PubMed, Scopus, and Web of Science to November 2022 were searched and all randomized trials (RCTs) evaluating the comparative effects of two or more nutraceuticals, or comparing a nutraceutical against a placebo for weight loss in adults with overweight or obesity were included. A random-effects network meta-analysis was conducted with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss.

One hundred and eleven RCTs with 6171 participants that investigated the effects of 18 nutraceuticals on body weight were eligible. In the main analysis incorporating all trials, there was high certainty of evidence for supplementation of spirulina (MD: -1.77 kg, 95% CI: -2.77, -0.78) and moderate certainty of evidence that supplementation of curcumin (MD: -0.82 kg, 95% CI: -1.33, -0.30), psyllium (MD: -3.70 kg, 95% CI: -5.18, -2.22), chitosan (MD: -1.70 kg, 95% CI: -2.62, -0.78), and Nigella sativa (MD: -2.09 kg, 95%CI: -2.92, -1.26) could result in a small improvement in body weight. Supplementations with green tea (MD: -1.25 kg, 95%CI: -1.68, -0.82) and glucomannan (MD: -1.36 kg, 95%CI: -2.17, -0.54) demonstrated small weight loss, also the certainty of evidence was rated low.

The authors concluded that supplementations with nutraceuticals can result in a small weight loss in adults with overweight or obesity.

The authors tell us little about the methodological quality of the studies. All they did report was this:

Among trials with a low risk of bias, only chitosan (mean difference: −1.72 kg, 95%CI: −3.37, −0.06) and green tea (mean difference: −1.61 kg, 95%CI: −3.14, −0.09) were effective for weight loss compared with placebo. There was no significant weight loss following increased consumption of other nutraceuticals in trials with a low risk of bias.

In view of the lack of reliability of the primary studies, I feel that the conclusions drawn by the authors are not justified. Even though far from recent, I much prefer our own conclusion of a similar data set:

The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.

In other words, if you want to lose weight, don’t rely on dietary supplements!

The history of so-called alternative medicine (SCAM) is rich with ‘discoveries’ that are widely believed to be true events but that, in fact, never happened. Here are 10 examples:

  1. DD Palmer is believed to have cured the deafness of a janitor by manipulating his neck. This, many claim, was the birth of chiropractic. BUT IT NEVER HAPPENED! How can I be so sure? Because the nerve responsible for hearing does not run through the neck.
  2. Samuel Hahnemann swallowed some Cinchona officinalis, a quinine-containing treatment for malaria, and experienced the symptoms of malaria. This was the discovery of the ‘like cures like’ assumption that forms the basis of homeopathy. BUT IT NEVER HAPPENED! How can I be so sure? Because Hahnemann merely had an intolerance to quinine, and like does certainly not cure like.
  3. Edward Bach, for the discovery of each of his flower remedies, suffered from the state of mind for which a particular remedy was required; according to his companion, Nora Weeks, he suffered it “to such an intensified degree that those with him marvelled that it was possible for a human being to suffer so and retain his sanity.” This is how Bach discovered the ‘Bach Flower Remedies‘. BUT IT NEVER HAPPENED! How can I be so sure? His experience was not caused by by the remedy, which contain no active ingredients, but by his imagination.
  4. William Fitzgerald found that pressure on specific areas on the soles of a patient’s feet would positively affect a specific organ of that patient. This was the birth of reflexology. BUT IT NEVER HAPPENED! How can I be so sure? Because there are no nerve connections from the sole of our feet to our inner organs.
  5. Max Gerson observed that his special diet with added liver juice, vitamin B3, coffee enemas, etc. cures cancer. This is how Gerson found the Gerson therapy. BUT IT NEVER HAPPENED! How can I be so sure? Because he never could demonstrate this effect and others never were able to replicate his alleged finfings.
  6. George Goodheart was convinced that the strength of a muscle group provides information about the health of inner organs. This formed the basis for applied kinesiology. BUT IT NEVER HAPPENED! How can I be so sure? Because applied kinesiology has been disclosed as a simple party trick.
  7. Paul Nogier thought that the function of inner organs can be influenced by stimulating points on the outer ear. This was the discovery that became auricular therapy. BUT IT NEVER HAPPENED! How can I be so sure? Because Nogier’s assumptions fly in the face of anatomy and physiology.
  8. Antom Mesmer discovered that by moving a magnet over a patient, he would move her vital fluid and affect her health. This discovery became the basis for Mesmer’s ‘animal magnetism‘. BUT IT NEVER HAPPENED! How can I be so sure? Because there is no vital fluid and neither real nor animal magnetism have specific therapeutic effects.
  9. Reinhold Voll observed that the electric resistance over acupuncture points provides diagnostic information about the function of the corresponding organs. He thus invented his ‘electroacupuncture according to Voll‘ (EAV). BUT IT NEVER HAPPENED! How can I be so sure? Because EAV and the various methods derived from it are not valid and fail to produce reproducible results.
  10. Ignatz von Peczely discovered that discolorations on the iris provide valuable information about the health of inner organs. This was the birth of iridology. BUT IT NEVER HAPPENED! How can I be so sure? Because discolorations develop spontaneously and Peczely’s assumptions about nerval connections between the iris and the organs of the body are pure fantasy.

I hope that you can think of further SCAM discoveries that never happened. If so, please elaborate in the comments section below; you will see, it is good fun!

PS

By sating ‘IT NEVER HAPPENED’, I mean to say that it never happened as reported/imagined by the inventor of the respective SCAM and that the explanations perpetuated by the enthusiasts of the SCAM regarding cause and effect are based on misunderstandings.

Anja Zeidler (born 1993) became known in 2012 as the most successful fitness personality in Switzerland. After joining the bodybuilding scene in Los Angeles, a phase of self-discovery followed. Anja published her development and became what one nowadays calls an ‘INFLUENCER’. As Managing Director and Content Director of her own company, Anja Zeidler GmbH, Anja has made a name for herself as a public figure far beyond the fitness market with her activities as a ‘Selflove Influencer’, blogger, book author, motivational speaker, presenter and expert in the food & health sector. Furthermore, she is completing a degree at the Academy of Naturopathy for Holistic Health.

About a year and a half ago, Anja Zeidler had a desmoid tumor removed from under her left breast – and now it was reported to be back. The conventional treatment methods are clear: another surgical procedure or radiation. But Zeidler said she wants to wait with such interventions. For the time being, she has decided to go her own way. She wants to “balance any imbalances” with her naturopathic doctor and wishes to fight the disease on her own and with a “positive mindset.”

“On a spiritual level, they say that tumors can be related to trauma. That’s why I’ve tried breathing exercises and cocoa ceremonies. With these methods, I get into my subconscious and get closer to traumas, which I am not aware of, and try to dissolve them. So far, blatant things have come up that I had long forgotten and repressed,” she says enthusiastically. In addition, Zeidler wants to give up refined sugar with immediate effect, keep better control of her diet in general – even in her stressful everyday life – and drink freshly squeezed celery and beetroot juice every morning. In addition, she relies on “natural capsules with and grape seed OPC.” “I’ve read in studies that certain types of fungi and strong antioxidants like OPC are supposed to fight tumor cells.” There I follow the motto: ‘if it doesn’t help, at least it does not harm.'”

Zeidler’s tumor is a desmoid tumor, an abnormal growth that arises from connective tissues. These tumors are generally not considered malignant because they do not spread to other parts of the body; however, they can aggressively invade the surrounding tissue and can be very difficult to remove surgically. These tumors often recur, even after apparently complete removal.

Zeidler commented: “I am convinced that with a positive mindset you can contribute extremely much to the healing process. If the checks reveal rapid growth, I will of course seek medical treatment. Then I would opt for radiation.”

The trouble with ‘influencers’ is that they are gullible and influence the often gullible public to become more gullible. Thus their influence might cost many lives. Personally, I hope that the young woman does well with her erstwhile refusal of evidence-based treatments. Yet, I fear that the ‘Academy of Naturopathy for Holistic Health’ will teach her a lot of BS about the power of natural cancer cures. The sooner she agrees to have her tumor treated based on evidence, the better her prognosis, I’m sure.

As we have recently discussed diet and its effects on health, it seems reasonable to ask whether there is a diet that is demonstrably healthy. A recent investigation attempted to answer this question.

This study was aimed at developing a healthy diet score that is associated with health outcomes and is globally applicable. It used data from the Prospective Urban Rural Epidemiology (PURE) study and tried to replicate it in five independent studies on a total of 245 000 people from 80 countries.

A healthy diet score was developed on the basis of the data from 147 642 people from the general population, from 21 countries in the PURE study. The consistency of the associations of the score with events was examined in five large independent studies from 70 countries.

The healthy diet score was developed based on six foods each of which has been associated with a significantly lower risk of mortality [i.e. fruit, vegetables, nuts, legumes, fish, and dairy (mainly whole-fat); range of scores, 0–6]. The main outcome measures were all-cause mortality and major cardiovascular events [cardiovascular disease (CVD)].

During a median follow-up of 9.3 years in PURE, compared with a diet score of ≤1 point, a diet score of ≥5 points was associated with a lower risk of:

  • mortality [hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.63–0.77)],
  • CVD (HR 0.82; 0.75–0.91),
  • myocardial infarction (HR 0.86; 0.75–0.99),
  • stroke (HR 0.81; 0.71–0.93).

In three independent studies with vascular patients, similar results were found, with a higher diet score being associated with lower mortality (HR 0.73; 0.66–0.81), CVD (HR 0.79; 0.72–0.87), myocardial infarction (HR 0.85; 0.71–0.99), and a non-statistically significant lower risk of stroke (HR 0.87; 0.73–1.03). Additionally, in two case-control studies, a higher diet score was associated with lower first myocardial infarction [odds ratio (OR) 0.72; 0.65–0.80] and stroke (OR 0.57; 0.50–0.65). A higher diet score was associated with a significantly lower risk of death or CVD in regions with lower than with higher gross national incomes (P for heterogeneity <0.0001). The PURE score showed slightly stronger associations with death or CVD than several other common diet scores (P < 0.001 for each comparison).

Association of Prospective Urban Rural Epidemiology healthy diet score vs. Events in those with and without prior cardiovascular disease in the four independent prospective studies (n = 191 476). Hazard ratios (95%) are per 20 percentile increment in the diet score. Hazard ratios (95% CI) are multivariable adjusted.

The authors concluded that consumption of a diet comprised of higher amounts of fruits, vegetables, nuts, legumes, and a moderate amount of fish and whole-fat dairy is associated with a lower risk of CVD and mortality in all world regions, but especially in countries with lower income where consumption of these natural foods is low. Similar associations were found with the inclusion of meat or whole grain consumption in the diet score (in the ranges common in the six studies that we included). Our findings indicate that the risks of deaths and vascular events in adults globally are higher with inadequate intake of protective foods.

The authors rightly stress that their analyses have a number of limitations:

First, diet (as in most large epidemiologic studies) was self-reported and variations in reporting might lead to random errors that could dilute real associations between diet scores and clinical outcomes. Therefore, the beneficial effects of a healthier diet may be larger than estimated.

Second, the researchers did not examine the role of individual types of fruits and vegetables as components in the diet score, since the power to detect associations of the different types of fruits and vegetables vs. CVD or mortality is low (i.e. given that the number of events per type of fruit and vegetable was relatively low). Recent evidence suggests that bioactive compounds and, in particular, polyphenols which are found in certain fruit or vegetables (e.g. berries, spinach, and beans) may be especially protective against CVD.

Third, in observational studies, the possibility of residual confounding from unquantified or imprecise measurement of covariates cannot be ruled out—especially given that the differences in risk of clinical events are modest (∼10%–20% relative differences). Ideally, large randomized trials would be needed to clarify the clinical impact on events of a policy of proposing a dietary pattern in populations.

Fourth, the use of the median intake of each food component as a cut-off in the scoring scheme for each diet may not reflect the full range of consumption or provide a meaningful indicator of consumption associated with the disease. However, the use of quintiles instead of medians within each study or within each region yielded the same results indicating the robustness of our findings.

Fifth, the level of intake to meet the cut-off threshold for each food group in the diet score may differ between countries. However, in sensitivity analyses where region-specific median cut-offs were used to classify participants on each component of the diet score, the results were similar to using the overall cohort median of each food component. Further, with unprocessed red meat and whole grains included or excluded from the diet score in these sensitivity analyses, the results were again similar.

Sixth, misclassification of exposures cannot be ruled out as repeat measures of diet were not available in all studies. However, the ORIGIN study, in which repeat diet assessments at 2 years were conducted, showed similar results based on the first vs. second diet assessments. This indicates that misclassification of dietary intake during follow-up was not undermining the findings.

Seventh, one unique aspect of the study is the focus on only protective foods, i.e. a dietary pattern score that highlights what is missing from the food supply, especially in poorer world regions, but this does not negate the importance of limiting the consumption of harmful foods such as highly processed foods. While the PURE diet score had significantly stronger associations with events than other diet scores, the HRs were only slightly larger for PURE than for most other diet scores. However, the Planetary score was the least predictive of events. The analyses provide empirical evidence that all diet scores (other than the Planetary diet score) are of value to predicting death or CVD globally and in all regions of the world.

So, what should we, according to these findings, be looking for and how much of it should we consume? Here is the table that should answer these questions:

Fruits and vegetables 4 to 5 servings daily 1 medium apple, banana, pear; 1 cup leafy vegs; 1/2 cup other vegs
Legumes 3 to 4 servings weekly 1/2 cup beans or lentils
Nuts 7 servings weekly 1 oz., tree nuts or peanuts
Fish 2 to 3 servings weekly 3 oz. cooked (pack of cards size)
Dairy 14 servings weekly 1 cup milk or yogurt; 1 ½ oz cheese
Whole grainsc Moderate amounts (e.g. 1 serving daily) can be part of a healthy diet 1 slice (40 g) bread; ½ medium (40 g) flatbread; ½ cup (75–120 g) cooked rice, barley, buckwheat, semolina, polenta, bulgur, or quinoa
Unprocessed meatsc Moderate amounts (e.g. 1 serving daily) can be part of a healthy diet 3 oz. cooked red meat or poultry
1 2 3 7
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