2008 - Bad Science

by Ben Goldacre

  So who is this person, and how did she come to be teaching us about diet, on a prime-time television show, on a national terrestrial channel? What possible kind of science degree can she have, to be making such basic mistakes that a schoolkid would spot? Was this an isolated error? A one-off slip of the tongue? I think not.

  Actually, I know not, because as soon as I saw that ridiculous quote I ordered some more McKeith books. Not only does she make the same mistake in numerous other places, but it seems to me that her understanding of even the most basic elements of science is deeply, strangely distorted. In You Are What You Eat (p.211) she says: ‘Each sprouting seed is packed with the nutritional energy needed to create a full grown healthy plant.’

  This is hard to follow. Does a fully grown, healthy oak tree, a hundred feet tall, contain the same amount of energy as a tiny acorn? No. Does a fully grown, healthy sugarcane plant contain the same amount of nutritional energy- measure it in ‘calories’ if you like—as a sugarcane seed? No. Stop me if I’m boring you, in fact stop me if I’ve misunderstood something in what she’s said, but to me this seems like almost the same mistake as the photosynthesis thing, because that extra energy to grow a fully grown plant comes, again, from photosynthesis, where plants use light to turn carbon dioxide and water into sugar and then into everything else that plants are made of.

  This is not an incidental issue, an obscure backwater of McKeith’s work, nor is it a question of which ‘school of thought’ you speak for: the ‘nutritional energy’ of a piece of food is one of the most important things you could possibly think of for a nutritionist to know about. I can tell you for a fact that the amount of nutritional energy you will get from eating one sugarcane seed is a hell of a lot less than you’d get from eating all the sugarcane from the plant that grew from it. These aren’t passing errors, or slips of the tongue (I have a policy, as it were, of not quibbling on spontaneous utterances, because we all deserve the chance to fluff): these are clear statements from published tomes.

  Watching McKeith’s TV show with the eye of a doctor, it rapidly becomes clear that even here, frighteningly, she doesn’t seem to know what she’s talking about. She examines patients’ abdomens on an examination couch as if she is a doctor, and confidently announces that she can feel which organs are inflamed. But clinical examination is a fine art at the best of times, and what she is claiming is like identifying which fluffy toy someone has hidden under a mattress (you’re welcome to try this at home).

  She claims to be able to identify lymphoedema, swollen ankles from fluid retention, and she almost does it right—at least, she kind of puts her fingers in roughly the right place, but only for about half a second, before triumphantly announcing her findings. If you’d like to borrow my second edition copy of Epstein and de Bono’s Clinical Examination (I don’t think there were many people in my year at medical school who didn’t buy a copy), you’ll discover that to examine for lymphoedema, you press firmly for around thirty seconds, to gently compress the exuded fluid out of the tissues, then take your fingers away, and look to see if they have left a dent behind.

  In case you think I’m being selective, and only quoting McKeith’s most ridiculous moments, there’s more: the tongue is ‘a window to the organs—the right side shows what the gallbladder is up to, and the left side the liver’. Raised capillaries on your face are a sign of ‘digestive enzyme insufficiency—your body is screaming for food enzymes’. Thankfully, Gillian can sell you some food enzymes from her website. ‘Skid mark stools’ probably don’t want oxygen inside your abdomen anyway: in keyhole surgery, surgeons have to inflate your abdomen to help them see what they’re doing, but they don’t use oxygen, because there’s methane fart gas in there too, and we don’t want anyone catching fire on the inside. There is no oxygen in your bowel.

  So who is this person, and how did she come to be teaching us about diet, on a prime-time television show, on a national terrestrial channel? What possible kind of science degree can she have, to be making such basic mistakes that a schoolkid would spot? Was this an isolated error? A one-off slip of the tongue? I think not.

  Actually, I know not, because as soon as I saw that ridiculous quote I ordered some more McKeith books. Not only does she make the same mistake in numerous other places, but it seems to me that her understanding of even the most basic elements of science is deeply, strangely distorted. In You Are What You Eat (p.211) she says: ‘Each sprouting seed is packed with the nutritional energy needed to create a full grown healthy plant.’

  This is hard to follow. Does a fully grown, healthy oak tree, a hundred feet tall, contain the same amount of energy as a tiny acorn? No. Does a fully grown, healthy sugarcane plant contain the same amount of nutritional energy—measure it in ‘calories’ if you like—as a sugarcane seed? No. Slop me if I’m boring you, in fact stop me if I’ve misunderstood something in what she’s said, but to me this seems like almost the same mistake as the photosynthesis thing, because that extra energy to grow a fully grown plant comes, again, from photosynthesis, where plants use light to turn carbon dioxide and water into sugar and then into everything else that plants are made of.

  This is not an incidental issue, an obscure backwater of McKeith’s work, nor is it a question of which ‘school of thought’ you speak for: the ‘nutritional energy’ of a piece of food is one of the most important things you could possibly think of for a nutritionist to know about. I can tell you for a fact that the amount of nutritional energy you will get from eating one sugarcane seed is a hell of a lot less than you’d get from eating all the sugarcane from the plant that grew from it. These aren’t passing errors, or slips of the tongue (I have a policy, as it were, of not quibbling on spontaneous utterances, because we all deserve the chance to fluff): these are clear statements from published tomes.

  Watching McKeith’s TV show with the eye of a doctor, it rapidly becomes clear that even here, frighteningly, she doesn’t seem to know what she’s talking about. She examines patients’ abdomens on an examination couch as if she is a doctor, and confidently announces that she can feel which organs are inflamed. But clinical examination is a fine art at the best of times, and what she is claiming is like identifying which fluffy toy someone has hidden under a mattress (you’re welcome to try this at home).

  She claims to be able to identify lymphoedema, swollen ankles from fluid retention, and she almost does it right—at least, she kind of puts her fingers in roughly the right place, but only for about half a second, before triumphantly announcing her findings. If you’d like to borrow my second edition copy of Epstein and de Bono’s Clinical Examination (I don’t think there were many people in my year at medical school who didn’t buy a copy), you’ll discover that to examine for lymphoedema, you press firmly for around thirty seconds, to gently compress the exuded fluid out of the tissues, then take your fingers away, and look to see if they have left a dent behind.

  In case you think I’m being selective, and only quoting McKeith’s most ridiculous moments, there’s more: the tongue is ‘a window to the organs—the right side shows what the gallbladder is up to, and the left side the liver’. Raised capillaries on your face are a sign of ‘digestive enzyme insufficiency—your body is screaming for food enzymes’. Thankfully, Gillian can sell you some food enzymes from her website. ‘Skid mark stools’

  (she is obsessed with faeces and colonic irrigation) are ‘a sign of dampness inside the body—a very common condition in Britain’. If your stools are foul-smelling you are ‘sorely in need of digestive enzymes’. Again. Her treatment for pimples on the forehead—not pimples anywhere else, mind you, only on the forehead—is a regular enema. Cloudy urine is ‘a sign that your body is damp and acidic, due to eating the wrong foods’. The spleen is ‘your energy battery’.

  So we have seen scientific facts—very basic ones—on which Dr McKeith seems to be mistaken. What of scientific process? She has claimed, repeatedly and to anyone who will listen, that she is engaged in clinical scientifi
c research. Let’s step back a moment, because from everything I’ve said, you might reasonably assume that McKeith has been clearly branded as some kind of alternative therapy maverick. In fact, nothing could be further from the truth. This doctor has been presented, consistently, up front, by Channel 4, her own website, her management company and her books as a scientific authority on nutrition.

  Many watching her TV show quite naturally assumed she was a medical doctor. And why not? There she was, examining patients, performing and interpreting blood tests, wearing a white coat, surrounded by test tubes, ‘Dr McKeith’, ‘the diet doctor’, giving diagnoses, talking authoritatively about treatment, using complex scientific terminology with all the authority she could muster, and sticking irrigation equipment nice and invasively right up into people’s rectums.

  Now, to be fair, I should mention something about the doctorate, but I should also be clear: I don’t think this is the most important part of the story. It’s the funniest and most memorable part of the story, but the real action is whether McKeith is capable of truly behaving like the nutritional science academic she claims to be.

  And the scholarliness of her work is a thing to behold. She produces lengthy documents that have an air of ‘referenciness’, with nice little superscript numbers, which talk about trials, and studies, and research, and papers…but when you follow the numbers, and check the references, it’s shocking how often they aren’t what she claimed them to be in the main body of the text, or they refer to funny little magazines and books, such as Delicious, Creative Living, Healthy Eating, and my favourite, Spiritual Nutrition and the Rainbow Diet, rather than proper academic journals.

  She even does this in the book Miracle Superfood, which, we are told, is the published form of her PhD. ‘In laboratory experiments with anaemic animals, red-blood cell counts have returned to normal within four or five days when chlorophyll was given,’ she says. Her reference for this experimental data is a magazine called Health Store News. ‘In the heart,’ she explains, ‘chlorophyll aids in the transmission of nerve impulses that control contraction.’ A statement that is referenced to the second issue of a magazine called Earthletter. Fair enough, if that’s what you want to read—I’m bending over to be reasonable here—but it’s clearly not a suitable source to reference that claim. This is her PhD, remember.

  To me this is cargo-cult science, as Professor Richard Feynman described it over thirty years ago, in reference to the similarities between pseudoscientists and the religious activities on a few small Melanesian islands in the 1950s:

  During the war they saw aeroplanes with lots of good materials, and they want the same thing to happen now. So they’ve arranged to make things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head as headphones and bars of bamboo sticking out like antennas—he’s the controller—and they wait for the aeroplanes to land. They’re doing everything right. The form is perfect. It looks exactly the way it looked before. But it doesn’t work. No aeroplanes land.

  Like the rituals of the cargo cult, the form of McKeith’s pseudo-academic work is superficially correct: the superscript numbers are there, the technical words are scattered about, she talks about research and trials and findings—but the substance is lacking. I actually don’t find this very funny. It makes me quite depressed to think about her, sitting up, perhaps alone, studiously and earnestly typing this stuff out.

  Should you feel sorry for her? One window into her world is the way in which she has responded to criticism: with statements that seem to be, well, wrong. It’s cautious to assume that she will do the same thing with anything that I write here, so in preparation for the rebuttals to come, let’s look at some of the rebuttals from the recent past.

  In 2007, as has been noted, she was censured by the MHRA for selling a rather crass range of herbal sex pills called Fast Formula Horny Goat Weed Complex, advertised as having been shown by a ‘controlled study’ to promote sexual satisfaction, and sold with explicit medicinal claims. They were illegal for sale in the UK. She was ordered to remove the products from sale immediately. She complied—the alternative would have been prosecution—but her website announced that the sex pills had been withdrawn because of ‘the new EU licensing laws regarding herbal products’. She engaged in a spot of Europhobic banter with the Scottish Herald newspaper: ‘EU bureaucrats are clearly concerned that people in the UK are having too much good sex,’ she explained.

  Nonsense. I contacted the MHRA, and they said: ‘This has nothing to do with new EU regulations. The information on the McKeith website is incorrect.’ Was it a mistake? ‘Ms McKeith’s organisation had already been made aware of the requirements of medicines legislation in previous years; there was no reason at all for all the products not to be compliant with the law.’ They went on. ‘The Wild Pink Yam and Horny Goat Weed products marketed by McKeith Research Ltd were never legal for sale in the UK.’

  Then there is the matter of the CV. Dr McKeith’s PhD is from Clayton College of Natural Health, a non-accredited correspondence course college, which unusually for an academic institution also sells its own range of vitamin pills through its website. Her masters degree is from the same august institution. At current Clayton prices, it’s $6,400 in fees for the PhD, and less for the masters, but if you pay for both at once you get a $300 discount (and if you really want to push the boat out, they have a package deal: two doctorates and a masters for $12,100 all in).

  On her CV, posted on her management website, McKeith claimed to have a PhD from the rather good American College of Nutrition. When this was pointed out, her representative explained that this was merely a mistake, made by a Spanish work experience kid who posted the wrong CV. The attentive reader may have noticed that the very same claim about the American College of Nutrition was also in one of her books from several years previously.

  In 2007 a regular from my website—I could barely contain my pride—took McKeith to the Advertising Standards Authority, complaining about her using the title ‘doctor’ on the basis of a qualification gained by correspondence course from a non-accredited American college: and won. The ASA came to the view that McKeith’s advertising breached two clauses of the Committee of Advertising Practice code: ‘substantiation’ and ‘truthfulness’.

  Dr McKeith sidestepped the publication of a damning ASA draft adjudication at the last minute by accepting—‘voluntarily’—not to call herself ‘doctor’ in her advertising any more. In the news coverage that followed, McKeith suggested that the adjudication was only concerned with whether she had presented herself as a medical doctor. Again, this is not true. A copy of that draft adjudication has fallen into my lap—imagine that—and it specifically says that people seeing the adverts would reasonably expect her to have either a medical degree, or a PhD from an accredited university.

  She even managed to get one of her corrections into a profile on her in my own newspaper, the Guardian: ‘Doubt has also been cast on the value of McKeith’s certified membership of the American Association of Nutritional Consultants, especially since Guardian journalist Ben Goldacre managed to buy the same membership online for his dead cat for $60. McKeith’s spokeswoman says of this membership: ‘Gillian has ‘professional membership’, which is membership designed for practising nutritional and dietary professionals, and is distinct from ‘associate membership’, which is open to all individuals. To gain professional membership Gillian provided proof of her degree and three professional references.’’

  Well. My dead cat Hettie is also a ‘certified professional member’ of the AANC. I have the certificate hanging in my loo. Perhaps it didn’t even occur to the journalist that McKeith could be wrong. More likely, in the tradition of nervous journalists, I suspect that she was hurried, on deadline, and felt she had to get McKeith’s ‘right of reply’ in, even if it cast doubts on—I’ll admit my beef here—my own hard-won investigative revelations about my dead cat. I mean, I don’t
sign my dead cat up to bogus professional organisations for the good of my health, you know. It may sound disproportionate to suggest that I will continue to point out these obfuscations for as long as they are made, but I will, because to me, there is a strange fascination in tracking their true extent.

  Although perhaps I should not be so bold. She has a libel case against the Sun over comments it made in 2004. The Sun is part of a large, wealthy media conglomerate, and it can protect itself with a large and well-remunerated legal team. Others can’t. A charming but obscure blogger called PhDiva made some relatively innocent comments about nutritionists, mentioning McKeith, and received a letter threatening costly legal action from Atkins Solicitors, ‘the reputation and brand-management specialists’. Google received a threatening legal letter simply for linking to—forgive me—a fairly obscure webpage on McKeith. She has also made legal threats to an excellently funny website called Eclectech for featuring an animated cartoon of her singing a silly song at around the time she was on Fame Academy.

  Most of these legal tussles revolve around the issue of her qualifications, but such things shouldn’t be difficult or complicated. If anyone wanted to check my degrees, memberships or affiliations, they could call up the institutions concerned and get instant confirmation: job done. If you said I wasn’t a doctor, I wouldn’t sue you; I’d roar with laughter.

  But if you contact the Australasian College of Health Sciences (Portland, Oregon), where McKeith has a ‘pending diploma in herbal medicine’, they say they can’t tell you anything about their students. If you contact Clayton College of Natural Health to ask where you can read her PhD, they say you can’t. What kind of organisations are these? If I said I had a PhD from Cambridge, US or UK (I have neither, and I claim no great authority), it would only take you a day to find it in their library.