The role of the #nutritional #therapist is to alleviate and prevent illness and disease in individuals through lifestyle and nutrition related changes. We do this using a #holistic approach and most importantly by listening to and also retelling their story. To remain rational and objective is key in both, but almost impossible to fully achieve. It can be very hard to interpret their journey to their current state of health simply relying on the narrative and evidence alone, rather than through our own #cognitive #bias. Cognitive bias is an important source of diagnostic and intervention error and to be aware of our own bias is half the battle.

The use of Randomised Clinical Trials are generally heralded by medics as being the gold standard for clinical assessment of validity of use for medicines and are frequently held out by skeptics as the intellectual anvil on which to pound complementary and alternative medicine.

There has over the last few years been a dedicated strategy by individuals and groups opposed to natural medicine to raise questions concerning the validity of research conducted to identify efficacy of natural therapies and in part this has been undertaken by applying the same rules of engagement for those required or favoured by pharmaceutical objectives.

Most basic research relies on the use of mice as the sacrificial animal. Many of these mouse are carefully engineered to have special gene abnormalities, or to be a consistent animal in order that different laboratories can limit variability by using the same strain/species. Without doubt millions of mice have been sacrificed in the name of science, and whilst there will be considerable polarisation on the validity of their use, they have contributed an enormous amount of information to human health.

But man is not a mouse, and indeed a mouse may be adversely affected by the choice of mouse chow given to it. A remarkably elegant study by Courtney Kozyul PhD demonstrated how by changing the diet of lab mice, significantly divergent results could be collected. A few years prior, there was an understanding from labs that the local environment would impact on outcomes, now the mice chow is the next item on their radar.

Swine flu has killed 12 799 people worldwide since it first emerged in Mexico in March 2009, the World Health Organisation said on the 8th January 2010.

The latest data posted by the United Nations health agency marked an increase of 579 deaths from the previous update published nine days ago.

The Americas continues to report the biggest number of casualties with at least 6,880 deaths while in Europe, at least 2,554 people have died from the A(H1N1) virus

Is it a False Pandemic Though?

The question of independence of decision making from financial benefits in medicine and other areas of healthcare remains an ongoing problem. It exists, it is being more exposed, it is insidious and it affects important decision making processes. No discipline is free of the pernicious influence of commercial pressure – how this translates into risk Vs benefit is a more complex question.

In the Journal Of The American Medical Association (JAMA) last month (sept9th 2009) a rather dull  article was published that continues to raise significant questions about the availability of quality data required for optimal clarity in making clinical decisions.

For some time now it has been understood that  trials can go missing, that is they are started but not reported on, mainly due to unwanted outcomes, rather than collapse of the trial. The result can be a level of selective publishing practice that highlights benefits rather than failure by excluding unsuccessful studies or may deliver a retrospectively applied outcome score to an allied interventional benefit when the proposed (wished for) outcome does not materialise.

Dr Miller an American Surgeon reviews the current state of iodine related health problems from a predominately American perspective. He does  summarises in his review, published in issue 75 of the UK journal Caduceus a substantive set of opinions and research that brings the importance of iodine and supplementation back into the clinic.

Used extensively until the mid 1900’s iodine has largely fallen out of medical favour and remains a controversial nutrient. Dr Miller elegantly describes the transition from ubiquitous therapy to supplement pariah and the extensive data collected from over 12,000 patients that indicate its therapeutic value.

We are not slaves to our genes. Even if we are born with an inherited predisposition to obesity, life style is important and will determine the outcome of weight related problems says this recent study in the American Journal of Clinical Nutrition.

Pancreatic Proteolytic Enzyme Therapy Compared With Gemcitabine-Based Chemotherapy for the Treatment of Pancreatic Cancer.

Dr Gonzalez, a recent expert speaker at one of the NL expert education seminars, has had his therapy heavily criticised in this recent article published in the  respected Journal of Clinical Oncology.

At first sight it can seem that the paper roundly demolishes the pancreatic enzyme and lifestyle treatment recommended by Dr Gonzalez, and adds considerable value to the mixed chemotherapy treatment provided as the competing arm of the therapy.

In fact this paper has already been lauded in the arenas frequented by the more committed anti-alternative or non RCT evidenced medicine as a gross failure of the enzyme therapy to show any benefit in the care of pancreatic cancer patients.

Surely this must be considered an experts review, especially as the lead author Dr John Chabot was the appointed independent trial Principal Investigator at Columbia? He would know and report accurately what went on – wouldn’t he?

Six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters, according to a study out on Thursday 10th September by editors of The Journal of the American Medical Association. This was then reported on in the New York Times, from where the essential elements of this post were extracted.