The rise of food allergies

June 5, 2016

One in two people suffers from a hidden food allergy. Find out if you are one of them.” Patrick Holford, advocate of alternative nutrition and diet methods

I was travelling on Ryanair – I think it was three or four years ago – and we were told that nobody was allowed to eat peanuts aboard because one of the passengers suffered from peanut allergy. And indeed it may well be the case that studies have been unable to detect peanut particles in the air in sufficient amounts to cause a reaction. However, one of my students, whose son was also allergic to peanuts, explained that if I had been eating peanuts and I had then touched his face, he would have had a severe reaction. John O’Farrell wrote a satirical novel a few ago, called May Contain Nuts in which he satirised modern parental paranoia, but for anyone with this problem, it is all too real.

Our interest in allergies does seem like a modern phenomenon, but the remains of a woman who died 2,000 years ago in Cosa, on the Tuscan coast in Italy tell a fascinating story. This area, which was not especially prosperous, was important for wheat-growing. The 20-year-old woman, who would have stood at 1m 40cm centimetres, appeared to be quite wealthy – archaeologists discovered gold and bronze jewellery buried with her. DNA analysis demonstrated that the woman carried two copies of an immune system gene variant that is associated with coeliac disease. Her skeleton showed signs of malnutrition and osteoporosis both can be complications of untreated coeliac disease. By analysing her bones the researcher were able to conclude the woman had tried to change her diet to cope with her condition

What is going on today? I’m sure you will have had this discussion. When I was growing up I don’t remember so many food allergies. Now they are said to affect between 5% and 10% of the populations of developing countries. A food allergy is an immune system reaction that occurs soon after eating a certain food. This might be mild skin reactions and respiratory distress, through to life-threatening reactions. Food allergies should not be confused with food intolerance, a less serious condition that does not involve the immune system. Severe food allergies do exist, but it is also true that many more people, 30% of the population believe they have one, than actually do.

What are the causes of this trend? One school of thought is that we are just too clean. According to Wikipedia, the hygiene hypothesis states that “a lack of early childhood exposure to infectious agents, symbiotic microorganisms (such as the gut flora or probiotics), and parasites increases susceptibility to allergic diseases by suppressing the natural development of the immune system.” And because of fear we are delaying the introduction of allergenic foods such as egg, peanut or tree nuts. Moreover we now eat more processed foods than ever and this may be affecting our immune system. Finally skin exposure to unrefined nut oil based moisturisers has been blamed. But these theories have not yet been demonstrated

Whenever there is a problem there are solutions. The food industry has given us gluten & wheat-free, milk-free, egg-free nut-free and very soon I’m sure nutrient-free. Next week Rotterdam will be hosting Free-From Food Expo 2016. I am a bit sceptical about these products. You always need to see what they are replacing the harmful substance with. Sugar-free sweets, for example, contain a chemical called lycasin which has a laxative effect. Consumers may believe that free-from means total absence, which is not the case. There was a wonderful example on QI earlier this year. The principal ingredient of sugar-free Tic Tacs is … sugar. This is because, according to the FDA, if there is only half a gram of sugar in a serving it is sugar-free.

Then alternative medicine has got into the act. This is just the type of terrain in which it thrives. We don’t know exactly what is going on and what the solutions are. Alternative medicine becomes the medicine of the gaps. Unfortunately naturopaths and their ilk do not diagnose allergies in evidence-based ways. Their methods are either not proven to work or proven not to work. Blood tests cannot identify food sensitivities. Then there is applied kinesiology which involves holding a suspected allergen and then pressing down on that limb. Muscle weakness is said to signify an allergy. Dr. Jimmie Scott of Health Kinesiology has pioneered the Allergy Tap™ method. The practitioner “places the offending substance over a specific acupuncture point on the belly and taps eight pairs of specific acupuncture points.” You can even do the Allergy Tap™ for yourself after buying the materials and doing a course. Scott claims that it can “eliminate allergies, release physical toxicity, emotional traumas, overcome learning blocks, & perform at your best, among other things. The tennis player Novak Djokovic was diagnosed with gluten intolerance using this kind of technique. Another line is Vega Testing. Vega machines are a type of electroacupuncture device, which they say can diagnose allergies and other illnesses. Here is a video showing the device in action:

Once again there is no evidence that it can identify allergies at all. There are others such as cytotoxic testing, hair analysis and a pulse test (this involves measuring the pulse before and after eating a suspected allergen). They all have little basis. It would be great if a simple blood test could offer a reliable shortcut. In The Guardian Alex Renton describes a visit to London’s Hale Clinic, an alternative therapy centre near Harley Street:

“It is amazing. I have won the hypochondriac lottery. I’m the owner of 29 different allergies, sensitive to substances from MSG to strawberries and including such regulars in my life as milk, chicken, wheat dust, red and green peppers, cheese, peanuts, honey, lentils, brewer’s yeast, lactose, various grasses, cat hair, tobacco and “summer and fall pollens”. The fact that I believe I have no hay fever or allergy is not of importance. I am aghast. I don’t know where to start. Cheese? I love cheese. “But your body doesn’t,” says Linda, wagging a finger.”

And of course you have celebrities and no-one does it better than Gwyneth Paltrow. She has her own line of gluten-free ready meals and three years ago she published a cookbook, It’s All Good. What inspired her was being on death’s door after eating too many chips. Paltrow thought she was suffering a stroke, but was actually diagnosed with a migraine and a panic attack. After a battery of tests, her doctor certified that she was allergic to just about everything. This is Hollywood neuroticism and pseudoscience in its purest form. It was pointed out that to eat as Paltrow suggests would cost $300 a day.

There are no easy answers to this problem. If you are allergic to a food at the moment the only solution is to abstain. Hopefully, science will get a better understanding of what is going on. We need to be looking for food diversity in our diets from an early age to keep our gut microbes as healthy as possible. Fermented plant-based foods such as sauerkraut, kimchi, and soy sauce are good. Beans should play a big role in our diet too. And without going to his extremes Novak Djokovic’s diet sounds pretty good. The world No 1’s diet is based on vegetables, beans, white meat, fish, fruit, nuts, seeds, chickpeas, lentils and healthy oils.

 

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A couple more food videos

June 5, 2016

Here a couple of videos from Michael Pollan:

This is his most recent series:


A primer on Indian food

April 17, 2016

Introduction

I really didn’t realise what I was letting myself when I began researching this article. I have been to hundreds of Indian restaurants, but I had no idea of the sheer scale of Indian cuisine. This was rather naïve I suppose. India, which is larger than the whole of Europe (excepting Russia), is, after all, the second most populous country in the world. Luckily, I had the invaluable assistance of Alan Davidson’s The Oxford Companion to Food 2nd Ed, a one-million word encyclopaedia of food.

The Indian subcontinent is the birthplace of four of the world’s major religions, Hinduism, Buddhism, Jainism and Sikhism. Christianity, and especially Islam, have an important presence in the country. And although 250 languages have died out in the last fifty years, people in India presently speak in 780 different languages according to a study published in 2013. The geography, from the snowy Himalayas to the coconut palms of the tropical south provides for a great variety of cuisines. Indeed, Wikipedia lists 37 different regional cuisines. I was going to do an historical overview, but in the end I will just do a survey.

The basics

However, I do want to try to seek out the common strands. Cereals are at the heart of an Indian meal, with savoury dishes added as accompaniments and to provide flavour. There is a strong vegetarian component lentils and pulses generally, and vegetables are staples. This vegetarianism has in its origins the doctrine of ahimsa or non-violence first set forth in the Upanishads, a 9th century BC collection of texts that contain some of the central philosophical concepts of Hinduism. Buddhism and Jainism developed the idea. Dairy products such as yoghurt, ghee, panir and kheer are very popular. In fact, India now has the world’s biggest dairy industry in terms of milk production. But it is the spices, especially ginger and garlic, but including coriander turmeric, fenugreek and cumin and many others, that make Indian cuisine so distinctive. Traditionally, meals in India were eaten while seated either on the floor or on very low stools or cushions. At the centre is the thali (platter) with its central pile of rice or bread surrounded by small containers of savoury accompaniments. Food is most often eaten with the right hand rather than cutlery.

Goa

Although now part of India, Goa was a Portuguese possession for four and a half centuries. This led to a fascinating mix an intriguing mix of Latin influences mixture with those of the Hindus and Muslims. It may have been a small territory, but its position as a gateway Portugal’s empire in the East and as centre of East–West trade, gave Goa, an importance quite disproportionate to the small size of the territory. The best known example of the Portuguese Indian collaboration must be Vindaloo. Originally a pork stew, the addition of various spices gave it that Indian touch. Goan chouriço sausages are Portuguese chouriços, but with an Indian masala. The ingredients include pork, pork fat, chilli, garlic, ginger, cumin and turmeric and they are filled into pig intestines.

Moghul cuisine

Moghul is the Indian version of Mongol. The Mongol Empire was by far the greatest force in Asia in the Middle Ages. See my post Genghis and the original Khan Academy. It was the Moghuls who over a period of two centuries introduced Persian dishes to India. There was a blend of Persian and Indian flavours. This legacy survives today. The Indian food that most of us are familiar with is this northern cuisine. All of these have a Moghul origin:

Kebabs

Koftas

Kormas

Pilaf and Biriani dishes

Samosas

Tandoor dishes;

And those rich dishes with almonds and pistachios are likely to be of Moghul origin, as are sweet rice dishes flavoured with saffron.

Anglo-Indian

The British were in India from 1612 to 1947 resulting in a great deal of influence. I will look at a few of the dishes or foodstuffs regarded as typical of Anglo-Indian cookery. Mulligatawny soup came about due to British requirement for soup as a separate course, something unknown in India. The name is a corruption of the Tamil milagu-tannir, “pepper-water”. The basic recipe for mulligatawny was always with some chicken or mutton, fried onion, curry powder, and stock or water. Another dish from this period is kedgeree. It was an Indian dish, but was adapted to British tastes with flaked smoked fish, hard-boiled eggs and even cream being added.  It has now become a British breakfast speciality. The long-term impact of Anglo-Indian cookery on English cookery apart the popularity of curry dishes and of chutneys was not that great. It was not until the arrival of Indian restaurants in Britain, in the second half of the 20th century, that the influence grew.

Curry

Curry, which comes from the Tamil word kari, entered the English language in the 1680s. In India it referred to a spiced sauce. The traditional South Indian kari does not have a fixed set of ingredients, but a typical mixture was and remains the following, all roasted and ground to a powder: kari patta (curry leaf); coriander, cumin, and mustard seeds; red and black pepper; fenugreek; turmeric; and oftentimes cinnamon, cloves and cardamom. In India this mixture is almost always freshly prepared. It was during the Raj that the British, in the name of convenience, created commercial ready-mixed curry powder. In 1747 Hannah Glasse published To Make a Currey the India Way’, said to be the first curry recipe in English,

The curry house

The colonial relationship between Britain and the Indian subcontinent is undoubtedly behind the rise of Indian restaurants in the UK. In the 18th century, thanks to employees of the British East India Company, curry began to appear on coffee house menus. In 1810, the Bengali entrepreneur Sake Dean Mahomed, opened the first Indian curry house in England: the Hindoostanee Coffee House in London. Veeraswamy’s, the oldest surviving Indian restaurant in London, opened in 1926. And in the 1930s and 1940s cheap curry houses began to spring up. It was given an English twist, with the emphasis on emphasized meat and sauce and often served with chips. What was lost was the sophistication and complexity of vegetable and pulse dishes. Although since the 1980s there has been a greater appreciation of the variety and subtlety of Indian cuisine. At the same time we have seen the emergence of an “English” curry.

Balti

The name refers to both the cuisine of Baltistan in the far north-east of Pakistan and the wok-like utensil which is the main piece of equipment used by Balti cooks. There are other theories: one dictionary of Anglo Indian terms claims it comes from the Portuguese word “balde” meaning bucket. Be that as it may, until the last quarter of the 20th century Balti food was virtually unknown outside Baltistan. Apparently it was the chance arrival one immigrant, Mohammed Arif, who claims to have opened, the first Balti restaurant, called Adil’s, in 1977. It has now become a mass phenomenon all over the U.K. especially in Birmingham.


Rowan Atkinson – Drunk English in Indian Restaurant

April 17, 2016

Here is a classic Rowan Atkinson sketch:

And thanks to Jeremy Harding for sending this link:


The story of breakfast

January 17, 2016

Breakfast literally means to break one’s fast, and has its origin in the Christian custom of fasting between supper Holy Communion the following morning. A related word that you probably don’t know is jentacular, an adjective which means of, or relating to breakfast. Alas, it has fallen into disuse. We would have to use something like breakfasty or breakfastish, but I don’t like them. This extract from John Murray’s 1820 The New Family Receipt-Book shows the majesty of this word:

To valetudinarians (a person of a weak or sickly constitution) and others the following method of making coffee for breakfast is earnestly recommended, as a most wholesome and pleasant jentacular beverage.”

Breakfasts vary and have varied throughout history and depending on the part of the world you are looking at The Romans didn’t really eat it, usually consuming only one meal a day around noon. The Romans thought that eating one meal a day was healthier; having two meals a day was gluttony. In the Middle Ages monastic life largely shaped when people ate. Nothing was supposed to be eaten before morning Mass. There were also restrictions on the consumption of meat, which could only be eaten for around half the days of the year. Collop Monday was the day before Shrove Tuesday. People wanted to use up meat, with pork and bacon being the most typical, before the start of Lent. The meat was often eaten with eggs, which also had to be used up. Thus bacon and eggs, precursor of the full English breakfast, was born.

It is thought that it wasn’t until the 17th Century that eating breakfast became prevalent among all social classes. With the restoration of Charles II, coffee, tea and dishes like scrambled eggs started to appear on the tables of the wealthy. In the 19th Century hunting parties became all the rage in aristocratic circles. These parties could go on for weeks and participants would want sustenance. Breakfasts of up to 24 dishes would be served. It was not just the upper classes. With the onset of Industrial Revolution working hours meant that factory workers and labourers needed a substantial early meal to sustain them at work.

The next important change came at the end of the 19th Century. It was in America where the breakfast cereal was born. John Harvey Kellogg accidentally left some boiled maize out and it went stale. He passed it through some rollers and baked it, creating the world’s first cornflake. Kellogg, who was a teetotal, vegetarian Seventh-day Adventist, was quite a character. In his sanatorium in Battle Creek, his pride and joy was an enema machine that would run water several gallons through the bowel. Every water enema was followed by a pint of yogurt — half was eaten, the other half was administered by … enema. The idea was to create a squeaky-clean intestine. This practice never really caught on.

Kellogg was also an advocate of sexual abstinence and an impassioned campaigner against masturbation; Kellogg thought that diet played a huge role in masturbation and one that was bland would put a dampener on all these sexual urges and prevent masturbation. He hoped that feeding children this plain cereal every morning would rid society of “self-abuse”

What began as a wacko religious, pseudo scientific health-food cure become a massive business. Will, Kellogg’s brother, was a more worldly man. He wanted to add sugar, and when John refused to countenance it, he started selling the cereals through his own business, which became the Kellogg Company.

The majority of modern cereals are basically modifications of the original types with added sugar or flavourings, or in new shapes. All Bran, which is in fact only 87% bran, was invented in the 1920s by John L. Kellogg, the original John Kellogg’s nephew. It was indeed a convenient way of using up bran left over from other products, and its laxative properties marked a return to the company’s health food origins.

I do like a good full English breakfast and I never say no a bowl of porridge. Nevertheless, there are many traditions and rituals around the world. In Spain it is typical to have two breakfasts, a small one at home. France of course has its croissants and café au lait in France, and Spain its chocolate and churros. Traditional Indian breakfasts include dal, rice, breads, samosas, and fruit.  In the Middle East bread, yoghurt, fruit, and preserves are staples. I have never been to Mexico, but I like the sound of a traditional Mexican breakfast, which consists of Huevos Rancheros eggs accompanied by beans with chile and tortillas. I’m not quite so sure about elephant’s foot. In 1790, François Le Vaillant was given an elephant’s foot for breakfast while visiting the Hottentot (Khoi) tribe of south-western Africa. This is how he described it in his journal:

“…it exhaled such a savoury odour, that I soon tasted and found it to be delicious. I … could not conceive that so gross and heavy an animal as the Elephant, would afford such delicate food. “Never,” said I, “can our modern epicures have such a dainty at their tables; let forced fruits and the contributions of various countries contribute to their luxury, yet cannot they procure so excellent a dish as I have now before me.”

Now I’m going to jenticulate. But I think I’ll give elephant’s foot a miss.


To diet for: the art of wishful shrinking

November 22, 2015

My doctor told me to stop having intimate dinners for four. Unless there are three other people. Orson Welles

A waist is a terrible thing to mind. Tom Wilson

If I had been around when Rubens was painting, I would have been revered as a fabulous model. Kate Moss? Well, she would have been the paintbrush. Dawn French

Eat, drink and be merry, for tomorrow ye diet. Lewis C. Henry

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Dieting is a massive business, worth over $20bn in the US alone, where there are said to be more 100 million people on a diet. There are low-fat, low-carbohydrate, low-calorie and detox diets. Some, such as the Atkins diet, have become famous around the world but there are diets in all shapes and sizes. Wikipedia has a list of them. Here is just a small sample of the more bizarre ones:

Beverly Hills diet: An extreme diet which has only fruits in the first days, gradually increasing the selection of foods up to the sixth week.

Breatharian diet: A diet in which no food is consumed, based on the belief that food is not necessary for human subsistence.

Grapefruit diet: A fad diet, intended to facilitate weight loss, in which grapefruit is consumed in large quantities at meal times.

Israeli Army diet: An eight-day diet. Only apples are consumed in the first two days, cheese in the following two days, chicken on days five and six, and salad for the final two days. Despite what the name suggests, the diet is not followed by Israeli Defence Forces. It is considered a fad diet.

KE diet: A diet in which an individual feeds through a feeding tube and does not eat anything.

Subway diet: A crash diet in which a person consumes Subway sandwiches in place of higher calorie fast foods. Made famous by former obese student Jared Fogle, who lost 245 pounds after replacing his meals with Subway sandwiches as part of an effort to lose weight.

Tongue Patch diet: Stitching a Marlex patch to the tongue to make eating painful.

Why has dieting become so popular? One factor is modernity: we are living in such anomalous abundance. In the past it was the rich who were fat; it was a sign of status. Now it is often the poor who are overweight. There is undoubtedly an evolutionary mismatch – food with sugar and fat was essential for survival and those who stored it passed on their genes. This helped us survive in less abundant times, but it is now creating a health epidemic. There is research which suggests that high sugar foods are addictive. They cause dopamine to be released in our brains, and they actually impair cognitive function.

In the end we have to deal with the world we actually live in. I know what I should do, despite some contradictory advice and some fads, Michael Pollan’s advice is a good place to start:

Eat food. Not too much. Mostly plants.

But the psychology is complicated. We face an internal struggle between systems 1 and 2 of our brain. The reflective part knows what to do, but the emotional parts often override these noble intentions. Willpower is necessary in the face of instant gratification. We face what is an immediate pleasure and an indeterminate harm some time in the future.  Perhaps we need to look at how we frame advice. Fear is usually the mechanism chosen; you will have a miserable and a premature death. Maybe we need to focus on the benefits of a healthy diet, all the energy and vitality you will gain,

One interesting idea from economics is the commitment contract. The idea is that you make a pledge to achieve a goal. There is a website, founded by two Harvard economists, https://www.stickk.com/, where you can make these pledges. If you do not reach this target then you have to pay donate a specified amount of money to the person or organisation you specified. On the stickk.com website the recipients are charities, but to really spice things up, it should be to organisations whose aims you despise. This gives an even stronger incentive to keep you word. The 2005 Nobel Memorial Prize in Economic Sciences winner, Tom Schelling, a key figure in game-theory analysis, suggested the American Nazi Party. As a sceptic I might plump for an organisation promoting homeopathy.

Temptation bundling involves together two activities together. One must be one you should do, but keep putting off, whereas the other one is you love to do but isn’t necessarily productive. The term was coined by Katherine Milkman an operations and information management professor at Wharton Business School. Interviewed on the Freakonomics podcast Milkman suggested some of these consumption complementarities:

“So what if you only let yourself get a pedicure while catching up on overdue emails for work? Or what if you only let yourself listen to your favourite CDs while catching up on household chores. Or only let yourself go to your very favourite restaurant whose hamburgers you crave while spending time with a difficult relative who you should see more of.”

This type of strategy could be applied to losing weight. In my own case I could do with losing around ten kilos. Maybe I should do a bit more exercise. It’s funny but I don’t drink coca cola. I’m not a fan of junk food. My problem is quantity, and I do eat too fast. I wish I could get nearer to Pollan’s advice. My intellectual brain understands that less is more, but my emotional brain has other ideas.


How chocolate can help you lose weight

June 6, 2015

Can you indulge your sweet tooth and lose weight at the same time? If it’s chocolate you crave, then the answer seems to be: yes. That is the surprising conclusion of a study by German researchers published this week in the International Archives of Medicine.

Confusion reigns in the diet world, with conflicting recommendations for diets that range from high-protein to low-carbohydrate and even high-fat. According to many nutrition researchers, the problem is that these tools are too blunt. “What is important is the specific combination of foods in your diet,” says lead author Johannes Bohannon, research director of the nonprofit Institute of Diet and Health. “Just lowering the proportion of carbohydrates is not a reliable weight loss intervention because it has different physiological effect depending on the bioactive compounds in your diet.”

Chocolate is a rich source of bioactive compounds, particularly a group of molecules called flavonoids, plant compounds associated with several positive health impacts. But teasing out the possible effects of such compounds in your diet, and how it may interact with various diet interventions, is rarely studied. It could be that simply consuming chocolate in combination with dietary interventions has no effect, or it could make such diets even more effective in the right dose.

To test the idea, the researchers divided volunteer human subjects aged 19 to 67 into three groups: One group followed a strict low-carbohydrate diet, another group followed the low-carbohydrate diet and also consumed 42 grams of dark (81%) chocolate per day, and a control group followed their status quo diet. Besides tracking their body weight and measuring blood chemistry before, during, and after the intervention, subjects filled out questionnaires to assess sleep quality and subjective well-being, a key predictor of dietary compliance.

As predicted, the low-carb group lost weight compared to the control. But surprisingly, the low-carb plus chocolate group lost 10% more weight. Not only that, but the weight loss persisted, compared to the low-carb group which saw a return of the weight after 3 weeks—a classic problem in dietary interventions known as the “yo-yo effect”. The chocolate group also reported better sleep and well-being, and their blood cholesterol levels were significantly reduced.

“To our surprise, the effect of chocolate is real,” says Bohannon. “It is not enough to just consume chocolate, but in combination with exercise and reduction in carbohydrates, our data indicate that chocolate can be a weight loss accelerator.”The researchers suggest that high-cocoa chocolate has the potential to enhance other diets as well. “The best part about this discovery,” says Bohannon, “is that you can buy chocolate everywhere, cheaply and without having to believe diet gurus or purchase expensive nutrition products over the Internet.”

Press release from The Institute of Diet and Health

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Don’t you just love this press release? It is just the kind of thing to get some newspaper editors salivating and social media users sharing online. If it sounds too good to be true, I’m afraid it actually is. The chocolate-helps-you-lose-weight hoax was the brainchild of German television reporter Peter Onneken who pitched the idea to American journalist John Bohannen. They set out to prove how easy it was to get a dodgy scientific study published. In fact, the study did take place, but as we shall see, it was deliberately shorn of any scientific value.

Some people may find this unethical, but elaborate hoaxes are a tradition among sceptics. In previous posts I have mentioned how physicist Alan Sokal was able to get a bullshit article, Transgressing the Boundaries: Towards a Transformative Hermeneutics of Quantum Gravity, published in an American cultural-studies discussion journal, Social Text. The spoof piece was made up of ideas and quotations from various postmodernist philosophers and full of mathematical absurdities, which the editors failed to spot. I have also featured the magician James Randi, who coached stage performer José Alvarez to pretend he was channelling a two-thousand-year-old spirit named “Carlos”. And who can forget science writer Dr. Ben Goldacre’s dead cat, Henrietta, who became a certified member of the American Association of Nutritional Consultants after Goldacre paid $60 to the Clayton College of Natural Health?

For the experiment Bohannon claimed to be Johannes Bohannon, Ph.D., a health researcher and lead author of the study. Onneken and his collaborator, Diana Löbl handled the logistics. They had a few thousand Euros to recruit research subjects on Facebook. They also required the services of Gunter Frank, a German doctor responsible for running the study, and Alex Droste-Haars, a financial analyst, to massage the data. The study was intentionally flawed with a ridiculously small sample size, measuring 18 variables (weight, sleep quality, and cholesterol levels among others) that naturally fluctuate in participants. The 16 subjects (5 men and 11 women, aged between 9 and 67) chosen were from Frankfurt, and were paid €150 to go on a diet for 3 weeks. They were divided into three groups – one was a low-carb. Another was low-carb plus chocolate a bar every day, and the final one was a control group who were told to follow their normal diet. The participants had to weigh themselves every day for the three weeks, and the researchers also took blood tests, measuring all the variables you can measure from a drop of blood. The subjects also filled out surveys about their sleep quality and well-being and physical complaints.

By the end of the study they had a mountain of data. The control group’s average body weight fluctuated up and down around zero. Both of the treatment groups lost an average of around 2.5 kilos over the course of the study. But the people on the low-carb diet plus chocolate lost weight 10% faster, a statistically significant result. Moreover, the chocolate group had better cholesterol results and higher scores on the well-being survey.

The amount of data was of course one of the problems with the study. If you have a small number of people and a large number of variables that you’re testing for, you’re more or less guaranteed to find something that will appear to be statistically significant. It is a tried-and-tested recipe for false positives. And If you don’t say ahead of time what exactly you’re looking for, then you can just pick up wherever random result you do get and claim that you have made an important discovery. In this case what varied was the speed at which the participants lost weigh, but the result could have just as easily been that chocolate improves sleep quality or lowers blood pressure or cholesterol levels.

Now Bohannon and Onneken wanted to share their “scientific breakthrough” with the world. They needed to get their study published ASAP. As it was such patently bad science, they had to avoid any kind of peer review. They had the perfect solution. For €600 Euros iMed.pub published it in their premier journal, the International Archives of Medicine, an open access medical journal.

What happened then? It did get picked by the German newspaper Bild and Britain’s the Daily Star. It also made it on to Cosmopolitan’s German website and both the German and Indian websites of Huffington Post. On the other hand none of Britain’s broadsheets were fooled. Nor was the New York Times. The story also failed to appear on a major national network. However, I’m sure that this kind of material does frequently get through. Just go to Ben Goldacre’s website.

Curiously, the Facebook page for the International Archives of Medicine featured a statement from Carlos Vazquez the journal’s CEO, claiming the paper was published by mistake and was only live for hours:

Disclaimer: Weeks ago a manuscript that was being reviewed in the journal “Chocolate with High Cocoa Content as a Weight-Loss Accelerator” appeared as published by mistake. Indeed that manuscript was finally rejected, although it went online for some hours. We are sorry for the inconvenience. We are taking measures to avoid this kind of mistakes happens [sic] again.

This appears to be a terminological inexactitude as the paper appears appears to have been on a number of weeks. What’s more there is apparently this email from Vazquez:

I’m contacting to let you know your manuscript “Chocolate with High Cocoa Content as a Weight-Loss Accelerator” has been pointed by our editors as an outstanding manuscript and could be accepted directly in our premier journal *International Archives of Medicine.

Bohannen’s hoax raises questions about scientific experiments. This has been an ongoing theme in this blog. The abovementioned Ben Goldacre is a trenchant critic of such practices by the pharmaceutical industry. In “Missing Data“, the first chapter of Bad Pharma he shows the tricks employed by Big Pharma so that clinical trials will reach conclusions favourable to the drug company. He describes publication bias, in which only tests with important results are published. If a lot of tests with inconclusive results are ignored, this will skew the results. If the trial seems to be producing negative data, it may be stopped prematurely and the results not published, or if it is producing positive data it may be stopped early so that longer-term effects are not examined.

Ultimately we have to look at the role of the journalists. If you’re reporting on a scientific study, you need to actually look at the paper. You need to talk to a source with real scientific expertise. They need to actually interview the people behind the studies, and they should seek independent researchers’ opinions. And a healthy dose of scepticism wouldn’t go amiss.