Friday, February 16, 2007


It's three weeks into the school term and you can barely turn on a radio without hearing an advertisement for the Dore Program, a supposed "miracle cure" for dyslexia, and other reading problems. But amid the hype is coming a sober warning from reading experts that parents may be wasting their money and valuable learning time on a program whose claims have not been independently scientifically verified and may, in fact, turn out to be the equivalent of educational snake oil.

The Dore Program may or may not work, but, "I think its theoretical basis is feeble", says Professor Max Coltheart, the scientific director of Macquarie University's Centre for Cognitive Science. He joins learning difficulties expert Kerry Hempenstall,from Melbourne's RMIT University, and a child psychologist, Michael Carr-Gregg, in criticising the program because there is no independent scientific evidence that it works.

Billed as the "answer" for children struggling to read, whether they have dyslexia, attention deficit hyperactivity disorder or Asperger's syndrome, the Dore Program uses a series of physical exercises over 12 to 15 months which it claims will develop a fist-sized area at the back of the brain known as the cerebellum, which controls motor skills and balance, and is also believed to be important in developing language skills. The program claims the exercises, such as threading beads or throwing a bean bag from hand to hand while balancing on one leg, create "new neural pathways which speed up the processing of information". The price tag is a hefty $4970.

The Dore Program has achieved phenomenal growth since arriving in Australia five years ago, claiming to have successfully treated more than 10,000 people at 13 treatment centres across Australia, including five in NSW, with a third Sydney centre, in Parramatta, due to open soon. "We are opening all the time," a Dore spokesman said yesterday. The company's website is full of testimonials from Australians who say their children's lives have been transformed by the program. Says Linda, of Singleton, whose son Chris received two As in exams for the first time: "We don't have to rely on medication any more. It is wonderful to see Chris using his own ability without drugs." The town of Parkes has embraced the program to the point that a clinic has been installed in a primary school and the council has subsidised children to be treated. Now Parkes proudly proclaims itself a "learning difficulty-free zone", a claim scoffed at by reading experts.

But the publicity for the Dore Program has been largely uncritical. When its British multimillionaire founder, Wynford Dore, was in town last year promoting his book, Dyslexia: The Miracle Cure, he was treated to a sycophantic 13-minute interview by 2UE's John Laws, who began by crediting himself with the program's success in Australia: "We started it all, together, many years ago." The program's website claims it is "fully researched and proven", citing a laudatory paper published in the scientific journal Dyslexia, whose independence has since been called into question. In fact, five editorial board members of Dyslexia resigned in protest late last year after the paper was published, amid allegations that one of its authors was paid $75,000 by Dore.

Nature magazine this month followed up with an editorial critical of Dore, claiming the editor of Dyslexia is a "long-time collaborator" with the study's other author, "with whom she has published over 30 articles and book chapters". Dore's national marketing manager, Murray Fay, yesterday countered the knockers by pointing to 30,000 happy customers around the world. And he says any criticism is fuelled by "the medical profession [which is] feeling challenged and threatened" by a treatment which is "completely drug-free".

But what most disturbs reading scientists in Australia is the aggressive way Dore protects its image, threatening legal action against critics raising legitimate concerns, as Coltheart discovered last year. Then the president of the registered charity Specific Learning Difficulties Association NSW, he posted links on its website to an International Dyslexia Association statement that the Dore Program "is not supported by current scientific knowledge". Dore immediately sent Coltheart a threatening legal letter and a nervous association took down the offending links, thus denying parents valuable information.

There are no miracle cures for dyslexia or ADHD. In fact, says Coltheart, all the scientific research shows that effective teaching, tailored to a child's particular reading difficulty, is the best treatment. "Virtually any child who's not, frankly, brain-damaged can learn to read. It doesn't require high intelligence," he says, citing the case of a Down syndrome child with an IQ of 70 who was taught to read.

"But parents are desperate," says Coltheart. If schools were doing a proper job of teaching children to read, there wouldn't be such a hunger for unproven programs like Dore. That so many parents are spending so much money on untested products in the burgeoning remedial reading industry is an indictment on the Australian education system. But it is not the fault of teachers, who are doing their heroic best with little preparation. As the report of the National Inquiry into the Teaching of Literacy, (of which I was a committee member) showed, a teacher can graduate with a bachelor of education having spent less than 10 per cent of course time learning how to teach reading. A year after the report was released, there is no sign that anything has changed.



If you know anything about biological science, some of the quack stuff noted below will have you in fits

Call her the Awful Poo Lady, call her Dr Gillian McKeith PhD: she is an empire, a multi-millionaire, a phenomenon, a prime-time TV celebrity, a bestselling author. She has her own range of foods and mysterious powders, she has pills to give you an erection, and her face is in every health food store in the country. Scottish Conservative politicians want her to advise the government. The Soil Association gave her a prize for educating the public. And yet, to anyone who knows the slightest bit about science, this woman is a joke.

One of those angry nerds took her down this week. A regular from my website - I can 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. He won. She may have 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. But would you know it, a copy of that draft adjudication has fallen into our laps, and it concludes that "the claim `Dr' was likely to mislead". The advert allegedly breached two clauses of the Committee of Advertising Practice code: "substantiation" and "truthfulness".

Is it petty to take pleasure in this? No. McKeith is a menace to the public understanding of science. She seems to misunderstand not nuances, but the most basic aspects of biology - things that a 14-year-old could put her straight on.

She talks endlessly about chlorophyll, for example: how it's "high in oxygen" and will "oxygenate your blood" - but chlorophyll will only make oxygen in the presence of light. It's dark in your intestines, and even if you stuck a searchlight up your bum to prove a point, you probably wouldn't absorb much oxygen in there, because you don't have gills in your gut. In fact, neither do fish. In fact, forgive me, but I don't think you really want oxygen up there, because methane fart gas mixed with oxygen is a potentially explosive combination.

Future generations will look back on this phenomenon with astonishment. Channel 4, let's not forget, branded her very strongly, from the start, as a "clinical nutritionist". She was Dr Gillian McKeith PhD, appearing on television every week, interpreting blood tests, and examining patients who had earlier had irrigation equipment stuck right up into their rectums. She was "Dr McKeith", "the diet doctor", giving diagnoses, talking knowledgeably about treatment, with complex scientific terminology, and all the authority her white coat and laboratory setting could muster.

So back to the science. She says DNA is an anti-ageing constituent: if you "do not have enough RNA/DNA", in fact, you "may ultimately age prematurely". Stress can deplete your DNA, but algae will increase it: and she reckons it's only present in growing cells. Is my semen growing? Is a virus growing? Is chicken liver pate growing? All of these contain plenty of DNA. She says that "each sprouting seed is packed with the nutritional energy needed to create a full-grown, healthy plant". Does a banana plant have the same amount of calories as a banana seed? The ridiculousness is endless.

In fact, I don't care what kind of squabbles McKeith wants to engage in over the technicalities of whether a non-accredited correspondence-course PhD from the US entitles you, by the strictest letter of the law, to call yourself "doctor": to me, nobody can be said to have a meaningful qualification in any biology-related subject if they make the same kind of basic mistakes made by McKeith.

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......

Shortly after the publication of McKeith's book Living Food for Health, before she was famous, John Garrow wrote an article about some of the rather bizarre scientific claims she was making. He was struck by the strength with which she presented her credentials as a scientist ("I continue every day to research, test and write furiously so that you may benefit ." etc). In fact, he has since said that he assumed - like many others - that she was a proper doctor. Sorry: a medical doctor. Sorry: a qualified conventional medical doctor who attended an accredited medical school.

Anyway, in this book, McKeith promised to explain how you can "boost your energy, heal your organs and cells, detoxify your body, strengthen your kidneys, improve your digestion, strengthen your immune system, reduce cholesterol and high blood pressure, break down fat, cellulose and starch, activate the enzyme energies of your body, strengthen your spleen and liver function, increase mental and physical endurance, regulate your blood sugar, and lessen hunger cravings and lose weight."

These are not modest goals, but her thesis was that it was all possible with a diet rich in enzymes from "live" raw food - fruit, vegetables, seeds, nuts, and especially live sprouts, which "are the food sources of digestive enzymes". McKeith even offered "combination living food powder for clinical purposes" in case people didn't want to change their diet, and she used this for "clinical trials" with patients at her clinic.

Garrow was sceptical of her claims. Apart from anything else, as emeritus professor of human nutrition at the University of London, he knew that human animals have their own digestive enzymes, and a plant enzyme you eat is likely to be digested like any other protein. As any professor of nutrition, and indeed many GCSE biology students, could happily tell you.

Garrow read the book closely, as have I. These "clinical trials" seemed to be a few anecdotes in her book about how incredibly well McKeith's patients felt after seeing her. No controls, no placebo, no attempt to quantify or measure improvements. So Garrow made a modest proposal, and I am quoting it in its entirety, partly because it is a rather elegantly written exposition of the scientific method by an extremely eminent academic authority on the science of nutrition, but mainly because I want you to see how politely he stated his case.

"I also am a clinical nutritionist," began Professor Garrow, "and I believe that many of the statements in this book are wrong. My hypothesis is that any benefits which Dr McKeith has observed in her patients who take her living food powder have nothing to do with their enzyme content. If I am correct, then patients given powder which has been heated above 118F for 20 minutes will do just as well as patients given the active powder. This amount of heat would destroy all enzymes, but make little change to other nutrients apart from vitamin C, so both groups of patients should receive a small supplement of vitamin C (say 60mg/day). However, if Dr McKeith is correct, it should be easy to deduce from the boosting of energy, etc, which patients received the active powder and which the inactivated one.

"Here, then, is a testable hypothesis by which nutritional science might be advanced. I hope that Dr McKeith's instincts, as a fellow-scientist, will impel her to accept this challenge. As a further inducement I suggest we each post, say, 1,000 pounds, with an independent stakeholder. If we carry out the test, and I am proved wrong, she will, of course, collect my stake, and I will publish a fulsome apology in this newsletter. If the results show that she is wrong I will donate her stake to HealthWatch [a medical campaigning group], and suggest that she should tell the 1,500 patients on her waiting list that further research has shown that the claimed benefits of her diet have not been observed under controlled conditions. We scientists have a noble tradition of formally withdrawing our publications if subsequent research shows the results are not reproducible - don't we?"

This was published in - forgive me - a fairly obscure medical newsletter. Sadly, McKeith - who, to the best of my knowledge, despite all her claims about her extensive "resesarch", has never published in a proper "Pubmed-listed" peer-reviewed academic journal - did not take up this offer to collaborate on a piece of research with a professor of nutrition. Instead, Garrow received a call from McKeith's lawyer husband, Howard Magaziner, accusing him of defamation and promising legal action. Garrow, an immensely affable and relaxed old academic, shrugged this off with style. He told me. "I said, `Sue me.' I'm still waiting." His offer of 1,000 pounds still stands; I'll make it 2,000.....

Let me be very clear. Anyone who tells you to eat your greens is all right by me. If that was the end of it, I'd be McKeith's biggest fan, because I'm all in favour of "evidence-based interventions to improve the nation's health", as they used to say to us in medical school. But let's look at the evidence. Diet has been studied very extensively, and there are some things that we know with a fair degree of certainty: there is convincing evidence that diets rich in fresh fruit and vegetables, with natural sources of dietary fibre, avoiding obesity, moderate alcohol, and physical exercise, are protective against things such as cancer and heart disease.

But nutritionists don't stop there, because they can't: they have to manufacture complication, to justify the existence of their profession. And what an extraordinary new profession it is. They've appeared out of nowhere, with a strong new-age bent, but dressing themselves up in the cloak of scientific authority. Because there is, of course, a genuine body of research about nutrition and health, to which these new "nutritionists" are spectacularly unreliable witnesses. You don't get sober professors from the Medical Research Council's Human Nutrition Research Unit on telly talking about the evidence on food and health; you get the media nutritionists. It's like the difference between astrology and astronomy.....

I've got too much sense to subject you to reams of scientific detail - I've learned from McKeith that you need theatrical abuse to hold the public's attention - but we can easily do one representative example. The antioxidant story is one of the most ubiquitous health claims of the nutritionists. Antioxidants mop up free radicals, so in theory, looking at metabolism flow charts in biochemistry textbooks, having more of them might be beneficial to health. High blood levels of antioxidants were associated, in the 1980s, with longer life. Fruit and vegetables have lots of antioxidants, and fruit and veg really are good for you. So it all made sense.

But when you do compare people taking antioxidant supplement tablets with people on placebo, there's no benefit; if anything, the antioxidant pills are harmful. Fruit and veg are still good for you, but as you can see, it looks as if it's complicated and it might not just be about the extra antioxidants. It's a surprising finding, but that's science all over: the results are often counterintuitive. And that's exactly why you do scientific research, to check your assumptions. Otherwise it wouldn't be called "science", it would be called "assuming", or "guessing", or "making it up as you go along".....

So what can you do? There's the rub. In reality, again, away from the cameras, the most significant "lifestyle" cause of death and disease is social class. Here's a perfect example. I rent a flat in London's Kentish Town on my modest junior doctor's salary (don't believe what you read in the papers about doctors' wages, either). This is a very poor working-class area, and the male life expectancy is about 70 years. Two miles away in Hampstead, meanwhile, where the millionaire Dr Gillian McKeith PhD owns a very large property, surrounded by other wealthy middle-class people, male life expectancy is almost 80 years. I know this because I have the Annual Public Health Report for Camden open on the table right now.

This phenomenal disparity in life expectancy - the difference between a lengthy and rich retirement, and a very truncated one indeed - is not because the people in Hampstead are careful to eat a handful of Brazil nuts every day, to make sure they're not deficient in selenium, as per nutritionists' advice.... How can I be sure that this phenomenal difference in life expectancy between rich and poor isn't due to the difference in diet? Because I've read the dietary intervention studies: when you intervene and make a huge effort to change people's diets, and get them eating more fruit and veg, you find the benefits, where they are positive at all, are actually very modest. Nothing like 10 years....

I am writing this article, sneakily, late, at the back of the room, in the Royal College of Physicians, at a conference discussing how to free up access to medical academic knowledge for the public. At the front, as I type, Sir Muir Gray, director of the NHS National Electronic Library For Health, is speaking: "Ignorance is like cholera," he says. "It cannot be controlled by the individual alone: it requires the organised efforts of society." He's right: in the 19th and 20th centuries, we made huge advances through the provision of clean, clear water; and in the 21st century, clean, clear information will produce those same advances. Gillian McKeith has nothing to contribute: and Channel 4, which bent over backwards to dress her up in the cloak of scientific authority, should be ashamed of itself.

More here


Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


1 comment:

Sophy said...

"There are no miracle cures for dyslexia or ADHD. In fact, says Coltheart, all the scientific research shows that effective teaching, tailored to a child's particular reading difficulty, is the best treatment. "Virtually any child who's not, frankly, brain-damaged can learn to read. It doesn't require high intelligence," he says, citing the case of a Down syndrome child with an IQ of 70 who was taught to read.''

I don't believe in miracles either. Luckily the Dore programme isn't a miracle. Yes, it sounds ridiculous - we're unfamiliar with the idea that physical exercises can help with reading and mental processing and so some people assume it's impossible. But I was one of the desperate parents. My 11 yr old son had been diagnosed severely dyslexic. He had terrible concentration, poor co-ordination and his self esteem was scraping the floor. None of the many and various attempt to help him read had worked. I had given up asking him to try to read to me because it only reinforced his idea of 'how crap I am at everything".
We took a gamble. !) months ago we enroled on the Dore. He did the 'ridiculous' exercises - twice a day, every day, including Christmas and Birthdays and the days when we were both tired and fed up of it.
Nothing obvious happened for 7 months. Then, he started trying to read. He was hesitant but for the first time his eyes weren't jumping about, he didn't miss out words or jump from line to line. He actually reminded me when it was time for reading practice (after years of doing everything in his power to avoid it). I even fell asleep listening to him because he went on for so long!!
The real proof that great changes really are happening was the phone call I had from his teacher last month. Note; he is now 12 yrs 6months old.

She was so excited to tell me that since the last tests 8 months ago his reading age has jumped from 8 years 6 months to 12 years 6 months putting him at the level he should be at, for the first time EVER. Spelling has been slower to improve but has still jumped sixteen months in the last eight.

We still have a long way to go and expect to continue the exercises for at least another 6-8 months. Good lord, both of us are sick of them ....but there's no way we're quitting now.

To return to the quote above form Coltheart - my child is not brain damaged, his IQ is well above average but no amount of teaching could compensate for the fact that his eye tracking was completely out of synch. I am grateful to all who tried to teach him but I could see it was like banging his head against a brick wall.
Dore recognised the problem, provided the exercises, we worked hard to do them. They did charge a lot of money – but knowing now how it has helped I would have paid anything. Plenty of people pay far more for dental-work or plastic surgery.

There are such a lot of people, journalists and scientist with vested interests who are prepared to criticise the programme but none of them have tried it! I have and many like me (we all compare notes on forums) and we are SO glad we did. I don’t care about lack of scientific evidence. I have living proof.