Sunday, May 25, 2008

Another medical ignoramus

When the specialists are talking garbage, what hope is there for the average person with a problem? News report below followed by an extended comment

REMOVING artificial colours and preservatives from the diets of children with ADHD should be considered a first-line treatment to reduce hyperactivity, a child allergy specialist says. Professor Andrew Kemp from the Children's Hospital at Westmead, in Sydney, said there was good scientific evidence that preservatives and colourings increased hyperactive behaviour. However, parents of children with attention deficit hyperactivity disorder (ADHD) were rarely encouraged to make dietary changes.

"Three main treatments are available for hyperactivity in children - drugs, behavioural therapy and dietary modification," Professor Kemp wrote in the British Medical Journal. "Interestingly, the use of drugs and dietary modification is supported by several trials, whereas behavioural therapy - which is presumably thought necessary for adequate treatment - has little or no scientifically based support."

He said eliminating colourings and preservatives was wrongly regarded by some as an "alternative treatment" rather than a standard treatment, like drugs, for ADHD. By contrast, Professor Kemp said, alternative medicines that were regarded with suspicion by many medical practitioners were used widely by up to half of ADHD families.

A recent trial in almost 300 British children without ADHD showed that eating a mixture of food additives, equivalent to that found in two 56g bags of lollies, significantly increased hyperactivity.

Professor Kemp said there was a strong case for trialling elimination in ADHD children given the evidence, the harmless nature of such intervention and the large numbers of children taking drugs for hyperactivity. Recent statistics from Western Australia show 2.4 per cent of that state's children had been prescribed stimulant drugs.


The fool seems to be hanging his hat on just a few studies -- ignoring the many studies that failed to find any effect. If a theory is popular and lots of studies are done, some will show an effect by chance alone. And even the "confirmatory" studies leave a lot to be desired. Let's look at one example of the amazing reasoning in such studies. I reproduce just 4 paragraphs:

Food additives are associated with symptoms of attention deficit hyperactivity disorder (ADHD), according to the results of a randomized trial published in the June issue of the Archives of Diseases in Childhood. The investigators suggest removing these from the diet of all children.

"There have been no population based studies examining the prevalence of hyperactivity related to intolerance to food additives following the initial claims of the detrimental effect of artificial additives on children's behaviour," write B. Bateman, from the University of Southampton in the U.K., and colleagues. "Subsequent studies, despite improved methodology, have failed to substantiate this claim or have only shown a small effect."

So they did a new study. The theory HAD to be proved. And they found?

During the withdrawal phase, there were significant reductions in hyperactive behavior. Based on parental reports, there were significantly greater increases in hyperactive behavior when children were given the drink containing additives than when given the placebo drink. The presence or absence of hyperactivity or of atopy did not influence these effects. There were no significant differences detected based on objective behavioral testing in the clinic by a tester blind to dietary status.

Study limitations include possible self-selection of families to take part in the food challenge, completion of all phases of the study by only 70% (277of 397) of those invited, and inability to demonstrate changes in hyperactivity on the basis of psychologist-administered tests. The authors recommend attempts at replication in other general population samples and extension of this study to older age groups.

They admitted the large limitations of their research and, on the most objective bit of evidence (in red above) that they had, they found (as did many studies before them) that there was NO EFFECT of the additives! Yet they still go on to make recommendations as if there had been an effect!

And note another revealing detail in the report: Kids with atopy (allergic tendencies) were NOT more likely to be affected by the additives! If anybody should have been, they should have been. But they were not.

An awful lot of medical research is just one big steaming heap of crap.

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