Ben Goldacre

“Paul Broca, for example, was a famous French craniologist in the nineteenth century whose name is given to Broca’s area, the part of the frontal lobe involved in the generation of speech (which is wiped out in many stroke victims). Among his other interests, Broca used to measure brains, and he was always rather perturbed by the fact that the German brains came out a hundred grams heavier than French brains. So he decided that other factors, such as overall body weight, should also be taken into account when measuring brain size: this explained the larger Germanic brains to his satisfaction. But for his prominent work on how men have larger brains than women, he didn’t make any such adjustments. Whether by accident or by design, it’s a kludge.”

“Like most things in the story the natural sciences can tell about the world, it’s all so beautiful, so gracefully simple, yet so rewardingly complex, so neatly connected—not to mention true—that I can’t even begin to imagine why anyone would ever want to believe some New Age ‘alternative’ nonsense instead. I would go so far as to say that even if we are all under the control of a benevolent God, and the whole of reality turns out to be down to some flaky spiritual ‘energy’ that only alternative therapists can truly harness, that’s still neither so interesting nor so graceful as the most basic stuff I was taught at school about how plants work.”

“If I was writing a lifestyle book it would have the same advice on every page, and you’d know it all already. Eat lots of fruit and vegetables, and live your whole life in every way as well as you can: exercise regularly as part of your daily routine, avoid obesity, don’t drink too much, don’t smoke, and don’t get distracted from the real, basic, simple causes of ill health. But as we will see, even these things are hard to do on your own, and in reality require wholesale social and political changes.”

“Two large trials of antioxidants were set up after Peto’s paper (which rather gives the lie to nutritionists’ claims that vitamins are never studied because they cannot be patented: in fact there have been a great many such trials, although the food supplement industry, estimated by one report to be worth over $50 billion globally, rarely deigns to fund them). One was in Finland, where 30,000 participants at high risk of lung cancer were recruited, and randomised to receive either ß-carotene, vitamin E, or both, or neither. Not only were there more lung cancers among the people receiving the supposedly protective ß-carotene supplements, compared with placebo, but this vitamin group also had more deaths overall, from both lung cancer and heart disease. The results of the other trial were almost worse. It was called the ‘Carotene and Retinol Efficacy Trial’, or ‘CARET’, in honour of the high p-carotene content of carrots. It’s interesting to note, while we’re here, that carrots were the source of one of the great disinformation coups of World War II, when the Germans couldn’t understand how our pilots could see their planes coming from huge distances, even in the dark. To stop them trying to work out if we’d invented anything clever like radar (which we had), the British instead started an elaborate and entirely made-up nutritionist rumour. Carotenes in carrots, they explained, are transported to the eye and converted to retinal, which is the molecule that detects light in the eye (this is basically true, and is a plausible mechanism, like those we’ve already dealt with): so, went the story, doubtless with much chortling behind their excellent RAF moustaches, we have been feeding our chaps huge plates of carrots, to jolly good effect. Anyway. Two groups of people at high risk of lung cancer were studied: smokers, and people who had been exposed to asbestos at work. Half were given 3-carotene and vitamin A, while the other half got placebo. Eighteen thousand participants were due to be recruited throughout its course, and the intention was that they would be followed up for an average of six years; but in fact the trial was terminated early, because it was considered unethical to continue it. Why? The people having the antioxidant tablets were 46 per cent more likely to die from lung cancer, and 17 per cent more likely to die of any cause,* than the people taking placebo pills. This is not news, hot off the presses: it happened well over a decade ago.”

“What can you do? There's the rub. The most important take-home message with diet and health is that anyone who ever expresses anything with certainty is basically wrong, because the evidence for cause and effect in this area is almost always weak and circumstantial, and changing an individual person's diet may not even be where the action is.”

“Nutritionists don't stop there, because they can't: they have to manufacture complication, to justify the existence of their profession. These new nutritionists have a major commercial problem with the evidence. There's nothing very professional or proprietary about 'Eat your greens,' so they have had to push things further. But unfortunately for them, the technical, confusing, overcomplicated, tinkering interventions that they promote - the enzymes, the exotic berries - are very frequently not supported by convincing evidence.”

“As it is a major component of blood, water is vital for transporting oxygen to the brain. Heaven forbid that your blood should dry out.”

“I'd like to submit to Bad Science my teacher who gave us a handout which says that 'Water is best absorbed by the body when provided in frequent small amounts.' What I want to know is this. If I drink too much in one go, will it leak out off my arsehole instead? Thank you. Anton.”

“I spend a lot of time talking to people who disagree with me - I would go so far as to say that it's my favourite leisure activity,”

“These corporations run our culture, and they riddle it with bullshit.”

“I think you'll find it's a bit more complicated than that.”

“…sometimes you need to be imaginative about what kinds of research you do, compromise and be driven by the questions that need answering, rather than the tools available to you.”

“In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement.”

“This process of professionalising the obvious fosters a sense of mystery around science, and health advice, which is unnecessary and destructive. More than anything, more than the unnecessary ownership of the obvious, it is disempowering.”

“Children can be disgusting, and often they can develop extraordinary talents, but I’m yet to meet any child who can stimulate his carotid arteries inside his ribcage.”

“Randomisation is not a new idea. It was first proposed in the seventeenth century by John Baptista van Helmont, a Belgian radical who challenged the academics of his day to test their treatments like blood-letting and purging (based on ‘theory’) against his own, which he said were based more on clinical experience: ‘Let us take out of the hospitals, out of the Camps, or from elsewhere, two hundred, or five hundred poor People, that have Fevers, Pleurisies, etc. Let us divide them into half, let us cast lots, that one half of them may fall to my share, and the other to yours … We shall see how many funerals both of us shall have.”

“We are talking about a programme which claims that ‘processed foods do not contain water’, possibly the single most rapidly falsifiable statement I’ve seen all week. What about soup?”

“You are a placebo responder. Your body plays tricks on your mind. You cannot be trusted.”

“And if, by the end [of this book], you reckon you might still disagree with me, then I offer you this: you'll still be wrong, but you'll be wrong with a lot more panache and flair than you could possibly manage right now.”

“Homeopathy pills are, after all, empty little sugar pills which seem to work, and so they embody [..] how we can be misled into thinking that any intervention is more effective than it really is.”

“You cannot reason people out of a position that they did not reason themselves into.”