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July 17, 2005

A New Dawn Revisited – PCOS and Inflammation

A New Dawn Revisited – PCOS and Inflammation

One of the objections I am getting to my previous post about Ian Stoakes, author of “A New Dawn” and his past as a scam artist, is that I haven’t read his books and so I don’t really know the information. Well, given my last post, I am certainly not going to spend $25 on them to find out, but I have been reading some other stuff about PCOS and inflammation that is of some interest to the issue.

From the other information provided on Mr. Stoakes’ website, it appears that he is making 3 premises:

1. PCOS is caused by inflammation.
2. That inflammation is caused by food.
3. Mr. Stoakes test can accurately test which foods cause the inflammation in each person.

The previous post certainly casts an awful lot of doubt on premise #3, but while we’re at it, let’s take a look at premise #1 – that PCOS is caused by inflammation.

Inflammation and PCOS is something that has been in a lot of research papers lately. In fact, these studies have found increased levels of inflammatory markers in women with PCOS.

Gonzalez F, Thusu K, Abdel-Rahman E, Prabhala A, Tomani M, Dandona P. Elevated serum levels of tumor necrosis factor alpha in normal-weight women with polycystic ovary syndrome. Metabolism 1999;48:437-41.
Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2001;86:2453-5.
Kelly CJ, Lyall H, Petrie JR, Gould GW, Connell JM, Rumley A, et al. A specific elevation in tissue plasminogen activator antigen in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2002;87:3287-90.
Atiomo WU, Bates SA, Condon JE, Shaw S, West JH, Prentice AG. The plasminogen activator system in women with polycystic ovary syndrome. Fertil Steril 1998;69:236-41.
Atiomo WU, Fox R, Condon JE, Shaw S, Friend J, Prentice AG, et al. Raised plasminogen activator inhibitor-1 (PAI-1) is not an independent risk factor in the polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf) 2000;52:487-92.

However, unlike what many seem to think, just because two things are related, doesn’t mean we can immediately assume that one causes another. While Mr. Stoakes and others who think inflammation is the cause of every disease on the planet might think that these studies prove that inflammation causes PCOS, there are in fact three possibilities:

1. Inflammation causes PCOS.
2. PCOS causes inflammation.
3. Some third problem (such as insulin resistance, for example) causes both inflammation and PCOS.

Lets take a look at another research paper on this subject and see what we can conclude.

Insulin resistance, insulin sensitization and inflammation in polycystic ovarian syndrome
Year : 2004 | Volume : 50 | Issue : 2 | Page : 140-144

Dhindsa G, Bhatia R, Dhindsa M, Bhatia Vishal
Department of Internal Medicine, State University of New York, Buffalo, NY, USA

Thiazolidinediones have been shown to decrease inflammation in obese and diabetic subjects.[74],[75],[76] TZDs have also been shown to reduce carotid intimal medial thickness, normalize vascular endothelial function and improve fibrinolytic and coagulation parameters.[77] Rosiglitazone therapy for 26 weeks reduced MMP-9 (a matrix metalloproteinase, implicated in atherosclerotic plaque rupture) and C-RP levels in type 2 diabetics.[78] In studies in PCOS women, Troglitazone reduced PAI-1 levels[53] and improved endothelial-dependent vasodilation.[79] It is possible that the beneficial effect of TZDs in PCOS may be partly due to the decrease in inflammation. Metformin has also been shown to decrease PAI-1 and C-RP levels in PCOS women.[80],[81]

So, to summarize in non-medical jargon, patients with PCOS (as well as obese patients and patients with diabetes) were treated with insulin sensetizers such as metformin and subsequently had their inflammatory markers decrease. This seems to imply that insulin resistance causes inflammation. If instead, as Mr. Stoakes implies, inflammation caused insulin resistance, treating the insulin resistance would not improve inflammation.

In fact, research is beginning to suggest that this inflammation is what contributes to the greater incidence of cardiovascular disease in patients with insulin resistance.

So Mr. Stoakes first and third premises really have no legs to stand on, unless of course there’s some secret research papers about PCOS and inflammation he will only give to people who pay him. I’m not feeling particularly confident about his second as he certainly hasn’t proven himself capable of logical scientific interpretation.

He has perpetrated scams in the past. They ban anyone from their forum who mentions Mr. Stoakes' past or asks too many insistant questions. He avoids giving direct answers to technical questions. People have told me privately in email about high-pressure sales techniques. I’ve also heard that he offers to perform tests for free to those who are able to convince others to buy the test. One of his associates even made a half-hearted attempt to threaten me with legal action.

What possible reason would I have to waste my time and money on his book? What reason would anyone have?

Posted by illuminaria at 11:32 PM | Comments (1)

July 11, 2005

A New Dawn or An Old Scam?

For the last several months Ian Stokes and some of his supporters have been posting on Polycystic Ovarian Syndrome websites about his book “A New Dawn.” The book claims that PCOS is caused by allergies to certain foods which lead to inflammation and disease, and that it is possible to cure PCOS, as well as a number of other diseases, by finding out which foods a person is allergic to and removing them from the diet.

This process can be carried out by an elimination diet (which Ian does not recommend) or a $1500 blood test. (Of course no one was told about the test until after they already spent $25 on the book.)

I have looked around his website. He references no research papers that either discuss the issue of whether or not PCOS is caused by inflammation, or the issue of whether this inflammation is caused by allergies to certain foods. (In fact, nearly half of the articles referenced in his PCOS article are from dental journals that discuss a disease that causes inflammation of the gums.) He also provides no information about his credentials, his research, the test name, or the technical process whereby food allergies are found.

After spending a few hours searching the web, I happened upon some interesting information. In an article in the July 1998 issue of Positive Health Magazine, this information about Ian Stoakes appeared. (All the many misspelled words were left as they were.)

Ian Stoakes trained as a teaccher, concentrating on behaviourally disturbed children. After running a unit for mentally handicapped children he was employed by the Home Office as principal of a secure unit. He has worked for a number of charities, primarily involved with children and nutrition. He was Chief Executive of the Dietary Research Foundation, which conducted research into the relationship between nutrition and intelligence. He is now Chief Executive of NuTron Analytical Limited.

A teacher, not a doctor. Now that’s certainly sounds like someone I’d trust to give me expensive medial advice without a single iota of pertinent backup research.

The article itself, of which only an abstract is available, discusses a blood test that detects which foods cause an inflammatory response.

Partially digested food particulates can adhere to the gut wall and, when sufficient amounts gather, they can be absorbed through the cells of the gut and into the blood stream. Once in the blood stream a food particle can be carried to any organ or tissue, anywhere in the body, hence the wide spectrum of inflammatory conditions that can be attributed to food intolerance. These include: Migraine, Acne, Hayfever, Psoriasis and Eczema, IBS and Crohn's disease, PMS, Glue Ear and Hyperactivity.

The food particulates in the blood are marked for immune response and the first cell to react is the neutrophil. This cell is recognised as producing more than fifty different inflammatory chemicals and is able to produce a wide range of subtle responses. The neutrophil's responses can be so fast and so subtle and the cell itself is so small that responses are very difficult to measure.

The NuTron Test uses a haematology analyser to assess the degree and nature of neutrophil response in blood incubated with reconstituted food samples. It is thus possible to detect foods that produce a neutrophil response and to construct a diet that avoids them.

Ian's current explanation for the test sounds pretty much exactly the same.

The automated hematology analyzer is employed to interogate a blood sample that has been incubated with food and to compare it to a control sample i.e. a sample from the same person that has not been exposed to a food extract.

The state of the cells are carefully checked for sign of activation, the platelets are checked for activation, too. In this way, it possible to build up a picture of the response that will occur if the food is eaten.

Let’s just forget, for the moment, the questions of whether or not food particles (as opposed to more basic nutritional building blocks) really pass through the gut wall and float around in the blood stream. Let’s also forget about the question of whether or not a hematology analyzer can really detect the “fifty different inflammatory chemicals.”

Instead, let’s just do a search on the internet for “NuTron.”

Several articles from the Health Watch newsletter, as well as a blog article show up. Let’s look at this one.

"Don't be tempted by the Nutron diet - it’s a con," says Which? magazine (11/94). The £135 diet is provided by the Individual Diet Company, which tests your blood and devises a personal food sheet for you. The sheet excludes foods to which it says you have an intolerance.

Which? investigated the company's claims by sending in two blood samples from the same person under different names. The company sent back two diet sheets. One listed 20 foods to avoid, the other listed 12 to avoid - there were only five foods in common to both lists.

More dangerously, the company failed to notice that the investigator was intolerant to gluten and similar proteins because of coeliac disease.

In fact, Nutron listed gluten as safe to eat. It told Which? when challenged that the test could not be expected to pick up a gluten allergy.

The company also did not tell the sufferer to avoid rye, wheat and oats, all of which must be avoided in this condition.

Nutron claims that its diet will help solve problems from irritable bowel syndrome to obesity.

Experts told Which? that the diet may lead to loss of weight simply because it bans a lot of calorie-high foods.

The other articles say the same thing. This isn’t something I’d advise anyone to spend $25 on, let alone $1500 on. (Besides, other scam artists, apparently old associates of Ian Stoakes, will provide the same useless thing for half the price elsewhere.)

Of course supporters say "oh, there's naysayers everywhere." Yeah. Uh-hu. That sounds like a great excuse for sending back two very different reports on two blood samples for the same person. Hey - who needs repeatability? Certainly not valid scientific health care procedures or anything.

I must admit the only thing that really surprised me about this was how old the scam really was. I certainly wasn’t surprised that it really was a scam – it had all the hallmarks including, but not limited to, a refusal to discuss the credentials of the writer, a refusal to provide research supporting his claims, paranoid accusations of the money driven pharmaceutical industry and doctors hiding the information, claims that the only reason that hadn’t published research was a lack of money, calls to “take control of your own health” by trying this expensive and unproven technique, escalating costs as people are drawn in, personal attacks on people voicing skepticism, and a supposition that it’s up to skeptics to prove them wrong rather than up to them to prove themselves right.

Instead we were expected to believe this miraculous cure merely on the basis of a few testimonials. Testimonials are all well and good, but they don’t prove anything: only carefully controlled double blind placebo research does and I have a hard time beliving that after over 10 years they haven't managed to scrounge together enough money for a study. The people testifying to the success of the program could be lying, or they could not. But either way their weight loss and other successes are mostly likely due to the placebo effect or the result of going on a very restrictive diet, rather than a result of avoiding an allergy to lettuce.

I don't care if one person or one million people swear by this method, that doesn't provide a lick of proof to its efficacy. The number of positive newspaper articles containing glowing testimonials also mean nothing. Reporters are no more or less guilible than anyone else. (Thousands of people have also believed in the healing power of everything from arsenic to distilled water.) Indeed the proponents don't provide ANY proof and instead expect you to just take them on their word.

Check out the next post for what the research REALLY says about PCOS and inflammation, as well as more reasons why you shouldn't trust Ian Stoakes.

Posted by illuminaria at 03:26 AM | Comments (4)