Bad science Medicine Quackery Skepticism/critical thinking

Paddison Program: Dietary quackery for rheumatoid arthritis

Clint Paddison is an Australian comedian with a science degree who developed rheumatoid arthritis at age 31. He now claims to have controlled it with a diet he developed to alter the gut microbiome. How plausible is his story, and does his “Paddison Program” work? Answer: Not very and almost certainly no.

If there’s one thing about blogging, day in and day out, over the course of fourteen and a half years, it’s that sometimes you get stuck for a topic. Back in my early days at my not-so-super-secret other blog, I used to be so obsessive that when that happened I’d find something—anything!—to write about, even the end result ended up being not so good. These days, I’ve mellowed considerably. If I don’t have a topic over there on a given day, I don’t sweat it and instead let the topics come to me. Unfortunately, Science-Based Medicine is different. I’m the editor; I’m scheduled every Monday. Writer’s block is not permitted. Usually it’s not a problem, as I have an idea by Friday or Saturday and my post written by Saturday night or Sunday morning, but yesterday morning arrived, and I had no idea what I was going to write about. Then I saw this about something called the Paddison Program:

It was almost like firing up the Bat Signal!

Even better, the Paddison Program is a treatment that I don’t recall ever having discussed. A search of SBM and my not-so-secret-other blog turned up no mention of this treatment for rheumatoid arthritis (RA). Google searches turned up nothing but the Paddison Program website and lots of laudatory material about the program. So there it was, a dubious-sounding dietary treatment for RA that I hadn’t heard of before and about which there appeared to be very little, if any skeptical material available on the web. Perfect! Let’s take a look!

The Paddison Program

If you peruse the Paddison Program website, you’ll immediately find a number of red flags for quackery. The site urges readers to “Get Fast And Dramatic Rheumatoid Arthritis Relief With A Proven Step-By-Step System That Is Recommended By Health Professionals”. The entry page for the website is festooned with little other than testimonials. Clicking on the Get The Paddison Program Now leads to a page urging:

Reverse Rheumatoid Arthritis Symptoms With The Paddison Program And Get Your Life Back.

Join over 10,000 others and have less joint pain, less swelling, more mobility and more energy with this unique program.

There’s also a video of a TEDx Talk by Clint Paddison, the inventor of the Paddison Program. (More on that later.) In addition, there are more testimonials. This time the testimonials go further, with people claiming that the Paddison Program allowed them to get off their methotrexate, sulfasalazine, prednisone, and Humira (adalimumab) for their RA, ankylosing spondylitis, etc. Even worse, there are testimonials from physicians, one of whose name I recognized, Dr. Michael Klaper. You might remember him as Penn Jillette’s water fast guru, and his big thing is to advocate vegan diets and extreme fasting as a treatment for, well, almost everything. As for the others, predictably, they ranged from “integrative medicine” quacks (e.g., Dr. Nina Malek, who’s on faculty at the University of Arizona working for Dr. Andrew Weil) to physicians pushing fad diets (Dr. John McDougall and Dr. Monica Aggarwal) to a “chiropractic neurologist” (Dr. Richard Matthews) who specializes in chronic Lyme disease and “brain fog” and appears to be heavily into unproven treatments based on the “gut microbiome.” (Watching his video was painful.)

It gets worse. The Paddison Program website also features glowing recommendations by naturopaths and other chiropractors. Meanwhile, it states:

The standard approach from Rheumatologists is to ‘hit the disease as hard as possible’ with dangerous pharmaceutical drugs that can have side effects that are as bad as the disease itself.

Whilst we must keep the inflammation as low as possible, we should also be addressing the underlying cause so as to stop the disease progression.

This is done by healing the gut (more on this below).

As if the numerous patient testimonials and recommendations by integrative medicine doctors, naturopaths, chiropractors, and purveyors of fad diets weren’t enough in the way of red flags for quackery, we’re now seeing the claim of “addressing the underlying cause” of a disease that is not the underlying cause (as you will see) and the inflammatory (if you’ll excuse the word—I couldn’t resist) characterization of how doctors do treat the disease. If you’re hearing echoes of how cancer quacks characterize cancer treatment as “cut, poison, burn,” you’re not alone. That’s the first thing I thought reading the website. I got the same vibe reading the next segment:

NSAID‘s (like Advil, Voltaren, Nurofen etc) cause digestive issues, quickly exacerbating RA. Taking these drugs usually worsens RA long term.

NSAID damage is so great that they are often accompanied by Proton Pump Inhibitors (PPI’s) which negative impact gut bacteria, cause more RA symptoms.

Clients on antibiotics for RA usually go backwards long term. I see these patients after treatment and they are some of the most difficult clients to help.

Prednisone is exceptionally bad for leaky gut, osteoporosis, vitamin D absorption and more. Long term use is both dangerous and results in worse RA symptoms.

Studies show that RA Sufferers have low levels of healthy bacteria and an overgrowth of pathogenic “unfriendly” bacteria. The more sever the bacterial overgrowth, the more severe your RA is. This bad bacteria, along with undigested food particles, can get into your bloodstream via a leaky gut. Your body sends in antibodies against these particles and creates circulating immune complexes which can get lodged in the joints triggering inflammation. Chronic acidosis, from poor dietary habits, lowers pH levels in the synovial tissue which promotes inflammation. Associated with RA sufferers is low stomach acid, resulting in undigested proteins. When undigested proteins enter the bloodstream the body can develop molecular mimicry, mistaking your own tissue’s proteins for those entering through the gut wall. Studies show that persons with RA have poor intestinal mucosal lining, often worse than that of people with intestinal disease, and some RA folks are lacking an epithelium altogether. This digestive disaster is exacerbated [sic] by low digestive enzymes, further promoting an under active, highly problematic digestive system that needs a massive overhaul.

Paddison even has a cutesy mnemonic for his program: BLAME (Bacteria, Leaky Gut, Acid, Mucosal Lining, Enzymes).

I’ll examine just what Mr. Paddison’s claims entail after I provide a brief primer on rheumatoid arthritis. Here’s his TEDx Talk video, which I will be discussing along the way:

Basically, the video above is Mr. Paddison’s story of his being diagnosed with RA, how it was treated, and how he came up with his protocol. The idea is that RA sufferers can take control of their disease through dietary interventions that alter their gut microbiota. Unfortunately, it’s the illusion of control.

Rheumatoid arthritis

Most readers of the blog probably know that rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints. Indeed, RA is the most common type of autoimmune arthritis. It affects more than 1.3 million Americans, about 75% of whom are women. The disease most often manifests itself between the ages of 30 and 50 but can start at any age. Classic symptoms include joint stiffness that is at its worst in the morning (which Mr. Paddington had and related in his talk, as you’ll see). This is in contrast to osteoarthritis, the stiffness and pain of which are usually not more pronounced in the morning. RA often improves with movement of the joints throughout the day. RA most commonly afflicts the joints of the hands, feet, wrists, elbows, knees and ankles, and the joint effect is usually symmetrical; i.e, if one ankle is affected usually the other will be too. Although there is a familial component, with a family history of RA being able to increase the risk of RA three to five times, most patients with RA do not have a family history. (In his video, Mr. Paddington makes a big deal of his not having a family history of RA, which means, really, little or nothing, contrary to his harping on it.)

Other signs and symptoms of RA include fever, loss of energy, loss of appetite, lumps known as rheumatoid nodules that grow beneath the skin in places such as the elbow and hands. Being an autoimmune disease, RA can affect many other organs besides the joints, including:

  • Kidneys
  • Skin
  • Liver
  • Neurological
  • Eyes
  • Lungs
  • Heart
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Blood vessels

RA is diagnosed by a combination of physical examination, radiological imaging, and blood tests. Blood tests include tests to look for specific antibodies, inflammation, and anemia. The most well-known of these is an antibody known as rheumatoid factor, which is found in about 80% of patients with RA in time, but as few as 30% when the arthritis starts. Antibodies to cyclic citrullinated peptides (anti-CCP, for short) are found in 60-70% of patients with RA. Erythrocyte sedimentation rate (ESR), a nonspecific indicator of inflammation, is often elevated as well. Some viral infections can cause symptoms that can be mistaken for RA, and false-positive blood tests can occur, so it’s important to be evaluated by a rheumatologist (which Mr. Paddington was).

RA is treated with a combination of drugs. Steroids are sometimes used initially because of their powerful nonspecific anti-inflammatory activity. The mainstay of RA treatment, though, consists of disease-modifying antirheumatic drugs, commonly abbreviated as DMARDs. Common DMARDs include methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine (Azulfidine). Gold and the antibiotics minocycline, azathioprine, and cyclosporine are also DMARDs, but are rarely prescribed for RA these days because of the advent of biological agents used for more severe disease or disease refractory to DMARDs. These include abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan, MabThera), sarilumab (Kevzara), and tocilizumab (Actemra), all monoclonal antibodies against proteins involved in the inflammation of RA. Usually, ultimately a combination of drugs, including nonsteroidal anti-inflammatory drugs (NSAIDS) are used to treat and control RA.

The concept of remission is important, too, because drug-free remission in RA is possible. It could also explain much of Mr. Paddison’s story. You see, Mr. Paddison came up with his protocol because he himself suffered from RA.

The goal in treating RA is to stop the inflammation and achieve remission, even better, drug-free remission.

Clint Paddison’s story versus science

In his TEDx Talk video, Mr. Paddison provides an engaging story of his RA diagnosis, symptoms, and treatment, describing how this led him to his protocol. Annoyingly, he talks about his “discoveries”, and how they might “provide hope” to others with this crippling disease. He begins by describing how, seven years ago, at the age of 31, he woke up with swelling in his fingers. (The talk is five years ago, which means that Mr. Paddison is now 43.) This happened a few times; so he went to see his GP, who examined him, ordered some blood tests, and diagnosed him with RA, referring him to a rheumatologist.

The rheumatologist, apparently, told Mr. Paddison that the standard approach to RA is to take drugs for the rest of your life. (I noticed immediately how Mr. Paddison led with that, given that it’s a standard talking point in alternative medicine testimonials.) The drug the rheumatologist wanted to start him on methotrexate, a DMARD, but he balked, noting, as I mentioned above, that no one in his family had had RA, plus that he was a young, fit guy, a runner, and more. He also noted that he had been working as a standup comedian (great qualification!), leading him to point out that he only worked a couple of nights a week and should be able to “work it out” on his own. Obviously, you and I see deadly hubris here, but apparently Mr. Paddison did not.

I will admit that the next part of the testimonial did surprise me a bit. Mr. Paddison describes going to see every naturopath, homeopath, Chinese herbalist, acupuncturist, and massage therapist that he could and being on up to ten supplements at a time. None of it worked, and his disease had progressed alarmingly after 18 months of this. One of his elbows had such limited range of motion that he needed surgery, a synovectomy, followed by six weeks of rehabilitation, to restore range of motion. His fingers were so swollen that he couldn’t close his hands into fists. He had chest pain that sounded like pulmonary involvement (pain with every breath), in his jaw, and in many other areas of his body, including his left knee, which had swollen enormously. So, yes, the quackery didn’t work.

I felt bad for Mr. Paddison, as he was in rough shape, but hopeful because he decided to go back to his rheumatologist, who put him on methotrexate, which he took for twelve months. Unfortunately, as is often the case, the methotrexate became less effective. The other problem Mr. Paddison had was that he wanted to have children but because methotrexate is mutagenic you can’t have children while on the drug and in fact have to wait six months. This is what inspired him to come up with his treatment. He also discussed how great he had been as an undergraduate science major. Specifically, he studied physics, and bragged about all the science awards he won (1st Class honours, The Macquarie Foundation Science Prize, Australian Institute of Physics prize, NSW Branch, and Semi-Finalist for Young Australian of the Year) and his one peer-reviewed publication, joking, “If I could do all that, I should be able to kick some rheumatoid butt.” Uh, no. Physics is a very different science than biology, and the skills are not necessarily transferrable. It’s also more hubris to think that you can succeed where generations of immunologists and rheumatologists had failed. I don’t care if, as he claims, Mr. Paddington really did spend the equivalent of a second university degree “studying” RA, especially when his research was guided by books by “the only two people who had ever recovered from this disease” and did it through diet.

Mr. Paddison claims that his great insight was what he calls the “cherry incident,” where he ate a bunch of unwashed cherries, got violently ill for 24 hours, and felt much better, including his joint pain. It’s at this point where he got into all sorts of dietary woo, and related that he felt pain whenever he was full but no pain whenever he was empty. Ultimately, he ended up on a raw food diet, then reintroduced some cooked vegetables. He showed a picture of his left hand before and after, claiming there was nothing wrong with his hand in the “after” photo. I’ll admit that the “after” image looks much better, but his middle finger’s proximal interphalangeal joint still looked quite swollen to me.

Now here’s the kicker. He did this for 24 months, during which time he was still taking methotrexate. As he felt better, eventually he got off of his methotrexate. As an aside, one thing I don’t understand at this point is why the rheumatologist apparently never added another drug or switched Mr. Paddington to a biological agent if he was really doing as poorly as he described at the point right before his “cherry incident”. Something sounds a bit fishy in the story there. Normally what you do when one drug isn’t working as well any more is to add or switch to another.

In any event, let’s move on to BLAME-ing the microbiome.

BLAME the microbiome and diet!

Mr. Paddison came up with his BLAME concept based on his experience. It’s very much a “just-so” story to explain how changes in gut microbiome can lead to damage to the intestinal mucosa, which in turn can lead to “leaky gut“, which leads to antigens getting into the bloodstream undigested, which leads to their triggering autoimmunity through molecular mimicry. Similarly, decreased stomach acid contributes, as do decreases in digestive enzymes, because both contribute to proteins making it to the intestine less digested. It all sounds so reasonable, but is there any evidence?

In a word, sort of. Basically what Mr. Paddison is doing is what so many other alternative medicine and diet mavens do. He’s taking correlative data that hasn’t been firmed up and definitively shown to be part of the pathophysiology of a disease, and extrapolating wildly based on it. For instance, research has been published showing differences in gut microbiota between RA patients and normal controls associated with disease and duration. However, there doesn’t appear (yet) to be good evidence that these are not epiphenomena, that they are causative. More importantly, there isn’t a lot of evidence that dietary interventions to alter the symptoms, pathology, or clinical course of RA. In fact, there’s almost no such evidence that I could find. There’s a study here and there suggesting that specific foods or nutrients affect symptoms. Most are observational or negative. In other words, although it’s certainly possible that the gut microbiome affects RA risk and progression and that dietary manipulation might be a useful adjunct treatment, most of what we know now is preliminary and speculative. Indeed, in this recent review, the microbiome is mentioned, but not as a critical new target for intervention.

None of that, of course, stops Mr. Paddison from building a veritable empire selling his dietary intervention program for RA. He hasn’t, as far as I can tell, published anything in the peer-reviewed medical literature on his program, or verified that his intervention has any significant effect on the gut microbiome at all. All he has are anecdotes. Sure, it’s not unreasonable that decreasing stress would be good for RA symptoms. Sure, it’s possible that dietary interventions might have an effect on the disease symptoms and progression. Unfortunately, Mr. Paddison has done none of the hard work to show any of this. He thinks he has, but he hasn’t. Yet, none of this stops him from selling unproven interventions to desperate patients, even though he is not a physician.

How do I explain Mr. Paddison’s recovery, though?

RA remission: Not as uncommon as you think

The first thing that struck me about Mr. Paddison’s story is how long it was. He spent 18 months after his diagnosis pursuing quackery. He spent twelve months on methotrexate before deciding he had to try something different, and it was two years after that before he got off of his methotrexate. All told, that’s four and a half years, by my estimation, three of which he was on a DMARD, methotrexate. During that time, despite Mr. Paddison’s claims of how poorly he was doing, his rheumatologist never switched drugs, which is very odd if he really was doing so poorly on just methotrexate. Again, most RA patients require more than one DMARD; if Mr. Paddison was doing reasonably well on just methotrexate, it suggests milder disease. Of course, we don’t know why he was never switched to another drug. Maybe he refused. On the other hand, if he was so afraid of methotrexate’s effects on his sperm, you’d think that he would have jumped at the chance to try a different drug.

What I suspect is that Mr. Paddison was fortunate enough to go into remission and that his diet probably had little or nothing to do with it. Indeed, a 2017 review article states, notes that “with new treatment strategies drug-free sustained remission is becoming an achievable goal”. It also cited several studies, dating back to the 1990s, that show that drug-free remissions are not uncommon in disease that is successfully managed with DMARDs:

Once a good response on DMARDs and stable remission are achieved, the treatment could be tapered; and once remission is further sustained, the treatment could be stopped.9 Drug-free remission has been described in several patient groups which supports that drug-free remission could truly be achieved. The approach of benefit/risk assessment of continuation or stopping DMARDs was examined as early as the 1990s in a double-blind placebo-controlled study.10 In this study, RA patients with a good long-term therapeutic response, after median duration of DMARD therapy of 5 years, were randomized to continue therapy, n = 142, or to receive placebo, n = 143. At 52 weeks of follow up, as many as 62% of the patients who were randomized to placebo and 78% of the patients who were randomized to continue therapy did not have a flare, defined as recurrence of synovitis. Side-effects that necessitated dose reduction or discontinuation occurred equally in each group.

This sounds not unlike Mr. Paddison, who was on his methotrexate three years, at which point he appeared to be in remission. Given that he reported that he wasn’t getting better on methotrexate, another possibility is that he might have undergone spontaneous remission, as described in this review:

Spontaneous remission is not uncommon in patients who present with very early arthritis, some of whom may meet criteria for RA over less than a few months. Spontaneous remission is thought of as a “natural remission,” in which disease activity essentially disappears, and medications are no longer required. Spontaneous remission may be seen in 13% to 55% of individuals presenting with undifferentiated arthritis, probably as a result of different underlying etiologies, such as a transient viral infection [32]. About one third of patients with undifferentiated arthritis go on to develop RA. In a study of three cohorts of recent-onset undifferentiated arthritis from the United Kingdom, Germany, and the Netherlands, the severity of morning stiffness and presence of autoantibodies were the strongest predictors of progression to RA [33]. Spontaneous remission can be seen not only in early undifferentiated arthritis but in RA pregnancy and juvenile idiopathic arthritis (JIA) as well.

So, what’s more likely, that Mr. Paddison cured his RA with a diet that altered his microbiome, a diet that he stumbled across through trial and error, or that he was fortunate enough to undergo remission? Barring compelling evidence, I vote for the latter, but leave open the possibility of the former, although I consider that possibility to be highly unlikely.

What Clint Paddison is really selling

Chronic disease is frustrating. Aside from the symptoms and the impact on quality of life, the patient suffering from a chronic disease like RA suffers from a loss of control. What Clint Paddison is selling, above all, is the same thing a lot of quacks sell: The illusion of control. I realized this when I came across this video:

In this video, a woman asks Paddison how she can eliminate random RA flares. Beginning at 0:45, Paddison goes on an extended discussion of why he never uses the term “flare”, because it implies something beyond the patient’s control. He defines a flare as meaning that a disease is out of our control, that it’s random, and that we can’t do anything about it. He then goes on to argue that RA is almost completely within the patient’s control and that “if we apply a consistent pattern of behavior with our foods—our exercises as well—our stress levels, and also supplementation, then we’re going to get the same outcome with our symptoms” and that “the disease responds to influences that are mostly and largely under our control.”

Holy hubris, Batman! No physician goes that far with almost any disease. Also note that the implication is that this woman is having flares because she’s not doing something right; in other words, her symptoms are her fault. It’s the common quack trope that the treatment doesn’t fail the patient, but the patient fails the treatment, and it’s despicable.

Unfortunately, for patients with a chronic disease like RA, that message of taking control is very seductive. Certainly, it’s that very idea of being able to control his disease himself, without the help of doctors, naturopaths, homeopaths, acupuncturists, etc., that led Mr. Paddison down the path to believing he had found the answer to RA when in reality his story of self-recovery due to his own treatment is dodgy at best when examined critically and his treatment is based on ideas that are speculative at best. If you’re an RA patient, run, don’t walk, from Clint Paddison. He was lucky, not good, and now, sadly, he appears to be descending into the role of charlatan. Stick with science-based treatment.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

61 replies on “Paddison Program: Dietary quackery for rheumatoid arthritis”

This is timely for me, as I was inflamed (sorry) by a couple of overwrought articles in the last couple of days linking diet to depression, featuring testimonials about how people tossed out their antidepressant meds once they ditched processed foods and other nasties and took to vegetable smoothies and similar healthy eats.

It’s not just chiros and naturopaths pushing this line – an article published yesterday had a microbiome researcher at Ohio State University doing the same thing.

“Joanie Delph used to eat doughnuts and pie and potato chips and store-bought cookies. And then she felt horrible. Not just her body, but her mind.

She would get this rush of sugar and then crash. And it caused her emotions to roil.

“Bread, sugar … even if I eat too much honey,” she said. “Within 40 or 60 minutes I am a raging, angry person. I have to understand that what I eat feeds certain moods.”

So after finding herself sick more than a decade ago — her problems ranged from liver damage and gallstones to numbness in her hands and feet, poor hearing and vision, and depression — she upended her life.

Delph started following Ayurveda, an ancient and holistic Hindu method of healing…
“The evidence is good that diet and mood are very much interactive,” said Janice Kiecolt-Glaser, a distinguished professor and director of the Institute for Behavioral Medicine Research at Ohio State University. “Bad diets promote bad moods.”

It all starts in the gut, she said…
Take, for example, inflammation. Studies have long linked inflammation in the body to depression. And now the link between food and inflammation is increasingly under study and perhaps being better appreciated, Kiecolt-Glaser said.

Virus and bacteria and fungi (the microbiome) live in our guts, and they help our bodies make vitamins and nutrients that we need.

The more diverse the bacteria are, the healthier we are, she said. So the things that are low in nutrients and bad for gut health (which is most of our common Western diet, such as red meat, excess caffeine and alcohol, processed foods, butter, dairy products, sugar) don’t improve that diversity, so our bodies don’t get the nutrients that make our neurotransmitters that control mood.

Bad diets (saturated fats, for example) can cause the intestine to leak. And when it leaks, bacteria flow into our bloodstream. That equals inflammation, and can equal poor mental health and depression.

As further evidence that food can affect mood and stress, just imagine a time when stress caused your insides to roll, leading to diarrhea or constipation, Kiecolt-Glaser said. If there’s a pathway from the brain to gut, then it only makes sense that there’s a pathway from the gut to the brain.”

It’s intriguing to think that depression is somehow an infectious disease (E. coli causes mood swings when it leaks out of your gut?) but I smell bullshit here, leaking out of what should be a rigorous research program.

Sounds to me like a massive case of correlation being equated to causation combined with terminal Dunning Kruger.

Oy. That’s taking “you are what you eat” a bit too far for my taste.

Eating a healthy diet, getting enough exercise and enough sleep will probably result in a happier, healthier person. But, if you’re depressed, doing those things can be close to impossible. I always laugh at the studies that say that exercise works as well as drugs for mild to moderate depression. They almost always fail to answer the question “How do you get a depressed person to exercise regularly?” We are talking people who can barely get out of bed in some cases.

Someone that depressed needs intervention. Medication and therapy are that intervention.

I’ve suffered from Major Depression; I recall what it’s like to not to want to get out of bed. Yeah, exercise DID help . . . a lot. But AFTER I started therapy and meds.

She would get this rush of sugar and then crash. And it caused her emotions to roil.

Insulin overshoot doesn’t seem like all that much to get excited about.


But, if you’re depressed, doing those things can be close to impossible.

Yup. Then again, it’s a lot easier to get moving if you don’t have a bed in the first place.

And what would (s)he say to those who eat properly (by this I mean a decent Mediterranean diet–not a buch of smoothies that often have 1000 calories or more–and still have depression, or whatever the mal de jour may be? I get really sick of these diet gurus assuming that everyone who has a complaint eats “doughnuts and pie and potato chips and store-bought cookies”–and that smoothies are the answer. (I know I’ve conflated a couple of things, but I think the overall point stands.)

Two of my kids and one grandkid (so far) have RA, and all told me that this “diet” has been brought to them more than once by well-meaning people. Happily, they’ve been well brought up and know better.

I’m on the program, and I’m doing it without paying anything as I have a strong science background educationally and professionally, and it’s working very well for me. I never took any RA drugs and saw improvements withing 48 hours, dramatic health improvements within weeks, and enduring improvements over the past seven months. I’m in it for the long haul and continue to read many research reports on PubMed and elsewhere, always looking for more information about anything related to my symptoms and what scientists have discovered.

This blog post looks like nothing more than cynicism and doesn’t demonstrate knowledge about the underlying science.

While you take credit for your progeny “knowing better,” this science professional urges you to learn more about the science before you make such comments. The science doesn’t care about how you “brought them up.” The science cares about results.

What you’re saying is that your grandkids don’t know squat about the program and rejected it out of hand, with your endorsement. Ignorance is bliss. I don’t mean that in an insulting way, despite the way it sounds. I mean that you’re congratulating yourself for endorsing your suffering grandkids for rejecting something that won’t hurt them and that science indicates will almost certainly help them–if they do it correctly.

Do you even realize how much science supports this program? You’re calling it a “diet,” but it’s much more than a diet. If I were you, I’d encourage them to learn about the science that supports this program. I’ve studied far more studies than Paddison cites, and, as he says, you have to work hard to individualize your program because everyone’s body is unique. It’s true. Some can eat white rice, and others can’t. Some can do Bikram yoga and others can walk twelve miles several times a week but can’t do Bikram yoga.

If you know how to read and understand scientific studies and if you do it, you’ll find that there is a great deal of knowledge supporting this program. All Clint has done is make it easier for even science-oriented people to get started and be successful before they’ve all the studies. Most people can’t understand the studies but can follow his program.

Your grandkids are losing an opportunity as they can follow the program while doing whatever their doctor is telling them to do and see improvements they are unlikely to see without the program.

if they do it correctly

Twice in one week. I’m waiting for the hat trick.

Ah, yes, the “individualization is difficult” trope beloved of quacks. It’s the quacks” “get out of jail free” card that lets them excuse never having done a proper randomized clinical trial and not being able to cite good evidence or to have to justify clear criteria (if they even have any) by which they “individualize” treatments.

Sorry, you’re not convincing.

‘If you do it correctly’ refers to the fact that this program advised a diet that is very hard to follow. I am just starting to follow it a bit (I am too afraid to jump right in). The hardest part of the diet is probably the ‘no oil’. I you’ll try anything that says ‘vegan’ I can guarantee you that 95% of the times, at least, there will still be oil in it. If you just go vegan you may think that that is already very healthy and it should be enough, but in that case you will not ‘do it correctly’. Also, there is an element of elimination and slowly allowing foods back in….I can imagine it will be easy to slip up there too.

Yes, even when they’re wrong, they can sometimes provide an entertaining performance filled with end-to-end nonsense. P.T. Barnum was another figure who was good at that.

TEDx is not the same as TED. TED talks get at least some amount of vetting and oversight. TEDx might as well be open-mic night at the local pub.

The guy who claimed he could attach a person’s head to a new body and was looking for a volunteer, even though he hadn’t gotten it to work in mice yet? TEDx.
A guy who claims that if you shake your hands 12 times in the sink you’ll only need one terrible public bathroom paper towel? TEDx.

Prof Arthur Benjamin on the importance of statistics over calculus for high school students? TED talk. (Also a great calculus professor, IMO.)

foolish physicist: Oh, absolutely. I think the “power positions” researcher was a TED as well?

My point was more, however bad TED is, TEDx is even less vetted.

Surely claims of guts leaking this that or the other thing into circulating blood can be quite readily verified, if they are real, by modern laboratory methods.. Of people such as Paddison wouldn’t have any hope of doing such work themselves and would need to convince real scientists with proper qualifications to conduct the testing.His claims bring to mind a certain (now apparently departed) commenter from hereabouts – whose “paper” was recently cited by someone commenting on a CBC article on allergy.

A lot of folks are referring to one researcher’s work,Fasano, who did some intestinal permeability work related to celiac disease, an autoimmune disease.

I believe some of the quacks are generalizing his findings pretty liberally. But there is a multi year study related to childhood diabetes, TEDDI, where one of the researchers mentioned they are starting to look at gut microbiome.

I did provide a link to one of his dozen papers in pubmed and a link to an article which provides an overview of some of his developments.

No, you did not. Try again. Also, the one from Physiology is old… try something more recent.

Correction… that was freaking old. Try something new and relevant.

Unfortunately, Paddison’s diet resembles the strongest foundations of woo:
— meds are dangerous
— diets and supplements work better and are safe.

A quick test for woo ( which resembles Orac’s test for aniti-vaxxers: ” Is any vaccine safe or acceptable to you?”)-

Are any meds safe or acceptable to you?
I’d be willing to bet that alties like Paddison or familiar woo-meisters would say none of extremely few ( maybe insulin, maybe
not) after all, if cancer, MS and gangrene can be cured by diet and exercise… (

AND obviously… Microbiome uber alles

He doesn’t say not take medication. He does cite published data about the known side effects, however. Where are you getting your info?

Ah, but he DOES make extravagant promises that he can get RA patients off of all their medication, which, given the existing science, is irresponsible at best, scammy at worst.

he was a young, fit guy, a runner, and more

Tell that to my neighbor, a runner who died of a heart attack at age 20.

There is an element of Protestant work ethic (or something like that, if you are not of that religious persuasion) to the thinking that living a “healthy” lifestyle (whatever that means) will ensure that you live a healthy life. The real world does not work that way. It can be tragic when it happens to somebody so young, but it happens. Life isn’t fair. Mr. Paddison seems not to have learned that lesson.

“The real world does not work that way.”

Yeah, science has pondered on for example, if I’m not mistaken, the idea that cancer could be due to “bad luck”

Vogelstein then stated:

“”Nous devons continuer à encourager le public à éviter des agents chimiques cancérogènes ou des modes de vie qui accroissent leur risque de développer des mutations cancéreuses””

Which translates as:

“We should continue to encourage the public to avoid carcinogenic chemical agents or lifestyles that raise their risks of developing cancer mutations”

Bwahahahah! So after these articles, the “rebuttals”, the “threat to public health” scare by conflicting couterintuitive yet scientific messages, the polemic, the “backpedalling” of Vogelstein lead him to say (almost) “Beware of chemicals and change your lifestyle!”. Hilarious: When scientists sound like quacks, seems like there is serious obfuscation of scientific work going on simply not to “mislead” the public. Makes you wonder what being mislead really means in this context.

And please don’t tell me I do not understand what the “debate” is about. Please…

Anyhow, I’ll go light up a cigarette: I know, I’m “pro-disease” and almost proud of it.

@Narad: “Correlation is not causation, but the Derangometer seems to have been turned up to 11 here.” It’s definitely causation: Not more than 2 comments means I have to condense my bitching in one single post instead of practicing “indirect confrontation”. It raises the likelihood that I go overboard, mechanically. Maybe you yearned for that? And yes, I already melted an ironymeter with my pseudonym. I also intend to melt the derangometer, but I wish I could have done it more progressively with “indirect confrontation”.

@Politicalguineapig: I wish I could have replied to your statement about “One Flew over the Cuckoo’s nest”, but I set my own limitations with respect to commenting. I’m sorry.

“Nothing that you’ve written suggests that you do.”

That’s counterfactual.

“So after these articles, the “rebuttals”, the “threat to public health” scare by conflicting couterintuitive yet scientific messages, the polemic, the “backpedalling” of Vogelstein lead him to say (almost) “Beware of chemicals and change your lifestyle!”.”

It clearly shows that I have read quite a lot about the polemic (though, yes, not that I understand it). The only thing in that statement that could construed as not understanding the topic is the scare quotes I used to mentions “rebuttals”. However, as quite a lot of the rebuttals are full of motivated thinking, the use of scare quotes remains justified.

With 2 comments per posts only, you cannot claim to be able to mind-read what I know or believe on the topic.

Nothing I’ve written suggests that I do not understand either. That even a bit more factual than your claim.

And the whole point of the post was not to debate Vogelstein’s scientific claims. It was to document the exciting adventures of his paper on the cognitive market.é_cognitif

“Le marché cognitif désigne l’espace dans lequel se diffusent hypothèses, croyances et explications implicites ou explicites du réel.”

“Cognitive market represents the sociological space on which propagates hypotheses, beliefs and explanations, implicit or explicit, of reality”.

Wait, if one has low stomach acid, what are the proton pump inhibitors for?

Its difficult to answer with logic, a position arrived at illogically.

foolish physicist:
re Elizabeth Holmes TED talk

No thanks, seeing half of the HBO film was bad enough

I did a lot of shouting at the screen for that. “That’s not how that works!” “You can’t do that!” “OMG they claimed to do that test?”

I think my MIL was pretty entertained.

I just read the book Bad Blood and am now slowly going through ABC’s six/seven part podcast about it, “Dropout.” The book was a slog in its first half because it is setting up the scenario. The rest is actually quite riveting.

Some of that is how they tried to avoid the FDA, including trying to use the military as a runaround. Only being stopped by actual military folk who went by the rules and refused to throw away science… despite what their commanding officer wished (that “officer” was for a short time part of Trump’s staff).

It is intriguing how they managed to bamboozle so many people. But she and her then boyfriend actually fired non-believers, and caused one eminent scientist to commit suicide.

It is a compelling story, though perhaps not through a documentary.

My boss has been reading Bad Blood and his primary comment was that it’s not technical enough (we don’t do blood testing per se, but we use a lot of the instruments and are generally familiar with how all this stuff should work).
My response was 1) the book is intended for the general public so it’s unlikely to be as technical as a bunch of scientists want and 2) maybe there isn’t any “technical” because it was so much smoke and mirrors.

I’m not saying that ( what I saw of) the show was bad but I found her Steve Jobs- cospla/y costuming and her manner intolerable.. There will be another version with comedian / mimic, Kate MacKinnon as her. .

( I’m watching Chernobyl – not as frightening**)

** joking of course

The guy who held the door open and his whole side is hemagoring seconds later; The guy they made to walk out and look into the core…. intense.

I wish that they would not leak only one episode a week out at a time. I wonder how historically accurate it is? I’m thinking it is pretty much accurate. For time considerations in a five hour series, they condensed the many scientists into the one but I think the story of subordinates not wanting to anger superiors, not telling the local people, locking them in thus containing the informatilon leaks to the rest of the world is probably pretty accurate.

It is funny (not funny haha but funny gay); there is a bit of buisness in tourism these days for taking people into the region today — sometimes, talking to residents who stayed.

disclaimer: I’m a big fanboy of the Shadow of Chernobyl games and in particular the S.T.A.L.K.E.R. Lost Alpha free release exploring all those towns.

Leaky gut, parasites in the gut, toxins -the alt health movement is fascinated by our digestive system. Funnily enough people in Restoration England also seemed to believed the gut was the root of all evil. Samuel Peeps writes about the use of “clysters”, in what seems to be a regular practice, one would retire for a day to allow the administration of enemas. I would guess that it did no more good then than now.

Side note: Peeps also had an annual celebration for the “cutting of the stone” where he would have a party to celebrate his surviving the surgical removal of a kidney stone.

Yes, his name is pronounced ‘Peeps’ but I believe it is spelt ‘Pepys’. And I find it depressing that so many of the “remedies” proposed by quacks today were already old in Samuel Pepys’ day.

Oops, I actually read the (abridged) diaries so I should know his name! Although the naughty bits were left in his mixture of Latin and whatever so I had to guess what it was and where it was he put it. It is interesting that the alt health crowd believe that diet an a good enema can fix anything, the whole food = medicine thing which this blog has addressed before. If only it was that easy.

I’ve worked for a family for 35 years. As long as I have been there, the wife had RA; gold shots, prednisone, the works. She often suffered through bronchial infections but this last time (after starting methotrexate) she went down for the count within a year.

I had been hinting to (my employer) that cannabis controls all those symtoms and causes.

When I was in school, they told me that cannabis destroys the immune system. No. It MODERATES it so you are not reacting to every grain of pollen and cell in your body when your immuine system gets confused. 25 years I’ve been trying to ‘convert’ the old white guy/southern bel family. We buried her on aug 27, 2017 — the north american total eclipse.

And now I see this:

19.9 grams of flower/leaf is a misdemeaner in Florida. One drop of CBD is a felony. And yes, she rubbed it on the skin.

It sickens me.

I am struggling with the bit that Paddison is a comedian, an Australian stand-up comedian at that. Who takes medical advice from a comedian?

Probably the same people who buy all kinds of ‘health’ stuff from an actress, or something against eczema developped by a bricklayer.

Ahh but they can afford it because there’s this simple online trick that the millionaires don’t want you to find out about apparently.

It is irrelevant. He has RA (and there is lots of proof that this is true) so he knows a lot more than anybody else about RA from experience.

Well there is the old saying that a population gets the government it deserves, but besides NZ most of us haven’t done too great a job with our elected leaders. Although for sheer entertainment value, watching the antics going on in the USA beats most other countries hands down.?


Been reading the blog for a few years now to have also another view about topics that interest me about nutrition and other health related topics.

Been a a few years vegan before my Ankylosing Spondylitis diagnosis.

Try to base my nutrition and handling of the disease to “scientific” methods and diets. Unfortunately not a lot of double blind studies have been (or can be) done in nutritional science & life style changes as far as I understand it.

Ankylosing Spondylitis (NSAID) medicine helped me a lot in the beginning to mobilize me. As I was not able to walk for 500 meters. Tried a raw vegan diet. Inflammation markers got a little better, or maybe it was the NSAID medicine.
Tried also the Peddison Program, which is basically an elimination diet that is also used by allergy patients as far as I understand.
1 months into the diet and my inflammation markers (CRP & BSR) were absolutely normal again.

The interesting part is that I could get rid of the medicine and after 2-3 months I was feeling better than before the diagnosis.

I was also doing bunch of other “crazy” stuff (that at least had some publications) like, meditation & breathing (stress reduction) and cold showers (ice baths – Wim Hof Method), fasting and feeling really good since then.

Not doing the elimination diet that strictly anymore but still feeling great. If I eat specific foods in a “large” quantity like pizza or certain vegetables/fruits
or eat late into the night; I still get the AS symptoms, like elevated pain and a lot of night sweats. If I follow the the paddison guidlines, like not eating late, chewing a lot and eating a lot of salads with cooked meals together I do not have any symptoms.

I mean this is all anecdotal, could be luck or placebo effect or whatnot…
But reading a lot of other anecdotal stories from persons that reversed their symptoms with life style & nutrition changes and got of the RA or AS medicine.
Doing Marathons and even Ironmans.
There are also of course others, that are on conventional therapy, still take their medication and doing also that kind of sporting events (even a professional Ironman triathlete that uses Biopharmaceutical medication).

I would love to give a citation of landmark studies about nutrition and autoimmune diseases, but as far as I know there are none until now. Maybe some of you more educated folks (nutrition, immunology scientist & researcher) have some resources?

Here are some resources from the paddison program:

I have also a question about Oraks statement that fasting is depriving the body of nutrients and decreasing the immune system response in autoimmune related diseases.

My AS pain (at the vertebra & sacroiliac area) was gone after just 48h of fasting (eating only lettuce), can the body be deprived of a large quantity of nutrients that immune system will be less active and would not attack the joints?

And after a couple of marathons, I will compete at an Iron Man Race next week, wish me luck 🙂


PS: Here is the Interview that I did with Paddison if you someone is interested in more details:

PSS: And terribly sorry for my english writing skills, also grammerly does not want to work today…

I would advise each and every researcher/MD and the author of this article to take a quick dive memory lane to this history of H pylori. The medical community is not always quick to accept new knowledge, even with evidence. Further, lots of “black-box” uses of medications started with anecdotal experiences which lead to research and lead to FDA approved uses.

Nutritional science is difficult in the science community because it’s hard to standardize the experiment and control all the variables. There are other physicians (like Dr. Brooke Golder) who are having similar results. This article is just a repeat of the ignorance of science. Without evidence, it’s quackery. That’s not science.


Just a random medical scientist

Thank you Ben, random medical scientist! By the way I am a graduate student in philosophy of science, BSc in physics, and I have a good bullshit radar, but it didn’t go off with the Paddison project. On the contrary, I am trying it myself right now.

Want not to show off but completed the Ironman 70.3 (fasted 3 days before it) and 2 weeks later the 140.7 (fasted for 4 days before it) just with 3 months intensive training and a plant based whole food diet.
I think there is really something to it if you eat well, exercise and try to do stress management.
If researchers and doctors following this forum want to do some studies related to Ankylosing spondylitis, nutrition and endurance sports, I be more than willing to participate.

I am very skeptical of bullshit….but also an RA sufferer. I have been looking into the Paddison program for a while. What makes me enthusiastic about it is that 1. I recognize the not eating equals no pain story (the cherry story), in the sense that when I have a cold I eat very little and have no RA symptoms (NO PAIN, such a relief that I wondered if having a permanent cold would be a better option, and I am not the only one with that) next to that my rheumatologist looked at me like I was kinda nuts when I asked her about it….so that part of the story also resonated. 2. What he sells is not expensive. The cheapest package with the necessary info is about $70, i think, and that is one time. However, if you sign up for the mailing list you’ll get that info for free, just not as nicely ordered. He does not sell any treatment or medication that you have to keep buying. I have not bought anything but am already trying out part of his diet: oil free, plant based, no dairy and I do feel a difference (when I eat something bad, chips or so,…BANG there is the pain….it is quite remarkable…..and yes having control, even if it were a bit of control, is an enormous relief). Next to the diet he tells you to go to Bikram yoga, that is a large part of the method….he makes no money off of that. 3. The diet he prescibes is very hard….so it’s not an easy way out that is alluring, pills are easier…. if you have good health insurance that is…(I don’t at the moment so I am glad to find his diet). 4. He strongly advises to keep going to your rheumatologist and even if you don’t to keep having regular blood test…..hence, he does not claim to be the sole solution.
So…..there is little to lose for anybody who wants to try it and it’s no money making scheme.

I just read most of the comments and really you all sound as ridiculous as the scam doctors out there. You just blah blah blah about this without knowing anything about RA and getting your info about the Paddison program wrong. No, it is not just any ‘healthy’ diet, it is very specific, and no it is not a money making scheme ( you can get most of the program info for free and he doesn’t sell meds or treatment). I have RA and I’m gonna try it. I am not a health freak at all….I love fries, pizza, cheese, beer…..I hate sports…..I will have to give up my favorite food and start doing yoga every day….no, I do not look forward to it. The typical RA patient is not a health freak or anti vaxxer….anybody can get it and I think many will at some point try to look into solutions online. I dare you to read some random RA forums….it is full of all types of people who suffer, talk about their pain, their isolation, their handicaps and generally they are just lost.

Oh, I forgot a very important detail: they do not know why sulfasalazine works! My rheumatologist has repeatedly told me that. I also take plaquenil, which used to be a malaria drug but turned out to work for RA my rheumatologist told me and I heard ( i’m not on that one, partly because I love beer too much and sulfasalazine + plaquenil allows me to drink still) methotrexate started as a cancer drug. (I ask a lot when I’m visiting the doctor…). So…’s not as if the drugs are that much better backed by science…..they admittedly do not know what causes the disease and why their meds work.

I don’t want to fill up your comments section BUT here’s another thing to consider: RA medication causes the inflammation to disappear by disabling the immune system. …….which, although it may work against lasting damage from RA and the pain, will leave a person vulnerable to a whole bunch of other illnesses. It is a far from sophisticated method, to say the least. This is because they don’t know what causes the disease nor what causes thd immune system to attack perfectly good tissue.
The Paddison program aims to take away the cause of the inflammation, hence the immune system will remain fully intact.
This is another really good reason to give the program a try.

The Paddison Program has worked extremely well for me for rheumayou’d arthritis, ankylosing spondylitis, Sjogens Syndrome, chronic alleges and skin problems. It also led to a loss of all excess weight, pain, and most stiffness and digestive issues but I’m still in progress. I used no med when on thus program and must stay on it to maintain gains. However, going off the diet briefly and rarely does not cause as severe or lasting problems as it did in the beginning. I avoid going off the program as doing so eventually, within days, leads to a gradual return of symptoms. It’s a longterm healing program, even though you can get noticeable results quickly. It’s a commitment and hard work. Lots of people who try it never really comply with it and then decide it’s too hard or think it doesn’t work because they are sabotaging it with noncompliance. They will say, “I’m 80% on it,” which means they are not on the program. If you’re doing the diet only, you’re not on the program. If you do the diet but add meat and dairy, you’re not on the program. If you do the diet and exercise but fight with your family daily and smoke, you’re not o the program. So, it’s not for the noncompliant. Having said that, you can make mistakes and fix them as you learn more and adjust and succeed with this program. Just don’t keep making the same mistakes. Mental discipline matters. Ask yourself what the motivation of people who have not been on the program or who failed to follow it precisely might be in tearing it down when it works for others. It’s hard but worth it.

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