Frontiers’ Bread Madness

The journal Frontiers in Human Neurosciences now published a paper titled: “Bread and Other Edible Agents of Mental Disease“. It is authored by two psychologists, Paola Bressan and Peter Kramer from the Department of General Psychology at University of Padova in Italy, and claims “in non-technical, plain English” that mental diseases such as schizophrenia and autism are caused by bread (yes, you read right, bread). In their “review article” Bressan and Kramer claim to provide evidence that bread gluten makes “holes in our gut”, thus activating an immune response, and is degraded into opioid substances (“some of them resemble morphine extremely much”). The casein in milk has allegedly exactly the same effect, and cure for “schizophrenia, bipolar disorder, depression, anxiety, and autism” is possible by adhering to a strict bread- and milk-free diet. In fact, other staple foods might make you mad as well, as authors conclude:

“Bread is the very symbol of food, and learning that it can threaten our mental wellbeing may come as a shock to many. Yet bread is not alone; like it, other foodstuffs, such as milk, rice, and corn, release exorphins during digestion”.

Though the paper appeared on March 29th, it was meant seriously and not as an April 1st joke.

As psychologists, Bressan and Kramer apparently feel fully qualified to address all possible aspects of biomedical sciences: microbiology and genetics, but also gastroenterology and immunology, like with their latest paper. In fact, the authors straight away postulate that it is the other sciences, the”gastroenterology, immunology, toxicology, and the nutrition and agricultural sciences” who are “outside of their competence and responsibility”. And the two Italian multispecialists came to their right journal: the Editor-in-Chief of Frontiers in Human Neurosciences, Hauke Heekeren, psychology professor at the Free University of Berlin, is very open to unconventional science by field-boundary defying colleagues. As I previously reported, Heekeren published in his Frontiers journal several research papers on parapsychology, where clairvoyance, mind-reading and life after death were dealt with as scientific facts. Now, when I attempted to phone Heekeren about the “bread makes mad” paper, he told me: “I have no interest in speaking with you”.

Also the handling editor Rajeev Krishnadas, consultant psychiatrist at the University of Glasgow did not reply to my email. His research follows a rather unconventional theory that inflammation is the cause of mental disorders like depression, a clinical trial is already scheduled. Krishnadas invited the “bread derangement” paper as part of a collection titled “Inflammation and the brain, in the context of mental health and illness“, where also a hypothesis paper by a US gynecologist appeared, claiming autism might be caused by the rubella virus. Luckily, not the vaccine against it, as Wakefield claimed.

But back to the bread lunacy. This Frontiers paper was spotted by the microbiologist Elisabeth Bik, research associate at the Stanford School of Medicine:

Bik then set on to batter the bready nonsense. She commented on my site:

In this paper, bread is presented as a food item that will cause damage to the intestinal lining in all people, not just people with gluten intolerance, eventually leading to mental health problems. This paper is presented as a Review, not a Hypothesis, suggesting that the statements of this papers are factual. Although an interesting hypothesis, this paper makes several ill-founded statements that lack citations or support. It also has a sensational and fear-evoking tone to it that does not belong in a scientific and peer-reviewed paper“.

Also, Bik shared her views on her microbiology blog, as Storify and on PubPeer. Among her detailed criticisms are:

  • The text is a mixture of true statements backed up by science, mixed with bible quotes, musings, speculations and gross extrapolations. It is very hard to tease apart where science ends and wild ideas start”.
  • “Several key statements in paper don’t have a citation. Eg “gluten is broken down into fragments some of which resemble morphine” – citation was needed here”
  • “One of the references is to an “Ancestral nutrition” YouTube video presentation from a conference – presumably not peer reviewed

Willem van Schaik, professor for medical microbiology at UMC Utrecht, reacted quite distinctly after learning of bread-induced psychosis:

The chemistry lecturer at University of Glasgow, Haralampos Moiras (aka Harry Miras) described the”bread makes mad” paper on Twitter as “bullshit”.

Finally, while Frontiers editors were convinced that two psychologists are fully qualified to do research on gastroenterology, immunology and nutrition, here is what some proper field specialists say.

Ole Haagen Nielsen is clinical professor at the University of Copenhagen (and one of the 31 former Frontiers medical editors who were sacked for their demand of editorial independence, as I reported).  Nielsen specialises in the molecular biology of inflammation  in patients with gastroenterological syndroms.  So, what the psychologists Bressan and Kramer claim to have studied in their leisure, is actually his very field of research. Nielsen judges:

When I read their article it appears as if they “bend the truth” into a direction that fits with their opinion. In recent years, there has been much focus on nonceliac gluten sensitivity (cf. article by A Fasano), but the delimitation to irritable bowel syndrome (a functional disorder) is rather difficult. […] Immediately, I believe that the text of Bressan & Kramers’ article seems tendentious or maybe the word “religious” is even more appropriate – and at the same time it is from your second mail [my hints to peer review issues, see below,- LS] questionable how Frontiers managed the editorial process prior to publication.

Today I am happy I left Frontiers a year ago“.

Michael Müller, professor of nutrigenomics and systems nutrition at the University of East Anglia, stated:

I am unfortunately not a real expert on this topic as I am a molecular nutrition/metabolism researcher but clearly have more expertise than these authors. The problem (and this is a scandal) that the topic is too complex and needs insider information to discuss it in such a review. These authors are no experts (food scientists, nutritionists) at all and therefore this paper should have been rejected. Most of the statements are nonsense and the references likely used in a very selective way. When I look at some of their other “papers” e.g. “Belief in God and in strong government as accidental cognitive by-products”  know enough. So from God to Bread……It is a shame for Frontiers but even for their own profession Psychology. I hoped that Human Neuroscience is a more exact science as exemplified in this Frontier article“.

Says “Nein!”: Bernd das Brot (Bernd the Bread), the sceptical German children TV character. Image source: KIKA.

Finally, also the peer review process of the “bread insanity” paper was heavily compromised by conflicts of interest (COI):

The reviewer declaring this strangely acceptable COI is  Paul Whiteley. Though he apparently has a PhD, he is not a scientist, neither academic nor even industrial, but commercially associated with an obscure group called “espa research” which claims to be researching “gluten- and/or casein-free diets for people with autism”.  Whitely also has other business interests in promoting bread-free diets to cure autism and has published in 2013 a Frontiers in Human Neuroscience review article, about treating autism through a gluten- and casein-free diet.

The other reviewer, Jessica Biesiekierski, postdoc at KU Leuven, published a controversial clinical study which claimed that “gluten may induce depression as a consequence of changes in brain serotonin, gluten exorphins or changes in gut microbiota“.

I attempted to engage an Associate Editor of an (unrelated) Frontiers journal, namely Rich Boden, lecturer at University of Plymouth, into commenting on editorial process and reviewer choice. Was Frontiers’ own peer review compromised, given the information from the reviewers’ Loop profiles? Boden denied this information was sufficient; the overall discussion was not at all productive, this is why I corrected the previous text version. Here are however some answers:

Good scientists on one side against bad scientists on the other? Maybe it is not that simple. One of the co-authors of the respectable 2015 Fasano et al study “Nonceliac Gluten Sensitivity” in Gastroenterology, which Bressan and Kramer were seemingly misinterpreting to support their wonky claims, was the Neapolitan Anna Sapone. She co-authored a 2011 paper in Hindawi  (a publisher I discuss together with Frontiers here), titled: “Autism Spectrum Disorders: Is Mesenchymal Stem Cell Personalized Therapy the Future?“. Yes , they did propose that “mesenchymal stem cell transplantation could offer a unique tool to provide better resolution for this disease”. Where is one to start at criticising this outrageously ill-informed and potentially highly dangerous nonsense?

Until the “bread madness” issue is objectively and competently resolved by Prof. Heekeren in Berlin and the highly qualified Frontiers journal managers in Lausanne, we all are probably best advised not to eat any bread or milk products. One is also safe to assume that the Italian researcher duo Bressan and Kramer are sustaining their sanity on a healthy diet of eggs, bacon, sausages and spam.

28 thoughts on “Frontiers’ Bread Madness

  1. So the conclusion is we should restrict ourselves to a diet of spam, spam, spam and spam, to avoid the dangers of these other products and ensure we maintain our full viking fitness? The spam industry has clearly missed a trick here by not branching out into the nutraceutical/homeopathy/quackery product line, though perhaps they don’t make duck-based products?

    Liked by 1 person

  2. It’s disturbing that a paper should be rejected based on the expertise of its authors. It’s the modern version of “ipse dixit”. What if papers were submitted anonymously? This paper contains a theory that most people seem to find very unlikely based on accepted theories and presents weak evidence at best. On the contents, it doesn’t stand, OK. But why always ask about the pedigree of the authors? If it were submitted by a humble patent office clerk, would you reject on that basis? A student? A Noble prize holder? Also, see the “antedisciplinary science” paper by Sean Eddy. Maybe some psychologists will educate themselves enough to find a real connection with nutrition. What’s wrong with that? A very weak paper allows people to blurt out their prejudices. I think we should judge a paper on its contents alone, and leave the turf wars out. This blog entry and comments do also that, but not exclusively, which weakens the overall message.

    Liked by 1 person

    1. Hello,
      academics enjoy research freedom, meaning they are free to research whatever they want. Of course they will be limited by funding which is awarded according to their publications in the relevant field. But these publications in turn should be evaluated and peer reviewed by proper field specialists, I hope you agree. Thus, if psychologists choose to prove themselves in gastroenterology, quantum physics, organic polymer chemistry or turbine engineering, they cannot expected to be given some slack and have their psychologists colleagues preside over the publishing process of such works. Their “amateurish” attempts must be handled at a field-related journal by a specialist editor and reviewed by qualified scientist peers from the appropriate field.
      This is why also this paper is problematic. Here, the journal’s scope is not really clear (it welcomes parapsychology research as well!), the EiC is a psychologist, the handling editor is a psychiatrist, one of the reviewers is not even a scientist, the suitability of the other reviewer is questionable as well. At no point was any gastroenterologist, immunologist, nutrition specialist or even a field-related neuroscientist invited to evaluate this publication. The two authors however can now use it to demonstrate their qualifications and obtain funding for just these very research fields.

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      1. Right now, science – “science”- seems to be a racket. Fraudulent, counterfeit coin passed off as real. But PubPeer and the open discussion that the internet has brought out, like here, is a radical change for the better. A revolushun!

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      2. A quick google search revealed that one of the reviewers (Biesiekierski) is in fact an active researcher in the area of gastrointestinal disorders.

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      3. I agree attempts at X should be reviewed in the X community, no discussion. I disagree the names and titles of the authors should matter.

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  3. “Yet bread is not alone; like it, other foodstuffs, such as milk, rice, and corn, release exorphins during digestion. Wheat, rice, and corn are the staples of over 4 billion people.”

    So, a majority of the human population is perpetually on the cusp of mental illness because of grains? Ah, well, I’ll be in good company when my mind goes (or is it already gone? darn evil toast with its odd faces). & They may want to rethink those gluten-free products that consist of rice and corn flour now that all grains are henceforth “toxic.” Spam and carrot loaf anyone?

    Liked by 1 person

  4. I think the problem of frontiers is they just care about money so everything depends on the quality of the editors that get to manage the journal and sadly this journal fell in the hands of psycologists. Butfor example I will stand behind frontiers in microbiology since the community is more serious and is heavily involved in its development. But I acknowledge that the continuous publishing of bullshit in other frontiers journals is a risk for the work that has been put by the community in other frontier journals.
    Disclaimer: I have published and review in/for frontiers in microbiology and I don’t consider psycology to be science just bullshiting (personal and very biased opinion and please don tell this to the 7 psicologists in my family)

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    1. Well Edgardo, I’m afraid that if you really think that psychology is not a science, then I really cannot have much trust in your judgment concerning Frontiers in Microbiology either…

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      1. If I may mediate here: psychology is a science (unlike theology, for obvious reasons), but it is a very discredited science, what with all these data manipulation and irreproducibility scandals. The blame here of course is not with the subject of psychology as such, but with its own scientists.

        Liked by 1 person

      2. I disagree: reproducibility is a problem for every life science at the moment. Just look at all the reports that pharmaceutical industries don’t want to use published academic research any more, because most of it doesn’t reproduce well or even at all. Psychology is the only field that has actually addressed this issue and has launched a large effort to try to reproduce findings. So it may SEEM that there is more irreproducibility in psychology, but that is mostly a result of the fact that psychologists have actually tried to tackle the problem. Data manipulation is something that unfortunately occurs in all fields, that is nothing specific to psychology. Yes, Diederik Stapel is a psychologist, but Olivier Voinnet is a botanist and we don’t dismiss all of botany for that reason either…

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      3. I am not sure what the definition of life science is, but it seems that the reproducibility crisis affects at least the social and bio-medical sciences, both the clinical and the fundamental sides. Shameless plug: I edit a modest microblog, scienceincrisis.info, trying to document the different aspects of the problem (flawed statistics, data manipulations, publication biases, weak reviewing, publishing industry interests, pharma interests etc) and the different fields affected. I am not sure physics is unaffected: the state of cosmology seems pretty dire these days, with a new ad hoc correction for each new observation (inflation, dark matter, dark energy). But it’s way over my head, so I don’t want to say something silly. I follow a number of people like Leonid going very deep on some aspects of the crisis, but I notice fewer looking at the larger picture.

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  5. I have started to read the paper and I am for example wondering why the authors do not provide insight in the current and past food pattern of Ethiopians. I also would like to ask readers of this blog post to provide me with some references which can back statements in the first sentence of the Introduction of this paper (“About 12,000 years ago, when the last ice age came to an end, the rapid change in climate decimated our traditional food sources, especially large game.”).

    Disclaimer. I am author of “Notes on the foraging behaviour of Eurasian Oystercatchers feeding on bread” (Wader Study Group Bulletin 121, 2014, 15-17, https://www.researchgate.net/publication/264234207 ). [“Abstract. I report the first documented records of free-living Eurasian Oystercatchers feeding on bread.”]

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  6. Here are some slides from a very recent Frontiers presentation ppt, used to recruit new editors. From this, it is clear that Frontiers Speciality Chief Editors (SCE) are always informed about current submissions and are free to interfere into the editorial process at certain stages. Also, Frontiers publisher office (or editorial office, as they call it, EOF) is supposed to be constantly doing quality control and COI checks.
    https://goo.gl/photos/aN9kdq4881aMQcKP9
    https://goo.gl/photos/Y3qHmSPK6x6p3fJKA

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  7. Snippets from an invitation from Frontiers to review a paper (note how reviewers are not paid, yet astronomical APCs are charged from authors, i.e., free labor). Why are professional scientists treated as pro bono slaves of the publishing world (and still have the pressure of having to complete this free labor in 10 days!)?

    “Dear Dr [redacted], You are invited to review the following manuscript submitted recently. Please, click the link to accept if this work falls within your area of expertise, you are interested and available to review the paper within 10 days, and have no conflict of interest [redacted]; otherwise, please click on the decline link.

    Note that, should you endorse publication after the review process, your name will be disclosed on the final publication. Read below for more information.

    Journal: [redacted]

    Information about the Frontiers Review

    The Frontiers peer-review is a collaborative process with a focus on objective criteria, efficiency and transparency.

    This includes that the reviewer’s identity is revealed at the end of the review process and you will be acknowledged for your work and contribution on the publication. Please note that you will remain anonymous throughout the entire review process. If irresolvable conflicts arise you may choose to withdraw from the review process and in such case you will remain anonymous. However, if the paper gets accepted for publication and no conflicts arose that led to your withdrawal, your contribution will be acknowledged on the publication.

    The Frontiers review process has unique features, including an interactive review stage, and a focus on objective criteria. To ensure an efficient review process please familiarize yourself with the Frontiers review guidelines: [redacted]

    Reviewers are obliged to keep all manuscript files confidential and to delete all records after completing the review process. The review reports are also confidential and may only be shared with the authors and the handling editor of the manuscript in the review forum. Posting of the review report publically is prohibited.”

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  8. Bressan and Kramer must have overdosed on bread. Now that I think about it, grains can get contaminated by ergot, whose alkaloids can produce interesting psychological states. Do you suppose that they had been ingesting ergot-infested rye bread while they were writing this nonsense? The funniest take on the “evil” grain quackery I’ve ever seen is at http://www.scribd.com/doc/115359242/WheatBelly-Diet-Dr-William-Davis-Ruled-a-Quack-Weight-Loss-Doctor-Lowcarb-Book-Author-now-considered-Health-Kook: “If someone is in an accident, the paramedics hook you up to an IV to save your life, in that clear bag is glucose. They don’t hook you up to a tube running to a lump of meat. In that Paramedics bag is glucose! That’s what saves and preserves your life. Carbs. Those are carbs in that IV bag. That’s what saves your life. They don’t squeeze a blob of yellow animal fat into your mouth, or shove a piece of bacon down your throat, medical professionals at a hospital save your entire life with a bag full of carbohydrates.”

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  9. Dear Leonid,

    I have noticed that there is at this blog post until now no rebuttal / response (etc.) from the authors and/or the reviewers and/or anyone from publisher Frontiers. I am wondering why this is the case, in particular because you wrote on Twitter: “Guess who blocked me on Twitter. @FrontiersIn! Here is why: https://forbetterscience.wordpress.com/?s=frontiers “.

    It is towards my opinion worrisome for Frontiers that this might indicate that Frontiers does not want to engage in a scientific debate / dialogue with critics about the scientific contents of this paper. Critics of publisher Frontiers might interprete such a behaviour of Frontiers as another piece of evidence that Jeffrey Beall was correct in his decision to put publisher Frontiers on his list with “potential, possible, or probable predatory scholarly open-access publishers” at https://scholarlyoa.com/publishers/

    I therefore propose that the authors (and/or the reviewers and/or anyone else from publisher Frontiers) will join the scientific dialogue at this blog post, for example by commenting on various statements of Elisabeth Bik at https://storify.com/eliesbik/problems-with-bread-and-mental-disease-paper

    I assume that the authors and reviewers are aware that almost all Ethiopians eat products (in particular injera) which are made from teff. I therefore invite the authors (reviewers etc.) to comment on statements of Elisabeth Bik about the global distribution of Schizophrenia in relation to the consumption of food made from wheat (please compare the situation in The Netherlands with the situation in Ethiopia, please also provide the readers of this blog post some insights about the situation in Indonesia).

    Disclaimer: I am living in The Netherlands and I have visited Ethiopia as a tourist for around one month in 2005.

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