Dr Caroline Leaf and the matter of mind over genes

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I think I might have to throw away my genetics textbook.

I was always taught that genes were the main driver behind health and disease, and I always thought it was a pretty good theory.

But not according to Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, who said on her social media feeds today, “Our health is not controlled by genetics – our health is controlled by our mind.”

Taking her statement at face value, she appears to be saying that genes have nothing to do with our health. Dr Leaf has made some asinine statements in the past, but to suggest that genes are irrelevant to human health seemed so stupid that no one in their right mind would suggest such a thing.

Perhaps I was taking her statement the wrong way? I wanted to make sure I didn’t jump to any rash conclusions about Dr Leaf’s statement, so I pondered it at length. Could she be referring to ‘control’ in the absolute sense? How much control do genes have on our health? What about the mind?

After deliberating for a while, I still came to the conclusion that Dr Leaf’s statement was nonsense.

Unfortunately, Dr Leaf’s statement is, like so many of her previous Facebook memes, so vague as to be misleading. The meaning of ‘health’ and ‘controlled’ could be taken so many ways … which part of our health? How much regulation constitutes ‘control’? What about genetics?

Looking at her statement in more depth, it becomes clear that no matter which way Dr Leaf meant it, it’s still wrong. For example, all of human health is controlled, in part, by genetics. That’s because life itself is controlled by genetics. The human genome provides a blueprint for the construction of all of the proteins in all of the cells in our entire body. The expression of those genes determines exactly how our body will run. If the genes are wrong, if the translation of the gene code into a protein is wrong, or if too much or too little of a protein is made, all determines whether our body is functioning at its optimum level or not.

The stimulus for the expression of our genes is influenced by the environment in which we live. If I go out into the sun a lot, the UV light triggers my skin cells to make the protein melanin, which makes my skin go darker and helps to provide some protection against the damaging effects of the UV light.

While the environment plays a part of the expression of some genes, it’s wrong to say that genetics doesn’t control the process. If I go into the sun too much, I risk developing a melanoma, because the sun damages the genes in some of my skin cells, causing them to grow without control.

Genes are still responsible for the disease itself. Sometimes the trigger is from the environment, sometimes it’s not. There are some people with genes for melanoma who don’t need an environmental trigger, because they develop melanoma on skin that’s exposed to very little UV light, like the genital skin.

So fundamentally, even taking the environment into account, our health is controlled by our genetics.

The other part of Dr Leaf’s meme is also wrong. Our health is not controlled by our mind. Our genes are influenced by “the environment”, which according to the seminal paper by Ottman, “The environmental risk factor can be an exposure, either physical (e.g., radiation, temperature), chemical (e.g., polycyclic aromatic hydrocarbons), or biological (e.g., a virus); a behavior pattern (e.g., late age at first pregnancy); or a “life event” (e.g., job loss, injury). This is not intended as an exhaustive taxonomy of risk factors, but indicates as broad a definition as possible of environmental exposures.” [1]

Even if one considers the mind as part of the sub classification of “a behavior pattern”, it’s still pretty clear that most of the factors that make up our environment are not related to our mind at all but are related to the external world, of which we have minimal or no control over. Sure, we make choices, but our choices aren’t truly free. They’re constrained by the environment in which we find ourselves. In the same way, our mind may have some tiny influence on our health, but only insofar as our environment and our genes will allow.

When it all boils down, this meme of Dr Leaf’s is rested on her foundational presumption that our mind can control matter, a very strong theme throughout her most recent book [2], but which is still preposterous. Our thoughts are simply a function of our brain, which is in turn determined by the function of our nerve cells, which is in turn a function of our genes and their expression.

Our mind doesn’t control matter. Matter controls our mind.

I can keep my genetics textbooks after all.


  1. Ottman, R., Gene-environment interaction: definitions and study designs. Prev Med, 1996. 25(6): 764-70 http://www.ncbi.nlm.nih.gov/pubmed/8936580
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:

Dr Caroline Leaf and the genetic fluctuations falsehood

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While idling away on Facebook, as is my usual pass time, I came upon Dr Leaf’s Facebook feed. There were her usual self-indulgent holiday happy-snaps and another couple of Pinterest-style fluffy inspirational posts. Then this: “Our genetic makeup fluctuates by the minute based on what we are thinking and choosing”.

Dr Caroline Leaf is a South African born and trained, US based, communication pathologist. She also claims that she’s a cognitive neuroscientist. Given the quality of the posts on her social media pages recently, no one could ever take such a claim seriously.

To make sure we’re all clear about what she just said, I’m going to say it again: “Our genetic makeup fluctuates by the minute based on what we are thinking and choosing”. It was an astonishing, if not bewildering statement, especially coming from someone with a PhD level education. If Dr Leaf were a medical doctor and publically made a statement like that, her registration would be reconsidered.

The core of the statement, which pushes it so far beyond the boundaries of rational scientific thinking, is the phrase “Our genetic makeup fluctuates by the minute.”

DNA in our cells is like an old audio cassette tape. Audio cassette tape is a long magnetic stripe, storing the code which the tape player decodes as sound. DNA is a chemical string which has a sequence of “bases” off to the side. The full DNA molecule is made of two matching strings joined by chemical bonds between the bases (hence the name, “base pairs”). Depending on what the cell needs, it runs the DNA through a decoder to either copy it, or to ‘play’ it (i.e. using the information stored in the code to build new proteins).

Like the tape in an audio cassette, the code of the DNA is incredibly stable. The rate of DNA mutation is about 1 in 30 million base pairs [1]. DNA doesn’t ‘fluctuate’, (“rise and fall irregularly in number or amount” [2]). It’s not the stock market. The number of genes in each cell of my body does not rise or fall depending on whether I’m having a good hair day.

The other part of Dr Leaf’s statement, that our DNA “fluctuates … based on what we are thinking and choosing” is also scientific nonsense. The only way that your thoughts and choices are capable of inducing genetic mutations is if those thoughts or choices involve cigarette smoking or standing next to industrial sources of ionising radiation.

I think Dr Leaf is trying to say that our thoughts and choices can change our gene expression, which is the construction of new proteins from the instructions in the DNA code. However, gene expression has nothing to do with our thoughts and choices. IVF embryos are expressing genes like crazy as they grow from one cell to an embryo in just a petri dish. It doesn’t think or choose.

More often than not, our thoughts and our choices are the result of gene expression, not the cause of it. We don’t have any specific control over the process either. The process of genetic expression is dependant on a complex series of promoters and tags on the DNA, which are controlled by other proteins and DNA within the cell, not thought or choice.

The truth is that gene expression occurs moment-by-moment, regardless of what we think or don’t think, do or don’t do. Gene expression is simply DNA being read. Our genetic makeup, the DNA code, is stable. It does not fluctuate. There is no part of Dr Leaf’s statement that is scientifically accurate.

Ultimately, Dr Leaf continues on her pursuit of pseudoscience, an affront to the people who trust her to tell them the truth, and the God of all truth that she purportedly represents.


  1. Xue, Y., et al., Human Y chromosome base-substitution mutation rate measured by direct sequencing in a deep-rooting pedigree. Curr Biol, 2009. 19(17): 1453-7 doi: 10.1016/j.cub.2009.07.032
  2. Oxford Dictionary of English – 3rd Edition, 2010, Oxford University Press: Oxford, UK.

Dr Caroline Leaf and the genetic remodelling myth

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We are all slowly mutating!

Yep, it’s true. Not to the same extent as you might see in shows like X-Files or Dr Who, but still, our DNA is slowly accumulating permanent changes to the pattern of the genes that it contains. Thankfully, it’s only in science fiction that the mutations result in zombie apocalypse scenarios.

Dr Caroline Leaf is a Communication Pathologist and a self-titled cognitive neuroscientist. Still glowing from the unquestioning adulation of her faithful followers at the Switch On Your Brain conference last week, Dr Leaf has hit social media again. Most of her posts have been innocuous quotes that look borrowed from Pinterest, but today, Dr Leaf has ventured into the pseudoscientific again by claiming that, “Our genes are constantly being remodeled by our response to life’s experiences.”

Unless your response to life’s experiences is to stand next to an industrial microwave generator or live in a nuclear waste dump, Dr Leaf’s statement is pure fiction. Dr Leaf confuses the mutation of our genes with the expression of our genes.

The only way our genes actually change is through mutation. A mutation is a permanent change in the sequence of the DNA molecule. A genetic mutation is a permanent change in the DNA sequence that encodes a gene. DNA is constantly mutating, because of environmental damage, chemical degradation, genome instability and errors in DNA copying or repair [1: p97]. Still, the actual rate of DNA mutation is about 1 in 30 million base pairs [2]. So DNA is very stable, and changes for a number of reasons, only some of which are related to our external environment. And as I alluded to just before, slightly tongue-in-cheek, our responses are not the main contributor to these environmental influences, unless we deliberately expose ourselves to ionizing radiation or smoke cigarettes. Our DNA does not change because of our thought processes as Dr Leaf advocates [3].

What does change more readily is the expression of those genes. Gene expression is the cell machinery reading the genes and making the proteins that the genes encode. The genes are expressed to make the proteins needed for the cell to maintain its function. Which genes are expressed is dependant on the cell’s stage of development and the environment it finds itself in. For example, when the body encounters a high level of dietary iron, a series of steps activates a gene to promote the production of ferritin, a protein that helps to carry iron in the blood stream [1: p375-6]. Gene expression isn’t solely dependent on our environment though, because an embryo is expressing genes like crazy in order to make the proteins to build a human being, but the gene expression in an embryo is largely following a pre-determined time course, not the environment [4] (and certainly not because of responses to life’s experiences).

In summary, our genes are controlled by a myriad of different factors, nearly all of which have nothing to do with our responses or choices. Our genes are not changed by our choices or our responses. Our genes may be mutating, but God designed our cells with mechanisms to repair them. Our genes are not being remodelled by our responses. That’s the realm of science fiction.


  1. Strachan, T. and Read, A., Human Molecular Genetics. 4th ed. 2011, Garland Science, New York, USA:
  2. Xue, Y., et al., Human Y chromosome base-substitution mutation rate measured by direct sequencing in a deep-rooting pedigree. Curr Biol, 2009. 19(17): 1453-7 doi: 10.1016/j.cub.2009.07.032
  3. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:
  4. Ralston, A. and Shaw, K. Gene Expression Regulates Cell Differentiation. Nature Education, 2008. 1(1): 127; http://www.nature.com/scitable/topicpage/gene-expression-regulates-cell-differentiation-931

Like to read more about Dr Leaf’s teaching and how it compares to current science? Download the free eBook HOLD THAT THOUGHT, Reappraising The Work Of Dr Caroline Leaf

Dr Caroline Leaf – Contradicted by the latest research

This is my most popular post by far.  I truly appreciate the support and interest in this post, but I’ve discovered and documented a lot more about Dr Leaf’s ministry in the last two years.  I welcome you to read this post, but if you’d like a more current review of the ministry of Dr Caroline Leaf, a new and improved version is here:
Dr Caroline Leaf – Still Contradicted by the Latest Evidence, Scripture & Herself

* * * * *

Mr Mac Leaf, the husband of Dr Caroline Leaf, kindly took the time to respond to my series of posts on the teachings of Dr Leaf at Kings Christian Centre, on the Gold Coast, Australia, earlier this month. As I had intended, and as Mr Leaf requested, I published his  reply, complete and unabridged (here).

This blog is my reply.  It is heavily researched and thoroughly referenced.  I think it’s fair to say that while Dr Leaf draws her conclusions from some scientific documents, there is more than enough research that contradicts her statements and opinions.  I have only listed a small fraction, and only on some of the points she raised.

In fairness, the fields of neurology and neuroscience are vast and rapidly expanding, and it is impossible for one person to cover all of the literature on every subject.  This applies to myself and Dr Leaf.  However, I believe that the information I have read, and referenced from the latest peer-reviewed scholarly works, do not support Dr Leaf’s fundamental premises.  If I am correct, then the strength and validity of Dr Leaf’s published works should be called into question.

As before, I welcome any reply or rebuttal that Dr Leaf wishes to make, which I will publish in full if she requests.  In the interests of healthy public debate, and encouraging people to make their own informed decisions on the teachings of Dr Leaf, any comments regarding the response of Mr Leaf, Dr Leaf or myself, are welcome provided they are constructive.

This is a bit of a lengthy read, but I hope it is worthwhile.

Dear Mr Leaf,

Thank you very much for taking the time out to reply to some of the points raised in my blog.  I am more than happy to publish your response, and to publish any response you wish to make public.


I published my blog posts to open up discussion on the statements made by Dr Leaf at the two meetings that I attended at Kings Christian Centre on the Gold Coast.  As you rightly point out, people should be able to make informed decisions.  A robust discussion provides the information required for people to make an informed choice.  Any contributions to this discussion from either yourself or Dr Leaf would be most welcome.

I apologise if you interpreted my blogs as judgemental, or if you believe there are any misunderstandings.  You may or may not have read my final two paragraphs from the third post, in which I acknowledged that I may have misunderstood where she was coming from, but that I would welcome her response.  If there were any misunderstandings, it is likely because Dr Leaf did not make any attempt to reference any of the statements she made on the day.  You may argue that she was speaking to a lay audience, and referencing is therefore not necessary.  However, I have been to many workshops for the lay public by university professors, who have extensively referenced their information during their presentations.  A lay audience does not preclude providing references.  Rather, it augments the speakers authority and demonstrates the depth of their knowledge on the subject at hand.


It’s interesting that you feel the need to resort to defence by association, and Ad Hominem dismissal as your primary counter to the points I raised.

Can you clarify how attending the same university as Dr Christaan Barnard, or a Nobel laureate, endorses her arguments or precludes her from criticism?  I attended the University of Queensland where Professor Ian Frazer was based.  He developed the Human Papilloma Virus vaccine and was the 2006 Australian of the Year.  Does that association enhance my argument?

Can you also clarify why a reference from a colleague was preferred to letting Dr Leaf’s statements and conclusions speak for themselves?  Dr Amua-Quarshie’s CV is certainly very impressive, no doubt about that, although he doesn’t list the papers he’s published.  (I’m assuming that to hold the title of Adjunct Professor, he’s published peer-reviewed articles.  Is he willing to list them, for the record?)

Whatever his credentials, his endorsement means very little, since both Dr Leaf and Dr Amua-Quarshie would know from their experience in research that expert opinion is one of the lowest forms of evidence, second worst only to testimonials [1].  Further, both he and Dr Leaf are obviously close friends which introduces possible bias.  His endorsement is noteworthy, but it can not validate every statement made by Dr Leaf.  Her statements should stand up on their own through the rigors of critical analysis.

On the subject of evidence, disparaging your critics is not a substitute for answering their criticism.  Your statement, “By your comments it is obvious that you have not kept up to date with the latest Scientific research” is an assumption that is somewhat arrogant, and ironic since Dr Leaf is content to use superseded references dating back to 1979 to justify her current hypotheses.


In the blog to which you referred, Dr Leaf makes a number of statements that are intended to support her case.  These include the following.

“A study by the American Medical Association found that stress is a factor in 75% of all illnesses and diseases that people suffer from today.”  She fails to reference this study.

“The association between stress and disease is a colossal 85% (Dr Brian Luke Seaward).”   But again, she fails to reference the quote.

“The International Agency for Research on Cancer and the World Health Organization has concluded that 80% of cancers are due to lifestyles and are not genetic, and they say this is a conservative number (Cancer statistics and views of causes Science News Vol.115, No 2 (Jan.13 1979), p.23).”  It’s good that she provides a reference to her statement.  However, referencing a journal on genetics from 1979 is the equivalent of attempting to use the land-speed record from 1979 to justify your current preference of car.  The technology has advanced significantly, and genetic discoveries are lightyears ahead of where they were more than three decades ago.

“According to Dr Bruce Lipton (The Biology of Belief, 2008), gene disorders like Huntington’s chorea, beta thalassemia, cystic fibrosis, to name just a few, affect less than 2% of the population. This means the vast majority of the worlds population come into this world with genes that should enable the to live a happy and healthy life. He says a staggering 98% of diseases are lifestyle choices and therefore, thinking.”  Even if it’s true that Huntingtons, CF etc account for 2% of all illnesses, they account for only a tiny fraction of genetic disease.  And concluding that the remaining 98% must therefore be lifestyle related is overly simplistic.  It ignores the genetic influence on all other diseases, other congenital, and environmental causes of disease.  I will fully outline this point soon.

Similarly, “According to W.C Willett (balancing lifestyle and genomics research for disease prevention Science (296) p 695-698, 2002) only 5% of cancer and cardiovascular patients can attribute their disease to hereditary factors.”  Science is clear that genes play a significant role in the development of cardiovascular disease and most cancers, certainly greater than 5%.  Again, I will discuss this further soon.

“According to the American Institute of health, it has been estimated that 75 – 90% of all visits to primary care physicians are for stress related problems (http://www.stress.org/americas.htm). Some of the latest stress statistics causing illness as a result of toxic thinking can be found at: http://www.naturalwellnesscare.com/stress-statistics.html”  These websites not peer-reviewed, and both suffer from a blatant pro-stress bias.

You’ll also have to forgive my confusion, but Dr Leaf also wrote, “Dr H.F. Nijhout (Metaphors and the Role of Genes and Development, 1990) genes control biology and not the other way around.”  So is she saying that genes DO control development?


Influence Of Thought On Health

Dr Leaf has categorically stated that “75 to 98% of all illnesses are the result of our thought life” on a number of occasions.  She repeated the same statement in her most recent book so it is something she is confident in.  However, in order to be true, this fact must be consistent across the whole of humanity.

And yet, in a recent peer-reviewed publication, Mara et al state, “At any given time close to half of the urban populations of Africa, Asia, and Latin America have a disease associated with poor sanitation, hygiene, and water.” [2]  Bartram and Cairncross write that “While rarely discussed alongside the ‘big three’ attention-seekers of the international public health community—HIV/AIDS, tuberculosis, and malaria—one disease alone kills more young children each year than all three combined. It is diarrhoea, and the key to its control is hygiene, sanitation, and water.” [3]  Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years [DALYs]), and poor-quality drinking water is an important risk factor for diarrhoea.” [4]

Toilets and clean running water have nothing to do with stress or thought.  We live in a society that essentially prevents more than half of our illnesses because of internal plumbing, with additional benefits from vaccination and population screening.  If thoughts have any effect on our health, they are artificially magnified by our clean water and sewerage systems.  Remove those factors and any effects of thought on our health disappear from significance.  Dr Leaf’s assertion that 75 to 98% of human illness is thought-related is a clear exaggeration.

Let me be clear – I understand the significance of stress on health and the economy, but it is not the cause of 75-98% of all illnesses.  I’m not sure if there is a similar study in the US, but the latest Australian data suggests that all psychological illness only counts for 8% of visits to Australian primary care physicians [5].

In terms of cancer, I don’t have time to exhaustively list every cancer but of the top four listed in the review “Cancer Statistics 2013” [6] , here are the articles that list the gene x environment interactions:

  1. PROSTATE – There are only two risk factors for prostate cancer, familial aggregation and ethnic origin. No dietary or environmental cause has yet been identified [7].  It is most likely caused by multiple genes at various loci [8].
  2. BREAST – Genes make up 25% of the risk factors for breast cancer, and significantly interacted with parity (number of children born) [9].
  3. LUNG/BRONCHUS – Lung cancer is almost exclusively linked to smoking, but nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. COLORECTUM – Approximately one third of colorectal cancer is genetically linked [11].

So the most common cancer is not linked to any environmental factors at all, and the others have genetic influences of 25% to more than 50%.  This is far from being 2% or 5% as Dr Leaf’s sources state.

Also in terms of heart disease, the INTERHEART trial [12] lists the following as significant risk factors, and I have listed the available gene x environment interaction studies that have been done on these too:

  1. HIGH CHOLESTEROL – Genetic susceptibility accounts for 40-60% of the risk for high cholesterol [13].
  2. DIABETES – Genetic factors account for 88% of the risk for type 1 diabetes [14].  There is a strong genetic component of the risk of type 2 diabetes with 62-70% being attributable to genetics [15, 16].
  3. SMOKING – nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. HYPERTENSION – While part of a much greater mix of variables, genetics are still thought to contribute between 30% and 50% to the risk of developing high blood pressure [17].

So again, while genes are a part of a complex system, it is clear from the most recent evidence that genetics account for about 50% of the risk for cardiovascular disease, which again is a marked difference between the figures that Dr Leaf is using to base her assertions on.

Atrial Natriuretic Peptide

I am aware of research that’s studied the anxiolytic properties of Atrial Natriuretic Peptide.  For example, Wiedemann et al [18] did a trial using ANP to truncate panic attacks.  However, these experiments were done on only nine subjects, and the panic attacks were induced by cholecystokinin.  As such, the numbers are too small to have any real meaning.  And the settling is completely artificial.  Just as CCK excretion does not cause us all to have panic attacks every time we eat, ANP does not provide anxiolysis in normal day to day situations.  Besides, if ANP were really effective at reducing anxiety, then why do people suffering from congestive cardiac failure, who have supraphysiological levels of circulating ANP [19] , also suffer from a higher rate of anxiety and panic disorders than the general population? [20]

The Heart As A Mini-Brain

As for Heartmath, they advance the notion of the heart being a mini-brain to give themselves credibility.  It’s really no different to an article that I read the other day from a group of gut researchers [21] – “‘The gut is really your second brain,’ Greenblatt said. ‘There are more neurons in the GI tract than anywhere else except the brain.’”  The heart as a mini-brain and the gut as a mini-brain are both figurative expressions.  Neither are meant to be taken literally.  I welcome Dr Leaf to tender any further evidence in support of her claim.

Hard-Wired For Optimism

As for being wired for optimism, the brain is likely pre-wired with a template for all actions and emotions, which is the theory of protoconsciousness [22].  Indeed, neonatal reflexes often reflect common motor patterns.  If this is true, then the brain is pre-wired for both optimism and love, but also fear.  This explains the broad role of the amygdala in emotional learning [23] including fear learning.  It also means that a neonate needs to develop both love and fear.

A recent paper showed that the corticosterone response required to learn fear is suppressed in the neonate to facilitate attachment, but with enough stress, the corticosterone levels build to the point where amygdala fear learning can commence [24].  The fear circuits are already present, only their development is suppressed.  Analysis of the cohort of children in the Bucharest Early Intervention Project showed that negative affect was the same for both groups.  However positive affect and emotional reactivity was significantly reduced in the institutionalised children [25].  If the brain is truly wired for optimism and only fear is learned, then positive emotional reactivity should be the same in both groups and the negative affect should be enhanced in the institutionalised cohort.  That the result is reversed confirms that neonates and infants require adequate stimulation of both fear and love pathways to grow into an emotionally robust child, because the brain is pre-wired for both but requires further stimulation for adequate development.

The Mind-Brain Link

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do anti-depressant medications correct depression or anxiety disorders?  There is high-level evidence to show this to be true [26-28].  The same can be said for recent research to show that medications which enhance NDMA receptors have been shown to improve the extinction of fear in anxiety disorders such as panic disorder, OCD, Social Anxiety Disorder, and PTSD [29].

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do some people with acquired brain injuries or brain tumours develop acute personality changes or thought disorders?  Dr Leaf has done PhD research on patients with closed head injuries and treated them in clinical settings according to her CV.  She must be familiar with this effect.

One can only conclude that there is a bi-directional effect between the brain and the stream of thought, which is at odds with Dr Leaf’s statement that the mind controls the brain and not the other way around.


One further thing.  Can you clarify which of Dr Leaf’s peer-reviewed articles have definitively shown the academic improvement in the cohort of 100,000 students, as you and your referee have stated?  And can you provide a list of articles which have cited Dr Leaf’s Geodesic Information Processing Model?  Google Scholar did not display any articles that had cited it, which must be an error on Google’s part.  If her theory is widely used as you say, it must have been extensively cited.

I understand that you are both busy, but I believe that I have documented a number of observations, backed by recent peer-reviewed scientific literature, which directly contradict Dr Leaf’s teaching.  I have not had a chance to touch on many, many other points of disagreement.

For the benefit of Dr Leaf’s followers, and for the scientific and Christian community at large, I would appreciate your response.

I would be grateful if you could respond to the points raised and the literature which supports it, rather than an Ad Hominem dismissal or further defense by association.

Dr C. Edward Pitt


1. Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107.

2. Mara, D., et al., Sanitation and health. PLoS Med, 2010. 7(11): e1000363.

3. Bartram, J. and Cairncross, S., Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med, 2010. 7(11): e1000367.

4. Hunter, P.R., et al., Water supply and health. PLoS Med, 2010. 7(11): e1000361.

5. FMRC. Public BEACH data. 2010  16JUL13]; Available from: <http://sydney.edu.au/medicine/fmrc/beach/data-reports/public&gt;.

6. Siegel, R., et al., Cancer statistics, 2013. CA Cancer J Clin, 2013. 63(1): 11-30.

7. Cussenot, O. and Valeri, A., Heterogeneity in genetic susceptibility to prostate cancer. Eur J Intern Med, 2001. 12(1): 11-6.

8. Alberti, C., Hereditary/familial versus sporadic prostate cancer: few indisputable genetic differences and many similar clinicopathological features. Eur Rev Med Pharmacol Sci, 2010. 14(1): 31-41.

9. Nickels, S., et al., Evidence of gene-environment interactions between common breast cancer susceptibility loci and established environmental risk factors. PLoS Genet, 2013. 9(3): e1003284.

10. Berrettini, W.H. and Doyle, G.A., The CHRNA5-A3-B4 gene cluster in nicotine addiction. Mol Psychiatry, 2012. 17(9): 856-66.

11. Hutter, C.M., et al., Characterization of gene-environment interactions for colorectal cancer susceptibility loci. Cancer Res, 2012. 72(8): 2036-44.

12. Yusuf, S., et al., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004. 364(9438): 937-52.

13. Asselbergs, F.W., et al., Large-scale gene-centric meta-analysis across 32 studies identifies multiple lipid loci. Am J Hum Genet, 2012. 91(5): 823-38.

14. Wu, Y.L., et al., Risk factors and primary prevention trials for type 1 diabetes. Int J Biol Sci, 2013. 9(7): 666-79.

15. Ali, O., Genetics of type 2 diabetes. World J Diabetes, 2013. 4(4): 114-23.

16. Murea, M., et al., Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabet Stud, 2012. 9(1): 6-22.

17. Kunes, J. and Zicha, J., The interaction of genetic and environmental factors in the etiology of hypertension. Physiol Res, 2009. 58 Suppl 2: S33-41.

18. Wiedemann, K., et al., Anxiolyticlike effects of atrial natriuretic peptide on cholecystokinin tetrapeptide-induced panic attacks: preliminary findings. Arch Gen Psychiatry, 2001. 58(4): 371-7.

19. Ronco, C., Fluid overload : diagnosis and management. Contributions to nephrology,. 2010, Basel Switzerland ; New York: Karger. viii, 243 p.

20. Riegel, B., et al., State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 2009. 120(12): 1141-63.

21. Arnold, C. Gut feelings: the future of psychiatry may be inside your stomach. 2013  [cited 2013 Aug 22]; Available from: http://www.theverge.com/2013/8/21/4595712/gut-feelings-the-future-of-psychiatry-may-be-inside-your-stomach.

22. Hobson, J.A., REM sleep and dreaming: towards a theory of protoconsciousness. Nat Rev Neurosci, 2009. 10(11): 803-13.

23. Dalgleish, T., The emotional brain. Nat Rev Neurosci, 2004. 5(7): 583-9.

24. Landers, M.S. and Sullivan, R.M., The development and neurobiology of infant attachment and fear. Dev Neurosci, 2012. 34(2-3): 101-14.

25. Bos, K., et al., Psychiatric outcomes in young children with a history of institutionalization. Harv Rev Psychiatry, 2011. 19(1): 15-24.

26. Arroll, B., et al., Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev, 2009(3): CD007954.

27. Soomro, G.M., et al., Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev, 2008(1): CD001765.

28. Kapczinski, F., et al., Antidepressants for generalized anxiety disorder. Cochrane Database Syst Rev, 2003(2): CD003592.

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