Why I'm quitting 'I Quit Sugar' - a response to Sarah Wilson's views on helmets

This is a slightly tongue in cheek yet factual response to claims made that helmet use will not prevent injury. If you are offended by (very ordinary) humour, my apologies but drawing attention to a serious issue is vitally important. Dear Sarah Wilson,

I have, in the past, enjoyed your cookbooks and some of the sentiment in your program I Quit Sugar. Western societies consume a lot of things, including sugar in excess. I have made a few recipes from your cookbooks and found them to be quite tasty. But you have overstepped the mark I am afraid with your comments on bicycle helmets lacking evidence and not preventing head injuries. I understand that when you ride your fixie bike with trendy basket full of fresh vegetables (not fruit, fruit apparently contains too much sugar), a helmet can ruin your perfectly coiffed hair. We all feel your pain on that matter. But let me put it to you plain and simple: helmets have been shown to reduce the risk of head injury. Fact.

Your 2010 blog post on why it's okay to not wear a bicycle helmet has recently resurfaced after an instagram post suggested that people don't ride bicycles anymore because we legislate that people wear helmets.

Sarah, I am a real, certified, trained, educated doctor. And I have seen many, many head injuries during my career. And a number of those patients that I have seen have been at organ retrievals when I go and bring home the beautiful gift of donor organs from a person who has had a bicycle accident and sustained a serious head injury. But as I am a doctor who is trained to look for (real) evidence and not just sprout my opinion, here is some evidence for you.

Head injuries account for 75% of deaths in cyclists. The Cochrane review is a collaborative database that reviews the scientific evidence of many topics. The Cochrane review in to bicycle helmets looked at all of the best available evidence into the use of helmets in cyclists and discovered a reduction in head injury of 63-88%. Helmets also reduce the incidence of injuries to upper and mid face region by 65%. Facial injuries don't just disfigure you, you can indeed bleed to death from severe facial injuries, lose your sight, have difficulty speaking and swallowing. Same goes for offering protection from serious scalp injuries - helmets can help prevent you exsanguinating from your scalp. Yes it can happen - the scalp is one of the most well vascularised regions in the body. Not wearing a helmet leaves you five times more likely to have a serious head injury. That's data from Sydney by the way.

Sarah, you are absolutely correct that we have never done a randomised control trial into helmets. And here's why. A randomised control trial involves taking two groups of people. You give one group the treatment (in this case, a helmet) and the other group nothing (in this case, no helmet) and then you would have to subject them to serious trauma and see who does better. As you can see, we could never do that. I'm quite certain even you would not volunteer for this experiment and not wear a helmet. In instances like these, we clever doctor types put together all of the information available and come up with what is still a scientifically sound answer. And thanks to people like yourself who do not wear helmets, we have plenty to compare with.

I understand Sarah that you consider yourself somewhat of a guru, navigating through science and picking out what the people really ought to know. You even throw in scientific jargon every now and again. Except that your jargon isn't scientific at all. Linear speeding and angular acceleration are made up, just like the Easter Bunny. Neither are terms that would be used in a hospital to describe how an injury happened. Real doctors use terms like direct blow, contrecoup injury, axial loading, hyperflexion or hyperextension to describe how an injury happens. But I'd hate to correct a wellness blogger like yourself. What would we know?

Helmets may not prevent every injury every time. If you are unfortunate enough to go head first at speed into a bus or a truck, then a helmet may reach it's limits of helpfulness. But for serious accidents, even when you do hit a car on your push bike, there is evidence to say that wearing a helmet just might save your life. I'm quite sure people who have been involved in accidents where they were wearing a helmet are pretty grateful that they were.

Sarah, everyone is entitled to have a thirst for knowledge and even share that knowledge. But what is insufferable and inexcusable is sprouting dangerous, unsupported rubbish that may affect some of our most vulnerable and precious people like children. I am terribly sad that the medical profession is not as appealing to the general public as you seem to be (for the moment). I feel like we sometimes fall short of protecting the general public from anti-helmet crusaders like yourself. Perhaps we need to harness the power of social media a bit more? Maybe we need an Instagram page dedicated to an intensive care unit or a rehab ward? Would our message get across then?

I hope that when you go on an unsupported, selfish, incorrect and vile rant next time, you will spare a thought for the people's who lives have been transformed by a traumatic brain injury. Aside from dying from these injuries, sufferers of traumatic brain injuries are forced to endure a lifetime of conditions like seizures, severe personality change, loss of independence (that means someone else may have to wipe your bottom for you Sarah), speech difficulties and memory loss. Imagine forgetting who you are, who your spouse is, or having to be fed through a tube for ever. Traumatic brain injury is a terrible, terrible waste of many people's lives and should not be trivialised by a 'wellness guru'.

I have always thought that I could take on board bits and pieces from your books and websites and integrate it into my own solid, scientific background. However, as I write this, I am putting your book into the trash where it belongs. I hope many, many others will follow suit. And I also hope that if you continue to ride your bike with no helmet, trendy glasses and golden locks flowing, that you never have an accident where you or your family wishes you were wearing your helmet.

Sincerely, wearing a bright green Stackhat,