Treat with extreme caution

Homoeopathic medicine is founded on a bogus philosophy. Its continued use is a drain on NHS resource

Two years ago, a loose coalition of like-minded scientists wrote an open letter to chief executives of the National Health Service Trusts. The signatories simply stated that homoeopathy and other alternative therapies were unproven, and that the NHS should reserve its funds for treatments that had been shown to work. The letter marked an extraordinary downturn in the fortunes of homoeopathy in the UK over the following year, because the overwhelming majority of trusts either stopped sending patients to the four homoeopathic hospitals, or introduced measures to strictly limit referrals.

Consequently, the future of these hospitals is now in doubt. The Tunbridge Wells Homoeopathic Hospital is set to close next year and the Royal London Homoeopathic Hospital is likely to follow in its wake. Homoeo paths are now so worried about the collapse of their flagship hospitals that they are organising a march to deliver a petition to Downing Street on 22 June. Local campaign groups are being formed and patients are being urged to sign the petition.

Homoeopaths believe that the medical Establishment is crushing a valuable healing tradition that dates back more than two centuries and that still has much to offer patients. Homoeopaths are certainly passionate about the benefits of their treatment, but are their claims valid, or are they misguidedly promoting a bogus philosophy?

This is a question that I have been considering for the past two years, ever since I began co-authoring a book on the subject of alternative medicine with Professor Edzard Ernst. He was one of the signatories of the letter to the NHS trusts and is the world's first professor of complementary medicine. Before I present our conclusion, it is worth remembering why homoeo pathy has always existed beyond the borders of mainstream medicine.

Homoeopathy relies on two key principles, namely that like cures like, and that smaller doses deliver more powerful effects. In other words, if onions cause our eyes to stream, then a homoeopathic pill made from onion juice might be a potential cure for the eye irritation caused by hay fever. Crucially, the onion juice would need to be diluted repeatedly to produce the pill that can be administered to the patient, as homoeopaths believe that less is more.

Initially, this sounds attractive, and not dissimilar to the principle of vaccination, whereby a small amount of virus can be used to protect patients from viral infection. However, doctors use the principle of like cures like very selectively, whereas homoeopaths use it universally. Moreover, a vaccination always contains a measurable amount of active ingredient, whereas homoeopathic remedies are usually so dilute that they contain no active ingredient whatsoever.

A pill that contains no medicine is unlikely to be effective, but millions of patients swear by this treatment. From a scientific point of view, the obvious explanation is that any perceived benefit is purely a result of the placebo effect, because it is well established that any patient who believes in a remedy is likely to experience some improvement in their condition due to the psychological impact. Homoeopaths disagree, and claim that a "memory" of the homoeopathic ingredient has a profound physiological effect on the patient. So the key question is straightforward: is homoeopathy more than just a placebo treatment?

Fortunately, medical researchers have conducted more than 200 clinical trials to investigate the impact of homoeopathy on a whole range of conditions. Typically, one group of patients is given homoeopathic remedies and another group is given a known placebo, such as a sugar pill. Researchers then examine whether or not the homoeopathic group improves on average more than the placebo group. The overall conclusion from all this research is that homoeopathic remedies are indeed mere placebos.

In other words, their benefit is based on nothing more than wishful thinking. The latest and most definitive overview of the evidence was published in the Lancet in 2005 and was accompanied by an editorial entitled "The end of homoeopathy". It argued that ". . . doctors need to be bold and honest with their patients about homoeopathy's lack of benefit".

An unsound investment

However, even if homoeopathy is a placebo treatment, anybody working in health care will readily admit that the placebo effect can be a very powerful force for good. Therefore, it could be argued that homoeopaths should be allowed to flourish as they administer placebos that clearly appeal to patients. Despite the undoubted benefits of the placebo effect, however, there are numerous reasons why it is unjustifiable for the NHS to invest in homoeopathy.

First, it is important to recognise that money spent on homoeopathy means a lack of investment elsewhere in the NHS. It is estimated that the NHS spends £500m annually on alternative therapies, but instead of spending this money on unproven or disproven therapies it could be used to pay for 20,000 more nurses. Another way to appreciate the sum of money involved is to consider the recent refurbishment of the Royal Homoeopathic Hospital in London, which was completed in 2005 and cost £20m. The hospital is part of the University College London Hospitals NHS Foundation Trust, which contributed £10m to the refurbishment, even though it had to admit a deficit of £17.4m at the end of 2005. In other words, most of the overspend could have been avoided if the Trust had not spent so much money on refurbishing the spiritual home of homoeopathy.

Second, the placebo effect is real, but it can lull patients into a false sense of security by improving their sense of well-being without actually treating the underlying conditions. This might be all right for patients suffering from a cold or flu, which should clear up given time, but for more severe illnesses, homoeopathic treatment could lead to severe long-term problems. Because those who administer homoeopathic treatment are outside of conventional medicine and therefore largely unmonitored, it is impos sible to prove the damage caused by placebo. Never theless, there is plenty of anecdotal evidence to support this claim.

For example, in 2003 Professor Ernst was working with homoeopaths who were taking part in a study to see if they could treat asthma. Unknown to the professor or any of the other researchers, one of the homoeopaths had a brown spot on her arm, which was growing in size and changing in colour. Convinced that homoeopathy was genuinely effective, the homoeopath decided to treat it herself using her own remedies. Buoyed by the placebo effect, she continued her treatment for months, but the spot turned out to be a malignant melanoma. While she was still in the middle of treating asthma patients, the homoeopath died. Had she sought conventional treatment at an early stage, there would have been a 90 per cent chance that she would have survived for five years or more. By relying on homoeopathy, she had condemned herself to an inevitably early death.

The third problem is that anybody who is aware of the vast body of research and who still advises homoeopathy is misleading patients. In order to evoke the placebo effect, the patient has to be fooled into believing that homoeopathy is effective. In fact, bigger lies encourage bigger patient expectations and trigger bigger placebo effects, so exploiting the benefits of homoeopathy to the full would require homoeopaths to deliver the most fantastical justifications imaginable.

Over the past half-century, the trend has been towards a more open and honest relationship between doctor and patient, so homoeopaths who mislead patients flagrantly disregard ethical standards. Of course, many homoeopaths may be unaware of or may choose to disregard the vast body of scientific evidence against homoeo pathy, but arrogance and ignorance in health care are also unforgivable sins.

If it is justifiable for the manufacturers of homoeopathic remedies in effect to lie about the efficacy of their useless products in order to evoke a placebo benefit, then maybe the pharmaceutical companies could fairly argue that they ought to be allowed to sell sugar pills at high prices on the basis of the placebo effect as well. This would undermine the requirement for rigorous testing of drugs before they go on sale.

A fourth reason for spurning placebo-based medicines is that patients who use them for relatively mild conditions can later be led into dangerously inappropriate use of the same treatments. Imagine a patient with back pain who is referred to a homoeopath and who receives a moderate, short-term placebo effect. This might impress the patient, who then returns to the homoeopath for other advice. For example, it is known that homoeopaths offer alternatives to conventional vaccination - a 2002 survey of homoeopaths showed that only 3 per cent of them advised parents to give their baby the MMR vaccine. Hence, directing patients towards homoeo paths for back pain could encourage those patients not to have their children vaccinated against potentially dangerous diseases.

Killer cures

Such advice and treatment is irresponsible and dangerous. When I asked a young student to approach homoeopaths for advice on malaria prevention in 2006, ten out of ten homoeopaths were willing to sell their own remedies instead of telling the student to seek out expert advice and take the necessary drugs.

The student had explained that she would be spending ten weeks in West Africa; we had decided on this backstory because this region has the deadliest strain of malaria, which can kill within three days. Nevertheless, homoeopaths were willing to sell remedies that contained no active ingredient. Apparently, it was the memory of the ingredient that would protect the student, or, as one homoeopath put it: "The remedies should lower your susceptibility; because what they do is they make it so your energy - your living energy - doesn't have a kind of malaria-shaped hole in it. The malarial mosquitoes won't come along and fill that in. The remedies sort it out."

The homoeopathic industry likes to present itself as a caring, patient-centred alternative to conventional medicine, but in truth it offers disproven remedies and often makes scandalous and reckless claims. On World Aids Day 2007, the Society of Homoeopaths, which represents professional homoeopaths in the UK, organised an HIV/Aids symposium that promoted the outlandish ambitions of several speakers. For example, describing Harry van der Zee, editor of the International Journal for Classical Homoeo pathy, the society wrote: "Harry believes that, using the PC1 remedy, the Aids epidemic can be called to a halt, and that homoeopaths are the ones to do it."

There is one final reason for rejecting placebo-based medicines, perhaps the most important of all, which is that we do not actually need placebos to benefit from the placebo effect. A patient receiving proven treatments already receives the placebo effect, so to offer homoeopathy instead - which delivers only the placebo effect - would simply short-change the patient.

I do not expect that practising homoeopaths will accept any of my arguments above, because they are based on scientific evidence showing that homoeopathy is nothing more than a placebo. Even though this evidence is now indisputable, homoeopaths have, understandably, not shown any enthusiasm to acknowledge it.

For now, their campaign continues. Although it has not been updated for a while, the campaign website currently states that its petition has received only 382 signatures on paper, which means that there's a long way to go to reach the target of 250,000. But, of course, one of the central principles of homoeopathy is that less is more. Hence, in this case, a very small number of signatures may prove to be very effective. In fact, perhaps the Society of Homoeopaths should urge people to withdraw their names from the list, so that nobody at all signs the petition. Surely this would make it incredibly powerful and guaranteed to be effective.

"Trick or Treatment? Alternative Medicine on Trial" (Bantam Press, £16.99) by Simon Singh and Edzard Ernst is published on 21 April

Homoeopathy by numbers

3,000 registered homoeopaths in the UK

1 in 3 British people use alternative therapies such as homoeopathy

42% of GPs refer patients to homoeopaths

0 molecules of an active ingredient in a typical "30c" homoeopathic solution

$1m reward offered by James Randi for proof that homoeopathy works

This article first appeared in the 21 April 2008 issue of the New Statesman, Food crisis

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The New Statesman’s ultimate Christmas lunchbreak guide 2016

What to eat and what not to eat while working during the festive season.

We all know the best thing about the festive season is working all the way up to Christmas Eve, so here’s a list of the best (and worst) high street Christmas lunch food my colleagues and I have painstakingly chewed up and spat out for your delectation:

Lunchbreak failsafes

Pret

Pret’s Christmas Lunch Sandwich, £3.60

Very much a Christmas sandwich by numbers this one – all the key ingredients of a traditional Christmas lunch, plus the inexplicable addition of mayonnaise. It’s a little too full, bits kept falling out, and while it’s not the best Christmas sandwich out there, it’s a solid midtable effort. Stephen Bush

Melvin the Melting Gingerbread Snowman, £1.25

If you take a morbid pleasure in melting a snowman, then Melvin is the gingerbread character for you. His marshmallow head wobbles above his dripping white icing body, but it’s only when you dunk Melvin in your tea that he truly crumbles into nothing but hot water. A festive treat. Julia Rampen

French Brie & Cranberry Toastie, £4.25 

Major disappointment. Tasted like feet, and not in the great cheese kind of way (more like Rachel from Friends’ traditional English trifle/shepherd’s pie way). I didn’t know it was possible to ruin brie. Pinja Saarikoski

Very Merry Christmas Lunch Vegan Baguette, £3.75

Great vegan sandwich, although the Christmas bells weren’t really a-ringing. Tasted more like a Moroccan feast, with the spicy, peppery veggies and pistachios. But I guess Christmas comes in all shapes and sizes, and it’s not always with turkey and stuffing. Pinja

Ham Hock & Sprout Macaroni Cheese, £5.50

We have reached peak comfort. Macaroni cheese: officially the world’s most comforting comfort food according to an extensive survey of all tastebuds and dopamine receptors. And Pret: the high street’s strong arms cradling you when you’re weak and vulnerable on a hungover mid-week lunchbreak, gently extracting a fiver in exchange for your regular dose of deliciously predictable flavours. This is what you get: a thick, creamy sauce with sprouts so cheese-drenched you’d never guess they were sprouts at all, and some unnecessary ham hock just to make it a bit Christmassy. Anoosh Chakelian

EAT

Festive Full Works Bloomer, £3.95

The texture of the bread is excellent and the serving of turkey and rocket is more than generous. But something about the after-taste doesn’t sit well. A potentially related disappointment is the failure of the press team to establish the meat’s exact provenance. While the ham has been procured “from the EU, with pigs raised in barns with natural sunlight”, the turkey “is cooked in the UK but is sourced from overseas”. India Bourke

Christmas Cheeseboard Bloomer, £3.96

This Eat sandwich takes its inspiration from a classic Christmas cheeseboard. As someone who is more excited by the abundance of yuletide cheese than Christmas presents, this was already right up my street. But cheese-filled Christmas sandwiches can often be bland, stodgy and – the greatest sin any festive meal can commit – boring. That’s not the case here. The cheddar is robust and nicely paired with soft, almost ricotta-like wensleydale, the multiseed bloomer pleasingly rustic, and the whole affair is well-seasoned with lemon and black pepper. But the inspired addition of slow-roasted figs and figgy pudding chutney are what turns a good, solid sandwich into a brilliant one. All in all, it leads to an unusual, irresistible taste and texture combo that is decidedly cheeseboard-esque. Anna Leszkiewicz

Brie and Truffle Mac ‘n’ Cheese, £6.50 for large portion

Hello! Is it brie you’re looking for? Well, this mac 'n' cheese has a lot of it. Loads. Tons. But it’s not the best brie in town – mild to the point of flavourlessness, but incredibly thick, this often felt more like an overly stodgy carbonara.  As for the alleged truffle – I couldn’t get so much as a whiff of it. Dull and heavy, for the price and whopping 1,000+ calories, this feels conspicuously lacking in luxury, despite the rumoured posh ingredients. (NB: This comes with an option of cranberry sauce, which I turned down. It’s possible that makes all the difference… but I’d be surprised.) Anna

Paul

Dinde de Noël baguette, £4.50

Paul’s “Dinde de Noel” is another sandwich suffering from the curse of the Christmas Cranberry. Once invisible in the UK at yuletide, the cranberry has gradually invaded the festivities, a culinary equivalent of  the green parakeet. In this case they are embedded in the baguette like war journalists, immovable and advancing on all the other flavours. Which is a shame as the turkey is nice, the spinach admirable in its attempts to get us to eat our greens on the sly and the baguette itself a vast improvement on yet another supermarket sandwich. Pretty good value too. I did find the horseradish isolated in one corner, but having it as well as the cream cheese is another case of excess. One or the other but not both. Stephen Brasher

Greggs

Greggs Festive Bake, £1.50

As my colleague ever so astutely observed last year, the Greggs Festive Bake is not actually a Christmas sandwich. A year on, that is still the case, but it remains a deliciously good value handful of crispy pastry and well-spiced turkey filling. The dusting of oniony-sagey crumbs on top of the pastry really improves what is a complex and satisfying flavour profile. If you’re already a fan of the versatile foodstuff that is the Greggs bake (and you should be: what other treat is always piping hot, can be eaten with one hand on the bus and costs less than £2?) you will love this Christmassy twist on a well-loved format. Caroline Crampton

Greggs Turkey Bacon and Cranberry Roll, £1.50

It’s like a sausage roll but with turkey, bacon and little cranberries instead of sausagemeat. My love of Greggs has spiralled out of control since they introduced their £2 coffee and bacon roll deal, and I love the sausage roll, but this didn’t quite work – the flavours don’t really blend, you just have a lot of turkey, the odd bit of bacon and a cranberry every now and then. It felt unnervingly like eating catfood. Stephen Bush

Benugo

Honey roast pulled ham and smoked cheddar bloomer, £3.75

A great sandwich, this manages to taste weirdly healthy yet also delicious, perhaps down to its deep brown bread. The cheese is plasticky and thin, in that perfect sliced way, contrasting nicely with the texture of the pulled pork. Token rocket adds to the virtue factor; the chutney takes it away again. Hearty. Helen Lewis

As someone who is not an enthusiastic meat-eater, I approached the ham sandwich with trepidation and no little guilt, but found it unexpectedly delicious – the combination of the bread, the cheese, the high-quality ham, and the chutney, if indeed it was chutney, made it a very pleasurable experience – even if I did feel a little bit guilty about eating ham. Jason Cowley

Brie, pistachio, spiced apple and chutney baguette, £3.75​

I feel about this sandwich the way I felt about my first love – though it would do me no wrong, it lacks true passion. The acidic tang of the chutney overpowers the brie, leaving me with the sensation of eating a chutney sandwich. If that’s what you want, go forth. If it isn’t, go elsewhere. Amelia Tait

Turkey, bacon and cranberry baguette, £4.25 

Another where the bread is the star – yeasty and wholesome. A good balance of flavours between the turkey and bacon, and a generous helping of cranberry sauce, plus the inevitable token rocket. Not too salty, not too sweety, and there’s even a cheeky bit of stuffing in there. The mayonnaise is possibly OTT, but really, who cares? Helen

This is slightly sweet, slightly salty and very Christmassy. Its cranberry, sage and horseradish flavourings are well-balanced. And while it’s no River Cottage in the wholesome stakes, it feels satisfyingly nutritious – a sensation backed-up by the later revelation (from their press team) that all their “turkey farms adhere to ISO901:2008 standard.” (That’s a good thing.) Plus, “the turkey is produced in South Yorkshire using exclusively British birds. The bacon is produced in Scotland using pork form the UK and EU. The pork in the stuffing is of UK origin and is also produced in Scotland.” You can taste it. India

Leon

Leon Christmas Wrap, £5.45​

“It would be Rudolph not to,” says the blurb for Leon’s hot wrap, featuring turkey, stuffing and ham hock. While I’m willing to award points for the triple meatiness, there is overall something a little generic about this wrap. Because it’s served hot, all the flavours smudge together, and the fresh spinach barely intrudes on the mix. Still, the cranberry and port sauce lifts the experience, adding sweetness what could otherwise be a weighty proposition. Helen

The Leon x Gizzi Christmas Turkey Curry, £6.45

Always a little bit afraid to find out who Gizzi Erskine actually is for fear of becoming an adult, I approached Leon’s Gizzi Christmas Turkey Curry with some apprehension. Everything from Leon is so wholesome and grainy and aspirational, it puts my usual eating habits in unflattering, baked bean-flavoured contrast. But this curry was delicious. The creamy, lightly spiced sauce was a lovely accompaniment to the juicy hunks of carrot and parsnip. Unusually, the turkey had some flavour too – lifted valiantly by the generous sprinkling of crispy onions. Apparently the Erskine family has this recipe on Boxing Day – a far cry from the customary stale crisps and backwash-addled Baileys, but almost as tasty. Anoosh

The Leon x Gizzi Pistachio & Pomegranate Sprout Salad, £2.25 out/£2.70 in

Even stalwart vegetarian colleagues were a little appalled at the idea of this pistachio and pomegranate sprout salad. And they were right not to let me palm it off on them. Although each of the flavours work on their own, the jarring mixture gives the impression of a salad that doesn’t know what it’s supposed to be. The pomegranate dressing is tart and sweet, the pistachio crunchy and earthy, and the mint and dill sort of pointless. Maybe it’s all just to cover up the flavour of the one actually festive ingredient: sprouts. But even uniting against this common enemy doesn’t give the salad’s component parts much cohesion. Anoosh

The Leon x Gizzi Mince Pie, £1.60 out/£1.90 in

Apparently this mince pie is wheat-free and infused with orange zest and earl grey. But what isn’t these days? I think I had a bikini wax of that description the other week. Anyway, regardless of its special features, this simply tasted like a very nice, very compact, very regular mince pie. Anoosh

Supermarket sweep

Tesco

Tesco Wensleydale & Spiced Carrot Chutney, £2.00

As soon as you open this sandwich, it smells like Christmas. The chutney to cheese ratio is one of the best I’ve ever seen, with equal servings of both making for the perfect consistency and taste. The fact it is carrot (carrot!) barely registers, and the overall sensation is extremely pleasant. That said, the perforated edges of the sandwich box were not properly perforated and thus it was difficult to open, something you might want to consider if you like an easy life. Amelia

Hovering somewhere between your standard cheese and pickle and the festive staple brie and cranberry, there isn’t much flourish to this Tesco sandwich. It’s what it says on the tin – cheese, chutney, plus a bit of spinach thrown into the mix. There are no hidden surprises, but what’s there is pretty good – the full-bodied wensleydale actually tastes of something (unlike a lot of the brie offerings) and the carrot chutney suits. If this sandwich was a date, it would probably be the right level of friendly towards your parents. Not a love match, but nice enough. Anna

Tesco Pigs Under Blankets, £2.35

There was gristle in the mini sausages which was exceptionally off-putting and I’m too traumatised to finish this sentence. Other than that, flavours were good. Amelia

Tesco Finest Turkey Feast, £3.00

According to this sandwich, vegetables are something that happens to other people. I thoroughly approve. The flavours here aren’t subtle – meat, meat and more meat – but they are clean and more-ish. The malted brown bread is quite posh, but could be posher. Some might find the egg mayonnaise texture jarring alongside the crisp bacon, moist turkey and doughy chestnut stuffing. Helen

Aldi

Festive Feast sandwich, £1.59

Aldi’s “Festive Feast” is no worse and a bit better than some other turkey/bacon/cranberry/stuffing combinations from rival supermarkets and no-one could complain about the price as it is only £1.59. Strangely, Aldi itself seems a bit shy about it with its logo hidden on the reverse of the carton underneath the recycling information. The brand seems to be “Just Tasty”, though whether this is to make it look more upmarket or downmarket against other sandwiches isn’t clear. Santa Claus is coming to town but he doesn’t want you to know about it. Stephen Brasher

Brie and Cranberry sandwich, £1.29

There are no shortages of brie and cranberry sandwiches at this time of year – only one or two will separate themselves from the pack to impress your tastebuds. This sandwich doesn’t. It’s a perfectly fine offering, not horrible, but forgettable. The word I’d use to describe it is “functional”. For those who think Christmas food should be about so much more than mere survival, this is not the one for you – but at £1.29 we can’t complain. Anna

Waitrose

Waitrose Christmas Roast beef, stilton and quince with crispy onions, £3.95 

Waitrose is so good at being Waitrose isn’t it? It just really owns it. And nowhere does it lean further in to its status as lord of the supermarket manor than its roast beef, stilton and quince sandwich. It comes in a little box the shape of a house, for god’s sake. You basically buy property when you buy this sandwich. And it is a sophisticated affair – succulent beef, fiery stilton, the sweet hit of quince on your saliva-drenched tongue. You will never quite be able to look Tesco in the eye again. Also, thrillingly, it comes with a mini add-your-own bag of crispy onions. The bourgeois equivalent of the salt ‘n’ shake crisps sachet. Crunch ‘n’ class. Anoosh

Waitrose Christmas Clementine Juice, £1.40

A shameless hasty seasonal rebrand of, uh, some orange juice. But a little weaker and without bits in. Anoosh

Waitrose Christmas Sandwich, £3.20

I can't work out why this sandwich was terrible, but it was. Despite the fact that it has everything you'd want, the essentials of a good Christmas sandwich (turkey, stuffing, cranberry), it doesn't work. The ingredients were poor – the bacon sharp and flavourless, as if a piece of plastic had been left in, the stuffing dry, the turkey forgettable – the bread dry, the mayonnaise overpowering. Avoid. Stephen Bush

Heston Charcoal Bagel with Tea Smoked Salmond, £3.60

This is a really posh bagel. First of all, it’s black. Way classier than your standard beige, or flashy Instagram-courting rainbow. And it has a picture of an opulently-robed salmon on the front of the packet, tempting you in with its knowing gaze. The dill and “caraway pickled cucumber” (ie. a bit of gherkin) lift the flavour of the classic cream cheese and salmon combo. The only real Christmassy element is the lump of coal (ok, charcoal). It all tastes delicious, but there are far too many chia seeds on the bagel. They drop off everywhere and get stuck in your teeth. A middle-class nightmare. Anoosh

Sainsbury’s

Brie and Cranberry, £2.60

Tasty, not too sweet, but also could have been a little bit more robustly stuffed with ingredients. Julia

Taste the Difference Crab, King Prawn & Avocado Sandwich, £3

This seafood smorgasbord is the most delicious lunchtime snack I’ve had in some time. Like a kiss from the sea, or, more accurately, a snog with a mermaid. The avocado was a perfect creamy bed for the tangy but sweet meat. But if crab, prawn and avo mean festive flavours to you, then I’m sorry, but I don’t ever want to come to yours for Christmas dinner. It’s all about chewy and bland poultry, not poncey sea beasts. Anoosh

M&S

Scorched Squash with Beetroot & Pomegranate Relish wrap, £2.80

This sandwich is trying too hard. Yes, there’s parsnip mayonnaise. Yes, the sage and thyme wrap has a slight stuffing aftertaste. Yes, 5 per cent of the £2.80 cost goes to charity. But, no it is not remotely festive. Finding interesting veggie options at Christmas can be tough, I admit, but the best idea is often to keep it simple. What even is “scorched squash”? Serena Kutchinsky

Festive Feast Trio, £3.30

Trios are very Christmassy. The three wise men. Seeing three ships. The number of days you stick to your New Year’s resolution. So M&S gets points for its “Festive Feast Trio” just for that. But it’s also a passable seasonal platter, spread between three rolls. The “posh” prawn cocktail sandwich is only really posh by Seventies starter standards – the slimy prawns are lent an all-important crunch by the cucumber and lettuce, but it’s nothing special. Then there’s the turkey feast and brie, which doesn’t have much flavour at all – but that’s probably because it’s turkey and brie. The third wise sandwich, cheddar and grape chutney, is more moist and punchy. Basic dry, unflashy bread all round. It’s an ok selection if you can’t decide which sandwich to buy, but honestly, you should be able to decide this far down this article. Anoosh

Venison & Sour Cherry Chutney, £4.50

With the sale of Sir Edward Landseer’s most famous painting in the news, what better to accompany a viewing than a M&S Venison and Sour Cherry Chutney sandwich? It’s a winner but a little less filling would allow you to taste the venison properly and the sandwich would be more Monarch of the Glen and less “The Stag at Bay”. Stephen Brasher

Morrisons

Turkey Dinner Sandwich, £2.30

The full-works supermarket sandwiches tend to all merge into one, but this one is slightly better than the others – the cranberry sauce is a bit tarter and less pointless. Anoosh

The ghost of Christmas future

HUEL

Christmas Pudding Huel, £28 for 1.7kg (14 meals), £45 for two

“Nutritionally complete meals in a couple of minutes.” This is the message from techy flour merchants Huel (“human fuel”, not “gruel”, despite appearances). Yes, once climate change destroys all the Big Macs, the food of the future will come in varying sizes of clinical sealed white pouches, complete with a helvetica font. Its mission? To make whole meals “with minimal impact on animals and the environment”. If you’re an eco-friendly health fadder, this will be just your cup of powder.

As it’s Christmas, I tried the Christmas Pudding flavour. I mixed one scoop (38g, 152 calories – nearly a packet of Walker’s crisps, I wistfully discovered) in my special giant space beaker with the required amount of cold water. Then I drank a little bit of it. Then I shuddered. It tastes of over-diluted, grainy powdered milk, with a sprinkling of grated cardboard. It has the consistency (but none of the sugary flavour) of leftover cereal milk. The aftertaste is a sort of woody processed spice, like really cold tiny fragments of clove coating your tongue. The vanilla flavour is more palatable, but I reckon the best thing to do with this Christmas pudding is to set fire to it and leave it at that… Anoosh

Coffee shop pitstops

Costa

Turkey & All the Trimmings Toastie, £3.95

Quite pleasant but the overwhelming taste is of a wet turkey struggling to get out of a vat of cranberries and ultimately drowning. Stephen Brasher

Pigs in Blankets Panini, £4.25

I will admit I consumed this in sub-optimal conditions – heated in the office microwave, rather than grilled. But that doesn’t really excuse its blandness. I mean, come on. There are two types of pork here, plus “herby stuffing” and cranberry sauce, and the damn thing is 559 calories. How do you make anything 559 calories and not be nice? By this point, the conscientious dieter will already have mentally rejected this in favour of a chicken salad, so why not go the whole hog and put some more cheese in it? And yet nothing in here really tasted of anything more than “vague meat”.

Also, because the ciabatta hadn’t been stamped flat in a grill, it was difficult to keep the sausages – which were unpleasantly flaccid – under control. They slid out and nearly landed in my lap. (I should have taken this as a sign and abandoned them.) On a bitterly cold day, I can see this being a tempting option when it emerges toasty fresh from a grill, but it isn’t to be contemplated under any other circumstances. Helen

Gluten Free Turkey, Bacon and Cranberry Wrap, £3.20

There are two things you need in a successful wrap, whatever the time of year: an even spread of tasty ingredients and enough structural integrity that it won’t leak in your hands. Sadly, this offering from Costa could provide neither of these things in full measure. The turkey was more flavourful than in your average shop sandwich (ie, it had a slight poultry taste) but it, as well as the lettuce and bacon, had bunched at the top, meaning that after a couple of bites I was just eating wrap and sauce. And that sauce – the sweet cranberry jam had leaked out the bottom of both halves of my wrap, leaving me with unpleasantly sticky fingers. The wrap itself is slightly chalky in texture, as is usual with gluten free products (it’s made mostly from tapioca starch, according to the list of ingredients). The flavour combination is reassuringly Christmassy, but unfortunately the starchy wrap rather dampens any festive spirit this contender might have evoked. Caroline

Starbucks

Starbucks Turkey Feast baguette, £3.99

This one really is a feast: bacon AND turkey in a harmonious conversation with each other. Surprisingly the turkey tastes like what your momma makes at home, and there really is some smoky maple in the bacon. Some more cranberry chutney would perk it up to perfection, but all in all I’m left happy. Right until I remember it came from Starbucks, and start thinking about America. Pinja

Festive Veggie Feast baguette, £3.99

A Starbucks food sceptic, I did not expect to be won over by their Veggie Feast Baguette. But it was a triumph. The baguette is crispy on the outside, soft and doughy on the inside, the squash full of autumnal flavour, the sage and onion stuffing ensuring this is decidedly Christmas fare. But it’s the cheese that really makes the sandwich – there is absolutely tons of rich brie, thoroughly melted and paired with a delicious real ale chutney. While other festive veggie options can feel far too healthy to really count as Christmas food, this is indulgent in the best way. Anna

High street treat

Pizza Express

Porchetta Natale Romana Pizza, £13.20

Before going further, I must admit to being an unpicky Pizza Express fan. Give me anything on a Romana base and I’m yours. So it’s unsurprising that I loved the seasonal special “Porcetta Natale Romana”, which is apparently a “delectable twist on the classic Christmas roast dinner” – or “pigging delicious”, according to a more straightforward bit of the press release. It is a juicy and delicious meat feast: pulled pork, herby stuffing, glistening scrunches of pancetta. Its triumph is also its downfall, however. By bypassing the dull flavours of turkey it also ducks being an authentic Christmas dinner on a pizza. Anoosh

Snowball Dough Balls, £3.85

The only thing more delicious than fluffy balls of dough are fluffy balls of dough with wordplay attached. So it was with disappointment that I learned Pizza Express’ seasonal rebrand of its classic dough balls starter aren’t called snow balls. Not even snough balls. No, they’re called Snowball Dough Balls. Which is silly. Still, piping hot, dusted with cinnamon and dipped in rich vanilla cream, their sheer tastiness almost makes you forget the missed opportunity to pun. Almost. Anoosh

Cauliflower Cheese Romana Pizza, £12.50

Have you ever eaten a delicious pizza, dripping with cheese, smothered in garlic, and thought, “Nice, but what would make this really amazing is some cauliflower?” No? Well, Pizza Express assumes you have with its veggie Christmas special, Cauliflower Cheese. It always slightly amazes me what meat-eaters think will get vegetarians salivating – hint: not cauliflower! But this pizza is actually really nice, mostly because of its other winning ingredients: pecorino, “pink” onion, and pine kernals. It loses points for me for having no tomato. There’s nothing that draws me to this pizza over the chain’s other (brilliant, in my humble opinion) offerings, but it’s not bad either. Anna

The artisan choice

Forman & Field

Traditional Smoked Salmon & Cream Cheese Bagel, the “Boris Bagel”,​ £5.95 for two

It’s the “Boris Bagel”, from the people who brought you the Boris Bike and the Boris Bus... Except this is not double-decker and you can open it, unlike a Boris Bus window. Actually H Forman & Son are the oldest remaining salmon smokery on Fish Island in the East End, an area once home to London’s largest Jewish population and still several legendary bagel shops. This bagel has definitely got that authentic chewy, glossy quality familiar to regulars at Brick Lane’s 24-hour Beigel Bake, and a world away from crumby supermarket fare. You know when you have top-quality smoked salmon, and this is it: a classy shade of pink, and you can taste that swirling oak smoke. It’s offset by some nice creamy cream cheese, and elevated with chopped chives and lemon juice. Not exactly a Christmassy choice – perhaps one for Hannukah. What makes it Boris-y? It seems it was named after him after he sang the praises of Forman’s, and opened their new factory. But that was back when he was Mayor of London. Does Brexit mean bagels too? Oh and where’s the Sadiq Sarnie? Tom Calvocoressi

Letterbox lunch

Graze

Merry Mince Pie Flapjacks, £1.19

It is arguably against the very spirit of baby Jesus to eat something that tastes like a mince pie but is not a mince pie. This, however, is good news for mail-order desk snack connoisseurs Graze’s Mince Pie Flapjack, as – despite the name – it tastes nothing like the traditional festive offering at all. What it does taste like, however, is gingerbread, which is fine, really. Better for everyone. As a spicy, Christmas flapjack, this will warm your bellies. As a mince pie? It is nought. Amelia

Posh crisps

Fairfield’s Farm

Kelly Bronze Turkey, Sage & Onion crisps, 80p

These high-quality crisps have a satisfying thickness, reminiscent of Kettle Chips and other similarly posh potato-based snacks. The simple, stylish black packaging is eye-catching. And you can assuage waistline guilt safe in the knowledge that this is a product with strong eco-credentials – the crisps are hand-cooked on a family-run farm in Essex using as many locally sourced ingredients as possible. The only problem is the flavour. The turkey taste is weak, and the sage and punchy onion is overwhelming. The overall effect is that on the first bite they seem flavour-free, only for a salty aftertaste to hit seconds later. Definitely one for sharing, rather than solitary scoffing. Serena

All images are publicity shots from the respective outlets, apart from those used to illustrate Waitrose and HUEL, which are the author's own.

Anoosh Chakelian is deputy web editor at the New Statesman.