By Marika Sboros
US investigative journalist Nina Teicholz calls it “a victory for science.” South African scientist Tim Noakes says it proves that one person can “change the world.” I say it’s a decisive defeat for medical, scientific and dietetic establishments in their ongoing war against the critics.
The BMJ (formerly the British Medical Journal) has announced that it will not retract the peer-reviewed investigation it published by Teicholz in September 2015. The feature documents in detail how the US Dietary Guidelines (DGAs) have ignored vast amounts of rigorous scientific evidence. This evidence is on key issues such as saturated fats and low-carbohydrate diets.
Teicholz’s article has been the target of an unprecedented retraction effort that was organized by an advocacy group that has long defended those guidelines. The BMJ stance is becoming a lesson in unintended consequences for those attempting to stifle debate on the topic. It raises fundamental questions about who was behind the retraction effort and their motivation.
In a press release, The BMJ states that two independent experts conducted formal post-publication reviews of the article and found no grounds for retraction. Thus, The BMJ stands by Teicholz’s article and the assertions it makes. The journal has made some corrections. However, these do not materially undermine any of the article’s key claims.
Teicholz says her article, therefore, stands as “one of the most serious ever, peer-reviewed critiques of the expert report for the US Dietary Guidelines for Americans.”
The article, which The BMJ commissioned, is titled: The scientific report guiding the US dietary guidelines: is it scientific?. Her conclusion: the current DGAs are founded on weak scientific evidence.
Teicholz notes that the guidelines are the world’s most influential dietary advice. Yet her article demonstrates in series of claims that have now been re-examined and confirmed that the DGAs do not reflect the best, most current science.
If ever there was tipping point in this argument, this is it. Diet-heart hypothesis officially died Friday Dec 2 2016.Thanks @bigfatsurprise https://t.co/D89gCH2MXK
— Tim Noakes (@ProfTimNoakes) December 3, 2016
The US government’s three recommended diets are generally based on a “minuscule quantity of rigorous evidence,” Teicholz writes. This evidence “ only marginally supports claims that these diets can promote better health than alternatives.”
She documents that for decades, DGA expert committees have ignored most of the rigorous (trial) evidence. This demonstrates that much of the DGA advice “is in error.”
The omission of crucial, government-funded trial evidence suggests “a distinct reluctance by the report’s committee (DGAC) to consider any evidence that contradicts the last 35 years of nutritional advice.”
Teicholz found that the most recent DGA expert committee reviewed the science in many ways that do not meet standard systematic standards. This allowed potential bias into the report. Both of The BMJ’s outside reviewers not only confirmed this point but elaborated on it.
Click here to read Teicholz on EXPLODING FAT BOMBS IN NOAKES TRIAL
Other revelations of Teicholz’s article include that the DGAC:
- Did not follow the standard US Department of Agriculture (USDA) review process on a majority of topics;
- Based a number of recommendations, including the new vegetarian “Dietary Pattern”, on inconclusive evidence.
- Stated that the evidence of a link between saturated fats and heart disease was “strong” but the evidence cited did not clearly support this;
- Recommended reducing red and processed meats yet did not conduct an analysis of the scientific literature on this subject;
- Recommended reducing salt as much as possible, yet the most recent, authoritative review on this subject, by the Institute of Medicine study, which the DGAC itself cited, does not support this.
Different kinds of bias may have caused these “lapses,” Teicholz says. These include financial conflicts of interest, outside agendas, and “a desire to confirm existing advice.”
Mark Helfand, professor of Medical Informatics and Clinical Epidemiology at the Oregon Health & Science University supports Teicholz’s contentions. He and Lisa Bero, chair of Medicines Use and Health Outcomes at the University of Sydney conducted the formal post-publication reviews of Teicholz’s article for the BMJ.
In The BMJ press release, Helfand says: “I found nothing to contradict Teicholz’ central concern that the DGAC’ processes to protect against bias are inadequate. It is clear that further investigation of the composition of the committee, as well as its conflict of interest policies and work group structure, are warranted.”
Not surprisingly, Teicholz’s claims have infuriated many of the experts whose science has been used to produce the Guidelines as well as those who have long defended them.
Teicholz has become a prominent critic of the conventional diet, high in carbohydrates and low in fat, especially saturated fat. That’s following nearly 10 years of research on nutrition science for her groundbreaking book, The Big Fat Surprise. It quickly became an international and New York Times best-seller. The Economist named it the Number 1 science book of 2014.
Unusually for a book by a lay writer, two academic journals, the American Journal of Clinical Nutrition and The BMJ, reviewed it at length and favourably.
The Center for Science in the Public Interest (CSPI) organized advocacy and research groups as well as all the members of the 2015 DGAC to sign a letter asking the BMJ for retraction. Click here to read the CSPI announcement. It says that more than 180 people, including prominent cardiovascular and nutrition scientists from 19 countries, called for the retraction.
Information obtained by public records requests reveals that many academics passed along the retraction request without asking a single question about its substance. It shows that Harvard epidemiologist Frank Hu was particularly active in soliciting his European colleagues. Hu was the DGAC member who chaired the review on saturated fats.
In an article in The Guardian earlier this year, journalist Ian Leslie reported that some signers had not even read the “offending” article. Leslie noted that Harvard epidemiologist Meir Stampfer asserted that Teicholz’s work was “riddled with errors.” Yet Stampfer declined to discuss any details with Leslie.
Editor in chief Fiona Godlee says that neither Teicholz nor The BMJ is new to criticism.
Healthcare is rife with controversy, she says, more so in nutrition science. Godlee describes it as characterized by “much weak science, polarized opinion and powerful commercial interests.”
Further, she writes that “nutrition is perhaps one of the most important and neglected of all health disciplines. Those in positions of power have traditionally relegated it to non-medical nutritionists.”
Godlee says that nutrition should be “a central part of medical training and practice.” It should be a matter of “grave concern to those attempting to develop evidence-based health and economic policies that truly serve public interests.”
A number of scientists lauded The BMJ’s for standing by Teicholz’s article.
In a press release issued by Teicholz, former editor-in-chief of The BMJ Richard Smith states that there is “an ugly tendency these days for powerful groups to call for retraction of any article they don’t like.” The BMJ has “stood up for science on a crucial subject that affects everybody.”
Also in the press release, Cheryl Achterberg, dean of the College of Education and Human Ecology at Ohio State University and a former DGAC member, says that “for future guidelines, as well as for the health of the nation, we need to consider these points and move towards reforming the dietary guidelines process.”
The press release also cites a statement by Arne Astrup, head of Department of Nutrition at the University of Copenhagen, when The BMJ article was first published. Astrup says that the DGAC seems to be “completely dissociated from the top level scientific community…and is “unaware of the most updated evidence.”
Teicholz hopes that The BMJ’s decision to stand by her article will “close the book on a prolonged retraction effort.” That effort has attempted to “silence science and stifle debate on this important topic.”
Click here to read Teicholz on: HOW LOW-FAT DIETS CAN KILL YOU
The intention of her article, she says, was to convey information that could improve the guidelines so that they “better reflect the science.” Ultimately, she hopes the guidelines will do “a better job in fighting the epidemics of obesity, diabetes, and heart disease, which afflict a majority of Americans.”
No one should underestimate the importance of the DGAs and, therefore, of her article. Teicholz’s critique has far-reaching implications not only for the US but also for professional societies and governments globally.
In the US, the DGAs inform the US food supply and military rations, says Teicholz. They also inform US government feeding assistance programs, such as the National School Lunch Program. Altogether, one in four Americans consumes these each month. As well, the US guidelines influence the guidelines of professional societies and governments around the world, and eating habits generally.
Yet as Teicholz has noted, rates of obesity began to shoot upwards in 1980 – the very year that the US introduced the DGAs. And the diabetes epidemic began soon thereafter.
“Why have the guidelines failed so spectacularly to safeguard health from the very nutrition-related diseases that they were supposed to prevent?” Teicholz asks in her comment that the BMJ published .
In documenting the fundamental failures in the science behind the DGAs, her BMJ article offers new insights to answer that question. She establishes that the authorities have, for decades, ignored or dismissed a vast amount of nutrition science, which the National Institutes of Health and governments worldwide have funded.
“Incorporating this long-ignored relevant science would likely lead to fundamentally different DGAs,” Teicholz says. “This could be an important step in infusing them with the power to better fight nutrition-related diseases.”
Click here for The BMJ press release on the issue. It includes links to comments by the outside reviewers, as well as those by Fiona Godlee and Nina Teicholz.
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First, Frank Hu tries to drum up support for a campaign to discredit Nina Teicholz and the BMJ. Then, just last week, Hu puts his name to a paper on saturated fat in the BMJ. Perhaps this is supposed to be science trying to succeed where politics failed.
However, Hu’s choice of co-authoring this paper with three employees of Unilever, a firm that profits from producing substitutes for the fats made by other firms and raised by smaller producers, introduces an extra element of outrageousness. The Unilever employees did not supply original data or perform analysis, but instead exercised editorial roles (editing, interpretation, and approval).
Now, I’m a supporter of industry-funded nutrition research, because someone has to pay for it and the Government isn’t interested in the answer to every question. However, I don’t think observational papers should be written to order in this way, especially not from people who take themselves and their roles as seriously as Frank Hu and Walter Willett do.
Further, this could be seen as evidence of collusion of some sort, as Hu, a supposedly objective researcher, is collaborating with employees of a firm that stands to lose profits if Nina’s advice becomes popular.
Frank Hu lost all credibility when he dissociated himself from the big metastudy he co-authored with Patty Siri-Tarino and Ron Krauss. Perhaps he thought no-one would notice that a similar conclusion had already been reached by Andrew Mente
http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108492
and there have since been more metastudies (for what THEY are worth) by Rajiv Chowdhury and I think Jakobsen. For a while I’m sure there was also a Cochrane Collaboration, which strangely was rapidly withdrawn and replaced.
Perhaps he is hoping that when he retires Walt Willett will pass on his moustache.
Its a pity you didn’t publish the corrections that the reviewers made BMJ Publish. That is that whilst the main point of possible bias is valid the author has not proven there is any actual bias.
Basically that the DGAC 1969s methodology could be open to bias but the author actually hasnt proven any.
So how the hell do you then make the leap that the DGAC is all crap until 2010 regression models are used (as the reviewers mentioned).
It just means the whole model needs redoing with modern statistical methodology
Like do you guys skim the web looking for possible validation but dont actually read the fine print?
Terrible science,
If “the whole model needs redoing with modern statistical methodology” then surely this would be the most logical thing to do to destroy Teicholtz’s arguments and all those who agree with her. Enlighten me as a layman, please. Like do you guys skim through counter viewpoints and not make any effort to link the dots that seem obvious to those whose opinions you would seek to denigrate.
As a layman I take some dots link them and arrive at a conclusion which I then apply. In this particular case dot one was my poor health arising from high carb low fat diet as advised by my doctor who took guidance from the DGAC. Dot two was the RMR. Dot three was switching to low carb high fat. Dot four was a dramatic improvement in my 5 essential metabolic markers. I have no inclination to hang around while some number cruncher faffs about with statistical methodology only to proven wrong anyway
O god, some people make me sick, this is just the tip of the ice burg in science corruption. Most doesn’t even see the light of day – most days I avoid talking to people as the ignorance hurts…it really does.
There are many factors in what diet suits best. For example, I eat all cooked vegetables daily, about 250 g meat, and little added fat as my meat has quite a bit. As a slow oxidiser with low mineral levels and copper toxicity this works best for me. A fast oxidiser with bio-unavailable and copper deficiency might do better with less meat, same veggies – but more fat. Shove your models. They don’t even fit with anything that actually should be used. Your model is like a flat earther.
None of the corrections that The BMJ chose to publish is material to Nina Teicholz’s assertions about the lack of science on which the US Dietary Guidelines are based. For that reason, I chose not to include them in the post on her victory. However, the post includes all the links to The BMJ decision not to retract her feature after the reviewers found no grounds to advise doing so.
Hi Thorhanson. I challenge you to read the Big Fat Surprise and see if you still feel the same way…
Thor, if you knew how to write a sentence and put an apostrophe in the right place, your views on science might not look like a badly educated teenager’s rant. I’m more inclined to accept Dr Fiona Godlee’s eminently sensible verdict.
The DGAC are nothing but a cabal of crooks funded by Big Agri, Big Food, Big Pharma, the USDA and the AMA, who shamelessly profit from conveying deadly diet recommendations responsible for the worldwide obesity and diabetes epidemic.
If you think how many thousands, nay, millions, of jobs, billions of profits, billions of industrial machine costs, are at risk if people are persuaded to clean up their eating habits, it becomes easy to understand the desperate, even maniacal, attempts to shut down Nina Teicholtz, Tim Noakes, Gary Fettke, Jennifer Elliott, and, and, and. Big Food, Big Agri, Big Pharma etc have all grown fat on the back of the post-McGovern guidelines. I’m surprised we haven’t seen worse, more brutal attacks, against people who try to help us to re-think the junk we are eating.
I see the other side of the coin too as I live in a high tech farming area surrounded by fields and fields of wheat, rape, sugar beet, barley, potatoes etc. It’s wall to wall carbs with some margarine thrown in, yet a few years back the farmers I know were being paid £30 – £50/tonne LESS than the cost of production for their wheat. Didn’t see the price of bread or breakfast cereal go down.
Most dairy farms have gone out of business except for one that invested in doing their own distribution and conversion into cream, ice cream, cheese etc.
It’s the middle men who make all the profit.
Fortunately there are still plenty of farms who do grass-fed lamb and beef,free range pigs and chickens and decent vegetables, some organic, but they are mostly small. Demand is increasing though as people return to traditional eating.
Good for Fiona Godlee for not backing down. Science is supposed to be about trying to demolish hypotheses. If you consistently fail to do so, there may be some truth in it and it may become a theory. Nowadays it’s all about manipulating the research and the results to “prove” what your sponsors require.
“Let food be thy medicine, and medicine thy food”. Who said that? Er, wasn’t it Hippocrates?
We are rejoicing in this outcome. I once read that it takes 70 years for people to except new scientific evidence as truth. I hope this time it will be much sooner!!
There is a statement out there that suggests where the “70 years” idea comes from, being that the hard-nose ‘experts’ do not change their minds, that one has to wait till they die off, (after 3 score years and 10), when the new science is accepted by new generation thought leaders.
more like they have tried to bury truth for well over 100 yrs….but yes it takes many many decades at times…
I am ecstatic to hear this. Hats off to Dr. Godlee for doing the right thing.
another nail in the half buried coffin of hypocrisy