Retraction Watch

Tracking retractions as a window into the scientific process

BMJ won’t retract controversial dietary guidelines article, says author

with 37 comments

bmjThe BMJ is not going to retract a 2015 article criticizing the expert report underlying the U.S. dietary guidelines, despite heavy backlash from readers, according to the author of the article.

As Politico reported today, the publication told journalist Nina Teicholz it wouldn’t retract the article, first published one year ago today.

Teicholz confirmed to us the journal emailed her in April to say the article would not be retracted:

The journal’s reason was that the outside reviewers found that the criticism of the methods used by [Dietary Guidelines for Americans] committee “are within the realm of scientific discussion, and are therefore not grounds for retraction.”

She added:

I am obviously relieved. The BMJ’s decision vindicates the view that it’s important to have open debate and discussion over scientific issues, especially when they have such an oversized impact on public health, and even when large, vested interests are at stake.

Soon after the article was published, The BMJ issued a “clarification” to the paper, in the “rapid response” section of the paper (the journal’s version of a comment section). That clarification noted the feature’s criticism that the expert report — which helps form the basis of the U.S. dietary guidelines — suggested “deleting meat from the list of foods recommended as part of its healthy diets” should have specified “lean” meats.

After posting a clarification, the publication issued a formal correction to the article, which didn’t mention the clarification, and instead addressed the research behind the analysis about saturated fats.

The article has drawn heavy fire from critics, outlined in an article in The Verge; the Center for Science in the Public Interest (CSPI) has dubbed the piece an “error-laden attack.”

A spokesperson for the CSPI forwarded us a series of emails between Director of Nutrition Bonnie Liebman and BMJ editor Fiona Godlee, as Liebman inquired about the status of the article. In March, Liebman wrote:

As you know, the serious questions we raised about factual accuracy of the BMJ feature have now lingered for more than 6 months, and the BMJ article has been used as a cudgel in the U.S. policy debates over the Dietary Guidelines.

See just these two articles about lobbying before the Dietary Guidelines were released and about a rider inserted into Congress’s omnibus spending bill instructing the National Academy of Medicine to review the entire process of developing the Guidelines.

The importance of the BMJ’s timely response to our request for a retraction cannot be overstated.

Godlee told us she couldn’t comment on the report the article would not be retracted:

You can be sure that we will let you know as soon as our review of this matter is complete, which we hope will be very soon.

Liebman told us that she wanted to wait to read the journal’s independent review of the article before reacting to the latest reports:

Until [the review is released], we really don’t know the end of the story. It would be a shame if the media handled the story as if the case is closed, when really it isn’t.

Specifically, Liebman noted that even if the journal doesn’t retract the article, it could correct portions of it to reflect the criticisms it has faced over the last year:

I’m frustrated. It’s been a year since the original article was published, and more than 10 months since more than 180 scientists called for a retraction…Here we are in September, and we still have heard nothing.

That delay has had a lasting impact, noted Liebman:

While The BMJ takes its time in conducting and evaluating the review, the work of the dietary guidelines advisory committee has been under a cloud.

In 2014, based on the advice of an expert panel, The BMJ chose to correct two controversial papers about statins, despite calls for their retraction.

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Written by Alison McCook

September 23rd, 2016 at 2:41 pm

Comments
  • Micki Jacobs September 23, 2016 at 2:55 pm

    Thank heavens BMJ has the guts to publish that which these narrow and strident organizations fight against. Surely we can have a discussion w/o all the name calling.
    The data and interpretations of Teicholz are worthy of consideration and respect. She makes many valid observations.

  • Steven St. John September 23, 2016 at 4:12 pm

    In my experience, Center for Science in the Public Interest is neither science nor in the public interest.

    • Jason m September 24, 2016 at 12:27 am

      That was well said. +1 to you!

  • Brian Sandle September 23, 2016 at 7:24 pm

    The Center for Science in the Public Interest are here promoting soy. They are trotting out the usual claim about Asian diets being high on soy and healthy. It needs to be said that traditional Asian diets have included fermented soy, Natto, Tempeh, Fluffy Tofu, and I think properly produced soy sauce? Isoflavones would be reduced by the fermentation.

    http://www.soyfoods.org/wp-content/uploads/CSPI-article-Soy-Oh-Soy.pdf

    The plant estrogens from soy I believe are added to by xenoestrogens from current soy farming, Roundup herbicide used on GMO crops.

    Years ago I was wondering if increase in the use of soy as a protein extender may be connected to increased behavioral problems of today. A search for phytoestrogens behavior turns up studies showing aggression in mice related to soy intake.

  • Peter M. Heimlich September 23, 2016 at 8:51 pm

    Related items via my blog, The Sidebar:

    November 30, 2015 – “Prominent University of Colorado prof, former AHA president (Robert Eckel MD) says he’s removing his name from retraction request letter to British Medical Journal”: http://tinyurl.com/zmcfjrk

    December 29, 2015 – “Disappearing Act: 18 co-signers of BMJ retraction request letter are now MIA”: http://tinyurl.com/jq7wdbp

    May 2, 2016 – “Ultimatum by US Dietary Guidelines chair Barbara Millen led to author/journalist Nina Teicholz being kicked off National Food Policy Conference panel”: http://tinyurl.com/jr28sbu

    May 5, 2016 – “Prominent Harvard prof/researcher Frank Hu solicited European colleagues to sign/circulate demand for BMJ to retract article by author/journalist Nina Teicholz — she says her article criticized a fed gov review headed by Hu”: http://tinyurl.com/hhhxrxf

    More in the pipeline. Tips always welcome.

  • Sammy Pepys September 24, 2016 at 2:25 am

    In her work, Nina Teicholz has demonstrated how we all suffer the continued impact of flawed food guidelines, built on a house of cards and focusing on ‘nutritionism’ rather than fresh food and natural ingredients.
    I am relieved that this factually based article will not be retracted in spite of heavy lobbying from interested parties.

  • Slipp Digby September 24, 2016 at 7:46 am

    Nina Teicholz is declaring this “A victory for good science” on twitter (https://twitter.com/bigfatsurprise/status/779475080032161792) but it seems premature to comment on this until the review is published and the full facts are known.

    We have to bear in mind that the criteria for retraction of a full article is a very high bar, and as the article relied upon multiple claims to build its argument it was never likely to be retracted in full if any, or even a number were deficient.

    The decision not to retract by the BMJ tells us little in isolation.

    While I don’t believe that the complainants were justified in calling for a retraction, they were justified to challenge the facts presented and they did this by listing 11 specific inaccuracies. It will be interesting to see whether the external reviewers found that these specific criticisms had merit, or not.

    • George Henderson (@puddleg) September 26, 2016 at 8:30 pm

      I believe that the 2 factual errors, among the 11 claimed, were the subject of a correction in the BMJ not long after the article was published, and I believe this is a normal practice in science publishing and not grounds for retraction.

  • Larry Diamond September 24, 2016 at 7:52 am

    The call for retraction was instigated by Frank Hu of Harvard University. This is incredibly disturbing as obesity, type 2 diabetes, and chronic, preventable diseases are pandemics now.

    This has happened under Hu’s watch. Could his work be one of the root causes of the chronic disease explosion? It is certainly correlated. Most of the world, excluding Hu, knows this doesn’t prove or show causation but warrants further investigation.

    The BMJ piece pointed out important errors in the science review leading to the 2015 DGA. The committee claimed no research on low carb for instance, when blatantly false. They also recommended the same tired 40 year old nutrition advice.

    Advice based on two things: dietary cholesterol and saturated fat raises cholesterol and this raise in cholesterol is a causal, driving factor of CHD. While progress was made on dietary cholesterol none was made on saturated fat.

    And absolutely none was made on the increasing evidence that low fat diets and seed oils drive CHD and chronic disease and high natural fat diets with natural saturated fats drive health and lower CHD. We need ideas discussed not buried. Hu’s call for retraction was reactionary, baseless, and the epitome of anti-science, anti-rationality. It was, sad and tragic. The signees will have to live with their cowardness for a lifetime. Fortunately the world gets to keep a seminal and important paper that can help turn our global health around.

  • Peter M. Heimlich September 24, 2016 at 9:33 am

    Via “NFL, take note: Calls for retraction are usually a bad idea” by Ivan Oransky & Adam Marcus, Stat, March 29, 2016: http://tinyurl.com/h7lo8ff

    (When) it comes to calls for retraction, we think advocates are better off exercising restraint.

    That may sound odd coming from the cofounders of Retraction Watch. But we rarely see anything good — including the sought-after retraction — coming from these petitions and public demands.

    Calls for retraction often seem politically motivated, and while that doesn’t necessarily make them wrong, it gives more heft to the “Oh, you’re just conflicted” arguments that leave everyone throwing up their hands, engaged in a shouting match. Scientists, journal editors, and universities often appear to be backed into a corner, reacting defensively, and sometimes not even making corrections.

    The sense one gets is that the people calling for these retractions — often followed by the word “immediately” — are less interested in correcting the scientific record than they are in punishing those whose views they don’t share.

    That doesn’t mean the criticisms are always wrong, by any stretch. But retractions are a kind of nuclear option in scientific self-correction — reserved, as the Committee on Publication Ethics recommends, for cases in which “the findings are unreliable, either as a result of misconduct (e.g. data fabrication) or honest error (e.g. miscalculation or experimental error),” duplicate publication, plagiarism, and unethical research — and their main purpose is, in fact, to clean up the record, not act as a scarlet letter, despite whatever stigma retractions have.

    Far better, we think, would be politely but firmly pointing out the alleged errors in a paper, publicly so that there is a record, and then giving authors and journals some reasonable amount of time to respond.

  • Edward Archer September 24, 2016 at 11:19 am

    This is a productive step forward. Both BMJ and Mayo Clinic Proceedings are defending rigorous science against dietary dogma.

    See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527547/

    and

    http://www.mayoclinicproceedings.org/article/S0025-6196(15)00797-1/fulltext

  • Rodolfo Gonçalves September 24, 2016 at 12:36 pm

    Nina did a wonderful job e deserves much respect.

  • Mie September 24, 2016 at 1:09 pm

    Larry

    “And absolutely none was made on the increasing evidence that low fat diets and seed oils drive CHD and chronic disease and high natural fat diets with natural saturated fats drive health and lower”

    It’s difficult to make something from nothing: there’s no evidence to indicate that LCHF diets are superior to other alternatives or that seed oils cause CHD.

    • Micki Jacobs September 24, 2016 at 4:10 pm

      Re: seed oils and CHD
      http://www.ncbi.nlm.nih.gov/pubmed/27251151
      Medicines and Vegetable Oils as Hidden Causes of Cardiovascular Disease and Diabetes.

      These are the folks whose input into this topic/debate needs to be included.
      They are Japanese lipid pharmacologists and they have many interesting things to offer.
      In fact, they need to be included in the topic of statins and bisphosphonates as well as dietary fats – especially their insights into how trans fats lead to inappropriate calcification and atherosclerosis.
      They offer mechanisms to explain why we have lipids wrong and this includes dietary lipids and those we tend to measure in us.
      Instead of how we have classified fats (saturated/nonsaturated/monosaturated), it may well be that these descriptions based on bonds are accurate, but not pertinent. The fat soluble nutrients are found in fats, and these have gotten the short shrift in recent time: vitamins A, D, E and K. Trans fats lead to inappropriate calcification because these fats represent an aberrant form of vitamin K called dihydrophylloquinone (dK), made when all these novel high vitamin K1 oils (all GM) took over in our food. dK cannot do the jobs of vitamin K and it mucks up health, leading to CVD, AD, cancer, diabetes and obesity (my claim). dK is not ackknowledged to be in our food, and admittedly it could be reduced with the alteration of dietary fats where the new guidelines ban trans fats, but now we seem to have gone into even more weird fats (see Teicholtz’s book to learn of what I speak).
      While she does not know about vitamin K2, I would offer that this nutrient/hormone is incredibly important and it is the fouling up of vitamin K2 that has led to many diseases.
      So I am offering an alternative way to see all this and it has merit and is getting some interest, but not so much in the US, where the Tufts Vitamin K lab has decided that vitamin K1 is our priority and that we must understand it before we take on vitamin K2.
      OTHER countries, however, ARE pursuing vitamin K2. Look into it!!

      • Mie September 26, 2016 at 10:38 am

        There’s no evidence in that paper indicates that seed oils cause CHD. Cherry-picked rat studies and speculation on possible mechanisms + misguided interpretation of a couple of – yet again – cherry-picked trials = Bad Science. And the same nonsense about statins (regardless of robust evidence from RCTs indicating otherwise)?

        That was REALLY bad. And I mean “Ravnskov bad”.

        • Micki Jacobs September 27, 2016 at 1:25 pm

          Whew! That is your best insult? Ravnskov bad?? Haha

          You clearly ‘know’ so very much…but the topic of dihydrophylloquinone (dK), the aberrant form of vitamin K that mucks up vitamin K actions is a topic you apparently have missed.
          A lot of folks have missed this. It is made when we hydrogenate high K1 oils – those vegetable oils – and has been identified as trans fats (as I said, it looks like our labels for dietary fats based on bonds is misguided – those trans fats are dK), but the re-use of fats for frying in restaurants also makes dihydrophylloquinone. This dihydrophylloquinone is the way to calcify soft tissues and weaken bones and more. All because we interfere with vitamin K actions – totally misunderstood by the ACC/AHA folks who admit that CAC is huge in risk of CHD, but cannot wrap their heads around what controls this calcium. One way is this fat soluble nutrient/hormone, vitamin K2. Mess with calcium and bad things tend to happen. Vitamin K2 is a big player in calcium regulation – not the only one, but the one we have especially fouled up with bad dietary fats and bad drugs and bad dietary guidelines.

          Vitamin K2 ‘tells’ calcium where to go or not to go by activating vitamin K-dependent proteins. This calcium regulation role is so important that we have back-up mechanisms where dietary vitamin K can be converted in a rather complex process into MK-4, the form of vitamin K2 most found in us, as well as long chain K2 made by gut bacteria and, of course, the dietary vitamin K we eat.

          This process of conversion at tissues throughout the body into MK-4 utilizes an enzyme, UBIAD1 (sometimes called a tumor suppressor) and statins can mess with this as do some bisphosphonates. That is why folks who take statins have more calcium in their arteries – some have suggested that this ‘stabilizes’ plaque, but these pharmacologists show otherwise. If you can see things differently, that is. Maybe you cannot. And the N based bisphosphonates make for ONJ and femur fractures. They make lousy but dense bones.

          I would suggest that you look into these Japanese lipid pharmacologists more (BTW, the statins were invented by some of them and these folks are now questioning this invention but the camel has gotten its proverbial nose under the tent and we are now stuck with lots of bad and spun info on statins).
          Right now, we are incredibly fat, diabetic and sick. And we DID follow the dietary guidelines that began with the Keys mis-steps and it not only did it not help, we got worse.
          Two human observations of supplemental vitamin K2 noted reduced cholesterol – one in CKD patients in Lancet and the other in Japanese osteoporosis patients.
          There are folks out there wanting more K2 research, but since this is not a patentable drug, there is no money in the US for this. So research has to come from outside the US.

          UBIAD1 is an enzyme involved in controlling calcium and cholesterol. And it make this endogenously created MK-4. Look into it! Or not. Since you ‘know’ so much, I doubt you can. Maybe you are too entrenched? I suspect so. Sigh. Can’t change, can you? Or expand? Sad.

          • George Henderson (@puddleg) September 27, 2016 at 4:28 pm

            Mie probably hasn’t read Ravnskov, was just there when the book was burned.

            The Japanese experience is illuminating because saturated fat intakes have increased a great deal since Keys’s day, cholesterol in the population has risen significantly, but CVD mortality (though low to begin with) has followed the exact same downwards trajectory since 1970 that it did in Western nations where trends in saturated fat and cholesterol were the opposite.
            As in the West, declines in CVD correlate well with environmental legislation regulating air quality and industrial safety, changes in smoking, the addition of vitamins to the food supply, and changes in medical treatment.

          • Mie September 28, 2016 at 3:19 pm

            Your reply didn’t really cover the issues I mentioned in my post. And talking about trans fat & vegetable oils is besides the point as the former aren’t found in properly stored, extra virgin oils (is are the ones recommended in daily use). You might as well argue against meat eating by talking about rancid meat.

            The point still is that using oils as PART of your fat intake is beneficial, just like choosing e.g. dairy products over meat (despite the issue with SAFA content).

  • Nina Teicholz September 26, 2016 at 8:37 am

    This piece, like the ones previously on this topic by Retraction Watch, have lacked balance: the preponderance of quotes and all the links embedded in the piece are critical of me or echo the CSPI playbook, which is to cast innuendo on my work, calling it “error laden” and somehow related to the meat industry. Neither of these allegations is based on any evidence, and neither is true. Moreover, Retraction Watch’s coverage has leaned heavily on reporting by The Verge, which has been the most defensive of the government’s Dietary Guidelines and uniquely critical of me (and is a difficult choice for RW to defend, given that The Verge is an obscure outlet, and that the reporter covering this issue has no experience in covering nutrition science or policy–a highly complex field). Meanwhile, RW has ignored a great deal more mainstream, balanced coverage of the issue, some of which I list below.

    Consider what a more balanced piece on this issue might look like (It’s impossible to embed links in the Comment section, so I’ve only included a few).

    Nina Teicholz, science journalist and author of the bestselling The Big Fat Surprise, has challenged some of the fundamental thinking on nutrition science and disease. Her piece in The BMJ questioned the science underlying the Dietary Guidelines, including whether it was systematically reviewed. When the piece came out, a year ago, it was criticized heavily by many scientists, including all the members of the Dietary Guidelines Advisory Committee and CSPI, who called it “error-laden.” But its allegations were supported by others, including prominent nutrition scientist Arne Astrup, who was quoted in Cardiobrief as saying, “The (DGA) committee seems to be completely dissociated from the top level scientific community, and unaware of the most updated evidence.” And others have echoed the criticisms, including a 2016 piece in The Annals of Internal Medicine by prominent cardiologist Steven E. NIssen, entitled, “US Dietary Guidelines, an Evidence Free Zone,” and an op-ed by former DGA committee member Cheryl Achterberg, questioning both the science and the process of the Guidelines. (see below for a list of many other critiques of the DGAs).

    In fact, concern about the DGAs and their inability to combat the crippling epidemics of obesity and diabetes, has grown recently, such that last year, the US Congress held a hearing on October 7, at which both the Secretaries of HHS and USDA, who jointly produce the Guidelines, were called to testify. [Statements of concern about the DGAs by members of Congress can be found at http://www.nutrition-coalition.org/congress-is-concerned/, in which many of the issues raised were similar to those in The BMJ article]. Indeed, the level of Congressional concern was so high that Congress subsequently mandated that the National Academy of Medicine conduct the first-ever major peer review of the DGAs. Moreover, Congress appropriated $1 million to ensure that the review be conducted. (Congress also required that all 2015 DGA committee members recuse themselves from the process.) The major goal of the review is understand how the DGAs “can better prevent chronic diseases.” Given that 2/3 of the nation are overweight or obese, and more than half pre-diabetic or diabetic, these public health issues are of urgent importance.

    CSPI, a staunch defender of the Dietary Guidelines, has called critics of the Guidelines “full of baloney” and portrayed their views as being motivated by industry funding.
    http://thehill.com/blogs/congress-blog/healthcare/257353-coalition-is-full-of-baloney-on-nutrition-guidelines
    CSPI in particular opposes new thinking on saturated fat, presumably because the group has campaigned against these fats for decades and indeed, is uniquely responsible for driving them out of the food supply. Yet these fats have undergone considerable reconsideration over the past five years [There are many articles on this, in mainstream publications]. In her BMJ piece, Teicholz argued that this recent science had not been systematically reviewed by the 2015 DGA committee.

    CSPI wrote the letter of retraction submitted to The BMJ and collected signatures from 180+ scientists, including all members of the Dietary Guidelines Advisory committee. This is virtually an unprecedented number of scientists (?) calling for retraction of an article [and is therefore arguably a subject that RW ought to address]. The original number of signers was actually higher, but 18 dropped out. Harvard professor Frank Hu made a particular effort to round up signatures. He is the DGA committee member who chaired the 2015 DGA review of saturated fats that Teicholz criticized. [Links to these topics can be found in Heimlich’s post, above]

    It’s not clear whether the 180+ scientists understood the alleged errors that formed the foundation of the BMJ retraction request, as reporter Ian Leslie reported in The Guardian: “When I asked them to name just one of the supposed errors in it [the BMJ article], not one of them was able to. One admitted he had not read it.”
    http://www.theguardian.com/society/2016/apr/07/the-sugar-conspiracy-robert-lustig-john-yudkin

    Many scientists believe that the DGAs do not reflect the most current and most rigorous science. Teicholz’s BMJ article could be part of the effort to shed light on these issues. And possibly, this retraction effort by CSPI and the DGA committee members is an attempt to shut down debate on their long-held positions rather than an earnest alarm about alleged errors. The fact that CSPI has also worked to maneuver Teicholz’s dis-invitation from a conference panel adds to the impression that they are trying to silence debate.

    http://www.politico.com/tipsheets/morning-agriculture/2016/03/teicholz-disinvited-from-food-policy-panel-stabenow-grassley-let-usda-fda-review-syngenta-merger-fda-to-release-food-safety-tests-on-cucumbers-213410
    http://www.the-sidebar.com/2016/03/craven-cave-in-how-journalistauthor.html

    OTHER EXPERTS WHO HAVE BEEN CRITICAL OF THE DIETARY GUIDELINES

    “The expert committee report repeatedly makes recommendations based on observational studies and surrogate end points, failing to distinguish between recommendations based on expert consensus rather than high-quality RCTs. Unfortunately, the current and past U.S. dietary guidelines represent a nearly evidence-free zone.”
    — Steven Nissen, Department Chair, Cardiovascular Medicine, Cleveland Clinic, The Annals of Internal Medicine, January 19 2016

    “Despite being controversial recommendations based on weak scientific evidence, the United States Department of Agriculture (USDA) created in 1980 a food pyramid and placed carbohydrates at its base. This national nutritional experiment contributed, as we know now, to the increased prevalence of obesity.”
    — Osama Hamdy, Medical Director, Joslin Diabetes Center, Harvard Medical School, Nutrition Revolution: The End of the High Carbohydrates Era for Diabetes Prevention and Management, January 11, 2015.

    “These guidelines are hugely influential, affecting diets and health around the world. The least we would expect is that they be based on the best available science. Instead the committee has abandoned standard methodology, leaving us with the same dietary advice as before – low fat, high carbs. Growing evidence suggests that this advice is driving rather than solving the current epidemics of obesity and type 2 diabetes. The committee’s conflicts of interest are also a concern. We urgently need an independent review of the evidence and new thinking about diet and its role in public health.”
    — Dr Fiona Godlee, Editor in Chief, The BMJ The BMJ, September 24, 2015.

    “Important aspects of these recommendations remain unproven, yet a dietary shift in this direction has already taken place even as overweight/obesity and diabetes have increased. Although appealing to an evidence-based methodology, the DGAC Report demonstrates several critical weaknesses, including use of an incomplete body of relevant science; inaccurately representing, interpreting, or summarizing the literature; and drawing conclusions and/or making recommendations that do not reflect the limitations or controversies in the science.”
    — Hite et al, Nutrition 2010.

    “It seems reasonable to consider…whether the guidelines can be trusted and whether they have done more harm than good.”
    — David A. McCarron, University of California, Davis Wall Street Journal, op-ed, Nov. 27, 2015

    “Dietary Guidelines: Are We on the Right Path?” The DGAs are only weakly associated to better health outcomes and reduced risk of chronic disease.
    — Joanne Slavin, University of Minnesota, former member of the Dietary Guidelines Advisory Committee, Nutrition and Policy (2012)

    “At the end of this year, the federal government will issue a new set of dietary guidelines, but what’s clear to many in the scientific community is that the dietary guidelines report is not ready for primetime. The process under which they were developed clearly needs enhancing to ensure that Americans are being provided the strongest, most accurate recommendations based on the most rigorous science available.”
    — Cheryl Achterberg, The Ohio State University, former member of the Dietary Guidelines Advisory Committee, “Rigorous Science Must Decide Dietary Guidelines to Combat Health Epidemics”, Roll Call (2015)

    “… these guidelines might actually have had a negative impact on health, including our current obesity epidemic. [There’s a] possibility that these dietary guidelines might actually be endangering health is at the core of our concern about the way guidelines are currently developed and issued.”
    — Paul Marantz, Albert Einstein College of Medicine, American Journal of Preventative Medicine (2008)

    “Government dietary fat recommendations were untested in any trial prior to being introduced.”
    — British OpenHeart Journal (2015)

    ”Despite our evidence-based review lens where we say that food policies are ‘science based,’ in reality we often let our personal biases override the scientific evidence… it may be time for a new approach to dietary guidance in the United States.”
    — Joanne Slavin, University of Minnesota, former member of the Dietary Guidelines Advisory Committee, Nutrition and Policy (2015)

    “The guidelines changed how Americans eat… In place of fat, we were told to eat more carbohydrates… Americans, and food companies and restaurants, listened — our consumption of fat went down and carbs, way up. But nutrition, like any scientific field, has advanced quickly, and by 2000, the benefits of very-low-fat diets had come into question… Yet, this major change went largely unnoticed by federal food policy makers.”
    — Dariush Mozaffarian, Tufts University and David Ludwig, Harvard Medical School, “Why is the Federal Government Afraid of Fat?”, New York Times (2015)

    “I and a team of researchers have studied the data that these guidelines are based on and have come to the conclusion that the data are scientifically flawed. That’s because most of the data on which dietary guidelines are based were gathered by asking people to recall what they had consumed in the recent past—something people are notoriously bad at remembering.”
    — Ed Archer, University of Alabama, “The Dietary Guidelines Hoax”

    “The U.S. government has been providing nutrition guidance to the public since 1980. Yet 35 years later their influence on eating habits has been negligible…If policy makers expect to influence Americans’ eating habits… things must change.”
    — Cheryl Achterberg, The Ohio State University, former member of the Dietary Guidelines Advisory Committee, “Government Food Cops are Out to Lunch”, Wall Street Journal (2015)

    “The low-fat–high-carbohydrate diet, promulgated vigorously by…National Institutes of Health, and American Heart Association…and by the U.S. Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate–high-protein diet may have a salutary effect on the epidemics in question.”
    — Sylvan Lee Weinberg, MD, “The Diet-Heart Hypothesis: A Critique. Journal of the American College of Cardiology (2004)

    “Very Disappointing,” Walter Willett, Harvard Chan School of Public Health

    “These Guidelines are effectively useless,” and “The Guidelines are a national embarrassment…It is a sad day for public health. It is a day of shame.” David L. Katz, Yale-Griffin Prevention Program

    “The Food Cops and Their Ever-Changing Menu of Taboos”
    Wall Street Journal (2015)
    David A. McCarron, M.D., F.A.C.P., Visiting Professor with the Department of Nutrition, University of California-Davis.

    “Government Food Cops are Out to Lunch”
    Wall Street Journal (2015)
    Cheryl Achterberg, PhD, Dean of the College of Education and Human Ecology, The Ohio State University, former member of the Dietary Guidelines Advisory Committee (2010).

    “Keep Dietary Guidance Evidence Based”
    Star Tribune (2015)
    Joanne Slavin, PhD, Professor, University of Minnesota, former member of the Dietary Guidelines Advisory Committee (2010).

    “Why is the Federal Government Afraid of Fat?”
    New York Times (2015)
    Dariush Mozaffarian, PhD, Dean of the Friedman School of Nutrition Science and Policy, Tufts University, and David Ludwig, PhD, MD, Harvard Medical School.

    “Make Science and Public Health the Focus of the Dietary Guidelines”
    The Hill (2015)
    Jeff Volek, PhD, Department of Kinesiology, the University of Connecticut and Stephen Phinney, PhD, MIT.

    “Dietary Guidelines for Americans: Playing Politics with Our Health”
    Roll Call (2015)
    Jeff Volek, PhD, Department of Kinesiology, the University of Connecticut.

    “Why Do Dietary Guidelines Keep Failing? Weak Evidence Invalidated by Rigorous Research”
    San Diego Union Tribune (2015)
    Bradley Fikes, biotechnology reporter.

    “The Government’s Bad Diet Advice”
    New York Times (2015)
    Nina Teicholz, author and science journalist.

    “Food Guidelines Are Broken. Why Aren’t They Being Fixed?”
    Newsweek (2015)
    Jeff Volek, PhD, Department of Kinesiology, the University of Connecticut.

    “Dietary Guidelines for Americans Science or …?”
    Protein Power blog (2015)
    Michael R. Eades, M.D.

    “Advisory Committee’s Violations of Federal Low Threaten Credibility of 2015 Dietary Guidelines”
    Forbes (2015)
    Glenn G. Lammi, contributor.

    “Next Time Government Gives You Dietary Advice, Consider Doing the Opposite”
    Reason,com (2015)
    David Harsanyi, columnist, senior editor.

    “The Red Meat, Eggs, Far, and Salt”
    Reason.com (2015)
    Ronald Bailey, science correspondent, columnist, and author.

    MAINSTREAM REPORTING ON THE BMJ ARTICLE

    “What the Government’s Dietary Guidelines May Get Wrong”
    The New Yorker (2015)
    Sam Apple, journalist and writer.

    “Report Says Proposed U.S. Dietary Guidelines Aren’t Backed Up by Relevant Science”
    Newsweek (2015)
    Jessica Firger, journalist.

    “Here’s What’s Wrong With the U.S. Dietary Guidelines, Report Says”
    Time (2015)
    Alexandra Sifferlin, journalist.

    “How Scientific Are the US Dietary Guidelines?”
    Mother Jones (2015)
    Samantha Michaels, journalist.

    “How Strong Is the Science Behind the U.S. Dietary Guidelines?”
    CNN (2015)
    Carina Storrs, science and health writer.

    “Expecting Scientifically Sound Nutritional Guidance from the Feds? Fat Chance”
    Reason.com (2015)

    “Are Fats Unhealthy? The Battle Over Dietary Guidelines”
    The New York Times (2015)
    Aaron E. Carroll, MD, MS is a Professor of Pediatrics, Associate Dean for Research Mentoring at Indiana University School of Medicine.

    “BMJ Paper Criticizes Proposed US Dietary Guidelines”
    CARDIOBRIEF (2015)
    Larry Huston

    “BMJ Lambasts U.S. Dietary Group for Shoddy Research”
    MEDPAGE TODAY (2015)
    Parker Brown, staff writer.

    “New Report Asserts Major Issues with the 2015 U.S. Dietary Guidelines”
    Yahoo Health (2015)
    Jenna Birch, contributing writer

    “Experts Day US Dietary Guidelines May Be A Danger to Millions of Americans’ Health”
    Medical Daily (2015)
    Samantha Olson, MS, Stony Brook University.

    “Science Used in Proposed U.S. Dietary Guidelines is Questioned”
    Chicago Sun-Times (2015)
    Sue Ontiveros, contributing blogger and scientist.

    • Mie September 26, 2016 at 10:42 am

      You post a long piece which is pure self-promotion (not to mention full of quote-mining and other nonsense) and call it “balanced”?

      Have you no shame?

      • Nina Teicholz September 27, 2016 at 11:06 am

        This is not cherry picking. It is providing evidence to show that 1. there many news outlets have covered this topic with more balance 2. that there are many experts other than me who are critical of the DGAs. I do not need to provide ‘balance’ by also including quotes by people who are critical of me and defending the DGAs. RW’s coverage documents this side of the issue extensively. My contribution here is to show that there are alternative viewpoints, which have not been represented by RW’s coverage.

        • Mie September 28, 2016 at 3:14 pm

          I mentioned “quote-mining”, which was indeed the case in your comment. Not to mention the nerve you have in suggesting that a piece discussing your work should follow wordings provided by you yourself. That’s the equivalent of e.g. reviewing your own paper in a journal.

  • rory robertson September 26, 2016 at 3:30 pm

    Mainstream nutrition “science” clearly took an incompetent wrong turn in the 1950s and 1960s after Dr Ancel Keys et al decided that saturated fat in fatty meat, eggs and diary causes CVD: http://circ.ahajournals.org/content/circulationaha/23/1/133.full.pdf

    As Nina and Gary Taubes have highlighted, the evidence was flimsy at the time and, in the cold light of today, now seems rather clownish: http://ajcn.nutrition.org/content/early/2010/01/13/ajcn.2009.27725.abstract

    Yet, as we sit, government dietary guidelines across the western world – USA, UK, Canada, South Africa, New Zealand and Australia – are based on this anti-saturated fat non-science.

    These guidelines tend to advise 45-65% carbohydrates for everyone, including diabetics, who by definition are harmed by carbohydrates and the excess insulin they promote: page 16 https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf

    Sadly, mistaken low-fat, high carb advice has been the main dietary intervention in our lifetimes. False, harmful information found its way right across Australia, including via regular meetings of Country Women’s Associations: http://www.australianparadox.com/pdf/rosemarystanton.pdf

    With thousands of comfortable careers having been devoted to inadvertently promoting the harmful high-carb advice that has driven global obesity and diabetes (“diabesity”), it is not surprising that influential nutrition “scientists” across the western world now are devoted to pretending that everything is fine.

    So they insist that Nina and Gary Taubes are just “journalists”, that saturated fat really is the main dietary cause of CVD, and that low-carb, high-fat diets are dangerous, happily ignoring dozens of randomised-controlled trials confirming the opposite: http://www.australianparadox.com/pdf/obesitysummit.pdf

  • George Henderson (@puddleg) September 26, 2016 at 8:49 pm

    It was a bizarre procedure for people who had not read a paper and did not know where it was at fault to sign a call for its retraction based on the request of the people whose work was critiqued in that paper.
    It tells us much about how our dietary guidelines are really composed that this was thought to be a suitable procedure for a scientific debate.
    Can we assume that the dietary guidelines are also approved by hundreds of people (perhaps mostly the same people) who have not read them in full and don’t know where they are at fault, because they are expected to do this by others higher in the establishment?
    We are at a point in history where dietary guidelines are not working for the majority. The evidence may show that they work for some, but harm others. In which case a divergent approach is the novelty required to prevent further harm.
    The dietary diseases of type 2 diabetes, obesity, metabolic syndrome, NAFLD and so on are too prevalent in the population, and doctors too ill-trained in nutrition, for their treatment to be considered a purely medical matter anymore. The DGAC needs to take some thought as to what it now should recommend to those who have not flourished under its past recommendations. Nina Teicholz did a good job, I thought, at describing faults in a process which was, and is still, capable of considerable improvement.

  • Paul Meyer September 26, 2016 at 9:57 pm

    If I understand correctly CSPI has not actually been able to cite any supposed factual errors. Indeed there are unlikely to find any as the researchers and journalists who have made similar arguments in the past have been pretty scrupulous in their characterization of the research literature. Conventional wisdom on many of these nutritional matters is a mass of unsubstantiated correlations (actually many of the attempts at experimental verification have failed to date) and the very worst that could be said of the Teicholz letter is that is no more unfounded than anyone else’s viewpoint (which is astonishing and even scandalous but undeniably true). BMJ would ultimately face a significant embarrassment if they required the article to be retracted.

  • Mie September 28, 2016 at 3:12 pm

    George Henderson (@puddleg)
    Mie probably hasn’t read Ravnskov, was just there when the book was burned.

    Cute. As always, George.

    The Japanese experience is illuminating because saturated fat intakes have increased a great deal since Keys’s day, cholesterol in the population has risen significantly, but CVD mortality (though low to begin with) has followed the exact same downwards trajectory since 1970 that it did in Western nations where trends in saturated fat and cholesterol were the opposite.

    Ecological correlation aka fallacies? Please.

    As in the West, declines in CVD correlate well with environmental legislation regulating air quality and industrial safety, changes in smoking, the addition of vitamins to the food supply, and changes in medical treatment.

    These matter too, of course. Which isn’t to say that diet -and fat choices – doesn’t matter.

    But you keep on living in the Denialville. 🙂

  • David Nunan September 28, 2016 at 7:12 pm

    There are a number of issues here of which others have pointed; one being the assumption that the majority (or even lots) of people follow dietary guidelines. Any changes to such guidelines are equally likely to be on the whole, ignored.

    Some may follow popular diet books – but again next to no impact at the population level.

    The modern day pandemics of obesity and diabetes are the product of obesogenic environments including cheap, calorie-dense foods. Focusing on macronutrients, and even worse, individual foods is futile.

    Nutrition science on the whole is poor (see Ioannidis), so anyone using it to support a certain position is already starting from a weak evidence-base (and should acknowledge this).
    It is notoriously difficult to do good research – if you try to be more accurate with our dietary measurements (generally accepted as woefully inadequate) then we sacrifice “real world”, external validity. Try to improve external validity and you sacrifice internal validity (i.e. does x cause y).

    The most important issue though is that the majority of folk on both sides of the debate have an undeniable allegiance and cognitive bias towards their own hypothesis/viewpoint and don’t ultimately care about the evidence (other than that which supports their argument and/or refutes that of their counterparts). This is case of those “leading the fight”, as well as their supporters.

    Author’s of diet books favouring certain foods/macronutrients etc cannot be relied up on to provide a balanced assessment of the evidence – they have a product to protect.

    Equally, researchers/scientists who’s work supports a particularly hypothesis are also open to questions of balance.

    There are few folk who can claim to be truly impartial/independent in this debate yet posses the skills to scrutinise the TOTALITY of the evidence, report only what the data show, the quality of the evidence and communicate it in a way comprehensible to most.
    But there are some. These, and only these, should be the ones to provide such scrutiny.

    Those on both sides of the argument should sign a publicly open document that they will accept and support the resultant findings as they stand – whether they support their own viewpoint or not. If they refuse to sign, the reasons given for not signing will be made public.

    To avoid “foul-play” being cried post-hoc, and demands for a “re-trial”, folks on all sides will input in to the methodology for conducting the evidence review and sign-off will indicate their agreement with the proposed methods and the integrity of the results.

    So how about it Nina?
    Frank Hu’s not on here but I’ll put the question direct to him too.

    • George Henderson September 28, 2016 at 7:42 pm

      The problem with that solution is that you have people agree to the outcome of a process that’s already heavily politicised and imbalanced, using evidence which as you ably state is not really fit for purpose.
      A bit like a Syrian ceasefire.
      Do we even need guidelines of the medicalised sort (as opposed to nutritional), and if so should the result be convergent or divergent, ie one diet to rule all or a range of plans for different needs?
      One thing all sides probably agree on is that populations which depart from traditional diets – whatever they are – into eating industrial food products suffer ill health in consequence.
      This means that there are quite a few diets as already that are better than the diet which is informed by, and trying to conform to, with some success as the DGA website does show, to historic guidelines.

    • rory robertson September 28, 2016 at 8:33 pm

      David,

      You wrote: “The modern day pandemics of obesity and diabetes are the product of obesogenic environments including cheap, calorie-dense foods. Focusing on macronutrients, and even worse, individual foods is futile.”

      I think a lot of people think that, for whatever reasons. It is basically the mainstream view among nutrition “scientists” and public-health “experts”.

      The trouble with that story is that it is wrong. Obviously wrong. Hopelessly wrong. It ignores the basic scientific facts that were authoritatively documented most of a century ago.

      That is, it is clear that the main driver of obesity and type 2 diabetes – now and ~100 years ago – is the excessive consumption of carbohydrates. Accordingly, the obvious solution is the removal of excess carbohydrates.

      By 1923, low-carb, high-fat (LCHF) diets – typically based on fatty meats, eggs and full-fat dairy plus green vegetables – were the simple, effective and mainstream fix for obesity and type 2 diabetes in the US and the UK: http://www.australianparadox.com/pdf/1923-Medicine-Textbook.pdf

      Then came that incompetent, global, anti-fat wrong turn – carefully documented by Nina and Gary Taubes – that was driven by the influential Dr Ancel Keys and others in the 1950s and 1960s.

      Disastrously, their mistaken claims were formalised in official pro-carb dietary advice across the western world, including in Australia in 1979: http://apjcn.nhri.org.tw/server/apjcn/procnutsoc/1990-1999/1995/1995%20p1-10.pdf

      That mainstream careerists have spent the past 50 or so years suppressing – most did it inadvertently, some deliberately – the effective and once-mainstream LCHF cure for obesity and type 2 diabetes is a major cause of today’s tragedy of immense proportions.

      In my opinion, mainstream experts should look more carefully at the core facts, concede the extraordinary errors that have been made, and then support Nina, Gary Taubes and many others in providing the factual information that will be central to any reversal of today’s pandemics of obesity and type 2 diabetes (aka “diabesity” and “metabolic syndrome”).

      Regards,
      Rory

    • Nina Teicholz October 4, 2016 at 2:59 pm

      David, I will go wherever the science leads. In my nearly decade-long review of (what I think came pretty close to) the totality of the science, I came to the conclusion that saturated fats and total fat are not bad for health. This is my view now, based on randomized, controlled clinical trial evidence conducted on some 100K people. However, if clinical trial evidence of a similar magnitude finds the opposite, then I would absolutely change my mind. I will go where the science leads, and I will sign my name to that.

      By contrast, most in the scientific establishment have committed themselves to the idea that saturated fat is bad, and that a plant-based diet is best. This is their bias, with papers, books, etc. all affirming this position. Their bias should also be recognized. And they can marshall the rigorous science that supports their view.

      This is exactly the debate that needs to happen. Let it happen!

      Instead, via retraction requests and conference disinvitations, we see attempts to shut down debate. That’s not the spirit of science, nor is it good for the policy that depends upon that science.

  • George Henderson September 28, 2016 at 10:53 pm

    The question of whether the guidelines have actually had a significant influence on the US population is a very valid one.
    The DGA website shows that consumption of grains is at recommended levels, and that oils are nearly there.[1]

    However, these relate to the latest guidelines, and not the 1980 formula which still holds sway in reality (for example, if you were to be fed in a US government funded institution), and which presided over the diabetes and obesity epidemic. What evidence is there about the 35 years from 1980 to 2015?
    Nina Teicholz, in a recent piece in the LA Times, cited the government’s own best data as showing that, while sugar consumption decreased, “Consumption of flour and cereal products increased by 41%, including a 183% increase in products from corn. Overall, as Americans cut their consumption of fat by 25% from 1965 to 2011, they increased carbohydrate intake by more than 30%.”[2]

    Polyunsaturated fat intake also increased, and we have convincing evidence of this from samples of depot fat taken over the years; the linoleic acid concentration of fat tissue has increased by approximately 136 percent over the last half century.[3]
    Both of these changes represent people following dietary guidelines, whether they know of them, or are just affected by the habits of supermarkets and fast food outlets – themselves influenced by the dietary guidelines and by para-official lobbying by the likes of CSPI.

    It is also likely that an unintended consequence that any good biochemist could have predicted has taken place; the death rate from chronic liver disease in white males 45-54 has risen steadily in recent years.[4] This is consistent with well-known experimental evidence that high intakes of polyunsaturated fat (and low intakes of saturated fat) strongly advance the progression of alcoholic liver disease.[5] (The same pattern can be seen in NAFLD, toxic hepatitis, and, with less available evidence on the question, viral hepatitis).

    Needless to say the question of whether any evidence at all existed for deciding whether there should be an upper limit or qualifications on increasing intakes of polyunsaturated fat was not considered at all by the DGA committee, despite European authorities taking a more prudent approach.

    Of course it can be argued that people did not follow the guidelines in one way, because they must have eaten too much. But this is only what John Yudkin, who tested and promoted low carb diets for weight loss as well as warning of the harms of sugar, had predicted in the 1960s would happen if carbohydrate foods replaced fats in the diet.

    [1] https://health.gov/dietaryguidelines/2015/guidelines/chapter-2/a-closer-look-at-current-intakes-and-recommended-shifts/

    [2] http://www.latimes.com/opinion/op-ed/la-oe-teicholz-big-sugar-saturated-fats-20160927-snap-story.html

    [3] Guyenet SJ, Carlson S. Increase in adipose tissue linoleic acid of US adults in the last half century.
    Adv Nutr. 2015 Nov 13;6(6):660-4. doi: 10.3945/an.115.009944. Print 2015 Nov.

    [4] Case A, Deaton A. Rising morbidity and mortality in midlife among white
    non-Hispanic Americans in the 21st century.
    PNAS 2015; 112(49): 15078–15083
    http://www.pnas.org/content/112/49/15078.full.pdf

    [5] Kirpich IA, Miller ME, Cave MC et al.
    Alcoholic Liver Disease: Update on the Role of Dietary Fat.
    Biomolecules 2016, 6(1), 1; doi:10.3390/biom6010001
    http://www.mdpi.com/2218-273X/6/1/1

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