Dietary Guidelines Debate Gets Ugly

8888885127_e0f089a5d0_zLet me catch you up on the latest, in case you haven’t been following.

Last week, the British Medical Journal publishes an article critical of the proposed 2015 Dietary Guidelines for Americans and the committee’s work.  Written by journalist Nina Teicholz, author of The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, the article is entitled The Scientific Report Guiding the U.S. Dietary Guidelines: Is It Scientific?  Curious title coming from a non-scientist herself. Here’s an excerpt outlining Nina’s major beef with the report:

The committee’s approach to the evidence on saturated fats and low carbohydrate diets reflects an apparent failure to address any evidence that contradicts what has been official nutritional advice for the past 35 years. The foundation of that advice has been to recommend eating less fat and fewer animal products (meat, dairy, eggs) while shifting calorie intake towards more plant foods (fruits, vegetables, grains, and vegetable oils) for good health. And in the past decades, this advice has remained virtually unchanged.

If you’re not familiar with The Big Fat Surprise, I’ve written about this book here.  Nina’s book was one of the reasons we saw so many misleading headlines last year extolling the virtues of saturated fat.  Nina’s BMJ article gripes about the conclusions in the report about saturated fat — claiming bias, conflicts of interest and a shoddy review of the evidence.

The overall lack of sound science and proper methods in the 2015 report could be seen as a reluctance to depart from existing dietary recommendations. Many experts, institutions, and industries have an interest in keeping the status quo advice, and these interests create a bias in its favor. Abandoning the NEL review methods, as the 2015 committee has done, opens the door not only for bias but also for influence from outside agendas and commercial interests, and all of these can be observed in the report.

Well, you don’t think the committee was going to sit back and take this.  No way.  They penned one of many responses to the article.  In fact, responses were pouring in from around the world by the end of the week.  Here’s a part of what the committee had to say:

In our opinion, Ms. Tiecholz’s article is woefully misleading and in many cases, factually incorrect. Its provenance is described as ‘commissioned’ and externally peer reviewed and fact checked. This statement is puzzling in its lack of detail and the validity of the statement on fact checking is doubtful. Ms Teicholz is a self-identified investigative reporter who has been on a quest for quite a long time to promote her own book in the popular press entitled ‘The Big Fat Surprise’ Why butter, meat and cheese belong in a healthy diet.’ In conclusion, the 2015 DGAC Scientific Report was developed in an open, evidence-based and transparent process that meets or exceeds the recommended scientific methods for issuing evidence-informed public health guidance. It is a disservice to these rigorous processes to publish commentaries that lack any scientific rigor and are inflammatory in nature. This publication without even a counterpoint detracts from the focused efforts needed to seek sound solutions to the preventable health problems we confront in the U.S. but also globally.

Bonnie Liebman, nutrition director of the Center for Science in the Public Interest, wrote a powerful response that tore apart each one of Nina’s criticisms.

Today’s “feature” in the BMJ by journalist Nina Teicholz continues her distorted and error-laden campaign against the Dietary Guidelines Advisory Committee report. Earlier this year, she wrote a similar mistake-filled op-ed for the New York Times. In fact, the DGAC’s advice is consistent with dietary advice from virtually every major health authority, including the American Heart Association, the American College of Cardiology, the American Diabetes Association, the American Cancer Society, World Health Organization, and the Obesity Society. Teicholz would have us believe that only she, not the dozens of experts who systematically reviewed the evidence for these health authorities, has the smarts to accurately interpret this evidence. In fact, she makes many glaring errors in her BMJ piece.

Bonnie concludes her response saying Nina’s article is a “hodge-podge of fact and fiction and will only confuse a confused public even more.”  I thought Bonnie’s response was so well done that I tweeted it last week.  Well, here’s Nina’s tweet back to me:

Hmmmm.  Curious attack response.

Perhaps the strongest rebuttal comes from Dr. David Katz, who is always so eloquent in his writing;  An open letter to the BMJ regarding U.S. Dietary Guidance:

I am rather stunned that the BMJ published a journalist’s commentary about the work of the 2015 United States Dietary Guidelines Advisory Committee as if it were an authoritative rebuttal. It’s as if someone selling horse paperweights is invited to critique the Olympic equestrian team. It is, in a word, absurd- and testimony to the breakdown in integrity where science and media come together. With all due respect to Ms. Teicholz, she is not a nutrition expert, and not a scientist. She is a journalist herself, and one with a book to sell. She refers to bias, but fails to highlight her own. If the DGAC report is valid, it calls into question her own conclusions- as well it should. She may therefore have suspect motives in seeking discredit this work.  The same author wrote much the same in the New York Times, and I was stunned then, as now, that what was once rarefied territory for truly expert opinion is being allocated so indiscriminately. The notion that the opinion of one journalist with a book to sell is in any way a suitable counterweight to the conclusions of a diverse, multidisciplinary, independent group of scientists who reviewed evidence for the better part of two years and relied upon knowledge and judgment cultivated over decades of relevant work- is nearly surreal. It is a disservice to the readership in both cases.

1096128898_9870a49953_zArielle Duhaime-Ross wrote an excellent piece for The Verge: Medical journal’s bogus investigation could derail better dietary guidelines.

It seems a shame that no editor at the British Medical Journal chose to respond to our questions. Obviously, greater oversight was needed for this article, or else such egregious mistakes would not appear in an “investigative” report in the journal’s pages.

So what does this all mean?  Of course butter, meat and cheese belong in a healthy diet.  I certainly enjoy all three.  But it’s important to not give them such virtuous qualities that it’s a green light to over do it. My recommendations remain the same as my earlier post when Nina’s book came out and there were a flurry of headlines declaring that saturated fat is back:

  • Enjoy your butter, just don’t over do it.
  • Don’t put so much faith in coconut oil or other trendy fats — use them because you like the taste, not because you think they’ll improve your health (or work miracles).
  • Just because a nutrient or food was found to be not as harmful as once thought, it does not mean it’s beneficial.
  • If you want the flavor of animal fats in your cooking (lard, duck fat, schmaltz), check it out. All things in moderation.
  • Rather than working so hard to increase saturated fat, find ways to swap in more good fats:  extra-virgin olive oil, nuts, olives, avocado.
  • Read beyond the headlines — and don’t rely on journalists as your main source of nutrition advice.

image: flickr user r.nial bradshaw, triple bacon cheeseburger; flickr user chun kit to, butter; all creative commons

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