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Tuesday, September 27, 2016

Nina Teicholz Reports in the British Medical Journal ~ The Conflicts & Funding

BUMP!

In working on a follow-up to The Slimey Truth About Sugar Slammers ~ Links & Background, I've received a few tweets that reminded me of this post from almost exactly a year ago.   Eventually we got answers to the questions below, and those will be discussed in the follow-up.  People are going bonkers over a pittance split between three scientists 50 years ago who published an article in a *professional* *peer-review* journal.  This was done at a time when such journals would publish articles countering and debating the findings of previous articles.  So in the intervening years it is the sugar industry that is solely responsible for confusing people?  I am not carrying water for that or any industry here, but I don't think so!

This article came before some answers were unearthed by yours truly in Nina Teicholz, The BMJ, The Nutrition Coalition and nutrition science's George Soros: The Laura and John Arnold Foundation.  Specifically that the Nutrition Coalition was finally revealed and it is not affiliated with Adele Hite's organization.  It is, however, also completely funded by the lobbying arm of the Laura and John Arnold Foundation.

In the end, it turns out that LJAF paid the BMJ directly for the publication of the article.   It is no surprise that the BMJ's crusading editor Fiona Godlee is of no inclination to retract it.  So we have an unprecedented action here that is going unscrutinized by those who are touting this latest JAMA piece  (written by two LJAF-funded individuals).   You have direct payment to the journal itself.  If unprecedented, it raises eyebrows as to the objectivity of that journal in its choice of people to commission for the investigation.  They didn't seek out an independent, unbiased (to the extent one can be), professional in the field.  They chose Teicholz.    So really it matters more that there are ties with Teicholz so that the LJAF paid the publishing fee for a Nina Teicholz hit piece, they didn't pay the BMJ to commission a scientific investigation.  The Nutrition Coalition has since been revealed, and no sooner than it was, its makeup began changing dramatically.  As such it no longer bears much resemblance to its initial form.   And the LJAF flagship NuSI is, well, flagging.  More to come.






Original Publish Date:  September 25, 2015

Summary of Open Questions for The BMJ & Nina Teicholz:

  1. What was the grant amount from the Laura and John Arnold Foundation associated with this article?  Where is this listed on the LJAF website?
  2. What is the Nutrition Coalition?  Please provide website URL, official title and documentation of the "non-profit" status of this entity.  Is it an official 501c3?  
  3. Why did it take 10 years to write and publish The Big Fat Surprise?   In other words, how did taking that project off the shelf come about?  
  4. What is meant by "modest honorariums"?  What would be the total from one of these interests listed -- the meat industry -- for the past 5 years?  Be sure to include the figures for being General Session Speaker on Feb 22, 2015 at the American Meat (Institute) Conference, and leading the American Meat Science Association's Diet and Health Session at the 68th Annual Reciprocal Meat Conference on June 17, 2015.   
  5. Can The BMJ officially review and fact check The Big Fat Surprise?
  6. When will The BMJ be commissioning an objective journalist to look into ALL SIDES (including the money trails) of the controversies surrounding the DGAC and Dietary Guidelines?  
That last one is rhetorical, as to do so would require investigating itself and its own part in the circus of one-sided coverage to date, but I put it out there anyway.






Introduction




Yet another assault on science is underway.  This time in the once prestigious British Medical Journal, or just The BMJ.




Nina Teicholz reports??

OK ... let's begin there.  The British Medical Journal group has so seriously lowered its standards and diminished its credibility in recent years that I'm not even sure this is worth mentioning anymore.  But mention I will.  Since when do we have "local news at 10" style coverage in a peer-reviewed medical journal?  It is one thing for an utterly unqualified person to masquerade as a "science journalist", write a book like The Big Fat Surprise  (a complete abomination), receive uncritical praise and publicity on just about every major news outlet.  It was bad enough it received a favorable review by the former editor of The BMJ!  But it's quite another for that person to get ink -- Feature! -- in the "real" BMJ.  Yet here we are.
The expert report underpinning the next set of US Dietary Guidelines for Americans fails to reflect much relevant scientific literature in its reviews of crucial topics and therefore risks giving a misleading picture, an investigation by The BMJ has found. The omissions seem to suggest a reluctance by the committee behind the report to consider any evidence that contradicts the last 35 years of nutritional advice.
What investigation?  This is confusing.  Nina Teicholz reports.  Is this her investigation then?  Or one done by the BMJ editorial staff?  It seems they commissioned her to do this "investigation".  There's nothing new here from Teicholz.  Just a little different twist and the undeserved credence of being a feature in The BMJ.
Provenance and peer review: Commissioned; externally peer reviewed and fact checked.
They say the article is fact checked.  I haven't seen any of her usual glaring inconsistencies, like claims that we have cut fat from 43% to 33%, but the facts hardly seem to be the biggest issue here anymore.   Sadly there's no "cross fact checking" possible between what someone writes in a peer-review journal and what is loosely described as "research" in a mass media book so riddled with error it might actually be rejected by today's BMJ.  Well ... one could hope were it seriously reviewed and fact checked  ...

It seems that The BMJ has long ago traded interest in substance and science for sensationalism and $s.  In 2013 it started the pay-to-play Open Heart journal, with a questionable editorial board if ever there was one.  Every sensationalistic headline at BMJ-OH has been accompanied by an article in Time Magazine.  One could say Time is merely an extension of the journal's publicity office.   It's even an advertised perk to sell bytes to those seeking "peer reviewed" fame.  Of course articles in The BMJ proper also make the Time rounds and have made stars out of otherwise unremarkable folks like Aseem Malhotra.   Here's the one for this current article in The BMJ :




   The Disclosures are Interesting   


Competing interests:


I [Nina Teicholz] have read and understood BMJ policy on declaration of interests and declare that I am the author of The Big Fat Surprise (Simon & Schuster, 2014), on the history, science, and politics of dietary fat recommendations. I have received modest honorariums for presenting my research findings presented in the book to a variety of groups related to the medical, restaurant, financial, meat, and dairy industries.

The BMJ and other journals have made quite a big tadoo over "industry funding" in recent years.  The tobacco industry, the drug industry, the various and sundry food industries ... But the slam has been mostly against the sugar and grain industries in recent years, with some less fervent flack for the veggie oil people mostly surrounding trans fats.   And yet as I've highlighted here before (see for example here), the meat (mostly beef) industry is heavily involved in nutrition research.  This gets a pass?  Teicholz's biggest "beef" with the DGAC is the "deletion" of even lean meats (blog post with more links) from the lists of suggested healthy foods.  

As indicated in my prefacing questionnaire, Nina Teicholz is big in the meat industry.  It may be that a single honorarium or perks in the travel expenses doesn't amount to much.  We can even leave out the intangibles such as the impact on book sales from the exposure and honor of speaking engagements.  But how much was the honorarium for her to speak to the American Meat Institute contingency just this past February?  

{highlighting mine}


Did she take breaks from writing this current article to prepare and deliver her speech at the 68th Annual Reciprocal Meat Conference in June?  This one is more telling.

{highlighting and pointy fingers mine}

First on the AMSA news is:
Nina Teicholz and Mary Ann Binnie to Lead the AMSA Diet and Health Session at RMC
Now look at the highlighted text in my image:
AMSA is excited to announce that Nina Teicholz and Mary Ann Binnie will engage attendees in an in-depth discussion on Diet and Health at the AMSA 68th Reciprocal Meat Conference (RMC). Come to this session on June 17th in Lincoln, Nebraska to gain the tools to intellectually and scientifically defend meat.
I would say that if this doesn't flat out violate the Competing Interests disclosure -- she's giving tips on meat advocacy -- then it sure as heck violates the spirit of the practice.   As this is being sold to the readers as some sort of "BMJ investigation" it truly draws the objectivity of that journal into serious question.

Do take note of all the sponsors of AMSA.

If there is any doubt as to the content of her talk, there needn't be.  This is because AMSA was so kind as to put the slides online at meatscience.org!  


You tell me, does her disclosure of "modest honorariums" from the meat industry really cover this level of involvement?   I certainly don't think so.  This section is concluded with the following:
I am also a board member of a non-profit organization, the Nutrition Coalition, dedicated to ensuring that nutrition policy is based on rigorous science.
OK.  I looked up Nutrition Coalition.  No such entity exists.  The only organization by that name is a for-profit supplement company.  I am, however, aware of another "coalition" that exists specifically to get the Dietary Guidelines abolished:  The Healthy Nation Coalition headed up by Adele Hite (who was ousted from her PhD program in nutrition).  On the whole, I have no idea what to make of Marion Nestle, but she sure nails HNC right on the head!  If nothing else, the comments are amusing, but this from Nestle's article is interesting:
A sense of community has arisen around questioning our current approach to food and nutrition. Healthy Nation Coalition has its beginnings in the ancestral health, Weston A. Price Foundation, and low-carbohydrate nutrition communities.
Dr. James Carlson
from this blog post with info
There's nothing on the current website about this, but I'm sure if it had been misquoted by Nestle, Hite herself would have objected in comments.  She does claim that the organization has no official "roots", and is responded to with a link to the page specifying where Nestle's quote originated in third paragraph below the graph.  Apparently the website was edited.  That's kinda funny considering that Dr. Robert "Carbs Can Kill" Su is still on the advisory board, though he died almost two years now.   (James Carlson who is also on that board is another dubious advisor).   It bears mentioning that I do not see Nina Teicholz listed.

I wrote rather extensively about Hite & Economists' (ahem) most recent contribution to the "science" here:  Zoe Harcombe and Adele Hite's Hyper-System(at)ic Meta-Statistical Bovine Fecalemia.  Both subjects of that post are highly relevant to Teicholz's screaming bias here.  Hite's article mentions Teicholz in an Acknowledgement for her "support and editorial contributions".  So presuming that the Nutrition Coalition is indeed Hite's Healthy Nation Coalition seems logical.   This raises other questions, but foremost being the tax and mission status of this organization.   I've seen it designated -- including by Teicholz -- as a non-profit.  But not making money does not a non-profit make.  I don't find the 501c3 designation anywhere on HNC's website and I'm having difficulty identifying a snail mail address for the state in which this organization might at least be designated as a nonprofit.   The usual sites like Guidestar don't list any such entity, nor for that matter does "Nutrition Coalition" turn up anything likely in the four related hits with that phrase in the charity name.  

Why am I harping on this?  Well, what is the purpose of these disclosures?  Presumably to put your cards on the table.  What THIS disclosure demonstrates is that The BMJ doesn't really check these for accuracy (let alone completeness).  If they had, they would have discovered, as I did, that no "Nutrition Coalition" exists.  And has they followed up on that they would have discovered that the organization most likely to be the one Nina refers to has a mission.  A singular mission.  To get rid of the US Dietary Guidelines and whatever detriment, real or perceived, they have had on industries with which Teicholz is closely affiliated.



Is the COI That Important??


In a word.  YES.   I'm not going to go into the content of Teicholz's article in this post, except on this point.  She writes:

Much has been written about how industries try to influence nutrition policy, so it is surprising that unlike authors in most major medical journals, guideline committee members are not required to list their potential conflicts of interest. A cursory investigation shows several such possible conflicts: one member has received research funding from the California Walnut Commission[61] and the Tree Nut Council,[62] as well as vegetable oil giants Bunge and Unilever.[63 64] Another has received more than $10,000 (£6400; €8800) from Lluminari, which produces health related multimedia content for General Mills, PepsiCo, Stonyfield Farm, Newman’s Own, and “other companies.”[65]
61 Kris-Etherton PM, Hu FB, Ros E, Sabaté J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008;138:1746-51S.
62 Bao Y, Han J, Hu FB, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med 2013;369:2001-11.
63 Shi Y, Hu FB. The global implications of diabetes and cancer. Lancet 2014;383:1947-8.
64 Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-404.
65 Herman J. Saving US dietary advice from conflicts of interest. Food Drug Law J 2010;65:285-316. 

I can assure you that my own investigation here is not all that much more than "cursory" in nature.  In other words, I did nothing more than rely on a few Google searches here and public documents.  Easily found at that.  Teicholz compiled data from at least one article that is behind a paywall as is #65 above.  Based on the authors of references 61-64, I presume the first member with evil ties is Harvard School of Public Health's Frank Hu.  This may well be fair enough, but guess who Hu works with?   A not inconspicuous name in Dariush Mozaffarian.  Ahhhh.  He's been in the news lately.  I blogged about it in response to his (and NuSI inextricably linked David Ludwig) absurdities in JAMA and the NYT recently:  Let's Do Away With The Dietary Guidelines.  If you are new to this blog, or the kind of real information I provide that goes beyond just the science, but includes relevant facts nonetheless, I strongly encourage you to read that post before proceeding further.   If nothing else, use your browser search to find the part about Bunge.

That post was inspired by this article by Mozaffarian and Ludwig in JAMA:  The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat.  It was followed up on by an equally ridiculous article in JAMA's news mouthpiece, The New York Times.  There was nothing about the glories of eating butter and bacon in those articles, just some ridiculous notion that we're restrained from eating nuts and veggie oils because of 30% fat (which is NOT low).   They're all tainted!  Except get a load of this Nina Teicholz post on Facebook:



Of course no Teicholz discussion is complete without her bragging on herself, so let's look at the more damning comments there.  Larry's is what every #LCHFer is thinking.



This is great.  ~ Nina Teicholz

Well, perhaps she missed Mozaffarian's Bunge problem.  Last comment:


So just realize, conflicts of interest only pertain to DGAC members, not to those who are somewhat on the "same side", and certainly not to Nina herself!   The BMJ article continues:
And for the first time, the committee chair comes not from a university but from industry: Barbara Millen is president of Millennium Prevention, a company based in Westwood, MA, that sells web based platforms and mobile applications for self health monitoring. While there is no evidence that these potential conflicts of interest influenced the committee members, the report recommends a high consumption of vegetable oils and nuts as well as use of self monitoring technologies in programs for weight management.
Yeah, well 2015 also saw, for the first time, some article on the Dietary Guidelines authored by a bunch of economists with even less relevant background than Teicholz herself, and an ousted nutrition PhD student.    Enough already.   

Speaking of financial interests ....




Funding:


This article was fully funded with a grant from the Laura and John Arnold Foundation (www.arnoldfoundation.org).  The analysis was conducted independently, and the report reflects the views of the author and not necessarily those of the foundation.

Well this is interesting.  For those who are unaware, LJAF is the sole major contributor to -- and provided the seed money for -- Gary Taubes and Peter Attia's NuSI (Nutrition Science Initiative) organization.  For what it's worth, NuSI is actually a bona fide 501c3, but in the 2012 and 2013 tax years alone, these two pocketed over $1 million in salaries and bonuses alone -- 2014 numbers are eagerly awaited!  LJAF has committed to donate roughly $45 million to the "cause".   


There's nothing outdated about the website here, some small grants to rather obscure organizations are listed, and the search appears to work just fine. I find nothing for Nina Teicholz.  



Nothing for BMJ except ... 


(and some irrelevant organ donation thing)    Ahh Ben Goldacre.  I suppose BMJ came up in the search because he is an editor of their pay-to-publish paragon of pontification, Open Heart.   Goldacre's reputation and his contributions to that journal just don't square.  But this strays from the topic at hand. 

Bottom line:  There is no record of a direct grant to The BMJ or Nina Teicholz (or any Nutrition Coalition) for any investigation of the science behind the Dietary Guidelines or the Committee responsible.

Perhaps this needs updating.  Usually grants for research, etc. are listed somewhere, including the amounts.  Perhaps this is just an oversight?  I have used the LJAF contact page to request this information formally, but as of this writing have not received a response.  Unfortunately there does not appear to be any auto-confirmation of the contact either, so I have no idea if/when I will receive any response.  I dare not openly speculate at this point, but you probably know what I'm thinking ...

It seems clear at this point that LJAF is a "partisan" organization in the nutrition game.   If LJAF was interested in an objective investigation, there are certainly other science journalists they could have commissioned.  There is no doubt that somewhere Gary Taubes figures into the networking here (or maybe they can say it was just Peter Attia).   The Taubes-Teicholz relationship goes quite a ways back.  She did manuscript review for him for Good Calories Bad Calories, he returned the favor for The Big Fat Surprise.  



In Summary:



This just stinks.  I am in the process of writing up an online petition to the editors of The BMJ.  I'll edit in a link and splash it all over social media when I do.  Will you help me?  Share, share, share.  I'll go on any podcast about this.  It is important.  Here are the contacts I will be addressing:

Fiona Godlee, Editor in chief: fgodlee@bmj.com
Rebecca Coombes, Head of investigations and features: rcoombes@bmj.com

There is no need to wait for the petition or me to do anything.  I hope to have that together shortly and I hope you'll help with that as well.  It is time for The BMJ to contribute constructively to the dialogue about nutrition and health.  A good first step will be to retract the Teicholz article in their journal.  I would suggest that an investigation into the writing of The Big Fat Surprise.  It would be of more use to a confused public.   And while we're at it, instead of fact checking editorials, how about fact checking that book?  THAT would be a true service to humanity as a whole.  I know several people who could contribute to such a fact checking exercise.  We're many months and bounds ahead of the game.

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