Saturday, September 26, 2015

British Medical Journal (BMJ) gives low-carb journalist Nina Teicholz an outlet to blast the Dietary Guidelines Advisory Committee (DGAC)

The British Medical Journal (BMJ) this week published an article/editorial by journalist Nina Teicholz blasting the Dietary Guidelines Advisory Committee (DGAC) for recommending diets with less saturated fat, red meat, and salt. In it, Teicholz offers a powerful stew of selective scientific evidence and blistering attacks on the integrity of opponents.

Teicholz is a journalist and author of The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. Her disclosure statement in the BMJ mentions honorariums for medical, restaurant, financial, meat, and dairy industries. She slams DGAC committee members for conflicts of interest with vegetable oil producers and, in one case, some funding from the California Walnut Commission. This tit-for-tat focus on conflicts might come out in Teicholz' favor ... if we lived in some upside-down universe where walnut growers and vegetable oil manufacturers controlled U.S. agriculture policy and the meat and dairy industries were oppressed and powerless minions.

Teicholz is most upset with the DGAC for "not only deleting meat from the list of foods recommended as part of its healthy diets, but also actively counseling reductions in 'red and processed meats.'" But the Dietary Guidelines Advisory Committee never has and never would recommend deleting meat. I have no idea what passage of the report she thinks recommended deleting meat.

As for eating less meat, the context for the DGAC recommendation is that per capita annual meat consumption in the United States is a remarkable 120 kg, far higher than the average amounts consumed globally (42 kg) or in other rich countries that have lower rates of chronic disease than we do, such as Japan (46 kg). The United States has plenty of room to improve healthy diets without eating as much meat as we currently do.

Teicholz never mentions why leading health authorities recommend moderating our consumption of red meat and processed meat in particular. For example, the American Institute of Cancer Research (AICR) advises less processed meat because of concern about colon cancer. Teicholz mentions "heart disease" 11 times, but ignores cancer (the two occurrences of the word "cancer" are later off-hand dismissals of concerns about saturated fat). It's not that Teicholz disputes the evidence, she simply never mentions it.

Teicholz offers rich and sanctimonious criticism of the DGAC for sometimes using its own best summary of the evidence without the formality of a systematic review. A systematic review is a process through which a research team with relevant expertise carefully defines the diet-health relationship under study, prepares a written protocol in advance for choosing eligible research articles, and systematically classifies and reports the results. The striking thing about the DGAC is that -- more than with any other such work that I know -- it is usually easy to trace the committee's reasoning from its conclusions, back to systematic reviews in the government's free online Nutrition Evidence Library (NEL) and other authoritative research associations, such as the American Heart Association (AHA). But, wow, does Teicholz really hate the AHA, describing the respected association as mere pawns of, once again, the vegetable oil industry.

The contrast between DGAC and Teicholz in transparency of selecting and reporting evidence is striking. A systematic review is precisely the opposite of what Teicholz does in her own work, as a journalist deep-diving willy-nilly into idiosyncratically selected sub-sections of a vast and complex literature, choosing those studies that support her argument and agree with the conclusions of her best-selling book.

Others have already prepared a line-by-line evisceration of the Teicholz article, and committee members submitted a response to the BMJ online site. Here, more broadly, for your comparison with Teicholz' article in BMJ, consider the reasonableness of the approach and conclusions used by the DGAC.
The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar sweetened foods and drinks and refined grains.
That won't sell so many books, but it makes sense to me. I hope it earns a more fair reading from you than it has from Teicholz.


Anonymous said...

Here we go again.. Pitting this food against that food! Does anybody look at what people are actually eating...... Junk!!! Look at the USDA findings, 3/4 of calories of the average American eats are pure crap!!! While policy makers argue passionately about their "rigorous scientific methods" when formulating their "healthy living guidelines" . They fail to recognize the consequences of their published guidelines. Can't the leaders of our medical community see that junk like low fat dairy products, loaded with sugar, all white meat chicken nuggets fried in all vegetable oil free from trans fats, and "whole grain" junk cereals, exists as a result of their well intentioned recommendations! All of the junk foods I listed follow their recommendations re: dairy fat, red meat and whole grains. While admittedly, nobody on the panel intended these to be recommended food choices, they seem to have zero understanding that most of their " expert opinions"are going to get spun by the food industry as blessings for their junk developments!

I think our policy makers need to spend a little more time looking at the consequences of their recommendations and how it is affecting the diets of the population at large as opposed to being ( accidently) a market machine for the junk food industry! Just a thought before you lump Big Mac in the same pile as a lamb chop.

Dr Rosemary Stanton said...

So why do so many people totally ignore the calls of Dietary Guidelines to eat more vegetables, fruit, wholegrains, nuts and seeds. Why do they concentrate only on less red meat. Part of the problem is that meat is so dominant that vegetables get very little attention. We even describe a meal by the type of meat.

Why not concentrate on praising dietary guidelines for what they tell us to consume in larger quantities.

And if the junk food industries choose to distort the messages, then let's blame them, not those who use evidence to create the messages.

Anonymous said...

It is documented that meat consumption is actually lower now than pre World War II. The only macro nutrients that have seen consistent increases in consumption in the USA are carbohydrates and vegetable oils.

Read the whole report if you actually want to understand fat as a nutrient and it's history.