Hiring a fact checker should be the first item on the agenda of The Nutrition Coalition (the Coalition), a newly announced group that is trying to “reform” the current process for the Dietary Guidelines for Americans.
Nina Teicholz, the author of The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet and a leading advocate of the “butter is back” movement, serves on the Coalition’s governing board and appears to have laid out its agenda in a recent “investigation” in the British Medical Journal detailing how the government updates the Dietary Guidelines for Americans. The Guidelines are important because they are the foundation for the government’s (and others’) food education efforts and set nutrition standards for school meals and other food and feeding programs.
In a letter to the BMJ, the Center for Science in the Public Interest’s (CSPI’s) nutrition director, Bonnie Liebman, cited that statement as just one of several “glaring errors,” writing: “The systematic [Cochrane] review to which [Teicholz] refers concluded that ‘reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14 percent.’”
Teicholz was undeterred, responding to Liebman by saying: “The primary and secondary outcomes of this analysis were total mortality and cardiovascular mortality, respectively. Neither of these was improved by reductions in saturated fats. The tertiary outcome was cardiovascular events, where the 14 percent improvement was seen, but ‘events’ is a less reliable outcome measure because the identification of a heart attack is subject to variations in detection and diagnosis as well as bias. Death, which is indisputable, is the more reliable outcome measure.”
Now, Teicholz is entitled to her reading of the data, but she is not entitled to misrepresent the data. In the Cochrane review “combined cardiovascular events” were analyzed as the third of three “primary outcomes,” not as a tertiary outcome. (Cochrane review) In fact, the paper examined 10 other “secondary” outcomes and 17 other “tertiary.” outcomes.
Moreover, here is the conclusion that the authors of the review drew from their data: ‘This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14 percent.” (Cochrane review) They went on to state: “The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.”
This is hardly a failure to confirm an association between saturated fats and heart disease.
Then we have the histrionic hyperbole of the Coalition chair, Cheryl Achterberg, who wrote earlier this year in the Wall Street Journal: “The classic American sandwich is about to get a radical makeover. Forget about roast beef or cold cuts. Red meats and processed meats are out.” It made for entertaining reading but was not based on what the DGAC recommended, which was “lower” consumption of red and processed meats.
The new coalition also likes to trumpet that it receives no industry funding, suggesting that they are engaged in an unbiased academic exercise. In fact, a several of its members have received industry funding over the years for their research and work. Achterberg has recently consulted for the Dannon Institute and has a history of consulting with Kraft General Foods and the National Dairy Council, a non-profit supported by the dairy checkoff program. In April, Theresa Nicklas co-authored a paper warning that recommendations to reduce saturated fat intake could unintentionally result in lowering protein intake; the paper was supported by The Beef Checkoff, Dairy Research Institute, Egg Nutrition Center, Global Dairy Platform, Hillshire Brands, and the National Pork Board. Ronald Krauss has received support from Campbell Soup Co. and the National Dairy Council. Given Teicholz’s complaint in her BMJ article about DGAC members’ “conflicts,” one would have expected more transparency from the Coalition.
It brings to mind the quote from Carl Sandberg: “If the facts are against you, argue the law. If the law is against you, argue the facts. If the law and the facts are against you, pound the table and yell like hell.”
So far, the facts and the science have been against The Nutrition Council, and that has left them a lot of pounding the table and yelling.
O'Hara is director of Health Promotion Policy at the Center for Science in the Public Interest.