Nina Teicholz made a very significant contribution to the arguments about a healthy diet with publication of her book entitled The Big Fat Surprise (1), which was extremely well received. The Economist named it as the Number One science book of 2014. Several US publications, including the Wall Street Journal, identified it as the “Best Book” of the year.
Significantly, a review in the American Journal of Clinical Nutrition said:
“This book should be read by every nutritional science professional.”
A former editor of The BMJ, Dr. Richard Smith, was even more complimentary. He concluded that Teicholz had done a remarkable job analysing the weak science, strong personalities, vested interests, and political expediency of nutrition science.
A year later, she wrote an article published in The BMJ (2). In it, she criticised the expert report (3) that formed the basis for the revision of the US Dietary Guidelines for Americans. In particular, because the report omitted reference to many reviews of crucial topics, it did not reflect accurately the current state of play in human nutrition. This indicated a reluctance to consider any evidence that contradicted the official dietary advice promoted over the last 35 years.
Call for retraction
This resulted in an extraordinary response from doctors and scientists, initiated by Bonnie Liebman, director of nutrition in a Washington-based pressure group, The Centre for Science in the Public Interest (4). In an email, she claimed that the article was “full of errors” and asked respondents to sign a letter to The BMJ demanding retraction of the Teicholz article.
As a result, Dr. Frank Hu, a prominent professor and researcher at the Harvard School of Public Health, emailed Professor Miguel A. Martinez-Gonzalez at the University of Navarra, Spain in which he said:
“I would greatly appreciate if you can ask your colleagues in Spain and other European countries to sign the letter. I think it is extremely important to retract the terrible BMJ article for the sake of science and public health.”
Martinez-Gonzalez forwarded the email to colleagues in Europe and asked them to sign the following:
“I have read the full version of the attached letter and I agree to include my signature on it. I endorse its full content and the request to the BMJ to retract the journalist’s article.”
As a consequence, more than 180 experts signed this letter. These included all the members of the 2015 Dietary Guidelines Advisory Committee, all the living authors of Ancel Keys’ Seven Countries Study, scientists involved in the American Heart Association, and others, including environmental scientists, management consultants, and graduate students (5).
Commenting on the retraction demand, Ian Leslie in a Guardian article commented that:
“Publishing a rejoinder to an article is one thing; requesting its erasure is another, conventionally reserved for cases involving fraudulent data.
As a consultant oncologist for the NHS, Santhanam Sundar, pointed out in a response to the letter on The BMJ website:
“Scientific discussion helps to advance science. Calls for retraction, particularly from those in eminent positions, are unscientific and frankly disturbing.”
The letter lists “11 errors” that on close reading turn out to range from the trivial to the entirely specious. I spoke to several of the scientists who signed the letter. They were happy to condemn the article but when I asked them to name just one of the supposed errors in it, not one of them was able to.
One admitted he had not even read it. Another told me that she had signed the letter because The BMJ should not have published an article that was not peer reviewed (it was peer reviewed). Meir Stampfer, a Harvard epidemiologist, asserted that Teicholz’s work was “riddled with errors”, while declining to discuss them”(6).
The BMJ stands firm
In September 2016, The BMJ announced that it would not retract the article. The details of the investigation were reported in December 2016 (7). In an article, the editor-in-chief, Dr. Fiona Godlee stated that:
“We stand by Teicholz’s article and its critique of this highly influential advisory committee’s processes for reviewing the evidence, and we echo her conclusion: “Given the ever increasing toll of obesity, diabetes, and heart disease, and the failure of existing strategies to make inroads in fighting these diseases, there is an urgent need to provide nutritional advice based on sound science.” “
She continued:
“Neither Teicholz nor The BMJ are new to criticism. Healthcare is rife with controversy, and the field of nutrition more so than many, characterised as it is by much weak science, polarised opinion, and powerful commercial interests. But nutrition is perhaps one of the most important and neglected of all health disciplines, traditionally relegated to non-medical nutritionists rather than being, as we believe it deserves to be, a central part of medical training and practice. The current state of nutrition research should be a matter of grave concern to those attempting to develop evidence based health and economic policies that truly serves the public interests.”
Richard Smith commented:
“I congratulate The BMJ on withstanding pressure to retract this article…. There is an ugly tendency these days for powerful groups to call for retraction of any article they don’t like. The BMJ has stood up for science on a crucial subject that affects everybody (8).”
Conclusion
It is gratifying that Fiona Godlee and her employers at The BMJ have had the good sense and sheer guts to stand up to this bullying. It is extremely nasty and disturbing. Essentially it is powerful vested interests and arrogance on the part of the researchers to misuse their positions. In effect it means that they do not have the confidence in the quality of their own results to stand up to scrutiny and have to resort to tactics that are totally unacceptable. The tragedy is that millions of people have complied with the advice promulgated by the authorities because it is regarded as reliable but has been responsible for human suffering on an enormous scale.
This is certainly not the first time this has happened and probably will not be the last. Let us hope that more and more people will resist this type of intimidation and take inspiration from the courageous action of Fiona Godlee and the The BMJ.
References
- Nina Teicholz (2014). “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet”. Simon & Shuster New York
- N. Teicholz (2015). The BMJ http://www.bmj.com/content/351/bmj.h4962/
- Dietary Guidelines Advisory Committee (2015). Advisory Report to the Secretary of Health and Human Services and to the Secretary of Agriculture. https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf
- D. S. Jones (2016). Silencing Science: The War on Nina Teicholz. https://shootingthemessenger.wordpress.com/2016/05/05/silencing-science-the-war-on-nina-teicholz/
- N. Teicholz (2016). Overview of BMJ Retraction Request. http://thebigfatsurprise.com/overview-bmj-retraction-request-including-response-11-allegations/
- I. Leslie (2016). Guardian https://www.theguardian.com/society/2016/apr/07/the-sugar-conspiracy-robert-lustig-john-yudkin?CMP=share_btn_tw
- F. Godlee (2016) The BMJ http://www.bmj.com/content/351/bmj.h4962/rr-48
- http://thebigfatsurprise.com/press-release-bmj-decision-not-retract/