The BMJ has recently published a Feature article, critical of the (United States) Dietary Guidelines Advisory Committee (DGAC) findings and its members, by journalist Nina Teicholz:

The scientific report guiding the US dietary guidelines:  it scientific? 

For the past several years, the quality of content in this once-prestigious journal has declined substantially, including publication of several commissioned opinion pieces favoring sensationalism over scientific substance.  While content labeled as opinion or editorial is subject to somewhat relaxed standards of objectivity, it is still important that authors fully disclose and generally be free from conflicts of interest that may compromise the integrity of their work. 

The BMJ has now stepped further over the customary lines by commissioning Ms. Teicholz to conduct “an investigation by The BMJ”, insinuating that Ms. Teicholz is merely reporting the findings of the journal staff.  Further adding to the confusion, this “commissioned, externally peer-reviewed and fact checked” article was “fully funded” by an unaffiliated third party: the Laura and John Arnold Foundation. 

This raises grave questions, not the least of which being why The BMJ is “investigating” the DGAC and its members in the first place.   The insinuation of wrongdoing is fostered by the Editor in chief, Dr. Fiona Godlee, when she is quoted in the press release as saying, “The committee's conflicts of interest are also a concern. We urgently need an independent review of the evidence and new thinking about diet and its role in public health.”

When commissioning an article for publication, it is customary for scientific journals to seek authors with knowledge and expertise in the subject area.   The selection of Ms. Teicholz is curious as she possesses neither a formal education nor any practical experience in the field of nutrition, or any remotely related scientific field.  Her sole qualification appears to be authorship of the factually tenuous book, The Big Fat Surprise.  Presumably whomever commissioned Ms. Teicholz has read this book and should be well aware of the clear lack of objectivity in her writing.   It is troubling, to say the least, that fact checking of this book seems to be furthest from the minds of the editorial staff of The BMJ.  As part of the vetting process, Ms. Teicholz should have been required to disclose potential competing interests in advance.  Had this been done, it is inconceivable that an unbiased editorial board of any academic journal would have gone forward with her selection as investigator.  This is of particular importance due to the nature of the article, replete with accusations of bias and conflicts of interest in the subjects of her investigation, while failing to acknowledge her own considerable issues in this regard.   It is therefore incumbent upon all parties involved to make public the details of this investigation from inception through publication.   

Since its publication, others, including some DGAC members, have responded to errors and inconsistencies in the factual content of this report.  In many ways these may even be secondary to the issues raised in this petition addressing the integrity of academic journalistic process at The BMJ.  Further details are included in the Supporting Information below this petition.

It is time to hold The BMJ accountable to the same standards of objectivity, independence and lack of bias that they claim to apply to the scientific community.  Please join me and sign this petition to support academic integrity and have The BMJ retract this publication that has no place in a peer-reviewed journal of medicine.   Pressure for full disclosure of the details of this entire investigation will help to insure that this never happens again.   By signing you are sending a clear message to the editors that the public desires substance over sensationalism, and high standards of journalistic conduct.

EDIT 10/8/2015:  Please read this update before signing.  http://carbsanity.blogspot.com/2015/10/nina-teicholz-bmj-nutrition-coalition.html 

After you sign, please contact Fiona Godlee, Editor in chief: fgodlee@bmj.com and/or Rebecca Coombes, Head of investigations and features: rcoombes@bmj.com and communicate your concerns.

Thank you!

BACKGROUND:

 1.      The following are concluding points in the article under the title “What you need to know”:

• The latest dietary guidelines for Americans are imminent and will affect the diet of tens of millions of citizens, as well as food labeling, education, and research priorities. In the past most Western nations have adopted similar dietary advice
• The scientific committee advising the US government has not used standard methods for most of its analyses and instead relies heavily on systematic reviews from professional bodies such as the American Heart Association and the American College of Cardiology, which are heavily supported by food and drug companies. The committee members, who are not required to list their potential conflicts of interest, also conducted ad hoc reviews of the literature, without defining criteria for identifying or evaluating studies
• This year in its report to government, the committee largely sticks to the same advice it has given for decades—to eat less fat and fewer animal products and eat more plant foods for good health. But this decision to keep with the status quo fails to reflect much of the current, relevant science. Exceptions include a proposal for a cap on sugar intake
• The committee recommends three diets to promote better health, again without the accompanying rigorous evidence
• The US Congress has stepped in, with a hearing scheduled in October

2.     The associated press release also contains an “endorsement” of sorts from BMJ Editor in chief Dr. Fiona Godlee:

“These guidelines are hugely influential, affecting diets and health around the world. The least we would expect is that they be based on the best available science. Instead the committee has abandoned standard methodology, leaving us with the same dietary advice as before - low fat, high carbs. Growing evidence suggests that this advice is driving rather than solving the current epidemics of obesity and type 2 diabetes. The committee's conflicts of interest are also a concern. We urgently need an independent review of the evidence and new thinking about diet and its role in public health.”

3.     An audio interview with Ms. Teicholz accompanying the online article ends with the interviewer listing what is needed to restore trust in the process:  transparency, scientific rigor, and consistency.  Ms. Teicholz responds in agreement, repeating the need for transparency and scientific rigor, but then replaces consistency with “protection against bias”.   

Although Ms. Teicholz spends much time speaking to bias and conflicts where others such as DGAC members are concerned, she is less than forthcoming about her own significant bias and conflicts.   Editor in chief Godlee’s remarks also fail to acknowledge any concerns about the objectivity of their investigative reporter.

SUPPORTING INFORMATION:

All readers desiring further information on The Big Fat Surprise and related writings by Nina Teicholz, including extensive fact checking, will find helpful content at the following two blogs: The Carb-Sane Asylum and The Science of Nutrition. 

In the spirit of the tone of the “BMJ investigation”, along with that of its accompanying media materials, the following questions are posed to Nina Teicholz and the editorial staff of The BMJ, and directed specifically to Dr. Fiona Godlee, Editor in chief, and Rebecca Coombes, Head of investigations and features.    These questions seek to clarify many issues arising from the disclosures made in the article regarding funding and potential conflicts of interest.   The information and questions are presented here together.  

1.     This Feature article was “Commissioned; externally peer-reviewed and fact checked”.  

Whose idea was it to launch an investigation of the DGAC?  Who was responsible for commissioning the investigation?  Who was responsible for selecting Nina Teicholz as investigator, and on what basis was she selected?  More specifically, was her mass media book The Big Fat Surprise a factor in her selection?  If so, have those responsible for selecting Ms. Teicholz read or attempted a fact check of her book?  What role, if any, did former BMJ editor Richard Smith’s favorable “review” of The Big Fat Surprise in the journal’s Christmas (satire) 2014 edition play in her selection? Were there any other investigators involved?  What exactly does “commissioned” mean?  This term usually implies financial compensation and this designation makes it appear as if The BMJ contracted Ms. Teicholz for this work.  Was financial compensation involved and/or were customary submission fees waived? 

There are a lot of questions on this point alone.  Considering the timing of this publication with regard to the upcoming Congressional action mentioned in the article, The BMJ should be forthcoming with details and a timeline for this investigation/article from conception to publication. 

The fact that this was commissioned, regardless of circumstances, draws the credibility of The BMJ into serious question.  Any cursory look into Ms. Teicholz’s investigative journalism and competing interests, that should have been reviewed in advance, should disqualify her from consideration to conduct an unbiased investigation of this nature. 

2.     “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.” 

A search of the LJAF website does not list this grant (to be certain, searches on known grants were conducted and the search function is fully operational).  This statement would indicate a direct grant from LJAF to Ms. Teicholz.  What was the amount of this grant, when did this occur, and where can this information be found on the foundation website?   Is it correct that the recipient was Ms. Teicholz individually?    Lastly, if the LJAF fully funded the investigation, how does this reconcile with the “commissioned” status of the report?  Specifically, were some LJAF funds used to defray customary submission costs?

As the record stands, the article implies that the LJAF is funding “an investigation by The BMJ”.  Is this customary procedure for this or other medical journals?

3.     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."

Given that Ms. Teicholz enumerates various potential conflicts of interest for DGAC members, it would seem incumbent upon her to divulge more details about the honorariums she mentions in her disclosure.  For example, the article specifically identifies one committee member receiving $10,000 from a single company, thus putting a dollar amount on what Ms. Teicholz believes is worthy of consideration.  It may be that more detail is available on the original disclosure, in which case The BMJ is called on to release it in full.  If not, Ms. Teicholz should be required to disclose further detail.   The term “modest honorarium” is vague and undefined, and while any single payment may be inconsequential, taken together the sum may be significant.   Therefore it would be appropriate for Ms. Teicholz to provide cumulative values for monies received from various industries for the past few years.  

A major contention in the article is with respect to recommendations surrounding consumption of red meat.  Is The BMJ aware that Ms. Teicholz has been a featured speaker for at least three meat industry associations in within the past year? 

• Speaker at Oct. 2014 Texas Cattle Feeder Association’s Annual Convention
• General Session Speaker on Feb. 22, 2015 at the American Meat (Institute) Conference
• Leading the American Meat Science Association's Diet and Health Session at the 68th Annual Reciprocal Meat Conference on June 17, 2015.  The slides of this AMSA talk are available online.

AMSA’s description of Ms. Teicholz’s role at the conference appears to go beyond your usual presentation:

"AMSA is excited to announce that Nina Teicholz … 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."  {emphasis mine}

It should be noted that this conference was itself sponsored by various industry interests, and according to the slides, Ms. Teicholz’s presentation was specifically sponsored by Merck Animal Health.  Does The BMJ feel that Ms. Teicholz’s disclosures are sufficient to inform readers of the level of her bias and industry affiliation?  Does The BMJ stand by this article as the objective findings of an unbiased investigator? 

4.     Disclosure:  “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.”  

There is no record of a non-profit Nutrition Coalition in any general internet search or search of Guidestar.com.    Who or what is the Nutrition Coalition?  Did The BMJ attempt to identify this organization to determine if Ms. Teicholz’s disclosed affiliation was problematic?  Ms. Teicholz was acknowledged for her support and editorial assistance in a recent paper in Nutrition co-authored by Adele Hite, head of the Healthy Nation Coalition, an organization with roots in the low carb diet community.   This affiliation requires clarification.  Is the Nutrition Coalition actually the Healthy Nation Coalition?  That organization does not appear to have formal 501c3 non-profit status.  As Ms. Teicholz is not listed on HNC’s website, and her disclosed non-profit organization does not appear to exist, The BMJ should take appropriate steps to correct the record here.