Saturated Fats, Conflicts of Interest, and Nutritional Partisanship

Last week saw the British Medical Journal publish an op-ed on the American dietary guidelines written by Nina Teicholz. I think a fair summary of Teicholz' piece is that she believes conflicts of interest and shoddy science led the Dietary Guidelines Advisory Committee (DGAC) to get everything all wrong in recommending diets lower in saturated fats.

I think it's important though to know, that Teicholz isn't just any old journalist, she's a journalist who recently authored a global, absolutely blockbusting, bestseller on diets, a fair summary of which, "Why Butter, Meat and Cheese Belong in a Healthy Diet", is included on its cover.

Oddly, despite her BMJ thesis being in large part about how conflicts of interest and personal biases clouded the DGAC's recommendations, in the embargoed version of Teicholz' BMJ piece that was shared with reporters in advance of publication, her conflict of interest statement failed to mention her million dollar (or more) baby,

"I have read and understood BMJ policy on declaration of interests and declare I have received modest honorariums for presenting my research findings to a variety of groups related to the medical, restaurant, financial, meat, and dairy industries. 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. This article was fully funded with a grant from the Laura and John Arnold Foundation."

What wasn't as odd, or at least not as unexpected as Teicholz' original lack of disclosure, was the passionate nature of responses to her piece, and then of course the passionate and rather partisan nature of the rebuttals to the rebuttals, and rich in all of them were cries of conflict of interest.

Coincidentally, on the same day that Teicholz' piece published, so too did a new saturated fats position statement from Canada's Heart and Stroke Foundation (HSF). The HSF, up until very recently, had some major food industry inclusive conflicts of interest, but over the course of the past few years the HSF has divested itself of those.

So what was the HSF's take on saturated fats? In summary, they argue that the current science on saturated fats would suggest that there may be health benefits if you replace them with unsaturated fats, and that,

"There is emerging evidence to suggest that the health effects of saturated fats could vary depending on the food sources in which they are found."

They then make a series of recommendations that eschew a threshold or limit for saturated fat and instead are reminiscent of Brazil's recently published national dietary guidelines - which can be boiled down to cooking more with fresh, whole ingredients while minimizing restaurant and ultra-processed foods.

Of Teicholz' and the HSF's takes, I'm with the HSF. That's not to say that Teicholz' concerns hold no water at all, but rather that they, perhaps consequent to her own clear and significant conflicts of interest, do the very thing she rages against - draw sweeping conclusions from less than sweeping data. The HSF on the other hand, at least in my opinion, are doing their best to summarize the unfortunate truth of nutrition research - that it's nowhere near as clear cut as it's often presented, and that our best evidence to date is supportive of benefits to broad patterns of eating that unfortunately haven't yet been drilled down to best diet style specificity.

The frustratingly partisan nature of the responses to Teicholz, and to the responses of the responses, I think is well summarized in this tweet by MPH candidate Sarah Kunkle

This back & forth is becoming so stale. Can we focus on what we agree upon? I.e. more whole foods, less processed https://t.co/FHdEnV3yrN

— Sarah Kunkle (@sareve) September 25, 2015

Amen.

If you're interested in wading through them, here are a collection of responses to Teicholz' piece in order of their publication, including a newly launched petition for the oped's removal which was posted just a few hours ago (last in line):

BMJ Publishes Error-Laden Attack on Dietary Guidelines Report - CSPI

Medical journal’s bogus investigation could derail better dietary guidelines - The Verge

Expert is as expert does: in defence of US dietary guidelines - The Conversation

The DGAC's official response to Teicholz' accusations - The BMJ

An Open Letter to the BMJ Regarding US Dietary Guidance - Dr. David Katz

Nina Teicholz Reports in the British Medical Journal ~ The Conflicts & Funding - The Carb-Sane Asylum

British Medical Journal (BMJ) gives low-carb journalist Nina Teicholz an outlet to blast the Dietary Guidelines Advisory Committee (DGAC) - U.S. Food Policy Blog

Call for The BMJ to retract Teicholz article on Dietary Guidelines Committee and Science - Evelyn (CarbSane)

Saturday Stories: Walking, Ultramarathoning, and Human Garbage

Antonia Malchik in Aeon Magazine laments the death of walking.

Bradley Stulberg in Outside covers what happens to a person's body when they run a 100 mile ultramarathon.

James Hamblin in the Atlantic covers the human garbage that is Martin Shkreli.

Personal Trainers of the World, This 6 Year Old is Coming For Your Jobs

Today's Funny Friday video is of a truly up and coming personal trainer from Jamaica.

Oh, and he's 6.

Have a great weekend!

Alberta Health Services Says, "Eat A Cookie For a Good Cause"

The Calgary Health Trust is the official fundraising arm of Alberta Health Services, and they want you to eat cookies, specifically Tim Horton's cookies, and more specifically their annual Smile campaign's cookies where $1 buys you a cookie and the proceeds go to charity.

According to the information provided by Calgary Health Trust, nationally, since its inception in 1996, Tim Horton's Smile Cookie campaign has raised $3.6 million. That's $189,473 raised annually (though no doubt it's been a growing campaign).

Take that number and divide by the 345 charities supported by the event and you get an average of $519 per charity per year.

Now that said, bigger cities like Calgary are able to generate more money for their local charities because there are both more people and more Tim Horton's locations, and an email sent out by Alberta Health Services' South Health Campus hospital encouraging its health care professionals to buy and promote the sale of cookies, reports that since 2010 in Calgary the Smile Cookie campaign has raised $813,000.

That's $135,500 per year. Sure sounds like a lot, but with South Health Campus' annual operating budget of $345,000,000, the cookie fundraiser covers less than 4 hours a year of the hospital's annual costs. And there are 9 other hospitals in Calgary.

So is that worth it? For Tim Horton's it sure is. It buys them incredible PR, a cause beyond reproach, brand loyalty, a ridiculous and invaluable amount of social media advertising, and a hefty tax deduction that undoubtedly more than covers the cost of the cookies' flour and sugar. It also supports the concept of junk food fundraising - a concept integral to Tim Horton's outright purchase of kid sport in this country.

Sure, it would require more work for Alberta Health Services to raise an additional $135,500 per year than it does to partner with Tim Horton's to sell cookies - that they choose not to make that effort is a failure of both vision and leadership.

The Canadian Olympic Committee Wants You To Eat Lots of Chocolate Bars

Thanks to Ottawa Fit Club for sending this my way.

It's Team Canada, Canada's official Olympic team, shilling for Cadbury with a contest sponsored by The Canadian Olympic Committee (COC) for a year's supply of Caramilk bars.

And if you, like me, are scratching your head and asking yourself "WTF, why would the Canadian Olympic Committee be sponsoring a contest for a year's supply of chocolate bars?", the answer is either money or stupidity

Or both.

And if the COC is reading this, let me remind you of how you bill yourselves,

"The COC is an internationally recognized leader in the fields of marketing and education. We work to promote sport as a positive and powerful force for all Canadians. In so doing, the COC will help ensure that sport continues to contribute to Canadians’ physical, social and moral development from coast to coast to coast."

I would love to hear how a year's supply of Caramilk bars fit into that mandate.

Parental No Files: Welcome to School Dance and "Candy Bar" Edition

I think the problem is the notion that "fun" requires junk food or candy.

Certainly food is celebratory and comforting, and while indeed it is and can be "fun", the use of junk food to supply entertainment at events that ought to be fun on their own have become endemic.

Take this welcome back to school "Dance and Candy Bar" that was put on through the Calgary Board of Education. Kids from Kindergarten through Grade 4 were tasked to bring different types of candy to school so that the "dance" would have a candy bar for them to eat from, whereas the associated school picnic - optional.

The photos below are from the party and were sent to me by an RD/parent who'd prefer anonymity and who in the end chose not to exclude her children from this wholly unnecessary elementary school/kindergarten event.

Odd, last time I checked with my Grade 1 and 3 year olds, helping them to have "fun" wasn't a high bar. While it's true that it might have taken a teeny tiny bit of thought, creativity, effort, and caring, I have to imagine that the administration involved could have found ways for kids to have "fun" that didn't include organizing for them a school sponsored Halloween in September.