Guest Essay by Kip Hansen — 20 January 2020
Rita Rubin, Senior Writer, JAMA Medical News & Perspectives, has stirred the pot on the controversy surrounding a series of studies published last Fall in the Annals of Internal Medicine, “one of the most widely cited and influential specialty medical journals in the world.” Her latest piece, titled “Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists”, appeared in JAMA online on 15 January 2020. It begins with this:
“It’s almost unheard of for medical journals to get blowback for studies before the data are published. But that’s what happened to the Annals of Internal Medicine last fall as editors were about to post several studies showing that the evidence linking red meat consumption with cardiovascular disease and cancer is too weak to recommend that adults eat less of it.
Annals Editor-in-Chief Christine Laine, MD, MPH, saw her inbox flooded with roughly 2000 emails—most bore the same message, apparently generated by a bot—in a half hour. Laine’s inbox had to be shut down, she said. Not only was the volume unprecedented in her decade at the helm of the respected journal, the tone of the emails was particularly caustic.
“We’ve published a lot on firearm injury prevention,” Laine said. “The response from the NRA (National Rifle Association) was less vitriolic than the response from the True Health Initiative.”
Welcome to The Meat Wars. Yet another Modern Scientific Controversy playing out in the mass media. I covered the story originally here at WUWT in “Modern Scientific Controversies Part 7: The Meat War” last October. Read this earlier essay to get a feel for what has happened so far.
A group of independent researchers, from several countries, have formed a group called NutriRECS, “an independent group with clinical, nutritional and public health content expertise, skilled in the methodology of systematic reviews and practice guidelines who are unencumbered by institutional constraints and conflicts of interest, aiming to produce trustworthy nutritional guideline recommendations based on the values, attitudes and preferences of patients and community members”. They have covered a wide range of issues since 2010.
NutriRECS authors published six papers simultaneously in Annals of Internal Medicine. 19 November 2019 Vol: 171, Issue 10, the papers in combination reviewed the evidence used to make public health recommendations for amounts of red and processed meat in the human diet. [ While the official publication date, issue, and volume of the journal show 19 November, the controversy breaks as early as September 2019 — with pre-publication copies of the papers sent out to the press, as evidenced by coverage in the NY Times on 30 September 2019. I was able to access all six papers online in early October 2019. — kh ]
Gina Kolata, of the NY Times Health section, characterized the furor over the papers last September this way:
“Public health officials for years have urged Americans to limit consumption of red meat and processed meats because of concerns that these foods are linked to heart disease, cancer and other ills.
But on Monday, in a remarkable turnabout, an international collaboration of researchers produced a series of analyses concluding that the advice, a bedrock of almost all dietary guidelines, is not backed by good scientific evidence.
If there are health benefits from eating less beef and pork, they are small, the researchers concluded. Indeed, the advantages are so faint that they can be discerned only when looking at large populations, the scientists said, and are not sufficient to tell individuals to change their meat-eating habits.”
Kolata characterized the reaction to the papers as:
“Already they have been met with fierce criticism by public health researchers. The American Heart Association, the American Cancer Society, the Harvard T.H. Chan School of Public Health and other groups have savaged the findings and the journal that published them.”
If you’ve followed some of the links, to my earlier essay or to the NY Times article by Koltata, you’ll be pretty well informed as to the immediate reactions to the papers.
Rita Rubin’s JAMA article really digs in, pointing out that “Subsequent news coverage criticized the methodology used in the meat papers and raised the specter that some of the authors had financial ties to the beef industry, representing previously undisclosed conflicts of interest.” There was, in fact, no specter, not even a suggestion that some or any of the authors had financial ties to the beef industry — except in ad hominem attacks from a certain small group of researchers and public health policy advocates.
In an article in The BJM (previously, the British Medical Journal), also published before the official publication of the meat guideline papers, Owen Dryer repeats the attack “from critics who note that the lead author of the principal paper also helped to write a 2016 paper questioning the benefits of limiting sugar intake, which was funded by an industry group.” Let’s look at this claim: The lead author of one of the six papers, out of the 14 authors involved in the six papers in the series, “also helped to write a 2016 paper questioning the benefits of limiting sugar intake” which paper was reportedly “funded by an industry group.” Any truth to this? Yes, Brad Johnston, lead author of this one paper in the NurtiRECS meat series, “Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium”, was one of five authors of a 2016 paper “The Scientific Basis of Guideline Recommendations on Sugar Intake: A Systematic Review”. The sugar intake paper was funded by the nonprofit International Life Sciences Institute (ILSI), which is primarily supported by the food and agriculture industry. ILSI supports private/public collaborations in nutrition science. Note that the NY Times has recently published an article attacking ILSI, which contained false information about ILSI, to which ILSI responded. (The NY Times did not print ILSI’s response.)
The JAMA article by Rita Rubin is a great deal more even handed. She states bluntly:
“But what has for the most part been overlooked is that Katz and THI and many of its council members [which includes Frank Hu and Walter Willett] have numerous industry ties themselves. The difference is that their ties are primarily with companies and organizations that stand to profit if people eat less red meat and a more plant-based diet. Unlike the beef industry, these entities are surrounded by an aura of health and wellness, although that isn’t necessarily evidence-based.”
So the attacks on the NurtiRECS papers come from researchers whose primary focus — and source of fame and wealth — is advocacy for “lifestyle medicine” and “plant-based diets” — researchers with ties to for-profit companies and organizations that will profit from their views.
The primary, and most vitriolic, of these players? David Katz, Frank Hu, Walter Willett, all council members of the True Health Initiative. What have they done? First, they attempted to preemptively prevent the publication of the NutriRECS papers:
“Katz, Willett, and Hu took the rare step of contacting Laine [editor of Annals] about retracting the studies prior to their publication, she recalled in an interview with JAMA. Perhaps that’s not surprising. “Some of the researchers have built their careers on nutrition epidemiology,” Laine said. “I can understand it’s upsetting when the limitations of your work are uncovered and discussed in the open.””
“Hours before the meat articles were posted and the embargo lifted, Barnard’s PCRM went so far as to petition the Federal Trade Commission (FTC) “to correct false statements regarding consumption of red and processed meat released by the Annals of Internal Medicine.” But the FTC describes its role as protecting consumers and promoting competition in the marketplace, so it’s unclear what authority or interest it would have in this case.
Despite PCRM’s name, less than 10% of its 175 000 members are physicians, according to its website, which describes the organization’s mission as “saving and improving human and animal lives through plant-based diets and ethical and effective scientific research.” [Rubin in source]
The plant-based diet advocates didn’t stop there: (all from Rubin’s JAMA article)
The rebukes continued for weeks after publication of the meat articles, but Katz didn’t comment via the typical routes of posting comments on the journal’s website or writing a letter to the editor. He said he did neither because he’s “able to react much more immediately and generate a much wider awareness with my own blog platforms.”
In his October 6 column for the New Haven Register, Katz compared the articles, which he called “a great debacle of public health” to “information terrorism” that “can blow to smithereens…the life’s work of innumerable careful scientists.”
“About 3 weeks later, [Neil Barnard ‘s] PCRM asked the district attorney for the City of Philadelphia, where the Annals editorial office is located, “to investigate potential reckless endangerment” resulting from the publication of the meat papers and recommendations.”
“Another salvo came during a recent 1-day preventive cardiology conference, where half the presentations were on plant-based diets. During his keynote address, Willett showed a slide entitled “Disinformation” that faulted several organizations and individuals: the “sensationalist media,” specifically the Annals and longtime New York Times science reporter Gina Kolata, who wrote the newspaper’s first story about the meat papers; “Big Beef,” specifically Texas A&M and nutrition scientist Patrick Stover, PhD, vice chancellor at the school and a coauthor of the NutriRECS meat consumption guideline; and “evidence-based academics,” namely NutriRECS and Gordon Guyatt, MD, MSc, chair of the panel that wrote the meat consumption guidelines.
“It was part of my talk addressing the confusion that the public gets from the media about diet and health,” Willett said in an email to JAMA. “Some of this relates to the triangle of disinformation that is…feeding into this. The same strategy is being used to discredit science on sugar and soda consumption, climate change, air pollution, and other environmental hazards.”
If any of this reminds readers of the attack tactics of The Climate Team and the Climate Science Rapid Response Team, it is no surprise. And while it is David Katz that slings the accusation of “information terrorism” — I am of the opinion that he has reversed the arrow of cause — it is THI and its cohorts that are engaging in “information terrorism” .
We see these same approaches taken to any research results which might weaken the advocacy case of the IPCC policy demands. In this venue, I don’t have to name names of those who engage in these nefarious, unscientific practices. But, in fact, we see the same response in every Modern Science Controversy that I have covered here at WUWT. The advocacy-science practitioners — those who depend on weak scientific results — vague, correlational, inferential, small effects, based on withheld data and methods, unreplicable — are terrified and outraged when the weaknesses in their findings, policy positions and opinions are challenged and made public.
Willett attacks every source of contrary science — even though the contrary science is evidence-based, transparent and extremely rigorous. He lets the cat out of the bag when he states: ”Some of this relates to the triangle of disinformation that is…feeding into this. The same strategy is being used to discredit science on sugar and soda consumption, climate change, air pollution, and other environmental hazards.”
What is this “same strategy” that is being used? Good, evidence-based science.
When the focus of solid evidence-based science turns its attention on advocacy-science, surprising results turn up. We saw this recently in Ocean Acidification Science in Clark et al.’s “Ocean acidification does not impair the behaviour of coral reef fishes” which was reported widely (and favorably), examples here and here. Science Magazine reported:
“In a major, 3-year effort that studied six fish species, they could not replicate three widely reported behavioral effects of ocean acidification. The replication team notes that many of the original studies came from the same relatively small group of researchers and involved small sample sizes. That and other “methodological or analytical weaknesses” may have led the original studies astray, they argue.”
Most of the papers that failed to have their findings supported were co-authored by Philip Munday of James Cook University. And although Munday has issued statements quibbling with the Clark paper and plans to publicly defend his findings, Science Magazine quotes Tim Parker, a biologist and an advocate for replication studies:
Replication studies often cause quibbles about methods, Parker says. But, he argues, “If the original finding is reasonably robust,” then researchers using even somewhat different methods should be able to replicate it. And he notes that the replication team went to great lengths to be transparent. Unlike the original authors, the team released video of each experiment, for example, as well as the bootstrap analysis code. “That level of transparency certainly increases my confidence in this replication,” Parker says.
The Bottom Line: It is solid, robust, transparent evidence-based science versus weak, secret, correlational advocacy-science.
This is, then, the crux of the Secret Science Battle that has been building in Washington, D.C. . The advocacy-scientists fear exposure of the weak science behind public policy recommendations and regulations on such topics as “on sugar and soda consumption, climate change, air pollution, and other environmental hazards.”
Advocacy-scientists fear that if strict scientific standards were applied to the foundational research supporting their advocacy views and policy recommendations, which underpin many governmental policies and regulations, the results would be the same as for public health meat recommendations and Ocean Acidificaton fish behavior studies — they might be discredited.
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This essay ends at the beginning of another more serious essay on the Secret Science Battle unfolding in the US and elsewhere. The topic is important to the overall health and success of scientific advances.
Readers can prep themselves for the coming discussion of the Secret Science Rule by reading a few teasers: here, here and here. My personal opinion? : The hysterical voices blasting the new rule openly state that they are trying to prevent reanalysis of the weak, correlational, inferential, small effect, non-transparent and just plain “iffy” science that has been used in the past to create volumes of possibly unnecessary, un-scientifically-founded regulations and policies, upon which their personal careers have been based. In many cases, it is specific studies that are of major concern — studies known to be questionable.
Address your comment to “Kip…” if speaking to me.
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