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.
Summary:
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.””
Another member of the THI council, Neil Barnard, MD, president of the Physicians Committee for Responsible Medicine (PCRM):
“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)
“Information Terrorism”
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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Author’s Comment:
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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anytime you let anyone make a decision for you, they will use it to their advantage. and you get upset? “how dare you!”
Everyone knows that wheat has been ‘selected’ by humans over the history of agriculture from the original grass
Everyone knows that sheep live on grass
So it must be clear that a lamb sandwich is , in fact a ‘grass grass’
so stop whining greenies and have a grass squared
Kip, thanks very much for this. You have nicely defined the battle lines between science and nonsense. The real existential battle isn’t over AGW (or eating meat, or fat or salt, etc. ) but over the hijacking of the trappings of science by the sellers of fairy dust.
BCBill ==> My next essay will address the EPAs proposed Secret Science rule.
I am surprised to learn of Walter Willett’s role in this story. It was about 10 years ago that I learned directly from Dr. Willett that the evidence against red meat was almost entirely based on *processed* meat, and that the evidence against minimally processed meat was weak to non-existent.
Good point! Too many studies have combined the investigation of red meat and processed meat to smear the positive nutritional value of red meat.
Unfrozen ==> That surprises me as well — I have mostly been familiar with his name in association with the plant-based-diet and ‘integrative-medicine’ movements. If you can recall the source — even a personal conversation — I would be interested to hear more.
The “evidence” against processed meat is just as non-existent. Same cultural and socio-economically biased “food questionnaires” that ask unanswerable questions like “How many cups of salami have you eaten in the last 6 months?”
Rich, college-educated white people are FAR more likely to follow “health” guidelines, not smoke or drink to excess, exercise and be compliant with medical protocols than the less advantaged. Full stop.
Confounders and biases all over the place render nearly ALL observational nutrition studies nonsense.
All this is now is an attempt to generate headlines for “thought-leading” the masses for the greater glory of emerging companies like Beyond Meat and Impossible Foods–products as “processed” as it GETS!
Kip – the only aspect absent in your excellent report concerns the reason red meat is red. The red color of muscle is due to the presence of the chemical compound myoglobin, a protein which stores oxygen in the muscles, so that whenever the involved muscles require an immediate supply of energy for strength, the oxygen is there.
White meat, however, is mainly composed of fast switch muscle fibers and thus lack myoglobin, because those muscles are not involved in any heavy lifting – they just utilized to get the hell out of the way of a predator as quickly as possible. The same can be said for fowl.
Understanding those issues will easily convince an open-minded person that the red meat scare is hogwash.
Chad ==> Thank you for that little bit of biology lesson — and you are right — not many know that.
UKs NHS lists:
Red meat includes:
beef, lamb and mutton, pork, veal, venison, goat
It does not include:
chicken, turkey, duck, goose, game birds, rabbit
Which is not the list I would have used.
My traditional culture is sheep and cattle farming NZ. When we ran out of butter we would spread cold dripping (mutton fat rendered out from roasted or fried mutton – our staple) on the bread then sprinkle over with salt. It can be very tasty. We ate mutton ( always the best in the paddock) 5 days/week and never grew sick of it.
All frying was done in dripping. There were few fat farmers in my neck of the woods and many reached their 80’s
Hi Michael Carter, – Sheep (mutton) gut microflora were found to be worth taking & put in a cleaned animal skin type of bladder with fresh milk. After a few days most of the milk is replaced & the fresh milk quantity replenished.
This cycling was done for a while & then the growth inside is ready to be culled. The mixed microbial culture mass(es) that established itself growing on the container skin’s inner surface itself is then used as inoculant of fresh milk; from then on the microbial consortia quickly (~24 hours) ferments new milk into a desirable edible.
This is the origin of what is popularly called “kefir” cultured milk; the mixed microbial masses themselves are called kefir “grains”. Strains of these inoculants are now readily found worldwide & adherents perpetually propagate existing kefir grains in milk; but few know how kefir grains actually started out (or how country folk generate the culture anew).
“When we ran out of butter we would spread cold dripping (mutton fat rendered out from roasted or fried mutton – our staple) on the bread then sprinkle over with salt. It can be very tasty.”
Yes, we had that too from time to time on our side of the ditch. Add some pepper and wow. Strewth it must be nearly 40 years since I had some of that.
Michael ==> Thanks for the ground truth report from New Zealand — one of the places I have never been to.
My family traditionally raised a “junk” lamb every year, bringing it on first with surplus goat milk from our dairy goats, and then just letting it mooch off the goats we kept. Slaughtered in the Fall at about 8 months. Would you consider that “lamb” in NZ?
The spear was invented before the plough.
Kip – One of biggest beef I have with a great deal of epidemiology is leaving out adjustments for social class / income / education if it suits the conclusion.
I was going to go to grad school in nutrition, but got passed by the ‘old boy network’ into neuroscience. I am eternally grateful.
FranBC ==> Nutritional Epidemiology is under a great deal of pressure to reform itself — Ioannidis and others hammering away. It has slipped off the path of true science and become some kind of alternate practice with its own bizarre rules.
It strikes me that the issue with diet is similar to the acrimony in ozone and global warming debates. The side attempting to make changes believe they hold some kind of moral high ground and feel justified in making poorly supported claims because it is in our best interest — in their minds. Would it were that they could just report their findings and leave it up to everyone to decide if the evidence was compelling, and if it was, to be allowed to make the choice whether the benefits of a change outweighed the loss of pleasurable activities, such as eating a rack of BBQ’d spare ribs. What I object to is those who are absolutely convinced that they are right (without considering the possibility of being wrong) and wish to use the force of government to change people’s behavior.
Clyde ==> I’ll try to clear some of this up on the coming essay on Secret Science.
Anyone for roast koala as it’s in vogue in certain places-
https://www.msn.com/en-au/news/australia/repopulation-of-pest-koalas-on-kangaroo-island-a-no-go-after-bushfires/ar-BBZag16
Outrageous! Fancy those ancestors interfering in nature like that? They should have known they’d be stealing their koala-hood.
I love koalas – but I couldn’t eat a whole one
Here in Australia an animal rights group have created a list of farms
https://www.abc.net.au/news/2019-01-21/animal-rights-group-aussie-farms-online-map-farmers-backlash/10731560
Why are you allowed to list farms with no evidence of wrong doing let alone farms with actual investigation and conviction being carried out.
Yet here in Victoria, Australia you can’t legally list address of convicted pedophiles
yeah and the morons trespassing risk serious biohazard risks TO those farms and yet?
very few have been busted for trespass OR the damage they caused, stressing chickens out at night removing lambs etc
neither their heads or their supposed caring hearts are “in the right place”
right place would be jail for a while
In New Jersey we have a diet doctor who advocates a strict plant based diet. Such a diet is dominated by 2 sugars glucose and fructose that make up the carbohydrates. I call it the “sugar diet”. Yet the same doctor strongly warns against added sugar. Which after all is plant based and composed of fructose and glucose. Bizarre! Either he is ignorant of food science or is lying.
Hi Mike McH. – If it interests you edible plants contain protein & fat, as well as carbohydrates. Here’s data from 2 categories of some Nigeria, Africa plant foods:
Leafy vegetables can be on average 24.6 to 51.4 % carbohydrates, plus 10.6 to 22.6 % fat & 15.9 to 35.7% protein.
Nuts & fruits can be on average 11.9 to 76. 1% carbohydrate, plus 10.6 to 72.6% fat & 3.2 to 43.1% protein.
A diet that cautions about added sugar is probably accounting for the carbohydrate content of recommended food items. Carbohydrates by themselves are not insidious. For example back in 1975 the Japanese diet was 62% carbohydrate (rice) & there was no food scarcity, yet the people were not considered over weight or unhealthy.
Plant eaters make up the vast bulk of ‘prey’ – I think that is what the Ivory Tower Know-Nothings see as further human “evolution”.
Kip, correct me where I’m wrong:
“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.”
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What do we see here:
During the Obama administration, “environmental studies” that were completely unsecured, even unfounded, were raised to environmental laws: EPA Regulations.
The study authors received their entry as “significant climate warners / protectors”. The affected industry had to buy their way out, at best, and was constantly exposed to new hostilities.
Scarce possibility to begin to dismantle that.
A complete disaster.
Johann Wundersamer ==> There has been a contagion spreading in much of Science for decades. In my opinion, it has to do with the fact that all the low hanging science discovery fruit has been picked — yet we have ten times as many scientists trying to make a name for themselves, earn tenure through publication, etc.
This, along with computational power, has led to the tendency to accept as truth weaker and weaker findings, to the point where the vaguest of hints of possibility of an effect are declared to be break-through discoveries and solid proof of something.
Combine the above with scientific fads and politically-driven science and we have a real mess.
Kip, “a contagion spreading in much of Science for decades”.
In fact: a mess. Thx!