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Appendix 1

From: Jayne Woodside


Sent: 23 November 2015 08:35
To: 'aamico@cspinet.org'
Subject: FW: COIs needed for BMJ retraction letter

Dear Angela,
Please fine attached.
Best wishes,
Jayne
Professor Jayne Woodside
Nutrition and Metabolism Group
Centre for Public Health
First Floor
Institute of Clinical Science B
Grosvenor Road
Belfast
BT12 6BJ
UK
Tel: 0044 2890 632585
Fax: 0044 2890 235900

From: Bonnie Liebman [mailto:bliebman@cspinet.org]


Sent: 19 November 2015 16:08
To: Bonnie Liebman
Subject: COIs needed for BMJ retraction letter

Dear Colleague:
In response to our letter asking the BMJ to retract the investigation by Nina Teicholz, the
journal has told us that the BMJ is continuing to review this article and plan to respond more
fully when our further enquiries are complete.
In the meantime, the BMJ has invited us to post the letter as a rapid response to the online
article. In order to post the letter, we have to send the journal a conflict-of-interest form for
each co-signer.
Please fill out page 4 of the form (attached) and email it back to my colleague, Angela Amico
(aamico@cspinet.org). Once we hear from everyone, she will submit the forms to the BMJ.
More information about competing interests for a rapid response is available here:
http://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declarationcompeting-interests

Best wishes,
Bonnie Liebman

_______________________________
Bonnie F. Liebman, MS
Director of Nutrition
Center for Science in the Public Interest
1220 L St., NW Suite 300
Washington, DC 20005
Ph: (202) 777-8335
Fax: (202) 265-4954

From: Bonnie Liebman [mailto:bliebman@cspinet.org]


Sent: 05 November 2015 17:27
To: Bonnie Liebman
Subject: request for retraction of Dietary Guidelines Advisory Committee report investigation

Dear Colleague: Thank you for agreeing to sign the letter urging the BMJ to retract its
investigation of the Dietary Guidelines Advisory Committees report. The letter was signed
by more than 180 scientists in 19 countries.
We sent the final version of the letter (attached) to the BMJ editors this morning. You can
also find a version of the letter with live links to the footnotes on our website (see URL
below). The letter notes (at the end of the last page) that affiliations were listed for purposes
of identification only.
http://cspinet.org/bmj-retraction-letter.html
Best wishes,
Bonnie Liebman
_______________________________
Bonnie F. Liebman, MS
Director of Nutrition
Center for Science in the Public Interest
1220 L St., NW Suite 300
Washington, DC 20005
Ph: (202) 777-8335
Fax: (202) 265-4954
From: Jeff Cronin
Sent: Thursday, November 05, 2015 10:17 AM
To: fgodlee@bmj.com
Cc: rcoombes@bmj.com
Subject: request for retraction of Dietary Guidelines Advisory Committee report
investigation
Dear Editors,
Please accept this letter asking the BMJ to retract the investigation by Nina Teicholz into the
report of the Dietary Guidelines Advisory Committee.
Sincerely,
Jeff Cronin
Director of Communications
Center for Science in the Public Interest
1220 L Street, NW, Suite 300
Washington, DC 20005
Ph: 202.777.8370
Cell: 202-421-8911
3

From: Angela Amico [mailto:aamico@cspinet.org]


Sent: 04 November 2015 15:23
To: Jayne Woodside
Subject: RE: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3

Great, thank you for your support.


Best,
Angela
Angela Amico, MPH
Project Coordinator
Health Promotion Policy & Biotechnology
Center for Science in the Public Interest
1220 L Street NW, Suite 300
Washington, D.C. 20005
Direct: 202-777-8307
aamico@cspinet.org
From: Jayne Woodside [mailto:j.woodside@qub.ac.uk]
Sent: Tuesday, November 03, 2015 2:50 AM
To: Angela Amico <aamico@cspinet.org>
Subject: RE: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3
Dear Angela,
I am PhD.
Best wishes,
Jayne
Professor Jayne Woodside
Nutrition and Metabolism Group
Centre for Public Health
First Floor
Institute of Clinical Science B
Grosvenor Road
Belfast
BT12 6BJ
UK
Tel: 0044 2890 632585
Fax: 0044 2890 235900

From: Jayne Woodside


Sent: 02 November 2015 07:52
To: Michelle McKinley (m.mckinley@qub.ac.uk); Marie Cantwell
Subject: FW: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3
Professor Jayne Woodside
Nutrition and Metabolism Group
Centre for Public Health
First Floor
Institute of Clinical Science B
Grosvenor Road
Belfast
BT12 6BJ
UK
Tel: 0044 2890 632585
Fax: 0044 2890 235900
From: Angeliki Papadaki [mailto:Angeliki.Papadaki@bristol.ac.uk]
Sent: 01 November 2015 12:48
To: Arne Astrup; Saris, Wim; Inge Huybrechts; manios@hua.gr; Inga rsdttir; Andy Ness;
susan.jebb@phc.ox.ac.uk; Agneta Yngve; Sibylle Kranz; lmoreno@unizar.es;
clare.collins@newcastle.edu.au; Antonis Kafatos; Jayne Woodside; Janet Cade; Dianne Ward
Subject: Fwd: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3

Dear colleagues,
Please see attached a suggestion for a BMJ retraction letter, instigated by Frank Hu at
Harvard. We were asked to circulate the letter for signatures.
If you agree, please send an email to Bonnie Liebman (bliebman@cspinet.org) with a similar
content to the below, in blue font, and circulate to your colleagues.

I have read the full version of the attached letter and I


agree to include my sign on it.
I endorse its full content and the request to the BMJ to
retract the journalist's article.
Kind regards,
Angeliki

From: Angela Amico [mailto:aamico@cspinet.org]


Sent: 02 November 2015 22:22
To: Jayne Woodside
Subject: RE: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3

Thank you for your support of the retraction letter to the BMJ. Can you please respond with
any post-graduate degrees you may have? We would like to ensure that we correctly credit all
the signatories.
Best,
Angela
Angela Amico, MPH
Project Coordinator
Health Promotion Policy & Biotechnology
Center for Science in the Public Interest
1220 L Street NW, Suite 300
Washington, D.C. 20005
Direct: 202-777-8307
aamico@cspinet.org
From: Jayne Woodside [mailto:j.woodside@qub.ac.uk]
Sent: Monday, November 02, 2015 2:52 AM
To: Bonnie Liebman <bliebman@cspinet.org>
Subject: Fwd: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3
Dear Bonnie,
I have read the full version of the attached letter and I agree to include my sign on it.
I endorse its full content and the request to the BMJ to retract the journalist's article.
Best wishes,
Jayne

Professor Jayne Woodside


Nutrition and Metabolism Group
Centre for Public Health
First Floor
Institute of Clinical Science B
Grosvenor Road
Belfast
BT12 6BJ
UK
Tel: 0044 2890 632585
Fax: 0044 2890 235900

From: Angeliki Papadaki [mailto:Angeliki.Papadaki@bristol.ac.uk]


Sent: 01 November 2015 12:48
To: Arne Astrup; Saris, Wim; Inge Huybrechts; manios@hua.gr; Inga rsdttir; Andy Ness;
susan.jebb@phc.ox.ac.uk; Agneta Yngve; Sibylle Kranz; lmoreno@unizar.es;
clare.collins@newcastle.edu.au; Antonis Kafatos; Jayne Woodside; Janet Cade; Dianne Ward
Subject: Fwd: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3

Dear colleagues,
Please see attached a suggestion for a BMJ retraction letter, instigated by Frank Hu at
Harvard. We were asked to circulate the letter for signatures.
If you agree, please send an email to Bonnie Liebman (bliebman@cspinet.org) with a similar
content to the below, in blue font, and circulate to your colleagues.

I have read the full version of the attached letter and I


agree to include my sign on it.
I endorse its full content and the request to the BMJ to
retract the journalist's article.
Kind regards,
Angeliki

---------- Forwarded message ---------From: Miguel ngel Martnez Gonzlez <mamartinez@unav.es>


Date: 1 November 2015 at 11:36
Subject: Fwd: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3
To: Antonia Trichopoulou <atrichopoulou@hhf-greece.gr>, denis.lairon@univmed.fr, Katia
Esposito <katherine.esposito@unina2.it>, giuseppe.grosso@studium.unict.it, Federico Jose
Armando Perez Cueto Eulert <apce@plan.aau.dk>, "ligia.dominguez"
<ligia.dominguez@unipa.it>, Matthias Schulze <mschulze@dife.de>, Iris Shai
<irish@bgu.ac.il>, elliotb@ekmd.huji.ac.il, dario.giugliano@unina2.it, Angeliki Papadaki
<Angeliki.Papadaki@bristol.ac.uk>, Arne Astrup <ast@nexs.ku.dk>,
ricardo.uauy@lshtm.ac.uk, jose luchsinger <luchsin@hotmail.com>, Nikolaos Scarmeas
<ns257@cumc.columbia.edu>, Christian Carpn <Christian.Carpene@inserm.fr>, Olle
Melander <olle.melander@med.lu.se>, boeing@dife.de, Marc Molendijk
<m.l.molendijk@fsw.leidenuniv.nl>, Adriano Maral Pimenta
<adrianompimenta@yahoo.com.br>, Helfimed Study UniSA
<Dorota.Zarnowiecki@unisa.edu.au>
Cc: Frank Hu <nhbfh@channing.harvard.edu>

Yes, of course, Frank.

I have read the full version of the attached letter and I


agree to include my sign on it.
I endorse its full content and the request to the BMJ to
retract the journalist's article.
I'm forwarding to my friends and colleagues this invitation to sign the attached
letter:
Dear colleagues,
if you agree, you can send an email to Bonnie Liebman <bliebman@cspinet.org>
with a similar content to what I have written above in blue font.

I would thank you all very much if you are so kind as to ask
also to your friends from different European countries to sign
the attached letter for the sake of science and public health.
Best regards,
miguel
-Miguel A. Martinez-Gonzalez
University of Navarra-CIBEROBN
www.unav.es/preventiva
www.proyectosun.es
www.predimed.es
www.predimedplus.com
www.ciberobn.es
Research Gate

On Sun, Nov 1, 2015 at 1:28 AM, Frank Hu <nhbfh@channing.harvard.edu> wrote:


Hi Miguel,
Would you like to sign the attached letter to retract the BMJ article? if so, please email
Bonnie Liebman <bliebman@cspinet.org>.
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.
Many thanks
frank

---------- Forwarded message ---------From: Bonnie Liebman <bliebman@cspinet.org>


Date: Sat, Oct 31, 2015 at 2:36 PM
Subject: Letter to BMJ re Dietary Guidelines--Please respond by Nov. 3
To: Bonnie Liebman <bliebman@cspinet.org>
Dear Colleague:
On Sept. 24, the BMJ (formerly the British Medical Journal) published an investigation entitled,
The Scientific Report Guiding the US Dietary Guidelines: Is it Scientific? The article (attached) was
written by Nina Teicholz, a journalist and author of The Big Fat Surprise Why Butter, Meat, &
Cheese Belong in a Healthy Diet.
The article is riddled with errors. For example, Teicholz claims that the report of the 2015 Dietary
Guidelines Advisory Committee used weak scientific standards because it relied on fewer reviews
by USDAs Nutrition Evidence Library (NEL) than the 2010 DGAC committee and instead conducted
ad hoc examinations of the scientific literature.
In fact, there were no ad hoc examinations. The appendices to the 2015 DGAC report specify the
search strategy, inclusion criteria, search results, and AMSTAR ratings for the systematic reviews,
meta-analyses, and other studies used by the DGAC. The attached letter documents ten additional
factual errors in the article.
(Note: The BMJ article was timed to coincide with an October 7 hearing of the House Agriculture
Committee, where it was used to criticize the 2015 DGACs scientific integrity.)
The attached letter urges the BMJ to retract the investigation. Please let us know by Tuesday,
November 3, if you would like to co-sign the letter. (Please also feel free to pass it on to your
colleagues.)
Thanks,
Bonnie Liebman

_______________________________
Bonnie F. Liebman, MS
Director of Nutrition
Center for Science in the Public Interest
1220 L St., NW Suite 300
Washington, DC 20005
Ph: (202) 777-8335
Fax: (202) 265-4954
-*******************************************************
Frank B. Hu, MD, PhD
9

Professor of Nutrition and Epidemiology


Harvard T.H. Chan School of Public Health
Professor of Medicine
Harvard Medical School
665 Huntington ave, Boston, MA 02115
tel: 617 432 0113 fax: 617 432 2435
<http://www.hsph.harvard.edu/faculty/frank-hu/>
http://www.hsph.harvard.edu/faculty/frank-hu/
******************************************************
-Miguel A. Martinez-Gonzalez
University of Navarra
www.unav.es/preventiva
www.proyectosun.es
www.predimed.es
www.predimedplus.com
www.ciberobn.es
Research Gate
-Angeliki Papadaki, PhD, MSc (Med Sci), FHEA
Lecturer in Public Health Nutrition
Programme Director, MSc Nutrition, Physical Activity and Public Health
Centre for Exercise, Nutrition and Health Sciences
School for Policy Studies
University of Bristol
8 Priory Rd
Bristol BS8 1TZ
UK
Tel: +44 (0) 117 3310453
Fax: +44 (0) 117 3310418
Office: Room 2G1, 12 Woodland Rd, BS8 1UQ
Personal webpage: http://www.bristol.ac.uk/sps/people/angelikipapadaki/overview.html
Twitter: @AngelikPapadaki
Our unique MSc in Nutrition, Physical Activity and Public Health is recruiting now for
September 2016 intake.

10

Suggested BMJ retraction letter (see Page 7, Appendix 1)

Appendix 2

Dear Editor:
A recent article by journalist Nina Teicholz,1 which was published as a BMJ Investigation
of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC),2
included numerous errors and misrepresentations. Below we have summarized only
factual errors, excluding incorrect or biased interpretations of research. The mistakes are
bolded.
Because the investigation as a whole is so riddled with errors, we urge the BMJ to retract
it, not only to inform your readers, but also to protect the BMJs credibility.

1. Teicholz states that in its 2015 report the committee stated that it did not use
NEL reviews for more than 70% of the topics, including some of the most
controversial issues in nutrition. Instead, it relied on systematic reviews by
external professional associations, almost exclusively the American Heart
Association (AHA) and the American College of Cardiology (ACC), or conducted
an [sic] hoc examination of the scientific literature without well defined
systematic criteria for how studies or outside review papers were
identified, selected, or evaluated.
Correction: In Appendix E-2, the Evidence Portfolios for the key topics addressed by
Teicholz specify the search strategy, inclusion criteria, search results, and AMSTAR ratings
for methodological quality for the existing systematic reviews (SR) and meta-analyses
(MA).3 Note that it was the NEL, not the DGAC, that identified any existing high-quality SRs
and/or MAs that addressed the topic or SR questions posed.4

2. Teicholz states that instead of requesting a new NEL review for the recent
literature on this crucial topic, however, the 2015 committee recommended
extending the current cap on saturated fats, at 10% of calories, based on a review
by the AHA and ACC, a 2010 NEL review, and the committees ad hoc selection of
seven review papers (see table A on thebmj.com). Table A states that no
methodology for this section of the report: no reason given for why certain
studies were selected for review and others were not, nor how they were
evaluated relative to each other.
Correction: Appendix E-2.43 gives the search strategy, inclusion criteria, search results,
and AMSTAR ratings for methodological quality for the seven review papers, along with a
list of excluded articles and the reasons for exclusion.5 (Note: In Table A, Teicholz states
1

http://www.bmj.com/content/351/bmj.h4962
http://health.gov/dietaryguidelines/2015-scientific-report/
3
http://health.gov/dietaryguidelines/2015-scientific-report/14-appendix-E2/
4
http://health.gov/dietaryguidelines/2015-scientific-report/05-methodology.asp
5
http://health.gov/dietaryguidelines/2015-scientific-report/14-appendix-E2/e2-43.asp
2

that the overall conclusion [of the 2012 Cochrane review by Hooper, et al.] is therefore
that while saturated-fat restriction appears to reduce heart attack risk, it does not reduce
overall or cardiovascular mortality (death), which is arguably the more important
endpoint.6 This statement contradicts Teicholzs article, which said that Hooper, et al.
failed to confirm an association between saturated fats and heart disease. The BMJ
corrected this error a month after it was published.)

3. Teicholz states that use of external reviews by professional associations is


problematic because these groups conduct literature reviews according to
different standards and are supported by food and drug companies.
Correction: The problematic external review cited by Teicholz was not conducted solely
by professional associations. The review was actually a clinical practice guideline
developed by the American Heart Association and the American College of Cardiology in
partnership with the National Heart, Lung, and Blood Institute.7 The NHLBIs website
clearly describes its rigorous standards for assessing the quality of studies and its policy for
managing potential conflicts of interest and relationships with industry. The NHLBIs
standards for identifying, grading, and assessing the quality of studies are as rigorous, if not
more rigorous, than those used by the NEL.

4. Teicholz states that in the NEL systematic review on saturated fats from
2010fewer than 12 small trials are cited, and none supports the hypothesis
that saturated fats cause heart disease (see table B on thebmj.com).
Correction: It is incorrect to state that none of the trials cited in the 2010 NEL review
supports the hypothesis that saturated fats cause heart disease. The 2010 NEL review
found strong evidence that saturated fat intake increases the risk of cardiovascular
disease. In Table B, Teicholz over-rules the 2010 NEL review by assigning each trial to one
of four categories (a) trials that should not have been included because they did not meet
inclusion criteria, (b) trials that should not have been included because they did not test
normally occuring [sic] saturated fats or saturated fats at all, (c) trials concluding that
saturated fats had a neutrial [sic] or beneficial effect on health, and (d) trials with mixed
results on blood lipid measures.8 (Note: Table B has additional errors too numerous to list
here.) Thus, Teicholz concludes that the 2010 NEL review is substandard, but she also
argues that the 2015 committees report used weak scientific standards, because it did
not rely sufficiently on NEL reviews.

http://www.bmj.com/content/bmj/suppl/2015/09/23/bmj.h4962.DC1/teicholzmaster2609.wt1_default.pdf
http://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/lifestyle
8
http://www.bmj.com/content/bmj/suppl/2015/09/23/bmj.h4962.DC1/teicholzmaster2609.wt2_default.pdf
7

5. Teicholz states that perhaps more important are the studies that have never
been systematically reviewed by any of the dietary guideline committees.
These include the large, government funded randomized controlled trials on
saturated fats and heart disease from the 1960s and 70s. Taken together, these
trials followed more than 25 000 people, some for up to 12 years. They are some
of the most ambitious, well controlled nutrition studies ever undertaken.
Correction: It is incorrect to state that these trials were not reviewed by the DGAC. The
DGAC considered a 2012 Cochrane review that included 4 of the 6 trials cited by Teicholz
and a 2010 meta-analysis that included 5 of the 6 trials cited by Teicholz.910 (The review
and meta-analysis both concluded that replacing saturated fats with unsaturated fats
reduce the risk of heart disease.) One trial cited by Teicholz is excluded from most metaanalyses because it tested a multifactorial intervention including drug treatment for
hypertension, counseling for cigarette smoking, and dietary advice for lowering blood
cholesterol levels.11

6. Teicholz states that there have been at a minimum, three National Institutes
of Health funded trials on some 50 000 people showing that a diet low in fat
and saturated fat is ineffective for fighting heart disease, obesity, diabetes,
or cancer. Two of these trials are omitted from the NEL review.When the
omitted findings from these three clinical trials are factored into the review, the
overwhelming preponderance of rigorous evidence does not support any of the
dietary committees health claims for its recommended diets.
Correction: The two trials that were omitted from the NEL review did not assess the
impact of diet for fighting heart disease, obesity, diabetes, or cancer. They assessed the

Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G. Reduced or modified
dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2012 May 16;5:CD002137. doi:
10.1002/14651858.CD002137.pub3
10
Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place
of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med
2010;7:e1000252.
11
Multiple Risk Factor Intervention Trial Research Group. Multiple risk factor intervention trial. Risk factor changes
and mortality results. JAMA 1982;248:1465-77.

impact of diet on serum cholesterol levels.12,13 Furthermore, all three trials were included
in the Cochrane review that was considered by the DGAC.14)

7. Teicholz states that The report also gave a strong rating to the evidence that its
recommended diets can fight heart disease.The committee reviewed other,
more recent studies but not using any systematic or predefined methods.
Correction: Appendix E-2.26 gives the search strategy, inclusion criteria, search results,
and AMSTAR ratings for methodological quality for the six more recent studies, along
with a list of excluded articles and the reasons for exclusion.15

8. In Table D, Teicholz includes sections (under dietary patterns and heart disease
and dietary patterns and obesity) entitled DGAC ad hoc review of the
scientific literature where she states that no systematic methodology is given
for the selection of these studies. It is therefore impossible to know if they
fairly represent the literature.
Correction: These were not ad hoc reviews. The DGAC details the systematic methodology
for selecting these studies in Appendices E-2.26 and E2.27.16 Note: Teicholzs Table D17
consists largely of Teicholzs criticism of the NELs Systematic Reviews on the Relationship
between Dietary Patterns and Health Outcomes, published in 2014.18 Note that Teicholz
argues that NEL reviews are substandard, but she also argues that the 2015 committees
report used weak scientific standards, because it did not rely sufficiently on NEL reviews.

9. Teicholz states that Consulting the NEL for a review on this topic turns up a
surprising fact: a systematic review on health and red meat has not been done.
Although several analyses look at animal protein products, these reviews
12

Walden CE, Retzlaff BM, Buck BL, Wallick S, McCann BS, Knopp RH. Differential effect of National Cholesterol
Education Program (NCEP) Step II diet on HDL cholesterol, its subfractions, and apoprotein A-I levels in
hypercholesterolemic women and men after 1 year: The beFIT Study. Arterioscler Thromb Vasc Biol 2000;20:15807.
13
Knopp RH, Walden CE, Retzlaff BM, et al. Long-term cholesterol-lowering effects of 4 fat-restricted diets in
hypercholesterolemic and combined hyperlipidemic men. The Dietary Alternatives Study. JAMA 1997;278:1509-15.
14
Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G. Reduced or modified
dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2012 May 16;5:CD002137. doi:
10.1002/14651858.CD002137.pub3
15
http://health.gov/dietaryguidelines/2015-scientific-report/14-appendix-E2/e2-26.asp
16
http://health.gov/dietaryguidelines/2015-scientific-report/14-appendix-E2/e2-26.asp
http://health.gov/dietaryguidelines/2015-scientific-report/14-appendix-E2/e2-27.asp
17
http://www.bmj.com/content/bmj/suppl/2015/09/23/bmj.h4962.DC1/teicholzmaster2609.wt4_default.pdf
18
http://www.nel.gov/vault/2440/web/files/DietaryPatterns/DPRptFullFinal.pdf

include eggs, fish, and dairy and therefore do not isolate the health effects of
red meat, or meat of any kind.
Correction: The NEL reviews cited by Teicholz do examine the results on red meat and
processed meats separately from the results on other animal proteins.19

10. Teicholz states that The committees approach to the evidence on saturated fats
and low carbohydrate diets reflects an apparent failure to address any evidence
that contradicts what has been official nutritional advice for the past 35 years.
The foundation of that advice has been to recommend eating less fat and
fewer animal products (meat, dairy, eggs) while shifting calorie intake
towards more plant foods (fruits, vegetables, grains, and vegetable oils) for good
health. And in the past decades, this advice has remained virtually unchanged.
Correction: The 2015 DGAC did not recommend eating less fat or reducing the
consumption of eggs or dairy products. (In fact, Teicholz wrote in a February New York
Times op-ed that experts on the committee that develops the countrys dietary guidelines
acknowledged that they had ditched the low-fat diet.20) The Dietary Guidelines for
Americans has never recommended eating less meat or dairy products. (In some editions,
the DGA has included advice such as moderate your use of eggs or use egg yolks and
whole eggs in moderation. Use egg whites and egg substitutes freely).

11. Teicholz states that studies showed mixed health outcomes for saturated fats,
but early critical reviews, including one by the National Academy of Sciences,
which cautioned against the inconclusive state of the evidence on saturated fats
and heart disease, were dismissed by the USDA when it launched the first
dietary guidelines in 1980.
Correction: The USDA (and DHHS) published the 1980 Dietary Guidelines for Americans in
February 1980. Toward Healthful Diets, the National Academy of Sciences report cited by
Teicholz, was published in May 1980.21 USDA could not have dismissed Toward Healthful
Diets, because the report was published after the Dietary Guidelines were released.

In summary, the Teicholz/BMJ investigation is based on non-facts. Such a paper has no


place in the pages of a prominent scientific journal and should be retracted.

19

http://www.nel.gov/template.cfm?template=sort_list_template&key=835
Teicholz N. The governments bad diet advice. The New York Times, 2015 Feb 20.
http://www.nytimes.com/2015/02/21/opinion/when-the-government-tells-you-what-to-eat.html
21
National Research Council, Food and Nutrition Board, National Academy of Sciences. Toward Healthful Diets.
National Academy Press, 1980.
20

Competing Interests Form (see Page 1, Appendix 1)

Appendix 3

BMJ policy on declaration of interests


BMJ is committed to ensuring the independence and integrity of our content, products, and services.
We strive, therefore, to be transparent about any interests that our users, customers, and partners
might want to know about. This policy on declaration of interests applies to everyone involved in the
conception, creation, and delivery of our content, products, and services.
1. What interests should I declare?
We want to hear about interests that might conflict with the work you are doing or have been asked to
do for BMJ. A conflict of interest arises when a person has a personal or organisational interest that
may influence or appear to influence the work they are doing. Usually this is a financial interest, but it
may also be non-financial.
Above all we want transparency about any personal or organisational interests that might be seen as
a conflict of interest in relation to the task a person is being asked to do for BMJ.
Conflicts of interest are often unavoidable, and should be managed as far as possible rather than
prohibited. But some interests may be so conflicting that the individuals involved should not do the
task the BMJ needs doing.
The examples given in this document are not an exhaustive list. Individuals should ask themselves if
there is anything that may strongly bias their judgement and potentially preclude them from
performing the task requested of them, as well as anything that someone using BMJ products and
services might want to know, or that might cause embarrassment or reputational damage if
discovered after the event.
We ask people to be as clear and specific as possible about the activities, relationships, and views
they are declaring. W e may ask for more details about any declaration. W e would want to know, for
example, what honorariums were for and how much they were for. In declaring travel expenses, we
would want to know the task that was carried out during that travel.
To make things manageable we would like to know about interests in the 36 months before the
declaration and those known to be going to occur during the next 12 months.

2. How we categorise declaration of interests


We categorise declaration of interests into four main areas:
2.1 Personal financial interests
A personal financial interest is considered present when payments are made directly to an individual,
whether as a salary or as fees or honorariums; or where an individual receives benefits from a third
party who is not their main employer, such as a fellowship, equipment, writing or administrative
assistance, or travel and accommodation expenses; or where an individual owns stocks and shares,
patents, or other assets.
Examples include:

Employment
Paid consultancy or directorship
Ownership of stocks and shares
Patent ownership or applications
Paid membership of speakers panels/bureaus and advisory board
Acting as an expert witness
Being in receipt of a fellowship, equipment, writing, or administrative support
Travel and accommodation expenses
Writing or consulting for a medical education promotional or communications
company.

We do not consider personal financial interests to be present in the case of assets over which
individuals have no control, such as unit trusts, occupational pension funds, and accrued pension
rights.
2.2 Organisational financial interests
An organisational financial interest is said to exist where the interest belongs at arms length to the
individualfor example, where payments are made to the individual's organisation rather than to their
own bank account.
Examples include:

Research grants
Funds for staff or department

2.3 Non-financial interests


Non-financial interests can take many different forms, including personal or professional relations with
organisations and individuals. Those that we want people to declare are unpaid positions that might
have a bearing on the product or service being delivered by BMJ. We would also want to know about
strongly held beliefs where they are relevant to the task in hand.
In addition, we encourage people to declare other personal interests that they consider may be a
conflict of interest in the context of the task they are being asked to perform for BMJ.
Examples include:

Unpaid officership of advocacy, charity, non-governmental organisation, or


relevant professional group
Unpaid membership of a guidelines panel
Unpaid advisory positions in commercial organisations
Personal relationships with authors or editors of material, including having
held grants, co-authored articles or papers, or worked together.

2.4 Interests of related parties


Conflicts of interest may also arise where a related party (spouse, partner, or other close family
member) has a financial or non-financial interest as described above that could be seen to conflict
with the task a person is being asked to do for BMJ.
Examples include:
A spouse holding stocks or shares or being on the board of an organisation
that might be affected by the task the person is doing for BMJ.

3. When will you be asked to make declarations of interest?


We expect people to declare their interests before taking up any work for BMJ or entering into a
contract with us for your services.
Where we are recruiting new staff, a declaration of interests will be part of the job application.
If we invite you to join an advisory board, or commission an article, lecture, or peer review report from
you, we will ask you to declare your interests at the first approach in case there are conflicts of
interest that preclude you from accepting the invitation.
Articles submitted for consideration must be accompanied by a completed declaration.
BMJ staff and members of advisory boards will be asked to review their declarations of interests
annually (for staff this will be at the time of appraisal).

4. Dealing with declarations of interest

In most cases disclosure will be sufficient, but in some cases an interest may be too conflicting. These
are most likely to be current financial relationships or contractual arrangements that appear to prevent
an individual from providing an unbiased expert judgement, such as where a person has signed a
contract in which he or she agrees to be paid for advocating the opinion of that organisation or
company. Any such conflicts would be discussed with the individual who has disclosed them by the
person who has asked them to do the work for BMJ.
Decisions about whether or not an interest disqualifies the person from taking on a particular task for
BMJ will be taken by the relevant senior staff member. For BMJ staff this would be the person that
they report to.
There would be a right for anyone considered to have a conflict of interest sufficient to preclude them
from working with BMJ on a particular task to appeal to the head of the relevant
department.
If a full declaration was not made at the time and a conflict of interest comes to light after the event,
BMJ reserves the right to retract any content affected by this conflict. BMJ may also seek to terminate
contracts or employment affected in this way, and may choose not to work with the individual in the
future.

5. Who should declare?


All of the following people are asked to declare their interests before working for or undertaking a task
for BMJ
Members of staff
Members of BMJ board
Editors in chief of BMJ journals and products
Members of BMJ advisory boards
Consultants, contractors, and freelancers producing material for BMJ products and services,
authors, series editors, peer reviewers.
We also encourage our partners and the co-owning societies we work with to use our declaration of
interest policy and forms.

6. What happens to declarations?


Whenever possible, we will publish declarations of interest statements alongside the material to which
it relates: at product level on the relevant website for senior staff, board members, and advisers or
otherwise at the level of the article, module, or event. These published statements may comprise the
full declarations, or summary statements with full declarations available on request.
Speakers at BMJ Masterclasses or conferences will be asked to show a slide summarising their
declaration at the beginning of their talk.
We will review staff, board member, and adviser declarations of interest annually. Signed declarations
from BMJ staff will be kept by the Human Resources department in accordance with our information
governance policy.
Where material is peer reviewed, requests for declarations will be sent to the peer reviewers, and
editors will send any author declaration of interest statements to the peer reviewer.
BMJ has regular brand integrity meetings where it will review declarations of interest policies and
audits of decisions.
Declarations of interest are kept on file in accordance with our information governance policies.

Last amended March 2014

BMJ Group declaration of interests statement


Please complete the declaration below. You may complete and return this form electronically in Word
formata physical signature/hard copy is not required.
I have read and understood the BMJ Group policy on declaration of interests and declare the
following interests: [list them or state none].
None
Name: Jayne Woodside

Date: 23/11/15

Manager sign off (for internal use)


Comments:
Review date
Name:

Date:

[For internal use]

Guidance on how to apply the BMJ Group declaration of interests


policy
This policy applies to people involved in the conception and creation of content and services or
making major business decisions on that content or services
Who is responsible for getting the declaration of interests?
1) Products and services (boards and advisors): the editorial director of the product of service, or his
or her delegate
2) Content or events (authors, speakers and reviewers): the commissioning/handling editor
3) Advice: the person getting the advice (e.g. an editor)
4) Staff: HR is responsible for getting declaration of interests when a new staff member arrives and
the line manager is responsible for existing staff. Staff will be told to read the policy and (in line with
the Business ethics policy) to inform their manager at any time if they have any personal interest
which might affect, could be seen to affect or leave them open to allegations that this could affect their
impartiality about the work they are doing.
How/when will the declaration be obtained?
1) Product or serviceat the time of convening of boards and advisory groups, and when new
members are recruited
2) Content or eventat commissioning or (for research and other unsolicited content) at submission
3) Adviceon requesting the advice
4) Staffas part of their application for the job.
What should be done with the information?
The person responsible for getting/receiving/using the information provided in the declaration should
ask themselves: does anything in this declaration compromise the persons ability to do the task that
needs doingor could be perceived as compromising this. If the answer is yes or possibly, the
responsible person should discuss it with their line manager or other appropriate person. Practices
may differ between products and department the point is that there should be some discussion
about this before a decision is made and there should be some documentation of the decision, the
decision making process, and the reasons for the decision.
What constitutes a conflict of interest too far will differ according to the task the person is being
asked to do. As far as possible the types of interest that we have agreed constitute a conflict of
interest too far will be listed within the quality indicators for individual products and services. At a
Group level they would be anything that interferes with the unbiased output of the BMJ Group. This is
likely to occur if the person declares a current financial relationships or contractual arrangements that
appear to prevent him or her from providing an unbiased expert judgement, e.g. where a person has
signed a contract in which he or she agrees to be paid for advocating the opinion of that organisation
or company, or where he or she is in receipt of significant personal financial benefits.
Where will the declaration be published?
1) Product or serviceon the relevant website
2) Content or eventalongside each article/module or at the beginning of each talk
3) Adviceto those receiving the advice (e.g. to authors and editors in the case of reviews)
4) Staffto line managers and department heads, and on the relevant website for staff making
editorial or business decisions (generally staff in grade 4 or above).
How often should declarations be reviewed?
1) Product or serviceannually
2) Content or eventfor content that is formally updated: at every updating

3) Adviceat least annually for on-going advisors. (For advisors who sit on boards or committees
updating declarations should be an agenda item at committee meetings at appropriate intervals, but
should be considered formally at least annually)
4) Staffat every annual appraisal. Staff have an obligation to tell their manager at any time if the
information changes.
What happens if a person fails to make a full declaration of interests?
If we are alerted to the fact that someone may have an undeclared and potentially conflicting interest,
this will almost always require careful handling. The first step is almost always to raise the concern
with the person involved and ask if the conflict does exist and for their reasons for not declaring it.
Based on their response various actions may follow. Their declaration of interests may simply need to
be updated or a clarification notice or response published. Where a conflict is substantial and risks the
integrity of the content, product, or service, the person is likely to have to be removed from
undertaking the relevant task and articles or other content they have been working on may need to be
retracted. Such cases must be discussed with senior staff (the line manager in the first instance) and
records kept of all decision making.
When documenting the decision making process care should be taken to only record the facts of the
case under review and to avoid any speculation or making any personal comments about a persons
declaration of interests.
FG, LD, RM December 2012