BMJ纠正美国膳食指南有争议的评论

The BMJ has published a correction to a critique of the U.S. dietary guidelines report that has received heavy criticism from nutrition experts.

The author, journalist Nina Teicholz, has also posted a response to the criticism of the article.

The BMJ investigation, released in September, asserted that the guidelines committee used “weak scientific standards” to make its recommendations. It also criticized several aspects of the new guidelines, such as “deleting meat from the list of foods recommended as part of its healthy diets.”

Soon after the feature appeared, The Verge — who first reported the news of the correction this week — called it “bogus.” The BMJ quickly issued a “clarification” to the paper, in the “rapid response” section of the paper (the journal’s version of a comment section). It noted that the feature should have specified “lean” meats.

The new, official, correction doesn’t formally put the clarification on the record. Instead, it addresses the research behind the analysis about saturated fats. Here it is in full:

This Feature (BMJ 2015;351:h4962, doi:10.1136/bmj.h4962) by Nina Teicholz stated that when the guidelines advisory committee started its work in 2012 there had been several prominent papers, including a meta-analysis and two major reviews (one systematic), that failed to confirm an association between saturated fats and heart disease. This statement did not aptly reflect the findings of the more authoritative of these reviews, by Hooper et al (Cochrane Database Syst Rev2012;5:CD002137), which found that saturated fats had an effect on cardiovascular events but failed to confirm an effect on cardiovascular mortality.

In its analysis, The Verge argues the correction doesn’t go nearly far enough:

Every five years, the US government issues a new set of dietary guidelines. These guidelines are highly influential; they affect food labeling, school lunches and even scientific research. But this September, the BMJ published an astounding piece of pro-fat propaganda that attacked the committee who issued the 2015 report using factual inaccuracies revealed by The Verge. Now, theBMJ has issued a correction for the article, but its scope is so limited that Teicholz’s article will likely still serve as ammunition for a meat industry that wants to squash the committee’s advice on lowering the consumption of red meat.

The Verge also highlighted the discrepancy between the latest correction and the previous clarification:

The first thing worth noting here is that the BMJ’s correction did not include the items listed in a “clarification” published by Rebecca Coombes — one of the BMJ‘s editors — one week after the article appeared on the journal’s website. This is an interesting choice, since the existence of the “clarification” heavily implies the BMJ felt Teicholz’s story needed further explanation. But given that the clarification was also full of errors, [even] these so-called clarifications wouldn’t make the story right.

For instance, the BMJ‘s clarification states that Teicholz shouldn’t have faulted the committee for “deleting meat” from the list of recommended foods contained in its report — instead, Teicholz should have written that the committee had “deleted lean meats.” But this, too, is factually incorrect.The committee didn’t delete lean meats at all. The committee’s report also states — in plain English — that “lean meats can be a part of a healthy dietary pattern.”

The original BMJ article received heavy criticism from nutrition experts who spoke to The Verge or postedresponses to the feature, such as this lengthy note from the 2015 Dietary Guidelines Advisory Committee, chaired by Barbara Millen.

Teicholz’s response to the criticism of her story addresses some of these criticisms that are not addressed in the correction or the clarification. She contends that the report’s methodology is “not reproducible:”

Firstly, Barbara Millen for the DGAC suggests that I was wrong to claim that the committee failed to use a systematic methodology for searching and selecting evidence. However, my article documents a lack of systematic methodology in several places in their report. For example, two statements in the report’s methodology section (Part C Methodology, page 11-12) indicate an approach that is not reproducible.

Teicholz also addresses a statement from Bonnie Liebman, posted on the CSPI website, which calls The BMJarticle an “error-laden attack.” Here, Teicholz concedes one point, which became the subject of the official correction notice:

In her response, the Center for Science in the Public Interest’s Nutrition Director Bonnie Liebman points out that, contrary to my statement that recent meta-analyses “failed to confirm an association between saturated fats and heart disease,” one of these reviews, by Hooper et al, 2012, concluded that “reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14%. That figure was increased to 17% in a 2015 update.”

Liebman was correct to point this out. The full sentence in my article was: “When the committee started its work in 2012, there had been several prominent papers, including a meta-analysis (8) and two major reviews (one systematic) (9) (10) that failed to confirm an association between saturated fats and heart disease.” This statement did not aptly reflect the findings of the more authoritative of these reviews, by Hooper et al, which did find an effect of saturated fats on cardiovascular events but failed to confirm an effect between saturated fats on cardiovascular mortality.” A correction to this statement will be posted.

Rafael Perez-Escamilla, a member of the Dietary Guidelines Advisory Committee, told The Verge that he thinks the feature should be retracted:

Hopefully, the BMJ eventually agrees to retract whole paper. [We] will see…

We’ve emailed The BMJ and will update this post if we hear back.

Hat tip: The Verge

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