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In praise of the ‘non-experts’

In Joseph Heller’s Catch-22, Major Danby asks Bombardier Yossarian, “But, Yossarian, what if everyone felt that way?” Yossarian replies: “Then I’d certainly be a damned fool to feel any other way, wouldn’t I?”

I wonder if this inspired dialogue occurred to any of the 173-plus eminent co-signatories to a letter from Bonnie Liebman of the American Centre for Science in the Public Interest, published in the BMJ (17 December 2015). It asked the BMJ to retract an article published on 23 September 2015 by Nina Teicholz, titled ‘The scientific report guiding the US dietary guidelines: Is it scientific’?

But Liebman et al’s condemnatory tone towards an article they deemed “riddled with errors” was tempered by a spirit of benevolence aimed at saving the journal from itself, as “we urge the BMJ to retract it, not only to inform your readers, but also to protect the BMJ’s credibility”. The BMJ may have justifiably suspected that it was Liebman et al’s credibility at stake and not its own, yet nonetheless sought post-publication advice on Teicholz’s article from two Cochrane-recommended experts. The upshot was that the BMJ refused to retract the article.

Teicholz suggests that the experts behind the next set of United States Dietary Guidelines are reluctant “to consider any evidence that contradicts the last 35 years of nutritional advice”. That advice has been to eat less fat and fewer animal products such as meat, dairy and eggs, favouring instead a calorie intake derived mainly from fruit and veg, grains and vegetable oils. The drawback is that these guidelines, according to Teicholz, have not promoted better health.

I’m not interested in debating the evidence here, but to consider Liebman et al’s letter in the context of the Danby/Yossarian exchange above. Two matters arise. First, Liebman conscripted what the title of an essay by art critic Harold Rosenberg (1906-1978) announced as ‘The Herd of Independent Minds’, each of whom, in Danby’s parlance, “felt that way” about the US Dietary Guidelines. Now, anyone ignorant of the power of group-think might assume that each of the 173-plus medical-scientist signatories, having read Teicholz’s article, would have been so outraged by its contents that they would have availed themselves of the Rapid Response facility on the BMJ website to ensure that their individual objection was promptly registered. This didn’t happen: There were 44 responses, many supporting Teicholz. And in Ian Leslie’s ‘The Sugar Conspiracy’, published in The Guardian (7 April 2016), he recalls speaking to several of the Liebman et al signatories who had objected to Teicholz’s article being “riddled with errors”. When Leslie asked them “to name just one of the supposed errors in it, not one of them was able to. One admitted he had not read it. Another told me she had signed the letter because the BMJ should not have published an article that was not peer reviewed (it was peer reviewed).”

The second point arising from Danby and Yossarian is that while 173-plus expert signatories claimed to have “felt that way” about Teicholz’s article, we should be grateful that Nina Teicholz was such “a damned fool to feel any other way”, leaving some eminent nutrition experts with saturated fat-enriched egg on their faces, and the BMJ’s endorsement ringing in their ears.

Relentless in my research on your behalf, I can reveal (because it’s on the first page of her article) that Nina Teicholz is neither a nutritionist nor a scientist, but a journalist. That fact alone was enough to stun Dr David L Katz of Yale University: “I am rather stunned”, he stated in his response to Teicholz, posted on the BMJ website. What had stunned Katz was the BMJ’s “transgression” in publishing the article, a transgression, moreover, that “is particularly glaring, since this commentary by a non-scientist purports to tell BMJ readers whether or not the work of the Dietary Guidelines Advisory Committee is… scientific”.

So I was puzzled to read Katz’s Preventive Medicine Column (16 December 2016) on his website (www.davidkatzmd.com), reminding readers that “the First Amendment protects the freedoms of speech and the press and it’s not likely to be an accident that the Founders gave it primacy”. But perhaps Katz’s interpretation of a free press is one in which journalists keep well away from the medical-scientific stuff and leave that to the experts.

In an earlier Preventive Medicine Column titled ‘Dietitians and the Power of Unity’ (21 October 2016), Katz had non-experts in his sights, noting that they “also have their passions, priorities and pet peeves related to nutrition and in cyberspace they can readily broadcast those in the guise of facts, their lack of relevant qualifications generally undeclared…  If actual experts — dietitians and others — broadcast a comparable scattershot of disparate opinion, how is the public to know what’s what, let alone who’s who?”

To at least one observer, it seems, nutrition advice in the 21st Century apparently consists of a “scattershot of disparate opinion”. That it takes journalists and authors of the calibre of Nina Teicholz and Ian Leslie to help lay it bare to self-proclaimed experts is telling.

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