Letter Requesting BMJ to Retract “Investigation”

Letter Requesting BMJ to Retract “Investigation”

November 5, 2015

 

Dear Editor:

A recent article by journalist Nina Teicholz, which was published as a “BMJ Investigation” of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC), 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 BMJ’s 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).


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 committee’s 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. (Note: In Table A, Teicholz states 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.” This statement contradicts Teicholz’s 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. The NHLBI’s 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.


4.) Teicholz states that “in the NEL systematic review on saturated fats from 2010…fewer 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.” (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 “committee’s report used weak scientific standards,” because it did not rely sufficiently on NEL reviews. 


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. (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 meta-analyses because it tested a multifactorial intervention including drug treatment for hypertension, counseling for cigarette smoking, and dietary advice for lowering blood cholesterol levels.


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 committee’s 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 impact of diet on serum cholesterol levels. Furthermore, all three trials  were included in the Cochrane review that was considered by the DGAC.


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.


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. Note: Teicholz’s Table D consists largely of Teicholz’s criticism of the NEL’s Systematic Reviews on the Relationship between Dietary Patterns and Health Outcomes, published in 2014. Note that Teicholz argues that NEL reviews are substandard, but she also argues that the 2015 “committee’s 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 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.


10.) Teicholz states that “The committee’s 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 country’s dietary guidelines acknowledged that they had ditched the low-fat diet.”) The Dietary Guidelines for Americanshas 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. 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. 

Sincerely,

*Steven Abrams, MD 
Chair of Pediatrics 
Director, Dell Pediatric Research Institute 
Dell Medical School 
University of Texas at Austin 
Austin, Texas, USA

*Lucile L. Adams-Campbell, PhD 
Professor of Oncology 
Associate Dean 
Associate Director, Minority Health & Health Disparities Research 
Georgetown University Medical Center 
Washington, D.C., USA

Sharon R. Akabas, PhD 
Director, MS in Nutrition 
Associate Director for Educational Initiatives 
Columbia University 
Institute of Human Nutrition 
New York, New York, USA

*Cheryl Anderson, PhD, MPH 
Associate Professor of Preventive Medicine 
Department of Family and Preventive Medicine 
School of Medicine 
University of California, San Diego 
La Jolla, California, USA

Lawrence J. Appel, MD, MPH 
C. David Molina, MD, MPH Professor of Medicine Epidemiology and International Health 
Director, Welch Center for Prevention, Epidemiology, and Clinical Research 
Johns Hopkins Medical Institutions 
Baltimore, Maryland, USA

Fernando Arós Borau, MD, PhD 
Department of Cardiology 
University Hospital of Araba 
Vitoria, Spain

Alberto Ascherio, MD, DrPH 
Professor of Epidemiology and Nutrition 
Department of Nutrition 
Harvard T.H. Chan School of Public Health 
Professor of Medicine 
Harvard Medical School 
Boston, Massachusetts, USA

Guy De Backer, MD, PhD 
Emeritus Professor in Public Health 
Ghent University 
Ghent, Belgium

Adam B. Becker, PhD, MPH 
Executive Director 
Consortium to Lower Obesity in Chicago Children 
Chicago, Illinois, USA

Maira Bes-Rastrollo, PharmD, PhD 
Associate Professor 
Department of Preventive Medicine and Public Health 
Faculty of Medicine 
University of Navarra 
Navarra, Spain

Henry Blackburn, MD 
Professor Emeritus, Epidemiology & Community Health 
Division of Epidemiology & Community Health 
University of Minnesota 
Minneapolis, Minnesota, USA

Carol J. Boushey, PhD, MPH, RD 
Associate Research Professor 
Epidemiology Program 
University of Hawaii Cancer Center 
University of Hawaii at Manoa 
Honolulu, Hawaii, USA

Marie-Christine Boutron-Ruault, MD, PhD 
Medical Practitioner, Internist, and Gastroenterologist 
Practitioner at Antoine Béclère University Hospital 
Inserm Research Director 
Head of INSERM UMR 1018 
Clamart, France

*J. Thomas Brenna, PhD 
Professor of Human Nutrition and of Chemistry 
Cornell University 
Ithaca, New York, USA

Ingeborg Brouwer, PhD 
Professor of Nutrition for Healthy Living 
Health Sciences 
VU University Amsterdam 
Amsterdam, The Netherlands

Kelly D. Brownell, PhD 
Dean, Sanford School of Public Policy 
Robert L. Flowers Professor of Public Policy 
Professor of Psychology and Neuroscience 
Duke University 
Durham, North Carolina, USA

Aurora Bueno Cavanillas, MD, PhD 
Professor of Preventive Medicine and Public Health 
University of Granada 
Granada, Spain

Pilar Buil-Cosiales, PhD, MD 
Primary Health Care Practitioner 
Servicio Navarro de Salud-Osasunbidea 
National Health System 
Navarra, Spain

Joanne Burke, PhD, RD, LD 
Director of the University of New Hampshire Dietetic Internship 
Thomas W. Haas Professor in Sustainable Food Systems 
University of New Hampshire 
Durham, New Hampshire, USA

Carlos A. Camargo, Jr., MD, DrPH 
Professor of Medicine, Harvard Medical School 
Professor of Epidemiology, Harvard School of Public Health 
Boston, Massachusetts, USA

*Wayne Campbell, PhD 
Professor, Department of Nutrition Science 
Purdue University 
West Lafayette, Indiana, USA

Raffaele De Caterina, MD, PhD 
Professor and Chair of Cardiology 
G. d’Annunzio University - Chieti-Pescara 
Chieti, Italy

Alan Chait, MD 
Edwin L. Bierman Professor of Medicine 
Head, Division of Metabolism, Endocrinology & Nutrition 
University of Washington 
Seattle, Washington, USA

Jorge E. Chavarro, MD, ScD 
Associate Professor of Nutrition and Epidemiology 
Harvard T.H. Chan School of Public Health 
Assistant Professor of Medicine 
Harvard Medical School 
Boston, Massachusetts, USA

*Steven K. Clinton, MD, PhD 
John B. and Jane T. McCoy Chair of Cancer Research 
The Ohio State University Comprehensive Cancer Center 
Professor 
Division of Medical Oncology 
Department of Internal Medicine 
The Ohio State University School of Medicine 
Columbus, Ohio, USA

Isobel R. Contento, PhD 
Mary Swartz Rose Professor of Nutrition and Education 
Coordinator, Program in Nutrition 
Faculty Director, Laurie M. Tisch Center for Food, Education & Policy 
Department of Health and Behavior Studies 
Teachers College Columbia University 
New York, New York, USA

Dolores Corella, PhD 
Professor, Preventive Medicine and Public Health 
Genetic and Molecular Epidemiology Unit 
School of Medicine 
University of Valencia 
Valencia, Spain

Patricia Crawford, DrPH 
Senior Director of Research, Nutrition Policy Institute 
Cooperative Extension Specialist 
University of California Agriculture and Natural Resources 
Berkeley, California, USA

Lidia A. Daimiel-Ruiz, PhD 
Principal Investigator 
Pabellón Central del Antiguo Hospital de Cantoblanco 
University de Cantoblanco 
Madrid, Spain

Richard J. Deckelbaum, MD, CM, FRCPC 
Robert R. Williams Professor of Nutrition 
Professor of Pediatrics 
Professor of Epidemiology 
Director, Institute of Human Nutrition 
College of Physicians and Surgeons 
Columbia University Medical Center 
New York, New York, USA

Jean-Pierre Després, PhD, FAHA, FIAS 
Scientific Director 
International Chair on Cardiometabolic Risk 
Professor, Department of Kinesiology 
Faculty of Medicine, Université Laval 
Director of Research, Cardiology 
Québec Heart and Lung Institute 
Québec, Canada

William Dietz, MD, PhD 
Director, Sumner M. Redstone Global Center for Prevention and Wellness 
Milken Institute School of Public Health 
George Washington University 
Washington, D.C., USA

Deirdre A. Dingman, DrPH, MPH, CHES 
Postdoctoral Fellow 
Public Health Law Research 
Temple University 
Philadelphia, Pennsylvania, USA

Ligia J. Dominguez, MD 
Geriatric Unit 
University of Palermo 
Palermo, Italy

Ana Clara Duran, MS, PhD 
Postdoctoral Research Fellow 
University of Illinois, Chicago 
Chicago, Illinois, USA

Robert H. Eckel, MD 
Professor of Medicine 
Division of Endocrinology, Metabolism and Diabetes 
Division of Cardiology 
Professor of Physiology and Biophysics 
Charles A. Boettcher II Chair in Atherosclerosis 
University of Colorado Anschutz Medical Campus 
Director Lipid Clinic, University Hospital 
University of Colorado, Denver 
Denver, Colorado, USA

Ibrahim Elmadfa, PhD 
Emeritus Professor of Nutrition 
University of Vienna 
Vienna, Austria

Javier Díez Espino, MD, PhD 
Primary Care Manager 
Servicio Navarro de Salud-Osasubidea 
Navarra, Spain

Ramon Estruch, MD, PhD 
Department of Internal Medicine 
Hospital Clinic, University of Barcelona 
Barcelona, Spain

Wafaie Fawzi, DrPH 
Richard Saltonstall Professor of Population Sciences 
Professor of Nutrition, Epidemiology, and Global Health 
Chair, Department of Global Health and Population 
Harvard T.H. Chan School of Public Health 
Boston, Massachusetts, USA

Alejandro Fernández-Montero, MD, PhD 
Project Director, “Healthy Diet, It’s up to you” 
Department of Prevention of Occupational Hazards 
University of Navarra-IDISNA 
Navarra, Spain

Oscar H. Franco, MD, PhD, FESC, FFPH 
Professor of Preventive Medicine 
PI Cardiovascular Epidemiology group 
Director ErasmusAGE 
CEO Erasmus Epidemiology Resources 
Deputy Science Director NIHES 
Department of Epidemiology 
Erasmus MC, University Medical Center Rotterdam 
Rotterdam, The Netherlands

Gary E. Fraser, MD, PhD 
Professor of Epidemiology 
Loma Linda University 
Loma Linda, California, USA

Itziar Zazpe Garcia, PhD, RD 
Professor 
Department of Clinical Science and Physiology 
Universidad de Navarra 
Navarra, Spain

Christopher Gardner, PhD 
Professor of Medicine 
Director of Nutrition Studies 
Director of NIH/NHLBI Postdoctoral Training Program 
Stanford Prevention Research Center 
Palo Alto, California, USA

Alfredo Gea, PhD 
Assistant Professor 
Department of Preventive Medicine & Public Health 
University of Navarra, Spain 
Navarra, Spain

Angel Gil, PhD 
President of the Iberoamerican Nutrition Foundation (FINUT) 
Full Professor Department of Biochemistry and Molecular Biology II 
Institute of Nutrition and Food Technology 
Centre of Biomedical Research 
University of Granada 
Granada, Spain

David C. Goff, Jr., MD, PhD 
Dean 
Colorado School of Public Health 
Aurora, Colorado, USA

Carlos A. González, MD, PhD 
Unit of Nutrition and Cancer (Emeritus) 
Cancer Epidemiology Research Programme 
Catalan Institute of Oncology (ICO) 
Barcelona, Spain

Teresita González de Cosío, PhD, MSc 
Directora de Departamento de Salud 
Universidad Iberoamericana 
Mexico City, Mexico

Michael I. Goran, PhD 
Director, Childhood Obesity Research Center 
Co-Director, USC Diabetes and Obesity Research Institute 
Professor of Preventive Medicine; Physiology & Biophysics; and Pediatrics 
The Dr. Robert C. & Veronica Atkins Chair in Childhood Obesity & Diabetes 
USC Keck School of Medicine 
Los Angeles, California, USA

Antonio M. Gotto Jr., MD, DPhil 
Professor of Medicine 
Provost for Medical Affairs and Dean Emeritus Weill Cornell Medical College 
New York, New York, USA

Philip Greenland, MD 
Harry W. Dingman Professor 
Department of Preventive Medicine 
Northwestern University Feinberg School of Medicine 
Chicago, Illinois, USA

Joan Gussow, EdD 
Mary Swartz Rose Professor Emerita of Nutrition Education 
Teachers College 
Columbia University 
New York, New York, USA

Michael W. Hamm, PhD 
C.S. Mott Professor of Sustainable Agriculture 
Director, Center for Regional Food Systems 
Departments of CSUS, PSM, FSHN 
Michigan State University 
East Lansing, Michigan, USA

Carole V. Harris, PhD 
Vice President, Public Health and Survey Research Division 
ICF International 
Atlanta, Georgia, USA

Serge Hercberg, MD, PhD 
Chef d'équipe - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN) 
Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité 
Université Paris 
Bobigny, France

*Frank B. Hu, MD, PhD 
Professor of Nutrition and Epidemiology 
Harvard T.H. Chan School of Public Health 
Professor of Medicine 
Harvard Medical School 
Boston, Massachusetts, USA

Rod Jackson, MBChB, PhD 
Professor of Epidemiology 
Faculty of Medical and Health Sciences 
University of Auckland 
Auckland, New Zealand

David Jacobs, PhD 
Professor, Division of Epidemiology & Community Health 
School of Public Health 
University of Minnesota 
Minneapolis, Minnesota, USA

Michael F. Jacobson, PhD 
President 
Center for Science in the Public Interest 
Washington, D.C., USA

Enrique Jacoby, MD, MPH 
Regional Advisor on Nutrition and Active Living 
NMH Pan American Health Organization 
World Health Organization 
Washington, D.C., USA

Philip T. James, CBE, MD, DSc 
Honorary Professor of Nutrition 
London School of Hygiene 
London, United Kingdom

David Jenkins, MD, PhD, DSc 
Professor, Canada Research Chair in Nutrition and Metabolism 
Department of Nutritional Sciences 
Director, Risk Factor Modification Centre, St. Michael’s Hospital 
University of Toronto 
Toronto, Canada

Laura Johnson, PhD 
Lecturer in Public Health Nutrition 
Centre for Exercise, Nutrition and Health Sciences 
School for Policy Studies 
University of Bristol 
Bristol, United Kingdom

Martijn B. Katan, PhD 
Emeritus Professor of Nutrition 
VU University Amsterdam 
Department of Health Sciences 
Amsterdam, The Netherlands

David Katz, MD, MPH, FACPM, FACP 
Director, Yale University Prevention Research Center 
President, American College of Lifestyle Medicine 
Founder, True Health Initiative 
New Haven, Connecticut, USA

George A. Kelley, DA, FACSM 
Professor & Director, Meta-Analytic Research Group 
School of Public Health 
Department of Biostatistics 
Co-Director, WVCTSI Clinical Research Design, Epidemiology, and Biostatistics Program 
West Virginia University 
Morgantown, West Virginia, USA

Thomas Kelly, PhD, MA 
Chief Sustainability Officer/Director 
Sustainability Institute 
University of New Hampshire 
Durham, New Hampshire, USA

Emmanuelle Kesse-Guyot, PhD 
Research Director 
COMUE Sorbonne-Paris-Cité 
Equipe de Recherche en Epidémiologie Nutritionnelle (EREN) 
Centre d’Epidémiologie et Biostatistiques Paris Nord 
Institute for Health and Medical Research (Inserm, U1153) 
Institut National de la Recherche Agronomique (INRA, U1125) 
Conservatoire National des Arts et Métiers (CNAM) 
Paris 13 University 
Paris, France

Kay-Tee Khaw, MD, MSc, PhD 
University of Cambridge School of Clinical Medicine 
Clinical Gerontology Unit 
Addenbrooke’s Hospital 
Cambridge, United Kingdom

Vivica I. Kraak, PhD, RD 
Assistant Professor of Food and Nutrition Policy 
Department of Human Nutrition, Foods & Exercise 
Virginia Tech 
Blacksburg, Virginia, USA

Fernanda Kroker, MSc, PhD 
Scientific Researcher 
Population Nutrition 
Institute of Nutrition of Central America and Panama -INCAP- 
Guatemala City, Guatemala

Daan Kromhout, PhD, MPH 
Emeritus Professor 
Division of Human Nutrition 
Wageningen University 
Wageningen, The Netherlands

Lewis H. Kuller, MD, DrPH 
Department of Epidemiology 
Graduate School of Public Health 
University of Pittsburgh 
Pittsburgh, Pennsylvania, USA

Larry Kushi, ScD 
Director of Scientific Policy 
Kaiser Permanente 
Oakland, California, USA

Darwin R. Labarthe, MD, MPH, PhD 
Professor of Preventive Medicine 
Northwestern University Feinberg School of Medicine 
Chicago, Illinois, USA

Rosa M. Lamuela-Raventos, PhD 
Associate Professor 
Department of Nutrition and Food Science 
School of Pharmacy, University of Barcelona 
Barcelona, Spain

José Lapetra, MD, PhD 
Médico de Familia 
Responsable del Grupo de Investigación "Dieta, Nutrición y Prevención de Enfermedades en Atención Primaria" 
CIBEROBN, Instituto de Salud Carlos III 
Unidad de Investigación del Distrito Sanitario Atención Primaria Sevilla 
Sevilla, Spain

Robert S. Lawrence, MD 
Director, Center for a Livable Future 
Professor of Environmental Health Sciences and International Health 
Johns Hopkins Bloomberg School of Public Health 
Baltimore, Maryland, USA

Sally Ann Lederman, PhD 
Special Lecturer 
Institute of Human Nutrition 
Columbia University 
New York, New York, USA

Allen S. Levine, PhD 
Professor, Food Science and Nutrition 
University of Minnesota 
Minneapolis, Minnesota, USA

Elyse Levine, PhD, RD 
Associate 
Booz Allen Hamilton 
Rockville, Maryland, USA

David A. Levitsky, PhD, MPhil, MS 
Stephen H. Weiss Presidential Fellow 
Professor of Nutrition and Psychology 
Cornell University 
Ithaca, New York, USA

Barry Lewis, MD, PhD, FRCP, FRCPath 
Emeritus Professor 
University of London 
London, United Kingdom

*Alice Lichtenstein, DSc 
Senior Scientist and Director 
Cardiovascular Nutrition Laboratory 
Jean Mayer USDA Human Nutrition Research Center on Aging 
Professor of Medicine 
Tufts University School of Medicine 
Boston, Massachusetts, USA

Bonnie F. Liebman, MS 
Director of Nutrition 
Center for Science in the Public Interest 
Washington, D.C., USA

Esther Lopez-Garcia, PhD, MPH 
Associate Professor 
Department of Preventive Medicine and Public Health 
School of Medicine 
Universidad Autónoma de Madrid 
Madrid, Spain

José López Miranda, MD, PhD 
Catedrático de Medicina Interna 
Vicedecano de Asuntos Hospitalarios 
Director UGC Medicina Interna 
Hospital Universitario Reina Sofia 
Facultad de Medicina 
Universidad de Cordoba 
Cordoba, Spain

Graham MacGregor, MA, MB, BChir 
Professor of Cardiovascular Medicine 
Wolfson Institute of Preventive Medicine 
Barts and The London School of Medicine and Dentistry, Queen Mary 
University of London 
London, United Kingdom 
Meena Mahadevan, PhD 
Associate Professor 
Program Coordinator for Applied Nutrition 
Department of Health and Nutrition Sciences 
Montclair State University 
Montclair, New Jersey, USA

Vasanti Malik, ScD 
Research Scientist 
Harvard T.H. Chan School of Public Health 
Boston, Massachusetts, USA

Mario Mancini, MD 
Emeritus Professor 
University of Naples 
Naples, Italy

James Mann, MD 
Professor, Human Nutrition and Medicine 
Dunedin School of Medicine 
University of Otago 
Otago, New Zealand

JoAnn E. Manson, MD, DrPH 
Professor of Medicine 
Michael and Lee Bell Professor of Women's Health 
Harvard Medical School 
Professor, Department of Epidemiology 
Harvard T.H. Chan School of Public Health 
Chief, Division of Preventive Medicine 
Brigham and Women's Hospital 
Boston, Massachusetts, USA

Barrie Margetts, PhD, FFPH, MSc 
Professor Emeritus of Medicine 
University of Southampton 
Southampton, United Kingdom

Miguel A. Martinez-Gonzalez, MD, PhD, MPH 
Chair, Department of Public Health 
University of Navarra-CIBEROBN 
Navarra, Spain

J. Alfredo Martinez Hernandez, D.Pharm, MD, PhD 
Professor 
Department of Nutrition, Food Science, Physiology and Toxicology 
School of Pharmacy 
University of Navarra 
Navarra, Spain

William McCarthy, PhD 
Adjunct Professor 
UCLA Fielding School of Public Health 
Department of Health Policy and Management 
Los Angeles, California, USA

*Barbara Millen, DrPH, RD 
Founder and President 
Millennium Prevention, Inc. 
Westwood, Massachusetts, USA

Nana Gletsu Miller, PhD 
Assistant Professor 
Department of Nutrition Science 
College of Health and Human Sciences 
Purdue University 
West Lafayette, Indiana, USA

Marc Molendijk, PhD 
Assistant Professor Clinical Psychology 
Leiden University and Leiden University Medical Center 
Leiden, The Netherlands

Carlos A. Monteiro, MD, PhD 
Professor of Nutrition and Public Health 
Department of Nutrition, School of Public Health 
University of Sáo Paulo 
Sáo Paulo, Brazil

Roni Neff, PhD, MS 
Assistant Professor, Environmental Health Sciences 
Bloomberg School of Public Health 
Program Director, Food System Sustainability 
Center for a Livable Future 
Johns Hopkins University 
Baltimore, Maryland, USA

*Miriam Nelson, PhD 
Associate Dean, Tisch College of Citizenship and Public Service 
Professor, Friedman School of Nutrition Science and Policy 
Tufts University 
Boston, Massachusetts, USA

*Marian L. Neuhouser, PhD, RD 
Full Member, Cancer Prevention Program 
Division of Public Health Sciences 
Fred Hutchinson Cancer Research Center 
Seattle, Washington, USA

Kaare R. Norum, MD, PhD 
Professor Emeritus 
Department of Nutrition 
Faculty of Medicine 
University of Oslo 
Oslo, Norway

Salvatore Panico, MD, MS 
Professor of Internal Medicine 
Federico II University 
Naples, Italy

Angeliki Papadaki, PhD, MSc, 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 
Bristol, United Kingdom

Diana C. Parra, PhD, PT, MPH 
Assistant Professor 
Program in Physical Therapy and Department of Surgery (Prevention) 
Scholar, Institute for Public Health 
Washington University School of Medicine 
St. Louis, Missouri, USA

Emma Patterson, PhD 
Project Manager for School Food Sweden 
Community Nutrition and Physical Activity 
Karolinska Institutet 
Stockholm, Sweden 
Jan I. Pedersen, MD, PhD 
Emeritus Professor 
Department of Nutrition 
Institute of Basic Medical Sciences 
University of Oslo 
Oslo, Norway

*Rafael Perez-Escamilla, PhD 
Professor of Epidemiology and Public Health 
Director, Office of Public Health Practice 
Director, Global Health Concentration 
Yale School of Public Health 
New Haven, Connecticut, USA

Francisco Perez-Jimenez, MD, PhD 
Full Professor of Internal Medicine 
Reina Sofia University Hospital 
University of Cordoba 
Cordoba, Spain

F. Xavier Pi-Sunyer, MD 
Professor of Medicine 
Institute of Human Nutrition 
Columbia University 
New York, New York, USA

María Puy Portillo, DPharm 
Professor of Nutrition 
Director, Nutrición y Obesidad 
Department of Pharmacy and Food Science 
University of the Basque Country 
Bilbao, Spain

John D. Potter, MD, PhD 
Senior Advisor, Public Health Sciences Division 
Fred Hutchinson Cancer Research Center 
Seattle, Washington, USA

Neil Poulter, MD 
Professor of Preventive Cardiovascular Medicine 
Imperial College 
London, United Kingdom

Pekka Puska, MD, PhD, MPolSc 
Professor, National Institute for Health and Welfare (THL), Finland 
Past President, World Heart Federation (WHF) 
Past President, International Association of National Public Health Institutes 
Helsinki, Finland

Kalevi Pyörälä, MD 
Emeritus Professor of Medicine 
University of Eastern Finland 
Kuopio, Finland

Tim Radak, DrPH, MPH, RD 
Academic Coordinator for DrPH and PhD Public Health Programs 
College of Health Sciences 
Walden University 
Minneapolis, Minnesota, USA

Sujatha Rajaram, PhD 
Chair, SPH Doctoral Committee 
Program Director, DrPH in Nutrition 
School of Public Health 
Loma Linda University 
Loma Linda, California, USA

Mike Rayner, DPhil 
Professor of Population Health 
Director, British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention 
Nuffield Department of Population Health 
University of Oxford 
Oxford, United Kingdom

Cristina Razquin Burillo, PhD 
Colaborador de investigación 
Department of Preventive Medicine and Public Health 
School of Medicine 
University of Navarra 
Navarra, Spain

Bill Reger-Nash, EdD 
Professor Emeritus 
West Virginia University School of Public Health 
Associate Chair, Morgantown Pedestrian Safety Board 
Morgantown, West Virginia, USA

Shaun Riebl, PhD, RDN, LDN 
Clinical Assistant Professor 
The University of North Carolina at Chapel Hill 
Gillings School of Global Public Health and UNC School of Medicine 
Department of Nutrition 
Department of Medicine - Division of Nephrology and Hypertension 
UNC Hospitals Kidney and Hypertension Specialty Clinic 
Chapel Hill, North Carolina, USA

Eric Rimm, ScD 
Professor of Medicine 
Harvard Medical School 
Channing Division of Network Medicine, Brigham and Women's Hospital 
Professor of Epidemiology and Nutrition 
Director, Program in Cardiovascular Epidemiology 
Harvard T.H. Chan School of Public Health 
Boston, Massachusetts, USA

Ulf Risérus, MMED, PhD 
Associate Professor in Clinical Nutrition 
Department of Public Health and Caring Sciences 
Clinical Nutrition and Metabolism 
Faculty of Medicine, Uppsala University 
Uppsala, Sweden

Lorrene Ritchie, PhD, RD 
Director, Nutrition Policy Institute 
Cooperative Extension Specialist 
University of California Agriculture and Natural Resources 
Berkeley, California, USA

Juan Rivera Dommarco, PhD, MS 
Director 
Center for Research in Nutrition and Health 
Instituto Nacional de Salud Publica 
Cuernavaca, Mexico

Kim Robien, PhD, RD, CSO, FAND 
Associate Professor 
Department of Exercise and Nutrition Sciences 
Department of Epidemiology and Biostatistics 
Milken Institute School of Public Health 
George Washington University 
Washington, D.C., USA

Fernando Rodríguez-Artalejo, MD, PhD 
Professor of Preventive Medicine and Public Health 
School of Medicine 
Universidad Autónoma de Madrid 
Madrid, Spain

Dora Romaguera, MSc, PhD 
Institut d’Investigació Sanitària de Palma (IdISPa) and CIBER-OBN 
Hospital Universitari Son Espases, Unitat de Recerca 
Palma de Mallorca, Spain

Emilio Ros, MD, PhD 
Former Director, Lipid Clinic 
Endocrinology & Nutrition Service 
Hospital Clínic 
CIBERobn, ISCIII, Spain 
Barcelona, Spain

Donald (Diego) Rose, PhD, MPH 
Professor and Head of Nutrition Section 
School of Public Health and Tropical Medicine 
Tulane University 
New Orleans, Louisiana, USA

Miguel Ruiz-Canela, PhD, MPH 
Associate Professor 
Department of Preventive Medicine and Public Health 
University of Navarra 
Navarra, Spain

Joan Sabaté, MD, DrPH 
Professor of Nutrition 
School of Public Health 
Loma Linda University 
Loma Linda, California, USA

Frank Sacks, MD, ScB 
Professor of Cardiovascular Disease Prevention 
Department of Nutrition 
Harvard T.H. Chan School of Public Health 
Boston, Massachusetts, USA

Guillermo Saez Tormo, MD, PhD 
Department of Biochemistry and Molecular Biology 
Coordinator for International Relations and Mobility Programs 
Faculty of Medicine and Odontology 
Service of Clinical Analysis 
University Hospital Doctor Peset Aleixandre 
University of Valencia 
Valencia, Spain

Jordi Salas-Salvadó, MD, PhD 
Professor of Nutrition 
Director, Human Nutrition Unit 
Department of Biochemistry & Biotechnology, IISPV 
School of Medicine 
Rovira i Virgili University 
CIBERobn, Instituto Carlos III 
Director, Centre Català de la Nutrició - Institut d'Estudis Catalans 
Past President, Federation of Spanish Food, Nutrition and Dietetic Scientific Societies 
Director, Red Iberoamericana RIBESMET 
Chairman, INC - World Forum for Nutrition Research and Dissemination 
Reus, Spain

Almudena Sánchez-Villegas, PhD 
Associate Professor of Preventive Medicine and Public Health 
Department of Clinical Sciences 
Universidad de las Palmas de Gran Canaria 
Las Palmas, Spain

Wim H.M. Saris, MD, PhD 
Professor of Human Nutrition 
Department of Human Biology 
NUTRIM: School of Nutrition and Translational Research 
Maastricht University Medical Centre 
Maastricht, The Netherlands

Dennis Savaiano, PhD, MS 
Virginia C. Meredith Professor 
Director, North Central Nutrition Education Center 
Department of Nutrition Science 
Purdue University 
West Lafayette, Indiana, USA

Matthias B. Schulze, DrPH 
German Institute of Human Nutrition 
Department of Molecular Epidemiology 
Nuthetal, Germany

Ursula Schwab, PhD 
Associate Professor, Nutrition Therapy 
Department of Public Health and Clinical Nutrition 
School of Medicine 
University of Eastern Finland, Kuopio Campus 
Kuopio, Finland

Marlene B. Schwartz, PhD 
Director 
Rudd Center for Food Policy and Obesity 
University of Connecticut 
Storrs, Connecticut, USA

Jacob C. Seidell, PhD 
Professor of Nutrition and Health/University Professor 
VU University Amsterdam 
Amsterdam, The Netherlands

Lluis Serra-Majem, MD, MSc, PhD 
Professor of Public Health 
Director, Public Health Nutrition Research Center, University of Barcelona 
President, Nutrition Without Borders 
University of Gran Canaria 
Gran Canaria, Spain

A. G. Shaper, FRCP, FRCPath, FFPHM 
Ex-director, British Regional Heart Study 
University College of London 
London, United Kingdom

*Anna Maria Siega-Riz, PhD 
Professor of Epidemiology and Nutrition 
Associate Dean for Academic Affairs 
Gillings School of Global Public Health 
Chapel Hill, North Carolina, USA

Lesley Schmidt Sindberg, MPH 
Senior Research Coordinator 
Healthy Eating Research 
University of Minnesota School of Public Health 
St. Paul, Minnesota, USA

Jeremiah Stamler, MD 
Professor Emeritus, Preventive Medicine and Epidemiology 
Northwestern University Feinberg School of Medicine 
Chicago, Illinois, USA

Meir Stampfer, MD, DrPH 
Professor of Medicine, Harvard Medical School 
Professor of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health 
Associate Director, Channing Division of Network Medicine 
Department of Medicine, Brigham and Women's Hospital 
Boston, Massachusetts, USA

Marie-Pierre St.-Onge, PhD, FAHA 
Assistant Professor, Department of Medicine 
New York Obesity Research Center 
Institute of Human Nutrition 
College of Physicians & Surgeons 
Columbia University 
New York, New York, USA

*Mary Story, PhD, RD 
Professor of Global Health and Community and Family Medicine 
Duke University 
Durham, North Carolina, USA

Boyd Swinburn, MBChB, MD, FRACP, FNZCPHM 
Professor of Population Nutrition and Global Health 
University of Auckland 
Alfred Deakin Professor 
Deakin University, Melbourne 
Melbourne, Australia

Daniel R. Taber, PhD, MPH 
Assistant Professor 
Department of Health Promotion & Behavioral Sciences 
University of Texas School of Public Health 
Austin, Texas, USA

Lindsey Smith Taillie, PhD, MPH 
Research Assistant Professor, Department of Nutrition 
Fellow, Carolina Population Center 
University of North Carolina at Chapel Hill 
Chapel Hill, North Carolina, USA

Linda Tapsell, PhD, FDAA, AM 
Discipline Leader, Nutrition and Dietetics 
Graduate School of Medicine 
Faculty of Science, Medicine and Health 
University of Wollongong 
Wollongong, Australia

Cynthia Thomson, PhD, RD 
Professor, Health Promotion Sciences 
Director, University of Arizona Canyon Ranch Center for Prevention & Health Promotion 
Mel & Enid Zuckerman College of Public Health 
University of Arizona 
Tucson, Arizona, USA

Francisco J. Tinahones, MD, PhD 
Professor of Medicine 
Director, Endocrinology and Nutrition Services, Hospital Universitario Virgen de la Victoria 
Coordinator, Complications of Obesity, CIBEROBN 
University of Málaga 
Málaga, Spain

Estefania Toledo, MD, PhD, MPH 
Associate Professor 
University of Navarra 
Navarra, Spain

Mathilde Touvier, PhD, HDR 
Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité 
Equipe de Recherche en Epidémiologie Nutritionnelle
Universités Paris 5, 7 et 13 
Bobigny Cedex, France

Alison Tovar, PhD, MPH 
Assistant Professor 
Department of Nutrition and Food Sciences 
University of Rhode Island 
Kingston, Rhode Island, USA

Antonia Trichopoulou, MD 
Emeritus Professor, Nutritional Epidemiology 
University of Athens Medical School 
Athens, Greece

Josep A. Tur, PhD 
Professor of Physiology 
Research Group on Community Nutrition & Oxidative Stress 
University of the Balearic Islands & CIBERobn CB12/03/30038 
Palma de Mallorca, Spain

Matti Uusitupa, MD, PhD 
Professor Emeritus 
Institute of Public Health and Clinical Nutrition 
University of Eastern Finland 
Joensuu, Finland

Linda Van Horn, PhD, RD 
Professor, Preventive Medicine 
Associate Dean for Faculty Development 
Feinberg School of Medicine 
Northwestern University 
Chicago, Illinois, USA

Carlo La Vecchia, MD 
Professor of Medical Statistics and Epidemiology 
Department of Clinical Sciences and Community Health 
Università degli Studi di Milano 
Milan, Italy

Jesus Vioque, MD, PhD, MPH 
Unidad de Epidemiología de la Nutrición 
Campus San Juan. Facultad de Medicina 
Universidad Miguel Hernandez 
Alicante, Spain

David Wallinga, MD 
Senior Health Officer 
Natural Resources Defense Council 
San Francisco, California, USA

May Wang, DrPH 
Professor, Community Health Sciences 
David Geffen School of Medicine 
University of California, Los Angeles 
Los Angeles, California, USA

Dianne S. Ward, EdD 
Professor, Department of Nutrition 
Gillings School of Global Public Health 
University of North Carolina 
Chapel Hill, North Carolina, USA

Julia Wärnberg, PhD 
Nutritionist 
University of Malaga 
Malaga, Spain

Connie M. Weaver, PhD 
Distinguished Professor and Department Head 
Department of Nutrition Science 
Director, Women's Global Health Institute 
Purdue University 
West Lafayette, Indiana, USA

Howell Wechsler, EdD, MPH 
Chief Executive Officer 
Alliance for a Healthier Generation 
Washington, D.C., USA

Elisabete Weiderpass, MD, PhD, MSc 
Professor of Cancer Epidemiology, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway 
Tromsø, Norway 
Senior Cancer Epidemiologist, Department of Etiological Cancer Research, Cancer Registry of Norway 
Oslo, Norway 
Professor of Medical Epidemiology, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet 
Stockholm, Sweden 
Group Leader, Genetic Epidemiology Group, Folkhälsan Research Center 
Helsinki, Finland

Shelley Weinstock, PhD, CNS, FACN 
Career Services 
Institute of Human Nutrition 
Columbia University 
New York, New York, USA

Emily Welker, MPH, RD 
Program Coordinator 
Healthy Eating Research 
Duke Global Health Institute 
Duke University 
Durham, North Carolina, USA

Paul Whelton, MD, MSc 
Show Chwan Professor of Global Public Health 
Tulane University School of Public Health and Tropical Medicine 
New Orleans, Louisiana, USA

Walter Willett, MD, DrPH, MPH 
Frederick John Stare Professor of Epidemiology and Nutrition 
Chair, Department of Nutrition 
Harvard T.H. Chan School of Public Health 
Professor, Department of Medicine 
Harvard Medical School 
Boston, Massachusetts, USA

Alicja Wolk, DMSc 
Professor of Nutritional Epidemiology 
Vice-chairman, Institute of Environmental Medicine 
Head, Division of Nutritional Epidemiology 
Karolinska Institutet 
Stockholm, Sweden

Jayne Woodside, PhD 
Nutrition and Metabolism Group 
Centre for Public Health 
Belfast, United Kingdom

Kana Wu, MD, PhD 
Senior Research Scientist 
Department of Nutrition 
Harvard T.H. Chan School of Public Health 
Boston, Massachusetts, USA

Lisa R. Young, PhD, RD 
Adjunct Professor of Nutrition 
New York University 
New York, New York, USA

*2015 Dietary Guidelines Advisory Committee member

Affiliations are listed for identification purposes only.

Graduate Students

Stacy Blondin, MSPH 
USDA Doctoral Fellow 
ChildObesity180 
Friedman School of Nutrition Science and Policy 
Tufts University 
Boston, Massachusetts, USA

Larissa Calancie 
Doctoral Candidate - Nutrition Interventions and Policy 
University of North Carolina Gillings School of Public Health 
UNC Center for Health Promotion and Disease Prevention 
Chapel Hill, North Carolina, USA

Christina Chauvenet, MSc 
Doctoral Student 
Maternal and Child Health 
Royster Fellow 
University of North Carolina Gillings School of Public Health 
Chapel Hill, North Carolina, USA

Cesar Octavio Ramos Garcia, MHN, CN 
Doctoral Student in Public Health Sciences 
Director of Nutrition 
Tonala University Center 
University of Guadalajara 
Guadalajara, Mexico

Violet Kiesel 
Graduate Student 
Purdue University 
West Lafayette, Indiana, USA

Alexandra B. Morshed 
Doctoral Student 
Brown School 
Washington University 
St. Louis, Missouri, USA

Taulant Muka, MD, MSc, DSc 
PhD Candidate, Erasmus MC, The Netherlands 
Visiting Researcher at Harvard School of Public Health 
Boston, Massachusetts, USA

Luis A. Rodríguez, MPH, RD, CNSC 
Doctoral Student, Epidemiology & Translational Sciences 
UCSF School of Medicine 
Pediatric Clinical Dietitian, UCSF Benioff Children's Hospital 
San Francisco, California, USA

Christian Wright, MS 
Doctoral Candidate 
Department of Nutrition Science 
Laboratory of Nutrition, Fitness, and Aging 
NSGSO President 
Purdue University 
West Lafayette, Indiana, USA

Affiliations are listed for identification purposes only.