Competing interest?

After the success of this paper and the huge media interest it generated, a backlash was inevitable. It came in the form of a personal attack on me that I had not declared a ‘competing interest’. What competing interest? I was accused of “the advice on this web site [the one you’re on now] on dairy fat consumption (it contains essential fats, complete protein and invaluable quantities of vitamins and minerals) being similar to the conclusions published in your study on Monday.”

I replied: “I have been doing a PhD examining the evidence base for dietary fat guidelines at the University of West of Scotland since September 2012. This paper is a systematic review and meta-analysis of randomised controlled trials available in 1983. The article was not about meat or dairy products – it does not mention them. The paper expressed no author views about dietary advice – it examined the evidence base for guidelines introduced over 30 years ago. There were no conclusions about dairy fats; I reiterate they were not even mentioned, in the published study from Monday. The media ran with a butter/dairy story, which had no more evidence base from our paper than dietary guidelines had from RCTs.”

Had I, or any of the other six authors, or us collectively as a research team, written a glowing article about dairy products and had any of us/we collectively been funded by the dairy industry to do so, this would absolutely have been a conflict of interest requiring declaration. We sought no funding for this paper. We received no funding for this paper.

One response of the CTSU, (which we now know has received £268 million from pharmaceutical companies that make statins), when challenged about their pro-statin papers and refusal to share Serious Adverse Effect data has been to sling mud back “but so-and-so has written a book on the topic.” As one recipient of this attack, Dr Malcolm Kendrick, said  “If you write in books what you write in papers, that does not make you conflicted, it makes you consistent.”

I considered it completely INappropriate to mention that I also write books at the end of a team academic article, which had nothing to do with “The Harcombe Diet” and which could be seen as a plug. I checked probably the most well known author connected to Open Heart, who is also an associate editor, Ben Goldacre, and there was no mention of his books. It would thus have been inappropriate to mention mine.

After a number of discussions with BMJ Open Heart and the whole research team (there are seven of us) yesterday, there will be a statement added to the paper. Not least, as this is already the most downloaded paper on BMJ Open Heart, this could, of course, generate book/diet interest/sales, completely counter to my intent or wishes.

25 thoughts on “Competing interest?

  • avatar
    April 17, 2015 at 2:26 pm
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    “I considered it completely INappropriate to mention that I also write books at the end of a team academic article, which had nothing to do with “The Harcombe Diet” and which could be seen as a plug. I checked probably the most well known author connected to Open Heart, who is also an associate editor, Ben Goldacre, and there was no mention of his books. It would thus have been inappropriate to mention mine.”

    I think there is a bit of a difference here, Dr. Goldacre’s books are about exposing poor science, yours is promoting your own diet. If you publish a review (a flawed one in my view) that promotes the principles of your diet then that should be reported as a conflict of interest. Likewise, Dr. Moseley in a review of intermittent fasting should have declared his commercial book on the topic as a conflict of interest.

    Best wishes,

    Ian

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      July 5, 2015 at 9:11 pm
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      Hmmm, I read all Zoe’s work as exposing poor science . . .

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    March 15, 2015 at 11:06 pm
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    I’ve seen book authorship listed as a conflict of interest in a science paper only once; when the authors owned shares in the company selling the book.
    You have to wonder. Did Darwin list his authorship of The Origin of Species as a conflict of interests when he published The Descent of Man?

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  • avatar
    March 4, 2015 at 4:33 pm
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    Friendly debate on the paper today. http://www.bbc.co.uk/programmes/b05410wx

    Sculthorpe

    On the face of it the conclusion is that the RCT evidence didn’t support it because in neither the control groups or the cohort that got the dietary intervention was any difference between those two groups in terms of mortality.

    Porter

    There was no evidence that switching to a low saturated fat diet actually improved outcomes?

    Sculthorpe

    That’s correct on the face of it. However, the devil is in the detail and the real issue is that none of these studies were really designed to address that question. And if you wanted to push me and say what did the paper really show – it showed that if you alter the diet of older men who’ve already had heart disease or heart attacks and follow them for five years has minimal difference.

    Porter

    Which, Christine, is very different from the way that it was portrayed.

    Williams

    It is very different.

    Interesting!

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  • avatar
    March 2, 2015 at 8:57 pm
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    Hi Zoe,
    I have a huge amount of respect for the work that you do – the constant battle must be exhausting!

    Why do you think people fear your message so much? Your book “The obesity epidemic” completely opened my eyes but I come under attack everyday for the choices I’ve made as a result (if I hear the words “but fruit contains natural sugars” one more time….!)

    If people took the time to read your work properly instead of panicking they would see there is not one subjective sentence in it – everything is backed by research which is why I trust you entirely. Keep up the good work and I’ll keep sending people to your blog every time I am attacked for not eating fruit haha!

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    February 27, 2015 at 1:02 am
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    Dr Zoe,

    I am most impressed with your web posts and your approach to nutrition. I award you a virtual PhD for busting wide open the intellectual fraud that passes as mainstream nutrition/ heart disease guidelines.

    Cheers

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      February 27, 2015 at 8:01 am
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      Ha ha – many thanks Simon!

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    February 23, 2015 at 9:22 am
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    Hi Zoe,
    yesterday I read the “correction” on the OpenHeart journal. I find it baseless, ridiculous, grotesque and humiliating.

    “A correction has been published”… Argggghhhhhhh!!!

    That was not a correction, just an unnecessary, inappropriate, addendum. Where do they see the competing interest if you receive the money from anonymous end-users in exchange for your books? How could that ever condition your opinion? It can (and I hope it will) condition your readers’.

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      March 1, 2015 at 10:53 am
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      Hi Robert
      I find this pointless. It takes one passage from one book and counters with one passage from something else. I could provide another n=1 to support or counter either side. Argue with the totality of the evidence, not a bit here and there. Plus the site seems to have a vegetarian/vegan base, which is never going to conclude in favour of meat. Anyone who think meat is out to get us needs to explain how we survived 3.5 million years!
      Best wishes – Zoe

      Reply
      • avatar
        March 3, 2015 at 5:20 am
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        * Research published in the journal Nature (on June 27, 2012) reports that almost the entire diet of our very early human ancestors, dating from 2 million years ago, consisted of leaves, fruits, wood, and bark—a diet similar to modern day chimpanzees.

        * According to research presented in a 2009 issue of Science, people living in what is now Mozambique, along the eastern coast of Africa, may have followed a diet based on the cereal grass sorghum as long as 105,000 years ago.

        * Research presented in a 2011 issue of Proceedings of the National Academy of Science shows that even the Neanderthals ate a variety of plant foods; starch grains have been found on the teeth of their skeletons everywhere from the warm eastern Mediterranean to chilly northwestern Europe. It appears they even cooked, and otherwise prepared, plant foods to make them more digestible—44,000 years ago.

        * A 2010 issue of the Proceedings of the National Academy of Science reported that starch grains from wild plants were identified on grinding tools at archeological sites dating back to the Paleolithic period in Italy, Russia, and the Czech Republic. These findings suggest that processing vegetables and starches, and possibly grinding them into flour, was a widespread practice in Europe as far back as 30,000 years ago, or even earlier.

        Falsehoods leading the general public to choose foods that threaten our very existence have been challenged for decades, but as I have said before, people like to hear good news about their bad habits; so the Paleo Diet continues to get a highly visible platform with too little public debate.

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    February 18, 2015 at 12:20 am
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    Hi Zoe,

    Sorry to hear you have to go through this. Though in a way, it’s to be a expected. It just goes to prove that someone out there feels threatened by your message; which in turn proves that you and the other authors wrote a persuasive, evidence-based paper, People are taking notice, and that can only be good in the long run. The ones who are deeply “entrenched” in the current dogma are not going to change; but think of all the other people who will be influenced by what you have to say. They are the important ones.

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    February 17, 2015 at 12:03 pm
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    Delighted to hear you on the Today programme last week, crisply refuting the woman who tried to downplay your report by interpreting it as merely saying the advice was premature. But now, I have been looking forward to your response on your blog to this “bombshell” in the Sunday Express. Are you planning to comment, as I don’t see anything yet?

    “Head researcher Prof Collins admitted he had not seen the full data on side effects”.

    http://www.express.co.uk/news/uk/558249/statins-expert-heart-drug-rory-collins

    Correct me if I am wrong, but that statement does not seem to compute with your findings here:
    http://www.zoeharcombe.com/2014/08/ctsu-funding-from-drug-companies/

    Reply
  • avatar
    February 15, 2015 at 10:23 pm
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    love your work Zoe! you make more sense than all of your critics put together.

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  • avatar
    February 14, 2015 at 11:14 am
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    Well defended. I’m persuaded.

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    February 14, 2015 at 10:59 am
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    Zoe it must be very hard to endure personal attacks, even though they are anticipated and I’m sorry you have to endure this kind of bullying. Please keep on keeping on at them in the knowledge that you have many, many grateful supporters. God knows we need incisive minds like yours and Malcolm’s to cut through the cr*ap that we’re – literally – served daily. I thank you on behalf of us all.

    Interestingly, those that ‘attack’ generally enjoy the safe stance of anonymity while publicly discrediting their victims. I’d call this ‘Corporate Cowardice’ and make the one that points the finger accountable.

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    • avatar
      February 14, 2015 at 11:23 am
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      Thank you Isabel (& others who have dropped lovely notes) Much appreciated :-)

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  • avatar
    February 14, 2015 at 6:53 am
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    Doctoring Data (Kendrick 2014), Chapter 6 – Challenges to the status quo are crushed… those in positions of power do not take kindly to anyone daring to question the established order…

    I’m sure you were expecting a backlash – success! You’re past stage 1 (being ignored). All power to your collective elbows.

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  • avatar
    February 13, 2015 at 10:37 pm
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    Yup, I’ve copped it plenty for not having qualifications, which is basically the first line of fire when people want to criticise my book (Principia Ketogenica – summaries of hundreds of LC/keto papers throughout history) – “what makes this guy the authority on this stuff?” – and my “competing interests” are that I run a site about meat and health stuff.

    I try to get across that I’m NOT a guru telling you what to do, and I am providing ZERO advice, and the book contains NO original research – it’s simply a collection of summaries of existing science that you’ll not find anywhere else. But some people… oh well.

    Also I’m trying to make it all available easily and free online – but it’s a super complex task with something like ~1,500-2,000 crosslinking references.

    This is the ONLY assertion I personally make in the entire book – spoiler alert, it’s the last page: https://twitter.com/HlthCoachPenny/status/522599870209990656

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  • avatar
    February 13, 2015 at 3:35 pm
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    Just finished your book The Obesity Epidemic. Great. Thank you. All power to your elbow. I think the tide is slowly turning.

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  • avatar
    February 13, 2015 at 2:35 pm
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    You’re right, a backlash was inevitable, and clearly shows that there is real substance to your research, otherwise why the personal attack? This is always the first resort of those who have little else to offer by way of argument.

    Less welcome, in my opinion, is simply shrugging off the research, which is what this article on the BBC website does: http://www.bbc.co.uk/news/health-31357438

    A brief mention of the research at the beginning and then it falls back – as these sorts of articles always do – on the old argument from authority. I.e. “Public Health England say…” and “UK guidelines suggest..” [what they suggest, the article goes on to say, is eating 5 portions of fruit and vegetables a day!] and “Experts say…” [and what THEY say, the article tells us, is that starchy food should make up around a third of the food we eat. Hmmm…]

    And it perpetuates the myth of the ‘balanced diet’, a completely unscientific phrase.

    “One thing experts agree on is that balance is key to a good diet.”

    Rubbish. Variety is key to a good diet. If the diet of our ancestors over the last few million years teaches us anything, it is that we should eat a great, great variety of different meats, fish, vegetables, nuts and occasional fruit, rather than base 90% of our diet around beef, potatoes and wheat products. Balance doesn’t come into it.

    I’ll stop now – this was supposed to be a quick post! Love the site Zoe, thank you for providing it.

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    • avatar
      February 18, 2015 at 12:33 am
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      Mathew: I agree with what you say about that BBC paper. Also ridiculous is their interpretation of the “Mediterranean Diet”. In all my years visiting the Mediterranean, I have never once seen a “healthy wholegrain”! And in many parts of the Mediterranean, they eat lamb- (red meat….horrors! And one high in saturated fat, at that). When I’ve been to Spain, they actually do eat quite a lot of meat like pork, serrano ham, things like that. And when I went to a Greek island, there weren’t many vegetables being served at all….a small amount of tomatoes and cucumbers, that was it. But the local people said they couldn’t really grow much in the way of vegetables on that island, they had to import them. So much for the “Mediterranean Diet”….it’s a myth that nutritionists made up!

      Reply
      • avatar
        March 3, 2015 at 4:52 am
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        Eh! The Italian gastronomic landscape is the equivalent of a minefield then for a low carber.

        Their diet of pasta, rice and an abundance of fruits and vegetables is loaded with carbs. (Or as Zoe would probably say “Evil carbs”)

        Italians consume 4 times more pasta than America and are surely no where near as obese. For one thing, the mere idea of giving up pasta would be cause for severe depression in an Italian.
        In general, Italians take their time when they eat. Many businesses in Italy still close in the middle of the day for three hours to allow for a leisurely lunch. The same in France a decent amount of time for lunch. Family mealtimes are also sacred.

        The fast food high fat way of eating plays a massive part over here.
        I have Californian family and remember witnessing the low carb mania that swept the USA ten years ago. Low Carb eating is nothing new folks its been doing its damage as long as Zoes’ a lapsed vegetarian.

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  • avatar
    February 13, 2015 at 12:08 pm
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    So basically the complaint is that you are consistent!

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    • avatar
      March 3, 2015 at 4:59 am
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      Consistent. Just in the high fat Low Carb camp obvioulsly.

      Reply

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