Q&A with Marika Sboros

“Not just a tide, a tsunami – Leading health and nutrition journalist Marika Sboros answers my questions about the low-carb high-fat (LCHF) diet and explains why the scientific consensus is starting to turn on diet and nutrition

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Marika Sboros

Marika Sboros is one of South Africa’s leading health journalists, with over 30 years experience in the newspaper industry. She has written for several major South African publications, including the Rand Daily Mail and Business Day (owned by Times Media Group), where she currently writes a regular fitness column and commissioned features.

At her highly recommended health and nutrition website FoodMed.net, she writes in-depth about the science behind low-carb, high-fat (LCHF) diets – or “Banting” as they are known in South Africa.

Since launching last year, FoodMed.net has become the go-to source for all things nutrition-related, with particular emphasis on the Kafka-esque “trial” of LCHF pioneer and University of Cape Town (UCT) emeritus professor Dr. Tim Noakes.

In 2014, the Health Professions Council of South Africa (HPCSA) charged Noakes with unprofessional conduct for giving “unconventional advice to a breastfeeding mother on a social network [Twitter].” That was for a single tweet in February 2014, in which he said good first foods for infant weaning are LCHF.

Last month, I contacted Marika to ask her about the LCHF diet, and about recent efforts by health authorities from around the world to shut down doctors, nutrition scientists, and even journalists whose work challenges the conventional wisdom on nutrition.

She generously agreed to answer my questions.

Q. How did you come to write about the LCHF diet?

A. Nearly three years ago, I started noticing a spate of nasty media reports aimed at South African scientist Prof. Tim Noakes. The reports created the impression that he had lost the scientific plot, that he was doing something terrible, advising beyond his scope of medical practice, expertise etc. Worst of all, that he was telling people to eat foods that would end up killing them on a grand scale.

That piqued my interest as a journalist. I had interviewed him many times in my career – mostly to do with high-carb eating, the benefits of carbo-loading for athletes, optimum nutrition for long-distance runners, that sort of thing. I had always found him to be very rational, a man of huge integrity and intellect. So, I wondered what could be behind this apparent change.

I contacted him to ask for a Skype interview. He agreed immediately, and we ended up speaking for ages.

One question I asked: “I see you only eat apples these days. Why?”

He answered: “I don’t eat apples. I only eat berries.”

“So why did you tell this journalist you only eat apples?” I asked. He told me he had never spoken to the journalist. I was gobsmacked. The journalist, who I knew well, had quoted him verbatim in a lengthy interview in a well-known magazine.

I wondered what on earth would motivate a good journalist to do something like that? I started digging deeper into media coverage and found it littered with similar instances of journalists quoting him directly without ever speaking to him – and without checking their facts.

LCHF proponent Prof. Tim Noakes (source)

I was skeptical about what Prof. Noakes was saying about the research that prompted his dramatic scientific U-turn – what I call his “Damascene” moment. However, because I had respect for him as a scientist and an ordinary human being, I started reading up on the literature, just as he had done.

Slowly but surely, the same awful realisation began to creep up on me: the “experts” had got it all very wrong for decades. We had all been fed a big fat lie. The diet-heart hypothesis was unproven dogma – and still is. It’s the basis on which the “experts” told us to avoid healthy animal fats. Far from avoiding fad diets, I had been on the biggest and most dangerous fad diet of them all most of my adult life because I listened to experts I trusted. I was horrified at the implications, both for my family’s health and people across the globe.

Thus began my journey, my very own Damascene moment, in February 2014.

A year later, I attended the first Low Carb Summit Prof. Tim Noakes and Karen Thomson organised in Feb 2015. Karen is a dynamo all on her own. She is author of a brilliant book, Sugar Free: 8 Weeks to Freedom from Sugar and Carb Addiction. I recommend everyone to read it.

She was so incensed at unprovoked, irrational attacks on Prof. Noakes, who she knew well, she mustered global scientific forces to support him.

The summit was an eye opener, a seminal event for me on my scientific journey. I met many of the world’s finest LCHF minds. Among them: Prof. Steve Phinney, Dr. Eric Westman, Dr. Jay Wortman, Dr. Jason Fung, Dr. Michael Eades, Dr. Aseem Malhotra, Dr. Gary Fettke, and British obesity researcher Dr. Zoe Harcombe. It was a revelation.

What was also a revelation was how nice and decent and perfectly rational these experts were – and are. They were approachable. They also didn’t speak with one “voice.” Some don’t even call their theories LCHF. However, they all say that when people eat real food, that is unprocessed food, as close to its natural state as possible, and avoid grains like the proverbial plague, they naturally tend to eat LCHF.

I began to feel even more confident that I was on to something really big in the world of nutrition science.

I attended the first HPCSA hearing against Prof. Noakes in June 2015. I started off skeptical of his view that there was a concerted campaign to discredit him. I came away convinced of it – and it had nothing to do with him trying to convince me.

I watched in horrified fascination as the HPCSA got to work – as they tried to load the panel with dietitians against him. It made me suspicious. All my interactions with the dietitian who started it all, Claire Julsing-Strydom, just confirmed all my suspicions about hidden agendas. As soon as I started asking questions Strydom didn’t like – about her links with Big Food and the Association for Dietetics in SA (ADSA) of which she was president at the time – she went silent. Until then, I had had a good relationship with her professionally.

Ditto for the HPCSA. They simply wouldn’t talk to me about why they were going after Prof. Noakes as if he were a medical devil incarnate.

Prof. Noakes at the “Banting for Babies” trial early last year (source)

Again, that piqued my interest as a journalist. If there were nothing to hide, why were they keeping everything such a secret?

From there, the rest, as they say, is history. The more I dug, the more orthodox doctors I spoke to, the more their criticisms – more like venomous personal attacks on a distinguished colleague – just didn’t make sense scientifically, ethically or professionally. It all seemed like a vicious over-reaction.

Would you say your experience with LCHF reflects the general experience of others who have come to the diet?

I can’t really answer for the experience of others. I know there is great variety. From my own experience, I can say that I only started on the lifestyle about nine months after I started writing about it. Twitter trolls kept accusing me of being a “closet Banter,” a “cheerleader” for Prof. Noakes, etc. They said that made me biased, unethical, etc., ad nauseum. So I thought I might as well be hanged for the lamb (a great LCHF food) as for the tougher sheep.

I decided to give LCHF eating a try. I had no preconceptions, as I had tried every other diet under the sun in more than 30 years writing on health. Not for weight loss, as I’ve never had a weight problem, but just for health. I was also mostly vegetarian at the time and didn’t much relish the prospect of eating meat. 

I went cold turkey (another good Banting meat). I cut out all bread, pasta, pizza, chocolate, sugar, all personal favourites. I was a BIG chocoholic. My experience was astoundingly positive. After a week to 10 days I started feeling different, better in many subtle ways. Especially mood swings and that predictable “afternoon slump” that would have me reaching for a high-carb snack as if my life depended on it. The only variable that had changed was to my diet.

I kept it quiet at first because I knew if I started bleating about my personal experience, it would energise the trolls. Now I don’t care what they say and no longer bother to give them oxygen. If anyone accuses me of bias in Prof. Noakes’ favour, or any other LCHF expert, I say: “sure I’m biased – in favour of good science.” And if anyone can show me the science to prove they’re wrong, I’ll publish it.

Why the recent clampdown on journalists (Nina Teicholz, US) and doctors (Dr. Gary Fettke, Australia) who question the conventional wisdom on nutrition?

On a macro level, I see it as powerful, global vested interests at work, drug, food and soft drink industries who have a lot to lose if the low-fat, high-carb paradigm is no longer mainstream. On a micro level, it is individual doctors, dietitians and academics who are in bed with those industries and who have bad cases of cognitive dissonance and confirmation bias.

As Upton Sinclair said: “It is difficult to get a man to understand something when his salary depends on his not understanding it.” Prof. Rory Collins in the UK and his irrational support for statins is but one of the most egregious examples.

One thing all these people lack is humility – and the courage it takes to say: “I got it wrong. I’m sorry.”

Is the tide turning on the old ways of thinking about nutrition, and do you see the science vindicating Prof. Noakes and Dr. Fettke, as with Nina Teicholz last month?

Oh I’d say the tide is most definitely turning. Developments in the HPCSA hearing – trial really – against Prof. Noakes in South Africa is one big sign. Another is Down Under – the Australian Health Practitioner Regulation Agency (AHPRA) attack on Dr. Gary Fettke; in the US, the attacks on Nina after publication of her groundbreaking book, The Big Fat Surprise. That’s another book I think every doctor and dietitian should read. 

US author/journalist Nina Teicholz (source)

Recently, nearly 200 assorted Canadian doctors and other health professionals having the courage to speak out.

And most recently, another blockbuster book by US science writer Gary Taubes, The Case Against Sugar. It continues the demolition job science has done on the science – or lack thereof – on which official dietary guidelines have been based for decades.

Not just a tide, a tsunami.

Any recommendations from the LCHF cookbook you think might possibly sway a long-time vegetarian like myself?

I’ve never heard any LCHF “guru” or pioneer I’ve spoken to say that LCHF is for everyone. They all say that there is no one-size-fits-all diet. LCHF is brilliant for those who are obese, diabetic, have heart disease, even cancer. But it’s very much trial and error.

Prof. Noakes once told me he knows of a vegan extreme athlete who is LCHF, and eats only avocado and coconut oil! He says he wouldn’t advise that anyone else do that, but it works for the athlete. His times are good, all his health markers are good – his microbiome clearly copes with that diet.

I have told Prof. Noakes to write Banting for Vegetarians. He has put it on his lengthy “To Do” list.

One of his favourite sayings has become indelibly etched in my mind: If you have to exercise to regulate your weight, your diet is wrong. Get rid of addictive foods.”

Great advice for us all.

To read more from Marika, click here to visit her website, FoodMed.net.
You can follow her on Twitter by clicking here.

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Butter, Meat and Free Speech

It’s official: The BMJ won’t retract “controversial” dietary guidelines article by New York Times best-selling author/journalist Nina Teicholz

Yesterday, the BMJ officially announced that it won’t retract a “controversial” 2015 article by investigative journalist Nina Teicholz, author of NYT best-seller The Big Fat Surprise.

Following a lengthy investigation lasting over a year, the BMJ said that two independent reviewers “found no grounds for retraction,” and that Teicholz’s criticisms of the methods used by the 2015 US Dietary Guidelines Advisory Committee (DGAC) “are within the realm of scientific debate.”

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Author/Journalist Nina Teicholz

As reported on this blog and The Sidebar (my US blogging buddy Peter M. Heimlich’s crack investigative journalism blog), Washington-DC based advocacy group the Center for Science in the Public Interest (CSPI) – in bed with prominent members of the DGAC – aggressively campaigned to get the article retracted.

Bonnie Liebman

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Leading the charge was CSPI’s Director of Nutrition Bonnie Liebman, who in her September 23, 2015 opening salvo called the article an “error-laden attack” on the 2015 DGAC report:

The DGAC’s advice is consistent with dietary advice from virtually every major health authority [but] Teicholz would have us believe that only she, not the dozens of experts who systematically reviewed the evidence for these health authorities, has the smarts to accurately interpret this evidence.

One month later, a letter organised by Liebman was sent to the BMJ highlighting what it claimed were a number of factual errors with Teicholz’s article.

The letter, which was signed by over 180 credentialed professionals including a number of prominent faculty members at major universities, plus all 14 members of the 2015 DGAC, urged the BMJ to retract the article on the basis that it harmed the journal’s credibility.

However, the credibility of the letter was itself soon called into question.

As reported by the Guardian in April, none of the signatories interviewed for Ian Leslie’s acclaimed article, “The Sugar Conspiracy” – including Dr. Meir Stampfer, an influential Harvard epidemiologist – were able to name any of the “trivial” errors with Teicholz’s article, with one even admitting he had not read it.

Frank Hu MD PhD MPH (source)

But the most explosive revelation came in May, when Peter – with help from my sweetie Kelsi White and I – exposed efforts by another Harvard epidemiologist, DGAC member Dr. Frank Hu, to solicit European signatures to Liebman’s retraction demand which resulted in a chain e-mail exchanged by European medical professionals and university faculty.

You can read more about that, and other related items, via Peter’s blog herehere and here.

Accompanying yesterday’s announcement, the BMJ has issued four corrections (plus three clarifications) of the 11 purported errors highlighted by the CSPI, but Editor in Chief Fiona Godlee said the journal is standing by Teicholz’s article:

We stand by Teicholz’s article with its important critique of the advisory committee’s processes for reviewing the evidence, and we echo her conclusion: ‘Given the ever increasing toll of obesity, diabetes, and heart disease, and the failure of existing strategies to make inroads in fighting these diseases, there is an urgent need to provide nutritional advice based on sound science.’

Via the BMJ’s press release, Teicholz thanked the journal for its support:¹

I am very grateful to The BMJ editors for their profound commitment to verifying the facts of my article and for their professionalism and integrity throughout this process. I am also grateful that they are providing a space for rigorous scientific debate, especially on a subject so important to public health. I hope the original intention of that article can now be fulfilled—to help improve nutritional advice, so that it is based on rigorous science. This will help us to better combat nutrition-related diseases that have caused so much human suffering around the world.

In a separate statement, Liebman doubled down on her position, claiming that the BMJ has “stained its reputation”:

The BMJ has stained its reputation by circling the wagons around Nina Teicholz’s discredited and opinionated attack on the science underpinning the Dietary Guidelines for Americans. The BMJ corrected or “clarified” 7 of the 11 errors cited by the letter from more than 180 scientists requesting a retraction, and failed to respond to the remaining four. (The clarifications are thinly veiled corrections.) It’s startling that despite this long list of corrections and clarifications—including several that undergirded the article’s attack on the Dietary Guidelines Advisory Committee report–the journal nevertheless stands by the article’s conclusions.

I’ll leave it to the experts to debate the scientific merits of Teicholz’s arguments. My opinion, from a free speech perspective, is that the CSPI’s retraction demand was not about merit, but about a powerful lobby group wielding its influence to try to suppress a voice of dissent.

As Ian Leslie remarked in his Guardian long-read“Publishing a rejoinder to an article is one thing; requesting its erasure is another, conventionally reserved for cases involving fraudulent data.”

20 years ago, Teicholz might have gone the way of the beleaguered British scientist John Yudkin, and others who have dared question the conventional wisdom on nutrition. As it stands, Teicholz has survived the ordeal, in no small part thanks to the support of a committed, widespread and ever-growing group of LCHF enthusiasts.

¹Teicholz’s full response is available to read by clicking here.

Voice in the Wilderness

Nina Teicholz by Laura Rose

“I guess history repeats itself, and the losers are not just me but a fair and public airing of the best and most current science” – The (ongoing) story of how top US nutritionists tried to gag New York Times best-selling author Nina Teicholz [Updated: CSPI’s BMJ retraction request goes missing – more after the jump]

As readers of Shooting the Messenger and The Sidebar (my Atlanta, GA blogging buddy Peter M. Heimlich’s world-beating website) will know, there have been some major developments in recent months re: efforts by members of the United States Dietary Guidelines Advisory Committee (DGAC) to gag journalist and author Nina Teicholz.

Taking stock of the story so far, it’s remarkable how closely each new development seems to mirror Teicholz’s own account of previous efforts by nutritionists to suppress dissenting viewpoints.

Via her seminal 2014 book on the history of nutritional science, The Big Fat Surprise:

At a conference that [Danish researcher Uffe Ravnskov] and I were both attending near Copenhagen in 2005, he stood out in the crowd simply because he was willing to confront this gathering of top nutrition experts by asking questions that were considered long since settled.

“The whole pathway, from cholesterol in the blood, to heart disease – has this pathway really been proven?” he stood up and asked, rightly though rhetorically, after a presentation one day.

“Tsh! Tsh! Tsh!” A hundred-plus scientists wagged their heads in unison.

“Next question?” asked an irritated moderator.

For Teicholz, who started her research “expect[ing] to find a community in decorous debate,” this incident illustrated a surprising lack of tolerance within the nutritional sciences for alternative viewpoints, or even simple scientific inquiry.

Unfortunately, her anecdote would prove eerily prescient.

On November 5 last year, a letter signed by over 180 credentialed professionals, including a number of prominent faculty members at major universities, was sent to the BMJ (formerly the British Medical Journal).

The letter – organised by Bonnie Liebman at the Center for Science in the Public Interest (CSPI), a Washington, DC-based advocacy non-profit – requested that the journal retract The scientific report guiding the US Dietary Guidelines: is it scientific?, Teicholz’s September 23 article criticising the methodology and findings of the 2015 DGAC.

If there’s any doubt as to whether this constituted an attempt to silence a critic, all 14 members of the 2015 DGAC signed their names to the letter.

But the effort to gag Teicholz didn’t end there.

In March this year, she was disinvited from the National Food Policy Conference, a prestigious Washington, DC food policy panel at which she was scheduled to speak the following month (her replacement – wait for it – was president and CEO of the Alliance for Potato Research & Education Maureen Storey).

Sound familiar? Check out this excerpt from The Big Fat Surprise:

As [Ancel] Key’s ideas spread and became adopted by powerful institutions, those who challenged him faced a difficult – some might say impossible – battle. Being on the losing side of such a high-stakes debate had caused their professional lives to suffer. Many of them had lost jobs, research funding, speaking engagements, and all the many other perks of prestige.

…they were not invited to conferences and were unable to get prestigious journals to publish their work. Experiments that had dissenting results, they found, were not debated but instead dismissed or ignored altogether.

Things took a sinister turn in late March, with Peter reporting on how DGAC chair Barbara Millen and US Department of Agriculture exec Angela Tagtow conspired with Thomas Gremillion – director of food policy at the Consumer Federation of America (CFA), which organised the conference – to kick Teicholz off the panel (click here to read Peter’s May 2 article showing the extent of Millen’s involvement).

Piling-on the anti-Nina Teicholz bandwagon was nutritionist and Huffington Post columnist Dr. David Katz, who was quoted in Ian Leslie’s acclaimed April 7 Guardian article, The sugar conspiracy, describing Teicholz as “shockingly unprofessional” and “an animal unlike anything I’ve ever seen before.”

Via The Big Fat Surprise:

…slander and personal ridicule were surprisingly not unusual experiences for…opponents of the diet-heart hypothesis.

Last month, several prominent physicians criticised Katz for his ad hominem remarks, leading Yale University’s School of Medicine to publicly disassociate from its otherwise unrelated namesake, the Yale-Griffin Prevention Research Centerof which Katz is the founding director.

Bringing the whole sorry story up-to-date, this month Peter – with help from my sweetie Kelsi White and I – exposed Harvard professor and DGAC member Dr. Frank Hu’s efforts to solicit European signatories to Bonnie Liebman’s CSPI retraction letter.

Is Teicholz surprised by the extreme measures taken by members of the DGAC to shut her out of the debate? Here’s what she had to say:

“Even though I had covered the vicious politics of nutrition science extensively in my book, I couldn’t quite imagine the force with which the various attack strategies would be applied against me. Virtually every tactic that Keys and his allies used to malign anyone who challenged them – false accusations about supposed errors and supposed industry backing as well as just sheer name-calling – has been employed aggressively against me. I guess history repeats itself, and the losers are not just me but a fair and public airing of the best and most current science.”

Like those whom she wrote about in The Big Fat Surprise – researchers such as John Yudkin, Pete Ahrens and Mary G. Enig – Teicholz has dared to challenge the scientific consensus on nutrition, and has paid the price. Yet unlike those before her, Teicholz remains a prominent voice of dissent.

Is the tide starting to turn on diet and nutrition? Will we soon see a crack in the consensus? Wouldn’t that be a big fat surprise.

Update, 14/07/2016: The CSPI’s November 5, 2015 retraction request of The scientific report guiding the US Dietary Guidelines: is it scientific?, Teicholz’s September 23, 2015 BMJ article criticising the methodology and findings of the 2015 DGAC, has gone missing from the CSPI’s website, in its place this 404 notice:

CSPI BMJ 404 Page

According to Teicholz, the BMJ is preparing to announce it will not retract her article.

A PDF of the CSPI’s retraction request is available by clicking here.

An updated, December 17, 2015 version – absent the names of 18 signatories – is available by clicking here.