Thursday, November 20, 2008

Corporate Beef Dietitian's Disgraceful Omissions


Two days ago Beef Information Centre corporate dietitian Carolyn Kallio wrote a letter to the editor of the Vancouver Sun. In her letter, "Canadian Beef is Healthy and Nutritious" Carolyn asserts the following,

"Red meat, in particular beef, is healthy and nutritious, and an important part of a balanced diet."

and

"Despite the naysayers, there is no convincing evidence that consuming moderate amounts of fresh red meat as part of a healthy balanced diet increases the risk of cancer."
Now Carolyn of course, as a corporate dietitian working for the Beef Information Centre, certainly has a vested interest in a positive spin on beef but the thing is according to the Jurisprudence Handbook for Dietitians in Ontario (where she's a member) and according to a common sense of ethics and morality, that shouldn't matter as her first priority as a registered dietetic professional should be to society and not to her employer and therefore her communications to the public must always provide evidence-based, unbiased information.

It seems like Carolyn may have forgotten that fact.

I say this because to me it is inconceivable that anyone schooled in nutrition and caring of professional ethics would feel comfortable stating that red meat is healthy and nutritious while willfully omitting the incredibly large body of evidence that has linked red and processed meat consumption with increased risk of colon cancer.

The most robust piece of evidence highlighting this link, evidence that absolutely lies within the scope of knowledge required by Carolyn both to do her job for the Beef Information Centre and simply by her as a dietetic professional, was last year's World Cancer Research Fund report Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective.

So how robust is the World Cancer Research Fund report? Its creation involved 9 independent teams of global scientists, hundreds of peer reviewers, 21 internationally renowned experts, and 5 years of time for them to review and analyze more than 7,000 large scale studies for the effects of diet on cancer.

Among their many conclusions was that red meat consumption is far from healthy.

In fact they concluded that a daily consumption of just 48 grams of processed meat boosts the risk of colon cancer by 21 per cent and every 48 grams of red meat consumption beyond a weekly limit of 500grams increases colon cancer risk by 15 per cent.

Her willful omission of these clear cut risks in her very public letter to the editor are made all the more disturbing by the tenor of her letter which reads that red meat and processed meats are, "healthy and nutritious" and that only quacks (the naysayers) would say otherwise. It is therefore an omission that when coupled with her letter could in fact endanger a public that may take her reassurance as a registered dietetic professional that beef is, "healthy and nutritious" and nothing to worry about, at face value.

I guess the experts who wrote that report are Carolyn's "naysayers".

So who are they?

Scroll down for complete bios but suffice it to say those pesky naysayers include:

  • The Chief of the Nutritional Epidemiology Branch and Senior Investigator of the National Cancer Institute.
  • The former Chief of the Chronic Disease Prevention Branch of the Nutrition Division at the Centers for Disease Control and Prevention.
  • The Director of the International Institute for Society and Health
  • The Center Director of the NIDDK-funded UNC Clinical Nutrition Research Unit
  • The Chairman of the Department of Nutrition at Harvard and the second most cited scientist in the history of medicine.

    What a bunch of hacks....I think I'll trust the corporate dietitian working for the Beef Information Centre.

    Ok, maybe not. And it's a shame as frankly my vested interest is in healthy red meat too because I find red meat to be absolutely delicious. Too bad about my ethics telling me that I can't go around trying to convince myself or others that it's healthy to eat.

    So what have I done?

    I took the opportunity to write a letter to the editor of the paper and more importantly a letter to the College of Dietitians of Ontario explaining what to me seems like a very clear cut case of a dietitian breaking their professional code of conduct whereupon she seems to have forgotten that the public's interest takes precedence over the folks' who write her paychecks.

    Disgraceful.

    I know a lot of dietitians read my blog. What do you folks think? Feel free to leave anonymous comments.

    THE "NAYSAYERS"

    Sir Dr. Michael Marmot MB BS MPH PhD FRCP FFPH, Director of the International Institute for Society and Health, Chair of the WHO Commission on Social Determinants of Health. He leads the English Longitudinal Study of Ageing (ELSA) and is engaged in several international research efforts on the social determinants of health. He chairs the Department of Health Scientific Reference Group on tackling health inequalities and has been awarded He won the Balzan Prize for Epidemiology in 2004, gave the Harveian Oration in 2006 and the William B. Graham Prize for Health Services Research in 2008. In 2000 he was knighted by Her Majesty The Queen for services to Epidemiology and understanding health inequalities.

    Dr. Tola Atinmo, Professor of Nutrition University of Ibadan Nigeria, past president of the Nutrition Society of Nigeria and past chairman of the Department of Human Nutrition at the University of Ibadan. He is a consultant to the World Bank, UNICEF, WHO, FAO and UNU on Food and Nutrition Security issues and Micronutrient malnutrition

    Dr. Tim Byers MD MPH University of Colorado Health Sciences Centre Denver, CO, USA, deputy director of the University of Colorado Cancer Center and former chief of the Chronic Disease Prevention Branch of the Nutrition Division at the Centers for Disease Control and Prevention in Atlanta.

    Dr. Junshi Chen MD Senior Research Professor at the Institute of Nutrition and Food Safety, Chinese Centre for Disease Control and Prevention, Beijing, People's Republic of China

    Dr. Tomio Hirohata MD DrScHyg PhD Professor Emeritus of the Kyushu University Medical School and the Research Supervisor for the Radiation Effects Research Foundation in Japan, Kyushu University Fukuoka City Japan

    Dr. Alan Jackson CBE MD FRCP FRCPCH FRCPath Director of the University of Southampton's Institute of Human Nutrition, appointed a Commander of the Order of the British Empire for his services to public health and nutrition, Chair of the Government's Scientific Advisory Committee on Nutrition, senior adviser to the World Health Organisation and the Food and Agriculture Committee of the United Nations, University of Southampton UK

    Dr. W Philip T James CBE MD DSc FRSE FRCP Chairman of the International Obesity Task Force London, UK

    Dr. Laurence N Kolonel MD PhD, Center Deputy Director, Cancer Research Center of Hawaii, Professor, Harvard School of Public Health, University of Hawaii Honolulu, HI, USA

    Dr. Shiriki Kumanyika PhD MPH, Senior Advisor to the Center for Public Health Initiatives, Professor of Epidemiology, Department of Biostatistics and Epidemiology, School of Medicine, Professor of Epidemiology, Department of Pediatrics, Section on Nutrition, Children’s Hospital of Philadelphia, Associate Dean for Health Promotion and Disease Prevention, School of Medicine, Senior Scholar, Center for Clinical Epidemiology and Biostatistics, School of Medicine, Senior Fellow, Institute on Aging, School of Medicine, Senior Fellow, Leonard Davis Institute for Health Economics, Director, Penn-Cheyney EXPORT Center for Inner City Health, University of Pennsylvania Philadelphia, PA USA

    Dr. Claus Leitzmann PhD Justus Liebig University Giessen, Germany, Director, Institute of Nutritional Sciences, University of Giessen, 1990 – 95, Journal “UGB-Forum”; consulting editor, Journal “Nutrition Ecology”; co-editor, Journal of Oncology; editorial board. Author of 27 books and over 400 publications on various aspects of nutrition

    Dr. Jim Mann DM PhD FFPH FRACP Professor in Human Nutrition and Medicine at the University of Otago and Consultant Physician (Endocrinology) in Dunedin Hospital New Zealand, Director of the recently established Edgar National Centre for Diabetes Research and the WHO Collaborating Centre for Human Nutrition, Chair of the Diabetes and Nutrition Study Group of the European Association for the study of Diabetes, the Scientific Advisory Committee of the National Heart Foundation of New Zealand, the Cardiovascular Guidelines Group and the convenor of the World Health Organisation (WHO), Food and Agriculture Organisation (FAO) Advisory Group: Carbohydrates and human health. Awarded the international Bristol-Myers Squibb/Mead Johnson Unrestricted Grant for Human Nutrition, was the third recipient of the University of Otago Distinguished Research Medal in 2002 and in 2004 he received the Sir Charles Hercus Medal of the Royal Society of New Zealand. He was appointed a Companion of the New Zealand Order of Merit for services to Medicine in 2003. He was also awarded the Distinguished Researcher Award from the Dunedin School of Medicine for 2005.

    Dr. Hilary J Powers PhD RNutr Professor of Nutritional Biochemistry, University of Sheffield, UK, Member, WCRF/AICR Expert Panel on Diet, Physical Exercise and Cancer, BBSRC DRINC Committee, BBSRC Agri-Food Committee, 2002-2006, Editor, Nutrition Research Reviews, 1997-2006, External Reviewer, Rowett Research Institute (BBSRC) Aberdeen, Member, BBSRC Evaluating group for the Institute of Food Research, Norwich. Editor, Human Nutrition (Elsevier, 2005)

    Dr. K Srinath Reddy MD DM MSc President, Public Health Foundation of India, Coordinator of the Initiative for Cardiovascular Health Research in the Developing Countries, and former Chair of the Department of Cardiology at All India Institute of Medical Sciences, and of the Scientific Council on Epidemiology of the World Heart Federation (2003-2006). Awarded the prestigious national award PADMA BHUSHAN by the President of India (one of the highest civilian awards conferred by the Government of India) on the occasion of the 57th Republic Day of India, in 2005. The Royal Society for the Promotion of Health, UK, conferred the award of the Queen Elizabeth Medal for 2005.

    Dr. Elio Riboli MD ScM MPH Chair in Cancer Epidemiology and Prevention Division of Epidemiology, Public Health and Primary Care, Imperial College London, UK, has co-authored over 310 peer-reviewed publications and over 100 book chapters and books and serves on editorial boards of major journals on nutrition, cancer and epidemiology.

    Dr. Juan A Rivera PhD Founding Director, Center for Research in Nutrition and Health, National Institute of Public Health, Mexico, Professor of Nutrition at the School of Public Health in Mexico, Adjunct Professor in the Division of Nutritional Sciences at Cornell University in Ithaca, NY and at the Rollins School of Public Health at Emory University in Atlanta, GA, former Director of Nutrition and Health at the Nutrition Institute of Central America and Panama (INCAP).

    Dr. Arthur Schatzkin MD DrPH Chief of the Nutritional Epidemiology Branch and Senior Investigator, National Cancer Institute Rockville, MD, received the NIH Merit Award in 1996.

    Dr. Jacob C Seidell PhD Professor of Nutrition and Health and Director of the Institute for Health at the Faculty of Life and Earth Sciences, Free University Amsterdam The Netherlands, former Head of the Department for Chronic Diseases Epidemiology at the National Institute for Public Health and the Environment in Bilthoven, and former President of the European Association for the Study of Obesity

    Dr. David E Shuker PhD FRSC The Open University Milton Keynes, UK, Advisor to the Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment, member of UK Department of Health Committee on Carcinogenicity.

    Dr. Ricardo Uauy MD PhD Professor of Nutrition and Pediatrics and former Director of Instituto de Nutricion y Tecnologia de los Alimentos Santiago, Chile's training programs, the Clinical Research Center, the Division of Human Nutrition and Medical Sciences and was resident-coordinator for UN University activities. Former President of the Chilean Nutrition Society and has participated as an expert in WHO/FAO on Protein and Energy Requirements 1981, Fats and Oils in Human Nutrition 1993, Food Based Dietary Guidelines 1987, Obesity 1997, Nutrition in the Elderly 1998, Human Nutritional Requirements for vitamins and minerals 1998. Protein Energy working group 2001. Energy Recommendations 2001. He was a member of the NIH (USA) Nutrition Study Section. He is on the editorial boards for Early Human Development, Nutritional Biochemistry, Journal of Pediatrics and Journal of Pediatric Gastroenterology and Nutrition. From 1995 to 2000 he was a member of the UN ACC/SCN Advisory Group in Nutrition (AGN) and chairman of the AGN for 1997-2000. He was elected as a member of the IUNS council in 1997 and chosen as president elect in 2001 and received the McCollum award presented by the American Society for Nutritional Sciences (USA) in 2000

    Dr. Walter C Willett MD DrPH Chair, Department of Nutrition, Fredrick John Stare Professor of Epidemiology and Nutrition, Harvard School of Public Health Boston, MA, Second most cited scientist in the history of clinical medicine, author of Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating, he is also one of the principal investigators on the Nurses Health Study, one of the largest, long-term studies to look at the effect of diet on health.

    Dr. Steven H Zeisel MD PhD, Kenan Distinguished University Professor in Nutrition and Pediatrics; former Chairman, Department of Nutrition; Director Nutrition Research Institute, Director UNC Human Clinical Nutrition Research Center, Director UNC Center for Excellence in Children’s Nutrition, School of Public Health, University of North Carolina at Chapel Hill and the center director of the NIDDK-funded UNC Clinical Nutrition Research Unit.


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    15 comments:

    1. Anonymous7:11 am

      All those names you list are just people who are teeing off of the same studies. They are not primary researchers with independent sources of information. They just read that some studies found a correlation, and they parrot it.

      Here's a (politically incorrect) op-ed that goes into some numbers to show that the contrarian view is not completely nuts:

      http://www.foxnews.com/story/0,2933,144326,00.html

      This whole discussion reminds me of the "wine is heathy" thing, where when they actually got access to supermarket scanner data, they discovered that wine purchases cooccur with purchases of a lot of other healthy foods, relative to non wine purchasers' purchases. Without an actual proven mechanism, correlation of beef with colon cancer (which is somewhat of a thin connection, if you read the link above) could be because of any number of behavioral factors beyond the beef.

      ReplyDelete
    2. Your op-ed Anonymous is referring to a single study published in JAMA. The op-ed was written by someone who makes a living taking a contrarian view to medical research.

      The names I listed who you refer to as "parrots" are in fact some of the world's most well respected nutritional epidemiologists and researchers who not only have participated as primary investigators on many of the 7000studies summarized in the World Cancer Research Fund Report, but who unlike your Fox News op-ed written by a man who makes a living taking a specific viewpoint, really don't care what they recommend so long as there is an evidence base to back it up.

      ReplyDelete
    3. For more information on the author of anonymous' Fox news op-ed piece, head over here:

      Steven Milloy Biography

      ReplyDelete
    4. Anonymous8:28 am

      Pardon my bluntness, but Yoni, you seem like a contrarian too, attacking for example the Eating Well with Canada's Food Guide, which has some pretty big names behind it.

      I strongly recommend the editorial from the Annals of Oncology (2008, 19:1665-1667), written by Boyle, Boffetta and Autier from the International Agency for Research on Cancer that states among other things:
      "Subsequently, it has crumbled as major analyses of prospective
      studies have continued to demonstrate consistently a lack of
      association between intake of fruits and vegetables and risk of
      several cancers. This major change in classification of one the
      few agents classified by WCRF in the category of strongest
      evidence in 1997 casts doubt on the rationale to classify
      ‘convincing’ to the evidence linking high meat intake to
      colorectal cancer risk in the current report [1]. This also raises
      questions about the evaluation process and about the
      robustness of the classification system."

      ReplyDelete
    5. I certainly don't mind bluntness.

      For my edification, could you provide me with the "Big Names" behind the Food Guide?

      Oh, and regarding the Food Guide, as I've alluded to in my posts before, please stay tuned to the news media in the New Year for some more contrarians like me.

      ReplyDelete
    6. Anonymous - the reference you mentioned is not available online.

      I'd be happy to read it however - if you wouldn't mind emailing it to me, that'd be great.

      ReplyDelete
    7. Anonymous3:34 pm

      I am a dietitian and the letter that came with my Food Guide "A Resource for Educators and Communicators" states "over the past three years, Health Canada has consulted extensively on the revised Food Guide. Widespread consultation brought comments from approximately 7,000 stakeholders including dietitians, scientists, physicians and public health experts with an interest in health and chronic disease prevention."

      Likely there is a way to find out more about the stakeholders.

      It is true that corporate dietitians still have their first responsibility to the public and their college, and they sometimes walk a fine line between being an asset to their company and publishing truly evidence based information. They can of course claim that beef is an excellent source of protein and other nutrients. However a general statment that the evidence on red meat and colon cancer is not convincing does not provide consumers with all the angles to make their own informed decision.

      ReplyDelete
    8. I know a fair bit about the Food Guide's consultation process given that I was one of those 7,000 folks referred to.

      I also know a fair bit about the stakeholders.

      To read more on the consultations feel free to head over to my old post, ,Consultation What Consultation? and to read more about the stakeholders, you can check Big Food has a Seat

      Thanks for the comments.

      ReplyDelete
    9. Anonymous9:37 am

      What do I think? I think you are an extremist who is completely out of line. You are the disgraceful one.

      ReplyDelete
    10. Anonymous11:45 am

      Hi Yoni,

      I just wanted to thank you for having the guts to state your opinions on this subject. Whether people agree or not, it doesn't matter. You are doing what is important, which is stimulating thought and discussion. People need spend more time thinking about WHAT and HOW much they are eating of a particular food, especially meat.

      It goes without stating once again, a person has to be pretty naive to think that a corporate dietician and any other health professional that serves on an industry-sponsored board, is doing anything but serving the needs of their employer. I don't think Carolyn would still be employed if she had issued a press release stating otherwise!

      Keep up the great blogs Yoni!

      Jill

      ReplyDelete
    11. Anonymous9:23 pm

      Whine whine whine. I found this blog through a link, and will never read it again. stop looking at all the negatives, as we can find flaws with everything in life. Go eat a cookie or run a marathon.
      While much of the media and unfortunately some of the information the government puts out is slightly flawed or biased, we all need to look at information critically. If we bought everything we read, we would be stupid and in big trouble.

      People are not perfect, and many of these organizations are doing what they can to improve shitty situations. Some companies (ie media) are just looking tomake money.

      Beef isnt so bad. In moderation. People consume too much beef, too often. period. we have been eating meat for ages, just not like we do today.

      Consumer responsibility is a big issue. People (in ontario) are generally lazy, shitty eaters, who are slightly uninformed and mostly just dont care, as long as it tastes good.
      The big corporations can send us messages, but we need to be critical about what we want to buy.

      (I have worked in the meat industry, nutrition field, health/healthcare, and fitness industry, and have seen many sides). I just dont get what youre trying to prove with this blog. But whatever floats your boat.

      ReplyDelete
    12. Anonymous2:52 pm

      I love beef.

      ReplyDelete
    13. Anonymous10:41 am

      I highly doubt that the illustrious authors of the WCRF report had much to do with it except glancing at the final product put together by staffers. The report says that obesity is oh so important as a cause of cancer, but I defy you to find the data that would actually support this statement. Yes, some cancers are definitely related to obesity, but overall most cancers aren't. The information that supposedly supports the statement isn't even in the report anywhere but in some inaccessible supplement. The International Obesity Task Force and its chair were important participants and the IOTF started life as a drug-company funded lobbying group (funded generously mostly by Roche) to get governments to change their obesity policies (basically to start paying for weight loss drugs for the populace). Gee, could that have some relation to why the WCRF report says obesity is so important as a cause of cancer, when most objective sources actually estimate something much lower? The report seems to emulate the approach of the tobacco industry - put together some gigantic report that no one can read and study in full, then put out some misleading summary about what the report shows.

      ReplyDelete
    14. Anonymous11:23 am

      Yoni, I would appreciate a clear concise comment from you summarizing your biggest "beef " with beef.
      I am an RD , I encourage patients to reduce their consumption of red meat and to eliminate processed meats except for a "treat". (I go with the "no forbidden foods" idea as you do).
      Do you eat beef as a treat? or are you so opposed that it is not in your family's diet at all -just curious!!
      I like the blog - it provokes my thoughts, makes me re-think long held notions about food and nutrition,
      - even tho' sometimes i find it gives me a headache if i read to much! lol!

      ReplyDelete
    15. Sure Anonymous RD,

      I think that beef at best is a food with little risk and little benefit, and at worst it carries with it more risk than benefit.

      And while the risks are likely pretty darn small, to promote it as "healthy" and something to strive to include in your diet does not reflect the current state of the evidence.

      Ultimately, like you, I think that people should enjoy the smallest amount of beef they need to be happy. For some that'll be lots, for others, none.

      Thanks for commenting.

      Yoni

      ReplyDelete