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     \) J Science IN THEPublic Interest

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    Letter Requesting BMJ to Retract "Investigation"

     Novembers, 2015Dear Editor:

    A recent  article by journalist Nina Teicholz,  which was published as a "BMJ Investigation" of the  ScientificReport of the 2015 Dietary Guidelines Advisory Committee (DGAC),  included numerous errors andmisrepresentations. Below we have summarized only factual errors, excluding incorrect or biasedinterpretations 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 toinform 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 morethan 70% of the topics, including some of the most controversial issues in nutrition. Instead, it relied onsystematic reviews by external professional associations, almost exclusively the American Heart Association(AHA) and the American College of Cardiology (ACC), or   cond uc t ed an [s ic ] hoc examin a t io n o f thes c ie n t i f i c l i t e ra tu re w i th o u t we l l d e f in e d s y s te ma t i c c r i t e r ia fo r h o w s tu d ie s o r o u ts id e re v ie w

    p a p e rs we r e id e n t i f i e d , s e le c te d , o r e v a lu a te d .

    Co r re c t io n :  In  Appendix E-2,  the Evidence Portfolios for the key topics addressed by Teicholz specify thesearch strategy, inclusion criteria, search results, and AMSTAR ratings for methodological quality for theexisting 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% ofcalories, based on a review by the AHA and ACC, a 2010 NEL review, and the committee's   ad hocse lec t ion o f seven rev i ew papers   (see table A on  thebmj.com)." Table A states that  " n o me th o d o l o g yfo r th is sec t ion o f the repor t :   no reason given for why certain studies were selected for review andothers were not, nor how they were evaluated relative to each other."

    Co r re c t io n : Appendix  E-2.43  gives the search strategy, inclusion criteria, search results, and AMSTARratings for methodological quality for the seven review papers, along with a list of excluded articles and thereasons for exclusion. (Note: In  Table A,  Teicholz states that "the overall conclusion [of the 2012 Cochranereview by Hooper, et al.] is there fore that while sat urated-f at restri ction appears to reduce heart attack risk,

    it does not reduce overall or cardiovascular mortality (death), which is arguably the more importantendpoint."This statement contradicts Teicholz's article, which said that Hooper, et al. "failed to confirm anassociation between saturated fats and heart disease."The BMJ corrected this error a month after it waspublished.)

    3.) Teicholz states that "use of   e x te rn a l r e v ie ws b y p r o fe s s io n a l a s s o cia t io n s i s p ro b le ma t i c  becausethese groups conduct literature reviews according to different standards and are supported by food and drugcompanies."

    Co r re c t io n :  The "problematic" external review cited by Teicholz was not conducted solely by professionalassociations. The review was actually a "clinical practice guideline" developed by the American HeartAssociation and the American College of Cardiology in partnership with the  National Heart, Lung, and BloodInstitute.  The NHLBI's website clearly describes its rigorous standards for assessing the quality of studiesand 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 trialsare cited, and  none suppor ts the hypothes is tha t sa tu ra ted fa ts cause hear t d isease  (see  table B onthebmj.com)."

    Co r re c t io n :  It is incorrect to state that none of the trials cited in the 2010 NEL review supports thehypothesis that saturated fats cause heart disease. The 2010 NEL review found "strong evidence" thatsatur ated fat int ake increases the risk of cardiov ascular di sease. In Table B, Teicholz over -ru les the 2010NEL review by assigning each trial to one of four categories (a) "trials that should not have been includedbecause they did not meet inclusion criteria," (b) "trials that should not have been included because they didnot test normally occuring [sic] saturated fats or saturated fats at all," (c) "trials concluding that saturatedfats had a neutrial [sic] or beneficial effect on health," and (d) "trials with mixed results on blood lipidmeasures." (Note: Table B has additional errors too numerous to list here.) Thus, Teicholz concludes that the2010 NEL review is substandard, but she also argues that the 2015 "committee's report used weak scientificstandards," because  it did not rely suffici ently on NEL revi ews.

    http://thebmj.com/http://thebmj.com/http://thebmj.com/http://thebmj.com/http://thebmj.com/http://thebmj.com/

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    5.) Teicholz states that "perhaps more important are the  s tud ies tha t have never been sys temat i ca l lyre v ie we d b y a n y o f t h e d ie ta ry g u id e l in e c o mmi t te e s .  These include the large, government fundedrandomized 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 mostambitious, well controlled nutrition studies ever undertaken."

    Co r re c t io n :  It is incorrect to state that these trials were not reviewed by the DGAC. The DGAC considered a2012 Cochrane review  that included 4 of the 6 trials cited by Teicholz and a   2010 meta-analysis  that included5 of the 6 trials cited by Teicholz. (The review and meta-analysis both concluded that replacing saturatedfats with unsaturated fats reduce the risk of heart disease.)  One trial  cited by Teicholz is excluded from mostmeta-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 a t a mi n i mu m, th ree Nat ion a l Ins t i tu tes o f Hea l th f und edtr ia ls on some 50 000 peop le sho win g th a t a d ie t low in fa t and sa tu ra t ed fa t is ine f f ec t iv e fo r

    f igh t ing hear t d isease , obes i ty , d iabe tes , o r cancer .  Two of these trials are omitted from the NELreview... When the omitted findings from these three clinical trials are factored into the review, theoverwhelming preponderance of rigorous evidence does not support any of the dietary committee's healthclaims for its recommended diets."

    Co r re c t io n :  The  two trials  that were "omitted from the NEL review" did not assess the impact of diet "forfighting heart disease, obesity, diabetes, or cancer." They assessed the impact of diet on serum cholesterollevels. Fur the rmo re, all thr ee trials wer e included in the Cochrane review that was consider ed by theDGAC.

    7.) Teicholz states that "The report also gave a strong rating to the evidence that its recommended diets canfight heart disease....The  com mi t t ee rev iew ed o th er , more recent s tud ies bu t no t us ing anys y s te ma t i c o r p re d e f in e d m e th o d s . "

    Co r re c t io n :  Appendix  E-2.26  gives the search strategy, inclusion criteria, search results, and AMSTARratings for methodological quality for the six "more recent studies," along with a list of excluded articles andthe reasons for exclusion.

    8.) In Table D, Teicholz includes sections (under "die tar y pat tern s and heart disease" and "di eta ry patt ernsand obesity") entitled "DGAC  ad hoc rev iew  of the scientific literature" where she states that  "nosys t emat ic met hod o lo gy is g iv en fo r the se lec t ion o f these s tud ies .   I t is theref ore impossible toknow if they fairly represent the literature."

    Co r re c t io n :  These were not ad hoc reviews. The DGAC details the systematic methodology for selectingthese studies in Appendices  E-2.26  and  E2.27.  Note: Teicholz's  Table D  consists largely of Teicholz's criticismof 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 the2015 "committee's report used weak scientific standards," because  it did not rely suffici ently on NELreviews.

    9.) Teicholz states that "Consulting the NEL for a review on this topic turns up a surprising fact: a systematicreview on health and red meat has not been done. Although several analyses look at "animal proteinproducts,'  t h e s e re v ie ws in c lu d e e g g s ,  f i s h ,  and da i ry and there fo re do no t iso la te the hea l the f fec ts o f red meat ,  or meat of any  kind.

    Co r re c t io n :  The  NEL reviews cited by Teicholz  do  examine the results  on red meat and processed meatsseparately from the results on other animal proteins.

    10.) Teicholz states that "The committee's approach to the evidence on saturated fats and low carbohydratediets reflects an apparent failure to address any evidence that contradicts what has been official nutritionaladvice for the past 35 years.  The foun dat io n o f th a t adv ice has been to rec omm end ea t in g less fa ta n d fe we r a n ima l p ro d u c ts (me a t , d a i r y , e g g s )  while shifting calorie intake towards more plant foods(fruits, vegetables, grains, and vegetable oils) for good health. And in the past decades, this advice hasremained virtually unchanged."

    Co r re c t io n :  The 2015 DGAC did not recommend "eating less fat" or reducing the consumption of eggs ordairy products. (In fact, Teicholz wrote in a February  New York Times  op-ed  that "experts on the committeethat develops the country's dietary guidelines acknowledged that they had ditched the low-fat diet.") TheDietary Guidelines for Americans  has never reco mmen ded eating less mea t or dair y products. (In someeditions, the  DGA  has included advice such as "moderate your use of eggs" or "use egg yolks and whole eggsin moderation. Use egg whites and egg substitutes freely...").

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    11.) Teicholz states that "studies showed mixed health outcomes for saturated fats, but early criticalreviews, including one by the National Academy of Sciences, which cautioned against the inconclusive stateof the evidence on saturated fats and heart disease,   were d ism issed by the USDA  when it launched thefirst dietary guidelines in 1980."

    Co r re c t io n :  The USDA (and DHHS) published the 1980 Dietary Guidelines for Americans in February 1980.Toward Healthful Diets,  the Nat ional Academy o f Sciences repo rt cited by Teicholz, was published in May1980.  USDA could not have dismissed  Toward Healthful Diets,  because the repor t was published  after   theDietary Guidelines were released.

    In sum mar y, the Teicholz/BMJ "i nve sti gat ion " is based on non-fact s. Such a paper has no place in the pagesof a prominent scientific journal and should be retracted.

    Sincerely,

    * Steven Ab ram s, MDChair of PediatricsDirector, Dell Pediatric Research InstituteDell Medical SchoolUniversity of Texas at AustinAustin,  Texas, USA

    *Luc i le L. Ad ams- Camp be l l , PhD

    Professor of OncologyAssociate DeanAssociate Director, Minority Health & Health Disparities Research

    Georgetown University Medical CenterWashington, D.C., USA

    Sharo n R. Ak abas , PhD

    Director, MS in NutritionAssociate Director for Educational InitiativesColumbia UniversityInstitute of Human NutritionNew York, New York, USA

    *  Chery l An ders on , Ph D, MPHAssociate Professor of Preventive MedicineDepartment of Family and Preventive MedicineSchool of MedicineUniversity of California, San DiegoLa Jolla, California, USA

    Law ren ce J. Ap pel , MD, MPHC. David Molina, MD, MPH Professor of Medicine Epidemiology and International HealthDirector, Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins Medical InstitutionsBaltimore, Maryland, USA

    Fernando Aros Borau, MD, PhD

    Department of CardiologyUniversity Hospital of ArabaVitoria, Spain

     A l b er t o A s c h er i o , MD , Dr PH

    Professor of Epidemiology and NutritionDepartment of NutritionHarvard T.H. Chan School of Public HealthProfessor of MedicineHarvard Medical School

    Boston,  Massachusetts, USA

    Guy De Backer, MD, PhD

    Emeritus Professor in Public HealthGhent UniversityGhent, Belgium

     A d am B. B ec k er , Ph D, MPH

    Executive DirectorConsortium to Lower Obesity in Chicago ChildrenChicago, Illinois, USA

    Maira Bes-Rastro l lo , PharmD, PhD

    Associate ProfessorDepartment of Preventive Medicine and Public HealthFaculty of Medicine

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    University of NavarraNavarra, Spain

    Henry Blackburn , MD

    Professor Emeritus, Epidemiology & Community HealthDivision of Epidemiology & Community HealthUniversity of MinnesotaMinneapolis, Minnesota, USA

    Carol J. Boushey, PhD, MPH, RD

    Associate Research ProfessorEpidemiology Program

    University of Hawaii Cancer CenterUniversity of Hawaii at ManoaHonolulu,  Hawaii, USA

    Mar ie -Chr is t ine Boutron-Ruau l t , MD, PhD

    Medical Practitioner, Internist, and GastroenterologistPractitioner at Antoine Béclère University HospitalInserm Research DirectorHead of INSERM UMR 1018Clamart, France

    * J .   Thomas Brenna, PhD

    Professor of Human Nutrition and of ChemistryCornell UniversityIthaca, New York, USA

    I n g e b o rg Bro u we r , Ph D

    Professor of Nutrition for Healthy LivingHealth SciencesVU University AmsterdamAmsterdam, The Netherlands

    Kelly D. Brownell , PhD

    Dean,  Sanford School of Public PolicyRobert L. Flowers Professor of Public PolicyProfessor of Psychology and NeuroscienceDuke UniversityDurham,  North Carolina, USA

     A u r o r a B u en o Ca v an i l l as , MD, Ph D

    Professor of Preventive Medicine and Public HealthUniversity of GranadaGranada, Spain

    Pilar Buil-Cosiales, PhD, MD

    Primary Health Care PractitionerServicio Navarro de Salud-OsasunbideaNational Health SystemNavarra, Spain

    Joanne Burke, PhD, RD, LD

    Director of the University of New Hampshire Dietetic InternshipThomas W. Haas Professor in Sustainable Food SystemsUniversity of New HampshireDurham,  New Hampshire, USA

    Carlos A. Camar go , Jr. , MD, DrPH

    Professor of Medicine, Harvard Medical SchoolProfessor of Epidemiology, Harvard School of Public HealthBoston,  Massachusetts, USA

    * Wayn e Campb e l l , PhD

    Professor, Department of Nutrition SciencePurdue UniversityWest Lafayette, Indiana, USA

    Raffaele De Caterina, MD, PhD

    Professor and Chair of CardiologyG. d’Annunzio University - Chieti-PescaraChieti,  Italy

     A l an Ch ai t , MD

    Edwin L Bierman Professor of MedicineHead,  Division of Metabolism, Endocrinology & NutritionUniversity of WashingtonSeattle, Washington, USA

    Jorge E. Chavarro, MD, ScD

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    Associate Professor of Nutrition and EpidemiologyHarvard T.H. Chan School of Public HealthAssistant Professor of MedicineHarvard Medical SchoolBoston,  Massachusetts, USA

    *St ev en K. Cl in ton , MD, PhD

    John B. and Jane T. McCoy Chair of Cancer ResearchThe Ohio State University Comprehensive Cancer CenterProfessorDivision of Medical OncologyDepartment of Internal Medicine

    The Ohio State University School of MedicineColumbus, Ohio, USA

    Isobe l R. Conten to , PhD

    Mary Swartz Rose Professor of Nutrition and EducationCoordinator, Program in Nutrit ionFaculty Director, Laurie M. Tisch Center for Food, Education & PolicyDepartment of Health and Behavior StudiesTeachers College Columbia UniversityNew York, New York, USA

    Dolores Core l la , PhD

    Professor, Preventive Medicine and Public HealthGenetic and Molecular Epidemiology UnitSchool of MedicineUniversity of ValenciaValencia, Spain

    Pa t r i c ia Cra wf o rd , D rPH

    Senior Director of Research, Nutrition Policy InstituteCooperative Extension SpecialistUniversity of California Agriculture and Natural ResourcesBerkeley, California, USA

    L id ia A. Da imi e l -Ru i z , PhD

    Principal InvestigatorPabellón Central del Antiguo Hospital de CantoblancoUniversity de CantoblancoMadrid,  Spain

    Rich ard J . Decke l bau m, MD, CM, FRCPC

    Robert R. Williams Professor of NutritionProfessor of PediatricsProfessor of Epidemiology

    Director, Institute of Human NutritionCollege of Physicians and SurgeonsColumbia University Medical CenterNew York, New York, USA

    Jean-Pi e r re Despr és , PhD , FAHA, F IA S

    Scientific DirectorInternat ional Chair on Cardiometabolic RiskProfessor, Department of KinesiologyFaculty of Medicine, Université LavalDirector of Research, CardiologyQuébec Heart and Lung InstituteQuébec, Canada

    Wil l i am Die t z , MD, PhD

    Director, Sumner M. Redstone Global Center for Prevention and Wellness

    Milken Institute School of Public HealthGeorge Washington UniversityWashington, D.C., USA

    Deird re A. Dingman, DrPH, MPH, CHES

    Postdoctoral FellowPublic Health Law ResearchTemple UniversityPhiladelphia, Pennsylvania, USA

    L ig ia J . Dom in gu ez, MD

    Geriatric UnitUniversity of PalermoPalermo, Italy

     A n a Cl ar a D u r a n , M S , Ph D

    Postdoctoral Research Fellow

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    University of Illinois, ChicagoChicago, Illinois, USA

    Robert H. Eckel, MD

    Professor of MedicineDivision of Endocrinology, Metabolism and DiabetesDivision of CardiologyProfessor of Physiology and BiophysicsCharles A. Boettcher II Chair in AtherosclerosisUniversity of Colorado Anschutz Medical CampusDirector Lipid Clinic, University HospitalUniversity of Colorado, Denver

    Denver, Colorado, USA

    Ib rah im Elmadfa , PhD

    Emeritus Professor of NutritionUniversity of ViennaVienna, Austria

    Javier Díez Espino, MD, PhD

    Primary Care ManagerServicio Navarro de Salud-OsasubideaNavarra, Spain

    Ramon Estruch, MD, PhD

    Department of Internal MedicineHospital Clinic, University of BarcelonaBarcelona, Spain

    Wafa ie Fawz i , DrPH

    Richard Saltonstall Professor of Population SciencesProfessor of Nutrition, Epidemiology, and Global HealthChair, Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBoston,  Massachusetts, USA

     A l ej an d r o Fe r n án d ez- Mo n t er o , MD, Ph D

    Project Director, “Healthy Diet, It’s up to you”Department of Prevention of Occupational HazardsUniversity of Navarra-IDISNANavarra, Spain

    Oscar H. Franco, MD, PhD, FESC, FFPH

    Professor of Preventive MedicinePI Cardiovascular Epidemiology groupDirector ErasmusAGE

    CEO Erasmus Epidemiology ResourcesDeputy Science Director NIHESDepartment of EpidemiologyErasmus MC, University Medical Center RotterdamRotterdam, The Netherlands

    Gary E. Fraser, MD, PhD

    Professor of EpidemiologyLoma Linda UniversityLoma Linda, California, USA

    I tz iar Zazpe Garcia, PhD, RD

    ProfessorDepartment of Clinical Science and PhysiologyUniversidad de NavarraNavarra, Spain

    Chr is topher Gardner , PhDProfessor of MedicineDirector of Nutrition StudiesDirector of NIH/NHLBI Postdoctoral Training ProgramStanford Prevention Research CenterPalo Alto, California, USA

     A l f r ed o Ge a, Ph D

    Assistant ProfessorDepartment of Preventive Medicine & Public HealthUniversity of Navarra, SpainNavarra, Spain

     A n g el Gi l , Ph D

    President of the Iberoamerican Nutrition Foundation (FINUT)Full Professor Department of Biochemistry and Molecular Biology II

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    Institute of Nutrition and Food TechnologyCentre of Biomedical ResearchUniversity of GranadaGranada, Spain

    Dav id C. Goff , Jr. , MD, PhD

    DeanColorado School of Public HealthAurora, Colorado, USA

    Car los A. Gonzá l ez , MD, PhD

    Unit of Nutrition and Cancer (Emeritus)

    Cancer Epidemiology Research ProgrammeCatalan Institute of Oncology (ICO)Barcelona, Spain

    Teres it a Gon zález de Cosío, Ph D, MSc

    Directora de Departamento de SaludUniversidad IberoamericanaMexico City, Mexico

    Mich ae l I . Gor an , PhD

    Director, Childhood Obesity Research CenterCo-Director, USC Diabetes and Obesity Research InstituteProfessor of Preventive Medicine; Physiology & Biophysics; and PediatricsThe Dr. Robert C. & Veronica Atkins Chair in Childhood Obesity & DiabetesUSC Keck School of MedicineLos Angeles, California, USA

     A n t o n i o M . Go t t o J r ., M D , DPh i l

    Professor of MedicineProvost for Medical Affairs and Dean Emeritus Weill Cornell Medical CollegeNew York, New York, USA

    Phi l i p Green lan d , MD

    Harry W. Dingman ProfessorDepartment of Preventive MedicineNorthwestern University Feinberg School of MedicineChicago, Illinois, USA

    Joan Guss ow, EdD

    Mary Swartz Rose Professor Emerita of Nutrition EducationTeachers CollegeColumbia UniversityNew York, New York, USA

    Mich ae l W. Ha m m, PhD

    C.S. Mott Professor of Sustainable AgricultureDirector, Center for Regional Food SystemsDepartments of CSUS, PSM, FSHNMichigan State UniversityEast Lansing, Michi gan, USA

    Caro le V. Harr is , PhD

    Vice President, Public Health and Survey Research DivisionICF InternationalAtlanta, Georgia, USA

    Serge Hercberg , MD, PhD

    Chef d'équipe - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN)Centre de Recherche Épidémiologie et Statistique Sorbonne Paris CitéUniversité ParisBobigny, France

    *F r an k B. Hu , MD, Ph D

    Professor of Nutrition and EpidemiologyHarvard T.H. Chan School of Public HealthProfessor of MedicineHarvard Medical SchoolBoston,  Massachusetts, USA

    Rod Jackso n, MBChB , PhD

    Professor of EpidemiologyFaculty of Medical and Health SciencesUniversity of AucklandAuckland,  New Zealand

    Dav id Jacobs , PhD

    Professor, Division of Epidemiology & Community Health

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    Department of Human Nutrition, Foods & ExerciseVirginia TechBlacksburg, Virginia, USA

    Fernanda Kroker, MSc, PhD

    Scientific ResearcherPopulation NutritionInstitute of Nutrition of Central America and Panama -INCAP-Guatemala City, Guatemala

    Daan Kromhout, PhD, MPH

    Emeritus Professor

    Division of Human NutritionWageningen UniversityWageningen, The Netherlands

    Lewis H. Kuller, MD, DrPH

    Department of EpidemiologyGraduate School of Public HealthUniversity of PittsburghPittsburgh, Pennsylvania, USA

    Larry Kushi, ScD

    Director of Scientific PolicyKaiser PermanenteOakland,  California, USA

    Darwin R. Labarthe, MD, MPH, PhD

    Professor of Preventive Medicine

    Northwestern University Feinberg School of MedicineChicago, Illinois, USA

    Rosa M. Lamuela-Raventos, PhD

    Associate ProfessorDepartment of Nutrition and Food ScienceSchool of Pharmacy, University of BarcelonaBarcelona, Spain

    José Lapetra, MD, PhD

    Médico de FamiliaResponsable del Grupo de Investigacion "Dieta, Nutrición y Prevención de Enfermedades en AtenciónPrimaria"CIBEROBN, Institute de Salud Carlos IIIUnidad de Investigación del Distrito Sanitario Atención Primaria SevillaSevilla, Spain

    Robert S. Lawrence, MD

    Director, Center for a Livable FutureProfessor of Environmental Health Sciences and International HealthJohns Hopkins Bloomberg School of Public HealthBaltimore, Maryland, USA

    Sal ly Ann Leder man, PhD

    Special LecturerInstitute of Human NutritionColumbia UniversityNew York, New York, USA

     A l l en S. L ev i n e, Ph D

    Professor, Food Science and NutritionUniversity of MinnesotaMinneapolis, Minnesota, USA

    Elyse Levine, PhD, RD

    AssociateBooz Allen HamiltonRockville, Maryland, USA

    David A. Levitsky, PhD, MPhil, MS

    Stephen H. Weiss Presidential FellowProfessor of Nutrition and PsychologyCornell UniversityIthaca, New York, USA

    Barry Lewis, MD, PhD, FRCP, FRCPath

    Emeritus ProfessorUniversity of LondonLondon,  United Kingdom

    * Al i ce Lich tens tei n, DSc

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    Senior Scientist and DirectorCardiovascular Nutrition LaboratoryJean Mayer USDA Human Nutrition Research Center on AgingProfessor of MedicineTufts University School of MedicineBoston,  Massachusetts, USA

    Bonnie F. L iebman, MS

    Director of NutritionCenter for Science in the Public InterestWashington, D.C., USA

    Esther Lopez-Garcia, PhD, MPHAssociate ProfessorDepartment of Preventive Medicine and Public HealthSchool of MedicineUniversidad Autónoma de MadridMadrid,  Spain

    José López Miranda, MD, PhD

    Catedrático de Medicina InternaVicedecano de Asuntos HospitalariosDirector UGC Medicina InternaHospital Universitario Reina SofiaFacultad de MedicinaUniversidad de CordobaCordoba, Spain

    Graham MacGregor, MA, MB, BChir

    Professor of Cardiovascular MedicineWolfson Institute of Preventive MedicineBarts and The London School of Medicine and Dentistry, Queen MaryUniversity of LondonLondon,  United KingdomMeena Mahadevan, PhD formatting error in originalAssociate ProfessorProgram Coordinator for Applied NutritionDepartment of Health and Nutrition SciencesMontclair State UniversityMontclair, New Jersey, USA

    Vasanti Malik, ScD

    Research ScientistHarvard T.H. Chan School of Public HealthBoston,  Massachusetts, USA

    Mario Mancini, MD

    Emeritus ProfessorUniversity of NaplesNaples, Italy

    James Mann, MD

    Professor, Human Nutrition and MedicineDunedin School of MedicineUniversity of OtagoOtago, New Zealand

    JoAnn E. Manson, MD, DrPH

    Professor of MedicineMichael and Lee Bell Professor of Women's HealthHarvard Medical SchoolProfessor, Department of Epidemiology

    Harvard T.H. Chan School of Public HealthChief, Division of Preventive MedicineBrigham and Women's HospitalBoston,  Massachusetts, USA

    Barrie Margetts, PhD, FFPH, MSc

    Professor Emeritus of MedicineUniversity of SouthamptonSouthampton, United Kingdom

    Migu el A. Mart i nez-G on zalez , MD, PhD, MPH

    Chair, Department of Public HealthUniversity of Navarra-CIBEROBNNavarra, Spain

    J .  A l f r e d o Ma r t in e z Hern a n d e z , D .Ph a rm, MD, Ph D

    Professor

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    Department of Nutrition, Food Science, Physiology and ToxicologySchool of PharmacyUniversity of NavarraNavarra, Spain

    Wil l iam McCar thy , PhD

    Adjunct ProfessorUCLA Fielding School of Public HealthDepartment of Health Policy and ManagementLos Angeles, California, USA

    * Bar bara Mil len, Dr PH, RD

    Founder and PresidentMillennium Prevention, Inc.Westwood,  Massachusetts, USA

    Nana Gletsu Mil ler, PhD

    Assistant ProfessorDepartment of Nutrition ScienceCollege of Health and Human SciencesPurdue UniversityWest Lafayette, Indiana, USA

    Marc Molendijk, PhD

    Assistant Professor Clinical PsychologyLeiden University and Leiden University Medical CenterLeiden,  The Netherlands

    Carlos A. Mon tei ro , MD, PhD

    Professor of Nutrition and Public HealthDepartment of Nutrition, School of Public HealthUniversity of Sáo PauloSáo Paulo, Brazil

    Roni Neff, PhD, MS

    Assistant Professor, Environmental Health SciencesBloomberg School of Public HealthProgram Director, Food System SustainabilityCenter for a Livable FutureJohns Hopkins UniversityBaltimore, Maryland, USA

    * Mir iam Nel son , PhD

    Associate Dean, Tisch College of Citizenship and Public ServiceProfessor, Friedman School of Nutrition Science and PolicyTufts University

    Boston,  Massachusetts, USA

    * Marian L. Neuho us er, P hD, RD

    Full Member, Cancer Prevention ProgramDivision of Public Health SciencesFred Hutchinson Cancer Research CenterSeattle, Washington, USA

    Kaare R. Norum, MD, PhD

    Professor EmeritusDepartment of NutritionFaculty of MedicineUniversity of OsloOslo,  Norway

    Salvatore Panico, MD, MS

    Professor of Internal Medicine

    Federico II UniversityNaples, Italy

     A n g el i k i Pap ad ak i , Ph D, MS c , FHEA

    Lecturer in Public Health NutritionProgramme Director, MSc Nutrition, Physical Activity and Public HealthCentre for Exercise, Nutrition and Health SciencesSchool for Policy StudiesUniversity of BristolBristol,  United Kingdom

    Diana C. Parra, PhD, PT, MPH

    Assistant ProfessorProgram in Physical Therapy and Department of Surgery (Prevention)Scholar, Institute for Public HealthWashington University School of Medicine

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    St. Louis, Missouri, USA

    Emma Pat te rson , PhD

    Project Manager for School Food SwedenCommunity Nutrition and Physical ActivityKarolinska InstitutetStockholm, SwedenJan I. Pedersen, MD, PhDEmeritus ProfessorDepartment of NutritionInstitute of Basic Medical SciencesUniversity of Oslo

    Oslo,  Norway

    * Rafael Perez-Es cami l l a, PhD

    Professor of Epidemiology and Public HealthDirector, Office of Public Health PracticeDirector, Global Health ConcentrationYale School of Public HealthNew Haven, Connecticut, USA

    Francisco Perez-Jimenez, MD, PhD

    Full Professor of Internal MedicineReina Sofia University HospitalUniversity of CordobaCordoba, Spain

    F. Xavi er Pi-S uny er, MD

    Professor of Medicine

    Institute of Human NutritionColumbia UniversityNew York, New York, USA

    María Puy Port i l lo , DPharm

    Professor of NutritionDirector, Nutrición y ObesidadDepartment of Pharmacy and Food ScienceUniversity of the Basque CountryBilbao, Spain

    John D. Potter, MD, PhD

    Senior Advisor, Public Health Sciences DivisionFred Hutchinson Cancer Research CenterSeattle, Washington, USA

    Neil Poulter, MD

    Professor of Preventive Cardiovascular MedicineImperial CollegeLondon,  United Kingdom

    Pekka Puska, MD, PhD, MPoISc

    Professor, National Institute for Health and Welfare (THL), FinlandPast President, World Heart Federation (WHF)Past President, International Association of National Public Health InstitutesHelsinki,  Finland

    Kalevi Pyörälä, MD

    Emeritus Professor of MedicineUniversity of Eastern FinlandKuopio, Finland

    Tim Radak, DrPH, MPH, RD

    Academic Coordinator for DrPH and PhD Public Health Programs

    College of Health SciencesWalden UniversityMinneapolis, Minnesota, USA

    Suja tha Ra ja ram, PhD

    Chair, SPH Doctoral CommitteeProgram Director, DrPH in NutritionSchool of Public HealthLoma Linda UniversityLoma Linda, California, USA

    Mike Rayner, DPhil

    Professor of Population HealthDirector, British Heart Foundation Centre on Population Approaches for Non-Communicable DiseasePreventior|Nuffield Department of Population Health

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    University of OxfordOxford,  United Kingdom

    Crist ina Razquin Buri l lo , PhD

    Colaborador de investigaciónDepartment of Preventive Medicine and Public HealthSchool of MedicineUniversity of NavarraNavarra, Spain

    Bil l Reger-Nash, EdD

    Professor Emeritus

    West Virginia University School of Public HealthAssociate Chair, Morgantown Pedestrian Safety BoardMorgantown, West Virginia, USA

    Shaun Riebl, PhD, RDN, LDN

    Clinical Assistant ProfessorThe University of North Carolina at Chapel HillGillings School of Global Public Health and UNC School of MedicineDepartment of NutritionDepartment of Medicine - Division of Nephrology and HypertensionUNC Hospitals Kidney and Hypertension Specialty ClinicChapel  Hill,  North Carolina, USA

    Eric Rimm, ScD

    Professor of MedicineHarvard Medical SchoolChanning Division of Network Medicine, Brigham and Women's Hospital

    Professor of Epidemiology and NutritionDirector, Program in Cardiovascular EpidemiologyHarvard T.H. Chan School of Public HealthBoston,  Massachusetts, USA

    Ulf Risérus, MMED, PhD

    Associate Professor in Clinical NutritionDepartment of Public Health and Caring SciencesClinical Nutrition and MetabolismFaculty of Medicine, Uppsala UniversityUppsala, Sweden

    Lorrene Ritchie, PhD, RD

    Director, Nutrition Policy InstituteCooperative Extension SpecialistUniversity of California Agriculture and Natural ResourcesBerkeley, California, USA

    Juan Rivera Dommarco, PhD, MS

    DirectorCenter for Research in Nutrition and HealthInstituto Nacional de Salud PublicaCuernavaca, Mexico

    Kim Robien, PhD, RD, CSO, FAND

    Associate ProfessorDepartment of Exercise and Nutrition SciencesDepartment of Epidemiology and BiostatisticsMilken Institute School of Public HealthGeorge Washington UniversityWashington, D.C., USA

    Fernando Rodr íguez-Ar ta le jo , MD, PhD

    Professor of Preventive Medicine and Public Health

    School of MedicineUniversidad Autónoma de MadridMadrid,  Spain

    Dora Romaguera, MSc, PhD

    Institut d’Investigació Sanitària de Palma (IdISPa) and CIBER-OBNHospital Universitari Son Espases, Unitat de RecercaPalma de Mallorca, Spain

    Emil io Ros, MD, PhD

    Former Director, Lipid ClinicEndocrinology & Nutrition ServiceHospital ClínicCIBERobn,  ISCI I I ,  SpainBarcelona, Spain

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    Dona l d (Di ego ) Rose, PhD , MPH

    Professor and Head of Nutrition SectionSchool of Public Health and Tropical MedicineTulane UniversityNew Orleans, Louisiana, USA

    Mig ue l Ru iz -Cane la , PhD , MPH

    Associate ProfessorDepartment of Preventive Medicine and Public HealthUniversity of NavarraNavarra, Spain

    Joan Sabaté , MD, Dr PHProfessor of NutritionSchool of Public HealthLoma Linda UniversityLoma Linda, California, USA

    Frank Sacks , MD, ScB

    Professor of Cardiovascular Disease PreventionDepartment of NutritionHarvard T.H. Chan School of Public HealthBoston,  Massachusetts, USA

    Gui l le rm o Saez Torm o, MD, Ph D

    Department of Biochemistry and Molecular BiologyCoordinator for International Relations and Mobility ProgramsFaculty of Medicine and OdontologyService of Clinical Analysis

    University Hospital Doctor Peset AleixandreUniversity of ValenciaValencia, Spain

    Jord i Sa las-Sa l vadó, MD, PhD

    Professor of NutritionDirector, Human Nutrition UnitDepartment of Biochemistry & Biotechnology, IISPVSchool of MedicineRovira i Virgili UniversityCIBERobn, Instituto Carlos IIIDirector, Centre Català de la Nutrició - Institut d'Estudis CatalansPast President, Federation of Spanish Food, Nutrition and Dietetic Scientific SocietiesDirector, Red Iberoamericana RIBESMETChairman,  INC - World Forum for Nutrition Research and DisseminationReus, Spain

     A l m u d en a Sán c h ez -Vi l l eg as , Ph D

    Associate Professor of Preventive Medicine and Public HealthDepartment of Clinical SciencesUniversidad de las Palmas de Gran CanariaLas Palmas, Spain

    Wi m H.M. Sar is , MD, Ph D

    Professor of Human NutritionDepartment of Human BiologyNUTRIM: School of Nutr iti on and Translational ResearchMaastricht University Medical CentreMaastricht, The Netherlands

    Denn is Sava iano , PhD, MS

    Virginia C. Meredith ProfessorDirector, North Central Nutrition Education Center

    Department of Nutrition SciencePurdue UniversityWest Lafayette, Indiana, USA

    Matth ias B. Schu lze , DrPH

    German Institute of Human NutritionDepartment of Molecular EpidemiologyNuthetal,  Germany

    Urs u la Sc h wa b , Ph D

    Associate Professor, Nutrition TherapyDepartment of Public Health and Clinical NutritionSchool of MedicineUniversity of Eastern Finland, Kuopio CampusKuopio, Finland

    Ma r le n e B . Sc h w a r t z , Ph D

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    DirectorRudd Center for Food Policy and ObesityUniversity of ConnecticutStorrs, Connecticut, USA

    Jacob C. Seidell, PhD

    Professor of Nutrition and Health/University ProfessorVU University AmsterdamAmsterdam, The Netherlands

    Lluis Serra-Majem, MD, MSc, PhD

    Professor of Public Health

    Director, Public Health Nutrition Research Center, University of BarcelonaPresident, Nutrition Without BordersUniversity of Gran CanariaGran Canaria, Spain

     A. G. Shaper, FRCP, FRCPath, FFPHM

    Ex-director, British Regional Heart StudyUniversity College of LondonLondon,  United Kingdom

    •Anna Maria Siega-Riz, PhD

    Professor of Epidemiology and NutritionAssociate Dean for Academic AffairsGillings School of Global Public HealthChapel  Hill,  North Carolina, USA

    Les ley Schmid t Sindberg , MPH

    Senior Research CoordinatorHealthy Eating Research)University of Minnesota School of Public HealthSt. Paul, Minnesota, USA

    Jeremiah Stamler , MD

    Professor Emeritus, Preventive Medicine and EpidemiologyNorthwestern University Feinberg School of MedicineChicago, Illinois, USA

    Meir Stampfer, MD, DrPH

    Professor of Medicine, Harvard Medical SchoolProfessor of Epidemiology and Nutrition, Harvard T.H. Chan School of Public HealthAssociate Director, Channing Division of Network MedicineDepartment of Medicine, Brigham and Women's HospitalBoston,  Massachusetts, USA

    Mar ie -Pie r re St . -Onge, PhD, FAHA

    Assistant Professor, Department of MedicineNew York Obesity Research CenterInstitute of Human NutritionCollege of Physicians & SurgeonsColumbia UniversityNew York, New York, USA

    * Mar y Sto ry , PhD, RD

    Professor of Global Health and Community and Family MedicineDuke UniversityDurham,  North Carolina, USA

    Boyd Swinburn, MBChB, MD, FRACP, FNZCPHM

    Professor of Population Nutrition and Global HealthUniversity of AucklandAlfred Deakin Professor

    Deakin University, MelbourneMelbourne, Australia

    Daniel R. Taber, PhD, MPH

    Assistant ProfessorDepartment of Health Promotion & Behavioral SciencesUniversity of Texas School of Public HealthAustin,  Texas, USA

    Lindsey Smith Tail l ie , PhD, MPH

    Research Assistant Professor, Department of NutritionFellow, Carolina Population CenterUniversity of North Carolina at Chapel HillChapel  Hill,  North Carolina, USA

    Linda Tapsell , PhD, FDAA, AM

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    Discipline Leader, Nutrition and DieteticsGraduate School of MedicineFaculty of Science, Medicine and HealthUniversity of WollongongWollongong, Australia

    Cynth ia Thomson, PhD, RD

    Professor, Health Promotion SciencesDirector, University of Arizona Canyon Ranch Center for Prevention & Health PromotionMel & Enid Zuckerman College of Public HealthUniversity of ArizonaTucson,  Arizona, USA

    Franc isco  3.  T inaho nes, MD, PhD

    Professor of MedicineDirector, Endocrinology and Nutrition Services, Hospital Universitario Virgen de la VictoriaCoordinator, Complications of Obesity, CIBEROBNUniversity of MálagaMálaga, Spain

    Estefania Toledo, MD, PhD, MPH

    Associate ProfessorUniversity of NavarraNavarra, Spain

    Mathi ld e Touv ier , PhD, HDR

    Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris CitéEquipe de Recherche en Epidémiologie NutritionnelleUniversités Paris 5, 7 et 13

    Bobigny Cedex, France

     A l i son To v ar , Ph D, MPH

    Assistant ProfessorDepartment of Nutrition and Food SciencesUniversity of Rhode IslandKingston,  Rhode Island, USA

     A n t o n i a Tr i c h o p o u l o u , MD

    Emeritus Professor, Nutritional EpidemiologyUniversity of Athens Medical SchoolAthens, Greece

    Josep A. Tur, PhD

    Professor of PhysiologyResearch Group on Community Nutrition & Oxidative StressUniversity of the Balearic Islands & CIBERobn CB12/03/30038

    Palma de Mallorca, Spain

    Matt i Uusitupa, MD, PhD

    Professor EmeritusInstitute of Public Health and Clinical NutritionUniversity of Eastern FinlandJoensuu,  Finland

    Linda Van Horn, PhD, RD

    Professor, Preventive MedicineAssociate Dean for Faculty DevelopmentFeinberg School of MedicineNorthwestern UniversityChicago, Illinois, USA

    Carlo La Vec ch ia , MD

    Professor of Medical Statistics and Epidemiology

    Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilan,  Italy

    Jesus Vioque, MD, PhD, MPH

    Unidad de Epidemiología de la NutriciónCampus San Juan. Facultad de MedicinaUniversidad Miguel HernandezAlicante, Spain

    Dav id Wal l inga , MD

    Senior Health OfficerNatural Resources Defense CouncilSan Francisco, California, USA

    May Wang, DrPH

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    Professor, Community Health SciencesDavid Geffen School of MedicineUniversity of California, Los AngelesLos Angeles, California, USA

    Dian ne S. War d, EdD

    Professor, Department of NutritionGillings School of Global Public HealthUniversity of North CarolinaChapel  Hill,  North Carolina, USA

    Ju l ia Wär nb erg , PhD

    NutritionistUniversity of MalagaMalaga, Spain

    Connie M. Weav er , PhD

    Distinguished Professor and Department HeadDepartment of Nutrition ScienceDirector, Women's Global Health InstitutePurdue UniversityWest Lafayette, Indiana, USA

    Howell Wechsler, EdD, MPH

    Chief Executive OfficerAlliance for a Healthier GenerationWashington, 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 NorwayTromsø,  NorwaySenior Cancer Epidemiologist, Department of Etiological Cancer Research, Cancer Registry of NorwayOslo,  NorwayProfessor of Medical Epidemiology, Department of Medical Epidemiology and Biostatistics, KarolinskaInstitutetStockholm, SwedenGroup Leader, Genetic Epidemiology Group, Folkhälsan Research CenterHelsinki,  Finland

    Shelley Weinstock, PhD, CNS, FACN

    Career ServicesInstitute of Human NutritionColumbia UniversityNew York, New York, USA

    Emily Welker, MPH, RDProgram CoordinatorHealthy Eating ResearchDuke Global Health InstituteDuke UniversityDurham,  North Carolina, USA

    Paul Whelton, MD, MSc

    Show Chwan Professor of Global Public HealthTulane University School of Public Health and Tropical MedicineNew Orleans, Louisiana, USA

    Walter Wil lett , MD, DrPH, MPH

    Frederick John Stare Professor of Epidemiology and NutritionChair, Department of NutritionHarvard T.H. Chan School of Public HealthProfessor, Department of Medicine

    Harvard Medical SchoolBoston,  Massachusetts, USA

     A l i c j a Wo l k , DMSc

    Professor of Nutritional EpidemiologyVice-chairman, Institute of Environmental MedicineHead,  Division of Nutritional EpidemiologyKarolinska InstitutetStockholm, Sweden

    Jayne Woods ide , PhD

    Nutrition and Metabolism GroupCentre for Public HealthBelfast, United Kingdom

    Kana Wu , MD, PhD

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    Senior Research ScientistDepartment of NutritionHarvard T.H. Chan School of Public HealthBoston,  Massachusetts, USA

    Lisa R. Young, PhD, RD

    Adjunct Professor of NutritionNew York UniversityNew York, New York, USA

    *2015 Dietary Guidelines Advisory Committee member

    Affiliations are listed for identification purposes only.

    Graduate Students

    Stacy Blondin, MSPH

    USDA Doctoral FellowChildObesity 180Friedman School of Nutrition Science and PolicyTufts UniversityBoston,  Massachusetts, USA

    Larissa Calancie

    Doctoral Candidate - Nutrition Interventions and PolicyUniversity of North Carolina Gillings School of Public HealthUNC Center for Health Promotion and Disease PreventionChapel  Hill,  North Carolina, USA

    Chr is t ina Chauvenet , MSc

    Doctoral StudentMaternal and Child HealthRoyster FellowUniversity of North Carolina Gillings School of Public HealthChapel  Hill,  North Carolina, USA

    Cesar Octavio Ramos Garcia, MHN, CN

    Doctoral Student in Public Health SciencesDirector of NutritionTonala University CenterUniversity of GuadalajaraGuadalajara, Mexico

    Vio le t Kiese l

    Graduate StudentPurdue UniversityWest Lafayette, Indiana, USA

     A l ex an d r a B. Mo rs h ed

    Doctoral StudentBrown SchoolWashington UniversitySt. Louis, Missouri, USA

    Taulant Muka, MD, MSc, DSc

    PhD Candidate, Erasmus MC, The NetherlandsVisiting Researcher at Harvard School of Public HealthBoston,  Massachusetts, USA

    Luis A. Rodríguez, MPH, RD, CNSC

    Doctoral Stude nt, Epide miology & Translat ional SciencesUCSF School of MedicinePediatric Clinical Dietitian, UCSF Benioff Children's HospitalSan Francisco, California, USA

    Chr is t ian Wr igh t , MS

    Doctoral CandidateDepartment of Nutrition ScienceLaboratory of Nutrition, Fitness, and AgingNSGSO PresidentPurdue UniversityWest Lafayette, Indiana, USA

    Affiliations are listed for identification purposes only.

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