On 24 and 31 October 2013, ABC television’s Catalyst program aired a two-part series that questioned the link between blood cholesterol and heart disease, and whether current dietary advice or statin medication was effective in lowering heart disease risk. Although the first program on diet was very biased Catalyst may have got away with it as the science around diet and heart disease is considered rather ‘soft’ and is still unfolding.

However, the second program on statins, cholesterol and heart disease was on very firm scientific ground. The last time I looked there were 24 meta-analyses on statin medication and heart disease risk and all showed benefit. But rather than present this perspective Catalyst decided that the public interest would be better served by sowing seeds of doubt.

There were howls of protest. To their credit, other journalists at the ABC took aim at Catalyst. Media Watch presenter Paul Barry said … Catalyst struck us as sensationalist and grossly unbalanced; and some of their so-called ‘experts’ had questionable qualifications.

The ABC’s health guru Dr Norman Swan considered the health implications saying that People will die as a result of the Catalyst program …. It doesn’t get much stronger than that. Was Swan going over the top, or did he just have a good understanding of his subject?

New University of Sydney study

A new study led by researchers at the University of Sydney’s Faculty of Pharmacy has provided some answers. The purpose of the study was to quantify any changes in the dispensing of statins after the airing of the Catalyst program in October 2013. The researchers found significant and sustained changes in statin dispensing following the airing of the program, 60,897 Australians having been affected up to 30 June 2014.

In relation to the health implications the researchers had the following to say:

If the 60,897 individuals we estimated to have been affected continue to be non-adherent, this could result in between 1522 and 2900 preventable, and potentially fatal, major vascular events.

So, unless the situation can be reversed a couple of thousand preventable heart attacks or strokes may occur as a direct result of the Catalyst program. It’s impossible to say how many of these events will be fatal so we can’t accurately answer the question posed at the top of this post. But it would appear that Norman Swan did indeed know what he was talking about when he made the claim that People will die.

Spare a thought for the poor souls working in the ABC’s legal section. Just imagine the litigation to come.

How did the ABC let it happen?

Although current affairs programs on commercial television often present shock-horror health stories, the community expects more from the ABC, especially from its science program. No doubt the credibility of both the ABC and Catalyst led to the high ratings and high impact of the cholesterol programs – people thought it was true. Yet these two programs would have to rate as the most irresponsible and dangerous piece of health journalism ever aired in Australia. Has any other single act of journalism ever put the health and lives of so many people at risk?

What is unclear, however, is why these programs ever saw the light of day? Who pitched the idea to Catalyst? Why would any producer of a reputable science program take it on? Why was the program’s research so bad and so one-sided? Who chose the dodgy ‘experts’ to mount the non-science argument? Why didn’t the ABC’s internal systems start flashing red lights before the program went to air?

The offending Catalyst programs have been removed from the internet so no more damage can be done. How the producer of the cholesterol programs managed to keep her job at Catalyst is a mystery? Wasn’t the casualty rate high enough?

In the meantime the next chapter in the cholesterol story is about to unfold. I’ll cover it in my next post.

That’s an interesting claim but is it true?

Actually, it’s a strange measure to have chosen as it is almost impossible to verify. Most countries in the world simply don’t have good dietary data on teenagers, or adults for that matter. Let’s look at the available data and consider whether the claim is close to being right.

Any global average for sugar intake will be greatly influenced by typical intakes in populous countries such as China, India and Indonesia. Yet sugar intakes in these countries are very low – of the order of 20 grams per day or less, which equates to a miserly 4 teaspoons of sugar per day.

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Added sugars or total sugars?

The figure used in That Sugar Film may have been referring to total sugars i.e. the naturally occurring sugars in fruit and milk plus ‘added sugars’. I’m not sure why anyone would be concerned about naturally occurring sugars but let’s push on.

Intakes of total sugar in China, India and Indonesia would be more than twice that of added sugar, maybe 10-12 teaspoons a day. If we assume that teenagers in these countries consume more sugar than everyone else their intake could be about 12-16 teaspoons a day. That’s still a long way from 40.

American sweet-tooths

One populous country stands out from the rest when it comes to sugar intakes – the United States, which fortunately has good dietary data. Sugar intake in the US appears to have peaked in the early 2000s and has been falling since, largely driven by falling intakes of sugary soft drinks.

Currently, adolescents in the US consume about 18 teaspoons of added sugar each day or about 28 teaspoons of total sugars. The makers of That Sugar Film chose to use a level teaspoon (4.2g) as their chosen measure rather than the usual 5g teaspoon, which inflates the intake up to about 33 teaspoons a day – still well short of 40.

So the figure for sugar consumption chosen for That Sugar Film was nothing like ‘just slightly more than the average teenager worldwide’.

Sugar intakes of Australian teenagers

For the record, the average Australian aged 14-18 years consumes about 24 teaspoons of sugar a day, about half of which occurs naturally in fruit and milk.

Had the makers of That Sugar Film consulted with someone who actually knew what they were talking about they would have avoided misleading their audience. Then again, perhaps that was the idea.

Views on the health impact of sugar and carbohydrates more generally differ quite widely and there is plenty of room for debate, but it needs to be informed debate. Wild overstatements don’t help and diminish the credibility of those who make them.

What’s wrong with food processing?

There are three major criticisms of food processing and how it affects the nutritional quality of foods. The first is that processing lowers the nutrient content of a food either by exposing it to heat or by discarding a nutrient-rich portion. Secondly, during processing so-called ‘nutrients of concern’, such as saturated fat, salt and sugar, may be added. A third criticism is that processing may alter the nature of a food unfavourably, for example, by increasing its glycaemic index.

All of these things are true, so processed foods are obviously worse for health than unprocessed foods. Right?

Not so fast.

What’s right with food processing?

If you buy a piece of lean rump steak from your local butcher, do you eat it in its natural raw form or do you toss it into a hot frying pan first? Yes, this heat processing causes some loss of nutrients but we do it because cooked meat tastes so much better than raw meat. Also, cooked meat is much safer to eat than uncooked meat.

The same issues apply when food is processed by a food manufacturer. Safety is the paramount concern and strict regulations must be adhered to. Modern processed foods are so safe that any breakdown in food safety standards usually makes front page news.

Taste versus ‘nutrients of concern’

Taste is one of key things determining whether people buy this food or that. Yet making, say, grain foods taste good inevitably involves adding some ‘nutrients of concern’. Even staple grain foods like bread have added salt, which makes the difference between a palatable product and one that very few people would buy.

Adding fewer ‘nutrients of concern’ to a food may make good sense from a nutritional point of view but if nobody buys the less palatable product the nutritional benefits are never realised.

Processed food is better than no food at all

Some natural products actually require processing to turn them into food for humans. Wheat in its raw, natural state is indigestible and passes straight through the body. But processing wheat turns it into food that feeds millions of people. The same goes for canola seeds. Canola oil certainly has fewer nutrients than the seed from which it came, but some food is better than no food. And besides, the meal from the canola seed isn’t wasted – it’s fed to animals which in turn nourish us.

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Inconsistency

Processed foods are often damned and praised selectively. Take processed milk for example: sweetening milk with sugar to make chocolate milk is generally frowned upon, yet processing milk into cheese is considered okay, despite the higher saturated fat and salt content of cheese. How come? Is it that we like the IDEA of cheese making – a process with a farmhouse tradition, and we don’t like the IDEA of making chocolate milk in a modern factory? Sounds more philosophical that scientific.

In the media we often hear that margarine is more processed than butter and therefore is a less healthy choice. Why? Isn’t the margarine richer in essential nutrients? Doesn’t margarine lower blood cholesterol relative to butter? What has processing got to do with it?

If processing fats is a concern, why aren’t we concerned about how cows process fats? Cows eat lots of essential polyunsaturated fats in grass and grain but then convert most of them to saturated and trans fats – bad fats – which end up in the milk and meat. But the adverse effects of this bovine processing seem to pass without comment.

The logic seems to be that if a cow processes fat, that’s a good thing, even if the outcome is bad. But if humans process fat, that’s a bad thing, even if the outcome is good.

Objective criteria required

Whether a food is processed or not is simply a very poor way of determining whether it’s a healthy choice. More objective criteria that are actually relevant to human health are required, such as whether a food is nutrient-rich or nutrient poor, low or high in fibre, low or high in glycaemic index, low or high in saturated and trans fats, and so on.

The trouble is, when you take this objective approach many processed foods actually appear to be healthy choices.

The changing science

The science relating to how much of what we should eat for good health has certainly evolved in recent decades, but it’s not a simple story.

• In the early 1980s, most health authorities recommended that saturated fat in the diet should be limited to lower heart disease risk.

• At that time trans fats were thought to be neutral but by the 1990s they were considered be as bad as saturated fats. And by the 2000s trans fats were thought to be worse than saturated fat.

• Three decades ago carbohydrate was thought to be the ideal replacement for saturated fat, which led to widespread support for low fat diets. But by the late 2000s scientific support for low fat diets had dropped away.

• Although the early science indicated that unsaturated fats may be the best option to replace saturated fat in the diet somehow they were less preferred to carbohydrate. Their time has now come.

The Willett Model

Harvard nutrition guru Professor Walter Willett has developed a simple model for explaining the current state of the science. His model puts saturated fat at the centre of our attention and then shows how heart disease risk is affected when other nutrients replace it in the diet.

Key points to note are:

If trans fats replace saturated fats in the diet, heart disease risk goes up. So trans fats should be minimised in the diet, which has been successfully achieved in Australia.

If unsaturated fats replace saturated fat, heart disease risk goes down. The resulting Mediterranean-type diet is moderate in total fat but enriched in unsaturated fats. This is now the preferred foundation for a heart-healthy diet.

Which brings us to the third point: there is no advantage in replacing saturated fat with carbohydrate, or vice versa. Heart disease risk is unchanged. The big lesson for nutritionists from this was to stop advocating low fat diets for heart disease prevention. The other lesson – for the general public in particular – is to ignore all the rhubarb from low carbohydrate advocates who argue that we should all eat more saturated fat, in general, and more coconut oil in particular. It has no basis in science.

Dubious motives

The motives of the saturated fat enthusiasts are particularly dubious. Not content with pushing the myth that saturated fat is better for health than carbohydrates they further muddy the waters by demonising ‘seed oils’, which is code for unsaturated fats. So we are asked to believe that carbohydrate and unsaturated fats are both evil and therefore the only safe thing for us to eat is saturated fat. Claptrap of the highest order.

Needless to say, all of the world’s leading nutrition authorities do not support these arguments.

If your suspicions were not already fully aroused, ask yourself why these dietary myths are pushed by non-nutritionists via social media. Hmmm, you don’t think it could be a thinly-veiled marketing campaign for coconut oil, do you?

Yikes! Why are our so-called health authorities putting this dreadful toxin in our drinking water?

Fluoridation: the pollution of our precious bodily fluids

An enlightened few have known about the dangers of water fluoridation for decades and have tried to warn us. In Stanley Kubrick’s 1964 film, Dr Strangelove, there is a telling scene in which General Jack D. Ripper, played by Sterling Hayden, ignores a hail of bullets from his own troops and asks a cowering colleague whether he has ever heard about water fluoridation.

Ripper then explains that “… fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face … I can no longer sit back and allow Communist infiltration, Communist indoctrination, Communist subversion and the international Communist conspiracy to sap and impurify all of our precious bodily fluids”.

Of course, General Ripper has totally lost it. Prior to the fluoridation scene he ordered the 34 B52 bombers under his command to make an unprovoked nuclear strike on Russia.

Early anti-fluoridation campaigner General Jack D. Ripper (source)

The crazification factor

Why does anyone listen to the modern day General Rippers and their bizarre claims about fluoridation? Dentist and public health epidemiologist Michael Foley puts it down to the crazification factor i.e. ‘the percentage of the population with a tenuous grasp on rational thought and an eagerness to embrace the conspiracy theory de jour’. Although willing to accept many conspiracy theories as harmless nonsense, Foley draws the line at those things that have the potential to adversely affect public health.

The NHMRC position on fluoridation

And public health is what fluoridation is all about. The National Health and Medical Research Council states that ‘… water fluoridation is the adjustment of the natural fluoride concentration in fluoride-deficient water to that recommended for optimal dental health.

Most of the world’s water naturally contains between 0.2 -10 mg/litre of fluoride, Australian water supplies being at the lower end of the scale i.e. fluoride-deficient. The fluoridation levels in Australian states vary between 0.6 and 1.0 mg/litre, the aim being to provide the Australian people with the Goldilocks level of fluoride – enough to prevent tooth decay but not enough to cause ‘fluorosis of aesthetic concern’ i.e. the mottling of the teeth that can occur at higher intakes of fluoride intake.

New review by NHMRC

The NHMRC is currently reviewing its policy on fluoridation but don’t expect any radical changes – the cool, calm world of science is a far cry from the hysteria on the internet. In a recent media release an NHMRC spokesman said “Based on the work already conducted in the review, NHMRC is expected to maintain its support for the fluoridation of water supplies.”

Better grab your gun! Our precious bodily fluids remain under threat!

The origins of the low fat diet

The low fat diet had its origins in 1980 with the publication of the first Dietary Guidelines for Americans. The recommendation to ‘Avoid too much fat, saturated fat and cholesterol’ was intended to lower blood cholesterol and reduce the risk for heart disease. Although the focus was really on lowering saturated fat, it was thought that lowering total fat intake may help prevent some cancers and obesity.

In Australia, the simpler guideline ‘Avoid eating too much fat’ was adopted to aid its communication.

Keys versus Yudkin

The low fat diet had a low key launch. Yet these humble origins are now being re-imagined as the disastrous consequences of a fight to the (professional) death of two of the great nutritionists their era – Ancel Keys and John Yudkin. As an epidemic of heart disease raged in the post-war years Yudkin pointed his finger at sugar. But Keys argued that the effect of different fats on blood cholesterol was the key mechanism affecting heart disease risk, and he won the day.

Yet Keys’ victory is now being portrayed as the fateful moment when nutrition science careered off course for four decades. Fortunately for humankind, ‘the truth’ that the problem was sugar all along has now been revealed by various journalists, lawyers, economists and B-list celebrities, all of whom seem to have made a packet in doing so.

Not content with challenging Ancel Keys’s views, the myth-makers have set out to destroy his reputation, arguing that he fudged his data – that Keys was a fraud. In contrast, Yudkin is now portrayed as a prophet, whereas he was discredited in his day.

The mythical fork in the road

Why the myth-makers need to construct this fanciful sugar or fat fork in the road is a mystery. After all, both the Australian and the American dietary guidelines published in the early 1980s discussed fat and sugar. The relevant sugar guideline in Australia was ‘Avoid eating too much sugar’ and the American guideline simply said ‘Avoid too much sugar’. And the advice to limit sugar intake has stayed in place ever since.

In contrast, as new scientific evidence about fat became available the cancer link was dismissed and recommendations steadily evolved to have more focus on fat type and less on lowering total fat. All the recent research is ignored by the myth-makers.

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Mistakes were made

Certainly, mistakes were made by some of our health authorities. By the mid-90s the ‘eat less fat’ message should have been disappearing into history. However, it was given a new lease of life when obesity experts latched onto it, based on insufficient evidence which soon fell away.

According to the myth-makers, this wasn’t a policy failure. No, it was the work of the sugar barons conspiring with their operatives in academia to prop up the low fat diet to further their commercial interests!

Fraud? Conspiracy?

Alternatively, maybe nutrition experts have just been gradually refining their dietary recommendations as new scientific evidence becomes available.

Fat in your liver

Most of the carbohydrate we eat ends up in the bloodstream as either glucose or fructose. The myth goes that glucose is the good sugar as it is used to power the brain, the muscles and most of the cells in the body. And the fructose is the bad sugar which is quickly taken up by the liver and turned into fat, giving rise to fatty liver.

Unfortunately for the myth-makers, no reputable health authority in the world agrees. Fatty liver is certainly a common problem but the experts see it as part of the metabolic syndrome – a cluster of abnormalities linked to central obesity and insulin resistance, where the cells of the body become less sensitive to insulin.

There is no recommended diet for fatty liver. Instead, health authorities encourage people with fatty liver to lose some weight and increase their physical activity, both of which improve insulin resistance.

Fat in your blood

Our liver certainly has the ability to turn both glucose and fructose into fat – it’s the perfect way to turn any excess carbohydrate calories into a form that can be stored for later use. And sooner or later this fat appears in the blood as ‘triglycerides’.

However, the idea that all the fructose we eat turns to fat pushing up the level of triglycerides in the blood is just plain wrong. If you are a healthy, normal weight person eating enough food to maintain your body weight your liver only turns a tiny fraction of fructose into fat, about 1-3%. Most of the fructose taken up by the liver is actually turned into glucose – supposedly the good sugar, so it’s much more accurate to say ‘fructose turns to glucose’ than it is to say ‘fructose turns to fat’.

It’s a different story if you overeat thereby forcing the body to turn excess sugars into fat. But the underlying problem here is not fructose; it’s overeating.

The best ways to lower the level of triglycerides in the blood are to lose some excess weight, increase physical activity and limit alcohol intake.

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Fat on your body

The silliest myth about fructose is that it is uniquely fattening. You would have thought that we would all have learned something from the fat-makes-you-fat fiasco, where the blame for the obesity epidemic was laid at the feet of just one nutrient – fat. This focussed everyone’s attention on the third of our calories that came from fat and allowed us to ignore the rest. And the nation got fatter.

Does it make any sense to target fructose, which typically provides just 10% of calories? Do the other 90% of calories not count?

None of the nutrients is uniquely fattening. People put on weight when they regularly eat more calories than their bodies need.

At first glance legumes appear to be rich sources of iron and zinc but their critics argue that this is misleading as the absorption of these nutrients is lessened by anti-nutrients, like phytic acid. Phytic acid in legumes binds to these minerals lowering their absorption from the gut. The iron and zinc in meat is more readily absorbed.

The other argument against legumes relates to protein. Compared to traditional ‘protein foods’ such as meat, poultry, fish and eggs, legumes generally have less protein and the protein is of lower quality. That is, some amino acids are in short supply.

So legumes are labelled as inferior foods, compared to red meat.

Legumes as ‘meat alternatives’

It comes as no surprise that these arguments come from fans of the Paleo diet. I suspect what really aggravates Paleo types is the description of legumes as ‘meat alternatives’ in some healthy eating guides. With meat at the centre of the Paleo world view any meat alternative is bound to be attacked.

Healthy eating guides need to cater for all sorts of people, including those who choose not to eat much meat for reasons of ethics or cost. For these people the choice of legumes as a source of protein is usually linked to moderate-to-high grain intake. The protein present in each nicely complements the other and together they provide adequate amounts of ‘complete’ protein. Many of the world’s poorer people rely on the legumes + grains combination to adequately feed themselves, a formula that has proven successful over centuries.

Of course, telling Paleo warriors that there might be benefits to eating both legumes and grains could be a step too far. After all, both foods contain the Paleo pariah – carbohydrate.

A better comparison

Comparing legumes with ‘protein foods’ is a bit misleading. After all, the major nutrient in legumes is not protein; it’s carbohydrate. And the nutritional qualities of legumes look very different when we compare them to other carbohydrate-rich foods. When Professor Noakes and I put legumes though our carbohydrate quality model they were one of the few groups of foods that fell into the highest quality category. The high rating was driven by the essential nutrients and dietary fibre in legumes and their low glycaemic index.

Even if you think that less carbohydrate is better, why would you target one of the best carbohydrate-rich foods? Why not eliminate the worst?

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Paleo confusion

Paleo advocates are confused. They recommend inclusion of seeds in the diet, but not legumes, which are seeds. They criticise legumes because of their phytic acid content, but then recommend nuts, which contain phytic acid. And they mindlessly bundle all carbohydrate-rich foods together and label them all as bad.

Advice to eliminate legumes from the diet reflects this confusion.

There is no substantial evidence that proves we need to consume grains to be healthy

I have to disagree with Mr Evans on this point – he seems unaware of grains’ contribution to thiamin intake and the importance of this essential B vitamin.

The healthy diets modelled for the latest Australian Dietary Guidelines contained plenty of thiamin, well above the Recommended Dietary Intake (RDI), but nearly two-thirds of it came from just one food group – grains. If grains were removed from the otherwise optimal diets the thiamin content would fall to well below the RDI. As no other food group is a major source of thiamin it is unlikely that replacement foods could correct the thiamin deficit. If the population adopted Mr Evans ‘no grains’ advice the likely consequence would be the emergence of the thiamin deficiency disease beri beri in vulnerable groups.

Those who strictly follow Mr Evans advice should be on the lookout for the early symptoms of beri beri which include tingling, burning or numbness in the fingers and toes, strange eye movements and vomiting. There may also be loss of appetite and severe constipation. As the heart failure starts to develop you can expect to experience shortness of breath and swelling in the lower part of the legs. In the final stages there will be mental confusion, problems with speech, difficulty walking, coma and death.

Alternatively, you could eat some wholegrain cereal at breakfast and have a sandwich for lunch and live a healthy life, just like normal people.

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Low fat milk and flavoured yoghurts are almost completely devoid of nutrients

Mr Evans’ claims about these dairy foods are just plain wrong. Here’s how milks and yoghurts performed when a colleague and I ran them through our carbohydrate quality model:

All of the milks and yoghurts appear to the right of the vertical centre line, indicating higher nutrient density. Rather than being ‘completely devoid of nutrients’ these foods contain considerable calcium, vitamin B12, riboflavin, vitamin A, potassium and zinc. And skim milk is one of the most nutrient-rich of all of them.

Vegetable oils are toxic and cause mutagenic and atherogenic changes in the body

Here Mr Evans is basically saying that commonly consumed oils such as canola, sunflower and soybean oil cause cancer and heart disease. If that were true the world’s leading nutrition and cancer authorities would recommend restriction of vegetable oils to prevent cancer. But none of them does – not the World Health Organisation, the World Cancer Research Fund, the Cancer Council or the National Health and Medical Research Council. Where does Mr Evans get his information?

In relation to vegetable oils and heart disease, Mr Evans is again in a minority of one. His recommendation to restrict unsaturated vegetable oils and instead to use saturated animal fats and coconut oil is the exact opposite of the advice provided by just about every nutrition and heart health authority in the world. It’s a recipe for increased heart disease risk.

Mr Evans’ claims are a threat to public health. He should be arrested.

Sugar, even from fruit juice, increases weight, accelerates ageing, is addictive and causes numerous mental and physical disorders

Mr Evans has obviously jumped on the anti-sugar bandwagon and is parroting the usual unsubstantiated claims so prevalent in social media. If you want to read some scientific evidence about sugar read the recent report on carbohydrates by the European Food Safety Authority. Scientists and zealots tend to look at sugar differently.

There will be plenty of new reports on carbohydrates and sugars in the next couple of years as authoritative organisations update their recommendations, but somehow I don’t think any of them will find that sugar causes ‘numerous mental disorders’.

Mind you, such disorders appear to be quite prevalent in people who avoid sugar altogether.

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The weight of scientific evidence proves that artificial sweeteners are unfit for human consumption

What scientific evidence is Mr Evans talking about? The latest scientific assessment of aspartame was conducted by the European Food Safety Authority just last year and gave it the green light.

Mr Evans obviously hasn’t got a clue about non-nutritive sweeteners and health, or food safety controls in general. Every developed country in the world has an authority responsible for food safety whose job it is to assess whether foods or additives are safe to eat. Anything found to be ‘unfit for human consumption’ or ‘toxic’ would be banned or restricted immediately.

I’m struggling with the logic too. If sugar is so bad for us, why attack a viable replacement for it?

Final comment

I don’t blame Pete Evans for what doing what he does. He is a successful entrepreneur who has no doubt found that dietary extremism is a path to notoriety and publicity. But why would the Murdoch press publish this article, thereby joining the recent race to the bottom in the reporting of food and health? In recent years the Fairfax media pushed David Gillespie’s non-science views at every opportunity and then last year the ABC’s Catalyst program weighed in with misleading programs about sugar, saturated fat and cholesterol.

And now it’s Murdoch. Just listen to the tosh from Stephen Brook, the Editor responsible for the Pete Evans article:

I admire fanatics. In fashion as well as food, they extend the limits of achievement, forcing us to reappraise that which we previously considered impossible.

Colleagues, we’re among savages.

In October last year ABC television’s science program Catalyst ran two controversial programs purporting to expose myths about diet, medication and cardiovascular disease. In the first program Catalyst presenter Dr Maryanne Demasi challenged the role of dietary saturated fat in affecting risk for coronary heart disease and in the second she questioned the efficacy of statin medication. Essentially, the Catalyst program argued that the world’s leading nutrition organisations and cardiovascular researchers had got it wrong over the last four decades.

Heart Foundation outraged

In an interview on the ABC radio program PM, Maryanne Demasi even stated that the Heart Foundation was ‘certainly supportive’ of the Catalyst program’s evidence. In fact, the Heart Foundation was livid, took offence and submitted a formal complaint. They weren’t alone – the ABC received a total of 146 complaints. To their credit, journalists within the ABC, such as health reporter Dr Norman Swan and Media Watch front man Paul Barry, challenged the accuracy of the programs and the standard of the journalism on display, respectively. For more of detail see my two posts on the Catalyst programs here and here.

Results of independent review

Yesterday, the results of a review of the Catalyst programs by the ABC’s Audience and Consumer Affairs Unit were made public and included findings that standards of impartiality had been breached. Here are some excerpts from the review:

It is clear from the reaction to the program that many members of the audience believed that in both episodes, one side of two highly contentious issues was unduly favoured …

In relation to the first program on saturated fat and heart disease:

In our judgement, the quality of the program would have been enhanced if it had more clearly communicated why the National Heart Foundation hold their views. Little substantive evidence was presented to support their perspective and the strength of the evidence that was referred to was doubted in the narration and directly challenged – and often emphatically rejected – by other contributors. Although the program did not explicitly endorse the unorthodox view, the language used by the reporter tended to add weight to the contrarian argument.

In relation to the second program on statins:

Furthermore, by omitting a principal relevant view – held by the National Heart Foundation and other experts – that statins are useful in primary prevention if carefully targeted, the program had the effect of unduly favouring the perspective that statins are ineffective in primary prevention.

In relation to Maryanne Demasi’s statement on the PM program that the Heart Foundation had signed off on the Catalyst program’s evidence:

While the comment was made in a live radio interview, it was nonetheless a misleading oversimplification which failed to acknowledge the clear and important areas of disagreement between the National Heart Foundation and the overall proposition being presented in the programs.

In summing up:

For Catalyst, the core problem identified in this investigation was omission of important information.

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Corrective action undertaken

Yesterday, ABC Managing Director Mark Scott announced that corrective action had been taken:

• The two Catalyst programs had been removed from the program’s website
• The PM program had added an Editor’s Note to the transcript of its story ‘Backlash against ABC’s Catalyst program questioning heart disease-cholesterol links’
• An appropriate entry had been made on the ABC Corrections page.

The Heart Foundation provided a polite response.

Unanswered questions

I guess the moral of this story is that when you see some misleading information about nutrition and health in the media, do what the Heart Foundation and others did – complain!

But there are still unanswered questions about these Catalyst programs. When the program about saturated fat went to air I thought it was so biased that I was convinced that a commercial interest must be involved, and suggested that it might be the palm oil industry. However, I have since had assurances that this industry was not behind it.

If it wasn’t commercially driven, the whole thing doesn’t make sense. How did a hitherto reputable science journalist, Maryanne Demasi, come up with a bizarre list of poorly qualified ‘experts’ in the United States to be interviewed for the Catalyst programs? And why would a journalist with a PhD accept recommendations about ‘experts’ who had virtually no scientific publications in the relevant field? Wouldn’t that be the first thing to check?

Who pitched this story to Catalyst?

And then there is the issue of cost. Why would the cash-strapped ABC agree to pay to fly Maryanne Demasi all the way to the United States to interview these ‘experts’? How could any responsible manager sign off on such expense?

The whole thing just doesn’t add up.