Letters to the Lancet, the Editor's tweets and more

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Read on for our letter to  the Lancet Series on Maternal and Child Nutrition about the fact that two of the authors are members of Nestlé's Creating Shared Value Committee.  Such roles  could, depending on the circumstance, result in exclusion from European Food Safety Authority Working Groups.

Richard Horton@richardhorton1 the Editor of the Lancet has since Tweeted the following questions:

Can anyone out there give me evidence about Nestlé's negative influences in health? Opinions are strong, and that's fine, but I need facts. 

then later:  What about Danone: are they the acceptable face of commercial influence in health? Or not? I just don't know

The power of big food: a few corporate conglomerates shape the way you live your life. How do we resist?  

Follow the Twitter correspondence  including  from Prof Anthony Costello:

"Maybe one way to resist big food is not to have members of Nestle's advisory board directing the Lancet Nutrition Series"  - and "Former head UNICEF nutrition asks why Lancet lead authors on nutrition series served on Nestlé Advisory Committe"

Our responses suggesting that he look at hard, on the ground evidence about Nestle or Danone - rather than what they say - have not been acknowledged. The suggestion from Gary Darmstadt of the Gates Foundation to look at FTSE4Good and ATNI (the two industry whitewashes ) was warmly welcomed.  Interesting. 

CLICK HERE  or HERE  for our Letter on Conflicts of Interest

The Lancet, Volume 382, Issue 9904, Page 1550, 9 November 2013 

CLICK HERE  for a letter questioning the recommendations HERE

CLICK HERE for the authors' reply


CLICK HERE for an interesting Reuters piece about formula promotion in China  http://www.reuters.com/article/2013/11/08/us-china-milkpowder-specialreport-idUSBRE9A700820131108


Here's the Text of our letter to the Lancet

Arun Gupta a, Urban Jonsson c, Patti Rundall b

Is it enough to declare conflicts of interest? In The Lancet Series on maternal and child nutrition, two authors declared conflicts of interest as members of the board of the Nestlé Creating Shared Value Advisory Committee—a company that repeatedly transgresses the International Code of Marketing of Breastmilk Substitutes.1 We wonder how the Lancet's policy on conflicts of interest was applied. We believe that other declarations should have been made. For example, the Global Alliance for Improved Nutrition (GAIN)—an adviser on the Series—lobbies governments and the UN to open up markets for its many corporate partners. In India, such concerns led to public debate that might jeopardise the acceptability of many of the recommendations made in the Series.2

In the fourth paper of the Series, the table 3 suggests that the private sector generate “evidence about the positive and negative effects of private sector and market-led approaches to nutrition.” Is this the best way to generate the independent evidence that governments need to make wise decisions?

The World Health Assembly is calling for clear conflict of interest rules that prevent private commercial entities having undue influence over policy making.4 The Supreme Court of India recently ruled that members of scientific panels must be independent and without conflicts of interest.5

In the interest of translating evidence into policy and maintaining the credibility of science, we call on The Lancet to revisit and possibly strengthen its conflicts of interest policy and ensure that it is followed.

AG works for Breastfeeding Promotion Network of India and is the convener of Alliance Against Conflict of Interest, India. PR works for Baby Milk Action, an International Baby Food Action Network group in the UK. UJ declares that he has no conflicts of interest.

For references follow the link above


Text of JP Dadhich letter: Jai Prakash Dadhich a, Mohammad Moonis Akbar Faridi b


The Lancet Series on maternal and child nutrition presents interventions for maternal and child nutrition, but is evidence synthesis adequate? Zulfiqar Bhutta and colleagues1 make a few assertions that need to be clarified.


 Although the use of multiple micronutrient supplements (MMS) during pregnancy is still a topic for debate, Bhutta and colleagues1 have included it in the packages of nutrition interventions for cost-evaluations, ignoring the conclusions of the Cochrane review2 asking for more evidence to guide a universal policy change while recommending replacement of iron-folate supplement with MMS.


 Similarly, although the evidence in favour of ready-to-use therapeutic food in comparison with the standard care in the community-based management of severe acute malnutrition is weak in terms of reducing mortality, severe acute malnutrition management (which includes ready-to-use therapeutic food) is presented number one of the top ten interventions to reduce child mortality. 


 The authors also recommended folic acid supplementation for women of reproductive age with universal fortification of cereals and other foods; however an increase in the risk of colorectal cancer has been reported with increased folate intake during the early post-fortification period,3 and also a risk of delay in the diagnosis of vitamin B-12 deficiency with excess folate intake.4


 Most of the interventions identified for modelling were based on products, and it is not clear why the modelling was not done for nutrition-sensitive interventions and interventions for disease prevention and management, especially when some of these were described as effective by the authors themselves.


Some of the tweets:

Gary L Darmstadt  @gdarmsta

 Danone had mothers report on breastfeeding practices, then informed them that breastmilk quantity inadequate!










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