The British Journal of Sports Medicine has “temporarily removed” an editorial arguing that physical activity alone will not cure the obesity epidemic, following an expression of concern.

In its place stands the following message:

This paper has been temporarily removed following an expression of concern.

First author Assem Malhotra, based at the Department of Cardiology, Frimley Park Hospital and Consultant Clinical Associate to the Academy of Medical Royal Colleges, told us the paper was pulled due to a “technical issue,” and an “official explanation” would be forthcoming.

Indeed, just this morning, we received a statement from Fiona Godlee, editor of the British Medical Journal, which publishes the British Journal of Sports Medicine:

The article was taken down temporarily, mainly to address concerns about some undeclared conflicts of interest. It will be reposted shortly.

Second author Timothy Noakes believes he has the explanation. He told us the article may have been pulled because he didn’t declare a potential conflict of interest related to his popular books about health:

It seems that it was largely my fault as I failed to declare a conflict of interest from the books that I write relating to exercise or nutrition or both. Since all the royalties from all those books are donated to two Trusts that I run to support research (as now fully declared in my COI statement) I did not consider it a conflict of interest. In 40 years of research I have never declared my books as a COI and I am not aware of many other authors who routinely declare books as COI.

Noakes, based at the University of Cape Town and Sports Science Institute of South Africa, even passed along a COI form he recently completed for the journal, declaring this potential conflict.

What’s puzzling, however, is that the journal appeared to pull the editorial from its website (although you can read in full here), and has not released the “expression of concern” referenced in the note (at least, not any EoC we can find). Does a missing potential COI warrant removing the article entirely before it can be added?

The strongly worded editorial received a good deal of press coverage when it was published last month. The authors argue that many people are being given the false message that exercise alone will help them lose weight, when bad diet is the main culprit:

…members of the public are drowned by an unhelpful message about maintaining a ‘healthy weight’ through calorie counting, and many still wrongly believe that obesity is entirely due to lack of exercise. This false perception is rooted in the Food Industry’s Public Relations machinery, which uses tactics chillingly similar to those of big tobacco… It is time to wind back the harms caused by the junk food industry’s Public Relations machinery. Let us bust the myth of physical inactivity and obesity. You cannot outrun a bad diet.

At the bottom of “It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet,” the authors note:

Competing interests None declared.

Update, 5 p.m. Eastern, 5/7/15: The journal has replaced the paper and issued a statement on the removal:

This article was first published online on 29 April 2015. It was temporarily removed on May 1 to include competing interests that had not been divulged by Stephen Phinney and Tim Noakes at the time of submission.Stephen Phinney is a paid member of the Atkins Scientific Advisory Board and has authored books on low carb/high fat diets.Tim Noakes has also written and co-authored books, the proceeds of which are donated to charitable trusts for the purposes of research. BMJ, the publisher of the British Journal of Sports Medicine (BJSM), stands by the content of the editorial. Professor Karim Khan, the journal’s editor, comments: “The editorial team subscribes to BMJ’s motto of ‘Asking questions, questioning answers’. It is clear from the international media uptake of Dr Malhotra’s editorial, and related content by him and others, that current dietary guidelines need questioning. “BJSM does not claim to have the answer to the question ‘What is the ideal diet for health?’ But we are ideally placed to contribute to the debate as BJSM does not receive funding from any of the key players who have declared interests. Healthy food choices are as central to sport and exercise medicine as knee ligament injuries.”He adds: “The BJSM editorial team has a responsibility to address readers’ concerns seriously and to take down material while undertaking due diligence. At no point did the BJSM editorial team question the legitimacy or the veracity of Dr Malhotra’s editorial.”We look forward to the amended version contributing to the important debate in the field, and to the improved health of those looking to make evidence-based choices.”

The “Footnotes” section of the paper now reads:

Correction notice This article has been amended from the original published on 29th April 2015. The body of the text was slightly edited and a reference removed. Competing interests have been added. Competing interests SP is a paid member of the Atkins Scientific Advisory Board and has authored books on low carb/high fat diets: New Atkins and You and The Art and Science of Low Carbohydrate Living; TN is the author of the books Lore of Running and Waterlogged and co-author of The Real Meal Revolution and Challenging Beliefs. All royalties from the sale of Real Meal Revolution are donated to the The Noakes Foundation of which he is the Chairman and which funds research of insulin resistance, diabetes and nutrition as directed by its Board of Directors. Money from the sale of other books is donated to the Tim and Marilyn Noakes Sports Science Research Trust which funds the salary of a senior researcher at the University of Cape Town, South Africa (research focuses on the study of skeletal muscle in African mammals with some overlap to the study of type 2 diabetes in carnivorous mammals and of the effects of (scavenged) sugar consumption on free-living (wild) baboons). Provenance and peer review Not commissioned; internally peer reviewed.

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