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I’m in Mexico City doing talks for El Poder del Consumidor, the advocacy group in part responsible for Mexico’s soda tax.  I had some time to be a tourist yesterday afternoon and got to see the Diego Rivera murals at the Palacio Nacional.

These are enormous, and stunning.  They deal with the history of Mexico in conflict and in peace.  Look closely, and you see Rivera’s deep respect for Mexico’s traditional food culture.

Along the corridor flanking the main mural, for example, is a painting above a plaque listing what the world owes Mexico—corn, obviously—but also beans, tobacco (oops), chocolate, hemp, and tomatoes.

Other panels also deal with corn—in this one, production.

Another shows how corn is used.

The corner panel at the end of the corridor is devoted to chocolate.

Along the way, quieter panels display the harvest of fruits and vegetables.

Leave the Palacio, cross the Zócolo, and you come to the Coca-Cola bar and toy store.

A brief look at Mexico’s food culture, then and now.

When the New York Times published an article describing Coca-Cola’s financial sponsorship of university researchers who de-emphasize the role of sugary drinks in raising the risk of obesity and type 2 diabetes, it kicked up a storm.

USA Today’s editorial board said:

It isn’t that companies pay scientists to put out false research. It’s that companies fund the work of scientists who happen to be doing research that spurs consumers to look away from science that hurts corporate interests.

Soft drinks are far less dangerous than cigarettes, but GEBN’s website, tweets and videos come right out of Big Tobacco’s playbook, brought into the digital era. Its leaders have done research in the past under about $3 million in grants given to their universities.

USA Today also printed a response by a Coca-Cola spokesman:

A recent New York Times article created confusion about our support of research and non-profit organizations, stating we want people to think that only exercise matters and not diet — but nothing could be further from the truth. We have always operated under the fact that a healthy, balanced diet and regular exercise are key ingredients for a healthy lifestyle.

That said, we need to do a better job of being even more transparent about the research we fund, the non-profit organizations we support and the way we publicly share this information. And we will.

Yesterday, Senator Richard Blumenthal sent letters to the University of Colorado, West Virginia University, and the University of South Carolina urging them to  clarify the nature of the University’s relationship with projects funded by Coca-Cola and to review the academic integrity of such grant agreements.

I believe your university must determine whether this research is in effect promoting a predisposed and biased agenda, rather than reflecting the impartiality and objectively (sic) expected from a public academic institution.

Years of litigation with tobacco companies were necessary to fully expose the tragic public health consequences when companies lie about the hazards of the products they sell.  I am deeply concerned that we may force future generations to relive this history if corporate-sponsored studies devoid of scientific integrity are permitted once again to deceptively downplay and conceal the dangers of a product consumed on a mass scale.

Do not underestimate Senator Blumenthal’s ability to deal with food companies.  He, you may recall, was responsible for withdrawal in 2009 of the ill-conceived Smart Choices program during his stint as Connecticut’s attorney general.

I’m still waiting for the Global Calorie Balance Network to issue its promised statement.  Stay tuned.

I wrote this piece for The Guardian in response to the New York Times article earlier this week about Coca-Cola’s funding of scientists who think obesity is more about exercise than drinking sodas:

These days, you almost have to feel sorry for soda companies. Sales of sugar-sweetened and diet drinks have been falling for a decade in the United States, and a new Gallup Poll says 60% of Americans are trying to avoid drinking soda. In attempts to reverse these trends and deflect concerns about the health effects of sugary drinks, the soda industry invokes elements of the tobacco industry’s classic playbook: cast doubt on the science, discredit critics, invoke nanny statism and attribute obesity to personal irresponsibility.

Casting doubt on the science is especially important to soda makers. Overwhelming evidence links habitual consumption of sugary drinks to poor health. So many studies have identified sodas as key contributors to chronic health conditions – most notably obesity, type-2 diabetes and coronary artery disease – that the first thing anyone trying to stay healthy should do is to stop drinking them.

Soda companies know this. For at least the last 10 years, Coca-Cola’s annual reports to the US Securities and Exchange Commission have listed obesity and its health consequences as the single greatest threat to the company profits. The industry counters this threat with intensive marketing, lobbying and millions of dollars poured into fighting campaigns to tax or cap the size of sugary drinks.

But it is also pours millions into convincing researchers and health professionals to view sodas as benign.

Just last month, the Mayo Clinic Proceedings published a study arguing that the results of national dietary surveys, such as those that link sugary drinks to type-2 diabetes, are so flawed that they constitute a major misuse of public funds. The authors report honoraria, speaking and consulting fees from Coca-Cola.

This week’s revelation of Coca-Cola’s funding of the Global Energy Balance Network is only the latest example of this strategy in action. The Network promotes the idea that to prevent obesity you don’t need to bother about eating less or drinking less soda. You just have to be more active. Never mind that most people can’t lose weight without also reducing their intake.

A reporter who looked into this group discovered that Coca-Cola had funded the research of the scientists behind it, and generously. The network’s website was registered to Coca-Cola. None of this, however, had been made explicit.

Most nutrition professional journals now require researchers to declare who funds their studies, making it possible to compare study outcomes with funding sources. Studies sponsored by Coca-Cola almost invariably report no association of sugary drinks with diabetes, they question the validity of studies that do find such associations or, as in the case of Global Energy Balance Network investigators, they find activity to be the most important determinant of body weight.

Analyses of studies funded by Coca-Cola or its trade association demonstrate that they have an 83% probability of producing results suggesting no harm from soda consumption. In contrast, the same percentage of studies funded by government agencies or independent foundations find clear linkages between sugary beverages and such conditions. Coincidence? I don’t think so.

Since March, I’ve been posting industry-funded studies with results that favor the sponsor’s interests every time I find five of them. They are easy to find. Despite pleas to readers to send me industry-funded studies that do not favor the sponsor, I hardly ever get them. Whenever I come across a study that shows no harm from sodas, I immediately look to see who paid for it.

Soda companies spend generously to convince researchers and health professionals not to worry about sodas’ health effects. But why do researchers take the money? It is too simplistic to say that they are “bought.” Industry-funded investigators say they believe the funding has no effect on the design, conduct or interpretation of their research. But research involves choices of questions, assumptions and methods. It is not difficult to carry out a study that appears to meet high scientific standards yet fails to include critical controls that might lead to alternative conclusions.

Researchers funded by Coca-Cola need to take special care to control for unconscious biases but can only do this if they recognize the possibility. Many do not. Neither do many peer reviewers or editors of scientific journals. Although food-company financial support should not necessarily bias results, it appears to do so in practice.

Industry-funded scientists resent questioning of the influence of sponsorship on the quality of their science. They charge that investigators who find adverse effects of sodas on health are equally biased by career goals, righteous zeal or anti-corporate morality. Yes, independent scientists may have biases of their own, but their overarching research goal is to improve public health. In contrast, the goal of soda companies is to use research as a marketing tool.

Disclosure is essential. If a study is funded by Coca-Cola, caveat emptor.

I’ve had a busy week dealing with the aftermath of Anahad O’Connor’s New York Times story about how Coca-Cola pays scientists who argue that obesity is more about activity than what you eat—drinking sodas, for example (I’m quoted).   It’s gotten 1180 comments.

Here’s Dan Wasserman’s from the Boston Globe:

In all fairness, let’s see what Coca-Cola’s Chief Technical Officer, Dr. Ed Hays, says in response (straight out of the tobacco industry’s playbook):

I was dismayed to read the recent New York Times’ inaccurate portrayal of our company and our support of the Global Energy Balance Network (GEBN). The story claimed Coke is funding scientific research to convince people that diets don’t matter – only exercise. In fact, that is the complete opposite of our approach to business and well-being and nothing could be further from the truth.

Yes, we fund scientific research through GEBN and we are proud to support the work that scientists such as Dr. Jim Hill and Dr. Steve Blair do – because their type of research is critical to finding solutions to the global obesity crisis.

At Coke, we believe that a balanced diet and regular exercise are two key ingredients for a healthy lifestyle and that is reflected in both our long-term and short-term business actions.

The article even got the attention of Congress.  Here’s the statement from Rosa de Lauro (Dem-CT), sponsor of The SWEET Act to tax sugars:

This research is reminiscent of the research conducted by the tobacco companies to mislead the public about the health risks of smoking.  The American public will not be fooled. There is a wealth of sound scientific research that demonstrates the link between sugar-sweetened beverage consumption and a host of health conditions, including diabetes, heart disease, and obesity.  This new group and their research are a sham,” DeLauro said.  “People want to be healthy and they want their kids to be healthy and realize that drinks full of empty calories are not good for them. That is why more and more Americans are opting to drink less soda every year.

I wrote a piece for The Guardian, which I will post tomorrow.

I don’t keep track of my interviews or media appearances unless people send me links (I post them under Media), but Rachel Harrison at NYU kept score yesterday.  As I said, a busy couple of days.

• Fortune
• RT
• USA Today
• US News & World Report
• NPR
• Washington Post Wonkblog
• Washington Post Health Section
• CBS Atlanta
• CBC
• PLoS Blog
• Take Part
• Huffington Post
• Latina
• Business Insider
• Journal of Public Heath Policy 

Additions, August 14

Fox News, August 11

• Shepard Smith says “the story “reminds you of exactly what the tobacco industry did back in day, and more recently, it also reminds you of what the climate deniers — the climate change deniers — are doing as well.”
• Rush Limbaugh said the Times‘ Coca-Cola story “undermine[s] the whole notion of a scientific consensus,” because it “can be bought and paid for.”

New York Times editorial, August 14

the evidence continues to mount that sugar-sweetened drinks are a major contributor to obesity, heart disease and diabetes, and that exercise makes only a modest contribution to weight loss compared to ingesting fewer calories.

The Trans-Pacific Partnership (TPP) negotiations are taking place this week in Maui, as usual, in deep secret.

Doug Palmer of Pro Politico describes the major food issues: dairy, origin names, pork, rice, and sugar.  The issues come down to market share.  Every country wants to protect its own products but have free access to markets in other countries.

Although not a food, tobacco best explains why the TPP makes people nervous.  US tobacco companies want the TPP to open new markets.  But one of the TPP provisions is said to allow corporations sue governments that pass rules that might hurt the corporation’s business.  Philip Morris sued Australia over its “plain packaging” law and is now suing Great Britain.

The US position is supposedly that a country’s measures  to protect the health of humans, animals, or plants should not be in violation of the TPP, and that challenges to tobacco-control measures should be cleared with TPP partners.   Malaysia, for example, has proposed to exempt tobacco-control measures from challenges under TPP.

Malaysia?

The State Department has just taken Malaysia off its list of the worst countries for human trafficking (see the July 2015 Trafficking in Persons Report).

What a coincidence.  This allows Malaysia to participate in TPP negotiations.

But what bad timing.  The Wall Street Journal has just published a harrowing story about the de facto slavery of palm-oil workers on Malaysian plantations (the New York Times just did one on “sea slaves” forced to fish for pet food or animal feed).

As Rainforest Action Network said of the Malaysia story in a press release:

July 27, 2015 (SAN FRANCISCO) – The Obama administration has removed Malaysia from the list of worst offenders for human trafficking and forced labor today, one day after The Wall Street Journal published an extensive report on human trafficking and forced labor on Malaysian palm oil plantations that directly supply major U.S. companies. Malaysia is one of 12 nations in the contentious Trans-Pacific Partnership trade deal, and inclusion of a country with the lowest ranking in the State Department’s Trafficking in Persons Report would be problematic for the administration.

And then, there’s the trans-fat connection:  The US demand for replacement of partially hydrogenated vegetable oils has pushed Malaysia and other palm-oil countries to produce more palm oil, faster.

The Wall Street Journal explains:

Palm oil has been repeatedly named on the U.S. Department of Labor’s list of industries that involve forced and child labor, most recently in 2014. Activists have blamed palm-oil plantations in Indonesia and Malaysia for large-scale deforestation and human-rights abuses. Oil palm growers respond that the palm tree, a high-yield crop, is a useful tool for socioeconomic development.

The TPP is hard to understand, not least because negotiations are secret.  In giving the President the go-ahead to sign the agreement, Congress made two stipulations:

• Congress must be notified 90 days in advance of signing.
• The terms of the agreement must be disclosed to the public 60 days prior to signing.

At least that.  TPP deserves very close scrutiny.

As noted in an earlier post, I was offline from from June 13-20 on a visit to Cuba with a Food First group visiting small organic farms, rural and urban.

This was my third trip to Cuba.  I came with other groups in 1990 and 1992 at the beginning of what Cubans refer to as the “Special Period,” the economic disaster caused by the collapse of the Soviet Union, the end of its support for the 1959 Castro revolution, and the U.S. embargo on trade with Cuba.

The embargo also required countries that trade with the U.S. to stop trading with Cuba.  For tourists like me, the lingering effects of the embargo are the travel restrictions, the failure of U.S. cell phones to work, and the scarce and slow Internet access.  Hence: Offline.

But change is imminent.  I heard many Cubans mention December 17, the day of President Obama’s 2014 announcement of resumption of relations with Cuba, as if it ought to be celebrated as a national holiday.

Our group traveled by charter flight from Miami.  My first surprise: We were not alone: The Miami airport devotes two entire concourses exclusively to Cuban charter flights.  As many as 20 flights every day are packed with people who have families in Cuba, business people, and tourists of one kind or another.

Our group was interested in Cuban agriculture and food systems.  This post deals with rural agricultural production.  In subsequent posts, I’ll talk about urban farming and what the Cuban food scene looks like.

The USDA provides useful background information and statistics on Cuban agriculture.

• USDA report on Cuban agriculture, 2008
• U.S.-Cuba Agricultural Trade: Past, Present and Possible Future, 2015

The 2015 report has this interesting tidbit: US agricultural exports to Cuba rose from $139.2 million in 1956-58 to $365.3 million in 2012-14.

This, however, does not break the embargo; it is classified as sales, not trade.  The Cubans buy agricultural products from us, mostly frozen chicken for people, and soybeans and soybean meal for animal feed.

We did not see much agriculture on this trip.  There is plenty of land, but gas, transportation, and tractors are extremely limited.  The highway between Havana and Pinar del Rio is well maintained but we saw few cars on it.  Horse-drawn carts, yes; cars and trucks, no.  And lots of land not in production.

The reasons for this go beyond the embargo.  We heard repeatedly that Cubans don’t like doing agricultural labor: the population is highly educated, is 80% urban, the climate is hot and humid, and Cuban culture does not value that kind of work.

Much of Cuban food is imported.  How much?  Estimates range from 35% to 85% depending on whether whoever is doing the estimating is for or against the Cuban revolution.

An official of the agriculture ministry told us that Cuba is self-sufficient or nearly so in eggs, mangos, sugar, and tobacco.  I took this photo of mangos grown on the remarkable farm in Pinar del Rio established as a model for sustainability by Fernando Funes-Monzote.

At present, food is grown in Cuba on large farms owned by the state or held by family-owned cooperatives of one kind or another, or on smaller farms that are owned by private individuals or families.  Only 70% or so of arable land is in production.  The state still has a million hectares to distribute, but has a hard time getting anyone to farm it.

Most production is organic, but not by choice.  The embargo makes agricultural inputs unavailable or prohibitively expensive. See, for example, Modern Farmer’s photo-essay on Cuban farming.  Rice and potatoes, however, are not organically grown, and neither is most tobacco.   We heard from farmers in the exceptionally beautiful Viñales region that tobacco is beginning to be grown organically.

They are proud of their tobacco.  It is used for high-quality cigars and is a major cash crop.

The agricultural situation in Cuba, like much else about the country, is full of contradictions.

Tomorrow: urban farming.

I’ve been posting summaries of studies funded by food companies or trade groups, all of which come up with results that the sponsor can use for marketing purposes.

In each of these posts, I ask for examples of industry-funded studies that produce results contrary to the interests of the funder.

In response, I received this comment from Mickey Rubin, Vice President for Nutrition Research, National Dairy Council.

He gave me permission to reproduce his letter: 

Dear Marion,

By way of introduction, my name is Mickey Rubin and I am a scientist at the National Dairy Council. I understand that you know Greg Miller, and I asked him for your contact information so I could write to you directly after reading with great interest your most recent post on industry-funded nutrition research, in which you selected a sample of 5 studies/papers sponsored by industry all showing favorable outcomes. Although none of the papers you selected were sponsored by the organization I represent (although there is one dairy industry sponsored review paper in the list), what struck me is your focus on the favorable vs. unfavorable dichotomy, rather than the reality of what much nutrition science research results in: null findings.

It seems that there are fewer and fewer nutrition studies published that report the null, or find no effect. I agree with you that the reason we don’t see more of these studies in the literature has to do with bias, but I suspect that it is publication bias as much as any other bias. From my interactions with nutrition researchers, I gather it is quite difficult and sometimes impossible to get a study with no significant effects published regardless of funding source, to say nothing of allegiance bias by some researchers hesitant to publish findings that may go against their own hypotheses. Dr. Dennis Bier of Baylor College of Medicine and editor in chief of the American Journal of Clinical Nutrition has presented eloquently on this issue previously. You may also be aware of David Allison’s papers on other types of bias. So I think it is important to discuss all types of bias, and not just industry bias. You of course wouldn’t want your discussion on bias to be biased to just one type.

At National Dairy Council we have an extensive program of nutrition research that we sponsor at universities both nationally and internationally. While I can’t speak for all of industry, we strongly encourage the investigators of all of our sponsored studies to publish the findings, no matter the results. Thus, we would expect our sponsored studies to have a similar “success” rate as those sponsored by the National Institutes of Health. In fact, that is exactly what one recent analysis – not sponsored by the dairy industry – found, reporting that there was no evidence that dairy industry funded projects were more likely to support an obesity prevention benefit from dairy consumption than studies sponsored by NIH.

We feel this transparency is not only critical to the credibility of the research we sponsor, but we also feel it is important that our research contributes to nutrition science knowledge as a whole. We hope that other scientists take the findings from studies we sponsor and build upon them, and if it is by using research dollars from other sources, even better! I’ll be the first to stand up and say that one favorable study on milk, as an example, does not close the books on the subject. We need many studies in many different labs sponsored by multiple agencies in order to produce a portfolio of knowledge. I suspect that is certainly an example of where you and I are in agreement.

That all said, please allow me to provide some examples of studies the National Dairy Council has sponsored that are published and, rather than showing a clear benefit, do not refute the null hypothesis. These are all studies published within the last 4 years. It’s not meant to be comprehensive, but rather just a sample similar to what you provided. I could also provide you a list of studies we have sponsored that have shown favorable results for dairy, but you seem to have that covered, and I’ll instead wait until one of our sponsored studies appears in a subsequent blog post J.

Thanks for taking the time to read. I appreciate the dialogue.

Here’s his list of papers:

Studies with null finding:

Bendtsen et al. 2014: http://www.ncbi.nlm.nih.gov/pubmed/24168904

• No unique benefit of dairy protein over other proteins for weight maintenance

Maki et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23901280

• No effect of three servings of dairy on blood pressure

Chale et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23114462

• Whey protein supplementation offered no additional benefit over resistance training alone in older individuals

Lambourne et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23239680

• No change in body weight or composition in adolescents performing resistance training and supplemented with milk, juice, or control

Van Loan et al. 2011: http://www.ncbi.nlm.nih.gov/pubmed/21941636

• Recommended dairy servings offered no additional weight loss benefit over calorie restriction without dairy servings 

Studies with mixed findings (some outcomes changed, others null):

Maki et al. 2015: http://www.ncbi.nlm.nih.gov/pubmed/25733460

• The main finding from the study was that dairy intake had no effect on glucose control whereas sugar sweetened product consumption contributed to a worsening of glucose control in at-risk adults.

Dugan et al. 2014: http://www.ncbi.nlm.nih.gov/pubmed/24236646

• Waist circumference and BMI were lower in women after consuming the dairy diet as compared to the control diet. Fasting glucose was lower in men following the dairy diet as compared to the control diet. There were no differences in blood pressure, serum lipids, fasting insulin, or insulin resistance between the treatments.

Here’s what I wrote in response:

I am familiar with charges of bias against independently funded researchers (“White-hat Bias”), which equates industry biases with biases that result from career objectives and other goals.  I do not view the biases as equivalent.  Industry-sponsored research has only one purpose: to be used in marketing to sell products.   As I have said repeatedly, it is easy to design studies that produce desired answers.

When I was in graduate school in molecular biology, we were taught—no, had beaten into us—to do everything we could to control for biases introduced by wishful thinking.  I don’t see that level of critical thinking in most studies funded by food companies.

You may be correct about the influence of publication bias with respect to dairy studies, but how do you explain the situation with sugar-sweetened beverages?  Studies funded by government and foundations typically indicate strong correlations between habitual consumption of sugary beverages and metabolic problems, whereas studies funded by the soda industry most definitely do not.   The percentages are too high to be due to chance: 90% of independently funded studies show health effects of soda consumption whereas 90% of studies funded by soda companies do not.  This is troubling.

We’ve seen the results of studies funded by tobacco and drug companies.  Are food-industry studies different?  I don’t think so.   What seems clear is that industry-induced biases are not recognized by funding recipients, a problem in itself.

That’s why I’m posting these studies as they come in and begging for examples of industry-funded studies that do not favor the interests of the donor.

Thanks to Mickey Rubin for writing and for permission to reproduce his letter.

Let the discussion continue!