by Marion Nestle

Currently browsing posts about: Conflicts-of-interest

Jan 20 2016

Congratulations to the Academy of Nutrition and Dietetics’ for its new sponsorship policy

Several members of the Academy of Nutrition and Dietetics (AND–formerly the American Dietetic Association) sent me a letter from the Academy’s president, Evelyn Crayton, announcing its new policy on sponsorship.

AND’s previous policy, which encouraged sponsorship by food companies selling fast food, salty snacks, and sugary drinks, has been the subject of a critical investigative report and induced members of the Academy to create Dietitians for Professional Integrity to get the policy changed.

This advocacy worked.  It induced AND’s leadership to appoint a Sponsorship Advisory Task Force (SATF) to recommend a less conflicted policy to AND’s Board of Directors.

The SATF delivered its report to the Board on January 13.  As Evelyn Crayton explains,

The Board voted to implement a pilot program encompassing many of the SATF’s recommendations. The one-year pilot program includes appointing a Sponsorship Committee to review national-level sponsor opportunities and to develop assessment tools that will support the sponsorship process.

The Board of Directors approved the following newly revised sponsorship guidelines, which take effect immediately for all Academy organizational units. Dietetic Practice Groups and Member Interest Groups will be required to adhere to these guidelines and Affiliates are encouraged to adopt them.

Sponsorship approval requires that:

  • The sponsor’s vision and mission align with the Academy’s Vision, Mission and Strategic Goals.
  • The sponsor’s product portfolio is broadly aligned with the Academy’s Vision: Optimizing health through food and nutrition.
  • The sponsor relationship and sponsor product portfolio are broadly aligned with official Academy positions.
  • All aspects of the sponsorship (such as research, consumer messaging or professional education for members) align with the Academy’s Scientific Integrity Principles.
  • The Academy does not endorse any company, brand or company products, nor does the Academy’s name or logo appear on any product. Such endorsement is neither actual nor implied.
  • The Academy maintains final editorial control and approval of all content in materials bearing the Academy name or logo.
  • There is clear separation of Academy messages and content from brand information or promotion.
  • Relevant facts and important information are included.
  • The Board is confident that these revised guidelines and the new Sponsorship Committee pilot program will enable the Academy to better serve the organization and our members.

This looks impressive and deserves congratulations.  The policy calls for transparency, separation, and alignment—all laudable goals.

I have only two concerns:

  • What did the SATF report actually say?  How about making it available?  [If anyone has a copy and can send, please do.]
  • What is the definition of “alignment with the Academy’s goals and principles?”

As always, the devil is in the details.  As Andy Bellatti explains,

Some of these guidelines (i.e.: “the sponsor’s mission and vision align with AND’s”) already exist in the current policy — the same policy that considered PepsiCo (and former sponsors Coca-Cola, Kellogg’s, and General Mills) an appropriate sponsor.

The Academy’s Board can start the process by making the SATF report public (at least to members) and then explaining its process for setting the policy.*

It also needs to explain how “alignment” will be defined.  What are the actual criteria for deciding whether AND will accept food-industry sponsorship.

But this is a great first step and deserves much praise.

*Update: the Academy released the report.

Jan 14 2016

Five more industry-sponsored studies. The score 100:9

If you have been following this saga, you will know that since mid-March 2015 I’ve been collecting examples of published research supported wholly or in part by food companies.  As of today, the collection includes 95 studies with results favorable to the sponsor’s marketing interests as opposed to just 9 with unfavorable results.

Here are the most recent five.  These bring up general and specific questions that I’m pondering these days and I’ve indicated them in red.

The Effects of Water and Non-Nutritive Sweetened Beverages on Weight Loss and Weight Maintenance: A Randomized Clinical Trial.  John C. Peters, Jimikaye Beck, Michelle Cardel, Holly R. Wyatt, Gary D. Foster, Zhaoxing Pan, Alexis C. Wojtanowski, Stephanie S. Vander Veur, Sharon J. Herring, Carrie Brill, and James O. Hill. Obesity (2015) 00, 00–00. doi:10.1002/oby.21327.

  • Conclusions: Water and NNS [non-nutritive sweetened] beverages were not equivalent for weight loss and maintenance during a 1-year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program.
  • Funding agencies: The study was fully funded by The American Beverage Association. The American Beverage Association was not involved in the design, conduct, interpretation, or manuscript preparation of this study. Furthermore, a third-party organization (Biofortis-Provident) was hired at the PIs’ request. Biofortis-Provident audited data at both clinical sites to check for the accuracy and integrity of the data…Disclosure: J.C.P. and J.O.H. received consulting fees from The Coca-Cola Company outside of the submitted work.
  • Questions: Does recruiting a third party to audit data increase confidence in the credibility of this study?  Isn’t it more relevant to ask about how the research question is framed? 

Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes.  Constance Brown-Riggs.  Int. J. Environ. Res. Public Health 2016, 13(1), 28; doi:10.3390/ijerph13010028.

  • Conclusion: Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children.
  • Funding: This work was supported by The Dannon Company Inc. (White Plains, NY). The Dannon Company Inc. provided information for this article but did not have final approval for its content.
  • Conflicts of Interest: Nutrition advisor for Dannon’s One Yogurt Everyday Initiative, providing consultation services on the health issues affecting African Americans.

Protein Supplementation at Breakfast and Lunch for 24 Weeks beyond Habitual Intakes Increases Whole-Body Lean Tissue Mass in Healthy Older Adults.  Catherine Norton, Clodagh Toomey, William G McCormack, Peter Francis, Jean Saunders, Emmet Kerin, and Philip Jakeman.  Nutr. 2016; 146:65-69 doi:10.3945/jn.115.219022.

  • Conclusions: Protein supplementation at breakfast and lunch for 24 wk in healthy older adults resulted in a positive (+0.6 kg) difference in LTM compared with an isoenergetic, nonnitrogenous maltodextrin control. These observations suggest that an optimized and balanced distribution of meal protein intakes could be beneficial in the preservation of lean tissue mass in the elderly.
  • Funding: Supported by Food for Health Ireland and Enterprise Ireland grant CC20080001.  Author disclosures: C Norton, C Toomey, P Francis, J Saunders, E Kerin, and P Jakeman, no conflicts of interest. WG McCormack was an employee of Carbery Ingredients on secondment to Food for Health Ireland during the in vivo data collection and analysis.
  • Comment: The Carbery Group advertises itself as “a global leader in food ingredients, flavours and cheese.”
  • Question: Why would Carbery put one of its employees to work on this study?

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.  Neil R Brett, Paula Lavery, Sherry Agellon, Catherine A Vanstone, Jonathon L Maguire, Frank Rauch, and Hope A Weiler.  Am J Clin Nutr 2016; 103:144-152 doi:10.3945/ajcn.115.115956.

  • Conclusion: Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D $50 nmol/L during periods of minimal ultraviolet B radiation exposure.
  • Supported by funding from Dairy Farmers of Canada, the Canadian Foundation for Innovation and Canada Research Chairs, and in-kind support from Agropur and Ultima Foods for the study products.
  • Question: Does providing study products introduce conflicts of interest?

Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial.  Sally Chiu, Nathalie Bergeron, Paul T Williams, George A Bray, Barbara Sutherland, and Ronald M Krauss.

  • Conclusions: The HF-DASH diet lowered blood pressure to the same extent as the DASH diet but also reduced plasma triglyceride and VLDL concentrations without significantly increasing LDL cholesterol
  • Supported by Dairy Management Inc. and by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through University of California, San Francisco Clinical & Translational Science Institute grant UL1 RR024131.  RMK has previously received and is currently receiving research funding from Dairy Management Inc. for this and other projects. None of the other authors reported a conflict of interest. This was an investigator-initiated study, and its financial supporters had no role in the study design, implementation, data analysis, or data interpretation.
  • Question: Does this mean that the investigators decided what they wanted to study and then asked Dairy Management Inc for funding, knowing that Dairy Management would have congruent interests?  Does something like this increase confidence in the results?

I don’t have clear, unambiguous answers to such questions and am collecting opinions in preparation for my next book project.  If you have thoughts about these matters, do share.

Jan 6 2016

Viewpoint: Food-industry Funding of Food and Nutrition Research

My latest Viewpoint, “Corporate funding of food and nutrition research: science or marketing,” was published yesterday in JAMA Internal Medicine 2016;176 (1):13-14.  doi:10.1001/jamainternmed.2015.6667.

The longstanding influence of food industry funding on nutrition research, researchers, and professional societies1 threatens the credibility of nutrition science. So much research is sponsored by industry that health professionals and the public may lose confidence in basic dietary advice. Although most journals now require authors to disclose who pays for their work, disclosure—even done diligently—is not sufficient to alert readers to the extent to which industry funding influences research results and professional opinion. As is well established from experimental and observational research, drug company gifts and grants can have substantial effects. To recipients, however, these effects are almost always unconscious, unintentional, and unrecognized, making them especially difficult to prevent.

Medical schools and medical journals have increased efforts to minimize and manage conflicts of interest with industry. But from my observations, nutrition researchers, journals, and professional societies, like medical researchers, often fail to realize that food-industry funding may affect their work and its credibility.

Two recent investigative articles in the New York Times illustrate the concerns about biases introduced by industry funding. The first3 described the support by Coca-Cola of academic researchers who founded a new organization, the Global Energy Balance Network, to promote physical activity as a more effective method than calorie control (eg, from avoiding sugary sodas) for preventing obesity. The second4 analyzed emails obtained through open-records requests to document how Monsanto, the multinational agricultural biotechnology corporation, on the one hand, and the organic food industry, on the other, recruited professors to lobby, write, and testify to Congress on their behalf.

Both articles3,4 quoted the researchers named in these reports as denying an influence of industry funding and lamenting the paucity of university research funds and the competitiveness of federal grants. Despite leaving their organizations open to accusations that they have sold out to industry,5 officers of nutrition research societies tell me that they cannot function without industry funding of journals and conferences. They have a point. Although the investment by federal agencies in food and nutrition research has increased steadily since the early 1990s, US Department of Agriculture grants are diminishing, and the National Institutes of Health are funding fewer researchers at state agricultural colleges. Investigators have a hard time obtaining grants for projects related to food composition, food technology, nutrients, and nutrient metabolism as federal agencies have understandably shifted priorities toward research on obesity, genetics, and chronic diseases.6

Food companies, such as Quaker Oats, used to support basic research conducted by in-house scientists, but Unilever and Nestlé (no relation) are among the very few companies that continue to do so. Instead, food companies outsource research, much of which can appear as designed for marketing purposes. Recently, in preparation for what I intend to be a more systematic analysis of corporate funding of nutrition research, I began collecting a convenience sample of studies funded by food and beverage companies or trade associations as they appear in journals I happen to be reading. I sort them by whether their results do or do not favor the interests of the sponsor, and post examples online at my blog, http://www.foodpolitics.com.7

Between March and October 2015, I identified 76 industry-funded studies. Of these, 70 reported results favorable to the sponsor’s interest. Despite ongoing requests to readers of my blog to help me identify funded studies reporting results contrary to a funder’s interest, I have found only 6.  [Note: Since writing this, the score has gone to 90:9.] This discrepancy is consistent with the results of systematic investigations of industry sponsorship, such as one on the role of sugar-sweetened beverages in obesity.8 In general, independently funded studies find correlations between sugary drinks and poor health, whereas those supported by the soda industry do not.9 In the studies I collected, companies or trade associations promoting soft drinks, dairy foods, eggs, breakfast cereals, pork, beef, soy products, dietary supplements, juices, cranberries, nuts, and chocolates supported the study itself, the investigators, or both. These studies all found significant health benefits or lack of harm from consuming the foods investigated, results that can be useful for deflecting criticism of a company or promoting its products.

Mars Inc, for example, the maker of chocolate candies such as M&Ms, funds studies on the effects of cocoa flavanols on arterial function and blood pressure. One such study, published in September 2015,10(p1246)concluded that these compounds “improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.” The study investigators,10 one of whom is employed by Mars, followed well-established scientific protocols in conducting the research. Science is not the issue here. Marketing is the issue. The question is why Mars would fund a study like this and assign one of its employees to help design and write it. In this instance, the answer is obvious. Mars issued a press release “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people,” and noted these results in a full-page advertisement in the New York Times on September 27, 2015, Neither the press release nor advertisement explained that cocoa flavanols are largely destroyed during all but the most careful processing of chocolate, nor did they mention chocolate at all. They didn’t have to. Uncritical readers are likely to interpret the statements as evidence that chocolate is good for them and that its sugar and calories can be ignored.

The second New York Times article4 raised more insidious concerns about industry involvement with scientists, using Monsanto and organic food companies as cases in point. Although both industries recruit scientists to speak on their behalf, Monsanto has far greater resources. In 1994, I was a member of the Food Advisory Committee to the US Food and Drug Administration (FDA) when that agency approved genetically modified (GM) foods. I observed how Monsanto-funded scientists convinced the FDA that labeling GM foods would be misleading.

Confronted with increasing public support for labeling foods that are produced with GM ingredients, the biotechnology industry supported—and the House of Representatives passed—H.R. 1599 in July 2015. This bill, expected to be considered by the Senate before the end of 2015, has the Orwellian title, “The Safe and Accurate Food Labeling Act,” but some critics call it the “Denying Americans the Right to Know (DARK) Act.” Proposed by Representative Mike Pompeo (Kansas) on the basis that GM foods are safe and, therefore, acceptable, the act would block states from enacting labeling laws (as Vermont has already done) and permit GM foods to be labeled as “natural.” Opponents question the safety of GM foods. But they also raise additional reasons for full transparency in labeling—patents, control of seed stocks, the widespread application of chemical herbicides to GM crops, and the increasingly widespread resistance of weeds to those herbicides. When evaluating conflicting scientific and policy arguments about GM foods, it is useful to know who funds the researchers and their studies.

Should nutrition researchers and professional societies accept funding from food companies? Not without careful thinking. It’s time that food and nutrition researchers and societies recognize the influence of food-industry sponsorship, take steps to control its effects, and ensure that sponsored studies promote public health, not the marketing of food products. Journal editors should ensure that editors and members of editorial boards are free of industry conflicts, require peer reviewers to note food-industry funding in manuscript evaluations, and be wary of accepting industry-funded publications with evident commercial implications. If food companies and trade associations want to fund research, they should consider pooling resources and setting up an independent foundation to administer the grants. Everyone involved in this system should be doing everything possible to advocate for more research funds from federal granting agencies. Nothing less than the credibility of nutrition research and advice is at stake.

REFERENCES

1 Nestle  M. Food Politics: How the Food Industry Influences Nutrition and Health.3rd ed. Berkeley: University of California Press; 2013.
2 Lo  B, Field  MJ, eds. Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: National Academies Press; 2009.
3 O’Connor  A. Coca-Cola funds scientists who shift blame for obesity away from bad diets. New York Times. August 9, 2015. http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/?_r=0. Accessed October 22, 2015.
4 Lipton  E. Food industry enlisted academics in G.M.O. lobbying war, emails show. New York Times. September 5, 2015. http://www.nytimes.com/2015/09/06/us/food-industry-enlisted-academics-in-gmo-lobbying-war-emails-show.html. Accessed October 22, 2015.
5 Simon  M. Nutrition scientists on the take from Big Food: has the American Society for Nutrition lost all credibility? June 2015. http://www.eatdrinkpolitics.com/wp-content/uploads/ASNReportFinal.pdf. Accessed October 22, 2015.
6 Toole  AA, Kuchler  F. Improving health through nutrition research: an overview of the U.S. nutrition research system. Econ Res Rep No. 182. January 2015.http://www.ers.usda.gov/media/1760111/err-182.pdf. Accessed October 27, 2015.
7 Nestle  M. Food Politics blog. http://www.foodpolitics.com. Accessed October 27, 2015.
8 Lesser  LI, Ebbeling  CB, Goozner  M, Wypij  D, Ludwig  DS.  Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Med. 2007;4(1):e5. PubMed   |  Link to Article
9 Massougbodji  J, Le Bodo  Y, Fratu  R, De Wals  P.  Reviews examining sugar-sweetened beverages and body weight: correlates of their quality and conclusions. Am J Clin Nutr. 2014;99(5):1096-1104. PubMed   |  Link to Article
10 Sansone  R, Rodriguez-Mateos  A, Heuel  J,  et al; Flaviola Consortium, European Union 7th Framework Program.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. Br J Nutr. 2015;114(8):1246-1255. doi:10.1017/S0007114515002822PubMed   |  Link to Article

ARTICLE INFORMATION

Corresponding Author: Marion Nestle, PhD, MPH, Department of Nutrition, Food Studies, and Public Health, New York University, 411 Lafayette, Fifth Floor, New York, NY 10003-7035 (marion.nestle@nyu.edu).

Published Online: November 23, 2015. doi:10.1001/jamainternmed.2015.6667.

Conflict of Interest Disclosures: Dr Nestle’s salary from New York University supports her research, manuscript preparation, website, and blog at http://www.foodpolitics.com. She also earns royalties from books and honoraria from lectures to university and health professional groups about matters relevant to this Viewpoint.

Dec 23 2015

Five more industry-sponsored studies with results favorable to the sponsor. The score since mid-March: 95:9

Systematic Review of Pears and Health. Holly Reiland, BS Joanne Slavin, PhD, RD.  Nutrition Today November/December 2015 – Volume 50 – Issue 6 – p 301–305.  doi: 10.1097/NT.0000000000000112.  

  • Conclusions: Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study.
  • Funding: The authors received a grant from USA Pears in the past. The authors provided their own funding to allow this article to publish as Open Access.
  • Comment: Pears are a great fruit but the marketing purpose of this study is evident from this press release from the Pear Bureau Northwest: “While the body of evidence connecting pear intake and health outcomes is still limited, USA Pears has been contributing to research efforts by commissioning independent studies to learn and affirm the heath attributes of pears. Visit www.usapears.org for additional pear research, nutrition resources and recipes.”

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study.  Norimah AK , H. C. Koo, Hamid Jan JM, Mohd Nasir MT, S. Y. Tan, Mahendran Appukutty, Nurliyana AR, Frank Thielecke, Sinead Hopkins, M. K. Ong, C. Ning, E. S. Tee.  PLoS ONE 10(10): e0138247. doi:10.1371/journal.pone.0138247

  • Conclusion: Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.
  • Funding: The Nutrition Society of Malaysia received an unrestricted research grant from Cereal Partners Worldwide, Switzerland and Nestleé R&D Center, Singapore. This financial support was provided in the form of salaries for authors but the funders did not have any additional role in the study design, data collection and analysis or decision to publish. Frank Thielecke was an employee of Cereal Partners Worldwide at the time this study was conducted. He now works for Nestec SA. Sinead Hopkins is employed by Cereal Partners Worldwide (CPW), Switzerland and Moi Kim Ong and Celila Ning are employed by Nestleé R&D Center, Singapore….Nestlé and Cereal Partners Worldwide have a commercial interest in breakfast cereals.
  • Comment: I learned about this study from a comment on Retraction Watch, which reported that PLoS One had filed a correction to the funding section.  The correction says that the salaries were for research assistants, not authors.

Walnuts Consumed by Healthy Adults Provide Less Available Energy than Predicted by the Atwater Factors.  David J Baer*, Sarah K Gebauer, and Janet A Novotny. J Nutrition First published November 18, 2015, doi: 10.3945/​jn.115.217372.

  • Conclusion: Consistent with other tree nuts, Atwater factors overestimate the metabolizable energy value of walnuts. These results could help explain the observations that consumers of nuts do not gain excessive weight and could improve the accuracy of food labeling.
  • Funding: This research was funded by the USDA and the California Walnut Commission… DJ Baer was funded by the USDA and the California Walnut Commission.

Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult WomenPrasad Vivek Kumar, Drenowatz Clemens, Hand Gregory A., Lavie Carl J., Sui Xuemei, Demello Madison, and Blair Steven N.  Journal of Women’s Health, 2015 ahead of print. doi:10.1089/jwh.2015.5307.

  • Conclusion: CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
  • Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation, or preparation and submission of this article. The authors thank the Energy Balance staff and study participants for their contributions. No competing financial interests exist. 
  • Comment: This is one of the papers produced by participants in the now defunct Global Energy Balance Network formerly sponsored by Coca-Cola.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including metaanalyses, of the evidence from human and animal studies. PJ Rogers, PS Hogenkamp, C de Graaf , S Higgs , A Lluch , AR Ness , C Penfold , R Perry , P Putz , MR Yeomans and DJ Mela.  International Journal of Obesity advance online publication, 10 November 2015; doi:10.1038/ijo.2015.177

  • Conclusion¨The preponderance of evidence from all human randomized controlled trials indicates that LES [low-energy sweeteners] do not increase EI [energy intake] or BW [body weight], whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
  • Conflict: This work was conducted by an expert group of the European branch of the International Life Science Institute (ILSI Europe). The expert group received funding from the ILSI Europe Eating Behaviour and Energy Balance Task Force. Industry members of this task force are listed on the ILSI Europe website at www.ilsi.eu.
  • Comment: ILSI is funded by food companies.
Dec 22 2015

Coca-Cola reveals who it funds in England—organizations, researchers, other individuals

Last Friday, Coca-Cola UK joined its US counterpart in revealing the names of the organizations, researchers, and individuals it funds and the amounts it pays for these services.

As Jon Woods, General Manager of Coca-Cola Great Britain and Ireland, explains:

Earlier this year, my colleagues in the US published a list of the health and wellbeing partnerships, research and individuals funded there, dating back to 2010. In October, I committed to do the same and today we have published the details of what we have funded in Great Britain.  I believe this is the right thing to do…The total amount of funding we have provided in GB since 2010 is £9,328,095.

Like the US list, which has been analyzed extensively by Ninjas for Health, this one is interesting to read.

Here is a small sample from the list of organizations:

  • Biotechnology and Biological Sciences Research Council — £20,000
  • British Dietetic Association — £5,600
  • British Feeding & Drinking Group Annual Meeting — £1,200
  • British Nutrition Foundation — £33,000

A sample from the list of scientists and other individuals (not otherwise identified, alas):

  • Fiona Hunter
  • Prof. Ken Fox
  • Lynne Garton
  • Dr. Geoffrey Livesey
  • Dr. Sigrid Gibson
  • Dr. David Haslam
  • Prof. Marion Hetherington
  • Penny Hunking
  • Angie Jefferson
  • Prof. Ian Macdonald

I’m sure British public health advocates will have fun looking up what these people have said about sugary drinks and obesity.

The Times of London explained who some of them are:

The advisers include Stuart Biddle, of Loughborough University, who was chairman of a health department group on obesity in 2010; Alan Boobis, a director at Public Health England, who stopped receiving funding in 2013; Ken Fox, who advised the government on obesity in 2009; and Carrie Ruxton, now on the board of Food Standards Scotland. In 2010 Dr Ruxton co-wrote a study sponsored by the UK Sugar Bureau, an industry group, that found no proven association between sugar intake and obesity.

According to Der Spiegel, Coca-Cola plans to reveal everyone it sponsors in Europe.  All of this is further fallout from August’s New York Times’ revelations of Coca-Cola sponsorship of the now defunct Global Energy Balance Network.

More to come, no doubt.  Stay tuned.

Dec 8 2015

Three rare industry-funded studies with disappointing results. The score: 85:9.

Here are three rare studies sponsored by food companies with results that must have disappointed their funders.  Since mid-March when I started this collection, these bring the score to 85:9 (studies with results favorable to the sponsor’s interests vs. those against).

Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat BreakfastArpita Basu, Nancy M Betts, Misti J Leyva, Dongxu Fu, Christopher E Aston, and Timothy J Lyons.  J. Nutr. 2015; 145:2325-2332 doi:10.3945/jn.115.215772

  • Conclusion: Acute cocoa supplementation showed no clear overall benefit in T2D [type 2 diabetes] patients after a high-fat fast-food–style meal challenge. Although HDL cholesterol and insulin remained higher throughout the 6-h postprandial period, an overall decrease in large artery elasticity was found after cocoa consumption.
  • Funding: Supported by NIH Centers of Biomedical Research Excellence Program of the National Center for Research Resources at University of Oklahoma Health Sciences Center…a grant from The Hershey Company (to AB), and the Dean’s Research Incentive program in the College of Human Sciences at Oklahoma State University.

Associations between flavan-3-ol intake and CVD risk in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk).  Vogiatzoglou A1Mulligan AA2Bhaniani A2Lentjes MA2McTaggart A2Luben RN2Heiss C3Kelm M3Merx MW3Spencer JP3Schroeter H4Khaw KT5,Kuhnle GG6.  ).  Free Radic Biol Med. 2015 Jul;84:1-10. doi: 10.1016/j.freeradbiomed.2015.03.005. Epub 2015 Mar 17.

  • Conclusion:  There were no consistent associations between flavan-3-ol monomer intake and baseline systolic and diastolic blood pressure (BP)…Flavan-3-ol intake in EPIC-Norfolk is not sufficient to achieve a statistically significant reduction in CVD risk.
  • Funding: The present study was supported by the EU (Grant 226588, “Flaviola”) and an unrestricted grant from Mars, Inc. Mars, Inc. had no role in the design and analysis of the study or in the writing of this article. EPIC-Norfolk is supported by Cancer Research UK (SP2024-0201 and SP2024-0204) and the Medical Research Council (G9502233). H.S. is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities. None of the other authors has a conflict of interest to declare.
  • Comment: This and the previous study are part of an effort to make chocolate seem like a health food.  Alas, these didn’t work.

No Change in 24-Hour Hydration Status Following a Moderate Increase in Fluid Consumption.  Matthew A. Tucker MA, J. D. Adams MS, Lemuel A. Brown MS, Christian B. Ridings MS, Jenna M. Burchfield MS, Forrest B. Robinson BS, Jamie L. McDermott MS, RD, LDN, Brett A. Schreiber MS, Nicole E. Moyen MS, Tyrone A. Washington PhD, Andrea C. Bermudez BS, Meredith P. Bennett BS, Maxime E. Buyckx MD & Matthew S. Ganio PhD.  Journal of the American College of Nutrition, DOI: 10.1080/07315724.2015.1046196.

  • Conclusions: Regardless of fluid volume or beverage type consumed, measures of 24-hour hydration status did not differ, suggesting that standard measures of hydration status are not sensitive enough to detect a 22% increase in beverage consumption.
  • Funding: This study was supported by a grant from The Coca-Cola Company. M.E.B., an employee of The Coca-Cola Company, contributed to study design and writing the article.
  • Comment: Coca-Cola has long advertised its products as promoting hydration.  In most people, thirst and normal food intake take care of hydration.  This study confirms that if you drink more than you need, you pee out the excess.
Dec 7 2015

Another five sponsored studies with expected results. The score: 85:6.

These are coming in so quickly that I am having a hard time keeping up with them.  Note that the first three are sponsored by Coca-Cola and that some of the investigators were involved with the ill-fated Global Energy Balance Network, now defunct.  As we now know from the e-mails obtained by the Associated Press, the statement that “the sponsor played no role…” is not necessarily correct.

As for the score: since mid-March, I have collected 85 sponsored studies with results just as the sponsor wanted, versus 6 with results that must have disappointed.  But stay tuned: tomorrow I will post 3 more in the disappointing category.

Low levels of physical activity are associated with dysregulation of energy intake and fat mass gain over 1 yearRobin P Shook, Gregory A Hand, Clemens Drenowatz, James R Hebert, Amanda E Paluch, John E Blundell, James O Hill, Peter T Katzmarzyk, Timothy S Church,11 and Steven N Blair.  Am J Clinical Nutrition November 11, 2015 as doi: 10.3945/ajcn.115.115360.

  • Conclusions: These results suggest that low levels of physical activity are a risk factor for fat mass gain. In the current sample, a threshold for achieving energy balance occurred at an activity level corresponding to 7116 steps/d, an amount achievable by most adults.
  • Funding: Supported by an unrestricted research grant from The Coca-Cola Company.

Association between cardiorespiratory fitness and submaximal systolic blood pressure among young adult men: a reversed J-curve pattern relationship. Vivek K. Prasada, Clemens Drenowatza, Gregory A. Handb, Carl J. Laviec, Xuemei Suia, Madison Demelloa, and Steven N. Blair.  Journal of Hypertension 2015, 33:2239–2244.

  • Conclusions: There was a reverse J-curve pattern relationship between SSBP [submaximal systolic blood pressure] and CRF [cardiorespiratory fitness], with the lowest SSBP among men with fair or good CRF and highest among those with poor CRF.
  • Funding: Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis and interpretation, or preparation and submission of this manuscript.

Relation of Body’s Lean Mass, Fat Mass and Body Mass Index with Submaximal Systolic Blood Pressure Among Young Adult MenVivek K. Prasad, MD, MPH, PhD, Clemens Drenowatz, PhD, Gregory A. Hand, PhD, Carl J. Lavie, MD, Xuemei Sui, MD, MPH, PhD, Madison Demello, MS, Steven N.Blair.  Am J Cardiology 2015 DOI: 10.1016/j.amjcard.2015.10.060 .

  • Conclusion: there was a J curve pattern between SSBP [submaximal systolic blood pressure] and components of body composition whereas, a linear relation between SSBP and BMI.
  • Funding: Funding for this project was provided through an unrestricted grant from the Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation,or preparation and submission of this manuscript.

Sugar- and artificially sweetened beverages and intrahepatic fat: A randomized controlled trial. Vanessa Campos, Camille Despland, Vaclav Brandejsky, Roland Kreis, Philippe Schneiter, Arnaud Chiolero, Chris Boesch and Luc Tappy.  Obesity Volume 23, Issue 12, pages 2335–2339, December 2015.

  • Conclusion: In subjects with overweight or obesity and a high SSB intake, replacing SSB with ASB decreased intrahepatic fat over a 12-week period.
  • Disclosure:  LT received research support from Nestlé SA, Switzerland, and Ajinomoto Co Inc, Japan, for studies unrelated to this work and speaker’s honoraria from Nestlé SA, Switzerland, Ferrero, Italy, and C3 collaborating for health, UK. The other authors declared no conflict of interest.

Probiotic supplementation attenuates increases in body mass and fat mass during high-fat diet in healthy young adults. Kristin L. Osterberg, Nabil E. Boutagy, Ryan P. McMillan, Joseph R. Stevens, Madlyn I. Frisard, John W. Kavanaugh, Brenda M. Davy, Kevin P. Davy and Matthew W. Hulver.  Obesity Volume 23, Issue 12, pages 2364–2370, December 2015.  DOI: 10.1002/oby.21230.

  • Conclusion: VSL#3 [the probiotic] supplementation appears to have provided some protection from body mass gain and fat accumulation in healthy young men consuming a high-fat and high-energy diet.
  • Funding agencies: This study was funded by VSL Pharmaceuticals, Inc.
  • Disclosure: The authors declared no conflict of interest.
Dec 1 2015

Five more sponsored studies with expected results. The score: 80:6

In case you haven’t been following this saga, I’ve been collecting studies funded by food companies since last March and posting them according to whether the results do or do not favor the sponsor’s interests.  So far, I’ve reported 80 that do, versus 6 that don’t (although I have a couple more saved up for posting soon).

The point of this exercise is to demonstrate that sponsored studies are far more likely to favor the interests of the sponsor than are studies funded by government agencies or foundations, and to argue for more independent funding of food and nutrition research (see my recent Viewpoint on this topic in JAMA Internal Medicine).

Here are five more examples.

Is consuming yoghurt associated with weight management outcomes? Results from a systematic review. J Eales, I Lenoir-Wijnkoop, S King, H Wood, F J Kok, R Shamir, A Prentice, M Edwards, J Glanville, R L Atkinson. Int’l J Obesity 2015 ahead of print.

  • Conclusions: Yoghurt consumption is associated with lower BMI, lower body weight/weight gain, smaller waist circumference and lower body fat in epidemiological studies. RCTs [randomized controlled trials] suggest weight reduction effects, but do not permit determination of a cause/effect relationship. Well-controlled, adequately powered trials in research and community settings appear likely to identify a modest but beneficial effect of yoghurt consumption for prevention of weight gain and management of obesity. The ready availability of yoghurt (a nutrient dense food) and its ease of introduction to most diets, suggests that educating the public to eat yoghurt as part of a balanced and healthy diet may potentially contribute to improved public health.
  • Funding: This project was funded by Danone Institute International.
  • Conflict of interest statement: York Health Economics Consortium received funding from Danone Institute International to conduct this review. York Health Economics Consortium has received funding from the Global Alliance for Probiotics, Danone and the European Food Safety Agency for projects involving food and health topics. FJK is member of the Scientific Advisory Board Global Dairy Platform, Chicago USA RS is President of Danone Institute International ILW is employed by the Danone Company, France.

Red Meat and Colorectal Cancer: A Quantitative Update on the State of the Epidemiologic ScienceDominik D. Alexander PhD, MSPHab*, Douglas L. Weed MD, PhDc, Paula E. Miller MPHb & Muhima A. Mohamed M PHd. J Am College Nutrition 2015;34: 521-43.  DOI:10.1080/07315724.2014.992553

  • Conclusion:  The state of the epidemiologic science on red meat consumption and CRC [colorectal cancer] is best described in terms of weak associations, heterogeneity, an inability to disentangle effects from other dietary and lifestyle factors, lack of a clear dose-response effect, and weakening evidence over time.
  • Funding: This manuscript was partially funded by Meat & Livestock Australia (MLA). MLA did not contribute to the writing, analysis, or interpretation of study findings.
  • Comment: The conclusion of this industry-funded study contradicts the findings of the WHO International Agency for Research on Cancer, which finds processed meats to be carcinogenic, and red meat to be a probable carcinogen.

The challenges of nutrition policymaking. Joanne Slavin.  Nutrition Journal (2015) 14:15 DOI 10.1186/s12937-015-0001-8.

  • Thrust of paper: As every DGAC [Dietary Guidelines Advisory Committee] wants to be bold and set new direction, nutrition science would support that first we must do no harm with our dietary guidance. Moderation and variety must be kept front and center…A suggestion that all Americans should reduce sodium intakes is not sound and is potentially dangerous. Targeting certain foods and beverages, including chocolate milk, processed meats, added sugars, and even the noble potato as villains in the nutrition wars is not a science-based strategy and may need to be countered on the political front if appointed scientific review committees continue to take this approach.
  • Competing interests: In the past 5 years Dr. Slavin has received research grants from Minnesota Beef Council, Minnesota Cultivated Wild Rice Council, Novartis Consumer Health, USA Rice, Nestle Nutrition, Tate and Lyle, General Mills, Inc., USA Pears and American Pulse Association. In the past 5 years Dr. Slavin has received speaking fees from food companies and commodity groups with interests in processed foods, dairy products, meat, pulses, fruits, vegetables, fiber, grains, and carbohydrates. Dr. Slavin has participated in scientific panels and advisory boards that are funded by food companies, ingredient companies, commodity groups, scientific societies, and trade groups. She holds a third interest in the Slavin Sisters LLC, a 119-acre farm in Southern Wisconsin.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies PJ Rogers, PS Hogenkam , C de Graaf, S Higgs, A Lluch, AR Ness, C Penfold, R Perry, P Putz, MR Yeomansand DJ Mela.International Journal of Obesity (2015), 1–14 10 November 2015; doi:10.1038/ijo.2015.177

  • Conclusions: Overall, the balance of evidence indicates that use of LES [low-energy sweeteners] in place of sugar, in children and adults, leads to reduced EI [energy intake] and BW [body weight], and possibly also when compared with water.
  • Conflict of interest: Peter J Rogers has received grants from Sugar Nutrition, UK in support of research on the effects of sugar on human appetite. Cees de Graaf has received grants from the Dutch Sugar Bureau in support of a study on brain responses to sugars and low energy sweeteners. Suzanne Higgs has received a grant from Canderel in support of research on the effects of low-energy sweeteners on human appetite. Anne Lluch and David J Mela are employees and shareholders of companies that manufacture products containing sugars and low-energy sweeteners. Peter Putz is an employee of ILSI Europe.

Walnut ingestion in adults at risk for diabetes: effects on body composition, diet quality, and cardiac risk measures Valentine Yanchou Njike, Rockiy Ayettey, Paul Petraro, Judith A Treu, David L Katz.  . BMJ Open Diabetes Research and Care 2015;3:e000115. doi:10.1136/bmjdrc-2015- 000115.

  • Conclusions: The inclusion of walnuts in an ad libitum diet for 6 months, with or without dietary counseling to adjust calorie intake, significantly improved diet quality, endothelial function, total and LDL cholesterol, but had no effects on anthropometric measures, blood glucose level, and blood pressure.
  • Funding: Funding for this study has been provided by the California Walnut Commission.
  • Competing interests. DLK has been compensated for public speaking by the California Walnut Commission.
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