by Marion Nestle

Currently browsing posts about: Conflicts-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.
Nov 25 2015

A retraction and apology

The Journal of Public Health Policy (JPHP) will soon announce the retraction of a Viewpoint—an opinion piece—I co-authored with a Guatemalan physician, Dr. Joaquin Barnoya, “The food industry and conflicts of interest in nutrition research: A Latin American perspective.” Because of factual errors in the piece, and in response to valid objections about the errors from its subjects, they and we requested its retraction and JPHP is doing so.

I believe it is useful to explain how this happened.  In late summer, Dr. Barnoya brought to my attention an advertorial, a sponsored news account, published in el Periódico and other Guatemalan newspapers announcing an alliance among the Central American Bottling Corporation (cbc), the largest beverage distributor in Guatemala and bottler for PepsiCo; the Guatemala-based Institute of Nutrition of Central America and Panama (INCAP); and the U.S.-based Shalom Christian Foundation to distribute a supplemental food product, Mani+, to chronically malnourished children in rural areas (here is a translation of the advertorial).  Mani+ is a sweetened, peanut-based, nutrient-fortified supplemental food made from local ingredients in Guatemala, used to prevent malnutrition in young children.  The advertorial displayed a photograph of the directors of the three organizations holding the agreement.  It also displayed statements from all three directors emphasizing the alliance’s importance in addressing childhood malnutrition.

As readers of this blog should know, I have long been concerned about the conflicts of interest that arise when food companies—especially soda companies—enter into alliances with public health organizations.   The New York Times made the consequences of such alliances clear in its recent revelations of Coca-Cola sponsorship of the Global Energy Balance Network and the fallout from those revelations.  The announced alliance between cbc and INCAP raises similar concerns, particularly in the light of more general food industry partnerships with research and health institutions in Latin America.  Our intention in writing the Viewpoint was to question the appropriateness of this alliance, as well as of other such partnerships and alliances.

We should, however, have exercised more care.  Shortly after publication of the Viewpoint, Carolina Siu Bermúdez, the director of INCAP who appears in the advertorial, wrote to object that our piece incorrectly implied a financial relationship with cbc, and that Dr. Barnoya had failed to disclose that INCAP paid a substantial portion of his salary via a grant from yet another organization.  We also received letters from Dr. Edward Fischer, the founder of NutriPlus/Mani+, Professor of Anthropology and Director of the Center for Latin American Studies at Vanderbilt University, objecting to our statement that the alliance was responsible for manufacturing (rather than just distributing) the product.   Both asked us to retract the Viewpoint.

Upon investigation, we realized their objections had merit.  Indeed, further investigation by us and by the editors of the JPHP exposed additional errors.  Together, these include the following clarifications and corrections:

  • The alliance is involved only in the distribution of Mani+, not its manufacture (as we had asserted).
  • The actual nature of the alliance between cbc, INCAP, and the Shalom Christian Foundation—who does what—is, in fact, unclear. The Viewpoint should have characterized the relationship with less certainty and specified that cbc has no financial relationship with either INCAP or the Foundation.
  • Dr. Barnoya should have disclosed his financial relationship with INCAP, and I should have insisted that he do so.
  • The Viewpoint was triggered by the advertorial, and we should have made this connection more explicit.
  • The reference in the Viewpoint to the advertorial is incorrect. It is listed as (2015) cbc co. Unidos contra la desnutricion. INCAP, cbc y Fundacion Crisitiana Shalom Firman Convenio 23(July): 9.  The correct reference is Alianza Contra la Desnutricion. elPeriódico. July 23, 2015;Advertorial: 9.

To correct and clarify these issues, we would need to revise the Viewpoint.  Doing so, however, is not possible once a paper is published.  That left us no choice but to request a retraction, which I believe is the right course of action in this situation.

In my books and other writing, I try as hard as I can to be precise and accurate.  This incident is a lapse that I regret deeply, for which I take responsibility, and for which I apologize to Carolina Siu Bermúdez, to Dr. Fischer, and to my readers.  I also apologize to Phyllis Freeman and Anthony Robbins, the editors of JPHP, and to Lucy Wheeler of Palgrave, who have set an exemplary standard of ethics and integrity throughout these investigations and discussions.

As for lessons learned: Although I fully intend to continue to write critically about alliances between food companies and public health organizations, I also intend to use this experience to recommit myself to accountability and to diligence in checking and double-checking facts and disclosures going forward.   Again, my deepest apologies.

Addition, December 14: The actual retraction notice is published here.  The discussion on Retraction Watch is here.

Nov 9 2015

University of Colorado returns Coca-Cola funding for Global Energy Balance Network

On Friday, the University of Colorado School of Medicine announced that it was giving back the $1 million that Coca-Cola had donated to fund the Global Energy Balance Network.

This is the group of scientists funded by Coca-Cola who were promoting activity as the best way to prevent obesity, but playing down any contribution of soft drinks and junk food to weight gain (see my post on this).

This is the fourth impressive result of the investigative report by Anahad O’Connor in the New York Times in August that revealed Coca-Cola’s funding of such initiatives.

  1. Coke’s chief executive, Muhtar Kent, disclosed that the company had spent almost $120 million since 2010 to pay for partnerships with medical and community health groups, and promised that the company would be more transparent.
  2. Coca-Cola set up a transparency website where it revealed the list of funded organizations.
  3. Coke ended its relationships with the Academy of Nutrition and Dietetics, the American Academy for Pediatrics, and the American Academy of Family Practice (or these groups pulled out—everyone seems to want to credit).
  4. Now this. Coke says it will donate the returned money to the Boys & Girls Clubs of America.

I am quoted in this story:

Marion Nestle, a professor of nutrition, food studies and public health at New York University, called the network “a front group” for Coca-Cola intended to promote the message that obesity is primarily caused by a lack of exercise, not by overconsumption of junk food.

On Friday, Dr. Nestle, the author of “Soda Politics,” said she was pleased that the university had returned the money.

“Both deserve congratulations for making a difficult but necessary decision,” said Dr. Nestle. “Let’s hope other groups also decide to do the right thing and end such financial relationships.”

Next?

Oct 29 2015

Another 5 industry-funded nutrition studies with results favorable to the sponsor. The score: 75:6

I’ve managed to collect another five industry-sponsored studies with results that the funder must love, bringing the total to 75 since mid-March.  As always, please keep your eye out for industry-funded studies that are contrary to the sponsor’s interests.  I’ve only managed to find 6 so far.

Dairy products consumption and metabolic syndrome in adults: systematic review and meta-analysis of observational studiesGuo-Chong Chen, Ignatius M. Y. Szeto, Li-Hua Chen, Shu-Fen Han, Yan-Jie Li, Rina van Hekezen, and Li-Qiang Qin.. Science Reports. 2015; 5: 14606. Published online 2015 Sep 29. doi:  10.1038/srep14606

  • Conclusions: Higher dairy consumption significantly reduced MetS [metabolic syndrome] by 17% in the cross-sectional/case-control studies…and by 14%…in cohort studies….Our findings suggest an inverse dose-response relationship between dairy consumption and risk of MetS.
  • Funding: This study was supported by Yili Innovation Center, Inner Mongolia Yili Industrial Group Co., Ltd. The funding source had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
  • Comment: The Yili Group is a privately owned Chinese company headquartered in Hohhot, Inner Mongolia, engaged in processing and manufacturing milk products, including ice-cream, powdered milk, milk tea powder, sterilized milk and fresh milk.

Energy compensation following consumption of sugar‑reduced products: a randomized controlled trial.  Oonagh Markey · Julia Le Jeune · Julie A. Lovegrove  Eur J Nutr First online: 09 September 2015 DOI 10.1007/s00394-015-1028-5.

  • Conclusion: Consumption of sugar-reduced products, as part of a blinded dietary exchange for an 8-week period, resulted in a significant reduction in sugar intake. Body weight did not change significantly, which we propose was due to energy compensation.
  • Conflict of interest. This work was supported by Sugar Nutrition UK; however, the sponsor had no input into the study hypothesis and design, data analysis and interpretation.
  • Comment: It is in the interest of sugar trade associations to demonstrate that eating less sugar has no effect on body weight. 

Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?  William Shrapnel.  Nutrients 2015, 7(9), 8189-8198; doi:10.3390/nu7095390.

  • Conclusions: drinks containing non-nutritive sweeteners enable the “small change” in health behaviour that individuals are willing to consider…Among those who currently consume carbonated beverages, the “small change” involved in moving from a sugar-sweetened beverage to a similar sugar-free beverage appears to be one that some consumers are willing to accept.  Facilitating this change may be a more productive public health strategy than advocacy for taxation of sugar-sweetened beverages.
  • Author disclosure: William Shrapnel was paid a consultancy fee by the Australian Beverage Council Ltd. to prepare this paper…The authors declare no conflict of interest.

Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis.  Jonathan Sackner-Bernstein, David Kanter,  Sanjay Kaul.  PLoS One, October 20, 2015.  DOI: 10.1371/journal.pone.0139817.

  • Conclusions: In conclusion, this trial-level meta-analysis of 17 randomized controlled trials shows that both LoCHO and LoFAT diets are effective in reducing weight. However, LoCHO diet appears to achieve greater weight loss and reduction in predicted risk of ASCVD [atherosclerotic cardiovascular disease] events compared with LoFAT diet. On the basis of these results, we suggest that dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of LoCHO diets.
  • Funding: The study was supported by Atkins Nutritionals….Jonathan Sackner-Bernstein owns and may receive compensation from ExVivos, LLC. ExVivos, LLC provided payment to authors (DK and SK) for their role as contractors to ExVivos, LLC.
  • Comment: ExVivos, LLC has one employee—Jonathan Sackner-Bernstein.  Atkins Nutritionals markets a low-carbohydrate diet plan.

Breast-feeding and postpartum maternal weight trajectories.  Laura Mullaney, Amy C O’Higgins, Shona Cawley, Rachel Kennedy, Daniel McCartney and Michael J Turner.

  • Conclusions: There are many reasons why breast-feeding should be strongly promoted but we found no evidence to support postpartum weight management as an advantage of breast-feeding.
  • Financial support: This project was supported by the UCD Centre for Human Reproduction and was partially funded by an unlimited educational grant from Danone Nutricia Early Life Nutrition for the first author.
  • Comment: Food companies often provide scholarships for doctoral research.  This particular arrangement raises some tough questions: Should dissertation research supervisors allow their students to accept such funding?  Or does accepting such an award run the risk of compromising the integrity of the student’s work?
Oct 12 2015

Independently funded study by Industry-funded authors finds sugary drinks to increase the risk of hypertension. The score: 70:6.

Do sugar-sweetened beverages increase the risk of high blood pressure?

Yes, says this study, which was conducted by investigators who accept research funding from Coca-Cola and the Calorie Control Council (a trade association for companies that make or use artificial sweeteners).  But the study itself was funded by independent government agencies or health associations in Canada.

I’m counting it in the category of studies with results unfavorable to the food industry sponsors.

This brings the score to 70 industry-funded studies since mid-March with results favorable to the sponsor, to 6 with unfavorable results.

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohortsViranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

  • Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
  • Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from Canadian government agencies or health associations.
  • Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….

Comment

This is an exception that proves the rule.  In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.

One possible explanation is that when investigators typically funded by soda companies are funded independently,  they design and conduct independent research.

If nothing else, this study is evidence for the need for and value of independent funding of nutrition research.

Oct 8 2015

Five more industry-funded studies with expected results. Score 70:5

A reminder that since mid-March I’ve been collecting studies funding by food companies.  These greatly tend to produce results favorable to the sponsor’s interests.  Today’s group makes 70.  I have an ongoing call out for sponsored studies that don’t.  So far I’ve found 5 .  If you run across either kind, please send.

Breakfasts Higher in Protein Increase Postprandial Energy Expenditure, Increase Fat Oxidation, and Reduce Hunger in Overweight Children from 8 to 12 Years of Age. Jamie I Baum, Michelle Gray, and Ashley Binns.  J Nutr 2015;145:2229–35.

  • Conclusion: This study indicates that breakfast macronutrient composition affects postprandial responses in both NW [normal weight] and OW [overweight] children. A PRO [high protein breakfast] increases postprandial EE [energy expenditure] and fat oxidation, reduces hunger, and increases satiety when compared with a carbohydrate-based breakfast.
  • Funding: Supported by a grant from the Egg Nutrition Center/American Egg Board, Chicago, IL.
  • Added note: this one is a repeat of one posted earlier.

Dietary Whey and Casein Differentially Affect Energy Balance, Gut Hormones, Glucose Metabolism, and Taste Preference in Diet-Induced Obese RatsAdel Pezeshki, Andrew Fahim, and Prasanth K Chelikani. J. Nutr. 2015; 145:2236-2244 doi:10.3945/jn.115.213843

  • Conclusion: Together, these data demonstrate that in obese rats, whey, casein, and their combination improve energy balance through differential effects on food intake, taste preference, energy expenditure, glucose tolerance, and gut hormone secretion.
  • Funding: Supported by operating grants from the Alberta Livestock and Meat Agency, Alberta Innovates Bio-Solutions, Alberta Milk…Whey protein isolate for this study was donated by Agropur Dairy Cooperative (Canada).

Consumption of Yogurt, Low-Fat Milk, and Other Low-Fat Dairy Products Is Associated with Lower Risk of Metabolic Syndrome Incidence in an Elderly Mediterranean PopulationNancy Babio, Nerea Becerra-Tomás, Miguel Ángel Martínez-González, Dolores Corella, Ramon Estruch, Emilio Ros, Carmen Sayón-Orea, Montserrat Fitó, Lluís Serra-Majem, Fernando Arós, Rosa M Lamuela-Raventós, José Lapetra, Enrique Gómez-Gracia, Miguel Fiol, Andrés Díaz-López, José V Sorlí, J Alfredo Martínez, Jordi Salas-Salvadó, on behalf of the PREDIMED Investigators.  J. Nutr. 2015; 145:2308-2316 doi:10.3945/jn.115.214593

  • Conclusions: Higher consumption of low-fat dairy products, yogurt (total, low-fat, and whole-fat yogurt) and low-fat milk was associated with a reduced risk of MetS [metabolic syndrome] in individuals at high cardiovascular disease risk from a Mediterranean population. Conversely, higher consumption of cheese was related to a higher risk of MetS.
  • Funding: This study was funded in part by the Spanish Ministry of Health…Thematic Network…the European Regional Development Fund, and the Catalan Nutrition Center of the Institute of Catalan Studies.
  • Author disclosures: N Babio received consulting fees from Danone. R Estruch served on the board of, and received lecture fees from, the Research Foundation on Wine and Nutrition…E Ros served on the board of, and received travel support and grant support through his institution from the California Walnut Commission; served on the board of the Flora Foundation (Unilever)… L Serra-Majem is a member of the Scientific Advisory Board and received consulting fees and grant support from the European Hydratation Institute, received lecture fees from the International Nut Council, and received travel support from Nestle. F Arós received payment for the development of educational presentations from Menarini and Astra Zeneca. RM Lamuela-Raventós serves on the board of, and received lecture fees from, the Research Foundation on Wine and Nutrition; received lecture fees from Cerveceros de España; and received lecture fees and travel support from PepsiCo. J Salas-Salvadó served on the board of, and received grant support through his institution from the International Nut and Dried Fruit Council; received consulting fees from Danone; and received grant support through his institution from Eroski and Nestlé. N Becerra-Tomás, MÁ Martínez-González, D Corella, C Sayón-Orea, M Fitó, J Lapetra, E Gómez-Gracia, M Fiol, A Díaz-López, JV Sorlí, and JA Martínez, no conflicts of interest.
  • Comment: This study was funded by independent agencies but the authors report many financial connections to food companies.

Type and amount of dietary protein in the treatment of metabolic syndrome: a randomized controlled trial.  Alison M Hill, Kristina A Harris Jackson, Michael A Roussell, Sheila G West, and Penny M Kris-Etherton.  Am J Clin Nutr 2015; 102:757-770 doi:10.3945/ajcn.114.104026

  • Conclusions: Weight loss was the primary modifier of MetS [metabolic syndrome] resolution in our study population regardless of protein source or amount. Our findings demonstrate that heart-healthy weight-loss dietary patterns that emphasize either animal or plant protein improve MetS criteria similarly.
  • Funding: Supported by The Beef Checkoff and the General Clinical Research Center, The Pennsylvania State University.
  • Comment: The point of this study was to demonstrate that animal protein is not harmful.

Oral Vitamin D Supplements Increase Serum 25-Hydroxyvitamin D in Postmenopausal Women and Reduce Bone Calcium Flux Measured by 41Ca Skeletal LabelingAndreas Schild, Isabelle Herter-Aeberli, Karin Fattinger, Sarah Anderegg, Tim Schulze-König, Christof Vockenhuber, Hans-Arno Synal, Heike Bischoff-Ferrari, Peter Weber, Arnold von Eckardstein, and Michael B Zimmermann.  J. Nutr. 2015; 145:2333-2340 doi:10.3945/jn.115.215004

  • Conclusion: In healthy postmenopausal women, increasing serum 25(OH)D primarily affects calcium transfer from the central compartment to a fast exchanging compartment…A serum 25(OH)D concentration of ∼40 μg/L achieves ∼90% of the expected maximal effect on this transfer rate.
  • Funding: This study was supported by DSM Nutritional Products Ltd. and the ETH Zurich, Switzerland.
  • Author disclosures: P Weber is employed by DSM Nutritional Products.
  • Comment: Although this study addresses a basic research question, its results favor the use of vitamin D supplements and, therefore, the interests of this supplement company.
Oct 6 2015

Two rare industry-funded studies with results that must have disappointed the funders

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.  Susan K Raatz, LuAnn K Johnson, and Matthew J Picklo.  J. Nutr. 2015; 145:2265-2272 doi:10.3945/jn.115.218016 

  • Conclusions: Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG [triglyceride] concentrations in both GT [glucose tolerant] and IGT [glucose intolerant] individuals and elevated glycemic and inflammatory responses in the latter.
  • Funding: Supported by a grant from the National Honey Board and by the USDA Agricultural Research Service.
  • Comment.  The authors hypothesized that honey would result in improved glycemia and insulin sensitivity compared with sucrose and HFCS.  But they found that their “data do not support the contention that the consumption of honey vs. HFCS or sucrose provides an added health benefit for maintenance of glucose homeostasis and other cardiometabolic outcomes because all 3 sugars evaluated exerted similar metabolic effects.”

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohortsViranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

  • Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
  • Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from other Canadian government agencies or health associations.  This, therefore is actually an independently funded study.
  • Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….
  • Comment: In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.  If nothing else, this study is evidence for the importance of independent funding of nutrition research.

The score, for those of you following this saga, is now 65 studies with results favoring the sponsor to 5 with unfavorable results.  But I will soon be posting another 5 of the former kind.

Sep 29 2015

Cocoa flavanols: science or marketing?

Sunday’s New York Times carried this full-page advertisement.

cocoa via

The ad is from Cocoa Via, a company owned by Mars.  It quotes a dietitian stating that cocoa flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”

The ad directs you to the full story at nytinmes.com/cocoavia (where you see more ads).

I posted the science behind this ad earlier this month in my collection of industry-funded studies with results favorable to the sponsor’s interests.  To repeat:

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 Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

  • Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
  • Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… 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. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
  • Comment: Lest the “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”

Now we have a full-page ad in the New York Times.

Here’s what the ad does not say:

  • CocoaVia is owned by MARS, Inc (this appears nowhere in the ad).
  • Flavanols are usually destroyed during normal cocoa processing.
  • Most chocolate contains few flavanols; CocoaVia’s process preserves some of the flavonols in very dark chocolate.
  • Flavonol-rich or not, chocolate candy is not a health food.

Like most conflicted research, this is about marketing—hence, the ad—not science.

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