by Marion Nestle

Currently browsing posts about: Conflicts-of-interest

Aug 14 2023

Industry-influenced study of the week: Kombucha

The study: Kombucha tea as an anti-hyperglycemic agent in humans with diabetes – a randomized controlled pilot investigation.  Mendelson Chagai, Sparkes Sabrina, Merenstein Daniel J., Christensen Chloe, Sharma Varun, Desale Sameer, Auchtung Jennifer M., Kok Car Reen, Hallen-Adams Heather E., Hutkins Robert.  Frontiers in Nutrition.  2023;10.  DOI=10.3389/fnut.2023.1190248.

Purpose: “Kombucha is a popular fermented tea that has attracted considerable attention due, in part, to its suggested health benefits. Previous results from animal models led us to hypothesize kombucha may reduce blood sugar levels in humans with diabetes. The objective of this pilot clinical study was to evaluate kombucha for its anti-hyperglycemic activities in adults with diabetes mellitus type II.”

Method: 12 study subjects were instructed to consume kombucha or a placebo (240 ml each) for 4 weeks, then later switch to the other one.

Results: “Kombucha lowered average fasting blood glucose levels at 4 weeks compared to baseline (164 vs. 116 mg/dL, p = 0.035), whereas the placebo did not (162 vs. 141 mg/dL, p = 0.078).”

Conclusion: “In this pilot study, the effect of kombucha consumption on blood glucose levels in adult T2D subjects revealed positive effects. Nonetheless, this study was not sufficiently powered to provide more definitive conclusions.”

Acknowledgment: “We thank Craft Kombucha, Kombucha Brewery in Washington, DC, and especially founder Tanya Maynigo-Loucks for donating the kombucha and for creating and donating the placebo drink for this study.”

Conflicts of interest: “RH is a co-founder of Synbiotic Health; JA has a financial interest in Synbiotic Health. DM serves as President of the Board of Directors of the International Scientific Association for Probiotics and Prebiotics, a non-paid position. All kombucha and placebo drinks were donated by Craft Kombucha. Craft Kombucha did not have any access to data reported in this study. No author has any financial ties with Craft Kombucha. SD was employed by MedStar Health. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Comment: Synbiotic Health develops and sells probiotic ingredients.  Its “mission is to harness the power of the human microbiome, using the best science to develop precise, scientifically validated microbiome ingredients that support optimal health in every age group.”  Craft Kombucha sells its products in classy cans.  Kombucha is a fermented sweet tea; it contains bacteria and yeast (probiotics).   It’s easy to find claims for its health benefits if you search for them, but much harder to find science to back them up.  IIf you can demonstrate benefits, you can sell more products.  Hence, this study.  High marks to the authors for including the disclaimer: “this study was not sufficiently powered to provide more definitive conclusions.”  Indeed.

My bottom line: drink kombucha if you like it, but don’t expect miracles.

Thanks to Laura Schmidt for this one.  Both of us like kombucha drinks, by the way.

Aug 7 2023

Industry-funded study of the week: sugar!

My thanks to Paola Baratto for sending this one.

The study: . Intakes of Added Sugars, with a Focus on Beverages and the Associations with Micronutrient Adequacy in US Children, Adolescents, and Teens (NHANES 2003–2018).  Ricciuto L, Fulgoni VL III, Gaine PC, Scott MO, DiFrancesco L.   Nutrients. 2023; 15(15):3285. https://doi.org/10.3390/nu15153285.

Method: This is an analysis of links between added sugars from different kinds of drinks and nutrient adequacy in children using combined data from 8 consecutive NHANES surveys (2003-2018).

Results: I found the results hard to understand because they are presented selectively by age, and they compare nutrient intakes to estimated average requirements.  Here is what I think they mean:

  • 2 to 8 year olds: If they got their sugar from flavored milk, they had better calcium intake.
  • 9 to 18 year olds: If they got their sugar from soft drinks, coffee, or tea, thei had worse intakes of magnesium and vitamins A and C.  But if they got their sugars from fruit drinks or flavored milk, they had better intake of vitamin C (from the fruit drinks), and of calcium, magnesium, phosphorus, vitamin A, and potassium (from the flavored milk).
  • 9 to 18 year olds: Higher intake of added sugars in the overall diet was associated with bettter intake of vitamins and minerals.

Conclusion: The results suggest that the relationship between added sugars intake and micronutrient adequacy depends on the added sugar sources and their nutrient composition.

Funding: The funding for this research was provided by The Sugar Association, Inc. P.C.G. and M.O.S. are employed by The Sugar Association Inc., had input in the study design, and reviewed and edited the manuscript.

Comment: The Sugar Association’s purpose in sponsoring this study is to buttress its argument that sugary drinks and foods have nutrients and, therefore, do not warrant restrictions.  If you get the idea from this study that the more sugary foods you eat, the more nutrients you and your kids get, the Association will be even happier.  Sorry Sugar Association, but it is quite possible to consume adequate intakes of vitamins and minerals without eating sugary foods and doing so will make calories easier to control.  With this study, the Sugar Association got what it paid for.

Jul 27 2023

Industry-funded research #4: why it matters

I posted several examples of industry-funded studies this week in part to reduce my backlog but also because of charges that (1) doing so constitites ad hominem (personal) attacks on authors, (2) I should be focusing on the science, not who paid for it, and (3) I have my own ideological biases.

To the first point:

I do not see industry funding of research as a personal matter.  I see it as a systematic problem.

If I see a study titled “Effect of food product X on disease Y,” I can often guess that

  • The food’s manufacturer or trade association paid for it
  • The study outcome will be favorable to the funder’s commercial interests

This phenomenon is so systematic that it has a name: The Funding Effect.

To the second point

Researchers who study funding effects, and there are many, note that the scientific conduct of the studies is not usually an issue.  Instead, the influence of the funders shows up in the way the research question is framed or the results are interpreted.

The easiest way to explain the research question bias is to cite the requests for research proposals I often receive from food trade associations.  These say: “we have (this much money) for research to demonstrate the benefits of our product on (one or more of these conditions).”

These groups will not fund research proposals unlikely to show benefits.

As for interpretation, industry-funded studies tend to report null results as positive; I posted several such examples this week.

To the third point

Yes, I have ideological or opinion biases and I try to be as clear as I can about them.  All investigators have such biases; otherwise they wouldn’t be doing science.  We all have something we believe in that we would like to prove.  Such biases are not discretionary; everyone has them.  In contrast, industry funding is about selling products, not science and is completely discretionary; investigators can do science without it.

The evidence?

I review the evidence for what I’ve just said here in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

In it, I cite many other books and papers addressing these points.

We all come to the same conclusions:

  • Industry funding biases research.  But funded investigators do not recognize the influence, and deny it.
  • The statement that accompanies many disclosure statements—“The funder had no influence on the design, conduct, interpretation, or publication of the results,”—is often untrue and must be taken with some degree of skepticism.

I see industry funding of food and nutrition research as a serious problem for public perception.  Even when the research is not conflicted, it appears conflicted.  That alone is a systematic problem.

Jul 25 2023

Industry-funded study #2: artificial sweeteners

Thanks to Arjan van Groningen for this one.

The study:  The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-analysis. Zhang, R.; Noronha, J.C.; Khan, T.A.; McGlynn, N.; Back, S.; Grant, S.M.; Kendall, C.W.C.; Sievenpiper, J.L. Nutrients 2023, 15, 1050. https://doi.org/10.3390/nu15041050.

Conclusions: The available evidence suggests that NNS beverages sweetened with single or blends of NNS have no acute metabolic and endocrine effects, similar to water. These findings provide support for NNS beverages as an alternative replacement strategy for SSBs in the acute postprandial setting.

Funding: This work was supported by an unrestricted grant from the Institute for the Advancement of Food and Nutrition Sciences (IAFNS). The grant was awarded through a competitive request for the proposal process. The sponsor was not involved in the development of the study protocol and design, execution, analyses, interpretation of the data, or decision to publish. The protocol and results were presented to the Low- And No-Calorie Sweeteners Scientific Committee of IAFNS on several occasions with an opportunity for scientific dialogue.

Comment:  IAFNS is the new name for ILSI North America, a classic industry front group.  To its credit, the authors disclose the involvement of IAFNS in this review.  Check out the Conflict-of-Interest declarations from this group; they are legendary.

Conflicts of Interest: J.C.N. has worked as a clinical research coordinator at INQUIS Clinical Research. He has also received research support from Glycemia Consulting Inc. T.A.K. has received research support from the Canadian Institutes of Health Research (CIHR), the International Life Science Institute (ILSI), and the National Honey Board. He has taken honorariums for lectures from the International Food Information Council (IFIC) and the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America). He is funded by the National Honey Board. N.M., was a former employee of Loblaw Companies Limited, and is a current employee of Enhanced Medical Nutrition. She has completed consulting work for contract research organizations, restaurants, start-ups, the International Food Information Council, and the American Beverage Association, all of which occurred outside of the submitted work. S.M.G. has received honoraria from Dietitians of Canada and Diabetes Canada for the development and delivery of educational resources on the glycemic index in the past five years. C.W.C.K has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), the Almond Board of California, Barilla, the Canadian Institutes of Health Research (CIHR), the Canola Council of Canada, the International Nut and Dried Fruit Council, the International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd., the Peanut Institute, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, Barilla, the CaliforniaWalnut Commission, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (PepsiCo), the Peanut Institute, Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from Barilla, the CaliforniaWalnut Commission, the Canola Council of Canada, General Mills, the International Nut and Dried Fruit Council, the International Pasta Organization, Lantmannen, Loblaw Brands Ltd., the Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, the Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, the International Pasta Organization, the McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), the Chair of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD, and is a Director of Glycemia Consulting and the  Toronto 3D Knowledge Synthesis and Clinical Trials foundation. J.L.S. has received research support from the Canadian Foundation for Innovation, the Ontario Research Fund, the Province of Ontario
Ministry of Research and Innovation and Science, the Canadian Institutes of health Research (CIHR),  Diabetes Canada, the American Society for Nutrition (ASN), the International Nut and Dried Fruit Council (INC) Foundation, the National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, the Quaker Oats Center of Excellence, the United Soybean Board (USDA soy “Checkoff” program), the Tate and Lyle Nutritional Research Fund at the University of Toronto, the Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), the Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF), and the Nutrition Trialists Network Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received food donations to support randomized controlled trials from the Almond Board of California, the California Walnut Commission, the Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, Nutrartis, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, the International Food Information Council (IFIC), the Calorie Control Council, the International Sweeteners Association, and the International Glutamate Technical Committee. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Phynova, and Inquis Clinical Research. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, the European Association for the study of Diabetes (EASD), the Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves or has served as an unpaid member of the Board of Trustees and an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a member of the International Carbohydrate Quality Consortium (ICQC), an Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. R.Z. and S.B. have no conflicts of interest to declare.

Jul 24 2023

This week’s Industry-funded study #1: breakfast cereals

I have been sent so many examples of industry-funded studies that I can’t keep up with them.  This is a slow news week and I’m traveling, so how about I post several.  Here’s the first.

My thanks to Katie Iwanowski for sending this one.

The study: The Relationship of Ready-to-Eat Cereal Intake and Body Weight in Adults: A Systematic Review of Observational Studies and Controlled Trials Lisa M. Sanders, Mary R. Dicklin, Yong Zhu, Kevin C. Maki.  Advances in Nutrition, Volume 14, Issue 4, 2023, Pages 671-684.  https://doi.org/10.1016/j.advnut.2023.05.001.

Results:  RTEC[Ready to Eat Cereal] consumers (2 – 4 servings a week), as compared with non- and less frequent consumers have lower BMI, lower prevalence of overweight/obesity, less weight gain over time,  less anthropometric evidence of abdominal adiposity.

Conclusions:

  • RTEC may be used as a meal or snack replacement as part of a hypocaloric diet, but this approach is not superior to other options for those attempting to achieve an energy deficit.
  • RTEC consumption was not associated with significantly less loss of body weight, or with weight gain, in any of the RCTs.
  • RTEC intake is associated with favorable body weight outcomes in adults in observational studies.
  • RTEC does not hinder weight loss when used as a meal or snack replacement within a hypocaloric diet.

Funding: This research was funded by Bell Institute of Health and Nutrition, General Mills Inc. The funding sponsor commented on the study design’s early aspects, reviewed the final data, and provided input to the manuscript.

Author disclosures: LMS is a consulting scientist, and MRD and KCM are employees of Midwest Biomedical Research, which has received research funding from General Mills Inc and Kellogg Company. LMS has received funding from Kellogg Company. YZ is an employee of General Mills Inc.

Comment: This cereal study was funded by a cereal company which—this is quite unusual—disclosed its involvement in the study’s design, interpretation, and writing.  The study results are a classic example of interpretation bias.  Basically, breakfast cereals don’t make much difference to body weight (it’s overall calorie balance that counts), but the conclusions are spun positively.  I especially like the double negative, “not associated with significantly less loss….”

Jul 20 2023

Ultra-processed pushback #4: a debate

The British journal, Public Health Nutrition, published a debate about ultra-processed foods this month.

Invited commentaries

CON:  Michael Gibney.  Ultra-processed foods in public health nutrition: the unanswered questions,

Several definitions of the degree of processing have been proposed. However, when each of these is used on a common database of nutritional, clinical and anthropometric variables, the observed effect of high intakes of highly processed food, varies considerably.. Moreover, assigning a given food by nutritional experts, to its appropriate level of processing, has been shown to be variable. Thus, the subjective definitions of the degree of food processing and the coding of foods according to these classifications is prone to error…Another issue that need[s] resolution is the relative importance of the degree of food processing and the formulation of a processed food. Although correlational studies linking processed food and obesity abound, there is a need for more investigative studies.

PRO: Mark Lawrence.  Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets.  Also an addendum: Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets.

This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers.

Letters to the editor

CON: Mark J Messina, John L Sievenpiper, Patricia Williamson, Jessica Kiel, John W Erdman.  Ultra-processed foods: a concept in need of revision to avoid targeting healthful and sustainable plant-based foods

we take issue with his perspective on our recently published article in which we make two fundamental points. First, the common criticisms of ultra-processed foods (UPF) do not apply to soya-based meat and dairy alternatives more so than they do to their animal-based counterparts, meat and cows’ milk, despite the former being classified as UPF and the latter as unprocessed/minimally processed foods. Second, NOVA is overly simplistic and does not adequately evaluate the nutritional attributes of meat and dairy alternatives based on soya….We therefore stand by our opinion that NOVA does a disservice to the public by suggesting that because soya burgers and soyamilk are NOVA-classified as UPF, they should be avoided. These foods can aid in the transition to and maintenance of plant-based diets.

PRO:  Mark Lawrence. The need for particular scrutiny of claims made by researchers associated with ultra-processed food manufacturers.

In this Commentary, I referred to challenges the UPF concept presents to researchers with declared associations with UPF manufacturers. The interplay between nutrition research and commercial interests is a widely recognised phenomenon in the commercial determinants of health literature…UPF-related research has become highly politicised and the integrity of the claims presented by researchers associated with UPF manufacturers demands close scrutiny.

Comment

In his letter, Mark Lawrence noted my having included the paper by Messina et al as one of my “industry-funded studies of the week” on this website.  In it, I reproduced the unusually long conflict of interest declaration of the authors, many of them disclosing ties to companies making ultra-processed foods.  Again, the ultra-processed concept is backed up by an extraordinary amount of research far beyond the point where it can be ignored or dismissed out of hand.

Professor Lawrence explains why there is so much pushback: “It [the UPF concept] challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system.”

Jul 18 2023

Ultra-processed pushback #2: The UK’s Scientific Advisory Committee

The U.K.’s Scientific Advisory Committee on Nutrition (SACN) has released its statement on ultra-processed foods.

It dealt with the NOVA classification system (the one I used in yesterday’s post to define ultra-processed foods).  The committee does not like it much.

Assessment beyond the initial screen identified that the literature is currently dominated by NOVA, raising the risk that any limitations or biases present within the NOVA classification system may be replicated throughout the research literature.
While NOVA also met criterion 2 on a clear, usable definition and criterion 4 on the availability of data on inter-assessor agreement, assessment beyond the initial screen dentified less certainty on the clarity, reliability and feasibility of the system.

The SACN’s conclusions:

The SRs identified have consistently reported that increased consumption of (ultra-) processed foods was associated with increased risks of adverse health outcomes. However, there are uncertainties around the quality of evidence available. Studies are almost exclusively observational and confounding factors or key variables such as energy intake, body mass index, smoking and socioeconomic status may not be adequately accounted for.

…In particular, the classification of some foods is discordant with nutritional and other food-based classifications. Consumption of (ultra-) processed foods may be an indicator of other unhealthy dietary patterns and lifestyle behaviours. Diets high in (ultra-) processed foods are often energy dense, high in saturated fat, salt or free sugars, high in processed meat, and/or low in fruit and vegetables and fibre.

…The observed associations between higher consumption of (ultra-) processed foods and adverse health outcomes are concerning – however, the limitations in the NOVA classification system, the potential for confounding, and the possibility that the observed adverse associations with (ultra-) processed foods are covered by existing UK dietary recommendations mean that the evidence to date needs to be treated with caution.

Comment: Kevin Hall  et al’s well controlled clinical trial of ultra-processed versus merely processed diets is neither discussed nor cited in this statement.  Once again, I have no personal knowledge of how this statement was developed, but the U.K.s Soil Association has published a statement with the provocative title, Sticky fingers of food industry on government ultra-processed food review.

While we’re pleased that SACN has prioritised this review, and has acknowledged that ultra-processed foods are of “concern”, we’re disturbed that the committee’s conclusions may have been skewed by industry ties, conflicted financial interests, and a narrow framing of the science.

…But the committee is also guilty of losing the wood for the trees, failing even to raise concern about how ultra-processed foods have overtaken their own nutritional advice….Most people in the UK are failing to eat such a [healthy] diet, precisely because these foods have been displaced by ultra-processed products. The average child’s diet is more than 60% ultra-processed, and rates of obesity and ill health are rising sharply in turn. …SACN is oddly silent on case for re-balancing the diet and addressing the corporate capture of children’s food.

These omissions should prompt us to look more closely at the composition of the committee. SACN has sixteen members. One is a paid consultant working for Cargill, Tate & Lyle, and CBC Israel (a manufacturer and marketer of fizzy drinks such as Coca-Cola and Sprite); two are in receipt of funding from the meat and dairy industry; one is a shareholder in Sainsbury’s; and five are members of the American Society of Nutrition, which is funded by Mars, Nestlé, and Mondelez. Among SACN’s members is the Chair of International Life Sciences Institute (ILSI) Europe, a body that receives funding from some of the world’s largest food companies, such as Barilla, Cargill, Danone, General Mills, Mondelez, and PepsiCo; and two individuals with financial relationships with the British Nutrition Foundation, an organisation funded by British Sugar, Cargill, Coca Cola, Danone, Greggs, Kellogg, KP Snacks, Mars, McDonald’s, Mondelez, Nestlé, PepsiCo, Tate & Lyle, and Tesco. Two SACN members have been funded by Danone, one of the largest ultra-processed food companies in the world; one sits on the council of the Nestlé Foundation; and another is a former employee of Unilever, with current shares in the company worth “more than £5000”.

These declared interests do not imply corruption or bias on the part of SACN members, but they illustrate how pervasive are industry ties at the interface of science and policy.

Jul 17 2023

Industry-influenced study of the week: Ultra-processed foods are good for you!

I am devoting this week to the pushback against advice to reduce consumption of ultra-processed foods.  It is coming from the food industry, of course, government agencies with ties to the food industry, and nutritionists who focus on  the benefits of nutrients, without contextualizing the foods and diets they come from (“nutritionism”).

For the record, ultra-processed foods are :

  • Industrially produced
  • Bear little resemblance to the foods they were derived from
  • Typically contain additives for color, flavor, and texture
  • Cannot be made in home kitchens,
  • Are formulated to be irresistable,
  • Are associated with excessive calorie intake and poor health
  • Are extremely profitable to their makers
  • Cannot be made in home kitchens (a brief operating definition)

Ultra-processed food pushback #1: A study from the USDA and authors with conflicted interests

The USDA’s Agricultural Research Service is so proud of this study that it sent out a press release.

Scientists at the USDA Agricultural Research Service’s (ARS) Grand Forks Human Nutrition Research Center led a study that demonstrates it is possible to build a healthy diet with 91 percent of the calories coming from ultra-processed foods (as classified using the NOVA scale) while still following the recommendations from the 2020-2025 Dietary Guidelines for Americans (DGA). The study highlights the versatility of using DGA recommendations in constructing healthy menus.

The Study: Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using Ultra-Processed Foods.  Julie M. Hess, Madeline E. Comeau, Shanon Casperson, Joanne L. Slavin, Guy H. Johnson, Mark Messina, Susan Raatz, Angela J. Scheett, Anne Bodensteiner, Daniel G. Palmer.  The Journal of Nutrition, 2023.  https://doi.org/10.1016/j.tjnut.2023.06.028.

Purpose: “The purpose of this proof-of-concept study was to determine the feasibility of building a menu that aligns with recommendations for a healthy dietary pattern from the 2020 DGA and includes ≥80% kcal from UPF as defined by NOVA.”

Method: “we first developed a list of foods that fit NOVA criteria for UPF, fit within dietary patterns in the 2020 DGA, and are commonly consumed by Americans. We then used these foods to develop a 7-d, 2000 kcal menu modeled on MyPyramid sample menus and assessed this menu for nutrient content as well as for diet quality using the Healthy Eating Index-2015 (HEI-2015).”

Results: “In the ultra-processed DGA menu that was created, 91% of kcal were from UPF, or NOVA category 4. The HEI-2015 score was 86 out of a possible 100 points.”

Conclusions: “Healthy dietary patterns can include most of their energy from UPF, still receive a high diet quality score, and contain adequate amounts of most macro- and micronutrients.”

 Conflicts of Interest: “MM serves as the Director of Nutrition Science and Research for the Soy Nutrition Institute (SNI) Global. The SNI Global receives funding from soybean farmers via the soybean national checkoff program and via membership dues from companies involved in manufacturing and/or selling soy ingredients and/or soyfoods. GHJ serves as Senior Advisor to the McCormick Science Institute. JLS serves on advisory/consultant boards for Simply Good Foods, Quality Carbohydrates Coalition, and the Sustainable Nutrition Scientific Board and has received funding from the National Institutes of Health, Taiyo, Barilla Foods, and the USDA in the past 12 mo. The other authors report no conflicts of interest.”

Funding: This work was supported by USDA Agricultural Research Service project grant #3062-51000-057-00D.

Comment:  I can think of only one reason for doing a study like this: to cast doubt on the concept of ultra-processed foods (UPF) and all the research showing that UPF diets induce people to eat more calories (see the study by Kevin Hall et al) and are strongly associated in hundreds of studies with poor health, evidence that by this time is overwhelming and incontrovertible.  Why now?  Because the 2025-2030 Dietary Guidelines Advisory Committee has been charged with examining the relationship of UPF to heart disease risk.

The first rule of the ‘Playbook” is to cast doubt on the research, which is what we are seeing here.  The message to reduce consumption of ultra-processed foods makes good sense for health reasons.  But such advice is very bad for the profits of food companies making junk foods.

The USDA’s Agricultural Research Service is a marketing arm of the food industry,.  It is heavily conflicted.

For one thing, the Healthy Eating Index is not useful for this purpose; it is strictly nutrient-based, which is not the issue here.  And the Dietary Guidelines are careful to leave plenty of room for eating junk foods and to say not one word about UPF.

I think the UPF concept is so solidly backed up by evidence that it is here to stay.  But it is so threatening to food companies making UPF products, and the USDA is so captured by the food industry (checkoff programs, anyone?) that it is understandable why they are so eager to cast doubt.

Thanks to the half dozen or so readers who sent this one to me, to Ted Kyle for calling it “oxymoronic healthy eating,” and  Kevin Hall for pointing out that the healthfulness of this diet is assumed, not tested: