by Marion Nestle

Currently browsing posts about: Sponsored-research

Jul 19 2016

Check out who funded this study of kids’ lunches in Brazil

Brazilian researchers have published a study clearly aimed at countering Brazil’s dietary guidelines, which the authors say, include advice to “avoid fast food.”

The study, which looked at the nutritional quality of children’s lunches, comes to three conclusions:

  1. The nutrition quality of lunch in fast food restaurants is similar to a typical Brazilian meal [Really?  Who paid for this?].
  2. The restaurant meals could fit into a balanced diet from time to time [Of course.  Anything can].
  3. Every meal observed here could be improved with regard to sodium and fiber to promote children’s health in adulthood [Ditto].

Did you guess?

The authors acknowledge Equilibrium Consultancy which led this study. Funding by McDonald’s Corporation for the project was primarily to Equilibrium.

This is yet another industry-funded study with results favorable to the sponsor’s interests.  These especially require scrutiny of hypotheses, methods, and interpretation and repetition by independently funded investigators.

Jul 5 2016

The Disney-funded paper episode comes to closure (I sincerely hope)

My invited, accepted—but omitted—commentary about a study funded by Disney has at last been published by the Journal of the Association of Consumer Research.

In February, I explained how the editors had solicited this commentary, but then given it to the article’s authors to rebut, and allowed me to comment on their rebuttal.  None of this correspondence appeared when the journal published the Disney-funded article.

Could Disney’s involvement have anything to do with this omission?  The editors said no; they had just ran out of page room.

But in April, I wrote about how Stat had obtained e-mails between Disney and one of the authors indicating that the company had attempted to withdraw its study because it feared adverse publicity.  Some of the study’s authors had been associated with the Global Energy Balance Network, the group funded by Coca-Cola to promote the idea that physical activity is more important than diet in maintaining healthy weight.

When I complained about the omission of my accepted piece, the editors arranged to have it and the correspondence published in the journal’s June issue.

While the correspondence was in proof, I added a last line bringing the situation up to date: “Disney’s now exposed attempt to withdraw their paper from publication (Kaplan 2016) provides further evidence for the hazards of industry-funded research.”

Done.  Finished.  Amen.

Jun 27 2016

Israel’s solution to peanut allergies

While in Israel, I kept hearing that peanut allergies are virtually unknown in that country.  Nobody I met knows anyone with problems with peanuts—not Jews, Arabs, children, nor adults.

The explanation?

Bamba (and its Arabic equivalent).

These things are peanut puffs.

Because they melt in the mouth, they are often fed to babies as a first food.  Apparently, babies love them.

How do they taste?  Just as you might expect (peanut-flavored straw?  peanut-flavored Cheetos?).  They are sold everywhere as a snack and I met adults who love them too.

Do they really prevent peanut allergies?  Indeed, there might be something to this idea.

Introduction of peanut products into the diets of infants at high risk of developing peanut allergy was safe and led to an 81 percent reduction in the subsequent development of the allergy, a clinical trial has found…Researchers led by Gideon Lack, M.D., of King’s College London, designed a study called Learning Early About Peanut Allergy (LEAP), based on observations that Israeli children have lower rates of peanut allergy compared to Jewish children of similar ancestry residing in the United Kingdom. Unlike children in the UK, Israeli children begin consuming peanut-containing foods early in life.

Translation:  Bamba.

These researchers also found that allergic reactions did not return even if the children in that trial stopped eating Bamba for a year.

Their studies were funded mainly by NIH and the UK Department of Health, but the researchers also report that their clinical trials unit was supported by the National Peanut Board, Atlanta, and that the manufacturer of Bamba supplied the products.  The lead author, Gideon Lack, reports holding stock in DBV Technologies, the maker of Viaskin Peanut, a product that helps people with peanut allergies tolerate exposure to peanuts.

I’d like to see these studies repeated by fully independent researchers.

In the meantime, pediatric allergists are advising parents to let their babies eat peanut butter (but not peanuts because babies can choke on them).

These allergists—and the authors of the Bamba studies—participated in an American Academy of Pediatrics consensus statement:

There is now scientific evidence (Level 1 evidence from a randomized controlled trial) that health care providers should recommend introducing peanut-containing products into the diets of ‘‘high-risk’’ infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy.

If these studies are right, introducing babies to the widest possible variety of foods as soon as they can handle solid foods (usually at 4 to 5 months) may well help prevent allergies later on.


A reader just sent another paper from the same authors, this one a randomized trial of six allergenic foods given to breastfed babies at 3 or 6 months of age.  By one analysis, allergies developed 1 to 3 years later in 7.1% of the later-introduction group and 5.6% of the earlier-introduction group—a result that was not statistically significant.  By another, allergies were much lower in the early-introduction group (2.4% vs 7.3%), especially with respect to peanut and milk allergies.  

Jun 3 2016

Weekend reading: Science & Nutrition Research

I’ve just started getting a new Science and Research newsletter from William Reed: Informing Business Growth.

Some of the listings focus on dietary patterns or emerging microbiome research:

But most of them focus on single nutrients, ingredients, or foods—suggesting that they are about marketing those ingredients, not necessary health (people don’t eat single foods exclusively; we eat meals and mixtures).

These are a lot of fun.  They raise the possibility of magic bullets (if only).

But watch out for the weasel words “may,” “could,” “might”.  These mean “may or may not,” “could or could not,” “might or might not.”

Wouldn’t you rather eat chocolate than beets?  That’s what such studies are about.  And I wonder how many of them are funded by the makers of the products.  Want to take a look?

May 5 2016

More on corporate funding of nutrition research: exchange of letters

In January this year, JAMA Internal Medicine published my Viewpoint on corporate funding of nutrition research: science or marketing.

Richard Kahn, former chief scientist and medical officer of the American Diabetes Association, wrote a letter in reply (see below for more about him**).  The journal published his letter, along with my response, in its current issue.  Here’s what I said.

In Reply Dr Kahn requests evidence that nutrition research funded by food companies is of lesser quality than studies funded by independent agencies or performed by investigators with nonfinancial conflicts of interest. Concerns about such issues are relatively recent; few published studies address them directly. Instead, concerns about industry sponsorship of nutrition research derive from comparisons with the results of studies of funding by tobacco, chemical, drug, or medical device companies. This research typically finds industry-sponsored studies to report results more favorable to the products of the sponsor than studies not funded by industry. It identifies subtle rather than substantive differences in the quality of this research; industry-funded studies are more likely to underreport unfavorable results and interpret neutral results more positively.1 When results are negative, they are less likely to be published.2

Between March 2015 and March 2016, I identified 166 industry-funded nutrition research studies and posted and discussed them on my blog.3 Of these, 154 reported results favorable to the interest of the sponsor; only 12 reported contrary results. The few studies systematically examining the influence of industry funding on nutrition research tend to confirm results obtained from other industries. For example, a systematic review comparing industry-funded and nonindustry-funded trials of probiotics in infant formula reported no association of funding source with research quality. Industry-funded studies, however, seemed more likely to report favorable conclusions unsupported by the data.4

Dr Kahn states that sponsored studies often specify that the funder had no role in the study. Only recently have some journals required such statements, and I am unaware of research on the extent of this practice or authors’ adherence to it. Among the 166 industry-funded studies that I reviewed, few disclosed involvement of a sponsor.

Dr Kahn asks whether industry funding is any more biasing than career self-interest or intellectual passion. Unlike industry funding, self-interest and passions are intrinsic to every scientist who conducts research, are a matter of public record, cannot be eliminated, and have not been shown to consistently bias research results in the same ways as industry funding.5 Fortunately, nutrition societies and research institutions are developing policies to manage financial relationships with industry.6 Such policies hold promise for preventing financial conflicts of research in nutrition research.

1. Lundh  A, Sismondo  S, Lexchin  J, Busuioc  OA, Bero  L.  Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012;12:MR000033. PubMed

2. Rising  K, Bacchetti  P, Bero  L.  Reporting bias in drug trials submitted to the Food and Drug Administration: review of publication and presentation. PLoS Med. 2008;5(11):e217. PubMed   |  Link to Article

3. Nestle  M. Food Politics Blog. Accessed March 2, 2016.

4. Mugambi  MN, Musekiwa  A, Lombard  M, Young  T, Blaauw  R.  Association between funding source, methodological quality and research outcomes in randomized controlled trials of synbiotics, probiotics and prebiotics added to infant formula: a systematic review. BMC Med Res Methodol. 2013;13:137. PubMed   |  Link to Article
5. Bero  L.  What is in a name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol. 2014;67(11):1239-1241. PubMed   |  Link to Article 
6. Charles Perkins Centre. Engagement with Industry Guidelines 2015. University of Sydney, 2015. Accessed March 2, 2016.
**Richard Kahn is infamous in my circles for supporting the positions of the sugar and soda industries while with the American Diabetes Association and now.  I wrote about what he said in an interview with Corporate Crime Reporter in my book What to Eat (pages 355-356).  Recently, The Russells (of CrossFit) had a lot more to say about Kahn’s ongoing opposition to public health measures.
Apr 19 2016

A rare industry-funded study with unhappy results for the Honey Board funder

The USDA has just done a write up on a study it funded in collaboration with the National Honey Board:  Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.

This was one of the 12 industry-negative studies I posted to my collection of 168 industry-funded studies from March 2015 to March 2016.


The USDA article explains:

Controversy exists over whether all sweeteners produce the same metabolic effects in consumers despite the sweeteners’ chemical similarities. A study conducted by U.S. Department of Agriculture (USDA) researchers indicates that consuming lower amounts of added sugars is a more effective approach to health than finding a sugar that is more neutral in terms of its health effects…Volunteers [consuming honey, white cane sugar, or HFCS] did not show any differences in blood sugar levels based on the dietary sugar source. In addition, blood levels of triglyceride, an indicator of blood fat concentrations (a marker for heart disease risk), increased in response to all three sugars tested.

White cane sugar is 50% glucose and 50% fructose, linked together (but quickly separated in the body).  Honey and High Fructose Corn Syrup are glucose and fructose, already separated, but with slightly higher percentages of fructose.  Biochemically, they are not all that different.

So the results of this study, disappointing as they may have been to the Honey Board, were predictable on the basis of basic sugar biochemistry.


Apr 11 2016

The strange story of my accepted but yet-to-be published commentary on a Disney-sponsored study gets stranger

Last week, revealed that the Walt Disney company tried to withdraw a research study it had funded because its University of Colorado authors, Jim Hill and John Peters, were behind the Global Energy Balance Network, the group funded by Coca-Cola to minimize the role of sugary drinks in obesity.

The headline: “Disney, fearing a scandal, tried to press journal to withdraw research paper.” based the story on e-mails obtained from the University of Colorado by Gary Ruskin of US Right to Know through open records requests.

An e-mail from John Peters to a Disney representative says “could I ask you to look this [draft press release] over and edit as you see fit.”

But the authors’ conflict-of-interest disclosure statement says:

This work was supported by the Walt Disney Company and by the National Institutes of Health (grant no. DK48520). The Walt Disney Company and the National Institutes of Health had no role in the design, analysis, or writing of this article.

This may be strictly true, but the authors were asking Disney to approve their press release, which is not exactly “no role.”

Readers: does any of this sound familiar?  In February, I wrote a blog post about precisely this article for which I wrote an invited Commentary, accepted by the journal but not published.  I said:

The paper turned out to be by a group of authors, among them John Peters and Jim Hill, both members of the ill-fated Global Energy Balance Network, the subject of an investigation by the New York Times last August…I thought Disney’s sponsorship of this research and its withholding of critical baseline and sales data on kids’ meals that the company considered proprietary did indeed deserve comment, and wrote my piece accordingly.  Brian Wansink [the journal editor] soon accepted it for publication but to my surprise, gave it to Peters et al. for rebuttal.  They filed a lengthy response.  I was then given the opportunity to respond, and did so, briefly.

My Commentary—and the back-and-forth—were omitted (although they are online and will be published in a later issue, apparently).

Brian Wansink wrote colleagues who are editing the next issue of the journal that the back-and-forth debate over the article “was heated, and it also dragged on (because of Disney approvals) and – as we feared – it missed the deadline of our issue.”

This suggests that Disney had even more of an involvement, but when I asked Wansink if Disney approvals were responsible for his having dropped my Commentary, he said no, they just ran out of room.

We now know that Disney was more involved than disclosed.  How involved?  We dont know but perhaps other e-mails will surface to answer that question.

In their Rebuttal to my Commentary, Hill and Peters said

We were disappointed by Dr. Nestle’s assertion that Disney’s decision to not allow publication of kid’s park attendance numbers or raw kid’s meal sales numbers (because of their proprietary nature in the competitive business of theme parks) and the fact that Disney funded the study raises “red flags” about the veracity of the data presented…While we believe caution and transparency are always key ingredients when working with industry we also believe that solving the obesity problem will require finding a productive model for working together that can channel everyone’s energy toward finding solutions.  The Disney study is a good example of why partnering with industry can help move the field forward.

I am sorry I disappointed them, but I disagree.

The e-mails demonstrate even more forcefully that the Disney study is a good example of why partnering with industry should raise acres of red flags.

To repeat my response:

The response from Peters and Hill still fails to acknowledge the severity of the problems posed by Disney’s sponsorship of their research—the company’s failure to produce data essential for proper interpretation of study results, and the level to which sponsorship by food companies biases such interpretations.  At one point, Disney boasted of the results of this research, confirming its benefit to marketing goals.  The threat of industry sponsorship to research credibility has received considerable press attention in recent months, as must surely be known to these authors. [References one and two]. 

Because of Disney’s funding, the company must have thought it had the right to determine whether and how its funded study would be published.  And, as these e-mails reveal, therein lies the problem.

Apr 7 2016

Sponsored research: raspberries this time

This morning, I received a query from a scientist:

I have been following your documentation of industry-funded research on health benefits. I’ve been thinking about this issue from the perspective of fruits and vegetables. We know that they are good in general, but how does one fund research to demonstrate that clinically? In particular, how does one get specific about the form and amount that his helpful for specific health benefits?  You may be interested in this press release from the raspberry industry telling about the papers at the Society for Experimental Biology meetings that are relevant to the health benefits of eating raspberries. This seems to be approaching what a good model might look like. I’m interested in your perspective. Furthermore, are the results relevant to nutritionists?

Here’s how I answered it:

Thanks for sending.  I guess my question would be something along the lines of why getting specific about form and amount of specific fruits and vegetables is important for public health.  People don’t eat just raspberries.  They put them in cereal or on desserts.  Raspberries are expensive.  Wealthy, educated and, therefore, healthy people are likely to consume them.  So this looks like marketing research to me—selling raspberries as a superfood.  If you think there is a special benefit to raspberries and that it would be good to quantify it, the best strategy would be to get the research funded by an independent agency.  Otherwise, it’s clearly marketing research (hence the press release).   At least that’s how I see it.

This, of course, gets us back to the question of sponsored research which, as my collection of sponsored studies has shown, almost inevitably produce results favorable to the sponsor.  I love raspberries and don’t doubt for a minute that they are healthy, but a superfood?  I don’t think so.

I’m still working on the descriptive analysis of the year’s collection of sponsored studies.  I will also be giving more thought to such questions, so send them along.

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