Currently browsing posts about: Sponsored-research

Hand Cardullo writes in Forbes: 87% Of Sweetened Products Contain Added Sugars Only, Study Finds.   

That seemed interesting.  But then I got to the sub-headline: New Georgetown University report cites need for more low- and no-calorie sweeteners.

As public health officials clamor to remove added sugars from food and beverage products, a new study published by the Georgetown University Business for Impact Center signals that there is much heavy lifing ahead (full disclosure: I served as an author of the paper). The report noted that added sugars dominate products containing sweeteners, with 87% of items formulated this way. Only 8% of sweetened items contain low- or no-calorie sweeteners (LNCS) only, with 5% consisting of a combination of the two. The paper concluded that increased use of LNCS was necessary to eliminate meaningful amounts of added sugars and that LNCS offered effective and safe ways to do so.

Cardullo says: “Here are some things to consider:

• If public health organizations want to achieve their added sugar reduction goals, they must step up and communicate the efficacy and safety of LNCS in helping consumers manage and lose weight. This will go a long way in helping to clear up consumer confusion.
• The evidence suggests that the public health community must use only the best studies to advance firm points of view on the use of LNCS.
• To help reduce added sugars, food and beverage companies should incorporate LNCS into more of their products.”

Really?  My usual question: Who paid for this?

The paper: Moving Towards Healthier Eating Habits: Why Low- and No-Calorie Sweeteners Play a Critical Role

The funder: “Funding for this paper was provided by the Calorie Control Council” [an international association representing the low- and reduced-calorie food and beverage industry].

Comment: Here is one of the figures from the paper.

This shows that 24% of added sugars come from sugar-sweetened beverages, and another 19% come from desserts and snacks.

Cutting down on both is a good idea on its own, and one that does not require the addition or substitution of artificial sweetneners.

I’m talking about the mushrooms in grocery stores here, not the psychodelic varieties.  A reader who is a member of the Academy of Nutrition and Dietetics, but wishes to remain anonymous, forwarded this message to members of the academy.

From: Mushroom Council <info@mushroomcouncil.com>
Date: August 18, 2023 at 11:04:09 AM EDT
To: [REDACTED]
Subject: Re: New, free meal plans for your clients + cognition research update
Reply-To: Mushroom Council <info@mushroomcouncil.com>

NUTRITION NEWS ABOUT MUSHROOMS  |

…Researchers have been exploring the potential role of mushroom consumption in cognitive function. While more research is needed, the emerging evidence is encouraging. Below are some highlights from the current body of evidence:

• • • • A cross-sectional study exploring the association between mushroom intake and mild cognitive impairment (MCI) among 663 Singaporean adults aged 60 and older found that individuals who consumed more than two servings of mushrooms per week (1 ½ cups total) had reduced odds of having MCI compared to people who consumed mushrooms less than once per week.¹ Fresh golden, oyster, shiitake, and white button mushrooms; dried mushrooms; and canned button mushrooms were included in the analysis of mushroom intake.
      • A prospective cohort study examined the relationship between mushroom consumption and incident dementia in a population of 13,230 elderly Japanese subjects aged 65 and older.² Participants who consumed mushrooms one to two times per week and more than three times per week had a 5% and 19% lower chance of developing dementia, respectively, compared to people who consumed mushrooms less than one time per week. After further analysis by gender, an inverse relationship between mushroom consumption and incident dementia was only found in women.
      • A double-blind, parallel-group, placebo-controlled trial investigated the impact of lion’s mane mushroom (Hericium erinaceus) supplementation on cognitive impairment among 30 Japanese men aged 50 to 80 years with MCI.³ Participants were randomized to two groups; one group took tablets containing lion’s mane in dry powder form three times a day for 16 weeks and other group was given a placebo. Participants were observed for four weeks after consuming the supplement for 16 weeks. Compared to the placebo group, the lion’s mane group showed significantly increased scores on the cognitive function scale, based on the Revised Hasegawa Dementia Scale (HDS-R), throughout the trial. Four weeks after stopping supplementation, the scores decreased significantly. The placebo group scores also showed significant increases at weeks 8 and 16, compared to the start of the trial. Researchers believe possible causes of an increase might be the placebo effect or familiarity with the cognitive function scale.
      • A cross-sectional study looking at the association between mushroom consumption and cognitive performance among 2,840 older adults aged 60 years and older found that greater mushroom intake was associated with certain cognitive performance tests.⁴

  Findings from cross-sectional and prospective cohort studies do not demonstrate cause and effect relationships – only associations. In addition, these studies cannot be generalized to the broader population, relied on self-reported dietary information which may not always be accurate, and residual confounding could have impacted the results even though researchers adjusted for a range of confounding factors, such as age, education, lifestyle behaviors, and more.

  Future clinical trials in broader populations will help shed light on the unique role of mushrooms in cognition and overall health.

  Sources:1. Feng L, Cheah IK, Ng MM, et al. The Association between Mushroom Consumption and Mild Cognitive Impairment: A Community-Based Cross-Sectional Study in Singapore. J Alzheimers Dis. 2019;68(1):197-203. doi:10.3233/JAD-180959 2. Zhang S, Tomata Y, Sugiyama K, Sugawara Y, Tsuji I. Mushroom consumption and incident dementia in elderly Japanese: The Ohsaki Cohort 2006 study. J Am Geriatr Soc. 2017;65(7):1462Y1469. 3. Mori K, Inatomi S, Ouchi K, Azumi Y, Tuchida T. Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial. Phyther Res. 2009;23(3):367Y372. 4. Ba DM, Gao X, Al-Shaar L, et al. Mushroom intake and cognitive performance among US older adults: the National Health and Nutrition Examination Survey, 2011-2014. Br J Nutr. 2022;128(11):2241-2248. doi:10.1017/S0007114521005195

Comment: This is typical of the kind of thing companies send out to dietitians nearly every day.  The Mushroom Council knows perfectly well that the probability of mushrooms having anything to do with improved cognitive ability has to be vanishingly small.  Its critique in the last paragraph tells you everything you need to know.  The Council sponsored some of the studies cited.  This is about marketing mushrooms.  If you like them, enjoy.  If not, don’t bother.  Note to the Academy of Nutrition and Dietetics: Such notices should be labeled clearly as advertisements.  Members should also be told how much companies pay the Academy for such mailings.

Thanks to a reader, Kevin Mitchell, for sending this news item: Animal vs. Plant Protein: New Research Suggests That These Protein Sources Are Not Nutritionally Equivalent.

Scientists found that two-ounce-equivalents (oz-eq) of animal-based protein foods provide greater essential amino acids (EAA) bioavailability than the same quantity of plant-based protein foods. The study challenges the Dietary Guidelines for Americans (DGAs) which suggest these protein sources are nutritionally equivalent.

I went right to the source.

• The study: Connolly G, Hudson JL, Bergia RE, Davis EM, Hartman AS, Zhu W, Carroll CC, Campbell WW. Effects of Consuming Ounce-Equivalent Portions of Animal- vs. Plant-Based Protein Foods, as Defined by the Dietary Guidelines for Americans on Essential Amino Acids Bioavailability in Young and Older Adults: Two Cross-Over Randomized Controlled Trials. Nutrients. 2023; 15(13):2870. https://doi.org/10.3390/nu15132870
• Objectives: We assessed the effects of consuming two oz-eq portions of pork, eggs, black beans, and almonds on postprandial EAA bioavailability in young and older adults.
• Methods: We conducted two investigator-blinded, randomized crossover trials in young (n = 30; mean age ± SD: 26.0 ± 4.9 y) and older adults (n = 25; mean age ± SD: 64.2 ± 6.6 y). Participants completed four testing sessions where they consumed a standardized meal with two oz-eq of either unprocessed lean pork, whole eggs, black beans, or sliced almonds.
• Conclusions: Pork resulted in greater EAA bioavailability than eggs in young adults (p < 0.0001), older adults (p = 0.0007), and combined (p < 0.0001)… The same “oz-eq” portions of animal- and plant-based protein foods do not provide equivalent EAA content and postprandial bioavailability for protein anabolism in young and older adults.
•  Funding: This research was funded by the Pork Checkoff and the American Egg Board—Egg Nutrition Center. The supporting sources had no role in study design; collection, analysis, and interpretation of data; writing of the report; or submission of the report for publication.
• Conflicts of Interest: When this research was conducted, W.W.C. received research funding from the following organizations: American Egg Board’s Egg Nutrition Center, Beef Checkoff, Pork Checkoff, North Dakota Beef Commission, Barilla Group, Mushroom Council, and the National Chicken Council. C.C.C. received funding from the Beef Checkoff. R.E.B. is currently employed by Archer-Daniels-Midland (ADM); the research presented in this article was conducted in a former role and has no connection with ADM. G.C., J.L.H., E.M.D., A.S.H. and W.Z. declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Comment: It is very much in the interest of the Pork Checkoff and the Egg Board t,o demonstrate that animal-source food protein is better for you than proteins from plant sources—and to cast doubt on any evidence to the contrary.  Proteins, whether from animal or plant sources, contain precisely the same 20 amino acids, although in different proportions.  Animal proteins are closer in amino acid composition than are plant proteins but if you eat a variety of plant foods you will get the amino acids you need.   People who eat largely plant-based diets are generally healthier than people who eat a lot of animal-based foods.  The conclusion of this study does not change that overall conclusion.  This, then, is another industry-funded study with predictable results.

It was hard to miss this headline in Dairy Reporter: “Cheese intake could lower risk of dementia, study suggests.”

No kidding?  I wonder who paid for this?

To its credit, the article did full disclosure:

The study was conducted as part of broader research commissioned by Japanese dairy major Meiji Co., Ltd. and part-funded by the company.

I went right to it.

The study: Kim H, Osuka Y, Kojima N, Sasai H, Nakamura K, Oba C, Sasaki M, Suzuki T. Inverse Association between Cheese Consumption and Lower Cognitive Function in Japanese Community-Dwelling Older Adults Based on a Cross-Sectional Study. Nutrients. 2023; 15(14):3181. https://doi.org/10.3390/nu15143181

Purpose: “We investigated whether cheese intake is associated with lower cognitive function (LCF) in community-dwelling older adults.”

Method: “This cross-sectional study included 1503 adults aged over 65 years. The analyzed data were obtained through face-to-face interviews and functional ability measurement.”

Results: Cheese intake, along with usual walking speed and calf circumference to be significant factors associated with LCF.

Conclusions: Cheese intake is inversely associated with lower cognitive function.

Funding: This study was funded by the Japan Agency for Medical Research and Development , the National Center for Geriatrics and Gerontology, and Meiji Co., Ltd.

Conflicts of Interest: “This study was conducted as a part of the ‘Epidemiology study of the relationship between dairy products intake and cognitive function’ commissioned by Meiji Co., Ltd. T.S. holds the position of Commissioned Research Chair, and H.K. is a member of the Commissioned Research group. K.N., C.O., and M.S. are employees of Meiji Co., Ltd. The other authors declare no conflict of interest. The funding sponsors had no role in the execution, analysis, or interpretation of the data or the writing of the manuscript.

Comment: Meiji Holdings Co Ltd (Meiji) 

is a manufacturer and distributor of dairy products, confectionery, and nutritional products. The company’s product portfolio comprises milk, yogurt, cheese, ice cream, chocolates, and gummy candies. The company also provides beauty supplements, protein products, nutritional products, vaccines, antibacterial agents, and generic drugs. The company markets its products under Meiji, Essel, Oishii Gyunyu, DepromeL, Reflex, Kaju Gummy, Kinoko no Yama, Galbo, Amino Collagen, Savas, Sycrest, Streptomycin, Kanamycin, Depromel, and Metact brand names…Meiji is headquartered in Chuo-Ku, Tokyo, Japan.

Five of the authors work for the company.

Does eating cheese reduce the risk of dementia?  You read the paper and decide.  I think you can’t make this stuff up.

When I saw this article—Study: Orange and pomegranate extract impacts major marker for healthy ageing—my first thought was “Who paid for this?”  Bingo.

The study: Ahles, S., Cuijpers, I., Hartgens, F. et al. The Effect of a Citrus and Pomegranate Complex on Physical Fitness and Mental Well-Being in Healthy Elderly: A Randomized Placebo-Controlled Trial. J Nutr Health Aging 26, 839–846 (2022). https://doi.org/10.1007/s12603-022-1834-4

• Objectives: This study investigates whether a citrus and pomegranate complex (CPC) improves physical fitness, mental well-being, and blood biomarkers for oxidative stress and endothelial function in healthy elderly.
• Design: A randomized placebo-controlled cross-over trial.
• Participants: The study included 36 healthy elderly aged 60–75 years old.
• Intervention and Measurements: Participants received four weeks of CPC supplementation and performed the handgrip strength and senior fitness test. Quality of life (QOL) was assessed and blood samples were analyzed for oxidative stress and endothelial function markers.
• Results: After four weeks of CPC supplementation, handgrip strength significantly improved (p=0.019), compared to placebo. Moreover, the thinking, memory, learning, and concentration facets were improved (p=0.042), compared to placebo, and plasma malondialdehyde decreased, compared to placebo (p=0.033). The intervention did not affect senior fitness and the other QOL domains and blood parameters.
• Conclusion: Four weeks of daily CPC supplementation significantly improves handgrip strength and self-evaluated measures of psychological function in healthy older adults. Further research should focus on mechanisms associated with physical performance.
• Funding: Funding: Authors IC and FT are supported by the Province of Limburg, The Netherlands [grant number HEFI-2]. This research project was supported by BioActor B.V.
• Ethics declarations: Conflict of interest: S.A. is an employee of BioActor BV. F.H. is a sports medicine consultant and owner of Sports Medicine Center Maastricht*Parkstad. All other authors declare no conflict of interest. The funders had no role in the design of the study, in the preparation of the manuscript, or in the decision to publish the results.

Comment: This is a classic example of a study nobody but the product maker would ever do.  The statement that the funders had nothing to do with the study design or anything else may or may not be true—there have been too many examples of its not being true to take any such statement seriously without much further discussion.  Even with that assurance, researchers who accept industry funding rarely recognize industry influence—it seems to occur at some unconscious level.

I missed posting these last week (oops).

Blueberries set the standard for industry-funded studies (I discussed the origins of blueberry-industry funding in my book, Unsavory Truth).  Blueberry producers are still at it.  Here are two examples.

I.  This one started with a press release sent to my email:

From: Blueberries <updates@blueberrycouncil.org>
Date: August 29, 2023 at 11:59:59 AM EDT
Subject: Study Alert: New Research Links Blueberries to Gut Health Benefits

A new study published in Nutrients suggests blueberries may hold benefits for those suffering from functional gastrointestinal disorders (FGID). In this study, FGID patients saw greater abdominal symptom relief and improved markers of well-being, quality of life, and life functioning after consuming freeze-dried blueberry powder for 6 weeks as compared to a placebo treatment.

The study: Wilder-Smith CH, Materna A, Olesen SS. Blueberries Improve Abdominal Symptoms, Well-Being and Functioning in Patients with Functional Gastrointestinal Disorders. Nutrients. 2023; 15(10):2396. https://doi.org/10.3390/nu15102396.

Conclusion: Blueberries relieved abdominal symptoms and improved general markers of well-being, quality of life, and life functioning more than placebo in patients with FGID. Consequently, the polyphenol and fiber components of blueberries exert broad beneficial effects separate from the sugars present in both treatments.

Funding: This research was funded by a grant from the US Highbush Blueberry Council.

Comment: Of course it was.

II.  I read about this one in ConscienHealth.

Burning Fat with Wild Blueberries in 11 Athletes

This is nearly perfect clickbait that is just about meaningless for an average person in real life. Researchers did a study of fat oxidation after consuming freeze-dried powder from wild blueberries. They found an increased oxidation rate associated with consuming that powder in the 11 aerobically trained males they studied. So the press office at Cal Poly Humboldt, where the researchers work, issued a release saying wild blueberries help with burning fat.  From there, twitter and health reporters take the next leap, writing headlines like “eating wild blueberries can help you lose weight.”

The study: Pilolla KD, Armendariz J, Burrus BM, Baston DS, McCarthy KA, Bloedon TK. Effects of Wild Blueberries on Fat Oxidation Rates in Aerobically Trained Males. Nutrients. 2023; 15(6):1339. https://doi.org/10.3390/nu15061339.

Conclusion: “Results indicate that WBs may increase the rate of FAT-ox during moderate-intensity activity in healthy, active males.”

Funding: “This research was funded by Cal Poly Humboldt’s Dean of Research.* Freeze-dried Wild blueberry powder was donated by the Wild Blueberry Association of North America (WBANA).“

Comment: I agree that simply providing product to be tested is not an earth-shaking conflict of interest, but because the powder came from the WBANA the ties seem closer.  In any case, the idea that blueberry powder—not nearly as delicious as the real thing—can have these kinds of effects should raise eyebrows from the get go.  Studies of the health effects of one sincle food always require critical thinking and more than a modicum of skepticism.

As for the asterisk*:  My son went to Humboldt State College (long before it was taken over by Cal Poly) so I was especially interested in this.

I want to end the week with this unusual example.

Yes, avocados are fruits (hint: fruits have seeds).

This story begins with an emailed ad from an avocado trade association to subscribers to Today’s Dietitian.

In the largest study of its kind, published in the Journal of the American Heart Association, researchers across multiple institutions looked at the impact of consuming one avocado per day on weight-related measures, markers of cardiometabolic risk and diet quality—insights you won’t want to miss.

If you click around to further discussion, you get this:

Daily avocado consumption led to reductions in total and LDL cholesterol and improved diet quality compared to the control group. The Avocado Nutrition Center supported this study, and although the findings from one study cannot be generalized to larger populations, this study supports a growing body of evidence that suggests consuming heart-healthy avocados is associated with better diet quality.

Let’s take a look:

• The study: Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial. J Am Heart Assoc. . 2022 Jul 19;11(14):e025657.  doi: 10.1161/JAHA.122.025657. Epub 2022 Jul 5.  Authors: Alice H Lichtenstein ¹, Penny M Kris-Etherton ², Kristina S Petersen ³, Nirupa R Matthan ¹, Samuel Barnes ⁴, Mara Z Vitolins ⁵, Zhaoping Li ⁶, Joan Sabaté ⁷, Sujatha Rajaram ⁷, Shilpy Chowdhury ⁴, Kristin M Davis ⁸, Jean Galluccio ¹, Cheryl H Gilhooly ¹, Richard S Legro ⁹, Jason Li ⁶, Laura Lovato ¹⁰, Letitia H Perdue ¹⁰, Gayle Petty ¹, Anna M Rasmussen ⁶, Gina Segovia-Siapco ⁷, Rawiwan Sirirat ⁷, April Sun ⁶, David M Reboussin ¹⁰
• Conclusions: “In conclusion, in this randomized controlled multicenter parallel trial, the addition of 1 avocado per day to the habitual diet for 6 months in individuals with visceral adiposity did not reduce VAT and had minimal effect on risk factors associated with cardiometabolic disorders.”
• Funding: This work was supported by the Avocado Nutrition Center.

Comment: I don’t usually include the names of authors of industry-funded studies because I don’t see the “funding effect” (a higher probability of positive results) as personal to individual investigators; I see it as systematic.  But I listed these authors because they produced something quite rare: an industry-funded study that did not find positive results.  And they said so explicitly, without hedging or trying to spin the results so they looked  more favorable.

The avocado marketers did the spinning.  This, alas, is yet another hazard of  doing studies funded by food trade associations with vested interests in research outcome.  Investigators have no control over how the sponsor will use or spin their research results, as we see in this example.

Addition, September 16

I often hear criticisms that I don’t deal with the science when I post industry-funded studies.  I don’t because how the science is conducted is rarely the problem.  Instead, industry influence turns up most frequently in the study design or in the interpretation of the results.  That’s what’s happening here, as a reader, mrpicasso2, writes:

Wow! This is astounding how the Avocado marketers try to spin the results in their favor. “Changes in most secondary and additional outcome measures (cardiometabolic risk factors), except for modest decreases in total cholesterol and LDL‐C concentrations, were not statistically significant” became “Daily avocado consumption led to reductions in total and LDL cholesterol and improved diet quality compared to the control group.”

And even the “improved diet quality” is a big stretch because the Healthy Eating Index (HEI) values (even when split into below and above the median subgroups) were not significantly different. It’s true the avocado arm values were numerically higher (0.064 vs 0.044, and 0.083 vs 0.069) but without reaching statistical significance they are indistinguishable.

Of course the Avocado marketers don’t mention that there were 9 adverse events in the Avocado diet arm compared with none in the habitual diet group.

This reminds me of the story of the boy who was so excited to get a pile of horse manure for his birthday because he reasoned that with so much manure there had to be a pony near by.

The study:  Martinez-Canton M, Galvan-Alvarez V, Garcia-Gonzalez E, Gallego-Selles A, Gelabert-Rebato M, Garcia-Perez G, Santana A, Lopez-Rios L, Vega-Morales T, Martin-Rincon M, et al. A Mango Leaf Extract (Zynamite^®) Combined with Quercetin Has Exercise-Mimetic Properties in Human Skeletal Muscle. Nutrients. 2023; 15(13):2848. https://doi.org/10.3390/nu15132848

Hypothesis:  Zynamite PX^®, a mango leaf extract combined with quercetin, enhances exercise performance by unknown molecular mechanisms.

Conclusion: Zynamite PX^® elicits muscle signaling changes in resting skeletal muscle resembling those described for exercise training and partly abrogates the stress kinases responses to exercise as observed in trained muscles.

Funding: This investigation was co-financed in part by Nektium Pharma S.L., Ministerio de Economía y Competitividad…Consejo Superior de Deportes de España (EXP_75097), FEDER and Cabildo de Gran Canaria…and FDCAN (Fondo de Desarrollo de Canarias).

Conflicts of Interest: The present investigation was partially financed by Nektium Pharma S.L, who provided the polyphenolic compounds and participated in the experimental design, although they were fully excluded from participation in experimental data collection, data analysis and interpretation of results. The remaining funding agencies had no role in study design, data collection, management, data analysis, interpretation of data, writing of the report, and the decision to submit the report for publication.

Comment: This is a classic example of an industry-funded supplement study with favorable interpreted favorably.  The manufacturer paid for the study as part of a private-public partnership to aid businesses in the Canary Islands.