by Marion Nestle
Mar 16 2015

Conflicts of interest in nutrition research: recent examples

I’ve been collecting examples of conflicted research for the past week or so.  These are studies paid for in part by food businesses or trade associations with a vested financial interest in the outcome of the research.

These almost invariably promote the financial interests of the sponsor.  To wit:

Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trialby Daniela Mastroiacovo, Catherine Kwik-Uribe, Davide Grassi, Stefano Necozione, Angelo Raffaele, Luana Pistacchio, Roberta Righetti, Raffaella Bocale, Maria Carmela Lechiara, Carmine Marini, Claudio Ferri, and Giovambattista Desideri.  Am J Clin Nutr 2015; 101:538-548 doi:10.3945/ajcn.114.092189.

  • Conclusion: These data suggest that the habitual intake of flavanols can support healthy cognitive function with age.
  • Sponsor: Mars, Inc.

Sugar-Sweetened Product Consumption Alters Glucose Homeostasis Compared with Dairy Product Consumption in Men and Women at Risk of Type 2 Diabetes Mellitus, by Kevin C Maki, Kristin M Nieman, Arianne L Schild, Valerie N Kaden, Andrea L Lawless, Kathleen M Kelley, and Tia M Rains.  J Nutr. 2015; 145:459-466 doi:10.3945/jn.114.204503.

  • Conclusion: These results suggest that SSP consumption is associated with less favorable values for HOMA2–%S, LMTT disposition index, HDL cholesterol, and serum 25(OH)D in men and women at risk of T2DM vs. baseline values and values during dairy product consumption.
  • Sponsor: Dairy Research Institute/National Dairy Council

Squeezing Fact from Fiction about 100% Fruit Juice, by Roger Clemens, Adam Drewnowski, Mario G Ferruzzi, Cheryl D Toner, and Diane Welland. Adv Nutr 2015;6: 236S-243S. doi: 10.3945/​an.114.007328.

  • Conclusion:  The preponderance of evidence supports the position that 100% fruit juice delivers essential nutrients and phytonutrients, provides year-round access to a variety of fruits, and is a cost-effective way to help people meet fruit recommendations.
  • Sponsor: Juice Products Association

Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study, by Michael J FoxKiran D K AhujaIain K RobertsonMadeleine J BallRajaraman D Eri.  BMJ Open 2015;5:e006474.  doi:10.1136/bmjopen-2014-006474.

  • Conclusion: A yogurt combination of LGG, La-5 and Bb-12 is an effective method for reducing the incidence of antibiotic-associated diarrhoea in children.
  • Sponsor: Parmelat Australia

Chronic consumption of flavanone-rich orange juice is associated with cognitive benefits: an 8-wk, randomized, double-blind, placebo-controlled trial in healthy older adults, by Rebecca J Kean, Daniel J Lamport, Georgina F Dodd, Jayne E Freeman, Claire M Williams, Judi A Ellis, Laurie T Butler, and Jeremy PE Spencer.  Am J Clin Nutr 2015; 101:506-514 doi:10.3945/ajcn.114.088518.

  • Conclusion: Chronic daily consumption of flavanone-rich 100% orange juice over 8 wk is beneficial for cognitive function in healthy older adults.
  • Sponsor: Partially funded by the State of Florida Government, Florida Department of Citrus.  The authors report: “Florida Citrus helped designed [sic] the research. None of the authors reported a conflict of interest related to the study.”

Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies, by Li-Qiang Qin PhD, Jia-Ying Xu PhD, Shu-Fen Han PhD, Zeng-Li Zhang PhD, You-You Zhao PhD, Ignatius MY Szeto PhD.   Asia Pac J Clin Nutr. 2015 Mar;24(1):90-100. doi: 10.6133/apjcn.2015.24.1.09.

  • Conclusion This meta-analysis provided further evidence supporting the beneficial effect of dairy consumption on CVD. Low-fat dairy products and cheese may protect against stroke or CHD incidence.
  • Sponsor: Nestec Ltd. (Nestlé R&D (China) Ltd.  Two of the authors work for the company (to which I am not related).

In each of these cases, the sponsors got what they paid for.  Recent sponsored studies have not come to conclusions contrary to the interests of the sponsor.

Coincidence?

You decide.

  • Jane Peters

    Profits before people or animals or even plants.

  • Dr. D

    Why isn’t the study methodology discussed for these examples? When it comes to deciding whether or not research is valuable or not, study design is much more important than the sponsor.

  • Casey

    Coincidence? Seems like yet another way the experts have failed us: http://www.beyondchron.org/when-the-experts-fail-us/

  • Food Scientist

    Quite a lazy post by Dr. Nestle (I can’t even call it an analysis.) Her rhetoric is a good example of how to make a persuasive argument with zero substance; first-year English students, take note! Nestle is smart and stops short of making actual accusations of scientific wrongdoing, but, if you read between the lines, her intentions are fairly obvious.

    The reality of the situation is that, in today’s funding environment, researchers do not have the luxury of only receiving funding from independent sources. What often happens is that a food company will have a hypothesis about a product or ingredient of theirs, based on published literature or in-house, unpublished findings.
    I’d venture to say the company is VERY confident that their hypothesis is accurate. However, because of the huge, gigantic, gaping COI in publishing in-house research, they will often supply funds to independent professors to complete the experiments and provide analysis. It’s a win-win, symbiotic relationship.

    So, is there a COI with this scenario? OF COURSE! However, is the presence of a COI alone evidence of actual wrongdoing or junk science? Of course not. In fact, I’d argue that for nearly all research, regardless of the funding source, there is a conflict of interest. Even if you’re getting funds from the NIH, a researcher will still be conflicted to find “positive” results. It’s human nature. What makes a good researcher is the ability to prevent it from actually influencing methodology, results, or analysis.

    I’d be interested in looking at research funded by groups Nestle typically agrees with, such as RWJF or Bloomberg. How often do those findings agree with the missions of the funding agencies? Could there be a COI there?

  • Eduard Baladia Rodríguez

    Thanks for this great post, and I think it is not a coincidence. Financial conflicts of interest are related to publication bias (more publication of positive results than negative), and in meta-analysis financial conflicts of interest may bias his conclusions (by fixing some eligibility criteria to select the studies that you need). In addition to the studies cited in your post, it may be of interest for your readers this article published on March 10, 2015 in the journal PLOSmedicine:

    Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents.

    Conclusions: […]. This historical example illustrates how industry protects itself from potentially damaging research, which can inform policy makers today. Industry opposition to current policy proposals—including a World Health Organization guideline on sugars proposed in 2014 and changes to the nutrition facts panel on packaged food in the US proposed in 2014 by the US Food and Drug Administration—should be carefully scrutinized to ensure that industry interests do not supersede public health goals.

    Source: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001798

    And maybe can add this infographic from BMJ- called “Sugar’s web of influence”.
    Source: http://www.bmj.com/content/350/bmj.h231/infographic

    Best regards.

  • lalit kumar

    Great post and we are expert in food packaging design find more is here-

    http://www.cartmelldesign.com/

  • This post brought to mind how impressed I was when the coconut water study came out in favor of…WATER…hydrating just as well! When searching for the link I found it right on Food Politics, here: https://www.foodpolitics.com/2014/07/coconut-water/
    It actually gave me respect for the company that had the nerve to tell the truth. Kudos. And smart marketing, too.

  • Betty

    In case somebody needs help in nutrition information you can always
    try Talk to Chef where
    chefs are more than willing to help.

  • Paleo Huntress

    Or you can do your own research, just like a chef can.

    What’s really shocking is how often the actual nutrition “professionals” are uninformed. Having a degree doesn’t make you an expert.

  • GCC

    I have to agree with Dr. D. Conflicts of interest can be a big problem in some cases, but studies shouldn’t automatically be dismissed just because of where the funding came from.

    If the studies themselves are flawed, by all means point out the problems with them. But well designed randomized, double-blind, placebo-controlled studies analyzed with appropriate statistical methods are a good thing regardless of who funded them and the researchers involved should get credit for doing good science, not scorn for accepting money from “Big Food”.

    Admittedly, publication bias is still an issue, but good studies funded by corporate interests can at the very least provide promising leads to be confirmed (or disproven) in independent trials.

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