by Marion Nestle

Search results: research bias

Feb 13 2015

Sugar politics: The BMJ’s series “Spinning a web of influence”

BMJ (formerly the British Medical Journal) has just released an editorial and four papers on ties between the sugar industry and public health scientists who advise the government on health policy.  Some health policies involve recommendations about intake of sugars.

The BMJ press release explains

Recipients of research funding from sugar and other related industries include members of the Scientific Advisory Committee on Nutrition (SACN), which is currently updating official advice on carbohydrates consumption, and researchers working for the Medical Research Council’s Human Nutrition Research unit (HNR).  HNR scientists have received research funding and funding in kinds from companies including Coca-Cola, Mars, Nestlé, Sainsbury’s, the Institute of Brewing and Distilling, Weight Watchers International and others…Of the 40 scientists affiliated with SACN between 2001 and 2012, only 13 have had no interests to declare.

This, of course, is no different than what we see here.  Food and beverage companies support food and nutrition research as well as professional societies, and conflicts of interest are rampant.

Even so, these well documented studies are alarming and worth serious attention.  And be sure to look at the map.

MedPage has a nice summary (I’m quoted).

The furor over these articles

Oct 20 2014

Food professionals’ relationships with food companies: a Q and A

In the past few weeks, I’ve been sent several questions asking my opinion of food professionals’ relationships with food companies.   I thought I would deal with them at one time (all are edited for succinctness and clarity):

Q.  I am a food science student looking into career options in the food industry. I love food science and truly believe that processing food is a good idea that can positively impact the planet and its people.  I want to do something worthwhile,, but I still need to eat.  Can’t the food industry be changed from the inside? Can’t you advise good companies, people, or places where I could start my search? 

A.  I have met social entrepreneurs who strongly believe that businesses can be ethical, do good, and still make heaps of money.  Maybe so.  If you are going to try that route, I think it essential that the company be family or cooperatively owned, and not publicly traded.  You might take a look at food companies incorporated as Benefit Corporations. These are now authorized in about half the states to consider the interests of all stakeholders, not just shareholders, when making decisions.  They are different from B corporations certifying companies that meet certain sustainability criteria.

Many companies work hard to reduce their environmental impact.  But the real question is what they are doing about health impact.  Are they going overboard on health claims?  Are they marketing to children?  These are questions I’d want to ask.  In your shoes, I’d start by looking at companies making products that you like, feel good about, and would be proud to be associated with.   And then take a closer look at how the companies operate.   Working for food companies is always a good learning experience, but if you really want to change the world, you might be better off with a nonprofit agency.

Q.  I’m a graduate student in nutrition and I would like to know what recommendations you may have for students to navigate conflicts of interest with food companies when beginning a career.  I intend to pursue an academic career but am concerned that my credibility as a scientist could be compromised by my participation in industry-funded publications and research. 

A.  It’s great that you are asking such questions. From the standpoint of ethics, that’s an important first step.  You should most definitely publish your research, no matter how it is funded.  Be sure to disclose potential sources of funding bias and conflicts of interest.  While you are doing your research, you can take special care to control for potential biases—conscious and unconscious—in your study design, conduct, and interpretation to ensure that they are not influenced by the funder.  In searching for jobs, you might consider those in academia, government, and NGOs that are less likely to require you to compromise principles.  Finding such jobs may not be easy, but you will be OK if you are always ethically transparent and as straightforward about biases as it is possible to be.

Q.  Do you believe that relationships between the food industry and nutrition professional organizations like the Academy of Nutrition and Dietetics (AND) and the Association for Nutritional Science (ASN) are problematic? Why?

A.  Sponsorship by food product makers puts nutrition professionals in conflict of interest.   Nutritionists ought to be advising clients and the public about what to eat to stay healthy and prevent chronic disease.  This necessarily means promoting consumption of some foods but discouraging consumption of others.  Nutritionists cannot speak truth to clients and protect corporate sponsorship at the same time.  If nothing else, food industry sponsorship gives the appearance of conflict of interest and makes AND and ASN appear as arms of food company marketers.  But it also affects—or appears to affect–AND ’s and ASN’s positions on key issues in nutrition and health.  Overall, financial relationships between these organizations and their food industry sponsors undermines the credibility of their positions on food issues.

Q.  What sort of changes do you think the Academy needs to make in order to make food industry relationships more beneficial to its members and the public overall?

A.  Nutrition and food professional organizations need to establish a firewall between corporate sponsorship and content or opinion.  This requires setting up rigorous guidelines for what food companies can and cannot expect from their donations.  They should not, for example, be permitted to sponsor content sessions at meetings, not least because opinions expressed at sponsored sessions rarely appear objective.  The organizations should have complete control over how and where corporate donations and company logos are used.

Q.  How can relationships between health professionals and the food industry be beneficial for public health overall?

A.  The role of health professionals is to give the best advice possible about diet and health.  The role of food companies is to provide profits to shareholders.  These goals are not the same and are only rarely compatible.  In my experience, people who want to work for food companies to change corporate culture from within do so from good motives, but soon discover that corporate imperatives take precedence over health goals. If health professional organizations want their advice to be taken seriously, they must establish and adhere to rules and guidelines designed expressly to protect their integrity.

Q.  I read your post on the revolving door,  It seems to me that your underlying premise is the notion that any company that makes food is indicted as part of the big evil food conspiracy. Surely, you can’t really believe that. 

A.  Of course I don’t. But food companies are not social service agencies.   Their job—their legal responsibility—is to continuously expand sales and distribute ever-increasing profits to shareholders.   If they can do this and promote health at the same time, more power to them.  But people would be healthier eating food, not food products.  In our present system, products are far more profitable and the focus on them is rarely works in the interest of public health.

Food and nutrition professionals need to make a living.  Unfortunately, jobs in industry pay better–and sometimes a lot better–than jobs in government or NGOs.  That’s the real dilemma that underlies all of these questions.

Sep 19 2014

Do artificial sweeteners cause–not cure–glucose intolerance?

The big nutrition scare last week was the study in Nature finding that in mice and, maybe, humans, artificial sweeteners mess up the microbiome and make some people even more intolerant of glucose.

The authors conclude that their results call for a reassessment of massive use of artificial sweeteners.

The study is complicated and difficult to read but the Wall Street Journal has a nice summary.  It explains why the study is getting so much attention:

The new Nature study marks a significant advance because it brings together two separate areas of research—the role of sweeteners in raising blood sugar levels, and the complex workings of the vast colonies of bacteria that inhabit the gut. Individuals can have differing bacterial colonies in their gut, meaning people respond differently to what they consume.

The study involved several experiments.  These found:

  • Mice fed saccharin, sucralose, or aspartame had significantly higher blood-glucose levels than mice whose diet included sugar, or just water.
  • Mice with sterilized digestive tracts, who were given bacterial transplants from artificial-sweetener-fed mice, displayed higher blood sugar levels than those receiving bacterial transplants from sugar-fed mice.
  • People who typically use artificial sweeteners have different kinds of bacteria in their intestines than those who do not.  They also are more glucose intolerant.
  • Seven volunteers fed artificial sweeteners for four days displayed higher blood-sugar levels as well as altered populations of bacteria in their gut.

The Wall Street Journal quotes the Calorie Control Council (the trade association of makers of artificial sweeteners).  The CCC said:

The results from the mouse experiments may not apply to humans, while the human experiments had a small sample size. It said further research was needed.

Despite my lack of enthusiasm for artificial sweeteners, I think the Calorie Control Council has a point.

The excellent report by Kenneth Chang in the New York Times explains why.

At present, the scientists cannot explain how the sweeteners affect the bacteria or why the three different molecules of saccharin, aspartame and sucralose result in similar changes in the glucose metabolism.

Chang ends with this:

Dr. Frank Hu, a professor of nutrition and immunology at the Harvard School of Public Health who did not take part in the study, called it interesting but far from conclusive and added that given the number of participants, “I think the validity of the human study is questionable.”

Here’s why I’m not fond of artificial sweeteners:

  • They taste bad (to me)
  • They have no demonstrated effectiveness in helping people lose or maintain weight.
  • They are artificial, and violate my rule to “never eat anything artificial.”

Do they mess up the microbiome and cause glucose intolerance, insulin resistance, and metabolic syndrome?

That would be fascinating, but I’m reserving judgment pending further research.

In the meantime, I’ll take sugar—in moderation, of course.

Sep 8 2014

Trade issues: eye-glazing, but worth the trouble. Today: The Trans-Pacific Partnership (TPP)

Sunday’s New York Times discussed how foreign governments are dropping millions on Washington DC think tanks to fund reports explicitly designed to influence government agencies to set policies favorable to the donor country’s interests.  One such interest is food trade with Asia.

The line between scholarly research and lobbying can sometimes be hard to discern.

Last year, Japan began an effort to persuade American officials to accelerate negotiations over a free-trade agreement known as the Trans-Pacific Partnership (TPP), one of Japan’s top priorities. The country already had lobbyists on retainer, from the Washington firm of Akin Gump, but decided to embark on a broader campaign.

Akin Gump lobbyists approached several influential members of Congress and their staffs…seeking help in establishing a congressional caucus devoted to the partnership, lobbying records show. After those discussions, in October 2013, the lawmakers established just such a group, the Friends of the Trans-Pacific Partnership.

To bolster the new group’s credibility, Japanese officials sought validation from outside the halls of Congress. Within weeks, they received it from the Center for Strategic and International Studies, to which Japan has been a longtime donor. The center will not say how much money the government has given — or for what exactly — but an examination of its relationship with a state-funded entity called the Japan External Trade Organization provides a glimpse.

In the past four years, the organization has given the center at least $1.1 million for “research and consulting” to promote trade and direct investment between Japan and the United States. The center also houses visiting scholars from within the Japanese government…one Japanese diplomat…said the country expected favorable treatment in return for donations to think tanks.  “If we put actual money in, we want to have a good result for that money — as it is an investment,” he said.

Ah yes, the Trans-Pacific Partnership (TPP).  Let’s start with the context: The US has trade agreements with 20 countries.

These, says the US, provide many benefits:

Trade is critical to America’s prosperity – fueling economic growth, supporting good jobs at home, raising living standards and helping Americans provide for their families with affordable goods and services.

Obviously, Japan must think the TPP will do all that and more for Japan.

But trade negotiations run into trouble when one partner has higher food safety standards—Sanitary and Phytosanitary (SPS) Measures—than another.

This is an issue in current negotiations over the TPP.

Like other trade agreements, the negotiations are conducted in secret.

Over the past two years there has been a steady drip of stories about the secretive negotiations regarding the Trans Pacific Partnership (TPP). Members of Congress and congressional staffers have been stymied in their efforts to perform some measure of oversight while major corporations have reportedly been given unfettered access and influence over the deal. The public has been kept almost completely in the dark regarding negotiations that affect everything from food prices to our ability to innovate on the Internet…Historically, international trade negotiations have happened through the World Trade Organization…Trade negotiators have had trouble closing major deals over the past decade, in part because the public, and sometimes their elected officials, have stood up to decry these secret negotiations, demanding oversight opportunities and setting up websites to post leaked drafts of the agreements.

According to PoliticoPro, negotiations on TPP with Japan and 10 other countries in the Asia-Pacific region are close to conclusion, but pork producers, other farm groups, and Republicans are insisting that Japan eliminate all agricultural tariffs and completely open its market to U.S. agricultural exports.

Japan says it can offer improved market access but cannot eliminate all tariffs because of pressures from its own farm groups.

At the end of July, some House members demanded that Japan—and Canada—be dropped from the TPP if they do not agree to eliminating tariffs.

Trade negotiations work in predictable ways.  for example, despite the North American Free Trade Agreement (NAFTA—and also see this link— which allows unfettered imports from Mexico, the US is imposing tariffs on Mexican sugar to prevent flooding the US market with cheap supplies that undermine sales of US sugar (NAFTA allows this).

The moral: In trade agreements, each country looks to maximize its own interests.  Hence: Japan’s lobbying via Washington think tanks.

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May 23 2014

GMO labels cost families $800/year: Guess who paid for the study?

Yesterday, Food Navigator reported that Cornell economists calculated that GMO labels would cost the average family of four a whopping $800 per year.

This seemed so improbable that I immediately wondered:  Who paid for it?

I clicked on the link to the study: Bingo!

The work on this report was supported financially by the Council for Biotechnology Information.

You won’t find the list of companies and groups that support the Council on its website, but Source Watch fills the gap.

I am increasingly alarmed by the increasing extent of industry research sponsorship—it’s become a huge issue in  studies of nutrition, diet, and health.

The influence of funding source on research outcomes is so predictable—many studies have now shown that industry-funded studies almost invariably produce results that favor the sponsor—that I’m batting nearly 100% on conflict-of-interest  checks, of which this GMO study is a particularly blatant example.

It’s not that industry pays investigators to find the desired answers to questions.  It’s more complicated than that.  It has to do with the way investigators ask and try to answer the research questions.  The industry favored biases get built into the study’s assumptions and controls, often (I think) unconsciously.

This study, for example, is based on an elaborate set of assumptions leading to the $800 per family estimate.  Other assumptions might give different results.   The authors do not discuss the limitations of their estimates, nor are they required to in this type of report.

But I’m willing to hazard a guess that independently funded studies would come to considerably lower estimates.

Moral: if a study produces surprising results that favor an industry position, look hard to see who sponsored it.

Addition, May 24:

A reader sent in further information about the Council for Biotechnology Information:

Council for Biotechnology Information

1201 Maryland Avenue, SW., Suite 900, Washington, DC 20024 USA

Phone: 202-962-9200 web site: http://gmoanswers.com

(CBI: http://www.sourcewatch.org/index.php?title=Council_for_Biotechnology_Information.

http://www.powerbase.info/index.php/Council_for_Biotechnology_Information.

Experts: http://gmoanswers.com/experts. Founding members and supporting partners:

http://gmoanswers.com/about. There are also offices in Saskatoon (SK, Canada)

(http://whybiotech.ca)  and Mexico City (AgroBio Mexico: http://agrobiomexico.org.mx.)

Nov 20 2013

Conflicts of interest in nutrition societies: American Society of Nutrition

I am a member of the American Society for Nutrition (ASN), the organization that publishes the American Journal of Clinical Nutrition (AJCN) and the Journal of Nutrition.

I’ve become increasingly worried about food company influence on ASN.  Food companies fund sessions at ASN annual meetings.

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But I’m even more concerned about food company sponsorship of scientific studies published in AJCN.

The results of sponsored studies almost invariably benefit the sponsor.  Exceptions are scarce.

The conflicts are so blatant that I can often guess from reading an abstract who the study’s sponsor must be.

A look at the conflicts of interest disclosed by the editorial board of AJCN suggests why this problem is occurring.

Of the 12 members of the editorial board, only 3 disclose no corporate conflicts of interest, and 2 others disclose minor conflicts.

But the majority—7 of the 12—list major corporate affiliations.  The list of food companies for which they consult or advise is too long to reproduce but it includes Coca-Cola, PepsiCo, The Sugar Association, The National Restaurant Association, ConAgra, McDonald’s, Kellogg, Mars, and many others.

This raises uncomfortable questions: How does this editorial board deal with papers suggesting harm to health from consuming products from these companies?  How does it deal with sponsored papers suggesting benefits of the products?

Affiliations with food companies may or may not lead to publication bias, but at the very least they give the appearance of serious conflicted interest.  This affects opinion not only of sponsored studies, but also of the overall credibility of research published in the journal.

For the results of papers published in the AJCN to be considered credible, the editorial board should:

  • List the editor responsible for review of published papers in the conflict disclosures.
  • Recuse individual members with conflicts from reviewing papers in their area of conflict.
  • Phase out conflicted editors as quickly as possible.
  • Appoint editors who have minimal or no conflicts.
  • Give special editorial scrutiny to papers sponsored by food and beverage companies.

ASN is not the only nutrition society raising doubts about its conflicts of interest with food company sponsorship.  The Academy of Nutrition and Dietetics (AND) is the subject of two recent reports analyzing its conflicts of interest.

I will say more about these reports tomorrow, but it looks like a similar report could be written about ASN, alas.

Aug 15 2011

Interventions in childhood obesity: ethical considerations

Imagine this.  A professional journal, Preventing Chronic Disease: Public Health Research, Practice and Policy (Vol 8, Issue 5, Sep 2011) has published a series of papers on the ethics of childhood obesity interventions. 

It is about time that these kinds of ethical issues are getting focused attention.  Applause for the journal’s editors and authors!

Ethical Issues In Interventions For Childhood Obesity

A92: Protecting Children From Harmful Food Marketing: Options for Local Government to Make a Difference
  Jennifer L. Harris, Samantha K. Graff

A93: Childhood Obesity: A Framework for Policy Approaches and Ethical Considerations
  Rogan Kersh, Donna F. Stroup, Wendell C. Taylor

A94: Childhood Obesity: Issues of Weight Bias
  Reginald L. Washington

A95: Children With Special Health Care Needs: Acknowledging the Dilemma of Difference in Policy Responses to Obesity
  Paula M. Minihan, Aviva Must, Betsy Anderson, Barbara Popper, Beth Dworetzky

A96: Public Policy Versus Individual Rights in Childhood Obesity Interventions: Perspectives From the Arkansas Experience With Act 1220 of 2003
  Martha M. Phillips, Kevin Ryan, James M. Raczynski

A97: A Question of Competing Rights, Priorities, and Principles: A Postscript to the Robert Wood Johnson Foundation Symposium on the Ethics of Childhood Obesity Policy
  Shiriki K. Kumanyika

A98: The Ethical Basis for Promoting Nutritional Health in Public Schools in the United States
  Patricia B. Crawford, Wendi Gosliner, Harvey Kayman

A99: Ethical Family Interventions for Childhood Obesity
  Mandy L. Perryman

A100: Public Policy Versus Individual Rights and Responsibility: An Economist’s Perspective
  Frank J. Chaloupka

A101: State Requirements and Recommendations for School-Based Screenings for Body Mass Index or Body Composition, 2010
  Jennifer Linchey, Kristine A. Madsen

A91: Ethical Concerns Regarding Interventions to Prevent and Control Childhood Obesity
  John Govea

Sep 21 2010

The GM salmon saga continues

The FDA has just concluded two days of hearings on the safety and labeling of genetically modified (GM) salmon. I’ve been collecting comments about this and will add a few of my own.

USA Today: Let’s begin with Elizabeth Weise’s clear, insightful summary of what this is about. She summarizes the situation with GM salmon in a nifty Q and A format:

Q: What happens next?

A: Nothing soon. Before issuing a decision on the application, FDA will publish an Environmental Assessment of the salmon, followed by a required 30-day comment period. The agency would then determine whether it would file a Finding of No Significant Impact or an Environmental Impact Statemen….then use those findings to make a decision on whether or not to allow the sale of the salmon. The agency has said it has no set timeline for reaching a decision. Were the agency to decide to approve the sale of the salmon, it would take two years before the first crop was ready, company officials say.

Food Chemical News (September 20):  reports that AquaBounty’s CEO has no intention of restricting GM salmon farms to Panama. At the FDA hearing, he “forecast a spread of transgenic salmon operations from a proposed site in Panama to other countries, including the United States.”

Oops. The FDA had to remind him that his company’s application is for Panama only, and any other sites would require supplemental applications from the firm.”  The FDA said it was “not interested in AquaBounty’s future business plans.”

FoodNavigator.com reporter Caroline Scott-Thomas predicts that the hearings will lead to no recommendation.

The FDA’s Veterinary Medicine Advisory Committee (VMAC) did not vote or make a recommendation at the end of the hearings, saying that it does not yet have sufficient data…After two days of hearings, a Food and Drug Administration (FDA) advisory panel has called for more research to decide whether genetically engineered salmon is safe for consumption.

The New York Times says that the advisory group favored approval of the GM salmon, but that this could take ages.

Food Chemical News (September 21) says that most speakers at the hearing on GM labeling did not want it to be mandatory. It quotes Greg Jaffe, the director of biotechnology at Center for Science in the Public Interest (CSPI), as opposing mandatory labeling. Apparently, Jaffe:

urged AquaBounty to require its customers to provide “real” voluntary labeling on food products, such as “AquaBounty salmon,” “fast-growing salmon” or “environmentally friendly salmon”….He agreed that “no ingredients from a genetically engineered source” would be acceptable language provided there’s a comparable GE product in the marketplace.

Why would a representative of a consumer organization oppose mandatory labeling?  For that, go to

Jill Richardson’s lengthy analysis of FDA’s actions, written for Grist.  She lays out some of the more complicated issues, and takes a tough look at the biases of the committee members.

Washington Post: Lindsey Layton writes about the debates over labeling (I’m quoted).

A Washington Post poll found 78% of respondents to be worried about the health and safety risks of GM salmon.

Meanwhile, in the UK, the new government has stopped a scheduled public dialogue about GM foods.  That’s one way to handle it. All those pesky consumers don’t want it? Too bad for them.

My interpretation: of course the public does not trust genetically modified foods. The foods are not labeled. If the biotech industry and the FDA want the public to trust them, they need to label the GM salmon and all the other GM foods in the marketplace.

The public wants the right to choose.  The public should have the right to choose.

The issue of GM foods cannot just be about safety.

My mantra on this one: Even if genetically modified foods are safe, they are not necessarily acceptable.

I was a member of the FDA’s Food Advisory Committee in 1993 when, under pressure from Monsanto, the agency rejected labeling of GM foods.  I wish the FDA had listened to me and the other consumer representatives on the committee, all of us convinced that labeling is essential for promoting trust, and giving the public a choice. And, we said, it’s the right thing to do.

The FDA now has a chance to redeem it’s bad decision.  I hope they take this opportunity and decide to require labeling.

Footnote: I wrote about all this in my book, Safe Food: The Politics of Food Safety, just published in a new edition in July.  In preparing the second edition seven years later, I was surprised by how little about food biotechnology had changed.  The issues have not changed.  The field is stuck.   Labeling is one way to break the stalemate.  Let the public have a choice.  I’ll bet doing that will solve a lot of problems.