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I could not keep up with the number of e-mails I got last week with the subject line “Have you seen this?”

“This” referred to an opinion piece in JAMA entitled Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists.

Definitely up my alley.

The article describes the outraged reaction to a series of papers in the Annals of Internal Medicine last year arguing that recommendations to eat less meat are unfounded (I posted about this at the time).  Some of the investigators involved in the meat papers turned out to have undisclosed ties to meat industry interests.

The JAMA article points out that the most outraged objections to the Annals papers came from investigators who have plenty of industry ties (plant-based) of their own.

My book, Unsavory Truth: How Food Companies Skew the Science of What We Eat, provides loads of evidence for a basic observation: research funded by food companies, regardless of the particular food studied, tends to produce results favorable to the sponsor’s interests.

It also describes how industry influence occurs at an unconscious level; recipients are unaware that they are being influenced.

How the influence gets expressed is also the subject of research.  Bias most frequently turns up in the framing of the research question.  It also turns up frequently in the interpretation of results.

Here is an example from a study of a healthy plant food—walnuts.

The study: Effect of a 2-year diet intervention with walnuts on cognitive decline. The Walnuts And Healthy Aging (WAHA) study: a randomized controlled trial.  Aleix Sala-Vila, Cinta Valls-Pedret, Sujatha Rajaram, Nina Coll-Padrós, Montserrat Cofán, Mercè Serra-Mir,  Ana M Pérez-Heras, Irene Roth, Tania M Freitas-Simoes, Mónica Doménech, Carlos Calvo, Anna López-Illamola, Edward Bitok, Natalie K Buxton, Lynnley Huey, Adam Arechiga, Keiji Oda, Grace J Lee, Dolores Corella, Lídia Vaqué-Alcázar, Roser Sala-Llonch, David Bartrés-Faz, Joan Sabaté, and Emilio Ros1.  Am J Clin Nutr 2020;00:1–11.

Conclusions: Walnut supplementation for 2 y had no effect on cognition in healthy elders. However, brain fMRI and post hoc analyses by site suggest that walnuts might delay cognitive decline in subgroups at higher risk. These encouraging but inconclusive results warrant further investigation.

Conflicts of Interest: AS-V, SR, JS, and ER have received research funding through their institutions from the California Walnut Commission, Folsom, CA, USA. JS and ER were nonpaid members of the California Walnut Commission Scientific Advisory Council. ER was a paid member of the California Walnut Commission Health Research Advisory Group. JS has received honoraria from the California Walnut Commission for presentations.  AS-V has received support from the CaliforniaWalnut Commission to attend professional meetings. All other authors report no conflicts of interest.

Comment: This looks to me like a classic example of interpretation bias.  Although the study showed no effect of walnut supplementation, the authors interpret its overall results as encouraging.  This is putting a positive spin on null results.

Walnuts—and other kinds of nuts—are plant foods with healthy fats.  Why does the California Walnut Commission need to do this?  So you will buy walnuts rather than hazelnuts, pecans, or macadamia nuts (all of which are sponsoring their own positive-result studies).  Studies like these are mostly about marketing.

Questions of whether meat is healthy or unhealthy—and, if unhealthy, at what level of intake—are about much more than marketing.   They need to be studied as objectively as possible.  It’s best to keep industry influence far away from such studies.

Even if the science is done well from start to finish, researchers’ ties to food company sponsors give the appearance of conflicted interests.  Such ties are best avoided from the get-go.

Follow-up

• A detailed analysis of the JAMA piece by the anonymous CarbSane blog
• Naomi Oreske’s comment in Scientific American
• Texas A&M’s letter to Harvard requesting an investigation of faculty belonging to True Health Initiative (who complained about the meat guidelines)
• Texas A&M’s Chancellor Calls on Harvard to Look Into Faculty’s Beef-science Ethics (AgDaily)
• Beef with Harvard (Inside Higher Ed)
• From Beef to Bots? Harvard Professors Mired in Debate over Spam Emails, Industry-Funded Research (Harvard Crimson)
• Conflict of Interest in the Post-Truth Era: What Is It, Now? (David Katz)
• Processed Meat “Guidelines:” Why the Exceptional Reaction? (David Katz)
• Tobacco, Soda, and the Beef with Truth (David Katz)
• Massive Meat Mayhem, Part 3 (ConscienHealth)
• Perspective: Red and Processed Meats and Health Risks: How Strong Is the Evidence? (Frank Hu et al)

In a recent NutraIngredients-USA commentary it was argued that dietary supplement companies that build up a suite of research do so carefully, and plan for success​​. With a careful design of the research program, positive results at the bench can naturally translate into successful randomized, placebo controlled trials.

Longtime critic of industry funded research

Marion Nestle, PhD, nutrition professor at New York University and author of the influential book Food Politics​ as well her most recent work Unsavory Truth: How Food Companies Skew the Science of What We Eat, ​ isn’t buying. Nestle responded to NutraIngredients-USA on the subject of the commentary to say that she has reviewed hundreds of company-funded studies and in her view the inherent biases built into that system are next to impossible to overcome.

Indeed, on her blog (also titled Food Politics​​) Nestle has a frequent feature called “Industry funded research of the week.” The feature is used to document instances of bias, which to Nestle’s eye are thick on the ground.

“The overriding issue is that industry-funded research almost invariably comes out with results favorable to the sponsor’s interests. This is so predictable that I can often recognize the funder by the title of the paper,”​ Nestle told NutraIngredients-USA.

Nestle noted that the phenomenon is not by any means restricted to research on food and supplement ingredients. It has been noted in studies on tobacco, chemicals and pharmaceuticals.

“Studies of these industries show that the influence apparently occurs at an unconscious level; investigators did not intend to be influenced and do not recognize that they were influenced. But the evidence for funding effects is overwhelming,”​ she said.

Bias starts with study design

Nestle said a key issue is how the research question is framed. Companies investing in research naturally want to succeed and get some return on their investment. But the best science doesn’t come when the question is framed in such a way that a positive result is overwhelmingly likely, she said.

“I get letters all the time from trade associations asking for proposals for research that will demonstrate the benefits of their products. That is not the same as asking open-ended questions about effects. Companies want data on benefits for marketing purposes. That’s why I view industry-funded studies as about marketing, not science,”​ Nestle said.

Nestle said she has noted that some of the larger funders, such as the larger food companies or industry associations supporting categories of products like walnuts, almonds, strawberries or what have you, churn out research supporting their products of interest. While some might argue this adds to the totality of evidence and thus could be a good thing, Nestle said she doubts the value of these investments when taking the inherent biases into account. This can result in studies that seek to demonstrate things like substituting junk food calories with a serving of something like almonds or strawberries is a good thing to do. Yes, but so what? In Nestle’s view, this kind of bias is all but inevitable in research funded in this way.

“That’s what decades of research on the effects of drug-industry funding says, and the few studies looking at funding effects in nutrition find similar results,” ​she said.

Independent funding mechanism

What Nestle said she’d like to see is a mechanism for funding research into food and supplement ingredients that was divorced from a marketing plan.

“I want to see a firewall between the funder and the scientist. In ​Unsavory Truth, I talk a lot about various attempts over decades to create such firewalls and develop a pool of industry research funds managed by independent third parties. They have never worked well,”​ she said.

Nestle said she believes that only by making contributions to research compulsory, with the resulting fund to be managed by a credible third party, can research of undeniable quality be done. Something like the Beef Checkoff Program but for independent research funding, even if the results of those studies might not immediately support the marketing of the products.

“My idea of an ethically funded study is to ask for investigator-initiated proposals, appoint third party reviewers who decide who gets funded, and stay completely out of the process from then on. I worry when I see disclosure statements that the funder had no role in the study because that statement has been demonstrated to be false so many times. Food companies are funding research because they want specific results. That’s not how science is supposed to work,”​ Nestle said.

In the wake of all the media fuss over the “don’t worry, eat meat” papers published on Monday (see my summary), my favorite is a tweet from Naomi Oreskes, one of the authors of Merchants of Doubt, an analysis of the tobacco and chemical industries’ playbook in action.

Thanks Naomi.

I’ve just ordered a copy of her new book.  Can’t wait for it to arrive.

I included a chapter on sugar and dental disease in my 2015 book, Soda Politics: Taking on Big Soda (and Winning), because billions of people have decayed teeth and other dental problems that could have been kept intact by dental hygiene, fluoride treatment, or—consuming less sugar or sugary drinks.

But:

• Dental disease has a long history of being overlooked as a public health problem.
• Sugar has a long history of being ignored as a cause of dental disease.

This may now be changing.

The Lancet has a new series on oral health:

It’s great that The Lancet has finally taken this on.

Here’s The Guardian’s Account.  There should be a lot more press coverage.  Dental conditions affect billions of people throughout the world.

The Lancet has been busy.  Last week, it published a blockbuster report on the need for worldwide dietary changes to improve human health and that of the environment.  I posted about this EAT-Forum report on Friday.

Now, The Lancet releases yet another report, this one taking a unified approach to dealing with the three most important nutrition issues facing the world: Malnutrition (undernutrition), obesity, and the effects of our food production and consumption system on the environment and climate change—for which this report coins a new term: The Global Syndemic.

This report breaks new ground in identifying the food industry as one of three main barriers to ending this “Syndemic.”  I’ve added the numbers for emphasis.

• Powerful opposition by [1] commercial vested interests, [2] lack of political leadership, and [3] insufficient societal demand for change are preventing action on The Global Syndemic, with rising rates of obesity and greenhouse gas emissions, and stagnating rates of undernutrition.
• New social movement for change and radical rethink of the relationship between policymakers, business, governance and civil society is urgently needed.
• The Commission calls for a global treaty to limit the political influence of Big Food (a proposed Framework Convention on Food Systems – modelled on global conventions on tobacco and climate change); redirection of US$5 trillion in government subsidies away from harmful products and towards sustainable alternatives; and advocacy from civil society to break decades of policy inertia.

Wow.  This is telling it like it is—at long last.  From the press release:

• A key recommendation from the Commission is the call to establish a new global treaty on food systems to limit the political influence of Big Food.
• The food industry’s obstructive power is further enhanced by governance arrangements that legitimise industry participation in public policy development, and the power that big corporations have to punish or reward governments by relocating investment and jobs.
• Regulatory approaches to product reformulation (eg. salt and sugar reduction), labelling and marketing to children are needed because industry-led, voluntary approaches have not been effective.

Yes!

The documents

• The Press Release
• The Policy Brief
• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report – Boyd A Swinburn et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32822-8/fulltext
• Obesity needs to be put into a much wider context – Sabine Kleinert, Richard Horton, The Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33192-1/fulltext
• Rethinking systems to reverse the global syndemic – Rachel Nugent, RTI International https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33243-4/fulltext
• Transforming food systems for better health – José Graziano da Silva, Director-General, Food and Agriculture Organization of the United Nations https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33249-5/fulltext

The press

▪ The Guardian
▪ The Times (London)
▪ Irish Farmers Journal

Additional press, posted January 30

Newswires (syndicated in international outlets):

• ‘Radical rethink’ needed to tackle obesity, hunger, climate: report – Agence France-Presse
• To fix climate change, fix the obesity and starvation epidemics, reports say – CNN
• Obesity, bad nutrition, climate change pose triple danger, commission says – Reuters
• Also covered by Xinhua, IANS.

UK:

• Public health experts call for global food treaty – Financial Times
• Take on food industry to beat malnutrition and obesity, says report – The Guardian
• Tackling obesity ‘needs treaty like climate change’ – The Times
• Also covered by BBC Radio 4, BBC 1 Breakfast, BBC News 24, The Economist (Espresso), The Guardian (Op-ed), The Telegraph, The Independent, Daily Mail.

US:

• Report: ‘Radical Rethink’ Needed to Tackle Obesity, Hunger, Climate – Voice of America
• Big Food Blamed for Ills Far Beyond Flab in Sweeping Report – Bloomberg
• Want to fix obesity and climate change at the same time? Make Big Food companies pay. – Vox
• Also covered by Thomas Reuters Foundation, Devdiscourse.

Rest of world:

• Vested interests, misplaced economic incentive major drivers: Lancet report – Indian Express
• Obesity, malnutrition 2 sides of climate change – Hindustan Times
• Eat right to save the planet – Deccan Chronicle
• Also covered by El Pais, O Globo, The Wire, Sydney Morning Herald, The Age, Japan Times, New Zealand Herald, The Australian, El Confidential, Algemeen Dagblad, Nouvel Observateur.

The World Health Organization is about to publish a report on how the palm oil industry is promoting obesity and chronic disease as well as environmental degradation as integral parts of its business model.

The draft report gets right to the point.

We highlight the industry’s mutually profitable relationship with the processed food industry and its impact on human and planetary health, including detrimental cultivation practices that are linked to respiratory illnesses, deforestation, loss of biodiversity and pollution. This analysis illustrates many parallels to the contested nature of practices adopted by the alcohol and tobacco industries.

The research behind the report supports the analytical framework for examining industry’s effects on health.

The report documents how the palm oil industry, working with the food industry, acts to maximize profits at the expense of health and the environment, through marketing, supply chain management, lobbying, and corporate “citizenship.”

The report calls for

• More research on the effects of palm oil on health
• Actions to mitigate industry influences to protect producers and sellers from needed regulations
• Use of the Sustainable Development Goals to aid these actions

You don’t get why palm oil raises health and environmental concerns?  Read this.  Now.

I have been trying to track what’s happening in our current tariff war with China.  Politico Morning Agriculture helps a lot, but even so keeping up with the rounds of retaliatory tariff impositions is challenging.

Here is our “second tranche” list of Chinese imports subject to tariffs.

The Chinese are retaliating by imposing tariffs on US agricultural exports.  They publish their lists in Chinese, obviously, meaning that we non-speakers must depend on Google Translate [and see note at end].

• Annex 1: List of 25% tariff items for the United States and Canada . pdf 
• Annex 2: List of 20% tariff items for the United States and Canada . pdf 
• Annex 3: List of 10% tariff items for the United States and Canada . pdf 
• Annex 4: List of 5% tariff items for the United States .pdf

Fortunately, CNN Money has published a partial list in English of US goods hit by Chinese Tariffs

Poultry
— Frozen beef
— Fresh or cold pork
— Dried, smoked or salted pork belly
— Frozen chicken nuggets
— Frozen whole duck

Fruit and vegetables
— Farming potatoes
— Mushrooms
— Truffles
— Apples
— Cherries
— Avocados

Dairy products
— Butter
— Cream
— Yogurt

Fish
— Frozen red salmon
— Frozen mackerel
— Frozen yellowfin tuna

Seafood
— Frozen squid
— Lobster
— Canned shark fin
— Octopus
— Sea urchins

Tobacco
— Tobacco cigarettes
— Tobacco cigars

Pet food
— Canned cat food
— Canned dog food

Beverages
— Whiskey
— Modified ethanol
— Non-frozen orange juice with less than 20% sugar

Its list leaves out baked goods, for example, items of great concern to BakeryAndSnacks.com.

A group called Farmers for Free Trade has launched an advertising campaign, “Tariffs Hurt the Heartland.”

This is a mess and clearly not good for US agriculture.  President Trump, as I noted earlier, has promised $12 billion in relief.  The administration has not said where that money—which in any case will not be nearly enough—is coming from.

Does anyone know where that money will be taken from?  Which budget line?

Note on Google Translate

A reader writes:

Small correction: the annexes you linked in the newsletter should be titled “Annex XX: List of XX% additional tariff items for the United States. pdf ”

Have you wondered why Canada is dragged into this? =)

In Mandarin the character for “additional” is the same as the abbreviated reference to Canada. It’s not surprising that Google Translate failed to catch this.

The Guardian’s account of the verdict: Monsanto ordered to pay $289m as jury rules weedkiller caused man’s cancer

Dewayne Johnson, a 46-year-old former groundskeeper, won a huge victory in the landmark case on Friday, with the jury determining that Monsanto’s Roundup weedkiller caused his cancer and that the corporation failed to warn him of the health hazards from exposure. The jury further found that Monsanto “acted with malice or oppression”…Johnson’s case was particularly significant because a judge allowed his team to present scientific arguments. The dispute centered on glyphosate, which is the world’s most widely used herbicide…During the lengthy trial, the plaintiff’s attorneys brought forward internal emails from Monsanto executives that they said demonstrated how the corporation repeatedly ignored experts’ warnings, sought favorable scientific analyses and helped to “ghostwrite” research that encouraged continued usage.

Here’s what this is about:

(1)  The carcinogenicity of Roundup (glyphosate)

In 2015, the World Health Organization’s International Agency for Research on Cancer (IARC) ruled that glyphosate, the weed killer used with genetically modified crops, is “probably carcinogenic to humans.”  Glyphosate’s maker, Monsanto (now merged with Bayer) did not like this decision and went to work casting doubt on the science.  As IARC explains and documents:

Following the classification of glyphosate in March 2015 as probably carcinogenic to humans (Group 2A) by the IARC Monographs Programme, IARC has been the target of an unprecedented number of orchestrated actions by stakeholders seeking to undermine its credibility. In the interest of transparency, IARC has documented some of these instances, and our responses can be found on the Agency′s Governance website.

(2) What’s at stake for Monsanto

Glyphosate is used in incomprehensibly huge amounts.  The organic advocate, Charles Benbrook, published statistics on its use in 2016.  Monsanto’s published a rebuttal to Benbrook’s paper, but did not dispute his figures; instead, it argued only glyphosate is safe.  Benbrook’s data show that 250 million pounds of glyphosate were applied to US crops in 2014 (by another source, worldwide use was 825,804,000 kilograms, or more than 1.8 billion pounds that year).

(3) What’s at stake for the plaintiff, Dewayne Johnson

As the San Francisco Chronicle’s account explains:

Johnson was a groundskeeper and pest-control manager for Benicia schools from 2012 until May 2016. His job included spraying glyphosate, in the high-concentration brand called Ranger Pro, from 50-gallon drums 20 to 30 times a year for two to three hours a day.

He testified he wore protective clothing, including a sturdy jacket, goggles and a face mask, but said he couldn’t fully protect his face from wind-blown spray. And twice, he told the jury, he got drenched with the herbicide, once when a spray hose became detached from a truck that was hauling it, and another time when a backpack container he was carrying leaked.

After the first drenching in 2014, he said, he got rashes on his skin that did not respond to treatment. Welts and lesions soon appeared on his legs, arms, face and eyelids. His first cancer diagnoses came soon afterward.

(4)  The evidence for the jury’s decision

Through discovery during the trial, documents came to light exposing Monsanto’s efforts to discredit the science linking glyphosate to cancer.

U.S. Right to Know (USRTK) has performed an extraordinary public service by posting the key documents in the case on its website.  There, you can find links to an astonishing number of federal court and discovery documents, exhibits, news reports, and commentary.

Also worth reading: Stacy Malkin’s Secret Documents Expose Monsanto’s War on Cancer Scientists (July 12)

Monsanto was its own ghostwriter for some safety reviews,” Bloomberg reported, and an EPA official reportedly helped Monsanto “kill” another agency’s cancer study. An investigation in Le Monde details Monsanto’s effort “to destroy the United Nations’ cancer agency by any means possible” to save glyphosate.

(5) What this means: Comment from USRTK’s Carey Gillam

Monsanto and its chemical industry allies have spent decades actively working to confuse and deceive consumers, farmers, regulators and lawmakers about the risks associated with glyphosate-based herbicides. As they’ve suppressed the risks, they’ve trumpeted the rewards and pushed use of this weed killer to historically high levels. The evidence that has come to light from Monsanto’s own internal documents, combined with data and documents from regulatory agencies, could not be more clear: It is time for public officials across the globe to act to protect public health and not corporate profits.

(6) What happens next?

Monsanto will appeal, of course; its owner, Bayer, continues to insist that glyphosate is safe.  Press accounts say that hundreds, if not thousands, of more such cases are in the pipeline, a situation similar to that faced by the tobacco industry before that industry gave up and settled.  Will Bayer do so as well?  I’m guessing not without a fight.