The Journal of Public Health Policy (JPHP) will soon announce the retraction of a Viewpoint—an opinion piece—I co-authored with a Guatemalan physician, Dr. Joaquin Barnoya, “The food industry and conflicts of interest in nutrition research: A Latin American perspective.” Because of factual errors in the piece, and in response to valid objections about the errors from its subjects, they and we requested its retraction and JPHP is doing so.

I believe it is useful to explain how this happened.  In late summer, Dr. Barnoya brought to my attention an advertorial, a sponsored news account, published in el Periódico and other Guatemalan newspapers announcing an alliance among the Central American Bottling Corporation (cbc), the largest beverage distributor in Guatemala and bottler for PepsiCo; the Guatemala-based Institute of Nutrition of Central America and Panama (INCAP); and the U.S.-based Shalom Christian Foundation to distribute a supplemental food product, Mani+, to chronically malnourished children in rural areas (here is a translation of the advertorial).  Mani+ is a sweetened, peanut-based, nutrient-fortified supplemental food made from local ingredients in Guatemala, used to prevent malnutrition in young children.  The advertorial displayed a photograph of the directors of the three organizations holding the agreement.  It also displayed statements from all three directors emphasizing the alliance’s importance in addressing childhood malnutrition.

As readers of this blog should know, I have long been concerned about the conflicts of interest that arise when food companies—especially soda companies—enter into alliances with public health organizations.   The New York Times made the consequences of such alliances clear in its recent revelations of Coca-Cola sponsorship of the Global Energy Balance Network and the fallout from those revelations.  The announced alliance between cbc and INCAP raises similar concerns, particularly in the light of more general food industry partnerships with research and health institutions in Latin America.  Our intention in writing the Viewpoint was to question the appropriateness of this alliance, as well as of other such partnerships and alliances.

We should, however, have exercised more care.  Shortly after publication of the Viewpoint, Carolina Siu Bermúdez, the director of INCAP who appears in the advertorial, wrote to object that our piece incorrectly implied a financial relationship with cbc, and that Dr. Barnoya had failed to disclose that INCAP paid a substantial portion of his salary via a grant from yet another organization.  We also received letters from Dr. Edward Fischer, the founder of NutriPlus/Mani+, Professor of Anthropology and Director of the Center for Latin American Studies at Vanderbilt University, objecting to our statement that the alliance was responsible for manufacturing (rather than just distributing) the product.   Both asked us to retract the Viewpoint.

Upon investigation, we realized their objections had merit.  Indeed, further investigation by us and by the editors of the JPHP exposed additional errors.  Together, these include the following clarifications and corrections:

• The alliance is involved only in the distribution of Mani+, not its manufacture (as we had asserted).
• The actual nature of the alliance between cbc, INCAP, and the Shalom Christian Foundation—who does what—is, in fact, unclear. The Viewpoint should have characterized the relationship with less certainty and specified that cbc has no financial relationship with either INCAP or the Foundation.
• Dr. Barnoya should have disclosed his financial relationship with INCAP, and I should have insisted that he do so.
• The Viewpoint was triggered by the advertorial, and we should have made this connection more explicit.
• The reference in the Viewpoint to the advertorial is incorrect. It is listed as (2015) cbc co. Unidos contra la desnutricion. INCAP, cbc y Fundacion Crisitiana Shalom Firman Convenio 23(July): 9.  The correct reference is Alianza Contra la Desnutricion. elPeriódico. July 23, 2015;Advertorial: 9.

To correct and clarify these issues, we would need to revise the Viewpoint.  Doing so, however, is not possible once a paper is published.  That left us no choice but to request a retraction, which I believe is the right course of action in this situation.

In my books and other writing, I try as hard as I can to be precise and accurate.  This incident is a lapse that I regret deeply, for which I take responsibility, and for which I apologize to Carolina Siu Bermúdez, to Dr. Fischer, and to my readers.  I also apologize to Phyllis Freeman and Anthony Robbins, the editors of JPHP, and to Lucy Wheeler of Palgrave, who have set an exemplary standard of ethics and integrity throughout these investigations and discussions.

As for lessons learned: Although I fully intend to continue to write critically about alliances between food companies and public health organizations, I also intend to use this experience to recommit myself to accountability and to diligence in checking and double-checking facts and disclosures going forward.   Again, my deepest apologies.

Addition, December 14: The actual retraction notice is published here.  The discussion on Retraction Watch is here.

I gave a talk on Soda Politics to NYU’s long-standing Experimental Cuisine Collective, a partnership between NYU’s chemistry and food studies programs.

I thought it would be fun to start it off with a soda tasting (thanks to Jeff Potter, author of Cooking for Geeks: Real Science, Great Cooks, and Good Food, for the photos):

In my book, I talk about research demonstrating that hardly anyone can tell the difference between Coke and Pepsi, or between colas sweetened with table sugar or high fructose corn syrup.  I thought it would be fun to double check.

We asked participants to taste 6 unlabeled soda samples.

The six choices:  Coca-Cola, PepsiCola, Caleb soda, Coca-Cola Life, Mexican Coca-Cola, and a duplicate of Coca-Cola.

The idea was to see whether people could tell which was which and whether they could tell the difference between Coke made with high fructose corn syrup (regular Coke), table sugar (Mexican Coke), or Stevia (Coca-Cola Life).

38 people participated.  Here are the results:

• Coca-Cola: this was identified correctly by 14/38, but only 10 correctly identified the duplicate.
• Mexican Coca-Cola: 4/38
• Coca-Cola Life: 17/38
• Pepsi: 11/38
• Caleb’s Cola: 29/38 (it’s color is distinctly different)

Only one person correctly identified all six.  I, alas, only got one right—Caleb’s.  It looks different and tastes less sweet.

You think you can do better?  Give it a try.

When I was in San Francisco last week, I met Janna Cordeiro and Real Food Challenge students from San Francisco State University (SFSU) who are taking on Big Soda.  As Janna explained in an e-mail,

Last spring, SFSU administration quietly released an RFP to solicit a corporate sponsor for Pouring Rights.

The Pouring Rights contract —for a 1 time minimum $2 Million donation and yearly $125K donation— not only includes 80% access to all drinks sold on campus, naming rights for the sports stadiums (and scholarships, seats, etc), access to students and alum for social media campaigns, access to STUDENT-owned campus center, and on and on BUT also an endowed chair in the school of the sponsor’s choice. Pepsi Professor anyone?

She points out that “The students believe that the release of the RFP violated important shared governance agreements that guide the campus, and that it was intentionally kept very low profile.”

She also notes that since San Francisco’s soda tax campaign, several high profile policies limiting SSBs have been passed:

1) City of SF has passed 2 important pieces of legislation: warning label requirements on ads,  ban on use of city funds to purchase ssbs (including the many contractors such as Department of Children Youth and Families), and ban on sub ads on city property

2) The SFUSD passed a comprehensive wellness policy which bans all sugary drinks sold or offered on school grounds including fundraisers/festivals/ and staff/teachers drinking.

3) Most major hospitals are SSB free INCLUDING all of UCSF campuses and our public hospital.

This means:

Essentially, SFSU and our City College Campuses are the only public spaces where SSBs are sold or advertised. So, we can’t let the SFSU administration go through with this, and this group of students from the Real Food Challenge SFSU are stepping up to fight back. Let’s join them and show our support!  They have already organized demonstrations when PepsiCo and Coca-Cola were on campus for their presentations, but have much more planned. The also have a 15 page resolution that covers ALL the bases!

And here’s her call to action:

What can you do?

1. Sign the petition:   Lots of information on this page so it’s a great place to start. 

2. Send them a letter of support for them to give the SFSU President Wong who has agreed to meet with them on Nov 19th in an open Town Hall mtg. email: realfoodchallengesfsu@gmail.com

3. If you’re local, attend the Town Hall meeting at 12noon on 11/19. Location TBD. Invite on Facebook.

4. Follow on Facebook—  show your support and Tweet about it. I’ve been pushing out tweets on OpenTruthNow if you need ideas.

5. If you have connections, help them get high visibility MEDIA attention. Contact me directly, and I can send you the media contact. for the group.

Let’s help them CRUSH Big Soda ! Student Rights not Pouring Rights!

Onwards!

Additions

November 13: The San Francisco Chronicle has a discussion of this action (I’m quoted)

November 19: The SFSU president drops the soda partnership proposal!

If you are a maker of processed foods, and have exhausted low-carb and low-fat marketing options, all you have left is proteins—the hot new marketing tool.  Protein-supplemented products are all over supermarket shelves.  Never mind that most Americans get twice the protein required, and that even vegans can easily meet and exceed protein requirements.

As FoodNavigator-USA puts it, “manufacturers are now competing to impress shoppers with how much they can pack into bars, beverages and yogurts. In this FoodNavigator-USA special edition we’ll look at what protein options are available for formulators, from new insect and algal-based proteins to pea, soy, and dairy-based proteins.”

• Protein water hits the mainstream as Protein2o rolls out at Walmart: Protein2o – a rapidly-growing line of flavored waters infused with electrolytes and 15g of protein – is rolling out to 750 Walmart stores this month, says the firm, which is targeting consumers that are looking for more refreshing beverages that pack in a meaningful amount of protein, without the calories… Read
• Flapjacked meets demand for more protein with easy-to-make pancake and muffin mixes: High protein, easy-to-eat foods are no longer limited to bars and shakes – now they can also be found in familiar baked goods that appeal to carb-loving consumers, thanks to companies like Flapjacked. .. Watch now
• fairlife: ‘We’re responsible for a large portion of the growth in the value-added dairy category‘: Coca-Cola-backed high-protein milk brand fairlife isn’t sharing any numbers, yet. But if you’re wondering how it’s performing, the answer is very nicely, says communications director Anders Porter, who says the firm is also working on a suite of products utilizing the milk “that can be consumed during any day part”. .. Read
• Earth’s first superfood? Solazyme’s whole algae protein gains traction as formulators seek more vegan options: New sources of protein from edible insects to hemp are being incorporated into a growing number of products from bars to beverages. But does microalgae have what it takes to become a serious player in the so-called ‘alternative proteins’ market?.. Read
• C-fu’s new processing platforms could help pave the way for an insect commodity market: Two new, versatile production platforms created by ingredient supplier C-fu FOODS could crack open the nascent insect protein commodity market in North America by “abstracting the product from its source,” a company co-founder says… Read
• Tiny plants with huge potential: Introducing two new players to the plant-based protein market: Two firms that generated a lot of buzz at the IFT show this year were Parabel and Hinoman, which are both selling brand new nutrient-packed ingredients from tiny aquatic plants. But do they have what it takes to give more established players in the plant-based protein category a run for their money?.. Watch now
• EPIC Provisions: ‘If an opportunity came with the right strategic partner, we would absolutely take it’: Revenues at EPIC Provisions more than tripled to $6.8m in 2014, and are on course to triple again to $20m in 2015 as the EPIC brand – which first hit shelves in 2013 – continues to lure new consumers to a category (premium meat snacks) that has rapidly gone from lukewarm to red hot… Read
• Jerky is the ultimate high protein, low fat, low carb, healthy snack, says Oberto: Most Americans eat meat. But only a small percentage eats meat snacks. So does this disconnect simply reflect the fact that beef doesn’t pair too well with a mid-morning mocha-latte, or is it proof of a huge, still largely untapped, market opportunity? .. Read
• Blending soy and dairy proteins adds benefits for consumers, manufacturers, DuPont says: Two sources of protein in a finished product are better than one when it comes to blending soy and dairy, according to DuPont Nutrition and Health… Read
• Trend toward higher protein doses to continue, but big tubs will still rule, consultant says: Innovation in protein sources and mixtures continues, but delivery mode innovation has not kept pace, at least not in the US market, said consultant Ralf Jaeger, PhD… Read
• Protein powders: The heavyweight in the $16bn sports nutrition market: The US market for sports nutrition plus energy/nutrition bars and sports drinks is set to cruise past $20 billion by 2020, says Euromonitor International, but which segments are driving growth, and how is the ‘regimentation of fitness’ influencing product development?.. Read
• Protein is hot, but customers are getting more discerning about the source and quality, says Glanbia Nutritionals: Glanbia Nutritionals has expanded beyond its dairy roots to add pea, chia and flax protein concentrates to its portfolio to meet growing demand for vegan protein, says business development manager Vicky Fligel, who caught up with us for our special edition on protein… Read
• Ancient, yet modern? Sacha inchi and hemp give formulators new options in plant-based proteins: Hemp and sacha inchi – two ‘ancient yet modern’ sources of protein from seeds – are gaining traction in the burgeoning plant-based protein set, although their premium price tag means they are unlikely to become as big as rice or pea protein – at least in the short term, says AIDP.  .. Read

Just remember: Diets adequate in calories are highly likely to be adequate in protein, and average protein intake in the population is twice the amount required.  From the standpoint of nutrition, protein is a non-issue.  But that doesn’t stop marketers from looking for ways to push it.

Yesterday, I received this ALERT from health advocates in Mexico:

Big Soda negotiates behind doors with PRI to reduce Mexican SSB tax to 5% for drinks with 5 grams of added sugars per 100ml– Public health advocates denounce conflict of interest and speak out in defense of the tax

Yesterday Mexico’s Congressional Finance Committee proposed and voted in favor of an alarming measure to reduce the rate of the current 10% sugar-sweetened beverage tax to 5% on products with 5 grams of added sugar or less per 100 milliliters. The measure was pushed through committee vote with a reservation from only one political party and moves on to a vote in the lower house within the next 24-48 hours. Beverages with more than 5 grams of added sugar per 100 milliliters would continue to be taxed at 10% (1 peso per liter).

A columnist in one of Mexico’s most prominent dailies indicates that this negotiation between the FEMSA Coca-Cola bottling company and the PRI political party (current administration and majority vote holder in Congress and Senate) came about after attempts at a food and beverage industry negotiation with the PRI, seeking to reduce Mexico’s SSB and snack taxes. The columnist says Bimbo (&the food industry) was eventually excluded from this negotiation to focus on an attainable goal of reducing the SSB tax. (See column in Spanish: http://www.dineroenimagen.com/2015-10-19/63221 )

After several recent press conferences and an act in Congress “to trap” industry lobby mosquitos (Oct 6), continuing to call for an increase to a 20% SSB tax in accordance with national and international expert recommendations, and warning the public and decision makers of industry lobby, today civil society advocates –the Nutritional Health Alliance and ContraPESO– published a full page ad in Mexico’s most important daily asking whether legislators are on the side of public health or soda industry interests and calling on them not to cede to the industry lobby.

In the ad (see translation below and image attached), advocates warn that the most currently consumed 600 ml sugary drink on the Mexican market that has 5 grams of sugar per 100 milliliters contains 30 grams of sugar, above the WHO’s new guidelines for healthy living.

The language of the initiative to reduce the tax recognizes the SSB tax as a public health measure and the progress made, yet proceeds to reduce the tax far below the expert recommended rate, representating a setback to Mexico’s landmark tax.

FYI: Although Mexico’s lower house of Congress (Chamber of Deputies) holds authority over final budget decisions on income, Mexican legislative process entails that the budget package, once voted in the lower house, passes to the Senate for review and a vote, before passing back to the lower house for final approval.

TO SUPPORT MEXICAN ADVOCATES:
Tweet indignation over industry back-door negotiation and support for the current tax and need for an increased tax: #ImpuestoAlRefresco
Press interviews: contact comunicacion@elpoderdelconsumidor.org
If you or your association can emit a declaration or letter of support, send to:
comunicacion@elpoderdelconsumidor.org
desarrolloinstitucional@elpoderdelconsumidor.org

PUBLIC HEALTH ADVOCATES IN MEXICO – Ad in Reforma newspapers OCT 19, 2015 – IN DEFENSE OF MEXICAN SSB TAX. Translation:
Members of Congress:

Have you let yourselves be bitten by the sugar-sweetened beverage lobby mosquitos?:

Do you serve soda industry or public health interests?

– The tax on sugar-sweetened beverages is 10% (1 peso) and not 20% (2 pesos) per liter as recommended by international and national organizations.

– The proposal to lower the tax to 5% to beverages with 5 grams or less of sugar per 100 milliliters acquiesces to soda industry interests, which are the parties mainly responsible for the collapse of public health in Mexico.

– The most consumed 600 milliliter drink in Mexico has 5 grams of sugar for every 100 milliliters contains 30 grams of sugar (6 spoonfuls).

– This surpasses the 25 grams (5 spoonfuls) that the World Health Organization establishes as a maximum amount of added sugars per day in order to preserve one’s health. (1)

– Sugar is not an essential nutrient and there is solid evidence showing that its consumption is harmful to health, contributing to overweight, obesity and caries, serious public health problems in Mexico.

Sugar-sweetened beverages kill more Mexicans a year than organized crime. (2)

Whose side are you on?

DO NOT GIVE IN TO INDUSTRY PRESSURE!

Show that you work to protect the public health of the Mexican population and not Big Soda’s profits.

We demand that the special tax be preserved and increased to 20% for ALL SUGAR-SWEETENED BEVERAGES, as recommended by international and national organizations.

Do sugar-sweetened beverages increase the risk of high blood pressure?

Yes, says this study, which was conducted by investigators who accept research funding from Coca-Cola and the Calorie Control Council (a trade association for companies that make or use artificial sweeteners).  But the study itself was funded by independent government agencies or health associations in Canada.

I’m counting it in the category of studies with results unfavorable to the food industry sponsors.

This brings the score to 70 industry-funded studies since mid-March with results favorable to the sponsor, to 6 with unfavorable results.

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts.  Viranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

• Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
• Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from Canadian government agencies or health associations.
• Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….

Comment

This is an exception that proves the rule.  In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.

One possible explanation is that when investigators typically funded by soda companies are funded independently,  they design and conduct independent research.

If nothing else, this study is evidence for the need for and value of independent funding of nutrition research.

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.  Susan K Raatz, LuAnn K Johnson, and Matthew J Picklo.  J. Nutr. 2015; 145:2265-2272 doi:10.3945/jn.115.218016 

• Conclusions: Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG [triglyceride] concentrations in both GT [glucose tolerant] and IGT [glucose intolerant] individuals and elevated glycemic and inflammatory responses in the latter.
• Funding: Supported by a grant from the National Honey Board and by the USDA Agricultural Research Service.
• Comment.  The authors hypothesized that honey would result in improved glycemia and insulin sensitivity compared with sucrose and HFCS.  But they found that their “data do not support the contention that the consumption of honey vs. HFCS or sucrose provides an added health benefit for maintenance of glucose homeostasis and other cardiometabolic outcomes because all 3 sugars evaluated exerted similar metabolic effects.”

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts.  Viranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

• Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
• Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from other Canadian government agencies or health associations.  This, therefore is actually an independently funded study.
• Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….
• Comment: In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.  If nothing else, this study is evidence for the importance of independent funding of nutrition research.

The score, for those of you following this saga, is now 65 studies with results favoring the sponsor to 5 with unfavorable results.  But I will soon be posting another 5 of the former kind.

Dr. Thomas Schlenker, who directs San Antonio’s Metropolitan Health, asked the City Council to support a “drink less soda” campaign.

The City Council said no.  It fired Dr. Schlenker.

A representative of the Texas Beverage Association and Coca-Cola’s director of public affairs sit on the City Council and have veto power over its actions.

Schlenker says his firing is due to his outspoken critique of sugary drinks; the City Council says he’s just rude.

Maybe, but as Dr. Schlenker explains, Big Soda has donated millions to city government.

Says the Wall Street Journal,

One of the soft drink industry’s biggest challenges: constantly fighting the perception that soda is really bad for you. No matter how much money it spends on research or argues that exercise lowers obesity, the industry is playing a never-ending game of Whac-A-Mole. When it beats down critics in one place, they pop right back up in another.

Other cities, even in Texas, are looking for ways to slow down the rising prevalence of obesity.  Cutting out sugary drinks is a great first step.  Other cities should hire Dr. Schlenker.