Currently browsing posts about: Conflicts-of-interest

When I see a study with a title like this, my first question is “Who paid for this study?”

The title:  Association of Egg Intake With Alzheimer’s Dementia Risk in Older Adults: The Rush Memory and Aging Project. The Journal of Nutrition Volume 154, Issue 7, July 2024, Pages 2236-2243.

The study: It collected dietary data by food frequency questionnaire from older adults (average age 81) and assessed Alzheimer’s dementia after nearly 7 years of follow up.

Results: Eating 1 or 2 eggs a week was associated with decreased risk.

Conclusions: “In conclusion, these findings suggest that more frequent egg consumption is associated with a lower risk of Alzheimer’s dementia, and this association is partially mediated through the effect of dietary choline on Alzheimer’s dementia…Once replicated in other prospective cohorts and confirmed by clinical trials, these findings may have important public health implications for reducing the population’s risk of AD.”

Funding: Funding for the Rush University qualifications of choline intake was provided through an unrestricted investigator-initiated grant from the Egg Nutrition Center to Think Healthy Group, LLC…The authors and sponsor strictly adhered to the American Society for Nutrition’s guiding principles for private funding for food science and nutrition research.

Conflicts of interest: One author is the Editor-in-chief of the Journal of Dietary Supplements and has received past research support from the Egg Nutrition Center.

Comment: At first glance, this is a standard egg industry funded study with an outcome favoring frequent egg consumption.  But egg consumption in this study—one or two a week—does not seem frequent to me.  What this study may really be about is choline, a conditionally essential nutrient (we make our own, but not always enough).  The “important public health implications?” Eat more eggs and take choline supplements, I guess.  If only.

CivilEats’ Lisa Held writes: The Industry Ties Within Trump’s Food and Ag Leadership: Many of the president’s top officials at the USDA, EPA, HHS, and FDA have connections to chemical, agribusiness, or fossil fuel interests.

Really?  Yes.  And the list is long.

As Lisa describes the situation,

The picture of influence is all the more noteworthy because no president has been louder about “draining the swamp” of corporate influence in D.C. Those calls have gotten even more strident around food issues as a result of Trump’s alignment with Robert F. Kennedy Jr., who is a frequent critic of corporate influence on government policies…To begin to track the influence that industry may exert on the food system over the next four years, Civil Eats dug into the backgrounds of the most prominent individuals currently working on food and agriculture within federal agencies.

She then goes through the list, agency by agency.  Two examples :

I.  Mindy Brashears, USDA Undersecretary for Food Safety (nominated, not yet confirmed)

Brashears has consulted for Cargill, Perdue, and other meat industry giants. She held the same role during Trump’s first term, during which she played an essential role in keeping meatpacking plants running at the height of the pandemic. Congress later called her the “meat industry’s go-to fixer.” In her most recent ethics disclosure forms, she says she’ll resign from positions with Boar’s Head and the Meat Institute, the trade and lobby organization that represents the country’s biggest meatpackers, upon confirmation.

II. Calley Means, Special Advisor (to HHS Secretary RFK Jr)

Means often acts as Kennedy’s mouthpiece on MAHA priorities related to food and health. He is an outspoken member of the team, often accusing government employees of being beholden to industry. Because he’s a special government employee, Means does not have to fill out financial disclosure forms.

Means co-founded Truemed, a company that directs health savings account dollars toward wellness products and memberships that reportedly raised more than $32 million in venture capital earlier this year. Truemed has extensive partnerships with makers of supplements (an industry that wants HHS to loosen regulations), health technology, and other wellness products.

Comment

The list of food (and drug) officials with financial conflicts of interest is long and extensive.  This situation explains the non-regulatory approaches to food issues, and leaving such approaches to states.  If you are hoping that this administration will do anything to refocus production agriculture on food for people (rather than feed for animals and fuel for cars or planes), stop junk food marketing to children, improve school food, reduce ultra-processed food consumption, regulate the content and labeling of supplements, or anything else that might reduce food industry profits, it’s best to keep expectations low.

I learned about this one from Women’s Health: New Study Confirms What We’ve Known About Eggs’ Health Impacts All Along.   Translation: Saturated fat raises blood cholesterol levels more than does dietary cholesterol.  Guess who paid for it!

The study: Impact of dietary cholesterol from eggs and saturated fat on LDL cholesterol levels: a randomized cross-over study. The American Journal of Clinical Nutrition. Volume 122, Issue 1, July 2025, Pages 83-91  https://doi.org/10.1016/j.ajcnut.2025.05.001.

A study funded by the Egg Nutrition Center concludes that eating two eggs a day reduces LDL-cholesterol, a risk factor for heart disease.

My NYU colleague, Mitchell Moss, sent me this news release:

Landmark study flips decades of cholesterol panic aimed at eggs:  In a groundbreaking clinical trial, researchers have unraveled the effects of cholesterol and saturated fat, finding that eggs may be far less harmful – and potentially more beneficial – than previously thought. It’s the latest research, using robust scientific work, to recast a nutritional villain in a new light.

My immediate reaction: Who paid for this?

I went right to the study: Impact of dietary cholesterol from eggs and saturated fat on LDL cholesterol levels: a randomized cross-over study, The American Journal of Clinical Nutrition  Volume 122, Issue 1, July 2025, Pages 83-91.

Conclusions: Saturated fat, not dietary cholesterol, elevates LDL cholesterol. Compared with consuming a high-saturated fat diet with only 1 egg/wk, consuming 2 eggs daily as part of a low-saturated fat diet lowers LDL concentrations, which may reduce CVD risk.

Funding.  This work was funded by the Egg Nutrition Center, a division of the American Egg Board. This funding source had no role in the design of this study, and no role in the analysis or interpretation of the data or writing of the manuscript.

Conflict of interest. JDB, AMC and AMH report financial support was provided by Egg Nutrition Center. All other authors report no conflicts of interest.

Comment: This seems like old news.  We’ve known for a long time that saturated fat raises blood cholesterol to a greater extent than does dietary cholesterol.  Eggs are the greatest source of cholesterol in U.S. diets.  But even during the fiercest days of pushing to lower dietary cholesterol, one egg a day was always OK.  Egg consumption has declined and the egg industry wants you to eat more of them.  Does eating two eggs a day really reduce heart disease risk?  It would be nice to have independentlyy funded corroborating research.  This, alas, is an industry-funded study conducted by investigators funded by the egg industry.  The claim that the funding source had no role should raise eyebrows.  Research shows that funding exerts influence, whether recognized by investigators or not.

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Forthcoming November 11, 2025: What To Eat Now

A new study says eating saffron will improve your mood.  Guess who funded it.

The Study: Lopresti AL, Smith SJ, Marx W, Díez-Municio M, Morán-Valero MI. An Examination into the Effects of a Saffron Extract (Affron) on Mood and General Wellbeing in Adults Experiencing Low Mood: A Randomized, Double-Blind, Placebo-Controlled Trial. J Nutr. 2025 Jul;155(7):2300-2311. doi: 10.1016/j.tjnut.2025.05.024. Epub 2025 May 23. PMID: 40414301.

Background: Saffron, derived from the stigmas of the Crocus sativus flower, has been shown in previous trials to have antidepressant effects in clinically diagnosed adults. However, the recruitment of small sample sizes, short treatment periods, and variability in the quality of studies have negatively impacted the strength of conclusions.

Objectives: The purpose of this 2-arm, 12-wk, parallel-group, randomized, double-blind, placebo-controlled trial was to examine the effects of supplementation with a saffron extract (Affron) on mood and sleep in adults experiencing subclinical depressive symptoms.

Methods: Two hundred and two adults aged 18-70 with depressive symptoms were supplemented with 28 mg saffron daily or a placebo.

Results: Compared to the placebo, saffron was associated with greater improvements in the Depression, Anxiety, and Stress scale….However, in the other secondary outcomes, there was no evidence of between-group differences.

Conclusions: This study…provides evidence supporting the beneficial effects of 3 mo of saffron supplementation on depressive symptoms in adults. Large placebo responses were evident in this study, which require consideration in future trials.

Funding: We thank Pharmactive Biotech Products, SLU, for funding the project and supplying the investigational products used for this
study.

Conflict of interest: ALL is the Managing Director of Clinical Research Australia, a contract research organization that receives research funding rom nutraceutical companies… SJS is an employee of Clinical Research Australia. WM has received funding and/or attended events funded by Cobram Estate Pty. Ltd. and Bega Dairy and Drinks Pty. Ltd…MD-M and MIM-V are employees of the study sponsor, Pharmactive
Biotech Products SLU.

Comment:  Let’s hear it for placebo responses!  Saffron is an extremely expensive spice usually used in pinch amounts.  If it’s hard for you to imagine that it could do anything to affect depression, subclinical depression yet, there’s a good reason for that—although saffron makes food taste delicious and that alone is a mood-improver.  But this study was done with a supplement, not the expensive spice.  Overall, this is a study done under contract from the supplement’s manufacturer by employees of the manufacturer.  As such, it is explicitly marketing research.  The interpretation of this study is predictable if you know who funded it.  The title of the study alone should generate the question: Who funded this?

The study: Maher, C. , Alcorn M., Childress A., Dawson J. A., and Galyean S.. 2025. “Increasing Vegetable Intake Using Monosodium Glutamate in a Randomized Controlled Trial: A Culinary Medicine Intervention.” Food Science & Nutrition 13, no. 6: e70441. 10.1002/fsn3.70441.

Purpose: “This study aimed to explore the effectiveness of monosodium glutamate (MSG) as a flavor enhancer in increasing vegetable intake compared to sodium chloride (NaCl) alone combined with a digital culinary medicine education program.”

Results: “The 50/50 NaCl/MSG group showed a mean increase in vegetable intake from 1.46 to 1.55 cups/day, while the NaCl group showed a decrease from 1.33 to 0.95 cups/day.”

Conclusion: “Although the differences in vegetable intake were not statistically significant, the findings suggest that MSG could enhance vegetable palatability and intake, aligning with the principles of culinary medicine.”

Conflicts of Interest: “The authors declare a conflict of interest due to Ajinomoto’s involvement in the funding and design of this study. Ajinomoto is a company that manufactures and sells MSG products. Their contribution included financial support and assistance in the study design, which could be perceived as influencing the outcomes of the research.”

Funding: “This study was funded by the American Society for Nutrition and its Foundation, grant number 1195905, and the APC [article processing charge] was funded by Ajinomoto.
Health & Nutrition North America Inc.”

Comment: The idea here is that if you sprinkle MSG rather than salt (NaCl) on your vegetables, they will taste better and you will eat more of them.  The study produced a non-significant result but is given a positive spin (“MSG could enhance…”).  The shocker here is the funding.  The authors say Ajinomoto funded it, but the funding statement mentions the American Society for Nutrition, an organization of nutrition researchers and clinicians to which I belong.  I had no idea ASN was funding research, let alone industry-funded research.  I have long been concerned about ASN’s industry partnerships, which I believe compromise the ability of the organization to issue advice on nutrition.  This is an old issue, but one that it seems time to bring up again.

I haven’t done one of these in a while.  This one is especially timely with all the fuss going on about the supposed toxicity of seed oils, soy among them.  To be clear: I do not see convincing evidence for this contention.

Still, it makes soy producers want to demonstrate that eating soy poses no health problems.  Hence, this study.

Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.  Gabrielle Viscardi, Songhee Back, Amna Ahmed, Shuting Yang, Sonia Blanco Mejia, Andreea Zurbau, Tauseef A Khan, Amanda Selk, Mark Messina, Cyril WC Kendall, David JA Jenkins, John L Sievenpiper, Laura Chiavaroli.  Advances in Nutrition, Volume 16, Issue 1, 2025, 100327, https://doi.org/10.1016/j.advnut.2024.100327.

The abstract begins:

Despite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods, especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women…This systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women.

Conclusion: “Current evidence suggests that soy isoflavones do not exhibit estrogenic effects compared with non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women.”

Funding: “This work was supported by the United Soybean Board (the United States Department of Agriculture soy check-off program)….”

Conflicts of interest:  Oh dear.  It’s hard to know where to begin, as the lists go on and on and on.  One of the authors “is the Director of Nutrition Science and Research at the Soy Nutrition Institute Global, an organization that receives partial funding from the principal funder, the United Soybean Board (USB).”  Others report financial ties to Soy Foods Association of North America, the Soy Nutrition Institute, and the United Soybean Board.

Comment.  Some of the authors on this review appear highly conflicted.  What is especially troubling is their apparent mocking of the concept of conflicted interests and conflating of personal views (which all researchers have, but these vary) with financial ties (which are discretionary and almost invariably produce results favorable to the sponsor’s interests).   Authors on this paper report as conflicts such things as awards, funding from professional societies, unpaid work for professional societies, vegan dietary preferences, and activities of their spouses and children—none of which are in the same category as financial ties to industries with direct interests in research outcome.  I don’t think this kind of conflicted research helps the soybean cause.

This is an example of what the late and much missed Sheldon Krimsky called “the funding effect,” the strong tendency for industry-funded studies to produce results favorable to the commercial interests of the sponsor.

The study: Industry study sponsorship and conflicts of interest on the effect of unprocessed red meat on cardiovascular disease risk: a systematic review of clinical trials. Miguel López-Moreno, Ujué Fresán, Carlos Marchena-Giráldez, Gabriele Bertotti, Alberto Roldán-Ruiz.  The American Journal of Clinical Nutrition, 2025, https://doi.org/10.1016/j.ajcnut.2025.02.030.

The findings:  

• Of 44 studies of meat and cardiovascular risks, 66% had links to the meat industry.
• All independently funded studies reported unfavorable (73.3%) or neutral (26.7%) results.
• All studies with funding ties to the meat industry reported favorable (20.7%) or neutral (79.3 %) results.
• Studies with conflicts of interest were nearly 4 times more likely to report favorable/neutral outcomes.

Conclusion: 

• Studies funded by the meat industry “may underestimate the cardiovascular benefits of reducing red meat intake.”

Comment

This study confirms an enormous body of research on this topic: industry funding influences research outcome.  How?  Usually by influencing how the research question is framed or in how the results are interpreted (unfavorable results reported as neutral, for example).  I’ve seen criticisms of this study arguing that ideology (favoring plant-based diets, for example) also influences research outcome.  It does, but all investigators have belief systems that influence their work.  These can go in any direction.  That’s why research needs repeating by other investigators with other biases.  Financial ties are different; they invariably skew results in the same direction—toward the commercial interests of the sponsor.