Currently browsing posts about: Conflicts-of-interest

I would not think the avocado industry would need to fund research on the benefits of avocados—surely the Superbowl takes care of sales—but its trade association is very busy.

The Hass Avocado Board has its own USDA-sponsored checkoff marketing program.

It also sponsors The Avocado Nutrition Center, where you can read all about the research studies it funds.

The avocado is well-loved but little-understood.

That’s why the Avocado Nutrition Center works to grow the world’s scientific understanding of the avocado.

Misinformation will fill the void if the pace of scientific knowledge does not match the pace of the avocado’s growing popularity.

I love avocados.  But really?

Apparently so.  Here are two recent examples.

I.  The Effect of Daily Avocado Intake on Food and Nutrient Displacement in a Free-Living Population with Abdominal Obesity. Current Developments in Nutrition, Volume 8, Issue 10, 2024, 104451, https://doi.org/10.1016/j.cdnut.2024.104451.

Conclusion: Incorporating 1 avocado daily led to favorable modifications in the dietary composition of participants, including an increase in potassium and fiber intake, which can improve diet quality.

Sponsor: Hass Avocado Board.

II.  Avocado consumption during pregnancy linked to lower child food allergy risk: prospective KuBiCo study. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-03968-4.  Thanks to Charles Platkin for this one.

Conclusion: Avocado consumption during pregnancy was associated with lower odds of infant food allergies at 12 months, even when accounting for potential covariates.

Conflict of interest: Three of the authors work for the Avocado Nutrition Center, Hass Avocado Board.

Comment: These are standard examples of what the late Sheldon Krimsky called the “funding effect,” the strong tendency of industry-funded studies to produce favorable outcomes.   They raise the question: Would independent researchers do one-food studies like these if they were not funded by an interested party?

A Canadian reader, Michel Lucas, sent this one (merci).

The report: Benoît Lamarche, Arne Astrup, Robert H Eckel, Emma Feeney, Ian Givens, Ronald M Krauss, Philippe Legrand, Renata Micha, Marie-Caroline Michalski, Sabita Soedamah-Muthu, Qi Sun, Frans J Kok.  Regular-fat and low-fat dairy foods and cardiovascular diseases: perspectives for future dietary recommendations.  The American Journal of Clinical Nutrition, Volume 121, Issue 5, 2025, Pages 956-964,  ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2025.03.009.

The workshop: Saturated Fat in Dairy and Cardiovascular Diseases, Amsterdam, 15–16 April, 2024.

Findings: “The most recent evidence indicates that overall, consumption of milk, yogurt and cheese, irrespective of fat content, is neutrally associated with CVD risk. There is also no evidence yet from randomized controlled trials that consumption of regular-fat milk, yogurt, and cheese has different effects on a broad array of cardiometabolic risk factors when compared with consumption of low-fat milk, yogurt, and cheese.”

Conclusion: “Thus, the body of evidence does not support differentiation between regular-fat and low-fat dairy foods in dietary guidelines for both adults and children.”

Implication: “Strategies focusing primarily on reduction of energy-dense, nutrient-poor foods, the main source of SFAs in Western diets, rather than on the fat content of dairy foods, are more likely to benefit the population’s cardiovascular health.”

Funding: The workshop “was supported by an unrestricted grant from the Dutch Dairy Association.”

Comment: Foods from animal sources—meat and dairy—are by far the main sources of saturated fatty acids in US diets (all food fats, no exceptions, are mixtures of saturated, unsaturated, and polyunsaturated fatty acids; it’s just the proportions that differ).

Cows eat grass; grass has fatty acids but they are mostly unsaturated; bacteria in the cows’ rumens saturate the fatty acids.

Pretty much everyone agrees that when saturated fatty acids are substituted for unsaturated or polyunsaturated fatty acids, they raise blood cholesterol and the risk for heart disease.  The disagreements are over by how much and whether clinically meaningful.

The dairy industry would like everyone to believe that the saturated fatty acids in dairy foods are benign.  Hence this workshop.

Conflict of interest: The disclosure statement begins with “The Dutch Dairy Association had no role in the discussions held at the high-level closed workshop and did not participate or provide comments during the development and writing of this manuscript.”  It didn’t have to.

Here’s the rest of the statement (I’ve emphasized dairy connections):

AA is a member of the Journal’s Editorial Board and is also an Associate Editor on The American Journal of Clinical Nutrition and played no role in the journal’s evaluation of the manuscript, reports a relationship with Rééducation Nutritionnelle et Psycho-Comportementale Scientific Committee and American Journal of Clinical Nutrition that includes board membership; and a relationship with Ferrero that includes funding grants. QS reports travel provided by Dutch Dairy Association. AA, RHE, IG, EF, RMK, PL, RM, M-CM, SS-M, and FJK reports financial support and travel provided by Dutch Dairy Association. BL reports writing assistance provided by Chill Pill Media Ltd and relationship with Health Canada that includes funding grants. EF reports a relationship with Food for Heath Ireland and Teagasc Food Research Ireland that includes funding grants; relationship with Irish section of the Nutrition Society and British Journal of Nutrition that includes board membership; relationship with National Dairy Council Ireland that includes consulting or advisory and travel reimbursement. IG reports a relationship with Global Dairy Platform, Dairy Australia, Barham Benevolent Foundation, UK Research and Innovation, Medical Research Council that includes funding grants; relationship with European Milk Federation, French National Interprofessional Centre for Dairy Economics, and Dairy Council Northern Ireland that includes speaking and lecture fees and travel reimbursement; relationship with ELSEVIER INC that includes consulting or advisory. RMK reports a relationship with Dairy Management Inc that includes funding grants. RM reports a relationship with National Institutes of Health and Gates Foundation that includes funding grants. M-CM reports a relationship with French Dairy Interbranch Organization, Sodiaal-Candia and Danone that includes funding grants; relationship with Sodiaal-Candia that includes consulting or advisory; relationship with International Milk Genomics Consortium that includes speaking and lecture fees and travel reimbursement; relationship with Danone Nutricia Research and French Dairy Interbranch Organization that includes travel reimbursement. SS-M reports a relationship with Dutch Dairy Association and Danish Dairy Research Foundation that includes funding grants.

 

 

My inbox was flooded last week with messages alerting me to this study.  Thanks to Matthew Kadey, Matthew Stasiewicz, Christopher Gardner, and others who preferred anonymity.

The study: Askow, Andrew T.; Barnes, Takeshi M.; Zupancic, Zan; Deutz, Max T.; Paulussen, Kevin J.M.; McKenna, Colleen F.; Salvador, Amadeo F.; Ulanov, Alexander V.; Paluska, Scott A.; Willard, Jared W.; Petruzzello, Steven J.; Burd, Nicholas A. Impact of Vegan Diets on Resistance Exercise-Mediated Myofibrillar Protein Synthesis in Healthy Young Males and Females: A Randomized Controlled Trial. Medicine & Science in Sports & Exercise ():10.1249/MSS.0000000000003725, April 4, 2025. | DOI: 10.1249/MSS.0000000000003725

Conclusions: “Our results demonstrated that the anabolic action of animal vs. vegan dietary patterns are similar. Moreover, there is no regulatory influence of distribution between the two dietary patterns on the stimulation of myofibrillar protein synthesis rates in young adults.”

Conflict of Interest and Funding Source: “This study was funded by The Beef Checkoff…Beef Checkoff sponsor was only involved in financial support of the project, without involvement in design, data collection, and analysis, nor interpretation and dissemination of the report.”

Comment: The idea here was that meat protein would promote muscle synthesis better than vegetable protein, especially at relatively low levels of intake. Hence, the Beef Checkoff’s interest.  Not only did this sponsored study come to what must have been an unexpected conclusion, but the University of Illinois issued a press release announcing it:  Omnivorous? Vegan? Makes no difference to muscle building after weight training, study finds.  High marks to the researchers and to the university press office.  This is one instance where you can be sure the Beef Checkoff really did stay out of the study design and interpretation.  Exceptions that prove the rule do happen. Sometimes.  I wish they happened more often.

Thanks again to Jim Krieger of Healthy Food America for sending this one.

The study: Sievenpiper JL, Purkayastha S, Grotz VL, Mora M, Zhou J, Hennings K, Goody CM, Germana K. Dietary Guidance, Sensory, Health and Safety Considerations When Choosing Low and No-Calorie Sweeteners [LNCSs]. Nutrients. 2025 Feb 25;17(5):793. doi: 10.3390/nu17050793.

The greater sweetness intensity of LNCSs compared to sucrose allows for the use of lesser amounts to achieve a similar level of sweetness, facilitating a reduction in an individual’s caloric and sugar consumption. Furthermore, the substitution of LNCSs for sugar supports individual and public health outcomes by addressing issues related to obesity, diabetes, and chronic illnesses…Lastly, emerging evidence from in vitro and a randomized controlled trial have investigated food intake and satiety management and suggests that natural LNCSs may be beneficial…The diverse range of LNCSs available in global food and beverage choices, coupled with their varying sweetness intensities, offers enjoyment and pleasure to consumers on their respective health and wellness journeys.

Conflict of interest statement: The following authors are employed at Ingredion, Inc.: Margaux Mora, Jing Zhou, Katie Hennings, and Kristen Germana. The following authors received an honorarium from Ingredion, Inc. for professional services provided: John L. Sievenpiper, Sidd Purkayastha, V. Lee Grotz and Cynthia Goody. Dr. John L Sievenpiper has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, American Society for Nutrition (ASN), National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), Institute for the Advancement of Food and Nutrition Sciences (IAFNS), Pulse Canada, Quaker Oats Center of Excellence, INC International Nut and Dried Fruit Council Foundation, The United Soybean Board (USDA soy “Checkoff” program), Protein Industries Canada (a Government of Canada Global Innovation Cluster), Almond Board of California, European Fruit Juice Association, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), The Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF among other donors), The Plant Milk Fund at the University of Toronto (a fund established by the Karuna Foundation through Vegan Grants), and The Nutrition Trialists Network Fund at the University of Toronto (a fund established by donations from the Calorie Control Council, Physicians Committee for Responsible Medicine, and Login5 Foundation). He has received food donations to support randomized controlled trials from the Almond Board of California, California Walnut Commission, Danone, Nutrartis, Soylent, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, International Food Information Council (IFIC), Arab Beverage Association, International Sweeteners Association, Calorie Control Council, and Phynova. He has or has had ad hoc consulting arrangements with Almond Board of California, Perkins Coie LLP, Tate and Lyle, Ingredion, and Brightseed. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves as an unpaid member of the Board of Trustees of IAFNS. He is a Director at Large of the Canadian Nutrition Society (CNS), founding member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is a former employee of Nestle Health Science and AB InBev.

If you have any doubts about the value of the concept of ultra-processed, the breadth and extent of industry pushback against the idea is excellent evidence.  The concept is an existential threat to the processed food industry, and it is fighting back.  The Italian food industry is especially concerned because it also has the Nutri-Score front-of-pack labeling system to contend with; the letter grades on ultra-processed products tend to be C’s, D’s, and E’s—as bad as they come.

Here’s an example of the pushback.

The opinion piece: Visioli, F., Del Rio, D., Fogliano, V., Marangoni F, Ricci C, Poli A.  Ultra-processed foods and health: are we correctly interpreting the available evidence?. Eur J Clin Nutr 79, 177–180 (2025). https://doi.org/10.1038/s41430-024-01515-8

Competing interests: AP and FM are the Chairman and Scientific Director, respectively, of NFI—Nutrition Foundation of Italy, a non-profit organisation partially supported by Italian and non-Italian Food Companies. All other authors declare no conflict of interest associated with this publication.

Comment: The senior (last) author and one other run the Italian Nutrition Foundation, an organization sponsored by food companies, Italan and international.  This makes the Foundation an industry front group, pretending to be independent, but not.  Its job is to further the commercial interests of its corporate sponsors, which is what it is doing here.  It is using the tobacco industry playbook: cast doubt on the research, suggest alternatives, argue against regulation.  The foundation’s authors are joined by academic and government authors, who have their own, not necessarily commercial, reasons for unhappiness with the UPF concept, which focuses on degree of processing, not nutrient content.  Yes, nutrients matter, but there are better ways of getting them than through UPFs.

A dietitian member of the Academy of Nutrition and Dietetics, who wishes to remain anonymous, emailed me about PepsiCo’s guide to research interpretation.

PepsiCo sent dietitians this webinar and handout for communicating nutrition science and evaluating studies. I took a look at the handout, which gives a “high quality research” distinction to any studies in which authors have clearly disclosed conflict of interest. So … As long as it’s disclosed, it can be high quality research?  Ok.

The handout: How to Communicate Nutrition Science Effectively.

As a credentialed healthcare professional, you have the power to inspire trust and deepen the general public’s understanding of nutrition through credible scientific communication. Let this guide help you to better understand scientific publications and to improve your effectiveness as a nutrition communicator.

Here’s what got the attention of my reader:

According to PepsiCo, high-quality science requires publication in a reputable, peer-reviewed journal, results based on the totality of evidence, conflicts of interest disclosed, and ethical questions, societal implications, limitations discussed.

This is good advice.

But as noted by my reader, disclosure of conflicts of interest should not be sufficient to determine research quality.

Disclosure is essential, but not enough to resolve the problems of conflict of interest.

As I endlessly repeat in these Monday posts, the recipients of industry funding rarely recognize the risk of undue influence; they did not intend to be influenced, and they believe themselves to be immune from the influence—despite the fact that tons of research shows otherwise.

Food companies fund research for reasons that have everything to do with marketing and little to do with science.  They do not fund research if they think it might show harm from their products.

Yes, this is a complicated issue.  But consider the benefit to PepsiCo from engaging dietitians in this endeavor.

The study: Amone F, Spina A, Perri A, Lofaro D, Zaccaria V, Insolia V, Lirangi C, Puoci F, Nobile V. Standardized Grape (Vitis vinifera L.) Extract Improves Short- and Long-Term Cognitive Performances in Healthy Older Adults: A Randomized, Double-Blind, and Placebo-Controlled Trial. Foods. 2024; 13(18):2999. https://doi.org/10.3390/foods13182999

The headline:  “Just 2 handfuls of pistachios daily could help protect your eyesight.”

Really?  Let’s take a look.

The Study: Pistachio Consumption Increases Macular Pigment Optical Density in Healthy Adults: A Randomized Controlled Trial.  Scott, Tammy M et al.  The Journal of Nutrition, Volume 155, Issue 1, 168 – 174. 2024 Oct 18:S0022-3166(24)01099-X.   doi: 10.1016/j.tjnut.2024.10.022.

Background: Pistachios are a bioavailable source of the xanthophyll lutein. Along with zeaxanthin, these plant pigments are major components of macular pigment (MP) in the human retina. MP can be non-invasively measured and is referred to as MP optical density (MPOD). MPOD is modifiable with dietary interventions that include lutein and zeaxanthin (L/Z). Higher MPOD protects the eye from light damage and is positively associated with eye health.

Objectives: This dietary intervention study aimed to evaluate the effect of pistachio consumption on MPOD.

Method: This single-blinded, randomized controlled trial compared a 12-week pistachio intervention (2 oz/d) with usual diet (UD) on MPOD and serum L/Z in middle-aged to older healthy adults (n = 36) in a 1:1 randomization scheme.

Conclusions: The results of our study demonstrate that a dietary intervention with pistachios is efficacious in increasing MPOD in healthy adults selected for habitually low intake of L/Z and low baseline MPOD. This suggests that pistachio consumption could be an effective dietary strategy for preserving eye health. Future studies need to evaluate the generalizability of our findings to other populations.

Funding: This project was supported by the American Pistachio Growers, who had no role in the final design, conduct, or interpretation of this study. The project described was also supported by the National Center for Advancing Translational Sciences, National Institutes of Health, Award Number UM1TR004398. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflict of interest: Tammy M Scott reports financial support provided by American Pistachio Growers. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Comment: When I saw the title, I wanted to know immediately, “Who paid for this?”  If you eat foods containing lutein and zeaxanthin, the levels of those factors will increase.  No surprise.  Are pistachios the only or best way to do this?  That’s not what this study aimed to find out.  This, as is true of much (most) industry-funded studies, this one is more about marketing than science.