Currently browsing posts about: Conflicts-of-interest

Sharp-eyed readers have sent in two studies sponsored by food companies with results that will be difficult to use for marketing.  This brings the score since mid-March to 105 sponsored studies useful in marketing to 11 that are not.

Effects of Pomegranate Extract Supplementation on Cardiovascular Risk Factors and Physical Function in Hemodialysis Patients. Wu Pei-Tzu, Fitschen Peter J., Kistler Brandon M., Jeong Jin Hee, Chung Hae Ryong, Aviram Michael, Phillips Shane A., Fernhall Bo, and Wilund Kenneth R.. Journal of Medicinal Food. September 2015, 18(9): 941-949. doi:10.1089/jmf.2014.0103.

• Conclusions: Systolic blood pressure and diastolic blood pressure were reduced by 24±13.7 and 10±5.3 mmHg, respectively, in POM (P<.05). However, the BP differences in POM were no longer significant after controlling for baseline BP…However, pomegranate supplementation had no effect on other markers of cardiovascular disease risk, inflammation and oxidative stress, or measures of physical function and muscle strength. While pomegranate extract supplementation may reduce BP and increase the antioxidant activity in HD patients, it does not improve other markers of cardiovascular risk, physical function, or muscle strength.
• Funding: This work was supported by the POM Wonderful, LLC.

The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition–Netherlands cohort.  Jaike Praagman, Joline WJ Beulens, Marjan Alssema, Peter L Zock, Anne J Wanders, Ivonne Sluijs, and Yvonne T van der Schouw.  Am J Clin Nutr. First published ahead of print January 20, 2016 as doi: 10.3945/ajcn.115.122671

• Conclusions: In this Dutch population, higher SFA intake was not associated with higher IHD risks. The lower IHD risk observed did not depend on the substituting macronutrient…Residual confounding by cholesterol-lowering therapy and trans fat or limited variation in SFA and PUFA intake may explain our findings.
• Authors’ disclosures: JP is financially supported by a restricted research grant from Unilever Research and Development, Vlaardingen, Netherlands. MA, AJW, and PLZ are employees of Unilever Research and Development. None of the other authors reported a conflict of interest related to this study.
• Comment: Unilever sells low-saturated fat/high-polyunsaturated fat margarines (e.g., Flora, Becel) for reducing coronary risk.  If higher saturated fat intake does not increase heart disease risk (perhaps because the study subjects were on statins), these products are unnecessary.

I’ve collected five more studies funded directly or indirectly by food companies or trade associations, with results useful for marketing purposes.  This brings the total to 105 that I’ve noticed since last March versus only 9 with results that must have disappointed the sponsors.

Canned Vegetable and Fruit Consumption Is Associated with Changes in Nutrient Intake and Higher Diet Quality in Children and Adults: National Health and Nutrition Examination Survey 2001-2010.  Marjorie R. Freedman, PhD; Victor L. Fulgoni III, PhD.  J Acad Nutr Diet. 2015  http://dx.doi.org/10.1016/j.jand.2015.10.013.

• Conclusions: Results suggest CVþCF consumption was associated with higher intake of select nutrients, a higher-quality diet, and comparable adiposity measures and blood pressure.
• Funding for this project was received from the Canned Food Alliance.  As senior vice president at Nutrition Impact, LLC, V. L. Fulgoni III provides food and nutrition consulting and database analyses for various members of the food and beverage industry.  No potential conflict of interest was reported by M. R. Freedman.

Regular Fat and Reduced Fat Dairy Products Show Similar Associations with Markers of Adolescent Cardiometabolic Health.   O’Sullivan, T.A.; Bremner, A.P.; Mori, T.A., Beilin, L.J., Wilson, C., Hafekost, K., Ambrosini, G.L., Huang, R.C., Oddy, W.H..Nutrients 2016, 8, 22.

• Conclusion: Although regular fat dairy was associated with a slightly better cholesterol profile in boys, overall, intakes of both regular fat and reduced fat dairy products were associated with similar cardiometabolic associations in adolescents.
• Conflicts of Interest: Therese A. O’Sullivan received a grant from The Dairy Health and Nutrition Consortium Australia…which provided funding for the analysis and write up of this study. No other authors declare a conflict of interest.

Suboptimal Plasma Long Chain n-3 Concentrations are Common among Adults in the United States, NHANES 2003–2004. Rachel A. Murphy, Elaine A. Yu, Eric D. Ciappio, Saurabh Mehta and Michael I. McBurney   Nutrients 2015, 7, 10282–10289; doi:10.3390/nu7125534.

• Conclusion: Suboptimal LCn-3 [omega-3] concentrations are common among U.S. adults. These findings highlight the need to increase LCn-3 intake among Americans.
• Conflicts of Interest: M.I.M., E.D.C. and R.A.M. are employees of D.S.M. Nutritional Products, L.L.C., manufacturers and suppliers of omega-3 nutritional lipids. E.Y. and S.M. have no conflicts of interest to disclose.

Red Raspberries and Their Bioactive Polyphenols: Cardiometabolic and Neuronal Health Links.  Britt M Burton-Freeman, Amandeep K Sandhu, and  Indika Edirisinghe.  Adv Nutr January 2016 Adv Nutr vol. 7: 44-65, 2016. doi: 10.3945/​an.115.009639

• Conclusion: The body of research is growing and supports a potential role for red raspberries in reducing the risk of metabolically based chronic diseases.
• Funding: Supported in part by various donors and the National Processed Raspberry Council.

Dietary flavonoid intake and incidence of erectile dysfunction. Aedín Cassidy, Mary Franz, and Eric B Rimm.  American Journal of Clinical Nutrition. First published ahead of print January 13, 2016 as doi: 10.3945/ajcn.115.122010.

• Conclusions: These data suggest that a higher habitual intake of specific flavonoid-rich foods is associated with reduced ED incidence. Intervention trials are needed to further examine the impact of increasing intakes of commonly consumed flavonoid-rich foods on men’s health.
• Authors’ disclosure: AC and EBR received funding from the US Blueberry Highbush Council for a separate project unrelated to this publication.
• Comment: The University of East Anglia, where the lead author works, sent out a press release “Blueberries associated with reduced risk of erectile dysfunction.”

Several members of the Academy of Nutrition and Dietetics (AND–formerly the American Dietetic Association) sent me a letter from the Academy’s president, Evelyn Crayton, announcing its new policy on sponsorship.

AND’s previous policy, which encouraged sponsorship by food companies selling fast food, salty snacks, and sugary drinks, has been the subject of a critical investigative report and induced members of the Academy to create Dietitians for Professional Integrity to get the policy changed.

This advocacy worked.  It induced AND’s leadership to appoint a Sponsorship Advisory Task Force (SATF) to recommend a less conflicted policy to AND’s Board of Directors.

The SATF delivered its report to the Board on January 13.  As Evelyn Crayton explains,

The Board voted to implement a pilot program encompassing many of the SATF’s recommendations. The one-year pilot program includes appointing a Sponsorship Committee to review national-level sponsor opportunities and to develop assessment tools that will support the sponsorship process.

The Board of Directors approved the following newly revised sponsorship guidelines, which take effect immediately for all Academy organizational units. Dietetic Practice Groups and Member Interest Groups will be required to adhere to these guidelines and Affiliates are encouraged to adopt them.

Sponsorship approval requires that:

• The sponsor’s vision and mission align with the Academy’s Vision, Mission and Strategic Goals.
• The sponsor’s product portfolio is broadly aligned with the Academy’s Vision: Optimizing health through food and nutrition.
• The sponsor relationship and sponsor product portfolio are broadly aligned with official Academy positions.
• All aspects of the sponsorship (such as research, consumer messaging or professional education for members) align with the Academy’s Scientific Integrity Principles.
• The Academy does not endorse any company, brand or company products, nor does the Academy’s name or logo appear on any product. Such endorsement is neither actual nor implied.
• The Academy maintains final editorial control and approval of all content in materials bearing the Academy name or logo.
• There is clear separation of Academy messages and content from brand information or promotion.
• Relevant facts and important information are included.
• The Board is confident that these revised guidelines and the new Sponsorship Committee pilot program will enable the Academy to better serve the organization and our members.

This looks impressive and deserves congratulations.  The policy calls for transparency, separation, and alignment—all laudable goals.

I have only two concerns:

• What did the SATF report actually say?  How about making it available?  [If anyone has a copy and can send, please do.]
• What is the definition of “alignment with the Academy’s goals and principles?”

As always, the devil is in the details.  As Andy Bellatti explains,

Some of these guidelines (i.e.: “the sponsor’s mission and vision align with AND’s”) already exist in the current policy — the same policy that considered PepsiCo (and former sponsors Coca-Cola, Kellogg’s, and General Mills) an appropriate sponsor.

The Academy’s Board can start the process by making the SATF report public (at least to members) and then explaining its process for setting the policy.*

It also needs to explain how “alignment” will be defined.  What are the actual criteria for deciding whether AND will accept food-industry sponsorship.

But this is a great first step and deserves much praise.

*Update: the Academy released the report.

If you have been following this saga, you will know that since mid-March 2015 I’ve been collecting examples of published research supported wholly or in part by food companies.  As of today, the collection includes 95 studies with results favorable to the sponsor’s marketing interests as opposed to just 9 with unfavorable results.

Here are the most recent five.  These bring up general and specific questions that I’m pondering these days and I’ve indicated them in red.

The Effects of Water and Non-Nutritive Sweetened Beverages on Weight Loss and Weight Maintenance: A Randomized Clinical Trial.  John C. Peters, Jimikaye Beck, Michelle Cardel, Holly R. Wyatt, Gary D. Foster, Zhaoxing Pan, Alexis C. Wojtanowski, Stephanie S. Vander Veur, Sharon J. Herring, Carrie Brill, and James O. Hill. Obesity (2015) 00, 00–00. doi:10.1002/oby.21327.

• Conclusions: Water and NNS [non-nutritive sweetened] beverages were not equivalent for weight loss and maintenance during a 1-year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program.
• Funding agencies: The study was fully funded by The American Beverage Association. The American Beverage Association was not involved in the design, conduct, interpretation, or manuscript preparation of this study. Furthermore, a third-party organization (Biofortis-Provident) was hired at the PIs’ request. Biofortis-Provident audited data at both clinical sites to check for the accuracy and integrity of the data…Disclosure: J.C.P. and J.O.H. received consulting fees from The Coca-Cola Company outside of the submitted work.
• Questions: Does recruiting a third party to audit data increase confidence in the credibility of this study?  Isn’t it more relevant to ask about how the research question is framed? 

Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes.  Constance Brown-Riggs.  Int. J. Environ. Res. Public Health 2016, 13(1), 28; doi:10.3390/ijerph13010028.

• Conclusion: Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children.
• Funding: This work was supported by The Dannon Company Inc. (White Plains, NY). The Dannon Company Inc. provided information for this article but did not have final approval for its content.
• Conflicts of Interest: Nutrition advisor for Dannon’s One Yogurt Everyday Initiative, providing consultation services on the health issues affecting African Americans.

Protein Supplementation at Breakfast and Lunch for 24 Weeks beyond Habitual Intakes Increases Whole-Body Lean Tissue Mass in Healthy Older Adults.  Catherine Norton, Clodagh Toomey, William G McCormack, Peter Francis, Jean Saunders, Emmet Kerin, and Philip Jakeman.  Nutr. 2016; 146:65-69 doi:10.3945/jn.115.219022.

• Conclusions: Protein supplementation at breakfast and lunch for 24 wk in healthy older adults resulted in a positive (+0.6 kg) difference in LTM compared with an isoenergetic, nonnitrogenous maltodextrin control. These observations suggest that an optimized and balanced distribution of meal protein intakes could be beneficial in the preservation of lean tissue mass in the elderly.
• Funding: Supported by Food for Health Ireland and Enterprise Ireland grant CC20080001.  Author disclosures: C Norton, C Toomey, P Francis, J Saunders, E Kerin, and P Jakeman, no conflicts of interest. WG McCormack was an employee of Carbery Ingredients on secondment to Food for Health Ireland during the in vivo data collection and analysis.
• Comment: The Carbery Group advertises itself as “a global leader in food ingredients, flavours and cheese.”
• Question: Why would Carbery put one of its employees to work on this study?

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.  Neil R Brett, Paula Lavery, Sherry Agellon, Catherine A Vanstone, Jonathon L Maguire, Frank Rauch, and Hope A Weiler.  Am J Clin Nutr 2016; 103:144-152 doi:10.3945/ajcn.115.115956.

• Conclusion: Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D $50 nmol/L during periods of minimal ultraviolet B radiation exposure.
• Supported by funding from Dairy Farmers of Canada, the Canadian Foundation for Innovation and Canada Research Chairs, and in-kind support from Agropur and Ultima Foods for the study products.
• Question: Does providing study products introduce conflicts of interest?

Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial.  Sally Chiu, Nathalie Bergeron, Paul T Williams, George A Bray, Barbara Sutherland, and Ronald M Krauss.

• Conclusions: The HF-DASH diet lowered blood pressure to the same extent as the DASH diet but also reduced plasma triglyceride and VLDL concentrations without significantly increasing LDL cholesterol
• Supported by Dairy Management Inc. and by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through University of California, San Francisco Clinical & Translational Science Institute grant UL1 RR024131.  RMK has previously received and is currently receiving research funding from Dairy Management Inc. for this and other projects. None of the other authors reported a conflict of interest. This was an investigator-initiated study, and its financial supporters had no role in the study design, implementation, data analysis, or data interpretation.
• Question: Does this mean that the investigators decided what they wanted to study and then asked Dairy Management Inc for funding, knowing that Dairy Management would have congruent interests?  Does something like this increase confidence in the results?

I don’t have clear, unambiguous answers to such questions and am collecting opinions in preparation for my next book project.  If you have thoughts about these matters, do share.

My latest Viewpoint, “Corporate funding of food and nutrition research: science or marketing,” was published yesterday in JAMA Internal Medicine 2016;176 (1):13-14.  doi:10.1001/jamainternmed.2015.6667.

Systematic Review of Pears and Health. Holly Reiland, BS Joanne Slavin, PhD, RD.  Nutrition Today November/December 2015 – Volume 50 – Issue 6 – p 301–305.  doi: 10.1097/NT.0000000000000112.  

• Conclusions: Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study.
• Funding: The authors received a grant from USA Pears in the past. The authors provided their own funding to allow this article to publish as Open Access.
• Comment: Pears are a great fruit but the marketing purpose of this study is evident from this press release from the Pear Bureau Northwest: “While the body of evidence connecting pear intake and health outcomes is still limited, USA Pears has been contributing to research efforts by commissioning independent studies to learn and affirm the heath attributes of pears. Visit www.usapears.org for additional pear research, nutrition resources and recipes.”

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study.  Norimah AK , H. C. Koo, Hamid Jan JM, Mohd Nasir MT, S. Y. Tan, Mahendran Appukutty, Nurliyana AR, Frank Thielecke, Sinead Hopkins, M. K. Ong, C. Ning, E. S. Tee.  PLoS ONE 10(10): e0138247. doi:10.1371/journal.pone.0138247

• Conclusion: Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.
• Funding: The Nutrition Society of Malaysia received an unrestricted research grant from Cereal Partners Worldwide, Switzerland and Nestleé R&D Center, Singapore. This financial support was provided in the form of salaries for authors but the funders did not have any additional role in the study design, data collection and analysis or decision to publish. Frank Thielecke was an employee of Cereal Partners Worldwide at the time this study was conducted. He now works for Nestec SA. Sinead Hopkins is employed by Cereal Partners Worldwide (CPW), Switzerland and Moi Kim Ong and Celila Ning are employed by Nestleé R&D Center, Singapore….Nestlé and Cereal Partners Worldwide have a commercial interest in breakfast cereals.
• Comment: I learned about this study from a comment on Retraction Watch, which reported that PLoS One had filed a correction to the funding section.  The correction says that the salaries were for research assistants, not authors.

Walnuts Consumed by Healthy Adults Provide Less Available Energy than Predicted by the Atwater Factors.  David J Baer*, Sarah K Gebauer, and Janet A Novotny. J Nutrition First published November 18, 2015, doi: 10.3945/​jn.115.217372.

• Conclusion: Consistent with other tree nuts, Atwater factors overestimate the metabolizable energy value of walnuts. These results could help explain the observations that consumers of nuts do not gain excessive weight and could improve the accuracy of food labeling.
• Funding: This research was funded by the USDA and the California Walnut Commission… DJ Baer was funded by the USDA and the California Walnut Commission.

Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult Women.  Prasad Vivek Kumar, Drenowatz Clemens, Hand Gregory A., Lavie Carl J., Sui Xuemei, Demello Madison, and Blair Steven N.  Journal of Women’s Health, 2015 ahead of print. doi:10.1089/jwh.2015.5307.

• Conclusion: CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
• Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation, or preparation and submission of this article. The authors thank the Energy Balance staff and study participants for their contributions. No competing financial interests exist. 
• Comment: This is one of the papers produced by participants in the now defunct Global Energy Balance Network formerly sponsored by Coca-Cola.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including metaanalyses, of the evidence from human and animal studies. PJ Rogers, PS Hogenkamp, C de Graaf , S Higgs , A Lluch , AR Ness , C Penfold , R Perry , P Putz , MR Yeomans and DJ Mela.  International Journal of Obesity advance online publication, 10 November 2015; doi:10.1038/ijo.2015.177

• Conclusion¨The preponderance of evidence from all human randomized controlled trials indicates that LES [low-energy sweeteners] do not increase EI [energy intake] or BW [body weight], whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
• Conflict: This work was conducted by an expert group of the European branch of the International Life Science Institute (ILSI Europe). The expert group received funding from the ILSI Europe Eating Behaviour and Energy Balance Task Force. Industry members of this task force are listed on the ILSI Europe website at www.ilsi.eu.
• Comment: ILSI is funded by food companies.

Last Friday, Coca-Cola UK joined its US counterpart in revealing the names of the organizations, researchers, and individuals it funds and the amounts it pays for these services.

As Jon Woods, General Manager of Coca-Cola Great Britain and Ireland, explains:

Earlier this year, my colleagues in the US published a list of the health and wellbeing partnerships, research and individuals funded there, dating back to 2010. In October, I committed to do the same and today we have published the details of what we have funded in Great Britain.  I believe this is the right thing to do…The total amount of funding we have provided in GB since 2010 is £9,328,095.

Like the US list, which has been analyzed extensively by Ninjas for Health, this one is interesting to read.

Here is a small sample from the list of organizations:

• Biotechnology and Biological Sciences Research Council — £20,000
• British Dietetic Association — £5,600
• British Feeding & Drinking Group Annual Meeting — £1,200
• British Nutrition Foundation — £33,000

A sample from the list of scientists and other individuals (not otherwise identified, alas):

• Fiona Hunter
• Prof. Ken Fox
• Lynne Garton
• Dr. Geoffrey Livesey
• Dr. Sigrid Gibson
• Dr. David Haslam
• Prof. Marion Hetherington
• Penny Hunking
• Angie Jefferson
• Prof. Ian Macdonald

I’m sure British public health advocates will have fun looking up what these people have said about sugary drinks and obesity.

The Times of London explained who some of them are:

The advisers include Stuart Biddle, of Loughborough University, who was chairman of a health department group on obesity in 2010; Alan Boobis, a director at Public Health England, who stopped receiving funding in 2013; Ken Fox, who advised the government on obesity in 2009; and Carrie Ruxton, now on the board of Food Standards Scotland. In 2010 Dr Ruxton co-wrote a study sponsored by the UK Sugar Bureau, an industry group, that found no proven association between sugar intake and obesity.

According to Der Spiegel, Coca-Cola plans to reveal everyone it sponsors in Europe.  All of this is further fallout from August’s New York Times’ revelations of Coca-Cola sponsorship of the now defunct Global Energy Balance Network.

More to come, no doubt.  Stay tuned.

Here are three rare studies sponsored by food companies with results that must have disappointed their funders.  Since mid-March when I started this collection, these bring the score to 85:9 (studies with results favorable to the sponsor’s interests vs. those against).

Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast.  Arpita Basu, Nancy M Betts, Misti J Leyva, Dongxu Fu, Christopher E Aston, and Timothy J Lyons.  J. Nutr. 2015; 145:2325-2332 doi:10.3945/jn.115.215772

• Conclusion: Acute cocoa supplementation showed no clear overall benefit in T2D [type 2 diabetes] patients after a high-fat fast-food–style meal challenge. Although HDL cholesterol and insulin remained higher throughout the 6-h postprandial period, an overall decrease in large artery elasticity was found after cocoa consumption.
• Funding: Supported by NIH Centers of Biomedical Research Excellence Program of the National Center for Research Resources at University of Oklahoma Health Sciences Center…a grant from The Hershey Company (to AB), and the Dean’s Research Incentive program in the College of Human Sciences at Oklahoma State University.

Associations between flavan-3-ol intake and CVD risk in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk).  Vogiatzoglou A¹, Mulligan AA², Bhaniani A², Lentjes MA², McTaggart A², Luben RN², Heiss C³, Kelm M³, Merx MW³, Spencer JP³, Schroeter H⁴, Khaw KT⁵,Kuhnle GG⁶.  ).  Free Radic Biol Med. 2015 Jul;84:1-10. doi: 10.1016/j.freeradbiomed.2015.03.005. Epub 2015 Mar 17.

• Conclusion:  There were no consistent associations between flavan-3-ol monomer intake and baseline systolic and diastolic blood pressure (BP)…Flavan-3-ol intake in EPIC-Norfolk is not sufficient to achieve a statistically significant reduction in CVD risk.
• Funding: The present study was supported by the EU (Grant 226588, “Flaviola”) and an unrestricted grant from Mars, Inc. Mars, Inc. had no role in the design and analysis of the study or in the writing of this article. EPIC-Norfolk is supported by Cancer Research UK (SP2024-0201 and SP2024-0204) and the Medical Research Council (G9502233). H.S. is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities. None of the other authors has a conflict of interest to declare.
• Comment: This and the previous study are part of an effort to make chocolate seem like a health food.  Alas, these didn’t work.

No Change in 24-Hour Hydration Status Following a Moderate Increase in Fluid Consumption.  Matthew A. Tucker MA, J. D. Adams MS, Lemuel A. Brown MS, Christian B. Ridings MS, Jenna M. Burchfield MS, Forrest B. Robinson BS, Jamie L. McDermott MS, RD, LDN, Brett A. Schreiber MS, Nicole E. Moyen MS, Tyrone A. Washington PhD, Andrea C. Bermudez BS, Meredith P. Bennett BS, Maxime E. Buyckx MD & Matthew S. Ganio PhD.  Journal of the American College of Nutrition, DOI: 10.1080/07315724.2015.1046196.

• Conclusions: Regardless of fluid volume or beverage type consumed, measures of 24-hour hydration status did not differ, suggesting that standard measures of hydration status are not sensitive enough to detect a 22% increase in beverage consumption.
• Funding: This study was supported by a grant from The Coca-Cola Company. M.E.B., an employee of The Coca-Cola Company, contributed to study design and writing the article.
• Comment: Coca-Cola has long advertised its products as promoting hydration.  In most people, thirst and normal food intake take care of hydration.  This study confirms that if you drink more than you need, you pee out the excess.