by Marion Nestle

Currently browsing posts about: Diabetes

Apr 24 2024

American Diabetes Association: conflicted interests

Thanks to everyone who flooded my mailbox with this piece from The Guardian: She was fired after not endorsing Splenda-filled salads to people with diabetes. Why?

According to a lawsuit {Elizabeth] Hanna recently filed against the ADA, the organization – which endorses recipes and food plans on its websiteand on the websites of “partner” food brands – tried to get her to greenlight recipes that she believedflew in the face of the ADA’s mission. These included recipes like a “cucumber and onion salad” made with a third of a cup of Splenda granulated artificial sweetener, “autumnal sheet-pan veggies” with a quarter cup of Splenda monk fruit sweetener and a “cranberry almond spinach salad” with a quarter cup of Splenda monkfruit sweetener.

Guess which company gave more than $1m to the ADA in 2022? Splenda.

I also was sent an email from Georgia Warren, the  Guardian’s Interim membership editor: The link between investigative reporting, some nightmarish recipes and the diabetes epidemic.

Why would a public health charity promote a product that its own science shows contributes to the disease it is fighting? Well, as Neil Barsky reported for us this week, the ADA took more than $1m from Splenda in 2022 – and then fired their chief nutritionist when, according to a lawsuit she recently filed, she refused to sign-off on the Splenda-based recipes that her bosses wanted the ADA to publicly endorse.

Neil – creator of our new series ‘Death by diabetes: America’s preventable epidemic’ – told me…“The ADA has bought into a system that requires them to raise money from corporations to fund their research. I don’t for a second doubt that every single person who works there cares about people with diabetes and wants to do the right thing, but being beholden to these groups distorts your judgment.”

..And what else is pharma funding? The ADA. The organization – whose guidance doctors rely on when treating their diabetes patients – boasts a $100m annual budget. Between 2017 and 2024, pharmaceutical and device manufacturers contributed over $134m to the organization – or roughly 20% of its total funding.

Comment: The ADA has long appeared to be in thrall the the drug industry.  I well remember the talk I gave at one of its annual conventions years ago.  I was one of two speakers about diet and diabetes (the other was a session on the role of sugar in diabetes sponsored by Coca-Cola—truly you can’t make this stuff up).  The other talks, hundreds of them, were about drugs.  At that time, the ADA said virtually nothing about diet on its website.

It’s gotten much better.  Here’s what it says about carbohydrates:

  • Try to eat less of these: refined, highly processed carbohydrate foods and those with added sugar. These include sugary drinks like soda, sweet tea and juice, refined grains like white bread, white rice and sugary cereal, and sweets and snack foods like cake, cookies, candy and chips.

And here’s what the ADA says about artificial sweeteners:

It’s also important to know that at this time, there is no clear evidence to suggest that using sugar substitutes will help with managing blood sugar or weight or improving cardiometabolic health in the long run. So here’s the bottom line:

  • Sugar substitutes are effective alternatives to sugar for some people, but not a perfect fit for all—it’s a personal choice.
  • If you’re looking to reduce your intake of sugar or sugar substitutes, start slowly. For example, start by replacing one soda or juice with water or a no-calorie drink at a time.
  • Water will always be a great choice! If you start feeling yourself get bored with just water, you can always spruce it up with fruits or herbs like this sparkling strawberry mint infused water.

And, finally for now, here are the ADA’s corporate sponsors, and its national sponsors.

Conflicted?  Sure looks like it.

Apr 23 2024

At long last: legislation to reduce childhood obesity and diabetes!

I received an e-mailed press release from the Senate Committee on Health, Education, Labor, and Pensions (HELP), chaired by Sen. Bernie Sanders (I-VT):  NEWS: Sanders and Booker Take on Food and Beverage Industry with New Legislation to Address Childhood Diabetes and Obesity Epidemics.

Sen. Sanders, along with Sens. Cory Booker (D-NJ) and Peter Welch (D-VT), have introduced legislation to

Take on the greed of the food and beverage industry and address the growing diabetes and obesity epidemics negatively impacting millions of American children and families across the country. The Childhood Diabetes Reduction Act establishes a first-of-its-kind federal ban on junk food advertising targeted to children in the United States, requires the Food and Drug Administration (FDA) to implement strong health and nutrient warning labeling, directs the National Institutes of Health (NIH) to investigate the dangers posed by ultra-processed foods, and develops a national education campaign for children and caregivers through the Centers for Disease Control and Prevention (CDC).

The press release quotes Sen. Sanders:

“Let’s be clear: The twin crises of type 2 diabetes and obesity in America are being fueled by the food and beverage industry that, for decades, has been making massive profits by enticing children to consume unhealthy products purposely designed to be overeaten…We cannot continue to allow large corporations in the food and beverage industry to put their profits over the health and well-being of our children.

Nearly 30 years ago, Congress had the courage to take on the tobacco industry, whose products killed more than 400,000 Americans every year. Now is the time for Congress to act with the same sense of urgency to combat these diabetes and obesity epidemics. That means banning junk food ads targeted to kids and putting strong warning labels on food and beverages with unacceptably high levels of sugar, salt, and saturated fat.”


At long last, congressional representatives are trying to do something to prevent childhood obesity.  Let’s urge our representatives to sign on to this bill.

Aug 21 2020

Weekend reading: Diabetes, race, and class

Arleen Tuchman.  Diabetes: A History of Race and Disease.  Yale University Press, 2020.Diabetes: A History of Race and Disease: 9780300228991: Medicine & Health Science Books @ Amazon.comI did a blurb for this book:

This is a superb, deeply researched history of the role of racism and class bias in perceptions of type 2 diabetes.  Its root causes?  Poverty and discriminationa new vision for a prevention agenda.

Tuchman does for type 2 diabetes what historians of other diseases have done: explore the central role of race and racism.  Racism, she explains, can

Generate ill health by producing pathological responses to the stress of living in a society in which skin color is endowed with privileges denied to others.  Racism, in other words, can make people sick.  In this way, racism—not race—becomes a fundamental cause of differential disease rates, making it impossible to draw a sharp line between what is biological and what is social.

As she documents, health professionals first viewed diabetes as a disease of the Jews—perhaps because they went to doctors more often.   It took decades for scientists to distinguish type 1 from type 2 diabetes, and more decades to recognize that its higher prevalence among non-white minority groups might be due to the obesity-promoting diets and lifestyles of poverty.

For documentation of the social determinants of health, this book is an instant classic.

Jun 10 2019

Industry-funded study of the week: dairy foods, type 2 diabetes, and cardiovascular disease

Knowing that this review was sponsored by the dairy industry, can you predict its conclusions?

Association between dairy intake and the risk of contracting type 2 diabetes and cardiovascular diseases: a systematic review and meta-analysis with subgroup analysis of men versus women. Moshe Mishali, Shiri Prizant-Passal, Tova Avrech, and Yehuda Shoenfeld . Nutrition Reviews 2019;77(6):417–429.

Conclusions: “In conclusion, these results, indicating that dairy product consumption decreases the risk of T2D and CVD, are in line with the recommendations for the public to consume dairy products. The findings about sex differences and the positive effect of milk on women need further establishment. Future studies should focus on isolating the effect of dairy products for men and women throughout their life span

Funding. This work was financed by the Israel Dairy Board.

Declaration of interests. M.M. is a consultant for the Israel Dairy Board. S.P. was paid for her work by the Israel Dairy Board. T.A. is Chief Health Officer at the Israel Dairy Board. Y.S. is a consultant for the Israel Dairy Board.

Comment: This is a study paid for by the Israeli dairy industry.  As such, it can well be considered an advertisement.  Like other such industry-funded studies (as I discuss in Unsavory Truth), it puts a positive spin on equivocal results (“need further establishment”).

Nov 21 2018

New recommendations for type 2 diabetes in kids

Dr. Robert Lustig notes that the American Diabetes Association (ADA) has just released its newest guidelines for management of type 2 diabetes in children.

He has plenty to say about this organization, its ties to the pharmaceutical industry, and its lack of focus on effective dietary approaches to prevention and treatment—at a time when “insulin prices have soared into the stratosphere.”

The ADA, he says,

is a “bought” organization. Bought by Big Pharma. It’s only about the money. It’s not about lives or health or society. This is extortion. Big Food is Al Capone. And the ADA is Frank Nitti, his henchman.

The ADA recommendations do talk about physical activity and diet, but judge the evidence for them as not particularly strong (grades B and C).

These are standard recommendations, but difficult to follow consistently, not least because they are not nearly forceful or specific enough.

Dr. Lustig would like much greater emphasis on restricting sugars.  That’s a good place to begin.

Dec 8 2016

Food Politics Alaska style: Supermarket prices

I visited the AC supermarket in Utqiagvik, the town formerly known as Barrow.

It could be anywhere USA, with anything you could possibly want, including fresh blueberries from Argentina.  How’s that for food miles?

Remember: all of this, no exceptions, comes in by cargo plane.

The produce section was lovely, with remarkably fresh foods at equally remarkable prices.

Would you believe the green leaf lettuce is $3.50, the baby carrots $7.29, and the romaine $4.69?  New York prices on steroids.

How about white potatoes at $3.29, red ones at $2.79, and baking potatoes at $18.99 for 10 pounds.

Or the reason I was so concerned about the tossed out school lunch milk cartons: $7.11 on sale.

How about bread on sale for $5.98 a loaf?

Just to make me feel at home, here are the sugary drinks down one entire aisle.  The 12-packs were on sale for $10.98, which must not be enough to discourage sales.

Are soft drinks a problem in Utqiagvik/Barrow?

Yes, they are.

The prevalence of obesity and diabetes is low, but rising steadily, and the Indian Health Service dentists told me that they see plenty of little kids with rotted teeth from drinking sodas and sweet juices in baby bottles.

The nutrition transition is taking place in America too, and for the same reasons that obesity and diabetes are becoming problems in the developing world.

Jul 15 2015

The curious incident of Nick Jonas, Coca-Cola, Crossfit, and Diabetes

Thanks to Melanie Nesheim for sending me a link to Russ Greene’s (The Russells) account of Nick Jonas’s dispute with Crossfit over its posting of this image.

As best as I can tell, here’s what happened.

Nick Jonas of the Jonas Brothers, who has Type 1 diabetes, sent out a tweet objecting to this image as insulting to people with type 1 diabetes.   Note: Sugary beverages are a not a risk factor for type 1 diabetes but they are for type 2 (see, for example thisthis, and this).

Russ Greene entered the fray with a tweet pointing out that Coca-Cola sponsors the Jonas Brothers’ concerts.

Apparently, this caught the attention of Good Morning America.

A spokesman for Nick Jonas denied that he had any kind of deal with Coca-Cola.


Maybe not, but as Mr. Greene pointed out, Coca-Cola presents or sponsors the concerts and advertises that it does so.

My conclusions from this incident:

  • In taking on CrossFit’s critique of the role of sugary drinks in diabetes, Nick Jonas became a de facto spokesman for Coca-Cola.
  • Coca-Cola’s support of Jonas Brothers’ concerts paid off.
  • Coca-Cola’s sponsorship of musicians and sports figures buys loyalty and deflects attention from the well documented role of sugary drinks in type 2 diabetes and other health conditions.

And, of course, I examine this sort of sponsorship in much greater detail in my forthcoming Soda Politics: Taking on Big Soda (and Winning)which comes out in October.

Nov 19 2013 on “Tackling Diabetes” has a special edition on “Tackling Diabetes: Formulating for Healthy Blood Sugar.”

We’ve been telling people to lose weight, eat more complex carbs and do more exercise for years to get their blood sugar under control, but the number of Americans with type two diabetes continues to rise at an alarming rate. So how can the food industry help? In this FoodNavigator-USA special edition we explore the growing number of tools in the formulator’s toolbox to help promote healthy blood sugar. We also look at what messages resonate with consumers, from the glycemic index to healthy blood sugar, plus what you can, and can’t, say about diabetes on a food label.

Here are the articles in this series:

It’s always interesting to look at such issues from the food industry’s perspective.  And FoodNavigator reporters do an especially good job of putting the issues in context.