Currently browsing posts about: Sponsored-research

I have posted several studies funded by blueberry trade associations over the years, including my all-time favorite, the one about prevention of erectile dysfunction.  Yes!

Can we please use some common sense here?  I love blueberries, grow and harvest them on my Manhattan terrace, and eat them whenever I can—but not because I think there is the remotest chance that they alone will keep me from dementia.

But scientists are seriously debating whether blueberries do or do not improve cognitive function in the elderly.

Study #1: Hein S, Whyte AR, Wood E, Rodriguez-Mateos A, Williams CM. Systematic review of the effects of blueberry on cognitive performance as we age. Journal of Gerontology: Series A. 2019;74(7):984-95

Conclusion: “Findings from these studies indicate that cognitive benefits may be found for delayed memory and executive function in children and for delayed memory, executive function, and psychomotor function in older healthy and MCI [mild cognitive impairment] adults”.

Funder: “This work was supported by an unrestricted grant from the Wild Blueberry Association of North America.”

The Debate:

• Errors or irreproducibility in effect size calculations and incomplete reporting of results in “Systematic Review of the Effects of Blueberry on Cognitive Performance as We Age:  The combination of irreproducible effect size calculations, selective reporting of effects, and general errors in systematic review methodology result in a misrepresentation of the strength of evidence about blueberries and cognitive performance.

Study #2:  The effect of blueberry interventions on cognitive performance and mood: A systematic review of randomized controlled trials.

Conclusion: “Based on the current evidence, blueberries may improve some measures of cognitive performance.”

Funding: The article, still in press, states that the authors declare no competing interests but provides no information about study funding.

The debate: 

• There is No Meta-Analytic Evidence of Blueberries Improving Cognitive Performance or Mood:  Based on the current research, however, researchers should avoid drawing any definitive conclusions regarding the effects of blueberries on cognitive performance.
• In Response to “There is No Meta-Analytic Evidence of Blueberries Improving Cognitive Performance or Mood”:  The authors of study #2 say that they “echo the conclusions of the authors [of the critique] that state that while both our review and their analysis provide limited support for the use of blueberry interventions, this should not be interpreted as conclusive evidence for a lack of efficacy but rather that further trials are required to resolve existing limitations.”

My Comment: Of course blueberries are healthy and wouldn’t it be wonderful if all you had to do to prevent dementia was to eat some every day.  Skeptic that I am, I am happy to see widespread agreement that these studies do not constitute conclusive evidence.  Of course eating blueberries (or any other fruit) is healthy; eating fruits and vegetables is healthy.   This kind of research is about getting you to eat more blueberries, rather than any other kind of berry or fruit.

The study: Potato ingestion is as effective as carbohydrate gels to support prolonged cycling performance.  Salvador AF, et al.  J Applied Physiology, 17 October 2019.

Conclusion: “Potato and gel ingestion equally sustained blood glucose concentrations and TT [time-trial] performance. Our results support the effective use of potatoes to support race performance for trained cyclists.”

Funder: The Alliance for Potato Research and Education, “a not-for-profit organisation funded by the potato industry in the US.”

Comment:  I learned about this study from an article in NutraIngrendients.com: “Powered by potato? Spuds ‘just as good’ as carb gels for athletic performance, says study.”

Despite my previous correspondence and interview with the editor of NutraIngredients, the article failed to mention the study’s industry sponsor.

This was especially disappointing because its sister publication, FoodNavigator.com, covered the same study but quoted the funding statement.

The study’s title and result should have triggered a look to see who paid for it.  Really?  Cyclists are supposed to carry potatoes with them to eat on long races?   Why would anyone other than potato sellers even think of such a thing?

Addition: But see comments from readers…

I was interested to hear this from Courtney Puidk, a dietitian:

Love your industry updates – BUT actually using potatoes as fuel has been a thing with cyclists for a long time. I have several friends and an ex who used baked potatoes as fuel during bike races and triathlons because potatoes are 99% glucose so they shoot through you fast, and they have lots of potassium and sodium so act as natural electrolytes. They fit nicely into the pockets of cycling jerseys and/or water bottle holders. And they’re cheap! Not to mention a whole food fuel source over some pricey, marketed sugar gel with lots of packaging.  Plenty of reasons to use potatoes as fuel!

And Simone Braithwaite, a reader from Australia, writes:

A friend of mine recently did the Comrades Marathon in South Africa. She has now done the 100km twice – once for each direction. Funny thing is, on the course the provided energy source is boiled potatoes (with salt). Runners actually carrying boiled potatoes along as they trudge this arduous race, apparently nibbling/sucking as they go.  In this developing world context I actually thought this was excellent as potatoes are an affordable and accessible food source for all. I also wondered how long this tradition would last – before multinationals got in with their ‘superior’ ultra processed products. Maybe this is one case where this study will be most useful!!!😂

OK.  I concede.

The study: Matthews LG, Smyser CD, Cherkerzian S, Alexopoulos D, Kenley J, Tuuli MG, et al. (2019) Maternal pomegranate juice intake and brain structure and function in infants with intrauterine growth restriction: A randomized controlled pilot study. PLoS ONE 14(8): e0219596.

The findings (my emphasis): “There were no group differences in brain injury, metrics or volumes. However, treatment subjects displayed reduced diffusivity within the anterior and posterior limbs of the internal capsule compared with placebo. Resting state functional connectivity demonstrated increased correlation and covariance within several networks in treatment subjects, with alterations most apparent in the visual network in per-protocol analyses. Direct effects on health were not found.

Conclusion: In conclusion, maternal pomegranate juice intake in pregnancies with known IUGR was associated with altered white matter organization and functional connectivity in the infant brain, suggesting differences in brain structure and function following in utero pomegranate juice exposure, warranting continued investigation.

Funding: This work was supported by National Institute of Health Grants R01 HD29190 (D. M. Nelson), K02 NS089852 (C.D. Smyser), U54 HD087011 and P30 HD062171 (T.E. Inder), The Foundation for Barnes-Jewish Hospital (D. M. Nelson) and an unrestricted gift to Washington University School of Medicine from POM Wonderful, Los Angeles, CA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Comment: This is a classic example of interpretation bias.  Studies of bias associated with industry funding find that it shows up mostly in the framing of the research question or in the interpretation, as this one demonstrates.  The study did not find anything significant but concluded that drinking pomegranate juice during pregnancy is good for the growing fetus.

Bottom line: Fruit juices (of any kind) are good for health as long as volumes are small.  Eating the fruit itself is better–less sugar, more fiber.

The Study:  Dairy Foods and Dairy Fats: New Perspectives on Pathways Implicated in Cardiometabolic Health.  Kristin M Hirahatake; Richard S Bruno; Bradley W Bolling ; Christopher Blesso; Lacy M Alexander, et al.  Advances in Nutrition, nmz105, https://doi.org/10.1093/advances/nmz105  Published: 25 September 2019

The Conclusions: Most observational and experimental evidence does not support a detrimental relationship between full-fat dairy intake and cardiometabolic health, including risks of cardiovascular disease and type 2 diabetes. Indeed, an expanded understanding of the dairy food matrix and the bioactive properties of dairy fats and other constituents suggests a neutral or potentially beneficial role in cardiometabolic health.

The Conflicted Interests (my emphasis): SHA’s research is funded in part by USDA-Agricultural Research Project…Support for RSB is provided by USDA-NIFA…the Ohio Agricultural Research and Development Center at the Ohio State University, and the National Dairy Council. BWB’s research is funded in part by the National Dairy Council. Author disclosures: SHA has received honoraria from ILSI North America, the National Dairy Council (NDC), the National Cattlemen’s Beef Association, Herbalife, and the Council for Responsible Nutrition as a presenter and participant at sponsored scientific conferences. RSB has received honoraria from NDC to serve as an external research advisor and from Abbott Nutrition for serving as a presenter at a sponsored scientific conference. BWB has received honoraria from NDC and Nederlanse Zuivel Oranisatie for presenting research at scientific conferences. CB has received honoraria from NDC and the America Egg Board as a presenter and participant at sponsored scientific conferences. LMA has received funding from NDC, NHLBI, and Performance Health. KMH has received funding from NDC to coordinate author contributions and to write the article. The National Dairy Council (NDC) sponsored the 2018 Scientific Summit: A New Look at Dairy Foods and Healthy Eating Patterns. The sponsor reviewed this manuscript prior to submission. All editorial decisions were solely left to the authors, and this report reflects the independent opinions and views of the authors.

Comment: The National Dairy Council funded this study and reviewed its manuscript.  The authors receive funding from the Dairy Council.  This review should be considered a paid advertisement.  Do dairy foods have any special role in cardiometabolic health?  I doubt it, but we are unlikely to find out until such questions are investigated independently.

I get letters like this from food trade associations all the time.  Here is the latest:.

The U.S. Highbush Blueberry Council has issued a request for research proposals (RFP) for which it offers grants ranging from $75,000 to $300,000 (or larger).

Here’s the get-go bias point (my emphasis):

The goal of our research funding is to provide initial funds, or additional funds, to explore blueberry health benefits.

The Council wants research to demonstrate benefits.  Of course it does.  These will be useful for marketing.

A priority for funding will be given to human clinical studies however the committee is also interested in further investigation of possible health benefits for pet or performance animals including dogs, cats and horses.

If the proposal is unlikely to demonstrate benefit, it won’t be funded.

That’s why I consider industry-funded research to be about marketing, not science.

The study: A Moderate-Fat Diet with One Avocado per Day Increases Plasma Antioxidants and Decreases the Oxidation of Small, Dense LDL in Adults with Overweight and Obesity: A Randomized Controlled Trial.  Li Wang, Ling Tao, Lei Hao, Todd H Stanley, Kuan-Hsun Huang, Joshua D Lambert, Penny M Kris-Etherton.  The Journal of Nutrition, nxz231, https://doi.org/10.1093/jn/nxz231  Published: 14 October 2019

The Press release: One avocado a day helps lower ‘bad’ cholesterol for heart healthy benefits  (thanks to reader Effie Seftel for sending).

Conclusions: “One avocado a day in a heart-healthy diet decreased oxLDL [oxidized LDL]in adults with overweight and obesity, and the effect was associated with the reduction in sdLDL [small-density LDL–the bad kind]…Avocados have a unique nutrient and bioactive profile that appears to play an important role in reducing LDL oxidation, hence decreasing LDL atherogenicity.”

Funding:  “Supported by a grant from the Hass Avocado Board.”  [I’ve written previously about other studies funded by this Board].

Author disclosures: LW, LT, LH, THS, K-HH, and JDL, no conflicts of interest. PMK-E received funding from the Hass Avocado Board to conduct this study and is a member of the Avocado Nutrition Science Advisory. The Hass Avocado Board had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

Comment: Thanks to Jeff Nelson for sending this one (his interview with me is online).  He points out that the diet of the group eating one avocado a day also ate less saturated fat and more fiber, which could help to account for the favorable result.  I love avocados (who does not?) but worry about what our demand for them is doing to Mexican food culture and personal safety.  Does the Hass Board really need to do this?

Addition, October 31

The London Daily Mail has, of all things, a critique of this study:  “Eating an avocado a day will NOT cut your cholesterol: Statistician debunks the ‘hilariously unimpressive’ results of study funded by ‘big avocado’.”

A reader, Jeff Nelson (whose interview with me is online here), sent me a link to this Japanese study that identified a link between eating mushrooms and prevention of prostate cancer.

The study:  Mushroom consumption and incident risk of prostate cancer in Japan: A pooled analysis of the Miyagi Cohort Study and the Ohsaki Cohort Study.  Shu Zhang, et al.  International Journal of Cancer. First published: 04 September 2019. 

Conclusion: “The present study showed an inverse relationship between mushroom consumption and incident prostate cancer among middle‐aged and elderly Japanese men, suggesting that habitual mushroom intake might help to prevent prostate cancer.”

Funding: “Our study was supported by the NARO Bio‐oriented Technology Research Advancement Institution.”

I looked up NARO:

The National Agriculture and Food Research Organization or NARO is the core institute in Japan for conducting research and development on agriculture and food. Our overall mission is to contribute to the development of society through innovations in agriculture and food, by promoting pioneering and fundamental R&D. We conduct technological development to make agriculture a competitive and attractive industry, and contribute to increasing the nation’s food self-sufficiency rate.

Jeff’s question: “Is this considered commercial research? Mushrooms’ magical impact of preventing cancer?”

My response: “Gastro-patriotism“

I would classify this one as ideologically driven more than commercially driven.  Mushrooms are part of traditional Japanese diets and this institute promotes commercialization of Japanese agricultural products.

The result is far-fetched enough (mushrooms prevent prostate cancer, really?) to be suspicious, but this looks more like gastro-patriotism to me than the result of mushroom industry lobbying–if such exists, it was not disclosed.

Gastro-patriotism is a term I just this minute coined.*  It describes the promotion of nationalism and civic pride through a country’s cuisine.  Examples leap to mind with French cuisine leading the way and anything having to do with terroir.  The Greek government’s promotion of olive oil is another example.

* Addition October 29

A reader, Polly Adema, reminds me that the term is hardly original. There is, she says:

an established concept and practice of gastronationalism. It is a recognized variation of gastrodiplomacy, one getting increasing attention within various academic circles…Lots of articles will come up if you search gastronationalism in google scholar or your search engine of choice.  The term is from and grows out of Michaela DeSoucey’s 2016 book, Contested Tastes: Foie Gras and the Politics of Food.  Here is a link to an earlier DeSoucey piece: https://journals.sagepub.com/doi/full/10.1177/0003122410372226#_i11

Oops.  Apologies to Michaela DeSoucey, for not citing her excellent book, which I had read, blurbed, and posted as weekend reading, but did not think of in this context.

This one was sent to me by a reader who wishes to remain anonymous (thanks!).

The Study: Dairy Fat Consumption and the Risk of Metabolic Syndrome: An Examination of the Saturated Fatty Acids in Dairy.  Allison L. Unger,Moises Torres-Gonzalez, and Jana Kraft.  Nutrients 2019, 11(9), 2200; https://doi.org/10.3390/nu11092200

The review argues: “it is likely that the diverse array of SFA [saturated fatty acid] constituents within full-fat dairy foods contributes to favorably modulating cardiometabolic health.”

It concludes: “In summary, previous work on the impact of dairy-derived SFA consumption on disease risk suggests that there is currently insufficient evidence to support current dietary guidelines which consolidate all dietary SFA into a single group of nutrients whose consumption should be reduced, regardless of dietary source, food matrix, and composition.”

Funding and Conflicted Interests (my emphasis): “The work involved for this manuscript was funded by National Dairy Council….M.T.-G. is employee of National Dairy Council. J.K. has received research funding from National Dairy Council.

Comment: This purpose of this dairy-funded review is to demonstrate that contrary to contradictory information, the saturated fatty acids in dairy foods are not only benign, but beneficial. The dairy industry would love that to be true.

This particular sponsored review is exceptionally well organized and illustrated.  I especially appreciated the timeline of dietary recommendations for saturated fat from 1977 to the present.  This is the bottom half:

This is a classic industry-funded review arriving at the desired conclusions.  In essence, it is a dairy industry advertisement and should be understood as such.

Why do this?  The dairy industry is in serious economic trouble these days, as I will discuss tomorrow.