Currently browsing posts about: Sponsored-research

Every now and then a study comes out that I just love.

Two apples a day lower serum cholesterol and improve cardiometabolic biomarkers in mildly hypercholesterolemic adults: a randomized, controlled, crossover trial.

At last, scientific proof of what we’ve always been taught.

Well, two apples, but OK.

Also OK, who paid for this?

Supported in part by AGER (Agribusiness and research) grant no. 2010-2119 funding the project “Apple fruit quality in the post-genomic era, from breeding new genotypes to post-harvest: nutrition and health.”

AGER is an Italian foundation devoted to promoting Italian agribusiness, supported, it says, by banking foundations.

I’ll take that at face value and enjoy the research.

I read a report in the Washington Post discussing a study done by Neal Barnard and his colleagues associated with the Physicians Committee for Responsible Medicine, a group advocating for plant-based diets and animal welfare.

More than 85 percent of the studies in Barnard’s meta-analysis, whether funded by industry or not, showed that eggs have unfavorable effects on blood cholesterol. Industry-funded studies, Barnard found, were more likely to play down these findings.

The study, a meta-analysis, reviewed 153 studies examining the effects of eggs on blood cholesterol levels.  It found the proportion of egg studies funded by the egg industry to have increased since 2010, and the industry-sponsored results to be spun—no surprise—in favor of the benefits of eggs.

This matters because advice in the 2015-2020 Dietary Guidelines for Americans is unhelpful about eggs.

Here’s how I explained the confusion in my January 7, 2016 post:

Cholesterol: the recommendation to limit cholesterol has been dropped, but the document says, confusingly, that “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”  Could the dropping of the limit have anything to do with egg-industry funding of research on eggs, the largest source of dietary cholesterol, and blood cholesterol?  The Physicians Committee for Responsible Medicine has just filed a lawsuit on that very point.

The lawsuit was about undue influence of the egg industry, but the judge threw the suit out of court because no legal standard exists for undue influence.  Oh.

What to do about eggs?  I vote for moderation, of course.

I saw this tweet from Washington Post columnist Tamar Haspel:

I took the bait.

Science Daily summarized the study.

Incorporating 2-3 serves (250g) of fresh lean pork each week, the Mediterranean-Pork (Med-Pork) diet delivers cognitive benefits, while also catering to Western tastes, and ensuring much lower greenhouse-gas emissions than beef production.

Since the article gave the name of the lead author, Alexandra Wade, and the name of the study, MedPork, I had no trouble finding the actual study.

The study:  A Mediterranean Diet with Fresh, Lean Pork Improves Processing Speed and Mood: Cognitive Findings from the MedPork Randomised Controlled Trial.  Wade A, et al.  Nutrients 2019, 11, 1521; doi:10.3390/nu11071521.

Conclusion: “Compared to LF [low-fat diet], the MedPork intervention led to higher processing speed performance (p = 0.01) and emotional role functioning (p = 0.03).”

Funding: “This study was funded by the Pork Cooperative Research Centre (#3B-113). The Pork CRC had no role in the study design, implementation, analysis or interpretation of data. Acknowledgments…We would also like to acknowledge the following organisations for their generous contributions: Almond Board of Australia for the donation of almonds; Cobram Estate for the donation of Australian extra virgin olive oil; and Simplot Australia Pty Ltd. for the donation of legumes, tuna and salmon.”

Comment:  This study was so obviously industry-funded that Haspel could tell without even looking at it (the Science Daily article did not mention the funder—it should have).  What these investigators did was to add a bit more than half a pound of pork a week to an otherwise healthful diet; They found that people like this diet better than one that is low-fat.  Why would anyone do a study like this?  I can think of only one reason: to give pork a health aura so you will eat more of it, obviously.

Addition

A reader points out that this is not Wade et al’s only sponsored study.  Here are some  others:

• A Mediterranean Diet with Fresh, Lean Pork Improves Processing Speed and Mood: Cognitive Findings from the MedPork Randomised Controlled Trial.  Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Keage HAD, Murphy KJ.  Nutrients. 2019 Jul 4;11(7). pii: E1521. doi: 10.3390/nu11071521. Sponsor: Pork Cooperative Research Centre
• A Mediterranean Diet to Improve Cardiovascular and Cognitive Health: Protocol for a Randomised Controlled Intervention Study.  Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Keage HA, Murphy KJ.  Nutrients. 2017 Feb 16;9(2). pii: E145. doi: 10.3390/nu9020145.  Sponsor: Dairy Australia.
• Including pork in the Mediterranean diet for an Australian population: Protocol for a randomised controlled trial assessing cardiovascular risk and cognitive function.  Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Keage HAD, Murphy KJ.  Nutr J. 2017 Dec 22;16(1):84. doi: 10.1186/s12937-017-0306-x.  Sponsor: Pork Cooperative Research Council
• A Mediterranean diet supplemented with dairy foods improves markers of cardiovascular risk: results from the MedDairy randomized controlled trial.  Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Murphy KJ.  Am J Clin Nutr. 2018 Dec 1;108(6):1166-1182. doi: 10.1093/ajcn/nqy207.  Sponsor: Dairy Australia Effects of Mediterranean diet supplemented with lean pork on blood pressure and markers of cardiovascular risk: findings from the MedPork trial.  Wade AT, Davis CR, Dyer KA, Hodgson JM, Woodman RJ, Murphy KJ.  Br J Nutr. 2019 Oct 28;122(8):873-883. doi: 10.1017/S0007114519001168. Epub 2019 Sep 23.  Sponsor: Pork Cooperative
  Research Centre. 

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.