Manipulating the Science

There is a lot of information out there about the best foods to help us lose weight, prevent cancer, fight inflammation – the list goes on. In fact, for everything about our health we try and improve, there’s someone with a new theory on how to do it. But what does the science say?

Welcome to the Nutrition Facts Podcast. I’m your host Dr. Michael Greger. And I’m here to give you the evidence-based approach to take the mystery out of the best way to live a healthier, longer life.

Peer-reviewed evidence is our bailiwick here at Nutrition Facts.  But what happens when industry tries to manipulate the research to fit their own agenda views.  In our first story we look how the sugar industry attempts to manipulate the science.

“Corporations are legally required to maximise shareholder profits and therefore have to oppose public health policies that could threaten profits.” It’s just how the system is set up. “Unequivocal, longstanding evidence shows that to achieve this, diverse industries with products that can damage health have worked systematically to subvert the scientific process.”

Take the sugar industry, for example. Internal documents showed they were concerned that health food “faddists” were becoming “an active menace to the industry.” Sugar was under attack, “and many of the poor unfortunate public swallow the misinformation broadcast by the propagandists.” What were books like Yudkin’s Pure, White and Deadly saying? “All of the propaganda is to the effect that sugar is a non-essential food.” Gasp! No! How dare they say sugar is a non-essential food? Next, they’ll be saying it’s not really food at all. And, that was the sugar industry’s line: “sugar is a cheap safe food” and this coming from the founder and chair of Harvard’s nutrition department, Fredrick Stare, long known as “Harvard’s sugar-pushing nutritionist.”

Not only did the sugar industry try to influence the direction of dental research, but heart disease research as well, paying Stare and colleagues to write this review to help downplay any risk from sugar. Now, to be fair, this was five years before we even realized triglycerides were also an independent risk factor beyond just cholesterol. The main reason attention stayed focused on saturated fat is not because of the might of the sugar industry; there was just not as much data to support it.

In fact, “the even more powerful meat and dairy industries” loved the anti-sugar message. Who do you think sponsored Yudkin? In fact, on like the first page of Pure, White and Deadly, he thanks all the food and drug companies that had provided him with “constant generous support.” Who paid for Yudkin’s speaking tour? The egg industry, of course to try to take some heat off cholesterol.

Hegsted, one of the co-authors of the funded review, wasn’t exactly an industry cheerleader. He recommended people cut down on all the risky stuff: “less meat, less saturated fat, less cholesterol, and less sugar, less salt.” It wasn’t the sugar industry that got him fired for speaking truth to power; it was the beef industry.

The sugar industry was able to conceal its funding, because the New England Journal of Medicine didn’t require disclosure of conflicts of interest until 17 years later. These muckraking researchers suggest policymakers “should consider giving less weight to food industry-funded studies.” But why is the food industry funding studies at all? When it comes to the “corporate manipulation of research,” ultimately conflicts of interest don’t just need to be disclosed and “managed,” but ideally “eliminated.”

Things may not change until public health researchers start “refusing to take money from the junk food industry,” period. “It worked for tobacco.” Many prestigious medical and public health institutions “have instituted bans on tobacco industry funding.”

But wait; can’t scientists remain “objective and impartial” even in the face of all that cash? Apparently not, as “industry funded research” has been shown to be up to 88 times more likely to produce funder-favorable outcomes. What, do we think corporations are in the business of just handing out money for free?

The classic example is the American Academy of Pediatric Dentistry, who “accepted $1 million grant from Coca-Cola.” Before the grant, their official position was that “frequent consumption of sugary beverages can be a significant factor in the initiation and progression of dental cavities,” which after the grant changed to “scientific evidence is certainly not clear on the exact role that soft drinks play.” As CSPI’s Integrity in Science Project put it, “What a difference a million dollars makes!”

Next, we look at what happened when the World Health Organization had the gall to recommend a diet low in saturated fat, sugar, and salt and high in fruit and vegetables.

The World Health Organization recommends we reduce our consumption of salt, trans fats, saturated fats, and added sugars. Why? Because consumption of such foods is the cause of at least 14 million deaths every year from chronic diseases.

Several decades ago, it was heresy to talk about an impending global pandemic of obesity, but now we’re seeing chronic disease rates skyrocket around the world. We have exported our Western diet to the far reaches of the planet, with white flour, sugar, fat, and animal-sourced foods replacing beans, peas, lentils, other vegetables, and whole grains.

Understanding the reasons underlying this trend toward increased consumption of animal products, oils, and sugar, and the reduced consumption of whole plant foods, begins with understanding the purposeful economic manipulations that have occurred since World War II relating to agricultural policies around the world.

For example, the U.S. government, since early in the last century, has supported food production through subsidies and other policies, resulting in large surpluses of food commodities, meat, and calories. In this artificial market, large food producers and corporations, Big Ag and Big Food became very profitable. And that may be part of the problem.

Last year, Dr. Margaret Chan, the Director-General of the World Health Organization gave the opening address at the 8th Global Conference on Health Promotion. One of the biggest challenges facing health promotion worldwide is that the efforts to prevent our top killers “go against the business interests of powerful economic operators.” It is not just Big Tobacco any more. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics; front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuse the evidence and keep the public in doubt.

And they should know. In 2003, the World Health Organization released a draft report outlining a global strategy to address issues of diet, making a series of rather tame recommendations, but six words in that report, “limit the intake of ‘free’ sugars,” stimulated a remarkable series of events (free sugars means added sugars).

The food industry went to work. Within days, the sugar industry, through the Sugar Association, enlisted the support of officials high in the U.S. government, and led a vigorous attack on both the report and the World Health Organization itself, culminating in a threat to get Congress to withdraw U.S. funding to the W.H.O., the organization that deals with AIDS, malnutrition, infectious disease, bioterrorism, and more threatened because of its stance on sugar, just as the U.S. went to bat for U.S. tobacco companies and led the charge against the World Health Organization’s Framework Convention on Tobacco Control.

But the threat from the sugar industry was described by WHO insiders as worse than any pressure they ever got from the tobacco lobby.

As revealed in an internal memo, the U.S. government apparently had a list of demands. Deletion of all references to the science they had experts compile on the matter. And having dietary guidelines are fine, as long as there are no references to “fat, oils, sugar or salt.”

The threats failed to make the WHO withdraw their report. Entitled Diet, Nutrition And The Prevention Of Chronic Disease, it formally launched and concluded that a diet low in saturated fat, sugar, and salt, and high in fruit and vegetables, was required to tackle the epidemic rise in chronic diseases worldwide, though they did end up watering it down. Gone was reference to the comprehensive scientific report, and gone was its call for recommendations to actually be translated into national guidelines.

History has since repeated. At the last high-level UN meeting to address chronic diseases, we helped block a consensus on action after lobbying from the alcohol, food, tobacco, and drug industries. When asked why Michelle Obama’s successful childhood obesity programs in the US should not be modeled around the world, a US official responded that they might harm American exports.

In our final story, we discover how food companies have been caught trying to undermine public health policies by manipulating the scientific process.

Just like mosquitos are the vectors of spread for malaria, a landmark article published last year in one of the most prestigious medical journals described food corporations as the vectors of spread for chronic disease. Unlike infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions. Most mosquitoes can’t afford the top-notch PR firms.

A key message was that alcohol and ultra-processed food and drink industries use similar strategies to the tobacco industry to undermine effective public health policies and programs. What they mean by ultra-processed is things like burgers, frozen meals, chicken nuggets, fish sticks, potato chips, doughnuts, and soda pop.

Ultra-processed foods and drinks can be thought of as a menace to public health all over the world. The best recommendation on all ultra-processed foods, irrespective of their nutrient profiles, is to avoid them, or at least minimize their consumption.

But how is the food industry like the tobacco industry? The first strategy is to bias research findings. For example, Philip Morris implemented the Whitecoat Project to hire doctors to publish ghostwritten confounder studies purporting to negate links between second-hand smoke and harm, publishing biased cherry-picked scientific reports to deny harm, and suppress health information.

Similarly, funding from these large food corporations biases research. Studies show systematic bias from industry funding, so we get the same kind of tactics from the food industry; supplying misinformation, use of supposedly conflicting evidence, and hiding negative data.

The same scientists-for-hire that downplayed the risks of secondhand smoke are the same hired by the likes of the National Confectioners Association to say candy cigarettes are A-OK as well. Of course, Exponent declared no conflict of interest.

The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds, and activities across these industries, which also have histories of joint ownership, like Philip Morris owned both Kraft and Miller Brewing.

So what’s their strategy? As a former FDA commissioner described, the tobacco industry’s strategy was embodied in a script written by the lawyers. Every tobacco company executive in the public eye was told to learn the script backwards and forwards; no deviation was allowed. The basic premise was simple, smoking had not been proved to cause cancer. Not proven, not proven, not proven. This was stated insistently and repeatedly. Inject a thin wedge of doubt; create controversy; never deviate from the prepared line. It was a simple plan and it worked.

Internal industry memos make this explicit. Doubt is our product, since it is the best means of competing with the body of fact that exists in the mind of the general public. See, the general public is convinced that cigarettes are in some way harmful to health. So, objective #1: To set aside in the minds of millions the false conviction that cigarette smoking causes lung cancer and other diseases–a conviction based on fanatical assumptions, fallacious rumors, unsupported claims and the unscientific statements and conjectures of publicity-seeking opportunists. We need to lift the cigarette from the cancer identification as quickly as possible, and to establish–once and for all–that no scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer, similar to what’s now coming out of the food industry, from the same folks that brought us smoke and candy.

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