How Big Sugar Undermines Dietary Guidelines

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Intro: The next eight videos first appeared in my webinar, How Much Meat Should We Eat? This series explores how Big Sugar and Big Meat have followed in the footsteps of Big Tobacco to warp the scientific process…see what the studies really say and what the corporations pay to manipulate it.

In 2019, a series of reviews was published in the Annals of Internal Medicine that concluded the same thing that past reviews have concluded: adherence to dietary patterns lower in red or processed meat intake may result in decreased risk for premature death, cardiometabolic disease and mortality––meaning the risk of getting and dying of diseases like heart disease and type 2 diabetes, as well as the risk of getting cancer and dying from cancer. Therefore, they concluded in their Dietary Guideline Recommendations, “continue [your] current red meat consumption,” “continue [your] processed meat consumption.” Wait, what?! Yeah, premature death, cancer, heart disease, diabetes––but keep eating your burgers and bacon.

To understand what just happened, we have to go back to 2015. The Dietary Guidelines for Americans had just had the audacity to recommend people reduce their sugar intake. Imagine you work for the sugar industry. The evidence is overwhelmingly against you; so, what do you do? Well, what did the tobacco industry do? One method involved the tobacco industry’s funding of and involvement in seemingly unbiased scientific groups to manipulate the scientific debate concerning tobacco and health. Groups like the ILSI, the International Life Sciences Institute, which has enjoyed a long and serious collaboration with the tobacco industry. That same industry group shapes food policy around the world.

The International Life Sciences Institute (ILSI), technically a nonprofit with an innocuous sounding name, “has been quietly infiltrating government health and nutrition bodies around the world.” It was created by a top Coca‑Cola executive, and “is almost entirely funded by Goliaths of the agribusiness, food, and pharmaceutical industries.” “After decades largely operating under the radar, the Institute is coming under increasing scrutiny by health advocates in the United States and abroad who say it is little more than a front group advancing the interests of the 400 corporate members,” among them Coca-Cola and PepsiCo.

So, when the 2015 US dietary guidelines advised eating less sugar, the soda-funded International Life Sciences Institute sponsored a review concluding that the guidelines on sugar were simply not trustworthy. Who did they pick for this hatchet job? Bradley Johnston. And here it is, published in the Annals of Internal Medicine. The Scientific Basis of Guideline Recommendations on Sugar Intake, and concluded there basically wasn’t one. “Guidelines on dietary sugar do not meet criteria for trustworthy recommendations as they are based on low-quality evidence.”

“This comes right out of the tobacco industry’s playbook: cast doubt on the science,” said Professor Marion Nestle. “This is a classic example of how industry funding biases opinion. It’s shameful.” Yes, the paper was paid for by the likes of Coca-Cola, Hershey, Red Bull, and the makers of Oreos. But the authors swore they wrote the protocol, and conducted the study independently. It turns out that was a lie, forcing the journal to publish a corrected version after the Associated Press obtained emails showing the industry front group “requested revisions.” It also came out that a co-author conveniently forgot to mention a $25,000 grant she got directly from Coca-Cola.

You know it’s bad when candy bar companies criticize an industry-funded paper on sugar. The maker of Snickers, Skittles, and M&Ms broke ranks with other food companies, and denounced the industry-funded paper. They themselves were a member of the ILSI, but come on, telling people to ignore guidelines to cut down on sugar? That’s just making us all look bad.

If you look at the relationship between funding source and the conclusions in nutrition-related scientific articles, there’s about seven or eight times the odds that the conclusion will skew favorable, compared to studies with no industry funding. For interventional studies, the proportion of studies paid for by industry that reached unfavorable conclusions about their own products was a big fat 0 percent, which should not surprise anyone.

So, what can journals do to counteract tactics that industry often uses to advocate for the safety of unsafe products, or question the integrity of science that calls their products into question? To combat the tobacco industry’s influence over scientific discourse, leading journal editors have refused to be passive conduits for articles funded by the tobacco industry. They just won’t accept tobacco industry-funded studies period. Accordingly, high-quality journals could refrain from publishing studies on health effects of added sugars funded by soda and cookie companies. But they’re not. This was published in the Annals of Internal Medicine.

And so, four years later, the next batch of dietary guidelines is on the way, and the last scientific report of the guidelines committee, encouraging people to eat diets not just lower in sugar, but lower in meat as well. So, Big Beef decided to follow in the footsteps of Big Butterfinger. Same journal, same guy, same scientist-for-hire, Bradley Johnston, as lead author, and the rest is history. We’ll dig into exactly how he pulled it off next.

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• Zeraatkar D, Johnston BC, Bartoszko J, et al. Effect of lower versus higher red meat intake on cardiometabolic and cancer outcomes: a systematic review of randomized trials. Ann Intern Med. 2019;171(10):721-31.
• Zeraatkar D, Han MA, Guyatt GH, et al. Red and processed meat consumption and risk for all-cause mortality and cardiometabolic outcomes: a systematic review and meta-analysis of cohort studies. Ann Intern Med. 2019;171(10):703-10.
• Han MA, Zeraatkar D, Guyatt GH, et al. Reduction of red and processed meat intake and cancer mortality and incidence: a systematic review and meta-analysis of cohort studies. Ann Intern Med. 2019;171(10):711-20.
• Valli C, Rabassa M, Johnston BC, et al. Health-related values and preferences regarding meat consumption: a mixed-methods systematic review. Ann Intern Med. 2019;171(10):742-55.
• Vernooij RWM, Zeraatkar D, Han MA, et al. Patterns of red and processed meat consumption and risk for cardiometabolic and cancer outcomes: a systematic review and meta-analysis of cohort studies. Ann Intern Med. 2019;171(10):732-41.
• Johnston BC, Zeraatkar D, Han MA, et al. Unprocessed red meat and processed meat consumption: dietary guideline recommendations from the nutritional recommendations (Nutrirecs) consortium. Ann Intern Med. 2019;171(10):756-64.
• U.S. Department of Health and Human Services, U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th ed. Published December 2015.
• Tobacco Free Initiative, WHO. The Tobacco Industry and Scientific Groups. ILSI: A Case Study. February 2001.
• Jacobs A. A shadowy industry group shapes food policy around the world. The New York Times. September 16, 2019.
• Lajous M. The elephant in the spoon: recognizing food industry influence in nutrition research. Am J Public Health. 2019;109(7):952-3.
• Erickson J, Sadeghirad B, Lytvyn L, Slavin J, Johnston BC. The scientific basis of guideline recommendations on sugar intake: a systematic review. Ann Intern Med. 2017;166(4):257-67.
• O’Connor A. Study tied to food industry tries to discredit sugar guidelines. The New York Times. December 19, 2016.
• Choi C. Snickers maker criticizes industry-funded paper on sugar. AP NEWS. December 21, 2016.
• Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS. Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Med. 2007;4(1):e5.
• Schillinger D, Kearns C. Guidelines to limit added sugar intake: junk science or junk food? Ann Intern Med. 2017;166(4):305-6.
• "The 2020-2025 Dietary Guidelines for Americans development process is under way. Public Participation Opportunities and the Dietary Guidelines Advisory Committee. February 2020."
• Scientific Report of the 2015 Dietary Guidelines Advisory Committee. United States Department of Agriculture. February 2015.

Motion graphics by Avo Media

• animal products
• candy
• cardiovascular disease
• diabetes
• health
• heart disease
• heart health
• industry influence
• junk food
• lifespan
• longevity
• meat
• mortality
• processed foods
• red meat
• soda
• sugar
• tobacco