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NY Times, Sept. 12 2016
How the Sugar Industry Shifted Blame to Fat
By ANAHAD O’CONNOR
The sugar industry paid scientists in the 1960s to downplay the link
between sugar and heart disease and promote saturated fat as the culprit
instead, newly released historical documents show.
The internal sugar industry documents, recently discovered by a
researcher at the University of California, San Francisco, and published
Monday in JAMA Internal Medicine, suggest that five decades of research
into the role of nutrition and heart disease — including many of today’s
dietary recommendations — may have been largely shaped by the sugar
industry.
“They were able to derail the discussion about sugar for decades,” said
Stanton Glantz, a professor of medicine at U.C.S.F. and an author of the
new JAMA paper.
The documents show that a trade group called the Sugar Research
Foundation, known today as the Sugar Association, paid three Harvard
scientists the equivalent of about $50,000 in today’s dollars to publish
a 1967 review of sugar, fat and heart research. The studies used in the
review were handpicked by the sugar group, and the article, which was
published in the prestigious New England Journal of Medicine, minimized
the link between sugar and heart health and cast aspersions on the role
of saturated fat.
The Harvard scientists and the sugar executives with whom they
collaborated are no longer alive. One of the scientists who was paid by
the sugar industry was D. Mark Hegsted, who went on to become the head
of nutrition at the United States Department of Agriculture, where in
1977 he helped draft the forerunner to the federal government’s dietary
guidelines. Another scientist was Fredrick J. Stare, the chairman of
Harvard’s nutrition department.
In a statement responding to the JAMA report, the Sugar Association said
that the 1967 review was published at a time when medical journals
didn’t typically require researchers to disclose funding sources or
potential financial conflicts of interest. The New England Journal of
Medicine did not begin to require financial disclosures until 1984.
The industry “should have exercised greater transparency in all of its
research activities,” the Sugar Association statement said. Even so, it
defended industry-funded research as playing an important and
informative role in scientific debate. It said that several decades of
research had concluded that sugar “does not have a unique role in heart
disease.”
The association also questioned the motives behind the new paper.
“Most concerning is the growing use of headline-baiting articles to
trump quality scientific research,” the organization said. “We’re
disappointed to see a journal of JAMA’s stature being drawn into this
trend.”
But even though the influence-peddling revealed in the documents dates
back nearly 50 years, the revelations are important because the debate
about the relative harms of sugar and saturated fat continues today, Dr.
Glantz said. For many decades health authorities encouraged Americans to
improve their health by reducing their fat intake, which led many people
to consume low-fat, high-sugar foods that some experts now blame for
fueling the obesity crisis.
“It was a very smart thing the sugar industry did because review papers,
especially if you get them published in a very prominent journal, tend
to shape the overall scientific discussion,” he said.
Dr. Hegsted used his research to influence the government’s dietary
recommendations, which emphasized saturated fat as a driver of heart
disease while largely characterizing sugar as empty calories linked to
tooth decay. Today, the saturated fat warnings remain a cornerstone of
the government’s dietary guidelines, though in recent years the American
Heart Association, the World Health Organization and other health
authorities have also begun to warn that too much added sugar could
increase cardiovascular disease risk.
Marion Nestle, a professor of nutrition, food studies and public health
at New York University, wrote an editorial accompanying the new paper
that said the documents provided “compelling evidence” that the sugar
industry initiated research “expressly to exonerate sugar as a major
risk factor for coronary heart disease.”
“I think it’s appalling,” she said. “You just never see examples that
are this blatant. The amount of money they were paid to do this is
staggering.”
Dr. Nestle noted that efforts by the food industry to shape nutrition
science continue today.
Last year, an article in The New York Times revealed that Coca-Cola, the
world’s largest producer of sugary beverages, had provided millions of
dollars in funding to researchers who sought to downplay the link
between sugary drinks and obesity. In June, The Associated Press
reported that candy makers were funding studies that claimed that
children who eat candy tend to weigh less than those who don’t.
The JAMA paper relied on thousands of pages of correspondence and other
documents that Cristin E. Kearns, a postdoctoral fellow at U.C.S.F.,
discovered in archives at Harvard, the University of Illinois and other
libraries.
The documents show that in 1964, John Hickson, a top sugar industry
executive, discussed a plan with others in the industry to shift public
opinion “through our research and information and legislative programs.”
At the time, studies had begun pointing to a relationship between
high-sugar diets and the country’s high rates of heart disease. At the
same time, other scientists, including the prominent Minnesota
physiologist Ancel Keys, were investigating a competing theory that it
was saturated fat and dietary cholesterol that posed the biggest risk
for heart disease.
Mr. Hickson proposed countering the alarming findings on sugar with
industry-funded research. “Then we can publish the data and refute our
detractors,” he wrote.
In 1965, Mr. Hickson enlisted the Harvard researchers to write a review
that would debunk the anti-sugar studies. He paid them a total of $6,500
– the equivalent of $49,000 today. Mr. Hickson selected the papers for
them to review and made it clear he wanted the result to favor sugar.
Harvard’s Dr. Hegsted reassured the sugar executives. “We are well aware
of your particular interest,” he wrote, “and will cover this as well as
we can.”
As they worked on their review, the Harvard researchers shared and
discussed early drafts with the sugar executive, who responded that he
was pleased with what they were writing. The Harvard scientists had
dismissed the data on sugar as weak and gave far more credence to the
data implicating saturated fat.
“Let me assure you this is quite what we had in mind, and we look
forward to its appearance in print,” Mr. Hickson wrote.
After the review was published, the debate about sugar and heart disease
died down, while low-fat diets gained the endorsement of many health
authorities, Dr. Glantz said.
“By today’s standards they behaved very badly,” he said.
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