How Big Sugar Followed the Tobacco/Fossil Fuel Playbook
September 13, 2016
New revelations, if you needed any.
Similar techniques have been used to sell tobacco, fossil fuels, and, it turns out, the ridiculously sugar-heavy standard American diet.
As nutrition debates raged in the 1960s, prominent Harvard nutritionists published two reviews in a top medical journal downplaying the role of sugar in coronary heart disease. Newly unearthed documents reveal what they didn’t say: A sugar industry trade group initiated and paid for the studies, examined drafts, and laid out a clear objective to protect sugar’s reputation in the public eye.
That revelation, published Monday in JAMA Internal Medicine, comes from Dr. Cristin Kearns at the University of California, San Francisco, a dentist-turned-researcher who found the sugar industry’s fingerprints while digging through boxes of letters in the basement of a Harvard library.
Her paper recounts how two famous Harvard nutritionists, Dr. Fredrick Stare and Mark Hegsted, who are now deceased, worked closely with a trade group called the Sugar Research Foundation, which was trying to influence public understanding of sugar’s role in disease.
The trade group solicited Hegsted, a professor of nutrition at Harvard’s public health school, to write a literature review aimed at countering early research linking sucrose to coronary heart disease. The group paid the equivalent of $48,000 in 2016 dollars to Hegsted and colleague Dr. Robert McGandy, though the researchers never publicly disclosed that funding source, Kearns found.
Hegsted and Stare tore apart studies that implicated sugar and concluded that there was only one dietary modification — changing fat and cholesterol intake — that could prevent coronary heart disease. Their reviews were published in 1967 in the New England Journal of Medicine, which back then did not require researchers to disclose conflicts of interest.
That was an era when researchers were battling over which dietary culprit — sugar or fat — was contributing to the deaths of many Americans, especially men, from coronary heart disease, the buildup of plaque in arteries of the heart. Kearns said the papers, which the trade group later cited in pamphlets provided to policymakers, aided the industry’s plan to increase sugar’s market share by convincing Americans to eat a low-fat diet.
“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 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 research on sugar, fat and heart disease. 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.
Even though the influence-peddling revealed in the documents dates back nearly 50 years, more recent reports show that the food industry has continued to influence nutrition science.
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 play down 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 do not.
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 was Dr. Fredrick J. Stare, the chairman of Harvard’s nutrition department.
Marion Nestle, a professor of nutrition, food studies and public health at New York University, wrote an editorial accompanying the new paper in which she said the documents provided “compelling evidence” that the sugar industry had 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.”
Dr. Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan School of Public Health, said that academic conflict-of-interest rules had changed significantly since the 1960s, but that the industry papers were a reminder of “why research should be supported by public funding rather than depending on industry funding.”
Dr. Willett said the researchers had limited data to assess the relative risks of sugar and fat. “Given the data that we have today, we have shown the refined carbohydrates and especially sugar-sweetened beverages are risk factors for cardiovascular disease, but that the type of dietary fat is also very important,” he said.