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For years now I have been posting on Mondays something about conflicts of interest in nutrition research and practice on this site .

My goal in doing so is to raise awareness of practices that give the nutrition profession the appearance of undue food industry influence at the expense of public health.

Occasionally someone involved with something I post requests a correction or clarification.

Most recently, I heard from Gunter Kuhnle, a researcher in the UK whom I do not know personally.   He wrote:

In your blog (https://www.foodpolitics.com/2023/11/chocolate-an-update-on-the-food-politics-thereof/), you comment about my article in “The Conversation” on flavanols. This comment concludes with a statement that could be interpreted as if I was paid to write this piece. I would like to make clear that I was not paid to write this article – it was conceived and written in order to address a number of misunderstandings in the reporting of various studies concerning flavanols.  I would appreciate if you could correct this.

Since that was not at all my intention, I clarified the post immediately.

But I also requested his permission to reprint his note so I could do some more explaining about why this issue so concerns me.

I want to start by emphasizing that I do not see this as a personal matter.  My original post did not mention the author’s name and in general I try to avoid mentioning names of authors of industry-funded research unless they report financial ties to companies with vested interests in the outcome of that research.

I see this as a systemic issue.

But to summarize the arguments—and the research—I make and summarize in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat:

An enormous body of evidence, most of it derived from studies of tobacco, chemical, or pharmaceutical drug industry-sponsored research, consistently shows:

• Industry-funded research generally yields results that favor the sponsor’s interests.
• Industry funding of research influences its outcome.
• The influence of industry funding usually shows up in the framing of the research question or in the interpretation of results.
• Recipients of industry funding do not recognize the influence, do not intend to be influenced, and deny the influence (“science is science”).
• Denial of influence contradicts an enormous body of evidence to the contrary.
• Disclosure of funding source or relationships is necessary but not sufficient; considerable evidence exists to show that the statement “the sponsor had nothing to do with the design, conduct, or publication of the study” is often misleading or false.
• Exceptions do exist, but they are rare.

That researchers do not recognize the risks of industry funding is disturbing.  At the very least, when nutrition researchers accept funding from food companies, they give the appearance of conflict of interest.

And that is all it takes to reduce public trust in nutrition research, nutrition professionals, and nutrition professional societies.

I think there is something seriously wrong when I can look at the title of a nutrition research article and make a good guess about what company or industry trade association funded it.

I think there is something seriously wrong when I can look at the funder of a study and guess what the outcome is.

One more point: an argument I hear often is that all nutrition researchers are biased because they have dietary or ideological preferences.  There is research on this point too.  It argues that all researchers have personal or ideological biases—that’s what motivates them to do studies to test their hypotheses.  Personal biases, therefore, are universal and do not cause conflicts of interest.

Industry funding introduces a quite different motive: proving the health benefits or safety of a food product for commercial—not scientific—purposes.

Unsavory Truth provides references for all of this.

Also see Science in the Private Interest:  Has the Lure of Profits Corrupted Biomedical Research? by the late Sheldon Krimsky (I miss him terribly).

Professor Kuhnle, I thank you for writing and for the opportunity to respond.

Jerry Mande, a co-founder of Nourish Science wrote me to urge support for a national action plan to reduce obesity—and the chronic diseases for which it raises risks. (Note: he also has an op-ed in The Hill on NIH research and leadership needs).

Here is what we should do. It’s time for a new federal nutrition goal. For decades it’s been some variation of “access to healthier options and nutrition information.” Jim Jones [the new head of food and nutrition at FDA] used that last week in his vision for the new human foods program. It’s in USDA FNS’s mission too. The WaPo reporting on life expectancy, fatty liver disease, & Lunchables in school meals reveals that goal has failed and needs to be replaced.

The goal should be updated to: ensuring that every child reaches age 18 at a healthy weight and in good metabolic health. Cory Booker proposed making it the U.S. goal in his attached letter to Susan Rice on the WHC [White House Conference]. It’s part of the Nourish Science vision.

It’s doable.  USDA has the necessary power, reach, and resources. Over half of infants are on WIC, 1/3 of children in CACFP [Child and Adult Care Feeding Program], virtually all in school meals, and almost ½ of SNAP recipients are under 18. If we leveraged those programs to achieve the new goal and with FDA’s & CDC’s help, we could make substantial progress. For example, USDA was able to raise school meal HEI [Healthy Eating Index] scores from failing U.S. average of 58 to an acceptable 82 in just three years.

We have a successful blueprint in FDA regulation of tobacco. When we began our FDA investigation in 1993 1/3 of adults and ¼ of kids smoked cigarettes. Today we have a $700M FDA tobacco center and 11% of adults and only 2% of high school students smoke cigarettes.

We should set the new goal in the upcoming Farm Bill. We should change USDA’s name to the U.S. Department of Food and Agriculture and state the new goal.

The only needed ingredient to make this happen is an effective federal nutrition champion. That’s how tobacco happened.

I’m optimistic. We can do this.

I like the vision.  I’m glad he’s optimistic.  Plenty of work to do to get this on the agenda.

Some background

• The CDC on how nearly 70% of American adults are overweight or have obesity.
• My report on the White House Conference, a year ago
• Politico (Helena Bottemiller Evich, now at Food Fix)  on how diet- and obesity-related diseases are a huge public health problem, especially for COVID-19, but no government program exists to prevent them.
• Politico (Catherine Boudreau and Helena Bottemiller Evich) on how federal research on prevention of diet- and obesity-related diseases hardly exists.

Last week, I attended and spoke at the UNICEF-WHO Global Congress on Implementation of the International Code of Marketing of Breast-Milk Substitutes at WHO headquarters in Geneva.

The meeting was attended by more than 400 government, health, and advocacy representatives from more than 100 countries.  Representatives of infant formula companies were not invited to participate.

Its purpose was to encourage governments to promote and enforce the International Code, which nearly all U.N. member states ratified and committed to in 1981 (the U.S. was a long-standing holdout).

This meant they would control inappropriate marketing of infant formulas by banning advertising to people who are pregnant or nursing, gifts of formula samples, and doing anything to make formula appear superior to breastfeeding.

The logic of the Congress:

• Breastfeeding is the superior method for feeding human babies.
• Successful breastfeeding requires support from families, society, and government.
• It is quite easy to undermine confidence in the ability to breastfeed.
• Formula companies do all they can to undermine confidence in breastfeeding.
• Formula companies’ main goal is to sell more formula.
• Formula companies promote their products as normal and superior.
• Breastfeeding is easier when formula marketing is controlled.y

I talked about the food industry “playbook”—strategies and tactics used by industries (tobacco, chemical, drug, alcohol, and food as well as infant formula) to cast doubt on unfavorable research, fund their own research, and lobby against public health recommendations (photo: Arum Gupta).

Many country representatives discussed the effects of the playbook in their areas, and what they are trying to do to stop formula companies from using  the playbook to get around the Code.

The general consensus:  Formula companies should NOT be allowed to:

• Advertise or market products in violation of the Code.
• Participate in public health policymaking.
• Partner with relevant government agencies or non-governmental groups.

Obviously, formula companies are not happy with such recommendations.  If you would like to see an example of the playbook in action, take a look at the response  from the International Special Dietary Foods Industries.

It was exciting to be with so many people who cared so deeply about this issue.

Resources

• WHO Breastfeeding page
• WHO International Code FAQ
• The Global Breastfeeding Collective

The prolific International Panel of Experts on Sustainable Food Systems has produced another must-see report:

Here’s what it’s about:

Corporate influence over food system governance has become the new normal: the 2021 UN Food Systems Summit exposed the ability of multinational agri-food corporations to influence food system decision-making and dominate seemingly inclusive ‘multi-stakeholder’ processes…corporations have
succeeded in convincing governments that they must be central in any discussion on the future of food systems. Public-private partnerships and ‘multi-stakeholder’ roundtables…have normalized a prominent role for corporations and given them an inside track to decision-making.

Here’s where it’s headed:

To meet the needs of those impacted by  worsening hunger and malnutrition, it will be necessary to address the influence of corporations at all levels, including through a UN-wide Corporate Accountability Framework and robust conflict of interest policies, taking inspiration from World Health Organization frameworks for tobacco control and engagement with non-state actors.

IPES Food is doing great work.  Read their reports!

For your calendar today at 6:30 pm EST:

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The World Health Organization has taken a major step: it calls on member countries to tax sugar-sweetened beverages.

“Taxes on sugar-sweetened beverages can be a powerful tool to promote health because they save lives and prevent disease, while advancing health equity and mobilizing revenue for countries that could be used to realize universal health coverage,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

SSB, tobacco, and alcohol taxes have proven to be cost-effective ways of preventing diseases, injuries, and premature mortality. SSB tax can also encourage companies to reformulate their products to reduce sugar content.

More than that, WHO has produced a manual on how to develop and implement SSB taxation policies.

This tax manual is a practical guide for policy-makers and others involved in SSB tax policy development to promote healthy diets and populations. It features summaries and case studies of SSB global taxation evidence, and provides support on the policy-cycle development process to implement SSB taxation — from problem identification and situation analysis through policy design, development and implementation to the monitoring and evaluation phase. Additionally, the manual identifies and debunks industry tactics designed to dissuade policy-makers from implementing these taxes.

SSB taxes can be a win-win-win strategy: a win for public health (and averted health-care costs), a win for government revenue, and a win for health equity.

The manual summarizes everything anyone needs to know to justify taxes and to craft policy.  Get to work!

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President Biden signed H.R. 2617, the Consolidated Appropriations Act, 2023.  

I’m interested in what the $1.7 trillion , 1600-page bill does for food issues.  It mentions the word “food” 786 times.  It mentions “agriculture” 213 times.  Fortunately, most of this is in Division A.  Even so, one longs for summaries. For whatever they are worth, here are a few I’ve collected.

• Senate Appropriations committee summary
• Sen. Patrick Leahy’s bill highlights
• Sen. Patrick Leahy’s highlights for USDA and FDA funding 
• Rep. Sanford Bishop’s summary for USDA and FDA funding 
• Rep. Sanford Bishop’s fact sheet 
• Congressional explanation of intent about Division A funding

Let me see if I can make some sense of this.

USDA highlights

• $25.48 billion in discretionary spending (more than last year, less than what Biden asked for).
• $3.7 billion for research ($1.74 billion for the Agricultural Reseach Service and $1.7 billion for the National Institute of Food and Agriculture
• $1.17 billion for Animal and Plant Health Inspection Service (APHIS), more than $60 million above last year’s.
• $1.15 billion for the Food Safety and Inspection Service, including funding to reduce user fees and to retain veterinarians.
• Nutrition programs: $154 billion for SNAP; $6 billion for WIC; an increase of $6.6 million for commodities; an increase of $11 million for emergency food assistance.
• International food assistance: $1.75 billion for Food for Peace grants (an increase), and $243 million for the McGovern-Dole education program (an increase).

FDA 

• $6.56 billion for everything (but this includes a large percentage to be derived from food, drug, and tobacco user fee revenues).  These include increases for food safety and  some core functions.

The bill does some other things worth mentioning.  It includes: funds to:

• Expand the Summer EBT program and makes it permanent as of 2024.
• Addresses SNAP EBT skimming (stealing benefits across state lines).
• Test for testing for per- and polyfluoroalkyl substances (PFAS—forever chemicals)
• Make sure lobster and crab fisheries are in compliance with rules about whales.

It takes a lot of expertise to analyze all of this.  Here are two reactions.

Heritage Action: This omnibus package represents the very worst of Washington: back-room deals, $1.85 trillion dollar spending bills full of pet projects and partisan priorities, and an Establishment more interested in their own power than the wellbeing of the American people. The GOP must stand united in their opposition to this bill.

The Center on Budget and Policy Priorities: The biggest disappointment of the year-end bill by far is the failure to expand the Child Tax Credit. The American Rescue Plan’s expanded credit and other relief measures drove the child poverty rate to a record low of 5.2 percent in 2021. But with the expansion’s expiration, that record progress in reducing child poverty in 2021 has sharply reversed.

There are lots of other criticisms of this bill floating around, mainly having to do with what the Biden Administration asked for but did not get, and concerns about inadequate funding of FDA for food safety.

On this last point, let me again say that the perennially underfunded FDA gets its appropriations from agriculture committees, even though it is an agency of the public health service.  Agriculture subcommittees could not care less about FDA.  FDA needs a mandated home in Congress and much better support than it now gets.

Happy new year.

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Stacy Malkan hasa new report out.

This report documents how Monsanto manipulated public opinion to minimize concerns about the potential dangers of glyphosate (Roundup).

In this report, we show how pesticide companies not only followed in the footsteps of Big Oil and Big Tobacco, they helped to write the public relations playbook that obscures the dangers of widely used products that science shows are threatening human and environmental health around the globe.

This report about Monsanto’s campaign to defend glyphosate tells one piece of a broader story: that for decades, pesticide companies have waged expensive PR campaigns to shape the narrative about science and our food system, pushing the twin ideas that pesticides — a term that encompasses insecticides, herbicides, fungicides, and more — are safe and that we need them to feed the world.

In recent years, groundbreaking global studies have shown the grave threat agricultural chemicals pose to biodiversity and public health and how they fail to deliver on their promises for greater agricultural productivity, leading to crop loss and weed and pest resistance.

Worth reading?  Definitely!

For the data and for the details of Monsanto’s highly effective PR campaign.