by Marion Nestle

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Feb 21 2020

Weekend reading: Industry schemes to deny harm

David Michaels.  The Triumph of Doubt: Dark Money and the Science of Deception.  Oxford University Press, 2019.  

Image result for The Triumph of Doubt: Dark Money and the Science of Deception

Even though this book is not strictly about food politics, it has enough about the sugar and alcohol industries to qualify.  I did a blurb for it.

Triumph of Doubt is an industry-by-industry account of how corporations manipulate science and scientists to promote profits, not public health.  Nothing less than democracy is at stake here, and we all should be responding right away to David Michaels’ call for action.

Michaels, a former OSHA official, has written an insider’s look at a wide range of industries that follow the tobacco industry’s playbook for casting doubt on inconvenient science.  The range is impressive: football, diesel fuel, opioids, silica dust, Volkswagen cars, climate denial, food packaging chemicals, alcohol, sugar, and Republican ideology

He’s got some ideas about what to do—keep conflicted scientists out of policy making, for example—but in this political environment?

That leaves it up to us folks to take to the streets.  If only.

Jan 20 2020

Conflicted research argument of the week: meat versus plants

I could not keep up with the number of e-mails I got last week with the subject line “Have you seen this?”

“This” referred to an opinion piece in JAMA entitled Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists.

Definitely up my alley.

The article describes the outraged reaction to a series of papers in the Annals of Internal Medicine last year arguing that recommendations to eat less meat are unfounded (I posted about this at the time).  Some of the investigators involved in the meat papers turned out to have undisclosed ties to meat industry interests.

The JAMA article points out that the most outraged objections to the Annals papers came from investigators who have plenty of industry ties (plant-based) of their own.

My book, Unsavory Truth: How Food Companies Skew the Science of What We Eat, provides loads of evidence for a basic observation: research funded by food companies, regardless of the particular food studied, tends to produce results favorable to the sponsor’s interests.

It also describes how industry influence occurs at an unconscious level; recipients are unaware that they are being influenced.

How the influence gets expressed is also the subject of research.  Bias most frequently turns up in the framing of the research question.  It also turns up frequently in the interpretation of results.

Here is an example from a study of a healthy plant food—walnuts.

The study: Effect of a 2-year diet intervention with walnuts on cognitive decline. The Walnuts And Healthy Aging (WAHA) study: a randomized controlled trial.  Aleix Sala-Vila, Cinta Valls-Pedret, Sujatha Rajaram, Nina Coll-Padrós, Montserrat Cofán, Mercè Serra-Mir,  Ana M Pérez-Heras, Irene Roth, Tania M Freitas-Simoes, Mónica Doménech, Carlos Calvo, Anna López-Illamola, Edward Bitok, Natalie K Buxton, Lynnley Huey, Adam Arechiga, Keiji Oda, Grace J Lee, Dolores Corella, Lídia Vaqué-Alcázar, Roser Sala-Llonch, David Bartrés-Faz, Joan Sabaté, and Emilio Ros1.  Am J Clin Nutr 2020;00:1–11.

Conclusions: Walnut supplementation for 2 y had no effect on cognition in healthy elders. However, brain fMRI and post hoc analyses by site suggest that walnuts might delay cognitive decline in subgroups at higher risk. These encouraging but inconclusive results warrant further investigation.

Conflicts of Interest: AS-V, SR, JS, and ER have received research funding through their institutions from the California Walnut Commission, Folsom, CA, USA. JS and ER were nonpaid members of the California Walnut Commission Scientific Advisory Council. ER was a paid member of the California Walnut Commission Health Research Advisory Group. JS has received honoraria from the California Walnut Commission for presentations.  AS-V has received support from the CaliforniaWalnut Commission to attend professional meetings. All other authors report no conflicts of interest.

Comment: This looks to me like a classic example of interpretation bias.  Although the study showed no effect of walnut supplementation, the authors interpret its overall results as encouraging.  This is putting a positive spin on null results.

Walnuts—and other kinds of nuts—are plant foods with healthy fats.  Why does the California Walnut Commission need to do this?  So you will buy walnuts rather than hazelnuts, pecans, or macadamia nuts (all of which are sponsoring their own positive-result studies).  Studies like these are mostly about marketing.

Questions of whether meat is healthy or unhealthy—and, if unhealthy, at what level of intake—are about much more than marketing.   They need to be studied as objectively as possible.  It’s best to keep industry influence far away from such studies.

Even if the science is done well from start to finish, researchers’ ties to food company sponsors give the appearance of conflicted interests.  Such ties are best avoided from the get-go.

Follow-up

Oct 8 2019

NutraIngredients.com: An Exchange with its editor

I am an avid follower of industry newsletters such as NutraIngredients.com, and was intrigued to see one titled “Does bias against company-funded research really serve consumers?When I read it, I was even more amused.  One of my Monday “industry-funded study of the week” posts had triggered it.I found an email address for the editor, Hank Schultz, and wrote him a note that I hoped would open up a conversation.

I’m glad you wrote this and hope it will open up an opportunity for an ongoing conversation about industry-funded research and the conflicts it generates…..I am a constant and grateful reader of your and other Reed newsletters, and greatly admire the consistently outstanding and objective reporting.  I have only one ask: if a study is funded by a company with a vested interest in its outcome, ask your reporters to be sure to state who the funder is.

Mr. Schultz wrote back and after some cordial back-and-forth asked if he could do an interview for the newsletter.  Of course he could.  Here is the result.

Bias inherent in company funded research calls value of evidence into question, critic maintains

By Hank Schultz, 

The results of company funded research are so predictable that the value of the studies is greatly reduced, a prominent critic of the practice says.

In a recent NutraIngredients-USA commentary it was argued that dietary supplement companies that build up a suite of research do so carefully, and plan for success​​. With a careful design of the research program, positive results at the bench can naturally translate into successful randomized, placebo controlled trials.

Longtime critic of industry funded research

Marion Nestle, PhD, nutrition professor at New York University and author of the influential book Food Politics​ as well her most recent work Unsavory Truth: How Food Companies Skew the Science of What We Eat, ​ isn’t buying. Nestle responded to NutraIngredients-USA on the subject of the commentary to say that she has reviewed hundreds of company-funded studies and in her view the inherent biases built into that system are next to impossible to overcome.

Indeed, on her blog (also titled Food Politics​) Nestle has a frequent feature called “Industry funded research of the week.” The feature is used to document instances of bias, which to Nestle’s eye are thick on the ground.

“The overriding issue is that industry-funded research almost invariably comes out with results favorable to the sponsor’s interests. This is so predictable that I can often recognize the funder by the title of the paper,”​ Nestle told NutraIngredients-USA.

Nestle noted that the phenomenon is not by any means restricted to research on food and supplement ingredients. It has been noted in studies on tobacco, chemicals and pharmaceuticals.

“Studies of these industries show that the influence apparently occurs at an unconscious level; investigators did not intend to be influenced and do not recognize that they were influenced. But the evidence for funding effects is overwhelming,”​ she said.

Bias starts with study design

Nestle said a key issue is how the research question is framed. Companies investing in research naturally want to succeed and get some return on their investment. But the best science doesn’t come when the question is framed in such a way that a positive result is overwhelmingly likely, she said.

“I get letters all the time from trade associations asking for proposals for research that will demonstrate the benefits of their products. That is not the same as asking open-ended questions about effects. Companies want data on benefits for marketing purposes. That’s why I view industry-funded studies as about marketing, not science,”​ Nestle said.

Nestle said she has noted that some of the larger funders, such as the larger food companies or industry associations supporting categories of products like walnuts, almonds, strawberries or what have you, churn out research supporting their products of interest. While some might argue this adds to the totality of evidence and thus could be a good thing, Nestle said she doubts the value of these investments when taking the inherent biases into account. This can result in studies that seek to demonstrate things like substituting junk food calories with a serving of something like almonds or strawberries is a good thing to do. Yes, but so what? In Nestle’s view, this kind of bias is all but inevitable in research funded in this way.

“That’s what decades of research on the effects of drug-industry funding says, and the few studies looking at funding effects in nutrition find similar results,” ​she said.

Independent funding mechanism

What Nestle said she’d like to see is a mechanism for funding research into food and supplement ingredients that was divorced from a marketing plan.

“I want to see a firewall between the funder and the scientist. In ​Unsavory Truth, I talk a lot about various attempts over decades to create such firewalls and develop a pool of industry research funds managed by independent third parties. They have never worked well,”​ she said.

Nestle said she believes that only by making contributions to research compulsory, with the resulting fund to be managed by a credible third party, can research of undeniable quality be done. Something like the Beef Checkoff Program but for independent research funding, even if the results of those studies might not immediately support the marketing of the products.

“My idea of an ethically funded study is to ask for investigator-initiated proposals, appoint third party reviewers who decide who gets funded, and stay completely out of the process from then on. I worry when I see disclosure statements that the funder had no role in the study because that statement has been demonstrated to be false so many times. Food companies are funding research because they want specific results. That’s not how science is supposed to work,”​ Nestle said.

Oct 4 2019

Weekend reading: Why Trust Science?

In the wake of all the media fuss over the “don’t worry, eat meat” papers published on Monday (see my summary), my favorite is a tweet from Naomi Oreskes, one of the authors of Merchants of Doubt, an analysis of the tobacco and chemical industries’ playbook in action.

Thanks Naomi.

I’ve just ordered a copy of her new book.  Can’t wait for it to arrive.

Jul 24 2019

At last: attention to sugar’s role in dental health

I included a chapter on sugar and dental disease in my 2015 book, Soda Politics: Taking on Big Soda (and Winning), because billions of people have decayed teeth and other dental problems that could have been kept intact by dental hygiene, fluoride treatment, or—consuming less sugar or sugary drinks.

But:

  • Dental disease has a long history of being overlooked as a public health problem.
  • Sugar has a long history of being ignored as a cause of dental disease.

This may now be changing.

The Lancet has a new series on oral health:

Radical action on oral health will benefit from harnessing a clear global health mandate. Because oral diseases share the main risk factors of other non-communicable diseases (NCDs)—sugar consumption, tobacco use, and harmful alcohol use—oral health should have a stronger place on the global NCDs agenda.

  • Oral diseases: a global public health challenge: Marco A Peres, Lorna M D Macpherson, Robert J Weyant, Blánaid Daly, Renato Venturelli, Manu R Mathur, Stefan Listl, Roger Keller Celeste, Carol C Guarnizo-Herreño, Cristin Kearns, Habib Benzian, Paul Allison, Richard G Watt.  The Lancet, Vol. 394No. 10194.  

Among this article’s key messages:

  • Oral conditions share common risk factors with other non-communicable diseases, which include free sugar consumption, tobacco use, and harmful alcohol consumption, as well as the wider social and commercial determinants of health
  • Of particular concern is the effect of free sugar consumption on the prevalence of caries and overweight or obesity, and associated conditions such as diabetes
  • Recognition is increasing of the influence, power, and effect of the global sugar industry as a threat to public health, which requires tighter regulation and legislation by governments
  • Ending the neglect of global oral health: time for radical action: Richard G Watt, Blánaid Daly, Paul Allison, Lorna M D Macpherson, Renato Venturelli, Stefan Listl, Robert J Weyant, Manu R Mathur, Carol C Guarnizo-Herreño, Roger Keller Celeste, Marco A Peres, Cristin Kearns, Habib Benzian.  The LancetVol. 394No. 10194

In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.

A check of dental research organisation websites shows that corporate members of ORCA include Cloetta, a Nordic confectionery company; Unilever, a global consumer goods company that sells ice cream and sugary beverages; and Mars Wrigley Confectionery, a leading manufacturer of chewing gum, chocolate, mints, and fruity confections (through its Wrigley Oral Healthcare Program). Corporate members of the International Association for Dental Research (IADR) include Unilever and Mondelēz International, one of the world’s largest snack companies, whose products include cookies, chocolate, and confectionery. These financial ties are slightly less shocking given the oral health-care products these companies sell: xylitol chewing gum and pastilles (Cloetta), sugar-free gum with xylitol (Mondelēz, Mars Wrigley), and toothbrushes and fluoridated toothpaste (Unilever). Nonetheless, as the dental research community comes to terms with its neglect of sugars intake, these relationships with industry are ripe for scrutiny.  [I’ve written previously about Kearns’ discovery of links between sugar trade associations and dental professional organizations].

Two key strategic aims for a global oral health movement will be to ensure that oral health treatment and prevention services are central to UHC [universal health coverage] and to support global efforts to limit the damage caused by the sugar industry…There is fragmented global action for reducing the damage of the sugar industry and some progress has been made in a number of cities and countries, especially with the introduction of taxes on sugary drinks.  However, there is no united global movement against sugar, as there is against the tobacco industry.

  • Perspective:  Richard Watt: time to tackle oral diseases: Rachael Davies.  The Lancet, Vol. 394No. 10194.  “The mouth really is a marker of people’s social position and future disease risk…and oral diseases are a canary in the coal mine for inequality.”
  • Perspective: Polished smiles and porcelain teeth.  Richard Barnett.  The Lancet, Vol. 394No. 10194. 
This is a history of George Washington’s teeth and the later development of the dental profession, ending with this thought: “in the early 21st century, the great global divide in dentistry remains—as it was in Washington’s day—between the rich and the poor.”

It’s great that The Lancet has finally taken this on.

Here’s The Guardian’s Account.  There should be a lot more press coverage.  Dental conditions affect billions of people throughout the world.

Jan 28 2019

New Lancet report: The Global Syndemic: Uniting Actions to Address Obesity, Undernutrition, and Climate Change

The Lancet has been busy.  Last week, it published a blockbuster report on the need for worldwide dietary changes to improve human health and that of the environment.  I posted about this EAT-Forum report on Friday.

Now, The Lancet releases yet another report, this one taking a unified approach to dealing with the three most important nutrition issues facing the world: Malnutrition (undernutrition), obesity, and the effects of our food production and consumption system on the environment and climate change—for which this report coins a new term: The Global Syndemic.

This report breaks new ground in identifying the food industry as one of three main barriers to ending this “Syndemic.”  I’ve added the numbers for emphasis.

  • Powerful opposition by [1] commercial vested interests, [2] lack of political leadership, and [3] insufficient societal demand for change are preventing action on The Global Syndemic, with rising rates of obesity and greenhouse gas emissions, and stagnating rates of undernutrition.
  • New social movement for change and radical rethink of the relationship between policymakers, business, governance and civil society is urgently needed.
  • The Commission calls for a global treaty to limit the political influence of Big Food (a proposed Framework Convention on Food Systems – modelled on global conventions on tobacco and climate change); redirection of US$5 trillion in government subsidies away from harmful products and towards sustainable alternatives; and advocacy from civil society to break decades of policy inertia.

Wow.  This is telling it like it is—at long last.  From the press release:

  • A key recommendation from the Commission is the call to establish a new global treaty on food systems to limit the political influence of Big Food.
  • The food industry’s obstructive power is further enhanced by governance arrangements that legitimise industry participation in public policy development, and the power that big corporations have to punish or reward governments by relocating investment and jobs.
  • Regulatory approaches to product reformulation (eg. salt and sugar reduction), labelling and marketing to children are needed because industry-led, voluntary approaches have not been effective.

Yes!

The documents

The press

▪ The Guardian
The Times (London)
Irish Farmers Journal

Additional press, posted January 30

Newswires (syndicated in international outlets):

UK:

US:

Rest of world:

Jan 24 2019

Palm oil politics: corporate effects on health

The World Health Organization is about to publish a report on how the palm oil industry is promoting obesity and chronic disease as well as environmental degradation as integral parts of its business model.

The draft report gets right to the point.

We highlight the industry’s mutually profitable relationship with the processed food industry and its impact on human and planetary health, including detrimental cultivation practices that are linked to respiratory illnesses, deforestation, loss of biodiversity and pollution. This analysis illustrates many parallels to the contested nature of practices adopted by the alcohol and tobacco industries.

The research behind the report supports the analytical framework for examining industry’s effects on health.

The report documents how the palm oil industry, working with the food industry, acts to maximize profits at the expense of health and the environment, through marketing, supply chain management, lobbying, and corporate “citizenship.”

The report calls for

  • More research on the effects of palm oil on health
  • Actions to mitigate industry influences to protect producers and sellers from needed regulations
  • Use of the Sustainable Development Goals to aid these actions

You don’t get why palm oil raises health and environmental concerns?  Read this.  Now.

 

Aug 22 2018

Trump’s trade war with China: the retaliation lists

I have been trying to track what’s happening in our current tariff war with China.  Politico Morning Agriculture helps a lot, but even so keeping up with the rounds of retaliatory tariff impositions is challenging.

Here is our “second tranche” list of Chinese imports subject to tariffs.

The Chinese are retaliating by imposing tariffs on US agricultural exports.  They publish their lists in Chinese, obviously, meaning that we non-speakers must depend on Google Translate [and see note at end].

Fortunately, CNN Money has published a partial list in English of US goods hit by Chinese Tariffs

Poultry
— Frozen beef
— Fresh or cold pork
— Dried, smoked or salted pork belly
— Frozen chicken nuggets
— Frozen whole duck

Fruit and vegetables
— Farming potatoes
— Mushrooms
— Truffles
— Apples
— Cherries
— Avocados

Dairy products
— Butter
— Cream
— Yogurt

Fish
— Frozen red salmon
— Frozen mackerel
— Frozen yellowfin tuna

Seafood
— Frozen squid
— Lobster
— Canned shark fin
— Octopus
— Sea urchins

Tobacco
— Tobacco cigarettes
— Tobacco cigars

Pet food
— Canned cat food
— Canned dog food

Beverages
— Whiskey
— Modified ethanol
— Non-frozen orange juice with less than 20% sugar

Its list leaves out baked goods, for example, items of great concern to BakeryAndSnacks.com.

A group called Farmers for Free Trade has launched an advertising campaign, “Tariffs Hurt the Heartland.

This is a mess and clearly not good for US agriculture.  President Trump, as I noted earlier, has promised $12 billion in relief.  The administration has not said where that money—which in any case will not be nearly enough—is coming from.

Does anyone know where that money will be taken from?  Which budget line?

Note on Google Translate

A reader writes:

Small correction: the annexes you linked in the newsletter should be titled “Annex XX: List of XX% additional tariff items for the United States. pdf ”

Have you wondered why Canada is dragged into this? =)

In Mandarin the character for “additional” is the same as the abbreviated reference to Canada. It’s not surprising that Google Translate failed to catch this.

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