Search results: research bias

Last summer, Brian Wansink, a friend and Cornell colleague and the editor of the new Journal of the Association for Consumer Research, asked me to write a commentary on a paper to be published in its inaugural issue.

The paper turned out to be by a group of authors, among them John Peters and Jim Hill, both members of the ill-fated Global Energy Balance Network, the subject of an investigation by the New York Times last August.

Titled “Using Healthy Defaults in Walt Disney World Restaurants to Improve Nutritional Choices,” the paper described the benefits of improving the composition of kids’ meals at Disney World.

The healthy defaults reduced calories (21.4%), fat (43.9%) and sodium (43.4%) for kid’s meal sides and beverages sold in the park. These results suggest that healthy defaults can effectively shift food and beverage selection patterns toward healthier options.

The authors explain:

This work was supported by the Walt Disney Company and by the National Institutes of Health…The Walt Disney Company and the National Institutes of Health had no role in the design, analysis, or writing of this article. Full disclosure: JH is a consultant for the Walt Disney Company and for McDonalds; KA is a consultant for the Walt Disney Company.”

I thought Disney’s sponsorship of this research and its withholding of critical baseline and sales data on kids’ meals that the company considered proprietary did indeed deserve comment, and wrote my piece accordingly.  Brian Wansink soon accepted it for publication but to my surprise, gave it to Peters et al. for rebuttal.  They filed a lengthy response.  I was then given the opportunity to respond, and did so, briefly.

The paper by Peters, et al. did was published in the journal’s first issue.   This issue also includes several commentaries on other papers (none of which are accompanied by rebuttals).

My commentary—and the back-and-forth—however, were omitted.

After some discussion, the journal published my commentary online.  You have to scroll down to find it.  The site provides no links to it in the table of contents or in the article by Peters et al.

Is it possible that Disney or the authors’ contractual relationships with Disney could have had anything to do with the omission of my accepted-for-publication commentary?  Brian Wansink says no, they just ran out of room (despite room for others).

Whatever.

Here’s what I wrote:

Dietary nudges for obesity prevention: They work, but additional policies are also needed

In 2006, the Walt Disney Company announced a new initiative to improve the nutritional quality of meals served to children at its theme parks. The company would be changing the default kids’ meals—the components that come without having to be ordered separately–to include low-fat milk, juice, or water rather than soft drinks, and sides such as apple sauce or carrots rather than French fries. Parents who wanted sodas or fries for their children would have to ask for them, something many might not bother to do. Health groups had long advocated for this policy change (Wootan 2012).

As I commented to a reporter at the time, “going to Disney World is an excuse for eating junk food…Disney or its advisers must be feeling they have some responsibility” (Horovitz and Petrecca 2006). Indeed, the healthier defaults were part of a larger effort by Disney to deal with its contribution to obesity in America. After ticket prices, food is the second greatest source of revenue at Disney World. Although reducing the amount of food consumed at the parks might help create a less “obesogenic” food environment, revenues might fall. But the default change might be revenue neutral. By 2008, Disney could report that two-thirds of U.S. customers ordering kids’ meals had accepted the default, with no loss in sales. In Hong Kong Disney parks, nearly all customers accepted the default. The report, however, did not include data on the numbers or proportions of customers ordering kids’ meals (Walt Disney Company 2008).

Disney’s more recent summary of its child health initiatives states that it is funding investigators at the University of Colorado to conduct a more formal evaluation of use of the default options (Walt Disney Company 2015). The paper by Peters et al. (2016) in this issue of the Journal presents the results of that research. Their work confirms the ongoing effectiveness of the strategy. Nearly half the customers ordering kids’ meals accepted the healthy default side dishes and two-thirds accepted the healthier beverages. These choices resulted in significant reductions in the calories, fat, and sodium in purchased kids’ meals, but not sugar (Peters et al 2016).

The authors argue that gentle nudges changes like these are preferable to more coercive policies that smack of nanny statism. Such reductions help, but are they enough to make a real difference? To answer this question, it would help to know what else the children were eating along with the drink and side dishes. Although the authors were given raw sales data, Disney did not permit them to use this information as part of the overall analysis. The company also refused to provide information about the number of children who visited the park or the number of kids’ meals sold.

These missing pieces raise red flags because this is a Disney-funded study that produced results that Disney can use to advertise itself as a company that cares about kids’ health, and to deflect attention from Disney World’s’ reputation as a junk-food paradise. Corporate funding of research introduces conflicts of interest and reduces the credibility of the results, not least because the biases inherent in such research are largely unconscious, unintentional, and unrecognized (Moore et al 2005) The results of this study merit especially careful scrutiny. Taking them at face value, the default strategy worked well for the drink, but the sides are still a problem, and so are the sugars. They do not reveal much about what kids eat in a day at Walt Disney World

Nudges like this default are an important part of strategies to counter childhood obesity. But are they enough to deal with the public health problem? To make a real difference, they need to be accompanied and supported by a range of policy approaches. Current thinking about such approaches recommends combining insights from behavioral research, economics, and public health to establish a food environment far more conducive to making the healthy choice not only easy choice, but also the preferred choice. Doing so is likely to require multiple actions—for example, regulation of nutrient content and marketing; incentives such as subsidies of healthier foods; disincentives such as taxes, warning labels, and nutritional rating systems for unhealthier foods; and education of adults and children (Hawkes et al 2015). Disney’s voluntary default is a small step in the direction of such policies, but many more are needed if we are to make real progress in reducing the prevalence of childhood obesity.

• Margo G. Wootan. Children’s meals in restaurants: families need more help to make healthy choices.   Childhood Obesity 2012;8(1):31-33.
• Bruce Horovitz and Laura Petrecca.  Disney to make food healthier for kids.  USA Today, October 17, 2006.
• Walt Disney Company. Walt Disney Company—2008 Corporate Responsibility Report. 2008.
• Walt Disney Company.  Magic of Healthy Living brochure.  2015. https://thewaltdisneycompany.com/sites/default/files/MOHL_Brochure.pdf.
• John C. Peters, Jimikaye Beck, Jan Lande, Zhaoxing Pan, Michelle Cardel, Keith Ayoob, and James Hill. Using healthy defaults in Walt Disney World restaurants to improve nutritional choices.  J Assoc Consumer Res., 2016;1:1.
• Don A. Moore, Daylian M. Cain, George Loewenstein, and Max H. Bazerman, editors.  Conflicts of Interest: Challenges and Solutions in Business, Law, Medicine, and Public Policy.  Cambridge University Press, 2005.
• Corinna Hawkes, Trenton G Smith, Jo Jewell, Jane Wardle, Ross A Hammond, Sharon Friel, Anne Marie Thow, Juliana Kain.  Smart food policies for obesity prevention. The Lancet 2015;385:2410–2421.

And here’s my response to the rebuttal by Peters et al.

The response from Peters and Hill still fails to acknowledge the severity of the problems posed by Disney’s sponsorship of their research—the company’s failure to produce data essential for proper interpretation of study results, and the level to which sponsorship by food companies biases such interpretations.  At one point, Disney boasted of the results of this research, confirming its benefit to marketing goals.  The threat of industry sponsorship to research credibility has received considerable press attention in recent months, as must surely be known to these authors.^1,2 

1  Anahad O’Connor.  Coca-Cola funds scientists who shift blame for obesity away from bad diets.  New York Times, August 9, 2015. http://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-who-shift-blame-for-obesity-away-from-bad-diets/

2  Candice Choi.  AP Newsbreak: Emails reveal Coke’s role in anti-obesity group.  US News, November 24, 2015.  http://www.usnews.com/news/business/articles/2015/11/24/apnewsbreak-emails-reveal-cokes-role-in-anti-obesity-group

The bill just passed by the House contains this language:

SEC. 734. None of the funds made available by this or any other Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans, revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), unless the Secretary of Agriculture and the Secretary of Health and Human Services ensure that each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and each new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans.

(1) is based on significant scientific agreement; and

(2) is limited in scope to nutritional and dietary information.

SEC. 735.

(a) Not later than 30 days after the date of the enactment of this Act, the Secretary of Agriculture shall engage the National Academy of Medicine to conduct a comprehensive study of the entire process used to establish the Advisory Committee for the Dietary Guidelines for Americans and the subsequent development of the Dietary Guidelines for Americans, most recently revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341). The panel of the National Academy of Medicine selected to conduct the study shall include a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information.

(b) The study required by subsection (a) shall include the following:

(1) An analysis of each of the following:

(A) How the Dietary Guidelines for Americans can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

(B) How the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints.

(C) How the Nutrition Evidence Library is compiled and utilized, including whether Nutrition Evidence Library reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards.

(D) How systematic reviews are conducted on longstanding Dietary Guidelines for Americans recommendations, including whether scientific studies are included from scientists with a range of viewpoints.

(2) Recommendations to improve the process used to establish the Dietary Guidelines for Americans and to ensure the Dietary Guidelines for Americans reflect balanced sound science.

(c) There is hereby appropriated $1,000,000 to conduct the study required by subsection (a).

Comment:  I continue to be astonished that the House of Representatives would take such an intense interest in the science of nutrition when it is so uninterested in the science of climate change.  And I am puzzled as to why the House thinks that nutrition scientists appointed by the Academy of Medicine (formerly Institute of Medicine) would have views any different from those of the current Dietary Guidelines Advisory Committee.

Will the USDA and HHS release the 2015 Dietary Guidelines before the Senate passes its version of the Appropriations bill?

I’m in Geneva this week and am hoping they wait until I get back.

Really, the Dietary Guidelines Advisory Committee’s (DGAC) report shouldn’t be this controversial and shouldn’t be controversial at all (as I’ve said before).  But lots of people—the food industry, of course, but also some scientists and journalists—seem to have exceptionally intense opinions about the fat recommendations [Recall:  The DGAC report does not constitute the Dietary Guidelines; these are written by USDA and HHS and are not due out until the end of this year].

Now, we have the journalist Nina Teicholz, author of The Big Fat Surprise, repeating the themes of her book in the BMJ: The scientific report guiding the US dietary guidelines: is it scientific?.

The BMJ has also found that the committee’s report used weak scientific standards, reversing recent efforts by the government to strengthen the scientific review process. This backsliding seems to have made the report vulnerable to internal bias as well as outside agendas.

Teicholz’s interpretation of the science relating dietary fat to health has been thoroughly critiqued (see end of post).   The way I see it, these arguments are difficult to resolve outside the context of dietary patterns as a whole.

My hypothesis (note: hypothesis) is that for people who balance calorie intake with expenditure, the type of fat—or carbohydrate—matters much less than it does for people who overeat calories.  This hypothesis needs testing to confirm it.

What troubles me about Teicholz’s work is the certainty with which she presents her ideas.  She comes across as utterly convinced she is right, even in the face of substantial and substantive criticism of her statements and interpretations.

At least one error

Here, for example, is one statement in the BMJ article that I know from personal experience cannot be correct.

Much has been written about how industries try to influence nutrition policy, so it is surprising that unlike authors in most major medical journals, guideline committee members are not required to list their potential conflicts of interest.

I was a member of the 1995 DGAC and I was required to declare conflicts of interest.  So were members of the committees in 2000, 2005, and 2010, as shown in this excellent short video.

Later, discussing conflicts of interest among DGAC members, Teicholz says:

Still, it’s important to note that in a field where public research dollars are scarce, nearly all nutrition scientists accept funding from industry. [Nearly all?  I don’t, and I doubt this is correct].  Of far greater influence is likely to be bias in favor of an institutionalized hypothesis as well as a “white hat” bias to distort information for what is perceived as righteous ends.

The “white hat bias” comment refers to a paper by authors who themselves report food-industry funding:

Competing Interests. Drs. Allison and Cope have received grants, honoraria, donations, and consulting fees from numerous food, beverage, dietary supplement, pharmaceutical companies, litigators, and other commercial, government, and nonprofit entities with interests in obesity and nutrition including in interests in breastfeeding and NSBs. Dr. Cope has recently accepted a position with The Solae Company (St Louis, MO.).

Responses to the BMJ article

The DGAC wrote a rebuttal to Teicholz.  It is published on the BMJ website.

HHS also published a statement, reproduced by Mother Jones.

The British Medical Journal’s decision to publish this article is unfortunate given the prevalence of factual errors. HHS and USDA required the 2015 Dietary Guidelines Advisory Committee to conduct a rigorous, systematic and transparent review of the current body of nutrition science. Following an 19-month open process, documented for the public on DietaryGuidelines.gov, the external expert committee submitted its report to the Secretaries of HHS and USDA. HHS and USDA are considering the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, along with comments from the public and input from federal agencies, as we develop the 2015 Dietary Guidelines for Americans to be released later this year.

Yoni Freedhoff’s Weighty Matters blog provides a handy summary of additional responses to the BMJ article.

• BMJ Publishes Error-Laden Attack on Dietary Guidelines Report – CSPI
• Medical journal’s bogus investigation could derail better dietary guidelines – The Verge
• Expert is as expert does: in defence of US dietary guidelines – The Conversation
• The DGAC’s official response to Teicholz’ accusations – The BMJ
• An Open Letter to the BMJ Regarding US Dietary Guidance – Dr. David Katz
• British Medical Journal (BMJ) gives low-carb journalist Nina Teicholz an outlet to blast the Dietary Guidelines Advisory Committee (DGAC) – U.S. Food Policy Blog
• Call for The BMJ to retract Teicholz article on Dietary Guidelines Committee and Science – Evelyn (CarbSane)

Scientific analysis of The Big Fat Surprise

Many of the scientific claims in this book seemed so far-fetched that they induced a nutritionist, Seth Yoder, to go over it line by line, read the references, and point out discrepancies.   These are posted on his website in two parts.

A summary quote from Part 1:

What makes this particular book interesting is not so much that it is bad (which it is) or that it is extravagantly biased (which it also is). No, what really fascinates me about this book is that the author excessively and shamelessly lifts other people’s material.

And a quote from Part 2

The Big Fat Surprise (BFS) by Nina Teicholz is yet another book in a long line of books that informs the reader that everything you thought you knew about nutrition is wrong: saturated fat from animals is actually quite good for you, cholesterol isn’t really important, the government lied to you, nutritionists and dietitians lied to you, the American Heart Association lied to you, etc… Leaving aside that the concept of that kind of a conspiracy actually existing is really absurd, what I’m surprised about is that publishers can keep churning out books like this and people are gullible enough to keep buying them.

Caveat emptor.

Additions: 

• The Conversation, Australia: In defence of the US Dietary Guidelines
• New research published in the J Am College of Cardiology. “Conclusions:  Our findings indicate that unsaturated fats, especially PUFAs, and/or high-quality carbohydrates can be used to replace saturated fats to reduce CHD risk.”
• The Verge on the BMJ’s backtracking on the Teicholz piece

Since mid-March, I’ve been collecting research studies funded by food companies or trade associations, and dividing them into those that come out with results favorable to the sponsor (50 so far–this is a corrected number) and those that do not (as of today, 3).

As always, if you run across others, please send.

A reader, Cole Adam, sent me this study on dark chocolate funded by a Finnish company that makes chocolate products.

Dark chocolate and reduced snack consumption in mildly hypertensive adults: an intervention study.  Raika Koli, Klaus Köhler, Elina Tonteri, Juha Peltonen, Heikki Tikkanen and Mikael Fogelholm.  Nutrition Journal 2015, 14:84  doi:10.1186/s12937-015-0075-3

• Results: Daily consumption of dark chocolate had no effects on 24 h blood pressure, resting blood pressure…or arterial stiffness.  Weight was reduced by 1.0 ± 2.2 kg during the control (reduced snack only) period, but was unchanged while eating chocolate (p < 0.027 between the treatments).
• Conclusion:  …inclusion of 49 g dark chocolate daily as part of a diet of mildly hypertensive participants had no significant effects on cardiovascular risk factors during 8 wks.  Apart from a small effect on body weight (dark chocolate seemingly prevented a slight decrease in body weight during the control period), no other negative effects were observed.
• Funding:  This work was funded by Oy Karl Fazer Ab. Authors declare no competing interests regarding this study.  [Oy Karl Fazer Ab sells bakery, biscuit, and confectionery products in Finland, Sweden, Estonia, Latvia, Lithuania, Norway, Denmark, Russia, and internationally]

Several points to note about this study:

• Eating 49 grams (just under 2 ounces) of dark chocolate a day may be fun, but it is not going to reduce your blood pressure.
• Eating 49 grams of dark chocolate a day makes weight loss more difficult.
• The authors do not view corporate funding as introducing competing interests.  OK.  Maybe not in this case, but this is a rare exception.

Another reader, who prefers to remain anonymous, sent this one:

Milk intake is not associated with low risk of diabetes or overweight-obesity: a Mendelian randomization study in 97,811 Danish individuals.  Helle KM Bergholdt, Børge G Nordestgaard, and Christina Ellervik.  Am J Clin Nutr 2015;102:487–96. 

• Conclusions: High milk intake is not associated with a low risk of type 2 diabetes or overweight-obesity, observationally or genetically via lactase persistence.  The higher risk of type 2 diabetes in   individuals without milk intake likely is explained by collider stratification bias.
• Conflict: HKMB’s PhD project was partly funded by the Research Unit at Naestved Hospital, the Danish Dairy Research Foundation, and the Regional Research Unit in Region Zealand. [The population studies were funded by a long list of government agencies, health organizations, and foundations].
• Comment: This study says that high milk intake is associated with a higher risk of type 2 diabetes, although it explains it away.  The Danish dairy industry paid for part of the first author’s dissertation research.  It looks like most of the funding came from independent sources, so this one is a bit of a stretch, but to be super scrupulous let’s count it as industry-funded.

NOTE: All three “negative” studies I’ve posted since March were funded by international food companies (the previous one was funded by the Danish Dairy Research Foundation).

Today’s New York Times has another front-page (and on the inside, full-page) story on the food industry’s financial relationships with academic scientists.

The article describes how Monsanto funded scientists to lobby for GMOs in Washington (I will say more about this in a subsequent post).

But, as is clear from this report, the organic industry is doing much the same.

The Times based the story on e-mails it collected through open records law requests (the equivalent of Freedom of Information Act requests for federal documents).

And surprise!  I turn up in Charles Benbrook’s.  I learned this from checking Twitter yesterday.

I’m only on the B-list for influencing public opinion?  Alas.

It seems that Charles Benbrook, a strong proponent of organics (as am I), was working with (for?) the Organic Valley Cooperative on a public relations campaign to promote his organics-funded study demonstrating that organic milk has a healthier fatty acid profile than conventional milk.

I vaguely remember him contacting me about the study, but I didn’t write anything about it.  It appeared to be an industry-funded study with results favoring the sponsor’s interests—much as, in this case, I sympathize with those interests.

A few months later, I did write write about another conflicted organic study:

The study is not independently funded….This study is another example of how the outcome of sponsored research invariably favors the sponsor’s interests.  The paper says “the  [Sheepdrove] Trust  had  no  influence  on  the  design  and management of the  research  project  and  the  preparation  of publications  from the project,” but that’s exactly what studies funded by Coca-Cola say.  It’s an amazing coincidence how the results of sponsored studies almost invariably favor the sponsor’s interests.  And that’s true of results I like just as it is of results that I don’t like.

Benbrook has been criticized recently for not fully disclosing his ties to the organic industry.  Even if he had, disclosure is not enough.

The bottom line: Conflicted studies are conflicted, no matter who pays for them.

Documents: Charles Benbrook

I wrote this piece for The Guardian in response to the New York Times article earlier this week about Coca-Cola’s funding of scientists who think obesity is more about exercise than drinking sodas:

These days, you almost have to feel sorry for soda companies. Sales of sugar-sweetened and diet drinks have been falling for a decade in the United States, and a new Gallup Poll says 60% of Americans are trying to avoid drinking soda. In attempts to reverse these trends and deflect concerns about the health effects of sugary drinks, the soda industry invokes elements of the tobacco industry’s classic playbook: cast doubt on the science, discredit critics, invoke nanny statism and attribute obesity to personal irresponsibility.

Casting doubt on the science is especially important to soda makers. Overwhelming evidence links habitual consumption of sugary drinks to poor health. So many studies have identified sodas as key contributors to chronic health conditions – most notably obesity, type-2 diabetes and coronary artery disease – that the first thing anyone trying to stay healthy should do is to stop drinking them.

Soda companies know this. For at least the last 10 years, Coca-Cola’s annual reports to the US Securities and Exchange Commission have listed obesity and its health consequences as the single greatest threat to the company profits. The industry counters this threat with intensive marketing, lobbying and millions of dollars poured into fighting campaigns to tax or cap the size of sugary drinks.

But it is also pours millions into convincing researchers and health professionals to view sodas as benign.

Just last month, the Mayo Clinic Proceedings published a study arguing that the results of national dietary surveys, such as those that link sugary drinks to type-2 diabetes, are so flawed that they constitute a major misuse of public funds. The authors report honoraria, speaking and consulting fees from Coca-Cola.

This week’s revelation of Coca-Cola’s funding of the Global Energy Balance Network is only the latest example of this strategy in action. The Network promotes the idea that to prevent obesity you don’t need to bother about eating less or drinking less soda. You just have to be more active. Never mind that most people can’t lose weight without also reducing their intake.

A reporter who looked into this group discovered that Coca-Cola had funded the research of the scientists behind it, and generously. The network’s website was registered to Coca-Cola. None of this, however, had been made explicit.

Most nutrition professional journals now require researchers to declare who funds their studies, making it possible to compare study outcomes with funding sources. Studies sponsored by Coca-Cola almost invariably report no association of sugary drinks with diabetes, they question the validity of studies that do find such associations or, as in the case of Global Energy Balance Network investigators, they find activity to be the most important determinant of body weight.

Analyses of studies funded by Coca-Cola or its trade association demonstrate that they have an 83% probability of producing results suggesting no harm from soda consumption. In contrast, the same percentage of studies funded by government agencies or independent foundations find clear linkages between sugary beverages and such conditions. Coincidence? I don’t think so.

Since March, I’ve been posting industry-funded studies with results that favor the sponsor’s interests every time I find five of them. They are easy to find. Despite pleas to readers to send me industry-funded studies that do not favor the sponsor, I hardly ever get them. Whenever I come across a study that shows no harm from sodas, I immediately look to see who paid for it.

Soda companies spend generously to convince researchers and health professionals not to worry about sodas’ health effects. But why do researchers take the money? It is too simplistic to say that they are “bought.” Industry-funded investigators say they believe the funding has no effect on the design, conduct or interpretation of their research. But research involves choices of questions, assumptions and methods. It is not difficult to carry out a study that appears to meet high scientific standards yet fails to include critical controls that might lead to alternative conclusions.

Researchers funded by Coca-Cola need to take special care to control for unconscious biases but can only do this if they recognize the possibility. Many do not. Neither do many peer reviewers or editors of scientific journals. Although food-company financial support should not necessarily bias results, it appears to do so in practice.

Industry-funded scientists resent questioning of the influence of sponsorship on the quality of their science. They charge that investigators who find adverse effects of sodas on health are equally biased by career goals, righteous zeal or anti-corporate morality. Yes, independent scientists may have biases of their own, but their overarching research goal is to improve public health. In contrast, the goal of soda companies is to use research as a marketing tool.

Disclosure is essential. If a study is funded by Coca-Cola, caveat emptor.

I’ve had a busy week dealing with the aftermath of Anahad O’Connor’s New York Times story about how Coca-Cola pays scientists who argue that obesity is more about activity than what you eat—drinking sodas, for example (I’m quoted).   It’s gotten 1180 comments.

Here’s Dan Wasserman’s from the Boston Globe:

In all fairness, let’s see what Coca-Cola’s Chief Technical Officer, Dr. Ed Hays, says in response (straight out of the tobacco industry’s playbook):

I was dismayed to read the recent New York Times’ inaccurate portrayal of our company and our support of the Global Energy Balance Network (GEBN). The story claimed Coke is funding scientific research to convince people that diets don’t matter – only exercise. In fact, that is the complete opposite of our approach to business and well-being and nothing could be further from the truth.

Yes, we fund scientific research through GEBN and we are proud to support the work that scientists such as Dr. Jim Hill and Dr. Steve Blair do – because their type of research is critical to finding solutions to the global obesity crisis.

At Coke, we believe that a balanced diet and regular exercise are two key ingredients for a healthy lifestyle and that is reflected in both our long-term and short-term business actions.

The article even got the attention of Congress.  Here’s the statement from Rosa de Lauro (Dem-CT), sponsor of The SWEET Act to tax sugars:

This research is reminiscent of the research conducted by the tobacco companies to mislead the public about the health risks of smoking.  The American public will not be fooled. There is a wealth of sound scientific research that demonstrates the link between sugar-sweetened beverage consumption and a host of health conditions, including diabetes, heart disease, and obesity.  This new group and their research are a sham,” DeLauro said.  “People want to be healthy and they want their kids to be healthy and realize that drinks full of empty calories are not good for them. That is why more and more Americans are opting to drink less soda every year.

I wrote a piece for The Guardian, which I will post tomorrow.

I don’t keep track of my interviews or media appearances unless people send me links (I post them under Media), but Rachel Harrison at NYU kept score yesterday.  As I said, a busy couple of days.

• Fortune
• RT
• USA Today
• US News & World Report
• NPR
• Washington Post Wonkblog
• Washington Post Health Section
• CBS Atlanta
• CBC
• PLoS Blog
• Take Part
• Huffington Post
• Latina
• Business Insider
• Journal of Public Heath Policy 

Additions, August 14

Fox News, August 11

• Shepard Smith says “the story “reminds you of exactly what the tobacco industry did back in day, and more recently, it also reminds you of what the climate deniers — the climate change deniers — are doing as well.”
• Rush Limbaugh said the Times‘ Coca-Cola story “undermine[s] the whole notion of a scientific consensus,” because it “can be bought and paid for.”

New York Times editorial, August 14

the evidence continues to mount that sugar-sweetened drinks are a major contributor to obesity, heart disease and diabetes, and that exercise makes only a modest contribution to weight loss compared to ingesting fewer calories.

Don’t miss the article on the front page of today’s New York Times about Coca-Cola’s paying scientists who argue that obesity is more about exercise than diet (I’m quoted).

Last week, I posted two industry-funded studies with results that must have made their sponsors extremely unhappy.

But results like that are rare—so rare that the Washington Post wrote about one of them.

Today, I’m doing another in my series of posts of 5 (sometimes 6) studies sponsored by food and beverage companies for the purpose of obtaining results that can be used in marketing.

Since March, the count is 42 studies with results favorable to the sponsor but only 1 unfavorable (the other was from last year).

If you run across either kind, but especially industry-funded studies that don’t produce expected results, please send.

Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. Berger, S., Raman, G., Vishwanathan, R., Jacques, P.F., Johnson, E.J., 2015. Am J Clin Nutr ajcn100305. doi:10.3945/ajcn.114.100305.

• Conclusion: Reviewed studies were heterogeneous and lacked the methodologic rigor to draw any conclusions regarding the effects of dietary cholesterol on CVD risk.  [Implication: suggestions that eggs might raise cardiovascular risk are unwarranted]
• Sponsor: Supported by USDA agreement 1950-51000-073 and the American Egg Board, Egg Nutrition Center.

Milk intake is not associated with low risk of diabetes or overweight-obesity: a Mendelian randomization study in 97,811 Danish individuals.  Helle KM Bergholdt, Børge G Nordestgaard, and Christina Ellervik.  Am J Clin Nutr.  doi: 10.3945/ajcn. 114.105049

• Conclusion: High milk intake is not associated with a low risk of type 2 diabetes or overweight-obesity, observationally or genetically via lactase persistence. The higher risk of type 2 diabetes in lactasepersistent individuals without milk intake likely is explained by collider stratification bias..
• Funding source: HKMB’s PhD project was partly funded by the Research Unit at Naestved Hospital, the Danish Dairy Research Foundation

Dietary Approaches to Stop Hypertension diet retains effectiveness to reduce blood pressure when lean pork is substituted for chicken and fish as the predominant source of protein. R Drew Sayer, Amy J Wright, Ningning Chen, and Wayne W Campbell. Am J Clin Nutr 2015; 102:302-308 doi:10.3945/ajcn.115.111757

• Conclusion: The results indicate that adults with elevated BP [blood pressure] may effectively incorporate lean pork into a DASH-style diet for BP reduction.
• Sponsor: This paper is sponsored by the national pork board.

Relationship between lifestyle behaviors and obesity in children ages 9-11: Results from a 12-country study. Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM, Chaput JP, Fogelholm M, Hu G, Johnson WD, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Zhao P, Church TS; ISCOLE Research Group.

• Conclusion: Behavioral risk factors are important correlates of obesity in children, particularly low MVPA [moderate to vigorous physical activity], short sleep duration, and high TV viewing.  [Implication: what they eat and drink doesn’t matter]
• Sponsor: This research was supported by The Coca-Cola Company.

A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. M. Elia, C. Normand, A. Laviano , K. Norman.  Clinical Nutrition 2015, online ahead of print. doi:10.1016/j.clnu.2015.05.010

• Conclusions: Overall, the reviewed studies, mostly based on retrospective cost analyses, indicate that ONS [oral nutritional supplement] use in the community produce an overall cost advantage or near neutral balance, often in association with clinically relevant outcomes, suggesting cost effectiveness. There is a need for prospective studies designed to examine primary economic outcomes.
• Authors’ disclosures: ME, CN and AL have received honoraria for giving independent talks at national/international conferences supported by industry. KN has received speakers’ fees as well as financial support for research projects by commercial companies.
• Comment: most studies of supplement use find little evidence of benefit.  Taking honoraria from industry doesn’t sound like much of a problem unless these financial ties are with supplement companies.  The authors do not specify and the journal’s editors must not require such specification.  They should.