by Marion Nestle

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Aug 23 2024

Weekend Reading: Soda Science

Susan Greenhalgh. Soda Science: Making the World Safe for Coca-Cola.  University of Chicago Press, 2024.

This terrific book picks up where I left off with Soda Politics: Taking on Big Soda (and Winning) (2015) and Unsavory Truth: How the Food Industry Skews the Science of What We Eat (2018).

Susan Greenhalgh’s focus, however, is on ILSI, the International Life Sciences Institute (now renamed the Institute for the Advancement of Food and Nutrition Sciences).  ILSI is a classic industry front group,  It was created originally by Coca-Cola to make sure science promoted corporate interests.  It is funded by big food companies.  It positions itself as an independent think tank.  Hence: front group.

Soda Science documents how ILSI, working through personal connections (guanxi) at the Chinese Ministry of Health, convinced the Chinese government to target obesity prevention measures at physical activity (“move more”), rather than diet (“eat less,” or “eat better”).

The first half of the book tells the story of ILSI’s role in the Global Energy Balance Network, a group outed as funded by Coca-Cola (I wrote about this in 2015, particularly here, here, and here in The Guardian).

The second half gives an intimate, first-hand account of how science politics works in China.

Greenhalgh is a distinguished anthropologist.  She retired from Harvard as as the John King and Wilma Cannon Fairbank Research Professor of Chinese Society (she is an expert on China).  She uses social science methods—interviews and qualitative research as well as document review—to study this particular example of soda politics.

We have never met but I have a vested interest in this book, and not just because I write about similar topics.  In 2018, the BMJ asked me to peer review an article she had written about ILSI’s machinations around obesity policy in China.
I thought her account of the inner workings of Chinese decision-making around obesity policy was wonderfully documented and well worth publishing. I commented that even though others had written about Coca-Cola and ILSI, “as an in-depth qualitative study it makes a critically important contribution to our understanding of how food companies use front groups to achieve policy objectives.”
I urged the BMJ to accept the article with some minor revisions. No such luck.  The BMJ rejected the article.
I was so appalled that I wrote the editors to reconsider, which they eventually did.
I also wrote Susan to offer help finding a journal to publish her writings on this topic and recommended she look at the Journal of Public Health Policy.
She followed through.  When her articles appeared, I cited and wrote about them: Coca-Cola’s political influence in China: documented evidence (Jan 15, 2019).
I’ve also had plenty to say about ILSI over the years, most recently:

The story she tells here is fascinating in its own right and a great read.

It also makes one other point: social science methods are really useful in getting information unavailable any other way.

I say this because bench scientists tend to look down on qualitative research and consider it non-research.  I disagree.  I think qualitative research is essential, and has plenty to contribute.  This book is a great example of why.

Jul 31 2024

Food politics at the Olympics: Kick Big Soda Out

Here’s what started all this:

P&G, Coca-Cola make Olympics promotional push: Procter & Gamble and Coca-Cola are among the companies making a promotional push around the 2024 Olympic Games in Paris. P&G is planning to focus its efforts on specific brands such as Pampers diapers and Gillette razors, and Coca-Cola has plans for over 70 markets. Sponsors of the International Olympic Committee have spent 18% more than they did for the Tokyo Games in 2021, Comcast reports.

And here’s the response:

TODAY, the global digital campaign, “Hey Big Soda!”  was launched demanding an end to Big Soda’s sponsorship of sport…Please share the campaign with the hashtag #KickBigSodaOutofSport!

Sign the petition from Kick Big Soda Out urging the International Olympic Committee (IOC) to terminate the Coca-Cola Company’s sponsorship.

For more information: info@kickbigsodaout.org.

In its Week #2 report, Kick Big Soda Out says:

Over 34,000 people have signed the petition, and 60 organizations from 21 countries have endorsed the campaign as Campaign Partner Organizations!

Partner materials are here.

Examples from the Mexico team:

Food Politics in action!  Join the campaign.

Jul 31 2023

Industry-funded study of the week: Matcha

Thanks to Matthew Kadey for sending this one.  Matcha is a new one for me.

The study: Matcha green tea beverage moderates fatigue and supports resistance training-induced adaptation.  Shigeta M, et al.  Nutrition Journal volume 22, Article number: 32 (2023)

Methods: Healthy, untrained men were randomized into placebo and matcha groups. Participants consumed either a matcha beverage containing 1.5 g of matcha green tea powder or a placebo beverage twice a day and engaged in resistance training programs for 8 (trial 1) or 12 weeks (trial 2).

Results: In trial 1, maximum leg strength after training tended to increase more in the matcha group than that in the placebo group. In the matcha group, subjective fatigue after exercise at 1 week of training was lower than that in the placebo group. Gut microbe analysis showed that the abundance of five genera changed after matcha intake. The change in RuminococcusButyricimonas, and Oscillospira compositions positively correlated with the change in maximum strength. In trial 2, the change in skeletal muscle mass in response to training was larger in the matcha group. In addition, the salivary cortisol level was lower in the matcha group than that in the placebo group.

Conclusion: Daily intake of matcha green tea beverages may help in muscle adaptation to training, with modulations in stress and fatigue responses and microbiota composition.

Funding: This work was supported by the Matcha and Health Research Group and the Japan Society for the Promotion of Science (JSPS) KAKENHI: Grant-in-Aid for Scientific Research,

Competing interests: Although the Matcha and Health Research Group was not involved in conducting experiments or data analysis, test samples were supplied from Nestlé Japan Ltd., a constituent organization of the Matcha and Health Research Group.

Comment:  Matcha is powdered green tea, so whatever is in it is more concentrated than in regular teas.  Besides that, is there anything special about matcha?  The study did not compare matcha to other teas, so it’s hard to know.  I’m curious about the funder.  I can’t find anything about it online other than its sponsorship of many studies about matcha, all with positive results.   I’m guessing that someone who profits from matcha sales is behind these studies, but can’t tell for sure.  If you enjoy matcha, by all means drink it.  Teas are healthy beverages  But reserve judgement on the research linking it to health miracles.  The studies I’ve seen pretty much all say: “more research needed.”

Jun 26 2023

Industry-funded study of the week: oxygen nanobubble beverages

Oxygen nanobubbles?  Oxygen in little tiny bubbles?

For this gem I am indebted to an item I read in NutraIngredients-Europe:

Oxygen nanobubble drink found to enhance athletic performance, study suggestsA new study finds the consumption of an oxygen nanobubble beverage significantly improves the time-to-completion of maximal and submaximal exercises performed by male cyclists…. Read more

I went right to the article.

The study: A Double-Blind, Randomized, Placebo-Controlled Pilot Study examining an Oxygen Nanobubble Beverage for 16.1-km Time Trial and Repeated Sprint Cycling Performance.  Journal of Dietary Supplements. https://doi.org/10.1080/19390211.2023.2203738.

The concept: Athletes need oxygen and water.  Therefore, oxygen-supplemented water should improve performance.

The result: As comparied to placebo, Althletes who consumed the oxygen-nanobubble beverage demonstrated significantly improved performance.

The conclusion:  “An oxygen-nanobubble beverage improves performance during submaximal and repeated sprint cycling, therefore may provide a practical and effective ergogenic aid for competitive cyclists.”

Guess who funded this: “This study was funded by Avrox Technologies Ltd, Harrogate, North Yorkshire, HG3 3SZ. Avrox Technologies provided the experimental beverages but had no role in study design, data storage, analysis and interpretation.

I wondered what the placebo was and whether study subjects could distinguish the drinks.  The beverages:

were supplied by Avrox Technologies in 500 mL individually sealed bottles and consisted of the same solution containing water, glycerol, glycyrrhizin, lecithin and citric acid. Both beverages have similar organoleptic properties, including taste, aroma, and texture. Previous investigations have indicated that the oxygen nanobubble drink consists of a suspension of lecithin vesicles with a modal diameter of ∼100 nm and concentration 7 × 1012 particles/ml.

The authors deal with my question in their discussion of the study’s limitations:

we did not evaluate the success of our double-blind design, therefore, changes in performance might be somewhat attributed to participants’ expectancy of positive outcomes from their belief that they successfully identified the O2 beverage…Whilst there were no notable differences in taste, texture or appearance of the O2 and PLA [not spelled out in the study but must refer to the placebo] beverages, we should have assessed blinding via treatment allocation questionnaires to determine whether participant biases influenced results.

Yes, you should have.

I also wonder whether club soda or Pellegrino might have the same benefit?  Or giving water a good shake?

May 22 2023

Industry-funded study of the week: Exercise!

My thanks to Arun Gupta for sending this one from a newspaper in India.

The clipping refers to this article.

  • The study: Ostendorf, D.M., Schmiege, S.J., Conroy, D.E. et al.Motivational profiles and change in physical activity during a weight loss intervention: a secondary data analysis.Int J Behav Nutr Phys Act18, 158 (2021). https://doi.org/10.1186/s12966-021-01225-5.
  • First sentence : “High levels of moderate-to-vigorous physical activity (MVPA) are strongly associated with sustained weight loss [12], and current guidelines recommend high levels of PA for weight management .”
  • Methods: Participants were asked to follow a weight-loss diet and to do 300 minutes per week of exercise.  The investigators lstudies participants’ motivation levels.
  • Conclusion: once exercise supervision and support was removed, adults in the high autonomous motivational profile were protected against the standard attenuation in MVPA following removal of support/supervision.
  • Competing interests: “The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. DC reports consulting income from Gelesis, Inc., a company that has developed a weight loss device.  SP has a grant from WW International [formerly, Weight Watchers] unrelated to this work.”

Comment: As far as I can tell, the paper says nothing about exercise being more important than diet.  The study didn’t find any differences in weight among people with different levels of motivation.  We can’t blame the authors for the press account.    But anything that minimizes the need for dietary changes gets pounced on.  Alas.

Jun 14 2021

Industry-funded study of the week: Coca-Cola

The study: Co-Occurrence and Clustering of Sedentary Behaviors, Diet, Sugar-Sweetened Beverages, and Alcohol Intake among Adolescents and Adults: The Latin American Nutrition and Health Study (ELANS)

Abstract: Poor diet, sedentary behaviors, sugar-sweetened beverages (SSB) and alcohol intake seem to co-exist in complex ways that are not well understood. The aim of this study was to provide an understanding of the extent to which unhealthy behaviors cluster in eight Latin America countries. A secondary aim was to identify socio-demographic characteristics associated with these behaviors by country…. Among 9218 individuals, the most prevalent behaviors were transportation and occupation–sedentary time, SSB and alcohol intake.

Conclusions:  EBRB, particularly excessive time spent on sedentary-activities and SSB intake, commonly co-occurred in a representative sample of LA adolescents and adults. While unhealthy behavior varied across LA countries, nearly half of sampled subjects in Argentina and Colombia presented at least two risk factor behaviors.

Recommendation: Public health policies and behavioral-change strategies should target SB domains (screen-time, occupational, and transportation), diet intake, and SSB and alcoholic intake in combination [my emphasis].

Funding: The ELANS data collection was originally supported by the scientific grant from the Coca-Cola Company (Atlanta, GA, USA) and by grants/supports from the ILSI Latin America branches (Argentina, Brazil, Sur-Andino, Nor-Andino, and Meso-America), Sabará Children’s Hospital, PENSI Institute, University of Costa Rica, Pontifical Catholic University from Chile, Pontifical Catholic University Javeriana, Colombia, Central University of Venezuela/Foundation Bengoa, University of San Francisco, Quito, and Nutritional Institute of Investigation, Peru. The funders had no role in study design, data collection, analysis, the decision to publish, or the preparation of this manuscript.

Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Comment: This is the first study I have seen funded by Coca-Cola since the scandal over its funding of  the Global Energy Balance Network (see my last post on it) and its announcement that it would no longer pay more than half the cost of a study (see policy statement).  This study is co-funded by ILSI (also industry) and universities (independent).  Coca-Cola is still funding lots of studies.  See here and here.

Why would Coca-Cola want to fund a study like this?  The answer lies in the recommendation.  My translation: Do not target sugar-sweetened beverages with tax or warning label policies alone.  If you want to improve unhealthy behavior, you have to target all of those behaviors—screen time, jobs, transportation, dietary intake, and alcohol—at the same time.

Apr 22 2019

Industry-funded study of the week: Coca-Cola again

Here is a summary of another funded study with results the funder must love.

Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity.  Li N, and 19 additional authors for the ISCOLE Research Group. International Journal of Obesity (2019) 43:691–700.

Conclusions: Lower levels of MVPA [moderate to vigorous physical activity] or higher levels of sedentary time on either weekdays or weekend were associated with increased odds of obesity in 9–11 year old children in 12 countries.

Funding: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was funded by The Coca-Cola Company… With the exception of requiring that the study be global in nature, the funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.

Comment: This is another paper from the ISCOLE study funded by Coca-Cola, that seems to be aimed at casting doubt on the idea that sugary beverages might promote weight gain.  Instead, these results suggest that physical activity is a more important factor.  Of course physical activity is important for health, but doesn’t expend nearly as many calories as is usually needed to compensate for soft drink intake.

I learned about this study from a Weighty Matters blog post by Dr. Yoni Freedhoff, who runs a weight management center in Ottawa.  In his view, the ISCOLE study ignores evidence that childhood obesity is a determinant of physical activity, “not the other way around.”

He also questions the “no influence” statement in the funding disclosure, on the basis of

emails between ISCOLE investigators and Coca-Cola that not surprisingly suggests that these relationships have the very real potential to influence the framing of results even if funders [are] not involved in study design.

As I discuss in Unsavory Truth, the influence of food-industry funders appears to occur at an unconscious level; investigators do not recognize the influence and typically deny it.

As I also discuss in that book, Coca-Cola generously funded the ISCOLE study some years ago.  It has since changed its policy on research funding.

Mar 23 2018

Get up and move. It’s good for you.

The Physical Activity Guidelines Advisory Committee’s 2018 Scientific Report promotes physical activity as a “best buy” for public health.

  • Physically active individuals sleep better, feel better, and function better.
  • Some benefits happen immediately.
  • Physical activity reduces the risk of a large number of diseases and conditions.
  • The benefits of physical activity can be achieved in a variety of ways.

The report recommends 50 to 300 minutes per week of moderate-intensity physical activity, but

  • Any is better than none
  • More is better than less
  • Any amount at any level or duration counts.

The good news is that huge benefits come with just being somewhat active.

The report recommends 50 to 300 minutes of at least moderate activity a week, and this can be done in increments.

A brisk walk around the office, anyone?

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