Currently browsing posts about: Conflicts-of-interest

Astaxanthin is the dye used by growers of farmed salmon to give the fish a pink color.  They do this by matching the desired amount of the dye to this SalmoFan template.

Astaxanthin, claim its makers, is an antioxidant and, therefore, good for you.

First the public relations: Screen shot: Astaxanthin reduces work-induced visual stress in people aged over 40 – BGG trial: Astaxanthin supplementation has been found to reduce visual display terminal (VDT) work-induced visual stress in people aged over 40, according to a new Japan trial sponsored by supplier BGG Japan. Read more

As for the actual research:

The study: Effects of diet containing astaxanthin on visual function in healthy individuals: a randomized, double-blind, placebo-controlled, parallel study.  Takahiro Sekikawa, Yuki Kizawa, Yanmei Li, Naoki Miura. J Clin Biochem Nutr.  https://doi.org/10.3164/jcbn.22-65.

Results:  In participants aged ≥40 years, corrected visual acuity of the dominant eye after visual display terminal work at 6 weeks after intake demonstrated a higher protective effect of astaxanthin in the astaxanthin group vs the control group (p<0.05). In participants aged <40 years, no significant difference was seen between the astaxanthin and control groups. Moreover, no significant difference was found in functional visual acuity and pupil constriction rate between the astaxanthin and control groups [my emphasis].

Conclusion: These results suggest astaxanthin reduces oxidative stress caused by visual display terminal work. Age-related reduction in ciliary muscle strength is likely the main detractor of visual acuity. Correspondingly, astaxanthin reduced visual display terminal work-induced visual stress in the middleaged and elderly.

Conflict of interest: This trial was sponsored by BGG Japan Co., Ltd., which provided all costs for the implementation of the trial. TS and YK are employees of BGG Japan Co., Ltd. YL is an employee of Beijing Gingko-Group Biological Technology Co., Ltd., which belongs to the same company group as BGG Japan Co., Ltd. NM received funding from BGG Japan Co., Ltd. to provide medical services to the trial participants.

Comment: BGG makes astaxanthin products.  This is a company-sponsored study conducted by researchers employed or paid by the company.  It is an excellent example of interpretation bias—putting a positive spin on results that are marginally significant in some groups but not others, or null.

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I saw this on NutraIngredients.com, one of those newsletters I read regularly: Study: Mulberry extract shrinks blood sugar spike by 40%.  

That headline was all I needed: Who paid for this?

Fortunately, the study was readily available: Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo‑controlled study.  Pariyarath Sangeetha Thondre Helen Lightowler, Lis Ahlstrom,  Andrew Gallagher.  Nutr Metab (Lond). .2021 Apr 15;18(1):41.   doi: 10.1186/s12986-021-00571-2.

Conclusion: “Mulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels.”

Acknowledgements:  The authors would like to thank Dr Chen Xie (CX) and Mrs Hongwen Yu (HY) for technical input during the conceptualization of the study and editorial commentary on the draft publication. CX and HY are both employees of Phynova Group Limited.

Funding: The work in this study was funded by Phynova Group Ltd, a privately held company that is the developer of Reducose® mulberry leaf extract. Phynova was involved in the study design and manuscript preparation but had no role in data collection and analysis.

Competing of interest: AG is an employee of Phynova Group Limited, the funder of the study. He was involved in the development of the product, design of the study and drafting of the manuscript, but was not involved in the collection, analysis or interpretation of data. PST, HL, and LA have declared they have no conflicts of interest.

Comment:  This degree of industry involvement turns this study into industry-funded marketing research, no matter how beautifully the science is conducted.  Please refer to my book, Unsavory Truth, for references to the studies backing up that statement.

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As regular readers know, I subscribe to the weekly newsletter, Obesity and Energetics Offerings, and particularly enjoy its section on Headline vs Study.

Here’s a particularly amusing example, which right away triggers my question: Who paid for this?

Headline vs Study

• Headline: Snacking on Almonds Can Help People Reduce Calorie Intake: Study.  
• Press Release: Believe It or ‘Nut’, Almonds Can Help You Cut Calories, Study Finds.  
• Study: “There was no significant difference in total energy intake ([…] p = 0.286) or energy from core ([…] p = 0.860) or discretionary foods ([…] p = 0.158) between [almonds and an isocaloric carbohydrate-rich snack bar].”

Let’s take a look.

Headline: Snacking on Almonds Can Help People Reduce Calorie Intake: Study.

A handful of almonds may be the latest weight loss hack, new research suggests.

A new study from the University of South Australia found that eating 30 to 50 grams of almonds could regulate appetite, leading to less calories consumed each day.

The research, which examined both the hormones that regulate appetite and how almonds could aid in controlling hunger, discovered that the consumption of the nut ultimately led to about 300 fewer calories [sic*]consumed at the following meal.

Press Release: Believe It or ‘Nut’, Almonds Can Help You Cut Calories, Study Finds.

Examining how almonds can affect appetite, researchers found that a snack of 30-50 grams of almonds could help people cut back on the number of kilojoules they consume each day.

Published in the European Journal of Nutrition, the study found that people who consumed almonds — as opposed to an energy-equivalent carbohydrate snack — lowered their energy intake by 300 kilojoules (most of which came from junk food) at the subsequent meal.

Study:  Acute feeding with almonds compared to a carbohydrate-based snack improves appetite-regulating hormones with no effect on self-reported appetite sensations: a randomised controlled trial. Carter, S., Hill, A.M., Buckley, J.D. et al.Eur J Nutr (2022). https://doi.org/10.1007/s00394-022-03027-2

Results: “…Cholecystokinin, ghrelin, glucagon-like peptide-1, leptin and polypeptide YY AUCs were not different between groups. Self-reported appetite ratings and energy intake following the buffet did not differ between groups.”

Conclusion: “More favourable appetite-regulating hormone responses to AL did not translate into better self-reported appetite or reduced short-term energy consumption. Future studies should investigate implications for longer term appetite regulation.”

Funding: “This work was funded by the Almond Board of California. This funding source had no role in the design of this study or the analysis and interpretation of the data.”

Conflict of interest: “AMC has consulted for Nuts for Life (an initiative of the Australian Tree Nut Industry). S-YT has previously been involved in studies funded by the Californian Walnut Commission. AMC, JDB and S-YT have previously been involved in studies funded by International Nut and Dried Fruit Council.”

*Comment: How could the headline get it so wrong?  The authors write: “Although not significant, the AL group consumed 300 kJ less energy in the meal challenge than the SB group, 270 kJ of which came from discretionary foods, which may be a clinically important benefit in weight management.”  The sic partly explains the problem.  The 300 refers to kilojoules (kj), not calories.  300 kj = 72 calories, not 300.  No wonder the result wasn’t statistically significant.

But the press release and resulting headline explain why the nut industry funds studies like this.  Even when the result shows no difference, the PR people can spin the data to produce the expected favorable result.

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Beyond Meat is taking a beating these days, and this study only adds to its  woes.

Assessing the effects of alternative plant-based meats v. animal meats on biomarkers of inflammation: a secondary analysis of the SWAP-MEAT randomized crossover trial.  Crimarco A, Landry MJ, Carter MM, Gardner CD.  J Nutr Sci.  2022;11:e82.  doi:10.1017/jns.2022.84

Abstract: Alternative plant-based meats have grown in popularity with consumers recently and researchers are examining the potential health effects, or risks, from
consuming these products…the purpose of this work was to conduct a secondary analysis of…a randomised crossover trial that involved generally healthy adults eating 2 or more servings of plant-based meats per day for 8 weeks (i.e. Plant phase) followed by 2 or more servings of animal meats per day for 8 weeks (i.e. Animal phase). Results of linear mixed-effects models indicated only 4 out of 92 biomarkers reached statistical significance. The results were contrary to our hypothesis, since we expected relative improvements in biomarkers of inflammation from the plant-based meats.

Conflicts of interest: “Gardner [the senior author] received gift funding from Beyond Meat which was used to conduct the original research study.”

Comment:  This is a follow up to the original research, which I wrote about previously.  That study found a positive result:

A diet that includes an average of two servings of plant-based meat alternatives lowers some cardiovascular risk factors compared with a diet that instead includes the same amount of animal meat…This study found several beneficial effects and no adverse effects from the consumption of plant-based meats.

The investigators tested the effects of substituting Beyond Meat for animal meats on 92 biomarkers of inflammation.  They found hardly any to be improved by the Beyond Meat substitution.

This disappointed the investigators but I’ll bet it disappointed Beyond Meat even more.

This study was not specifically funded by Beyond Meat.

This work was supported by Stanford University’s Precision Health and Integrated Diagnostics Center (PHIND) and in part by a training grant from the NIH National Heart, Lung, and Blood Institute [T32 HL007034].

It is consistent with the overall observation that industry-funded research tends to find results favorable to the sponsor’s interest; independently funded research can go either way.  See my book, Unsavory Truth, for details and references.

Thanks to Stephen Zwick for sending this one.

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My theme for this week is meat, poultry, and their alternatives, starting today with this:

The study: Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss.  Faidon Magkos, Sidse I Rasmussen, Mads F Hjorth, Sarah Asping, Maria I Rosenkrans, Anders M Sjödin, Arne V Astrup, Nina R W Geiker.  The American Journal of Clinical Nutrition, nqac152, https://doi.org/10.1093/ajcn/nqac152.  

Objectives: “We sought to investigate the effects of healthy diets that include small or large amounts of red meat on the maintenance of lost weight after successful weight loss….”

A big question for discussion is whether plant-based meat alternatives are better for health and the environment than regulat meat.  Are they?  Here is one study.

Plant-based animal product alternatives are healthier and more environmentally sustainable than animal products.  
Christopher J. Bryant.  Front Nutr.  2022 Jul 19;9:934438.   doi: 10.3389/fnut.2022.934438. eCollection 2022.

Rationale:   There are strong reasons to move away from industrial animal agriculture for the good of the environment, animals, our personal health, and public health. Plant-based animal product alternatives (PB-APAs) represent a highly feasible way to reduce animal product consumption, since they address the core consumer decision drivers of taste, price, and convenience.

Method: This paper reviews 43 studies on the healthiness and environmental sustainability of PB-APAs compared to animal products.

Findings:  In terms of environmental sustainability, PB-APAs are more sustainable compared to animal products across a range of outcomes including greenhouse gas emissions, water use, land use, and other outcomes. In terms of healthiness, PB-APAs present a number of benefits, including generally favourable nutritional profiles, aiding weight loss and muscle synthesis, and catering to specific health conditions.

Conclusion:  As more conventional meat producers move into plant-based meat products, consumers and policymakers should resist naturalistic heuristics about PB-APAs and instead embrace their benefits for the environment, public health, personal health, and animals.

Conflict of interest: Although there is no specific conflict of interest or funding related to this project, the author is an independent research consultant and works with alternative protein companies.

Comment:  You would think that plant-based meat alternatives would be better for the environment than beef but without an agreed-upon method for assessing environmental impact, much depends on researchers’ assumptions.  This literature review was done by a consultant who does research for companies making alternative-to-meat proteins.   His conclusion based on his study—the takeover of small plant-based meat companies by Big Meat is a Good Thing—is predictable from his conflicted interest.  I’d prefer an independent assessment of the environmental implications of these products.

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The advocacy group, U.S. Right to Know, sent out a press release to announce publication of an article in the British journal, Public Health Nutrition: The corporate capture of the nutrition profession in the USA: the case of the Academy of Nutrition and Dietetics.

The Academy of Nutrition and Dietetics [AND, formerly the American Dietetic Association] accepted millions of dollars from food, pharmaceutical and agribusiness companies, had policies to provide favors in return, and invested in ultra-processed food company stocks, according to a study published today in Public Health Nutrition…The study was produced by public health scholars and U.S. Right to Know, a nonprofit investigative public health group that obtained tens of thousands of pages of internal Academy documents through state public records requests.

I’ve been writing about corporate capture of AND (formerly the American Dietetic Association) for years (see below), but this study shocked even me, for two reasons.

• AND holds stock in food companies making ultra-processed foods.

The documents show that the Academy and its foundation invested funds in ultra-processed food companies. The Academy’s investment portfolio in January 2015 included $244,036 in stock holdings in Nestle S.A. and $139,545 in PepsiCo. The Academy foundation’s investment portfolio in June 2013 included $209,472 in stock holdings in Nestle S.A and $125,682 in PepsiCo.

• The list of food companies donating to AND is extraordinarily long; it goes on for pages.

The Academy accepted more than $15 million from corporate and organizational contributors in the years 2011 and 2013-2017. The Academy’s top contributors in 2011 and 2013-2017 were:

• National Dairy Council $1,496,912
• Conagra Inc. $1,414,058
• Abbott Nutrition $1,246,389
• Abbott Laboratories $824,110
• Academy of Nutrition and Dietetics Foundation: $801,261
• PepsiCo Inc. $486,335
• Coca-Cola Co. $477,577
• Hershey Co. $368,032
• General Mills Inc. $309,733
• Agency for Healthcare Research and Quality $296,495
• Aramark Co. $293,051
• Unilever Best Foods $276,791
• Kellogg USA $273,272

The Academy’s response: Inaccuracies in U.S. Right to Know Article

The report is disjointed, mostly opinion, emails taken out of context, picking and choosing items based on words out of Board reports, etc.

The Academy lists facts

• One of the authors has strong financial ties to CrossFit, a staunch opponent to RDN licensure.
• Less than 9% (12 out of 149) of named scholarships, awards and named research grants were established through industry. The funds that are established have input into scholarship criteria, which are approved by the Foundation’s Board. An independent review committee then reviews applications and selects recipients.
• Less than 2% (32 out of 2,812) of donors to the Academy’s Second Century were industry donors.

Additional Academy facts

• Fact: The Academy is NOT influenced by sponsorship money
• Fact: Less than 3% of the Academy’s and the Foundation’s investments are in food companies.
• Fact: The Academy has never changed a position at the request of sponsors.
• Fact: Less than 9% of Academy funding comes from sponsorship.
• Fact: The Foundation’s Fellows program allows participants to serve as catalysts for change and advancement in emerging areas of need for the evolving nutrition and dietetics profession.
• Fact: The Academy and Foundation have always been committed to accountability through transparency and fiduciary responsibility.

Comment

I have been writing about the Academy’s ties with food companies for years.  See, for example,

• March 17, 2008  OK. Time to talk about the American Dietetic Association’s alliances with food companies
• March 13, 2015  Dietitians put seal on Kraft Singles (you can’t make this stuff up)
• March 18, 2015  Dietitians in turmoil over conflicts of interest: it’s about time
• March 1, 2017  The recent Academy of Nutrition and Dietetics’ election: controversy over non-disclosure of industry ties
• September 9, 2020  Dietetic Association lets Bayer, owner of glyphosate, educate its members about pesticides (but see correction below)
• A chapter in my book, Unsavory Truth: How the Food Industry Skews the Science of What We Eat

In my book, I document how food companies exert influence through sponsorship of research and professional societies.  Typically, recipients of industry funding do not recognize the influence of sponsorship and deny it, as we see here.

If AND wants to be taken seriously as an organization devoted to public health, it needs to set strong guidelines for conflicts of interest and adhere to them.  At the moment, this organization gives the appearance of a public relations arm of the food industry.

The same can be said of the American Society of Nutrition, but that’s another story.

Resources

• U.S. Right to Know publishes a fact sheet on AND: available here.
• MedPage: Nutrition Group Has Close Ties to Food, Pharma Companies —
• Washington Post: Group shaping nutrition policy earned millions from junk food makers (I’m quoted in this)

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I haven’t posted anything about pistachio industry conflicts of interest since 2019 so it’s time for another one.

Here’s a press release sent to me by a reader, Matthew Kadey:

NEW STUDY REVEALS PISTACHIOS ARE AN ANTIOXIDANT POWERHOUSE…Antioxidant-rich foods are regularly encouraged as part of a healthy lifestyle, and research suggests that a diet high in antioxidants may even help to reduce the risk of death.¹ While certain fruits and vegetables are often thought of as high-antioxidant foods, a new study conducted by Cornell University and published in the journal, Nutrients, produced surprising results². Pistachios have a very high antioxidant capacity, among the highest when compared to values reported in research of many foods commonly known for their antioxidant capacity, such as blueberries, pomegranates, cherries, and beets.^3,4,5  (I’ve posted the references at the end).

My first question, as always when I see a press release like this: Who paid for it?

The study: uan, Wang, Bisheng Zheng, Tong Li, and Rui Hai Liu. 2022. Quantification of Phytochemicals, Cellular Antioxidant Activities and Antiproliferative Activities of Raw and Roasted American Pistachios (Pistacia vera L). Nutrients 14, no. 15: 3002. https://doi.org/10.3390/nu14153002

Conclusion:  It is shown that the roasting of pistachios could produce a series of beneficial phytochemical changes, leading to enhanced biological activity. Pistachios are a nutrient-dense food containing a unique profile of good-quality protein, fats, minerals, vitamins, and antioxidants, such as carotenoids and polyphenols, with cellular antioxidant activity. Dietary Guidelines for Americans 2020–2025 suggested including nuts as a health dietary pattern. Further research on antiproliferative activity and mechanisms of action of free-form extracts of roasted pistachios, and more biological activities related cellular antioxidant activity and oxidative stress, are worthy of further investigation.

Funding: This study was partially supported by Innovative Leading Talents Project of Guangzhou Development Zone and 111 Project: B17018, Cornell China Center, and American Pistachio Growers: 2021-09.

Conflicts of Interest: The authors declare no conflict of interest.

Comment: Roasted pistachios are healthy?  No surprise here.  Further research needed?  Also no surprise.  This is another example of an industry-funded study with unimpressive results but plenty of interpretation bias, along with the usual contention that industry funding does not induce conflicts of interest.  Alas, it does.

References to the press release paragraph

¹ Jayedi A, Rashidy-Pour A, Parohan M, Zargar MS, Shab-Bidar S. Dietary Antioxidants, Circulating Antioxidant Concentrations, Total Antioxidant Capacity, and Risk of All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Observational Studies. Adv Nutr. 2018 Nov 1;9(6):701-716. doi: 10.1093/advances/nmy040. PMID: 30239557; PMCID: PMC6247336.
² Yuan W, Zheng B, Li T, Liu RH. Quantification of Phytochemicals, Cellular Antioxidant Activities and Antiproliferative Activities of Raw and Roasted American Pistachios (Pistacia vera L.). Nutrients. 2022; 14(15):3002. https://doi.org/10.3390/nu14153002
³ Wolfe KL, et al. Cellular Antioxidant Activity (CAA) Assay for Assessing Antioxidants, Foods, and Dietary Supplements. J Agric. Food Chem. 2007, 55, 8896–8907.
⁴ Song W, et al. Cellular Antioxidant Activity of Common Vegetables. J. Agric. Food Chem. 2010, 58, 6621–6629. DOI:10.1021/jf9035832
⁵ Wolfe, K., Kang, X., He, X., Dong, M., Zhang, Q., and Liu, R.H. Cellular antioxidant activity of common fruits. J. Agric. Food Chem. 56 (18): 8418-8426, 2008.

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