Currently browsing posts about: Conflicts-of-interest

I learned about this study from an article in FoodNavigator.com, “Baobab industry welcomes study linking the fruit to good gut health.”

The title raised the question, “Who funded this?”  Bingo, as it turns out.

Baobabs are enormous African trees that produce a highly fibrous fruit.

I can’t say it looks particularly yummy.  In fact, it is described as “floury, dry, and powdery” and works best as a powdered ingredient.

But the baobab industry?  Who knew such an entity existed?

It does.  Hence this study:

The study: A Pectin-Rich, Baobab Fruit Pulp Powder Exerts Prebiotic Potential on the Human Gut Microbiome In Vitro.  Martin Foltz, Alicia Christin Zahradnik, Pieter Van den Abbeele, Jonas Ghyselinck, Massimo Marzorati.  Microorganisms. 2021 Sep 17;9(9):1981.

Methods: Test tube mixing of baobab powder with colonic bacteria.

Results: Baobab fruit pulp powder boosted colonic acidification across three simulated human adult donors due to the significant stimulation of health-related metabolites.

Conclusions: Overall, Baobab fruit pulp powder fermentation displayed features of selective utilization by host microorganisms and, thus, has promising prebiotic potential.

Funding: The studies described in this manuscript were performed at the request of and were funded by Döhler, 94295 Darmstadt, Germany  Surprise!  This company makes baobab powder.

Conflict of interest:  M.F. and A.C.Z. are employees of Döhler. While M.F. participated in the design of the study, the interpretation of the data, and the revision of the manuscript, M.F. did not participate in the collection and analyses of data.

Comment: No food, product, or ingredient is too obscure to avoid industry attempts to demonstrate that it can be marketed as a “superfood” (see, for example, this product).

Reference: For a summary of research on the “funding effect”—the observation that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests but that recipients of industry funding typically do not recognize its influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Jackfruit?  No, I’m not kidding.

For one thing, it’s JSTOR Daily’s Plant of the Month: “The newly hot alternative to meat has a long history.”

Jackfruit is not new in South Asia and its surrounding regions, where it has been a culturally significant foodstuff for centuries. Nor is jackfruit new in the West. Rather, it has a long and disquieting history: British imperialists wielded jackfruit as a tool to provide cheap nutrition to enslaved and coerced laborers throughout their empire.

Here’s what it looks like on the tree:

And off:

If you are in the business of selling Jackfruit, or products made from it, you will want research demonstrating health benefits.

Voila!

The study: Efficacy of green jackfruit flour as a medical nutrition therapy replacing rice or wheat in patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study  Gopal Rao, K. Sunil Naik, A. G. Unnikrishnan & James Joseph.  Nutrition & Diabetes volume 11, Article number: 18 (2021)

Methods: This was a randomized, double-blind, placebo-controlled study of patients with type-2 diabetes who were being treated with oral antihyperglycemic agents.  They were either given jackfruit flour 30 g/day (Group A) or placebo flour (Group B) for 12 weeks.

Results: Patients from Group A had a better reduction in glycosylated hemoglobin, fasting plasma glucose, and postprandial plasma glucose than patients in Group B.

Conclusion: This study demonstrates the efficacy of jackfruit flour in glycemic control as medical nutrition therapy replacing an equal volume of rice or wheat flour in daily meal.

Funding: Diet Fibre 365 Food Products Pvt Ltd, India.

Acknowledgment: “The authors would like to acknowledge Abiogenesis Clinpharm Pvt Ltd, Hyderabad, for medical writing assistance funded by Diet Fibre 365 Food Products Pvt Ltd, Mumbai, India.”

Competing interests: JJ is the inventor of Jackfruit 365™ Green Jackfruit Flour with a pending patent and CEO of God’s Own Food Solutions Pvt Ltd which along with its subsidiary Diet Fibre 365 Food Products Pvt Ltd manufactures and markets the product. AGR, KSN, and UAG have no conflict of interest to declare.

Comment: This is a classic example of the funding effect in nutrition research.  The author owns the Jackfruit flour and the company that markets it, and the funder wrote (OK, helped to write) the paper.  The results were predictable.

Reference: For a summary of research on the “funding effect”—the observation that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests, but that recipients of industry funding typically do not recognize its influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Thanks to Tufts Professor Sheldon Krimsky for sending me this gem.

Residues of glyphosate in food and dietary exposure.  John L. Vicini,Pamela K. Jensen,Bruce M. Young,John T. Swarthout, Comprehensive Reviews in Food Science and Food Safety.  First published: 16 August 2021.

The study: A review of existing data on amounts of glyphosate residues in foods as compared to maximum limits or tolerances set by European or American regulatory agencies.  The study also reviewed data on levels of glyphosate in urine samples.

Conclusion: “Exposures to glyphosate from food are well below the amount that can be ingested daily over a lifetime with a reasonable certainty of no harm.”

I learned about this one from an article in FoodNavigator: Study: Walnut consumption linked to improved life expectancy

New research from the Harvard T.H. Chan School of Public Health funded by the California Walnut Commission has found a possible link between higher walnut consumption and increase in life expectancy among older US adults.

The article quotes the senior author:

What we’ve learned from this study is that even a few handfuls of walnuts per week may help promote longevity, especially among those whose diet quality isn’t great to begin with. It’s a practical tip that can be feasible for a number of people who are looking to improve their health, which is top of mind for many people.

Washington Post columnist Tamar Haspel tweeted about this study: “I have a pretty big beef with nutritional epidemiology, and there’s a new study on walnuts that pushes all my button[s].”

Her beefs:

• Difficulties interpreting information from food frequency questionnaires
• Complications of correcting for confounding variables (18 in this case)
• Implications of causation (“lots of talk about the cardioprotective aspects of walnuts”)
• The study was not pre-registered
• It was funded by the walnut industry

Her view (with which I concur):

• “Studies like the [sic] have helped create the mess that is nutrition advice”
• “We DO NOT have the tools to assess the health impact of specific foods.”
• “Eat a wide variety of whole-ish foods you enjoy in quantities consistent with the weight you want to be.  Eat walnuts if you like them.”

The study: Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Adults.  Xiaoran Liu, Marta Guasch-Ferré, Deirdre K. Tobias, Yanping Li.

Method: Correlated information on dietary intake of walnuts from two large epidemiological studies  with mortality.

Conclusions: We reported that higher consumption of walnut was associated with a lower risk of all-cause mortality and CVD mortality in two large prospective studies of U.S. elder adults, especially among those with suboptimal dietary quality. We estimated a greater life expectancy at age 60 of 1.3 years in women and 1.26 years in men, among those who consumed walnuts more than 5 servings/week compared to non-consumers.

Conflicts of interest: Li has received research support from California Walnut Commission. The funder has no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review, or in the decision to publish the results. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Comment: In addition to Haspel’s comments, I would add that the statement that the funder had no role is difficult to evaluate.  Industry funders generally do not pay for research likely to come out with results unfavorable to their products and much evidence suggests that influence is exerted at an unconscious level.  I provide evidence for this and other observations about industry “funding effects”—observations that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests but that recipients of industry funding typically do not recognize its influence—in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

I must also point out that walnuts are not the only nuts singled out for specific health benefits.  See, for example, “Pecan-Enriched Diets Alter Cholesterol Profiles and Triglycerides in Adults at Risk for Cardiovascular Disease in a Randomized, Controlled Trial” in a recent issue of the Journal of Nutrition.  Its sponsor was the Georgia Pecan Commission.

The bottom line: eat whatever nuts you like.

The study: Impact of low-fat and full-fat dairy foods on fasting lipid profile and blood pressure: exploratory endpoints of a randomized controlled trial.  Kelsey A Schmidt, et al. The American Journal of Clinical Nutrition, nqab131, https://doi.org/10.1093/ajcn/nqab131.  Published: 13 July 2021

Background: “Dietary guidelines traditionally recommend low-fat dairy because dairy’s high saturated fat content is thought to promote cardiovascular disease (CVD). However, emerging evidence indicates that dairy fat may not negatively impact CVD risk factors when consumed in foods with a complex matrix.”

Method: “Participants were then randomly assigned to 1 of 3 diets, either continuing the limited-dairy diet or switching to a diet containing 3.3 servings/d of either low-fat or full-fat milk, yogurt, and cheese for 12 wk.”

Conclusions: “In men and women with metabolic syndrome, a diet rich in full-fat dairy had no effects on fasting lipid profile or blood pressure compared with diets limited in dairy or rich in low-fat dairy. Therefore, dairy fat, when consumed as part of complex whole foods, does not adversely impact these classic CVD risk factors.”

Funding: “National Dairy Council, Dairy Farmers of Canada, Dutch Dairy Association (Nederlandse Zuivel Organisatie), Dairy Australia, and the French Dairy Interbranch Organization (CNIEL),” and NIH and others.

Conflict of interest: “This study was initiated by the principal investigator (MK). The dairy-related funding organizations suggested changes to details of the study design prior to the conduct of the study, some of which were implemented. Otherwise, the funding organizations had no impact on the design or conduct of the trial or the analysis and interpretation of study data.”

Comment: Let’s give these investigators high marks for disclosing that the dairy funders influenced the design of the study, which, as we know from the data of Lisa Bero and her colleagues, is the place where biases caused by industry funding most typically show up.  Food companies that fund research are looking for benefits; they won’t risk study designs that might yield inconvenient results.

Reference: For a summary of research on the “funding effect”—the observations that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests and that recipients of industry funding typically did not intend to be influenced and do not recognize the influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

One Potato

Thanks to David Ludwig for alerting me to an e-mail from the Alliance for Potato Research & Education (APRE), a trade association “dedicated to advancing the scientific understanding of the role potatoes play in promoting the health of all people.”

A new APRE-funded study published in Nutrients investigated the effect of increased dietary potassium from a whole food source – baked/boiled potatoes and baked French fries – or a potassium supplement on blood pressure and other cardiovascular disease risk factors compared to a ‘typical American’ control diet (lower potassium intake) among 30 pre-hypertensive-to-hypertensive men and women.

Results showed that baked/boiled potato consumption had the greatest benefit on reducing sodium retention, even more than the supplement, and resulted in a greater reduction in systolic blood pressure (SBP) compared to the control diet.

Further, despite commonly held misbeliefs about French fries and their role in heart-healthy lifestyles, the authors observed that a 330-calorie serving of baked French fries, when eaten as part of a ‘typical American’ diet, had no adverse effect on blood pressure or blood vessel function.

The study concludes:

This was the first controlled feeding study of potassium from food and supplements on BP and CVD outcomes in an unhealthy population…Of public health relevance is our observation that French fries in amounts typical of a large serving in a fast food restaurant has no adverse effect on blood pressure or endothelial function.

It discloses the funding source: “This research was funded by Alliance for Potato Research and Education.”

Comment: Because some (but not all) observational studies have linked potatoes, and especially French fries, to poor health outcomes, the potato industry wants research to give these foods a healthier image.  This study says that potatoes are high in potassium and a high potassium-to-sodium ratio is good for blood pressure and heart disease.  I could have told them that on the basis of food composition data alone: 100 grams of French fries contains 435 mg potassium versus 295 of sodium.  Does that make French fries a health food?  No, alas, it does not.

Once more for the record: industry-funded research is about marketing, not public health.

Two Potato

Last week, I received an emailed notification from APRE, the Alliance for Potato Research & Education announcing a new study.

For decades, people have often associated higher intakes of carbohydrate-containing foods with less healthy lifestyles. Yet, evidence suggests this view is overly simplistic, and it is instead the type and quality of carbohydrate foods that matter most for supporting health…In a newly published perspective in Nutrients, a group of nutrition researchers, who collectively make up the Quality Carbohydrate Coalition-Scientific Advisory Council (QCC-SAC), outline the opportunity for a stronger, more evidence-based approach to defining quality carbohydrate foods to support overall health and provide clearer dietary guidance.

The study: Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report.  Kevin B. Comerford, Yanni Papanikolaou,  Julie Miller Jones, Judith Rodriguez. Joanne Slavin,  Siddhartha Angadi.  and Adam Drewnowski.  Nutrients2021, 13(8), 2667.

Conclusion: The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans. 

Thanks to Frank Lindner for sending this study.  He is a campaigner for foodwatch Nederland, which among other campaigns, runs Stop the sale of science for better transparency in science.

He says this Tweet made him curious:

He followed up and found the study: The place of animal products in a sustainable diet.  Authors: Stephen Peters, Jolande Valkenburg, Thom Huppertz, Luuk Blom, Lionel van Est. Norwegian Journal of Nutrition, Nr. 2 – June 2021.

The study begins with this premise:

Replacing animal-based foods with plant-based foods does not necessarily lower the diets [sic] carbon footprint.

Why?

In an average Dutch person’s diet, animal products are an important source of protein, minerals and vitamins…Animal products contribute significantly to the intake of important nutrients, such as high-quality protein, vitamins A, B2 and B12, calcium, magnesium, zinc and (in the case of meat) heme iron. These nutrients are not naturally, or often, found in plant products. Omitting animal products from the diet therefore can have major consequences for nutrient intake.

Lindner wrote that “I read the article and my jaw fell wide open at the very end….”

Funding: The research has been sponsored by the Dutch Dairy Association.

Conflicts of interest: Dr. Peters is a employed by the Dutch Dairy Association as manager of dairy health and sustainability. Dr. Huppertz is employed by FrieslandCampina, The Netherlands and is a professor of Dairy Science at Wageningen University and Research, The Netherlands, Distinguished Visiting Professor at Victoria University, Australia and Editor-in-Chief of International Dairy Journal. Dr. Bloom and Dr. van Est are the founders of Nutrisoft. A (commercial) company that combines the knowledge of nutrition and ICT.

Comment: FrieslandCampina is a large dairy cooperative operating in 38 countries and employing nearly 24,000 people.   It sponsors research at Wageningen University.

Milk and dairy may be at the heart of what we do, but at FrieslandCampina, we make more than just cheese and yogurt. We also produce dairy nutrition for specific groups of consumers, such as toddlers or adults with specific requirements.

Lindner was surprised by the disclosures and said “At least they are open and honest about it (they don’t even bother to hide it).”  He should not be surprised.  Industry-funded studies almost always produce results favorable to the sponsors’ interests.  That is one reason why journals require authors to disclose financial relationships with sponsors.

Here, the interests are obvious.  It is very much in the economic interests of dairy companies to demonstrate the nutritional superiority of dairy products over plant-based alternatives.

Reference: For a summary of research on the “funding effect”—the observations that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests and that recipients of industry funding typically did not intend to be influenced and do not recognize the influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

So many readers have asked me to comment on the recent study comparing the nutrient content of meat versus plant-based alternatives that I thought I better get to it.

For example, Andrew Wilder of eatingrules.com writes:

They conclude that there are nutritional differences…My first thought was “Duh!”… so I started wondering why they would even do this study…Surprise surprise, two of the authors have connections to the beef industry.  I also thought it was interesting that in the Abstract, they say “This has raised questions of whether plant‑based meat alternatives represent proper nutritional replacements to animal meat.” So they’re framing everything with the baseline that animal meat is “proper nutrition” which seems like a pretty obvious bias right out of the gate…

Indeed it does.  But the study is a bit more complicated than that, and definitely worth a look.

The study: A metabolomics comparison of plant‑based meat and grass‑fed meat indicates large nutritional differences despite comparable Nutrition Facts panels. Stephan van Vliet, James R. Bain Michael J. Muehlbauer, Frederick D. Provenza, Scott L. Kronberg, Carl F. Pieper & Kim M. Huffman. Nature Scientific Reports (2021) 11:13828.

The research question: Do plant‑based meat alternatives represent proper nutritional replacements to animal meat?

The method: The study compared 190 metabolites (chemical compounds capable of being used by the body) in meat and plant-based alternatives.

Result: Big differences.

Conclusion:  “In conclusion, metabolomics revealed that abundance of 171 out of 190 profiled metabolites differed between beef and a commercially-available plant-based meat alternative, despite comparable Nutrition Facts panels. Amongst identified metabolites were various nutrients (amino acids, phenols, vitamins, unsaturated fatty acids, and dipeptides) with potentially important physiological, anti-inflammatory, and/or immunomodulatory roles—many of which remained absent in the plant-based meat alternative when compared to beef and vice versa. Our data indicates that these products should not be viewed as nutritionally interchangeable, but could be viewed as complementary in terms of provided nutrients. It cannot be determined from our data if either source is healthier to consume [my emphasis].”

Competing interests: “S.V.V. reports a grant from the North Dakota Beef Association to study the impact of diet quality on the relationship between red meat and human health. S.V.V reports additional grant support from USDA-NIFA-SARE (LS21-357), the Turner Institute of Ecoagriculture, and the Dixon Foundation for projects that link agricultural production systems to the nutritional/metabolite composition of foods and human health. S.V.V also reports having received honoria [sic] for talks linking food production systems to human health, which was used to support scientific research. F.D.P. reports receiving honoraria for his talks about behavior-based management of livestock. J.R.B., M.J.M., S.L.K., C.F.P., and K.M.H report no conflicts. S.V.V., J.R.B., M.J.M., F.D.P., S.L.K., and C.F.P. consume omnivorous diets; K.M.H. consumes a vegetarian diet.”

Comment: To the question of nutritional differences, duh, indeed.  Why would anyone not expect nutritional differences?  From the abstract and conclusion, the study appears to suggest that meat is nutritionally better.

But then, the authors throw in those hedge-betting comments.

Really?   If they can’t figure out which is better, why do this study?

Andrew Wilder’s analysis and mine too: the underlying purpose of this study is to demonstrate the nutritional superiority of meat and the lack of equivalence of plant-based substitutes.

As for the conflicted interests: My first reaction to seeing this study was to ask: “Who paid for this?”

But the reported conflicts are somewhat confusing.  The lead author has meat-industry funding to do studies of this type.  But most of the other authors report no conflicts, and one is a vegetarian.

Maybe the vegetarian was responsible for the hedging comments?