Previously I had presented information demonstrating how sugar has negative health consequences, often denied—for obvious reasons—by the sugar industry.

Now it has been brought to light how the sugar industry paid for and was closely involved in development of an influential literature review, published by the New England Journal of Medicine in 1967, that downplayed dietary sugar’s links to coronary heart disease while pointing the finger at fat and cholesterol intake, according to a report published September 12, 2016 in JAMA Internal Medicine.

The sugar industry’s funding and other participation were not disclosed in the 1967 articles, which had a major influence on dietary recommendations for sugar in the following decades, notes Dr C. E Kearns (University of California, San Francisco).

The literature review from almost 50 years ago—when conflicts of interest were not required—served as a lobbying tool for the industry and likely influenced the first dietary guidelines of the 1980s. It put the focus on dietary cholesterol and deflected sugar intake as a risk factor for heart disease. If the evidence had been fairly presented, the recommendations would have been to reduce both fat and sugar, not just saturated fat. Even today, the sugar industry, led by the Sugar Association, the industry’s Washington, DC–based trade association, steadfastly denies that there is a relationship between added sugar consumption and cardiovascular disease risk.

The present group (Kearns) analyzed previous internal documents from the Sugar Research Foundation (SRF), the precursor to the Sugar Association, that had become available in academic libraries and other publicly accessible locations. They also reviewed historical reports and statements made in early debates about health effects of sugar. According to those documents, the SRF set the journal’s review’s objective, contributed articles for inclusion, and received drafts. Kearns and colleagues describe finding documentation that the SRF paid two nutrition researchers, Dr D Mark Hegsted and Dr Robert McGandy (Harvard School of Public Health, Boston, MA), to conduct the literature review; the payments amounted to about $48,900 in 2016 dollars.

Also among the evidence of influence, they write, is correspondence from July 30, 1965, to Hegsted from SRF vice president John Hickson. In it, they report, Hickson emphasized the SRF’s objective for funding the review: “Our particular interest had to do with that part of nutrition in which there are claims that carbohydrates in the form of sucrose (table sugar) make an inordinate contribution to the metabolic condition, hitherto ascribed to aberrations called fat metabolism. I will be disappointed if this aspect is drowned out in a cascade of review and general interpretation.” Hegsted, the current report states, responded “We are well aware of your particular interest in carbohydrate and will cover this as well as we can”.

The Sugar Association responded to the recent report from Kearns and colleagues on September 12, 2016 with a statement: “We acknowledge that the Sugar Research Foundation should have exercised greater transparency in all of its research activities; however, when the studies in question were published, funding disclosures and transparency standards were not the norm they are today. Beyond this, it is challenging for us to comment on events that allegedly occurred 50 years ago and on documents we have never seen.”

I believe that Kearns and colleagues have found the “smoking gun,” having produced compelling evidence that a sugar trade association not only paid for but also initiated and influenced research expressly to exonerate sugar as a major risk factor for coronary heart disease.

The consequences of this deception are deeply disturbing.

First–and most obvious–is the misdirection of subsequent research and government efforts to improve heart health. Thanks largely to the reputation of Harvard and its research faculty, the publications sent other medical researchers down different paths, and retarded accurate evaluation of the role sugar plays in heart disease. These, and similar, research reports led to the belief that fat, not sugar, was the culprit, and Americans went on a low-and-no fat binge. What was particularly pernicious about the hundreds of new products designed to meet the goal of lowering fat content was the food industry’s preferred method of making low-fat offerings taste good: the addition of sugar—lots of sugar.

The discovery of the sugar industry’s role in twisting nutritional research results joins what we now know about the similar machinations of cigarette companies and fossil fuel industries.

Unfortunately, this type of subterfuge gives science itself a black eye. In the long-run, however, science is usually a self-correcting process, as evidenced by the recent investigation. But I must admit, 50 years is far too long!


Sugary Drinks and Increased Risk of Cardiovascular Disease



American adults who drink one (or more) sugary drinks a day have a 27% greater increase in abdominal fat tissue compared with Americans who don’t, according to a new data analysis from the Framingham Heart Study in the journal Circulation.

Deposition of fat in this location is associated with the development of cardiovascular disease and type 2 diabetes, both of which produce adverse health consequences.

Although the exact biological mechanism is unknown, added sugars—especially fructose—may trigger insulin resistance and increase fat accumulation, which raises the risks for these serious consequences.

In this investigation, researchers enrolled 1,003 participants (mean age 45) from the Framingham Study’s Third Generation cohort and measured their quantity and quality of abdominal fat tissue at baseline and again 6 years later using C.A.T. scans. Subjects also reported their sugar-sweetened beverage and diet soda intake on a food frequency questionnaire.

Over a 6-year follow-up period—and after adjusting for participants’ age, gender, physical activity, body mass index, and other factors—abdominal fat tissue volume increased by:

  • 658 cm3 for non-drinkers and occasional drinkers (once a month or less than once a week)
  • 707 cm3 for frequent drinkers (once a week or less than once a day)
  • 852 cm3 for those who drank at least 1 beverage daily

The researchers concluded that, although age alone accounts for increasing fat, drinking sugar-sweetened beverages led to a significantly greater increase in abdominal fat tissue. In contrast, they observed no such association with drinking diet soda. Needless to say, observation of general dietary guidelines is also required to minimize accumulation of excess fat.

As a result, the researchers urged all people to be mindful of how many sugar-sweetened beverages they drink. To policy makers, this study adds more evidence to the growing body of research suggesting sugar-sweetened beverages may be harmful to health, providing arguments for public efforts to restrict such consumption.

Sugar-sweetened beverages are the largest contributor of added sugar intake in the United States. In 2001 to 2004, the usual intake of added sugars for Americans was 22.2 teaspoons per day, or an extra 355 calories. The American Heart Association recommends a limit of 100 calories per day of added sugars for most women and 150 calories per day for most men.

This information simply adds more support to the idea that sugar, in itself, is a dangerous dietary component. I will disclose more about this in the next blog.




Despite all the issues raised during this election season, arguably the two most important challenges faced by humanity are nutrition and global warming, neither of which seems to be gaining sufficient attention, especially the former.

In this discussion, I will address the issue of nutrition.

Poor nutrition is the leading cause of poor health in the U.S. and globally, casing more deaths and disability than any other factor, being the number one cause of illness. Nevertheless, it is largely ignored by the political system. Our food procurement is also the leading cause of environmental impact on the planet. Food production accounts for 70% of water use, 90% of tropical deforestation, immense challenges to the oceans and fish stock, and as much greenhouse gas emissions as all of the world’s transportation—cars buses, planes, trains and ships—combined. Food production is the crucial cause for either harm or positive change, requiring secure sustainable systems for us, and especially, our future generations.

To gain some perspective, we spend $3 trillion each year on U.S. health care—five times more than all our military spending, and nearly one in five dollars of the entire U.S. economy. Despite this emphasis on health care, which certainly could be improved and made more cost efficient, the only real way to reduce the hundreds of billions of dollars we spend each year on preventable and curable diseases is through better lifestyle in the population, especially better dietary habits. Just the cost of diabetes alone, which is largely preventable though better lifestyle, amounts to about $322 billion yearly. If we add the costs of other diet-related diseases, such as heart disease, obesity and its consequences, cognitive decline, and several cancers, we reach approximately $1 trillion annually. These stark facts alone should trigger major bipartisan political efforts, something akin to our past moon and present cancer efforts.

As a societal issue, our food system contributes to harsh inequities. Those with lower incomes and less political clout often have the worst diets, leading to a vicious cycle of poor health, lower productivity, increased health costs, and sustained poverty.  These disadvantages usually start with kids, resulting in poor health in general with associated poor concentration and school performances.

Thus food strongly influences disease, the environment, the economy, and social justice. Despite these profound effects, however, as the current elections unfold, we see little attention devoted to the effects of preventable diseases and their spending implications. These considerations should thrust our food system into a leading role among politicians, media and candidates for office, but they do not. Candidates for office should be familiar with nutrition’s central role in the current and future success or our nation, and the voters must demand to know where they stand on these issues. The electorate must be informed enough to ask the right questions and cast their votes appropriately.

In the near future we need another White House Conference on Nutrition. The only previous conference of the nature was in 1969—47 years ago—which established important advances such as improved programs for school lunch, child nutrition, nutrition education, greater access to food assistance for women, and children, consumer protection and information, and others. In these intervening 50 years, our food system has changed considerably. A new emphasis on food and nutrition is essential, including for health, hunger, medical care, jobs, the economy, and sustainability. For instance, genetic modification of food sources offers—despite widespread misunderstanding—the opportunity for increased worldwide production with reduced adverse environmental impact and less need for potentially toxic insecticides, as we explained previously ( Other advances in nutrition science have us poised to deliver major breakthroughs toward a healthier and more prosperous nation. But first we must have the conversation, and as we enter the final phase of the 2016 elections, it’s time for food to be subject of major conversation. If we ask the right questions and elect our leaders wisely, we can bring together modern science and the public to a position to achieve real change.