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!