How the Sugar Industry Shifted Blame to Fat
By ANAHAD O’CONNOR
September 12, 2016
The sugar
industry paid scientists in the 1960s to play down the link between sugar and
heart disease and promote saturated fat as the culprit instead, newly released
historical documents show.
The
internal sugar industry documents, recently discovered by a researcher at the
University of California, San Francisco, and published Monday in JAMA
Internal Medicine, suggest that five decades of research into the
role of nutrition and heart disease, including many of today’s dietary
recommendations, may have been largely shaped by the sugar industry.
“They
were able to derail the discussion about sugar for decades,” said Stanton
Glantz, a professor of medicine at U.C.S.F. and an author of the JAMA Internal
Medicine paper.
The
documents show that a trade group called the Sugar Research Foundation, known
today as the Sugar Association, paid three Harvard scientists the equivalent of
about $50,000 in today’s dollars to publish a 1967 review of research on sugar,
fat and heart disease. The studies used in the review were handpicked by the
sugar group, and the article, which was
published in the prestigious New England Journal of Medicine, minimized the
link between sugar and heart health and cast aspersions on the role of
saturated fat.
Even
though the influence-peddling revealed in the documents dates back nearly 50
years, more recent reports show that the food industry has continued to
influence nutrition science.
Last
year, an article in The New York
Times revealed that Coca-Cola, the world’s largest producer of
sugary beverages, had provided millions of dollars in funding to researchers
who sought to play down the link between sugary drinks and obesity. In June, The Associated Press reported
that candy makers were funding studies that claimed that children who eat candy
tend to weigh less than those who do not.
The
Harvard scientists and the sugar executives with whom they collaborated are no
longer alive. One of the scientists who was paid by the sugar industry was D.
Mark Hegsted, who went on to become the head of nutrition at the United States
Department of Agriculture, where in 1977 he helped draft the forerunner to the
federal government’s dietary guidelines. Another was Dr. Fredrick J. Stare, the
chairman of Harvard’s nutrition department.
In a
statement responding to the JAMA journal report, the Sugar Association said
that the 1967 review was published at a time when medical journals did not
typically require researchers to disclose funding sources. The New England
Journal of Medicine did not begin to require financial disclosures until 1984.
The
industry “should have exercised greater transparency in all of its research
activities,” the Sugar Association statement said. Even so, it defended
industry-funded research as playing an important and informative role in
scientific debate. It said that several decades of research had concluded that
sugar “does not have a unique role in heart disease.”
The
revelations are important because the debate about the relative harms of sugar
and saturated fat continues today, Dr. Glantz said. For many decades, health
officials encouraged Americans to reduce their fat intake, which led many
people to consume low-fat, high-sugar foods that some experts now blame for
fueling the obesity crisis.
“It was a
very smart thing the sugar industry did, because review papers, especially if
you get them published in a very prominent journal, tend to shape the overall
scientific discussion,” he said.
Dr.
Hegsted used his research to influence the government’s dietary
recommendations, which emphasized saturated fat as a driver of heart disease
while largely characterizing sugar as empty calories linked to tooth decay. Today, the saturated fat warnings
remain a cornerstone of the government’s dietary guidelines, though in recent
years the American Heart Association, the World Health Organization and other
health authorities have also begun to warn that too much added sugar may
increase cardiovascular disease risk.
Marion
Nestle, a professor of nutrition, food studies and public health at New York
University, wrote an editorial accompanying the new
paper in which she said the documents provided “compelling evidence”
that the sugar industry had initiated research “expressly to exonerate sugar as
a major risk factor for coronary heart disease.”
“I think
it’s appalling,” she said. “You just never see examples that are this blatant.”
Dr.
Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan
School of Public Health, said that academic conflict-of-interest rules had
changed significantly since the 1960s, but that the industry papers were a
reminder of “why research should be supported by public funding rather than
depending on industry funding.”
Dr.
Willett said the researchers had limited data to assess the relative risks of
sugar and fat. “Given the data that we have today, we have shown the refined carbohydrates and especially sugar-sweetened
beverages are risk factors for cardiovascular disease, but that the type of
dietary fat is also very important,” he said.
The JAMA
Internal Medicine paper relied on thousands of pages of correspondence and
other documents that Cristin E. Kearns, a postdoctoral fellow at U.C.S.F.,
discovered in archives at Harvard, the University of Illinois and other
libraries.
The
documents show that in 1964, John Hickson, a top sugar industry executive,
discussed a plan with others in the industry to shift public opinion “through
our research and information and legislative programs.”
At the
time, studies had begun pointing to a relationship between high-sugar diets and
the country’s high rates of heart disease. At the same time, other scientists,
including the prominent Minnesota physiologist Ancel Keys, were investigating a
competing theory that it was saturated fat and dietary cholesterol that posed the biggest risk for heart
disease.
Mr. Hickson
proposed countering the alarming findings on sugar with industry-funded
research. “Then we can publish the data and refute our detractors,” he wrote.
In 1965,
Mr. Hickson enlisted the Harvard researchers to write a review that would
debunk the anti-sugar studies. He paid them a total of $6,500, the equivalent
of $49,000 today. Mr. Hickson selected the papers for them to review and made
it clear he wanted the result to favor sugar.
Harvard’s
Dr. Hegsted reassured the sugar executives. “We are well aware of your
particular interest,” he wrote, “and will cover this as well as we can.”
As they
worked on their review, the Harvard researchers shared and discussed early
drafts with Mr. Hickson, who responded that he was pleased with what they were
writing. The Harvard scientists had dismissed the data on sugar as weak and
given far more credence to the data implicating saturated fat.
“Let me
assure you this is quite what we had in mind, and we look forward to its
appearance in print,” Mr. Hickson wrote.
After the
review was published, the debate about sugar and heart disease died down, while
low-fat diets gained the endorsement of many health authorities, Dr. Glantz
said.
“By
today’s standards, they behaved very badly,” he said.
