Historical analysis examines sugar industry’s role in heart disease research

Using archival documents, a new report published online by JAMA internal medicine examines the sugar industry’s role in coronary heart disease research and suggests that industry-sponsored research influences scientific debate to cast doubt on the dangers of sugar and promote dietary fat as the culprit of heart disease .

Stanton A. Glantz, Ph.D., of the University of California, San Francisco, and his co-authors reviewed internal documents from the Sugar Research Foundation (SRF), which later evolved into the Sugar Association, historical reports and other documents to create a timeline. case study. The documents included correspondence between SRF and a Harvard University nutrition professor who was co-director of SRF’s first coronary heart disease research program in the 1960s.

The SRF initiated research on coronary heart disease in 1965 and its first project was a literature review published in the New England Journal of Medicine in 1967. The review focused on fat and cholesterol as dietary causes of coronary heart disease and downplayed sugar intake as a risk factor. The SRF set the journal’s purpose, contributed to the inclusion of articles and received drafts, while funding and the role of the SRF were not disclosed, according to the article.

“This landmark account of industry efforts demonstrates the importance of having reviews written by individuals without conflicts of interest and the need for financial disclosure,” note the authors, who point out that the NEJM requires authors that they disclose all conflicts of interest since 1984. there is also no direct evidence that the sugar industry wrote or modified the NEJM review manuscript and evidence that the industry shaped its conclusions is circumstantial, acknowledge the authors.

The limitations of the article include the fact that the articles and documents used in the research provide only a small overview of the activities of a commercial group in the sugar industry. The authors did not analyze the role of other organizations, nutrition leaders or food industries. The key characters of the historical episode detailed in this article could not be interviewed because they died.

“This study suggests that the sugar industry sponsored its first CHD [coronary heart disease] research project in 1965 to downplay the warning signs that sucrose consumption was a risk factor for coronary heart disease. Since 2016, sugar control policies have been enacted in international, federal, state and local bodies. Yet the risk of coronary artery disease is inconsistently cited as a health consequence of consuming added sugars. Since coronary artery disease is the leading cause of death worldwide, the health community should ensure that the risk of coronary artery disease is assessed in future risk assessments of added sugars. Policy-making committees should consider giving less weight to studies funded by the food industry and include mechanistic and animal studies as well as studies evaluating the effect of added sugars on several coronary biomarkers and disease development. », concludes the article.

Commentary: Funding of nutrition research by the food industry

“This 50-year-old incident may seem like ancient history, but it is very relevant, not least because it answers some questions about our current times. … The authors have given back to the community nutritional science a great public service by bringing May it serve as a warning not only to policy makers, but also to researchers, clinicians, peer reviewers, journal editors and journalists about the need to consider harm to the scientific credibility and public health when dealing with studies funded by food companies with vested interests in the results – and to find better ways to fund such studies and to prevent, disclose and manage potentially conflicting interests,” writes Marion Nestle, Ph.D., MPH, of New York University, in a related comment.

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Rachel J. Bradford