Not so sweet: Newly discovered documents reveal sugar industry’s role in shaping dietary advice

By the mid-1960s, scientists had identified sugar and saturated fat as potential dietary risk factors for heart disease and premature death.

In 1980, however – the year the first “Dietary Guidelines for Americans” were published – the role of sugar in heart disease was ignored. Health officials had focused almost exclusively on getting people to reduce their intake of dietary fat.

Today, the link between high sugar consumption and heart disease is widely, but not universally, recognized. Most major health organizations, including the American Heart Association, warn against excessive sweetener consumption.

So what happened between 1965 and 1980? Why did the worry about sugar suddenly disappear?

A disturbing discovery

A newly discovered set of documents provides a startling and disturbing answer. They show that beginning in 1965, a sugar industry trade group paid off three influential nutrition professors at Harvard to downplay the association between sugar and heart disease.

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The first effort of this group was a major literature review, published in two parts in the New England Journal of Medicine (NEJM) in 1967. In this review, Harvard professors apparently chose the research to not only under- estimate the role of sugar. in the development of heart disease, but also to exaggerate the role of fat.

Because the review came from such eminent researchers, it has helped shape dietary recommendations for decades — and with devastating results. In fact, many health officials and others believe that downplaying the unhealthy role of sugar in the diet has been a major factor in the epidemics of obesity and diabetes.

The Harvard researchers’ financial ties to the Sugar Research Foundation, now known as the Sugar Association, were not disclosed in the NEJM article. This newspaper did not require such disclosures until 1984.

Researchers from the University of California, San Francisco reported on the uncovered documents in an article published Monday in JAMA Internal Medicine.

More public relations than science

The Harvard professors who wrote the NEJM literature review in 1967 were Frederick Stare, chairman of the Department of Nutrition at the Harvard School of Public Health, and two of his colleagues in the department, David Mark Hegsted and Robert McGandy. Hegsted then became chief of nutrition at the United States Department of Agriculture.

All three men died and were therefore not interviewed by the authors of the JAMA Internal Medicine article. Its authors also point out that there is no direct evidence in the newly discovered documents that sugar industry officials wrote or modified the Harvard professors’ NEJM manuscript.

Still, “the documents leave no doubt that the intent of the industry-funded review was to reach an early conclusion,” writes Marion Nestle, professor of nutrition and food science at the University of New York, in a comment that accompanies the article. “The investigators knew what the funder wanted and produced it. It’s unclear if they did this deliberately, unknowingly, or because they honestly believed that saturated fat was the biggest threat. But science isn’t supposed to work that way. The papers make this review seem more about PR than science.

A persistent problem

This disturbing 50-year-old incident is relevant today, Nestlé argues, as it provides even more evidence of how food companies have manipulated research over the years to favor their products.

“And the practice continues,” she wrote. “In 2015, The New York Times received emails revealing Coca-Cola’s intimate relationship with sponsored researchers who were conducting studies aimed at downplaying the effects of sugary drinks on obesity. Even more recently, The Associated Press obtained emails showing how a candy trade association funded and influenced studies to show that children who eat candy have healthier body weights than those who don’t.

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“Today, it’s almost impossible to keep up with the range of food companies sponsoring research – from makers of the most highly processed foods, beverages and supplements to producers of dairy, meats, fruits and nuts – generally yielding results favorable to the interests of the sponsor,” adds Nestlé.

A need for more skepticism

USCF researchers urge health officials to be wary of industry-funded studies and ensure that heart disease risk is included in all future risk assessments of added sugars in the diet.

“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 heart disease] biomarkers and disease development,” they conclude.

“These authors have done the nutritional science community a great public service by bringing this historic example to light,” writes Nestlé. “May it serve as a warning not only to policy makers, but also to researchers, clinicians, peer reviewers, journal editors and journalists of the need to consider the harm to scientific credibility and public health when These are studies funded by grandfathered food companies. interests in the results – and to find better ways to fund these studies and to prevent, disclose and manage potentially conflicting interests.

IMF: You can find summaries of the USCF article and Nestlé’s commentary on the JAMA Internal Medicine website, but unfortunately the full articles are behind a paywall.

Rachel J. Bradford