Sugar Industry Minimized Heart Risks From Sugar And Promoted The Risks Of Fat: Study

(Reuters Health) – In the 1960s, before conflict of interest disclosure was required, the sugar industry sponsored research promoting dietary fat as a major cause of coronary heart disease and downplaying the role of sugar , according to a special report published in JAMA Internal Medicine. .

A file photo of a sugar jar taken on March 11, 2015. REUTERS / Lucas Jackson / Illustration / Files

A 1967 literature review in the New England Journal of Medicine indicated that fat and cholesterol were the dietary culprits of heart disease, ignoring evidence from the 1950s that sugar was also linked to heart disease. According to the new report, the NEJM review was sponsored by the Sugar Research Foundation (SRF), which is now the Sugar Association, although its role was not disclosed at the time.

In the report, Laura A. Schmidt of the University of California, San Francisco and colleagues point out that Harvard professor of nutrition Dr. Mark Hegsted co-led the first SRF heart disease research project. from 1965 to 1966. Schmidt and his colleagues say that communications between SRF, Hegsted and another professor, Roger Adams, uncovered in the records of the University of Illinois and the Harvard Medical Library, reveal that the foundation has set the objective of the literature review, funded it and revised drafts of the manuscript.

“I thought I saw it all, but this one blew me away,” said Marion Nestlé of New York University, who wrote an op-ed on the new findings. “It was so blatant. And the “bribe” was so important. “

“Funding for research is ethical,” Nestlé told Reuters Health by email. “Bribing researchers to produce the evidence you want isn’t. “

Researchers also reviewed the symposium proceedings and historical reports. In 1954, they say, the president of the Henry Haas Foundation gave a speech highlighting the potential to reduce American fat intake and recover those calories as carbohydrates, which would increase per capita sugar consumption by more. a third.

In 1962, a nutrition report from the American Medical Association indicated that diets low in fat and high in sugar may actually encourage the development of cholesterol. Two years later, according to the new report, SRF vice president John Hickson proposed that the SRF embark on a major program to counter “negative attitudes towards sugar.”

Increasingly, epidemiological reports suggest that blood sugar, rather than blood cholesterol or high blood pressure, was a better predictor of plaque buildup in the arteries. Two days after the New York Herald Tribune published a full-page article on the sugar link in July 1965, the SRF approved “Project 226,” a review of the cholesterol metabolism literature led by Hegsted and, among others, Fredrick Stare, another Harvard Nutritionist with financial ties to the industry. The authors of Project 226 ultimately received $ 6,500, or $ 48,900 in 2016 dollars, from the SRF, according to the report.

Nine months later, write Schmidt and his colleagues, Hegsted explained that the project had been delayed to continually rewrite the rebuttals to new evidence linking sugar to heart disease that had been published in the meantime.

In September 1966, according to the report, Hickson was requesting additional drafts of the literature review from Harvard researchers, although there is no direct evidence that the Foundation commented or edited the drafts. On November 2, Hickson had approved the latest draft as “quite what we had in mind.” The two-part review, concluding that the only change needed to prevent heart disease was to reduce dietary fat intake, was published in the NEJM the following year, with no mention of SRF involvement or funding. .

The newspaper did not require disclosure of conflicts of interest until 1984.

The Sugar Association paid top Harvard scientists to publish a journal focusing on saturated fat and cholesterol as the leading causes of heart disease as studies were starting to pile up indicating that sugar was a risk factor for heart disease, ”Schmidt told Reuters. Health by phone. “This has an impact on the entire research community and on its direction. “

“For example, a lot of the heart disease prevention posts during this time focused on why you don’t use margarine instead of butter, which has less saturated fat,” Schmidt said. Now we know that margarine is full of trans fat, which causes heart disease and has been nearly wiped out from the American food supply.

In the United States, about 610,000 people die of heart disease each year, according to the Atlanta Centers for Disease Control and Prevention, making heart disease the leading killer of both men and women. Risk factors include being overweight or obese as well as diabetes, all of which are made worse by too much sugar.

“When the manufacturers took the fat out, they added the sugar,” Schmidt said. “We’ve really wasted a lot of time assessing the impact of sugar on coronary heart disease,” but the real impact on public health over the past five decades is impossible to measure.

Large amounts of sugar and saturated fat are both detrimental to health, and their effects are difficult to separate, Nestlé said, but it seems reasonable to keep sugar intake at around 10 percent of daily calories.

Today, industry money still funds a lot of scientific research, but more journals and scientists are disclosing these sources of funding, Schmidt said.

“We recognize 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, ”the Sugar Association told Reuters Health in a statement. “Beyond that, it is difficult for us to comment on events that would have happened 60 years ago and documents that we have never seen.”

“The Sugar Association is always working to better understand the role of sugar and health, but we rely on good science and facts to drive our claims,” ​​the statement said.

SOURCE: JAMA Internal Medicine, online September 12, 2016.

Rachel J. Bradford