More Sugar Industry Expose

Sugar Papers Reveal Industry Role in Shifting Focus from Heart Disease to Saturated Fat

By Sugar Editor

It all started with a secret PR campaign dating back to the 1970s. For forty years, the Sugar Association, key trade group for sugar producers, deflected all threats to its multi-billion dollar empire, while sweetening the world’s food supply. As obesity, diabetes, and heart disease rates skyrocket, doctors are now treating the first generation of children suffering from fatty liver disease. The sugar industry is once again under siege.

When the doors closed at the Great Western Sugar Company in Colorado in 1976, someone forgot to sweep the floor. Gathering dust in the archives were 1500 pages of internal documents exposing how the Sugar Industry used Tobacco-style tactics to dismiss troubling health claims against their products. Denver dentist turned postdoctoral scholar at the UCSF School of Medicine, Cristin Kearns, knew she’d stumbled on something big: the industry’s secret playbook. Her story is vividly captured in the Canadian documentary, Sugarcoated, now available on Netflix.

Along with her mentors, Stan Glantz and Laura Schmidt, Kearns has produced another powerful peer-reviewed paper on sugar industry tactics.

It reveals that the sugar industry began working closely with nutrition scientists in the mid-1960s to single out fat and cholesterol as the dietary causes of coronary heart disease and to downplay evidence that sucrose consumption was also a risk factor. This analysis appears September 12, 2016, in JAMA Internal Medicine.

The internal industry documents showed that a sugar industry trade organization recognized as early as 1954 that if Americans adopted low-fat diets, then per-capita consumption of sucrose would increase by more than one-third. The trade organization represented 30 international members.

Meanwhile, evidence linking sugar consumption to high blood cholesterol and triglyceride levels – both thought to be risk factors for coronary heart disease – began to emerge in the scientific literature and popular press.

After a 1965 spike in media attention to the heart disease risks of sucrose, the sugar industry commissioned Project 226, a literature review written by researchers at the Harvard University School of Public Health Nutrition Department, which was published in the highly respected New England Journal of Medicine (NEJM) in 1967. It concluded there was “no doubt” that the only dietary intervention required to prevent coronary heart disease was to reduce dietary cholesterol and substitute polyunsaturated fat for saturated fat in the American diet.

“The literature review helped shape not only public opinion on what causes heart problems but also the scientific community’s view of how to evaluate dietary risk factors for heart disease,” said lead author Cristin Kearns, DDS, MBA, who discovered the industry documents.

The UCSF researchers analyzed more than 340 documents, totaling 1,582 pages of text, between the sugar industry and two individuals: Roger Adams, then a professor of organic chemistry who served on scientific advisory boards for the sugar industry; and D. Mark Hegsted, one of the Harvard researchers who produced the literature review.

To conduct the literature review, the sugar industry paid the Harvard scientists the equivalent of $50,000 in 2016 dollars, then set the review’s objective, contributed articles to be included, and received drafts. Yet the industry’s funding and role were not disclosed in the final NEJM publication.

The literature review heavily criticized studies linking sucrose to heart disease, while ignoring limitations of studies investigating dietary fats. The review argued that blood cholesterol levels were the only significant risk factor for coronary heart disease, which made the high sucrose content of the American diet seem less hazardous than if blood triglycerides were also considered to be a risk factor.

The authors emphasized that this analysis demonstrates the importance of having scientific reviews written by people without conflicts of interest, as well as the need for financial disclosure in nutrition science.

“As the saying goes, he who pays the piper calls the tune,” said senior author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education. “There are all kinds of ways that you can subtly manipulate the outcome of a study, which industry is very well practiced at.”

Co-author Laura Schmidt, PhD, who is also principal investigator on the UCSF-led SugarScience initiative and Professor of Health Policy at the Philip R. Lee Institute for Health Policy Studies, noted that after decades of focusing on saturated fat as the dietary culprit in heart disease, the science is building around sugar’s role, but health policy has only just begun to catch up.

“There is now a considerable body of evidence linking added sugars to hypertension and cardiovascular disease, which is the No. 1 cause of premature death in the developed world,” Schmidt said. “Yet, health policy documents are still inconsistent in citing heart disease risk as a health consequence of added sugars consumption.”

Read more:

JAMA Internal Medicine: Author Interview

CNN Video: Sugar raises heart concerns

STAT: Sugar industry secretly paid for favorable Harvard research

VOX: How the sugar industry has distorted health science for more than 50 years

Bloomberg: How Big Sugar Enlisted Harvard Scientists to Influence How We Eat—in 1965

Business Insider: The sugar industry funded one of the biggest misconceptions in modern nutrition

TIME: How the Sugar Lobby Skewed Health Research

Associated Press: Study details sugar industry attempt to shape science

Food Politics: Sugar industry funding of research, 1967 style (with many lessons for today)

The Guardian: Sugar lobby paid scientists to blur sugar’s role in heart disease

STAT: Sugar industry secretly paid for favorable Harvard research