How Sweet It Is(n’t): Part II

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A few years ago, I blogged about something near and dear to the hearts of many: sugar. The Journal of the American Medical Association (JAMA) had just released in early 2014 results of the first nationally representative study that examined diets high in sugar. The lead author from the U.S. Centers for Disease Control and Prevention called the results “sobering” and here’s why:

Previous studies have linked diets high in sugar with increased risks for non-fatal heart problems, and with obesity, which also can lead to heart trouble. But in the new study, obesity didn’t explain the link between sugary diets and death. That link was found even in normal-weight people who ate a lot of added sugar.

This was not good news for those of us who like to indulge our sweet tooth. And, unfortunately, the bad news does not end there…..

In the early 1960s, research was starting to show a link between the high rates of heart disease in the U.S. and high-sugar diets while, simultaneously, dietary cholesterol and saturated fat were being posited as the primary culprits. Based on the prominent dietary recommendations to which we had been advised to adhere until earlier this year, we know which causes were deemed to be the greater risk factors by food scientists and our government all those years ago.

Fast forward 50 years. A fellow at the University of California, San Francisco (UCSF), attended a conference to hear a dentist present on diabetes and dentistry. The speaker provided resources to assist dentists in their counseling of diabetic patients; however, nowhere in the literature did it mention anything about restricting sugar intake to manage diabetes. Being a dentist herself, the aforementioned UCSF fellow found this omission noteworthy and started doing a little research on the sugar industry. She hit the jackpot. She stumbled across a decades-old, confidential memo by the Sugar Research Foundation (SRF) (now known as the Sugar Association) about a public relations campaign. Turns out the campaign had been initiated by the sugar industry to manipulate the Food and Drug Administration’s review of the safety of sugar in the mid-1970s. Together with her UCSF colleagues, they used this memo and the plethora of subsequent documents found to create a narrative case study that suggests the sugar industry secretly sponsored research in the 1960s and 1970s to cast doubt about the harmful effects of sugar in order to protect their interests. (Anyone remember Big Tobacco and the Master Settlement Agreement in the late 90’s? Sounds familiar, right?) The UCSF findings were published online by JAMA Internal Medicine in September 2016.

So, here’s the Readers’ Digest version of what has been going on behind the scenes since the middle of the 20th century. As can be expected, the SRF was not pleased about the growing number of studies pointing the finger at sugar as a potential cause of heart disease. So, they contrived a deal with three Harvard scientists. For about 50K (in today’s dollars), these scientists were to critique existing research, specifically selected by the SRF, on fat, sugar, and heart disease and publish a review in the New England Journal of Medicine (NEJM). Without disclosing the role and funding of the SRF, the Harvard scientists published their findings in 1967, downplaying the alarming evidence connecting sucrose to coronary heart disease and, instead, vilifying the roles of saturated fat and dietary cholesterol. As a result, the low-fat (high sugar) diet movement was born, which, according to many health experts, is the pretext for our obesity crisis. The UCSF authors acknowledge that there is no direct evidence that the SRF wrote or changed the NEJM review themselves, though it is abundantly clear that there was an understanding with the Harvard scientists about the intended literature review outcomes.

While the UCSF authors’ case study focuses on the activities of only one sugar industry trade group decades ago, its implications are far-reaching. It is not new news that the food industry funds nutrition research—as recently as last year, it was learned that Coca–Cola paid researchers to claim that the negative effects of soda consumption could be mitigated by increased physical activity. With the recent exposure of the 1960s scandal, however, we now know just how far back that corruption goes, and how successful the sugar industry was in manipulating data to serve its purpose of derailing the debate, as well as more intensive research, about sugar’s role in heart disease for decades. We know that one of the paid scientists was the chair of the Harvard nutrition department and another eventually became the head of nutrition at the USDA where he helped draft early versions of the U.S. dietary guidelines. We know that he used his research to influence the government’s dietary recommendations which encouraged the consumption of low-fat, high-sugar foods to minimize the risk of heart disease. As a result, his warnings about saturated fat are still prominent in our dietary guidelines today.

While it is great news that sugar control policies are currently being promulgated locally, nationally and internationally to address the now-known link between sugar and heart disease, it will take much time, energy, education and financial resources to undo the damage wrought by the sugar industry. We will never be able to recover all the money and lives lost as the result of their deceptive practices—all for the purpose of monetary gain. And, as I now reflect on that sobering JAMA study released in 2014, I cannot help but lament about how tragic it is that it wasn’t big news 20-30 years ago.

Be well (and enjoy your sweets in moderation over the holidays!).

Mcneill_Stacy_150px_1411Stacy
smcneill@ocmboces.org

 

 

 

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