From:
http://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-industry-shifted-blame-to-fat.html

How the Sugar Industry Shifted Blame to Fat

By ANAHAD O'CONNOR  SEPT. 12, 2016

The sugar industry paid scientists in the 1960s to play down the link 
between sugar and heart disease and promote saturated fat as the 
culprit instead, newly released historical documents show.

The internal sugar industry documents, recently discovered by a 
researcher at the University of California, San Francisco, and 
published Monday in JAMA Internal Medicine, suggest that five decades 
of research into the role of nutrition and heart disease, including 
many of today's dietary recommendations, may have been largely shaped 
by the sugar industry.

"They were able to derail the discussion about sugar for decades," 
said Stanton Glantz, a professor of medicine at U.C.S.F. and an 
author of the JAMA paper.

The documents show that a trade group called the Sugar Research 
Foundation, known today as the Sugar Association, paid three Harvard 
scientists the equivalent of about $50,000 in today's dollars to 
publish a 1967 review of research on sugar, fat and heart disease. 
The studies used in the review were handpicked by the sugar group, 
and the article, which was published in the prestigious New England 
Journal of Medicine, minimized the link between sugar and heart 
health and cast aspersions on the role of saturated fat.

Even though the influence-peddling revealed in the documents dates 
back nearly 50 years, more recent reports show that the food industry 
has continued to influence nutrition science.

Last year, an article in The New York Times revealed that Coca-Cola, 
the world's largest producer of sugary beverages, had provided 
millions of dollars in funding to researchers who sought to play down 
the link between sugary drinks and obesity. In June, The Associated 
Press reported that candy makers were funding studies that claimed 
that children who eat candy tend to weigh less than those who do not.

The Harvard scientists and the sugar executives with whom they 
collaborated are no longer alive. One of the scientists who was paid 
by the sugar industry was D. Mark Hegsted, who went on to become the 
head of nutrition at the United States Department of Agriculture, 
where in 1977 he helped draft the forerunner to the federal 
government's dietary guidelines. Another scientist was Dr. Fredrick 
J. Stare, the chairman of Harvard's nutrition department.

In a statement responding to the JAMA report, the Sugar Association 
said that the 1967 review was published at a time when medical 
journals did not typically require researchers to disclose funding 
sources. The New England Journal of Medicine did not begin to require 
financial disclosures until 1984.

The industry "should have exercised greater transparency in all of 
its research activities," the Sugar Association statement said. Even 
so, it defended industry-funded research as playing an important and 
informative role in scientific debate. It said that several decades 
of research had concluded that sugar "does not have a unique role in 
heart disease."

The revelations are important because the debate about the relative 
harms of sugar and saturated fat continues today, Dr. Glantz said. 
For many decades, health officials encouraged Americans to reduce 
their fat intake, which led many people to consume low-fat, 
high-sugar foods that some experts now blame for fueling the obesity crisis.

"It was a very smart thing the sugar industry did, because review 
papers, especially if you get them published in a very prominent 
journal, tend to shape the overall scientific discussion," he said.

Dr. Hegsted used his research to influence the government's dietary 
recommendations, which emphasized saturated fat as a driver of heart 
disease while largely characterizing sugar as empty calories linked 
to tooth decay. Today, the saturated fat warnings remain a 
cornerstone of the government's dietary guidelines, though in recent 
years the American Heart Association, the World Health Organization 
and other health authorities have also begun to warn that too much 
added sugar may increase cardiovascular disease risk.

Marion Nestle, a professor of nutrition, food studies and public 
health at New York University, wrote an editorial accompanying the 
new paper in which she said the documents provided "compelling 
evidence" that the sugar industry had initiated research "expressly 
to exonerate sugar as a major risk factor for coronary heart disease."

"I think it's appalling," she said. "You just never see examples that 
are this blatant."

Dr. Walter Willett, chairman of the nutrition department at the 
Harvard T. H. Chan School of Public Health, said that academic 
conflict-of-interest rules had changed significantly since the 1960s, 
but that the industry papers were a reminder of "why research should 
be supported by public funding rather than depending on industry funding."

Dr. Willett said the researchers had limited data to assess the 
relative risks of sugar and fat. "Given the data that we have today, 
we have shown the refined carbohydrates and especially 
sugar-sweetened beverages are risk factors for cardiovascular 
disease, but that the type of dietary fat is also very important," he said.

The JAMA paper relied on thousands of pages of correspondence and 
other documents that Cristin E. Kearns, a postdoctoral fellow at 
U.C.S.F., discovered in archives at Harvard, the University of 
Illinois and other libraries.

The documents show that in 1964, John Hickson, a top sugar industry 
executive, discussed a plan with others in the industry to shift 
public opinion "through our research and information and legislative programs."

At the time, studies had begun pointing to a relationship between 
high-sugar diets and the country's high rates of heart disease. At 
the same time, other scientists, including the prominent Minnesota 
physiologist Ancel Keys, were investigating a competing theory that 
it was saturated fat and dietary cholesterol that posed the biggest 
risk for heart disease.

Mr. Hickson proposed countering the alarming findings on sugar with 
industry-funded research. "Then we can publish the data and refute 
our detractors," he wrote.

In 1965, Mr. Hickson enlisted the Harvard researchers to write a 
review that would debunk the anti-sugar studies. He paid them a total 
of $6,500, the equivalent of $49,000 today. Mr. Hickson selected the 
papers for them to review and made it clear he wanted the result to 
favor sugar.

Harvard's Dr. Hegsted reassured the sugar executives. "We are well 
aware of your particular interest," he wrote, "and will cover this as 
well as we can."

As they worked on their review, the Harvard researchers shared and 
discussed early drafts with Mr. Hickson, who responded that he was 
pleased with what they were writing. The Harvard scientists had 
dismissed the data on sugar as weak and given far more credence to 
the data implicating saturated fat.

"Let me assure you this is quite what we had in mind, and we look 
forward to its appearance in print," Mr. Hickson wrote.

After the review was published, the debate about sugar and heart 
disease died down, while low-fat diets gained the endorsement of many 
health authorities, Dr. Glantz said.

"By today's standards, they behaved very badly," he said.