Kellogg as Sponsor

[Kellogg Foundation and Trust Financial Statement for 2013]

The idea of Kellogg as a sponsor is complicated because several different entities are involved. Yesterday, Childhood Obesity News mentioned the many programs backed by the W.K. Kellogg Foundation. In the 2013 fiscal year, the foundation gave away $259,898,647 worth of grants. It gets most of its money from the yearly earnings of the W. K. Kellogg Trust.

The illustration on this page, extracted from the “2013 Kellogg Foundation and Trust Financial Statements,” shows that among its nearly $8 billion in assets, the trust owns close to $4.5 billion in Kellogg Company common stock, which accounts for about half of the trust’s wealth. Via the trust, the foundation is the Kellogg Company’s biggest stockholder, owning about 22% of the food manufacturer’s total shares. The “History and Legacy” section of the Kellogg Foundation website says:

In 2007, the foundation also became one of a small group of foundations seeking to use its assets more effectively while preserving and growing its endowment. Under a pilot program of mission driven investments, the foundation is investing assets in a way that realizes both financial and social returns, a concept also known as ‘double bottom-line investing.’

This is why the financial statement also shows nearly $3 billion in “diversified investments,” which could be anything — but hopefully, not more corporations that also make cereal and snacks. In support of the Institute for Professional Education (IPE) during the 2014-2016 time period, the foundation gave it $300,000. IPE’s purpose is to:

Advance current research and best practice for addressing childhood obesity by producing a journal and e-newsletter focused on culturally sensitive, evidence-based prevention, treatment and management.

IPE characterizes itself as a provider of “end to end solutions for 21st century professional development” and lists the following professional credentials:

  • Manage and develop CME conferences
  • Access to world-renowned scientific expertise
  • Access to highest level policy makers
  • Working relationship with major universities, scientific institutions, and foundations worldwide

In other words, this is where funding originates for the journal Childhood Obesity and for the e-publication Briefings in Childhood Obesity. Under the heading “A Briefings Partner,” the newsletter on its main page lists only one sponsor, the W. K. Kellogg Foundation. If there are others, they are not mentioned here.

Because of the Kellogg Foundation’s support, the journal can afford to give free subscriptions to public schools, community-based organizations, officials, and other community health-oriented people who need to know these things. So basically, a corporation that makes processed food creates the financial possibility to share its opinions about obesity with the people.

None of this is illegal, but there is a potential for mischief, because that process only accounts for half of the unease felt by some observers about the seemingly beneficent activity of paying for these publications.

Next… the other half of the unease.

Your responses and feedback are welcome!

Source: “Investor FAQs,” Kelloggs.com, undated
Source: “History & Legacy,” WKKF.org, undated
Source: “Institute for Professional Education,” WKKF.org, 2014
Source: “The Institute for Professional Education,” instituteforprofessionaled.org, undated
Source: “Briefings in Childhood Obesity,” LiebertPubMail.com, undated
Image by W.K. Kellogg Foundation

Childhood Obesity and Kellogg-Backed Publications

Two headed Berber Daisy

When the journal Childhood Obesity started up, with financial sponsorship from the W.K. Kellogg Foundation, Fat Boy Thin Man author Michael Prager got in touch with the publisher and expressed concern about the dual role filled by the foundation’s vice president of program strategy. Gail C. Christopher was and still is a member of the editorial board at Childhood Obesity. One of Liebert Publishing’s executives, Vicki Cohn, replied and assured Prager that Christopher does not participate in the peer-review process, to which he responded:

That’s worth mentioning, certainly, but not persuasive. The obvious concern is not whether she’s involved in peer review, but whether the foundation can influence editorial decisions. Take note of the obvious: Whether to publish an article is an editorial decision.

Prager goes into some detail about what a strange choice it seems to him. He points out that the reason an editorial board exists is, presumably, to exercise authority over editorial content. It seems odd that the foundation would put somebody there for no reason, so there must be a reason. If there were no positive benefit involved, why would the foundation expose itself to criticism by placing a staff member at the publication? Then, fair-minded as always, he looks at the other side:

If I was funding a journal, I’d want a voice on its editorial board, too, so it’s to be expected. But once you take that step, you’d have to expect the obvious questions about editorial integrity. My assumption is that the money spends a lot better than integrity.

Cohn requested that Prager should print her reply unedited or not at all, which we can’t do here. But hopefully it will not be a bad thing to pass along the invitation she extended to Prager’s readers to visit the magazine’s website.

Soon after Childhood Obesity started up, Dr. David Katz became the publication’s editor-in-chief. The current issue, which offers some of its contents free online, includes an editorial by Dr. Katz. The title asks whether it’s time to break out the champagne — an allusion to the popular but unfounded belief that the childhood obesity battle has turned around and it’s time to celebrate.

The list of contents includes symbols indicating whether each article is free or available only by subscription. Some of the other subjects include cardiovascular disease risk factors in urban minority children; the relation between BMI and the development of the sympathetic nervous system; the U.S. Department of Agriculture’s snack food and beverage standards; school-based obesity prevention programs; youth baseball; a global obesity update; and an overview of current interesting academic papers.

A reminder

One article has a troubling title – “Discrepant Body Mass Index: Behaviors Associated with Height and Weight Misreporting among US Adolescents from the National Youth Physical Activity and Nutrition Study.” Childhood Obesity News has discussed how self-reporting can cause uncertainty in any study where it is employed. In many cases it seems unavoidable, because the alternative would be an unbearably Orwellian condition of surveillance. Is it possible to even imagine a recording system that would account for every molecule of food or drink consumed by a teenager, for a year?

The W.K. Kellogg Foundation, one of the world’s largest private philanthropic organizations, has been around for a long time. Its main interests are healthy, educated kids and secure families. It has done a lot of great things, concentrating on children in the prenatal-to-8-years age range, where the opportunity exists to make the biggest difference. It aims to compensate for some of the world’s inequities, and has found that focusing on specific projects in specific geographical areas is the key to maximum impact. Tomorrow, we continue looking at the publications it sponsors.

Your responses and feedback are welcome!

Source: “Independent-ish,” MichaelPrager.com, 12/21/10
Source: “Childhood Obesity,” Liebertpub.com, June 2014
Image by Jinx!

An Interesting Development at Childhood Obesity, the Journal

Message board comments from "Fat Amy"

From 2005 until June of 2010, a publication existed under the name Obesity and Weight Management. Starting in August of that year, its focus narrowed and its name changed. Childhood Obesity announced its intention to be the premier journal concerned with childhood and adolescent obesity, as well as prevention and treatment methods, and the encouragement of changes in policy and the environment. Its target audience includes “physicians, nurses, dietitians, diabetes educators, nutritionists, psychologists, educators and school nurses, community organizers, and policymakers.”

The aspect that worried Dr. Pretlow and many others was that a magazine indirectly funded by one of the biggest makers of snack food is perhaps not an appropriate venue from which to expect unbiased information. One red flag was an announcement that the editorial content would address the genetic factors contributing to obesity. While there is nothing wrong with that in and of itself, tunnel vision could be a problem.

Red herrings

Dr. Pretlow sees food addiction as the overwhelmingly prevalent cause of the obesity epidemic. By concentrating on genetics and energy balance, Big Food bamboozles the public with red herrings, with misleading clues that contain enough truth to distract the attention and send the detectives down the wrong trail. Yes, genetic origins can account for a small fraction of the total amount of obesity. Lack of exercise is certainly a big problem also. Everybody should get more of it.

But by concentrating on genetic causes, the food industry gets to blame pre-existing conditions that nobody could have done anything about. By persuading people that insufficient activity is the main thing making them fat, the food industry can place the largest share of responsibility squarely on the customer. If we the people don’t get out there and run enough miles to burn off the calories from their over-sweetened pseudo-foods, it’s our own darn fault!

An archived Childhood Obesity News post speculated:

It will be interesting to see how much attention the journal Childhood Obesity pays to the importance of viewing the childhood obesity epidemic through the psychological food dependence-addiction lens.

The question became more intriguing with the editorship of Dr. David Katz, co-founder and Director of Yale University’s Prevention Research Center. This was not long after some of his Yale colleagues had published “Neural Correlates of Food Addiction,” which confirmed the addictive power of food. The following year, Dr. Katz referenced that paper in a Huffington Post article titled “Sugar Isn’t Evil: A Rebuttal,” where he wrote:

The media attention this study has generated would suggest that it delivers an epiphany. But I think the case is just as strong that it delivers a tautology: those who report receiving a stronger, more irresistible reward message from their brain in response to food have a stronger, more irresistible reward response in their brain in response to food.

Throughout this piece, these sentences appear:

With or without brain scans, we knew that food affects the brain.
The surprise, then, is not that foods are addictive….
Of course food is addictive.

But despite such strong sentiments, the bottom line is that Dr. Katz then shies away from identifying any particular edible substance, even sugar, as addictive.

The journal

Back when the journal launched, Dr. Pretlow remarked, “The Kellogg Company may not want articles on food addiction to appear in Childhood Obesity.” A search through all issues for the keyword “addiction” brings back 19 results, a pretty small number for a journal that has appeared six times a year since 2005. From then until June 2010, 11 articles are reported to include the word “addiction” in some context. After the re-christening and reorganization, eight articles have included the word, though in only one does it appear in the title.

The current (June 2014) issue contains an article titled, “A Systematic Review of Pediatric Obesity and Family Communication Through the Lens of Addiction Literature,” by Ashley Mogul, Megan B. Irby, and Joseph A. Skelton. Its “Conclusions” are described like this:

Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.

Your responses and feedback are welcome!

Source: “For Immediate Release,” Liebertpub.com, 05/26/10
Source: “Sugar Isn’t Evil: A Rebuttal,” HuffingtonPost.com, 04/18/11
Source: “Childhood Obesity” Liebertpub.com, June 2014
Image by “Fat Amy” (Anonymous)

Childhood Obesity and Kellogg’s Split Personality

A Kellogg's Ice Cream Shoppe Frosted Rainbow Cookie Sandwich Pop-Tarts

A Kellogg’s Ice Cream Shoppe Frosted Rainbow Cookie Sandwich Pop-Tart

The Kellogg Company has a split personality that is fascinating to people who care about and write about childhood obesity. Through its W.K. Kellogg Foundation, it funds researchers who study the problem and magazines that publish the work of those researchers. At the same time, the company itself is a big part of what has gone wrong. When the journal Childhood Obesity launched, Dr. Pretlow noted:

The Kellogg Foundation’s trust assets include $4.1 billon of Kellogg Company common stock (out of $6.4 billion total assets)…. In effect, a major food company is funding a childhood obesity scientific journal.

What’s the problem exactly? Here is an example. Dr. Pretlow’s post listed some of the many sugar-laden Kellogg products, and he took particular notice of the fact that Pop-Tarts “are marketed as entertainment for kids with the slogan, ‘Made for Fun.’ ” If there is any notion that does not need to be planted in the minds of children, it is the concept of recreational eating. Can a peer-reviewed scientific journal hold onto objectivity and impartiality when its allowance is paid by a foundation whose ability to bestow grants comes from selling Pop-Tarts?

In essence, the company itself proposes that if we buy more sugar-laden, nutritionally void products, they will give a little bit of their profits to a foundation that supports research into how to escape the consequences of consuming a lot of sugar-laden, nutritionally void products. Does this make any sense at all? But on the other hand, it makes all the sense in the world. Because who else should be more obligated to fix the problems that result from the products?

The snack food industry, by the way, does not characterize any of its creations as sugar-laden or as nutritionally void. Their word for it is “energy-dense,” and it seems to be a term accepted by both sides so they can communicate with each other. Last year, for instance, the Australian authorities closed down a Coco Pops TV ad for marketing a product made of about 35% sugar directly to children. Jane Martin of the Obesity Policy Coalition said:

Consumption of energy dense, high-sugar products such as Coco Pops can contribute to poor diets and lead to weight gain and obesity in children. It is irresponsible to promote a high sugar cereal to children.

When the magazine Childhood Obesity began publication, the apparent conflict was also picked up on by Michael Prager, who addressed the concerns in a post titled “Independent-ish.” One of his points was that about two-thirds of the W.K. Kellogg Foundation’s wealth consisted of Kellogg’s stock. While acknowledging the good reputation of the foundation, he did express misgivings:

If someone’s research shows that highly sugared cereals such as Frosted Flakes are unhealthy for children – and does anyone think otherwise?! – that paper seems pretty unlikely to find receptive editors at Childhood Obesity.

The W.K. Kellogg Foundation website helpfully lists its donations to various causes. Searching “healthy kids” brings back 651 results, while a search for “childhood obesity” yields 24. The foundation supports the National Hispanic Health Foundation, the Notah Begay Foundation, the Mississippi Public Health Institute, and many other worthy institutions.

But if super-intelligent aliens landed and studied humanity by assessing this particular situation, they would surely ask, “Rather than sell these products to kids and then pay organizations to study obese children, why not just stop selling these products to kids?” What answer would we have for them?

Your responses and feedback are welcome!

Source: “Kellogg pulls Coco Pops ad after OPC complaint,” vic.gov.au, 06/20/13
Source: “Independent-ish,” MichaelPrager.com, 12/21/10
Source: “Healthy Kids,” WKKF.org, undated
Image by theimpulsivebuy

Michele Simon and the Academy of Nutrition and Dietetics

Corporate sponsors of AND

Corporate sponsors of AND

Childhood Obesity News is interested in a paper titled “And Now a Word from Our Sponsors,” whose subtitle is a pointed question: “Are America’s Nutrition Professionals in the Pocket of Big Food?” Written by public health specialist Michele Simon, it takes a close look at the Academy of Nutrition and Dietetics (AND).

Simon wonders about AND’s failure to speak up about such matters as proposed soda taxes, limiting soft drink sizes, the labeling of genetically modified foods, and other nutritional hot topics. Why might this be? Perhaps because of the multitude of food industry corporate sponsors — 25 of them listed in the 2013 annual report; 38 back in 2011.

The bottom line is, a group financed by the food industry has the exclusive right to deem someone a professional expert in, and advisor about, nutrition. That’s harsh. And it answers one of Simon’s questions: “What does the food industry gain from such partnerships?” Well, if you’re a Big Food sponsor of AND, you get an army of people who owe their professional existence to you. They can’t be credentialed as nutrition experts unless they give the right answers to the questions on your test. That creates quite an obligation.

As we know, Dr. Pretlow has written, not favorably, about infant formula. Sarah Eye, the certified performance technologist and critic of AND quoted in yesterday’s post, has also covered the topic and says this about the Similac brand of formula:

The main ingredient is corn syrup. And on top of this, they continue to add more sugar via 6 different formulations inside the ingredients, and top it all off with a ton of GMO soy and other harsh additives and preservatives. I’m not sure how they were able to conjure up this list of ingredients and say it’s the next best thing to breast milk.

Similac is made by Abbott Nutrition, one of AND’s corporate sponsors. These are the jokers who are educating nutritionists! Incredibly, AND’s list of approved continuing education providers includes Coca-Cola, Kraft Foods, Nestlé, and PepsiCo. Eye says:

Among the messages taught in Coca-Cola-sponsored continuing education courses are: sugar is not harmful to children; aspartame is completely safe, including for children over one year; and the Institute of Medicine is too restrictive in its school nutrition standards.

Continuing education for professionals is not the only area infiltrated by these companies.They also sponsor education sessions at AND’s yearly meeting. For instance, in 2012, the Corn Refiners Association (lobbyists for high fructose corn syrup) sponsored not one but three “expo impact” sessions at the annual confab.

As of last summer, they also claimed as sponsors the National Cattleman’s Beef Association, the National Dairy Council, Kelloggs, General Mills, ConAgra Foods, the National Dairy Council, Aramark, Coca-Cola, Mars, Pepsico, Abbott Nutrition, Truvia, SoyJoy, and Unilever.

Michele Simon calls the internal contradiction a “disconnect” but there are stronger words that would fit. The disconnect (or whatever) undermines confidence in AND. (Was is a coincidence that a month after the publication of Simon’s report, a new group called Dieticians for Professional Integrity was formed?)

What a terrible and baffling paradox — or is it a conundrum? The very organization that christens nutritional and dietetic professionals is the worst threat to the profession’s reputation. Simon asks, “Does forming partnerships with the food industry compromise such a group’s credibility?” A lot of the evidence says “yes.” What makes it worse is that, although they don’t have an official mechanism through which to voice their objections, many registered dieticians do not care for the corporate sponsorship. A survey was taken, and Simon writes, “A majority of RDs surveyed found three current AND sponsors ‘unacceptable.’ (Coca-Cola, Mars, and PepsiCo.)”

One of her recommendations is to demand from the organization a degree of transparency that has not so far been evident. For instance, “Roughly 23 percent of annual meeting speakers had industry ties, although most of these conflicts were not disclosed in the program session description.”

Simon also urges that AND should institute and implement stronger and more meaningful sponsorship guidelines. But she also notes that “AND’s sponsors and their activities appear to violate AND’s own sponsorship guidelines,” so how much good would it do to pile on even more guidelines, which would probably be ignored in a similar manner?

The last quotation is from Sarah Eye: “Not one single voice of authority is calling B.S on the obvious conflicts of interest here.”

Your responses and feedback are welcome!

Source: “And Now a Word from Our Sponsors,” EatDrinkPolitics.com, January 2013
Source: “Second-Guessing the Dietician,” AustinPrimalFitness.com, 07/25/13
Image by Joki Gauthier for Oxfam 2012

Conflict of Interest at the Academy of Nutrition and Dietetics

Senator Stabenow

U.S. Senator Debbie Stabenow, center, with AND members

Sara Eye, a certified performance technologist from Austin, Texas, wrote a comprehensive description of the Academy of Nutrition and Dietetics (AND), which is…

…now the largest organization for professionals in nutrition … in the world. They are THE authority on health & nutrition, and also, are the ones who are responsible for formulating, creating and publishing the educational content and textbooks for students going into this field. They provide the licenses and registration that allow professionals to get steady jobs in the medical and health field.

Now 75,000 members strong, AND is an influential organization with huge potential to shape national policy in ways that might be beneficial… or not. Who belongs? You don’t have to be a registered dietician to join AND – you can be a lot of other things. The membership requirements are readily available.

A registered dietician gives nutritional advice specific to someone’s condition, disease, athletic training status, or other individual need. With the blessing of AND, a person can become either a registered dietitian or a dietetic technician, registered. If you want to be either of these things, AND is the only game in town. They have exclusive certification rights.

The organization also doesn’t much care for plain old nutritionists, chiropractors, naturopaths, holistic coaches or other types of practitioners. To some observers, it all looks suspiciously like a group wanting to eliminate the competition, corner the market, create a monopoly, and just generally mess up the idea of free choice in medical care. Sarah Eye says:

I don’t want to make all RDs appear like the villain…. I know of many who have pursued further education and sought out better quality information and research about nutrition and health.

Eye did not become either an RD or a DTR, but her history is fascinating. More than 10 years ago she received a diagnosis of celiac disease. Following the AND’s party line, she took all the prescribed meds, while experiencing chronic pain, inflammation, insomnia, and repeated flare-ups that resulted in emergency room visits. This was not her idea of a successful cure. Eye went rogue, followed her own nutritional star, and got better. She believes she has much to offer other sufferers, but says:

Despite my education, and advanced certifications, they want to prevent people like me and other practitioners from doing our jobs because we are not associated by the AND. In other words; we are not giving out the advice that their sponsors want delivered to the masses…. I knew that if I became a university-educated RD, I would be forced to regurgitate the very advice that got me sick in the first place.

The 51-page PDF file titled “And Now a Word from Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food?” is a very disheartening report by public health specialist Michele Simon, all about AND. She paints a convincing picture of why we should care about how these folks, when gathered together in their professional organization, utilize their energies. It’s beginning to look like the whole club is just a giant puppet manipulated by Big Food.

It’s not a particularly secret infiltration, and Simon mentions the observable effects. For instance, at AND’s annual meeting in 2012, fruit and vegetable vendors only occupied a bit more than one-tenth of the expo hall’s floor space. She also remarks, rather tartly it seems:

To date, AND has not supported controversial nutrition policies that might upset corporate sponsors, such as limits on soft drink sizes, soda taxes, or GMO labels.

More about this next time!

Your responses and feedback are welcome!

Source: “Second-Guessing the Dietician,” AustinPrimalFitness.com, 07/25/13
Source: “And Now a Word from Our Sponsors,” EatDrinkPolitics.com, January 2013
Image by Office of U.S. Senator Debbie Stabenow

 

Organizations on the Corporate Dole

monkey scratching another monkey's back

Of course it is beneficial to have experts explain things to CEOs and politicians. In the hard sciences, it can be a very difficult task to translate concepts into language that nonprofessionals (in that field) are able to understand and make use of. In the soft sciences, explanations are fraught with risky areas where even the best rationales and motivations can be shipwrecked.

Trying to make sure that non-experts understand things is a serious undertaking. In the realm of business, one expert’s recommendation can gain or lose incredible amounts of money for a company. In the political arena, one expert’s opinion can affect the lives of millions of people and set an entire country on a different course.

No harm, no foul

There is nothing wrong with hiring experts to explain things, but a problem arises when the opinion or endorsement can be bought. This is why “conflict of interest” is such a concern. If the same expert is being paid by a government body that wants, for instance, to initiate a soda tax, and is also being paid by a corporation that wants, for instance, no soda tax, that’s a problem.

In a blog post titled “Childhood Obesity Conflicts of Interest,” Dr. Pretlow noted a few examples of questionable motives that have come to his attention:

Pepsico is funding obesity research at Yale, and The American Dietetic Association recently announced that it has inked a partnership with the Hershey Company. McDonald’s has a Global Advisory Council consisting of childhood obesity and nutrition professionals.

McDonald’s was a supporter of National Childhood Obesity Awareness Month, as part of an esteemed group which included the American Academy of Pediatrics, the CDC, the National League of Cities, and the YMCA. Does anyone really believe that McDonald’s will do what is necessary to combat the childhood obesity epidemic?

Of course, it’s not every expert whose blessing on a project is actually for sale to the highest bidder. It is to be hoped that such transactions constitute a very small portion of academia’s relationship with business and government. But even when everybody is totally honest, the appearance or perception of a possible conflict of interest can be just as destructive as a real one.

The same holds true of sponsorship. When a corporation pays for programs, events, and gatherings, it’s not always possible to believe that their intentions are high-minded. Whether it’s fair or not, an ordinary person often wonders, “What are they up to now?” These are high-level entanglements whose consequences are far-reaching. Ideally, such relationships are a bit more sophisticated than “you scratch my back and I’ll scratch yours.”

Not looking good

Dr. Pretlow also mentions that the Obesity Society has made some puzzling choices over the years, like accepting sponsorship of its 2008 scientific meeting from the makers of high fructose corn syrup, and censoring the word “addiction” from the titles of presentations at its 2010 scientific meeting. Apparently, looking at childhood obesity through the “psychological food dependence-addiction lens” provokes some type of conflict with the vested interests of the members. If it turns out that the addiction model is the best way to treat obesity, that would threaten some entrenched agendas and render a lot of huge, established programs moot or irrelevant.

Next time, Childhood Obesity News will look at a major organization that has a lot to do with childhood obesity and how its credibility has been compromised by close relationships with a number of mega-corporations in the food business.

Your responses and feedback are welcome!

Source: “Childhood Obesity Conflicts of Interest,” ChildhoodObesityNews.com, 12/20/10
Image by ePi.longo

Experts on the Corporate Payroll

man holding wad of bills

Childhood Obesity News has raised the question of how a typical academic figure can manage to carry out duties related to health policy while in the employ of manufacturers of products whose qualities are not aligned with the public good.

Many experts are hired by corporations as consultants, in an advisory capacity or to do research. At the same time, many of the same experts work for their respective governments and, at least nominally, for the people. An expert might be asked to decree whether sugar should make up 20% of a person’s caloric intake, or only 10%. (Health professionals who believe that even 10% is ludicrously high tend to not be hired to make such determinations.)

Is it okay that experts make money off the very companies that need to be controlled? Why should they not make money off their expertise? It took a lot of years and a lot of dollars to acquire that level of knowledge. How is a world-renowned expert supposed to keep the lights turned on — by selling T-shirts?

A reasonable expectation

There are many good points on both sides about what should be permissible. What is an acceptable level of conflict of interest? In such a climate, full disclosure is not too much for the public to ask, especially when tax money is involved.

Thought leaders can exercise authority over policy, either by endorsing it, carrying it out, or dissuading Washington from adopting it. One person’s say-so can cause millions of dollars to change hands, or end careers, or throw an entire state into insolvency. An expert can do a lot for a corporation, or against it.

How do payments tip the equation? Does money translate into undue influence on opinions, decisions, and recommendations? How, for instance, can a health care expert, who sits on the board of a beverage corporation, give fair consideration to the idea of a soda tax, or of keeping soda vending machines out of schools? Forbes writer Larry Husten suggests that divided loyalties have effects that are sometimes subtle, sometimes obvious. He speaks of studies demonstrating

…that gifts, even very small gifts, can exert strong unconscious effects. When combined with the flattery and attention of being designated a “key opinion leader” an unconscious alignment with a company can easily occur.

This is not a new problem, and one of the more widely publicized instances was Dr. David Allison’s resignation as president-elect of the Obesity Society in 2011, after it was revealed that his expert opinion on fast-food calorie listings was paid for by the New York State Restaurant Association. 

Nor is it an exclusively American problem. In Great Britain, nutrition expert Ian Macdonald was made chairperson of a government panel. Then a reporter mentioned that he was making about $10,000 a year from Coca-Cola and at least that much from the giant food corporation Mars, and controversy ensued.

Also in the U.K., government scientist Tom Sanders received a research grant worth about $7.5 million from a sugar companyDaily Mail reporter Alex Renton writes:

[T]here are studies showing medical scientists funded by any industry tend to produce work biased in that industry’s favour…. One influential paper from last year examined research on sugary drinks and weight gain. The researchers looked at 17 academic studies and found that when the authors had connections to the sugar industry, they were five times as likely to conclude sugary drinks did not make you fat.

Is anyone so pure that they can avoid being influenced by powerful interests putting money into their bank account?

Your responses and feedback are welcome!

Source: “What Role Should Coca-Cola Play In Obesity Research?” Forbes.com, 04/27/14
Source: “Obesity tsars, sugar firms paying them a fortune and a VERY unhealthy relationship,” DailyMail.co.uk, 01/20/14
Image by TaxCredits.net

A New Species of Conflict of Interest

Playa Tropical Resort Hotel Infinity Pool

When prominent academic figures are on corporate payrolls, and when corporations finance groups whose mission is to end childhood obesity, alarm bells ring in the minds of vigilant observers — in some cases, alarm bells that have tolled very many times before.

For Forbes, reporter Larry Husten takes a trip down memory lane to a previous article in which he questioned the extracurricular activities of Victor Dzau, MD. Up until recently, Dr. Dzau, a cardiologist, was CEO of Duke University’s Health System as well as that institution’s chancellor for health affairs. While filling those posts, he also sat on the boards of several corporations — Alnylam Pharmaceuticals, Genzyme (biotech), Medtronics (medical devices), and PepsiCo.

His official Duke U. bio at the time, which Husten characterizes as “less than forthcoming about fully disclosing Dzau’s board memberships,” only mentioned one of those four rather significant affiliations. Husten wrote:

[I]n 2009, Dr. Dzau received $1,081,073 in compensation to be a director of these four companies. In 2009, Dr. Dzau owned stock or equivalent in these four companies valued at $7,854,090.

That’s just short of $8 million, along with the million-plus for a year of multiple board-sitting, on top of the $2.2 million annual academic salary. Although he still has the same relationship with at least three of those companies, the current version of the bio mentions none of them. It merely states a generality, that as a preeminent health leader, the doctor “advises governments, businesses and universities worldwide, serving on advisory councils and boards of directors.”

Why does any of this matter? On July 1, Dr. Dzau will begin his new job, a six-year term as president of the Institute of Medicine. Although it is one of the United States National Academies, the IOM is described as a non-governmental and nonprofit organization, independent and staffed by volunteers. Here is the IOM in its own words:

Our aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely…. Many of the studies that the IOM undertakes begin as specific mandates from Congress; still others are requested by federal agencies and independent organizations.

We are talking about Influence with a capital I. It goes without saying that the information given out by the Institute is supposed to be not only authoritative and evidence-based, but unbiased. Why is this a problem? Roy M. Poses, MD, explains:

Dr Dzau’s service on the board of each of these companies means he has fiduciary duties to each company, and is supposed to show unyielding loyalty to the companies’ stockholders…
Even in the best case, showing unyielding loyalties to the stockholders of companies that make drugs, medical devices, and sugary drinks seems to be likely to influence a leader of an academic medical institution in ways that risk degrading the leader’s responsibilities to uphold the institution’s mission, i.e., to create severe conflicts of interest.

The phrase “a new species of conflict of interest” was first used by Dr. Poses in 2006.

Your responses and feedback are welcome!

Source: “Newly Elected President Of Institute of Medicine Is On The Pepsico Board Of Directors,” Forbes.com, 02/19/14
Source: “About the IOM,” IOM.edu, undated
Source: “Duke Divinity Students Protest Pay of Chancellor for Health Affairs,” HCRenewal.Blogspot.com, 12/06/10
Source: “A New Species of Conflict of Interest in Health Care,” HCRenewal.blogspot.com, 03/29/06
Image by Constantine Agustin

Big Soda’s Arsenal — Who Is the Enemy?

old sideshow sign: "shoot the freak, live human targets"

Last time, we left off with a quotation from spin doctor Jeff Nedelman, to the effect that “No one commissions research anticipating a negative response.” It would appear that when giant corporations pay for studies to show the harmlessness of their products, they expect agreeable results. It might be coincidence that so many industry-financed studies turn out as they do, or it may be a case of confirmation bias with deep pockets.

For Forbes.com, Larry Husten examined the role of beverage and food corporations in funding and publicizing obesity research. He was intrigued by a paper published in the Journal of the American College of Cardiology that let sugar-sweetened beverages off the hook and blamed the obesity epidemic on insufficient exercise. Husten notes:

The article downplays the role of calories and diet and does not include the words “sugar,” “soda,” or “beverage.” Three of the five authors of the paper report financial relationships with Coca Cola…. It also seems clear that the perspective on this controversy as presented in this paper is remarkably congruent with the interests of Coca Cola.

Husten asked the paper’s lead author, Dr. Carl Lavie, for his take on it. His response:

[T]he research from my colleagues and I show that very marked declines in physical activity, which is also a major component in leading to fitness, is by far the major cause of obesity, not sugar and fast foods.

If Lavie’s science is as bad as his grammar, we’re all in trouble. Not surprisingly, this latest research conforms to the industry’s party line. We are rendered fat by our laziness and refusal to engage in sufficient physical activity, and it’s our own fault and has nothing to do with sugar-sweetened beverages. Just like Coca-Cola “had nothing to do with the details of the study, analyzing results, or publishing the paper.” No connection between soda and obesity; no connection between Coke’s financing of studies and the results. Nothing to see here — move on.

Terminology matters

Apparently, as long as a scientist’s compensation is called a “non-restricted educational grant,” then everything is cool. Replying to a series of questions, Dr. Lavie (which in French means “life”) opined that industry-funded research is fine, as long as the full-disclosure principle is followed. And apparently the danger of corruption is only present with a respectably hefty reward, for as Lavie says, “receiving a few minor honorarium would hardly taint my views.”

Husten mentions a paper with the intriguing title “Financial Conflicts of Interest and Reporting Bias Regarding the Association between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews,” published by PLOS Medicine. He explains it thus:

For the papers in which the authors reported no conflict of interest, 10 out of the 12 findings supported the association between sugar-sweetened beverages and weight gain or obesity. In stark contrast, 5 out of the 6 papers with industry support failed to find evidence for any such association. In other words, systematic reviews with industry support were 5 times more likely to find no significant association.

Interestingly, one of Dr. Lavie’s quotations might be interpreted as a Freudian slip:

Regarding Coca Cola, although their “flagship” product is a sugary beverage, keep in mind that they have many more low or no calorie products in their comprehensive arsenal!!

An arsenal is a collection of military firepower, like rifles and cannons and bombs. If Coca-Cola’s numerous products represent its stock of combat-ready weapons… who is the enemy?

Your responses and feedback are welcome!

Source: “What Role Should Coca-Cola Play In Obesity Research?” Forbes.com, 04/27/14
Source: “Financial Conflicts of Interest and Reporting Bias Regarding the Association between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews,” PLOSmedicine.org, 12/31/13
Image by Dan DeLuca

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