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More About High Fructose Corn Syrup
It is estimated that nearly 7% of daily caloric consumption in the United States is from high fructose corn syrup. This estimate has been labeled as conservative, with other studies indicating that over 10% of daily calories come from fructose in the U.S. today. That's a whole lot of calories! The research over the last five years has been mixed on whether HFCS has contributed to folks being overweight or obese. I don't find any definitive studies that prove that it does, but there's enough evidence to be concerning.

Lying With Statistics: Kellogg's Does It So Well
Now, Kellogg's makes a fair number of cereals that contain a lot of sugar and they work hard to market them as healthy. With their Frosted Mini-Wheats they've gone over the top, however. They have been making claims in their advertising (directed at moms) that a breakfast of Mini-Wheats helps keep kids focused in school.

What The American Beverage Association wants you to think
Yet sometimes what appears to be of high quality simply isn't, and today's Health & Nutrition Bite is one of them.


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Consider the source - of funding

a bowl of cereal garnished with blueberries

When people find out about my interest in diet and nutrition, they sometimes seem to be surprised that I am an evidence-based physician. I don't tout fad diets. I don't think carbohydrates are bad for you, and I certainly don't think wheat is bad for you, unless, of course, you've been formally diagnosed with Celiac disease (as I have). And when I say "evidence-based" I don't mean that I'll pick only the studies that support my point of view (this is called "cherry-picking") and I certainly don't mean evidence that comes from research that is not well-designed, reviewed by other professionals in the field ("peer-reviewed"), and published in a reputable journal for others in the field to read and respond to.

Unfortunately, when a lot of money is at stake some companies or industry associations do their utmost to sway public opinion by essentially buying scientific "evidence," sometimes in fairly subtle ways. Just two years ago I told you about a study that purported to show that drinking diet soda would help you lose more weight than if you drank water. This made a big splash in the news, as you might expect, but of course the problem? Fully funded by The American Beverage Association (which includes Coca-Cola, PepsiCo, and Dr. Pepper Snapple Group). Kellogg's research on breakfast cereal is another example, where the results are sound, but the design of the study itself served their purposes.

In the most recent issue of JAMA Internal Medicine (2016;176(12):1769-1777), a team of researchers performed a meta-analysis of published articles that compared the quality and outcomes of nutrition research that had been at least partially funded by industry with similar studies that had no such sources of funding. (A meta-analysis groups together multiple studies that are themselves analyses of multiple studies.)

Of the several hundred articles they assessed for relevance to their inquiry, only 8 articles, which included 340 studies, could be included in their analysis. For the purposes of this research, the authors chose to focus on whether industry sponsorship had an effect on whether the results were for or contrary to the industry's interests, whether those results were clinically significant, and how large those effects might be.

In the question of whether the results were for or against the industry's interests, the authors note that there are really two types of outcomes: it's not just whether the product or diet is good for you, but also whether that product or diet produces harm. Thus results that are in line with an industry's interests might be positive (in the first case) or result in a lack of a negative (the second case). They found that overall, while industry-sponsored studies tended to favor the industry, the difference between industry-sponsored and non-industry-sponsored studies was not clinically significant. Further, industry-sponsored studies appeared to be of better overall quality than those studies not receiving funding.

That said, when authors of the analyzed studies disclosed the existence of conflicts of interest (for example, when a study author has been paid to do other work for that industry), 100% of the time the outcomes of that research was favorable to the industry. When there were no conflicts of interest, the outcomes were favorable only 76% of the time.

What this means for you

Industry influence is not limited to affecting the outcomes of the research, however: funding can also help decide what questions are asked, and how; whether the questions are asked at all; whether the research, once completed, is even published (and where); and can even extend to how those outcomes are interpreted, not just by the scientists themselves but also by the media. I hope this study is just the beginning of ongoing inquiries into the effects that industry might have on nutrition research.

First posted: December 7, 2016