April 4, 2015

Stanton A. Glantz, PhD

Sugar industry criticism of our paper on how they influenced NIH contradicts industry's own internal documents

On March 23, 2015, Dr Richard Cottrell, the Director General of the World Sugar Research Organisation, published comment criticising of the paper, "Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents" Cristin Kearns, Laura Schmidt and I published in PLoS Medicine.
 
The most interesting thing about Dr. Cottrell's criticisms is that they are all contrdicted by the sugar industry's own internal documents.  Here is our response to what he wrote:
 

The World Sugar Research Organization’s (WSRO) response [1] to our paper Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents [2] illustrates how the sugar industry continues to try to protect itself from potentially damaging research.

None of the criticisms in the WSRO letter contest the substantive results of our analysis of internal sugar industry documents.

The criticisms instead seek to distance WSRO from the industry efforts to influence taxpayer-funded research on sugar documented in our paper. This letter in fact provides an excellent illustration of the industry’s continuing efforts to shift attention away from sugar’s role in promoting tooth decay, the same strategies that we document from a half-century ago.

First, WSRO claims that it is unrelated to the International Sugar Research Foundation (ISRF), which spearheaded efforts to influence National Institute of Dental Research (now the National Institute of Dental and Craniofacial Research) science in the late 1960s. This claim is false. As documented in our paper, WSRO was formed from ISRF [3]. In a 1978 internal industry document, the President of the Sugar Association described the relationship between ISRF and WSRO as follows:

This past month [March 1978], 'ISRF has become WSRO' (World Sugar Research Organisation). The first meeting of this new organization was held in London in March and it would seem that it is now progressing along the lines recommended by the Sugar Association membership. Basically this means that the new WSRO will be acting as a clearing house for research information and a meeting place for world sugar organizations. [3] [emphasis added]

Furthermore, as described in March 1978 by KC Sinclair, Chief Executive of the British Sugar Corporation, [4] the last ISRF meeting and first WSRO meeting were one in the same:

At the Annual Meeting of the International Sugar Research Foundation held in London in March 1978 one day was devoted to a discussion of Nutritional Guidance, and in particular as it relates to Government involvement. A panel of four speakers introduced the subject and a full discussion followed. In view of the importance and great interest in nutrition these days and strong and sometimes mistaken views held by many on this subject a full report of the meeting was made. It is available in typescript to members, on demand.

'The meeting was held under the auspices of the International Sugar Research Foundation which is being replaced by the World Sugar Research Foundation.' This report may therefore be regarded as the last publication of the ISRF and the first of the new WSRO. It is hoped that this summary of addresses will be of value to those concerned with advising what we eat and that it may be a worthy successor to the high standard reports of the ISRF. [5] [emphasis added]

WSRO’s disavowal of any relationship to ISRF also contradicts its 2011 publication titled, A Guide for Members:

Shortly after the Second World War, the Sugar Research Foundation (SRF) was created by the US Sugar Association as its ‘research arm’. The Foundation supported projects at leading institutions and universities initially in the US and later in the UK. The main areas of research were sugar technology, non-food applications and health aspects of sugar. In 1970, when Tate & Lyle, the British Sugar Corporation and the Belgian company Raffinerie Tirlmontoise joined the SRF it became the International Sugar Research Foundation.

In the seventies, ‘sugar and health’ issues were becoming important in the US and emphasis on non-food applications was therefore reduced. In view of the consequent divergence of research objectives amongst the members of the ISRF, a new co-operative venture resulted which led to the creation in 1978 of the World Sugar Research Organisation (WSRO). Its members then included the US Sugar Association, the British Sugar Bureau, Tate & Lyle, the South African Sugar Association and a number of sugar companies in Canada, Europe and Latin-America. [6]

Second, in its critique of our study, WSRO dismisses its role in ensuring that the quantitative limit for free sugars of less than 10% of total calories recommended by the Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases in 2003 [7] was omitted from the 2004 WHO Global Strategy on Diet, Physical, Activity and Health [8], as documented by Norum [9] In its letter, WSRO claims that because it has no official standing with the WHO, it was in no position to block any WHO proposal. This statement ignores the fact that the WHO, one of many specialized agencies within the United Nations [10], works with other UN agencies, including the Food and Agriculture Organization (FAO), to develop and implement policies that concern both agencies [11]. The 2011 WSRO A Guide to Members describes WSRO’s relationships to UN agencies, including its official standing with the FAO and Codex Alimentarious Commission. In particular, the Guide lists numerous successful collaborations between the WSRO and the WHO and FAO, which include:

'WSRO ACHIEVEMENTS

World Level Relationships'

WSRO collaborates with such world-wide bodies as the Food and Agriculture Organisation (FAO) and the World Health Organisation (WHO) of the United Nations and the International Life Sciences Institute (ILSI).

WSRO has an International Non-Governmental Organisation (INGO) liaison status with the FAO and has represented its Members at FAO meetings, especially the Committee on Agriculture.

WSRO has Observer status with the Codex Alimentarius Commission and has represented its Members in many Codex meetings on topics related to nutrition labelling and health claims.

'Collaborative programmes with FAO and WHO include:'

WSRO has completed a collaborative programme with WHO on “Oral Health,” referring to the fluoridation of sugar and involving research projects in several countries. The programme resulted in a series of research papers published in Advances in Dental Research, volume 9, 1995.

The “Carbohydrate Expert Consultation” programme with the FAO/WHO, initiated in 1996, resulted in a report: Report of a Joint Food and Agriculture Organisation / World Health Organisation Expert Consultation (1998). Carbohydrates in Human Nutrition. FAO Food and Nutrition Paper No 66. FAO, Rome.

The “Obesity Expert Consultation” programme with WHO, initiated in 1996, has resulted in a WHO Technical Report 894, “Obesity - Preventing and Managing the Global Epidemic”. WHO 2000.

WSRO was among a number of organizations invited to comment on the Draft of WHO/FAO Technical Report 916 “Diet, Nutrition and the Prevention of Chronic Diseases” in 2002. Its comments were published on the WHO web site. [6]

Third, while WSRO dismisses the importance of the omission of the quantitative limit on free sugars from the 2004 WHO Global Strategy on Diet, Physical, Activity and Health, it clearly understands the potential adverse effect on sugar sales if the 10% quantitative limit had been implemented. The May 9, 2013 edition of the Sugar Association newsletter Sugar E-News reports that:

WSRO commissioned an analysis quantifying the impact of this WHO recommendation. 'If a 10% sugar limit were adopted worldwide, the year-2005 global demand for sugar would be nearly 23 million tons lower than year-2000 global demand.' [12] [emphasis added]

The WSRO’s remaining criticisms of our paper fail to address anything specific to our analysis. They simply represent a continuation of the strategy, documented in our paper, whereby the sugar industry tries to deflect attention away from the clear need for public health measures that reduce sugar consumption to prevent dental caries.

Finally, WSRO dismisses our analysis, suggesting that the historical events uncovered have no relevance to nutrition debates today. This claim, in fact, echoes the statement Brown and Williamson Tobacco issued in 1995 in response to the first research papers [13,14,15,16,17] that analyzed internal tobacco industry documents:

Lifting single phrases or sentences from 30 year-old documents and using that information to distort and misrepresent B&W's position on a number of issues is clearly what is occurring ... We continue to believe that nicotine is not addictive because over 40 million Americans have quit smoking, 90 percent of them without any help at all. [18]

Nothing in the WSRO letter contradicts the evidence we present. In fact, this letter reinforces our point that “the sugar industry’s current position—that public health recommendations to reduce dental caries risk should focus on sugar harm reduction as opposed to sugar restrictions—is grounded in more than 60 years of protecting industry interests.” This letter from WSRO underscores the importance of our historical analysis and its relevance to today’s nutrition policy debate. Industry opposition to current policy proposals to restrict sugar intake should be carefully scrutinized to ensure that industry interests do not supersede public health goals.

Cristin Kearns, DDS, MBA
Stanton Glantz, PhD
Laura Schmidt, PhD

University of California, San Francisco

REFERENCES

1. Cottrell RC (2015) Response to PLOS Medicine paper by Kearns et al.; Available: http://www.plosmedicine.o.... Accessed 26 March 2015.

2. Kearns CE, Glantz SA, Schmidt LA (2015) Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents. PLoS Med 12: e1001798.

3. The Sugar Association (1978) The Sugar Association, Inc. Annual Meeting of Members May 11, 1978, Washington, D.C. Records of the Great Western Sugar Company. Fort Collins (Colorado): Agricultural and Natural Resources Archive, Colorado State University.

4. International Sugar Research Foundation (1975) Planning the Research Effort: I. Identification of Priorities II. Specific Recommendations, September 11 & 12, 1975. Records of the Great Western Sugar Company. Fort Collins (Colorado): Agricultural and Natural Resources Archive, Colorado State University.

5. International Sugar Research Foundation/World Sugar Research Organisation (1978) International Sugar Research Foundation/World Sugar Research Organisation symposium, March 1978. London: International Sugar Research Foundation/World Sugar Research Organisation.

6. World Sugar Research Organisation (2011) World Sugar Research Organisation: A Guide to Members. Accessed at: http://www.wsro.org. on 13 February 2013.

7. Joint WHO/FAO Expert Consultation on Diet Nutrition and the Prevention of Chronic Disease (2003) WHO Technical Report Series, No. 916 (TRS 916): Diet, nutrition and the prevention of chronic diseases: Report of the joint WHO/FAO expert consultation, Geneva 28 January - 1 February 2002. Available: http://whqlibdoc.who.int/.... Accessed 20 October 2014.

8. World Health Organization (2004) Global Strategy on Diet, Physical Activity, and Health. Available: http://www.who.int/dietph.... Accessed 19 December 2014.

9. Norum KR (2005) World Health Organization’s global strategy on diet, physical activity and health: the process behind the scenes. Food & Nutrition Research 49: 83-88.

10. United Nations (2015) Funds, Programmes, Specialized Agencies and Others. Available: http://www.un.org/en/sect.... Accessed 26 March 2015.

11. Food and Agriculture Organization of the United Nations World Health Organization (2007) FAO/WHO Framework for the Provision of Scientific Advice on Food Safety and Nutrition. Available: ftp://ftp.fao.org/docrep/.... Accessed 26 March 2015.

12. The Sugar Association Inc. (2003) Sugar E-News Vol. 6#18 May 9, 2003. Available: http://www.sweetbeet.com/.... Accessed 26 March 2015.

13. Glantz SA, Barnes DE, Bero L, Hanauer P, Slade J (1995) Looking through a keyhole at the tobacco industry. The Brown and Williamson documents. Jama 274: 219-224.

14. Slade J, Bero LA, Hanauer P, Barnes DE, Glantz SA (1995) Nicotine and addiction. The Brown and Williamson documents. Jama 274: 225-233.

15. Hanauer P, Slade J, Barnes DE, Bero L, Glantz SA (1995) Lawyer control of internal scientific research to protect against products liability lawsuits. The Brown and Williamson documents. Jama 274: 234-240.

16. Bero L, Barnes DE, Hanauer P, Slade J, Glantz SA (1995) Lawyer control of the tobacco industry's external research program. The Brown and Williamson documents. Jama 274: 241-247.

17. Barnes DE, Hanauer P, Slade J, Bero LA, Glantz SA (1995) Environmental tobacco smoke. The Brown and Williamson documents. Jama 274: 248-253.

18. Graham T (1995) The Brown and Williamson documents: The company's response. JAMA 274: 254-255.

 
You can read the criticism and our response here.

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