For decades, docs have been advising Americans to limit the saturated fat in their diets by eating fewer delicious foods like butter.
It makes sense, considering that heart disease is the leading cause of death in the United States, and fatty foods surely clog your arteries, right? Over the past few years, though, a debate has been heating up about whether fat is really the the main driver of heart disease, or if sugar may also be to blame.
Then, last month, an exposé came out showing that back in the '60s, the sugar industry framed fat as the bad guy and exited out the back door of the heart disease blame game. Early evidence that sugar might play a role in all sorts of chronic disease shifted quickly into an all-out public health war on fat. How could this happen?
The short answer is: bribes. How does anything get done? But there's more to the story.
Sugar was losing, and it got desperate
Back in the 1960s, people were seriously freaking out about heart disease. In just one decade, the death rate from the condition rose nearly 25%, and everyone was trying to figure out how to curb it.
Diet surely played some role, and since the 1950s, scientists had been scrutinizing the two major suspects: fat and sugar. By the early 1960s, evidence was beginning to suggest that folks with high-sugar diets were getting heart disease, even if they didn't eat much fat. This had the sugar industry -- represented by the Sugar Research Foundation (SRF), which today is the National Sugar Association -- concerned, to say the least. They devised a plan.
The authors of the exposé discovered that the sugar industry “identified a strategic opportunity for the sugar industry: increase sugar’s market share by getting Americans to eat a lower-fat diet.” In the business world, "market share" usually means percentage of total dollars people spend on a product. But the sugar folks weren’t talking about total dollars -- they were talking about total calories.
There are three essential macronutrients that provide your daily calories: fat, carbohydrates, and proteins. Fat is fat. Sugar is a carbohydrate. Protein was lucky to avoid this war. If you reduce one of these in your diet, you'll probably make up for it with calories from another group. So if the sugar people could get people to eat less fat, that would free up all those extra calories so that they could eat (meaning buy) more sugar.
Big Sugar decided to "help" scientists with funding
One question remained: with evidence about sugar's role in heart disease starting to mount, how could the industry hope to secure those extra calories? The Sugar Research Foundation got a meeting with D. Mark Hegsted, a top nutrition researcher at Harvard, and offered to give him and his team a hand with research funding -- specifically so that they could take a second look at the heart disease research on sugar and fat that was already out there and use it to convict fat and acquit sugar.
A couple weeks later, they shook hands on a deal not at all suspiciously called “Project 226.” As scientists reviewed past research on heart disease, the sugar people made themselves chummy with the Harvard scientists, sending them research articles to support their argument and reviewing drafts for them. Just nice, friendly help from the good folks at Big Sugar.
This isn't just conspiracy theory mumbo-jumbo, either -- the documents show that three scientists were paid what works out to $50,000 in current dollars to publish the research. Industry influence didn't stop there, either, with around 1,500 pages of Sugar Research Foundation correspondence show how Big Sugar tried to get the sweet stuff off the hook for causing cavities. As there was no email in those days, these were... written. By hand. Now that’s some dedication to deceiving the public.
Sugar won, and fat lost
In 1967, Harvard researchers finally published their star review article on fat, sugar, and heart disease in the New England Journal of Medicine, a journal whose name is a stand-in for credibility. The fact that the paper was a review -- not a single scientific study, but a giant explanation of a bunch of different studies and how their findings can be combined to demonstrate something that no one but the people writing it can understand -- definitely helped.
To make a review legit, scientists can’t ignore important studies in the field. So the authors did talk about all the evidence that showed sugar was associated with heart disease, but they explained why those studies couldn’t be taken seriously -- because either the scientists conducting those studies used the wrong kind of sugar, or they used the wrong kinds of study participants, or they were just dumbasses and interpreted the results totally wrong. After tearing apart the existing sugar research, the authors pulled together a bunch of studies on how saturated fats were clearly the ones that caused heart disease and called it a day. Everybody was impressed.
Ten years after the Harvard article was published, D. Mark Hegsted became Administrator of Nutrition at the USDA, where he helped write the now-hilariously-outdated first Dietary Guidelines for Americans in 1980, officially telling your parents what to eat and feed their kids.
And there you have it, the guy who was bribed was running the show.
What you call "bribery," industry groups call "funding"
While it seems like the ultimate scandal though, what went down with the sugar industry funding was actually pretty normal. Today, leading medical journal JAMA Internal Medicine requires what they call “conflict of interest and financial disclosures," but they didn’t back then, and it wasn’t even standard practice for other journals, either.
Now disclosures are required, but industry funding of scientific research itself remains routine, and has actually increased dramatically in the past few decades. Professors are always scrambling for cash to publish their papers and pay their bills, and while government funding still occurs, it's tougher and tougher to come by.
On the one hand, private money offers a necessary bridge between the number of researchers seeking funding and the amount of government money available. But private money also tends to have ulterior motives attached, whether they're explicitly stated or not. More than half of biomedical research, for instance, is funded by pharmaceutical companies. And... big surprise! Funding is associated with results. Research has found that 51% of privately funded medication trials say the drug being tested to be the best treatment, compared to only 16% of trials funded by nonprofits.
So how do you know which research is legit, and which is BS?
It's certainly tricky! When it comes to nutrition, though, a good question to ask yourself when reading news about a study is: who stands to benefit? If the research says you're supposed to eat more chocolate, for example, check to see if it was funded by a chocolate lobby (there's seriously a lobby for pretty much everything).
Ultimately, nutrition isn't as complex as media coverage of the subject would have you believe. If you stick to real, unprocessed foods, and get plenty of fruits and vegetables, you shouldn't have too much to worry about -- no matter what industry-funded studies say to the contrary.
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