What role did the sugar industry play in 1960s heart disease research?

A report by JAMA Internal Medicine suggests the sugar industry sponsored research to influence the scientific debate to cast doubt on the hazards of sugar and to promote dietary fat as the culprit in heart disease.

Stanton A Glantz, PhD, of the University of California, San Francisco, and coauthors examined internal documents from the Sugar Research Foundation (SRF) (which later evolved into the Sugar Association), historical reports and other material to create a chronological case study. The documents included correspondence between the SRF and a Harvard University professor of nutrition who was co-director of the SRF’s first coronary heart disease research program in the 1960s.

The SRF initiated coronary heart disease research in 1965 and its first project was a literature review published in the New England Journal of Medicine in 1967. The review focused on fat and cholesterol as the dietary causes of coronary heart disease and downplayed sugar consumption as also a risk factor. SRF set the review’s objective, contributed articles to be included and received drafts, while the SRF’s funding and role were not disclosed, according to the article.

The authors point out the NEJM has required authors to disclose all conflicts of interest since 1984. They further acknowledge there is no direct evidence that the sugar industry wrote or changed the NEJM review manuscript and evidence that the industry shaped its conclusions is circumstantial.

The papers and documents used in the research provide only a small view into the activities of one sugar industry trade group. The authors did not analyse the role of other organisations, nutrition leaders or food industries, and key figures in the historical episode detailed in this article could not be interviewed because they have died.

“This study suggests that the sugar industry sponsored its first CHD [coronary heart disease] research project in 1965 to downplay early warning signs that sucrose consumption was a risk factor in CHD. As of 2016, sugar control policies are being promulgated in international, federal, state and local venues. Yet CHD risk is inconsistently cited as a health consequence of added sugars consumption. Because CHD is the leading cause of death globally, the health community should ensure that CHD risk is evaluated in future risk assessments of added sugars. Policymaking committees should consider giving less weight to food industry-funded studies, and include mechanistic and animal studies as well as studies appraising the effect of added sugars on multiple CHD biomarkers and disease development,” the article concludes.