Newly released documents reveal that the sugar industry bribed high-profile and influential scientists from Harvard University, paying them to publish fake news about the primary causes of heart attacks.
The Harvard scientists false claims significantly influenced public health strategies regarding nutrition for decades, and the results are still being experienced today.
The news was disclosed in a recent special report in JAMA Internal Medicine and has shocked the research community. If the experts are taking bribes and lying about the causes of heart attacks, what else might they be lying about?
In the 1960s, there was no obligation to disclose conflicts of interest, enabling sugar industry executives to collaborate extensively with the researchers in revising and refining their paper until it met their desired standards, all without the need to acknowledge their own involvement.
‘I thought I had seen everything but this one floored me,’ said Marion Nestle of New York University, who wrote an editorial on the new findings.
‘It was so blatant. And the “bribe” was so big. Funding research is ethical,’ Nestle said. Bribing researchers to produce the evidence you want is not.’
The fake research was published in a literature review in The New England Journal of Medicine in 1967.
It claimed that fat and cholesterol were the main dietary factors contributing to heart disease while disregarding evidence from the 1950s that linked sugar to heart disease as well.
According to the latest report, the review in NEJM was funded by the Sugar Research Foundation (SRF), which is now known as the Sugar Association.
The SRF’s involvement in the study was not disclosed until 1984.
Dr. Mark Hegsted, a nutrition professor at Harvard, co-directed the SRF’s initial research project on heart disease from 1965 to 1966.
In the new report, Laura A. Schmidt from the University of California, San Francisco, along with her colleagues, discovered correspondence that revealed how Dr. Hegsted was commissioned by the SRF to arrive at a predetermined conclusion.
Archives from the University of Illinois and the Harvard Medical Library demonstrate that the foundation established the objective for the literature review, provided funding, and reviewed drafts of the manuscript.
In 1962, an American Medical Association nutrition report indicated that low-fat, high-sugar diets might actually contribute to the development of cholesterol.
According to the new report, two years later, John Hickson, the vice president of the SRF, proposed a major program to counter negative perceptions of sugar.
Increasingly, epidemiological reports suggested that blood sugar, rather than blood cholesterol or high blood pressure, was a more accurate predictor of atherosclerosis.
Two days after The New York Herald Tribune published a full-page story linking sugar to various health issues in July 1965, the SRF approved “Project 226,” a literature review on cholesterol metabolism led by Hegsted and, among others, Fredrick Stare, another Harvard nutritionist with financial ties to the industry.
Nine months later, as Schmidt and her colleagues state, Hegsted explained that the project had been delayed due to the constant need to write counterarguments against new evidence linking sugar to heart disease published during that period.
By September 1966, according to the report, Hickson requested additional drafts of the literature review from the Harvard researchers, although there is no direct evidence of the Foundation commenting on or editing the drafts.
By November 2, Hickson had approved the latest draft as “exactly what we had in mind.”
The two-part review, concluding that the only necessary change to prevent heart disease was to reduce dietary fat intake, was published in the NEJM the following year, with no mention of the SRF’s involvement.
The journal did not require disclosure of conflicts of interest until 1984.
“The sugar association paid highly esteemed Harvard scientists to publish a review that focused on saturated fat and cholesterol as the primary causes of heart disease at a time when studies were starting to accumulate indicating that sugar is a risk factor for heart disease,” Schmidt said.
“That has had an impact on the entire research community and the direction it took.”
“For example, during this period, much of the messaging on how to prevent heart disease revolved around choosing margarine over butter, which has lower saturated fat content,” Schmidt said. “Now we know that margarine is high in trans fats, which contribute to heart disease and have been mostly eliminated from the U.S. food supply.”
“When manufacturers reduced fat, they added sugar,” she said. “We’ve lost a significant amount of time in evaluating how sugar affects coronary heart disease,” but it is impossible to measure the actual impact on public health over the last five decades.
Both large amounts of sugar and saturated fats are detrimental to health, and their effects are difficult to separate, according to Nestle. However, it seems reasonable to limit sugar intake to around 10 percent of daily calories.
Even today, industry funding continues to support a significant amount of scientific research, but journals and scientists are increasingly disclosing these funding sources, Schmidt noted.
“While we acknowledge that the Sugar Research Foundation should have been more transparent in all of its research activities, it is important to note that funding disclosures and transparency standards were not the norm at the time these studies were published,” the Sugar Association stated in a response.
“Moreover, it is challenging for us to comment on events allegedly occurring 60 years ago and on documents we have never seen.”
“The Sugar Association always seeks to further understand the role of sugar in health, but we rely on quality science and factual evidence to support our claims,” the statement concluded.