What’s a favorable scientific finding worth? Almost $50,000, apparently. That’s how much the Sugar Research Foundation, an industry-organized group, paid Harvard University scientists in 1965 to write a review of existing studies about the effects of eating fat and sugar on people’s cholesterol and triglyceride levels. (The fee in 1965 dollars was $6,500.) The review, which a Sugar Research Foundation representative read drafts of before publication, concluded that, to avoid heart disease, people should eat less saturated fat and cholesterol — but didn’t make the same recommendation for sugar. It was published in one of the nation’s leading journals, the New England Journal of Medicine.
The review was a part of a decades-long industry effort to maintain scientific uncertainty around whether eating too much sugar causes diabetes and heart disease. In Pacific Standard’s January/February 2016 issue, I wrote about the work of Cristin Kearns, an archives researcher at the University of California–San Francisco, to piece together that history. The $50,000 review is her latest finding.
The commission was paid and the paper published long ago, but Americans are still feeling the consequences today. The lingering scientific questions around sugar and health are why doctors and standards, such as the Dietary Guidelines for Americans, only began recommending a hard cap on how much added sugar people should eat last year. In contrast, recommended limits have long existed for fat, cholesterol, salt, and other nutrients. Meanwhile, the evidence is growing that eating sugar does indeed contribute to heart disease, although the Sugar Association — the modern-day name of the Sugar Research Foundation — disagrees. “The last several decades of research have concluded that sugar does not have a unique role in heart disease,” a statement on the association’s website reads.
“Systematic reviews are highly influential in policymaking.”
The 1965 review appeared in a prestigious, peer-reviewed journal—a distinction that many of the other sugar papers Kearns has analyzed lack. (The journal did not mention the paper’s funding source, which most journals did not begin requiring of authors until the mid-1980s.) The work was supposed to have been checked for quality. Yet Kearns and her team found numerous, subtle problems with the way Harvard nutritionists Robert McGandy, Mark Hegsted, and Fred Stare, all now deceased, conducted the review. For one thing, they “tore apart” studies that linked eating too much sugar with coronary heart disease. But the papers showing that eating less fat led to better cholesterol levels? “It’s like they gave the fat studies a free pass,” Kearns says.
That amount of money—$50,000—may seem like a lot to pay to try to influence a single paper, but Kearns thinks the then-Sugar Research Foundation was right to expect it would be a reasonable investment if the review turned out in the foundation’s favor. “Systematic reviews are highly influential in policymaking,” she says. Because they offer an overview of many studies, reviews are supposed to be more reliable than single experiments, so guideline-makers often rely on them. In the end, the Sugar Research Foundation was happy with McGandy, Hegsted, and Stare’s work. In a letter to Hegsted, the foundation’s vice president, John Hickson, wrote, “Let me assure you this is quite what we had in mind and we look forward to its appearance in print.”
“We acknowledge that the Sugar Research Foundation should have exercised greater transparency in all of its research activities,” the Sugar Association says in a statement. “Beyond this, it is challenging for us to comment on events that allegedly occurred 60 years ago, and on documents we have never seen.”
As Kearns read through the 1965 New England Journal of Medicine sugar review, she found it reminded her of the famed 1964 Surgeon General’s report that declared smoking causes lung cancer and heart disease. “The way the evidence was being critiqued and collated was really similar,” she says. “I believe the industry was trying to get ahead of policymakers trying to define how the risks of sugar would be assessed.” It appears that, for many years, they succeeded.
