When reports revealed that the Global Energy Balance Network, a nonprofit that used obesity research to stress fitness over healthy eating, was actually quietly funded by Coca-Cola, many people felt misled. The "Coca-Cola debacle" — or as some have been calling it, the "GEBN debacle" — has also left many in nutrition research feeling embarrassed.
Coke's shifty involvement with the group reignited a longstanding debate about corporate-sponsored science and "funding bias" — the idea that sponsors of research have an inherent bias that influences results. It's a pervasive issue in nutritionist circles, but many folks might be surprised to know how often the nutrition claims they read about have roots in corporate sponsorship. Common claims like chocolate is good for health, or that grape skins and wine have anti-aging properties, or that the Mediterranean diet prevents heart disease have been touted using research supported with funds or scientists closely connected to all kinds of potentially biased organizations, from Mars, Inc. to the California Walnut Commission.
But the research community has been markedly at odds over the amount of damage funding bias is bringing to people's understanding of food and health, and what should be done stop it. On one end, experts have been highly critical of industry-funded studies and say that type of research should almost always be avoided. On the other end, researchers who accept corporate funds say funding is a very small part of a larger issue, if even an issue at all.
Dr. Marion Nestle, nutrition and food studies professor at New York University, falls in the first group. "I worry a lot about the effects of industry sponsorship on public belief in the credibility of nutrition science," Nestle, the author of Soda Politics: Taking on Big Soda (and Winning), told Eater via email. Just because a claim is supposedly backed by "clinical studies" doesn't mean it can be trusted. Even if the research is scientifically sound, Nestle said, ultimately the basis for many corporate-sponsored research is marketing, not just public health. And if there is no scientific basis for the research, companies can make one up.
"The most cogent example is POM Wonderful," Nestle said. "That company spent a fortune, reportedly $35 million, to demonstrate that pomegranate juice has antioxidant properties (really, I could have told them that up front) and other properties that they used for health claims so absurd that the Federal Trade Commission got after them."
Nestle has found examples of 95 studies with results that favored their sponsors. Only nine studies did not.
The FTC acts on leads from consumers, businesses, and the media to investigate misleading marketing claims, which can result in litigation. The commission has also gone after companies that try to spin or hide research in order to promote products. That happened in 2010, when the FTC discovered that Dannon claimed Activia yogurt "was clinically proven to relieve temporary irregularity." In fact, several studies showed that Activia actually had little effect on users when compared to a placebo group, showing that single servings of Activia were not clinically proven to work the way the company suggested.
While these are glaring examples of bias companies bring to or take from the studies they sponsor, Nestle believes consumers should take most scientific claims from industry-sponsored research with a grain of salt. In her observations, most corporate-funded studies favor the sponsors' interests. Nestle has spent much of the last year collecting examples of corporate-sponsored nutrition research found in health journals and across the web. She keeps score of the ratio of sponsor-favoring results to non-favorable results on her blog Food Politics, where she scrutinizes the food industry's influence in nutrition. She's become one of the most vocal critics of funding bias in nutrition and uses her observations to support her claims.
"I have 95 published studies funded by every food company you can think of that favor that company's interests," Nestle said. "I've found nine that don't." That's in line with funding bias studies, which show corporate-sponsored research is very likely to reach conclusions that appease its funders. She says that's why it's important to be critical of all corporate research.
But other researchers think that approach is too extreme. According to them, critics like Nestle are overlooking larger issues and putting excessive pressure on well-intentioned scientists.
"Damned if you do, damned if you don't"
Dr. David Katz, nutritionist and the founding director of Yale University's Prevention Research Center, says there is a difference between conflict of interest and confluence of interest (when funders' vested interests are in line with the public's interest). According to him, it's a mistake for people to just assume that corporate bias always falls under the former: Instead of the rush to judgement, nutritionists should focus on raising industry standards and improving elusive nutrition research.
"I think that's what we should be working on," Katz said. "Where do we draw the line? What are the things that are required to avoid conflict of interest, to allow for confluence of interest, and to ensure that research is reliable, objective, impartial, and responsible no matter who funds it?"
An all-out ban on corporations in research would leave people in need. Katz uses the impact of corporate-led research on the pharmaceutical industry as an example. Without corporations, many common medicines and pharmaceutical products people use, such as antibiotics and cancer-treating drugs, wouldn't exist. If food companies want to use research to make a better product and improve consumers' health at the same time, let them, he says.
Nestle disagrees. "Industry-funded studies are hardly ever aimed at open-ended, basic research. They are about how specific foods, ingredients, or products affect some aspect of health," Nestle said. "My collection includes research funded by trade groups for walnuts and pears and plenty of other foods everyone would judge ‘healthy,' but having a Pear Association fund research on the health benefits of pears gives nutrition research a bad name — it's embarrassing."
"It’s kind of damned if you do, damned if you don’t. People don’t even bother to make it through the science."
This hasn't stopped researchers from openly vouching for corporate money and offering to help companies with research. The Maryland Industrial Partnerships at the University of Maryland seeks collaborations between companies and university researchers. One of the program's most recent projects showed that a Maryland-based muscle milk company that targets athletes seeking workout recovery fuel, helped to improve concussion-related measures in high school football players. The startup company Fifth Quarter Fresh touts the research on its website. But critics were quick to point out that an actual peer-reviewed study, aside from a press release, has not been released yet.
With researchers defending such partnerships, corporate influence in nutrition research is unlikely to stop in the near future. Advocates of industry funding, like Dr. Andrew Brown, a scientist and researcher at the Nutrition and Obesity Research Center & Office of Energetics at the University of Alabama at Birmingham, argue that corporate funding is not really the issue on which to focus. "We like to say that with science, there's only three things that matter: the data, the way the data were collected, and the logic connecting the data to the conclusions," Brown said.
When scientists focus on those three things, the entire scientific enterprise is accounted for, not just one part, he said. Solely targeting funding could end up being counterproductive. One example is what Brown and his colleagues call "forelashing," when researchers or event organizers are criticized for disclosing their sponsors, sometimes before critics have had the chance to see the actual study or event. Others still get backlash after they've published reports without fully disclosing conflicts of interest.
"It's kind of damned if you do, damned if you don't," Brown said. "People don't even bother to make it through the science." The result is critics zooming so far in on funding, they leave no room for the findings. This has happened to Brown and his colleagues before, he said. "Unfortunately, that just distracted from the entire project. Instead of looking at our question, our methods, our results, and our conclusions, it just looked at funding and stopped."
Brown echoes Katz in saying there are bigger fish to fry in nutrition research. Instead of immediately labeling corporate-sponsored studies as problematic, Brown argues critics should tackle the larger issue of conflict of interest in nutrition research, finding far-reaching ways to hold researchers accountable for their scientific methods, not who they allow to fund them.
Corporate dollars entice many researchers, who have few options for funding their projects: Government grants, usually from the National Institutes of Health (NIH), private grants and corporate sponsorship are the most common methods. But while the amount of money the government has given to nutrition research has increased slightly over the past years, the NIH and government agencies have started to tighten guidelines for the projects they fund, making the grants more competitive. A recent study found that NIH-sponsored research declined 24 percent between 2006 and 2014, while private sponsored research increased by 43 percent.
It's easy for people to criticize funding methods when they don't rely on them to make a living, critics say. Researchers like Brown want to keep corporate sponsorship in the field while ensuring the public's trust in the science at the time.
But this balance is hard to find, Nestle says. "Every nutrition research society I am aware of is frantically trying to set up policies that will allow them to take industry funding, but protect their integrity," Nestle said. "I wish them luck." Meanwhile, consumers and public health are paying the price when dubious research slips through the cracks. Another approach, Nestle said, is to ask food companies to contribute to a larger pool and have an independent organization distribute the funds based on scientific merit. But few companies will want to do that.
"The more people understand how industry funding biases research, the better it will be for all concerned."
Nestle's way of helping is keeping the public aware of the scope of corporate sponsorship, through her blogs and books. She said she also hopes to make policy suggestions for researchers and societies.
That's one thing on which the experts agree — if nutrition researchers want to keep public trust, they have to work on improving policies and practices that prevent conflict of interests from influencing studies or the way results are revealed to the public. Consumers can also do their part by fact-checking claims and studies or reading the fine print before rushing out to buy the latest foods "clinically proven" to make them feel and look better.
"This is a critically important issue," Nestle said. "And the more people understand how industry funding biases research, and how little the bias is recognized by researchers who accept industry funding, the better it will be for all concerned."