I love nutrition science. On my first teaching job, I was assigned to teach a nutrition course, and it was like falling in love. To this day, I love the intellectual challenge of figuring out what we eat, why we eat what we do, and how diets affect our health. I love the complexity of food issues and the passion people bring to every one of them. But I do not love the way the food industry has added an unnecessary complication: engaging nutrition professionals in marketing objectives, sometimes against the interests of public health.
My new book, Unsavory Truth, is about how food, beverage, and supplement companies (collectively, food companies) fund nutrition researchers and practitioners and their professional associations, with the ultimate goal of promoting sales. This book appears at a time when scandals created by such funding make front-page news. Let me plunge right in with an unexpected — and highly surreal — example of why this topic should matter to all of us.
You may recall that during the especially contentious U.S. presidential race of 2016, hackers linked to the Russian government stole a trove of electronic messages from Democratic Party officials and posted them on the WikiLeaks website. They also stole emails from people working on Hillary Clinton’s campaign and posted them on a new website, DCLeaks. International intrigue like this ought to seem light-years removed from food-industry funding of nutrition professionals, except for one truly bizarre coincidence: The cache on DCLeaks included messages exchanged between Capricia Marshall, an adviser to the Clinton campaign, and Michael Goltzman, a vice president at the Coca-Cola Company. While working with Clinton, Marshall was also consulting for Coca-Cola and billing the company $7,000 a month for her services.
The Coca-Cola emails may have been collateral damage from Russian interference in the U.S. election, but for my research, they were a gift — not least because I turn up in them. The hacked emails included a January 2016 message from the director of an Australian agency doing public relations for Coca-Cola with notes taken at a lecture I had just presented to the Sydney chapter of the Nutrition Society of Australia. The emailed notes on my lecture — quite nicely done, actually — name some of the people attending my talk, review its content, and advise Coca-Cola to monitor my future presentations, research, and presence on social media.
Food-company funding often does exert undue influence, and it invariably appears to do so. Even a hint of industry funding is all it takes to reduce trust among the public.
I vaguely remember someone telling me that a representative from Coca-Cola was at my talk, but I thought nothing of it. My 2015 book about the soft-drink industry, Soda Politics: Taking on Big Soda (and Winning), had just been published, and I assumed that someone from that industry was in the audience at every talk I gave. The stolen emails demonstrate Coca-Cola’s intense interest in the activities of individuals anywhere in the world who might question the health effects of its products.
The emails also reveal this particular company’s pressures on reporters — and their editors — who write about such topics. In 2015, Candice Choi, a reporter for the Associated Press (AP), was investigating Coca-Cola’s recruitment of dietitians to promote sodas on social media. The company’s public relations staff had been working with dietitians for years to get them “to place sponsored content that promotes how our beverages can fit within a healthy, balanced diet.” Because the staff expected Choi’s article “to have a cynical, negative perspective,” they “reached out to the AP’s editors to formally register concerns about the story,” promising to “continue to urge them not to run with the story.” In this instance, the pressures did not succeed. As published, Choi’s article described the ways food companies worked “behind the scenes to cast their products in a positive light, often with the help of third parties who are seen as trusted authorities.” She quoted a company spokesman’s defense of this strategy: “We have a network of dietitians we work with… Every big brand works with bloggers or has paid talent.” Really? Thanks to the emails, we now know something about how this system works.
The emails show how Coca-Cola operates to influence reporters who write about such topics. Coca-Cola staff were on a first-name basis with Mike Esterl, a reporter for the Wall Street Journal. They had learned about a study demonstrating the benefits of soda taxes and wanted to make sure that “Mike understood the source of the study and that it had not been published or peer reviewed yet.” Another message said, “FYI — please note we have been engaging Candice Choi AP reporter since April on this story and there have been numerous engagements — both verbal and written.”
This same email also refers to the cozy relationship between Coca-Cola’s then–chief scientific officer, Rhona Applebaum, and university scientists conducting research funded by the company. Coca-Cola staff wrote that they had confirmation from Choi that her story would include an email exchange in which Applebaum referred to the group of university researchers she works with regularly as the “cartel” and another in which Applebaum referred to critics of Coca-Cola as “trolls.” Choi’s published article (in which I am quoted) made two points: Industry-funded research typically promotes the sponsor’s interests, and some researchers make a living doing research funded by food companies and trade associations. She noted that one such group “regularly delivered favorable conclusions for funders — or as they call them, clients.”
Other messages referred to Coca-Cola’s lobbying to influence federal nutrition advice. The public relations team worried that the academic advisory committee responsible for reviewing the research for the 2015 Dietary Guidelines for Americans had proposed “eliminating sugar-sweetened beverages from schools, taxing them, and restricting advertising of foods and beverages with ‘high’ sodium or added sugars for all populations.” The public relations team suggested that the company “should be prepared for this report to be cited frequently by activists” and should “work together to balance coverage.” Coca-Cola’s director of government relations later assured colleagues that his team had been working closely with Congress and federal agencies “to ensure that policy recommendation on a soda tax is not included in the final guidelines.” These efforts succeeded; the word “tax” does not appear anywhere in the 2015 dietary guidelines.
Overall, the hacked emails offer a rare glimpse into how this beverage company — simply in the normal course of doing business — attempted to influence nutritionists, nutrition research, journalists covering this research, and dietary advice to the public. Other food companies do this too when they can. The difference? Coca-Cola got caught.
This was not the first time Coca-Cola got caught. In August 2015, the New York Times ran a front-page story on Coca-Cola’s funding of university researchers who had created a group called the Global Energy Balance Network (GEBN). GEBN’s purpose was to convince the public — against much evidence to the contrary — that physical activity is superior to dieting (and to avoiding Coca-Cola, of course) as a means of controlling body weight. Because I was quoted in that story, reporters called me for further comment. They could hardly believe that a company as prominent as Coca-Cola would fund research so obviously self-serving, that researchers at respected universities would accept funds from Coca-Cola for this purpose, or that universities would allow faculty to do so.
Coca-Cola is by no means alone in sponsoring marketing research masquerading as basic science. Here is another example. Late in 2017, the Journal of the American Heart Association published the results of a clinical trial concluding that incorporating dark chocolate and almonds in your diet may reduce your risk of coronary heart disease. I love that. But can you guess who paid for this study? The Hershey Company and the Almond Board of California were its funders. They also paid seven of the nine authors for their participation; the other two were employees of the funders.
But what if the findings of such studies are true? If exercise, chocolate, and almonds are good for health, what’s wrong with funding research to prove it? This is a serious question that deserves a serious answer.
Let me state for the record that financial ties with food companies are not necessarily corrupting; it is quite possible to do industry-funded research and retain independence and integrity. But food-company funding often does exert undue influence, and it invariably appears to do so. Even a hint of industry funding is all it takes to reduce trust among some segments of the public. Nutrition professionals have long recognized the reputational hazards of accepting sponsorship from food companies but for the most part have considered the benefits — in money, resources, and contacts — to be well worth the risk. From the food industry’s standpoint, “capturing” nutrition scientists and practitioners is a well-established strategy for influencing dietary advice and public policy.
In public health terms, industry-induced conflicts constitute a “wicked” problem, one with no easy solution beyond not taking the money. But in the real world of nutrition research and practice, not taking the money is easier said than done, especially by those who are more dependent than I am on external funding for their research and salaries. Even so, I think it would be healthier for all of us if nutrition professionals — practitioners as well as researchers — grappled much harder with the risks and consequences of food-company sponsorship and set firm policies to minimize these problems.