Time to give up the "fat bad, sugar neutral" mantra for weight control. After 40 years of doctors blaming fat (like butter, eggs and beef fat) for clogged arteries, in 2013, the British Medical Journal (BMJ) led the way in publishing studies that showed researchers could find no actual correlation between heart conditions and dietary fat.
Now JAMA, the Journal of the American Medical Association, has published, "Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents." One of the co-authors, Cristin Kearns, is a dentist and an administrator who was jarred when colleagues said sugar posed no hazards to anyone's teeth or health. She has spent years researching why they would say such a thing.
The article's abstract explains that, "This Special Communication uses internal sugar industry documents to describe how the industry sought to influence the scientific debate over the dietary causes of CHD [Chronic Heart Disease] in the 1950s and 1960s, a debate still reverberating in 2016." The story that unfolds evokes echoes of Big Tobacco's efforts to conceal how dangerous their product is to their consumers.
The sugar industry knew as early as 1962 that there was a link between sugar consumption and higher cholesterol. The Sugar Research Foundation's (SRF) vice president and director of research, John Hickson, drew up plans for a publicity campaign to counter growing evidence, including a public opinion poll and a medical literature review article in a prestigious medical journal. "We should carefully review the reports [linking sugar to heart problems], probably with a committee of nutrition specialists," he wrote to the SRF Board, "see what weak points there are in the experimentation, and replicate the studies with appropriate corrections. Then we can publish the data and refute our detractors."
In 1965, Hickson recruited Harvard professor Marc Hegsted to prepare the literature review, which took two years and cost the SRF the equivalent of nearly $50,000 in modern money. Hegsted published a two-part literature review (with two co-authors) -- "Dietary Fats, Carbohydrates and Atherosclerotic Disease" – in the New England Journal of Medicine (NEJM) in 1967. Says the JAMA article, "The review concluded there was 'no doubt' that the only dietary intervention required to prevent CHD was to reduce dietary cholesterol and substitute polyunsaturated fat for saturated fat in the American diet."
The article proved to be hugely influential in shaping medical policies about diet. "Low fat!" became the mantra on prepared foods, which rarely mentioned that they'd replaced fat's flavour and texture by increasing the sugar. Sales of butter, a saturated fat, dropped, while sales of margarine soared -- although margarine, a trans fat, is now known to be the more dangerous spread. Meanwhile, food manufacturers devised more and more ways to whip sugar and margarine into endless products, included at the deli meat counter as well as the bakery shop; in fast food hamburger buns as well as ketchup flavoured potato chips. And Americans grew fatter and fatter.
The SRF's publicity campaigns were persuasive and pervasive. In 1971, they influenced the American Dental Association to pursue an anti-caries vaccine instead of campaigning to reduce sugar consumption. In 2007, Dr. Kearns was flabbergasted to attend a conference about diabetes and dental problems where all the speakers downplayed sugar role in causing cavities, let alone chronic disease.
At the end of healthy-living guru Steven G. Aldana’' talk, he handed out free "health guides" to fast food. As Kearns wrote in one of her Mother Jones articles,
"I caught him halfway up the stairs leading to the street. 'How can you say sweet tea is good for you?' I blurted out, less eloquently than I had intended. Aldana's book had given Lipton Brisk -- which contains 11 teaspoons of sugars per 16-ounce can -- his 'You're eating healthy!' seal of approval. Earlier in my career, working as a dental director for low-income clinics in Denver, I had seen firsthand the damage these kinds of sugary drinks incur on people's teeth -- never mind the causative role they may play in chronic diseases such as diabetes and obesity.
Perched three steps above me, Aldana looked down calmly. 'There is no research to support that sugar causes chronic disease,' he said. Then, before I could string another sentence together, he was out the door."
Other speakers also overlooked sugar, even when they talked about managing diabetes. Perplexed, Kearns gave up her social life to run Google searches evenings and weekends, until she believed she had evidence of the sugar industry's interference in medical policies and practices. Then she gave up her comfortable job in administration at the dental wing of Kaiser Permanente to pursue her research full time.
Fifteen months later, near the end of her savings, Kearns unearthed some personal papers in an out-of-state library, an archive documenting a milestone in advertising and PR history. Piecing together photos and news stories, Kearns concluded that,
"Many of the documents were saved to give context to a photograph of two Sugar Association bigwigs accepting the prestigious Silver Anvil award from a Public Relations Society of America representative. In the years before the awards ceremony, sugar was coming to be seen as a likely culprit in diabetes and obesity. In the years to follow, sugar was portrayed as a largely innocent victim of misguided food nannies, and managed to escape regulation by the Food and Drug Administration -- a public relations coup."
She spent her next two years researching how this came to happen.
Since the low-fat fad begain, the U.S. diabetes rate has climbed from less than one per cent in 1958, to more than seven per cent in 2014. In 2009 and 2010, two-thirds of U.S. adults were considered to be overweight or obese, including three-quarters of adult men. Heart disease prevalence climbed from the 1970s to the 90s, when it levelled out and started to decline.
HealthyDay.com points out that high rates have simply shifted locations:
"In the early 1970s, almost half of counties in the northeast were considered to have high rates of death from heart disease, versus the rest of the country. By 2010, that had plummeted to just four per cent of northeastern counties. The South, however, has seen the opposite trend. In 2010, 38 per cent of the region's counties had high death rates from heart disease, versus 24 percent in the 1970s."
Two lessons leap out from this story. First, Dr Cristin Kearns has proved once again that one determined person can make a difference in the world through research and reason. Second, although buying and selling serves many useful purposes, when commerce takes priority over human health and life, then the economy moves from nurturing humankind to something closer to parasite status. The sugar industry proved again that the "free market" has no conscience.
Addendum: The day this article appeared, CBC TV's The Fifth Estate aired an investigative segment about Dr Cristin Kearns and the sugar industry.
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