I spend a lot of time looking over medical studies that cover my areas of interest and I am often dismayed how certain medical studies can be used to distort and twist the truth. Science can lead us down the road to improved health, but it can also have a dark side that can potentially be misused by those with ulterior motives. My wife Irene went to medical school the brilliant physician and Greek thinker John Ionnidis. A few years ago he published a landmark paper titled “Why Most Published Research Findings are False”. Dr. Ionnidis concludes: “Despite a large statistical literature for multiple testing corrections, usually it is impossible to decipher how much data dredging by the reporting authors or other research teams has preceded a reported research finding.”
Follow the Money
Dr. Ionnidis is really saying that many research teams go into a project with strong motives and biases. They are highly motivated–sometimes by strong financial considerations, to have their research come to certain conclusions. One of the best ways to root out the worst of these biases is to pay careful attention to who is actually funding the research. Peter Gotzsche in his book “Deadly Medicines and Organized Crime” points out that most research done by pharmaceutical companies is worthless or even dangerous because of these strong motivations pushing for positive outcomes that are favorable to their medications. These same companies often bury research that doesn’t support the effectiveness of their medications. In other words, when it comes to medical research, follow the money and the motives.
A recent research paper published in a prominent peer-reviewed journal illuminates this point. The other day I opened my copy of the European Journal of Clinical Nutrition and one of their lead articles immediately caught my eye. I pay over $500 dollars a year to receive this journal because it does have the reputation of being one of the best peer reviewed nutrition journals in the world. The paper was titled “Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials.” I have a strong interest in the issue of fructose and health problems so I dived in. I was surprised when I read the conclusions of the paper: “Isocaloric exchange of fructose for other carbohydrates does not induce NAFLD changes in healthy participants.” In other words, you can replace those fruits, vegetables, steak and fish with fructose loaded sugar and HFCS without harming your health. This study certainly contradicts most published research on the topic. Shortly after this article was published, headlines around the world touted the fact that fructose is not responsible for non-alcoholic fatty liver disease (NAFLD). This is critical because NAFLD is considered the gateway to the insulin resistance, diabetes and obesity that is now epidemic in modern societies.
The Sugar Purveyors Head for the Trenches
In recent years many studies in animals and humans have shown that fructose intake increases the production of triglycerides in the liver and eventually the liver fills up with fat leading to NAFLD. Many adults now have this condition and we are even seeing it in some young children. When I started practicing medicine decades ago the condition was rare. Large amounts of fructose from sugar and HFCS are likely driving these changes. Companies that make a living selling sugary foods and beverages are in a panic because the public and medical profession are beginning to understand the toxic nature of excessive sugar. As the tobacco industry did decades ago when confronted with evidence of the harm of smoking, they will clearly not go down without a fight. They have tons of money and will use it to protect their turf.
Garbage in, Garbage Out
It’s also interesting to note the “limitations” offered by the authors: “Few trials were available for inclusion, most of which were small, short (<4 weeks), and of poor quality.” Huh? They basically admit that they didn’t have access to enough high quality trials to conduct a proper meta-analysis, but they went ahead and did it anyway! Why the heck would they waste their time and money on such a losing project? As I have already stated, to find out you need to follow the money. Go to the very end of the article and scan the section of small print under “Acknowledgments” to find out who actually paid for the study: “This work was funded by a Canadian Institutes of Health Research (CIHR) Knowledge Synthesis grant (funding reference number, 102078) and a research grant from the Calorie Control Council.”
The Calorie Control Council—A Flash From the Past
Hmmm. What the heck is the Calorie Control Council? I’ve been in healthcare for over 35 years and I’ve never heard of them, so I decided to visit their web site: “The Calorie Control Council, established in 1966, is an international association representing the low- and reduced-calorie food and beverage industry. Today it represents manufacturers and suppliers of low- and reduced-calorie foods and beverages, including manufacturers and suppliers of more than two dozen different alternative sweeteners, fibers and other low-calorie, dietary ingredients.”
Holly smokes—it’s as if I had gone back 40 years in some type of time capsule. The folks on this council are still trying to push the low fat, low calorie processed foods that triggered our current epidemic of obesity and diabetes. They’re big on artificial sweeteners and fructose (think sugar and HFCS) and they abhor fat. They clearly aren’t fans of real whole foods. It states right on their web site that fructose has nothing to do with our current epidemic of obesity and diabetes, so they had already made up their minds before funding this study. As Peter Gotzsche points out in his book, research that is funded by entities with a large financial stake in the outcome should be ignored because their objectivity cannot be trusted.
Conflict of Interest: A Who’s Who of Nutritional Nasties
If you are looking for real entertainment, I suggest you read the “conflict of interest” section of the paper. With small print it’s almost longer than the original article! The list is too long to reproduce here, but it contains some familiar players like Coca-Cola, Pepsi, Kellogg’s, Quaker Oats, the Canadian Sugar Institute, Dr. Pepper, Snapple, The Calorie Control Council, Unilever, the Coca-Cola Sugar Advisory Board and many others. What I find interesting is that virtually all the authors of the article received payments from the Calorie Control Council. This amazing group paid for the research and also paid off all the researchers involved in the study. How likely is it that any study done by these clowns would find any harm in fructose consumption? Can anyone say “A snowball’s chance in hell?”
The Fructose Protection Hit Men
Remind me again why Coca-Cola needs a “Sugar Advisory Board”. I did a little snooping around and it turns out that many of the esteemed authors of this paper have been popping up all over the place to defend the health benefits of fructose. Whenever a paper is published showing the health risks of fructose—and believe me there are a ton of them, Dr. Sievenpiper and his cronies show up to defend fructose, sugar and HFCS. Each and every time they publish or speak out, the above companies and Boards are listed as their conflicts of interest.
What I find really disturbing is the so-called medical reporting that goes on when flimsy studies like this one are published. It certainly didn’t take me long to figure out what these folks were up to. Why is it that trained journalists can’t seem to do the same? They plaster the conclusions of the study in headlines without any objective oversight or independent thinking. It’s no wonder the public is so confused about nutritional issues.
Look For the Good Stuff
If you really want to know about fructose, I suggest that you read one of the hundreds of papers on the topic published by my medical school classmate Richard Johnson. When you read one of his papers, you will see that the studies are funded primarily by government agencies and under the conflict of interest section he lists one drug company that he has consulted for. Or you might want to read one of the studies published by Robert Lustig on the toxic nature of sugar. If you really want to know about calories, forget about the Calorie Control Council. They are slaves to a bygone era of fake low fat diet food loaded with sugar or artificial sweeteners. Instead I suggest you read Gary Taubes’ excellent books “Good Calories, Bad Calories” or “Why We Get Fat”.
When it Comes to Scientific Publishing, Buyer Beware
So lets take another look at this headline-generating study. If you use the criteria outlined by John Ionnidis in his article, this study has a zippo chance of generating meaningful information. If you look at the criteria suggested by Peter Gotzsche in his book—finding out who is funding the study and researchers, and outlining their conflicts of interest, this study clearly needs to go in the trashcan. The question then arises why a prestigious Journal like the European Journal of Clinical Nutrition would get mixed up in this mess. In an article Gotzsche suggests that it is because industry sponsored trials like this paper generate more reprint sales and many journals make much of their money from such reprints.
Be Your Own Science Detective
I know this must make your head spin. After all, isn’t science supposed to guide us in a better direction? In an ideal world I would say yes, but the world of science is permeated with the same biases and monetary influences that exist in other areas of our society. Your only protection is to be your own detective when it comes to medical headlines generated from a study. Try to get your hands on a copy of the study and look to see who is paying for it. Then go to the “conflicts of interest” section and you will get a sense of how objective the authors are likely to be. When you do so, Dr. Sievenpiper and his cronies will always come up on the short end of the stick. They appear to be unethical shills representing food companies that promote dangerous and unhealthy fake food. Ethical researchers like Richard Johnson will always shine bright. It isn’t rocket science, but it is science.
I know what I am going to do. I just cancelled my subscription to the European Journal of Clinical Nutrition. I can think of a lot better ways to spend $500.