30 Aug 2023 Guest blog: Conflicts of interest in nutrition research – Cause for concern?
In this guest blog, we hear from Robin Ireland, Director of Research at Food Active and Healthy Stadia, about the issue of conflicts of interest in food and nutrition research, and the influence this may have on public health policy.
A Guardian editorial on ultra-processed foods (UPF) on 13th August was unequivocal on the health costs of these products. The editorial was also clear that the blame for the high share of UPF in our diets lies with the multinational food companies whose business raison d’être is to drive up their profits whilst encouraging us to consume more. This provides an explanation why organisations such as the Soil Association have raised concerns about conflicts of interest in the UK Government’s Scientific Advisory Committee on Nutrition (SACN)’s statement on UPF.
Why does the funding of research or of food researchers matter so much? Academics have long pointed out the problems that may ensue. The tobacco industry is a well-documented manipulator of the truth through funding research amongst other tactics. Companies such as Brown and Williamson and Philip Morris spread uncertainty about the health risks of tobacco for decades, influencing and delaying public health regulation. Similarly, in the 1960s and 1970s, it has been argued that the sugar industry paid scientists to play down the link between sugar and heart disease and helped to influence research into nutrition and noncommunicable diseases.
A paper published by Public Health Nutrition in 2020 showed how Coca-Cola funded a global network of scientists, the Global Energy Balance Network. This was ostensibly to shift the discourse from blaming the consumption of sugary drinks as a significant contributor to population levels of overweight and obesity, to highlighting inadequate exercise as the principal cause. Let’s face it, Coca-Cola have history in this area.
Marion Nestle, in her book Soda Politics (Oxford University Press, 2015), highlighted the multi-national company’s tactics in preventing measures that may influence their drink sales; in sponsoring medical studies to influence scientific debate; in donating money to encourage good will and deflect public opinion. This summer, the Coca-Cola brand, one of the most famous in the world, can be seen regularly on the digital boards surrounding the pitches in this year’s FIFA Women’s World Cup as the company seeks to benefit from an association with the excitement surrounding the tournament. They have done the same for years with the Olympic Games.
The UK government’s tight hold on spending and real-time reductions in public health budgets have led to local authorities and charities desperately seeking funding to support their core activities. A study into the corporate sponsorship of physical activity programmes by Coca-Cola in the UK showed how this partnership between the sugary-drink giant and local authorities and other organisations, enabled Coca-Cola to target its marketing at children whilst allowing increased access to policy-makers.
Most public health professionals, and indeed many members of the public, are very familiar with the social determinants of health and understand that the size of our income, where we live, and our level of education, have a major impact on our health. But should we take the activities of multi-national companies on our health more seriously and take more measures to protect our populations (and government) from the influences of its funding? In Dahlgren and Whitehead’s famous and influential Rainbow Model, there is no mention of commercial determinants of health. In a recent paper, Dahlgren and Whitehead argue that they consider profit-driven commercial interests as impacting on almost all determinants of health and therefore should not be included as an individual determinant. Whilst in no way disagreeing with this assessment, the omission of any mention of commercial determinants may however lead to an underestimation of their impact on population health.
Environmental campaigners are often in advance of public health advocates in making their voices heard. Sugary drinks companies have been keen to be associated with climate summits in recent years. Irn-Bru were the exclusive soft drink and water supplier at Cop26 in Glasgow. But Coca-Cola’s sponsorship of Cop27 at Sharm el-Sheikh in November of last year was rightly called out as ‘greenwashing’. After all Coca-Cola is one of the biggest users of plastic producing an estimated 120 billion throwaway plastic bottles a year. Another famous campaigner Greta Thunberg, pulled out of the Edinburgh Book Festival recently as their principal sponsor, Baillie Gifford, was claimed to have billions invested in fossil fuel companies.
So, where funding comes from matters. A lot. We can see how much attention (rightly) is being given to climate protests. Why are we not angrier about ‘healthwashing’ and the antics of food companies seeking to benefit from the health haloes of being associated with sports events and the promotion of physical activity?
Those of us who work to support healthier environments in our communities have found it increasingly hard to promote healthier weight policies in the current economic environment. The UK Government has argued that measures to address obesity such as banning ‘buy one, get one free’ deals, are not appropriate during a cost-of-living crisis. Meanwhile charities such as FareShare, who aim to improve access to food for vulnerable communities whilst cutting food waste, say they are working with Coca-Cola to reduce food poverty. Caraher and Furey argued in a recent paper that the corporate influence on food charity and aid, are another backdoor method to influence policy by food companies.
I am not attempting to berate all charities that have taken money from Coca-Cola or their sugary-drink company competitors. We live in a very complex world where our decisions are affected by multiple factors. However, it would be naïve in the extreme to not appreciate that any commercial funding comes at a price. As we have seen, there is a long history of companies seeking to influence research and policies. It is perhaps easier to identify the tactics of the big tobacco companies, but that should not excuse us for ignoring the lessons of years of advocating for better health legislation to support our most vulnerable communities against the use of tobacco.
Thus, when there is evidence mounting of the negative health impact of UPF, it is hardly surprising when campaigners question whether government pronouncements on nutrition and health may have been subjected to corporate capture.
Robin is the former Chief Executive of the Health Equalities Group having led the Heart of Mersey charity from its launch in 2003. Robin stood down as CEO in December 2016 and is now Director of Research (Honorary) for Food Active and Healthy Stadia.