Posted on | December 16, 2016 | 2 Comments
“NIH Charts a Path for Nutrition Science” read the JAMA release offering on-air interviews with Griffin P. Rodgers, MD, chair of the new NIH Nutrition Research Task Force. “We hope that the strategic planning … encourages scientists to conduct innovative and really ground-changing studies in nutrition as they relate to health,” was the top line quote. Dr. Rodgers mentioned target areas like creating a strategic plan for research over the next 10 years, pursuing more accurate high-tech measurements of what people say they eat, nutrition effects on a wide range of diseases, genetic influences, the microbiome, and the impact of the timing of meals on metabolism.
Exercise garnered special mention by Dr. Rodgers. He said, “… we know that physical activity has many beneficial effects in terms of health and weight control, as well as metabolic and cardiovascular health, even cognition. But we don’t know at the moment the precise molecules or molecular mechanisms whereby exercise provides this beneficial effect.” Only a moment later he stressed our lack of certainty with these words, “There is a lot of confusion, obviously. You hear that you should be consuming certain types of foods and then you’re told that you shouldn’t. We hope that one of the goals is to try to really examine what we know, what we think we know, and the types of studies that might provide better guidance.”
These two comments, in juxtaposition, perked up my ears for four reasons. First, Michelle Obama’s nobel efforts to combat childhood obesity, driven in part by the food and beverage industries unhealthy food promotions in schools, were diverted soon after their initiation. Industry lobbyists had offered exercise programs as a substitute for substantive nutritional reform.
Second, in 2016 it was revealed that the NIH had received 2 million in grants from CocaCola between 2010 and 2014. They were only one of 96 health organizations on the receiving end of CocaCola and PepsiCo, a list that included the American Heart Association ($400,000), the American Diabetes Association ($140,000), and the Academy of Nutrition and Dietetics ($875,000).
Third, it is unclear whether the new task force will supplant the already existing NIH Obesity Research Task Force which lists nearly identical leadership and organizational composition.
Finally, the CDC has been reporting progress on the childhood obesity front. They noted a 43% decline in obesity in 2 to 5 year olds, from 14% to 8% when comparing the Bush to the Obama years. This progress directly tracked the decline in carbonated soda sales in the U.S. It struck me as odd that Dr. Rodgers interview in JAMA made no mention of carbonated beverages and the childhood ingestion of sugar calories, especially as the President-elect prepares to take office.
My experience with industry is that when times are tough, they invest more energy in government relations, ie. lobbyists. And make no mistake about it, times are tough, at least for non-alcoholic carbonated beverages. Over the past two decades, sales of full calorie soda sales have declined by 20%.
In 2015, the industry registered its 10th consecutive year of decline in soft drink sales in the U.S. In 2015, soda consumption declined by 1% to just under 13 billion gallons. That’s 36 gallons per American. The fact that overall sales of non-alcoholic beverages for the companies rose 2.2% owes a debt to bottled water consumption, up over 7%. By 2017, water sales will exceed carbonated beverages.
Originally CocaCola and PepsiCo thought they could buck the trends by going diet. But health concerns about ingestion large amounts of synthetic sweeteners like aspartame have limited that horizon. Diet Pepsi is down by over 5%, and Coke Zero down by 2%. And yet, revenues from carbonated beverages actually rose 1.4% in 2014 to over $77 billion. How is that possible? Marketing genius. Tipping their hats to weight concerns, the companies have pushed smaller 7.5-ounce cans, which deliver more profit per ounce than larger containers. Loyal customers associate the smaller portion size with health and are willing to pay a premium, at least for now.
Water on the other hand, generally derived from publicly available community water sources, is booming. At the top of the list is Nestle’s Pure Life and Poland Spring, up by over 9%. Coke’s Dasani and PepsiCo’s Aquafina are not far behind. Not satisfied with plain old water, the companies are heavily marketing water tinged with a range of artificial chemical flavors. Energy drinks and sports drinks are hot as well, up 6.4% and 3%.
But the big activity is behind the scenes where the American Journal of Preventive Medicine has documented that 96 health groups received millions between 2011 and 2015, as the companies battled to defeat soda tax legislation like that proposed by then New York Mayor Michael Bloomberg, and dampen the spirit gathering around the First Lady’s campaign.
A year earlier, evidence revealed that Coke had taken a page out of the old playbook of public health nememes from tobacco to Oycontin and Adderall by paying scientists to produce research that undermined the connection between carbonated beverages and the obesity epidemic.
CocaCola created a sham scientific platform, the Global Energy Balance Network, at the University of Colorado with a seed grant of $1.5 million. When the New York Times revealed the effort in 2014, the university returned the money. The company shut down the effort pledging new transparency, and dumped their chief science and health officer, Rhonda Applebaum, who had listed “cultivating relationships” as an overarching goal of the effort.
As part of the “new transparency”, Coke admitted to $120 million in grants since 2010 to health organizations. These included the American Academy of Pediatrics ($3 million), the American Academy of Family Physicians ($3.5 million), the American Cancer Society ($2 million). They also revealed a $7.5 million grant over 5 years to Louisiana State University’s Pennington Biomedical Research Center. In August, 2015, Coke broadcasted the findings of an 12 nation study of 6000 children exploring the lifestyle factors related to childhood obesity. The culprits? Too little sleep, too little exercise, too much TV.
So you can see, with all this recent history, my concern with the JAMA interview. How does the optimistic announcement of the “NIH Nutrition Research Task Force” manage to field a range of questions that exclude focused research where preventive pay dirt has been firmly established with carbonated sugar beverages?
Let me close with JAMA’s final question, and Dr. Rodger’s response:
JAMA: “You recently moderated a panel on obesity and type 2 diabetes at the National Academy of Medicine’s annual meeting. Was there anything that came up that really caught your eye?”
Dr Rodgers: “Insulin resistance is such an interesting topic. Not only did [the speaker] cover this for obesity and diabetes, but he related the concept of insulin resistance to other conditions, such as certain types of cancers or polycystic ovary syndrome. Something that may not be well appreciated is that the brain, at least in animal models of Alzheimer disease, shows a striking pattern of insulin resistance. In fact, some people call Alzheimer disease type 3 diabetes. Another area covered was the intergenerational transmission of type 2 diabetes risk. And so the risk for type 2 diabetes not only lies in our genes but also in the environment to which we’re exposed. What this speaker discussed is that that environment actually begins in utero. What the mother is exposed to in terms of her metabolic status and her nutrition may imprint on the developing infant something that will be played out decades later in terms of diseases like diabetes or conditions like obesity.”
Or maybe it’s just sugar in the water.