Big food, big pharma: is science for sale?

Elizabeth Loder, acting head of research, The BMJ

eloder@bmj.com

We have grown accustomed to allegations of conflicts of interest, biased research, and manipulative marketing on the part of the drug industry. Valentine’s Day is a good time to spare a thought for the same problems as they involve the sugar industry. In a BMJ investigation this week Jonathan Gornall examines the not so sweet side of what might be called "Big Sugar": large food companies whose products include sugary foods (doi:10.1136/bmj.h231). Using methods that seem borrowed wholesale from the pharma playbook, they provide consultancies and research support to prominent scientists who also work on nutrition issues for the UK government.
Such strategies mirror those of the drug industry, and the arguments used to defend these associations are strikingly similar. Engagement with the private sector is desirable because it enables "more rapid transfer of the best ideas into new interventions," and scientists are using the money for "important pieces of research." These things may well be true. The existence of such financial connections is not evidence of "research malpractice." It does, however, contribute to perceptions that nutrition science might be for sale.
Perceptions about the trustworthiness of nutritional research matter because consensus has not been achieved on the extent to which sugar contributes to health problems or what should be done about it. Is sugar "pure, white, and deadly," as the late John Yudkin suggested well over 40 years ago (doi:10.1136/bmj.e8612)? Much evidence points in that direction (Curr Diab Rep2012;12:195-203; Am J Clin Nutr 2014;100:65-79). But which way does the causation run? Are we hardwired to crave sweet things? Or do we crave sugary treats because we are manipulated to do so? Policy initiatives to curb sugar intake will be developed on the basis of research on these questions. To gain public cooperation the science must be above reproach.
Sadly, this is not the only area where there is reason to be concerned about corporate influences on public policy. Crowcroft and colleagues examine the controversy over the UK government decision on public funding for a new vaccine (Bexsero) for meningococcal disease (doi:10.1136/bmj.h308). The problems they outline are all too familiar: "lobbying may have influenced the alteration" of the original decision. Links between some "vocal clinicians" and the drug industry were not disclosed. The lack of transparency makes it unsurprising that "conspiracy theories emerged, including the idea of undue influence of industry."
This piece could not be timelier, published as it is in the midst of a large US outbreak of the vaccine preventable disease measles (doi:10.1136/bmj.h622). Powerful commercial interests will advocate widespread use of any new vaccine they develop, even when the benefits do not justify the cost. They may pursue these arguments in ways that undermine public trust in vaccination in general. A cynical public won’t accept that general vaccination is vital for some potent diseases if they believe that vaccines of questionable benefit are being promoted for profit. Crowcroft and colleagues’ conclusion about the lesson of the Bexsero affair should be heeded by all medical researchers, including those in the field of nutrition science: "We risk losing public trust . . . by allowing people with close links to industry to be involved in decision making." Put another way, we cannot expect the public to have confidence in science that seems to be for sale.

Cite this as: BMJ 2015;350:h795