The bitter truth of sweet hearts, economy and regulation

We have frequently heard about how high sugar consumption in our daily diets is a risk factor for type II diabetes. The message is sometimes interpreted by many to mean that eating too much sugar will necessarily lead to type II diabetes, which is not true. Genetics plays a significant role in disease, and diabetes is no different. It’s a combination of genetics and lifestyle that affects pathogenesis as far as diabetes in concerned. Apart from sugar consumption, overall calorie consumption and amount of daily activity are important lifestyle factors. However, there is a definitive relationship between sugar consumption and type II diabetes in populations where risk for diabetes is moderate to high, and an individual cannot know the exact odds that they will develop type II diabetes, so it’s a good idea to have a balanced, sugar and calorie-controlled diet and regular exercise to keep the odds as low as possible. We are also usually told that excessive consumption of sweet food is bad for the teeth, because it attracts bacteria that might cause tooth decay. One warning we hear less commonly is that binging on sugar might lead to cardiovascular disease. While it’s true that there isn’t a great deal of information that can tell us to what extent sugar consumption is associated with cardiovascular disease and it’s still a matter of debate and further research, evidence from rather recent research has consistently pointed towards a positive association. And the reason why the evidence has been rather recent is, well, the sugar industry, a recent article published in the Journal of American Medical Association (JAMA) suggests.

This goes all the way back to the 1950s and ’60s, when it was found that a high number of American men were dying because of coronary heart disease. This led to research into the possible causes behind such high incidence of coronary heart disease, and two distinct associations were found between heart disease and two different dietary factors, fat and sugar:

By the 1960s, 2 prominent physiologists were championing divergent causal hypotheses of CHD2,3: John Yudkin identified added sugars as the primary agent, while Ancel Keys identified total fat, saturated fat, and dietary cholesterol. However, by the 1980s, few scientists believed that added sugars played a significant role in CHD, and the first 1980 Dietary Guidelines for Americans4 focused on reducing total fat, saturated fat, and dietary cholesterol for CHD prevention.

Over time, the idea that higher proportion of saturated fats and cholesterol in diet led to higher risks for heart disease became popular, even among scientists, and it stuck. The authors of the article examined what the cause behind this marginalization of research into sugar consumption as a potential risk factor for developing cardiovascular affliction was, since John Yudkin’s research conclusions were compelling enough to warrant further investigation. As part of their work, they looked into the history of the Sugar Association, the organization that lobbies for dietary sugar:

The Sugar Association evolved from the Sugar Research Foundation (SRF), founded in 1943.8 We located correspondence between the SRF and Roger Adams, a professor who served on the SRF’s scientific advisory board (SAB) between 1959 and 1971, in the University of Illinois Archives9 (319 documents totaling 1551 pages). We located correspondence between the SRF and D. Mark Hegsted, professor of nutrition at the Harvard School of Public Health and codirector of the SRF’s first CHD research project from 1965 to 1966,10 in the Harvard Medical Library11 (27 documents totaling 31 pages).

The following is what they found:

Sugar Research Foundation president Henry Hass’s 1954 speech, “What’s New in Sugar Research,”12 to the American Society of Sugar Beet Technologists identified a strategic opportunity for the sugar industry: increase sugar’s market share by getting Americans to eat a lower-fat diet: “Leading nutritionists are pointing out the chemical connection between [American’s] high-fat diet and the formation of cholesterol which partly plugs our arteries and capillaries, restricts the flow of blood, and causes high blood pressure and heart trouble… if you put [the middle-aged man] on a low-fat diet, it takes just five days for the blood cholesterol to get down to where it should be… If the carbohydrate industries were to recapture this 20 percent of the calories in the US diet (the difference between the 40 percent which fat has and the 20 percent which it ought to have) and if sugar maintained its present share of the carbohydrate market, this change would mean an increase in the per capita consumption of sugar more than a third with a tremendous improvement in general health.”12

The industry would subsequently spend $600 000 ($5.3 million in 2016 dollars) to teach “people who had never had a course in biochemistry… that sugar is what keeps every human being alive and with energy to face our daily problems.12

So there was a clear industrial motive to promote sugar as an especially healthy component of the daily diet. However, things took an uglier turn when in 1962, Yudkin published his research study showing that low-fat, high-sugar diet could lead to elevated serum cholesterol levels, which was a direct contradiction of the claims of the SRF. Yudkin followed up and continued publishing studies that showed more definitively that sucrose, more than starch, were responsible for higher carbohydrate-induced triglyceride levels, which in previous research had been implicated in atherogenesis, or formation of cardiovascular blockages. This led to panic in the SRF ranks, and they actively sought to stamp out this piece of early scientific evidence so that its findings didn’t reach the consumers. A slew of conferences and symposia ensued, which led to the SRF concluding by 1965 that they should fund research into the causes of coronary heart disease (CHD). And this they did, leading to massive amount of material which focused on discrediting all of Yudkin’s work – either claiming that Yudkin’s data were incorrect, or were misinterpreted. They added massive amounts of “data” of their own to counter the incriminating evidence Yudkin’s results had against sugar. They “found” that the data had not been controlled for confounding factors, and suggested that the risks associated with sucrose as well as fructose in Yudkin’s research were not concerning since the average American didn’t cosume those levels. Additionally, the foundation discovered and published the fact that polyunsaturated fats were comparatively more heart-healthy dietary options than saturated fats and cholesterol. Even in this case, though, they exaggerated the consistency of their results in subsequent published studies and their own studies lacked proper controls. This aggressive industrial funding and motivated research campaign eventually led to ultimate retiring of the concept that sugars had anything to do with cardiovascular disease.

The authors of the article conclude:

This study suggests that the sugar industry sponsored its first CHD research project in 1965 to downplay early warning signals that sucrose consumption was a risk factor in CHD. As of 2016, sugar control policies are being promulgated in international,61 federal,62,63 state, and local venues.64 Yet CHD risk is inconsistently cited as a health consequence of added sugars consumption. Because CHD is the leading cause of death globally, the health community should ensure that CHD risk is evaluated in future risk assessments of added sugars. Policymaking committees should consider giving less weight to food industry–funded studies, and include mechanistic and animal studies as well as studies appraising the effect of added sugars on multiple CHD biomarkers and disease development.65

This particular example suggests how research done without standards can lead to massive data manipulation and mala fide misinformation through seemingly legitimate studies. The studies in question were conducted at a time when research standards were not as high as they are today, and a lot of junk and fraudulent research made their way into mainstream research literature. Regulation was hardly as strict as it is today, and meta-analyses of research findings were near to non-existent, in this case mostly because those were early years of research into the phenomenon. Conflicts of interest and source of funding were not necessary to be declared, and reviewers were not encouraged to be skeptical about research results obtained through industrial/business funding. All this led to needless obfuscation and hence we have much less research than we should have had into the possible association between sugar consumption and risk to cardiovascular health. Science and research – endeavors to find the truth – should never be modulated or modified by bias and ideology. It’s a good thing that we have stricter regulations to oversee scientific research, and that science is indeed self-correcting. However, unscrupulous individuals and institutions will always look to cheapen the value of science through their skulduggery motivated by vested interests, and it is important for the general public to be educated and skeptical in order to minimize such malpractices.

Speaking of value, the latest acquisition of biotechnology giant Monsanto by German chemical/pharmaceutical colossus Bayer is worth a whopping $66 billion. This merger has led to a variety of speculations about the implications this particular move will have for the seed and fertilizer industries.

U.S. Senate Judiciary Committee Chairman Chuck Grassley has called a hearing next Tuesday to scrutinize the wave of consolidation. Farmers in Iowa, the Republican senator’s home state, are worried that seed and chemical costs are rising while grain prices are near their lowest levels in years. Farm incomes have plunged.

Since these two companies are giants in their respective trades, it is feared that the merger will lead to reduced competition. This will essentially make the association a monopoly, or at most a duopoly:

Senators Mike Lee and Amy Klobuchar, the two top antitrust lawmakers, also expressed concern. “The transaction has the potential to result in a significant loss of competition and reduced incentives and ability to innovate, thereby raising prices,” said Lee, a Republican from Utah.

Monsanto agreed to sell itself to Bayer for $128 per share in cash, yet its shares hovered around $107 Wednesday, reflecting investor uncertainty about regulators. Bayer has agreed to pay Monsanto a $2 billion breakup fee if the deal is thwarted.

The German company aims to create a one-stop shop for seeds, crop chemicals and computer-aided services to farmers.

Bayer’s project might sound like a good idea on the surface, which is about making a farmer’s job easier by providing them a single portal, but the lack of competition and an incentive to innovate negates the advantage that might provide. Pricing will be a monopoly issue and likely to be arbitrarily high by generating high demand.

Monsanto and Bayer have had “initial contacts with regulatory agencies describing what this combination would be about,” Bayer Chief Executive Officer Werner Baumann said on an investor call, and “received encouraging feedback.”

The value of assets Bayer is willing to divest is to be revealed by next week, when details of the merger agreement become public, according to sources familiar with the deal.

Areas of potential overlap include some soybeans, canola and cotton seeds.

Bayer’s share of the U.S. cotton seed market sits at 38.5 percent, while Monsanto is 31.2 percent, according to data compiled by the Konkurrenz Group.

“People don’t get the enormous impact that these deals can have on innovation markets. You need more innovators in there battling it out so that you actually do produce new technology for farmers,” she said.

The deals would leave farmers facing a duopoly in seed (Bayer/Monsanto and Dow) and two big firms in chemicals (Syngenta and Bayer/Monsanto), she said.

This is the classic problem with industrial complexes. In the interest of the public, there should be multiple options available for the same product so that there is a tab on the prices at which these products are sold. But the companies desire would be to root out all competition through being as large a capitalist venture as possible. Once again, we see how important regulation is in order to balance the two interests. Of course, it’s difficult to frame laws that would prevent such moves from industries, but it is necessary to find a way to balance the aforementioned interests legally. It will be interesting to see how the Bayer-Monsanto experiment pans out in the end. What is for certain is that it’s going to be a challenge for policy, and will probably lead to a precedent being set.

 

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